Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PELVIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population.

OBJECTIVE: The purpose of this study was to determine the incidence of minor degrees of renal pelvis dilatation that is detected by antenatal ultrasound scanning in an unselected population and its value in the prediction of significant uropathies. STUDY DESIGN: This prospective study was conducted over a 24-month period. Infants with an anteroposterior pelvic diameter of >or=4 mm in the second trimester and/or >or=7 mm but <15 mm in the third trimester were enrolled. RESULTS: Pyelectasis was found in 4.5% of 5643 fetuses (1.5% with significant uropathy). Among the 213 infants whose cases were followed, 132 infants (62%) had renal anomalies, but only 83 infants (39%) had significant uropathies. The ability of the third-trimester renal pelvis dilatation to predict renal abnormalities showed a positive predictive value of 69%. Pyelectasis that was detected only in the second trimester revealed a significant uropathy in 12% of the infants. CONCLUSION: Pyelectasis was found in 4.5% of fetuses. The third-trimester anteroposterior renal pelvis diameter of >or=7 mm was the best ultrasound criterion to predict postnatal uropathies.

Dilatation, Pathologic↗

Carcinosarcoma and squamous cell carcinoma of the renal pelvis associated with nephrolithiasis: a case report of each tumor type.

Both squamous cell carcinoma and carcinosarcoma of the renal pelvis are uncommon. We report on two cases, one carcinosarcoma and one squamous cell carcinoma of the renal pelvis. In the patient with squamous cell carcinoma of the left kidney, the tumor was neither detectable on preoperative radiological evaluation nor grossly visible in the surgical specimen. This patient, a 56-year-old man, presented with left lumbar pain, hematuria, fever, 4-5 kg weight loss, and untreated nephrolithiasis of the left kidney that had been diagnosed 20 years earlier. The second patient, an 87-year-old woman, also had a long history of left kidney nephrolithiasis and presented with left lumbar pain and hematuria. Both patients underwent nephrectomy for removal of the non-functioning hydronephrotic left kidney. In both cases, microscopic examination of the surgical specimen revealed squamous metaplasia and dysplasia in the pelvicalyceal mucosa, and islands of atypical squamous cells in the renal parenchyma. In the second case, the kidney also showed sarcomatous changes in the pelvis.

Aged↗

Measuring the tilt of the pelvis.

A simple and easy-to-use device for measuring forward-backward rotation of the pelvis is introduced. It consists of a small rod, which can be attached to the skin of the sacrum. This 'antenna' follows the movements of the pelvis. The article describes the use of this device and the calibration of this method; to this end the antenna position is related to the 'actual' rotation of the pelvis, defined as the rotation of a set of easily palpable landmarks. Each landmark is found by palpation and its spatial coordinates are measured with a palpator. The results show that pelvic rotation with respect to a reference position can be obtained with an inaccuracy of 10%. With special care this can be reduced to 5%.

Adolescent↗

Antenatal renal pelvis dilatation emphasizing vesicoureteric reflux: two-year follow-up of minor postnatal dilatation.

AIM: To describe the occurrence of foetal renal pelvis dilatation in an unselected population of pregnancies and to describe the clinical course in a subgroup of infants with minor renal pelvis dilatation (RPD). METHODS: During 1996-1999 the foetuses of 17850 consecutive pregnant women were scanned with ultrasonography (USG) in the 16th-19th gestational week and later in the pregnancy when indicated. RPD was defined as anterior-posterior pelvic diameter > or = 5 mm. After birth all infants were examined with USG twice. If any postnatal USG showed RPD > or = 10 mm, extended radiological investigation was performed. Infants with pelvis dilatation < 10 mm and no calyceal or ureteric dilatation were not investigated further and antibiotic prophylaxis was discontinued. The children were followed up at 2 y of age. RESULTS: 109 foetuses (0.6%) with RPD were identified. Postnatally, 94/109 were available for follow-up: 43 had postnatal dilatation > or = 10 mm and were investigated and treated according to clinical routine, while 51 had dilatation < 10 mm and were followed up after they had reached at least 2 y of age. No case of pyelonephritis was recorded. USG in 48/51 children was normal. CONCLUSION: The data indicate that infants with minor RPD do not constitute a risk group for renal morbidity and thus do not need antibiotic prophylaxis and extensive radiological examination.

Dilatation, Pathologic↗

Optimization of attenuation correction for positron emission tomography studies of thorax and pelvis using count-based transmission scans.

The quality of thorax and pelvis transmission scans and therefore of attenuation correction in PET depends on patient thickness and transmission rod source strength. The purpose of the present study was to assess the feasibility of using count-based transmission scans, thereby guaranteeing more consistent image quality and more precise quantification than with fixed transmission scan duration. First, the relation between noise equivalent counts (NEC) of 10 min calibration transmission scans and rod source activity was determined over a period of 1.5 years. Second, the relation between transmission scan counts and uniform phantom diameter was studied numerically, determining the relative contribution of counts from lines of response passing through the phantom as compared with the total number of counts. Finally, the relation between patient weight and transmission scan duration was determined for 35 patients, who were scanned at the level of thorax or pelvis. After installation of new rod sources, the NEC of transmission scans first increased slightly (5%) with decreasing rod source activity and after 3 months decreased with a rate of 2-3% per month. The numerical simulation showed that the number of transmission scan counts from lines of response passing through the phantom increased with phantom diameter up to 7 cm. For phantoms larger than 7 cm, the number of these counts decreased at approximately the same rate as the total number of transmission scan counts. Patient data confirmed that the total number of transmission scan counts decreased with increasing patient weight with about 0.5% kg(-1). It can be concluded that count-based transmission scans compensate for radioactive decay of the rod sources. With count-based transmission scans, rod sources can be used for up to 1.5 years at the cost of a 50% increased transmission scan duration. For phantoms with diameters of more than 7 cm and for patients scanned at the level of thorax or pelvis, use of count-based transmission scans is feasible and results in statistically more consistent transmission scans as compared with fixed transmission scan duration.

Algorithms↗

Comparison of symptoms related to positioning of double-pigtail stent in upper pole versus renal pelvis.

PURPOSE: This study was a comparison of the symptomatology associated with placement of the upper coil of a double-pigtail stent in the upper pole or the renal pelvis. PATIENTS AND METHODS: A prospective study with 40 patients was performed. In 20 patients, the stent was placed in the upper pole (Group A) and in another 20 patients (Group B) in the renal pelvis. A questionnaire was addressed to all patients before the removal of the stent concerning the presence and severity of flank pain (using a standardized 10-point scale), the presence and severity of urinary urgency (using a standardized 10-point scale), the presence of dysuria, and quality of life with the stent in place. RESULTS: Flank pain was present in 17 (85%) and 15 (75%) patients in Groups A and B, respectively. The average severity of flank pain was 4.3 (range 0-7) and 4.5 (range 0-10) in Group A and B, respectively (p = 0.764). Urinary urgency was present in 13 (65%) and 15 (75%), patients in Group A and B, respectively. The average severity of urgency was 3.1 (range 0-7) and 5.3 (range 0-10) in Group A and B, respectively (p = 0.037). Dysuria was present in 4 (20%) and 13 (65%), and the average quality of life score was 2.5 and 3.05 in Group A and B, respectively (p = 0.04). CONCLUSION: Positioning of the proximal end of the double-pigtail stent in the upper pole of the kidney appears to be better tolerated by patients than is the standard insertion in the renal pelvis.

Adult↗

Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases.

Urothelial carcinomas of the renal pelvis are relatively rare tumors, and large series that include clinicopathologic and outcome data are few. We reviewed 130 consecutive nephroureterectomies performed for urothelial carcinoma of the renal pelvis at our institution. Tumors were graded using the World Health Organization/International Society of Urologic Pathologists (WHO/ISUP) grading system and were staged according to the 2002 TNM classification; 83 (63.6%) of the patients were men and 47 (36.4%) were women. The mean age at diagnosis was 67 years (range, 41-93 years). The average tumor size was 3.7 cm; 36 of the cases were multifocal and 5 were bilateral. Lower tract disease occurred in 50.7% (66 cases); 38 of the cases (29.3%) were low grade and the remaining 92 (70.7%) were high grade. A total of 50% of the cases were pTis, pTa, or pT1, while 45% invaded deeply (pT2 or more). Depth of invasion could not be assessed with certainty in 7 cases (5%). Regional lymph nodes were identified/submitted in only 50 cases. Of those, 12 cases (24%) had lymph node metastasis. Follow-up information was available in 125 (96%) patients. The period of follow-up ranged from 1 week to 176 months (mean, 48.9 months). At last follow-up, 47 patients (36%) had died of other causes, 18 (13.8%) were dead of disease, 8 patients (6%) were alive with disease, and 52 patients (40%) were alive with no evidence of disease. In univariate analysis, histologic grade (P = 0.001), TNM stage (P = 0.0001), vascular invasion (P = 0.001), margin status (P = 0.021), and size (P = 0.0003) were significantly associated with survival. On multivariate analysis, TNM stage (P = 0.03) was the only variable associated with survival. In conclusion, our study shows that a high percentage of the urothelial carcinoma of the renal pelvis present with locally advanced (pT2 or more) disease at the time of nephroureterectomy. Pathologic stage is the most potent predictor of survival, similar to lower tract disease. A subset of the cases could not be staged due to processing issues; we thus recommend fixation prior to prosecting.

Adult↗

The usefulness of Tc-99m DMSA SPECT and three-dimensional surface rendering in an asymptomatic patient with a single kidney in the pelvis.

The diagnostic problems in a clinically asymptomatic patient with a previously unknown ectopic single kidney in the pelvis and the diagnostic utility of three-dimensional surface rendering of Tc-99m DMSA SPECT for delineating ectopic functional renal parenchyma are reported. Inconclusive dynamic planar Tc-99m MAG3 renal scintigraphy was performed with the field of view centered at the upper abdomen. Twenty-four hours later, static planar Tc-99m DMSA scintigraphy 3 hours after injection delineated functional renal parenchyma only in the pelvis but did not reveal the shape of the organ. Three-dimensional surface rendering exposed a single ectopic kidney in the pelvis. This case is the first description of the advantages of three-dimensional surface rendering of Tc-99m SPECT in the diagnosis of an ectopic kidney.

Adult↗

Gastropyeloplasty: an alternative procedure in reconstruction of the renal pelvis.

We report our first experience with the use of a small gastric patch for reconstruction of the renal pelvis. We performed left gastropyeloplasty based on the right gastroepiploic artery in 1 patient suffering from recurrent urinary tract infections and renal stones, and moderate renal failure. The use of a gastric patch for reconstruction of the renal pelvis prevented the recurrence of calculi and bacterial infections, and produced an improvement in renal function. We confirm the feasibility of the use of a small gastric patch in reconstruction of the renal pelvis and we argue that there are several possible ways to use stomach in upper urinary tract reconstruction.

Female↗

Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type.

STUDY DESIGN: A retrospective study investigated the sagittal alignment in adolescent idiopathic scoliosis (AIS). OBJECTIVE: To evaluate the sagittal alignment of the spine and pelvis in adolescent idiopathic scoliosis on the basis of curve type. SUMMARY OF BACKGROUND DATA: The relation between the spine and pelvis highly influences the sagittal balance in adults. However, the sagittal alignment of the spine and pelvis in adolescent idiopathic scoliosis is poorly defined in the literature. METHODS: Five sagittal parameters were evaluated on lateral radiographs of 160 patients with adolescent idiopathic scoliosis: thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence. The patients were classified according to their coronal curve type. Analysis of variance was used to compare the parameters between the curve types, and Pearson coefficients were used to investigate the relation between all parameters (alpha = 0.05). RESULTS: The thoracic kyphosis was significantly lower for King I, II, and III curves than for lumbar curves. The lumbar lordosis was higher for lumbar curves, although not significantly. No significant change between the groups was observed for the sacral slope, pelvic tilt, or pelvic incidence. The pelvic incidence was significantly correlated with the lumbar lordosis, sacral slope, and pelvic tilt for all the groups. The lumbar lordosis was strongly related to the sacral slope in all cases, but not with the thoracic kyphosis, except in the case of thoracolumbar curves. CONCLUSIONS: Thoracic kyphosis depended mostly on the spinal deformity, whereas lumbar lordosis was influenced mainly by the pelvic configuration. The scoliotic curve type was not associated with a specific pattern of sagittal pelvic morphology and balance. The pelvic incidence found in this study was significantly higher than that reported in the literature for normal adolescents. The role of the pelvic incidence in the pathogenesis of adolescent idiopathic scoliosis needs to be explored in a longitudinal study involving patients with adolescent idiopathic scoliosis and normal adolescents.

Adolescent↗

Genetics of canid skeletal variation: size and shape of the pelvis.

The mammalian skeleton presents an ideal system in which to study the genetic architecture of a set of related polygenic traits and the skeleton of the domestic dog (Canis familiaris) is arguably the best system in which to address the relationship between genes and anatomy. We have analyzed the genetic basis for skeletal variation in a population of >450 Portuguese Water Dogs. At this stage of this ongoing project, we have identified >40 putative quantitative trait loci (QTLs) for heritable skeletal phenotypes located on 22 different chromosomes, including the "X." A striking aspect of these is the regulation of suites of traits representing bones located in different parts of the skeleton but related by function. Here we illustrate this by describing genetic variation in postcranial morphology. Two suites of traits are involved. One regulates the size of the pelvis relative to dimensions of the limb bones. The other regulates the shape of the pelvis. Both are examples of trade-offs that may be prototypical of different breeds. For the size of the pelvis relative to limb bones, we describe four QTLs located on autosome CFA 12, 30, 31, and X. For pelvic shape we describe QTLs on autosome CFA 2, 3, 22, and 36. The relation of these polygenic systems to musculoskeletal function is discussed.

Animals↗

Cystic hamartoma of the renal pelvis.

Cystic hamartoma of the renal pelvis is a rare benign tumor in the same category as mixed epithelial and stromal tumors. We present a 33-year-old woman with a solid and cystic intrarenal tumor extending into the renal pelvis. She underwent radical nephrectomy and ureterectomy under the diagnosis of renal tumor or renal pelvic tumor. Histopathologically, the tumor was composed of a biphasic proliferation of epithelial and mesenchymal elements. We believe the present case is best classified as a cystic hamartoma of the renal pelvis in the category of mixed epithelial and stromal tumors because of the coexistence of hamartomatous lesions, such as the proliferation of adipose cells and well to poorly differentiated fibromuscular lesions.

Adult↗

Increased expression of lung resistance-related protein in lower grade urothelial carcinoma of the renal pelvis and ureter.

BACKGROUND: Lung resistance-related protein (LRP), like multidrug resistance gene 1 (MDR1) and multidrug resistance-associated proteins (MRP), has been associated with intrinsic therapeutic resistance in various malignancies. To date, there has been no study on the expression of LRP in urothelial carcinomas of the renal pelvis and ureter. We investigated the protein and mRNA expression levels of LRP, MDR1 and MRP1 in this malignancy and the clinical significance of their expression was evaluated. METHODS: Forty urothelial carcinomas of the renal pelvis and ureter and 31 normal upper urothelial samples were examined by immunohistochemistry and reverse transcription polymerase chain reaction to determine the protein and mRNA levels of the multidrug resistance-related genes, respectively. RESULTS: The positive staining rates and mRNA levels of LRP were the highest among these multidrug resistance-related genes in both normal urothelium and carcinoma examinations. In contrast to the up-regulated expression of MDR1, the expression of LRP tended to be down-regulated in carcinomas. Moreover, the expression of LRP inversely correlated with tumor grades, but this correlation was not found for the other two genes. However, there was no correlation among the expression of the three genes observed. CONCLUSION: Lung resistance-related protein was strongly expressed in urothelial carcinomas of the renal pelvis and ureter, particularly in well-differentiated carcinomas.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Combined small cell carcinoma and sarcomatoid squamous cell carcinoma in the renal pelvis.

We report here a case of combined small cell carcinoma and sarcomatoid squamous cell carcinoma in the renal pelvis. A 61-year-old female presented with right flank discomfort, microhematuria and progressive renal dysfunction. Following diagnosis of right renal pelvic carcinoma, radical nephroureterectomy with lymph node dissection was performed through a midline incision. The tumor was pathologically diagnosed to be combined small cell carcinoma and sarcomatoid squamous cell carcinoma in the renal pelvis. The patient had no evidence of recurrence or metastasis, 16 months postoperatively. Small cell carcinoma or sarcomatoid squamous cell carcinoma of the renal pelvis is very rare. We believe this is the first such case to be reported in the world.

Carcinoma, Small Cell↗

An unusual case of multilocular cystic nephroma with prominent renal pelvis involvement.

Multilocular cystic nephroma (MCN) is a relatively rare, benign tumor of uncertain etiology. It typically arises from the renal parenchyma and is often treated with nephrectomy. We report a case of MCN with unusual prominent renal pelvis extension. A left nephrectomy was performed. A multilocular cystic lesion was found in the removed specimen, which had a direct tumor extension into the renal pelvis. There were no signs of malignancy. The tumor extension into the renal pelvis has been found in very few reports. This growth pattern might be one of the characteristics of this benign renal tumor.

Child↗

Functional obstruction of the ureter and renal pelvis. A histological and electron microscopic study.

Histological, histochemical and electron microscopic techniques have been used to compare dilated and normal calibre segments of ureter and renal pelvis in cases of idiopathic hydronephrosis and primary obstructive megaureter. In both conditions a marked increase in collagen and elastic tissue occurs in the wall of the distended segment and this infiltration extends throughout the proximal dilated ureter and renal pelvis. Evidence is presented to show that in the dilated segment, smooth muscle cells are directly involved in the synthesis of connective tissue elements. These findings support the view that the primary anomaly in idiopathic hydronephrosis and primary obstructive megaureter can be attributed to a malfunction of smooth muscle cells in the ureter and renal pelvis. However, the possibility remains that the changes in smooth muscle are secondary and have been induced by obstruction and distension caused in these pathological conditions by unknown aetiological factors.

Cholinesterases↗

Estimations of the S phase fraction in situ in transitional cell carcinoma of the renal pelvis and ureter with bromodeoxyuridine labelling.

This report concerns the estimation of the S phase fraction (SPF) in situ and its value in predicting the malignant potential of transitional cell carcinoma of the renal pelvis and ureter. Eighteen patients with transitional cell carcinoma of the renal pelvis and ureter were given a 0.5 h intravenous infusion of the thymidine analogue bromodeoxyuridine (BrdU) (500 mg) at the time of surgery to label tumour cells in the DNA synthesis phase. The tumour specimens were stained by an indirect immunoperoxidase method using anti-BrdU monoclonal antibody as the first antibody. The BrdU labelling index, S phase fraction, was determined by counting the number of bromodeoxy-uridine labelled cells in the tissue sections. All grade 1 tumours had an S phase fraction lower than 10%. The average S phase fraction for non-invasive tumour (12 cases) and invasive tumour (6 cases) were 9.7 and 20.9%, respectively. Two patients with rapid spread of ureteric tumour showed an S phase fraction of 18.4 and 22.3%. The results obtained with the S phase fraction were comparable with histological tumour grade and invasive potential. The higher S phase fraction may indicate greater biological malignancy. We believe that determination of the S phase fraction of transitional cell carcinoma of the renal pelvis and ureter offers a new objective and quantitative assay of the biological potential of individual tumours and might have practical value in their management.

Bromodeoxyuridine↗

Tachykinin receptors in the guinea-pig renal pelvis: activation by exogenous and endogenous tachykinins.

1. The contractile response to substance P, neurokinin A, selective agonists for the NK1, NK2 and NK3 tachykinin receptors and the activity of receptor-selective antagonists has been investigated in circular muscle strips of the guinea-pig isolated renal pelvis in the presence of indomethacin (3 microM). 2. Neurokinin A was the most potent agonist tested, being about 32 times more potent than substance P. The action of both substance P and neurokinin A was enhanced by peptidase inhibitors (bestatin, captopril and thiorphan, 1 microM each). The selective NK2 receptor agonist [beta Ala8] neurokinin A (4-10), was slightly less potent and effective than neurokinin A itself. The selective NK1 receptor agonist [Sar9] substance P sulphone was effective at low (nM) concentrations but its maximal effect did not exceed 30% of maximal response to substance P or neurokinin A. The NK3-selective agonist [MePhe7] neurokinin B was effective only at high (microM) concentrations. 3. The pseudopeptide derivative of neurokinin A(4-10), MDL 28,564, displayed a clear-cut agonist character, although it was less potent than neurokinin A. 4. The responses to roughly equieffective (25-35% of maximal response) concentrations of [beta Ala8] neurokinin A (4-10), MDL 28,564 and [MePhe7] neurokinin B were antagonized to a similar extent by MEN 10,376 (3 microM), a selective NK2 tachykinin receptor antagonist, while the response to [Sar9] substance P sulphone was unchanged. 5. The response to [Sar9] substance P sulphone was inhibited by the NK1 receptor-selective antagonist, GR 82,334 (3 microM) while the response to [beta Ala8] neurokinin A (4-10) was unchanged. 6. The selective NK2 receptor antagonists MEN 10,376, L 659,877 and R 396 antagonized competitively the response to [PAla8] neurokinin A (4-10) with the following rank order of potency (pA2 values in parentheses): MEN 10,376 (7.41)>L 659,877 (7.15)>R 396 (6.43). MEN 10,376 and L 659,877 also competitively antagonized the response to neurokinin A, although with lower potency as compared to the selective NK2 receptor agonist.7. MEN 10,376, L 659,877 and R 396 reduced in a concentration-dependent manner the contractile response produced by electrical field stimulation (1 Hz, 100 V, 0.25 ms pulse width, trains of 10 s). The rank order of potency of NK2 receptor antagonists in blocking the response to electrical stimulation (MEN 10,376> L 659,877> R 396) closely mimicked their potency in antagonizing exogenous tachykinins.8. The inhibitory effect of MEN 10,376 toward responses produced by electrical field stimulation was significantly reduced when tested in the presence of peptidase inhibitors, which increased significantly the response to nerve stimulation.9. GR 82,334 (3 pM) did not significantly affect the response to nerve stimulation in untreated preparations and slightly reduced it in the presence of peptidase inhibitors.10. We conclude that both NK, and NK2 receptors mediate the contractile effect of tachykinins in the circular muscle of the guinea-pig renal pelvis and that the response ascribable to NK2 receptor stimulation is larger than that ascribed to NK, receptor stimulation. The NK2 receptor in the guinea-pig renal pelvis belongs to the same subtype previously identified in the rabbit pulmonary artery. NK2 receptors play a dominant role in the physiological response determined by the release of endogenous tachykinins and a contribution of NKI receptors becomes evident after inhibition of peptide degradation.

Amino Acid Sequence↗