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At least 559 records · Page 31Linked to original sources
PubMed2000

Prognostic significance of p27Kip1 and Ki-67 expression in carcinoma of the renal pelvis and ureter.

OBJECTIVE: To determine the significance of p27(Kip1) (p27) for tumour behaviour and prognosis of patients with transitional cell carcinoma (TCC) of the renal pelvis and ureter. PATIENTS AND METHODS: Using immunohistochemical staining, the relationship was evaluated between p27 protein level (low < 50%, high > 50%) and the Ki-67 labelling index (low < 30%, high > 30%) and clinicopathological features of 37 consecutive Japanese patients with TCC of the renal pelvis and ureter. RESULTS: Low levels of p27 correlated with higher tumour stage (P < 0.05) and positive lymph node metastases (P < 0.05). There was no significant association between p27 staining and the grade and tumour proliferation as assessed by the Ki-67 index. A high Ki-67 index correlated with higher grade and stage (P < 0.05). Kaplan-Meier plots of survival rate in patients with low or high p27 staining showed that low levels correlated with a shorter disease-free and overall survival (P < 0.001 and P < 0.01, respectively). Similarly, patients with a high Ki-67 index had lower disease-free and overall survival than those with a low Ki-67 index (P < 0.01 and P < 0.05, respectively). The Cox proportional hazards model showed that a low level of p27 was an independent predictor of a shorter disease-free (P < 0.01) and overall survival (P < 0.05) on univariate analysis, but not of overall survival on multivariate analysis. A high Ki-67 index was an independent prognostic marker for shorter disease-free survival on univariate and multivariate analysis (P < 0.01) and for overall survival on multivariate analysis (P < 0.05). In those with a high Ki-67 index, increased p27 staining was associated with a better prognosis than decreased staining for disease-free and overall survival (log-rank test, P < 0. 01 and P < 0.05, respectively). CONCLUSIONS: The finding that a low level of p27 is associated with tumour invasion and unfavourable prognosis indicates that p27 may be a useful prognostic marker for survival in upper urinary tract cancer.

Aged↗
PubMed2001

Retroperitoneoscopic dismembered pyeloplasty for pelvi-ureteric junction obstruction in infants and children.

OBJECTIVE: To report our initial experience of endoscopic dismembered pyeloplasty through a retroperitoneal approach in infants and children with pelvi-ureteric junction (PUJ) obstruction. PATIENTS AND METHODS: Thirteen infants and children with PUJ obstruction underwent retroperitoneoscopic dismembered pyeloplasty (mean age at operation 2.7 years, range 0.25-10). Nine patients presented with complications secondary to PUJ obstruction, including urinary tract infection, pyonephrosis and increasing hydronephrosis with impairment in renal function. The other four patients had recurrent loin pain secondary to intermittent PUJ obstruction. The patient was placed in semi-prone (for left-sided) or a semilateral position (for right-sided PUJ obstruction). The retroperitoneal space was entered via a 1-cm incision over the mid-axillary line and further developed using a glove balloon. Video-retroperitoneoscopy was undertaken using a 5-mm laparoscope. Dismembered pyeloplasty was carried out with the pelvi-ureteric anastomosis fashioned using fine polydioxanone sutures over a double-pigtail ureteric stent. RESULTS: The retroperitoneoscopic dismembered pyeloplasty was successful in 12 patients, while one with previous percutaneous nephrostomy drainage for pyonephrosis required open conversion because of difficulties in developing the retroperitoneal space. The mean (range) operative duration was 143 (103-235) min. All patients had a rapid and uneventful recovery. The drainage was satisfactory in all 12 patients on a follow-up scan. CONCLUSIONS: Retroperitoneoscopic dismembered pyeloplasty is effective and safe in infants and young children giving a good early outcome, although the long-term results await further studies.

Anastomosis, Surgical↗
PubMed2002

Does the lumbar spine need to be supported to stabilize the pelvis during total hip arthroplasty in the lateral position?

Total hip arthroplasty is done commonly with the patient in the lateral position. It has been postulated that the lumbar spine may sag in this position because it forms a mobile link between the rigidly held thoracic spine and the sacrum and may cause the pelvis to tilt in the coronal plane, leading to malpositioning of the acetabular cup. To confirm this hypothesis, 10 consecutive patients seen in the preoperative assessment clinic had 2 anteroposterior radiographs taken in the lateral position. The area of exposure was from the lower thoracic spine to the sacrum. In the first radiograph, the lumbar spine was unsupported, and in the second, it was supported. The radiographs showed that the support did not make any significant difference to the position of the lumbar spine or to the position of the pelvis.

Arthroplasty, Replacement, Hip↗
PubMed2003

[Improvement of the image quality of MSCT of the pelvis with a raw data-based, multidimensional filter].

PURPOSE: To evaluate the potential of raw data-based multidimensional adaptive filtering (MAF) by determining its effects on image noise and image quality in multi-slice spiral CT (MSCT) of the pelvis. MATERIALS AND METHODS: Fifty patients with rectal and bladder cancer were examined with MSCT using a high-resolution protocol. Reconstructions were performed with dedicated reconstruction software and a standard algorithm, both without and with MAF, with four different modification fractions selected from 5 % to 20 %. The noise was measured at six anatomic sites of the pelvis. Image quality and image noise were rated on a 5-point-scale. RESULTS: Modification fractions of 15 % (15 % MAF) and 20 % (20 % MAF) significantly reduced the noise level at all measurement points in comparison with lower modification fractions (p < 0.05). Overall quality of the reconstructed images was rated better with 15 % MAF and 20 % MAF than with other modification fractions (p < 0.05). No further improvement of the image quality was observed by changing from 15 % MAF to 20 % MAF (p > 0.05). 15 % MAF achieved a mean noise reduction of 33 %. All examinations showed an improved visualization of the rectal wall and perirectal lymph nodes. CONCLUSIONS: MAF improves the image quality by reducing the noise level and by removing noise structures. This technique offers new perspectives to radiation dose reduction in CT.

Humans↗
PubMed2005

[Magnetic resonance imaging (MRI) of the pelvis in diagnosing endometriosis].

Widely accepted as an established method in the diagnostic imaging of diseases of the female pelvis, magnetic resonance imaging (MRI) holds promising potential for the diagnosis of endometriosis. This review describes the general prerequisites for performing MRI scans of the pelvis and presents, based on recent studies, an imaging protocol suited to the diagnosis of endometriosis. Typical manifestations and sites of endometriosis are discussed and illustrated with sample images. For endometriotic cysts and implants, axial T (1)-weighted, fat-saturated turbo spin echo sequences (TSE) have the highest diagnostic value. In diagnosing adenomyosis, sagittal T (2)-weighted TSE sequences visualise changes in the uterine zonal anatomy. In essence, MRI is capable of detecting many manifestations of endometriosis in a non-invasive, yet reliable manner, and its value in relation to laparoscopy must be considered as complementary.

Endometriosis↗
PubMed1986

[Pelvi-trainer, a training device in operative pelviscopy for teaching endoscopic ligation and suture technics].

Unlike in laparotomy, the art of pelviscopic surgery cannot be learned through assisting. For this reason, a training dummy, called a Pelvi-Trainer, has been developed. With this device, all surgical measures occurring in abdominal surgery can be simulated, such as adhesiolysis, internal ligature, internal sutures, resection, adnexectomy, enucleation of myomas, etc. The Pelvi-Trainer, designed for a three-stage plan, allows one to become gradually acquainted with the field of endoscopic surgery, and to make the transition from binocular vision to perfect three-dimensional control over intra-abdominal surgery under monocular endoscopic vision.

Endoscopes↗
PubMed1986

[Value of phlebo-scintigraphy for clarifying thromboembolic processes in the pelvis and legs].

In 64 patients suspected of having had pulmonary emboli due to thrombo-embolic disease, radionuclide venography (RNV) and contrast phlebography were carried out (84 examinations of extremities, 64 examinations of extremities and pelvis). Phleboscintigraphy proved informative in the thigh and in the pelvis. Around the knee, RNV was sufficiently accurate as a screening method. In the calf, RNV was of diagnostic value only in the presence of positive findings on scintigraphy.

Humans↗
PubMed2006

Is screening for vesicoureteral reflux mandatory in infants with antenatal renal pelvis dilatation?

AIM: To determine whether postnatal ultrasound (US) can guide the use of voiding cystourethrography (VCUG) in infants with antenatally detected renal pelvis dilatation (ARPD). METHODS: 14,000 pregnant women consecutively underwent routine US examination during the second trimester. US examinations later in pregnancy were performed as follow-up of previous anomalies or on obstetrical indications. One hundred and six fetuses with ARPD > or =5 mm were identified. Two postnatal US examinations were performed in the newborns: on the 5th to 7th day and during the 3rd week of life. The findings were considered normal when renal pelvis dilatation (RPD) was < or =7 mm on both US examinations, and no calyceal or ureteric dilatation or signs of renal dysplasia or other anomalies were present. VCUG was done 6 to 8 wk after birth. RESULTS: In 53 of 103 analysable infants, the postnatal ultrasonographic findings were normal. The VCUG was abnormal in three of these 53 infants, all with vesicoureteral reflux (VUR) grade I. Of 50 infants who had abnormal US examinations, six had VUR, four of which were grade IV and V reflux. CONCLUSION: In infants with ARPD who undergo two postnatal US examinations with RPD < or =7 mm and have no other abnormalities, VCUG is unnecessary.

Female↗
PubMed2002

A mathematical model of the stability control of human thorax and pelvis movements during walking.

A mathematical model is developed to study the human thorax and pelvis movements in the frontal plane during normal walking. The model comprises of two-link base-excited inverted pendulums with one-degree of rotational freedom for each link. Since the linear motion of the pelvis has a significant effect on the upper body stability, this effect is included in the model by having a base point moving in the frontal plane in a general way. Furthermore, because the postural stability is the primary requirement of normal human walking, the control law is developed based on Lyapunov's stability theory, which guarantees the stability of the pendulum system around the up-right position. To evaluate the model, the simulation results, including the angular displacement of each link and the torque applied on each link, are compared with those from gait measurements. It is shown that the simulation results match those from gait measurements closely. These results suggest that the proposed model can provide a useful framework for analysis of postural control mechanisms.

Algorithms↗
PubMed1982

Determination of the active marrow dose distribution within the paediatric pelvis and spine.

The active marrow dose distributions have been determined inside the pelvis and the spine of two heterogeneous phantoms representing children aged one and five years. Both theoretical calculation and experimental measurement were used to simulate radiographic examinations typical for those ages. Twelve typical radiographic examinations were performed on these phantoms to represent common paediatric diagnostic procedures. The calculated and measured tissue-air ratios were compared for the pelvis and the spine. Uncertainty associated with the measured dose was estimated to be +/- 7%. The results show that most calculated absorbed doses agreed with those measured within twice the coefficient of variation of the calculated value.

Bone Marrow↗
PubMed2004

Optimization of standard patient radiographic images for chest, skull and pelvis exams in conventional x-ray equipment.

Optimized radiographic techniques for clinical images of chest, skull and pelvis using conventional single-phase, three-phase and high-frequency x-ray units for a standard patient have been developed. Optimization of image contrast and optical density was obtained by using a homogeneous phantom (PEP) and an Anderson Rando anthropomorphic phantom. Image quality was evaluated by nine radiologists in independent analyses, leading to the choice of the optimized technique. A course of action to implement and validate these techniques in other radiographic systems has also been introduced. A realistic-analytic phantom (RAP) was constructed to certify the validation process. The optimized radiographic technique was implemented in the routine of our home hospital radiodiagnostic routine, enabling a reduction in patient doses around 25, 14 and 72%, respectively, for chest, skull and pelvis exams when compared with the previously used techniques. In addition, a corresponding reduction in the x-ray tube load of 68, 14 and 62% for the respective mentioned exams has been observed. In conclusion, implemented optimal techniques can lead to a reduction in the rate of film rejection, thus contributing to a better risk-benefit relationship for the patient and cost-benefit for the radiodiagnostic facility.

Humans↗
PubMed2001

Transitional-cell carcinoma of the renal pelvis: ureteroscopic and percutaneous approach.

There are a variety of publications advocating the ureteroscopic or the percutaneous approach for the treatment of transitional cell carcinoma of the renal pelvis. The diagnostic tool of choice for the upper urinary tract and collecting system is the flexible ureteroscope. One of the major concerns about ureteroscopic management of renal disease initially was the lack of flexibility of the instruments and therefore the inability to deal with demanding sites. The advent of new ureteroscopic techniques, as well as the continuous evolution of the technology, have paved the way for safe and effective access to the upper urinary tract. In the hands of an experienced urologist, such procedures can provide reliable treatment options for small upper urinary tract lesions. Coupling minimal morbidity with ever-improving optics and flexibility, the ureteroscope of today leaves no area of the urinary tract unseen. In patients with bulky tumors or in whom easy access and resection is not possible ureteroscopically, the percutaneous approach to the renal pelvis, although more invasive, provides a better working environment. Clearly, the most difficult aspect of ureteroscopic access to the lower pole is not just visibility but the loss of deflection caused by passage of various instruments through the working channel. Direct access via percutaneous approach with a large resectoscope avoids these problems.

Carcinoma, Transitional Cell↗
PubMed2005

Risk factors for pelvis fracture in older persons.

From 1996 to 2001, the authors undertook a case-control study of 192 pelvis fracture cases (men and women) and 2,402 controls aged > or = 45 years at five Kaiser Permanente medical centers in Northern California. Most information on potential risk factors was obtained by means of an interviewer-administered questionnaire. Number of fractures since age 45 years and a maternal history of hip fracture were associated with increased risks. Several factors thought to protect against loss of bone mass, including recent use of menopausal hormone therapy (adjusted odds ratio (OR) = 0.55, 95% confidence interval (CI): 0.33, 0.91) and high body mass index (weight (kg)/height (m)2; per 5-unit increase, adjusted OR = 0.65, 95% CI: 0.52, 0.81), were associated with decreased risks, while cigarette smoking (adjusted OR = 2.17, 95% CI: 1.34, 3.52) and hysterectomy (adjusted OR = 1.75, 95% CI: 1.15, 2.66) were associated with increased risks. Various conditions related to propensity to fall were associated with increased risks. Most indicators of frailty, including use of walking aids and needing help with or being unable to perform various activities of daily living, conferred increased risks. Thus, low bone mass, frailty, and probably a propensity to fall appear to be associated with increased risk of pelvis fracture.

Age Factors↗
PubMed1998

Assessment of cell cycle-related elements p53, p21WAF1/Cip1, cyclin D1 and PCNA in a mixed transitional cell carcinoma and adenocarcinoma of the renal pelvis: a case report.

A case featuring a well differentiated adenocarcinoma mixed with a transitional cell carcinoma (TCC) arising in the renal pelvis of a 63-year-old woman is presented. Daughter tumors, located in the ureter and the uretero-vesical junction, were entirely TCC in character. Immunohistochemical assessment of cell cycle-related proteins revealed overexpression of cyclin D1 but reduced p21WAF1/Cip1 or PCNA expression in the adenocarcinomatous regions. Conversely, expression of p21WAF1/Cip1 and PCNA was high in the TCC components. Immunohistochemical staining for p53 was negative and PCR-SSCP analyses confirmed the absence of any mutation. Therefore, assessments on the altered expression of cell cycle-related elements may contribute to our understanding of tumor biology in adenocarcinomas and TCCs of the renal pelvis and to identifying the similarities and differences between the two different cell types.

Adenocarcinoma↗
PubMed1988

Normal anatomy of the lumbosacral spine and pelvis. A correlation of SPECT and radiographic techniques.

SPECT of the lumbosacral spine and pelvis is an advancement over planar imaging, which allows for improved lesion detection and more precise anatomic localization of an abnormality. Recognition of skeletal anatomy shown by SPECT is paramount for diagnostic accuracy as well as for meaningful consultations with referring physicians and diagnostic radiologists. This is a correlative study of normal anatomy of the lumbosacral spine and pelvis demonstrated by SPECT and radiography in order to assure that morphologic detail resulting from SPECT is recognized and matched with radiographic landmarks in the same area.

Humans↗
PubMed1988

A false positive I-131 MIBG due to dilated renal pelvis: a case report.

A case of false positive I-131 MIBG imaging for detection of pheochromocytoma is presented. There was an area of increased tracer uptake in the left renal region that showed steadily reducing activity over a period of three days. This raised the suspicion of a dilated renal pelvis, which was later confirmed by Tc-99m DTPA imaging. It is advisable in cases of ambiguous I-131 MIBG imaging to use Tc-99m DTPA rather than Tc-99m DMSA for localizing the kidneys and renal pelvis.

3-Iodobenzylguanidine↗
PubMed1988

SPECT imaging of the lumbosacral spine and pelvis.

This is a prospective comparison of SPECT versus planar imaging of the lumbosacral spine and pelvis, performed in order to assess which technique was more useful in clinical practice. One hundred adults were studied with both techniques, and abnormalities uncovered by either imaging method were graded 1-4 based on the lesion's relative uptake intensity. SPECT imaging significantly improved lesion detection, especially in conditions resulting in only low grade tracer uptake on planar studies. Precision in anatomic localization furthermore improved the quality and usefulness of diagnostic information resulting from SPECT imaging compared to planar examinations. SPECT is recommended for routine imaging of the lumbosacral spine and pelvis in symptomatic patients, especially when planar examinations are normal or equivocal.

Adolescent↗