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At least 991 records · Page 55Linked to original sources
PubMed1990

Clinical use of a wing field with transmission block for the treatment of the pelvis including the inguinal node.

Treatment planning of photon and electron beams to include the pelvis and the groin poses a technical difficulty of positioning beams, and a dosimetric problem of abutting fields at the groin. We have analyzed a simpler AP/PA method using a central transmission block. The posterior portal is smaller and opposes only the pelvic portion of the anterior portal under the transmission block, while the anterior extended portion (hence the wing) is unattenuated to treat the inguinal region. By calculating the attenuation thickness according to the patient's separation and the beam quality, the dose distribution is tailored to yield the proper dose to the pelvic mid-plane and the inguinal nodes while minimizing the dose to the femora. Measured dose distribution (6MV) using film dosimetry in a tissue-equivalent phantom indicates that a 30% hot spot is created by the posterior portal diverging into the wings of the anterior field. Therefore, the pelvic attenuator is tapered at its lateral edges, thereby significantly reduced the dose inhomogeneity (5%) at the groin. Clinical methods are outlined for the verification of the patient portal films against possible mismatch in beam divergence.

Groin↗
PubMed1992

Development and distribution of adipose tissue in the human pelvis.

The development of the pelvic adipose tissue was studied using 300-600 microns thick sections through the pelves of 9-37-week-old fetuses and newborn children. During fetal life three different anlagens of adipose tissue appear within the pelvic cavity. Development and topography of these anlagens are described, and correlations with the development of the connective tissue compartments within the pelvis were demonstrated.

Adipose Tissue↗
PubMedDate not supplied

MRI of the abdomen and pelvis: an update in The Netherlands.

MRI with its excellent contrast resolution and direct multiplanar imaging has become a valuable medical tool in diagnostic imaging. Due to physiological motion artifacts, the role of MRI in the abdomen is still under discussion. The use of ultrafast sequences and the development of oral contrast agents, however, offers new promises for abdominal MRI. In the area of the retroperitoneum and pelvis, MRI produces excellent images as motion-artifacts are absent. Up to the end of 1989 clinical MRI in The Netherlands was performed in only four University hospitals; nevertheless these centers proved able to compete with international standards. The rapidly increasing number of MR units that recently became available in The Netherlands could result in a surpassing of CT in many pelvic and abdominal pathological conditions.

Abdomen↗
PubMed2005

Features of the peritoneal covering of the lesser pelvis with special reference to stomata regions.

Occasional reports describe various aspects of the fine morphology of the pelvic peritoneum, but its complete organ characteristics remain undefined. The peritoneal covering of the urinary bladder, rectum, uterus, uterine tube, ovary, broad ligament (BL) and testis in Wistar rats was examined by means of transmission and scanning electron microscopy (TEM, SEM). Unusually complicated relief and stomata between the cubic mesothelial cells characterized the surface of the BL. Deep, parallel furrows separated the wide longitudinal folds over the entire length of the uterine tube. The uterus and the ovary formed less numerous, shallow or extremely deep crypt-like invaginations, as well as serous villus-like or papilla-like evaginations. The flat cells were the predominant cell type over the BL, while the cubic mesothelium was the basic covering of the organs. Most of the cubic cells were located in the invagination of the submesothelial layer (SML). Such cells formed an almost smooth surface over the urinary bladder or formed larger areas of the rectum and the testis surfaces. Numerous microvilli, ciliae, round evaginations and complex lamellar bodies characterized their apical plasmalemma. In conclusion, the mesothelial heterogeneity is a stable feature of the lesser pelvis peritoneum, confirmed by TEM and SEM. The cubic mesothelium characterizes the organ peritoneum, while the BL plays the role of the parietal sheet, involving lymphatic units in the SML. The different types of contacts between the mesothelio-endothelial cells, large lymphatic vessels and occasional stomata are the usual components of the lymphatic units in norm, visible by TEM. Images of stomata, seen by SEM, demonstrate oval-shaped deep channel-like gaps surrounded by cubic mesothelium. The last data extend the evidence on stomata regions, which resemble the diaphragmatic ones. Clusters of cells (macrophages, mastocytes and Lymphocytes), small vessels (blood or lymphatic) and nerve fibers (unmyelinated and rare myelinated) form highly specialized complexes in the SML of the ovary, the uterus and the testis.

Animals↗
PubMed2006

Isotropic CT examination of abdomen and pelvis diagnostic quality of reformat.

RATIONALE AND OBJECTIVES: To evaluate the image quality of axial and coronal reformats obtained from isotropic resolution abdomino-pelvic computed tomography (CT) examinations. MATERIALS AND METHODS: Thirty consecutive patients with intravenous contrast-enhanced abdomino-pelvic CT examinations (Brilliance 40, Philips Medical Systems, Cleveland, OH) were enrolled for the study. The raw data were reconstructed into two sets of source axial images: 0.9-mm slice widths with 0.45-mm reconstruction interval (isotropic resolution) and 4-mm slice widths with 3-mm reconstruction interval (anisotropic resolution: group A). Isotropic data set was reformatted into axial and coronal stacks (groups B and C, respectively) with 4-mm slice width and 3-mm interval. Three independent readers evaluated stacks A to C using a 3-point scale for resolution of hepatic vessels, edge sharpness of kidneys, respiratory motion artifact, reconstruction artifact, noise, and overall image quality. RESULTS: There was no statistical difference among the groups A to C for vessel resolution, motion artifact, noise, and overall quality. The scores given to group C were significantly lower than those to groups A and B for reconstruction artifacts. There was no difference among groups A to C for overall impression of image quality. The interreader agreements were excellent for axial images (groups A and B) and moderate for coronal reformats. CONCLUSION: Isotropic scanning of the abdomen and pelvis allows creation of reformats with similar image quality as similar thickness axial source images. These reformats are of sufficient quality to form the basis of clinical interpretation.

Abdominal Cavity↗
PubMed2004

Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis.

OBJECTIVE: The arcus tendineous fasciae pelvis (ATFP) provides support to the anterior vagina. The objective of this study was to determine the impact of menopause on the structural components of the ATFP. STUDY DESIGN: Biopsy specimens of the ATFP were obtained from 10 premenopausal, 5 postmenopausal, and 12 postmenopausal women on hormone therapy. Scanning confocal microscopy of fluorescent micrographs was used to define the amount of collagen subtypes, smooth muscle, and elastin. Collagen fiber orientation was determined by scanning electron microscopy. RESULTS: The ATFP is comprised primarily of parallel bundles of type III collagen fibers (84%), an intermediate amount of elastin (13%), and very little smooth muscle. The ratio of collagen I/(III+V) was decreased in postmenopausal not on hormones relative to premenopausal women (P=.04) due to a 75% decrease in collagen I (P=.046). The decrease in collagen I and change in collagen ratios was not present in women on hormone therapy. Comparison of the amounts of elastin and smooth muscle showed no difference in the ATFP of premenopausal and postmenopausal women. CONCLUSION: Menopause in the absence of hormone therapy is associated with a decrease in quantity of collagen I in the ATFP resulting in a decrease in the ratio of collagen I/(III+V). This may compromise the tensile strength and an increase susceptibility to anterior vaginal wall prolapse.

Adult↗
PubMed2005

The distance between the perceived and the actual arcus tendineus fascia pelvis during vaginal paravaginal repair.

OBJECTIVE: This study was undertaken to determine whether the arcus tendineus fascia pelvis (ATFP) can be accurately identified from the paravaginal space (PVS) without entering the retropubic space (RPS). STUDY DESIGN: Eight patients undergoing vaginal paravaginal repair were enrolled. The paravaginal dissection was completed to the most cephalad portion of the PVS without entering the RPS. The apex of each PVS was stained with methylene blue. The RPS was entered, the ATFP visualized, and 4 sutures were placed along its length to be used for the repair. The perpendicular distance between each suture and the most cephalad area of stain was measured. RESULTS: The mean distance from the perceived to actual ATFP at each suture point (1-4) was 3.5 cm, 2.75 cm, 2.0 cm, and 0.91 cm, respectively. CONCLUSION: In these 8 cases, the RPS had to be entered to accurately identify the ATFP. The degree of error increases as the ischial spine is approached (P < .001).

Adult↗
PubMed2005

[About two big buttocks: an erysipelas with lymphoedema after pelvis surgery].

We report the case of a 58-year-old man with erysipelas of both buttocks secondary to lymphoedema after pelvis surgery for prostatic cancer and multiple vascular interventions for iliofemoral thrombosis. The diagnosis was based on clinical examination and lymphoscintigraphy. This location of lymphoedema, limited to the buttocks, is uncommon; lower limbs are usually affected. This location needs a specific curative and preventive treatment, including antibiotic therapy, lymphatic drainage and contention to abate the condition and prevent a relapse.

Buttocks↗
PubMed2005

[Coverage of pelvis and thigh region by pedicled perforator flap like deep inferior epigastric perforator (DIEP)].

The deep inferior epigastric perforator flap (DIEP) is a variation of the transverse rectus abdominis myocutaneous flap (TRAM). This flap was used as a pedicled flap to reconstruct the pelvis and thigh region after resection for cancer (four cases). Various flaps have been described for covering theses tissue defects but we prefer this perforator flap for its many advantages. This flap is very reliable and generates minimal functional sequelae on donor site. This flap is useful to cover soft tissue defects after vascular and oncologic surgery, a situation that was rarely reported to our knowledge.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging of gastrointestinal stromal tumor in the abdomen and pelvis.

This study aimed to evaluate magnetic resonance (MR) imaging appearances of 11 gastrointestinal stromal tumors in the abdomen and pelvis and compared them with some histological findings. Gastrointestinal stromal tumor showed nonhomogeneous signal intensity and included hemorrhage in large tumors. Gastrointestinal stromal tumors showed a wide variety of enhancement, and contrast enhancement of the tumor was consistent with mitosis index as well as the largest diameter of the tumor. Contrast-enhanced MR imaging may be useful in the assessment of tumor activity.

Abdominal Cavity↗
PubMed2005

Our experience with retroperitoneal and transperitoneal laparoscopic pyeloplasty for pelvi-ureteric junction obstruction.

OBJECTIVE: Laparoscopic dismembered pyeloplasty has been quoted to have equivalent success rates to the traditional open procedure in the treatment of pelvi-ureteric junction obstruction (PUJO). The aim of this study was to report our experience with laparoscopic pyeloplasty. PATIENTS AND METHODS: All patients with PUJO are entered into a database to record patient, operative and post-operative details. Over an eleven-year period, 176 procedures were performed. Eighty-three procedures were dismembered laparoscopic pyeloplasties, of which two retroperitoneal procedures were converted to open. The first 17 procedures were performed via the retroperitoneal approach and the following 66 via the transperitoneal route. Thirty-one procedures were open pyeloplasty. RESULTS: The retroperitoneal group had a mean follow up of 35 (16-66) months. Five patients (33%) developed recurrent symptoms with evidence of obstruction seen on the renogram within 4 months and required further surgery. The transperitoneal group had a mean follow up of 15 (3-38) months. Five patients were classified as failures (mean time to failure 4.6 months) resulting in a success rate of 92% for the transperitoneal route. Both groups had a mean post-operative hospital stay of 3.6 days. Open pyeloplasty at our institution has a success rate of 88% at a mean follow up of 85 months (range 3-260 months) and a mean length of post-operative stay of 6 days. CONCLUSION: Overall our success rate following laparoscopic pyeloplasty is 88%. However, our preferred approach is transperitoneal, which is associated with a success rate of 92%. This is equivalent, if not better than that seen following open pyeloplasty with the additional benefits of reduced hospital stay and time to recovery. There are many possible explanations for this difference in success rates between approaches, however equivalent results are reported in the literature and therefore the learning curve is likely to be the major factor in this series.

Adolescent↗
PubMed2005

Coordination of pelvis-HAT (head, arms and trunk) in anterior-posterior and medio-lateral directions during treadmill gait in preadolescents with/without Down syndrome.

In human biped gait, movements in the frontal plane such as side-to-side rocking, are as essential as the alternating movement of the legs in the sagittal plane. In addition, the top-heavy structure of human body necessitates control of the trunk during walking. In this study, we evaluated the pelvis and HAT (head, arms and trunk) movements and their coordination during treadmill walking in the anterior-posterior and medio-lateral directions in children with typical development (TD) and those with Down syndrome (DS). Participants were 12 children with DS aged 8-10 years and 10 age-matched children with TD. They walked on a treadmill at 40%, 75% and 110% of their preferred overground walking speeds. Kinematic data were collected using a 3D-motion-capture system; movements of the mid-point of hip joints (OPELVIS) and the center of mass of HAT (COMHAT) were reduced. Children with DS showed larger and speed dependent amplitude responses compared to their TD peers. Coordination patterns for children with DS were less stable, especially in medio-lateral direction at slow speed. Differences in amplitude response may be the result of poorer trunk control in children with DS or, alternatively, part of a necessary and sufficient propulsion/stabilization mechanism for this population with reduced tone and muscle strength. Response differences observed between the anterior-posterior and medio-lateral directions for both groups may reflect relative differences in the involvement of active neuromuscular control.

Arm↗
PubMedDate not supplied

[Anthropologic evolution of women's pelvis].

The existence of dystocia in human presents a vexing problem for an evolutionary point of view. Dealing with the great apes and modern human's pelvis evolution, considering the bipedalism and the cerebral growth, the adaptative mechanisms and their obstetrical and social consequences are discussed.

Adaptation, Physiological↗
PubMed2005

Glomus tumor of renal pelvis: a case report and review of the literature.

Glomus tumors are uncommon benign perivascular neoplasms that have rarely been described outside of their usual peripheral soft tissue sites. We report a unique case of glomus tumor of the renal pelvis in a 53-year-old woman who presented with microscopic hematuria associated with obstruction of the ureteropelvic junction and marked hydronephrosis. At initial gross examination, the tumor mimicked a urothelial carcinoma.

Diagnosis, Differential↗
PubMed2004

Recovery of walking speed and symmetrical movement of the pelvis and lower extremity joints after unilateral THA.

In 17 patients with unilateral hip disease who underwent total hip arthroplasty (THA), the gait was analyzed preoperatively and 1, 3, 6, and 12 months after unilateral THA using a Vicon system to assess the recovery of walking speed and symmetrical movement of the hip, knee, ankle, and pelvis. The walking speed of these patients reached that of normal Japanese persons by 12 months after surgery. Walking speed was correlated with the range of hip motion on the operated side at 1 month postoperatively, and was correlated with the hip joint extension moment of force on both sides from 3 to 6 months after surgery. Before THA, asymmetry was observed in the range of the hip motion, maximum hip flexion, maximum hip extension, maximum knee flexion, as well as in pelvic obliquity, pelvic tilt, and pelvic rotation. There were no differences of the stride length or step length between both sides throughout the observation period. The preoperative range of hip flexion on the operated side during a gait cycle (21.3+/-7.9 degrees ) was significantly smaller than on the non-operated side (46.7+/-7.1 degrees ), and the difference between sides was still significant at 12 months after surgery (35.1+/-6.2 degrees on the operated side and 43.6+/-5.7 degrees on the non-operated side). The majority (74%) of the difference in hip motion range during this period was due to the difference in maximum extension of the hip. The increase in the range of pelvic tilt and the range of motion of the opposite hip showed an inverse correlation with the range of motion of the operated hip, suggesting a compensatory preoperative role. However, this correlation became insignificant after 6 months postoperatively. Asymmetry of the range of hip motion persisted at 12 months after THA in patients with unilateral coxoarthropathy during free level walking, while the operation normalized the spatial asymmetry of other joints and the walking speed prior to the recovery of hip motion.

Arthroplasty, Replacement, Hip↗
PubMed2006

Propagation of the hip joint centre location error to the estimate of femur vs pelvis orientation using a constrained or an unconstrained approach.

To estimate hip joint angles during selected motor tasks using stereophotogrammetric data, it is necessary to determine the hip joint centre position. The question is whether the errors affecting that determination propagate less to the angles estimates when a three degrees of freedom (DOFs) constraint (spherical hinge) is used between femur and pelvis, rather than when the two bones are assumed to be unconstrained (six DOFs). An analytical relationship between the hip joint centre location error and the joint angle error was obtained limited to the planar case. In the 3-D case, a similar relationship was obtained using a simulation approach based on experimental data. The joint angle patterns resulted in a larger distortion using a constrained approach, especially when wider rotations occur. The range of motion of the hip flexion-extension, obtained simulating different location errors and without taking into account soft tissue artefacts, varied approximately 7 deg using a constrained approach and up to 1 deg when calculated with an unconstrained approach. Thus, the unconstrained approach should be preferred even though its estimated three linear DOFs most unlikely carry meaningful information.

Artifacts↗
PubMed2006

Primary vesicoureteral reflux detected in neonates with a history of fetal renal pelvis dilatation: a prospective clinical and imaging study.

OBJECTIVE: To assess the clinical outcome and imaging features of neonatal primary vesicoureteral reflux (VUR). STUDY DESIGN: We prospectively followed 43 infants with primary VUR identified from among a cohort of 497 infants with fetal renal pelvis dilatation. Postnatal renal ultrasound (US) examinations were performed at 5 days and 1, 3, 6, 12, and 24 months of life. Voiding cystourethrography was performed in the neonatal period and repeated at 12 and 24 months when VUR was persistent. Two radioisotopic examinations, including a 99mTc-MAG3 renogram and a plasma clearance of Cr-51 EDTA, were performed in all children with high-grade reflux. RESULTS: The incidence of primary VUR in our study group was 9%. Among the 43 patients followed, 11 (26%) had high-grade (IV-V) VUR and 32 (74%) had low-grade VUR. Resolution of reflux occurred in 2 of 11 (18%) patients with high-grade VUR and in 29 of 32 (90.6%) patients with low-grade VUR at age 2 years (P < .001). At age 2 years, 91% of the low-grade refluxing kidneys were normal on US, compared with only 35% of the high-grade refluxing kidneys. Split renal function was within normal range and single-kidney GFR was significantly increased in 13 of the 17 high-grade refluxing kidneys during follow-up. Furthermore, a strong association between dysplasia on US and poor renal function outcome was found. CONCLUSIONS: In most infants with VUR, the reflux is of low grade and resolves rapidly. In those children with high-grade VUR, spontaneous resolution is rare at age 2 years, but persistent reflux rarely impairs the maturation of renal function.

Anti-Infective Agents, Urinary↗
PubMed2004

The length and collapsibility of the ureter play roles in the augmented reflection of intraabdominal pressure into the renal pelvis.

BACKGROUND/PURPOSE: Flow of a fluid through a collapsible tube is under the influence of various factors including the external compressing pressure. The intraabdominal pressure (IAP) should influence the flow through the ureter. Therefore, an experimental study was planned to investigate the effects of ureteral length and external compressing pressure onto the intrapelvic pressure (IPP) in rabbits. METHODS: Nineteen adult rabbits were used for the experiment. Under general anesthesia, an intraperitoneal and an intrapelvic catheter were placed to measure IAP and IPP. A urethral catheter was placed for bladder decompression. After this standard preparation, a ureteric stent was placed in the ureter in group 1 (n = 7). Distal or proximal ureter transection was performed in group 2 (n = 6) and group 3 (n = 6), respectively. Basal pressure measurements have been recorded. Then the pressures were recorded every 5 minutes, and IAP was increased gradually for 4 cm of water pressure in each subsequent 30-minute period. All analyses were performed for a standard IAP interval (5 to 25 cm H2O). RESULTS: IAP did not differ between groups (P = .08). IPP values were significantly higher than the corresponding IAP values in each group (P = .0001). IPP showed significant difference between IAP values of groups (P = .0001). IPP was significantly increased in group 2 when compared with group 1 and group 3 (P = .0001; P = .0001), but no difference was encountered between groups 1 and 3 (P = .1). There has been a strong relationship between IPP and IAP values in all groups. The Rsq values were 0.912, 0.783, and 0.943 for group 1, group 2, and group 3, respectively (P < .0001). Mathematic relations between IPP and IAP also were analyzed. The relations were IPP = 3.9 + 1.10 x IAP, IPP = 10.3 + 1.10 x IAP, and IPP = 3.3 + 1.12 x IAP for groups 1, 2, and 3, respectively. CONCLUSIONS: Renal pelvis pressure responds with augmented increases to increments in IAP in urinary tracts with different ureteric lengths. Increase in IPP is more pronounced in longer ureters possibly owing to increased resistance to flow. Prevention of ureteric wall collapse reverses the augmented increase in IPP responses. Therefore, both the length and collapsibility of the ureter play a detrimental role in the generation of augmented IPP responses to increments in IAP. The magnitude of IPP as a response to increments in IAP can be estimated by using mathematical relations between IPP and IAP. Increases in IAP may simulate proximal ureteric obstruction and may take part in the pathogenesis of hydronephrosis.

Abdomen↗