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At least 163 records · Page 9Linked to original sources
PubMed2006

Does the composition of voided urine reflect that of the renal pelvis?

Studies have shown that the urothelium has a transport function and that urine composition changes on its way through the urinary tract. In this study, we investigated the hypothesis that the composition of voided urine differs from and does not reflect that of the renal pelvis. Urine samples were obtained from the renal pelvis and voided urine of 18 healthy volunteers (mean age 36.2+/-5.1 SD years, 10 men, 8 women). The pH was determined using a pH electrode, osmolality by means of micro-osmometry and Na and K using flame photometry. In comparison to the urine of the renal pelvis, voided urine showed significant increases in pH, osmolality and Na and K concentrations (P<0.05 for each). There were no significant differences in gender and age. This study has demonstrated that the pH, osmolality, Na and K of voided urine differ significantly from the values in the renal pelvis. Urine composition is thus modified as it passes through the urinary tract, which would support the concept of a dynamic urothelium. The composition of voided urine does not seem to compare to renal pelvic urine. This concept needs to be considered in urine analysis evaluation and its relation to renal function.

Adult↗
PubMed2004

Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists.

To analyze the current management recommendations among French-speaking physicians treating infants with antenatal renal pelvis dilatation, we surveyed 83 pediatric nephrologists and 68 pediatric urologists by questionnaire. A total of 45 (54%) pediatric nephrologists and 38 (56%) pediatric urologists responded. The threshold for the diagnosis of abnormal fetal renal pelvis dilatation was significantly higher among pediatric urologists than nephrologists. All responders perform renal ultrasound examinations after birth. Postnatal renal pelvis dilatation was considered abnormal if the anteroposterior diameter was >/=11+/-1.9 mm by the pediatric urologists and >/=9+/-2.9 mm by the pediatric nephrologists ( P=0.003). Pediatric urologists were more likely than nephrologists to recommend routine voiding cystourethrography [41% versus 20% ( P=0.04)]. Mercaptoacetyl-triglycine renography was the most routinely used tool to achieve functional evaluation during follow-up among the responders. Pediatric urologists were more likely to recommend surgical treatment in dilated kidneys with initial function <40%. In conclusion, pediatric urologists had significantly higher thresholds for the detection of prenatal and neonatal renal pelvis dilatation. They also more frequently recommended routine voiding cystourethrography and surgical therapy of dilated kidneys with low function than pediatric nephrologists. The variability in attitudes is most probably due to the absence of clear guidelines based on prospective and controlled trials.

Dilatation, Pathologic↗
PubMed2002

Sagittal morphology and equilibrium of pelvis and spine.

A prospective analysis of the sagittal profile of 100 healthy young adult volunteers was carried out in order to evaluate the relationship between the shape of the pelvis and lumbar lordosis and to create a databank of the morphologic and positional parameters of the pelvis and spine in a normal healthy population. Inclusion criteria were as follows: no previous spinal surgery, no low back pain, no lower limb length inequality, no scoliotic deviation. For each subject, a 30 x 90-cm sagittal radiograph including spine, pelvis and proximal femurs in standing position on a force plate was performed. The global axis of gravity was determined with the force plate. Each radiograph was digitized using dedicated software. The spinal parameters registered were values for thoracic kyphosis and lumbar lordosis. The pelvic angles measured were: pelvic incidence, sacral slope and pelvic tilt. The global axis of gravity was on average 9 mm anterior of the center of the femoral heads. The anatomic parameter of pelvic incidence angle varied from 33 degrees to 85 degrees (mean: 51.7 degrees, SD: 11 degrees). The average lumbar lordosis was 46.5 degrees. The average thoracic kyphosis was 47 degrees. We found a statistical correlation between incidence angle and lumbar lordosis (r=0.69, P<0.001) and between sacral slope angle and lumbar lordosis (r=0.75, P<0.001). Spine and pelvis balance around the hip axis in order to position the gravity line over the femoral heads. We propose a scheme of sagittal balance of the standing human body.

Adult↗
PubMed1996

Volume changes within the true pelvis during disruption of the pelvic ring--where does the haemorrhage go?

Fractures of the pelvis are not only common but are very varied in their complexity. They represent 3% of all fractures (1), they account for 1 in every 1000 surgical admissions and are the third most commonly encountered injury in motor vehicle accident fatalities (2). However, only a small percentage of all pelvic fractures are associated with major disruption of the pelvic ring (3). Life threatening haemorrhage is a frequent complication of major pelvic fractures (1, 4) and haemorrhage is the leading cause of death in these patients (5, 6). It was believed that fracture and subsequent displacement of the ring greatly increased pelvic volume. However, clinical practice seemed to indicate that this might not be true. This study aimed to assess the change in pelvic volume which occurs in severely displaced pelvic fractures. A model of the bony pelvis was designed to permit extreme displacements of the symphyseal and sacroiliac joints. The volume of a polythene balloon placed within the true pelvis was measured as an indication of true pelvic volume. Our finding was that the increase in the volume of the true pelvis which occurs in a fracture with massive diastasis is much smaller than previously assumed.

Fractures, Bone↗
PubMed1986

Primary amyloidosis of renal pelvis with duplicate collecting system.

A case of primary amyloidosis localized to the inferior renal pelvis of a kidney with a duplex collecting system is described. The onset of gross hematuria and mild flank pain necessitated investigations which yielded a clinical impression of tumor within the lower pelvis of a duplex collecting system. At laparotomy a grossly hemorrhagic-appearing mass in the lower pelvis was noted and a left ureteronephrectomy was undertaken. Histologic examination of the surgical specimen revealed amyloid deposition within the inferior pelvis, the corresponding distal portions of the papillae, and the most proximal ureter. Amyloid was not present elsewhere within either the renal parenchyma or the superior collecting system.

Aged↗
PubMed2005

Insights into the pathogenesis and natural history of fetuses with renal pelvis dilatation.

Fetal renal pelvis dilatation is a frequent abnormality that has been observed in 4.5% of pregnancies. The majority of these cases have a tendency to resolve during infancy. Nevertheless, fetal renal pelvis dilatation may be due to significant structural abnormalities such as pelvi-ureteric junction stenosis or vesico-ureteral reflux that may adversely affect renal function or cause urinary infection or sepsis. This review article aims to summarize the data regarding fetal renal pelvis dilatation and to analyze controversial attitudes in the light of the various lines of practice, and to present rational antenatal and postnatal investigation strategy.

Dilatation, Pathologic↗
PubMed2006

How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.

In healthy walking, the timing between trunk and pelvic rotations, as well as erector spinae (ES) activity varies systematically with walking velocity, whereas a comparable velocity-dependent adaptation of trunk-pelvis coordination is often reduced or absent in persons with low back pain (LBP). Based on the hypothesis that trunk-pelvis coordination is linked to overall gait stability, persons with LBP can be expected to have difficulties in dealing with perturbations. We examined the ability of 12 persons with LBP and 12 controls to adapt trunk and pelvis rotations and ES activity to sudden changes in velocity. 3D angular movements of thoracic, lumbar, and pelvic segments and surface EMG were recorded during treadmill walking at six different velocities, which increased or decreased unexpectedly. Relative phases of segmental rotations were determined and (in-)variant properties of kinematics and ES activity were studied using principal component analysis. Compared to healthy controls, persons with LBP exhibited a reduced ability to adapt trunk-pelvis coordination and ES muscle activity to changes in velocity. Altered coordination and muscular control may reflect an attempt to stabilise the spine and prevent the occurrence of unexpected perturbations. The assessment of gait patterns in terms of coordination may help clinicians to quantify movement impairments and may suggest interventions aimed at facilitating the emergence of desired coordination patterns.

Acceleration↗
PubMed2004

Improved treatment of pelvis and inguinal nodes using modified segmental boost technique: dosimetric evaluation.

PURPOSE: To describe a novel, yet simple, modified segmental boost technique (MSBT) and to compare the dosimetry of our method with that of other traditional methods of treatment for the pelvis and inguinal nodes. METHODS AND MATERIALS: We developed a radiotherapy technique that uses linear accelerators with multileaf collimators to treat the pelvis and sequentially boost the inguinal regions, while minimizing "hot spots" across the match-line. This was achieved by angling the gantry for the inguinal fields so that their medial borders aligned with the divergence of the posterior pelvic field. Film dosimetry was performed to compare the MSBT with the traditional segmental boost technique, partial transmission block, and photon/electron combination techniques. These treatment techniques were scored on the basis of the dose homogeneity index, defined as the ratio of match-line maximum dose to the average dose at a given depth in the groin treatment area. RESULTS: The values of the dose homogeneity index were the same (1.04) for MSBT and partial transmission block, and 1.21, 1.39, and 1.18 for the segmental boost technique, photon pelvis with electron tags, and photon pelvis with electron boost, respectively. CONCLUSION: The MSBT proved to be technically simple while optimizing dose homogeneity compared with the other techniques and allows for maximum use of the features of modern linear accelerators.

Electrons↗
PubMed2004

Vasopressin excitatory action on smooth muscle from human renal calyx and pelvis.

The motor response to vasopressin, a neuropeptide promoting the reabsorption of water, was isometrically investigated in vitro in human renal calyces and pelvis in relation to possible modulation of urinary flow by these tubular structures. Kidneys were obtained from nine male patients who underwent nephrectomy for either renal or ureteral cancer. Minor calyces and pelvis were carefully removed. Strips (10 mm x 3 mm) were cut from infundibular region of minor calyces and from renal pelvis and placed in 10 ml organ bath for isometric tension recordings. Calyceal and pelvic smooth muscle strips exhibited spontaneous phasic contractions which occurred with regular frequency and amplitude. Vasopressin induced a dose-dependent [10(-10) to 10(-6) M] enhancement of basal tone (P <0.01) and a decrease of spontaneous contractions on isolated strips from minor calyces and pelvis. The effect of vasopressin was inhibited by prior administration of D(CH2)5Tyr(Me)2-Arg8-Vasopressin antagonist [10(-7) M]. The excitatory response to vasopressin was Tetrodotoxin [TTX]-resistant and was not affected by pre-treatment with phentolamine [10(-5) M], atropine [10(-5) M], and hexamethonium [10(-5) M]. After incubation of the specimens in Ca2+-free medium containing EGTA [0.5 mM] or after treatment with nifedipine [10(-5) M], both spontaneous and vasopressin-induced contractions [10(-10) to 10(-6) M] were completely inhibited in all specimens. Our results can be interpreted to imply that the tonic contractions induced by vasopressin facilitate the reabsorption of water by increasing the hydraulic resistance of the tubular structures below collecting ducts.

Dose-Response Relationship, Drug↗
PubMed2006

Renal pelvis flap--guide for ureteral spatulation and handling during dismembered pyeloplasty.

INTRODUCTION: To present a technical modification of the classic dismembered pyeloplasty technique. We have implemented it in 112 pyeloplasties performed during the past 15 years. TECHNICAL CONSIDERATIONS: The technical modification is based on a renal pelvis flap kept undetached from the ureteropelvic junction, and consequently from the ureter, until near completion of the new ureteropelvic anastomosis. This flap is used for ureteral handling (a "no touch" technique) during pyeloplasty and also serves as a very reliable guide for lateral ureteral spatulation, preventing ureteral twisting and subsequent misalignment of the de novo ureteropelvic junction. We experienced early complications in 4 patients (3.6%). Two patients had excessive urinary leakage from the ureteropelvic anastomosis because of misplacement of a Nelaton retroperitoneal tube drain. We have used soft Penrose drains for retroperitoneal drainage since. Two other patients needed reoperation because of a redundant renal pelvis and ureter consequent to a remnant high anastomosis and insertion of the ureter to the renal pelvis with subsequent kinking and obstruction. No other early or late complications attributable to obstruction of the anastomosis resulting from devascularization or misalignment between the ureter and renal pelvis were encountered. CONCLUSIONS: Modification of the classic pyeloplasty technique has proved relatively easy and reliable in our experience. With the increasing popularity of the laparoscopic approach for pyeloplasty, the described technical modification may become useful for laparoscopic handling of the ureter.

Follow-Up Studies↗
PubMed1998

Morphometric analysis of the fibroadipose tissue of the female pelvis.

PURPOSE: The structure of the retroperitoneal connective tissue of the female pelvis was evaluated to determine whether its spatial arrangement may have a role in supporting the pelvic viscera. MATERIALS AND METHODS: After in situ formalin fixation the pelvic viscera with the surrounding connective tissue were removed together with the pelvic floor from 18 female cadavers 48 to 68 years old. Serial macrosections of the bladder base, cervix, lower rectum and pelvic floor complex, cut in coronal (4 cases) and horizontal (10 cases) planes, were stained with azan-Mallory, and the remaining 4 were cut in the horizontal plane and plastinated using von Hagens E12 technique. Morphometry of the retroperitoneal connective tissue was performed using a computerized system for image analysis connected through a black and white television camera to an optic microscope. The diameters of the adipose lobules and density of the connective tissue were evaluated in the proximity of the visceral adventitia and the parietal pelvic fascia, respectively. RESULTS: The retroperitoneal connective tissue of the female pelvis consists of varying amounts of adipose tissue divided into small lobules by thin connective laminae. These laminae are connected to the visceral and parietal layers of the pelvic fascia, and are closely connected to the vascular and nervous bundle sheaths crossing the pelvis. At the level of the sacrouterine and cardinal ligaments we were unable to find any connective ligamentous structure. Only an areolar tissue was seen, which after removal of the lipids demonstrated a fibrillar structure. The mean area of the adipose lobules was smaller (average of 1.41 mm.2) near the viscera with respect to the lateral retroperitoneal connective tissue (average of 1.73 mm.2) due to greater ramification of the connective laminae. CONCLUSIONS: In the absence of real connective ligaments the retroperitoneal connective tissue forms a 3-dimensional network of thin connective laminae that are connected to the visceral adventitia, parietal layer of the pelvic fascia and neurovascular bundles crossing the pelvis. These connective laminae are bounding adipose lobules of different size (smaller near the viscera, larger at the periphery). Overall, the retroperitoneal connective tissue constitutes an anatomical structure that, beyond the functional limits of any individual ligament, may have supporting properties.

Aged↗
PubMed1992

Local motor responses to bradykinin and bacterial chemotactic peptide formyl-methionyl-leucyl-phenylalanine (FMLP) in the guinea-pig isolated renal pelvis and ureter.

The local motor response to bradykinin and the bacterial chemotactic peptide, formyl-methionyl-leucyl-phenylalanine (FMLP) was investigated in the guinea-pig isolated renal pelvis and ureter in relation to possible activation of capsaicin-sensitive primary afferent nerves and release of sensory neuropeptides. Both bradykinin (1 nM-10 microM) and FMLP (10 nM-10 microM) produced a concentration-dependent positive inotropic effect in the isolated renal pelvis which was unaffected by in vitro capsaicin desensitization. The response to bradykinin was antagonized by HOE 140, a bradykinin receptor antagonist, while it was unaffected by MEN 10,376, a tachykinin receptor antagonist, hCGRP(8-37) a calcitonin gene-related peptide (CGRP) receptor antagonist and N-t-BOC-Phe-DLeu-Phe-DLeu-Phe (BPLPLP), an FMLP antagonist. The response to FMLP was blocked by BPLPLP while it was unaffected by HOE 140, MEN 10,376 or hCGRP(8-37). Indomethacin (10 microM) enhanced the response to both bradykinin and FMLP. Bradykinin transiently activated rhythmic contractions in the isolated ureter. The response to bradykinin was blocked by HOE 140 and was unaffected by in vitro capsaicin desensitization, indomethacin, MEN 10,376 or BPLPLP. FMLP had no motor effect on the resting ureter but when rhythmic background contractions were evoked by the addition of 100 nM endothelin 1, it produced a transient suppression of ureteral motility. This inhibitory effect was unchanged by in vitro capsaicin desensitization or HOE 140 while it was abolished by indomethacin or BPLPLP pretreatment. Both bradykinin and FMLP evoked the release of CGRP-like immunoreactivity in the renal pelvis. The effect of bradykinin but not that of FMLP was abolished by indomethacin. By contrast neither bradykinin nor FMLP did evoke a significant CGRP-LI release in the ureter. It is concluded that bradykinin and FMLP affect pyeloureteral motility through specific and independent pathways. The local motor responses produced by these chemical stimulants are independent from the release of sensory neuropeptides from capsaicin-sensitive primary afferent neurons. Direct neurochemical evidence was obtained for activation of capsaicin-sensitive primary afferents in the renal pelvis: such a mechanism could be involved in the genesis of ureteral pain whenever bradykinin or FMLP come into contact with sensory nerves in the pyeloureteral wall.

Animals↗
PubMed1989

Neuroanatomy of the pelvis in an infant with cloacal exstrophy: a detailed microdissection with histology.

The internal anatomy of the pelvis in the patient with cloacal exstrophy has not been described in detail previously. We present in detail the pelvic anatomical relationships of a patient with cloacal exstrophy who died 72 days after birth and whose body subsequently was perfused with a formalin-based anatomical fluid. Microdissection of the pelvis with histological confirmation of the identity of structures dissected was performed. The vascular supply to the urinary hemibladders arises from the internal iliac arteries, which pass along the lateral portion of the pelvis and enter each hemibladder. The autonomic innervation to the bladder and corporeal bodies arises from a pelvic plexus that lies on the anterior surface of the sacrum. The innervation to the hemibladders then travels in the midline along the posteroinferior surface of the pelvis before extending laterally to communicate with each hemibladder. Autonomic innervation to the duplicated corporeal bodies arises from the sacral pelvic plexus and travels in the midline to pierce the inferior portion of the pelvic floor posterior and medial to the hemibladders. These nerves then enter the crural region of the corpora. Sensory innervation to the corporeal bodies arises from the sacral trunk and passes posterior to the pelvic floor muscles, traveling just medial to the widely separated ischial spines and then laterally along the corporeal bodies. Illustrations of the anatomy and implications for management of the exstrophy patient are presented.

Abnormalities, Multiple↗
PubMed2001

Evaluation of cell proliferation, apoptosis, and angiogenesis in transitional cell carcinoma of the renal pelvis and ureter.

OBJECTIVES: To investigate cell proliferation, apoptosis, and angiogenesis and their roles in transitional cell carcinoma (TCC) of the renal pelvis and ureter. METHODS: Formalin-fixed and paraffin-embedded tissue blocks from 42 patients with TCC of the renal pelvis and ureter were studied. Cell proliferation was assessed by Ki-67 immunostaining, and the proliferation index (PI) was expressed as a percentage of Ki-67-positive cells. Apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL), and the apoptotic index (AI) was expressed as a percentage of TUNEL positive cells. Angiogenesis was evaluated by CD31 immunostaining, and microvessel density (MVD) was expressed as the average of the microvessel count. RESULTS: The PI ranged from 5.9% to 48.0% (median 20.03%), AI from 1.0% to 4.2% (median 2.26%), and MVD from 16.0 to 146.0 (median 56.88) in TCC of the renal pelvis and ureter. Statistical analysis revealed close associations of both PI and MVD with tumor stage and of AI with tumor grade. Our study demonstrated a strong relationship between PI and MVD, but did not show associations of AI with PI or MVD in TCC of the renal pelvis and ureter. CONCLUSIONS: It is suggested that the high activity of tumor cell proliferation with rich neovascularization may be related to the high malignant potential of the cancer, and evaluation of cell proliferation combined with angiogenesis may be useful in predicting the progression of the renal pelvic and ureteral TCC.

Adult↗
PubMedDate not supplied

[Subepithelial hemorrhage of renal pelvis (Antopol-Goldman lesion). Report of 4 cases and review of the literature].

OBJECTIVES: The subepithelial hematoma of renal pelvis (Lesion of Antopol-Goldman) is a rare entity that preferably is diagnosed clinically as a neoplasic lesion. METHODS: We present four new cases of subepithelial hematoma of renal pelvis diagnosed in our hospital from 1989. RESULTS: Our cases presented clinically with hematuria and flanc pain, preferably in the left side (3 out of 4). After nephrectomy, all the cases showed a subepithelial hematoma of variable extension that can occupy the renal pelvis and calices, associated to hidronefrosis, cortical infartion, renomegaly or renal angioma. Additionally, two of our patients presented with dilation of the pielocalicial system, and a third one presented with urotelial carcinoma of the ureter, being therefore the lesion of Antopol-Goldman an incidental discovery. In the remaining case, the presence of multiple renal hemangiomas was identified as cause of the renal pelvic hematoma. CONCLUSIONS: The preoperatore diagnosis of the lesion of Antopol-Goldman is difficult although it should be included as differential diagnosis in those cases with hematuria and alterations of renal pelvis in the image techniques, because an early diagnosis could imply a conservative treatment with pieloplastia or partial nephrectomy.

Adult↗
PubMed1999

Lumbar coupling during lateral translations of the thoracic cage relative to a fixed pelvis.

OBJECTIVE: To determine lumbar coupling during lateral postural translations (lumbosacral list) of the thoracic cage relative to a fixed pelvis. DESIGN: Digitized measurements from anteroposterior lumbar radiographs of 17 volunteers were obtained in neutral, maximal left lateral translation and maximal right lateral translation posture of the thoracic cage compared to a fixed pelvis. Subjects were constrained with two sets of clamps at the lateral borders of the pelvis and lower ribs. BACKGROUND: Data. Clinically, lumbosacral list is a common posture. Range of motion and spinal coupling results have not been reported for the lumbosacral list movement. METHODS: Four vertebral body corners, mid narrow-waisted body margins, superior and inferior pedicle margins, and spinous-lamina junction of T12-L5 were digitized on 51 anterior-posterior lumbar radiographs. Using the orthogonal axes of positive x-direction to the left, vertical as positive y, and anterior as positive z, digitized points were used to measure projected segmental z-axis rotation, y-axis rotation, and segmental lateral translations of each vertebra. RESULTS: Using the displacement of T12, subjects could translate 35-70 mm left or right along the x-axis with an average of 53.2 mm to the left and 52.1 mm to the right. Using superior endplates to superior sacral base, lateral flexion was largest at L1 and decreased from L1 to L5, but the segmental rotation angles for lateral flexion were largest at L2-L3 (3.9 degrees ), L3-L4 (6.2 degrees ) and L4-L5 (5.7 degrees ) and were in the same direction as the main motion translation. The relative z-axis rotation of T12 was opposite to the direction of L1-L5. The coupled y-axis rotations were less than 1 degrees and coupled segmental lateral translations were averaging less than 1 mm. CONCLUSIONS: Thoracic cage x-axis translations compared to a fixed pelvis are significant, between 35 and 70 mm. The z-axis lumbar coupled rotation was largest at L2-L3, L3-L4 and L4-L5 and to the same side of the main motion translation in L1-L5, but opposite the main motion direction for T12. All other movements were small, averaging less than 1 degrees or 1 mm. RELEVANCE: The clinically common posture of lateral translation of the thoracic cage (lumbosacral list) is often associated with disc herniation. Yet normal lumbar coupling patterns and total range of motion of this movement have not been established in the literature. Normal values for lumbar segmental coupling on anterior-posterior lumbo-pelvic radiographs during trunk list might be important for an analysis of segmental instability since segmental translations were determined to be 1 mm or less.

Adult↗
PubMed1999

Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study.

To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy (n = 71), nephroureterectomy and lymphadenectomy (n = 20), nephroureterectomy and partial bladder resection or transurethral resection (n = 20), nephrectomy (n = 10), and ureterectomy (n = 5). Sixty-one per cent (n = 77) of the tumours were located in the renal pelvis, and 21% (n = 27) in the ureter (both in 22 [17%]). Following surgery, residual tumour was still present in 33 patients (16 microscopic and 17 macroscopic). Postoperative radiotherapy was given to 45 (36%) patients. The median follow-up period was 39 months. In a median period of 9 months, 66% of the patients relapsed (34 local, 7 locoregional, 16 regional, and 24 distant). The 5- and 10-year survival were 29% and 19%, respectively, in all patients. In univariate analyses, statistically significant factors influencing the outcome were Karnofsky index, pT-classification, pN-classification, tumour localisation, grade, and residual tumour after surgery. Multivariate analysis revealed that independent prognostic factors influencing outcome were pT-classification, the existence of residual tumour, and tumour localisation. In patients with urothelial renal pelvis and/or ureter tumours, a radical surgical attitude is mandatory; and the presence of tumour in the ureter is associated with a poorer prognosis.

Aged↗
PubMed2002

Pelvis-thorax coordination in the transverse plane during gait.

The coordination between horizontal pelvic and thoracic rotations during treadmill walking was studied in ten subjects. Previous studies have considered the relative phase using the mean to characterize coordination mode, and the S.D. as an index of its stability. However, to use S.D. of relative phase as a measure for coordinative stability, the underlying oscillations have to be phase-locked at a certain value. Random fluctuations around this value can then be viewed as stochastic perturbations of a stable fixed point, resulting in a unimodal distribution of relative phase. Using methods of circular statistics this study shows that these conditions were not met in pelvis-thorax coordination. Spectral analyses revealed that, as walking velocity increased, a triphasic component emerged in the pelvic rotations, while the thoracic rotations remained harmonic across all walking velocities. These findings refute the use of standard relative phase measures to capture pelvis-thorax coordination. An alternative measure is introduced, namely the difference between the continuous Fourier phases of the component oscillations as determined for the main frequency of the thorax oscillation. With this measure, pelvis-thorax coordination was found to evolve from in-phase coordination towards antiphase coordination as walking velocity increased. This method may be used to assess reliably the properties of pelvis-thorax coordination in both healthy and pathological gait patterns in the future.

Adult↗