Imaging plays an indispensable role in diagnosing and managing urologic conditions. Conventional radiography such as intravenous urography has been critical for assessing conditions of the adrenals, kidneys, ureters, and bladder that cannot be examined physically. Developments in computed tomography and intravenous contrast agents provide detailed anatomic and functional information. Magnetic resonance imaging is also useful due to its excellent soft tissue resolution without needing contrast in many cases.
uses and indication of radiology in surgeryanimesh kunwar
1.Introduction
2.Diagnostic modalities in radiology
3.Role of radiological imaging in emergency surgical situation
4.Role of radiological imaging in elective surgical situation
5.Conclusion
A presentation about Intravenous Urography (Also known as Intravenous Pyeography).
The presentation contains 41 slides, and is divided into 4 parts :
1 - Introduction.
2 - The procedure.
3 - Examples for abnormal findings.
4 - Studies comparing IVU accuracy with KUB & USG with CT Scan.
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
A presentation about Imaging the urinary tract using contrast.
contains 45 slides, and covers the following methods :
1 - Antegrade urography
2 - Retrograde urography
3 - Retrograde cystography
4 - Voiding cystography
5 - Retrograde Urethrography
Intravenous urography is covered in a separate presentation, that you can read and download from here :
http://www.slideshare.net/abdallamutwakil/intravenous-urography-ivu-35107052
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
Hepatobiliary system radiology revision notesTONY SCARIA
hepatobiliary system
hepatic segments
image based questions
last minute revision
radiology radiodiagnosis
hepatic investigations
based image based questions f
genitourinary tb - contains radiological findings of genitourinary tuberculosis including ivp,, hsg, usg and ct findings in kidney, ureter, urinary bladder, uterus and prostate
uses and indication of radiology in surgeryanimesh kunwar
1.Introduction
2.Diagnostic modalities in radiology
3.Role of radiological imaging in emergency surgical situation
4.Role of radiological imaging in elective surgical situation
5.Conclusion
A presentation about Intravenous Urography (Also known as Intravenous Pyeography).
The presentation contains 41 slides, and is divided into 4 parts :
1 - Introduction.
2 - The procedure.
3 - Examples for abnormal findings.
4 - Studies comparing IVU accuracy with KUB & USG with CT Scan.
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
A presentation about Imaging the urinary tract using contrast.
contains 45 slides, and covers the following methods :
1 - Antegrade urography
2 - Retrograde urography
3 - Retrograde cystography
4 - Voiding cystography
5 - Retrograde Urethrography
Intravenous urography is covered in a separate presentation, that you can read and download from here :
http://www.slideshare.net/abdallamutwakil/intravenous-urography-ivu-35107052
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
Hepatobiliary system radiology revision notesTONY SCARIA
hepatobiliary system
hepatic segments
image based questions
last minute revision
radiology radiodiagnosis
hepatic investigations
based image based questions f
genitourinary tb - contains radiological findings of genitourinary tuberculosis including ivp,, hsg, usg and ct findings in kidney, ureter, urinary bladder, uterus and prostate
The presence of haematuria may be the sole symptom of an underlying disease, either benign or malignant. It is one of the most common presentations of patients with urinary tract diseases and of patients referred for urinary imaging. Painless visible haematuria (VH) is the commonest presentation of bladder cancer.
computed tomography intravenous urography protocol and advancements ,,, slides coves urinary system anatomy glance ,, contrast media used in procedure , radiation doses and some pathological findings
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Imaging in urology
1.
2. • Imaging continues to play indispensable role in diagnosis and
management of urologic diseases
• Because many urologic conditions cannot be assessed by physical
examination, conventional radiography has long been critical to
diagnosis of conditions of the adrenals, kidneys, ureters, and
bladder.
• Development of computed tomography (CT) imaging and use of
intravenous contrast agents have provided detailed anatomic,
functional, and physiologic information about urologic conditions.
3. • PLAIN FILM IMAGING (KUB)
• ULTRASONOGRAPHY
• X RAY IVU
• X RAY RETROGRADE PYELOGRAPHY
• X RAY URETHROGRAM
• CYSTOGRAM
• VCUG
• COMPUTED TOMOGRAPHY
• MAGNETIC RESONANCE IMAGING
• RADIONUCLIDE IMAGING (DISCUSSED IN PREVIOUS
PRESENTATION)
4. • Remains useful for preoperative diagnosis and
postoperative evaluation in variety of different
urologic conditions.
• Conventional radiography includes
• ABDOMINAL PLAIN RADIOGRAPHY
• INTRAVENOUS EXCRETORY UROGRAPHY
• RETROGRADE PYELOGRAPHY
• RETROGRADE URETHROGRAPHY
• CYSTOGRAPHY
12. • FILM IS TAKEN WITH PATIENT SUPINE AND SHOULD INCLUDE ENTIRE
ABDOMEN FROM BASE OF STERNUM TO PUBIC SYMPHISIS
13.
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32. • A non-invasive method of urinary tract imaging.
• It provides good images of kidneys and bladder
• Anatomical detail of ureter is poor and mid-ureter cannot be imaged at all
by ultrasound because of overlying bowel gas.
USES OF ULTRASOUND
RENAL
• Assessment of haematuria.
• Determination of nature of renal masses—can differentiate simple cysts
(smooth, well-demarcated wall, refl ecting no echoes; benign) from solid
masses (almost always malignant; cystic masses with solid components or
multiple septae or calcifi cation may be malignant), from those casting an
‘acoustic shadow’
• Can determine presence/absence of hydronephrosis (dilatation of
collecting system) in patients with abnormal renal function
• Allows ultrasound-guided nephrostomy insertion in patients with hydro-
nephrosis and renal impairment or with infected, obstructed kidneys.
33. Bladder
• Measurement of post-void residual urine volume.
• Allows ultrasound-guided placement of suprapubic
catheter.
Prostate: TRUS
• Measurement of prostate size (where gross
prostatic enlargement is suspected on the basis of a
DRE and surgery in the form of open prostatectomy
is contemplated).
• To assist prostate biopsy (allows biopsy of hypo- or
hyper-echoic lesions).
• Can establish presence of ejaculatory duct
obstruction.
34. Testes
• Assessment of patient complaining of ‘lump in
testicle (or scrotum)’—can differentiate benign
lesions (hydrocele, epididymal cyst) from
malignant testicular tumours (solid, echo poor,
or with abnormal echo pattern).
• When combined with power Doppler, can
establish the presence/ absence of testicular
blood flow in suspected torsion.
35.
36. • It can detect very small differences in X-ray
absorption values of tissues, providing very wide
range of densities (therefore, differentiation
between tissues) when compared with plain
radiography.
• Computer calculates absorption value
(attenuation) of each pixel and reconstructs this
into an image.
37. • Attenuation values are expressed on scale from
–1000 to +1000 Hounsfi eld units
• (water = 0 air = –1000 bone = +1000).
• More recently, advances in computing power
have enabled data to be reformatted so that
images can be produced in sagittal and coronal
planes as well as in the more familiar horizontal
plane
• ‘Plain’ CT scans (without contrast) can detect
calcifi cation and calculi within urinary tract.
38. • Administration of intravenous contrast is used to
investigate haematuria,to evaluate nature of
solid renal lesions, and to determine nature of
soft tissue masses (e.g. to differentiate bowel
from lymph nodes in cancer staging CTs).
• ‘Spiral’ or ‘helical’ CT (also known as multidetec-
tor CT urography—MDCTU—when done
following intravenous contrast administration) is
very rapid scanning while table on which patient
is lying is moved though scanner. Multiple
images (‘slices’) of patient are taken.
39. • A large volume of body can be imaged in single
breath hold, thus eliminating movement artefact
and increasing spatial resolution
• Overlapping thin sections can be ‘reconstructed’
into images in multiple planes (multiplanar
reformatting—MPR) so lesions can be imaged in
multiple planes (sagittal, coronal) as opposed to
the traditional transverse sections.
40.
41. Renal
• Investigation of renal masses—characterizes solid from
cystic lesions differentiates benign (e.g. angiomyolipoma)
from malignant solid masses (e.g. renal cell carcinoma).
• Staging of renal cancer (establishes local, nodal, and
distant spread).
• Assessment of stone size and location (within collecting
system or within parenchyma of kidney).
• - Detection and localization of site of intrarenal and
perirenal collections of pus (pyonephrosis, perinephric
abscess).
• ‘Staging’ (grading) of renal trauma.
• Determination of cause of hydronephrosis.
42. • IVU, previously the mainstay of imaging in patients with
flank pain, has been superseded by CT-KUB, a non-contrast
CT of the kidneys, ureters, and bladder.
ADVANTAGE OF C.T KUB SCAN OVER IVU
• Compared with IVU, CT-KUB Has greater specificity (97%)
and sensitivity (94–100%) for diagnosing ureteric stones.
• Can identify non-stone causes of flank pain.
• Requires no contrast administration so avoiding chance of a
contrast reaction
• Is faster, taking just few minutes to image kidneys and
ureters.
• An IVU, may take hours to identify tprecise location of the
obstructing stone.
• Is equivalent in cost to IVU in high CT volume hospitals.
43. • A non-contrast CT-KUB radiation dose:
approximately 4.7mSv compared to 1.5mSv for IVU
• Ultra-low dose CT (ULDCT) lowers radiation
exposure (0.6–2mSv), but at the expense of lower
sensitivity (68–86%) for small (<3mm) ureteric
stones.
• Contrast-enhanced ultra low dose CT (CEULDCT)
uses contrast which increases sensitivity (97%) and
specifi city (100%) for detecting small ureteric stone
disease while limiting radiation dose to levels
comparable with IVU (1.7mSv vs 1.4mSv).
Bladder
• Bladder cancer staging (establishes local, nodal, and
distant spread).
44.
45. • A significant advantage of MRI is excellent resolution of soft
tissue, without need for IV contrast in many situations.
• To obtain MR images, patient is placed on gantry that
passes through bore of magnet.
• When exposed to a magnet field of sufficient strength, free
water protons in patient orient themselves along magnetic
field’s z-axis.
• This is head to- toe axis, straight through bore of magnet.
• An RF antenna or “coil” is placed over body part to be
imaged. It is the coil that transmits RF pulses through
patient.
• When the RF pulse stops, protons release their energy,
which is detected and processed to obtain the MR image.
46. • Weighting of image depends on how energy is
imparted through physics of pulse sequence and
whether energy is released quickly or slowly.
• Images are described as being T1 or T2 weighted.
• T1-weighted images are generated by time
required to return to equilibrium in the z-axis.
• T2-weighted images are generated by time to
return to equilibrium in xy-axis.
• On T1-weighted MR images, fluid has a low SI and
appears dark.
• T2-weighted MR images have a high SI and appear
bright.
47. • In kidney this translates into the cortex having higher SI or being
brighter than the medulla, which gives off lower signal and is
darker.
• MRI has significant advantages over other imaging modalities.
• First, and most importantly, no risks are associated with secondary
malignancies from radiation exposure
• It is the modality of choice in patients who are pregnant, suffer
from renal insufficiency, and/or have an iodine contrast allergy.
• The contrast agents in MRI are noniodinated compounds.
• Iodinated compounds as used in CT imaging function by absorbing
x-rays.
• Gd-based contrast agents function on MRI secondary to
shortening the relaxation times of water. This results in an
increase in SI (enhancement), most commonly assessed in a T1
sequence.
48.
49. • Staging of bladder and prostate cancer
(establishes local, nodal, and distant spread).
• Good for identifying seminal vesicle invasion.
• As with CT, oedema and fibrosis cannot be
reliably distinguished from tumour within bladder
wall, leading to ‘overstaging’ of cancer.
• Especially useful for diagnosis of
phaeochromocytomas (very bright image on T2-
weighted images).
50. • Localization of undescended testes.
• Identifi cation of ureteric stones, where ionizing
radiation is best avoided (e.g. pregnant women
with loin pain).
• In authors’ experience, few radiologists seem to
be able to confidently diagnose or exclude
presence of stones on MR urography, at least in
part because this test is still so seldom used.