Ter Arkh
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Dynamic scintigraphy with progesterone and furosemide, as well as excretory urography and ultrasound, were used to determine if stenosis of the pelviureteral segment was reversible or irreversible in patients with nephrolithiasis or hydronephrosis. Dynamic scintigraphy was found to be less informative than other methods for distinguishing the nature of the stenosis in nephrolithiasis patients. All diagnostic methods were also less effective in nephrolithiasis patients compared to hydronephrosis patients.
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![Ter Arkh. 1992;64(1):93-7.
[Pharmacological modifications of radiation methods for
studying the kidneys in determining the nature of the stenosis of
the pelviureteral segment in patients with nephrolithiasis. Its
outpatient diagnosis].
[Article in Russian]
Iudin LA, Reznichenko AA, Uskov IA, Budkevich IuB.
Abstract
As many as 17 nephrolithiasis and 6 hydronephrosis patients with surgically verified irreversible (n = 13)
and reversible (n = 10) stenosis of the pelviureteral segment were examined. To distinguish the character
of the stenosis, use was made of excretory urography and dynamic scintigraphy with progesterone,
ultrasound, and dynamic scintigraphy with furosemide. In nephrolithiasis patients, dynamic scintigraphy is
less informative as compared to other modifications. As compared to hydronephrosis patients, all the
modifications indicated are less informative in nephrolithiasis patients in differentiating the character of
the stenosis.
PMID:
1523575
[PubMed - indexed for MEDLINE]](https://image.slidesharecdn.com/f875e04a-9a5c-4ded-8411-b9a48be9ffe2-160115002813/85/Ter-Arkh-1-320.jpg)
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2. The kidneys are sensitive to radiation damage due to their low mitotic rate. Acute radiation nephritis occurs 6-12 months after exposure and can cause malignant hypertension, edema, and kidney damage. Chronic radiation nephritis occurs 18+ months later.
3. Histopathology shows early endothelial damage and late changes like sclerosis, scarring, and reduced renal mass. The kidney is considered a parallel organ where damage to individual nephrons can impact overall function. Laboratory and imaging tests are used to diagnose and monitor radiation nephropathy
A Peripheral Blood Diagnostic Test for Acute Rejection in renal transplantati...
This study aimed to develop a non-invasive blood test to diagnose acute renal allograft rejection (AR) after kidney transplantation. Researchers analyzed gene expression in peripheral blood samples from kidney transplant recipients paired with contemporary kidney biopsy results. They identified a set of 5 genes that accurately classified AR in two independent validation sets with over 90% sensitivity and specificity. This 5-gene signature differentiated AR from stable transplant function and other non-AR conditions. The results support further prospective validation of this blood-based diagnostic tool to potentially avoid invasive kidney biopsies for rejection monitoring.
Plnd athens 2011
Robotic-assisted extended pelvic lymphadenectomy (ePLND) during radical prostatectomy can achieve a comparable nodal yield to open surgery. A study of 99 patients who underwent robotic-assisted ePLND found a median nodal yield of 19 nodes removed, ranging from 8 to 53 nodes. Other studies on ePLND for bladder cancer also found comparable nodal yields between robotic and open surgery. Performing an ePLND is currently indicated at the O.L.V. Robotic Surgery Institute for prostate cancer patients with a biopsy Gleason score of 4+3 or higher, or 3+4 with a PSA over 10 ng/mL or more than 50% positive cores.
SaudiJKidneyDisTranspl2661130-7083467_015803
This study analyzed 96 renal transplant patients to evaluate aortic stiffness and its relationship to renal function. The study found:
1) Aortic pulse wave velocity (APWV), a measure of aortic stiffness, was inversely correlated with estimated glomerular filtration rate (eGFR), a measure of renal function - the poorer the renal function, the higher the aortic stiffness.
2) APWV increased with more advanced stages of chronic kidney disease (CKD), based on eGFR levels.
3) APWV was positively correlated with blood pressure levels.
The study concludes that aortic stiffness, as measured by APWV, is related to renal graft dysfunction as reflected by decreased e
22 kim acute interstitial nephritis
This document summarizes a clinical case conference on acute interstitial nephritis (AIN). It discusses the history, causes, diagnosis, prognosis and treatment of AIN. Experimental evidence suggests drug-induced AIN results from an immune reaction against renal antigens triggered by certain drugs. Retrospective studies indicate corticosteroid therapy may improve outcomes in AIN, though prospective trials are still needed.
Reseach section: Dorsal disc herniation
The document discusses a study of 11 patients with surgically confirmed degenerative dorsal disc herniation. Clinical exams and tests found higher rates of vascular risk factors and increased blood viscosity in these patients compared to controls. MRI and CT myelography showed partially or heavily calcified disc herniations in the lower dorsal spine. The clinical presentation was characterized by a mainly motor myelopathy with remissions and exacerbations. The findings help explain the pathogenesis and clinical presentation of myelopathy from degenerative dorsal disc disease.
Renal Tumour Angiomyolipoma - Bizarre Presentation
A 28-year old female presented with fever, chills, and flank pain. Imaging showed a large liver lesion initially thought to be a tumor or abscess. Further CT and MRI revealed the lesion to be retroperitoneal and connected to the upper pole of the right kidney. At surgery, 1.5 liters of pus was drained. Histopathology of the renal mass found it to be an angiomyolipoma, a rare renal tumor. Literature review discussed diagnostic challenges and optimal imaging techniques for diagnosing renal angiomyolipomas.
Ace-I and Contrast induced nehropathy
This document summarizes the current evidence on whether angiotensin-converting enzyme inhibitors (ACEIs) should be stopped, started, or continued prior to administering contrast agents. While some early studies found ACEIs increased the risk of contrast-induced nephropathy (CIN), larger and more recent randomized controlled trials found no significant difference in CIN risk between continuing or stopping ACEIs prior to contrast. Overall, there is no clear evidence that changing ACEI therapy pre-procedure reduces CIN risk, so providers should continue patients' chronic ACEI regimens when administering contrast.
Nss and mit final
1. Nephron sparing surgery (NSS), also known as partial nephrectomy, aims to remove renal tumors while preserving as much healthy kidney tissue as possible.
2. NSS has similar oncologic outcomes as radical nephrectomy but offers advantages like preserving renal function and reducing risks of chronic kidney disease.
3. While NSS was historically more complex and risky than radical nephrectomy, advances in surgical techniques like laparoscopic and robotic partial nephrectomy have reduced risks and made NSS a viable option for more patients with renal cell carcinoma.
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Laparoscopic Nephrectomy Experience at a Community Teaching Hospital
Laparoscopic Nephrectomy Experience at a Community Teaching Hospital
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Crimson Publishers-Loin Pain and Haematuria Syndrome (LPHS) Linked to Symptom...
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A Peripheral Blood Diagnostic Test for Acute Rejection in renal transplantati...
A Peripheral Blood Diagnostic Test for Acute Rejection in renal transplantati...
Renal Tumour Angiomyolipoma - Bizarre Presentation
Renal Tumour Angiomyolipoma - Bizarre Presentation
More from Aleksandr Reznichenko
Simultaneous Renal Cell Carcinoma and Giant
This case report describes a 61-year-old woman who presented with a large abdominal mass and was found to have two separate tumors - a 27x20cm retroperitoneal liposarcoma involving the small intestine and a 2.5x2cm renal cell carcinoma. She underwent surgery to remove the retroperitoneal tumor and her right kidney. Eight months later, she developed a recurrence of the sarcoma which was debulked. She subsequently received chemotherapy for recurrent and metastatic disease. Despite the aggressive nature of the tumors, she had no evidence of recurrence 7 years after her initial surgery. This case demonstrates the rare occurrence of two primary malignancies presenting simultaneously and the patient's long-term survival following surgical resection and chemotherapy.
Successful Repeated CT-Guided Drainage Of Rectal Mucocele After L
This document describes a case study of a rectal mucocele that was successfully treated with repeated CT-guided drainage after a patient underwent low anterior resection for rectal prolapse. A rectal mucocele developed as a fluid-filled cyst near the rectal stump that caused symptoms. It was drained multiple times under CT guidance, with catheters inserted each time. Analysis of the fluid indicated it was a rectal mucocele rather than an abscess. This case demonstrates that repeated CT-guided drainage can successfully treat a rectal mucocele in a patient who was not a candidate for surgical resection.
10.1007_s11605-016-3097-z HAP
1. The patient presented with right upper quadrant pain 6 months after liver transplantation. Imaging showed a 1 cm pseudoaneurysm arising from the hepatic artery.
2. Due to the tortuosity of the hepatic artery and pseudoaneurysm, endovascular treatment was not possible. The patient underwent surgery to resect the pseudoaneurysm and reconstruct the hepatic artery.
3. At surgery, the pseudoaneurysm was larger than imaging showed, at 2x1.5 cm. It was successfully resected and the hepatic artery was reconstructed with an interrupted suture. The patient had an uneventful recovery.
Med Radio1
A study using dynamic scintigraphy with lasix (diuretic) on 59 patients with kidney issues such as hydronephrosis and kidney stones found that it helped identify urine retention and abnormalities in urine excretion. Surgical findings later confirmed that a lack of an excretory segment on the initial scintigram accurately detected urinary tract stenosis regardless of whether it appeared after lasix. Ureteropelvic stenosis could also be seen when the excretory segment was present initially but excretion time was prolonged, with time cutting in half after lasix.
Urol Nefrol
1) Ureteropelvic stenoses in nephrolithiasis can be classified as reversible or irreversible depending on lesions to the upper urinary tract and adjacent fat.
2) The progesterone test is used to determine reversibility by assessing if progesterone can dilate the ureter.
3) Impulse lithotripsy is indicated for reversible stenoses without retention, while open surgery is recommended for large stones and irreversible stenoses. The scope of surgery is decided during the operation based on isolating the ureter
downloadfile-7
This study retrospectively reviewed 11 patients who underwent laparoscopic repair of large hiatal hernias with reinforcement of the diaphragmatic crura using various biologic grafts. Three different biologic grafts were used - acellular human dermal collagen in 6 patients, cellular porcine dermal implant in 1 patient, and porcine urinary bladder matrix in 4 patients. Outcomes were evaluated including perioperative data, complications, recurrence rates, and improvement in symptoms. The study found the laparoscopic repair of large hiatal hernias can be safely performed in rural hospitals using biologic grafts for crural reinforcement, with the choice of graft depending on availability, cost and surgeon preference.
Adrenal Hematoma in ITP
This case report describes a 65-year-old female with idiopathic thrombocytopenic purpura (ITP) who presented with a large left adrenal mass. Imaging and hormonal testing could not rule out a malignant tumor. She underwent an adrenalectomy and the mass was found to be an adrenal hematoma, representing a rare case of an adrenal hemorrhage in a patient with ITP that simulated malignancy. This is the first reported case of an adrenal hematoma mimicking cancer in a patient with ITP. Large adrenal masses should be surgically removed after excluding hormone secretion to rule out potential malignancy.
265-1738-1-PB APPENDIX CYSTADENOMA
This case report describes a rare case of a giant mucinous cystadenoma of the appendix in a 51-year-old female who presented with symptoms of acute appendicitis. Imaging revealed a large tubular structure connected to the cecum. Surgery found a 12 cm mass involving the cecum, so a right hemicolectomy was performed. Pathology confirmed a mucinous cystadenoma with low-grade dysplasia. The report reviews 18 similar giant cystadenoma cases from the literature defined as over 10 cm. Giant cystadenomas more often presented in older patients as a palpable mass and usually required colectomy if involving the cecum.
238-1617-1-PB
1) The patient presented with abdominal pain and vomiting and was found to have a hernia between the posterior rectus sheath and rectus muscle on the right side.
2) A CT scan confirmed a hernia with small bowel extending into the right rectus abdominis muscle.
3) In surgery, 65 cm of strangulated and necrotic small bowel was found within the hernia sac located between the posterior rectus sheath and rectus muscle. The small bowel was resected and the hernia was repaired.
245-1682-1-PB URACHUS
- A 30-year-old male with a BMI of 43 presented with tenderness and foul-smelling discharge from his umbilicus for 8 months. Imaging showed a urachal remnant connecting the urinary bladder to the umbilicus.
- The patient underwent a laparoscopic resection of the urachal remnant. The umbilical skin was excised down to the fascia along with the superficial part of the urachal sinus tract. The urachal sinus was then dissected completely and removed.
- The procedure was successful in removing the urachal remnant and provided an excellent outcome for the patient's morbid obesity and urachal infection.
More from Aleksandr Reznichenko (10)
Successful Repeated CT-Guided Drainage Of Rectal Mucocele After L
Successful Repeated CT-Guided Drainage Of Rectal Mucocele After L
Ter Arkh
- 1. Ter Arkh. 1992;64(1):93-7. [Pharmacological modifications of radiation methods for studying the kidneys in determining the nature of the stenosis of the pelviureteral segment in patients with nephrolithiasis. Its outpatient diagnosis]. [Article in Russian] Iudin LA, Reznichenko AA, Uskov IA, Budkevich IuB. Abstract As many as 17 nephrolithiasis and 6 hydronephrosis patients with surgically verified irreversible (n = 13) and reversible (n = 10) stenosis of the pelviureteral segment were examined. To distinguish the character of the stenosis, use was made of excretory urography and dynamic scintigraphy with progesterone, ultrasound, and dynamic scintigraphy with furosemide. In nephrolithiasis patients, dynamic scintigraphy is less informative as compared to other modifications. As compared to hydronephrosis patients, all the modifications indicated are less informative in nephrolithiasis patients in differentiating the character of the stenosis. PMID: 1523575 [PubMed - indexed for MEDLINE]