SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
There is a significant positive correlation between the brim index and the conjugate dimension (r = 0,66). The latter also shows a high degree of correlation with stature (r = 0,58). The inverse covariability between the transverse inlet diameter and the brim index is weak (r = -0,17). The larger brim areas and brim indices of taller women are due to their greater sagittal inlet measurements.
Four partial innominate bones, attributed to the parapithecid primates Parapithecus grangeri and Apidium phiomense, have recently been recovered from Oligocene deposits in the Fayum of Egypt. These fossils provide the first documentation of pelvic morphology for early anthropoids. In pelvic anatomy, parapithecids show definite similarities to higher primates rather than to prosimians, but cannot be clearly allied with any one extant group. Functionally, the fossils indicate quadrupedal or leaping habits rather than suspensory or bipedal behaviors.
Pelvic lymph nodes from 80 patients with primary invasive cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were evaluated morphologically. Six to 25 (mean 14) lymph nodes from each patient were examined histologically and classified as follows: lymphocyte preominant, germinal center predominant, unstimulated, or lymphocyte depleted. Tumors were classified according to their primary cell type: large cell non-keratinizing, keratinizing squamous cell, small cell, and adenocarcinoma. There was no direct relationship between lymph node morphology and patient age, lesion size, or tumor cell type. A lymphocyte predominant nodal pattern was associated with a statistically significant decrease in lymph node metastases, and tumor recurrence, and an increase in patient survival. In contrast, patients with a lymphocyte depleted nodal pattern had a high incidence of metastatic disease and tumor recurrence, and a decreased survival. Patients with lymph nodes showing an unstimulated or germinal center predominant pattern had an intermediate incidence of nodal metastases and tumor recurrence. These findings suggest that regional lymph nodal morphology may be of prognostic significance in patients with invasive carcinoma of the uterine cervix.
BACKGROUND: Recurrent inguinal hernia remains a significant challenge in abdominal wall surgery despite advances in mesh-based repair techniques and minimally invasive approaches. Although pelvic skeletal morphology has been implicated in inguinal hernia development, its association with recurrent disease remains incompletely understood. This study aimed to evaluate computed tomography (CT)-derived pelvic morphometric parameters and investigate their potential value in preoperative recurrence risk assessment. METHODS: This retrospective study included 251 male patients with preoperative abdominal CT examinations and complete clinical records who underwent elective inguinal hernia repair at a tertiary referral center. After applying the predefined eligibility criteria, 188 patients with unilateral inguinal hernias constituted the primary study cohort, including 162 primary and 26 recurrent unilateral hernias. The Radoievitch angle and Ami's line were measured independently by two blinded radiology residents using a standardized CT-based pelvic morphometric measurement protocol, and the mean values were used for analysis. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between pelvic morphometric parameters and recurrent inguinal hernia. RESULTS: Patients with recurrent unilateral inguinal hernias demonstrated significantly greater affected-side Ami's line measurements (8.27 ± 0.63 vs. 7.90 ± 0.71 cm, p = 0.014) and larger Radoievitch angles (40.68 ± 4.02° vs. 38.80 ± 3.68°, p = 0.018) than patients with primary unilateral hernias. Both the Radoievitch angle (OR 1.14, 95% CI 1.01-1.28, p = 0.033) and Ami's line (OR 2.26, 95% CI 1.14-4.49, p = 0.020) remained independently associated with recurrent inguinal hernia after adjustment for age and body mass index. ROC analysis demonstrated modest discriminatory performance (AUC 0.634 for the Radoievitch angle and 0.633 for Ami's line), while the multivariable model incorporating age, body mass index, and Ami's line showed slightly improved discrimination (AUC 0.655). CONCLUSION: CT-derived pelvic morphometric parameters were independently associated with recurrent unilateral inguinal hernia. Although their individual discriminatory performance was modest, standardized CT-based pelvimetry may serve as an objective adjunctive tool for individualized preoperative recurrence risk assessment in patients who already undergo CT imaging for unrelated clinical indications. Prospective multicenter studies are warranted to validate these findings and determine their clinical applicability.
The renal pelvis of the hamster has been studied by light microscopy (epoxy resin sections), transmission electron microscopy, and morphometric analysis of electron micrographs. Three morphologically distinct epithelia line the pelvis, and each covers a different zone of the kidney. A thin epithelium covering the outer medulla (OM) consists of two cell types: (1) granular cells are most numerous and have apically positioned granules which stain intensely with toluidine blue, are membrane-bound, and contain a fine particulate matter that stains light grey to black in electron micrographs. (2) Basal cells do not have granules, are confined to the basal lamina region, and do not reach the mucosal epithelial surface. The inner medulla (IM) is covered by a pelvic epithelium morphologically similar to collecting duct epithelium of IM. Some cells in this portion of the pelvic epithelium (IM) stain intensely dark with toluidine blue, osmium tetroxide, lead, and uranyl acetate. Transitional epithelium, which separates cortex (C) from pelvic urine, has an asymmetric luminal plasma membrane and discoid vesicles, each of which is similar to those previously observed in mammalian ureter and urinary bladder epithelia. Based on morphological comparisons with other epithelia, the IM and OM pelvic epithelia would appear permeable to solutes and/or water, while the transitional epithelium covering the C appears relatively impermeable. It would also appear that the exchange of solutes and water between pelvic urine and OM would involve capillaries, primarily, since morphometric analysis showed that both fenestrated and continuous capillaries of the OM were extremely abundant (greater than 60% of OM pelvic surface area) just under the thin pelvic epithelium.
The prostates of eight patients scheduled to undergo prostatectomies were studied prospectively by transabdominal gray scale ultrasound and computed tomography. Computed tomography gave excellent visualization of prostate morphology and pelvic anatomic relationships. Ultrasound provided more histopathologic information in the cases of carcinoma and prostatitis. Additionally, its capacity to distinguish surgical capsule from adenoma, in benign prostatic hypertrophy, made it more useful for volume determinations.
Pelvic crests of 265 autopsies were histologically investigated. In nearly all cases with chronic diseases a remodelling of bones and especially processes of bone resorption were found. A fibroosteoclastic bone resorption was evident in 28 of 40 cases with chronic renal failures, in 5 of 26 cases with chronic lung diseases and/or chronic insufficiency of the right heart ventricle, in 4 of 12 cases with chronic diseases of the gastro-intestinal tract, and in a case of lung cancer. Processes of bone formation were less prominent. The findings indicate that several chronic diseases caused by different overlapping pathogenetic mechanisms can principally lead to the same spectrum of alterations of bone structure. This and the aetiological ambiguity of typical patho-histological reaction patterns of bones require a critical reserve in the interpretation of adequate findings in bone biopsies. It has been pointed out that the use of morphometric methods and the use of slices of undecalcified bones are necessary to obtain a reliable diagnostic tool in bone biopsies.
Explore the source record for details and available documents.
The authors demonstrate the innocuousness of the method of removal of the Pouch of Douglas after a critical analysis of 50 cases followed up for between 6 months and 5 years. They believe that simple removal of the pelvic peritoneum is sufficient to overcome the condition of a pathological fold of peritoneum, but not sufficient on the other hand to correct the condition of retroverted uterus because two new peritoneal fossae form lateral to the viscerae easily because of the morphology of the pelvic cavity. They therefore stress that, at the time of the operation, it is important to suture the utero-sacral ligaments together in the sagittal plane.
Congenital obstructions of the uretero-pelvic junction of the urinary tract have severe sequelae: urine retention, hydronephrosis, and infections, leading to renal insufficiency without adequate therapy. As the operative results are not always optimal, we studied the morphology of 56 operative specimens and analyzed the structural changes. We found the following conditions causing stenosis of the proximal ureter: 47 localized hypoplasia of the proximal segments of the ureter, systematic hypoplasia in 4 cases, and hypertrophy of the total upper urinary tract in 5 cases. The intrapelvic increase of pressure and the necessary additional work cause characteristic changes of the renal pelvis in the form of hypertrophy of the muscularis and the tunica propria, fibrous destruction of the wall, and secondary formation of valves, which eventually enhance the stenotic effect of the proximal ureter. In the kidneys caliectasis, reduction and hypoplasia of the renal medulla with minor reduction of the renal cortex may be observed. Finally, infections complicate the clinical course. The choice of the surgical procedure should be determined by type and progression of the structural changes and not by personal opinions.
The hamster renal pelvis has been studied by means of low-power light microscopy, scanning electron microscopy and morphometric analyses. The results of this study are highly suggestive that the contact of pelvic urine with the other medulla as well as with the inner medulla may be an important aspect of final urine formation. The outer medulla constituted nearly 50% of the total pelvic surface area, with the inner stripe of the outer medulla more than twice the pelvic surface area of the outer stripe of the outer medulla. The large outer medullary pelvic surface area was accounted for by the elaboration of the upper pelvic walls into peripelvic columns, opercula ("secondary pyramids"), fornices and secondary pouches. A thin simple-squamous to low cuboidal pelvic epithelium separated pelvic urine from outer medullary parenchyma. The inner medulla which constituted about one quarter of the total pelvic surface area was covered by a cuboidal to columnar pelvic epithelium which appeared morphologically similar to the papillary collecting duct epithelium. Tubules and capillaries of the inner medulla did not appear as closely juxtaposed to the pelvic epithelium as did those of the outer medulla. Cortical tissue comprised only 11.7% of the total pelvic surface area and was covered by transitional epithelium similar to that of ureter and bladder. The previously reported impermeability of this epithelium suggests that pelvic urine contact with the cortex is unimportant in final urine formation. The rich layer of smooth muscle under the transitional epithelium probably functions to move urine into and out of the pelvis during pelvic peristalsis, which has been observed in vivo.
The examination of resorption from the urinary bladder had previously been restricted almost exclusively to animal research, since, as a rule, a separation of the bladder from the urinary tract is required. If this is not done, the resorbed test substance quickly finds its way back into the bladder. More than 95 per cent of the xenon which has been resorbed from the bladder becomes eliminated through the lungs. The detection and measurement of xenon in the exhaled air enables one to conduct, in a relatively simple fashion, urinary bladder resorption research using human subjects. Studies based on 141 patients showed that the xenon exhalation tests currently represent the most sensitive and exact method for detecting and determining the nature of inflammatory diseases of the urinary bladder. With a number of so-called "irritable bladder" cases it became clear that functional disorders of the bladder epithelium could be present without any evidence of associated morphologic changes. With radiogenic treatment of tumors in the lower pelvic region one experiences an increase in bladder resorption with increased exposure to radiation. There exists, as it were, a linear correlation between the radiation dosage and the degree of resorption from the urinary bladder. Three months after terminating radiotherapy one can detect, as a rule, only a negligible increase in resorption. If at this time the rate of xenon resorption still remains clearly high, one must reckon with permanent radiation damage of the bladder, insofar as it proves unsuccessful to eliminate the cause of cystitis.
Sequential gray-scale sonograms were obtained during 20 menstrual cycles in 16 normal female volunteers. Hormonal and physical parameters of an ovulatory cycle were correlated with morphological changes in the ovaries, uterus, and cul-de-sac as seen on the sonogram. Ovarian cysts of two sizes were observed, corresponding chronologically and morphologically to Graafian follicles and corpora lutea. Small amounts of free pelvic fluid were demonstrated in many women at ovulation. A characteristic uterine appearance is seen prior to menstruation and is related to hormonal influences on the uterus. These findings emphasize the importance of recognizing normal physiological changes when interpreting gynecologic sonograms.
The ovarian follicles of 23 of 33 women undergoing elective pelvic laparotomy during menstrual cycle days 11 to 17 were aspirated by a low-vacuum device. The study compared the ovulatory status of women in midcycle with the health of the oocytes obtained, and determined the frequency of recovery of mature oocytes without the preadministration of exogenous hormones. Maturing or mature oocytes were obtained from 22% and nonmature oocytes from 48% of the 23 women. Sixty per cent of the women in each of the maturing or mature and nonmature groups were postovulatory as judged by evaluation of the endometrial and ovarian tissue recovered. Furthermore, 20% of the maturing or mature oocytes and 65% of the nonmature oocytes showed a moderately heavy amount of cytoplasmic degeneration, which was independent of ovulatory status. Therefore, it is concluded that, because of the relatively low rate of return of oocytes, the frequent postovulatory status of patients in midcycle, and uncertainty about the viability of the oocytes so obtained, women not stimulated by exogenous hormones are ill-suited for recovery of maturing or mature follicular oocytes for in vitro fertilization studies.
Histological structure of endometrial cancer reflecting the degree of morphological differentiation is of great prognostic value. In tumors of I-II degree of differentiation 5-year results of treatment (86.8%) are considerably better than in tumors of III degree of differentiation (57.5%). A diminished degree of morphological differentiation results in greater frequency of deep myometrial invasion and metastases in pelvic lymph nodes. The secretory activity in high-differentiated and differentiated tumors is a positive prognostic sign (89.3% of 5-year cure versus 68.3% in the absence of secretion).
Casts with numerous and unusually large granules were seen in the urine of a child with renal Fanconi's syndrome. When the urine sediment was sealed under a coverslip for several days, many granules changed to filamentous bacterial variants that segmented and, finally, appeared as streptococcal-like forms. When the patient's blood was cultured by a special method, bacterial variants grew consistently, and frequently reverted to parent coccal forms, although conventional cultures were negative. Variants from blood cultures had the same morphology and staining properties as granules in casts and in cystic structures found within hypertrophied renal pelvic epithelial cells. Cryptic parasitization with bacterial variants probably occurs in many nephropathies. Variants are known to produce toxins and immunogens, which could lead to mesangial and basement membrane deposits as well as to occlusive reactions in the renal microcirculation.
This study from a community hospital documents the relatively frequent occurrence of Actinomyces in 36 women diagnosed by Papanicolaou stained cervicovaginal smears. Actinomyces was identified exclusively in patients wearing an intrauterine or vaginal foreign body (intrauterine devices and pessaries). By using fluorescein isothiocyanate labeled antiserum, the organisms were shown to be Actinomyces israelii in eight randomly selected smears. In five cases Actinomyces was demonstrated in tissues obtained by endocervical and endometrial curettage. Anaerobic microbiologic studies performed in 11 of the 36 cases showed a relatively high rate of recovery of Actinomyces (36.3 per cent) with a yield of four positive cultures. In two cases the isolated organisms were shown to be Actinomyces israelii. In the remaining two cases the exact species of Actinomyces has remained uncertain. Of the 36 patients with smear evidence of Actinomyces, nine (25 per cent) had pelvic inflammatory disease, a rate that appears to be much higher than the already high rate among all intrauterine device users. This observation underscores the importance and clinical significance of the finding of Actinomyces in the vaginal smears of intrauterine device users. Papanicolaou stained cervicovaginal smears provide a relatively easy, inexpensive, fast, and highly specific method for the morphologic diagnosis of Actinomyces and allows us to recognize at a relatively early stage a group of patients who are potentially at risk for the development of pelvic inflammatory disease and its associated more severe complications. The hope is that prompt identification of Actinomyces in cervicovaginal smears can help to prevent the more serious infectious complications in intrauterine device users.
Surgical specimens from 100 patients with stage I B cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were reviewed with respect to vascular invasion and lymphoplasmacytic infiltration. Lymph nodes from these patients were classified morphologically according to the criteria proposed by Cottier. Vascular invasion was associated with a significant increase in nodal metastases and tumor recurrence particularly to extrapelvic sites. A marked lymphoplasmacytic infiltrate around tumor cells was associated with decreased nodal metastases and tumor recurrence. There was no significant relationship between the degree of lymphoplasmacytic infiltration of the primary tumor and regional lymph node morphology.