[The biomechanical behavior of the normal pelvis and of the pelvis with total hip prosthesis: experimental study].
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Biomechanical Phenomena↗
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Diuresis urography in equivocal pelvi-ureteric obstruction.
In 43 patients with equivocal pelvi-ureteric obstruction, conventional urography was supplemented with diuresis urography. After peroral hydration with 0.5 liters fluid, a large volume of urographic contrast medium was administered and increased diuresis provoked by intravenous injection of furosemide. A relative obstruction of flow was then accentuated by increased dilatation of the renal pelvis. The technique deserves a wider use in the radiologic investigation of patients with equivocal obstruction at the pelvi-ureteric junction.
Adolescent↗
Castleman's disease. Angiofollicular benign lymph-node hyperplasia. Radiological features in the differential diagnosis of vascular tumours of the pelvis.
An unusual case of benign lymph-node hyperplasia (Castleman) in the pelvis is reported and its clinical, histological and radiographic characteristics discussed. The angiographic appearances in this situation have to our knowledge not been described before in the literature. The angiographic features are not diagnostic, being mimicked by a wide variety of vascular tumours in the pelvis. The benign nature of the condition is stressed. BLH should be considered in the differential diagnosis of vascular tumours in the pelvis.
Angiography↗
Extracorporeal surgery and autotransplantation for carcinoma of the pelvis and ureter.
Multiple transitional cell tumours of the renal pelvis and proximal ureter of a solitary kidney were successfully managed by total ureterectomy, extracorporeal subtotal resection of the renal pelvis, autotransplantation, and calicovesicostomy. The method permits resection of a maximum of the uroepithelium of the upper urinary tract at the same time as it preserves available renal parenchyma. It also implies a new and exciting approach to the renal pelvis for endoscopic postoperative control and local treatment of the malignancy.
Carcinoma, Transitional Cell↗
[Reticulum cell sarcoma of the pelvis. Diagnostic and therapeutic problems].
Diagnostic and operative problems of malignant bone tumors of the pelvis are discussed. Especially mentioned is resection therapy of pelvis tumor including large parts of the pelvis and the hip joint. A case-report is given. In this case replacement of the entire hip joint was successfully performed with a special prosthesis. Stabile fixation of the prosthesis is one of the major problems to be dealth with. Follow-up examination of our patient one year after the operation showed no loosening of the prosthesis and free movement of the hip joint iwth partial loack capacity of the leg.
Angiography↗
[Cytodiagnosis of pathologic changes in the renal pelvis and ureter].
In 80 cases of roentgenologic filling defects in renal pelvis and ureter, which could be determined exactly preoperatively, we could confirm the diagnostic value of cytology from washings of renal pelvis and ureter (lavage cytology) especially in preoperative diagnosis of carcinoma of renal pelvis and ureter. Twenty of 25 tumors (80%) were detected preoperatively. There were no false positive results. The diagnostic reliability of this method was more accurate than with normal exfoliative urinary cytology from other authors. The results are discussed together with the literature.
Carcinoma↗
Anatomy of the renal pelvis in the hamster.
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.
Adipose Tissue↗
Ultrastructural organization of the hamster renal pelvis.
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.
Animals↗
In vitro studies on smooth muscle of the human renal pelvis.
Isolated segments of human renal pelvis were studied by an isometric technique. Increases in tension following the addition of adrenaline, noradrenaline and phenylephrine were shown to be mediated via alpha-adrenoceptors. Similar responses to acetylcholine were demonstrated to be due to muscarinic receptor stimulation. Specimens responded to transmural electrical stimulation only when the pulse width was greater than 4 msec, and such responses were unaffected by pretreatment with tetrodotoxin, phentolamine and atropine. These experiments suggest that there is no effective innervation of the receptor sites identified, and hence that renal pelvis motility in vivo is not amenable to regulation by the autonomic nervous system.
Adrenergic alpha-Agonists↗
Radiolucent defects within renal pelvis.
Radiolucent filling defects within the renal pelvis are common findings in diagnositc urography, and because of their myriad causes the diagnostician is often faced with a challenging problem. Several of the more unusual causes of renal pelvis filling defects are described and their diagnosis, pathophysiology, and therapy discussed.
Adenocarcinoma↗
Duplication of the renal pelvis and blind-ending bifid ureter in twins.
Blind-ending bifid ureter in a woman with urinary tract infection and a duplicated renal pelvis in her twin sister are reported. The blind-ending bifid ureter terminated as a fibrous cord with a terminal mass of immature renal tissue. This type of ureter may be a transitional form between histologically blind-ending bifid ureter and duplication of the renal pelvis and/or kidneys. Findings in twins support this opinion.
Adult↗
Tumours of the renal pelvis and ureter. Symptomatology, diagnosis, treatment and prognosis.
Forty-two cases of tumour of the renal pelvis and/or ureter are presented. The primary tumour was in the renal pelvis in 25 cases and in the ureter in nine. A co-existent tumour elsewhere in the uroepithelium was found in 16 of these 34 patients. In the remaining eight patients, tumour of the urinary bladder was the initial diagnosis, but tumours of the upper urinary tract subsequently appeared. The principal symptom (38 of 42 cases) was haematuria, but flank pain and a mass in the kidney region also occurred. In most cases the diagnosis was indicated by the urograms and was confirmed by retrograde pyelography. Nephro-ureterectomy was done in most of the patients. The possibility that local tumour resection may be sufficient is briefly discussed. The tumours were classified as papillary in 24 patients and as solid in nine. There was no histologic classification in nine cases. The mean observation time was 29 months. Since new growths tend to arise at other sites in the uro-epithelium, follow-up examination should always include cystoscopy and urography. The prognosis was particularly poor in solid tumours: two-thirds of these patients died in the first postoperative year. Survival was clearly dependent on the tumour differentiation. High-grade tumours carried a poor prognosis.
Adult↗
Temperature gradients at various points within the human pelvis as measured during laparoscopy.
Temperatures have been measured during pelvic laparoscopy, under general anesthesia, in 59 women. Temperatures on the serosal surface of the rectum, the mesovarium, the ovarian arteries and the surface of the external iliac artery have been compared with the temperature deep in the rectal cavity on the rectal mucosa. The mean temperatures recorded at all sites within the pelvic cavity were lower than the mean temperatures recorded on the rectal mucosa. The mean differences between rectal mucosa and the other pelvic sites are: rectal mucosa -0.20 +/- standard error of the mean (SEM) 0.03C, mesovarium -0.28 +/-SEM 0.04C, ovarian artery -0.35 +/- SEM 0.05C and external iliac artery -0.44 +/- SEM 0.06C. All differences are highly significant from zero and do not appear to be related to the time from the onset of anesthesia, the temperature of the gas used to fill the abdominal cavity, the time from the last menustrual period and any pathology present in the pelvis. The results are consistent with a previous suggestion, by Grayson,2 that the human rectal mucosa may be an organ of heat production and that arterial blood within the pelvis may be precooled by counter current heat exchange with veins draining cold blood from the extremities.
Body Temperature↗
The response of the renal pelvis to infection: a scanning electron microscopic study.
The response of the rat renal pelvis to Pseudomonas aeruginosa infection was examined using scanning electron microscopy. Bacterial attachment was noted in regions of microplical alteration with subsequent strand formation and epithelial cell exfoliation. These observations support the hypothesis that bacterial invasion initiates defense mechanisms in the renal pelvis similar to those noted in bladders, namely, membrane alteration with increased bacterial attachment, strand formation with further bacterial entrapment, and exfoliation of bacteria-laden epithelial cells which are eliminated via voiding.
Animals↗
[Differential diagnosis of contrast medium recesses of the renal pelvis or the renal calyx system (author's transl)].
Contrast medium recesses in the renal pelvis and calyx system of a retrograde pyelogram or urogram are due to many widely different pathologico-anatomical changes in the renal region. It is the aim of the present study to show up this multitude of differential diagnostic possibilities which lead to contrast medium recesses in the renal pelvis and renal calyx system of a pyelogram.
Contrast Media↗
Osteoporosis of the spine, pelvis and hand. A comparative study in a femoral neck fracture series.
In a comparative study of the degree and prevalence of osteoporosis in the hand, pelvis and spine of a group of femoral neck fractures in the elderly, it was noted that spinal osteoporosis was much more frequent and appeared much earlier than pelvic osteoporosis. Similarly, a one way correlation existed between osteoporosis of the hand and spine. No relationship was noted between osteoporosis of the pelvis as measured by our criteria and by the Singh technique.
Adult↗
[The effectiveness of the lead covering in roentgen studies of the pelvis].
This is a report on the protective covering of the infant's pelvis. Comparative measurements of two customary lead covers, phantom measurements and comparative measurements on infants were carried out. Results show that a properly applied lead cover with a correct lead value (at least the equivalent of 1 mm of lead) may be considered a very effective protection against irradiation, a method that reduces irradiation to the gonads by a factor of 100. The initial dosis is at the surface and, as a rule is below 1 mR. The dosis attacking the gonads is most likely within the micro-R-range. Thus we state for practical purposes that a lead protective cover is very effective in X-raying the infant pelvis--indeed it should be mandatory for every pelvic X-ray taken in infants.
Female↗
[A new method for the preparation of special alloplastic implants for partial replacement of the pelvis].
Partial replacement of the pelvis by special prosthesis after resection for malignant lesions becomes more and more a rewarding alternative to the mutilating amputive procedures. A new method is recommended facilitating the forming of suitable prostheses. With computerized axial tomography it is possible to construct an actual sized three-dimensional model of the patients pelvis. This model is a very useful aid in preparing the special prosthesis as it corresponds exactly with the anatomic shape of the resected part.
Adult↗