Relation between Cajal Cell Density and Radiological and Scintigraphic Outcomes in Patients with Ureteropelvic Junction Obstruction

2021 ◽  
pp. 1-6
Author(s):  
Eda Tokat ◽  
Serhat Gurocak ◽  
Ozgur Akdemir ◽  
Ipek Isik Gonul ◽  
Mustafa Ozgur Tan
Keyword(s):  
Cell Density ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Differential Function ◽  
Cajal Cells ◽  
Significant Difference ◽  
The Mean ◽  
Density Regression ◽  
Cajal Cell

<b><i>Introduction:</i></b> In this study, we aimed to investigate the correlation between Cajal cell density and preoperative and postoperative radiological and scintigraphic parameters in ureteropelvic junction obstruction (UPJO). <b><i>Methods:</i></b> The study group consisted of 41 renal units (38 consecutive patients; 13 female and 25 male) surgically treated for UPJO. UPJ specimens from patients were immuno-stained with CD117 (c-kit) antibody for interstitial Cajal cells (ICCs). The relation between Cajal cell density and preoperative and postoperative radiological and scintigraphic parameters was evaluated. <b><i>Results:</i></b> The mean age of the patients was 8.52 ± 8.86 (0–35) years. The density of Cajal cells was defined in 2 groups for convenient analysis as 0–5 cells (low) in 19 (46.3%) patients and &#x3e;5 cells (moderate-high) in 22 (53.6%). There was significant difference between the preoperative and postoperative anteroposterior diameters of the related kidneys in both Cajal groups (<i>p</i> = 0.001-low, <i>p</i> = 0.000-moderate-high) independent of Cajal cell density. Regression in hydronephrosis postoperatively was determined in both Cajal groups (77.8%-low, 64.7%-moderate-high); however, there was no difference between them (<i>p</i> = 0.39). Preoperative T1/2 was significantly longer in the low Cajal group (<i>p</i> = 0.02). Postoperative T1/2 decreased in both low (<i>p</i> = 0.000) and moderate-high (<i>p</i> = 0.001) Cajal groups, but no difference was found between them (<i>p</i> = 0.24). There was significant improvement in the kidney differential function after surgery in the low Cajal density group (<i>p</i> = 0.015) while there was no correlation between the scintigraphic success or improvement and Cajal cell density (<i>p</i> = 0.51). <b><i>Discussion/Conclusion:</i></b> ICC deficiency/density could not be shown as a predictive factor for the determination of success rate of pyeloplasty. Despite the lack of any evidence for the degree of deficiency as an indicator for the severity of obstruction and prediction of surgical success, further studies are needed for confirmation.

Modified Laparoscopic and Robotic Flap Pyeloplasty for Recurrent Ureteropelvic Junction Obstruction with a Long Proximal Ureteral Stricture: The “Wishbone” Anastomosis and the “Ureteral Plate” Technique

2021 ◽  
pp. 1-8
Author(s):  
Sida Cheng ◽  
Xinfei Li ◽  
Kunlin Yang ◽  
Shengwei Xiong ◽  
Ziao Li ◽  
...  
Keyword(s):  
Success Rate ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Ureteral Stricture ◽  
Effective Treatment Option ◽  
Plate Technique ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Mean

<b><i>Objectives:</i></b> The aim of the study was to present our modified flap pyeloplasty techniques for recurrent ureteropelvic junction obstruction (UPJO) with a long proximal ureteral stricture and compare outcomes of laparoscopic and robotic procedures. <b><i>Materials and Methods:</i></b> Between March 2018 and January 2020, 21 patients underwent modified laparoscopic or robotic flap pyeloplasty for recurrent UPJO with a long proximal ureteral stricture. Our surgical modifications included the “wishbone” anastomosis and “ureteral plate” technique. Demographic, perioperative, and follow-up data were recorded and compared retrospectively between the groups. Success was defined as subjective pain alleviation and hydronephrosis improvement. <b><i>Results:</i></b> Thirteen modified laparoscopic flap pyeloplasty (mLFP) and 8 modified robotic flap pyeloplasty (mRFP) were performed successfully without conversion. mRFP tended to have shorter overall operative time (142.4 vs. 179.1 min, <i>p</i> = 0.122) and anastomosis time (43.1 vs. 61.0 min, <i>p</i> = 0.093) than mLFP. No difference was found in estimated blood loss (<i>p</i> = 0.723) and pararenal draining time (<i>p</i> = 0.175) between the groups. The mean postoperative hospital stay of mRFP was significantly shorter than that of mLFP (5.0 vs. 8.2 days, <i>p</i> = 0.015). No major complications occurred. During the mean follow-up of 17.9 months, the overall success rate was 90.5%, and there was no significant difference between 2 groups. <b><i>Conclusions:</i></b> The modified flap pyeloplasty could be considered a practical and effective treatment option with a high success rate for recurrent UPJO with a long proximal ureteral stricture, and the robotic procedures showed advantages of higher efficiency and faster recovery.

Changes in Cajal cell density in ureteropelvic junction obstruction in children

2016 ◽  
Vol 12 (2) ◽  
pp. 89.e1-89.e5 ◽  
Author(s):  
Cem Senol ◽  
Metin Onaran ◽  
Serhat Gurocak ◽  
Ipek Isık Gonul ◽  
Mustafa Ozgur Tan
Keyword(s):  
Cell Density ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Cajal Cell

Detection of Circulating Tissue Factor and Factor VII in a Normal Population

1996 ◽  
Vol 75 (05) ◽  
pp. 772-777 ◽  
Author(s):  
Sybille Albrecht ◽  
Matthias Kotzsch ◽  
Gabriele Siegert ◽  
Thomas Luther ◽  
Heinz Großmann ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Normal Population ◽  
Mean Value ◽  
Factor Vii ◽  
Significant Difference ◽  
Age Dependent ◽  
The Mean ◽  
Highly Correlated ◽  
And Gender

SummaryThe plasma tissue factor (TF) concentration was correlated to factor VII concentration (FVIIag) and factor VII activity (FVIIc) in 498 healthy volunteers ranging in age from 17 to 64 years. Immunoassays using monoclonal antibodies (mAbs) were developed for the determination of TF and FVIIag in plasma. The mAbs and the test systems were characterized. The mean value of the TF concentration was 172 ± 135 pg/ml. TF showed no age- and gender-related differences. For the total population, FVIIc, determined by a clotting test, was 110 ± 15% and the factor VIlag was 0.77 ± 0.19 μg/ml. FVII activity was significantly increased with age, whereas the concentration demonstrated no correlation to age in this population. FVII concentration is highly correlated with the activity as measured by clotting assay using rabbit thromboplastin. The ratio between FVIIc and FVIIag was not age-dependent, but demonstrated a significant difference between men and women. Between TF and FVII we could not detect a correlation.

scholarly journals Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

2015 ◽  
Vol 9 (11-12) ◽  
pp. 775 ◽  
Author(s):  
Pejman Shadpour ◽  
H. Habib Akhyari ◽  
Robab Maghsoudi ◽  
Masoud Etemadian
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Left Kidney ◽  
Operation Time ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Referral Centre ◽  
Laparoscopic Management ◽  
The Mean ◽  
Crossing Vessels

Introduction: We report our experience with laparoscopic management of ureteropelvic junction obstruction in horseshoe kidneys.Methods: Between February 2004 and March 2014, 15 patients with horseshoe kidneys and symptomatic ureteropelvic junction obstruction underwent laparoscopic management at our national referral centre. Depending on the anatomy and presence of obtrusive vessels or isthmus, we performed either dismembered, Scardino or Foley YV pyeloplasty, or Hellstrom vessel transposition. Patients were initially evaluated by ultrasonography, then diuretic scintiscan at 4 to 6 months, and followed by yearly clinical and sonographic exams.Results: This study included 11 male and 4 female patients between the ages of 4 to 51 year (average 17.7). The left kidney was involved in 12 patients (80%). Operation time was 129 minutes (range: 90–186), and patients were discharged within 2.8 days (range: 1–6). Although 8 (53.3%) patients had crossing vessels, of which 6 required transposing, the Hellstrom technique was solely used in 3 cases, of which notably 1 case failed to resolve and required laparoscopic Hynes within the next year. Eight cases underwent dismembered pyeloplasty, 2 Foley YV, 1 Scardino flap and 1 required isthmectomy and vessel suspension. At the mean follow-up of 60 (range: 18–120) months, the overall success rate was 93.3%.Conclusions: To our knowledge, this represents the largest report on laparoscopic pyeloplasty for horseshoe kidneys, providing the longest follow-up. Our findings confirm prior reports supporting laparoscopy and furthermore show that despite the prevalence of crossing vessels, transposition alone is seldom sufficient.

Colorimetric Method for Rapid Determination of Serum Arginase

1967 ◽  
Vol 13 (10) ◽  
pp. 900-908 ◽  
Author(s):  
Brigitta Mellerup
Keyword(s):  
Rapid Determination ◽  
Colorimetric Method ◽  
Normal Range ◽  
Clinical Routine ◽  
Mean Values ◽  
Enzymatic Formation ◽  
Significant Difference ◽  
The Mean ◽  
Normal Men

Abstract A method for the determination of serum arginase is given which combines the enzymatic formation of urea with the sensitive method of Coulombe (1) for measuring this substance. This procedure allows more accurate determinations in the normal range than do previous methods described and is convenient for clinical routine. Significant difference is found between the mean values of normal men and women, 3.9 units/L. for the former and 2.9 units/L. for the latter.

scholarly journals Zero order and area under curve spectrophotometric methods for determination of Levocetirizine in pharmaceutical formulation

2015 ◽  
Vol 1 (6) ◽  
pp. 270
Author(s):  
Audumbar Digambar Mali ◽  
Ritesh Bathe ◽  
Manojkumar Patil ◽  
Ashpak Tamboli
Keyword(s):  
Area Under The Curve ◽  
Zero Order ◽  
Pharmaceutical Dosage Forms ◽  
Mean Values ◽  
Spectrophotometric Methods ◽  
Ich Guidelines ◽  
Significant Difference ◽  
Curve Method ◽  
The Mean

Simple, fast and reliable spectrophotometric methods were developed for determination of Levocetirizine in bulk and pharmaceutical dosage forms. The solutions of standard and the sample were prepared in methanol. The quantitative determination of the drug was carried out using the zero order derivative values measured at 230 nm and the area under the curve method values measured at 227-234 nm (n=2). Calibration graphs constructed at their wavelengths of determination were linear in the concentration range of Levocetirizine using 5-25?g/ml (r=0.998 and r=0.999) for zero order and area under the curve spectrophotometric method. All the proposed methods have been extensively validated as per ICH guidelines. There was no significant difference between the performance of the proposed methods regarding the mean values and standard deviations. Developed spectrophotometric methods in this study are simple, accurate, precise and sensitive to assay of Levocetirizine in tablets.

Surgery for Pediatric Ureteropelvic Junction Obstruction—Comparison of Outcomes in Relation to Surgical Technique and Operating Discipline in Germany

2018 ◽  
Vol 29 (01) ◽  
pp. 033-038 ◽  
Author(s):  
M. Klora ◽  
J. Zeidler ◽  
S. Eberhard ◽  
S. Bassler ◽  
S. Mayer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Ureteropelvic Junction Obstruction ◽  
Length Of Hospital Stay ◽  
Ureteropelvic Junction ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Laparoscopic Pyeloplasty ◽  
Small Children ◽  
The Mean ◽  
Open Pyeloplasty

Introduction Surgery for ureteropelvic junction obstruction (UPJO) is performed by both pediatric surgeons (PS) and urologists (URO). The aim of this study was to analyze treatment modalities for UPJO and results in relation to the surgical technique and the operating discipline in Germany. Materials and Methods Data of patients aged 0 to 18 years were extracted from a major public health insurance (covering ∼5.7 million clients) during 2009 to 2016 and were analyzed for sociodemographic variables, surgical technique, and treating discipline. Logistic regression analysis was performed for the risk of a complication within the first postoperative year. Results A total of 229 children (31.0% female) were included. Laparoscopic pyeloplasty (LP) was performed in 58 (25.3%) patients (8.6 ± 6.4 years), and open pyeloplasty (OP) was applied in 171 (74.7%; 4.6 ± 5.9 years). LP was the dominant technique in females (p < 0.02); males preferentially underwent OP (p < 0.02). Length of hospital stay was 4.3 days (p = 0.0005) shorter in LP compared with that in OP, especially in children ≤ 2 years (6.7 days, p = 0.007). PS operated on 162 children (70.7%), and URO performed surgery on 67 patients (29.3%). The mean age of children operated by PS (3.5 ± 4.7 years) was significantly younger compared with that operated by URO (10.8 ± 6.5 years, p < 0.0001). Complication rates were independent of surgical technique or treating specialty. Conclusion In Germany, UPJO was treated by LP in 25.3% of patients, which was associated with a shorter length of stay, especially in children ≤ 2 years. Complication rates were independent of the operating specialty and surgical technique. Therefore, LP should be further promoted for the treatment of UPJO in small children.

scholarly journals Orexitropic Signaling Proteins in Obese Children

2007 ◽  
Vol 7 ◽  
pp. 1263-1271 ◽  
Author(s):  
Ljiljana Saranac ◽  
Bojko Bjelakovic ◽  
Hristina Stamenkovic ◽  
Borislav Kamenov
Keyword(s):  
Body Mass ◽  
Central Obesity ◽  
Energy Homeostasis ◽  
Leptin Resistance ◽  
Signaling Proteins ◽  
Obese Children ◽  
Significant Difference ◽  
The Mean ◽  
Very High

Adipose tissue is not only the main organ for energy storage, but it also has endocrine properties, producing “adipokines” responsible for energy homeostasis, insulin sensitivity, and inflammation. Leptin, produced by adipocytes, is the key hormone in appetite regulation and suppression of orexigenic, hypothalamic neuropeptide Y (NPY). We wanted to establish and compare levels of leptin and NPY in different obesity types in childhood, and to investigate their correlations with auxological parameters. Twenty-one obese children (seven girls and 14 boys), divided into two groups, were compared with 14 controls. The mean age of the study group was 10.81 ± 3.69 years and the mean puberty stage was 2.21. The mean body mass index (BMI) was 32.80 kg/m2(range 23.30– 47.02) and the mean overweight 30.73 kg (range 8.00–74.00). The mean leptin level was higher in boys and in the group with central obesity, but was not significant. Leptin/NPY ratio and leptin/BMI ratio was also higher in the central obesity group and there was a more significant difference compared with controls. We found significant correlation of the leptin level with body mass (BM), body mass excess (BME), and BMI (p < 0.05). The mean leptin level in obese children was very high (36.39 ng/ml). Leptin and NPY levels showed inverse values in two different obesity types. Results are suggestive for leptin resistance rather than leptin deficiency in our group of obese children. Orexitropic signaling proteins correlated significantly with auxological parameters. Determination of the leptin and NPY concentrations provided evidence that obesity represents disease with neuroendocrine dysfunction and high leptin/NPY ratio, which could be a useful marker for central obesity.

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