scholarly journals Study of variations in the pelvicalyceal system of kidney and its clinical importance

2013 ◽  
Vol 8 (3) ◽  
pp. 17-21 ◽  
Author(s):  
PR Wadekar ◽  
SD Gangane
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Clinical Importance ◽  
Percutaneous Nephrostomy ◽  
Clinical Implications ◽  
Clear Understanding ◽  
Medical Sciences ◽  
Pelvicalyceal System ◽  
Collecting System

Objective The present study has been undertaken to study the variations in renal pelvicalyceal system, to compare them with previous studies and to find their clinical implications. Materials and Methods A total of 100 kidneys (from 50 cadavers) were included in this study. The following parameters were measured 1)Lower Infundibular length, 2)Infundibular Width – Lower Infundibular Width (LIW), Middle Infundibular Width (MIW), Upper Infundibular Width (UIW), 3)Number of minor calyces and 4)Number of major calyces. Results The obtained data showed that there were numerous variations not only in the numbers of calyces of kidneys but also in the infundibular length and width. Conclusion Developments in endourology, percutaneous nephrolithotomy and techniques for retrograde percutaneous nephrostomy have rekindled interest in the anatomy of the renal collecting system. To perform these procedures safely and efficiently it is essential to have a clear understanding of pelvicalyceal anatomy and its variations. Thus the in-depth knowledge of pelvicalyceal anatomy will be of immense value to the clinicians of related specialties. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 17-21 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8681

scholarly journals Visualization of the renal vein filled with contrast agent may indicate the renal vein injury during percutaneous nephrolithotomy: two case reports

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-Feng Chen ◽  
Jian-Jun Zhou ◽  
Jian-Ming Sun ◽  
Guo-Can Cao ◽  
Yi-Hua Zou ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Percutaneous Nephrolithotomy ◽  
Renal Vein ◽  
Percutaneous Nephrostomy ◽  
Good Evidence ◽  
Nephrostomy Tube ◽  
Optimal Position ◽  
Puncture Needle ◽  
Vein Injury ◽  
Collecting System

Abstract Background Intravenous misplacement of a nephrostomy tube is a rare complication of percutaneous nephrolithotomy (PCNL) or percutaneous nephrostomy. The mechanism of misplacement of a nephrostomy tube into the vascular system is seldom investigated. One type of the possible mechanism is that the puncture needle penetrates a major intrarenal tributary of the renal vein and enters the collecting system. However, the guidewire is located outside the collecting system near the large branches of renal vein or perforates into the renal vein. The dilation is performed and causes a large torn injury. Subsequently, the nephrostomy tube is placed inside the vessel when radiological monitoring is not used. However, there is no imaging evidence and the scene of procedure is not demonstrated. This paper reports two cases of visualization of the renal vein filled with contrast agent during PCNL. The findings may be good evidence to support the step of renal vein injury in patients with intravenous nephrostomy tube misplacement. Case presentation We presented two cases with visualization of the renal vein filled with contrast agent during PCNL. In the process of injecting the contrast agent through the puncture needle, we could see the renal vein. Moreover, it was identified that the puncture needle tip was not on the optimal position. The position of puncture needle tip lay outside the collecting system, which was close to the calyceal infundibulum and branches of renal vein. Conclusions Visualization of the renal vein filled with contrast agent may be good evidence to verify the renal vein injury in patients with intravenous nephrostomy tube misplacement during PCNL or percutaneous nephrostomy. The suboptimal location of the puncture needle tip and visualization of the renal vein filled with contrast agent indicate the renal vein injury. One type of mechanism of intravenous nephrostomy tube misplacement is as following. Firstly, the guidewire stays outside the collecting system. Subsequently, dilatation directed by the guidewire results in the injury of the vein. Then, the nephrostomy tube migrates into the venous system due to prompt tube inserting and the direction of the sheath and/or the guidewire to the injured vein.

A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

2012 ◽  
Vol 6 (4) ◽  
pp. 49-52
Author(s):  
N Satyanarayana ◽  
R Guha ◽  
P Sunitha ◽  
GN Reddy ◽  
G Praveen ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Clinical Importance ◽  
Medical Sciences ◽  
Nerve Roots ◽  
Rare Variation ◽  
Lower Trunk ◽  
Male Cadaver ◽  
The Right

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

scholarly journals Variation of Fluoroscopic Radiation Dose during Endourological Procedures for Renal Stones

2020 ◽  
Vol 3 (1) ◽  
pp. 272-275
Author(s):  
Prakash Chhettri ◽  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha
Keyword(s):  
Radiation Dose ◽  
Percutaneous Nephrolithotomy ◽  
Prospective Observational Study ◽  
Renal Stones ◽  
Retrograde Intrarenal Surgery ◽  
Stone Size ◽  
Ureteral Access Sheath ◽  
Pelvicalyceal System ◽  
Ureteric Catheter ◽  
Fluoroscopic Time

Introduction: Fluoroscopic guidance is routine for endourological procedures like percutaneous nephrolithotomy and retrograde intrarenal surgery in vast majority of centers. It is used for the initial retrograde ureteral access to define the pelvicalyceal system, puncture of the desired calyx and dilatation of the tract, aid navigation of stones and calyces, and placement of guide wires and stents. Both the patient and operating staffs are exposed to the radiation during surgery. The purpose of this study is to measure that exposed fluoroscopic radiation dose during these procedures and make operating surgeons aware of their fluoroscopic habit. Materials and Methods: This is prospective observational study, who underwent percutaneous nephrolithotomy (n=60) and retrograde intrarenal surgery (n=43) in our institute between December 2017 and August 2018. Percutaneous nephrolithotomy was done in prone position with prior insertion of ureteric catheter. Retrograde intrarenal surgery was carried out with or without insertion of ureteral access sheath. Fluoroscopic time was taken from the insertion of the ureteric catheter or UAS to the completion of the procedure with double J stenting. Results: For percutaneous nephrolithotomy and retrograde intrarenal surgery group, mean stone size were 21.89 mm and 10.56 mm; mean fluoroscopic time were 117.95 s (range 24-350) and 31.83 s (range 3-103); mean fluoroscopic dose were 29.71 mGy and 6.19 mGy respectively. Introduction: Fluoroscopic guidance is routine for endourological procedures like percutaneous nephrolithotomy and retrograde intrarenal surgery in vast majority of centers. It is used for the initial retrograde ureteral access to define the pelvicalyceal system, puncture of the desired calyx and dilatation of the tract, aid navigation of stones and calyces, and placement of guide wires and stents. Both the patient and operating staffs are exposed to the radiation during surgery. The purpose of this study is to measure that exposed fluoroscopic radiation dose during these procedures and make operating surgeons aware of their fluoroscopic habit. Materials and Methods: This is prospective observational study, who underwent percutaneous nephrolithotomy (n=60) and retrograde intrarenal surgery (n=43) in our institute between December 2017 and August 2018. Percutaneous nephrolithotomy was done in prone position with prior insertion of ureteric catheter. Retrograde intrarenal surgery was carried out with or without insertion of ureteral access sheath. Fluoroscopic time was taken from the insertion of the ureteric catheter or UAS to the completion of the procedure with double J stenting. Results: For percutaneous nephrolithotomy and retrograde intrarenal surgery group, mean stone size were 21.89 mm and 10.56 mm; mean fluoroscopic time were 117.95 s (range 24-350) and 31.83 s (range 3-103); mean fluoroscopic dose were 29.71 mGy and 6.19 mGy respectively. Conclusions: Among the endourological procedures for renal stones, retrograde intrarenal surgery was associated with less fluoroscopic hazard than percutaneous nephrolithotomy. Awareness of fluoroscopic exposure duration and experience of a surgeon can minimize the radiation hazard during endourological procedures.

scholarly journals Morphometry of Acromion Process of Human Scapulae and Its Clinical Importance Amongst Nepalese Population

2013 ◽  
Vol 10 (2) ◽  
pp. 33-36 ◽  
Author(s):  
DI Mansur ◽  
K Khanal ◽  
MK Haque ◽  
K Sharma
Keyword(s):  
Shoulder Joint ◽  
Surgical Repair ◽  
Average Length ◽  
Clinical Importance ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Bipedal Gait ◽  
Measuring Tape ◽  
The Right

Background Morphometry of the acromion process of the scapula is an important factor implicated in impingement syndrome of the shoulder joint. Authors who have studied this process have tried to classify it according to the standard Bigliani classification viz., type 1, 2 and 3. Objectives To analyze and classify the acromion process of human scapulae. Methods The present study was observational, cross-sectional and descriptive in nature. The present study was conducted on 68 adult human scapulae (30 right and 38 left) of unknown age and sex in the Department of Anatomy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal. The length and breadth of the acromion process and the distances from the tip of the acromion process to the uppermost point of the glenoid cavity and to the tip of the corocoid process were measured with a help of caliper and measuring tape. Results The average length of acromion process on the right and left scapulae were 46.46 ± 5SD mm and 45.57 ± 5.21 SD mm respectively. The average breadth of acromion process of right and left scapulae were 26.63 ± 3.55 SD mm and 27.23 ± 3.06 SD mm respectively. The acromio-coracoid distance on the right and left side were 39.03 + 6.20 mm and 39.39 +5.32 mm respectively. The acromio-glenoid distance was also measured which was 31.83 +3.66 mm & 31.97 +3.96 mm on right and left side respectively. The acromion process was classified in the present study into 3 types, based on the shape as: Triangular - 36.76%, Quadrangular - 52.94% and Tubular - 10.29%. Conclusions Knowing the data on the shape and various distances of acromion may not only help the orthopaedicians during surgical repair around the shoulder joint but also may be of interest to the anthropologists when studying about the evolution of the bipedal gait. The morphometric analysis of the acromion should be used like an auxiliary to promote a better knowledge about the disease that appears in this area. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 33-36 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7340

scholarly journals Lumbar plexopathy as a complication of percutaneous nephrolithotomy in a horseshoe kidney

2015 ◽  
Vol 9 (1-2) ◽  
pp. 78 ◽  
Author(s):  
Andrea Gail Lantz ◽  
R. John D'A Honey
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Psoas Muscle ◽  
Horseshoe Kidney ◽  
Vascular Supply ◽  
Stone Disease ◽  
Laparoscopic Pyelolithotomy ◽  
Staghorn Calculus ◽  
Leg Weakness ◽  
Independent Ambulation ◽  
Collecting System

Treatment of nephrolithiasis in horseshoe kidneys can be challenging due to anomalies in renal position, collecting system anatomy and vascular supply. We report on a patient who was referred after a failed percutaneous nephrolithotomy for a left moiety staghorn calculus in a horseshoe kidney. Two punctures had been performed involving upper and middle posterior calyces. Both were very medially placed and inadvertently traversed the psoas muscle, resulting in lumbar plexopathy with permanent deficit. This complication presented postoperatively with left leg weakness, paresthesia, and pain which impaired independent ambulation. The patient went on to be successfully treated for her stone disease with robotic-assisted laparoscopic pyelolithotomy.

The use of pathological grief outcomes in bereavement studies on African Americans

2017 ◽  
Vol 54 (3) ◽  
pp. 384-399 ◽  
Author(s):  
Leeat Granek ◽  
Tal Peleg-Sagy
Keyword(s):  
African American ◽  
African Americans ◽  
Research Area ◽  
Clinical Implications ◽  
Medical Sciences ◽  
Prolonged Grief ◽  
Traumatic Grief ◽  
Scientific Databases ◽  
Pathological Grief ◽  
Epistemological Violence

Pathological bereavement outcomes (i.e., complicated grief, traumatic grief, prolonged grief disorder) are a robust and growing research area in the psychological and medical sciences. Although grief is considered to be a universal phenomenon, it is well documented that grieving processes and outcomes are culturally and contextually bound. The objectives of this study were: (a) to examine representations of African Americans in the grief and mourning literature and to assess the extent to which this research utilizes pathological grief outcomes; and (b) to examine the characteristics of pathological grief constructs in the literature to assess their relevance for African American populations. We conducted comprehensive searches of three scientific databases including PsycNET, Medline, and CINAHL, which contain the majority of grief and mourning literature published between January 1998 and February 2014. We found 59 studies addressing grief and mourning in African Americans. Thirteen of these studies used pathological grief outcomes. Pathological grief outcomes that were constructed and validated on White populations were frequently used as outcome variables with African American participants. We discuss the implications for the grief and mourning field and argue that the failure to use culturally sensitive outcome measures in research studies is a form of epistemological violence that may have negative research and clinical implications for African Americans and other ethnic minorities.

scholarly journals Study on Curvatures of Clavicle With Its Clinical Importance

2012 ◽  
Vol 9 (4) ◽  
pp. 279-282 ◽  
Author(s):  
M K Haque ◽  
D I Mansur ◽  
K Sharma
Keyword(s):  
Intramedullary Nailing ◽  
Total Curvature ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
First Year ◽  
Medical Sciences ◽  
Human Skeleton ◽  
Left Clavicle ◽  
Lateral Curvature ◽  
The Right

Background The clavicle is the most frequently fractured bone of the human skeleton. 70–80% of fractures occur at the middle third of the shaft of the bone. Anatomical variations in the clavicle of relevance to form intramedullary fixation. Objectives The purpose of this study was attempted to know about comparative differences between curvatures of the right and left clavicles, from certain metrical parameters. Methods The materials for the present study consisted of 257 (135 right and 122 left) adult clavicles, which were collected from the Department of Anatomy and from the students of the first year M.B.B.S during the period 2010 - 2011, Department of Anatomy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal. The deepest points of the curvatures of the clavicle, where the convexities were the maximum. These angles were measured with the help of a protractor. The sum of the two angles constituted the total curvature of the bone. Results The average medial angle, lateral angle and sum of the two angles of right side were 150.97º ±6.16 SD, 139.76º ±7.55 SD and 290.73º ±11.14 respectively and that of the left side were 151.50º ±5.67SD, 141.73º ±8.44 SD and 293.23º ±11.69SD respectively. The present study revealed that the medial and lateral angles of the left clavicle were greater than that of the right clavicle and medial curvature was more than the lateral curvature of the same clavicle. Conclusions It is important to recognize anatomical variations in the curvatures of clavicle when considering intramedullary nailing techniques. It also helps Anthropologists in their study of evolution.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6344 Kathmandu Univ Med J 2011;9(4):279-82

Sign in / Sign up

Export Citation Format

Share Document