SONOGRAPHIC FEATURES OF RADIOLOGICALLY NON-FUNCTIONING KIDNEYS ON INTRAVENOUS UROGRAPHY (IVU) IN KANO METROPOLIS, NIGERIA

2021 ◽  
Vol 35 (1) ◽  
pp. 11-19
Author(s):  
Mansur Umar
Keyword(s):  
Pediatric Patients ◽  
Imaging System ◽  
Imaging Modality ◽  
Left Kidney ◽  
Adult Patients ◽  
Technological Advancement ◽  
Mean Values ◽  
Grade Ii ◽  
The Right ◽  
Grade Iii

Background: Despite technological advancement in uroradiology, renal ultrasonography remains the imaging modality of choice for evaluating various pathological conditions affecting the urinary tract (GIT) system. Aim: This study was aimed at evaluating sonographic features of radiologically nonfunctional kidneys in Kano metropolis, Nigeria. Methods: A prospective study involving 94 subjects each from the diseased and control groups were conducted in Kano metropolis from January 2019 to January 2021. Renal scans were performed using a digital ultrasound imaging system; model DP-8800Plus fitted with a 3.5MHz curvilinear transducer. The maximum length, width, and thickness were measured. The renal echogenicity was assessed and graded. Data were analyzed using SPSS Version 22.0 Results: The mean values of the right and left renal volumes among adult patients was 400.5 ± 527.3 cm3 and 177.6 ± 174.3 cm3 respectively. For pediatric patients, it was 72.3 ± 308.6 cm3 and 241.6 ± 228.7 cm3 for the right and left kidney respectively. The renal parenchymal echogenicity of the right kidney among adult patients was scored as grade II 2 (5.3%), grade III 27 (71%), and grade IV 9 (23.7%), while those pediatric patients were Grade 0 (11.1%), and 8 (88.9%) as grade III. The adults left kidneys were scored grade II 2 (6%), and 16 (47%) each as grades III and IV, while the pediatric group scored 3 (25%) as grade II, and 9 (75%) as grade III. Conclusion: Increased renal volume, shrunken kidney, increased renal parenchymal echogenicity, and severe hydronephrosis were strong sonographic indicators of nonfunctional kidneys.

Age-dependent revascularization patterns in the treatment of moyamoya disease in a European patient population

2009 ◽  
Vol 26 (4) ◽  
pp. E9 ◽  
Author(s):  
Marcus Czabanka ◽  
Peter Vajkoczy ◽  
Peter Schmiedek ◽  
_ _ ◽  
Peter Horn
Keyword(s):  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Clinical Results ◽  
Adult Patients ◽  
Suitable Alternative ◽  
Relative Contribution ◽  
Grade Ii ◽  
Indirect Revascularization ◽  
Revascularization Procedures ◽  
Grade Iii

Object Different revascularization procedures are used in the treatment of patients with moyamoya disease (MMD). The aim of this study was to investigate the relative contribution of direct and indirect revascularization procedures to the restoration of collateral blood supply in adult and pediatric patients with MMD. Methods The authors performed 39 combined cerebral revascularization procedures (standard extraintracranial bypass [STA-MCA bypass] plus encephalomyosynangiosis [EMS]) in 10 pediatric and 10 adult patients. All patients underwent physical examination and digital subtraction angiography before and 6 months after surgery. The STA-MCA bypass and EMS function were graded as Grade I (poor), II (moderate), or III (good) on the basis of the angiograms. Results In pediatric patients, bypass function was Grade I in 12, Grade II in 8, and Grade III in 0 hemispheres; EMS function was Grade I in 0, Grade II in 12, and Grade III in 8 hemispheres. In the adult patients, bypass function was Grade I in 8, Grade II in 8, and Grade III in 3 hemispheres; EMS function was Grade I in 10 hemispheres, Grade II in 5, and Grade III in 1 hemisphere. In the pediatric patients disease was classified as improved in 14 hemispheres on the basis of clinical results and stable in 6. In the adults it was classified as improved in 12 hemispheres stable in 7 hemispheres. Conclusions Combined revascularization led to good angiographic and clinical results in both patient populations. Especially in pediatric patients, EMS represents a suitable alternative to bypass surgery.

119 ASSESSMENT OF OVARIAN FOLLICULAR DYSPLASIA UTILIZING ULTRASOUND AND HISTOLOGIC EXAMINATION

2017 ◽  
Vol 29 (1) ◽  
pp. 168
Author(s):  
J. A. Gard ◽  
J. Roberts ◽  
T. Braden ◽  
M. Mansour ◽  
J. Yelich ◽  
...  
Keyword(s):  
Beef Cows ◽  
Ultrasound Images ◽  
Imaging Analysis ◽  
Small Individual ◽  
Cull Cows ◽  
Grade Ii ◽  
Hilar Region ◽  
The Right ◽  
Cut Surface ◽  
Grade Iii

A slaughterhouse study commissioned by Florida Cattleman’s Association in 2007 identified ovarian follicular dysplasia (OFD) as a primary cause of infertility in Florida beef cows. Ovaries with OFD have progressive bilateral development of solid clustered follicles containing multiple Call-Exner bodies that originate in the rete ovarii and the hilar region, and progress into the cortex to eventually form bilateral Sertoli-type granulosa theca cell tumours (GTCT). The objectives of this study were to assess the distribution of OFD in cull animals and to evaluate utilisation of ultrasound for diagnosis of OFD in cattle. Ultrasound images of the right and left ovaries from 390 cull cows and heifers representing 4 Florida ranches were made with 5-MHz linear probes (Aloka, Ibex). Then, 10 to 12 females per ranch were followed to slaughter the proceeding day for collection of reproductive tracts. The fixed ovaries were measured, sectioned para-sagittally through the hilus, photographed, and arranged in histology cassettes for complete examination of the cut surface. Large ovarian structures including corpus luteum, Graafian follicles, atretic follicles, dysplastic follicles, rete ovarii, dysplastic follicles, and tumours were counted and measured for each ovary. Ovaries with OFD were graded I to IV. Grade I OFD contained small individual dysplastic follicles with diameter less than 200 µm mostly limited to the rete ovarii and medulla. Grade II OFD possessed dysplastic follicles greater than 200 µm diameter that were present in the medulla and cortex. Grade III OFD had extensive multi-sized dysplastic follicles scattered throughout the entire cortex of the ovary and Grade IV OFD had Sertoli-type GTCT. Grade II–IV often had dystrophic mineralization of dysplastic follicles. Gross morphology of fixed sagittal sections and ultrasound images were blindly compared against OFD grade in 40 individual ovaries. The OFD was identified at slaughter in 29/41 cows and in 1/5 of heifers. The distribution of OFD for 30 affected females was Gr I 16/30, Gr II 9/30, Gr III 4/30, and Gr IV 1/30. Characteristics that could be detected by routine ultrasound included increased size and length, increased hyperechogenicity and decreased number of fluid-filled follicles. Hyperechogenic shadows were evident in higher grade OFD. The study demonstrated that Grade III and IV OFD can be observed by routine ultrasound but Grade I and II may require higher resolution ultrasound probes, imaging analysis software, or Doppler ultrasound.

Human Mesenchymal Stroma Cells (hMSCs) Expanded with Human Platelets Lysate Are Safe and Effective For the Treatment of Graft Versus Host Disease

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1171-1171 ◽  
Author(s):  
Martino Introna ◽  
Ettore Biagi ◽  
Chiara Capelli ◽  
Agnese Salvadè ◽  
Giovanna D’Amico ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Graft Versus Host Disease ◽  
Pediatric Patients ◽  
Human Platelets ◽  
Adult Patients ◽  
Third Party ◽  
Host Disease ◽  
Graft Versus Host ◽  
Grade Iii

Abstract Background Very recently, encouraging results indicate that third party human mesenchymal stromal cells (hMSCs) are a rapidly available therapeutic tool for the treatment of severe (grade III–IV), steroid resistant, acute graft versus host disease (aGVHD). In the clinical experience published so far, hMSCs have been expanded in Fetal Bovine Serum (FBS), which may constitute a problem for its antigenicity and as a possible vehicle of animal pathogens. We have established a highly efficient protocol for the in vitro expansion, under strict GMP compliance, of bone marrow derived hMSCs using human platelets lysate (PL) in place of FBS (Capelli C. et al.: BMT, 2007). In this study, upon Ethical Committee approval and patient’s informed consent, hMSCs were administered on a compassionate basis for the treatment of refractory GVHD. Methods hMSCs were prepared from washouts of bags and filters, left over at the end of the standard filtration procedures of the bone marrow harvests from third party HLA mismatched healthy donors. Cells were grown in the presence of DMEM with 5% PL obtained from the Blood Bank of our Hospitals. In a short period of time (10–33 days), low density seeding of unmanipulated cells (100–200/cm2), obtained from 7 bone marrow harvests allowed to prepare large quantities of hMSCs (median 115×106, range: 67–375), with only one in vitro passage. Twenty-three frozen bags of hMSCs (each containing approximately 1×106/kg of recipient body weight) have been quarantined until the completion of quality tests, including viability, phenotype, absence of detectable bacteria, fungi, mycoplasma or endotoxin, according to European Pharmacopea guidelines. Differentiation to osteogenic and chondrogenic cells as well as the immunosuppressive potential of these cells was confirmed when tested in mixed lymphocyte reaction (MLR). Q banding and clonogenic assays were performed for each batch and never showed abnormalities of karyotype or autonomous growth in vitro. Results Two adult and 4 pediatric patients were treated for aGVHD (grade II–IV) and 2 adults for extensive chronic GVHD (cGVHD) between January and July 2008, using 12 hMSCs bags that had completed quarantine. Before hMSCs, second or third line treatments had been given to patients with aGVHD, including Etanercept (n= 5), Mycophenolate Mofetil (MMF, n= 4) and Extracorporeal Photopheresis (ECP, n= 3), Rituximab (1 patient). Patients with cGVHD were previously treated with ECP and MMF (n= 2), Imatinib (n= 1) and Etanercept (n= 1). Each infusion contained a median dose of 1×106/kg (range, 0.7–1.2×106) hMSCs. For patients with aGVHD, a single infusion was performed in 4 pediatric patients while 1 and 3 infusions were performed in 2 adult patients. The 2 patients with cGVHD received 1 and 4 infusions, respectively. All infusions were very well tolerated with no immediate or late adverse events according to WHO common criteria. Among pediatric patients with aGVHD, 3 complete and 1 partial responses were registered and all patients are alive and in complete hematologic remission. A complete response was observed in 1 adult with grade III cutaneous aGVHD although the patient rapidly relapsed and died of leukemia progression. No response was observed in the other adult patient who died of progressive grade IV gut and liver aGVHD. The 2 adult patients with cGVHD had both a partial response and are alive. Conclusions These data show that large numbers of third party hMSCs can be expanded in vitro with PL containing medium and stored for immediate use in patients with GVHD. Moreover, the clinical results and the toxicity profile confirm those reported with hMSCs expanded in FBS containing media.

scholarly journals Indocyanine Green Near-Infrared Fluorescence Imaging-Guided Laparoscopic Heminephrectomy for Left Ureteral Cancer in Patient with Horseshoe Kidney

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Takao Natsuyama ◽  
Yozo Mitsui ◽  
Masato Uetani ◽  
Shigeyuki Ohta ◽  
Shin-ichi Hisasue
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Imaging System ◽  
Left Kidney ◽  
Horseshoe Kidney ◽  
Near Infrared Fluorescence ◽  
Nirf Imaging ◽  
Novel Approach ◽  
The Right ◽  
Near Infrared Fluorescence Imaging

Laparoscopic surgery for patients with a horseshoe kidney is challenging because of the location, aberrant vasculature, and difficulty with division of the isthmus with adequate hemostasis. We herein report performance of a laparoscopic heminephrectomy for left ureteral cancer in a patient with a horseshoe kidney under guidance from near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG). A 62-year-old male was referred to our hospital for treatment of left ureteral cancer associated with a horseshoe kidney. We performed a laparoscopic left nephroureterectomy and bladder resection in June 2017. During the operation, the NIRF imaging system was used to evaluate the border of the kidney parenchyma isthmus after ligation of the left kidney vasculature supply. Interestingly, the dominant region of the right kidney showed strong ICG fluorescence as compared to the left kidney region. With the assistance of ICG-based NIRF imaging, isthmus division was performed with monopolar scissors and adequate hemostasis was obtained by electrocautery coagulation. This is the first report of use of an ICG-based NIRF imaging system and this novel approach can help to demarcate the left moiety isthmus from right one with more certainty.

scholarly journals Sonographic Assessment of Renal Length of Adults in Lagos, Nigeria

2019 ◽  
Vol 2 (2) ◽  
pp. 255-258
Author(s):  
Ese Anibor
Keyword(s):  
Imaging Modality ◽  
Statistical Significance ◽  
Left Kidney ◽  
Radiology Department ◽  
P Value ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Kidney Length ◽  
The Right ◽  
Renal Length

Introduction: Ultrasound is an important imaging modality used in the prognosis and diagnosis of renal conditions and diseases and also in the evaluation of kidney donors. This study aimed at providing a reference for the normal metric variables of the kidney such kidney lengths of healthy Nigerian adults in Lagos State and to compare with previously obtained results.Materials and Methods: This study was conducted in the radiology department of Ikorodu Hospital. This study adopted a descriptive cross-sectional study design with a cluster sampling approach which consisted of 150 adults (with 300 kidneys) participants ages 18-87 years. Real-time gray-scale ultrasonic scanning using Prosound 3500 Aloka device and a 3.5–5 MHz curvilinear explorer was employed for the abdominal imaging. The data acquired were compiled and explored via the Statistical Package for the Social Sciences (SPSS) version 20. The student’s t-test was utilized in probing for statistical significance between age as well as gender in relation to renal length. P-value < 0.05 was adjudged to be significant.Results: The kidney length was of a greater distance in males, and the length of the left kidney was more extensive than that of the right kidney in both sexes. Average kidney length was greater on the left when compared to the right among the various age groups. No significant association was noted between kidney length and age as well as gender.Conclusions: Normal values for kidney length and diversifications in the kidney length of healthy adults in Nigeria have been established.

scholarly journals Varicocele and its effect on fertility

2021 ◽  
Vol 11 (2) ◽  
pp. 105-112
Author(s):  
Sergey A. Zamyatnin ◽  
Irina S. Gonchar ◽  
Andrey A. Schmidt
Keyword(s):  
Spermatic Cord ◽  
Sperm Morphology ◽  
Varicose Veins ◽  
Sperm Quality ◽  
Screening Examination ◽  
True Prevalence ◽  
Grade Ii ◽  
The Right ◽  
Urological Diseases ◽  
Grade Iii

Varicocele is recognized as one of the most common urological diseases, but its true prevalence is a matter of debate. In the present study, during a screening examination of 442 young men (mean age 21.6 years), grade I varicocele was detected in 7.2%, grade II in 42.1%, and grade III in 15.2% of men, varicocele was absent only in 35.5% of men. In 41% of cases, varicocele was diagnosed in isolation on the left side, in 36.5% of cases, bilateral varicocele was detected, and in 22.5%, varicose veins of the spermatic cord were detected on the right. Pathozoospermia was found in 47.3% of patients with grade II varicocele and 61.2% with grade III varicocele. The data obtained in the course of the study showed a significant effect of varicocele and its duration on sperm quality, in particular, on sperm morphology.

The Outcome of Unrelated Hematopoietic Stem Cell Transplants with Total Body Irradiation (800 cGy) and Cyclophosphamide (120 mg/kg) in Adult Patients with Severe Aplastic Anemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3397-3397
Author(s):  
Jong Wook Lee ◽  
Byung Sik Cho ◽  
Yoo-Jin Kim ◽  
Hee Je Kim ◽  
Seok Lee ◽  
...  
Keyword(s):  
Stem Cell ◽  
Total Body Irradiation ◽  
Cumulative Incidence ◽  
Disease Duration ◽  
Adult Patients ◽  
Platelet Recovery ◽  
Grade Ii ◽  
Total Body ◽  
Mismatched Donor ◽  
Grade Iii

Abstract Abstract 3397 Poster Board III-285 Backgrounds: We had reported the results of a pilot prospective study demonstrating the superiority of 800 cGy of total body irradiation (TBI) in combination with a 120 mg/kg of cyclophosphamide (CY) [TBI-800/CY-120] compared to the higher doses of TBI (1000 and 1200 cGy) as a conditioning regimen for unrelated stem cell transplantation (SCT) in adult patients with severe aplastic anemia (SAA) [Biology of Blood and Marrow Transplant 2007;13:836-870]. Patients and methods: To analyze the long-term results of unrelated SCT with TBI-800/CY-120 for adult SAA who failed to respond to immunosuppressive treatment, we prospectively enrolled 50 adult patients with SAA [median age, 28 years (range, 15-53)], including 26 patients of a previous pilot study. All patients received fractionated TBI (400 cGy/day) for 2 days followed by CY (60mg/kg/day, 2 days). Nine patients (18%) were very SAA. Enrolled patients had received multiple transfusions (median 64 units, range, 10-363) and long disease duration (median 48 months, range 2-323). High resolution DNA typing was done at HLA-A, -B, -C, -DR level. Seventeen patients (34%) received HLA-mismatched SCT at allele level. Thirty-eight patients (76%) received bone marrow and 12 (24%) peripheral blood stem cells (PBSC). All patients received tacrolimus and short-course of methotrexate as GVHD prophylaxis. Results: All patients achieved engraftment and the median day of neutrophil and platelet recovery was 13 days (range, 8-30) and 20 days (range, 9-200), respectively. There was one case of delayed platelet recovery, but platelet count rose slowly to the normal level thereafter. At a median follow-up of 38 months (range, 1-84), the estimated 3-year overall survival was 87.8%. The cumulative incidence of acute GVHD (aGVHD) over grade II (6/23, grade III and IV) and chronic GVHD (cGVHD) were 46.0% and 50.3% [limited (39%) vs. extensive (61%)], respectively. Among 7 patients who died, 4 patients and 1 patient died of severe aGVHD (grade III and IV) and cGVHD, respectively, 1 patient multi-organ failure, and 2 patient sepsis. Univariate analysis revealed the following risk factors: very SAA (P=0.018), HLA-mismatched donor at allele level (P=0.012), and older donor age (P=0.080) for aGVHD and previous aGVHD (P=0.030) and PBSC (P=0.024) for cGVHD. Multivariate analysis showed that only a HLA-mismatched donor at allele level (hazard ratio: 2.7, 95% CI: 1.2-6.2, P=0.018) was a significant factor associated with higher cumulative incidence of aGVHD over grade II. Conclusions: TBI-800/CY-120 conditioning resulted in excellent outcome of unrelated transplants in adult patients with SAA who had received multiple transfusions and long disease duration, which was comparable to those of matched sibling transplants. Additional strategies to prevent severe GVHD, for example, adding anti-thymocyte globulin, particularly for HLA-mismatched transplant and in case of PBSC as a stem cell source, will be helpful to improve the outcome in the future. Disclosures: No relevant conflicts of interest to declare.

scholarly journals A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas

2013 ◽  
Vol 11 (6) ◽  
pp. 673-681 ◽  
Author(s):  
Tene A. Cage ◽  
Aaron J. Clark ◽  
Derick Aranda ◽  
Nalin Gupta ◽  
Peter P. Sun ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pediatric Patients ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Who Grade ◽  
Free Survival ◽  
Grade Ii ◽  
Infratentorial Tumors ◽  
Who Grade Iii ◽  
Grade Iii

Object Ependymoma is the third most common primary brain tumor in children. Tumors are classified according to the WHO pathological grading system. Prior studies have shown high levels of variability in patient outcomes within and across pathological grades. The authors reviewed the results from the published literature on intracranial ependymomas in children to describe clinical outcomes as they relate to treatment modality, associated mortality, and associated progression-free survival (PFS). Methods A search of English language peer-reviewed articles describing patients 18 years of age or younger with intracranial ependymomas yielded data on 182 patients. These patients had undergone treatment for ependymoma with 1 of 5 modalities: 1) gross-total resection (GTR), 2) GTR as well as external beam radiation therapy (EBRT), 3) subtotal resection (STR), 4) STR as well as EBRT, or 5) radiosurgery. Mortality and outcome data were analyzed for time to tumor progression in patients treated with 1 of these 5 treatment modalities. Results Of these 182 patients, 69% had supratentorial ependymomas and 31% presented with infratentorial lesions. Regardless of tumor location or pathological grade, STR was associated with the highest rates of mortality. In contrast, GTR was associated with the lowest rates of mortality, the best overall survival, and the longest PFS. Children with WHO Grade II ependymomas had lower mortality rates when treated more aggressively with GTR. However, patients with WHO Grade III tumors had slightly better survival outcomes after a less aggressive surgical debulking (STR+EBRT) when compared with GTR. Conclusions Mortality, PFS, and overall survival vary in pediatric patients with intracranial ependymomas. Pathological classification, tumor location, and method of treatment play a role in outcomes. In this study, GTR was associated with the best overall and PFS rates. Patients with WHO Grade II tumors had better overall survival after GTR+EBRT and better PFS after GTR alone. Patients with WHO Grade III tumors had better overall survival after STR+EBRT. Patients with infratentorial tumors had improved overall survival compared with those with supratentorial tumors. Progression-free survival was best in those patients with infratentorial tumors following STR+EBRT. Consideration of all of these factors is important when counseling families on treatment options.

scholarly journals A patient with two gliomas with independent oligodendroglioma and glioblastoma biology proved by DNA-methylation profiling: a case report and review of the literature

2022 ◽  
Author(s):  
Theo F. J. Kraus ◽  
Christoph Schwartz ◽  
Lukas Machegger ◽  
Barbara Zellinger ◽  
Dorothee Hölzl ◽  
...  
Keyword(s):  
Brain Tumors ◽  
New Left ◽  
Anaplastic Oligodendroglioma ◽  
Who Grade ◽  
Grade Ii ◽  
The Right ◽  
Work Up ◽  
Who Grade Iii ◽  
Grade Iii ◽  
Methylation Profiling

AbstractHere, we report on a patient presenting with two histopathologically distinct gliomas. At the age of 42, the patient underwent initial resection of a right temporal oligodendroglioma IDH mutated 1p/19q co-deleted WHO Grade II followed by adjuvant radiochemotherapy with temozolomide. 15 months after initial diagnosis, the patient showed right hemispheric tumor progression and an additional new left frontal contrast enhancement in the subsequent imaging. A re-resection of the right-sided tumor and resection of the left frontal tumor were conducted. Neuropathological work-up showed recurrence of the right-sided oligodendroglioma with features of an anaplastic oligodendroglioma WHO Grade III, but a glioblastoma WHO grade IV for the left frontal lesion. In depth molecular profiling revealed two independent brain tumors with distinct molecular profiles of anaplastic oligodendroglioma IDH mutated 1p/19q co-deleted WHO Grade III and glioblastoma IDH wildtype WHO grade IV. This unique and rare case of a patient with two independent brain tumors revealed by in-depth molecular work-up and epigenomic profiling emphasizes the importance of integrated work-up of brain tumors including methylome profiling for advanced patient care.

Functional hemispherotomy for refractory epilepsy in pediatric patients: the right person at the right time

2010 ◽  
Vol 41 (02) ◽  
Author(s):  
G Ramantani ◽  
T Bast ◽  
T Gerstner ◽  
G Wiegand ◽  
K Strobl ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Refractory Epilepsy ◽  
The Right
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