Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have encountered a 23-year-old pregnant woman with macrohematuria, which occurred from the 8th or 9th week of gestation. Blood pressure and renal function were normal during the total course of pregnancy. Macrohematuria did not disappear after childbirth. Cystoscopy was conducted and the excretion of hematuria from the left ureter was confirmed. Therefore, a left renal venogram was performed although abdominal ultrasonography and CT scanning showed no abnormality. There were two branches of the left renal vein (LRV), such as the anterior and posterior branch. The pressure gradient was 4.4 cm H2O between the anterior branch of LRV and the inferior vena cava (i.v.c.). However, a significant pressure gradient (6.6 cm H2O) was demonstrated between the posterior branch of the LRV and IVC. From these findings we diagnosed this patient as venous hypertension in the posterior branch of the left renal vein (= posterior Nutcracker syndrome, PNS). Enlargement of the uterus in pregnancy might not be important in the occurrence of PNS because macrohematuria was observed from the 8th or 9th week of gestation. Functional hemodynamic change in pregnancy might cause a widening of the diameter or a shift of the aorta, that might result in compression of the posterior branch of the left renal vein. Persistence of macrohematuria after childbirth might have been due to irreversible hemodynamic alteration by the development of co-lateral circulation. To the best of our knowledge, this is the first case of PNS occurring in pregnancy.
 ...
PMID:[A case of posterior nutcracker syndrome occurring in pregnancy]. 948 45

Retroperitoneal endoscopic nephrectomy with the patient in the prone position was performed in 12 patients. Indications for this procedure were end-stage kidneys with ureteropelvic junction stenosis or distal ureteric obstruction, nonfunctional kidneys with drug resistant renin-mediated hypertension, and distal ureter malignancy. The retroperitoneal area was exposed using an open surgical technique in combination with the use of a liquid-filled dissection balloon. Removal of kidney tissue was performed with a morcellator through one of the ports. On average, the operating time was 210 min (range 160-480 min) to complete a one-sided nephrectomy. No major complications occurred. Mean hospital stay in this series was 6.6 days, and the follow-up period was uncomplicated in all cases. Retroperitoneal endoscopic nephrectomy with the patient in the prone position is an acceptable alternative to open nephrectomy in selected indications.
 ...
PMID:Initial experiences with the retroperitoneal approach for endoscopic nephrectomy with the patient in the prone position. 953 3

Tribulus terrestris L. is an annual plant which has been commonly used in folk medicine as diuretic and against colic pains, hypertension and hypercholesterolemia in Turkey. This study investigated the effects of liophilized saponin mixture of this plant on several smooth muscle preparations in vitro. The liophilized material was obtained from dried and powdered T. terrestris L. by specific extraction method for saponins. Median lethal dose (LD50) of saponin mixture on Swiss albino mice was calculated according to Litchfield-Wilcoxon method via i.p. route. LD50 and its 95% confidence limits were 813 and 739-894 mg.kg-1 respectively. Saponin mixture has caused a significant decrease on peristaltic movements of isolated sheep ureter and rabbit jejunum preparations in a dose-dependent manner (p < 0.05). However it has been observed no effect on isolated rabbit aorta and its contractile response to KCl or noradrenaline (p > 0.05). According to these results it has been suggested that T. terrestris L. or its saponin mixture may be useful on some smooth muscle spasms or colic pains.
 ...
PMID:Effect of Tribulus terrestris L. saponin mixture on some smooth muscle preparations: a preliminary study. 1007 81

A primary mucosa associated lymphoid tissue tumor (MALT) of the kidney in a 50-year-old man who suffered from on therapy resistant high blood pressure over 15 years period is presented. A mass in the right kidney (6x5x3 cm) during routine check up was discovered on ultrasonography and confirmed on CT scan and NMR. The patient was submitted to nephrectomy. A mass involving kidney, pyelon and upper part of the ureter was found. Histology showed low grade non-Hodgkin B-cell lymphoma of MALT type. The neoplastic cells were positive for monoclonal antibodies CD20, CD79alpha, surface and cytoplasmic and IgM immunoglobulins and showed light chain restriction (kappa+). After histology was available, a careful staging was performed. The disease was not found anywhere else. It was concluded that the patient belonged to the stage IE of primary kidney MALT lymphoma. Gastroscopy showed signs of chronic superficial gastritis. Urease test was positive and IgG antibodies against Helicobacter pylori in titer 421 were found as well. Except for Helicobacter pylori no additional therapy was given.
 ...
PMID:Primary MALT lymphoma of the kidney. 1065 Nov 24

With the widespread use of obstetric echography the incidence of fetal hydronephrosis has been reported more frequently. Consequently, many uropathies have been detected in asymptomatic neonates. The authors report their experience with prenatally detected primary non-refluxing megaureter. Newborns with fetal hydronephrosis were investigated by ultrasonography and micturating cystourethrogram after the beginning of chemoprophylaxis. If primary megaureter was identified, after 1 month the children underwent 99tm-DMSA, diuretic 99tm-DTPA, and intravenous urography. Eight infants with primary megaureter (bilateral in 3 cases) were identified, for a total of 11 renal units for study. All children were submitted to non-operative management. We performed ultrasonography and diuretic 99tm-DTPA during follow-up, which lasted on average 75 months. The mean cross-sectional diameter of the dilated ureter was 13.6 mm during neonatal period, and reached 8.4 mm at the end of follow-up. The renal function and the diuretic renogram remained stable throughout follow-up. Two neonates presented transitory hypertension. Our results support the notion that conservative management is safe for primary megaureter detected in asymptomatic neonates, with most cases showing spontaneous regression during a prolonged follow-up.
 ...
PMID:Primary megaureter detected by prenatal ultrasonography: conservative management and prolonged follow-up. 1105 66

Based on an extensive review of the literature and on our own clinical experience, this article attempts to present clear guidelines for the management of various kidney stones, particularly regarding the extracorporeal shock waves lithotripsy (ESWL) treatment nowadays. Few technical developments have changed medicine more within a short period of time than ESWL. Fifteen years after the first clinical application, ESWL has gained world-wide acceptance as first choice therapy for most forms of urolithiasis. Ninety-eight per cent of stones can be successfully fragmented by the application of shock-waves, but the ability of the kidney and ureter to clear the resulting fragments is far more important in terms of successful treatment outcome. Increasing experience with new ultrasound-guided lithotriptors has shown that there are some advantages: cost reduction, permanent monitoring and lack of exposure to ionising radiations. ESWL is a safe procedure for the treatment of urolithiasis; nevertheless some problems remain. In ureteric stones, ureteroscopy (rigid or flexible device) allows a rate of stone-free patients better than ESWL. For treatment of large staghorn calculi combined approach of PCNL and ESWL is preferred. For stones located at lower calyx, the stone-free rate in patients treated by ESWL fell to 50%, when unfavourable anatomy is present. The potential long-term renal damage, associated with ESWL in children, have delayed the acceptance of shock-waves into paediatric practice. Recent reports suggest that the renal damage, including the potential risk of hypertension induced by ESWL, is mild and transient. A subgroup of patients (e.g. solitary kidney, impaired renal function, children) required further attention. The fate of residual fragments is unclear. In some cases residual lithiasis tend to result in regrowth and further progression, although ESWL itself does not increase the recurrence rate of urolithiasis. Nevertheless follow-up of stone patients after ESWL is mandatory and the ultimate goal of treating stones by whatever means is to get the patient stone-free and prevent recurrence.
 ...
PMID:Lithotripsy in the treatment of urinary lithiasis. 1113 37

Laparoscopy and palpation offer only a rough estimate of the extent of endometriosis. Consequently, endometriosis involving the bowels and urinary tract is under-diagnosed. Bowel obstruction and retroperitoneal endometriosis with obstruction of the ureter are uncommon conditions, but awareness of them is important. Ureteric obstruction develops slowly from periureteral fibrosis and often results in an asymptomatic hydronephrosis, loss of renal function and hypertension. Although renography is the first line of choice in investigation of the upper urinary tract in cases of suspected ureteric obstruction, ultrasound of the kidneys may be useful in the hands of the experienced gynecologist as a screening tool at consultation. The rationale for this recommendation is that ureteric obstruction and hydronephrosis often occur simultaneously. We present a case with bowel obstruction mimicking sigmoid carcinoma, ureteric obstruction and hypertension, caused by endometriosis, where the diagnostic difficulties are illustrated. Collaboration between gynecologist and urologist is essential in selected cases of endometriosis.
 ...
PMID:[A case report. Endometriosis caused colonic ileus, ureteral obstruction and hypertension]. 1140 1

Nephrectomy is a radical operation successfully used over more than a century. It should be resorted to only in exceptional situations whenever an organ salvaging operation is precarious for the patient's health (T Patrashkov, 1980). The indications for nephrectomy depend on the type of disease, extent of renal damage, state of the second kidney and the patient's general condition, established by the basic examination methods in urology (T Patrashkov 1982). The study covers 388 nephrectomies in cases presenting diverse diseases of the kidney and ureter, diagnosed and treated in the Department of Urology--University Hospital "Alexandrovska" in the period 1990 to 1995. The commonest causes leading to nephrectomy comprise: 1. Neoplasms of kidney and ureter--134 (34.54%). 1.1. Parenchymal tumors--116 (29.90%)/ 1.2. Papillary tumors--18 (4.64%). 2. Pyonephrosis--88 (22.68%). 3. Nephrolithiasis (presence of renal calculi)--53 (13.66%). 4. Secondary operations of the kidney and ureter--46 (11.86%). 5. Hydronephrosis--38 (9.80%). 6. Anomalies (hypoplasia)--8 (2.06%). 7. Cystic diseases--7 (1.80%). 8. Tuberculosis of kidney--6 (1.55%). 9. Renovasal hypertension--4 (1.02%). 10. Nephrectomy for other diseases--4 (1.02%). As shown by the results the rate of nephrectomy undertaken for renal malignancy is still the highest which is by no means considered as a favourable diagnostic sign.
 ...
PMID:[Kidney diseases most often considered as indications for nephrectomy]. 1148 42

Retroperitoneal fibrosis has been described as a rare occurrence during the course of inflammatory bowel disease, mainly Crohn's disease. This is the third report on retroperitoneal fibrosis occurring during the course of ulcerative colitis. A 62-year-old male patient with a 5-year history of ulcerative colitis developed stenosis of the left ureter due to retroperitoneal fibrosis. Treatment consisted in surgically releasing the ureter from the mass and steroids. During a 2.5-year follow-up, renal function was stable and ulcerative colitis in remission. Important aspects of this case are the moderate course of ulcerative colitis, ultrasound confirmation of normal kidney structure before manifestation of fibrosis, hypertension diagnosed four years before retroperitoneal fibrosis, a non-functioning kidney at diagnosis, and reduction of retroperitoneal mass after steroid treatment. Retroperitoneal fibrosis, although a rare disease entity should be considered when a patient with ulcerative colitis develops otherwise unexplained renal insufficiency.
 ...
PMID:Retroperitoneal fibrosis during the course of ulcerative colitis. A simple coincidence? 1181 49

We describe the successful laparoscopic resection of a functional paraganglioma in the organ of Zuckerkandl. A 47-year-old man with hypertension and diabetes mellitus was found to have an abdominal mass beside the aorta. The tumor was diagnosed as a functional paraganglioma by diagnostic imaging and biochemical tests. We then performed a transperitoneal laparoscopic resection for removal. After freeing the left ureter, resecting the inferior mesenteric artery, and dividing the small blood vessels, the tumor was isolated and found to be preserved in its capsule. It was retrieved in a bag through an enlarged incision. The operation time was 450 min and blood loss was 410 ml. The postoperative course was uneventful and there has been no local recurrence or distant metastasis during the 18-month follow-up period. Laparoscopic resection of functional extraadrenal paragangliomas is technically feasible and safe if adequate pre- and intraoperative medical management and a careful, steady surgical technique are used.
 ...
PMID:Laparoscopic resection of a functional paraganglioma in the organ of Zuckerkandl. 1196 57


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>