Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Single-stomal ureterostomy such as double barreled ureterocutaneostomy and cutaneous transureteroureterostomy have usually been performed by transperitoneal approach. However, extraperitoneal method is preferable since the patients for whom ureterocutaneostomy is indicated usually have a deteriorating general condition. We have reported single-stomal ureterocutaneostomy which can be done extraperitoneally. A total of thirteen patients, one man and twelve women, for whom permanent urinary diversion was indicated, have undergone this extraperitoneal ureterocutaneostomy for February 1988 to June 1994. Those with retroperitoneal lesions or with a history of paraaortic radiotherapy were excluded. The mean age was 61.7 (range: 42-76). The reasons for urinary diversion were vesicovaginal fistula in seven, obstructive nephropathy in four, rectovesical fistula in one and postoperative urine leak from the bladder in one. All patients had been treated for malignant diseases and had undergone transperitoneal surgery. Six patients had colostomy and ten had clinically evident recurrent diseases. In the operation, left ureter was dissected and severed extraperitoneally through left paramedian incision or left lumbotomy. The ureteral end was pushed to the right in a retroperitoneal tunnel created by blunt dissection. Then the ureter was picked up through the contralateral retroperitoneal approach. After both ureters were exposed, ureterocutaneostomy was made in right hypogastrium. Transureteroureterstomy with end-cutaneous ureterostomy, double barreled ureterocutaneostomy and ureteroureterostomy with loop ureterostomy were done in six, four and three patients, respectively. The mean operative time was 119 (range: 75-175) minutes and the mean intraoperative blood loss was 210 (range: 48-682) grams. Arrhythmia developed during retroperitoneal manipulation in one patient for whom the operation was done under spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Single-stomal ureterostomy by extraperitoneal approach]. 759 79

We report a 26-month-old child diagnosed with prune-belly syndrome and end-stage renal disease who received intraperitoneal implantation of an adult cadaveric renal graft which functioned very well for approximately 6 weeks. The patient then presented with acute renal failure which was proved to be secondary to torsion of the graft, twisting the artery and vein. The ureter was wrapped 360 degrees around the graft. These conditions resulted in loss of the graft and nephrectomy. Ours is the second report of such an occurrence; the first was from a living-related kidney donor. We believe the lack of abdominal wall tone contributes to graft mobility and risk of torsion of the kidney. We recommend that nephropexy be considered in these patients. In addition, the risk of torsion must be at the forefront of the differential diagnosis in a prune-belly renal transplant patient with acute onset of oliguria. Renal sonography with Doppler should be employed as soon as possible so that the graft can be saved.
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PMID:Renal allograft torsion associated with prune-belly syndrome. 774 30

Complete obstruction of one ureter was created in 3-week-old weanling rats. The endothelin concentration in the renal tissue was measured by radioimmunoassay. In the obstructed kidney, a substantial increase was observed, after 1 week +90%, after 2 weeks +55%, and after 4 weeks +145% compared to the control rat kidneys. The endothelin-1/endothelin-3 ratio was found to be considerably raised, indicating a predominance of the vasoconstrictor effects of the--with reference to vasoactivity--bi-potential endothelin. Its contribution to vasoconstriction and to glomerular destruction in obstructive nephropathy is discussed.
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PMID:Renal tissue endothelin in long-term complete ureteric obstruction in the young rat. 780 17

Transperitoneal laparoscopic nephrectomy was integrated into our daily routine within a 6-month period by means of a step-by-step training program progressing from a pelvic trainer to animal studies (N = 15) to laptent-assisted surgery. The pneumoperitoneum is created with the patient in the flank position, enabling insertion of three trocars: 10-mm periumbilical (Port I), 5/12-mm subcostal (Port II), and 12/5-mm above the iliac spine (Port III). After medial mobilization of the colon, two additional 5-mm trocars (Ports IV and V) are inserted into the lateral abdominal wall parallel to Ports II and III. Once clipping and dissection of the ovarian (spermatic) vein has been carried out, the ureter is identified and dissected. Retraction of the proximal ureter exposes the renal hilum, allowing dissection of the renal vessels. The renal vein is dissected using an endoscopic stapling device, while accessory veins and the renal artery are clipped. Organ retrieval is achieved with a specially designed tissue pouch (Lapsac) and digital fragmentation of the kidney within the organ bag. Using this technique, we have treated 24 patients with benign (N = 20) and malignant (N = 4, including adrenalectomy) renal disease. The mean operative time was 239 (115-300) minutes. In four cases, open surgery was required because of bleeding (N = 2), severe perinephric inflammation (N = 1), or bowel injury (N = 1). For relief of wound pain, an average of 1.15 vials of analgesic (morphine derivatives)/patient were administered for 2.4 days. The postoperative hospital stay averaged 6.2 (4-10) days.
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PMID:Transperitoneal laparoscopic nephrectomy: training, technique, and results. 812 47

This study was designed to evaluate renal functional reserve (RFR) in obstructive nephropathy using amino acid loading and the effect of angiotensin converting enzyme (ACE) inhibitor on RFR. We divided 24 rabbits into 4 groups, consisting of a control, 6-hours-bilateral ureteral obstruction (BUO), 24-hour BUO and 24-hour BUO pretreated with ACE inhibitor. Following the ligation of the bilateral ureters at the vesicoureteral junction, a unilateral ureter was released after a 6-hour or 24-hour duration in the obstructive groups. We measured RFR and renal vascular resistance after releasing a unilateral ureter in BUO. The baseline GFR values in the 6-hour and 24-hour BUO groups were significantly lower than that in the control. RFR were 0.34 + 0.04 ml/min/kg (control), 0.10 + 0.03 (6-hour BUO), 0.01 + 0.03 (24-hour BUO) and 0.10 + 0.01 (ACE inhibitor), respectively. RFR in the 6-hour BUO group was well preserved compared with that in the 24-hour BUO group. Pretreatment with ACE inhibitor in the 24-hour BUO group enhanced RFR to the extent of 6-hour BUO. Our results demonstrated that angiotensin II plays an important role in decreased GFR with obstructive nephropathy. Moreover, the present data suggested that evaluation of RFR might play a key role in the recovery of the post-obstructive renal function.
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PMID:[Renal functional reserve in obstructive nephropathy]. 813 45

In Norway, the total consumption of non-opioid analgesics has not changed during the last ten years and was 36 defined daily doses/1,000 inhabitants/day in 1992. However, there has been a clear switch from acetyl-Salicylic acid (ASA) to paracetamol during this period. The consumption of phenazone is relatively high. Phenacetin consumption has never been a problem, and out of 3,000 renal transplanted patients at Rikshospitalet, Oslo, during the last 25 years less than 1% suffered analgesic nephropathy. It is beyond doubt that phenacetin, when taken together with either ASA or phenazone, increases the risk of urothelial cancer, especially of the renal pelvis and ureter in humans. The dramatic reduction in the incidence of analgesic nephropathy after the sale of phenacetin was prohibited has not been paralleled by a decrease in kidney or urothelial cancer. The human carcinogenicity data for paracetamol in the kidney and urinary tract is discussed. Clinical and epidemiological data, including several population based case-control studies, provide inadequate evidence of any carcinogenicity of paracetamol in the kidney or urinary tract in humans. However, chronic use of high doses of paracetamol should be avoided, probably also consumption of paracetamol in combination with ASA.
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PMID:[Paracetamol--kidney and urinary tract. A cause of analgetic nephropathy or cancer?]. 820 12

Chronic abuse of the analgesic drug phenacetin is associated with an increased risk of development of transitional cell carcinomas of the urinary tract. It is unclear whether phenacetin acts through chronic tissue damage (phenacetin nephropathy) or via a genotoxic metabolite causing promutagenic DNA lesions. In the present study, we investigated 15 urothelial carcinomas from 13 patients with evidence of phenacetin abuse. Tumors were screened for p53 mutations in exons 5-8 by single-strand conformation polymorphism (SSCP) analysis, followed by direct sequencing of PCR-amplified DNA. p53 Mutations were detected in 8/14 primary tumors (57%). All except one were missense mutations located in exon 5 (three mutations), exon 6 (one), exon 7 (two) and exon 8 (one). The type of mutation varied, with a preference for CpG sites. A frameshift mutation resulting from the insertion of a single cytosine at codons 151/152 was detected in a bladder tumor and its lung metastasis. Urothelial carcinomas located in the renal pelvis and in the ureter of the same patient exhibited two different mutations, strongly suggesting that they developed independently. Another patient had tumors in the renal pelvis and bladder, both of which contained the same p53 mutation, indicating intracavitary metastatic spread. This demonstrates that screening of p53 mutations allows the clonal origin of tumors in patients with multiple primary and metastatic lesions to be determined. None of the tumors investigated contained mutations in codons 12, 13 or 61 of H-ras or K-ras protooncogenes.
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PMID:p53 mutations in phenacetin-associated human urothelial carcinomas. 822 64

We report our experience with 3 uraemic patients who were found to have transitional cell carcinoma of the renal pelvis, ureter and urinary bladder after undergoing haemodialysis for an average of 18 months (range 11-28). The underlying causes of renal failure were chronic glomerulonephritis or pyelonephritis. Bloody urethral discharge was the cardinal symptom. Because of anuria, it was often discovered at a late stage. In spite of their poor general condition and advanced stage, palliative surgical intervention was still performed. After a mean follow-up of 9 months, progression of disease was noted in 1 patient. The importance of regular follow-up in patients with end-stage renal disease for early detection of concomitant cancer cannot be over-emphasised. Uraemic patients with urothelial cancer should be treated in the same way as non-uraemic patients, since aggressive surgical intervention may improve their quality of life and prolong their survival.
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PMID:Uraemia with concomitant urothelial cancer. 826 4

End-stage renal disease secondary to vesicoureteral reflux often necessitates removal of the affected kidney and its refluxing ureter. Advances in laparoscopic techniques have made nephroureterectomy through the laparoscope possible in a minimally invasive way. We describe our surgical steps for laparoscopic nephroureterectomy in all 11-year-old girl with end-stage reflux nephropathy. Reduced trauma of surgical access, minimal postoperative morbidity, shorter hospital stay, and minimal scarring make laparoscopic nephroureterectomy a comparatively desirable surgical approach, especially in pediatric patients.
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PMID:Laparoscopic nephroureterectomy for end-stage reflux nephropathy in a child. 826 65

Forty-eight patients with strong clinical suspicion of vesicoureteric reflux (VUR) as the cause for their renal disease; were subjected to direct radionuclide cystography and roentgenographic micturating cystourethrography for its detection. Forty-four of them underwent cystoscopy under local anaesthesia to document the position and appearance of the ureteric orifices. Of the 92 kidney-ureter 'units' available for study, 20 had reflux positive on micturating cystourethrography and 22 had direct radionuclide cystography positivity. Two of the three units picked up on direct radionuclide cystography but missed on micturating cystourethrography were severe refluxes up to the renal pelvis. On the other hand, one unit missed on direct radionuclide cystography but picked up on micturating cystourethrography was a lower ureteric reflux. The sensitivity and specificity of direct radionuclide cystography to detect VUR as compared to micturating cystourethrography is 95% and 95.8% respectively. The localization and appearance of ureteric orifices which were classified as per Lyon's classification greatly enhanced the predictive value of determining past or present VUR. Patients with golf-hole orifices placed laterally had 100% incidence of reflux. Thus, combining direct radionuclide cystography with cystoscopy may enhance the predictive value for diagnosis of VUR even higher than a micturating cystourethrography study.
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PMID:Comparison of direct radionuclide cystography with micturating cystourethrography for the diagnosis of vesicoureteric reflux, and its correlation with cystoscopic appearances of the ureteric orifices. 839 42


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