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Xanthinuria, xanthine oxidase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
Xanthinuria was first definitively reported by Dent and Philpot [1] in 1954 in a four-year-old girl who had hematuria and urinary frequency and passed a smooth oval, radiolucent stone which was found to be composed of xanthine. This same patient was later studied at 9, 14, and 19 years of age [2] and found to have some persistent clubbing of the left renal calyces and reduced size of the left kidney but to be normotensive and in good health.
Uro-Angiographic Contrast Agents—The Holy Grail
Published in Christoph de Haën, X-Ray Contrast Agent Technology, 2019
Declaredly stimulated by Volkmann’s reports, additional studies with intravenous sodium iodide were performed at the University of Padua in Italy. Guerrino Lenarduzzi, assistant in the radiology unit of the department of clinical surgery and Renzo Pecco, assistant in that department, studied in intravenous excretion urography with 10% sodium iodide in dogs. With typical doses of 1 g/kg body weight, they exceeded by factors of more than two those explored by others. Despite the high doses, successful imaging of renal calyces and ureters required ligation of the latter (Lenarduzzi and Pecco 1927). In man, this meant external compression of the ureters (Ziegler and Köhler 1930). Notwithstanding this patient manipulation, combined with extensive patient preparation, such as oral doses of contrast agent on previous days and induced bowel voiding (Volkmann 1924f), or use of pneumoradiology (Rosenstein [1924] 1925; von Lichtenberg [1928] 1929), the diagnostic performance of simple salt solutions was never really satisfactory. In addition, there were significant adverse reactions (von Lichtenberg 1932).
Renal disease
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
There is dilatation of the ureters and renal calyces in pregnancy. This must be remembered when interpreting ultrasound scans of the renal and urinary tract systems in pregnancy. Both renal plasma flow and glomerular filtration increase dramatically in pregnancy.1 This results in an increased urinary protein excretion and increased creatinine clearance.1 Thus, in the second trimester, the upper limit of normal for serum creatinine falls to around 65 µmol/L with a mean of 54 µmol/L,1 and throughout pregnancy the upper limit of normal for proteinuria is taken as 300 mg/24 hours or a protein:creatinine ratio less than 30 mg/mmol.
‘Boxing in the corner’: A modified retrograde approach for the management of proximal ureteric stones of 1–2 cm
Published in Arab Journal of Urology, 2021
Omar Farid Elgebaly, Hussein Abdeldaeim, Tamer Abouyoussif, Ahmed Mahmoud Fahmy, Faisal Edris, Abdelrahman Zahran, Akram Assem
All patients received general anaesthesia and were placed in the lithotomy position. Cystoscopy was initially done to identify the ureteric orifice and two hydrophilic tipped guidewires (Sensor PTFE-Nitinol guidewire with hydrophilic tip; Boston Scientific Corp., Natick, MA, USA) were inserted. One wire was used as a safety wire, while the other wire was used to backload a flexible ureteroscope (fURS; Flex X2, Karl Storz Endoscope, Tuttlingen, Germany), which was advanced over the wire till reaching the stone. Intracorporeal lithotripsy was done by holmium-YAG laser (Auriga XL 50-W holmium laser, Boston Scientific Corp.) using a 200-µm fibre. The laser energy was applied at a setting of 0.5–0.8 J/pulse and frequency of 20 Hz with short pulse duration to achieve stone lithotripsy. Saline was used as the irrigant fluid and manual pressure was sometimes applied by a syringe to obtain clear vision. After complete dusting of the stone the surgeon had to inspect the renal calyces systematically for any sizable residual stone fragment, which was treated by laser lithotripsy. A JJ stent was inserted in all patients at the end of the procedure (5 F, 26 cm, Percuflex; Boston Scientific Corp.).
Pyelonephritis and bacteremia caused by Haemophilus parainfluenzae: case-report of an unusual pathogen
Published in Acta Clinica Belgica, 2021
Louis Nevejan, Truus Goegebuer, Philippe Mast, Ann Lemmens
Eighteen months after the second ureteral reimplantation, the patient presents at the emergency department with pain in the left flank, dysuria and fever (38.1°C). Blood examination reveals leucocytosis (15.15 x 10*3/µL), although barely elevated CRP (5.9 mg/L). Creatinine level is normal (0.93 mg/dL [0.72–1.25 mg/dL]. Blood cultures and a urine sample are taken before the start of antibiotic therapy. Renal ultrasound shows a strongly dilatated renal pelvis left and a ureter with minor renal calyces dilation. The right kidney shows no abnormalities. Microbiological investigation of the urine sample shows pyuria (650.8 leukocytes/µL), bacteriuria (1079.3/µL) and hematuria (398.5 erythrocytes/µL) (UF 500i, Sysmex). Urine dipstick is positive for proteins (++++) and nitrates (Cobas U411, Roche). The patient is diagnosed with early pyelonephritis and sent home with oral ciprofloxacin 500 mg b.i.d. for ten days.
Renal cryoablation: five- and 10-year survival outcomes in patients with biopsy-proven renal cell carcinoma
Published in Scandinavian Journal of Urology, 2020
Tommy Kjærgaard Nielsen, Peter Fisker Vedel, Jens Borgbjerg, Gratien Andersen, Michael Borre
To ensure successful treatment and reduce the risk of serious complications, correct patient selection is crucial. In early experience tumor complexity, including some polar and hilar locations, played a role in tumor selection for the modality. But with increasing experience and the use of fluid or gas infusion under image guidance to displace adjacent viscera most SRM’s can now be treated using PCA. Endophytic tumors with proximity to the renal collecting system are not considered an absolute contraindication, but awareness of the relative warming of the ablation zone by large central vessels is important as more aggressive freezing may be necessary to achieve cryocidal temperatures. In rare cases we have experienced obstruction of renal calyces in relation to treatment of very central tumors. Close attention must be paid to lower pole tumors with close proximity to the ureter, and often we avoid treating these tumors with CA due to the risk of damage to the proximal ureter (urothelial stricture). In general, CA represents an attractive treatment option for patients with von Hippel-Lindau or other inheritable renal tumors owing to the multifocal recurrent nature of their disease. Other indication for CA may include patients with a solitary or transplanted kidney and also recurrence after previous ablation or PN are potential indications for CA. The minimally invasive nature and maximal preservation of renal function are the main advantages of CA.