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Çilesiz NC, Onuk Ö, Özkan A, Kalkanlı A, Gezmiş CT, Nuhoĝlu B. Four-Point Injection Technique of Polyacrylate/Polyalcohol Copolymer in Vesicoureteral Reflux After KidneyTransplant. EXP CLIN TRANSPLANT 2023; 21:434-440. [PMID: 37073991 DOI: 10.6002/ect.2022.0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVES Vesicoureteral reflux after kidney transplant is mostly asymptomatic, but recurrent urinary tract infections can cause graft rejection. Although the gold standard treatment is open surgical repair, we believe that endoscopic treatment can be further improved. Here, we investigated the long-term outcomes of 4-point endoscopic injection of polyacrylate/polyalcohol copolymer in patients with vesicoureteral reflux after kidney transplant. MATERIALS AND METHODS Patients who had undergone 4-point endoscopic injectionofpolyacrylate/polyalcohol copolymer for symptomatic vesicoureteral reflux after kidney transplant and were followed for atleast 3 years were included. Patients with dysfunctional and/or obstructive voiding patterns, unsuccessful primary endoscopic treatment, concomitant injection of native kidney reflux, and incomplete follow-up were excluded. We evaluated patient characteristics, perioperative data, and clinical and radiological outcomes. Urine culture, serum creatinine, and renal ultrasonography were assessed every 3 months. Voiding cystourethrography was performed at month 3 and when recurrence was suspected. Clinical success was defined as absence of febrile urinary tract infection during follow-up, and radiological success was defined as absence of vesicoureteral reflux in the voiding cystourethrography. RESULTS Of 21 study patients, 14 (66.6%) were female and 7 (33.3%) were male patients. Average age was 37.1 years (range, 12-62 years). According to preoperative voiding cystourethrography, 3 patients (14.2%) had grade II, 13 patients (61.9%) had grade III, and 5 patients (23.8%) had grade IV vesicoureteral reflux. Eighteen patients (85.7%) had clinical success with the first injection, and 20 patients (95.2%) had success with the second injection. Eleven patients (52.3%) demonstrated radiological success. The reflux degree of all patients, except 2, had partially or completely regressed. Ureteral balloon dilatation and double J stent implantation was performed in 1 patient (4.7%) due to ureteral obstruction. CONCLUSIONS The 4-point injection of polyacrylate/- polyalcohol copolymer provided long-term permanent success for symptomatic vesicoureteral reflux after kidney transplant.
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Bristow TF, Grotzinger JP, Rampe EB, Cuadros J, Chipera SJ, Downs GW, Fedo CM, Frydenvang J, McAdam AC, Morris RV, Achilles CN, Blake DF, Castle N, Craig P, Des Marais DJ, Downs RT, Hazen RM, Ming DW, Morrison SM, Thorpe MT, Treiman AH, Tu V, Vaniman DT, Yen AS, Gellert R, Mahaffy PR, Wiens RC, Bryk AB, Bennett KA, Fox VK, Millken RE, Fraeman AA, Vasavada AR. Brine-driven destruction of clay minerals in Gale crater, Mars. Science 2021; 373:198-204. [PMID: 34244410 DOI: 10.1126/science.abg5449] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/28/2021] [Indexed: 11/02/2022]
Abstract
Mars' sedimentary rock record preserves information on geological (and potential astrobiological) processes that occurred on the planet billions of years ago. The Curiosity rover is exploring the lower reaches of Mount Sharp, in Gale crater on Mars. A traverse from Vera Rubin ridge to Glen Torridon has allowed Curiosity to examine a lateral transect of rock strata laid down in a martian lake ~3.5 billion years ago. We report spatial differences in the mineralogy of time-equivalent sedimentary rocks <400 meters apart. These differences indicate localized infiltration of silica-poor brines, generated during deposition of overlying magnesium sulfate-bearing strata. We propose that destabilization of silicate minerals driven by silica-poor brines (rarely observed on Earth) was widespread on ancient Mars, because sulfate deposits are globally distributed.
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Affiliation(s)
- T F Bristow
- Eobiology Branch, NASA Ames Research Center, Moffett Field, CA 94035, USA.
| | - J P Grotzinger
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - E B Rampe
- Astromaterials Research and Exploration Science Division, NASA Johnson Space Center, Houston, TX 77058, USA
| | - J Cuadros
- Department of Earth Sciences, Natural History Museum, London SW7 5BD, UK
| | - S J Chipera
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - G W Downs
- Department of Geosciences, University of Arizona, Tucson, AZ 85721, USA
| | - C M Fedo
- Department of Earth and Planetary Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - J Frydenvang
- Globe Institute, University of Copenhagen, Copenhagen, Denmark
| | - A C McAdam
- Solar System Exploration Division, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - R V Morris
- Astromaterials Research and Exploration Science Division, NASA Johnson Space Center, Houston, TX 77058, USA
| | - C N Achilles
- Solar System Exploration Division, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D F Blake
- Eobiology Branch, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - N Castle
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - P Craig
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - D J Des Marais
- Eobiology Branch, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - R T Downs
- Department of Geosciences, University of Arizona, Tucson, AZ 85721, USA
| | - R M Hazen
- Earth and Planets Laboratory, Carnegie Institution for Science, Washington, DC 20015, USA
| | - D W Ming
- Astromaterials Research and Exploration Science Division, NASA Johnson Space Center, Houston, TX 77058, USA
| | - S M Morrison
- Earth and Planets Laboratory, Carnegie Institution for Science, Washington, DC 20015, USA
| | - M T Thorpe
- Jacobs Technology-Jacobs JETS Contract, Astromaterials Research and Exploration Science Division, at NASA Johnson Space Center, Houston, TX 77058, USA
| | - A H Treiman
- Lunar and Planetary Institute, Universities Space Research Association, Houston, TX 77058, USA
| | - V Tu
- Jacobs Technology-Jacobs JETS Contract, Astromaterials Research and Exploration Science Division, at NASA Johnson Space Center, Houston, TX 77058, USA
| | - D T Vaniman
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - A S Yen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - R Gellert
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - P R Mahaffy
- Solar System Exploration Division, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - R C Wiens
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - A B Bryk
- Department of Earth and Planetary Science, University of California Berkeley, Berkeley, CA 94720, USA
| | - K A Bennett
- U.S. Geological Survey, Astrogeology Science Center, Flagstaff, AZ 86001, USA
| | - V K Fox
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - R E Millken
- Department of Earth, Environmental Sciences and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - A A Fraeman
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A R Vasavada
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
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