Prenatal diagnosis and outcomes for fetuses with suspected pelvic kidney

OBJECTIVE

Evaluation of demographic characteristics and postnatal outcomes of patients with suspected fetal pelvic kidney diagnosis followed in a tertiary center.

METHODS

This retrospective study was conducted in Ankara Bilkent City Hospital perinatology clinic between 2020-2023. Demographic features, prenatal ultrasound findings, and postnatal outcomes were reported.

RESULTS

Pelvic kidney localization was on the left in 11(55 %) patients, on the right in 7(35 %), and bilateral in 2(10 %) patients in prenatal ultrasonography. The gender of the 12(60 %) fetuses were male and 8(40 %) of them were female. The pelvic kidney was an isolated finding in 8(40 %) fetuses, additional findings were present in the remaining 12(60 %) fetuses. Pelvic kidney was confirmed postnatally by ultrasound in all 18 fetuses. However two cases with prenatal ultrasound findings resulted in intrauterine fetal demise and the final diagnosis could not be confirmed as the parents refused autopsia. Cases were divided into 3 groups according to postnatal follow-up duration as 0-12 months (n = 7), 12-24 months (n = 7) and 24-44 months (n = 4). Atrial septal defect was the most common accompanying abnormality in the postnatal period (n = 4). Smaller kidney size (n = 7), vesicoureteral reflux (n = 3), and impaired renal function (n = 3) were the most common postnatal complications.

CONCLUSION

Pelvic kidney can be diagnosed in fetal abnormality screening ultrasound and postnatal follow-up should be performed closely for the assessment of renal functions.

Evaluation of differential renal function in children - a comparative study between magnetic resonance urography and dynamic renal scintigraphy

BACKGROUND

Urinary system anomalies, both congenital and acquired, constitute a relatively common clinical problem in children. The main role of diagnostic imaging is to determine early diagnosis and support therapeutic decisions to prevent the development of chronic renal disease. The aim of this study was to evaluate the utility of magnetic resonance urography (MRU) in assessment of urinary system in children, by comparing differential renal function calculated using MRU with dynamic renal scintigraphy (DRS).

MATERIALS AND METHODS

The study group consisted of 46 patients aged 1 week to 17 years (median 7 (0.5; 13) years, 17 (37%) girls, 29 (63%) boys), who underwent dynamic renal scintigraphy due to various clinical reasons. All participants underwent MRU, which was used to measure differential renal function. Functional analysis was performed using dedicated external software (CHOP-fMRU and pMRI without prior knowledge of DRS results. MRU results acquired using pMRI were assessed for inter and intraobserver agreement.

RESULTS

Statistical analysis of the results showed excellent agreement between MRU and DRS in measuring differential renal function with Pearson correlation coefficient 0.987 for CHOP-fMRU and 0.971 for pMRI, p < 0.001. Interclass correlation coefficient (ICC) for these programs was 0.987 (95% CI 0.976-0.993) and 0.969 (95% CI 0.945-0.983) respectively, p < 0.001. The Bland-Altman 95% limits of agreement for CHOP-fMRU results vs. DRS was - 6.29-5.50 p.p. and for pMRI results vs. DRS - 9.15-9.63 p.p. The differential renal function measurements calculated in pMRI showed excellent intraobserver and interobserver agreement with ICC 0.996 (95% CI 0.994-0.998) and 0.992 (95% CI 0.986-0.996) respectively, p < 0.001.

CONCLUSIONS

The study showed no significant differences between magnetic resonance urography and dynamic renal scintigraphy in calculating differential renal function. It indicates high utility of MRU in the evaluation of urinary system in children.

The 15-year national trends of urinary cancers incidence among Iranian men and women; 2005-2020

BACKGROUND

Urinary tract cancers including bladder, kidney, ureter, and pelvis are a common malignancy worldwide with high mortality ratio. Aimed to investigate the prevalence of these cancers, we conducted this study.

METHODS

In this study, all the information related to ICD10 codes, gender, age and province of residence of individuals were obtained from the data of Iran's cancer registry by the Ministry of Health, Medicine and Medical Education and demographic evidence for each sub-country from the reports of Statistics Center of Iran (SCI). Also, the data of two Iranian national survey studies CASPIAN-III, IV, and V (information related to the care and prevention of non-communicable diseases (NCD) in childhood and adolescence) and STEPs (including information on NCD in adults over 18 years old) were used. The data was analyzed using Poisson regression with mixed effects to estimate the incidence of cancers.

RESULTS

Bladder and kidney neoplasm are the most common cancers of the urinary system in Iran. The prevalence of bladder cancer has increased from 5.82 to 11.50 per 100,000 individuals. The increasing trend is growing faster in men compared with women. The incidence of kidney neoplasm has increased over the years (2.03 in 2005 vs. 7.02 in 2020 per 100,000). Having a higher incidence ratio compared with bladder cancer, kidney cancer is responsible for 35.06% of all urinary cancers in 2020 compared with 23.71% in 2005. Both neoplasms of the ureter and renal pelvis were recorded rarely and with lower incidence in both sexes during this period.

CONCLUSION

Considering the increasing trend in the incidence of urinary neoplasms in Iran during these years, the advantage of focusing on the risk of urinary cancers is highlighted. Therefore, investigating the prevalence and incidence of urinary cancers to plan and manage these cancers will result in prevention and reduction of the disease burden on the Iranian society. Future studies in this field can help in the prevention and well-timed diagnosis of these cancers.

Long-term chronic food-derived arsenic exposure induce the urinary system metabolic dysfunction in mice

The consumption of rice contaminated with arsenic on a long-term basis has emerged as a pressing public health issue of global significance. Arsenic-induced urinary injury, particularly kidney damage, has received widespread attention. In this study, mice model under long-term arsenic exposure was established, mouse were exposed to rice arsenic (30 mg/kg) for 14 months. Changes of related metabolites were observed based on kidney metabolomics and lipidomics, and major biomarkers were screened by urine metabolomics. The results showed that phosphatidylethanolamine (PE) was significantly increased and phosphatidycholine (PC) and phosphatidylglycerol (PG) were significantly reduced after arsenic exposure, leading to related downstream lipid metabolism disorders. The metabolic pathways for amino acid and energy were observed to be impacted. In addition, metabolic disorders due to arsenic exposure may be associated with inherited neurometabolic disorders, such as D-2-hydroxyglutaric aciduria (D-2-HGA), and pyruvate carboxylase deficiency (PCD), which is predicted based on significant difference biomarkers (2-oxoglutarate, malic acid, and succinic acid) screened for urine. This study elucidates the mechanism of toxicity in the urinary system induced by arsenic exposure at nearly half life cycle, which furnishes crucial scientific evidence pertaining to the toxicity and risk evaluation associated with chronic exposure to the arsenic.

Cornerstones of CT urography: a shared document by the Italian board of urogenital radiology

CT urography is a single term used to refer to different scanning protocols that can be applied for a number of clinical indications. If, on the one hand, this highlights the role of the radiologist in deciding the most suitable technique to perform according to the patient's needs, on the other hand, a certain confusion may arise due to the different technical and clinical variables that have to be taken into account. This has been well demonstrated by a previous work based on an online questionnaire administered to a population of Italian radiologists that brought out similarities as well as differences across the national country. Defining precise guidelines for each clinical scenario, although desirable, is a difficult task to accomplish, if not even unfeasible. According to the prementioned survey, five relevant topics concerning CT urography have been identified: definition and clinical indications, opacification of the excretory system, techniques, post-processing reconstructions, and radiation dose and utility of dual-energy CT. The aim of this work is to deepen and share knowledge about these main points in order to assist the radiology in the daily practice. Moreover, a synopsis of recommendations agreed by the Italian board of genitourinary imaging is provided.

Inaugurating a novel adjuvant therapy in urological cancers: Ferroptosis

Ferroptosis, a distinctive form of programmed cell death, is involved in numerous diseases with specific characteristics, including certain cell morphology, functions, biochemistry, and genetics, that differ from other forms of programmed cell death, such as apoptosis. Many studies have explored ferroptosis and its associated mechanisms, drugs, and clinical applications in diseases such as kidney injury, stroke, ischemia-reperfusion injury, and prostate cancer. In this review, we summarize the regulatory mechanisms of some ferroptosis inducers, such as enzalutamide and erastin. These are current research focuses and have already been studied extensively. In summary, this review focuses on the use of ferroptosis induction as a therapeutic strategy for treating tumors of the urinary system.

Bladder duplication in infant girls: role of imaging in two rare cases with variants of a complete sagittal septum

Bladder duplication is an extremely rare congenital anomaly of the urinary system that is more frequent in boys; the literature is limited to case reports and case series. We describe two cases of bladder duplication in two infant girls with an uncommon variant of complete sagittal septum not included in the Abrahamson classification. The diagnosis was made using magnetic resonance urography, combining excellent anatomical information and static and dynamic evaluation of the urinary tract. The diagnostic information provided by MR-urography was confirmed on surgical exploration. These cases provide an opportunity for paediatric radiologists and urologists to learn more about bladder duplication and improve their diagnosis of this rare condition.

Application of microfluidic chips in the simulation of the urinary system microenvironment

The urinary system, comprising the kidneys, ureters, bladder, and urethra, has a unique mechanical and fluid microenvironment, which is essential to the urinary system growth and development. Microfluidic models, based on micromachining and tissue engineering technology, can integrate pathophysiological characteristics, maintain cell-cell and cell-extracellular matrix interactions, and accurately simulate the vital characteristics of human tissue microenvironments. Additionally, these models facilitate improved visualization and integration and meet the requirements of the laminar flow environment of the urinary system. However, several challenges continue to impede the development of a tissue microenvironment with controllable conditions closely resemble physiological conditions. In this review, we describe the biochemical and physical microenvironment of the urinary system and explore the feasibility of microfluidic technology in simulating the urinary microenvironment and pathophysiological characteristics in vitro. Moreover, we summarize the current research progress on adapting microfluidic chips for constructing the urinary microenvironment. Finally, we discuss the current challenges and suggest directions for future development and application of microfluidic technology in constructing the urinary microenvironment in vitro.

Urinary involvement in Erdheim-Chester disease: computed tomography imaging findings

PURPOSE

To describe the urological manifestations of Erdheim-Chester disease (ECD) and their computed tomography (CT) findings.

METHODS

We retrospectively reviewed 48 patients diagnosed with ECD at Peking Union Medical College Hospital from January 2014 to January 2020. Twenty-four patients exhibited urological manifestations. Their CT findings, including appearances of the involved area (e.g., perirenal space, renal sinus, ureters, renal arteries, and adrenal glands), occurrence rate of ECD involvement in each area, signal enhancement pattern after CT contrast agent administration, disease progression, and causes of hydronephrosis were discussed.

RESULTS

In 24 patients with evidence of ECD urological involvement, the most common manifestation was perirenal infiltration, appearing as "hairy kidney" on unenhanced CT scans and moderate signal enhancement on enhanced CT scans (17/24, 70.8%). Other manifestations included renal sinus infiltration (16/24, 66.7%), proximal ureter involvement (14, 58.3%), renal artery sheath (10, 41.7%), hydronephrosis (14, 58.3%), and adrenal glands involvement (8, 33.3%). The histiocytic infiltrate was mostly bilateral, starting from the perirenal space and spreading to the renal sinus and ureters. Hydronephrosis was usually associated with infiltration of ureters.

CONCLUSION

Kidneys are the most common visceral organs affected by ECD. CT scanning is not only advantageous in early diagnosis, but also critical for designing the treatment regime for patients with ECD.

Investigation of a novel brachytherapy ureteral stent: trial studies on normal beagle dogs

PURPOSE

To evaluate the safety and feasibility of a newly designed ¹²⁵I brachytherapy ureteral stent (BUS) in normal dogs.

METHODS

A BUS loaded with 10 ¹²⁵I seeds (Group A: 0.8 mCi, Group B: 0.4 mCi, Group C: 0 mCi) was designed and tested in 27 normal beagle dogs. Routine blood tests, gross observations, cumulative radiation doses, tissue reaction assessed by hematoxylin-eosin/Masson staining, mRNA analysis by RT-qPCR and protein expression of Caspase-3, Collagen I, PCNA, and α-SMA were performed at 2, 4 and 8 weeks.

RESULTS

The BUS was implanted successfully in all dogs (27/27) without surgery-related death. The ureter diameter and radiation injury score increased along with radiation accumulation (p < 0.05). Histopathologic analysis showed necrotic tissue and lateral fibrosis to different extents in the ureteral walls that gradually increased in all groups (p < 0.05); however, epithelial cell proliferation in groups A and B was lighter than that in the control group (p < 0.05).

CONCLUSION

Placement of the newly designed ¹²⁵I BUS was safe and feasible in dogs, and clinical studies are required to test its use in humans.

Inflammatory Myofibroblastic Tumor of the Urinary System on Computed Tomography at a High-Volume Institution in China

OBJECTIVE

Inflammatory myofibroblastic tumors (IMTs) of the urinary system are relatively rare and often misdiagnosed. We aimed to summarize and analyze the clinical manifestations, imaging features, management, and follow-up of renal and bladder IMTs.

METHODS

In this retrospective study, 22 patients with IMT pathologically verified between 2009 and 2018 were included. Epidemiologic, clinical, pathologic, and imaging findings were recorded. Tumor size, location, and shape were analyzed and summarized.

RESULTS

There were 22 patients with a median age of 45 years (range: 20-74), including 14 patients with renal IMT and 8 patients with bladder IMT, who met the eligibility criteria. In 21 patients, IMT appeared as a single lesion, whereas 1 patient showed bilateral renal lesions. Surgical resection was the sole therapy, and follow-up information was acquired from 13 individuals with no evidence of recurrence or metastasis. In our study, a slightly hypodense or isodense homogeneous tumor with a clear boundary was more often seen. On contrast-enhanced computed tomography (CT), they were often manifesting as a slightly heterogeneous enhancement.

CONCLUSIONS

The nature of IMTs might cause a lack of generalizability. However, it will be useful to know that there are various CT demonstrations of IMTs. CT images are useful for the detection, location, and characterization of urinary IMTs, which can help in better clinical decision-making and can also be an optimal imaging technique for follow-up.

Construction and application of urinary system model with functional bladder module

In order to study the construction and application of urinary system model with functional bladder module, bladder model was designed, and appropriate materials was selected to make it, and its performance was studied. The results showed that in the analysis of pressure performance of bladder model, more detrusor instability was found in the model than in the urodynamic test, and there was significant statistical difference (P < 0.01). In the analysis of bladder safety capacity, it was found that the bladder safety capacity in the model was much larger than that measured by urodynamics, and there was significant statistical difference (P < 0.01). In the analysis of detrusor workmanship and contraction rate, it was found that the normal model group was significantly smaller than the obstruction group, and there was significant statistical difference (P < 0.01). Comparing the detrusor contraction rate of the two groups, it was found that the normal group and the obstruction group had significant difference at t3, and there was no statistical difference between the other two groups. Therefore, through this study, it is found that the understanding of urinary system can be enhanced by building bladder model, and the basic operating skills of medical staff can be improved more easily by using bladder model, which achieves the expected results of the experiment. Although some shortcomings have been found in the course of the study, it still provides experimental reference for the clinical study of bladder in the future.

[Cancers of urinary system, prevalence, demographic]

BACKGROUND

The aim of this study was to clarify period prevalence (PP) and incidence associated to urinary system cancers in Isfahan Province/Iran.

METHOD

s: Data from 2011 to 2015 was obtained from the Isfahan Cancer Registry. The location of cancers was distinguished by the related established topography code (C64-C68). Period prevalence (PP) was calculated and expressed per 100000 persons.

RESULTS

There were 2117 patients with urinary system cancers. The mean age +/- SD was 63.6+/-14.9 years old, that in 62% ranged between 20 and 70 years old. For total population the PP was calculated as 42. 5 per 100000 persons. This value was corresponded to PP of 66.4 for males and 17.9 for females (p<0.001). The total PP was corresponded to values of 33.2 for bladder, 8.1 for kidney, 0.42 for renal pelvis, 0.36 for ureter and 0.38 for other unspecified related organs. Of these populations the estimated living cases corresponded to the 368 females and 1513 males.

CONCLUSION

The PP for urinary system cancers in male population was 3.7 times higher than females. There was a 23.2% increase in the Irs over the study period. These findings highlighted the advantage of further strategy base-research toward pharmacotherapy and surgery management of such patients.

Ortholinea scatophagi (Myxosporea: Ortholineidae), a novel myxosporean infecting the spotted scat, Scatophagus argus (Linnaeus 1766) from southwest coast of India

A new species of myxosporean, Ortholinea scatophagi n. sp. infecting the urinary bladder of the spotted scat, Scatophagus argus (Linnaeus 1766) is described. O. scatophagi n. sp. is characterized by spherical myxospores with a slightly flattened anterior end and equal spore valves with extra sutural ridges on its surface; measured 7.34 ± 0.67 μm in length, 6.90 ± 0.71 μm in width and 6.48 ± 0.37 μm in thickness. Two polar capsules, equal, spherical to oval in shape, arranged diametrically opposite and measured 2.59 ± 0.42 μm in length and 2.24 ± 0.35 μm in width. Polar filaments, 21.84 ± 2.86 μm long, with four to five coils. Scanning electron microscopy revealed the presence of extra sutural ridges on spore surface. Pansporoblasts spherical to irregular in shape, measured 31.08 ± 2.67 μm in length and 13.88 ± 5.40 μm in width; Monosporic, disporic and polysporic plasmodial stages were observed; plasmodia spherical or irregular in shape with granular cytoplasm containing refractile granules. The species was compared with 23 existing nominal species of Ortholinea, based on morphology and morphometry. Molecular analysis resulted in a 1773 bp long SSU rDNA sequence (GenBank accession number MN 310514). In phylogenetic analyses the present parasite clustered with other members of Ortholinea, under the freshwater urinary clade. Considering the morphologic, morphometric and molecular differences with previously described species of Ortholinea, and differences in host and geographic locations, the present species is treated as new and the name Ortholinea scatophagi n. sp.is proposed.

Host-parasite relationship of Ortholinea lauquen sp. nov. (Cnidaria: Myxozoa) and the fish Galaxias maculatus in northwestern Patagonia, Argentina

Galaxias maculatus (Jenyns, 1842) is a widespread freshwater fish and an important component of the economically important whitebait fisheries across the Southern Hemisphere. We report a new myxosporean parasite (Cnidaria: Myxozoa) infecting the kidney of G. maculatus from northwestern Patagonia (Argentina). Ortholinea lauquen sp. nov. was characterized using myxospore morphology, morphometrics and small subunit rDNA (ssrDNA) sequence data. Our ssrDNA phylogenetic analyses showed that O. lauquen sp. nov. is a member of the oligochaete-freshwater urinary tract clade and basal to a clade containing 4 different spore morphotypes (Chloromyxum, Myxidium, Zschokkella, Hoferellus). We explored host-parasite relationships at the macro- and microscale by analyzing the distribution, tissue tropism and pathology of O. lauquen sp. nov. Prevalence was relatively low (7%) by microscopy, but PCR detection revealed hidden levels of infection (49%), with the highest detection in lakes Morenito and Moreno (63-90%, Río Negro Province). The only locality negative by both microscopy and PCR was the Caleufu River (Neuquén Province), suggesting differences in fish life history traits (landlocked vs. potamodromous) or preference of the putative obligate invertebrate host for lentic habitats. O. lauquen sp. nov. sporulates in the renal tubules and occasionally in the glomerular space. The plasmodia frequently occluded the tubule lumina, and cellular necrosis and disintegration of the epithelium were observed. O. lauquen sp. nov. could represent a potential threat to G. maculatus culture under intensive farming conditions.

The association between ethnic background and prostate cancer

Prostate cancer is a complex disease which is more prevalent among men of black and minority ethnic (BME) background than their Caucasian counterparts, with men of African-Caribbean background experiencing higher levels of incidence and mortality than any other ethnic group. The reasons behind this health inequality are poorly understood and likely to be multifactorial. Several theories have been posited, including genetic disposition, poorer access to health care, a lack of understanding of the risks posed by prostate cancer and an unwillingness to access mainstream health care. There is, however, a notable disparity between the amount of literature focusing on prostate cancer as it affects those with a BME background and on prostate cancer in general. This further compounds the difficulties encountered by BME men, who rely on health professionals being aware of the greater risk they face. More knowledge and understanding is required by both the general population and medical practitioners to address this health inequality.

The probability of re-treatment after discontinuation of a 3-month versus a 6-month course of solifenacin for female overactive bladder: A prospective randomized controlled study

OBJECTIVES

The aim of this study is to compare the re-treatment probabilities after a 3-month versus a 6-month course of antimuscarinic treatment for women with overactive bladder syndrome (OAB).

STUDY DESIGN

A prospective randomized controlled study.

MAIN OUTCOME MEASURES

Between-group differences in the probability of re-treatment for OAB between the 3-month and 6-month groups.

METHODS

Women with OAB were randomly allocated to receive solifenacin (5 mg per day) for a treatment interval of either 3 or 6 months.

RESULTS

Ninety-one patients were treated in each group. The probability of re-treatment did not differ between the 3-month and 6-month groups (P = 0.11). Parity (hazard ratio = 1.81, P = 0.001), number of incontinence episodes (hazard ratio = 1.09, P = 0.008) and suboptimal response (hazard ratio = 3.56, P = 0.006) were independent predictors of re-treatment of OAB. Physical limitation, as indicated on the King's Health Questionnaire, was the only independent factor predicting completion of the scheduled treatment period (odds ratio = 1.01, P = 0.008).

CONCLUSIONS

Prolonged antimuscarinic treatment does not decrease the need for re-treatment of OAB. Nonetheless, female patients with increased parity, more severe incontinence and a suboptimal response to antimuscarinic treatment are more likely to seek re-treatment of OAB due to recurrence of symptoms. In addition, patients with more serious physical limitation related to OAB are more likely to complete the scheduled treatment period. These findings could serve as a guide in clinical consultations regarding antimuscarinic treatment and if taken into consideration in future studies could lower the dropout rate.

Morphological and molecular characterization of Chloromyxum argusi n. sp. (Myxosporea) infecting the urinary bladder of Scatophagus argus Linnaeus 1766 (Scatophagidae) from the southwest coast of India

The present paper describes a new species of Chloromyxum infecting the urinary bladder of the estuarine fish, Scatophagus argus, from the southwest coast of India. The parasite exhibited an overall prevalence of 41.93%; the prevalence is influenced by host size and seasons. Mature spores are subspherical, measure 9.40 ± 0.66 by 9.32 ± 0.87 μm, and are characterized by the presence of sutural and extra-sutural ridges, binucleated sporoplasm, and a pair of caudal extensions. Four pyriform, unequal polar capsules with raised polar filament discharge pores and ribbon-like polar filaments are present. Polar filament coils numbered four to five in large polar capsules and three in small polar capsules. Pansporoblast is irregular with granulated cytoplasm and has fine villosites on its surface. Plasmodia are spherical/irregular with monosporic and polysporic forms. In molecular and phylogenetic analysis, the myxosporean stands out with a high bootstrap value and was positioned as a sister branch of Chloromyxum kurisi. In view of the morphologic, morphometric, and molecular differences with the existing species of Chloromyxum, and considering the differences in hosts and geographic locations, the present species is treated as new and the name Chloromyxum argusi n. sp. is proposed.

Secondary Tumors of the Urinary System: An Imaging Conundrum

Imaging features of metastases to the urinary system may closely mimic primary urinary tract tumors, and differential diagnosis by imaging alone may be problematic or even impossible in some cases. The main purpose of this article was to familiarize radiologists with imaging findings of metastasis to the urinary system on cross-sectional imaging, with an emphasis on abdominal and pelvic computed tomography and magnetic resonance imaging. In addition, we review the clinical importance and implications of metastases to the urinary tract and provide information on diagnostic work-ups.

T-Box Genes in the Kidney and Urinary Tract

T-box (Tbx) genes encode an ancient group of transcription factors that play important roles in patterning, specification, proliferation, and differentiation programs in vertebrate organogenesis. This is testified by severe organ malformation syndromes in mice homozygous for engineered null alleles of specific T-box genes and by the large number of human inherited organ-specific diseases that have been linked to mutations in these genes. One of the organ systems that has not been associated with loss of specific T-box gene function in human disease for long is the excretory system. However, this has changed with the finding that mutations in TBX18, a member of a vertebrate-specific subgroup within the Tbx1-subfamily of T-box transcription factor genes, cause congenital anomalies of the kidney and urinary tract, predominantly hydroureter and ureteropelvic junction obstruction. Gene expression analyses, loss-of-function studies, and lineage tracing in the mouse suggest a primary role for this transcription factor in specifying the ureteric mesenchyme in the common anlage of the kidney, the ureter, and the bladder. We review the function of Tbx18 in ureterogenesis and discuss the body of evidence that Tbx18 and other members of the T-box gene family, namely, Tbx1, Tbx2, Tbx3, and Tbx20, play additional roles in development and homeostasis of other components of the excretory system in vertebrates.

Endourological treatment of foreign bodies in the urinary system

Background and Objectives:

In this retrospective study, nature, clinical presentations, diagnostic modalities, and endoscopic treatment of urinary system foreign bodies were evaluated.

Methods:

A total of 8 cases were treated with endoscopic surgery between February 15, 2007 and June 12, 2012. Clinical findings, radiologic diagnosis, and management were reviewed.

Results:

We observed that urinary tract foreign bodies were generally secondary to iatrogenic causes; however, bladder/urethral foreign bodies could also be due to self-insertion. Clinical findings were different secondary to their location in the urinary system. All foreign bodies were treated endoscopically.

Conclusions:

Foreign bodies of the urinary system can successfully be treated with endoscopic modalities without any complications.

Bladder Endometriosis Mimicking TCC - A Case Report

Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings.

Pediatric clinical pathology

This article provides clinically relevant and applicable information about normal biochemical values in puppies and kittens younger than 6 months, and is intended to provide practical guidelines for the interpretation of serum biochemical results in these young animals. At present there are no published sets of normal hematologic reference ranges for mixed-breed puppies and kittens younger than 6 months. Reference-value sets for closed research colonies composed of a few selected breeds are available, which help to provide insight into trends in normal hematologic and biochemical values for puppies and kittens.

Urinary tract disease in dogs: US findings. A mini-pictorial essay

Ultrasound (US) is the most commonly used imaging method for studying urinary tract disorders in dogs, as it is easy to perform, inexpensive and provides excellent contrast resolution in real-time. However, US examination of dogs presents a series of technical difficulties, and the US operator must therefore have a longstanding experience and access to high-quality equipment including a range of different probes to achieve a correct diagnosis. The aim of this mini-pictorial essay is to describe US findings and patterns which permit identification of the most common pathologies of the urinary tract in dogs. The technical difficulties that may be encountered are also evaluated as well as integration with other imaging modalities (traditional X-ray, computed tomography, magnetic resonance imaging).

Systemic lupus erythematosus with gastrointestinal symptoms as the first manifestation: A case report

Systemic lupus erythematosus (SLE) presenting with gastrointestinal symptoms is rare, and SLE with gastrointestinal symptoms as the first manifestation is an even rarer condition. Here we report a case of SLE with gastrointestinal symptoms as the first manifestation in a 28-years-old woman. She developed abdominal pain, diarrhea, nausea and vomiting about a month ago. An abdominal CT scan demonstrated intestinal obstruction, ascites and marked edematous thickening of the bowel wall, which appeared as "target sign", "double-track sign" and "comb-like sign". Laboratory tests showed that her serum complement levels decreased and that she was positive for anti-nRNP/Sm antibodies, anti-Sm antibodies, anti-SS-A antibody, and antinuclear antibodies. Treatmen consisting of high dose glucocorticoids and cyclophosphamide led to rapid remission of both digestive tract and urinary tract symptoms.