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Renal Vein (renal + vein)
Kinds of Renal Vein Terms modified by Renal Vein Selected AbstractsGASTRIC FUNDIC VARICES: HEMODYNAMICS AND NON-SURGICAL TREATMENTDIGESTIVE ENDOSCOPY, Issue 3 2005Seishu Hayashi The hemodynamics and non-surgical treatment of gastric fundic varices (FV) are reviewed. FV are more frequently supplied by the short and posterior gastric veins than esophageal varices (EV), and are formed mostly by large spontaneous shunts in which the gastric or splenic vein is continuous with the left renal vein via the inferior phrenic veins and the suprarenal vein (so-called gastric-renal shunt). Concomitant collaterals such as EV, para-esophageal vein, and para-umbilical vein were also observed in nearly 60% of FV. Endoscopic injection sclerotherapy (EIS) with Histoacryl is thought to be the most approved treatment for hemorrhage from FV, but repeated treatment for residual FV and care for ensuing hepatic failure are required. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a notable interventional radiological procedure specially developed for the elective or prophylactic treatment of FV. If the procedure is technically successful, long-term eradication of treated FV is found in most patients without recurrence. B-RTO includes another significance, obliteration of the unified portal-systemic shunt. Follow-up abdominal CT scan revealed a high incidence of long-term obliteration of the gastric-renal shunt after B-RTO. Benefits such as elevation of serum albumin, improvement in 15-min retention rate of indocyanine green, decrease in blood ammonia levels, and improvement of encephalopathy are sometimes observed. [source] Renal cell carcinoma with a huge solitary metastasis to the contralateral adrenal gland: A case reportINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2008Takanobu Utsumi Abstract Renal cell carcinoma (RCC) is capable of metastasizing to several organs. Synchronous isolated contralateral adrenal metastasis of the primary RCC is, however, very rare. Herein we report a case of RCC with a huge solitary metastasis to the contralateral adrenal gland that was surgically treated. We scheduled nephrectomy for the left primary RCC and adrenalectomy for the right adrenal tumor. However, at surgery we found a huge right adrenal tumor that had invaded the right kidney, right renal vein, and inferior vena cava. Therefore right nephrectomy was performed simultaneously with resection and reconstruction of the inferior vena cava. Pathological findings demonstrated that the left renal tumor and right adrenal tumor had the same histology. Although the patient required hemodialysis, he remains well at six months postoperatively. So far, there have been only two cases of a solitary contralateral metastatic adrenal tumor that was larger than the primary RCC, thus the present case is the third one. [source] Intravenous extended liposarcoma arising from renal sinusINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2007Mabumi Matsushita Abstract: Liposarcoma arising from the renal sinus is rare and there have been no reports of intravenous extended liposarcoma of the renal sinus thus far. We report a case of liposarcoma of the renal sinus that extended into the renal venous lumen. A 58-year-old woman was referred to our hospital for an intravascular fatty tumor of the right renal vein incidentally discovered by an abdominal screening ultrasonogram. Computer tomography revealed a fatty tumor extending from the right kidney to the right renal vein with no evidence of metastatic lesions. Total right nephrectomy and extirpation of the intravascular tumor of the right renal vein were carried out. Pathological findings showed well-differentiated liposarcoma of the renal sinus. The tumor invaded to the right renal vein and the renal parenchyma. [source] Control of the large renal vein in limited dissected space during laparoscopic nephrectomy: A simple and reliable methodINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2006KITTINUT KIJVIKAI Abstract, We describe our technique for large renal vein control in the limited dissected space during laparoscopic nephrectomy. This technique is a simple, inexpensive and reliable method, especially for large and short renal vein ligation. [source] Solitary floating vena caval thrombus as a late recurrence of renal cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2004ANDREA MINERVINI Abstract We report an unusual case of solitary thrombus floating in the inferior vena cava (IVC) in a patient who underwent radical nephrectomy for a renal cell carcinoma (RCC) of the right kidney extended into the renal vein with no capsular and perinephric tissue invasion (pT3b). Twenty months after surgery, a routine computed tomography scan identified an intraluminal mass floating in the IVC. Cavotomy and thrombectomy with no caval resection were successfully performed. A review of the literature showed only three previous published cases of RCC recurring in the IVC only, with no local recurrence or distant metastases. We outline the possible etiology of these unusual and solitary recurrences in the IVC and we emphasize the need for a strict surveillance for all patients with RCC and especially for those with pT1b, pT2 and pT3 disease. An early diagnosis of this rare recurrence can permit an easy removal of the thrombus with no caval resection and graft replacement, making this disease potentially curable by surgery. [source] Draining of a retroaortic left renal vein via the ,subcentral veins' into the inferior vena cavaJOURNAL OF ANATOMY, Issue 5 2001V. MACCHI No abstract is available for this article. [source] Inferior Vena Cava Percentage Collapse During Respiration Is Affected by the Sampling Location: An Ultrasound Study in Healthy VolunteersACADEMIC EMERGENCY MEDICINE, Issue 1 2010David J. Wallace MD Abstract Objectives:, Physicians are unable to reliably determine intravascular volume status through the clinical examination. Respiratory variation in the diameter of the inferior vena cava (IVC) has been investigated as a noninvasive marker of intravascular volume status; however, there has been a lack of standardization across investigations. The authors evaluated three locations along the IVC to determine if there is clinical equivalence of the respiratory percent collapse at these sites. The objective of this study was to determine the importance of location when measuring the IVC diameter during quiet respiration. Methods:, Measurements of the IVC were obtained during quiet passive respiration in supine healthy volunteers. All images were recorded in B-mode, with cine-loop adjustments in real time, to ensure that maximum and minimum IVC dimensions were obtained. One-way repeated-measures analysis of variance (ANOVA) was used for comparison of IVC measurement sites. Results:, The mean (±SD) percentage collapse was 20% (±16%) at the level of the diaphragm, 30% (±21%) at the level of the hepatic vein inlet, and 35% (±22%) at the level of the left renal vein. ANOVA revealed a significant overall effect for location of measurement, with F(2,35) = 6.00 and p = 0.006. Contrasts showed that the diaphragm percentage collapse was significantly smaller than the hepatic (F(1,36) = 5.14; p = 0.03) or renal caval index (F(1,36) = 11.85; p = 0.002). Conclusions:, Measurements of respiratory variation in IVC collapse in healthy volunteers are equivalent at the level of the left renal vein and at 2 cm caudal to the hepatic vein inlet. Measurements taken at the junction of the right atrium and IVC are not equivalent to the other sites; clinicians should avoid measuring percentage collapse of the IVC at this location. ACADEMIC EMERGENCY MEDICINE 2010; 17:96,99 © 2009 by the Society for Academic Emergency Medicine [source] Ultrarapid nonsuture mated cuff technique for renal transplantation in rabbitsMICROSURGERY, Issue 4 2003Jun Wu M.D., Ph.D. An effective and ultrarapid technique for kidney transplantation in the rabbit is introduced. Vascular anastomosis was completed using a novel cuff technique in which mating cuffs were used to join the delicate renal vein. The ureter was reconstructed by spatulated end-to-end anastomosis, with special attention to the rabbit's unique ureteral vascular anatomy. The total vascular anastomosis time was 3.4 ± 1.3 min, and there were no episodes of bleeding or thrombosis. The ureter complication rate was 7.3%. Kidneys transplanted after 5 h of cold storage using the new technique yielded better postoperative creatinine results than similar preserved kidneys transplanted using previously described methods. We suggest this technique for studies of long- and short-term kidney preservation and transplantation in the rabbit, as well as for veterinary transplantation in which donor kidneys must be stored for only a short time before use. © 2003 Wiley-Liss, Inc. MICROSURGERY 23:369,373 2003 [source] Early phase of reperfusion of human kidney allograft does not affect an erythrocyte anti-oxidative systemNEPHROLOGY, Issue 5 2006LESZEK DOMA SUMMARY: Background: Generation of reactive oxygen specimens is the basic mechanism leading to ischaemia/reperfusion injury of the kidney graft. Oxygen burst is a trigger for sophisticated biochemical changes leading to generation of oxygenated lipids and changes in microcirculation, which recruit recipient's neutrophils and contribute to delayed graft function. It has been shown that the free radicals generation correlates with the activity of anti-oxidative system. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione (GSH) are involved in protection against free radicals. Aim: To examine the activity of erythrocyte anti-oxidative system during reperfusion of the transplanted kidney allograft. Methods: The study included 40 renal transplant recipients. Blood was taken from the iliac vein before transplantation and from the graft's renal vein immediately, as well as 2 and 4 min after total reperfusion. The authors assessed the process of reperfusion using ThermaCAM SC500 termovision camera. Spectrophotometric methods were used to measure superoxide dismutase, glutathione peroxidase and catalase activity as well as glutathione concentrations in erythrocytes. Results: There were no statistically significant differences in the activities of superoxide dismutase, catalase and glutathione peroxidase as well as glutathione concentrations during the first 4 min after total graft reperfusion. Nevertheless, there was a positive correlation between the activity of superoxide dismutase and glutathione peroxidase. Conclusion: The results suggest that the erythrocyte anti-oxidative system is stable during the early phase after reperfusion. An association between some anti-oxidative enzymes was noted. [source] Successful adult-to-child renal transplantation utilizing the ovarian vein in children with inferior vena cava/iliac vein thrombosisPEDIATRIC TRANSPLANTATION, Issue 6 2010Ran Tao Tao R, Shapiro R. Successful adult-to-child renal transplantation utilizing the ovarian vein in children with inferior vena cava/iliac vein thrombosis. Pediatr Transplantation 2010: 14:E70,E74. © 2009 John Wiley & Sons A/S. Abstract:, IVC/iliac vein thrombosis has previously been considered to be a contraindication to renal transplantation because of the technical difficulties and the increased risk of graft thrombosis. We report two successful cases of adult-to-child kidney transplantation in which we anastomosed the graft renal vein to the recipient ovarian vein in the presence of IVC and/or iliac vein thrombosis, with no short or long term vascular complications. Our experience, which adds to the successful reports from several other centers, suggests that the inability to use the iliocaval axis should no longer be considered a contraindication to pediatric renal transplantation. [source] Technical Aspects of Unilateral Dual Kidney Transplantation from Expanded Criteria Donors: Experience of 100 PatientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010B. Ekser One option for using organs from donors with a suboptimal nephron mass, e.g. expanded criteria donors (ECD) kidneys, is dual kidney transplantation (DKT). In adult recipients, DKT can be carried out by several techniques, but the unilateral placement of both kidneys (UDKT) offers the advantages of single surgical access and shorter operating time. One hundred UDKT were performed using kidneys from ECD donors with a mean age of 72 years (Group 1). The technique consists of transplanting both kidneys extraperitoneally in the same iliac fossa. The results were compared with a cohort of single kidney transplants (SKT) performed with the same selection criteria in the same study period (Group 2, n = 73). Ninety-five percent of UDKTs were positioned in the right iliac fossa, lengthening the right renal vein with an inferior vena cava patch. In 69% of cases, all anastomoses were to the external iliac vessels end-to-side. Surgical complications were comparable in both groups. At 3-year follow-up, patient and graft survival rates were 95.6 and 90.9% in Group 1, respectively. UDKT can be carried out with comparable surgical complication rates as SKT, leaving the contralateral iliac fossa untouched and giving elderly recipients a better chance of receiving a transplant, with optimal results up to 3-years follow-up. [source] Successful Urgent Transplantation of an Adult Kidney into a Child with Inferior Vena Cava ThrombosisAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2009R. B. Stevens Poor venous drainage options following inferior vena cava (IVC) thrombosis have been considered to complicate or preclude renal transplantation of adult kidneys into pediatric patients. We describe urgent renal transplantation in a 5-year-old (15.3 kg) male with IVC thrombosis using an adult living donor. Preoperative magnetic resonance venography revealed a patent infrahepatic/suprarenal vena cava and portal system. In surgery, the right liver lobe was mobilized sufficiently to anastomose the graft renal vein to the native IVC at the confluence of the native left renal vein and proximal vena cava. Graft function has remained excellent with serum creatinine of 0.5 mg/dL at 36 months. IVC thrombosis need not preclude successful transplantation of adult-sized kidneys into children. [source] A new experimental inbred Wistar rat varicocele model: anatomy of the left spermatic vein and the effect on histologyANDROLOGIA, Issue 1 2008Y. Zhang Summary Because of venous anatomical differences between rats and humans and the personal interpretation of these differences, there is neither consistent animal prototype nor consistent results in the study of varicocele. We established a new substrain of Wistar inbred rats, of which the left testis vein has no significant branches to the common iliac vein up pampiniform plexus, but instead enters the left renal vein directly (similar to humans) and used them to create experimental varicocele model by partial ligation of the left renal vein. One month later, the predominant lesion of the left testis in induced group was spermatogenic arrest at the spermatid and preliminary spermatocyte phases, and considerable interstitial and Sertoli cell vacuolation. The right testis also showed spermatogenic arrest. Most important, the characteristics of the lesions differed in both testes, with the left testis having more severe lesions. Allowing for the unique anatomy of the left spermatic vein, the standard of the surgical procedure, the high rate of varicocele induction, and identical histological alteration as occurs in humans, we believe that this inbred Wistar rat substrain is suitable for the creation of an experimental varicocele model, which has promise for practical application in humans. [source] Congenital absence of the portal vein,Case report and a review of literatureCLINICAL ANATOMY, Issue 7 2010Jana Mistinova Abstract Congenital absence of the portal vein (CAPV) is a rare anomaly in which the intestinal and the splenic venous drainage bypass the liver and drain into systemic veins through various venous shunts. To our knowledge, we have reviewed all 83 cases of CAPV, since first described in 1793. This equates to a rate of almost 2.5 cases per year over the last 30 years. Morgan and Superina (1994, J. Pediatr. Surg. 29:1239,1241) proposed the following classification of portosystemic anomalies; either the liver is not perfused with portal blood because of a complete shunt (Type I) or the liver is perfused with portal blood due to the presence of a partial shunt (Type II). In our case, abdominal venous blood drained into the suprarenal inferior vena cava via the left renal vein and dilated left gastric veins. After analyzing all reported cases, we recognize that more than 65% of patients are females and more than 30% of all published cases had been diagnosed by the age of 5 years. Additional anomalies are common in CAPV. In the reported cases, more then 22% of patients had congenital heart disease. Other commonly found anomalies include abnormalities of the spleen, urinary and male genital tract, brain as well as skeletal anomalies. Hepatic changes such as focal nodular hyperplasia, hepatocellular carcinoma, and hepatoblastoma are diagnosed in more then 40% of patients. This article also illustrates the radiological findings of CAPV. Radiological evaluation by ultrasound, CT, and MRI is helpful to detect coexisting abnormalities. Clin. Anat. 23:750,758, 2010. © 2010 Wiley-Liss, Inc. [source] Altered course of the right testicular arteryCLINICAL ANATOMY, Issue 1 2004M. Bülent Özdemir Abstract An unusual course of the right testicular artery was observed during routine dissection of the posterior abdominal wall of a 60-year-old male cadaver. It arose from the abdominal aorta, inferior and posterior to the origin of the right renal artery, and passed posterior to the inferior vena cava and right renal vein; it then arched anterior to the inferior pole of the right kidney and descended anterior to the psoas major muscle, crossing anterior to the genitofemoral nerve, ureter and the proximal part of the external iliac artery. Finally, it passed to the deep inguinal ring and through the inguinal canal to enter the spermatic cord with the other constituents. The left testicular artery arose from the abdominal aorta about 1 cm higher than the right testicular artery and followed a normal course. The embryologic basis and clinical importance of this case are discussed. Clin. Anat. 17:67,69, 2004. © 2003 Wiley-Liss, Inc. [source] Pivotal role of the sub-supracardinal anastomosis in the development and course of the left renal veinCLINICAL ANATOMY, Issue 4 2003V. Macchi Abstract A retroaortic left renal vein is encountered frequently in the dissecting room and in radiological investigations. A number of recent reports of this variation led us to review the development of the renal veins and the inferior vena cava to understand its etiology. For further insight, we also examined our collection of serial sections of cat embryos. In human embryos of about 15 mm the "renal collar," a venous ring around the aorta, is formed by anastomoses between subcardinal and supracardinal veins. The ventral part of the "renal collar" is formed from the intersubcardinal anastomosis, the dorsal part from the intersupracardinal anastomosis and the lateral parts from the sub-supracardinal anastomoses. The primitive renal veins drain venous blood from the metanephros into the sub-supracardinal anastomoses. A retroaortic left renal vein would form if the dorsal part of the sub-supracardinal anastomosis and the intersupracardinal anastomosis persist whereas the ventral part of the sub-supracardinal anastomosis and the intersubcardinal anastomosis regress. Clin. Anat. 16:358,361, 2003. © 2003 Wiley-Liss, Inc. [source] Doppler ultrasonographic detection of nutcracker syndrome in a young child with intussusception: A case reportACTA PAEDIATRICA, Issue 10 2005Jae Il Shin Abstract We report on a 2-y-old male with intussusception accompanying nutcracker syndrome detected by renal Doppler ultrasound. Renal Doppler ultrasound revealed a significant difference in the peak velocity between the hilar and aortomesenteric portions of the left renal vein. Conclusion: Renal Doppler ultrasound has been very useful and effective in detecting nutcracker syndrome in a young child. [source] Activity of CuZn-superoxide dismutase, catalase and glutathione peroxidase in erythrocytes in kidney allografts during reperfusion in patients with and without delayed graft functionCLINICAL TRANSPLANTATION, Issue 1 2006L Doma Abstract:, Background:, Generation of reactive oxygen species (ROS) is the main mechanism involved in the ischemic/reperfusion damage of the transplanted organ. Oxygen burst is a trigger for complex biochemical events leading to generation of oxygenated lipids and changes in microcirculation. Many markers have been researched to prove the presence of ROS in the transplanted tissue. Some of them, like superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) are considered to play a major role in graft protection against oxygen stress during reperfusion. Methods:, The aim of this study was to examine the changes of SOD1, CAT and GPx activity in erythrocytes during the first minutes after total graft reperfusion. Forty patients undergoing kidney transplantation at our center were assigned to two groups: with or without delayed graft function (DGF). Before anastomosing kidney vessels with recipient's iliac vessels, the ,0' blood sample was taken from the iliac vein. Next blood samples I, II and III were taken from the graft's renal vein. The reperfusion of the transplanted kidney was evaluated precisely with the thermovision camera. Erythrocyte SOD1, CAT and GPx activity was measured with a spectrophotometric method. Results:, We did not observe statistically significant changes in SOD1, CAT and GPx activity in erythrocytes during the early phase of reperfusion in patients with and without DGF. Conclusions:, Erythrocyte-antioxidative system in graft's vein remain stable during the early phase of reperfusion. The results of the study suggest that further studies on extracellular enzymes are required for the assessment of antioxidant system in the conditions of ischemia/reperfusion. [source] BNP and N-terminal proBNP are both extracted in the normal kidneyEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2006J. P. Goetze Abstract Background, Increased plasma concentrations of cardiac-derived B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (proBNP) are both associated with left ventricular dysfunction. Information on the regional elimination of the peptides is, however, still scarce. We therefore examined the renal and peripheral extraction of N-terminal proBNP and BNP. Materials and methods, The study comprised 18 patients with essential arterial hypertension, 51 with cirrhosis, and 18 control patients without kidney or liver disease. All patients underwent a haemodynamic investigation with catheterization of the femoral artery and femoral and renal veins. Blood sampling from the catheters allowed determination of the arteriovenous extraction ratio of N-terminal proBNP and BNP. Results, Neither the peripheral N-terminal proBNP (13, 11, 19 pmol L,1, NS) nor the BNP plasma concentrations (4, 12, 9 pmol L,1, NS) differed between the patient groups. In addition, similar renal extractions were observed in the groups. The renal extraction of N-terminal proBNP (0·16) was not different from that of BNP (0·16). In contrast, the N-terminal proBNP extraction in the lower extremity was markedly lower compared with BNP (0·00 vs. 0·125, P = 0·007). Conclusions, A comparable renal elimination of N-terminal proBNP and BNP is contrasted by a selective extraction of BNP in the lower extremity. Our results suggest a different elimination mechanism in the renal and peripheral circulation, which partly may explain the higher N-terminal proBNP compared with BNP concentrations in normal plasma. [source] Computed tomography angiogram: Accuracy in renal surgeryINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2009Danny M Rabah Objectives: To determine the sensitivity and specificity of computed tomography angiogram (CTA) in detecting number and location of renal arteries and veins as well as crossing vessels causing uretero-pelvic junction obstruction (UPJO), and to determine if this can be used in decision-making algorithms for treatment of UPJO. Methods: A prospective study was carried out in patients undergoing open, laparoscopic and robotic renal surgery from April 2005 until October 2006. All patients were imaged using CTA with 1.25 collimation of arterial and venous phases. Each multi-detector CTA was then read by one radiologist and his results were compared prospectively with the actual intra-operative findings. Results: Overall, 118 patients were included. CTA had 93% sensitivity, 77% specificity and 90% overall accuracy for detecting a single renal artery, and 76% sensitivity, 92% specificity and 90% overall accuracy for detecting two or more renal arteries (Pearson ,2 = 0.001). There was 95% sensitivity, 84% specificity and 85% overall accuracy for detecting the number of renal veins. CTA had 100% overall accuracy in detecting early dividing renal artery (defined as less than 1.5 cm branching from origin), and 83.3% sensitivity, specificity and overall accuracy in detecting crossing vessels at UPJ. The percentage of surgeons stating CTA to be helpful as pre-operative diagnostic tool was 85%. Conclusion: Computed tomography angiogram is simple, quick and can provide an accurate pre-operative renal vascular anatomy in terms of number and location of renal vessels, early dividing renal arteries and crossing vessels at UPJ. [source] Changes in oxyhemoglobin dissociation curve in intrabdominal organs during pig experimental orthotopic liver transplantationLIVER TRANSPLANTATION, Issue 7 2005Georgia Kostopanagiotou Liver transplantation has become a gold standard treatment for irreversible liver disease. Conventional measures of oxygenation are inadequate to understand the dynamics of regional oxygen metabolism during liver transplantation because they represent global markers of tissue dysoxia. Therefore, the addition of an assessment of the hemoglobin O2 binding capacity can give a better insight into systemic and regional tissue oxygenation and can reflect a more accurate estimation of oxygen release to the tissues than can the hemoglobin, the PaO2 and SaO2 alone. This prospective study was designed to evaluate possible alterations in the oxyhemoglobin dissociation curve of vital end organs (small bowel, liver, and kidney) in an experimental liver transplantation model. Fifteen pigs with body weights ranging from 25 to 30 kg were used for the study. Five healthy pigs underwent a sham operation under general anesthesia (group A-control). Ten pigs underwent orthotopic liver transplantation (OLT). Five of them were healthy (group B), whereas the other five were in acute liver failure, which had been surgically induced (group C). Systemic arterial blood pressure, cardiac index, and pulmonary and systemic vascular resistance indexes were measured. Venous blood gas analysis was also performed from pulmonary artery, superior mesenteric, hepatic, and renal veins at well-defined timepoints during the course of the OLT. A statistically significant (P < 0.05) decrease of P50 in groups B and C compared with group A was observed 30 minutes after reperfusion in the systemic circulation, hepatic, and renal veins. This coincided with a decrease in animal temperature 30 minutes after reperfusion. Regarding group C, after reperfusion of the newly transplanted liver there was a significant increase of P50 in the small bowel in comparison to baseline values. In conclusion, these changes in P50 may suggest the occurrence of abnormal tissue oxygenation after reperfusion. (Liver Transpl 2005;11:760,766.) [source] Prenatal diagnosis of ductus venosus agenesis and its association with cytogenetic/congenital anomaliesPRENATAL DIAGNOSIS, Issue 11 2002Paolo Volpe Abstract Objectives We present an observational study of 12 cases of anomalies of the umbilical and portal vein systems associated with absence of the ductus venosus (DV) diagnosed over the past 5 years. The hemodynamic implications of each pattern of umbilico-portal system anomalies associated with absence of the DV have been investigated, as well as the frequency and types of associated anomalies and their embryological origin. Methods In all cases ultrasound, color Doppler, and cytogenetic investigations were performed. Results Four main patterns of abnormal venous circulation were documented: (1) the umbilical vein (UV) bypasses the liver and drains into the right atrium directly or through a dilated coronary sinus (three cases); (2) the UV bypasses the liver, with an infrahepatic or suprahepatic connection directly to the inferior vena cava (IVC) (two cases); (3) the UV bypasses the liver and drains directly into the iliac or renal veins (four cases); and (4) the UV drains directly into the portal veins (three cases). Among seven cases with other associated anomalies (58%), there were three cases of Turner's and Noonan's syndromes. Two fetuses and two neonates died and there were two terminations of pregnancy (TOP). Conclusions In utero diagnosis of ultrasound patterns associated with DV anomalies is feasible. Fetal karyotyping should be considered, serial ultrasound examinations recommended and, in the presence of heart failure, delivery can be anticipated. Copyright © 2002 John Wiley & Sons, Ltd. [source] Invasion of renal sinus fat is not an independent predictor of survival in pT3a renal cell carcinomaBJU INTERNATIONAL, Issue 12 2009Stephen A. Poon OBJECTIVE To clarify the significance of the location of extrarenal tumour extension of renal cell carcinoma (RCC) as in the 2002 Tumour-Nodes-Metastasis classification. Renal cortical tumours with perirenal fat invasion (PFI) or sinus fat invasion (SFI) are consolidated within the pT3a grouping; tumours with SFI are close to the renal veins, lymphatics and the collecting system. This might carry a worse prognosis for disease-specific survival (DSS), but reports are limited and contradictory. PATIENTS AND METHODS We retrospectively reviewed 1244 patients treated with nephrectomy from 1988 to 2007, to identify patients with pT3a renal tumours. They were classified as having PFI or SFI. Kaplan-Meier analysis and Cox proportional hazards regression models were used to assess predictors of survival. RESULTS The 230 patients who met the inclusion criteria had a median follow-up of 24 months. SFI was found in 63 (27.4%) patients and was associated with a worse 5-year DSS than the 167 (72.6%) with PFI (62.5% vs 75.0%; log rank P = 0.022). On univariate analysis, diameter (hazard ratio, HR 1.1), nuclear grade (HR 4.5), margin status (HR 5.8), lymph node metastases (HR 6.4), and systemic metastases (HR 15.4) were significant for DSS. In a multivariate model, only nuclear grade (HR 3.1), margin status (HR 8.9) and systemic metastases (HR 9.8) were independent predictors. CONCLUSION Patients with renal tumours with SFI are more likely to die from RCC than those with PFI. However, in the present patients the presence of SFI was not an independent predictor of DSS. [source] Pivotal role of the sub-supracardinal anastomosis in the development and course of the left renal veinCLINICAL ANATOMY, Issue 4 2003V. Macchi Abstract A retroaortic left renal vein is encountered frequently in the dissecting room and in radiological investigations. A number of recent reports of this variation led us to review the development of the renal veins and the inferior vena cava to understand its etiology. For further insight, we also examined our collection of serial sections of cat embryos. In human embryos of about 15 mm the "renal collar," a venous ring around the aorta, is formed by anastomoses between subcardinal and supracardinal veins. The ventral part of the "renal collar" is formed from the intersubcardinal anastomosis, the dorsal part from the intersupracardinal anastomosis and the lateral parts from the sub-supracardinal anastomoses. The primitive renal veins drain venous blood from the metanephros into the sub-supracardinal anastomoses. A retroaortic left renal vein would form if the dorsal part of the sub-supracardinal anastomosis and the intersupracardinal anastomosis persist whereas the ventral part of the sub-supracardinal anastomosis and the intersubcardinal anastomosis regress. Clin. Anat. 16:358,361, 2003. © 2003 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||