Pelvic Extension Research Articles

Intra-abdominal telangiectatic osteosarcoma: a case report

BackgroundTelangiectatic osteosarcoma is rare and it rarely affects flat bones, especially the bones of the pelvis. It is uncommon for telangiectatic osteosarcoma to be considered as a differential diagnosis when assessing a large intrabdominal mass.Case reportWe present our case of a 33-year-old African female who presented with a sizeable telangiectatic osteosarcoma of the left iliac bone. She reported a 3-year duration of a painless, slow-growing mass arising from the left flank. At examination, a large bony hard mass extending from the left ilium to the umbilicus was noted, almost mimicking an intra-abdominal pregnancy. All laboratory tests were within normal limits and an unconventional surgical approach was used for a one-stage excision of the tumor without complications. The definitive histopathological diagnosis postexcision was that of a telangiectatic osteosarcoma only on the second review of the histological specimen.ConclusionsPelvic telangiectatic osteosarcoma is rare, and the ilium is the commonly affected pelvic bone. These tumors can be sizeable at presentation with intra-abdominal or pelvic extension with a high chance of misdiagnosis. Fortunately surrounding soft tissue involvement seems to be a rare and late finding when present.

Assessment of BFX cup version in a three-dimensional model simulating the ventrodorsal radiographic view.

To measure truncated face and open face versions of the biological fixation (BFX) cup in a three-dimensional (3D) model simulating the ventrodorsal radiographic projection with different cup and pelvis positions. Computer simulation. Simulated ventrodorsal views were generated in silico using 3D models of a BFX cup and a medium-sized canine pelvis. Truncated face and open face versions of the BFX cup were defined and measured with various angles of cup version, cup inclination, and pelvic extension. Truncated face version was different from and underestimated open face version by 12° to 22° (p < .001). Open face version varied with inclination while truncated face version was unaffected by inclination. Open face version was dependent on the degree of pelvic extension while truncated face version was unaffected. Open face version differed from truncated face version. Changes in open face version were not consistently matched by a change in truncated face version. The open face of the cup may be excessively retroverted without this being reflected by truncated face retroversion as seen on a ventrodorsal radiographic view. However, in this study, BFX cups placed with truncated face version and inclination in the normal range and an ALO of 45° yielded predictable open face version.

Pseudo tumor pelvic actinomycosis revealed by colonic obstruction with hydronephrosis: Can extensive surgery be avoided? A case report.

Pelvic actinomycosis with an intrauterine device accounts for approximately 3% of all actinomycoses. It is a chronic infectious disease characterized by infiltrative, suppurative, or granulomatous inflammation, sinus fistula formation, and extensive fibrosis, and caused by filamentous, gram-positive, anaerobic bacteria called Actinomyces israelii. The slow and silent progression favors pseudo tumor pelvic extension and exposes the patient to acute life-threatening complications, namely colonic occlusion with hydronephrosis. Preoperative diagnosis is often difficult due to the absence of specific symptomatology and pathognomonic radiological signs simulating pelvic cancer. We discuss the case of a 67-year-old woman who complained of pelvic pain, constipation, and weight loss for 4 months, and who presented to the emergency department with a picture of colonic obstruction and a biological inflammatory syndrome. The computed tomography scan revealed a suspicious heterogeneous pelvic mass infiltrating the uterus with an intrauterine device, the sigmoid with extensive upstream colonic distension, and right hydronephrosis. The patient underwent emergency surgery with segmental colonic resection and temporary colostomy, followed by antibiotic therapy. The favorable clinical and radiological evolution under prolonged antibiotic therapy with the almost total disappearance of the pelvic pseudo tumor infiltration confirms the diagnosis of pelvic actinomycosis and thus makes it possible to avoid an extensive and mutilating surgery with important morbidity.

Hip-Spine Relationship between Sagittal Balance of the Lumbo-Pelvi-Femoral Complex and Hip Extension Capacity: An EOS Evaluation in a Healthy Caucasian Population.

A prospective study of healthy volunteers. The influence of the sagittal alignment of the spine and its influence on the extension reserve have been reported in the literature. However, specific analysis of the intrinsic coxofemoral and extrinsic pelvic component in subjects without any spinal or hip pathologies remains poorly reported. The aim of this study was to categorize the hip extension capacity, or extension reserve (ER), in relation to spinal sagittal alignment whilst standing, in a young healthy population. We hypothesized that the global extension reserve (GER) of the hip joint was influenced by the sagittal spinopelvic alignment. We evaluated the ER of 120 healthy Caucasian volunteers (56 females (46.7%), 74 males (53.3%); mean age 25.6years), using low dose radiographs from an EOS® X-ray imaging system in 2 functional positions; neutral standing position and in a forward lunge position. The GER is defined as the sum of the intrinsic (hip) extension reserve (IER) and the extrinsic (pelvic) extension reserve (EER). Cases were grouped into 4 sagittal alignment subtypes according to the Roussouly classification, and analyzed. Global extension reserve values were not significantly different between the 4 Roussouly subtypes (P = .094), nor between patients with a sacral slope (SS) <35° (types 1/2) and ≥ 35° (type 3/4) (P = .837). Statistically significant differences were seen between IER in each subtype (P = .015), and EER (P = .006). No difference in ER was seen between subtypes regarding pelvic incidence (PI). An inverse relationship was found between IER and EER among Roussouly subtypes. The range of motion of the pelvis and the hip joint was higher in patients with a greater sacral slope.

Surgical management of large, connected perineal and pelvic epidermal inclusion cysts mimicking a dumbbell-shaped lesion in an adult male.

Introduction and importanceEpidermal inclusion cysts are a common benign finding, and they are predominantly asymptomatic. They can rarely form in the pelvis or abdomen, however, and may cause symptoms secondary to mass effect. This case highlights management of an anterectal epidermal inclusion cyst connected to the perineal cyst, mimicking a dumbbell-shaped lesion, found in a male.Case presentationThis is a unique case of a 21-year-old Caucasian male with a palpable perineal mass, lower extremity hypoesthesia, and constipation who was found to have a complex-shaped cyst on computed tomography and magnetic resonance imaging. This was ultimately managed with a two-stage perineal and transabdominal resection.Clinical discussionThis case highlights that perineal epidermal inclusion cysts may have pelvic extension, especially in patients with additional new-onset neurologic, gastrointestinal, or urologic symptoms. These symptoms should completely resolve after resection. Additionally, resection is recommended to prevent complications including malignant degeneration and fistulization.ConclusionThis is the first reported case of an anterectal, epidermal inclusion cyst connected to a perineal cyst found in a male. Perineal and pelvic cysts may be synchronous and may be connected through the pudendal canal. These masses can be safely removed via a combined perineal and transabdominal resection. The connecting portion of lesions that have both pelvic and perineal components should be meticulously identified and dissected because even a thin, patent segment – if left unresected – may result in lesion recurrence.

Wilms' tumor may be a rare presentation of ovarian neoplasms in girls

Extrarenal Wilms' tumor is a rare malignant disorder. It represents 0.5-1% of Wilms' tumor. Management for ERWT is challenging regarding its pathological diagnosis, staging, treatment and prognosis. Here we report a 4 years old girl, presented with huge pelvi abdominal mass originating from the left ovary which was seen by radiologic assessment as a large lobulated heterogeneously enhancing mixed solid and cystic retroperitoneal mass away from both kidneys, occupying most of the abdomen with pelvic extension; it was displacing bowel loops and pancreas, measuring 13 x 15 x 16 cm without evidence of enlarged lymphadenopathy. The mass was diagnosed postoperatively as an extrarenal Wilms' tumor proved by immunohistochemical staining for Wilms' Tumor1 (WT1) with the negative reaction for other markers that exclude other diagnostic possibilities. The patient had an aggressive presentation and advanced disease. The diagnosis was difficult due to the lack of specific radiologic stigmata and aberrant origin. She was treated with aggressive chemotherapy to suit the advanced stage of her disease and unfavorable histology pattern.

Oncological Properties of Intravenous Leiomyomatosis: Involvement of Mesenchymal Tumor Stem-Like Cells.

Uterine leiomyoma, also known as fibroids, is the most common benign neoplasm of the female genital tract. Leiomyoma is the most common uterine tumor. The leiomyoma subtypes account for approximately 10% of leiomyomas. Intravenous leiomyomatosis, a uterine leiomyoma subtype, is an intravascular growth of benign smooth muscle cells, occasionally with pelvic or extrapelvic extension. Uterine leiomyosarcoma, a malignant tumor, tends to metastasize hematogenously, and distant metastasis to the lungs and liver is common. Therefore, the oncological properties of this intravenous leiomyomatosis resemble those of the malignant tumor uterine leiomyosarcoma. Cancer stem cells migrate to distant organs via intravascular infiltration, leading to micrometastases. We examined the oncological properties of intravenous leiomyomatosis using molecular pathological techniques on tissue excised from patients with uterine leiomyoma. CD44-positive mesenchymal tumor stem-like cells were detected in both patients with intravenous leiomyomatosis and uterine leiomyosarcoma. The oncological properties of intravenous leiomyomatosis were found to be similar to those of uterine leiomyosarcoma. However, in intravenous leiomyomatosis, cyclin E and Ki-67-positive cells were rare and no pathological findings suspecting malignancy were observed. It is expected that establishing a treatment method targeting cancer stem cells will lead to the treatment of malignant tumors with a low risk of recurrence and metastasis.

The water-hopping kinematics of the tree-climbing fish, Periophthalmus variabilis

In this communication, we describe the water-hopping kinematics of the dusky-gilled mudskipper (Periophthalmus variabilis), and by doing so elucidate an entirely new form of fish locomotion that has yet to be reported in the public domain. Water-hopping is defined herein as an ability to hop once, or in succession, on the surface of water without full submergence and without a fin-guided glide. We find that taxiing on the water surface is the predominating kinematic movement used for the execution of successful water-hops. We observe that an initial concentric ripple forms as the mudskipper impacts the water, and that subsequent taxiing on the water surface generates a sinusoid-like ripple pattern in the water prior to take off. Interestingly whilst airborne, the pectoral fins of P. variabilis appear to remain stationary, only to be deployed upon contact with the water. When landing back onto the surface of the water, P. variabilis makes the initial contact via its pelvic region, occasionally extending its pectoral fins during its descent. The reasons for pectoral and pelvic fin extension are unclear, however, there may be either aerodynamic or hydrodynamic benefits in its doing so. This motion furthermore prepares the mudskipper for either, a follow-on water-hop, or a discontinuation of movement altogether, as the body of the mudskipper becomes aligned in a way conducive to either. P. variabilis will launch and land using both, horizontal surfaces such as littorals, and inclined-to-vertical surfaces such as rocks and trees.

Segmental hypoplasia of the spinal cord and syringomyelia in a calf

ABSTRACT: Congenital malformations are functional and structural changes in organ systems, tissues, or organs that may develop during the embryonic or fetal phase. Spinal cord malformations, such as segmental hypoplasia of the spinal cord (SHSC) and syringomyelia, are rare in bovines. A Girolando calf from Valença, Rio de Janeiro, was admitted to the Veterinary Hospital of Universidade Federal Rural do Rio de Janeiro because of motor incoordination. Clinical evaluation revealed a 5-cm depression area in the spine at the dorsal line of the thoracic region. Neurological examination revealed reduced proprioception, pelvic limb extension with increased nociceptive activity, and reduced anal reflex. In radiographic examination, the body of the T11 vertebra had a trapezoidal wedge shape with ventral hemivertebra, probable agenesis or hypoplasia of the T11-T12 spinous processes, and fusion of the T9-T10 spinous processes. Myelography revealed extradural spinal compression caused by vertebral malformations. Necropsy showed no spinous processes (T11-T12), cranial stenosis in the medullary canal (T11-T13), and 1-3-mm pores in the white matter of the thoracic spinal cord (T8-T11). Microscopy revealed cystic dilatations in the white matter (T9-T11), cystic areas of varying sizes (T8-T9), and moderate reduction in the gray matter around the central canal of the medulla (T11-T13). Here, we reported the clinical and pathological findings of SHSC and syringomyelia in a Girolando calf. The features should be differentiated from other spinal cord syndromes. Congenital malformations are of economic importance, and their etiology and diagnosis are fundamental to disease control and progenitor-selection programs.

Demons meigs’ syndrome secondary to begnin brenner tumor with high ca125 plasmatic level: first case described in kara teaching hospital

To report the first case of Demons-Meigs’ syndrome secondary to benign Brenner tumor with high CA125 plasmatic level managed in kara teaching hospital. A 40-year-old female patient was admitted with a 6-month history of abdominal distension. Clinical examination found abdomino-pelvic mass and declive dullness. Abdominal ultrasound found heterogeneous abdomino-pelvic mass of 180 mm in length and a large free ascites. Pelvic computorized tomography scan found heterogeneous extra-uterine mass of 180 mm in length, large ascites without pelvic or lombo-aortic lymphadenopathy or tumoral extension. Front thorax X-ray found bilateral pleural effusion; CA125 plasmatic level was 1138 IU/ml. Median laparotomy allow to aspire 2 liters of ascitic fluid and to perform left adnexectomy. Histological examination of surgery sample diagnosed begnin ovary Brenner tumor. Outcome after surgery was without complications with disappearance of ascites and pleural effusion, and CA125 plasmatic level back to normal value. Demons-Meigs’ syndrome is a rare benign ovarian tumor whose symptoms looks like ovarian cancer. Its fundamental characteristic is the disappearance of symptoms after ovarian tumor removal.

Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

Urolithiasis is a worldwide problem due to its high prevalence and recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones. Seventy patients who presented in between June 2013 and September 2017 with lower pole calyceal stones and lower calyceal stones with pelvic extension were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen. Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 -28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion. Percutaneous nephrolithotomyis a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.

Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

Background: Urolithiasis is a worldwide problem due to its high prevalence and recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones. Methods: Seventy patients who presented in between June 2013 and September 2017 with lower pole calyceal stones and lower calyceal stones with pelvic extension were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone &lt;20mm and 90.7% stone size &gt;20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.Keywords: Lower calyx; lower pole stones; percutaneous nephrolithotomy; stone free rate.

Kinetic and kinematic follow-up gait analysis in Doberman Pinschers with cervical spondylomyelopathy treated medically and surgically.

BackgroundThe efficacy of treatment of dogs with cervical spondylomyelopathy (CSM) is commonly based on the owner's and clinician's perception of the gait, which is highly subjective and suffers from observer bias.Hypothesis/ObjectivesTo compare selected kinetic and kinematic parameters before and after treatments and to correlate the findings of gait analysis to clinical outcome.AnimalsEight Doberman Pinschers with CSM confirmed by magnetic resonsance imaging.MethodsPatients were prospectively studied and treated with either medical management (n = 5) or surgery (n = 3). Force plate analysis and 3‐D kinematic motion capture were performed at initial presentation and approximately 8 weeks later. Force plate parameters evaluated included peak vertical force (PVF). Kinematic parameters measured included number of pelvic limb strides, stifle flexion and extension, maximum and minimum thoracic limb distance, truncal sway, and thoracic limb stride duration.ResultsKinematic analysis showed that deviation of the spine to the right (truncal sway) was significantly smaller (P < .001) and the degree of right stifle flexion was significantly larger (P = .029) after treatment. Force plate analysis indicated that PVF was significantly different after treatment (P = .049) and the difference of the PVF also was significantly larger (P = .027). However, no correlation was found with either method of gait analysis and clinical recovery.Conclusions and Clinical ImportanceKinetic and kinematic gait analysis were able to detect differences in dogs with CSM before and after treatment. A correlation of gait analysis to clinical improvement could not be determined.

Which factors are associated with the recurrence of endometrioma after cystectomy?

Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. Medical treatment options can be successful in endometrioma smaller than 1 cm, but ineffective for growing and symptomatic endometriomas. Conservative surgical interventions that preserve fertility, such as laparoscopic removal or destruction of endometriotic tissue or aspiration of cystic content are typically used to treat the condition. One of the most frustrating aspects of endometrioma treatment is disease recurrence. The underlying mechanisms explaining recurrence are uncertain. Several risk factors have been evaluated in order to predict recurrence after cystectomy. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, presence of preoperative symptoms of non-cyclic pelvic pain, dysmenorrhoea and adhesion extension may be associated with recurrent endometrioma. In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients.Impact statementWhat is already known on this subject: Endometrioma is the most common form of endometriosis and is a sign of wide-spread disease in symptomatic patients. One of the most frustrating aspects of endometrioma treatment is disease recurrence. Several risk factors have been evaluated in order to predict recurrence after cystectomy. However, the risk factors have not been precisely defined.What the results of this study add: This study aimed to investigate the contribution of possible risk factors to the recurrence of endometrioma after laparoscopic surgery. In looking at the results overall, our study can conclude that the presence of greater cyst dimension, higher CA-125 level, adhesion extension, presence of preoperative symptoms of non-cyclic pelvic pain and dysmenorrhoea may be associated with recurrent endometrioma.What the implications of these findings are for clinical practice and/or further research: In clinical practice, identification of risk factors for recurrence helps clinicians to inform patients. Detection of preoperative risk factors would be helpful in counselling patients on their future prognosis. This may also increase treatment success by providing accurate preoperative treatment planning and by assisting the scheduling of postoperative follow-ups.

PD49-01 ADJUVANT PELVIC RADIATION IS ASSOCIATED WITH IMPROVED SURVIVAL AND DECREASED DISEASE RECURRENCE IN PELVIC NODE-POSITIVE PENILE CANCER AFTER LYMPH NODE DISSECTION: A MULTI-INSTITUTIONAL STUDY

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2017PD49-01 ADJUVANT PELVIC RADIATION IS ASSOCIATED WITH IMPROVED SURVIVAL AND DECREASED DISEASE RECURRENCE IN PELVIC NODE-POSITIVE PENILE CANCER AFTER LYMPH NODE DISSECTION: A MULTI-INSTITUTIONAL STUDY Dominic Tang, Rosa Djajadiningrat, Gregory Diorio, Zhenjun Ma, Braydon Schaible, Mario Catanzaro, Dingwei Ye, Yao Zhu, Nicola Nicolai, Simon Horenblas, Peter Johnstone, and Philippe Spiess Dominic TangDominic Tang More articles by this author , Rosa DjajadiningratRosa Djajadiningrat More articles by this author , Gregory DiorioGregory Diorio More articles by this author , Zhenjun MaZhenjun Ma More articles by this author , Braydon SchaibleBraydon Schaible More articles by this author , Mario CatanzaroMario Catanzaro More articles by this author , Dingwei YeDingwei Ye More articles by this author , Yao ZhuYao Zhu More articles by this author , Nicola NicolaiNicola Nicolai More articles by this author , Simon HorenblasSimon Horenblas More articles by this author , Peter JohnstonePeter Johnstone More articles by this author , and Philippe SpiessPhilippe Spiess More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2225AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Few studies have examined the role of adjuvant radiation therapy (AXRT) in advanced penile squamous cell carcinoma. We sought to evaluate the association of pelvic AXRT with survival and recurrence for patients with penile cancer and positive pelvic lymph nodes (PLN) after lymph node dissection. METHODS Data were collected retrospectively across 4 international centers of patients with penile squamous cell carcinoma (PeCa) undergoing lymph node dissections from 1980 to 2013. 92 patients with positive PLN were analyzed. Variables recorded included age, stage, histological grade, PLN status, pelvic extranodal extension (ENE), chemotherapy status, disease-specific survival, overall survival, and recurrence. RESULTS 43% (n=40) patients received AXRT after a positive PLN dissection. Median follow up was 9.3 months (IQR 5.2-19.8). The median number of positive PLN was 2 (IQR 1-3). Patients receiving AXRT had an improved median overall survival (OS) of 12.2 months versus 8 months in those who did not receive radiation (p=0.0447). Median disease-specific survival (DSS) was 14.4 months versus 8 months in the AXRT and non-AXRT group respectively (p=0.0232). Patients not receiving AXRT was associated with worse OS (HR: 1.9; 95% CI: 1.11-3.26; p=0.0195) and DSS (HR: 2.08; 95% CI: 1.18-3.66; p=0.0112) on multivariable analysis. Median time to recurrence was 7.7 months versus 5.3 months in the radiation and non-radiation arm respectively (p=0.0425). Patients not receiving AXRT was also independently associated with higher overall recurrence on multivariable analysis (HR: 1.98; 95% CI: 1.15-3.42; p=0.0131). CONCLUSIONS AXRT is associated with improved OS and DSS, and decreased recurrence in this population of PeCa patients with positive PLN. Further studies with a prospective design and larger data sets are required to validate this finding. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e973 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dominic Tang More articles by this author Rosa Djajadiningrat More articles by this author Gregory Diorio More articles by this author Zhenjun Ma More articles by this author Braydon Schaible More articles by this author Mario Catanzaro More articles by this author Dingwei Ye More articles by this author Yao Zhu More articles by this author Nicola Nicolai More articles by this author Simon Horenblas More articles by this author Peter Johnstone More articles by this author Philippe Spiess More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Differentiation of Lymphoma Presenting as Retroperitoneal Mass and Retroperitoneal Fibrosis: Evaluation with Multidetector-row Computed Tomography.

Background:Retroperitoneal fibrosis (RPF) and lymphoma presenting as retroperitoneal mass may closely resemble each other and misdiagnosis may occur. This study investigated the differential imaging features of RPF and lymphoma which presented as a retroperitoneal soft tissue using multidetector-row computed tomography (MDCT).Methods:The 42 consecutive patients were included in this retrospective review, including 19 RPF patients (45.2%; including 13 males and 6 females; mean age: 56.7 ± 6.2 years) and 23 patients with lymphoma (54.8%; including 14 males and 9 females; mean age: 57.4 ± 12.3 years). An array of qualitative computed tomography (CT) features of lesions in 42 consecutive patients with newly diagnosed untreated RPF and lymphoma were retrospectively analyzed. The quantitative size of the lesion at the para-aortic region and attenuation in the precontrast, arterial, and portal phases were calculated in regions of interest and compared between the patients with newly diagnosed untreated RPF and with lymphoma. Receiver operating characteristic curve analysis was used to assess the potential diagnostic value of each quantitative parameter. Inter-reader concordance was also calculated.Results:Mean ages between patients with RPF and lymphoma were not significantly different (56.7 ± 6.2 years vs. 57.4 ± 12.3 years P = 0.595). Compared to those in patients with lymphoma, homogeneous enhancement (65.2% vs. 94.7%, P = 0.027) and pelvic extension (52.2% vs. 89.5%, P = 0.017) were significantly more common while the involvement of additional nodes (78.3% vs. 5.3%, P < 0.001), suprarenal extension (60.9% vs. 15.8%, P = 0.004), and aortic displacement (43.5% vs. 5.3%, P = 0.006) were significantly less common in patients with RPF. Lesion size at the para-aorta was significantly greater in patients with lymphoma, compared with RPF patients (3.9 ± 1.2 cm vs. 1.8 ± 0.6 cm; P < 0.001). The attenuation values in three phases were not significantly different between patients with RPF and lymphoma. Inter-reader concordance for subjective features ranged from very good to excellent (range: 85.7–100.0%).Conclusions:This study showed that MDCT can help differentiate between untreated RPF and lymphoma on the basis of qualitative CT features and lesion sizes. Differentiating RPF from lymphoma on the basis of attenuation values in the precontrast, arterial, and portal phases was difficult to accomplish.

Kinematic control of extreme jump angles in the red-legged running frog, Kassina maculata.

The kinematic flexibility of frog hindlimbs enables multiple locomotor modes within a single species. Prior work has extensively explored maximum performance capacity in frogs; however, the mechanisms by which anurans modulate performance within locomotor modes remain unclear. We explored how Kassina maculata, a species known for both running and jumping abilities, modulates take-off angle from horizontal to nearly vertical. Specifically, how do 3D motions of leg segments coordinate to move the centre of mass (COM) upwards and forwards? How do joint rotations modulate jump angle? High-speed video was used to quantify 3D joint angles and their respective rotation axis vectors. Inverse kinematics was used to determine how hip, knee and ankle rotations contribute to components of COM motion. Independent of take-off angle, leg segment retraction (rearward rotation) was twofold greater than adduction (downward rotation). Additionally, the joint rotation axis vectors reoriented through time, suggesting dynamic shifts in relative roles of joints. We found two hypothetical mechanisms for increasing take-off angle. Firstly, greater knee and ankle excursion increased shank adduction, elevating the COM. Secondly, during the steepest jumps, the body rotated rapidly backwards to redirect the COM velocity. This rotation was not caused by pelvic angle extension, but rather by kinematic transmission from leg segments via reorientation of the joint rotation axes. We propose that K. maculata uses proximal leg retraction as the principal kinematic drive while dynamically tuning jump trajectory by knee and ankle joint modulation.

Utility of peritoneal washing cytology in staging and prognosis of ovarian and fallopian tube neoplasms: a 10-year retrospective analysis.

The prognostic significance of peritoneal washing cytology in gynecologic neoplasms is controversial. The presence of neoplastic cells in peritoneal washings is currently part of the Federation of Gynecology and Obstetrics and American Joint Committee on Cancer TNM staging systems in cases of ovarian and fallopian tube neoplasms without metastasis beyond the pelvis. In this study, we retrospectively reviewed all cases of ovarian and fallopian tube neoplasms in which cytologic studies were performed. The utility of cytology in tumor staging and the relationship between cytology results and patient outcome are studied. All cases of ovarian and fallopian tube neoplasms in our institution between July 2002 and July 2012 were reviewed. Primary tumor characteristics including type and pelvic extension were collected, categorized, and correlated with peritoneal washing cytology. Final tumor staging was reviewed and the impact of positive cytology was evaluated. A total of 120 cases of ovarian and fallopian tube neoplasms without extrapelvic metastasis were identified within the study period. Peritoneal washing cytology was positive in 24% (29/120) of neoplasms and upstaged the tumor 83% (24/29) of the time when positive. Overall, 20% (24/120) of reviewed cases were upstaged based on positive cytology results. Peritoneal washing cytology remains a useful staging tool for ovarian and fallopian tube neoplasms limited to the pelvic cavity. Positive cytology results in upstaging in a significant proportion of the cases regardless of the tumor type. A larger study is needed to analyze follow-up data to determine if upstaging based on positive cytology adversely affects outcome.

CT Pelvis in Children; Should We Routinely Scan Pelvis for Wilms Tumor and Hepatoblastoma? Implications for Imaging Protocol Development.

Wilms tumor and hepatoblastoma are the most common intra-abdominal solid organ childhood tumors. CT examination is one of the routinely performed procedures in hospitals for children with these tumors inspite of high radiation exposure associated with CT scans. Sixty patients (Wilms tumor = 45, hepatoblastoma = 16) were evaluated retrospectively. Higher proportion (44.4%) of metastatic disease was identified at presentation in the Wilms tumor subset as compared to hepatoblastoma (6.3%) [p=0.006]. Metastatic disease was noted in 6 patients having Wilms tumor on follow-up while it was also low in hepatoblastoma which was noted in only 2 patients (p > 0.05). No significant difference was identified in pelvic extension of disease at presentation in both studied population (p > 0.05). Pelvic metastasis was noted in 1 patient only with Wilms tumor on follow-up while no pelvic metastasis was seen in the hepatoblastoma patients (p-value > 0.05).

Uterine sarcomas.

Uterine sarcomas.