Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p>Intrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding after percutaneous nephrolithotomy and angiography confirms the diagnosis which allows endovascular management.</p> <p>Case presentation</p> <p>We present a case of a 65-year old Caucasian woman who underwent percutaneous nephrolithotomy in the supine position for a two centimetre renal calculus. The postoperative course was complicated by persistent bleeding due to a renal pseudoaneurysm. The vascular lesion was successfully managed by endovascular exclusion through the use of a covered stent graft. We report the first successful use of this method for the management of iatrogenic pseudoaneurysm in a branch of the left renal artery and we focus on the imaging findings, technical details, advantages and limitations of this technique.</p> <p>Conclusion</p> <p>As a result of its high efficacy, interventional radiology has largely replaced open surgery for the management of renal pseudoaneurysm related to percutaneous nephrolithotomy. Recent technical advancements have allowed the use of covered stent grafts as an alternative to embolisation for the angiographic management of visceral artery pseudoaneurysm located in other organs. This novel technique allows the endovascular exclusion of the pseudoaneurysm, without compromising arterial supply to the end-structures - an advantage of critical importance in organs supplied by segmental arteries - in the absence of collateral vasculature, such as the kidney.</p

Inherent High Correlation of Individual Motility Enhances Population Dispersal in a Heterotrophic, Planktonic Protist

Quantitative linkages between individual organism movements and the resulting population distributions are fundamental to understanding a wide range of ecological processes, including rates of reproduction, consumption, and mortality, as well as the spread of diseases and invasions. Typically, quantitative data are collected on either movement behaviors or population distributions, rarely both. This study combines empirical observations and model simulations to gain a mechanistic understanding and predictive ability of the linkages between both individual movement behaviors and population distributions of a single-celled planktonic herbivore. In the laboratory, microscopic 3D movements and macroscopic population distributions were simultaneously quantified in a 1L tank, using automated video- and image-analysis routines. The vertical velocity component of cell movements was extracted from the empirical data and used to motivate a series of correlated random walk models that predicted population distributions. Validation of the model predictions with empirical data was essential to distinguish amongst a number of theoretically plausible model formulations. All model predictions captured the essence of the population redistribution (mean upward drift) but only models assuming long correlation times (minute), captured the variance in population distribution. Models assuming correlation times of 8 minutes predicted the least deviation from the empirical observations. Autocorrelation analysis of the empirical data failed to identify a de-correlation time in the up to 30-second-long swimming trajectories. These minute-scale estimates are considerably greater than previous estimates of second-scale correlation times. Considerable cell-to-cell variation and behavioral heterogeneity were critical to these results. Strongly correlated random walkers were predicted to have significantly greater dispersal distances and more rapid encounters with remote targets (e.g. resource patches, predators) than weakly correlated random walkers. The tendency to disperse rapidly in the absence of aggregative stimuli has important ramifications for the ecology and biogeography of planktonic organisms that perform this kind of random walk

Prey detection and prey capture in copepod nauplii

Copepod nauplii are either ambush feeders that feed on motile prey or they produce a feeding current that entrains prey cells. It is unclear how ambush and feeding-current feeding nauplii perceive and capture prey. Attack jumps in ambush feeding nauplii should not be feasible at low Reynolds numbers due to the thick viscous boundary layer surrounding the attacking nauplius. We use high-speed video to describe the detection and capture of phytoplankton prey by the nauplii of two ambush feeding species (Acartia tonsa and Oithona davisae) and by the nauplii of one feeding-current feeding species (Temora longicornis). We demonstrate that the ambush feeders both detect motile prey remotely. Prey detection elicits an attack jump, but the jump is not directly towards the prey, such as has been described for adult copepods. Rather, the nauplius jumps past the prey and sets up an intermittent feeding current that pulls in the prey from behind towards the mouth. The feeding-current feeding nauplius detects prey arriving in the feeding current but only when the prey is intercepted by the setae on the feeding appendages. This elicits an altered motion pattern of the feeding appendages that draws in the prey

Multitrophic Interactions in the Sea: Assessing the Effect of Infochemical-Mediated Foraging in a 1-d Spatial Model

The release of chemicals following herbivore grazing on primary producers may provide feeding cues to carnivorous predators, thereby promoting multitrophic interactions. In particular, chemicals released following grazing on phytoplankton by microzooplankton herbivores have been shown to elicit a behavioural foraging response in carnivorous copepods, which may use this chemical information as a mechanism to locate and remain within biologically productive patches of the ocean. In this paper, we use a 1D spatial reaction-diffusion model to simulate a tri-trophic planktonic system in the water column, where predation at the top trophic level (copepods) is affected by infochemicals released by the primary producers forming the bottom trophic level. The effect of the infochemical-mediated predation is investigated by comparing the case where copepods forage randomly to the case where copepods adjust their vertical position to follow the distribution of grazing-induced chemicals. Results indicate that utilization of infochemicals for foraging provides fitness benefits to copepods and stabilizes the system at high nutrient load, whilst also forming a possible mechanism for phytoplankton bloom formation. We also investigate how the copepod efficiency to respond to infochemicals affects the results, and show that small increases (2%) in the ability of copepods to sense infochemicals can promote their persistence in the system. Finally we argue that effectively employing infochemicals for foraging can be an evolutionarily stable strategy for copepods

Effect of type and concentration of ballasting particles on sinking rate of marine snow produced by the Appendicularian Oikopleura dioica

Ballast material (organic, opal, calcite, lithogenic) is suggested to affect sinking speed of aggregates in the ocean. Here, we tested this hypothesis by incubating appendicularians in suspensions of different algae or Saharan dust, and observing the sinking speed of the marine snow formed by their discarded houses. We show that calcite increases the sinking speeds of aggregates by ~100% and lithogenic material by ~150% while opal only has a minor effect. Furthermore the effect of ballast particle concentration was causing a 33 m d(-1) increase in sinking speed for a 5×10(5) µm(3) ml(-1) increase in particle concentration, near independent on ballast type. We finally compare our observations to the literature and stress the need to generate aggregates similar to those in nature in order to get realistic estimates of the impact of ballast particles on sinking speeds

Eggs of the copepod Acartia tonsa Dana require hypoxic conditions to tolerate prolonged embryonic development arrest

Additional file 1. Raw data and calculations for all experiments as well as an overview of experiments in this study

Turbulence drives microscale patches of motile phytoplankton

Patchiness plays a fundamental role in phytoplankton ecology by dictating the rate at which individual cells encounter each other and their predators. The distribution of motile phytoplankton species is often considerably more patchy than that of non-motile species at submetre length scales, yet the mechanism generating this patchiness has remained unknown. Here we show that strong patchiness at small scales occurs when motile phytoplankton are exposed to turbulent flow. We demonstrate experimentally that Heterosigma akashiwo forms striking patches within individual vortices and prove with a mathematical model that this patchiness results from the coupling between motility and shear. When implemented within a direct numerical simulation of turbulence, the model reveals that cell motility can prevail over turbulent dispersion to create strong fractal patchiness, where local phytoplankton concentrations are increased more than 10-fold. This "unmixing" mechanism likely enhances ecological interactions in the plankton and offers mechanistic insights into how turbulence intensity impacts ecosystem productivity