Laparoscopic Upper-pole Nephroureterectomy In Infants

Objective: Report the results of laparoscopic upper-pole nephroureterectomy in infants. Materials and Methods: Six consecutive infants underwent 7 laparoscopic upper-pole nephroureterectomy. Pre and post-operative evaluation included renal sonography, voiding cystourethrogram and renal scintigraphy. All infants showed upper-pole exclusion. Surgery was performed through a transperitoneal approach with full flank position in all infants. Three or 4 ports were used according to the necessity of retracting the liver. The distal ureter was ligated close to the bladder whenever reflux was present and the dysplastic upper-pole was divided with the help of an electrocautery. Data regarding operative time, postoperative use of analgesics, time to resume oral feeding, hospital stay and tubular function were collected and analyzed. Results: All procedures were concluded as planned. Mean operative time was 135 min. One patient underwent staged bilateral upper-pole nephrectomy. There were no complications and the postoperative hospital stay was 48 hours in 5 procedures and 24 hours in 2 procedures. Pain medication was required only in the first day. Renal tubular function showed improvement in half of the cases. Conclusion: Laparoscopic partial nephrectomy is a safe and feasible procedure in infants. Due to the magnification provided by the lenses, a better vision of the structures is achieved, facilitating selective dissection of vascular upper-pole, renal parenchyma and distal ureter. This approach is less damaging to the lower pole, and is associated to low morbidity and a short hospital stay.3318791Peters, C.A., Laparoscopic and robotic approach to genitourinary anomalies in children (2004) Urol Clin North Am, 31, pp. 595-605Robinson, B.C., Snow, B.W., Cartwright, P.C., De Vries, C.R., Hamilton, B.D., Anderson, J.B., Comparison of laparoscopic versus open partial nephrectomy in a pediatric series (2003) J Urol, 169, pp. 638-640Steyaert, H., Valla, J.S., Minimally invasive urologic surgery in children: An overview of what can be done (2005) Eur J Pediatr Surg, 15, pp. 307-313Koyle, M.A., Woo, H.H., Kavoussi, L.R., Laparoscopic nephrectomy in the first year of life (1993) J Pediatr Surg, 28, pp. 693-695Valla, J.S., Breaud, J., Carfagna, L., Tursini, S., Steyaert, H., Treatment of ureterocele on duplex ureter: Upper pole nephrectomy by retroperitoneoscopy in children based on a series of 24 cases (2003) Eur Urol, 43, pp. 426-429Jordan, G.H., Winslow, B.H., Laparoendoscopic upper pole partial nephrectomy with ureterectomy (1993) J Urol, 150, pp. 940-943Horowitz, M., Shah, S.M., Ferzli, G., Syad, P.I., Glassberg, K.I., Laparoscopic partial upper pole nephrectomy in infants and children (2001) BJU Int, 87, pp. 514-516Gill, I.S., Delworth, M.G., Munch, L.C., Laparoscopic retroperitoneal partial nephrectomy (1994) J Urol, 152, pp. 1539-1542Borzi, P.A., A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children (2001) BJU Int, 87, pp. 517-520Desgrandchamps, F., Gossot, D., Jabbour, M.E., Meria, P., Teillac, P., Le Duc, A., A 3 trocar technique for transperitoneal laparoscopic nephrectomy (1999) J Urol, 161, pp. 1530-1532Hulbert, W.C., Rabinowitz, R., Prenatal diagnosis of duplex system hydronephrosis: Effect on renal salvage (1998) Urology, 51, pp. 23-26El-Ghoneimi, A., Farhat, W., Bolduc, S., Bagli, D., McLorie, G., Khoury, A., Retroperitoneal laparoscopic vs open partial nephroureterectomy in children (2003) BJU Int, 91, pp. 532-535Jednak, R., Kryger, J.V., Barthold, J.S., Gonzalez, R., A simplified technique of upper pole heminephrectomy for duplex kidney (2000) J Urol, 164, pp. 1326-1328Borzi, P.A., Yeung, C.K., Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children (2004) J Urol, 171, pp. 814-816Guillonneau, B., Ballanger, P., Lugagne, P.M., Valla, J.S., Vallancien, G., Laparoscopic versus lumboscopic nephrectomy (1996) Eur Urol, 29, pp. 288-291Janetschek, G., Seibold, J., Radmayr, C., Bartsch, G., Laparoscopic heminephroureterectomy in pediatric patients (1997) J Urol, 158, pp. 1928-193

Sensitivity of frost occurrence to temperature variability in the European Alps

In this study, we set out to investigate the linkage of frost frequency to monthly mean temperature and its sensitivity to temperature changes. According to other related studies, the linkage between frost frequency and monthly mean temperature is approximated month per month via hyperbolic tangent functions. These models are validated using three validation experiments including split sample tests and temporal cross-validation. As there are quality-checked station data in Austria, whose temporal resolution and length allow for such a validation procedure, the validation experiments are conducted there. After the performance of the empirical models is evaluated and found adequate, the hyperbolic tangent approach is applied to about 500 stations within the so called Greater Alpine region (GAR), which extends from about 4 degrees E to 18 degrees E and from 44 degrees N to 49 degrees N. Using these models, it is possible to derive the sensitivity of frost frequency for any location for which the annual temperature cycle is known. This strategy is explicitly demonstrated for the Po Plain, where vertical temperature profiles on a monthly base are on hand as well as in Austria, where spatially high resolved maps of monthly mean temperature are available. Moreover, at stations for which long-term homogenised series of monthly mean temperature are available, reconstructions of frost frequency via the empirical models are done, returning to historical periods where no measurements of minimum temperature exist. On the basis of these findings, the impact of a possible future warming can be assessed, which is essential with regard to glaciers, permafrost and avalanches. Reduction in frost might bring positive economic aspects for agriculture, but negative consequences for low level skiing areas. Copyright (c) 2005 Royal Meteorological Society

Adult human bone cells from jaw bones cultured on plasma-sprayed or polished surfaces of titanium or hydroxylapatite discs.

Studio reattivit\ue0 in vitro degli osteoblasti mascellari umani al contatto con superfici di titatnio o idrossiapatit

Laparoscopic upper-pole nephroureterectomy in infants

OBJECTIVE: Report the results of laparoscopic upper-pole nephroureterectomy in infants. MATERIALS AND METHODS: Six consecutive infants underwent 7 laparoscopic upper-pole nephroureterectomy. Pre and postoperative evaluation included renal sonography, voiding cystourethrogram and renal scintigraphy. All infants showed upper-pole exclusion. Surgery was performed through a transperitoneal approach with full flank position in all infants. Three or 4 ports were used according to the necessity of retracting the liver. The distal ureter was ligated close to the bladder whenever reflux was present and the dysplastic upper-pole was divided with the help of an electrocautery. Data regarding operative time, postoperative use of analgesics, time to resume oral feeding, hospital stay and tubular function were collected and analyzed. RESULTS: All procedures were concluded as planned. Mean operative time was 135 min. One patient underwent staged bilateral upper-pole nephrectomy. There were no complications and the postoperative hospital stay was 48 hours in 5 procedures and 24 hours in 2 procedures. Pain medication was required only in the first day. Renal tubular function showed improvement in half of the cases. CONCLUSION: Laparoscopic partial nephrectomy is a safe and feasible procedure in infants. Due to the magnification provided by the lenses, a better vision of the structures is achieved, facilitating selective dissection of vascular upper-pole, renal parenchyma and distal ureter. This approach is less damaging to the lower pole, and is associated to low morbidity and a short hospital stay