Liposarcoma is a malignant mesenchymal neoplasm composed of adipose tissue with varying degrees of atypia. While generally indolent, some tumors have the potential to grow enormously particularly if located in the retroperitoneum. We report a 49-year-old female generally asymptomatic except for a 1-year history of gradual abdominal enlargement. Contrast-Enhanced Computed Tomography (CT) of the abdomen showed a large retroperitoneal mass with characteristic features consistent with liposarcoma. On laparotomy, the mass was encapsulated with good plane of dissection, great vessels were preserved, however the right kidney and suprarenal gland were undetachable from the primary tumor hence was removed en bloc with the liposarcoma. The post-operative course was uneventful with excellent outcome after 6 months of follow-up. Final histopathologic diagnosis revealed low-grade, dedifferentiated liposarcoma, which has favorable prognosis following radical surgery.

It is difficult to insert long-term dialysis catheters after severe stenosis or occlusion of the internal jugular vein and innominate vein. We used REcanalisation and balloon-oriented puncture for Re-insertion of dialysis catheter in nonpatent central veins (REBORN) in seven patients with severe central venous lesions, and all patients were inserted with long-term dialysis catheters successfully. None had severe complications such as pneumothorax, hemothorax, or pulmonary embolism during operation. All catheters functioned well after postoperative follow-up of 2 months. REBORN provides a novel approach to establish difficult dialysis pathways.
Humans ; Catheterization, Central Venous/adverse effects* ; Catheters, Indwelling ; Renal Dialysis ; Jugular Veins ; Punctures

BACKGROUND: Kidney transplantation (KT) remains to be the preferred mode of renal replacement therapy as it offers the best clinical outcomes, a better quality of life, and lesser complications compared to dialysis. However, KT still carries a number of complications, one of which is graft thrombosis. Despite advancements in treatment, graft thrombosis is still an important cause of early graft loss. Prevention therefore, is of significance. A growing number of evidence suggests that low-dose aspirin has a role in the primary prevention of allograft thrombosis. RESEARCH QUESTION: Among renal transplant recipients, does postoperative aspirin prevent early renal allograft thrombosis? OBJECTIVE: To conduct a meta-analysis to determine the effect of postoperative aspirin on preventing renal allograft thrombosis. METHODS: A systematic search of PubMed, Google Scholar, CENTRAL, and clinicaltrials.gov was done by two independent authors. All randomized and non-randomized studies determining the effect of postoperative aspirin on renal vein/allograft thrombosis were reviewed for eligibility and quality assessment. Studies on both adult and pediatric kidney transplant recipients were included. RESULTS: Five non-randomized cohort studies (3 in adults, 2 in children) with a total of 2,393 patients were included. Using the Newcastle-Ottawa scale, two studies were found to have good quality, while three had poor quality. In a fixed-effects meta-analysis, aspirin was associated with a reduced risk for renal allograft thrombosis in adults (RR 0.13; 95% CI 0.06, 0.28;I2 22%) and children (RR 0.11; 95% CI 0.03, 0.40; I2 0%). CONCLUSION: Post-operative aspirin was associated with reduced risk for renal allograft thrombosis in both adults and children. However, the best available evidence is limited to observational studies. A well-designed randomized controlled trial is needed to confirm this finding.
Aspirin ; Kidney Transplantation ; Renal Veins ; Venous Thrombosis ; Transplantation, Homologous ; Kidney Diseases ; ; Veins ; Allografts

Hemodialysis patients rarely experience neurologic symptoms related to their vascular accesses. However, occlusion of venous drainage induces extreme venous hypertension and in rare cases cause intracranial venous congestion. We report a patient with cerebral venous infarction resulting from reflux flow into the cranium induced by an arteriovenous jump graft to the internal jugular vein. Clinicians should take into account the possibility of neurologic deficit related to intracranial venous hypertension in hemodialysis patients.
Arteriovenous Fistula ; Drainage ; Humans ; Hyperemia ; Hypertension ; Infarction ; Jugular Veins ; Neurologic Manifestations ; Renal Dialysis ; Skull ; Transplants ; Veins

renal veins which drain the ectopic kidney was found to be persisting subcardinal vein and it is a novel finding. Such ectopic pelvic kidneys are susceptible to blunt trauma, iatrogenic injuries as well as pathologic manifestations.]]>
Abdomen ; Aorta, Abdominal ; Cadaver ; Colon, Sigmoid ; Deception ; Humans ; Kidney ; Male ; Pelvis ; Renal Veins ; Sacrum ; Veins

renal arteries originating not only from the aorta but also from the testicular artery was found in a 75-year-old Korean male cadaver. Three renal arteries arose from the lateral aspect of the abdominal aorta on the right side and four from the left side. Two additional renal parenchymal branches originated from the left testicular artery, accompanied by a pair of veins out of the four testicular veins on the left side. Embryological development of the urogenital vessels is of particular importance for anatomists and clinicians.]]>
Aged ; Anatomists ; Aorta ; Aorta, Abdominal ; Arteries ; Cadaver ; Humans ; Male ; Renal Artery ; Veins

renal venous origin are limited. This information is important in various surgical and clinical procedures including venous embolization, vascular reconstruction during renal transplantation and localizing the source of origin of a pelvic mass. We examined 94 sides of 47 formalin fixed female cadavers and noted the course and termination of ovarian veins. We measured the diameter of ovarian veins at their termination point and the termination distance in respect to the termination point of renal veins at inferior vena cava (IVC) on respective sides. We found two cases of variations related to right ovarian vein -one, right ovarian vein joined the right renal vein; two, right ovarian vein duplicated and joined with IVC at two different points. We found one case of variation related to left ovarian vein—a partially duplicated left ovarian vein. All the variations were unilateral. The mean diameters of right and left ovarian veins were 3.66±1.18 and 4.20±0.96 mm, respectively. The distance of termination of ovarian veins ranged from 19–40 mm and 13–41 mm, respectively from termination points of right and left renal veins at IVC on respective sides. Our study presents a set of data regarding variation of ovarian veins, diameters and termination distances which could be useful for gynecologists, surgeons and radiologists.]]>
Cadaver ; Female ; Formaldehyde ; Humans ; Kidney Transplantation ; Renal Veins ; Surgeons ; Veins ; Vena Cava, Inferior

PURPOSE: Computed tomography (CT) is the most useful diagnostic modality for staging renal cell carcinoma (RCC). However, CT is limited in its ability to predict renal sinus fat invasion (SFI). Here, we aimed to evaluate whether preoperative neutrophil-to-lymphocyte ratio (NLR) could predict pathological SFI in patients with RCC of ≤7 cm for whom preoperative imaging reveals potential renal SFI. MATERIALS AND METHODS: We reviewed the medical records of 1311 patients who underwent extirpative renal surgery for non-metastatic RCC of ≤7 cm between November 2005 and December 2014. After excluding patients with no SFI in preoperative imaging, unavailable preoperative data, and morbidity affecting inflammatory markers, a total of 476 patients were included in this study. Multivariate logistic regression analysis was used to evaluate predictors of pathological SFI. RESULTS: We implemented a cut-off value of 1.98, which was calculated by ROC analysis to obtain high (≥1.98) and low (<1.98) NLR groups. A total of 93 patients with pathological SFI had larger clinical tumor size, higher preoperative NLR, larger pathological tumor size, more frequent renal vein involvement, and higher Fuhrman nuclear grade. Multivariate analysis indicated that high NLR [odds ratio (OR) 2.032, p=0.004], clinical tumor size (OR 1.586, p<0.001), and collecting system involvement on preoperative imaging (OR 3.957, p=0.011) were significantly associated with pathological SFI in these tumors. CONCLUSION: Preoperative high NLR was associated with pathological SFI in patients with RCC of ≤7 cm and presumed SFI on preoperative imaging. Greater surgical attention is needed to obtain negative margins during partial nephrectomy in these patients.
Carcinoma, Renal Cell ; Humans ; Logistic Models ; Lymphocytes ; Medical Records ; Multivariate Analysis ; Nephrectomy ; Neutrophils ; Renal Veins ; ROC Curve

The primary site for a hemodialysis catheter insertion is the right internal jugular vein (IJV) followed by the left IJV and subclavian vein. In cases when veins of the upper extremities are exhausted, femoral veins are an alternative insertion location. Femoral catheter insertions should only be used for short periods because of the increased risk of infection. There is a percutaneous technique to recanalize occluded central veins for hemodialysis catheter insertion. We experienced success with a cut-down method for permcath through a completely occluded IJV. We, therefore, find surgical recanalization to be better than percutaneous method in terms of cost and safety.
Catheters ; Femoral Vein ; Humans ; Jugular Veins ; Methods ; Renal Dialysis ; Subclavian Vein ; Upper Extremity ; Veins

BACKGROUND AND OBJECTIVES: The feature of chronic kidney failure (CKF) is loss of kidney functions due to erosion of healthy tissue and fibrosis. Recent studies showed that Mesenchymal stem cells (MSCs) differentiated into tubular epithelial cells thus renal function and structures renewed. Furthermore, MSCs protect renal function in CKF. Therefore, we aimed to investigate whether human amnion-derived mesenchymal stem cells (hAMSCs) can repair fibrosis and determine the effects on proliferation and apoptosis mechanisms in chronic kidney failure. METHODS AND RESULTS: In this study, rat model of CKF was constituted by applying Aristolochic acid (AA). hAMSCs were isolated from term placenta amnion membrane and transplanted into tail vein of rats. At the end of 30 days and 60 days of recovery period, we examined expressions of PCNA, p57 and Parp-1 by western blotting. Immunoreactivity of PCNA, Ki67, IL-6 and Collagen type I were detected by immunohistochemistry. Besides, apoptosis was detected by TUNEL. Serum creatinine and urea were measured. Expressions of PCNA and Ki67 increased in hAMSC groups compared with AA group. Furthermore, expressions of PARP-1 apoptosis marker and p57 cell cycle inhibitory protein increased in AA group significantly according to control, hAMSC groups and sham groups. IL-6 proinflammatory cytokine increased in AA group significantly according to control, hAMSCs groups and sham groups. Expressions of Collagen type I protein reduced in hAMSCs groups compared to AA group. After hAMSC treatment, serum creatinine and urea levels significantly decreased compared to AA group. After injection of hAMSC to rats, Masson’s Trichrome and Sirius Red staining showed fibrosis reduction in kidney. CONCLUSIONS: According to our results hAMSCs can be ameliorate renal failure.
Amnion ; Animals ; Apoptosis ; Blotting, Western ; Cell Cycle ; Collagen Type I ; Creatinine ; Epithelial Cells ; Fibrosis ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Interleukin-6 ; Kidney ; Kidney Failure, Chronic ; Membranes ; Mesenchymal Stromal Cells ; Models, Animal ; Placenta ; Proliferating Cell Nuclear Antigen ; Rats ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Tail ; Urea ; Veins