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1. Bilateral proximal ureteral and ureterovesical junction obstruction in a child

Author

Daniel A. Reich, Christopher E. Bayne, Cynthia A. Sharadin, and Romano T. DeMarco

Subjects
Ureteropelvic obstruction, Ureterovesical obstruction, Congenital obstructive megaureter, Dismembered pyeloplasty, Ureteral reimplantation, Pediatric, Diseases of the genitourinary system. Urology, RC870-923
Abstract

The most common sites of ureteral obstruction in children are at the level of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ). Bilateral hydronephrosis or hydroureteronephrosis due to varying degrees of obstruction at the UPJ or UVJ is common in children and typically improves with time. Clinically significant obstruction at both locations in an ipsilateral ureter occurs less commonly and rarely requires both dismembered pyeloplasty and ureteral reimplantation. We believe this case report is the first description of bilateral proximal and distal ureteral obstruction requiring both dismembered pyeloplasty and ureteral reimplantation.

Published
2023
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2. Simulating future land-use within the uThukela and uMngeni catchments in KwaZulu-Natal

Author

Kimara Moodley, Michele L. Toucher, and Romano T. Lottering

Subjects
LULCC, CA-Markov model, Environmental change, Sustainable land-use planning, Science
Abstract

Due to anthropogenic activities, the earth's surface is consistently being altered. These alterations take the form of Land-use/cover change (LULCC), which is a fundamental driver of global, regional and local environmental change. LULCC studies have become pivotal in supplementing our understanding and observations of environmental change. However, understanding the past and present spatial-temporal variability of LULCC characteristics and their link to future land-use/cover trajectories at a catchment scale is limited, particularly in Southern Africa. To address this limitation, this study simulated future land-use change utilising a spatially distributed, empirical land-use modelling approach for the uThukela and uMngeni catchments in the KwaZulu-Natal province of South Africa. The CA-Markov model, a popular and frequently utilised model employed in land-use and land-cover (LULC) predictive modelling, was selected to simulate LULCC conjointly with Geographic Information Systems (GIS) techniques. The obtained kappa values (Kstandard, Klocation and Kno) achieved during the validation were all above 80%, thus indicating the model's reliability and capability to successfully predict future LULC in the study sites. Future projections indicated that both study areas are anticipated to experience anthropogenic induced LULCC, which further fragments the landscape configuration, functionality and ecological stability. Historical analysis of LULCC between 1990 and 2018, in the study catchments revealed considerable declines in the areas under grassland and indigenous forest, while the areas under cultivated land, commercial forestry and urban LULC classes increased. Future LULC projections showed that urban and agriculture land-uses increased significantly, with natural land-use classes such as grassland, other vegetation and indigenous forest declining in spatial extent across both. With an understanding of the extent of projected LULCC by 2030 within both catchments, proactive planning and management within the framework of sustainable land-use planning and water resource management in the respective catchments can be undertaken. Moreover, the results of the land-use modelling study can be used to infill historical data gaps, support effective land-use planning and provide a means to evaluate the impacts of different future development pathways.

Published
2023
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3. Indocyanine green (ICG) assessment of ureteral perfusion during pediatric robotic surgery

Author

Katelyn N. Carty, Alexander Hwang, Ashley Gordon, Rachel Locke, Romano T. DeMarco, and Christopher E. Bayne

Subjects
Pediatric urology, Near-infrared technology, Fluorescence imaging, Indocyanine green, Ureteroureterostomy, Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

Background: Vascular preservation is a tenet of successful ureteral reconstruction. Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) provides real-time identification of tissue perfusion during robotic surgery. Here, we present our utilization of NIRF with ICG to ensure adequate ureteral perfusion during robotic reconstruction in 3 pediatric patients. Case presentation: Between July 2019 and May 2020, we utilized NIRF with ICG during 3 consecutive robotic ureteral reconstructive cases in an academic pediatric urology practice. Patients were 3-, 14-, and 17-years-old and presented with congenital ureteral stricture, mid-ureteral polyp disease, and distal-ureteral polyp disease, respectively. Following surgical reconstruction of each patient's underlying pathology, ICG doses of 0.039–0.086 mg/kg IV were used to elucidate blood supply to the affected segment of ureter prior to closing. In all 3 cases, NIRF with da Vinci Xi endoscope's Firefly® technology confirmed perfusion proximal and distal to target anatomy within 60 seconds of administration. Conclusion: Use of ICG appears to be low-cost, safe, and useful during pediatric urologic robotic surgery. This technology may be helpful to confirm satisfactory blood supply to the ureter following robotic ureteral reconstruction, as demonstrated in our case series of 3 pediatric patients.

Published
2021
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4. C-BLUE One : A family of CMOS high speed cameras for wavefront sensing

Author

Gach, J. L., Boutolleau, D., Carmignani, T., Clop, F., De Kernier, I., Feautrier, P., Florentin, M., Lemarchand, S., Pettigiani, J., Romano, T., Stadler, E., Tugnoli, J., and Wanwanscappel, Y.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics, Physics - Instrumentation and Detectors
Abstract

We present the evolutions of the C-BLUE One family of cameras (formerly introduced as C-MORE), a laser guide star oriented wavefront sensor camera family. Within the Opticon WP2 european funded project, which has been set to develop LGS cameras, fast path solutions based on existing sensors had to be explored to provide working-proven cameras to ELT projects ready for the first light schedule. Result of this study, C-BLUE One is a CMOS based camera with 1600x1100 pixels (9um pitch) and 481 FPS refresh rate. It has been developed to answer most of the needs of future laser based adaptive optics systems (LGS) to be deployed on 20-40m-class telescopes as well as on smaller ones. We present the main features of the camera and measured performance in terms of noise, dark current, quantum efficiency and image quality which are the key parameters for the application. The camera has been declined also in fast smaller format (800x600x1500FPS) and large format (3200X2200x250FPS) to cover most of the AO applications., Comment: arXiv admin note: substantial text overlap with arXiv:1910.00374

Published
2022

5. Percutaneous Nephrolithotomy in Children

Author

Romano T. DeMarco

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL) in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL) were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi.

Published
2011
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9. The Unexploited Potential of Small-Scale Fisheries in Italy: Analysis and Perspectives on the Status and Resilience of a Neglected Fishery Sector

Author

Raicevich, Saša, Grati, Fabio, Giovanardi, Otello, Sartor, Paolo, Sbrana, Mario, Silvestri, Roberto, Baino, Romano T., Andaloro, Franco, Battaglia, Pietro, Romeo, Teresa, Spagnolo, Massimo, Dubois, Mark, Bavinck, Maarten, Series Editor, Jentoft, Svein, Series Editor, Pascual-Fernández, José J., editor, and Pita, Cristina, editor

Published
2020
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17. Ovotesticular Disorder Mimicking Acute Spermatic Cord Torsion

Author

Eric Midenberg, Christopher E. Bayne, Sara M. Falzarano, and Romano T. DeMarco

Subjects
endocrine system, Testicular tissue, Gonad, endocrine system diseases, urogenital system, business.industry, Urology, Ovary, Anatomy, Ambiguous genitalia, medicine.anatomical_structure, Older patients, Normal external genitalia, Medicine, Spermatic Cord Torsion, business
Abstract

Ovotesticular disorder is a rare form of sexual development in which a patient may have one ovary and one testis, or more commonly a gonad or gonads containing both ovarian and testicular tissue. Patients with this condition typically present in infancy with ambiguous genitalia. Delayed presentations of clinically symptomatic, older patients with normal external genitalia are extremely rare. We present a case of a 14-year-old male with normal external genitalia who presented with symptoms and signs consistent with spermatic cord torsion but found to have ovotesticular disorder on evaluation.

Published
2022
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21. Adressen der Autoren

Author

Adams, Mark C., primary, Albala, David M., additional, Anger, Jennifer T., additional, Anoia, Elizabeth, additional, Assimos, Dean G., additional, Auge, Brian K., additional, Bagley, Demetrius H., additional, Baker, Linda A., additional, Barocas, Daniel A., additional, Barry, John M., additional, Baskin, Laurence S., additional, Beck, Stephen, additional, Bella, Anthony J., additional, Bishoff, Jay T., additional, Bivalacqua, Trinity J., additional, Blaivas, Jerry G., additional, Blute, Michael L., additional, Boorjian, Stephen Anthony, additional, Borer, Joseph, additional, Borin, James F., additional, Brant, William O., additional, Brock, John W., additional, Broghammer, Joshua A., additional, Brugh, Victor M., additional, Buckley, Jill C., additional, Bullock, Travis L., additional, Burkhard, Fiona C., additional, Burnett, Arthur L., additional, Cadeddu, Jeffrey A., additional, Campbell, Jeffrey B., additional, Canes, David, additional, Cartwright, Patrick C., additional, Castle, Erik P., additional, Champagne, Bradley, additional, Chang, Sam S., additional, Chen, Tony Y., additional, Cheng, Earl Y., additional, Cherullo, Edward, additional, Christie, Alison M., additional, Clark, Peter E., additional, Clayman, Ralph V., additional, Cookson, Michael S., additional, Corbett, Sean T., additional, Costabile, Raymond A., additional, Davis, Rodney, additional, Deane, Leslie A., additional, Dechet, Christopher B., additional, DeLancey, John O.L., additional, DeMarco, Romano T., additional, Denstedt, John D., additional, Desai, Mahesh R., additional, Desai, Mihir M., additional, Desai, Rahul A., additional, Disick, Grant, additional, Dmochowski, Roger R., additional, Elder, Jack S., additional, Elliott, Sean P., additional, Elmajian, Donald A., additional, Fergany, Amr, additional, Flynn, Brian J., additional, Fossett, Lindsay, additional, Foster, Richard, additional, Ganpule, Arvind P., additional, Gargollo, Patricio, additional, Gill, Inderbir S., additional, Gjertson, Carl K., additional, Goldfarb, David A., additional, Goldstein, Marc, additional, Gonzalgo, Mark L., additional, Gormley, E. Ann, additional, Guralnick, Michael, additional, Haber, Georges-Pascal, additional, Haleblian, George E., additional, Hartke, David, additional, Hellstrom, Wayne J.G., additional, Herrell, S. Duke, additional, Hinman, Frank, additional, Holzbeierlein, Jeffrey M., additional, Horowitz, Andrew I., additional, Hulbert, William C., additional, Ihara, Hiroyuki, additional, Inman, Brant, additional, Jarrett, Thomas W., additional, Jordan, Gerald H., additional, Kaplan, Steven A., additional, Kaufman, Melissa R., additional, Kavoussi, Louis R., additional, Kesler, Stuart, additional, Kick, Phillip S., additional, Kirsch, Andrew J., additional, Klein, Frederick A., additional, Kobashi, Kathleen C., additional, Koenig, Philippe, additional, Koh, Chester J., additional, Kokorowski, Paul, additional, Krishnamurthi, Venkatesh, additional, Kropp, Bradley P., additional, Kuo, Ramsay L., additional, Landman, Jaime, additional, Larson, Kindra, additional, Latini, Jerilyn M., additional, Leach, Gary E., additional, Lee, David I., additional, Leng, Wendy W., additional, L’Esperance, James O., additional, Leveillee, Raymond J., additional, Levy, David A., additional, Lingeman, James E., additional, Lue, Tom F., additional, Makari, John H., additional, Marderstein, Eric L., additional, Marguet, Charles G., additional, Martin, Frances M., additional, McAninch, Jack W., additional, McClure, R. Dale, additional, McGuire, Edward J., additional, McVary, Kevin T., additional, Mevorach, Robert A., additional, Middleton, Richard G., additional, Milam, Douglas F., additional, Miller, Elizabeth A., additional, Miller, Nicole, additional, Modder, Joshua K., additional, Moinzadeh, Ali, additional, Monga, Manoj, additional, Montague, Drogo K., additional, Montie, James, additional, Moore, Charles R., additional, Morey, Allen F., additional, Morgan, Daniel M., additional, Morrisroe, Shelby N., additional, Mufarrij, Patrick W., additional, Munver, Ravi, additional, Ng, Christopher S., additional, Nisbet, Alan A., additional, Novick, Andrew C., additional, O’Connor, R. Corey, additional, Okeke, Zeph, additional, Pak, Raymond W., additional, Parekh, Dipen J., additional, Pearle, Margaret S., additional, Perer, Elise, additional, Peterson, Andrew C., additional, Phillips, Courtney K., additional, Pierre, Ketsia, additional, Polascik, Thomas J., additional, Ponsky, Lee, additional, Pope, John, additional, Preminger, Glenn M., additional, Prieto, Juan C., additional, Rabinowitz, Ronald, additional, Rapp, David E., additional, Raz, Shlomo, additional, Redman, John F., additional, Richstone, Lee, additional, Roberts, William W., additional, Rosen, Michael J., additional, Rosenblatt, Gregory S., additional, Rowland, Randall G., additional, Saini, Rajiv, additional, Sampaio, Francisco J.B., additional, Scarpero, Harriette M., additional, Scherr, Douglas S., additional, Schlegel, Peter N., additional, Sherman, Neil D., additional, Shields, John, additional, Shinohara, Katsuto, additional, Siegel, Steven W., additional, Skinner, Eila, additional, Skoog, Steven J., additional, Smith, Arthur D., additional, Smith, Joseph A., additional, Snodgrass, Warren T., additional, Soltanian, Hooman, additional, Sotelo, Rene, additional, Spirnak, J. Patrick, additional, Steers, William D., additional, Stein, John P., additional, Stifelman, Michael D., additional, Studer, Urs E., additional, Sundaram, Chandru P., additional, Sur, Roger L., additional, Sutherland, Richard W., additional, Suzuki, Kazuo, additional, Tan, Yeh Hong, additional, Tanrikut, Cigdem, additional, Thiel, David D., additional, Thomas, John C., additional, Thomas, Raju, additional, Triaca, Veronica, additional, Trunzo, Joseph A., additional, Tsuru, Nobuo, additional, Turek, Paul J., additional, Twiss, Christian O., additional, Vanderbrink, Brian A., additional, Vasavada, Sandip P., additional, Vaughan, E. Darracott, additional, Venable, Dennis D., additional, Vourganti, Srinivas, additional, Wagner, Kristofer R., additional, Walsh, Dena L., additional, Walsh, Thomas J., additional, Wan, Julian, additional, Waters, W. Bedford, additional, Webster, George D., additional, Wessells, Hunter, additional, White, Wesley M., additional, Wiener, John S., additional, Wignall, Geoffrey R., additional, Winfield, Howard N., additional, Wise, Paul E., additional, Wolf, J. Stuart, additional, Wolter, Christopher E., additional, Woods, Michael E., additional, and Zeltser, Ilia S., additional

Published
2017
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25. Pediatric Robot-Assisted Laparoscopic and Ureteroscopic Ureterolithotomy and Ureteroplasty

Author

Rachel A Locke, Elizabeth P Kwenda, Jeremy M. Archer, Romano T. DeMarco, Christopher E. Bayne, Jeremy A Bergamo, and Maria Paula Domino

Subjects
medicine.medical_specialty, business.industry, Urology, Urinary system, medicine, Robot-Assisted Laparoscopic Surgery, Pediatric urolithiasis, Robotic surgery, Case Reports, business, Lithotomy position, Surgery
Abstract

Background: Pediatric urolithiasis may coexist with congenital urinary tract abnormalities, complicating conventional methods of stone treatment. Here, we present an effective case of robot-assisted laparoscopy and simultaneous ureteropyeloscopy for the definitive management of pediatric urolithiasis complicated by a congenital ureteral stricture. Case Presentation: A 3-year-old girl presented to clinic with an outside noncontrast CT scan showing two 6–7 mm nonobstructing calculi in a mildly distended upper pole moiety of a duplex left kidney. Ureteral duplication status was unclear. The patient had suffered multiple febrile urinary tract infections throughout her life. Retrograde ureteropyelogram showed a stenotic waist in the upper pole ureter just proximal to the duplex ureteral convergence, and flexible ureteroscopy confirmed a congenital ureteral stricture. Simultaneous robot-assisted laparoscopic and ureteroscopic ureterolithotomy and ureteroplasty were offered and performed using a 3-armed robotic approach. The precise location of the stricture was identified robotically with simultaneous left ureteroscopy. A medial 1.5 cm longitudinal ureterotomy was made through the ureteral stricture to facilitate upper moiety ureterorenoscopy. The calculi were visualized in the upper moiety and retrieved in whole using a stone basket. The calculi were passed via the ureterotomy to the robotic instruments intraperitoneally. The longitudinal ureterotomy was closed transversely. A ureteral stent was placed, and indocyanine green was administered intravenously to confirm good perfusion of the ureteroplasty segment via fluorescence imaging. The stent was removed at 4 weeks. Retrograde ureterography and flexible ureteroscopy revealed complete patency of the anastomosis. At 11 months, the upper pole moiety remained decompressed on ultrasonography. The patient has remained off antibiotic prophylaxis without further infection. Conclusion: Robot-assisted approaches can be primary or adjunct tools in the definitive treatment of pediatric urolithiasis with concomitant urinary tract abnormalities.

Published
2020
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26. Medical Expulsive Therapy (MET) for Ureteral Calculi in Children: Systematic Review and Meta-Analysis

Author

Michael W. Bacchus, Rachel A. Locke, Elizabeth P. Kwenda, Romano T. DeMarco, Campbell Grant, and Christopher E. Bayne

Abstract

BackgroundMedical expulsive therapy (MET) is the use of medication to facilitate ureteral stone passage prior to surgical intervention. Practice guidelines for the use of MET in the pediatric population remain limited, primarily due to a scarcity of randomized controlled trials and concerns regarding dosing and side effects. To address this, we conducted a systematic review and meta-analysis to clarify the impact of MET on the spontaneous passage of pediatric stones located within the distal ureter.MethodsA narrow scope search using PubMed and Embase with a predefined search strategy was performed in September 2021 to identify all randomized controlled trials involving the use of pediatric MET for stones located in the distal ureter. Raw data from 6 eligible articles were extracted for pooled analysis. Our primary outcome was the overall effect of MET on ureteral calculi passage within 28 days compared to controls.ResultsThe mean age of patients in included studies was 7.6 years-old, with a range of ages 2–18 years old. In the pooled analysis of eligible studies, 235 patients received MET and 176 received placebo. The mean stone size was 6.40 mm in the treatment arm and 6.42 mm in the control arm. Children receiving MET were more likely than controls to experience spontaneous stone passage [Relative risk 1.39 (CI 95% 1.21–1.60)]. Considering all included studies, only one child treated with MET withdrew due to medication side effects.ConclusionOur systematic review and meta-analysis of the use of pediatric MET on spontaneous distal ureteral stone passage demonstrates a statistically significant benefit. The benefits of MET are diverse and include, possibly, minimizing exposure to anesthesia and radiation alongside improving surgical outcomes if ureteroscopy must be performed. Given the increasing incidence of ureteral stones in children and the nuances inherent to pediatric surgery due to smaller anatomy, MET represents an opportunity for safer and more effective pediatric stone management.

Published
2022
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50. Robot-Assisted Laparoscopic Resection of the Mesonephric Duct Remnant in a Patient with Zinner Syndrome

Author

Christopher E. Bayne, Li-Ming Su, Elizabeth P Kwenda, Rachel A Locke, Romano T. DeMarco, Archana Shenoy, and Jeremy S Archer

Subjects
Right Seminal Vesicle, medicine.medical_specialty, business.industry, MESONEPHRIC DUCT REMNANT, Urology, Pelvic pain, 030232 urology & nephrology, Case Reports, medicine.disease, Pediatric urology, Surgery, body regions, 03 medical and health sciences, surgical procedures, operative, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Cyst, Laparoscopic resection, medicine.symptom, business, Left kidney
Abstract

Introduction: A 17-year-old male with Zinner syndrome, a right seminal vesicle cyst, and a solitary left kidney presented with chronic pelvic pain. Previous surgeons had attempted robot-assisted laparoscopic seminal vesicle cyst aspiration and transurethral resection of the ejaculatory duct. Neither surgery provided sustained symptom relief. Abdominal and pelvic MRI showed a cystic structure lodged between the prostate and bladder. The right seminal vesicle, kidney, and ureter were not observed. Materials and Methods: A robot-assisted laparoscopic seminal vesiculectomy was planned. Dissection distal to the right vas deferens and between the bladder neck and prostate revealed a cystic seminal vesicle-like structure. Attached to this was a tubular structure coursing deep to the vas deferens from the right renal fossa. This was presumed to be a dysplastic ureter. The dysplastic ureter was transected from the seminal vesicle and the seminal vesicle was marsupialized to the deep pelvis. Proximally, the dysplastic ureter was transected and left open. Results: Histologic assessment of the specimen revealed an ∼12.1 cm tubular mesonephric remnant. The postoperative course was uncomplicated. At 6 months follow-up, the patient remains free of symptoms with preserved ejaculatory volume. Conclusions: Mesonephric duct abnormalities and symptoms present on a spectrum. We present a safe and effective resection of a mesonephric duct remnant from a 17-year-old male with Zinner syndrome. A robotic approach localized to the right allowed for excellent observation without compromising left-sided genitourinary anatomy. In males presenting with renal agenesis and pelvic symptoms, clinicians should be suspicious of Zinner syndrome and other mesonephric abnormalities.

Published
2020

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