955 resultados para upper-limb muscles


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The probability for a halo coronal mass ejection (CME) to be geoeffective is assumed to be higher the closer the CME launch site is located to the solar central meridian. However, events far from the central meridian may produce severe geomagnetic storms, like the case in April 2000. In this work, we study the possible geoeffectiveness of full halo CMEs with the source region situated at solar limb. For this task, we select all limb full halo (LFH) CMEs that occurred during solar cycle 23, and we search for signatures of geoeffectiveness between 1 and 5 days after the first appearance of each CME in the LASCO C2 field of view. When signatures of geomagnetic activity are observed in the selected time window, interplanetary data are carefully analyzed in order to look for the cause of the geomagnetic disturbance. Finally, a possible association between geoeffective interplanetary signatures and every LFH CME in solar cycle 23 is checked in order to decide on the CME's geoeffectiveness. After a detailed analysis of solar, interplanetary, and geomagnetic data, we conclude that of the 25 investigated events, there are only four geoeffective LFH CMEs, all coming from the west limb. The geoeffectiveness of these events seems to be moderate, turning to intense in two of them as a result of cumulative effects from previous mass ejections. We conclude that ejections from solar locations close to the west limb should be considered in space weather, at least as sources of moderate disturbances.

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The geologic structures and metamorphic zonation of the northwestern Indian Himalaya contrast significantly with those in the central and eastern parts of the range, where the high-grade metamorphic rocks of the High Himalayan Crystalline (HHC) thrust southward over the weakly metamorphosed sediments of the Lesser Himalaya along the Main Central Thrust (MCT). Indeed, the hanging wall of the MCT in the NW Himalaya mainly consists of the greenschist facies metasediments of the Chamba zone, whereas HHC high-grade rocks are exposed more internally in the range as a large-scale dome called the Gianbul dome. This Gianbul dome is bounded by two oppositely directed shear zones, the NE-dipping Zanskar Shear Zone (ZSZ) on the northern flank and the SW-dipping Miyar Shear Zone (MSZ) on the southern limb. Current models for the emplacement of the HHC in NW India as a dome structure differ mainly in terms of the roles played by both the ZSZ and the MSZ during the tectonothermal evolution of the HHC. In both the channel flow model and wedge extrusion model, the ZSZ acts as a backstop normal fault along which the high-grade metamorphic rocks of the HHC of Zanskar are exhumed. In contrast, the recently proposed tectonic wedging model argues that the ZSZ and the MSZ correspond to one single detachment system that operates as a subhorizontal backthrust off of the MCT. Thus, the kinematic evolution of the two shear zones, the ZSZ and the MSZ, and their structural, metamorphic and chronological relations appear to be diagnostic features for discriminating the different models. In this paper, structural, metamorphic and geochronological data demonstrate that the MSZ and the ZSZ experienced two distinct kinematic evolutions. As such, the data presented in this paper rule out the hypothesis that the MSZ and the ZSZ constitute one single detachment system, as postulated by the tectonic wedging model. Structural, metamorphic and geochronological data are used to present an alternative tectonic model for the large-scale doming in the NW Indian Himalaya involving early NE-directed tectonics, weakness in the upper crust, reduced erosion at the orogenic front and rapid exhumation along both the ZSZ and the MSZ.

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BACKGROUND: Gastric banding (GB) is one of the most popular bariatric procedures for morbid obesity. Apart from causing weight loss by alimentary restriction, it can interfere with functions of the esophagus and upper stomach. The aim of this study was to evaluate if the results of extensive preoperative upper GI testing were correlated with long-term outcome and complications after GB. METHODS: Using a prospectively maintained computerized database including all the patients undergoing bariatric operations in both our hospitals, we performed a retrospective analysis of the patients who underwent complete upper gastrointestinal (GI) testing (endoscopy, pH monitoring, and manometry) before GB. RESULTS: One hundred thirty-four patients underwent complete testing before GB. Abnormal pH monitoring (increased total reflux time, increased diurnal reflux time, increased number of reflux episodes) predicted the development of complications and especially pouch dilatation and food intolerance. The mean De Meester score was higher among patients who developed complications than in the remaining ones (25.4 vs 17.7, P=0.03). High lower esophageal sphincter pressure also predicted progressive long-term food intolerance. Endoscopic findings were not predictive of the long-term outcome. CONCLUSIONS: There is some association between the function of the upper digestive tract and long-term complications after gastric banding. Abnormal pH monitoring predicts overall long-term complications, especially food intolerance with or without reflux, and pouch dilatation, and a high lower esophageal sphincter pressure predicts long-term food intolerance. Extended upper gastrointestinal testing with endoscopy, 24-h pH monitoring, and esophageal manometry is probably worthwhile in selecting patients for gastric banding.

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Résumé Cette étude porte sur le flanc inverse de la nappe de Siviez-Mischabel et sur les unités tectoniques sous jacentes (zone de Stalden supérieur et zone Houillère) dans la vallée menant à Zermatt. L'étude structurale du granite permien de Randa (orthogneiss oeillé) permet de mieux comprendre les effets de la déformation alpine sur les roches de socle. La cartographie détaillée de l'orthogneiss et de son encaissant, ainsi que l'étude lithostratigraphique des terrains sédimentaires associés permettent de proposer un schéma structural et cinématique du flanc inverse de la nappe de Siviez-Mischabel et de mieux comprendre ses relations avec les unités tectoniques sous-jacentes. L'analyse structurale de l'orthogneiss de Randa et de son encaissant révèle la superposition de plusieurs phases de déformation ductile. Cet orthogneiss formé sous des conditions métamorphiques du faciès schiste vert possède une forte schistosité alpine avec au moins deux linéations d'extension. La première, L1, orientée NW-SE est associée à la mise en place de la nappe. La seconde, L2, orientée SW-NE, se corrèle au cisaillement ductile du Simplon. La quantification de la déformation au moyen de la méthode de Fry sur les faciès porphyriques donne des ellipses à rapports axiaux compris entre 1.9 et 5.3, en accord avec les valeurs obtenues par d'autres marqueurs {tourmalines étirées, fibres). Les valeurs mesurées parallèlement à L1 ou L2 sont très semblables. La méthode de Fry a nécessité une étude théorique préalable afin de vérifier son applicabilité aux orthogneiss oeillés. La méthode requiert une distribution spatiale homogène et isotrope des marqueurs utilisés. Les tests statistiques effectués ont révélé que les phénocristaux de feldspath alcalin satisfont à cette condition et qu'ils peuvent être utilisés comme marqueur de la déformation au moyen de la méthode de Fry. Les valeurs obtenues révèlent l'importance du cisaillement ductile du Simplon sur la géométrie de la nappe dans la région d'étude. Le levé cartographique a permis d'améliorer la lithostratigraphie de la base de la nappe de Siviez-Mischabel. Trois formations en position renversée peuvent être observées sous les gneiss formant le coeur de la nappe. Ces trois formations forment le coeur du synclinal de St-Niklaus qui connecte la nappe de Siviez-Mischabel à la zone de Stalden supérieur. La datation par U-Pb de zircons détritiques et magmatiques par LA-ICP-MS permet de contraindre l'âge des formations observées (probablement Carbonifère à Trias précoce). Ces données ont des répercussions importantes sur la structure de la nappe dans la région, prouvant l'existence de plusieurs plis avec des séries normales et renversées bien préservées. La définition et la datation de ces formations, ainsi que leur identification dans la-Zone- Houillère avoisinante permettent de mieux comprendre la géométrie initiale et les relations tectoniques des nappes du Pennique moyen dans la vallée de Zermatt. Summary This study investigates the overturned limb of the Siviez-Mischabel nappe and underlying tectonic units (Upper Stalden zone and Houillère zone) in the Mattertal area. Detailed structural analysis in the Permian Randa granite (augen orthogneiss) allows a better understanding of the Alpine deformation effects on basement rocks. Detailed mapping of this orthogneiss and surrounding rocks, and the study of the lithostratigraphy in the related sedimentary horizons allow the proposition of a structural and kinematic model for the overturned limb of the Siviez-Mischabel and to better understand the relations with the underlying tectonic units. The structural analysis of the Randa orthogneiss and surrounding rocks revealed the superposition of several phases of ductile deformation. This orthogneiss formed under greenschist facies metamorphic conditions displays a strong Alpine foliation with at least two stretching lineations. The first lineation, L1, is oriented NW-SE and is related to the nappe emplacement northward. The second one, L2, is related to the Simplon ductile shear zone. Strain estimation using the Fry method has been performed on porphyritic facies of the Randa orthogneiss. The obtained ellipses have axial ratios varying between 1.9 and 5.3, in agreement with strain estimation obtained from other markers (stretched turmalines, fringes). The strain values are very similar if measured parallel to L1 or to L2. A theoretical approach was necessary to verify the relevant application of the Fry method to augen orthogneiss. This method requires that the distribution of the used markers has to be homogeneous and isotropic. Statistical tests have been done and revealed that K-feldspar phenocrysts satisfy these conditions and can be used as strain markers with the Fry method. The obtained strain measurements revealed the importance of the Simplon ductile shear zone on the geometry of the nappe in the studied area. Mapping has improved the lithostratigraphy at the base of the Siviez-Mischabel nappe. Three overturned formations can be observed below the gneisses forming the core of the nappe. These three formations form the St-Niklaus syncline, which connects the Siviez-Mischabel nappe to the underlying Upper Stalden zone. U-Pb dating of detrital and magmatic zircons by LA-ICPMS allowed the age of the observed formations to be constrained (presumably Carboniferous to Early Triassic). This data has critical implications for nappe structure in the region, composed of few recumbent folds with well preserved normal and overturned limbs. The definition and dating of these formations, as well as their identification in the adjacent "Houillère Zone" improve the understanding of the geometry and tectonic relations of the Middle Penninic nappes in the Mattertal.

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Understanding the emplacement and growth of intrusive bodies in terms of mechanism, duration, ther¬mal evolution and rates are fundamental aspects of crustal evolution. Recent studies show that many plutons grow in several Ma by in situ accretion of discrete magma pulses, which constitute small-scale magmatic reservoirs. The residence time of magmas, and hence their capacities to interact and differentiate, are con¬trolled by the local thermal environment. The latter is highly dependant on 1) the emplacement depth, 2) the magmas and country rock composition, 3) the country rock thermal conductivity, 4) the rate of magma injection and 5) the geometry of the intrusion. In shallow level plutons, where magmas solidify quickly, evi¬dence for magma mixing and/or differentiation processes is considered by many authors to be inherited from deeper levels. This work shows however that in-situ differentiation and magma interactions occurred within basaltic and felsic sills at shallow depth (0.3 GPa) in the St-Jean-du-Doigt (SJDD) bimodal intrusion, France. This intrusion emplaced ca. 347 Ma ago (IDTIMS U/Pb on zircon) in the Precambrian crust of the Armori- can massif and preserves remarkable sill-like emplacement processes of bimodal mafic-felsic magmas. Field evidence coupled to high precision zircon U-Pb dating document progressive thermal maturation within the incrementally built ioppolith. Early m-thick mafic sills (eastern part) form the roof of the intrusion and are homogeneous and fine-grained with planar contacts with neighboring felsic sills; within a minimal 0.8 Ma time span, the system gets warmer (western part). Sills are emplaced by under-accretion under the old east¬ern part, interact and mingle. A striking feature of this younger, warmer part is in-situ differentiation of the mafic sills in the top 40 cm of the layer, which suggests liquids survival in the shallow crust. Rheological and thermal models were performed in order to determine the parameters required to allow this observed in- situ differentiation-accumulation processes. Strong constraints such as total emplacement durations (ca. 0.8 Ma, TIMS date) and pluton thickness (1.5 Km, gravity model) allow a quantitative estimation of the various parameters required (injection rates, incubation time,...). The results show that in-situ differentiation may be achieved in less than 10 years at such shallow depth, provided that: (1) The differentiating sills are injected beneath consolidated, yet still warm basalt sills, which act as low conductive insulating screens (eastern part formation in the SJDD intrusion). The latter are emplaced in a very short time (800 years) at high injection rate (0.5 m/y) in order to create a "hot zone" in the shallow crust (incubation time). This implies that nearly 1/3 of the pluton (400m) is emplaced by a subsequent and sustained magmatic activity occurring on a short time scale at the very beginning of the system. (2) Once incubation time is achieved, the calculations show that a small hot zone is created at the base of the sill pile, where new injections stay above their solidus T°C and may interact and differentiate. Extraction of differentiated residual liquids might eventually take place and mix with newly injected magma as documented in active syn-emplacement shear-zones within the "warm" part of the pluton. (3) Finally, the model show that in order to maintain a permanent hot zone at shallow level, injection rate must be of 0.03 m/y with injection of 5m thick basaltic sills eveiy 130yr, imply¬ing formation of a 15 km thick pluton. As this thickness is in contradiction with the one calculated for SJDD (1.5 Km) and exceed much the average thickness observed for many shallow level plutons, I infer that there is no permanent hot zone (or magma chambers) at such shallow level. I rather propose formation of small, ephemeral (10-15yr) reservoirs, which represent only small portions of the final size of the pluton. Thermal calculations show that, in the case of SJDD, 5m thick basaltic sills emplaced every 1500 y, allow formation of such ephemeral reservoirs. The latter are formed by several sills, which are in a mushy state and may interact and differentiate during a short time.The mineralogical, chemical and isotopic data presented in this study suggest a signature intermediate be¬tween E-MORB- and arc-like for the SJDD mafic sills and feeder dykes. The mantle source involved produced hydrated magmas and may be astenosphere modified by "arc-type" components, probably related to a sub¬ducting slab. Combined fluid mobile/immobile trace elements and Sr-Nd isotopes suggest that such subduc¬tion components are mainly fluids derived from altered oceanic crust with minor effect from the subducted sediments. Close match between the SJDD compositions and BABB may point to a continental back-arc setting with little crustal contamination. If so, the SjDD intrusion is a major witness of an extensional tectonic regime during the Early-Carboniferous, linked to the subduction of the Rheno-Hercynian Ocean beneath the Variscan terranes. Also of interest is the unusual association of cogenetic (same isotopic compositions) K-feldspar A- type granite and albite-granite. A-type granites may form by magma mixing between the mafic magma and crustal melts. Alternatively, they might derive from the melting of a biotite-bearing quartz-feldspathic crustal protolith triggered by early mafic injections at low crustal levels. Albite-granite may form by plagioclase cu¬mulate remelting issued from A-type magma differentiation.

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We present measurements of hydrogen and oxygen isotopes in MORB glasses from Macquarie Island (SW. Pacific Ocean) coupled with determination of bulk H2O content by two independent techniques: total dehydration and FTIR. The incompatible trace elements in these glasses vary by a factor of 12 to 17, with K2O varying from 0.1 to 1.7 wt.%; these ranges reflect a variable degree of closed-system mantle melting, estimated from 1 to 15%. Water concentrations determined by the two techniques match well, yielding a range from 0.25 to 1.49 wt.% which correlates positively with all of the measured incompatible trace elements, suggesting that water is un-degassed, and behaves conservatively during mantle melting. Also, the agreement between the FTIR-determined and extracted water contents gives us confidence that the measured isotopic values of hydrogen reflect that of the mantle. Comparison of the range of water content with that of other incompatible trace elements allows estimation of the water partition coefficient in lherzolite, 0.0208 (ranging from 0.017 to 0.023), and the water content in the source, 386 ppm (ranging from 370 to 440 ppm). We observe a fairly narrow range in delta D and delta O-18 values of -75.5 +/- 4.5 parts per thousand and 5.50 +/- 0 .05 parts per thousand respectively, that can be explained by partial melting of normal lherzolitic mantle. The measured delta D and delta O-18 values of Macquarie Island glasses that range from nepheline- to hypersthene-normative, and from MORB to EMORB in composition, are identical to those in average global MORB. The observed lack of variation of delta D and delta O-18 with 1 to 15% degree of mantle melting is consistent with a bulk melting model of delta D and delta O-18 fractionation, in which water is rapidly scavenged into the first partial melt. The narrow ranges of delta D and delta O-18 in normal mantle are mostly due to the buffering effect of clino- and orthopyroxenes in the residual assemblage; additionally, fast ``wet'' diffusion of oxygen and hydrogen isotopes through the melting regions may further smooth isotopic differences. (C) 2012 Elsevier B.V. All rights reserved.

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INTRODUCTION: Hypospadias is associated with anomalies of the urinary tract, but the exact prevalence and significance of these anomalies are still controversial. OBJECTIVES: To assess the percentage of patients with hypospadias and associated urological anomalies, either requiring or not requiring medical or surgical attention. MATERIAL AND METHODS: We searched several databases using the following Mesh terms: hypospadias AND urination, ultrasonography, urinary tract/abnormalities, urinary bladder/radiography, ureteral obstruction, hydronephrosis or vesico-ureteral reflux. Type of uroradiological studies performed, type of urological anomalies, medical or surgical interventions, number of patients available, enrolled and undergoing uroradiological studies and number of patients with abnormal uroradiological exams were recorded. RESULTS: We found 24 studies. Four studies included 100% of available patients. In the other ones, the percentage of patients undergoing uroradiological screening varied from 12 to 82%. Frequency of anomalies varied from 0 to 56%. The most common anomalies were kidney position anomalies, vesico-ureteral reflux and hydronephrosis. CONCLUSIONS: The data published about screening patients with hypospadias for associated anomalies of their urinary tract are of poor quality. The clinical significance of the anomalies found is difficult to evaluate. We found no relationship between the severity of the hypospadias and associated anomalies of the upper or lower urinary tract.

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The deposits of two volcanic debris avalanches (VDA I and II) that occur in the upper Maronne valley, northwest sector of Cantal Volcano, France, were studied to establish their mechanisms of formation, transport and deposition. These two volcanic debris avalanches that clearly differ with regard to their structures, textures and extensions, exemplify the wide spectrum of events associated with large-scale sector collapse. VDA I is voluminous (similar to1 km(3) in the upper Maronne valley) and widespread. The deposits comprise two distinct facies: the block facies that forms the intermediate and upper part of the unit and the mixed facies that crops out essentially at the base of the unit. The block facies consists of more or less brecciated lava, block-and-ash-flow breccia and pumice-flow tuff megablocks set in breccias resulting from block disaggregation. Mixing and differential movements are almost absent in this part of the VDA. The mixed facies consists of breccias rich in fine particles that originate from block disagregation, as well as being picked up from the substratum during movement. Mixing and differential movements are predominant in this zone. Analysis of fractures on lava megablocks suggests that shear stress during the initial sliding is the principal cause of fracture. These data strongly indicate that VDA I is purely gravitational and argue for a model in which the initial sliding mass transforms into a flow due to differential in situ fragmentation caused by the shear stress. VDA II is restricted to low-topography areas. Its volume, in the studied area, is about 0.3 km(3). The deposits consist of brecciated, rounded blocks and megablocks set in a fine-grained matrix composed essentially of volcanic glass. This unit is stratified, with a massive layer that contains all the megablocks at the base and in the intermediate part, and in the upper part a normally graded layer that contains only blocks <1 m in size. The different lithologies present are totally mixed. These observations suggest that VDA II may be of the Bezymianny-type and that it underwent a flow transformation from a turbulent to a stratified flow consisting of a basal hyperconcentrated laminar body overlain by a dilute layer. (C) 2000 Elsevier Science B.V. All rights reserved.

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OBJECTIVES: This study investigated the relationship between inter-arm coordination and the energy cost of locomotion in front crawl and breaststroke and explored swimmers' flexibility in adapting their motor organization away from their preferred movement pattern. DESIGN: Nine front-crawlers performed three 300-m in front crawl and 8 breaststrokers performed three 200-m in breaststroke at constant submaximal intensity and with 5-min rests. Each trial was performed randomly in a different coordination pattern: freely chosen, 'maximal glide' and 'minimal glide'. Two underwater cameras videotaped frontal and side views to analyze speed, stroke rate, stroke length and inter-limb coordination. METHODS: In front crawl, inter-arm coordination was quantified by the index of coordination (IdC) and the leg beat kicks were counted. In breaststroke, four time gaps quantified the arm to leg coordination (i.e., time between leg and arm propulsions; time between beginning, 90° flexion and end of arm and leg recoveries). The energy cost of locomotion was calculated from gas exchanges and blood lactate concentration. RESULTS: In both front crawl and breaststroke, the freely chosen coordination corresponded to glide pattern and showed the lowest energy cost (12.8 and 17.1Jkg(-1)m(-1), respectively). Both front-crawlers and breaststrokers were able to reach 'maximal glide' condition (respectively, +35% and +28%) but not 'minimal glide' condition for front crawl. CONCLUSIONS: The freely chosen pattern appeared more economic because more trained. When coordination was constrained, the swimmers had higher coordination flexibility in breaststroke than in front crawl, suggesting that breaststroke coordination was easier to regulate by changing glide time.

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Objective: Existing VADs are single-ventricle pumps needing anticoagulation. We developed a bi ventricular external assist device that reproduces the physiological heart muscle movement completely avoiding anticoagulants. Methods: The device has a carbon fibre skeleton fitting a 30-40 kg patient's heart, to which a Nitinol based artificial muscle is connected. The artificial muscle wraps both ventricles. The strength of the Nitinol fibres is amplified by a pivot articulation in contact with the ventricle wall. The fibres are electrically driven and a dedicated control unit has been developed. We assessed hemodynamic performances of this device using a previously described dedicated bench test. Volume ejected and pressure gradient has been measured with afterload ranging from 25 to 50mmHg. Results: With anafterload of 50mmHg the system has an ejection fraction (EF) of 10% on the right side and 8% on the left side. The system is able to generate a systolic ejection of 5,5 ml on the right side and 4,4 ml on the left side. With anafterload of 25mmHg the results are reduced of about 20%. The activation frequency is 80/minute resulting in a total volume displacement of 440 ml/minute on the right side and 352 ml/minute on the left side. Conclusions: The artificial muscle follows Starling's law as the ejected volume increases when afterload increases. These preliminary studies confirmed the possibility of improving the EF of a failing heart using artificial muscle for external cardiac compression. This device could be helpful in weaning CPB and/or for short-term cardio-circulatory support in paediatric population with cardiac failure.

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Introduction: La survenue d'une hémorragie dans les muscles iliopsoasconstitue une pathologie grave, dont le diagnostic est souventtardif et grevé d'une morbidité importante. Sa présentation cliniquedoit être reconnue précocement, en particulier par les médecins depremier recours.Cas clinique: Un patient de 65 ans est admis aux urgences en raisonde douleurs invalidantes de la jambe droite, prédominant sur la faceantérieure de la cuisse. Les douleurs irradient dans le pli inguinal, leflanc, la région lombaire, ainsi que la hanche droite. Elles sont associéesà une parésie du quadriceps droit. Le patient a bénéficié en2006 d'un remplacement de valve aortique, avec implantation d'unevalve mécanique motivant une anticoagulation par acenocoumarol.Il présente par ailleurs une parésie sur le territoire du nerf sciatiquedroit, après fracture du bassin en 1970. Le diagnostic est évoqué auvu d'une antioagulation supra-thérapeutique (INR 5).Un CT-scan de l'abdomen confirmera un important hématome(11 x 7 cm) du muscle iliaque droit (fig. 1) qui sera drainé chirurgicalement,après réversion partielle de la crase, permettant une évolutionfavorable.Discussion: Les hématomes des muscles ilio-psoas surviennentclassiquement de manière spontanée. Les symptômes sont peu spécifiques,à type de douleurs diffuses abdominales, lombaires ou crurales,de paresthésies, de limitation fonctionnelle ou de chute isoléede l'hémoglobine (Hb). Les patients sous anticoagulants (héparine,acenocoumarol) ou présentant des troubles de la coagulation (hémophilie,thrombopathie, maladie de von Willebrand) sont particulièrementà risque. Les complications sont fréquentes: compressions dunerf fémoral (avec hypoesthésie, parésie du quadriceps ou abolitiondu réflexe rotulien), anémie, état de choc. Le traitement implique lacorrection des troubles de la coagulation, ainsi qu'un suivi clinique,radiologique et biologique (Hb) régulier. Le traitement conservateurest proposé lors d'hématome de petite taille, si le patient est stable etpeu symptomatique. Dans les autres cas, un drainage chirurgical parvoie ouverte ou par voie percutanée est recommandé. L'embolisationartérielle s'affiche comme une future option thérapeutique.Conclusions: Ce cas illustre les différents éléments cliniques etbiologiques qui orientent précocement vers le diagnostic d'hématomedes muscles ilio-psoas. Il devrait favoriser l'évocation d'une pathologierare, permettant de garantir un diagnostic précoce.

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PURPOSE OF REVIEW: This article reviews and summarizes current knowledge on kidney-sparing surgery (KSS) for upper tract urothelial carcinoma (UTUC). RECENT FINDINGS: Radical nephroureterectomy (RNU) has been central to the treatment of UTUC for decades, but KSS has been applied to a rising number of patients to preserve renal function. Ablation or resection through flexible ureteroscopy or the percutaneous route seems to provide comparable cancer-specific survival and overall survival to RNU, but the risk of local and bladder recurrence remains relatively high. Segmental ureterectomy is used for low-risk unifocal UTUC with recent studies confirming its oncologic safety and equivalence to RNU. Antegrade or retrograde instillation therapy may be considered as adjuvant treatment after conservative surgery, but their efficacy needs to be proven. Intravesical single-dose chemotherapy is likely to become part of the therapy algorithm of UTUC treated by KSS or RNU to lower bladder seeding and recurrence. Postoperative vigilant radiographic and endoscopic surveillance are obligatory because of the high probability of recurrence. SUMMARY: KSS should be regarded as a valid alternative to RNU in case of technically resectable low-risk upper tract urothelial cell carcinoma, even in case of a normal contralateral kidney. Advances in technology and biological and clinical risk estimation will make the management of UTUC more evidence based thereby lowering overtreatment.

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The effect of caponisation on fat composition by parts (wing, breast, thigh, and drumstick) and tissues (skin, subcutaneous adipose tissue, intermuscular adipose tissue and muscle) was examined in the present study and fatty acid profiles of abdominal fat and edible meat by parts and tissue components were determined. The sample was made up of twenty-eight castrated and twenty male Penedesenca Negra chicks reared under free-range conditions and slaughtered at 28 wk of age; the birds were castrated at four or eight weeks. Caponisation significantly increased (P < 0.01) the chemical fat content in all parts (16.31% to 37.98% in breast; 21.98% to 34.13% in wing; 21.09% to 49.57% in thigh; 14.33% to 24.82% in drumstick) and led to minor modifications in fat haracteristics, particularly in the thigh and the drumstick, where the unsaturated vs. saturated fatty acid ratio increased from 1.31 to 1.76 ( P < 0.01) and from 1.48 to 2.07 (P < 0.01), respectively. Delaying the age of castration from 4 to 8 weeks increased this ratio by 0.35 in the edible meat. Even though the profile of the abdominal fat is less saturated in capons, all changes occurring on fat quality after caponisation indicate that increased fatness after castration does not imply worse fat nutritional properties.