A Case of Incomplete Removal of Horseshoe Kidney by Laparoscopic Nephrectomy in an Adult Leading to Urinary Leak: An Eye Opener.

Horseshoe kidney is a common congenital fusion anomaly of the kidneys. It poses a challenge to surgeon because of its very variable anatomy in terms of location and lie, fusion, pelvicalyceal system, and the renal vessels. Here we describe a case of laparoscopic nephrectomy in a horseshoe kidney complicated by incomplete removal because of not realizing the lower and medial extent of pelvicalyceal system across midline to the contralateral side leading to persistent urine leak. The relevant anatomy and the necessary precautions to prevent such complication have been discussed.

Effect of calmodulin on sarcoplasmic reticular Ca2+-transport in the aging heart.

Heart failure is common among the elderly and an alteration in myocardial Ca2+ transport is believed to be involved in its depressed contractile performance. Although ATP-dependent sarcoplasmic reticular (SR) Ca2+ transport has been reported to decrease in old hearts, virtually nothing appears to be known about the Ca2+ pump activity of SR in aging myocardium in the presence of calmodulin, one of its endogenous activators. In this study, the activity of the Ca2+ pump of aging cardiac SR was assessed in the presence of this endogenous stimulator. This assessment was therefore designed to give additional information about the status of this enzyme in old hearts. Male Sprague-Dawley rats were used and were divided into 3 groups: young (4-6 months old); middle-aged (15-17 months old) and old age (24-25 months old). Purified SR membranes were isolated from ventricular tissues. ATP-dependent Ca2+ accumulation by membrane vesicles of middle-aged and old hearts was significantly depressed in comparison to young hearts at all Ca2+ concentrations employed in the absence and presence of calmodulin. The activity of this Ca2+ transporter was similar in middle-aged and old hearts even in the presence of calmodulin. These results suggest that the activity of the Ca2+ pump in SR of aging hearts is depressed even in the presence of calmodulin.

An assessment of phospholipid methylation in sarcolemma and sarcoplasmic reticulum of the aging myocardium.

The stepwise N-methylation of phosphatidylethanolamine (PE) to phosphatidylcholine (PC) (phospholipid methylation) was assessed in cardiac sarcolemma and sarcoplasmic reticulum of aging rats. This phenomenon was depressed in aging hearts relative to young ones. A decrease in activity of catalytic sites appears to be involved in the depressed phospholipid methylation of aging myocardium.