Assessment and comparison of endothelial function between dialysis and kidney transplant patients.

Dialysis and kidney transplant patients display endothelial dysfunction. Previous studies concerning comparisons of endothelial function in dialysis and kidney transplant patients included subjects with cardiovascular risk factor(s) that alone may lead to endothelial dysfunction. In this study, we compared endothelial function between dialysis and transplant patients who did not show known cardiovascular risk factors that lead to endothelial dysfunction. We studied age- and gender-matched cohorts: 30 hemodialysis (HD), 30 peritoneal dialysis (PD), and 30 kidney transplant patients. We also included 20 age- and gender-matched healthy controls. We assessed the endothelial function of patients and controls by a noninvasive technique. Serum biochemistry profiles of patients were also similar to controls in terms of lipid profile and fasting blood glucose level. Although mean FMD% levels of HD and PD patients were similar (6.6% +/- 3.1% vs 6.8% +/- 3.0%, P > .05), the mean percent of flow-mediated endothelium-dependent dilatation (FMD%) level in transplant patients was higher than those in HD or PD patients (10.50% +/- 3.0% vs 6.6% +/- 3.1% and 6.8% +/- 3.0%, respectively; P < .01). In addition, the mean FMD% level in healthy controls was higher than those in HD, PD, and transplant patients (14.0% +/- 2.3% vs 6.6% +/- 3.1%, 6.8% +/- 3.0% and 10.50% +/- 3.0%; P < .01, respectively). In conclusion, endothelial functions in transplant patients were better than those in dialysis patients.

The importance of the anatomy of the splenic artery and its branches in splenic artery embolisation.

Splenic artery embolisation can be performed preoperatively in an attempt to decrease thrombocyte destruction, or as an alternative to surgery, to obtain partial or total organ ablation. During this procedure, it is very important to deliver embolising agents distal to the origin to pancreatic branches to avoid the risk of pancreatitis. Therefore, a detailed knowledge of the anatomy of the splenic artery and its branches is required to achieve safe embolisation. The purpose of our study is to measure the average distance between the origin of the last pancreatic branch and the splenic hilum in digital angiograms and cadaver specimens.

Relationship between carotid artery intima-media thickness and brachial artery flow-mediated dilation in peritoneal dialysis patients.

BACKGROUND AND AIM: Carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation percentage (FMD%) are two commonly used parameters for detecting subclinical atherosclerosis. However, studies investigating the relationship between CIMT and brachial artery FMD% in different populations have produced conflicting results. The aim of this study was to determine the relationship between CIMT and brachial artery FMD% in patients on peritoneal dialysis (PD) METHODS: Fifty-two PD patients without known cardiovascular disease and 30 age-gender matched controls were included in the study. Endothelial function was determined using ultrasonography (US) to measure the FMD of the brachial artery, and this parameter was expressed as the percentage change from the baseline diameter of the brachial artery (FMD%). We also measured CIMT by US and analysed the relationship between CIMT and brachial FMD%. RESULTS: The CIMT was significantly higher in patients than in the control group (0.84 +/- 0.08 vs. 0.75 +/- 0.06 mm, P < 0.01), whereas brachial artery FMD% was lower in patients than in the controls (8.2 +/- 5.0 vs. 11.7 +/- 5.5%, P < 0.01). There was no significant correlation between CIMT and FMD% (r = -0.004, P = 0.94). CONCLUSION: Although PD patients are known to be characterized by an impaired flow-mediated vasodilatation of brachial artery and increased in CIMT, we did not find a significant correlation between FMD% and CIMT in our PD patient cohort. One possible explanation for our results is that each method measures a different aspect and stage of atherosclerosis.

Hepatic toxocariasis: US, CT and MRI findings.

Visceral larva migrans (VLM) most commonly occurs as a febrile disease of childhood particularly affecting children between 1 and 7 years of age. Pulmonary, dermatological, hepatic, lymphatic, cardiac, rheumatological and neurological manifestations may occur. VLM seems to be a rare disease in adults. We report the imaging findings of a woman with hepatic toxocariasis. Ultrasonography showed a solitary hepatic lesion measuring 4 x 3 cm, displaying a hypoechoic-heterogeneous pattern with ill-defined borders and distal acoustic enhancement, located in the right sub-diaphragmatic area. Two enlarged periportal lymph nodes and moderately dilated intrahepatic biliary ducts were also noted. The probability of toxocariasis was discussed, based on sonographic and biopsy findings, and the final diagnosis was confirmed by a specific ELISA test. In summary, a clinical picture of cholestasis initially resembling hepatitis or malignancy should be further evaluated by imaging techniques, and the ultrasound examiner should be familiar with the possible findings of hepatic toxocariasis, which consist of focal ill-defined hepatic lesions, hepato-splenomegaly, biliary dilatation, sludge and periportal lymph node enlargement.

Schwachman-Diamond syndrome. A case report.

Schwachman-Diamond syndrome is an autosomal recessive disorder consisting of exocrine pancreatic insufficiency and neutropenia. The typical pathological finding with this syndrome is fatty infiltration in the pancreas of patients. We report a case of Scwachman-Diamond syndrome examined with abdominal ultrasonography, CT and radiography.

Vertebral pneumatocysts.

OBJECTIVE: To review the prevalence and location of vertebral pneumatocysts and evaluate the CT findings of these benign lesions. MATERIAL AND METHODS: Retrospectively we reviewed CT images of 89 patients with suspected disc disease during a 6-month period. RESULTS: Distinctive CT pattern of intraosseous pneumatocysts involving the cervical, thoracic and lumbar spine was found. In 8 patients (9%), 10 vertebral pneumatocysts were detected. Five were located in the vertebral body and 4 of these were associated with vacuum phenomenon in adjacent intervertebral discs. Five were located near the facet joint and all were associated with vacuum phenomenon in adjacent facet joint. CONCLUSION: Intraosseous pneumatocyst is a benign lesion, therefore biopsy and follow-up are unnecessary. Although vertebral pneumatocysts seem to be uncommon with a few reported cases, this study shows them to be more frequent than previously thought.

Subintimal recanalization of long superficial femoral artery occlusions through the retrograde popliteal approach.

PURPOSE: To investigate the value of the retrograde popliteal artery approach for the percutaneous intentional extraluminal recanalization (PIER) of long superficial femoral artery (SFA) occlusions. METHODS: During a period of 17 months, PIER through ultrasound-guided retrograde popliteal artery puncture was performed for 39 long SFA occlusions in 37 patients. In six patients, six additional iliac artery stenoses were also treated via the popliteal approach. RESULTS: The procedure was technically successful in 32 (82%) of 39 SFA occlusions; in 29, lesions were treated with balloon angioplasty alone, and in three, stents were also used. Cumulative patency rate was 66% at 6 months, 62% at 1 year, and 59% at 18 months. Additional iliac artery stenoses were successfully treated in the same session. Complications included two minor hematomas and two SFA ruptures, which required no treatment. CONCLUSION: PIER through retrograde popliteal puncture is a safe and effective method in the treatment of long femoropopliteal occlusions, with a high technical success, low complication rate and a reasonable short-term patency rate. The technique offers an alternative in cases where standard PIER is unsuccessful or contraindicated.