501
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Maged AM, Hashem AMT, Gad Allah SH, Mahy ME, Mostafa WAI, Kotb A. The effect of loading dose of magnesium sulfate on uterine, umbilical, and fetal middle cerebral arteries Doppler in women with severe preeclampsia: A case control study. Hypertens Pregnancy 2016; 35:91-9. [PMID: 26909769 DOI: 10.3109/10641955.2015.1116552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED SYNOPSIS IV MgSO4 administration in women with severe preeclampsia resulted in a decrease in umbilical artery, uterine artery, and fetal middle cerebral artery Doppler indices. OBJECTIVE To evaluate Doppler parameters of the umbilical artery (UmA), uterine artery (UA), and fetal middle cerebral artery (MCA) before and after MgSO4 administration in women with severe preeclampsia. METHODS A case control study included 100 pregnant women with severe preeclampsia. Umbilical artery, uterine artery, and fetal middle cerebral artery Doppler were measured before and 20 minutes after intravenous administration of 6 g of magnesium sulfate. RESULTS There was a significant difference between maternal systolic blood pressure (173.20 ± 22.72 vs. 156.60 ± 19.18), diastolic blood pressure (109.60 ± 9.14 vs. 101.90 ± 10.05), and heart rate (80.52 ± 11.52 vs. 88.48 ± 12.08) before and after administration of MgSO4 in the studied patients (p value < 0.001). There was a significant difference between umbilical artery, middle cerebral artery, and uterine artery Doppler parameters before and after administration of MgSO4 in the studied patients (p value < 0.001). There was no significant difference between umbilical artery/middle cerebral artery with regard to RI and PI. However, there was significant difference with regard to the S/D ratio (p value < 0.001). The decrease in the values of Doppler parameters before and after administration of MgSO4 was more in the middle cerebral artery than in the umbilical artery. CONCLUSION Intravenous administration of magnesium sulfate in pregnant women with severe preeclampsia resulted in a decrease in umbilical artery, uterine artery, and fetal middle cerebral artery Doppler indices with reduced resistance to blood flow in these vessels.
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Affiliation(s)
- Ahmed M Maged
- a Obstetrics and Gynecology Department , Kasr Aini Hospital, Cairo University, Cairo, Egypt and
| | - Ahmed M T Hashem
- a Obstetrics and Gynecology Department , Kasr Aini Hospital, Cairo University, Cairo, Egypt and
| | - Sherine H Gad Allah
- a Obstetrics and Gynecology Department , Kasr Aini Hospital, Cairo University, Cairo, Egypt and
| | - Mohamed El Mahy
- a Obstetrics and Gynecology Department , Kasr Aini Hospital, Cairo University, Cairo, Egypt and
| | - Walaa A I Mostafa
- a Obstetrics and Gynecology Department , Kasr Aini Hospital, Cairo University, Cairo, Egypt and
| | - Amal Kotb
- b Obstetrics and Gynecology Department , Beni-Suef University, Beni-Suef, Egypt
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502
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Jawad N, Parker P, Lakshminarayan R. The role of contrast-enhanced ultrasound imaging in the follow-up of patients post-endovascular aneurysm repair. Ultrasound 2016; 24:50-9. [PMID: 27433275 PMCID: PMC4760610 DOI: 10.1177/1742271x15627303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/22/2015] [Indexed: 11/16/2022]
Abstract
Endovascular aneurysm repair is a minimally invasive technique for the treatment of abdominal aortic aneurysms. Patients who undergo endovascular aneurysm repair are potentially at risk of developing problems related to the graft such as the development of endoleaks. Endoleaks can cause expansion of the aneurysmal sac, which can potentially lead to rupture. It is for this reason that lifelong surveillance of patients is required to assess the graft and the aneurysmal sac. This article discusses the role of contrast-enhanced ultrasound in the follow-up of patients post-endovascular aneurysm repair. Contrast-enhanced ultrasound is rapidly becoming a powerful, accurate and cost-effective tool to complement computed tomography in the follow-up of endovascular aneurysm repair patients. Real-time imaging of contrast filling into the arterial system means that contrast-enhanced ultrasound is an excellent problem-solving tool, particularly when assessing for the type and anatomy of endoleaks. In some instances, contrast-enhanced ultrasound can detect endoleaks when other modalities are equivocal.
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503
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Mambetov ZS, Salimov BG. [Renal hemodynamic in hydronephrosis concurrent with hepatobiliary system disorders, its dynamics in the course of treatment]. Urologiia 2016:16-17. [PMID: 28247697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article examines measurements of renal vascular ultrasound in 85 patients with hydronephrosis concurrent with disorders of the gallbladder and biliary tract, depending on severity and dynamics during treatment. The estimation of blood flow changes depending on applied renoprotective and hepatoprotective therapy is provided.
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Affiliation(s)
- Zh S Mambetov
- Republican Scientific Center of Urology at the National Hospital of Ministry of Health of Kyrgyz Republic, Kyrgyzstan, Bishkek
| | - B G Salimov
- Republican Scientific Center of Urology at the National Hospital of Ministry of Health of Kyrgyz Republic, Kyrgyzstan, Bishkek
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504
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Ma L, Lu Q, Luo Y. Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography. World J Gastroenterol 2016; 22:1617-1626. [PMID: 26819527 PMCID: PMC4721993 DOI: 10.3748/wjg.v22.i4.1617] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/12/2015] [Accepted: 11/13/2015] [Indexed: 02/06/2023] Open
Abstract
Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrast-enhanced ultrasound (CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional gray-scale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT.
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505
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Smith A, Parker P, Byass O, Chiu K. Contrast sonovenography - Is this the answer to complex deep vein thrombosis imaging? Ultrasound 2016; 24:17-22. [PMID: 27433271 DOI: 10.1177/1742271x15625432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 11/30/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Deep vein thrombosis (DVT) is a potentially fatal condition causing significant morbidity and mortality in the patient population. Ultrasound (USS) is the mainstay for detecting DVT. This can sometimes be difficult in hostile limbs due to factors such as large body habitus and oedema. This pilot study investigated contrast-enhanced ultrasound (CEUS) as a viable method to improve visualisation of the venous system of the lower limb. METHODS Patients at high risk for DVT were selected after an initial negative USS. A follow-up scan was performed 1 week later utilising standard B-mode imaging with a curvilinear 3-5 MHz transducer array. After the fundamental scan, intravenous Sonovue™ contrast was administered and visualisation of the proximal limb veins and visualisation gains in distance were mapped onto a proforma. RESULTS Twelve patients were selected. Visualisation was not improved in the common femoral vein (CFV) but increases in full visualisation were demonstrated in the femoral vein (FV) and popliteal vein (Pop V) from (n = 8) 67% and (n = 10) 83-100% in both veins, respectively. Significant gains in visualisation distance were observed in the posterior tibial vein (PTV) (p = 0.0005) and peroneal vein (Per V) (p = 0.02) with increased full visualisation of the Per V from (n = 3) 25% to (n = 7) 58%. CONCLUSION CEUS is a viable and clinically safe method for increasing visualisation of the deep venous system. It has the potential to improve visualisation of the lower limb venous system, reducing follow-up costs and diagnostic uncertainty for patients and the clinician.
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Affiliation(s)
- Agw Smith
- Department of Academic Radiology, Hull Royal Infirmary, Hull, UK
| | - P Parker
- Department of Academic Radiology, Hull Royal Infirmary, Hull, UK
| | - O Byass
- Department of Academic Radiology, Hull Royal Infirmary, Hull, UK
| | - K Chiu
- Department of Academic Radiology, Hull Royal Infirmary, Hull, UK
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506
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Thomé HE, de Arruda RP, de Oliveira BMM, Maturana Filho M, de Oliveira GC, Guimarães CDF, de Carvalho Balieiro JC, Azedo MR, Pogliani FC, Celeghini ECC. Uterine lavage is efficient to recover endometrial cytology sample and does not interfere with fertility rate after artificial insemination in cows. Theriogenology 2016; 85:1549-1554. [PMID: 26850464 DOI: 10.1016/j.theriogenology.2016.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/07/2016] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Abstract
Productivity rates directly depend on the fertility of a herd, which in turn can be influenced by many factors. Semen deposited in the female reproductive tract is foreign to the body and, in response to this invasion, produces an inflammatory reaction, which is characterized by rapid infusion of polymorphonuclear (PMN) cells. Techniques to obtain an endometrial sample are usually invasive and can mask the true inflammatory response. Ultrasound is a noninvasive technique and can contribute to the diagnosis of postartificial insemination (AI) inflammatory response in cattle. The present study was divided into two experiments. The aim of experiment 1 was to compare two methods of endometrial cytology collection, uterine cytobrush (UC) and uterine lavage (UL), and their effects on uterine hemodynamics that provide information about blood flow. The two methods were evaluated by Doppler ultrasound using the spectral and color modes. For that purpose, 19 Nellore cows were synchronized for timed AI and subjected to UC (n = 9) or UL (n = 10). The techniques were performed 4 hours after AI. The results showed that both techniques allow collection of a good quality sample and with enough PMN cells to perform counting. More PMN cells were obtained by UL than UC. There was no difference in uterine blood flow between the UC and UL groups in any of the periods evaluated (34 hours before and 4, 24, and 48 hours after collection of uterine sample). On the basis of results of experiment 1, the effect of UL on fertility was studied in experiment 2. A total of 128 Nellore cows were synchronized for TAI; 35 cows were subjected to endometrial cytology by UL 4 hours after AI, and 93 were not submitted to any procedure (control). Pregnancy diagnosis was performed by transrectal ultrasound 30 days after AI. Pregnancy rates did not differ between UL (54.29%) and control (56.99%) groups. The results of this study showed that UL allows the collection of more representative cells of the surface of the uterus than UC technique and causes no damage to the reproductive tract. Moreover, UL did not affect pregnancy rate when performed 4 hours after AI.
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Affiliation(s)
- Helder Esteves Thomé
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Rubens Paes de Arruda
- Department of Animal Reproduction, Laboratory of Semen Biotechnology and Andrology, Center of Biotechnology in Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Pirassununga, São Paulo, Brazil
| | - Bruna Marcele Martins de Oliveira
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Milton Maturana Filho
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Guilherme Cain de Oliveira
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Carina de Fátima Guimarães
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Júlio César de Carvalho Balieiro
- Department of Animal Production and Nutrition, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Milton Ricardo Azedo
- Department of Medical Clinic, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Fábio Celidônio Pogliani
- Department of Medical Clinic, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Eneiva Carla Carvalho Celeghini
- Department of Animal Reproduction, Laboratory of Teaching and Research in Pathology of Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, Brazil.
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507
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Finn D, Boylan GB, Ryan CA, Dempsey EM. Response: Commentary: Enhanced Monitoring of the Preterm Infant during Stabilization in the Delivery Room. Front Pediatr 2016; 4:73. [PMID: 27489229 PMCID: PMC4948017 DOI: 10.3389/fped.2016.00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/01/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Daragh Finn
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - Geraldine B Boylan
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - C Anthony Ryan
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - Eugene M Dempsey
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
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508
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Abstract
Background: Corticosteroids are widely used in obstetrics due to their striking effect on perinatal morbidity and mortality of premature neonates. Despite this, relatively few studies have explored short term fetal effects of corticosteroids as measured by ultrasound. Objectives: 1) To present a literature review of short term fetal cardiovascular effects of corticosteroids 2) To describe the protocol of a current observational study (SUPER-A*STEROID) of cardiovascular effects of dexamethasone and betamethasone in the first week after their administration. This trial is nested within the A*STEROID blinded multicentre randomised controlled trial of the two steroid preparations. Findings: Existing data suggest corticosteroids have little effect on the major measured fetal blood vessels when the baseline ultrasound is normal. In the compromised fetus, where the umbilical artery end-diastolic flow is abnormal prior to maternal corticosteroids, flow is temporarily restored in approximately 50% of cases. Whether such changes are beneficial is uncertain. Very little data exist that directly compare the short-term effects of betamethasone and dexamethasone. The SUPER- A*STEROID study described will help provide this information.
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Affiliation(s)
- Amanda Henry
- School of Women's and Children's HealthUNSW MedicineSydneyNew South WalesAustralia; Department of Maternal-FetalMedicine Royal Hospital for WomenRandwickNew South WalesAustralia; Women's and Children's Health St George HospitalKogarahNew South WalesAustralia
| | - Antonia Shand
- School of Women's and Children's HealthUNSW MedicineSydneyNew South WalesAustralia; Department of Maternal-FetalMedicine Royal Hospital for WomenRandwickNew South WalesAustralia; Kolling Institute of Medical ResearchRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Alec Welsh
- School of Women's and Children's HealthUNSW MedicineSydneyNew South WalesAustralia; Department of Maternal-FetalMedicine Royal Hospital for WomenRandwickNew South WalesAustralia
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509
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Batista PR, Gobello C, Rube A, Corrada YA, Tórtora M, Blanco PG. Uterine blood flow evaluation in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex. Theriogenology 2015; 85:1258-61. [PMID: 26810829 DOI: 10.1016/j.theriogenology.2015.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 10/17/2015] [Accepted: 12/14/2015] [Indexed: 11/18/2022]
Abstract
Doppler ultrasound is a useful diagnosis tool to evaluate uterine blood flow in different canine reproductive states. The aim of this study was to describe and compare uterine blood flow in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex (CEH-P). Ninety diestrous bitches were clinically, hematologically, and ultrasonographically classified into four groups: (1) clinical signs, leukocytosis, CEH, and uterine luminal contents (CEH-P, n = 31); (2) asymptomatic bitches with CEH and uterine contents (CEH-C, n = 15); (3) asymptomatic bitches with CEH without uterine contents (CEH, n = 16); and (4) normal diestrous bitches (ND, n = 28). The widest cross-sectional diameter and uterine wall thickness (W) of uterine horns were measured using two-dimensional ultrasound. Peak systolic velocity and end diastolic velocity of uterine arteries were measured by Doppler ultrasound in all the bitches. Peak systolic velocity and end diastolic velocity were higher in CEH-P than in CEH-C, CEH, and ND (P < 0.01); although both parameters did not show differences among the latter three groups (P > 0.1). Conversely, resistance index (RI) reported lower values in CEH-P than that in the other three groups (P < 0.01), being ND higher (P < 0.01) than both CEH-C and CEH which did not differ between themselves (P > 0.1). When all the bitches were considered, correlation between RI and cross-sectional diameter was r = -0.69 (P < 0.01) and between RI and uterine wall thickness was r = -0.02 (P > 0.1). It is concluded that the uterine artery blood flow velocity of bitches suffering from pyometra was higher, not only from normal bitches, but also from females with endometrial hyperplasia. Furthermore, endometrial hyperplasia, accompanied or not by luminal contents, had a higher blood flow velocity than normal uterus. Hemodynamic parameters appear as useful markers to differentiate uterine pathologic conditions.
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Affiliation(s)
- P R Batista
- Cardiology Laboratory, Clinics Department, Faculty of Veterinary Sciences, National University of La Plata (FVS-NULP), La Plata, Argentina; CONICET, Argentina.
| | - C Gobello
- CONICET, Argentina; Laboratory of Reproductive Physiology, Basic Sciences Department, FVS-NULP, La Plata, Argentina
| | - A Rube
- Cardiology Laboratory, Clinics Department, Faculty of Veterinary Sciences, National University of La Plata (FVS-NULP), La Plata, Argentina
| | - Y A Corrada
- CONICET, Argentina; Teaching Hospital, Clinics Department, FVS-NULP, La Plata, Argentina
| | - M Tórtora
- Cardiology Laboratory, Clinics Department, Faculty of Veterinary Sciences, National University of La Plata (FVS-NULP), La Plata, Argentina
| | - P G Blanco
- Cardiology Laboratory, Clinics Department, Faculty of Veterinary Sciences, National University of La Plata (FVS-NULP), La Plata, Argentina; CONICET, Argentina; Laboratory of Reproductive Physiology, Basic Sciences Department, FVS-NULP, La Plata, Argentina
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510
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Lechowicz R, Elwertowski M. Standards of the Polish Ultrasound Society. Ultrasound examination of the portal system and hepatic vessels. J Ultrason 2015; 15:208-26. [PMID: 26675583 PMCID: PMC4579749 DOI: 10.15557/jou.2015.0018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 02/21/2015] [Accepted: 02/27/2015] [Indexed: 12/02/2022] Open
Abstract
Increased incidence of liver diseases, the development of liver surgery and other invasive methods for managing portal hypertension, plus an increasing number of liver transplant procedures pose more and more new challenges for ultrasonography. Ultrasonography, being an effective and clinically verified modality, has been used for several decades for diagnosing diseases of the liver, its vessels and portal hypertension. It is used for both initial and specialist diagnosis (performed in reference centers). The diagnostic value of ultrasonography largely depends on the knowledge of anatomy, physiology, pathophysiology and clinical aspects as well as on the mastering of the scanning technique. In the hands of an experienced physician, it is an accurate and highly effective diagnostic tool; it is of little use otherwise. The paper presents elements of anatomy, physiology and pathophysiology which make the portal system exceptional and the knowledge of which is crucial and indispensable for a correct examination and, above all, for the correct interpretation of results. The authors also present requirements regarding the equipment. Moreover, various technical aspects of the examination are presented and the normal morphological picture and hemodynamic parameters of healthy individuals are described. The authors discuss the most common clinical situations and rare cases during ultrasound examinations. The paper is based on the experience of the author who works in the largest center of liver diseases in Poland, and on the current literature.
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Affiliation(s)
- Robert Lechowicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Elwertowski
- Department of General Surgery and Thoracic Diseases, Medical University of Warsaw, Warsaw, Poland
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511
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García Carriazo M, Gómez de las Heras C, Mármol Vázquez P, Ramos Solís MF. Doppler ultrasound study and venous mapping in chronic venous insufficiency. Radiologia 2016; 58:7-15. [PMID: 26655801 DOI: 10.1016/j.rx.2015.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/20/2022]
Abstract
Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.
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512
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Neimark AI, Kiptilov AV, Lapiy GA. [Clinical and pathomorphological features of chronic prostatitis in chemical industry workers]. Urologiia 2015:68-73. [PMID: 28247683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
During periodic screening on the chemical industry, an increased incidence of chronic prostatitis in workers at sulfuric acid section was revealed. Detailed examination has revealed features of the clinical picture of the pathological process that develops in the prostate gland of workers exposed to harmful labor conditions. Complex pathomorphologic analysis of prostate biopsies of workers with chronic abacterial prostatitis found fundamental differences of morphological manifestations observed in other forms of chronic prostatitis. They include the prevalence of dystrophic and atrophic changes of glandular components with the presence of focuses of simple and small acinar atrophy, reduction of the microvasculature vessels, progressive fibrosis of the stroma with the phenomena of periglandular and perivascular sclerosis, as a rule, in the absence of inflammatory cell infiltration. Doppler ultrasound data indicated a change in hemodynamics, accompanied by a decrease in blood flow in the prostate gland.
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Affiliation(s)
- A I Neimark
- Department of Urology and Nephrology SBEI HPE Altai State Medical University of RMPH, Barnaul
| | - A V Kiptilov
- FSBIS Institute of Molecular Pathology and Pathomorphology, Novosibirsk
| | - G A Lapiy
- RSBHCI CCH, Urological Department, Biysk
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513
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Salvi S, Badade A, Khatal K, Bhide A. Reliability of Doppler Assessment of the Middle Cerebral Artery in the Near and Far Fields in Healthy and Anemic Fetuses. J Ultrasound Med 2015; 34:2037-2042. [PMID: 26432826 DOI: 10.7863/ultra.14.11078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 02/13/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the reliability of the middle cerebral artery pulsatility index (PI) and peak systolic velocity (PSV) at the proximal portions of the near- and far-field vessel sites in healthy and anemic fetuses. METHODS The middle cerebral artery PSV and PI were prospectively assessed in 50 normal singleton pregnancies. The Doppler waveforms for the middle cerebral artery PI and the PSV were recorded independently by 2 operators at the most proximal portions of the near- and far-field sites. Data for the PSV and PI at the proximal portions of both the near- and the far-field sites were also retrospectively collected in 7 anemic fetuses. RESULTS No significant difference between the operators was detected for the middle cerebral artery PSV (P = .60) and PI (P = .88) measured in the conventionally used near-field proximal site in the 50 healthy fetuses. No significant difference between the proximal portions of the near- and far-field sites was detected for the PSV (P = .53) and PI (P = .23) in healthy or anemic fetuses. CONCLUSIONS The findings of this study suggest that the use of the far-field vessel is an acceptable alternative for measurement of the middle cerebral artery PI and PSV when investigation of the near-field vessel is technically difficult.
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Affiliation(s)
- Silvia Salvi
- Fetal Medicine Unit, Academic Department of Obstetrics and Gynecology, St George's University of London, London, England (S.S., A.Bh.); Department of Obstetrics, Gynecology and Pediatrics, Catholic University of Sacred Heart, Rome, Italy (S.S.); and Chikitsa, Center for Excellence in Ultrasound, Mumbai, India (A.Ba., K.K.)
| | - Anirudh Badade
- Fetal Medicine Unit, Academic Department of Obstetrics and Gynecology, St George's University of London, London, England (S.S., A.Bh.); Department of Obstetrics, Gynecology and Pediatrics, Catholic University of Sacred Heart, Rome, Italy (S.S.); and Chikitsa, Center for Excellence in Ultrasound, Mumbai, India (A.Ba., K.K.)
| | - Kalpesh Khatal
- Fetal Medicine Unit, Academic Department of Obstetrics and Gynecology, St George's University of London, London, England (S.S., A.Bh.); Department of Obstetrics, Gynecology and Pediatrics, Catholic University of Sacred Heart, Rome, Italy (S.S.); and Chikitsa, Center for Excellence in Ultrasound, Mumbai, India (A.Ba., K.K.)
| | - Amar Bhide
- Fetal Medicine Unit, Academic Department of Obstetrics and Gynecology, St George's University of London, London, England (S.S., A.Bh.); Department of Obstetrics, Gynecology and Pediatrics, Catholic University of Sacred Heart, Rome, Italy (S.S.); and Chikitsa, Center for Excellence in Ultrasound, Mumbai, India (A.Ba., K.K.).
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514
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Agladioglu K, Pekel G, Citisli V, Yagci R. Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables. J Clin Ultrasound 2015; 43:567-572. [PMID: 25802013 DOI: 10.1002/jcu.22269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/20/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables. METHODS In this cross-sectional and observational study, 43 eyes and ICAs of 43 healthy volunteers were examined. Spectral domain optical coherence tomography was used to measure subfoveal choroidal thickness (SFCT) and retinal vascular caliber. The ICA Doppler ultrasonographic parameters were diameter, flow volume, peak-systolic velocity, end-diastolic velocity, resistance index (RI), and pulsatility index (PI). RESULTS Negative correlations emerged between ICA RI and SFCT (p = 0.017, r = -0.36) as well as between ICA PI and retinal arteriolar caliber (p = 0.015, r = -0.37). A negative linear correlation appeared between ICA diameter and SFCT (p = 0.005, r = -0.42), although ICA diameter and flow volume showed no association with retinal vessel caliber (p > 0.05). CONCLUSIONS Choroidal thickness is negatively correlated with ICA diameter and ICA RI, while retinal arteriolar caliber is inversely related with ICA PI in normal volunteers.
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Affiliation(s)
| | - Gökhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Veli Citisli
- Department of Neurosurgery, Pamukkale University, Denizli, Turkey
| | - Ramazan Yagci
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
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515
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Perren F, Kremer C, Iwanovski P, Savva E, Landis T. Detection of Right-to-Left Cardiac Shunt in the Absence of Transcranial Acoustic Bone. J Neuroimaging 2015; 26:269-72. [PMID: 26514230 DOI: 10.1111/jon.12311] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/04/2015] [Accepted: 09/11/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Paradoxical thrombotic embolism via right-to-left cardiac shunt (RLS) is a risk factor of cryptogenic ischemic stroke. Transtemporal Doppler (TTD) is a valid method used in the detection of patent foramen ovale (PFO). Temporal acoustic bone windows are missing with increasing age and in some younger subjects. We studied prospectively whether Doppler ultrasound of the cervical arteries (submandibular internal carotid artery [ICA] and vertebral artery [VA]) is an alternative, when compared to TTD, in the detection and quantification of PFO. MATERIAL AND METHODS A total of 94 patients with sufficient temporal bone windows suffering from recent ischemic stroke underwent TTD and ICA (n = 51) or TTD and VA (n = 43). After injection of microbubbles, the numbers of artificial high-intensity signals (HITS) were recorded at rest and after Valsalva maneuver. RESULTS For 47 patients in the ICA group, an RLS was found at rest in 23 patients and after Valsalva in 28 patients. At rest, sensitivity was 100%, specificity 96%, positive predictive value (ppv) 95.6%, and negative predictive value (npv) 100%. After Valsalva, sensitivity was 100%, specificity 95%, ppv 96.4%, npv 100%. For 43 patients in the VA group an RLS was found at rest in 14 patients and after Valsalva in 19 patients. At rest, sensitivity was 71.4%, specificity 100%, ppv 100%, and npv 87.8%. After Valsalva, 94.4%, 96%, 94.4%, and 96%, respectively. Pearson's correlations of the number of HITS between TTD and ICA and between TTD and VA were highly significant. CONCLUSIONS When transcranial acoustic bone windows are missing, Doppler ultrasound of the cervical submandibular ICA and VAs are valid screening methods to detect RLS due to a PFO.
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Affiliation(s)
- Fabienne Perren
- Department of Clinical Neurosciences, Neurology, Neurovascular and Neurosonology Unit, HUG, University Hospital and Medical Faculty of Geneva, Geneva, Switzerland
| | - Christine Kremer
- Department of Neurology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Patricia Iwanovski
- Department of Clinical Neurosciences, Neurology, Neurovascular and Neurosonology Unit, HUG, University Hospital and Medical Faculty of Geneva, Geneva, Switzerland
| | - Elena Savva
- Department of Clinical Neurosciences, Neurology, Neurovascular and Neurosonology Unit, HUG, University Hospital and Medical Faculty of Geneva, Geneva, Switzerland
| | - Theodor Landis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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516
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Abstract
AIM Vascular access (VA) dysfunction limits hemodialysis delivery, which increases morbidity and mortality. The most com mon cause of VA failure is thrombosis, due to flow limiting stenosis resulting from neointimal hyperplasia. This occurs not only due to hemodynamic factors but also by systemic ones related to vascular atherosclerosis, inflammation and calcification, which has developed a simple vascular calcification score (SVCS) predictor of vascular calcification and arterial stiffness. The NKF-K/DOQ recommends several diagnostic procedures for VA surveillance. Blood access flow (Qa) has predictive power for the detection of stenosis. Our aim was to evaluate the role of systemic factors, especially SCVS, on Qa. MATERIAL AND METHODS Transversal study in 50 patients. Qa value was obtained with Blood Temperature Monitor and Doppler method. Pearson coefficient evaluated correlation between them. Clinical, lab and radiological variables were recorded and non-parametric tests evaluated how both Qa varied with them. RESULTS Pearson's corelation between DU-Qa and TD-Qa was 0.851 (p-value <0.001). DU-Qa varied significantly with age (p = 0.012), VA type (p = 0.021), SCVS (p = 0.030), intra-access arterial pressure (p = 0.015) and time on dialysis (p = 0.002). BTM-Qa varied significantly with diabetes status (p = 0.027), age (p = 0.017), first VA status (p = 0.036), intra-access arterial pressure (p = 0.028) and dialysis time (p = 0.001). Nevertheless, gender, hypertensive status and analitical parameters did not change the flow values. CONCLUSION Higher SVCS was associated only with lower DU-Qas, giving this method an advantage towards the indirect one. Additionally, a simple method like SVCS may be used to guide new surveillance recommendations accordingly to risk stratification.
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Affiliation(s)
| | - Carlos Botelho
- a Vascular Access Center of Nephrocare Coimbra , Coimbra , Portugal
| | - Pedro Maia
- a Vascular Access Center of Nephrocare Coimbra , Coimbra , Portugal
| | - José Ibeas
- b Department of Nephrology , University Hospital Parc Tauli of Sabadell , Barcelona , Spain , and
| | - Pedro Ponce
- c Vascular Access Center of Nephrocare Lisboa , Lisbon , Portugal
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517
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Kondo T, Maruyama H, Sekimoto T, Shimada T, Takahashi M, Yokosuka O. Reversed portal flow: Clinical influence on the long-term outcomes in cirrhosis. World J Gastroenterol 2015; 21:8894-8902. [PMID: 26269679 PMCID: PMC4528032 DOI: 10.3748/wjg.v21.i29.8894] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/27/2015] [Accepted: 06/26/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To elucidate the natural history and the longitudinal outcomes in cirrhotic patients with non-forward portal flow (NFPF).
METHODS: The present retrospective study consisted of 222 cirrhotic patients (120 males and 102 females; age, 61.7 ± 11.1 years). The portal hemodynamics were evaluated at baseline and during the observation period using both pulsed and color Doppler ultrasonography. The diameter (mm), flow direction, mean flow velocity (cm/s), and mean flow volume (mL/min) were assessed at the portal trunk, the splenic vein, the superior mesenteric vein, and the collateral vessels. The average values from 2 to 4 measurements were used for the data analysis. The portal flow direction was defined as follows: forward portal flow (FPF) for continuous hepatopetal flow; bidirectional flow for to-and-fro flow; and reversed flow for continuous hepatofugal flow. The bidirectional flow and the reversed flow were classified as NFPF in this study. The clinical findings and prognosis were compared between the patients with FPF and those with NFPF. The median follow-up period was 40.9 mo (range, 0.3-156.5 mo).
RESULTS: Twenty-four patients (10.8%) demonstrated NFPF, accompanied by lower albumin level, worse Child-Pugh scores, and model for end-stage liver disease scores. The portal hemodynamic features in the patients with NFPF were smaller diameter of the portal trunk; presence of short gastric vein, splenorenal shunt, or inferior mesenteric vein; and advanced collateral vessels (diameter > 8.7 mm, flow velocity > 10.2 cm/s, and flow volume > 310 mL/min). The cumulative incidence rates of NFPF were 6.5% at 1 year, 14.5% at 3 years, and 23.1% at 5 years. The collateral vessels characterized by flow velocity > 9.5 cm/s and those located at the splenic hilum were significant predictive factors for developing NFPF. The cumulative survival rate was significantly lower in the patients with NFPF (72.2% at 1 year, 38.5% at 3 years, 38.5% at 5 years) than in those with forward portal flow (84.0% at 1 year, 67.8% at 3 years, 54.3% at 5 years, P = 0.0123) using the Child-Pugh B and C classifications.
CONCLUSION: NFPF has a significant negative effect on the prognosis of patients with worse liver function reserve, suggesting the need for careful management.
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518
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Kenwright DA, Anderson T, Moran CM, Hoskins PR. Assessment of Spectral Doppler for an Array-Based Preclinical Ultrasound Scanner Using a Rotating Phantom. Ultrasound Med Biol 2015; 41:2232-2239. [PMID: 25957754 PMCID: PMC4510153 DOI: 10.1016/j.ultrasmedbio.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 03/24/2015] [Accepted: 04/06/2015] [Indexed: 06/04/2023]
Abstract
Velocity measurement errors were investigated for an array-based preclinical ultrasound scanner (Vevo 2100, FUJIFILM VisualSonics, Toronto, ON, Canada). Using a small-size rotating phantom made from a tissue-mimicking material, errors in pulse-wave Doppler maximum velocity measurements were observed. The extent of these errors was dependent on the Doppler angle, gate length, gate depth, gate horizontal placement and phantom velocity. Errors were observed to be up to 172% at high beam-target angles. It was found that small gate lengths resulted in larger velocity errors than large gate lengths, a phenomenon that has not previously been reported (e.g., for a beam-target angle of 0°, the error was 27.8% with a 0.2-mm gate length and 5.4% with a 0.98-mm gate length). The error in the velocity measurement with sample volume depth changed depending on the operating frequency of the probe. Some edge effects were observed in the horizontal placement of the sample volume, indicating a change in the array aperture size. The error in the velocity measurements increased with increased phantom velocity, from 22% at 2.4 cm/s to 30% at 26.6 cm/s. To minimise the impact of these errors, an angle-dependent correction factor was derived based on a simple ray model of geometric spectral broadening. Use of this angle-dependent correction factor reduces the maximum velocity measurement errors to <25% in all instances, significantly improving the current estimation of maximum velocity from pulse-wave Doppler ultrasound.
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Affiliation(s)
- David A Kenwright
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
| | - Tom Anderson
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Carmel M Moran
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter R Hoskins
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
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519
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Kolonko A, Chudek J, Więcek A. Initial kidney graft resistance index and the long-term cardiovascular mortality in transplanted patients: a paired grafts analysis. Nephrol Dial Transplant 2015; 30:1218-1224. [PMID: 25839739 DOI: 10.1093/ndt/gfv083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/04/2015] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Cardiovascular complications remain the most frequent cause of death in kidney transplant recipients. We analysed the prognostic value of early measured resistance index (RI) in the aspect of long-term cardiovascular mortality. In order to eliminate potential donor-related confounders, we analysed the mortality of recipients, transplanted with organs procured from the same donor, in whom the initial RI values substantially differed. METHODS Doppler sonography was performed in 725 consecutive kidney graft recipients early after transplantation. We identified 133 pairs (266 patients) who received their kidney grafts from the same donor and their initial RI values differed by >0.1. RESULTS During 109 ± 37 months of follow-up after transplantation, 84 patients lost their graft and 29 died, 14 of them due to cardiovascular causes. Two groups of paired patients with higher RI and lower RI did not differ significantly with respect to their age, BMI, HLA mismatch and cold ischaemia time. There were more patients with diabetes in the higher RI group (14.3 versus 6.8%). Survival analysis revealed a higher mortality for cardiovascular (8.3 versus 2.3%, P = 0.02) and all causes (14.3 versus 7.5%, P = 0.06) among patients with higher initial RI values. In the Cox regression model, not including age, a higher RI value was a strong predictor of cardiovascular death (HR = 4.88), independent of previous cardiovascular episodes (HR = 6.78). Both these variables lost its significance as a predictors after inclusion of age in the regression model. CONCLUSION Increased intrarenal resistance index in the early posttransplant period may help to identify the recipients with increased cardiovascular risk.
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Affiliation(s)
- Aureliusz Kolonko
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Silesia, Katowice, Poland
| | - Jerzy Chudek
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Silesia, Katowice, Poland Department of Pathophysiology, Medical University of Silesia, Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Silesia, Katowice, Poland
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520
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Gómez-Choco M, Schreiber SJ, Weih M, Doepp F, Valdueza JM. Delayed Transcranial Echo-Contrast Bolus Arrival in Unilateral Internal Carotid Artery Stenosis and Occlusion. Ultrasound Med Biol 2015; 41:1827-1834. [PMID: 25890887 DOI: 10.1016/j.ultrasmedbio.2015.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/11/2015] [Accepted: 03/12/2015] [Indexed: 06/04/2023]
Abstract
Some patients with internal carotid artery (ICA) occlusion or stenosis are at risk of developing a hemodynamic stroke. Transcranial ultrasonography using an echo-contrast bolus technique might be able to assess the extent of hemodynamic compromise. We describe a transcranial Doppler sonographic method that analyzes the differences in echo-contrast bolus arrival between both middle cerebral arteries after intravenous echo-contrast application. Ten patients with 50%-79% ICA stenosis, 10 patients with 80%-99% ICA stenosis and 22 patients with ICA occlusion were studied and compared with 15 age-matched controls. There were significant increases in delayed filling of the middle cerebral artery in both 80%-99% stenoses and occlusions compared with controls. The extent of the observed delays did not correlate with vasomotor reactivity. Echo-contrast bolus arrival time can be used to gain additional information on the intracranial hemodynamic effects of extracranial carotid artery disease that seems to be independent of the established ultrasound indices.
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Affiliation(s)
| | | | | | - Florian Doepp
- Department of Neurology, University Hospital Charité, Berlin, Germany
| | - José M Valdueza
- Neurological Center, Segeberger Kliniken, Bad Segeberg, Germany.
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521
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Landres IV, Small M, Sirjusingh A, Ramsewak S, Williams KP. A comparison of Doppler waveform parameters versus flow-mediated vascular dilation of the brachial artery in pregnant women. Pregnancy Hypertens 2015; 4:220-3. [PMID: 26104609 DOI: 10.1016/j.preghy.2014.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 04/21/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Flow mediated dilation of the brachial artery is impaired with endothelial dysfunction. We previously identified that brachial artery waveforms were changed in preeclamptic women. We therefore sought to compare Doppler waveform analysis with flow mediated vascular dilation (FMVD) measurements in pregnant women. STUDY DESIGN A cross sectional study of 71 pregnant women at >20weeks gestation comparing FMVD measurements with Doppler waveform parameters was performed. Research was conducted at three hospitals and two geographic settings; (1) Yale-New Haven Hospital in New Haven, CT, (2) Mount Hope Maternity and (3) Port of Spain General Hospital in Trinidad. Brachial artery Doppler waveform measurements were done at baseline and 90s post cuff-release. From the Doppler waveforms we assessed percent change in Peak Systolic Velocity (% ΔPSV), systolic acceleration, acceleration time and pulsatility index and compared them with the percent change in FMVD. Statistical analysis using Student's t tests and correlation coefficient was done as necessary. RESULTS Correlation analysis between the % change in the Doppler waveform parameters and the % change in mean FMVD identified only the waveform parameter of % ΔPSV as significantly correlated (p=0.040). CONCLUSION FMVD remains the gold standard for assessment of endothelial dysfunction. A correlation was observed between the Doppler measured % ΔPSV and FMVD, which may allow it to be used to assess endothelial dysfunction changes under different conditions was identified.
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Affiliation(s)
- Inna V Landres
- Stony Brook Department of Obstetrics and Gynecology, 6 Technology Drive, Suite 200, East Setauket, NY 11733, United States
| | - Maria Small
- Department of Obstetrics and Gynecology, Duke University Medical Center, DUMC 3967, Durham, NC 27710, United States
| | - Adesh Sirjusingh
- Department of Obstetrics and Gynecology, Mount Hope Maternity Hospital, University of the West Indies, Trinidad and Tobago
| | - Samuel Ramsewak
- Department of Obstetrics and Gynecology, Mount Hope Maternity Hospital, University of the West Indies, Trinidad and Tobago
| | - Keith P Williams
- Department of Obstetrics and Gynecology, Rowan University - School of Osteopathic Medicine, Stratford, NJ, United States.
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522
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Abstract
The median arcuate ligament syndrome (MALS) or celiac artery compression syndrome (CACS) is a rare entity, presenting clinically with postprandial abdominal pain and weight loss. The diagnosis is made on computed tomography (CT) angiography, which reveals extrinsic compression of the proximal part of the celiac artery by the median arcuate ligament, producing a characteristic hooked appearance. We report a case of the celiac artery compression syndrome, diagnosed by Doppler USG evaluation.
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Affiliation(s)
- Raina Anil Tembey
- Department of Radiology and Imaging, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Aneeta S Bajaj
- Department of Radiology and Imaging, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Prasad K Wagle
- Department of Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Abdul Samad Ansari
- Department of Critical Care Medicine, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
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523
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López-Hernández N, García-Escrivá A, Ballenilla F, Gallego-Leon JI. Hemodynamic effects of proximal supra-aortic artery stenosis on anterior cerebral artery. Ultrasound Med Biol 2015; 41:1488-1492. [PMID: 25641601 DOI: 10.1016/j.ultrasmedbio.2014.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 11/14/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
Alternating flow in the anterior cerebral artery is a rare finding, associated with innominate artery stenosis. We present a series of four patients with this finding on transcranial color coded sonography, under basal conditions. In all of these patients, vascular studies detected an ipsilateral proximal stenosis, three in the innominate artery and, for the first time, one at the left common carotid artery origin. Successful angioplasties with stenting were performed, resulting for the first time in the normalization of orthograde flow in all cases. We conclude that an early systolic hemodynamic compromise in the first segment of the anterior cerebral artery, in the form of alternating flow, is an indirect indicator of ipsilateral proximal stenosis in the supra-aortic arteries, either in the innominate artery or at the origin of the left common carotid artery.
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524
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Tonni G, Martins WP, Guimarães Filho H, Araujo Júnior E. Role of 3-D ultrasound in clinical obstetric practice: evolution over 20 years. Ultrasound Med Biol 2015; 41:1180-1211. [PMID: 25748522 DOI: 10.1016/j.ultrasmedbio.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 06/04/2023]
Abstract
The use of 3-D ultrasound in obstetrics has undergone dramatic development over the past 20 years. Since the first publications on this application in clinical practice, several 3-D ultrasound techniques and rendering modes have been proposed and applied to the study of fetal brain, face and cardiac anatomy. In addition, 3-D ultrasound has improved calculations of the volume of fetal organs and limbs and estimations of fetal birth weight. And furthermore, angiographic patterns of fetal organs and the placenta have been assessed using 3-D power Doppler ultrasound quantification. In this review, we aim to summarize current evidence on the clinical relevance of these methodologies and their application in obstetric practice.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Guastalla Civil Hospital, ASL Reggio Emilia, Italy; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
| | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto School of Medicine, University of São Paulo (DGO-FMRP-USP), Ribeirão Preto-SP, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
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525
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Lubomirova M, Krasteva R, Bogov B, Paskalev E. Incidence of A-V Fistulas after Renal Biopsy of Native and Transplanted Kidney - Two Centers Experience. Open Access Maced J Med Sci 2015; 3:241-4. [PMID: 27275228 PMCID: PMC4877860 DOI: 10.3889/oamjms.2015.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
AIM: The aim of the study is to make a retrospective analysis of the incidence of AV fistulas after renal biopsy (RB) of native and transplanted kidney. MATERIALS AND METHODS: Five hundred and sixteen (516) RB were analyzed. One hundred twenty nine (129) were native kidneys RB performed in Clinic of Nephrology (CN), 190 were performed in Clinic of Nephrology and transplantation (CNT) and 197 were transplanted kidney biopsies from the same clinic. Biopsy technique type Gun with needle 14G, 16 and 18 G was used in CN, CNT used the same technique with needles 16G. Doppler ultrasound was made for A-V fistulas diagnosis. RESULTS: The A-V fistulas incidence was 0.8%. The frequency of A-V fistulas registered in CN was significantly higher than that registered in CNT (2.3% vs. 0.5%, p < 0.01). Biopsies performed by 14 G needles provide a higher percentage of A-V fistulas compared to those done by 16 G. (3.3% vs. 2.4%, p < 0.5). The frequency of the A-V fistulas in native and transplanted kidneys in CNT was similar (0.5% vs. 0.5%, p > 0.05). CONCLUSION: The A-V fistulas incidence is very low. The needle thickness is an important factor relevant to the risk of occurrence of A-V fistulas.
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Affiliation(s)
- Mila Lubomirova
- Department of Nephrology, University Hospital "Aleksandrovska", Sofia, Bulgaria
| | - Rumiana Krasteva
- Department of Nephrology, University Hospital "Aleksandrovska", Sofia, Bulgaria
| | - Boris Bogov
- Department of Nephrology, University Hospital "Aleksandrovska", Sofia, Bulgaria
| | - Emil Paskalev
- Department of Nephrology and Transplantation, University Hospital "Aleksandrovska", Sofia, Bulgaria
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526
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Towse TF, Childs BT, Sabin SA, Bush EC, Elder CP, Damon BM. Comparison of muscle BOLD responses to arterial occlusion at 3 and 7 Tesla. Magn Reson Med 2015; 75:1333-40. [PMID: 25884888 DOI: 10.1002/mrm.25562] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 10/21/2014] [Accepted: 11/12/2014] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this study was to determine the feasibility of muscle BOLD (mBOLD) imaging at 7 Tesla (T) by comparing the changes in R2* of muscle at 3 and 7T in response to a brief period of tourniquet-induced ischemia. METHODS Eight subjects (three male), aged 29.5 ± 6.1 years (mean ± standard deviation, SD), 167.0 ± 10.6 cm tall with a body mass of 62.0 ± 18.0 kg, participated in the study. Subjects reported to the lab on four separate occasions including a habituation session, two MRI scans, and in a subset of subjects, a session during which changes in blood flow and blood oxygenation were quantified using Doppler ultrasound (U/S) and near-infrared spectroscopy (NIRS) respectively. For statistical comparisons between 3 and 7T, R2* rate constants were calculated as R2* = 1/T2*. RESULTS The mean preocclusion R2* value was greater at 7T than at 3T (60.16 ± 2.95 vs. 35.17 ± 0.35 s(-1), respectively, P < 0.001). Also, the mean ΔR2 *END and ΔR2*POST values were greater for 7T than for 3T (-2.36 ± 0.25 vs. -1.24 ± 0.39 s(-1), respectively, Table 1). CONCLUSION Muscle BOLD contrast at 7T is as much as six-fold greater than at 3T. In addition to providing greater SNR and CNR, 7T mBOLD studies may offer further advantages in the form of greater sensitivity to pathological changes in the muscle microcirculation.
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Affiliation(s)
- Theodore F Towse
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Benjamin T Childs
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Shea A Sabin
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Emily C Bush
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Christopher P Elder
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce M Damon
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
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527
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Abstract
This article describes four technologies relevant to vascular ultrasound which are available commercially in 2015, and traces their origin back through the research literature. The technologies are 3D ultrasound and its use in plaque volume estimation (first described in 1994), colour vector Doppler for flow visualisation (1994), wall motion for estimation of arterial stiffness (1968), and shear wave elastography imaging of the arterial wall (2010). Overall these technologies have contributed to the understanding of vascular disease but have had little impact on clinical practice. The basic toolkit for vascular ultrasound has for the last 25 years been real-time B-mode, colour flow and spectral Doppler. What has changed over this time is improvement in image quality. Looking ahead it is noted that 2D array transducers and high frame rate imaging continue to spread through the commercial vascular ultrasound sector and both have the potential to impact on clinical practice.
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Affiliation(s)
- P R Hoskins
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4TJ
| | - D A Kenwright
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4TJ
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528
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Nagano S, Yahiro Y, Yokouchi M, Setoguchi T, Ishidou Y, Sasaki H, Shimada H, Kawamura I, Komiya S. Doppler ultrasound for diagnosis of soft tissue sarcoma: efficacy of ultrasound-based screening score. Radiol Oncol 2015; 49:135-40. [PMID: 26029024 PMCID: PMC4387989 DOI: 10.1515/raon-2015-0011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/09/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The utility of ultrasound imaging in the screening of soft-part tumours (SPTs) has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool. PATIENTS AND METHODS This study included 189 cases of pathologically confirmed SPTs (122 cases of benign disease including SPTs and tumour-like lesions and 67 cases of malignant SPTs). Ultrasound imaging included evaluation of vascularity by colour Doppler. We established a scoring system to more effectively differentiate malignant from benign SPTs (ultrasound-based sarcoma screening [USS] score). RESULTS The mean scores in the benign and malignant groups were 1.47 ± 0.93 and 3.42 ± 1.30, respectively. Patients with malignant masses showed significantly higher USS scores than did those with benign masses (p < 1 × 10(-10)). The area under the curve was 0.88 by receiver operating characteristic (ROC) analysis. Based on the cut-off value (3 points) calculated by ROC curve analysis, the sensitivity and specificity for a diagnosis of malignant SPT was 85.1% and 86.9%, respectively. CONCLUSIONS Assessment of vascularity by Doppler ultrasound alone is insufficient for differentiation between benign and malignant SPTs. Preoperative diagnosis of most SPTs is possible by combining our USS score with characteristic clinical and magnetic resonance imaging findings.
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Affiliation(s)
- Satoshi Nagano
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuhei Yahiro
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masahiro Yokouchi
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takao Setoguchi
- The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yasuhiro Ishidou
- Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiromi Sasaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hirofumi Shimada
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Ichiro Kawamura
- Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Setsuro Komiya
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan ; The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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529
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Shakeri A, Varshochi M, Atapour N, Nemati M, Khoshbaten M, Fouladi DF. Vascular Doppler ultrasonographic indices in cirrhosis: a case-control study with emphasis on the common carotid arteries. Radiol Med 2015; 120:982-8. [PMID: 25725791 DOI: 10.1007/s11547-015-0524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare vascular Doppler waveform indices, particularly in the common carotid arteries, between cirrhotic and healthy subjects. MATERIALS AND METHODS A total of 60 patients with Class-B cirrhosis and 60 healthy matched counterparts were enrolled in this prospective study. Vascular Doppler waveform parameters including resistance and/or pulsatility indices (RI and PI, respectively) were obtained from the common carotid, renal, celiac, superior mesenteric, femoral and brachial arteries. RESULTS Compared to patients, healthy subjects had significantly higher mean PI and RI obtained from the common carotid (1.53 ± 0.20 vs. 1.43 ± 0.14, p = 0.03; 0.75 ± 0.02 vs. 0.72 ± 0.02, p < 0.001, respectively) and celiac arteries (2.00 ± 0.36 vs. 1.81 ± 0.34, p = 0.03; 0.80 ± 0.03 vs. 0.78 ± 0.02, p < 0.001, respectively). Both the mean PI and RI derived from the renal arteries, in contrast, were significantly higher in patients compared to that in controls (1.05 ± 0.13 vs. 1.11 ± 0.07, p = 0.03; 0.59 ± 0.03 vs. 0.63 ± 0.03, p < 0.001, respectively). The mean vascular impedance values obtained from the remaining arteries were comparable between the two groups. CONCLUSIONS Blood flow increases in the common carotid and celiac arteries of Class-B cirrhotic patients with elevated renovascular impedance.
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530
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Radhakrishnan K, Haworth KJ, Peng T, McPherson DD, Holland CK. Loss of echogenicity and onset of cavitation from echogenic liposomes: pulse repetition frequency independence. Ultrasound Med Biol 2015; 41:208-21. [PMID: 25438849 PMCID: PMC4258473 DOI: 10.1016/j.ultrasmedbio.2014.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 05/11/2023]
Abstract
Echogenic liposomes (ELIP) are being developed for the early detection and treatment of atherosclerotic lesions. An 80% loss of echogenicity of ELIP has been found to be concomitant with the onset of stable and inertial cavitation. The ultrasound pressure amplitude at which this occurs is weakly dependent on pulse duration. It has been reported that the rapid fragmentation threshold of ELIP (based on changes in echogenicity) is dependent on the insonation pulse repetition frequency (PRF). The study described here evaluates the relationship between loss of echogenicity and cavitation emissions from ELIP insonified by duplex Doppler pulses at four PRFs (1.25, 2.5, 5 and 8.33 kHz). Loss of echogenicity was evaluated on B-mode images of ELIP. Cavitation emissions from ELIP were recorded passively on a focused single-element transducer and a linear array. Emissions recorded by the linear array were beamformed, and the spatial widths of stable and inertial cavitation emissions were compared with the calibrated azimuthal beamwidth of the Doppler pulse exceeding the stable and inertial cavitation thresholds. The inertial cavitation thresholds had a very weak dependence on PRF, and stable cavitation thresholds were independent of PRF. The spatial widths of the cavitation emissions recorded by the passive cavitation imaging system agreed with the calibrated Doppler beamwidths. The results also indicate that 64%-79% loss of echogenicity can be used to classify the presence or absence of cavitation emissions with greater than 80% accuracy.
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Affiliation(s)
- Kirthi Radhakrishnan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Kevin J Haworth
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Tao Peng
- Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - David D McPherson
- Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Christy K Holland
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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531
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Szczyrba S, Kozera GM, Neubauer-Geryk J, Wolnik B, Nyka WM, Bieniaszewski L. Diabetic symmetric polyneuropathy is associated with increased aortal stiffening but not cerebral angiopathy in type 1 diabetes. J Diabetes Complications 2015; 29:73-6. [PMID: 25456818 DOI: 10.1016/j.jdiacomp.2014.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 09/22/2014] [Accepted: 10/02/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Diabetic symmetric polyneuropathy (DSP) and cerebral microangiopathy are common complications of type 1 diabetes (T1DM). However, little is known about associations between DSP, cerebral microcirculation and macrovascular injury in T1DM. We aimed to assess relationships between those complications. MATERIAL AND METHODS We examined 42 patients (25 females; mean age 37.1±5.6years) with T1DM (mean disease duration 20.6±6.1years). DSP was diagnosed with the use of quantitative vibration sensory testing (QVST) and Michigan Neuropathy Screening Instrument (MNSI). Cerebral microvasculature was evaluated with measurements of vasomotor reactivity reserve (VMR) and pulsatility index (PI) of middle cerebral artery, macroangiopathic injury by measuring intima-media complex thickness (IMT) in the common carotid artery and carotid-femoral pulse-wave velocity (PWV). RESULTS Patients with DSP (33.3%) showed higher PWV than those without DPS (10.5 vs 9.1m/s; P=0.03); no differences concerning VMR, PI or IMT existed. There were correlations between PWV and vibration perception thresholds (VPT) (r=0.44; P=0.004) and MNSI score (r=0.43; P=0.003); VPT showed impact on PWV (beta 0.34; P<0.03). CONCLUSIONS DSP is associated with systemic macroangiopathy, reflected by increased carotid-femoral PWV, but not with the cerebral macro- and microangiopathy.
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Affiliation(s)
| | - Grzegorz M Kozera
- Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Bogumił Wolnik
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Walenty M Nyka
- Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland
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532
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Linask KK, Han M, Bravo-Valenzuela NJM. Changes in vitelline and utero-placental hemodynamics: implications for cardiovascular development. Front Physiol 2014; 5:390. [PMID: 25426076 PMCID: PMC4227466 DOI: 10.3389/fphys.2014.00390] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/21/2014] [Indexed: 12/31/2022] Open
Abstract
Analyses of cardiovascular development have shown an important interplay between heart function, blood flow, and morphogenesis of heart structure during the formation of a four-chambered heart. It is known that changes in vitelline and placental blood flow seemingly contribute substantially to early cardiac hemodynamics. This suggests that in order to understand mammalian cardiac structure-hemodynamic functional relationships, blood flow from the extra-embryonic circulation needs to be taken into account and its possible impact on cardiogenesis defined. Previously published Doppler ultrasound analyses and data of utero-placental blood flow from human studies and those using the mouse model are compared to changes observed with environmental exposures that lead to cardiovascular anomalies. Use of current concepts and models related to mechanotransduction of blood flow and fluid forces may help in the future to better define the characteristics of normal and abnormal utero-placental blood flow and the changes in the biophysical parameters that may contribute to congenital heart defects. Evidence from multiple studies is discussed to provide a framework for future modeling of the impact of experimental changes in blood flow on the mouse heart during normal and abnormal cardiogenesis.
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Affiliation(s)
- Kersti K Linask
- Department of Pediatrics, Morsani College of Medicine, Children's Research Institute, University of South Florida Health St. Petersburg, FL, USA
| | - Mingda Han
- Department of Pediatrics, Morsani College of Medicine, Children's Research Institute, University of South Florida Health St. Petersburg, FL, USA
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533
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Hannon K. Renal artery stenosis on duplex ultrasound due to inferior vena cava filter leg impingement. Ultrasound 2014; 22:240-2. [PMID: 27433226 PMCID: PMC4760549 DOI: 10.1177/1742271x14548938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a case study of renal artery duplex findings for new onset of hypertension in a young woman with a history of inferior vena cava filter placed a year prior and failed percutaneous retrieval. Duplex ultrasound showed significantly elevated velocities in the mid-right renal artery, consistent with renal artery stenosis. Computed tomography angiography images suggested that a leg from the inferior vena cava filter was impinging on her right renal artery, with perforation through the vena cava possibly into the wall of her duodenum. Open surgical intervention was required to disentangle the filter legs from the wall of the duodenum and relieve impingement on the right renal artery with thrombolysis of clot found within the right renal artery.
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Affiliation(s)
- Kathleen Hannon
- Clinical Vascular Diagnostic Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA
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534
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Maruotti GM, Rizzo G, Sirico A, Sarno L, Cirigliano L, Arduini D, Martinelli P. Are there any relationships between umbilical artery Pulsatility Index and macrosomia in fetuses of type I diabetic mothers? J Matern Fetal Neonatal Med 2014; 27:1776-81. [PMID: 24397275 DOI: 10.3109/14767058.2013.879706] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To establish whether there are relationships between umbilical artery Pulsatility Index (PI) and fetal macrosomia in pregnancies complicated by type I diabetes. METHODS In a retrospective observational study, 102 singleton pregnant women with type I diabetes were considered. Umbilical artery PI was measured by Doppler ultrasonography within one week from delivery and related to neonatal weight. Pregnancies were grouped according to birtweight in macrosomic group (≥4000 g) and normal growth group (<4000 g). Relationships between umbilical artery PI and birth weight and birth weight centile were tested by Pearson's correlation analysis. Further umbilical artery PI values were compared between macrosomic and normally grown fetuses. RESULTS Birth weight was ≥4000 g in 24 pregnancies (23.5%). A significant relationship was found between umbilical artery PI and neonatal weight (r = 0.512; p < 0.01) and neonatal weight centile (r = 0.400; p < 0.01). Umbilical artery PI were significantly lower (t = -6.013; p < 0.001) in the macrosomic group (0.78; 95% confidence interval (CI) 0.73-0.84) than in the normal growth group (1.00; 95% CI 0.97-1.04). CONCLUSIONS In pregnancies complicated by type I diabetes there is a significant relationship between umbilical artery PI value before delivery and absolute birth weight and birth weight centile. Macrosomic fetuses show a significant reduction in umbilical artery PI when compared with diabetic pregnancies without fetal overgrowth.
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Affiliation(s)
- G M Maruotti
- High Risk Pregnancy Centre, Department of Gynaecology and Obstetrics, University Federico II Naples , Naples , Italy and
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535
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Pitzele A, Rahimi M, Armbrecht E, Havranek T. Packed red blood cell transfusion (PRBC) attenuates intestinal blood flow responses to feedings in pre-term neonates with normalization at 24 hours. J Matern Fetal Neonatal Med 2014; 28:1770-3. [PMID: 25269406 DOI: 10.3109/14767058.2014.971746] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether packed red blood cell (PRBC) transfusion affects post-prandial superior mesenteric artery blood flow velocities (SMA BFVs) in very-low birth weight (VLBW) neonates and if so, at what time point after transfusion restoration of previous SMA BFV patterns occurs. DESIGN/METHODS VLBW pre-term neonates, older than 14 days and tolerating bolus enteral feedings administered every 3 h were enrolled in this prospective observational study. Pulsed Doppler ultrasound was used to measure pre- and post-prandial (at 45 min) time-averaged mean, peak and end diastolic velocities (TAMV, PSV, EDV) immediately before and after 15 ml/kg of PRBC transfusion was given over 3 h; patent ductus arteriosus (PDA) status was also evaluated. Subsequent pre- and post-prandial SMA BFVs were recorded 24 and 48 h after the transfusion. RESULTS Pre- and post-prandial measurements were obtained for 21 out of 25 enrolled infants. Post-prandial SMA BFVs were attenuated during the feedings immediately after transfusion; at 24 and 48 h after transfusion, changes in post-prandial SMA BFVs were similar to those measured prior to transfusion; the presence of the PDA did not affect results. CONCLUSIONS PRBC transfusion blunted SMA BFV responses to feedings immediately after the transfusion with normalization observed 24 h post-transfusion.
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536
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Zheng G, Wang L, Jia X, Li F, Yan Y, Yu Z, Li L, Wei Q, Zhang F. Application of high frequency color Doppler ultrasound in the monitoring of rheumatoid arthritis treatment. Exp Ther Med 2014; 8:1807-1812. [PMID: 25371736 PMCID: PMC4218660 DOI: 10.3892/etm.2014.2001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 08/29/2014] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to explore the use of high frequency color Doppler ultrasound to measure synovial thickness and blood flow to assess the therapeutic value of the recombinant human tumor necrosis factor (TNF) II receptor antibody fusion protein in rheumatoid arthritis (RA) treatment. A total of 36 clinically-diagnosed patients with RA were treated with methotrexate tablets or the recombinant TNF-receptor antibody fusion protein for 24 weeks. Joint synovial thickness and synovial blood flow integrity were monitored by high frequency color Doppler in the second metacarpophalangeal joint in one hand. The correlation of the erythrocyte sedimentation rate, C-reactive protein (CRP) and 28-joint disease activity score (DAS28) with the ultrasound parameters were analyzed. Metacarpophalangeal second joint 2 (MCP2) synovial thickness, wrist joint synovial thickness and MCP2 synovial blood flow, prior and subsequent to the treatment, have a high correlation with DAS28 (P<0.05), and the MCP2 synovial blood flow integral has a strong correlation with CRP. Evaluating the wrist joint synovial thickness and synovial integrity of the second metacarpophalangeal joint using high frequency ultrasound detection can effectively evaluate the disease status in patients with RA. This procedure is potentially valuable as a means of evaluating the curative effects of RA treatments.
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Affiliation(s)
- Guimin Zheng
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Lei Wang
- Department of Medicine Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Xiuchuan Jia
- Department of Medicine Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Fang Li
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Yonglong Yan
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zhibo Yu
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Li Li
- Department of Ultrasound Imaging, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Qun Wei
- Department of Nosocomial Infection Control, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Fengxiao Zhang
- Department of Rheumatology, Hebei Province General Hospital, Shijiazhuang, Hebei 050051, P.R. China
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537
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Kopljar M, Patrlj L, Bušić Z, Kolovrat M, Rakić M, Kliček R, Zidak M, Stipančić I. Potential use of Doppler perfusion index in detection of occult liver metastases from colorectal cancer. Hepatobiliary Surg Nutr 2014; 3:259-67. [PMID: 25392837 PMCID: PMC4207836 DOI: 10.3978/j.issn.2304-3881.2014.09.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 08/31/2014] [Indexed: 02/05/2023]
Abstract
Many clinical and preclinical studies demonstrated that measurements of liver hemodynamic [Doppler perfusion index (DPI)] may be used to accurately diagnose and predict liver metastases from primary colorectal cancer in a research setting. However, Doppler measurements have some serious limitations when applied to general population. Ultrasound is very operator-dependent, and requires skilled examiners. Also, many conditions may limit the use of Doppler ultrasound and ultrasound in general, such as the presence of air in digestive tract, cardiac arrhythmias, vascular anomalies, obesity and other conditions. Therefore, in spite of the results from clinical studies, its value may be limited in everyday practice. On the contrary, scientific research of the DPI in detection of liver metastases is of great importance, since current research speaks strongly for the presence of systemic vasoactive substance responsible for observed hemodynamic changes. Identification of such a systemic vasoactive substance may lead to the development of a simple and reproducible laboratory test that may reliably identify the presence of occult liver metastases and therefore increase the success of adjuvant chemotherapy through better selection of patients. Further research in this subject is therefore of great importance.
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Affiliation(s)
- Mario Kopljar
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Leonardo Patrlj
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Zeljko Bušić
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Marijan Kolovrat
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mislav Rakić
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Robert Kliček
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Marcel Zidak
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Igor Stipančić
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb, Croatia
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538
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Mulcahy C, McAuliffe FM, Breathnach F, Geary M, Daly S, Higgins J, Hunter A, Morrison J, Burke G, Higgins S, Dicker P, Mahony R, Tully E, Malone F. Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation. Ultrasound Obstet Gynecol 2014; 44:461-467. [PMID: 24407772 DOI: 10.1002/uog.13302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 12/23/2013] [Accepted: 12/30/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To construct monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin reference ranges for umbilical artery (UA) pulsatility index (PI), UA resistance index (RI), fetal middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and cerebroplacental ratio (CPR) from 24 weeks' to 38 weeks' gestation and compare these with published normal values for singleton pregnancies. METHODS This prospective multicenter cohort study included 1028 unselected twin pairs recruited over a 2-year period. Participants with dichorionic twins underwent fortnightly ultrasound surveillance from 24 weeks' gestation, with monochorionic twins being followed every 2 weeks from 16 weeks until delivery. A total of 7536 fetal Doppler examinations in 618 twin pregnancies were included in the analysis, with reference ranges for MCDA and DCDA pregnancies constructed for each of the Doppler indices using multilevel modeling. RESULTS UA-PI and UA-RI appear to be higher in twins than in singletons, and MCA-PI and MCA-PSV appear to be lower. The CPR also appears to be lower in twins than in singletons. Similar MCA indices were observed in MCDA and DCDA twins. CONCLUSION We have established longitudinal reference ranges for UA-PI and UA-RI, MCA-PI and MCA-PSV and CPR in twin pregnancies, which appear to differ from those in singleton pregnancies. The derived twin-specific reference ranges may be more appropriate in the surveillance of these high-risk pregnancies. Applying the singleton CPR cut-off of ≤ 1.0 may lead to a large number of false-positive diagnoses of cerebral redistribution in twin fetuses.
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Affiliation(s)
- C Mulcahy
- National Maternity Hospital, Dublin, Ireland
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539
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Cassel M, Baur H, Hirschmüller A, Carlsohn A, Fröhlich K, Mayer F. Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes. Scand J Med Sci Sports 2014; 25:e310-8. [PMID: 25212527 DOI: 10.1111/sms.12318] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2014] [Indexed: 11/26/2022]
Abstract
Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 ± 1.9 years; 160 ± 13 cm; 50 ± 14 kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8% and patellar tendinopathy in 5.8%. Vascularizations were visible in 3.0% of ATs and 11.4% of PTs, hypoechogenicities in 0.7% and 3.2% as well as hyperechogenicities in 0% and 0.3%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P ≤ 0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P ≤ 0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy.
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Affiliation(s)
- M Cassel
- University Outpatient Clinic, Department Sports Medicine, University of Potsdam, Potsdam, Germany
| | - H Baur
- Applied Research and Development Physiotherapy, Health Section, Bern University of Applied Sciences, Bern, Switzerland
| | - A Hirschmüller
- Department of Orthopaedics and Traumatology, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - A Carlsohn
- Institute of Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - K Fröhlich
- University Outpatient Clinic, Department Sports Medicine, University of Potsdam, Potsdam, Germany
| | - F Mayer
- University Outpatient Clinic, Department Sports Medicine, University of Potsdam, Potsdam, Germany
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540
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Ceylan I, Yener S, Bayraktar F, Secil M. Roles of ultrasound and power Doppler ultrasound for diagnosis of Hashimoto thyroiditis in anti-thyroid marker-positive euthyroid subjects. Quant Imaging Med Surg 2014; 4:232-8. [PMID: 25202658 DOI: 10.3978/j.issn.2223-4292.2014.07.13] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/17/2014] [Indexed: 11/14/2022]
Abstract
PURPOSE The present study was performed to investigate the contribution of ultrasonographic (US) findings to diagnosis in anti-thyroid marker-positive patients with normal hormone levels among euthyroid subjects with Hashimoto's thyroiditis (HT). METHODS Forty premenopausal euthyroid patients with a median age of 32 years (range, 20-44 years) with normal levels of free triiodothyronine (FT3) and free thyroxine (FT4), and elevated anti-thyroid peroxidase (TPO) antibodies were enrolled in this study. A control group of 46 healthy individuals with a median age of 29 years (range, 18-43 years) was composed of randomly selected volunteers. The examinations included basic morphometric (measurement of thyroid gland dimensions in three axes, the volume of each thyroid lobe, and the total thyroid volume), morphological grayscale imaging (echogenicity, nodularity, septations, undulation of the margins, and reactive lymph nodes), and thyroid gland vascularity. RESULTS There were no statistically significant differences in morphometric parameters of the thyroid gland between the study and control groups. There were significant differences in the presence of nodularity, undulation of the gland margins, septations inside the glands, infrathyroidal and/or pretracheal reactive lymph nodes, and increased vascularity on power Doppler imaging between the groups. The use of all parameters together yielded a sensitivity of 90%, specificity of 84.8%, positive predictive value (PPV) of 83.7%, negative predictive value (NPV) of 90.7%, and accuracy of 87.2% for diagnosis of HT. CONCLUSIONS US and power Doppler US are helpful for the diagnosis of HT in anti-thyroid marker-positive patients with normal thyroid hormone levels.
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Affiliation(s)
- Isin Ceylan
- 1 Department of Radiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35340, Turkey ; 2 Division of Endocrinology of Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir, Turkey
| | - Serkan Yener
- 1 Department of Radiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35340, Turkey ; 2 Division of Endocrinology of Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir, Turkey
| | - Firat Bayraktar
- 1 Department of Radiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35340, Turkey ; 2 Division of Endocrinology of Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir, Turkey
| | - Mustafa Secil
- 1 Department of Radiology, Dokuz Eylul University, Faculty of Medicine, Izmir 35340, Turkey ; 2 Division of Endocrinology of Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir, Turkey
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541
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Zhang CX, Xu XY, Wang L, Huang M, Li L. Esophageal varix predictive performance of lower esophageal Doppler signals during the swallowing process. Ultrasound Med Biol 2014; 40:2058-2063. [PMID: 24951299 DOI: 10.1016/j.ultrasmedbio.2014.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/09/2014] [Accepted: 03/12/2014] [Indexed: 06/03/2023]
Abstract
The objective of this study was to assess whether the swallowing action can improve the display of lower esophageal Doppler signals (LEDS) during transabdominal ultrasound (TUS). Eighty-four patients with cirrhosis underwent both TUS and endoscopic examination for esophageal varices (EVs). LEDS were assessed under the esophageal resting state and during the swallowing process. Univariate analysis indicated that spleen diameter, spleen vein diameter, portal vein diameter, LEDS and left gastric vein hepatofugal flow were significantly associated with the presence of EVs. No LEDS were detected in patients without EVs at rest or during swallowing. Of the 69 patients with EVs, LEDS could be detected in 21 cases (30.4%) in the esophageal resting state and in 58 cases (84.1%) during the swallowing process. Compared with the esophageal resting state, the swallowing action can significantly improve display of LEDS during TUS (p = 0.000), which may be beneficial for TUS detection of EVs.
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Affiliation(s)
- Chao-Xue Zhang
- Department of Ultrasound, First Affiliated Hospital, Anhui Medical University, Anhui, China.
| | - Xiao-Yong Xu
- Department of Gastroenterology, First Affiliated Hospital, Anhui Medical University, Anhui, China
| | - Ling Wang
- Department of Ultrasound, First Affiliated Hospital, Anhui Medical University, Anhui, China
| | - Meng Huang
- Department of Ultrasound, First Affiliated Hospital, Anhui Medical University, Anhui, China
| | - Liang Li
- Department of Ultrasound, First Affiliated Hospital, Anhui Medical University, Anhui, China
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542
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Thuring A, Brännström KJ, Jansson T, Maršál K. Audio spectrum analysis of umbilical artery Doppler ultrasound signals applied to a clinical material. Acta Obstet Gynecol Scand 2014; 93:1320-4. [PMID: 25168261 DOI: 10.1111/aogs.12468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/03/2014] [Indexed: 11/30/2022]
Abstract
Analysis of umbilical artery flow velocity waveforms characterized by pulsatility index (PI) is used to evaluate fetoplacental circulation in high-risk pregnancies. However, an experienced sonographer may be able to further differentiate between various timbres of Doppler audio signals. Recently, we have developed a method for objective audio signal characterization; the method has been tested in an animal model. In the present pilot study, the method was for the first time applied to human pregnancies. Doppler umbilical artery velocimetry was performed in 13 preterm fetuses before and after two doses of 12 mg betamethasone. The auditory measure defined by the frequency band where the spectral energy had dropped 15 dB from its maximum level (MAXpeak-15 dB ), increased two days after betamethasone administration (p = 0.001) parallel with a less pronounced decrease in PI (p = 0.04). The new auditory parameter MAXpeak-15 dB reflected the changes more sensitively than the PI did.
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Affiliation(s)
- Ann Thuring
- Department of Clinical Sciences Lund, Obstetrics and Gynecology, Lund University, Lund, Sweden
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543
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Sethi SS, Lau JF, Godbold J, Gustavson S, Olin JW. The S curve: a novel morphological finding in the internal carotid artery in patients with fibromuscular dysplasia. Vasc Med 2014; 19:356-62. [PMID: 25135311 DOI: 10.1177/1358863x14547122] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Fibromuscular dysplasia (FMD) is a non-atherosclerotic vascular disease commonly affecting the renal and internal carotid arteries (ICAs). A previously unrecognized finding is a redundancy of the mid-distal ICA in FMD patients causing an 'S'-shaped curve. Carotid artery duplex ultrasounds were reviewed in 116 FMD patients to determine S-curve prevalence. FMD patients with an S curve were matched to four control patients divided equally into two groups: (1) age and sex-matched and (2) age ≥70 and sex-matched. S curves were present in 37 (32%) FMD patients. Of these, nine (24%) had angiographic evidence of FMD in their ICA only, 13 (35%) had renal artery FMD only, and 15 (41%) had both ICA and renal FMD. Two patients in the age and sex-matched group had S curves (odds ratio 16.86, 95% CI 3.92-72.48; p<0.0001) while 12 (16.2%) patients in the age ≥70 and sex-matched group had S curves (odds ratio 2.42, 95% CI 1.16-5.03; p=0.016). In conclusion, the S curve is a novel morphological pattern of the mid-distal ICA. While the S curve may not be specific, its presence in individuals <70 years old should alert the clinician to the possibility that FMD is present.
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Affiliation(s)
- Sanjum S Sethi
- Zena and Michael A Wiener Cardiovascular Institute & the Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joe F Lau
- Zena and Michael A Wiener Cardiovascular Institute & the Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James Godbold
- Zena and Michael A Wiener Cardiovascular Institute & the Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susan Gustavson
- Zena and Michael A Wiener Cardiovascular Institute & the Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey W Olin
- Zena and Michael A Wiener Cardiovascular Institute & the Marie-Josée and Henry R Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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544
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Abstract
This study used high-frequency ultrasound to evaluate the flow distribution in the mouse fetal circulation at late gestation. We studied 12 fetuses (embryonic day 17.5) from 12 pregnant CD1 mice with 40 MHz ultrasound to assess the flow in 11 vessels based on Doppler measurements of blood velocity and M-mode measurements of diameter. Specifically, the intrahepatic umbilical vein (UVIH), ductus venosus (DV), foramen ovale (FO), ascending aorta (AA), main pulmonary artery (MPA), ductus arteriosus (DA), descending thoracic aorta (DTA), common carotid artery (CCA), inferior vena cava (IVC), and right and left superior vena cavae (RSVC, LSVC) were examined, and anatomically confirmed by micro-CT. The mouse fetal circulatory system was found to be similar to that of the humans in terms of the major circuit and three shunts, but characterized by bilateral superior vena cavae and a single umbilical artery. The combined cardiac output (CCO) was 1.22 ± 0.05 ml/min, with the left ventricle (flow in AA) contributing 47.8 ± 2.3% and the right ventricle (flow in MPA) 52.2 ± 2.3%. Relative to the CCO, the flow percentages were 13.6 ± 1.0% for the UVIH, 10.4 ± 1.1% for the DV, 35.6 ± 2.4% for the DA, 41.9 ± 2.6% for the DTA, 3.8 ± 0.3% for the CCA, 29.5 ± 2.2% for the IVC, 12.7 ± 1.0% for the RSVC, and 9.9 ± 0.9% for the LSVC. The calculated flow percentage was 16.6 ± 3.4% for the pulmonary circulation and 31.2 ± 5.3% for the FO. In conclusion, the flow in mouse fetal circulation can be comprehensively evaluated with ultrasound. The baseline data of the flow distribution in normal mouse fetus serve as the reference range for future studies.
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Affiliation(s)
- Yu-Qing Zhou
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada;
| | - Lindsay S Cahill
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael D Wong
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Mike Seed
- Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christopher K Macgowan
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - John G Sled
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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545
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Granata A, Di Nicolò P, Scarfia VR, Insalaco M, Lentini P, Veroux M, Fatuzzo P, Fiorini F. Renal transplantation parenchymal complications: what Doppler ultrasound can and cannot do. J Ultrasound 2014; 18:109-16. [PMID: 26191098 DOI: 10.1007/s40477-014-0118-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/06/2014] [Indexed: 12/13/2022] Open
Abstract
Kidney transplantation is the treatment of choice in end-stage renal disease, given the better quality of life of transplanted patients when compared with patients on maintenance dialysis. In spite of surgical improvements and new immunosuppressive regimens, parts of transplanted grafts still develop chronic dysfunction. Ultrasonography, both in B-mode and with Doppler ultrasound, is an important diagnostic tool in case of clinical conditions which might impair kidney function. Even though ultrasonography is considered fundamental in the diagnosis of vascular and surgical complications of the transplanted kidney, its role is not fully understood in case of parenchymal complications of the graft. The specificity of Doppler is low both in case of acute complications, such as acute tubular necrosis, drugs toxicity and acute rejection, and in case of chronic conditions, such as chronic allograft nephropathy. Single determinations of resistance indices present low diagnostic accuracy, which is higher in case of successive measurements performed during the follow-up of the graft. Modern techniques such as tissue pulsatility index, maximal fractional area and contrast-enhanced ultrasound increase ultrasonography diagnostic power in case of parenchymal complications of the transplanted kidney.
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Affiliation(s)
- Antonio Granata
- Nephrology and Dialysis Unit, "San Giovanni di Dio" Hospital, Agrigento, Italy ; Via F. Paradiso n°78/a, 95024 Acireale, CT Italy
| | - Pierpaolo Di Nicolò
- Nephrology and Dialysis Unit, "Santa Maria della Scaletta" Hospital, Imola, Bo Italy
| | - Viviana R Scarfia
- Nephrology and Dialysis Unit, "San Giovanni di Dio" Hospital, Agrigento, Italy
| | - Monica Insalaco
- Nephrology and Dialysis Unit, "San Giovanni di Dio" Hospital, Agrigento, Italy
| | - Paolo Lentini
- Nephrology and Dialysis Unit, "San Bassiano" Hospital, Bassano del Grappa, Italy
| | - Massimiliano Veroux
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy
| | - Pasquale Fatuzzo
- Nephrology and Dialysis Unit, University Hospital of Catania, Catania, Italy
| | - Fulvio Fiorini
- Nephrology and Dialysis Unit, "Santa Maria della Consolazione" Hospital, Rovigo, Italy
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546
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Urban A, Mace E, Brunner C, Heidmann M, Rossier J, Montaldo G. Chronic assessment of cerebral hemodynamics during rat forepaw electrical stimulation using functional ultrasound imaging. Neuroimage 2014; 101:138-49. [PMID: 25008960 DOI: 10.1016/j.neuroimage.2014.06.063] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/10/2014] [Accepted: 06/27/2014] [Indexed: 01/29/2023] Open
Abstract
Functional ultrasound imaging is a method recently developed to assess brain activity via hemodynamics in rodents. Doppler ultrasound signals allow the measurement of cerebral blood volume (CBV) and red blood cells' (RBCs') velocity in small vessels. However, this technique originally requires performing a large craniotomy that limits its use to acute experiments only. Moreover, a detailed description of the hemodynamic changes that underlie functional ultrasound imaging has not been described but is essential for a better interpretation of neuroimaging data. To overcome the limitation of the craniotomy, we developed a dedicated thinned skull surgery for chronic imaging. This procedure did not induce brain inflammation nor neuronal death as confirmed by immunostaining. We successfully acquired both high-resolution images of the microvasculature and functional movies of the brain hemodynamics on the same animal at 0, 2, and 7 days without loss of quality. Then, we investigated the spatiotemporal evolution of the CBV hemodynamic response function (HRF) in response to sensory-evoked electrical stimulus (1 mA) ranging from 1 (200 μs) to 25 pulses (5s). Our results indicate that CBV HRF parameters such as the peak amplitude, the time to peak, the full width at half-maximum and the spatial extent of the activated area increase with stimulus duration. Functional ultrasound imaging was sensitive enough to detect hemodynamic responses evoked by only a single pulse stimulus. We also observed that the RBC velocity during activation could be separated in two distinct speed ranges with the fastest velocities located in the upper part of the cortex and slower velocities in deeper layers. For the first time, functional ultrasound imaging demonstrates its potential to image brain activity chronically in small animals and offers new insights into the spatiotemporal evolution of cerebral hemodynamics.
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Affiliation(s)
- Alan Urban
- Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France.
| | - Emilie Mace
- 1A Allée des bois de Gagny, 93340 Le Raincy, France
| | - Clément Brunner
- Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France
| | - Marc Heidmann
- Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France
| | - Jean Rossier
- Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France
| | - Gabriel Montaldo
- Université Paris Descartes Sorbonne Paris Cité, Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France
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547
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Olver TD, Grisé KN, McDonald MW, Dey A, Allen MD, Rice CL, Lacefield JC, Melling CJ, Noble EG, Shoemaker JK. The relationship between blood pressure and sciatic nerve blood flow velocity in rats with insulin-treated experimental diabetes. Diab Vasc Dis Res 2014; 11:281-289. [PMID: 24853907 DOI: 10.1177/1479164114533357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Peripheral nerve blood flow (NBF) does not autoregulate but, instead, responds passively to changes in mean arterial pressure (MAP). How this relationship is impacted by insulin-treated experimental diabetes (ITED) is unknown. We tested the hypothesis that ITED will reduce NBF across a range of MAP in Sprague Dawley rats. Following 10 weeks of control or ITED conditions, conscious MAP (tail-cuff) was measured, and under anaesthesia, the MAP (carotid artery catheter, pressure transducer) and NBF (Doppler ultrasound, 40 MHz) responses to sodium nitroprusside (60 µg/kg) and phenylephrine (12 µg/kg) infusion were recorded (regression equations for MAP vs NBF were created for each rodent). Thereafter, motor nerve conduction velocity (MNCV) and nerve vascularization (haematoxylin and eosin stain) were determined. Conscious MAP was higher and MNCV was lower in the ITED group (p < 0.01). In response to drug infusions, the ΔMAP and ΔNBF were similar between groups (p ≥ 0.18). Estimated conscious NBF (based on substituting conscious MAP values into each individual regression equation) was greater in the ITED group (p < 0.01). Sciatic nerve vascularization was similar between groups (p ≥ 0.50). In contrast to the hypothesis, NBF was not reduced across a range of MAP. In spite of increased estimated conscious NBF values, MNCV was reduced in rats with ITED.
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Affiliation(s)
- T Dylan Olver
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Kenneth N Grisé
- Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Matthew W McDonald
- Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Adwitia Dey
- Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Matti D Allen
- Neuromuscular Research Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Charles L Rice
- Neuromuscular Research Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - James C Lacefield
- Department of Electrical and Computer Engineering, Western University, London, ON, Canada Department of Medical Biophysics, Western University, London, ON, Canada Robarts Research Institute, Western University, London, ON, Canada
| | - Cw James Melling
- Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - Earl G Noble
- Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada
| | - J Kevin Shoemaker
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, ON, Canada Department of Physiology and Pharmacology, Western University, London, ON, Canada
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548
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Fallahzadeh MK, Yatavelli RK, Kumar A, Singh N. Acute transplant renal artery thrombosis due to distal renal artery stenosis: A case report and review of the literature. J Nephropathol 2014; 3:105-8. [PMID: 25093158 PMCID: PMC4119325 DOI: 10.12860/jnp.2014.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/24/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acute renal artery thrombosis is a devastating complication of renal transplantation that can result in graft loss if not detected early. Surgical and technical errors are the major cause of renal artery thrombosis. In this article, for the first time, we are reporting a case of acute renal artery thrombosis that developed early post-transplantation due to distal renal artery stenosis. CASE PRESENTATION A 71-year-old woman presented with nausea, vomiting and decreased urine output 7 days after a deceased donor kidney transplant. Doppler ultrasound showed absent renal and venous flow in the transplanted kidney. Transplant renal artery angiogram showed renal artery thrombosis. Catheterization and thrombectomy were done in the occluded renal artery. After thrombectomy, renal angiogram showed distal renal artery stenosis which was dilated by stenting. Post-stenting angiogram showed good blood flow in the entire renal arterial system. However, the patient(,)s kidney function did not improve within next 24 hours and the patient eventually lost the kidney. Kidney biopsy showed widespread kidney infarction with no evidence of rejection. CONCLUSIONS Our case shows that renal artery thrombosis can develop due to distal renal artery stenosis and if not detected early could result in graft loss.
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Affiliation(s)
- Mohammad Kazem Fallahzadeh
- Division of Nephrology, Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
- John C. McDonald Transplant Center, Willis-Knighton Health System, Shreveport, Louisiana, USA
| | - Rajini Kanth Yatavelli
- Division of Nephrology, Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Ajay Kumar
- Division of Nephrology, Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Neeraj Singh
- Division of Nephrology, Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
- John C. McDonald Transplant Center, Willis-Knighton Health System, Shreveport, Louisiana, USA
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549
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Lai WK, Chiu YT, Law WS. The deformation and longitudinal excursion of median nerve during digits movement and wrist extension. ACTA ACUST UNITED AC 2014; 19:608-13. [PMID: 25024110 DOI: 10.1016/j.math.2014.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 06/05/2014] [Accepted: 06/17/2014] [Indexed: 11/20/2022]
Abstract
The use of electronic devices, such as mobile phones and computers, has increased drastically among the young generation, but the potential health effects of carpal tunnel syndrome (CTS) on university students has not been comprehensively examined. Thirty-one university students aged 18 to 25 y with no symptoms of CTS were successfully recruited in this study. By using noninvasive ultrasonography, the morphological characteristics of the median nerve of each volunteer, and the extent of its longitudinal excursion movement under experimental conditions, in which a real operating environment of electronic devices was simulated, were quantified. The results demonstrated that the median nerve at the carpal tunnel inlet was flattened during wrist extension: the flattening ratio increased from 3.40 ± 0.91 at the neutral position to 4.10 ± 1.11 at the angle of 30° and 4.09 ± 1.11 at the angle of 45°. In addition, the median nerve became swollen after the students performed rapid mobile-phone keying for 5 min, indicated by a significant increase in the cross-sectional area from 6.05 ± 0.97 mm(2) to 7.56 ± 1.39 mm(2). Passive longitudinal excursion was observed at the median nerve when the students performed mouse-clicking (2.4 ± 1.0 mm) and mobile-phone keying tasks (1.7 ± 0.6 mm), with the mouse-clicking task generating a greater extent of longitudinal excursion than the mobile-phone keying task did. In conclusion, the findings of the present study verify the potential harm caused by using electronic devices while maintaining an inappropriate wrist posture for a substantial period.
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550
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Zhou YQ, Cahill LS, Wong MD, Seed M, Macgowan CK, Sled JG. Assessment of flow distribution in the mouse fetal circulation at late gestation by high-frequency Doppler ultrasound. Physiol Genomics 2014; 46:602-14. [PMID: 24963005 DOI: 10.1152/physiolgenomics.00049.2014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study used high-frequency ultrasound to evaluate the flow distribution in the mouse fetal circulation at late gestation. We studied 12 fetuses (embryonic day 17.5) from 12 pregnant CD1 mice with 40 MHz ultrasound to assess the flow in 11 vessels based on Doppler measurements of blood velocity and M-mode measurements of diameter. Specifically, the intrahepatic umbilical vein (UVIH), ductus venosus (DV), foramen ovale (FO), ascending aorta (AA), main pulmonary artery (MPA), ductus arteriosus (DA), descending thoracic aorta (DTA), common carotid artery (CCA), inferior vena cava (IVC), and right and left superior vena cavae (RSVC, LSVC) were examined, and anatomically confirmed by micro-CT. The mouse fetal circulatory system was found to be similar to that of the humans in terms of the major circuit and three shunts, but characterized by bilateral superior vena cavae and a single umbilical artery. The combined cardiac output (CCO) was 1.22 ± 0.05 ml/min, with the left ventricle (flow in AA) contributing 47.8 ± 2.3% and the right ventricle (flow in MPA) 52.2 ± 2.3%. Relative to the CCO, the flow percentages were 13.6 ± 1.0% for the UVIH, 10.4 ± 1.1% for the DV, 35.6 ± 2.4% for the DA, 41.9 ± 2.6% for the DTA, 3.8 ± 0.3% for the CCA, 29.5 ± 2.2% for the IVC, 12.7 ± 1.0% for the RSVC, and 9.9 ± 0.9% for the LSVC. The calculated flow percentage was 16.6 ± 3.4% for the pulmonary circulation and 31.2 ± 5.3% for the FO. In conclusion, the flow in mouse fetal circulation can be comprehensively evaluated with ultrasound. The baseline data of the flow distribution in normal mouse fetus serve as the reference range for future studies.
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Affiliation(s)
- Yu-Qing Zhou
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada;
| | - Lindsay S Cahill
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael D Wong
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Mike Seed
- Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christopher K Macgowan
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - John G Sled
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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