Haemodynamic changes in ocular Behcet's disease

WOS: 000075889600027PubMed ID: 9893603

Giant varicose inferior mesenteric vein

In portal hypertension, a variety of portocaval collateral pathways develops in attempt to decompress the portal circulation. The most common collateral pathway is the coronary-gastroesophageal route. Here we report a case of portocaval anastomosis of inferior mesenteric vein (IMV) reaching to iliac veins via hemoroidal veins with the findings on ultrasonography, computed tomography (CT) and splenoportography. The route of this portocaval anastomoses is not frequent and the huge caliber of IMV is unusual in our case. © 2002 Elsevier Science Ireland Ltd. All rights reserved

Effects of iloprost (a prostacyclin analogue) on the endothelial dysfunction and foot ulcers in diabetic patients with peripheral arterial disease

Objectives: To asses the efficiency of iloprost (an analogue of prostacyclin) infusion on endothelial functions and amputation rate in diabetic foot ulcers with complicated macroangiopathy. Material and Methods: Sixty (36 men/24 women) type 2 diabetic patients (61.8 ± 9.7 years, mean ±SD) with diabetic foot ulcer and peripheral arterial occlusive disease, stage III or more by Wagner classification, and 15 (9 male/6 female) healthy controls (60.7 ± 9.1 years, mean ±SD) were enrolled in the study. Thirty patients (group I) had iloprost infusion (0.5-2 ng/kg/min for 6 h) for 10 consecutive days. Endothelial functions were determined by brachial arterial flow mediated dilation (FMD) method at stage 0 (basal), 10th and 30th days. Group II patients (n=30) were treated in the same manner as group I except iloprost treatment constituting a patient control group. Results: Group I patients showed a significant improvement in the endothelial functions at 10th day, and 30th day (p=0.002) in respect to group II. There were no differences between group I and group II regarding the hospitalization period and amputation rates. Iloprost was well tolerated. Three patients had adverse reactions such as maculo-papular skin eruptions, itching, hypotension and dyspnea due to iloprost infusion; one completed the treatment and 2 had to discontinue the iloprost infusion. Conclusion: Ten-day iloprost infusion therapy to patients with diabetic foot ulcers seems to be efficient in the improvement of endothelial function, but, despite our positive clinical observation, this improvement does not affect the outcome of the amputation rates at 30 days follow up period

Haemodynamic changes in ocular Behcet's disease [1]

PubMedID: 9893603[No abstract available

The effect of retroperitoneal fat tissue thickness on testicular venous drainage

PubMedID: 19641367Introduction: We evaluated a possible effect of the amount of retroperitoneal fat tissue on testicular venous drainage to shed light on the mechanism of varicocele occurrence. Patients andMethods: A total of 132 patients with no fertility complaints were included in this study. Retroperitoneal fat thickness (RPFT) was measured during abdominal computed tomography examinations. According to the calculated body mass index (BMI), patients were categorized as normal, overweight or obese using National Institutes of Health criteria. Relationships were sought between RPFT, BMI and testicular vein-pampiniform plexus diameters measured with ultrasonography on both sides. Results: Left and right testicular vein maximum diameters were significantly larger in obese patients compared with normal and overweight men (p = 0.01 and p = 0.003, respectively). In accordance with this, the left and right pampiniform plexus diameters were larger in the obese group than in the normal and overweight groups (p = 0.004 and p = 0.006, respectively). There was a moderate but significant correlation between the right testicular vein maximum diameter and mean RPFT (p = 0.003). The relationship between bilateral pampiniform plexus diameters and retroperitoneal fat distribution was stronger and significant (p = 0.0001). Correlation analysis revealed a significant relationship between BMI and retroperitoneal fat distribution (R = 0.53, p = 0.0001). Conclusions: The amount of retroperitoneal fat, which is related to BMI, could be a contributing factor in the etiology of right varicocele. Copyright © 2009 S. Karger AG, Basel

Osteopenia and osteoporosis in postmenopausal women

WOS: 000179908900013PubMed ID: 12485260Purpose: To compare the ability of the medial cortical thickness ratio to the width of the second metacarpal bone at the midshaft (MCR) in discriminating patients as normal, osteopenic or osteoporotic. Material and Methods: MCR was calculated from radiographs of 120 postmenopausal women. By dual-energy X-ray absorptiometry, the mineral density was measured in the lumbar spine, the wrist and the femoral neck. Patients were grouped in accordance with the diagnostic criteria of WHO on the basis of t -scores. MCR values were compared with t -scores and the ability of the MCR technique in discriminating the patient groups was evaluated. Results: Analysis of radiogrammetric data revealed significant differences in MCR value between the 3 groups. The MCR was lower in patients with osteoporosis and osteopenia compared with the normal group. The mean value of MCR was also slightly lower in patients with osteoporosis than in those with osteopenia. Accuracy assessment (ROC analysis) of MCR in the discrimination of patients with osteoporosis showed that test accuracy was acceptable, but less accurate than spinal, wrist and femoral neck t -scores. Compared with t -scores, this test was found to fairly discriminate those with and without osteopenia. Conclusion: The MCR method can discriminate patients as osteoporotic or normal. However, it seems that the MCR method should not be used for decisions concerning treatment of osteoporosis because of its low accuracy and thereby a risk for misclassification

Color Doppler ultrasonography of renal vascular resistance in sickle cell disease: Clinical implications

The major complications in sickle cell disease (SCD) are microcirculation lesions and impairment of renal function. The aim of this study was to evaluate renal vascular resistance by means of color and duplex ultrasonography (CDU) and its relationships with hematological and clinical features in patients with SCD. Forty patients with SCD (mean age 22.4 ± 7.0) and 14 age- and sex-matched healthy subjects (mean age 25.7 ± 9.5) were included in the study. CDU of the main renal, segmental, and interlobar arteries was performed in both kidneys in all patients and controls. Peak systolic, end diastolic, and mean velocities through the entire cardiac cycle were obtained with further calculation of resistive (RI) and pulsatile (PI) indices. All the patients were investigated in stable state condition and had not been transfused within a month before investigation. Patients had a 6- month follow-up. Patients with SCD had higher RI and PI values than control subjects (p 0.70) had more pronounced disturbances of blood parameters (all p < 0.05) than patients with normal RI values (<0.70). The significant positive correlation between RI and ISC number, MCHC level (r = 0.52, p < 0.001 and r = 0.42, p < 0.01), as well as RBC and Hgb level, correlated inversely with RIs (r = -0.39, p < 0.01 and r = -0.42, p < 0.01). During the follow-up, in nine patients (33.3%) with high RIs and one (5.5%) with normal RIs developed painful crises. In conclusion, renal vascular resistance, assessed by CDU is raised in SCD patients as compared with age-matched, apparently healthy persons. These changes are more pronounced in those with more severe manifestations of disease and correlated with hematological and clinical features of sickle cell disease

The prevalence and variations of inferior right heratic veins on contrast-enchanced helical CT scanning

WOS: 000224728900008PubMed ID: 15380849Purpose: To present the prevalence and variations of inferior right hepatic veins (IRHVs) on contrast-enhanced helical computed tomography (CEHCT) scans. Materials and methods: The routine abdominal CEHCT scans of 349 patients were reviewed. Three hundred and eight patients (88.2%) were included in the study. Of the 349 patients, 41 (11.8%) were excluded from the study because of improper opacification of hepatic veins and right hepatic lobe lesions which made difficult the optimal visualization and assessment of IRHVs. The mean age of 308 patients was 43 years (range 3-97 years). One hundred and forty-three patients (46.4%) were men and 165 (53.6%) women. Scans were examined whether the IRHVs were demonstrated or not and classified according to their numbers, levels, diameters, and joinings to inferior vena cava (IVC). Results: Of the 308 patients, 65 (21.1%) had one or two IRHVs. Fifty-four patients (83.1%) had only one IRHV and 11 (16.9%) patients had two. More than two IRHVs were not seen in any patient. Eight (72.7%) of 11 double IRHVs joined the IVC at the same level and others (27.3%) did not. There was no truncal opening to the IVC. In five patients (7.7%) the IRHV were large (greater than or equal to0.5 cm). Conclusion: The presence of IRHVs is common and routine CEHCT scanning is efficacious in assessment of IRHVs. (C) 2003 Elsevier Ireland Ltd. All rights reserved

Bladder pheochromocytoma encountered on sonography

PubMedID: 15344994Pheochromocytomas of the bladder are rare neoplasms, constituting <0.06% of all vesical tumours. Common presenting features of this tumour include episodes of sweating, hypertension, haematuria and postmicturition syncope. We describe a case of bladder pheochromocytoma in a 66-year-old man whose only symptom of macroscopic haematuria was initially assessed with ultrasonography. Clinical presentation highlights the need for a high index of suspicion during sonographic evaluation of bladder neoplasms because such tumours might present without symptoms of adrenergic excess