Sonographic evaluation of renal artery aneurysm in childhood

We report a child presenting with renovascular hypertension and sonographic evidence of a renal artery aneurysm (RAA). The diagnosis of RAA was made sonographically by demonstrating vascular flow in an aneurysmal segment adjacent to but continuous with the right renal artery and externally compressing the inferior vena cava. Comparison of the sonographic studies and an abdominal angiogram illustrate the sensitivity of sonography in diagnosing this condition. We suggest that with renal doppler sonography, RAA may be diagnosed less invasively and possibly with greater frequency yet believe that the gold standard of angiography is necessary prior to surgical intervention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46697/1/247_2005_Article_BF02018637.pd

Needle Electrode-Based Electromechanical Reshaping of Cartilage

Electromechanical reshaping (EMR) of cartilage provides an alternative to the classic surgical techniques of modifying the shape of facial cartilages. The original embodiment of EMR required surface electrodes to be in direct contact with the entire cartilage region being reshaped. This study evaluates the feasibility of using needle electrode systems for EMR of facial cartilage and evaluates the relationships between electrode configuration, voltage, and application time in effecting shape change. Flat rabbit nasal septal cartilage specimens were deformed by a jig into a 90° bend, while a constant electric voltage was applied to needle electrodes that were inserted into the cartilage. The electrode configuration, voltage (0–7.5 V), and application time (1–9 min) were varied systematically to create the most effective shape change. Electric current and temperature were measured during voltage application, and the resulting specimen shape was assessed in terms of retained bend angle. In order to demonstrate the clinical feasibility of EMR, the most effective and practical settings from the septal cartilage experimentation were used to reshape intact rabbit and pig ears ex vivo. Cell viability of the cartilage after EMR was determined using confocal microscopy in conjunction with a live/dead assay. Overall, cartilage reshaping increased with increased voltage and increased application time. For all electrode configurations and application times tested, heat generation was negligible (<1 °C) up to 6 V. At 6 V, with the most effective electrode configuration, the bend angle began to significantly increase after 2 min of application time and began to plateau above 5 min. As a function of voltage at 2 min of application time, significant reshaping occurred at and above 5 V, with no significant increase in the bend angle between 6 and 7.5 V. In conclusion, electromechanical reshaping of cartilage grafts and intact ears can be effectively performed with negligible temperature elevation and spatially limited cell injury using needle electrodes

Institutional Credibility and Leadership: Critical Challenges for Community-Based Natural Resource Governance in Rural and Remote Australia

Community-based natural resource management (CBNRM) institutions are challenged with finding common ground as a basis for action among diverse resource users and stakeholders. Establishing and maintaining institutional credibility within their regions, catchments, communities and among their membership is fundamental to overcoming the challenge. So too is applying appropriate institutional and governance structures and appointing appropriate leaders. Drawing on triangulated case study data collected over a 12-month period using multiple methods, this paper examines the influence of institutional credibility and leadership on the functioning, decision-making and governance of two CBNRM institutions in Queensland, Australia. The paper shows that stakeholders have very different expectations of what makes a CBNRM institution credible. Satisfying the multiple expectations requires CBNRM institutions to incorporate diverse stakeholder representation, assert their legitimacy and demonstrate accountability, transparency, fairness and justice. The paper also draws attention to the value and importance of appointing inspirational leaders who focus on encouraging followers to pursue collective goals. Comparing the merits and constraints of appointing average Joes versus community elites to the Boards of CBNRM institutions, the paper highlights the urgent need for community-based natural resource governance and inspirational leadership education and training programs to improve the availability and quality of CBNRM leadership in rural Australia. Since combining credible CBNRM institutions with inspirational leaders does not necessarily equate to sustainable on-ground NRM outcomes, it is critical that the education and training programs emphasise the importance of monitoring and evaluating the improvements in decision-making processes and in decision outcomes