Selective arterial embolization for a high-flow priapism following perineal trauma in a young gymnast

Introduction. High-flow priapism is a rare condition in children, usually due to a perineal trauma. Materials and methods. We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. Results. A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. Conclusions. Selective arterial embolization is a safe treatment that can also be used in pediatric patients

Accumulation of α-synuclein mediates podocyte injury in Fabry nephropathy

Current therapies for Fabry disease are based on reversing intracellular accumulation of globotriaosylceramide (Gb3) by enzyme replacement therapy (ERT) or chaperone-mediated stabilization of the defective enzyme, thereby alleviating lysosomal dysfunction. However, their effect in the reversal of end-organ damage, like kidney injury and chronic kidney disease, remains unclear. In this study, ultrastructural analysis of serial human kidney biopsies showed that long-term use of ERT reduced Gb3 accumulation in podocytes but did not reverse podocyte injury. Then, a CRISPR/Cas9–mediated α-galactosidase knockout podocyte cell line confirmed ERT-mediated reversal of Gb3 accumulation without resolution of lysosomal dysfunction. Transcriptome-based connectivity mapping and SILAC-based quantitative proteomics identified α-synuclein (SNCA) accumulation as a key event mediating podocyte injury. Genetic and pharmacological inhibition of SNCA improved lysosomal structure and function in Fabry podocytes, exceeding the benefits of ERT. Together, this work reconceptualizes Fabry-associated cell injury beyond Gb3 accumulation, and introduces SNCA modulation as a potential intervention, especially for patients with Fabry nephropathy.publishedVersio

Music models aberrant rule decoding and reward valuation in dementia.

Aberrant rule- and reward-based processes underpin abnormalities of socio-emotional behaviour in major dementias. However, these processes remain poorly characterized. Here we used music to probe rule decoding and reward valuation in patients with frontotemporal dementia (FTD) syndromes and Alzheimer's disease (AD) relative to healthy age-matched individuals. We created short melodies that were either harmonically resolved ('finished') or unresolved ('unfinished'); the task was to classify each melody as finished or unfinished (rule processing) and rate its subjective pleasantness (reward valuation). Results were adjusted for elementary pitch and executive processing; neuroanatomical correlates were assessed using voxel-based morphometry. Relative to healthy older controls, patients with behavioural variant FTD showed impairments of both musical rule decoding and reward valuation, while patients with semantic dementia showed impaired reward valuation but intact rule decoding, patients with AD showed impaired rule decoding but intact reward valuation and patients with progressive non-fluent aphasia performed comparably to healthy controls. Grey matter associations with task performance were identified in anterior temporal, medial and lateral orbitofrontal cortices, previously implicated in computing diverse biological and non-biological rules and rewards. The processing of musical rules and reward distils cognitive and neuroanatomical mechanisms relevant to complex socio-emotional dysfunction in major dementias

Bankernas roll i ett hållbart samhälle : om bankers CSR-arbete

Lately it has become more common to question the companies’ actions in how they affect their surroundings. Today, the expression “Corporate Social Responsibility” often is mentioned in this connection. Corporate Social Responsibility (CSR), is a concept whereby companies voluntarily integrate social and environmental concerns in their business operation. In Sweden there is a big difference between different businesses when it comes to their Corporate Social Responsibility. The Swedish finance companies, for example, have not come very far when it comes to CSR. The fact that Sweden is behind many countries when it comes to CSR and the fact that the finance companies is among the worst in this area made us interested in investigating how banks work with Corporate Social Responsibility and what they are good at and what they have to improve in regard to that work. The purpose with this paper is to study and compare the work Swedish banks do in taking their Corporate Social Responsibility. By comparing the Swedish banks among themselves and in relations with a bank that internationally is associated with good CSR work it will be possible to distinguish where the banks may have some shortcomings. In this study we have chosen to conduct a deductive and a qualitative approach as the purpose is to interpret and understand the banks’ engagement and interest in Corporate Social Responsibility on the basis of the theoretical frame of reference. The main theories the study is based on are the Triple Bottom Line Theory and the Stakeholder Theory. The empirical material for this study has foremost been collected through a survey of the banks’ homepages and annual reports. Furthermore, semi-structured e-mail and telephone interviews were carried out to obtain a deeper understanding of the subject. Five banks are included in the study: Nordea, Swedbank, Handelsbanken, SEB and ABN AMRO. The conclusion of this thesis is that the Swedish banks work with CSR but they do to a limited extent. Comparing to the Dutch bank ABN AMRO there is a big difference. The largest differences between the Swedish banks and the Dutch bank are the fundamental values and strategies. ABN AMRO points out CSR as the bank’s basic view while the Swedish banks mainly focus on maximization of profits. ABN AMRO has a comprehensive view that does not separate sustainability from the business operations while the Swedish banks look upon CSR as something that has to be added to the business operations

Paradoxical Pulmonary Embolism in a Patient with Bilateral Renal Infarction: The Role of Contrast-enhanced Ultrasound Imaging

We present the case of a 52-year-old male who was admitted to the hospital for a bilateral pulmonary embolism. On the 5th day of hospitalization, an acute kidney injury (AKI) occurred. A transesophageal echocardiogram was performed and it demonstrated a large patent foramen ovale with a consistent right-to-left shunt. Contrast-enhanced ultrasound (CEUS) was performed and it demonstrated multiple bilateral renal ischemic areas. CEUS represents a valid alternative to computed tomography or magnetic resonance to confirm the diagnosis of bilateral kidney infarction, especially in patients who experience an AKI

Contrast-enhanced ultrasound for characterizing renal masses

On cross-sectional imaging studies performed for other indications, incidental discovery of renal lesions is not uncommon. In daily use, grey-scale ultrasonography (US) and conventional Doppler modes are often the modality of choice for the initial assessment. While simple cysts are fully characterized with US, other lesions require further characterization, which is traditionally obtained by multiphase imaging, such as contrast-enhanced CT and MRI. Contrast-enhanced ultrasound (CEUS) has become a powerful additional tool for imaging renal lesions. With its lack of nephrotoxicity, the absence of ionizing radiation, and the ability to evaluate the enhancement pattern of renal lesions quickly and in real- time, CEUS has unique advantages over traditional modes. Established applications are differentiation between solid tumours, pseudolesions, and complex cysts; characterization of complex cysts with different malignant potential, and evaluation of tumor ablation. Microbubble contrast agents are safe. Adverse reactions are rare. This article provides an overview of the current clinical applications of CEUS in characterizing renal masses, discussing advantages and limitations. The aim is to provide the framework for sonologists to make informed decisions regarding this emerging imaging test in appropriate circumstances