Invalidisierende Kalziphylaxie (Calcific uraemic arteriolopathy)

Zusammenfassung: Ein 45-jähriger Patient mit langjährigem Diabetes mellitus Typ1 und diabetischer Nephropathie stellt sich vor. Nach zweijähriger Hämodialyse erfolgte im Alter von 35Jahren eine Nierentransplantation. Aufgrund des klinischen Verlaufs mit rezidivierenden akralen Nekrosen wurde die Diagnose Kalziphylaxie gestellt. Im weiteren Verlauf erfolgten mehrfach Amputationen im Bereich der oberen und unteren Extremitäten. Die Pathogenese, das klinisches Bild und die Behandlung der Kalziphylaxie werden im Artikel besproche

The search for valved conduit tissue grafts for adults (>22 mm): an ultrasonographic study of jugular vein diameters of horses and cattle

BACKGROUND: Natural heterologous valved conduits with a diameter greater than 22 mm that can be used for right ventricular outflow tract reconstruction in adults are not commercially available. The purpose of this study was to measure by ultrasonography the maximum diameter of the distended jugular veins of horses and cattle, respectively, to identify a population of animals that would be suitable for post-mortem collection of jugular veins at sizes greater than 22 mm. METHODS: The study population included 60 Warmblood horses, 25 Freiberger horses, 20 Brown Swiss cows, and 20 Holstein cows (including 10 Holstein and 10 Red Holstein). The maximum cross-sectional diameter of the distended jugular veins was measured at a location half-way between the mandibular angle and the thoracic inlet. The thoracic circumference (heart girth length) was used as a surrogate of body size. The jugular vein diameters of the different populations were compared by analysis of variance and the association between heart girth length and jugular vein diameter was determined in each of the four study populations by linear regression analysis. RESULTS: There was considerable individual variation of jugular vein diameters within each of the four study populations. There was no statistically significant relationship between thoracic circumference and jugular vein diameter in any of the populations. The jugular vein diameters of Brown Swiss cows were significantly larger than those of any of the other populations. Warmblood horses had significantly larger jugular vein diameters compared to Freiberger horses. CONCLUSION: The results of this study suggest that the production of bovine or equine xenografts with diameters of greater than 22 mm would be feasible. Differences between species and breeds need to be considered. However, prediction of the jugular vein diameter based on breed and heart girth length in an individual animal is inaccurate