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

Outcomes in Patients with Chronic Kidney Disease and End Stage Renal Disease and Durable Left Ventricular Assist Device: Insights from United States Renal Data System Database

BACKGROUND: There is paucity of data regarding durable LVAD outcomes in patients with chronic kidney disease (CKD) stage 3-5 and CKD stage 5 on dialysis (ESRD: end stage renal disease). METHODS: We conducted a retrospective study of Medicare beneficiaries with ESRD and 5% sample of CKD with LVAD (2006 to 2018) to determine one-year outcomes utilizing the United States Renal Data System (USRDS) database. The LVAD implantation, comorbidities and outcomes were identified using appropriate ICD-9 and ICD-10 codes. RESULTS: We identified 496 CKD and 95 ESRD patients who underwent LVAD implantation. The ESRD patients were younger (59 vs 66 years; p CONCLUSIONS: Patients with ESRD undergoing LVAD implantation had significantly higher index and 1-year mortality compared to CKD patients