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ABSTRACT: Arterial venous malformations (AVM) of the uterus are uncommon entities and should be considered in patients who present with profuse genital bleeding. There are two types of uterine AVM: acquired and congenital. Acquired uterine AVMs are conformed by communications between the uterine arteries and the myometrial veins, and are caused by an iatrogenic event or a pathological condition. Congenital AVMs are the result of abnormal development of primitive vessels that result in connections between pelvic arteries and veins in the uterus without an interconnecting capillary bed. Ultrasonography is a noninvasive diagnostic method able to demonstrate and characterize AVMs of the uterus. AVM in the pelvis may be noted incidentally by computed tomography (CT) of the pelvis, and magnetic resonance imaging (MRI) is frequently used to confirm and further characterize the sonographic findings of uterine AVM. Catheter angiography and embolization are very effective in defining the vascular anatomy and treating uterine vascular abnormalities.
Acta Radiologica 07/2009; 50(7):823-9. · 1.37 Impact Factor
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ABSTRACT: Endovascular treatment of atherosclerotic lesions can provide a clinical benefit, but arterial interventions are not exempt from complications. Embolization in the peripheral circulation may result in unfavorable outcomes. The purpose of this article is to review the technical applications, the clinical indications, and the risks and benefits of different protection devices, occlusions balloons, and filters commonly used during endovascular interventions in the carotid circulation, renal arteries, and lower extremities.
Acta Radiologica 11/2007; 48(10):1066-76. · 1.37 Impact Factor
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ABSTRACT: Uterine fibroids are common tumors of the female pelvis. Uterine artery embolization (UAE) is an effective treatment of symptomatic uterine leiomyoma in the appropriate candidates, reducing or eliminating leiomyoma-related symptoms of bleeding, bulk, and/or pain. Magnetic resonance imaging (MRI) can be used to assess women with symptoms potentially attributable to uterine leiomyomas, and help to determine who is an appropriate candidate for UAE. Because of soft tissue characterization, multiplanar imaging capabilities, and enhancement, MR imaging not only accurately detects and characterizes uterine leiomyomas but also may predict who will benefit from the embolization. MRI ability to detect coexistent uterine or pelvic pathology may change the diagnosis and treatment management of patients being evaluated for UAE.
Acta Radiologica 01/2007; 47(10):1105-14. · 1.37 Impact Factor
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ABSTRACT: In this study, 66 patients with Henoch-Schönlein nephritis (HSN) were investigated clinicopathologically.
The patients were classified according to their initial presentation, histologic findings, recurrences of purpura, type of treatment and clinical outcome. Logistic regression analysis was performed.
Sixty-eight percent of patients were hospitalized with mild renal disease. Most patients were evaluated as class I and II according to light microscopy. In addition to IgA deposition alone, 33% of patients showed IgA + C3 and 27% had IgA + IgG + C3 depositions. After the follow-up period of 3.3 years, 15 patients had minor urinary findings, 4 had active renal disease and 1 had renal insufficiency. Recurrences occurred in 37.9% of patients and 37.1% of patients with recurrences had persistent pathologic findings. Symptomatic treatment was given to 51.5% of patients, while 27.2% were given corticotherapy.
Clinical presentation was found to be correlated with outcome. Recurrence of the disease and the type of the treatment also affected the outcome. It was also thought that mesangial IgG and C3 depositions may have a role in the pathogenesis of renal damage in HSN.
Pediatrics International 09/1999; 41(4):353-6. · 0.63 Impact Factor
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ABSTRACT: Platelet activating factor (PAF) is synthesized and secreted by glomerular mesangial and endothelial cells. It increases glomerular basement membrane permeability and induces proteinuria. Leukotrienes (LT) are mediators released by either leukocytes or glomerular cells under the PAF effect. The possible role of PAF in steroid sensitive nephrotic syndrome (SSNS) of childhood was studied in 8 children with SSNS in the acute stage, 5 children in remission and 8 healthy controls. The PAF concentrations in urine and plasma were determined. Leukocytes were stimulated in vitro and the LT release in response to stimulation was determined. The urinary and plasma concentrations of PAF were significantly higher in the acute phase than in remission and in control patients. Children with SSNS were found to have peripheral leukocytes with increased LT releasing activity in vitro. These results are in accordance with clinical and experimental observations indicating that PAF originates in the kidney and plays a role in normal kidney physiology. Urinary PAF concentrations may be related to proteinuria because they were strongly correlated in the present study. Elevated plasma PAF concentrations in the acute stage of SSNS could result from either its secretion from the circulating leukocytes or decreased acetyl hidrolase activity needed for its hydrolysis in plasma. The increased LT release in vitro suggests that these cells might have been activated by PAF secreted from glomeruli. It is proposed that PAF and different LT in systemic and glomerular circulation are important mediators in childhood SSNS.
Acta paediatrica Japonica; Overseas edition 03/1998; 40(1):57-62.
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Pediatric Nephrology 05/1997; 11(2):265-6. · 2.52 Impact Factor
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ABSTRACT: The clinical criteria to assess hydration status are not always reliable. Hence, the development of techniques to estimate more accurately post-dialysis dry weight (DW) remains a major challenge. The present study evaluates the value of the inferior vena cava (IVC) diameter, plasma concentration of atrial natriuretic peptide (ANP), and plasma renin activity (PRA) in determining the DW in chronic haemodialysis children.
Twelve overhydrated haemodialysis patients (4 girls, 8 boys) with a mean age of 12.8 were admitted to the study. Clinical, electrocardiographic, telecardiographic and echocardiographic findings, IVC and collapsibility indices and plasma concentrations of ANP and PRA were investigated before and after ultrafiltration (UF) therapy. Twelve age-matched normal children were studied as controls. Analysis of variance and Dunnett's test were applied for comparisons between patients and controls.
Following UF therapy the patients' mean IVC collapsibility index was increased from 42.3 to 53.6% and IVC index was decreased from 1.08 to 0.81 cm/m2, both statistically significant. The pre-UF therapy collapsibility and IVC indices of the patient group were significantly different from those of the control group (56.9% and 0.70 cm/m2 respectively). The patients' mean plasma concentrations of ANP were 171 +/- 47.4 pg/ml before UF, 129 +/- 51.3 pg/ml after UF and 102 +/- 38.7 pg/ml in the control group. The ANP levels of the patients showed a significant decrease following the UF therapy. PRA was measured as 0.82 ng/ml/h before UF and 1.08 ng/ml/h after UF, but the increase was not statistically significant.
Our findings revealed increased diameter of the IVC and plasma ANP concentrations and decreased collapsibility due to overhydration. Echography of IVC may be a promising non-invasive tool to estimate the DW in haemodialysis children. Further studies providing normative values for the IVC indices in both haemodialysis and normal children are required.
Nephrology Dialysis Transplantation 09/1996; 11(8):1564-7. · 3.40 Impact Factor
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ABSTRACT: Recent studies have shown 1,25(OH)2D3-mediated modulation of the immune system. We examined lymphocyte subpopulations of 16 children with nutritional rickets. Most of the patients suffered more frequent infection episodes than the control group of 15 healthy children and low serum levels of 25OHD and 1,25(OH)2D, such as 38.2 +/- 8.6 ng/mL and 15.7 +/- 2.6 pg/mL respectively. This decrease correlated with a significant decrease in total T lymphocytes and an increase in B lymphocytes expressing surface IgA, IgM, IgG molecules. These results suggest that vitamin D plays an important role in the impaired functions of T lymphocytes which may lead to frequent infection episodes in nutritional rickets.
Acta paediatrica Japonica; Overseas edition 09/1995; 37(4):500-2.
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Transplantation Proceedings 29(1-2):171-2. · 1.00 Impact Factor
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ABSTRACT: Thinner which contains aromatic hydrocarbons such as xylene, toluene and N-hexane is widely used in industrial plants manufacturing dyes, plastic, varnishes and glues. Chronic intoxication due to abuse of solvents, including thinner, by workers who inhale the solvent vapor is frequently encountered. Acute intoxication with ingestion of excessive amounts is relatively rare and usually fatal. It is reported that 45-50 ml of orally ingested thinner is enough to cause severe complications. The case reported here was forced to drink 200 ml of thinner by an older friend, and presented with severe complications such as rhabdomyolysis, polyneuropathy, chemical pneumonia and coma. To the best of our knowledge this is the first case reported in the literature to survive acute thinner intoxication with such complications.
The Turkish journal of pediatrics 38(2):223-5. · 0.44 Impact Factor
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ABSTRACT: Inflammatory lipid mediators, PAF and leukotrienes (LTs), are thought to have an important role in biocompatibility in hemodialysis. PAF, LTB4 and LTC4 were studied both in controls (n: 12) and in 11 children on regular hemodialysis (150 minutes) with cuprophane dialyzers. Blood samples were collected initially (0'-precapillary), at first minute (1'-postcapillary) and at one hour after the hemodialysis sessions (210'-venous). Presence of LTs and high levels of PAF in 0' samples compared to levels in controls and significant increases in 1' samples suggested the alterations in PAF and LTs likely originated from the peripheral leukocyte activation. In 210' samples, PAF and LTs levels were decreased but still higher than the levels in 0' samples. This study suggested that PAF and LTB4 may be the control elements in biocompatibility in hemodialysis with cuprophane membranes, and demonstrated that the effects of activation last until the following session.
The Turkish journal of pediatrics 40(3):413-20. · 0.44 Impact Factor
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ABSTRACT: Quantitation of protein excretion in urine is used for diagnostic and prognostic purposes and also to assess the effects of therapy in children. The method in common use is to measure urinary protein in a 24-hour urine sample, which may be time consuming and is often inaccurate. The aim of this study was to determine if the urine protein/creatinine ratio in a single-void urine sample had a high correlation with the quantity of protein in a 24-hour urine specimen. We found that there was an excellent correlation between the protein content of a 24-hour urine excretion and the protein/creatinine ratios in single morning urine samples of 50 patients. We also discovered that a protein/creatinine ratio greater than 4.9 could signify "nephrotic-range" proteinuria, while a ratio less than 2.5 indicated nephritic syndrome or other renal diseases. We concluded that the determination of urinary protein/creatinine concentration ratios in a single morning urine sample under most clinical circumstances, especially in nephrotic syndrome, could replace the measurement of protein excretion in 24-hour urine specimens.
The Turkish journal of pediatrics 34(4):219-24. · 0.44 Impact Factor
