The influence of orthoses on the proprioception of the ankle joint

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested regarding their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used of the study: single-leg stance test, single-leg jumping course test, angle-reproduction test. The influence of three stabilization devices (lace-on-brace/Mikros, stirrup-brace/ Aircast, taping) on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the singleleg jumping course without any stabilizing device (category standard) ranged between 8.06 and 13.68 (10.65±1.29). In the categories Mikros (9.85±0.99), and Aircast (9.99±1.14) as well as with the tape bandage (10.27±0.81) better scores were achieved. The differences standard vs. Mikros and standard vs. Aircast revealed a significant reduction of the scores with orthoses (P<0.01). The error rate in the single-leg stance test was within the range of 0–16 (5.12±2.85) for the category standard. It was lower for the categories Mikros (3.65±2.65) and Aircast (4.17±2.59). The error rate was highest in the group with a tape bandage (5.79±3.53). The differences standard vs Mikros as well as standard vs. Aircast were significant (P<0.01). There was also a significant difference between these categories regarding injured and not injured ankle joints (P<0.01). The angle-reproduction-test showed higher values for the category standard (2.36°±0.97) in comparison to the categories Mikros (1.46°±0.72), Aircast (1.62°±0.91) and taping (1.84°±0.41). In the category standard the reproduction error was lower testing not injured ankle joints (2.30°±1.04) than testing the group of unstable ankle joints (2.44°±0.81), whereas in all other categories the reproduction error was higher in the group of not injured joints. The differences in all measurements between standard vs. Mikros and standard vs. Aircast were significant (P<0.01). The results of the three tests showed a highly significant difference between injured and not injured ankle joints (P<0.01).     

Technical parameters influencing the severity of injury of front-seat,belt-protected car passengers on the impact side in car-to-car side collisions with the main impact between the front and rear seats (B-pillars)

Summary Authentic car-to-car side collisions (n = 30) with the main impact area at the B-pillar were analyzed to find technical parameters corresponding with the injury severities of the front seat, belt-protected car passengers on the impact side. EES (Energy Equivalent Speed) and Av (delta v, change in velocity) were highly significant predictors of the severity of thoracic and abdominal injuries and total injury severity coded according to the Abbreviated Injury Scale (AIS). At an EES or v 40 km/h all front-seat car passengers on the impact side sustained a total injury severity of Maximum AIS (MAIS) 4 and died. Although a passenger could survive the crash without injury to one or more body regions up to the highest EES- and Av-values, at EES or v 40 km/h fatal injuries were sustained in at least one body region. At an EES 35 km/h or a Av 15 km/h no front-seat car passenger on the impact side remained uninjured.     

Comparison of iodine-123 labelled 2β-carbomethoxy-3β-(4-iodophenyl)tropane and 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane for imaging of the dopamine transporter in the living human brain

Several cocaine congeners are of potential for imaging the dopamine transporter (DAT). Previous studies have shown that iodine-123 labelled 2-carbomethoxy-3-(4-iodophenyl)tropane ([¹²³I]-CIT) is a promising radiotracer for imaging the serotonin (5-HT) and dopamine (DA) transporters in the living human brain with single-photon emission tomography (SPET). [¹²³I]-CIT was found to be not very practical for 1-day DAT imaging protocols since peak DAT uptake occurs later than 8 h. Here we report a pilot comparison of [¹²³I]-CIT and 2-carbomethoxy-3-(4-iodophenyl)-N-(3-fluoropropyl)nortropane ([¹²³I]-CIT FP), using SPET imaging in four healthy male subjects. Peak uptake of [¹²³I]-CIT-FP into the basal ganglia occurred earlier (3–4 h after injection of tracer) than that of [¹²³I]-CIT (>8 h). However, the specific DAT binding of [¹²³I]-CIT-FP in the basal ganglia was somewhat less (0.813±0.047) than that of [¹²³I]-CIT (0.922±0.004). Imaging quality is excellent with both tracers and they are potentially of value for brain imaging in various neuropsychiatric disorders.     

“Menigeal sign”: a characteristic finding of meningiomas on contrast-enhanced MR images

Summary In meningiomas, a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on Gadolinium-DTPA enhanced MR images. This so called meningeal sign was evaluated with respect to the differential diagnosis of meningiomas in MR imaging. The study included 29 patients with intracranial meningiomas and 24 patients with non-meningeal brain tumors. In all meningiomas, MR studies included T2-weighted as well as unenhanced and Gadolinium-DTPA-enhanced T1-weighted images. In all nonmeningeal tumors, Gd-DTPA-enhanced MR images were available. All images were evaluated with respect to the presence of the meningeal sign. In meningiomas, a meningeal sign was seen in 15/29 cases on Gadolinium-DTPA-enhanced images. No abnormalities corresponding to the areas of contrast enhancement were found on unenhanced T2- and T1-weighted MR images. In nonmeningeal tumors only 2/24 cases showed a meningeal sign. In conclusion, with a sensitivity of 52% and a specificity of 92%, the demonstration of the meningeal sign improved the differential diagnosis of intracranial meningiomas in contrast-enhanced MR imaging.     

The “lamellated” skull in β-thalassaemia

The skull in homozygous -thalassaemia may present several abnormalities, such as osteopenia, widening of the diploic space, and a hairon-end appearance. In some cases it presents also a particular stratified appearance caused by a variable number of osseous lamellae, parallel with the inner table. This lamellated skull was observed in 16 out of 150 patients affected by the disease (10.6%). Possible mechanisms are discussed. The lamellar osseous changes could be due to repeated periosteal osteoblastic reactions to the sinusoidal neovascularization associated with marrow hyperplasia in poorly transfused patients.     

Zur Technik des emissionsspektrographischen Nachweises von Schwermetallen in biologischem Material

Zusammenfassung Zum Nachweis der forensisch wichtigen Schwermetalle in Organen und Körperflüssigkeiten wird empfohlen, diese nach der Veraschung mit Diäthylammonium-Diäthyldithiocarbamat in Chloroform zu extrahieren und den mit Spektralkohle aufgenommenen Rückstand der organischen Phase spektrographisch zu untersuchen. Auf diese Weise ist es z. B. möglich, noch 1 Blei, Quecksilber und Thallium sowie 5 Arsen in 100 ml Urin oder 10 g Leber in einem Arbeitsgang zu erfassen.

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Summary For the detection of heavy metals of forensic importance in organs and body fluids it is usefull to extract them with diethylammonia-diethyldithiocarbamate in chloroform after mineralisation and to analyse the residue of the organic phase after absorption to carbon powder spectrographically. Thus it is possible to detect even such small amounts as 1g of lead, mercury and thallium and 5g of arsenic in 100 ml of urine or 10 g of liver e.g.

     

Zur Entstehung fluoreszierender Verbindungen in formalinfixierten Organen

Zusammenfassung In formalinfixierten Organen bilden sich fluoreszierende Verbindungen. Wir konnten nachweisen, daß es sich bei diesen Verbindungen um 3,4 Dihydroisochinoline bzw. 3,4 Dihydro--carboline handelt, die durch eine Reaktion des Formaldehyds mit biogenen Aminen des Typs -Phenyläthylamin bzw. -(3 Indolyl)äthylamin entstehen.

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On formation of fluorescent compounds in formaldehyde treated tissues

Summary In formaldehyde treated tissues, fluorescent compounds are formed. We could demonstrate, that these compounds result from a reaction of biogenic amines such as -phenylethylamines or -(3 indolyl) ethylamines with formaldehyde to yield the fluorescent 3,4 dihydroisoquinolines or 3,4 dihydro--carbolines.

Auszugsweise vorgetragen auf der 54. Jahrestagung der Deutschen Gesellschaft für Rechtsmedizin in Frankfurt, September 1975     

The “dural tail” adjacent to meningiomas studied by dynamic contrast-enhanced MRI: a comparison with histopathology

We examined 32 patients with intracranial tumors (17 meningiomas, 8 neuromas, 7 pituitary adenomas) by conventional and dynamic contrast-enhanced MRI. Our aim was to clarify whether the pathological dural contrast enhancement adjacent to meningiomas (the dural tail) is specific to meningiomas and, more important, whether it represents neoplastic dural infiltration or hypervascularization as a tumor accompanying reaction. A dural tail was found in 9 of 17 meningiomas. None of the other extra-axial tumours (neuromas, pituitary adenomas) showed comparable dural enhancement. Dynamic examinations with an ultrafast single slice imaging technique (snapshot-FLASH) after a bolus injection of contrast medium showed a dural tail in seven out of these nine meningiomas, while in two cases the dural tail turned out to be a cortical vein with a characteristic dynamic contrast enhancement pattern. In the dynamic study all seven dural tails were found to have earlier, steeper contrast enhancement than the corresponding tumours. All the tumours and part of the adjacent dura mater in four of the seven meningiomas with dural enhancement were examined histopathologically. In none of these four cases was neoplastic tissue found more than 2 mm away from the main tumour. The results strongly support the suggestion that the dural tail adjacent to meningiomas represents a hypervascular, non-neoplastic dural reaction.     

Erhöhter Abfall der Blutalkoholkonzentration nach Verkehrsunfällen

Zusammenfassung An 90 Fällen konnte nachgewiesen werden, daß nach Verkehrsunfällen sehr häufig oberhalb der vonWidmark, Jungmichel undKriebs angegebenen Schwankungsbreite liegt.Die beobachtete höhere Ausscheidungsgeschwindigkeit ist wesentlich abhängig von der Höhe der BAK. Bei Konzentrationen um 1,5 und über 2,0 wurden die höchsten Werte för beobachtet.Die Durchschnittswerte für waren nachmittags, kurz nach Mitternacht und in den frühen Morgenstunden höher als zu den übrigen Tageszeiten; entsprechend verhielten sich die Mittelwerte der gefundenen BAK.Die gröten individuellen Schwankungen von fanden sich im 3. und 5. Lebensjahrzehnt.Auf Grund allgemeiner Beobachtungen wird angenommen, daß auer der Höhe der BAK nervöse und hormonale (Insulin) Störungen, die durch erhebliche Erregung ausgelöst werden, als Ursache für die erhöhte Alkoholausscheidung anzusprechen sind.     

Giant cell tumour of the mandibular condyle

The authors report a case of giant cell tumour of the mandibular condyle, which is a rare finding. This tumour, studied using the main three radiological modalities (plain radiography, CT and MRI), showed characteristic radiological features of giant cell tumour. Correspondence to: S. W. Della Sala     

New Retrievable Coil Anchors: Preliminary In Vivo Experiences in Swine

Purpose To design and test retrievable coil anchors to improve the safety and efficacy of coil embolization.Methods Fifty-two 0.038-inch homemade retrievable stainless steel coils were equipped with one of four different pre-shaped nitinol anchors and tested in 38 pigs. All coils with the anchor were completely retrieved and redeployed 3–18 times (median 7 times) prior to release. Types 1 and 2 anchored coils were acutely deployed in the external iliac arteries (n=10 each), and chronically tested (1 week) in the common carotid arteries (n=6 each). Larger type 1 (n=4), type 3 (n=6), and type 4 (n=4) anchored coils were acutely deployed in the abdominal aorta. The largest type 1 anchors (n=6) were acutely tested in the inferior vena cava.Results All anchored coils were successfully retrieved and repositioned several times. All but two coils formed a compact plug and there was no coil migration except with two mechanically defective type 3 anchors.Conclusion The use of retrievable anchors allowed the coils to be retrieved and repositioned, prevented coil migration, and enabled compact coil configuration.     

Transcatheter Closure of Patent Foramen Ovale in Patients with Platypnea-Orthodeoxia: Results of a Multicentric French Registry

Background Dyspnea and the decrease in arterial saturation in the upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS). POS is secondary to the occurrence of an atrial right-to-left shunt through a patent foramen ovale (PFO).Methods This French multicentric study reports on 78 patients (mean age 67±11.3 years) with POS who had transcatheter closure of the PFO; frequently associated diseases were pneumonectomy (n=36) and an ascending aortic aneurysm (n=11). In all patients, the diagnosis was confirmed by transthoracic or/and transesophageal echocardiography. Five different closure devices were used: Amplatz (n=45), Cardioseal (n=13), Sideris (n=11), Das Angel Wings (n=8) and Starflex (n=1). Closure was successful in 76 patients (97%).Results Oxygen saturation increased immediately after occlusion from 84.6±10.7% to 95.1±6.4% (p < 0.001) and dyspnea improved from grade 2.7±0.7 to grade 1±1 (p < 0.001). A small residual shunt was immediately observed in 5 patients (3 with the Cardioseal device, 1 with the Sideris and 1 with the Amplatz) leading to the implantation of a second device in one case (Cardioseal). Two early deaths occurred unrelated to the procedure (one due to sepsis probably related to pneumonectomy, another due to respiratory insufficiency). Other complications were: a small shunt between the aorta and the left atrium, two atrial fibrillations and a left-sided thrombus which disappeared with anticoagulant therapy. At a mean follow-up of 15±12 months, there were 7 late deaths related to the underlying disease.Conclusion Percutaneous occlusion of the foramen ovale is safe and gives excellent results thanks to continuing improvement in available devices. This technique enables some patients in an unstable condition to avoid a surgical closure.     

Cranio-cervical growth collision: another explanation of the Arnold-Chiari malformation and of basilar impression

Summary Analysis of neuro-cranio-spinal development suggests a cranio-cervical growth conflict as the cause of the Arnold-Chiari malformation and of basilar impression. The ascending course and elongation of the upper cervical nerves associated with the Arnold-Chiari malformation reflects the abnormal, caudo-cranially proceeding growth of the cervical spine. This is the opposite of the normal cranio-caudal direction of growth (which includes the brain) with downward slanting of the cervical nerve roots. The cervical growth reversal is a compensatory event related to the impairment of distal spinal growth at the level of the coexistent myelomeningocele. With the reversal of the cervical growth, the initial descent (uncoiling) of the primordial brain curvatures is compromised owing to the growth-collision with the ascending cervical spine. Their subsequent growth proceeds into the upper cervical spinal canal. The contents of the posterior cranial fossa are actively sucked up, devoured by the latter. In contrast to the adaptively enhanced growth of the early craniocervical nervous structures in the Arnold-Chiari malformation, as an answer to the growth-shifts of the encasing skeleton, basilar impression is a postembryonic adaptation of the cervico-cranial skeleton to the inadequate growth of the nervous structures after the latter have lost their growth adaptability. Arnold-Chiari malformation and basilar impression are just two representatives of osteo-neural growth pathology encompassing some dysplastic disorders of the axial as well as of the limb skeleton such as platyspondyly, scoliosis, Scheuermann's kyphosis, achondroplasia-like conditions, congenital dysplasia of the hip etc. Not unlike basilar impression, they result from accomodation of otherwise normally growing skeletal parts to the vulnerable, inadequately growing spinal and peripheral nervous structures. Critical evaluation of some prevailing views concerning neural growth, spinal and peripheral, above all the presumed passivity and invulnerability of that growth is put forward.     

γ-Glutamyltransferase test as a new tool for identification of seminal stains

Summary A simple qualitative method for identification of seminal stains based on a high activity of -glutamyltransferase (-GTP) in human semen is described. It employs the release of -naphthylamine from N--glutamyl--naphthylamide by the -GTP action; -naphthylamine couples with Fast Garnet GBC salt to produce a strong brownish-red color. The data on its simplicity, specificity, and stability show that the present method is suitable for medicolegal examination of seminal stains as a preliminary test.     

DNA extraction from mixtures of body fluid using mild preferential lysis

Summary A modification to the DNA extraction method preferential lysis (Gill et al. 1985) is proposed which can be applied to DNA mixtures of vaginal cells and spermatozoa. In mixtures with a low sperm content the further loss of sperm DNA caused by the extraction can be avoided by using mild preferential lysis. Amplification by PCR (polymerase chain reaction) then yields sufficient DNA to be able to identify both components in the mixture.     

Early enzyme changes in skin wounds demonstrated by isoelectric focusing in polyacrylamide gel

Summary Esterase patterns in vital skin wound extracts were observed and compared to those seen in normal skin. Employing the relatively simple method of isoelectric focusing in polyacrylamide gel, it was demonstrated that three, consecutively appearing, characteristic changes were visible in the esterase zymograms of vital (pre-mortally) injured skin as compared with skin which was uninjured or post-mortally damaged. One of these characteristics (characteristic a), since it is found only in wound reactions and not in uninjured skin, may represent an enzyme specifically produced during the wound reaction process. All three features normally appeared within 30 min of trauma and the first change within 5 min, even though it had been generally assumed that vital reactions, i.e. wound reactions, could be demonstrated only after a longer period of time. It was possible therefore to determine victim survival time and distinguish between pre- and post-mortal wounds. Also the isoelectric focusing of enzymes apparently gives a more efficient pattern band separation than previous methods.

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Zusammenfassung Durch isoelektrische Fokussierung der Extrakte aus vital verletzter Haut wurden die -Naphthylacetat-spaltenden Enzyme aufgetrennt und mit gleichartig hergestellten Extrakten unverletzter Haut desselben Menschen verglichen. Es konnten 3 nacheinander auftretende Merkmale im Esterasemuster der verletzten Haut festgestellt werden. Die mit a, b und c bezeichneten Unterschiede im Esterasemuster sind für die frühen Wundreaktionen kennzeichnend. Das Merkmal a ist eine nur in vitalen Hautwunden nachweisbare Esterase-Fraktion, die innerhalb 5 min nach der Wundsetzung auftritt. Die Merkmale b und c erscheinen nach dem Merkmal a innerhalb 30 min nach der Verletzung. Der Nachweis von a, b, c in einer Wunde erlaubt eine Beurteilung der Überlebenszeit und ermöglicht außerdem eine Unterscheidung von vitalen und postmortalen Wunden. Die isoelektrische Fokussierung von Enzymen scheint leistungsfähiger zu sein als die bisher zur Kennzeichnung von Wundenzymen angewandten histoenzymatischen und elektrophoretischen Methoden.

     

In vitro and in vivo characterisation of nor-β-CIT: a potential radioligand for visualisation of the serotonin transporter in the brain

Radiolabelled 2-Cabomethoxy-3-(4-iodophenyl)tropane (-CIT) has been used in clinical studies for the imaging of dopamine and serotonin transporters with single-photon emission tomography (SPET). 2-Carbomethoxy-3-(4-iodophenyl)nortropane (nor--CIT) is a des-methyl analogue of -CIT, which in vitro has tenfold higher affinity (IC₅₀=0.36 nM) to the serotonin transporter than -CIT (IC₅₀=4.2 nM). Nor--CIT may thus be a useful radioligand for imaging of the serotonin transporter. In the present study iodine-125 and carbon-11 labelled nor--CIT were prepared for in vitro autoradiographic studies on post-mortem human brain cryosections and for in vivo positron emission tomography (PET) studies in Cynomolgus monkeys. Whole hemisphere autoradiography with [¹²⁵I]nor--CIT demonstrated high binding in the striatum, the thalamus and cortical regions of the human brain. Addition of a high concentration (1 M) of citalopram inhibited binding in the thalamus and the neocortex, but not in the striatum. In PET studies with [¹¹C]nor--CIT there was rapid uptake of radioactivity in the monkey brain (6% of injected dose at 15 min) and high accumulation of radioactivity in the striatum, thalamus and neocortex. Thalamus to cerebellum and cortex to cerebellum ratios were 2.5 and 1.8 at 60 min, respectively. The ratios obtained with [¹¹C]nor--CIT were 20%–40% higher than those previously obtained with [¹¹C]-CIT. Radioactivity in the thalamus and the neocortex but not in the striatum was displaceable with citalopram (5 mg/kg). In conclusion, nor--CIT binds to the serotonin transporter in the primate brain in vitro and in vivo and has potential for PET and SPET imaging of the serotonin transporter in human brain.     

Anflutung und Verteilung von Alkohol bei oraler Resorption

Zusammenfassung Die geringere Alkohol-Konzentrationstoleranz während der Anflutungsphase kann auf eine stärkere Alkoholanflutung im Gehirn zurückgeführt werden. Die Ursache liegt in der gegenüber dem peripheren Venenblut überhöhten Alkoholkonzentration im arteriellen Blut und einem schnellen Konzentrationsausgleich zwischen arteriellem Blut und Hirngewebe. Die arterio-venöse Alkohol-Konzentrationsdifferenz nach Gabe von 0,8 g Alkohol (33 W/W% Lösung, 15 min Trinkzeit) wurde bei 5 Patienten einer Intensivstation bestimmt. Sie betrug maximal 0,27±0,20. Als maximale Alkoholkonzentration wurden im arteriellen Blut 0,94, im venösen 0,81 erreicht. Die Eliminationsrate ( 60) war mit 0,30±0,05 sehr hoch. Vergleichsweise wurde die Eliminationsrate ( 60-Wert) bei 5 Patienten während einer Halothan-Narkose bestimmt. Sie betrug 0,15±0,02 und lag damit im Normbereich. Auch Tierversuche an Ratten ergaben keine sicher verminderte Alkohol-Eliminationsrate unter Halothan. Eine mögliche geringe Verminderung des Äthanolabbaus durch kompetitive Hemmung der ADH-Aktivität durch das Halothan-Abbauprodukt Trifluoräthanol erscheint bei der Rückrechnung durch Anwendung eines 60-Wertes von 0,10 hinreichend berücksichtigt.Vortrag: 50. Jahrestagung der Deutschen Gesellschaft für Rechtsmedizin, Köln, 3.–7. 10. 1971.     

Immunoelektrophoretische Differenzierung der Proteine faulen Leichenblutes

Zusammenfassung Leichenblute verschiedener Fäulnisgrade wurden immunoelektrophoretisch untersucht. Für die Differenzierung der einzelnen Blutplasmafraktionen wurden Anti-Humanserum vom Kaninchen und die spezifischen Antiseren der Behringwerke gegen die nachstehend aufgeführten Proteine benutzt: Präalbumin, Albumin, ₁-Lipoprotein, ₂-Makroglobulin, ₂-Lipoprotein, ₁-Globulin (Transferrin),-Lipoprotein, Fibrinogen, ₂-A-Globulin, ₂-M-Globulin,- Globulin.Infolge der mangelnden Proportionalität zwischen Fortschritt der Fäulnis und Leichenalter gestattet die Immunoelektrophorese des Leichenblutes keine Todeszeitbestimmung.Albumin und- Globulin widerstehen der Fäulnis am längsten. Es folgen ₂-Makroglobulin, Transferrin und Fibrinogen. Die Proteine, die am reichlichsten im Menschenblut vorhanden sind, lassen sich im faulen Leichenblut auch am längsten nachweisen. Die Proteolyse folgt jedoch nicht nur quantitativen Gesetzen. Die Lipoproteine bilden insofern eine Ausnahme, als sie früher durch die Fäulnis eliminiert werden, als es ihrem Anteil am Gesamtprotein entspricht.Die Eiweißkörper des faulen Leichenblutes weisen im Vergleich zu ihren Homologen frischer Blutproben z. T. Veränderungen der Wanderungsgeschwindigkeit auf. Bei erhaltener Antigenstruktur treten Bruchstücke in Erscheinung, die mit dem Antiserum in ungleichmäßig geschwungenen oder aufgesplitterten Linien präcipitieren.Im Doppeldiffusionstest nachOuchterlony ließen sich im Vergleich zu den frischen Homologen keine Veränderungen der Antigenkomponenten der Proteine des faulen Leichenblutes nachweisen.Mit Unterstützung der Deutschen Forschungsgemeinschaft, der hiermit unser herzlicher Dank ausgesprochen wird.In Anlehnung an einen Vortrag auf der Tagung der Deutschen Gesellschaft für Gerichtliche und Soziale Medizin vom 30. 9. bis 3. 10. 62 in Münster (Westf.).Herrn Professor G.Weyrich zum 65. Geburtstag gewidmet.     

Pulmonary Hypertension Among End-Stage Renal Failure Patients Following Hemodialysis Access Thrombectomy

Purpose: Percutaneous hemodialysis thrombectomy causes subclinical pulmonary emboli without short-term clinical consequence; the long-term effects on the pulmonary arterial vasculature are unknown. We compared the prevalence of pulmonary hypertension between patients who underwent one or more hemodialysis access thrombectomy procedures with controls without prior thrombectomy.Methods: A retrospective case-control study was performed. Cases (n=88) had undergone one or more hemodialysis graft thrombectomy procedures, with subsequent echocardiography during routine investigation of comorbid cardiovascular disease. Cases were compared with controls without end-stage renal disease (ESRD) (n=100, group 1), and controls with ESRD but no prior thrombectomy procedures (n=117, group 2). The presence and velocity of tricuspid regurgitation on echocardiography was used to determine the prevalence and grade of pulmonary hypertension; these were compared between cases and controls using the chi-square test and logistic regression.Results: The prevalence of pulmonary hypertension among cases was 52% (46/88), consisting of mild, moderate and severe in 26% (n=23), 10% (n=9) and 16% (n=14), respectively. Prevalence of pulmonary hypertension among group 1 controls was 26% (26/100), consisting of mild, moderate and severe pulmonary hypertension in 14%, 5% and 7%, respectively. Cases had 2.7 times greater odds of having pulmonary hypertension than group 1 controls (p=0.002). The prevalence of pulmonary hypertension among group 2 controls was 42% (49/117), consisting of mild, moderate and severe pulmonary arterial hypertension in 25% (n=49), 10% (n=12) and 4% (n=5), respectively. Cases were slightly more likely to have pulmonary hypertension than group 2 controls (OR=1.5), although this failed to reach statistical significance (p=0.14).Conclusion: Prior hemodialysis access thrombectomy does not appear to be a risk factor for pulmonary arterial hypertension. Patients with ESRD are more likely to have pulmonary hypertension.