Bile resistance of coated transjugular intrahepatic portosystemic shunt stents in a flow-model

PURPOSE: We sought to test the bile resistance of transjugular intrahepatic portosystemic shunt (TIPS) stents with 3 different coatings. MATERIALS AND METHODS: Three stents with different coating materials (monolayer polyethylene terephthalate [PETP], monolayer polytetrafluoroethylene [PTFE], and double layer [PTFE]) were tested in a flow model. After testing the sealing of the system with isotonic saline solution, fresh human bile was circulated. Constant pressure was 50 cm H2O. Bile resistance of the stent membranes was analyzed. RESULTS: Two of the 3 stents proved completely resistant to water. Only the PETP stent was resistant to bile. The PTFE-coated stents were not bile resistant. CONCLUSION: The bile resistance of coated TIPS stents and, thus, the dependency of TIPS shunt patency is called into question. The stent with the reported superior patency rates does not show experimental bile resistance.     

SPECT imaging of cerebral arteriovenous angiomas. A preliminary report

BACKGROUND AND PURPOSE: The purpose of this study was to demonstrate scintigraphic evaluation of cerebral perfusion in patients with intracranial hemangiomas. MATERIAL AND METHOD: The examination was carried out in 12 patients aged from 12 to 67 years. In all the patients cerebral angiomas were previously diagnosed and all of them were qualified for intravascular embolization. Brain scintigraphy was performed after IV injection of 99mTcECD and included the dynamic phase with images obtained every 2 seconds for 1.5 minutes and SPECT imaging. The semiquantitative analysis of regional cerebral blood flow was based on the comparison between activity in two symmetrical regions of interest. Cerebral angiography combined with intravascular embolization followed the scintigraphic examination. RESULTS: Based on angiograms, the size of the nidus was estimated at 1.0 to 9.0 cm. In 8 patients the dynamic study showed an increased tracer accumulation in the region of angioma. On SPECT images the nidus was visualized as focally decreased perfusion in all cases. A decreased tracer accumulation in the area adjacent to the nidus was detected in 8 patients. The ratio of activity in the region of angioma to activity in normally perfused tissue calculated using the semiquantitative analysis was 52% to 89%. CONCLUSIONS: SPECT images and dynamic phase of cerebral perfusion scintigraphy allow perfusion changes caused by the presence of intracranial angiomas to be identified.     

Influence of Eqb 761 on the function of the retina in children and adolescent with long lasting diabetes mellitus--preliminary report

PURPOSE: Early detection of patological function of the retina, before anatomical changes, plays very important role in monitoring of visual complications in patients with diabetes mellitus. The aim of the study was the evaluation of anatomical and functional changes in visual organ in children and adolescents with long lasting diabetes mellitus type 1 and taking Egb 761 (Tanakan Beaufour Ipsen) as an adjuvant. MATERIALS AND METHODS: Group consists of 15 patients, age between 11 and 19 years, with diabetes mellitus lasting 6-12 years. All patients had full ophthalmologic examination and color vision tests (Panel D 15 saturated and desaturated). The examination was done 3 times, every 3 months. Egb 761 was given: 1 tablet - 3 times a day, during 3 months. RESULTS: No diabetic retinopathy was found. The results of color vision test were better after therapy (25% of pathological results) and 3 months later (only 4 % of patients). CONCLUSIONS: 1. Egb 761 seems to be good adjuvant in patient with long lasting diabetes mellitus. 2. Color vision tests are sensitive tests of the retinal function and are easy to perform.     

Serum leptin level in prepubertal children with simple obesity. Part II

The aim of the study was to determinate the serum leptin level, glucose concentration, lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride) and thyroid hormones level (triiodothyronine, thyroid stimulating hormone and free thyroxine) in a group of prepubertal children with simple obesity. Fourfold higher leptin concentration in obese (23.3 +/- 11.8 ng/mL) in comparison to a group of slim children (6.8 +/- 2.7 ng/mL), (p<0.0001) was shown. There was no significant difference in serum glucose level (87.3 +/- 9.7 mg/dL) between both studied groups. In obese subjects we showed higher triglyceride, insignificantly lower HDL-C concentrations and invariable other lipid fractions. Mean values of triiodothyronine (T3) were 3.0 +/- 0.7 nmol/L in obese children and 2.8 +/- 0.8 nmol/L in slim children. On the contrary, mean values of thyroid stimulating hormone (TSH) were 2.5 +/- 1.7 mIU/L and 2.8 +/- 0.7 mIU/L in the group of obese and normal children respectively. Free thyroxine (FT4) concentrations in our obese children were lower (11.5 +/- 2.9 pmol/L) than in slim subjects (14.6 +/- 3.1 pmol/L) but were within the reference range. The results obtained indicate that in children with simple obesity there was no dyslipidemia connected with leptin and thyroid hormones levels. However, higher triglyceride and lower HDL-C concentrations suggest a necessity of monitoring the body mass index and lipid profile in these patients.     

Laryngocoele

Three cases of laryngocoele operated in ENT Department University of Medical Sciences in Poznań by an external approach are presented. Role of larynx tomography in diagnosis procedure and surgical technique is emphasised. Origin, classification, diagnosis and treatment methods are discussed.     

Tinnitus in systemic diseases

Permanent or temporary degenerative changes in the internal ear causing tinnitus may occur with particular intensity in patients suffering from systemic disease (diabetes, hypertension, rheumatic diseases, kidney and thyroid gland diseases). Pathomechanisms of hearing impairment and the risk of tinnitus and its character in particular cases are discussed in the paper. The research was carried out on 1200 patients treated in the Laryngological Rehabilitation Centre in Poznań between 1.1.1998 and 04.2001 due to tinnitus. The analysis included the diagnosis of general health condition, general laryngological examination as well as additional tests. In the examined group 34% suffered from systemic diseases. Among them the highest percentage (47%) suffered from hypertension, 41% from hypercholesterolaemia, 22% from rheumatic diseases and 16% from diabetes. 96% of the patients had a long family history of diseases. The additional factor causing damage of the internal ear may be ototoxic drug used in the treatment of many systemic diseases.