Use of tissue Doppler to assess right ventricle function in hemodialysis patients

AIMS: Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafiltration in dialysis patients. METHODS: 27 end-stage renal failure patients who were hypervolemic and undergoing hemodialysis were included in the study. TD studies of the right ventricle were performed before and 1 h after dialysis. These data were compared. RESULTS: The mean age of the patients was 41 +/- 15 years and mean volume of ultrafiltration was 3.8 +/- 1.8 liters. Systolic, early and late diastolic lateral annular TD velocities before dialysis were 0.109 +/- 0.029, 0.088 +/- 0.039, 0.111 +/- 0.039 m/s, and after dialysis were 0.099 +/- 0.028, 0.078 +/- 0.036, 0.106 +/- 0.037 m/s, respectively (p = 0.216, p = 0.112, p = 0.350). Myocardial early diastolic velocity decreased significantly (p = 0.049) but systolic and late diastolic velocities did not change significantly (p = 0.579, p = 0.146). CONCLUSION: Right ventricular systolic and diastolic velocities detected by TD were not or only minimally affected by preload reduction in hemodialysis patients and the TD early/late ratio is the most valuable variable that can predict right ventricular diastolic function. The right ventricular systolic and early diastolic TD velocities were positively correlated with left ventricle ejection fraction.     

Unilateral syringoma of the face associated with hyperthyroidism

Syringomas are benign tumors derived from the intraepidermal portion of eccrine sweat ducts. They usually occur on the periobital area, but have also been found on the scalp, forehead, cheeks, axillae, abdomen, extremities, genitalia, and buttocks. We describe a patient with an unusual presentation of unilateral syringoma of the face associated with hyperthyroidism.     

Hair zinc level in Down syndrome

Immunological, endocrinological, and haematological abnormalities are relatively common in people with Down syndrome (Cuadrado & Barrena, 1996; Decoq & Vincker, 1995; Hestnes et al., 1991; Sustrova & Strbak, 1994; Nespoli, Burgio, Ugazio & Maccario, 1993; Kempski, Chessells & Reeves, 1997; Kivivuori, Rajantie, & Siimes, 1996; David et al., 1996; Gjertson, Sturm & Berger, 1999). Zinc is one of the elements that act in the maintenance of normal function of these systems. This study was designed to investigate zinc levels in children with Down syndrome. Zinc levels were measured in hair using atomic absorption spectrophotometry. The hair zinc level of 19 children with Down syndrome was compared with the zinc level of 11 typically developing children. Hair zinc levels were found to be significantly lower (p < .05) in those with Down syndrome (average 95.18 +/- 56.10 ppm) than in the typically developing children (average 208.88 +/- 152.37 ppm). Some of the problems experienced by children with Down syndrome may be due to these low zinc levels, but further research is required to confirm these results, and to establish any correlation with these problems.     

Intra-abdominal Ectopic Thyroid Presenting with Hyperthyroidism: Report of a Case

Ectopic thyroid tissue has been found in the developmental pathway of the thyroid gland and has also been reported in the abdominal cavity. Intra-abdominal thyroid tissue was totally resected around the mesentery of the small intestine in a 56-year-old woman. She had hyperthyroidism preoperatively and had also undergone a bilateral subtotal thyroidectomy 10 years earlier. No signs or symptoms of a thyroid tumor were present. Received: February 26, 2001 / Accepted: July 17, 2001     

Advanced leiomyosarcoma of the stomach

Retrospective studies of twelve patients with advanced gastric leiomyosarcomas were undertaken to evaluate radical surgical resection and combined modality treatment with regard to the patient survival and symptom palliation. All but one patient were found to have metastases or involvement of adjacent organs at the initial operation. Despite radical resection, multidrug chemotherapy, and radiation therapy, no patient survived beyond the third year. Patients with objective response to chemotherapy and radiation and chemotherapy had a mean survival of 27 months, while those who did not respond survived only 7 months. The longest survival among untreated group was 8 months. Successful palliation of advanced gastric leiomyosarcoma requires early diagnosis, surgical resection and multimodal therapy.