Renal resistive index in healthy children

OBJECTIVE: The objective of the study was to investigate the relationship between age and renal resistive index (RI) and to determine the normal values and ranges of RI in intrarenal arteries in healthy children. MATERIALS AND METHOD: Color duplex Doppler sonography of interlobar or arcuate arteries was performed in 115 children without clinical or laboratory pathologic changes of the urinary tract. Of these 115 healthy children, 23 were under 12 months of age (group 1), 24 between 12 and 35 months (group 2), 23 between 36 and 71 months (group 3), and 45 between 72 months and 16 years (group 4). Normative data for RI were established for each age group. RESULTS: When age groups were compared, statistically significant differences were observed between age groups 1 and 2 (P=0.007), 1 and 3 (P=0.00), 1 and 4 (P=0.00) and 2 and 4 (P=0.00). No significant differences were observed between age groups 2 and 3 (P=0.452), and 3 and 4 (P=0.078). There was no significant difference between mean RI values of right and left kidney within any age group (P=0.315). CONCLUSION: Results obtained in this study demonstrates that RI is age dependent; it is the highest at birth, from birth declines gradually with increasing age and stabilizes in a certain range (mean RI range regarded as normal for adults) by reaching adult levels.     

Renal Transplant Ureteral Stenosis: Treatment by Self-Expanding Metallic Stent

We report the use of a metallic stent in a transplant ureteral stenosis. A 28-year-old man with chronic renal failure due to chronic pyelonephritis, who received a living-donor renal transplant, presented with transplant ureteral stenosis. The stenosis was unresponsive to balloon dilation and was treated by antegrade placement of a self-expanding Memotherm stent. The stented ureter stayed patent for 3 years. It may be reasonable to treat post-transplant ureteral stenosis resistant to balloon dilation with self-expanding metallic stents. However, long-term follow-up is required to evaluate the efficacy of this treatment.     

Cardiac biopsy in childhood

Endomyocardial biopsy was attempted in 18 children aged 5 months to 15 years with 82% success. Biopsies obtained from 15 children were examined by light and electron microscope making positive morphological diagnoses in 3 cases. The biopsy findings were actively helpful in 7 other cases, which contrasts with experience in adult biopsy series. This is a low risk procedure which does not add to the hazards of cardiac catheterization in children.     

Prolonged QT interval and cardiac arrhythmias in two neonates: sudden infant death syndrome in one case

Two neonates with arrhythmias and the long QT syndrome are described. The arrhythmias were detected in utero and both infants were apparently well after birth. The first infant, although well, had a bradycardia for the first 9 days of life. A normal heart rate was documented at 10 days but a prolonged QT interval was not appreciated on the ECG. He was discharged from hospital but died suddenly and unexpectedly 3 days later. A post-mortem examination failed to find a cause for his death which therefore fell into the category of the sudden infant death syndrome (SIDS). A retrospective analysis of the perinatal electrocardiogram showed a probable junctional rhythm with 2:1 conduction to the ventricle; the QT interval was prolonged at 0.52 seconds (QTC = 0.63). The second infant had a QT interval of 0.52 seconds (QTC = 0.54) and frequent ventricular premature beats on a 24-hour electrocardiogram. She was treated with propranolol and remains well 2 years later. Sudden infant death has often been described in the siblings of children with the long QT syndrome and one other report described a case of SIDS which was said to have had a prolonged QT interval on the perinatal ECG. This report, however, provides unquestionable evidence, in one case, of an association between the long QT syndrome and SIDS.     

Endosulfan-induced cardiotoxicity and free radical metabolism in rats: the protective effect of vitamin E

Endosulfan is widely used in insect control and it is absorbed by both humans and animals through ingestion, inhalation and percutaneously. The aim of this work was to study antioxidant enzyme system which include superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) and malondialdehyde (MDA), the end product of lipid peroxidation and ultrastructural changes that might occur in the heart tissue of adult male Wistar rats as a result of endosulfan intoxication. Vitamin E (200 mg/kg, twice a week), endosulfan (2 mg/kg, per day, once a day in corn oil) and vitamin E (200 mg/kg, twice a week)+endosulfan (2 mg/kg, per day, once a day in corn oil) combination were given to rats (n = 10/group) orally via gavage for 6 weeks. SOD, GPx, CAT activities and MDA level increased in the endosulfan-treated group heart tissue compared to control group (P < 0.01, P < 0.01, P < 0.05 and P < 0.01, respectively). SOD, GPx activities and MDA level decreased in the vitamin E + endosulfan-treated group compared to endosulfan-treated group (P < 0.05, P < 0.05 and P < 0.05, respectively). Decrease of CAT activity was not significant statistically in the vitamin E + endosulfan-treated group compared to endosulfan-treated group. CAT activity increased in the vitamin E + endosulfan treated group compared to control group (P < 0.05). Increase of SOD, GPx activities and MDA levels were not significant statistically in the vitamin E + endosulfan-treated group compared to control group. In electron microscopic investigations while cytoplasmic edema and swelling and vacuolization of mitochondria of myocardial cells in endosulfan-treated group was observing, only a weak swelling of mitochondria of myocardial cells in vitamin E + endosulfan-treated group was observed. We conclude that vitamin E significantly reduce endosulfan-induced cardiotoxicity in rats.     

Whole body MR imaging in ankylosing spondylitis: a descriptive pilot study in patients with suspected early and active confirmed ankylosing spondylitis

Background  

Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis.     

结节性硬化症的CT诊断（附7例分析）

目的：探讨结节性硬化症（TSC）的CT表现和鉴别诊断。方法：分析7例诊断为结节性硬化症的CT资料。重点观察病变部位、大小、钙化程度及其他改变。结果：7例均有室管膜下结节,共计77个,其中钙化结节39个．80％结节位于侧脑室体部室管膜下;5例皮质及皮质下多发结节均无钙化,额枕叶为著,其次为颞顶叶：4例皮质下白质有不同程度低密度改变,主要围绕侧脑室体部及额角周围。4例合并其他畸形。结论：室管膜下多发结节并钙化,皮质异常脑回及不规则形低密度影、脑白质放射状分布的低密度改变是CT诊断结节性硬化症的主要征象,其中室管膜下结节并钙化是较有特征性的表现。CT结合临床可做出明确诊断并发现其他畸形。     

<Emphasis Type="Italic">TCF7L2</Emphasis>variant genotypes and type 2 diabetes risk in Brazil: significant association,but not a significant tool for risk stratification in the general population

Background  

Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population.     

侧脑室注射血管紧张素Ⅱ促进内源性洋地黄样因子释放

目的 探讨侧脑室注射血管紧张素Ⅱ对内源性洋地黄样因子（EDLF）释放的影响。方法 大鼠侧脑室注射血管紧张素Ⅱ及侧脑室注射Saralasin或损毁第三脑室前腹区（AV3V）预处理,放射免疫方法测定血清EDLF浓度的变化。结果 侧脑室注射AngⅡ可引起血清EDLF浓度升高;Saralasin预处理或海人酸损毁AV3V区可阻断侧脑室注射AngⅡ引起的血清EDLF升高效应。结论 侧脑室注射血管紧张素Ⅱ促进EDLF释放。     

13Carbon mixed triglyceride breath test and pancreatic enzyme supplementation in cystic fibrosis

Children with cystic fibrosis have variable degrees of exocrine pancreatic insufficiency which, if untreated, is the main cause of fat malabsorption. The impact of pancreatic enzyme supplementation on fat digestion was measured in 41 children with cystic fibrosis, 11 healthy controls, and five children with mucosal diseases by a non-invasive test of intraluminal lipolysis using 13carbon (13C) labelled mixed triglyceride (1,3-distearyl, 2[13C] octanoyl glycerol). The children with cystic fibrosis without pancreatic supplements had a median (range) 13C cumulative percentage dose recovered over six hours (cPDR) of 3.1% (0-31.7), the controls 31.0% (21.8-41.1), and the subjects with mucosal disease 27.8% (19.7-32.5). In 23 subjects with cystic fibrosis the usual dose of pancreatic enzyme supplements increased the cPDR to a median of 23.9% (0-45.6), and twice the usual dose of enteric coated microspheres increased the cPDR to 31.1% (11.1-47.8). There was no significant difference between the median cPDR of normal controls and children with mucosal disease, but there was a highly significant difference between these groups and children with untreated cystic fibrosis. Thirteen children with cystic fibrosis had no 13C recovery in their breath without enzymes and 10 showed marked increases with regular enzymes. In eight children doubling the dose of enzymes caused no or minimal improvement. The mixed triglyceride breath test offers a simple, non-invasive way of assessing the need for pancreatic enzyme supplementation in children with cystic fibrosis and could be used to optimise treatment.