Pattern of proteinuria in IgA nephropathy

Summary: Proteinuria is one of the bad prognostic indices in IgA nephritis (IgAN). This study compares the pattern of protein excretion in 10 patients with IgAN (IA) with that 5 years later (IB), when they developed renal impairment or hypertension. The pattern of proteinuria was analysed by SDS-PAGE and isoelectric focusing (IEF) and assayed for orosomucoid, α-1-microglobulin, retinol-binding protein, lysozyme, beta-2-microglobulin and N-acetyl-β-D-glucosaminidase activity. The data suggest that the changing pattern of proteinuria from IgA₁ to IgA₂ may reflect hyperfiltration as well as tubular injury.     

Temporomandibular joint: comparison of single- and double-contrast arthrography

Lower-space, single-contrast arthrography and dual-space, double-contrast arthrotomography were sequentially applied to 58 fresh temporomandibular joint (TMJ) autopsy specimens, and the findings were compared with observations in corresponding cryosections. Both modalities had high accuracy rates (greater than or equal to 84%) and no statistically significant differences between the two techniques were found. A side-by-side comparison of the two types of arthrograms, however, revealed that video tape recording of lower-space, single-contrast arthrography was superior in demonstrating joint dynamics and that dual-space, double-contrast arthrotomography was superior in demonstrating the soft-tissue anatomic features of the joint. It appears that lower-space, single-contrast arthrography can be recommended for examination of patients with clicking, catching, and intermittent locking, and that dual-space, double-contrast arthrotomography is preferable when information about morphologic alterations is clinically more important than information about joint dynamics.     

Intraarterial digital subtraction angiography in diagnostic arteriography

Intraarterial digital subtraction angiography (DSA) was performed in 133 diagnostic arteriographic procedures during a 10-month period. The increased contrast resolution of DSA permitted the use of a dilute (15%) contrast material. A significant reduction in contrast material dose compared with conventional film-screen arteriography and intravenous DSA was thus achieved. This was especially advantageous in patients with diminished renal function. The dilute contrast material also resulted in less patient discomfort. Subtracted images were available immediately on cathode ray tube display, resulting in faster procedures, and a considerable saving in film cost compared with conventional arteriography. It is concluded that intraarterial DSA is a useful technique that may replace conventional film-screen arteriography in many applications.     

Long-segment femoropopliteal stenoses: is angioplasty a boon or a bust?

Analysis of 193 femoropopliteal angioplasties demonstrated patency rates in the stenotic group of 75.5% at 6 months and 54.4% at 54 months. The patency rates for the occlusive group were 93.7% at 6 months and 72.9% at 54 months; these rates were significantly better than those in patients with stenoses. A group of 14 patients with long-segment (greater than 7 cm) stenosis had the highest risk of early failure, with a 6-month patency of 23.1%. After removal of the long-segment stenosis group from the results, there were no significant differences between the long-term patencies for stenotic and occlusive lesions. If angioplasty of long stenoses is attempted, a high initial success rate but early failure should be anticipated.