Color Doppler Ultrasound Examination Research Articles

Correlations of IL-1 and IL-6 Gene polymorphisms with hypertrophic cardiomyopathy.

The purpose of this study was to explore the correlations of interleukin-1 (IL-1) and IL-6 gene polymorphisms with hypertrophic cardiomyopathy (HCM). A total of 200 patients with HCM were enrolled as disease group, and 200 healthy individuals were included as control group. Peripheral blood was collected from all subjects in both disease and control groups. Gene polymorphisms and serum expression levels of IL-1 and IL-6 were detected, and conjoint analysis was performed based on results of cardiac color Doppler ultrasound examination. The allele distribution of IL-1 rs1878320 showed a difference between disease and control groups (P=0.000). The frequency of the allele T was lower in disease group. The genotype distribution of IL-1 rs1878320 (P=0.001) and IL-6 rs1474347 (P=0.000) in disease group was different from that in control. The frequency of TC genotype of IL-1 rs1878320 was lower in disease group, and that of CA genotype of IL-6 rs1474347 was higher in disease group. There was a difference in the distribution of the dominant model of IL-6 rs1474347 between disease and control groups (P=0.021), and the frequency of CC + CA in the dominant model was 171 (0.855). The frequency of AC haplotype of IL-1 gene was overtly higher in disease group (P=0.000), while the frequency of AT haplotype was lower in disease group (P=0.000). The IL-1 rs1516792 polymorphism had an association with serum IL-1 level (P<0.05), the IL-1 level was notably increased in the patients with the genotype AA, and it was higher in disease group. The polymorphism of rs1878320 locus in IL-1 gene was correlated with interventricular septal (IVS) (P=0.047), and IVS was reduced in the patients with TC genotype. The polymorphism of rs1516792 locus in IL-1 gene was distinctly related to left ventricular outflow tract (LVOT) (P=0.041), and LVOT was lowered in the patients with GG genotype. The IL-6 rs2069831 polymorphism was associated with left ventricular ejection fraction (LVEF) (P=0.035), and LVEF declined in the patients with TT genotype. The IL-1 and IL-6 gene polymorphisms are correlated with the susceptibility and progression of HCM.

PENDEKATAN RADIOLOGIS PADA KASUS MALROTASI INTESTINAL DENGAN MIDGUT VOLVULUS

Midgut volvulus is a condition in which the intestine has become twisted as a result of malrotation of the intestine during fetal development. It cause of an acute abdomen in neonates and important entity to be diagnosed urgently. Midgut volvulus may lead to small intestinal ischemia and gangrene. The correct diagnosis depends on both high clinical suspicion and the radiologist’s ability to recognize the specific signs of malrotation and the normal variants that can lead to the wrong diagnosis. Radiological examination; such as abdominal x-ray, ultrasound and colon in loop play an important role in the diagnosis of volvulus . A color Doppler ultrasound examination may reveal a whirlpool sign, a colon in loop (CIL) examination may show an aberrant intestinal rotation, and a plain abdominal xray may show a double bubble sign due to midgut volvulus

Clinical analysis of 12 cases of ovarian yolk sac tumor

Objective: To investigate the diagnosis, treatment and prognosis of ovarian yolk sac tumor (OYST). Methods: The clinicopathological data and follow-up data of 12 patients with OYST admitted to the Affiliated Hospital of Qingdao University from January 2013 to December 2020 were retrospectively analyzed, and the diagnosis, treatment and prognosis of OYST patients were summarized. Results: (1) The age of 12 patients with OYST ranged from 11 to 37 years, with a median age of 20 years. At the first visit, all 12 patients had pelvic masses. Reasons for seeing a doctor: 6 cases of abdominal distension and abdominal pain, 4 cases of mass in the lower abdomen, 1 case of vaginal bleeding, and 1 case of appendicitis. International Federation of Obstetrics and Gynecology (FIGO) 2014 staging: 4 cases in stage Ⅰa, 2 cases in stage Ⅰc, 1 case in stage Ⅱc, 4 cases in stage Ⅲc, and 1 case in stage Ⅳb. (2) All 12 patients were examined by color Doppler ultrasound before operation, among which 10 cases showed unilateral adnexal masses and 2 cases bilateral adnexal masses. The median maximum diameter of tumor was 16.5 cm (range: 6.0-28.0 cm). The preoperative levels of alpha fetoprotein (AFP) in 12 patients (all >1 210 μg/L) were significantly higher than normal (<25 μg/L). Among the 11 patients with cancer antigen 125 (CA125) detection results, 9 patients showed elevated serum CA125 levels. (3) Among the 12 patients, 8 young infertile patients who needed to preserve their reproductive function underwent appendectomy, 3 infertile patients underwent staged surgery for ovarian malignant germ cell tumor, and only one bilateral lesion and infertile patient underwent unsatisfactory staged surgery for ovarian malignant germ cell tumor. Of the 12 patients, 11 patients were given combined chemotherapy regimen of bleomycin, cisplatin, and etoposide (BEP) after operation. One patient without chemotherapy developed metastasis 3 months after operation, and was given BEP chemotherapy, and her condition was controlled. (4) The deadline for follow-up was December 31st, 2022, and the median follow-up time was 60 months (range: 25-115 months). All the 12 patients survived without tumor during the follow-up period, and the median disease-free survival time was 84.5 months (range: 25-115 months). Conclusions: OYST mostly occurs in children and young women. Color Doppler ultrasound examination and serum AFP and CA125 detection have diagnostic value for OYST. Surgical treatment after diagnosis of OYST includes surgery to preserve reproductive function and timely and standardized chemotherapy after operation. The prognosis of patients is good regardless of stage.

Cutting scheme and clinical application effects of ultrathin thoracodorsal artery perforator flap assisted by color Doppler ultrasound

Objective: To explore the cutting scheme and clinical application effects of ultrathin thoracodorsal artery perforator flap assisted by color Doppler ultrasound. Methods: This study was a retrospective historical control study. From February 2017 to October 2019, 20 patients who were admitted to the Third Department of Orthopedics of Xingtai General Hospital of North China Medical and Health Group (hereinafter referred to as our department), met the inclusion criteria, and underwent repair of skin and soft tissue defects of extremities with ultrathin thoracodorsal artery perforator flap designed and harvested based on the surgeon's clinical experience were selected as control group, including 16 males and 4 females, aged (37±5) years. From November 2019 to December 2022, 21 patients who were admitted to our department, met the inclusion criteria, and underwent repair of skin and soft tissue defects of extremities with ultrathin thoracodorsal artery perforator flap designed and harvested under the assistance of color Doppler ultrasound were selected as ultrasound-assisted group, including 15 males and 6 females, aged (38±6) years. After debridement, the area of skin and soft tissue defects of extremities ranged 5.0 cm×4.0 cm to 19.0 cm×8.0 cm, and the area of thoracodorsal artery perforator flaps ranged 6.0 cm×5.0 cm to 20.0 cm×9.0 cm. The wounds in flap donor sites were closed directly. For patients in ultrasound-assisted group, the time and cost required for color Doppler ultrasound examination were recorded, and the number, type, and location of thoracodorsal artery perforator vessels detected by preoperative color Doppler ultrasound were compared with those of intraoperative actual detection. The time required for complete flap harvest of patients in 2 groups was recorded. On postoperative day (POD) 1, 3, 5, 7, and 14, the blood perfusion of flaps in the 2 groups of patients was assessed using a flap perfusion assessment scale. On POD 14, flap survival of patients in 2 groups was observed, and the percentage of flap survival area was calculated. In postoperative 6 months, satisfaction of patients with the treatment outcome in the 2 groups was assessed using 5-grade Likert scale, and the satisfaction rate was calculated. Results: For patients in ultrasound-assisted group, the time required for preoperative color Doppler ultrasound examination was (10.5±2.3) min, and the cost was 120 yuan; 21 thoracodorsal artery perforator vessels were detected and marked using preoperative color Doppler ultrasound, including 8 (38.10%) type 1 perforator vessels, 10 (47.62%) type 2 perforator vessels, and 3 (14.29%) type 3 perforator vessels; the number, type, and location of thoracodorsal artery perforator vessels detected preoperatively were consistent with those detected intraoperatively. The time required for complete flap harvest of patients in ultrasound-assisted group was (41±10) min, which was significantly shorter than (63±12) min in control group (t=6.32, P<0.05). On POD 1, 3, 5, 7, and 14, the blood perfusion scores of flaps of patients in ultrasound-assisted group were significantly better than those in control group (with t values of 6.67, 7.48, 8.03, 8.75, and 7.99, respectively P<0.05). On POD 14, only one patient in ultrasound-assisted group had partial flap necrosis and 6 patients in control group had complete or partial necrosis of the flap; the percentage of flap survival area of patients in ultrasound-assisted group was (99±8)%, which was significantly higher than (87±8)% in control group (t=4.57, P<0.05). In postoperative 6 months, there was no significant difference in the satisfaction rate of patients with the treatment outcome between the two groups (P>0.05). Conclusions: Preoperative color Doppler ultrasound is highly accurate in detecting the number, type, and location of perforator vessels. The cutting scheme of ultrathin thoracodorsal artery perforator flaps can be designed according to the different types of perforator vessels, with shorted flap cutting time and improved flap survival rate.

Doppler ultrasound-based evaluation of hemodynamic changes in the ophthalmic artery and central retinal artery in patients with type 1 diabetes mellitus without retinopathy and with mild non-proliferative retinopathy.

Determination of blood flow parameters in the ophthalmic artery and central retinal artery using Doppler ultrasound in patients with type 1 diabetes mellitus without fundus signs of diabetic retinopathy and with mild non-proliferative retinopathy. To eliminate the impact of other systemic factors on vascular flow, the study enrolled a total of 80 patients with type 1 diabetes mellitus, aged between 18 and 45 years. The study participants did not have any diabetic complications or other systemic or ocular comorbidities. The control group comprised 81 healthy individuals within a similar age range. Color Doppler ultrasound examinations of the ophthalmic artery and central retinal artery were performed to evaluate selected blood flow parameters including peak systolic velocity, end-diastolic velocity, and resistance index. Patients with type 1 diabetes mellitus exhibited statistically significant decrease in both systolic and end-diastolic velocities in the central retinal artery, accompanied by an elevation in resistance index, compared to the control group. The study revealed differences in blood flow parameters between the patients without fundus changes and those exhibiting mild non-proliferative retinopathy. Specifically, patients with retinopathy showed a significant decrease in both systolic velocity and end-diastolic velocity in the central retinal artery. No differences were observed for the same parameters in the ophthalmic artery. When analyzing the patients' blood flow parameters in relation to the degree of diabetes control, as determined by glycated hemoglobin levels, a statistically significant reduction in systolic velocity was identified in both the ophthalmic and central retinal arteries in the group with poorly controlled diabetes. Examination of the orbital vessels using Doppler ultrasound in patients with type 1 diabetes mellitus holds promise as an effective method for early detection of vascular abnormalities.

Neonatal pyocele originating from a urinary tract infection: a case report

BackgroundThe origins of pyocele are primarily idiopathic, with reports suggesting the spread from intraperitoneal or hematogenous infection. However, we found no information in the literature regarding the pathogen’s spread from the urinary tract.Case presentationWe report here a case of a 23-day-old term Iranian boy (Fars ethnicity) with complaints of new-onset fever, irritability, poor feeding, right hemiscrotal erythema, and edema. Moreover, the physical examination revealed an enlarged, erythematous, tender right hemiscrotum and edematous scrotal walls. Along with leukocytosis and elevated C-reactive protein levels, the urine culture indicated an infection with Escherichia coli. However, as the color Doppler ultrasonographic examination was inconclusive, he underwent surgical exploration on which a hydrocele sac with reddish cloudy pus fluid was noted, with its culture indicating growth with the same mentioned pathogen. Therefore, an appropriate antibiotic regimen was administered, and the patient was discharged a few days later after achieving full recovery and demonstrating no urinary tract structural abnormalities.ConclusionIn neonatal pyocele, the spectrum of evaluating the source of the infection should also be extended to the urinary tract. Moreover, administering suitable antibiotics would produce favorable results in cases with no structural abnormalities.

Ultrasound Features of Nail Lichen Planus.

To describe the ultrasonographic features of nail lichen planus (NLP), which, so far, have not been reported in the literature. A retrospective single-center study of NLP patients' color Doppler ultrasound examinations was performed between March 2014 and January 2023. Inclusion criteria were patients ≥15 years with a confirmed clinical diagnosis of NLP in sequential order. Exclusion criteria included concomitant systemic or local cutaneous or nail diseases and systemic or local nail treatments before the ultrasound examination. The ultrasound protocol included the examination of all fingernails or toenails following the reported protocol for dermatologic ultrasound examinations at high and ultra-high frequencies. Patient demographics and ultrasound features of the nail bed, periungual region, nail plate, and regional vascularity were registered and analyzed statistically. A total of 36 patients met the criteria. All cases presented thickened and decreased echogenicity of the nail bed. A hypoechoic halo surrounding the origin of the nail plate was present in 78% of cases. Exactly 58% of patients presented decreased echogenicity of the proximal periungual dermis, and 86% showed thickening of the periungual dermis. Hypervascularity of the nail bed was seen in 94% of cases. The mean maximum thickness of vessels, the peak systolic velocity of the arterial vessels, and other blood flow findings are provided. Ultrasonography can support the diagnosis of NLP, which benefits the non-invasive discrimination of nail conditions and can avoid the potential permanent scars derived from nail biopsies. Furthermore, ultrasound may be a powerful tool to monitor this disease's treatment.

Long-term Outcome of Laparoscopic Surgery for Nonpalpable Undescended Testis.

The aim of this study was to objectively assess the long-term results of laparoscopic orchidopexy in patients who were diagnosed clinically to have nonpalpable undescended testis (UDT). All operated cases of nonpalpable UDT from January, 2000, to January, 2014, were reviewed. After informed consent, all patients were subjected to a color Doppler ultrasound examination to assess the location of the testis, its size, blood supply, and consistency. The size of the testis, operated and nonoperated, was noted down in volume using the formula of 0.71 × length × breath × height. A total of 114 patients could be identified, who had undergone laparoscopy for nonpalpable UDT in the study period. Of these, 44 patients (54 units) underwent a color Doppler study to assess the testes. All the testes were found to lie in the scrotum with preserved blood supply. The volume of the operated unilateral testes (mean = 1.605 cm3) was smaller than the normal nonoperated side (mean = 2.524 cm3). The smaller testicular volume was observed in spite of maintained blood supply to the testes. In cases of bilateral UDT, both the testes were smaller in size (mean = 2.2 cm3), but were comparable to each other. In addition, the ultrasound examination revealed the presence of normal homogenous parenchyma of all the testes similar to the nonoperated side. Laparoscopic orchidopexy is a safe and effective option in the treatment of nonpalpable UDT. On a long-term basis, it is possible to achieve scrotal position along with preserved blood flow following laparoscopic orchidopexy in all patients suffering from nonpalpable UDT.

Objective Evaluation of Pulse Width Using an Array Pulse Diagram.

Pulse width, which can reflect qi, blood excess, and deficiency, has been used for diagnosing diseases and determining the prognosis in traditional Chinese medicine (TCM). This study aimed to devise an objective method to measure the pulse width based on an array pulse diagram for objective diagnosis. The channel 6, the region wherein the pulse wave signal is the strongest, is located in the middle of the pulse sensor array and at the guan position of cunkou during data collection. Therefore, the main wave (h1) time of the pulse wave was collected from the channel 6 through calculation. The left h1 time was collected from the remaining 11 channels. The amplitudes at these time points were extracted as the h1 amplitudes for each channel. However, the pulse width could not be calculated accurately at 12 points. Consequently, a bioharmonic spline interpolation algorithm was used to interpolate the h1 amplitude data obtained from the horizontal and vertical points, yielding 651 (31 × 21) h1 amplitude data. The 651 data points were converted into a heat map to intuitively calculate the pulse width. The pulse width was calculated by multiplying the number of grids on the vertical axis with the unit length of the grid. The pulse width was determined by TCM doctors to verify the pulse width measurement accuracy. Meanwhile, a color Doppler ultrasound examination of the volunteers' radial arteries was performed and the intravascular meridian widths of the radial artery compared with the calculated pulse widths to determine the reliability. The pulse width determined using the maximal h1 amplitude method was comparable with the radial artery intravascular meridian widths measured using color Doppler ultrasound. The h1 amplitude was higher in the high blood pressure group and the pulse width was greater. The pulse width determined using the maximal h1 amplitude was objective and accurate. Comparison between the pulse widths of the normal and high blood pressure groups verified the reliability of the method.

Is there correlation between flow volume and Kt/V ratio in upper arm arteriovenous fistula in patients end stage renal failure?

Introduction: Chronic kidney disease is irreversible and may result in end-stage renal failure (ESRF). The kidney replacement program is determined by calculating Kt/V ratios, one of the dialysis efficiency indicators in treatment planning in routine dialysis applications in ESRF patients. We aimed to investigate whether there is a correlation between flow rate and Kt/V ratio. Methods: All patients were evaluated by B-mode ultrasonography (US) and color doppler ultrasonography (CDUS). The anastomosis line diameter was measured in the B-mode US. The fistula flow rate was calculated in a spectral examination at the anatomical location where the fistulized flow was best obtained at the anastomosis level. Patients with a fistula flow rate above 300 mL/min in CDUS examinations were considered reasonable flow rates. The fistula flow rate in these patients was compared with the Kt/V ratios. Spearman’s rank correlation coefficient was calculated since the normal distribution condition was not met to determine the relationship between variables. Results: The results of this study showed a high level (r=0.72, P=0.001) of positive and statistically significant correlation between flow rate and Kt/V ratio in upper arm arteriovenous fistula in patients with end stage renal failure. Conclusion: We found a highly positive and statistically significant correlation between fistula flow rate and Kt/V ratio. Low Kt/V ratios have different causes. Low fistula flow should be considered first in low Kt/V values.

Dapagliflozin improves erectile dysfunction in patients with type 2 diabetes mellitus: An open-label, non-randomized pilot study.

The role of dapagliflozin on erectile dysfunction (ED), a condition widely affecting patients with type 2 diabetes mellitus (T2DM), has not yet been studied. The aim of the study was to evaluate the effects of dapagliflozin alone or in combination with tadalafil on ED in patients with T2DM. This was an open-label, non-randomized pilot study involving 30 Caucasian male patients with T2DM and severe ED. They were equally divided into three groups, assigned to treatment with tadalafil 5 mg/day (Group 1), tadalafil 5 mg/day plus dapagliflozin 10 mg/day (Group 2) and dapagliflozin 10 mg/day (Group 3) for 3 months. The presence and the severity of ED were evaluated at enrolment and after treatment, by the International Index of Erectile Function 5-item (IIEF-5) questionnaire and the dynamic penile echo colour Doppler ultrasound (PCDU) examination. At the end of treatment, the three groups showed a significant improvement in IIEF-5 score, by 294%, 375% and 197%, in Groups 1, 2 and 3, respectively. PCDU evaluation showed a significant increase in peak systolic velocity by 178.9%, 339% and 153%; acceleration time was significantly shortened in Group 2 (-26.2%) and was significantly lower than in Group 1 and 3 (-7.2% and -6.6%), while no significant difference was found in end-diastolic velocity after treatment. The greatest rates of improvement were observed in Group 2 for all the end points. Dapagliflozin improves ED in patients with T2DM and enhances the efficacy of tadalafil. Further studies are needed to confirm our results explain the mechanism(s) by which dapagliflozin exerts its effects on ED.

Risk factors and prediction model of nomogram for preoperative calf muscle vein thrombosis in geriatric hip fracture patients.

Calf muscular vein thrombosis (CMVT) is a common complication in geriatric hip fracture patients. Despite its high incidence, prior research on the topic is limited. The occurrence of CMVT in patients will prolong the preoperative waiting time and even lead to serious thromboembolic events, which can be detrimental to the patient's prognosis. Therefore, this study aimed to identify the risk factors for preoperative CMVT in geriatric hip fracture patients and construct a nomogram model to predict the risk of preoperative CMVT in patients. Geriatric hip fracture patients who underwent surgery between January 2019 and January 2022 were included. The patients were categorized into two groups depending on whether they had preoperative CMVT, confirmed through Color Doppler ultrasound or venography examination. Univariate and multivariate logistic regression analyses were used to analyze demographic characteristics, medical history, comorbidities, and laboratory tests. A nomogram was constructed to predict preoperative CMVT in geriatric hip fracture patients based on the results of the multivariate logistic regression. Three hundred and eighty-eight geriatric hip fracture patients, including one hundred and thirty-four patients with CMVT and two hundred and fifty-four patients without CMVT, were ultimately included in our study. After multivariable logistic regression analysis, the time from injury to admission, smoking history, serum albumin levels, and D-dimer levels was identified as independent risk factors and was entered into a nomogram model. The nomogram showed robust discrimination, with an area under the receiver operating characteristic curve of 0.805. The calibration curve showed strong agreement between the CMVT probabilities predicted by the nomogram and the actual probabilities. The decision curve analysis illustrates the excellent clinical utility of the model. We have constructed a new nomogram prediction model that can effectively predict the risk of preoperative CMVT in geriatric hip fracture patients based on their medical history and blood test results. This model can help clinicians make individualized predictions of CMVT that are tailored to each patient's unique circumstances.

An observational study of endometrial vascularity in implantation

Background: According to Ayurveda, Ambu is one of the four essential factors of Garbhasambhav Samugri for formation and development of the embryo. The word Ambu means nutrients essential for formation and growth of embryo which it receives from mother. According to modern science, during implantation, embryo receives its nutrients from endometrium. Though some women have normal endometrial thickness, normal endometrial pattern, normal endometrial morphology, still they are unable to get impregnated. During peri-implantation period of menstrual cycle, endometrial vascularity has major role in implantation of fertilised egg and also further growth of foetus. Objectives: The objective of this study is to evaluate implantation rates in women having endometrial vascularity upto V1, V2, V3, V4 zones. Material &amp; Methods: Anonymous data of endometrial vascularity by transvaginal colour doppler ultrasound examination done, on the day of rupture of follicle of menstrual cycle, on 160 women, willing to conceive, has been collected from gynaecologist. And also, her status whether she was implanted or not implanted was collected from the gynaecologist. Data about her pregnancy status upto 20 weeks were collected. From this collected data, results regarding endometrial vascularity were derived. Results: Implantation rate in cases having vascularity upto V1 zone, upto V2 zone, upto V3 zone, upto V4 zone were 0 %, 8.33 %, 25 %, 30.5% respectively. Conclusion: Implantation rate is greater in cases having vascularity upto V3 and V4 zone than V1 &amp; V2 zone. Endometrial vascularity is an important factor for implantation of fertilized egg and also for further growth of embryo.

#6682 RENAL ARTERY STENOSIS: A SINGLE CENTRE STUDY

Abstract Background and Aims Renal artery stenosis (RAS) is present from 1% to 5% in people affected by arterial hypertension and it is often associated with peripheral artery disease and coronary artery disease; as the matter of fact, it is commonly found in people undergoing cardiac catheterization (18-20%) or angiography for aorto-iliac and lower extremities diseases. The major cause of renal artery stenosis is an atherosclerotic lesion localized in the proximal segment or to the ostium. Clinical presentations are renovascular hypertension and ischemic nephropathy. The aim of the study is to define either endovascular treatment gives a significant benefit on renal function and blood pressure control, when associated to medical therapy. Method This is a retrospective study focused on patients who underwent renal artery angioplasty and stenting in the last ten years, from November 2011 to April 2021 in the Nephrology Department, at Sant'Andrea Hospital, La Spezia (Italy). The primary outcome was kidney function, while secondary outcomes were blood pressure and the number of antihypertensive drugs one year after the revascularization. Patients included in the study had uncontrolled and refractory arterial hypertension (PA ≥140/90 mmHg) and/or progressive worsening of renal function, secondary to bilateral or unilateral stenosis in one functional kidney, that was identified at the color-doppler ultrasound examination by a peak systolic velocity (PSV) &amp;gt;200 ml/min and an aortic-renal ratio &amp;gt;3,5. We found 36 patients who had these characteristics. They were all affected by chronic kidney disease (CKD) (mean±SD eGFR 25,3±15,3 ml/min/1,73 m2) equally divided into stage 3 (33%, eGFR 30-60 ml/min/1,73 m2), stage IV (31% eGFR 15-29 ml/min/1,73 m2) and stage V (36%, eGFR &amp;lt;15 ml/min/1,73 m2). Results Kidney function, measured as serum creatinine (SCr) (mg/dl), improved immediately after the revascularization (mean ± SD SCr after vs before 2,52 ± 1,61 vs 3,31 ± 2,47 mg/dl p&amp;lt;0.05), after 30 days (mean ± SD SCr after vs before creat. 2,36 ± 1,53 vs 3,19 ± 2,39 mg/dl p&amp;lt;0.05) and after one year (mean ± SD SCr after vs before creat. 2,04 ± 1,16 vs 2,99 ± 2,40 mg/dl p&amp;lt;0.05) (Fig. 1). Regarding arterial hypertension, a significant reduction of both systolic (SBP) and diastolic (DBP) blood pressure was detected in the subgroup of people under 75 years old (mean ± SD SBP after vs before, 144,62 ± 12,55 vs 168,18 ± 36,40 mmHg, p&amp;lt; 0,01; after one year vs before, 143,95 ± 21,10 vs 167,83 ± 38,16 mmHg, p&amp;lt;0.05) (mean ± SD DBP after vs before, 73,62 ± 9,62 vs 83,07 ± 21,75 mmHg, p&amp;lt; 0,05; after one year vs before 75,20 ± 9,02 vs 83,33 ± 23,10 mmHg, p = 0.07) (Fig. 2). The number of antihypertensive drugs dropped immediately after the angioplasty (mean ± SD tablets after vs before 2,28 ± 1,11 vs 3,21 ± 1,43, p&amp;lt;0.01), while after one year there was not a significant increase of therapy (mean ± SD tablets after one year vs before, 3,00 ± 1,41 vs 3,23 ± 1,42, p = 0,47), even if blood pressure was better controlled than before the procedure with the same amount of tablets (Fig. 3). Conclusion Although our population was quite small, we demonstrated the advantages of renal artery revascularization in atherosclerotic renovascular disease, as demonstrated by kidney function and blood pressure control. Our results contrast the larger studies considered, that found no relevant clinical benefit on renal function and incidence of major adverse cardiovascular and renal events by comparing patients treated with medical therapy alone or with medical therapy plus angioplasty. The different conclusions are probably due to our strict adhesion to the endovascular treatment indications, which consider the revascularization as the optimal strategy for a well-defined population.

Vascular Inflammatory Markers as Predictors of Peripheral Arterial Disease Patients' Quality-of-Life Changes after Endovascular Treatment.

The association between chronic inflammation and depression, anxiety, anhedonia, and quality of life (QoL) has been recently emphasized. However, the pathophysiology of this relationship remains unsolved. This study aims to assess the dependence between vascular inflammation represented by eicosanoid concentration and quality of life in patients with peripheral arterial disease (PAD). A total of 175 patients undergoing endovascular treatment due to lower limbs ischemia were covered with eight years of observation after the endovascular procedure, including ankle-brachial index (ABI), color Doppler ultrasound examination, urinary leukotriene E4 (LTE4), thromboxane B2 (TXB2) and 5-Hydroxyeicosatetraenoic acid (5-HETE) measurement and quality-of-life assessment with VascuQol-6. The baseline concentrations of LTE4 and TXB2 reversely correlated with preoperative VascuQol-6 and were predictive of the postoperative values of VascuQol-6 at each follow-up. At every follow-up timepoint, the results of VascuQol-6 reflected the LTE4 and TXB2 concentrations. Higher concentrations of LTE4 and TXB2 were correlated with lower life quality during the next follow-up meeting. Changes in VascuQol-6 at eight years vs. preoperative values were reversely related to the preoperative concentrations of LTE4 and TXB2. This is the first study to confirm that changes in life quality in PAD patients undergoing endovascular treatment are highly dependent on eicosanoid-based vascular inflammation.

The diagnostic value of Doppler Resistive Index in the differential diagnosis of focal liver lesions.

To investigate the diagnostic value of resistance index (RI) in differentiating focal liver lesions. In this retrospective study, a total of 576 patients with histologically confirmed focal liver lesions were included. Each patient underwent B-mode ultrasound examination and color Doppler ultrasound examination. The RI values of different focal liver lesions were recorded and compared. The mean RI value of benign lesions was significantly lower than that of malignant lesions (0.54 ± 0.10 vs. 0.71 ± 0.12) (p <0.05). In malignant lesions, the RI value of intrahepatic cholangiocarcinoma was significantly lower than that of hepatocellular carcinoma lesions. Furthermore, in hepatocellular carcinoma lesions, the RI of large lesions (group 4: >10 cm) was significantly lower than that of small lesions (group 1: ≤2 cm, group 2: 2-5 cm) (p <0.05). Taken RI of 0.615 as a cutoff value to differentiate malignant and benign lesions, the sensitivity, specificity, positive predictive value and negative predictive value were 82.80%, 81.00%, 81.34% and 82.48%, respectively. Color Doppler ultrasound examination is a valuable imaging method in detecting blood flow signal within liver lesions. The RI parameter should be helpful in differentiating malignant and benign liver tumors.

Combination of cardiac color Doppler ultrasound, serum MR-ProANP and NT-ProBNP forecasted hypertensive LVH and LFH

ABSTRACT To analyze the value of the combined test of the cardiac color Doppler ultrasound, the serum middle receptor pro-atrial natriuretic peptide (MR-ProANP) and the N-terminal pro-brain natriuretic peptide (NT-ProBNP) in forecasting the hypertensive left ventricular hypertrophy (LVH) and left heart failure (LHF). All patients were subjected to cardiac color Doppler ultrasound examination to obtain left atrium volume index (LAVI), left ventricular end-diastolic diameter (LVEDD), early-diastolic peak flow velocity (E), early-diastolic mean flow velocity (e’), early-diastolic peak flow velocity/early-diastolic mean flow velocity (E/e’) and left ventricular ejection fraction (LVEF). Biomarkers were performed to obtain serum MR-ProANP and NT-ProBNP concentrations, and statistical analysis was performed. The LVEF was obviously lower than that in the control group (P<0.01). The area under the receiver operating characteristic (ROC) curve (AUC) values of LVEF, E/e’, serum MR-ProANP and NT-ProBNP alone were in the range of 0.7–0.8. The AUC, sensitivity and specificity of LVEF and E/e’ combined with MR-ProANP and NT-ProBNP to diagnose hypertensive LVH and LHF were 0.892, 89.14% and 78.21%, which were higher than those of single diagnosis. In the heart failure group, LVEF was negatively correlated with serum MR-ProANP and NT-ProBNP concentrations (P<0.05), and E/e’ was positively correlated with serum MR-ProANP and NT-ProBNP concentrations (P<0.05). Pump function and ventricular remodeling in patients with hypertensive LVH and LHF are closely related to serum MR-ProANP and NT-ProBNP levels. Combination of the two testing can improve the prediction and diagnostic efficacy of LHF.

Loss of Radial Artery Pulse after Coronary Catheterization Through Trans-radial Route in Patients Acute Coronary Syndrome

Objectives: The objective of this study was to determine the frequency of loss of radial artery pulse after one month of the coronary catheterization through trans-radial route in patients diagnosed with acute coronary syndrome (ACS). Methodology: A sample of consecutive patients diagnosed with ACS who undergo coronary catheterization through trans-radial route were evaluated for the loss of radial pulse through color Doppler ultrasound and clinical examination (palpatory) after one month of the intervention. Results: A total of 115 patients were included, 107 (93%) of which were male patients, and mean age was 57.1 ± 9.9 years. Among these, 99 (86.1%) were diagnosed with ST elevation myocardial infarction (STEMI) and remaining 16 (13.9%) had non-ST elevation ACS. Only left heart catheterization was performed in 9 (7.8%) and 106 (92.2%) underdone percutaneous coronary intervention (PCI). The most commonly observed co-morbid condition was hypertension (47%) followed by diabetes (38.3%). A total of 72 (62.6%) were categorized as overweight/obese with body mass index of ≥ 25 kg/m2. The loss of radial artery pulse was noted in three (2.6%) patients at one month follow-up through both palpatory method and color Doppler ultrasound. Conclusion: The loss of radial artery pulse was noted in a significant proportion of patients after one month of coronary catheterization in patients with ACS. Both palpatory assessment method and color Doppler ultrasound showed full concordance in the identification of patients with radial artery occlusion.

Ortalama Trombosit Hacmi/Trombosit Sayısı (MPV/PLT Oranı ile Periferik Arter Hastalığı Arasındaki İlişki

Background/Aim: In our study, we aimed to evaluate the effect of mean platelet volume/platelet count ratio on the development of peripheral artery disease (PAD) by comparing it with the control group. Material and Methods: A total of 115 patients with peripheral artery disease as a result of lower extremity color Doppler ultrasonography examination in our hospital were included in the study as the patient group and 100 individuals without peripheral artery disease as the control group. Results: History of coronary artery disease (p&amp;lt;0.001), diabetes mellitus (p=0.009), hypertension (p&amp;lt;0.001) and smoking history (p&amp;lt;0.001) were significantly higher in the PAD group than in the control group. Serum glucose (121.27±25.66 vs. 104.81±34.77; p&amp;lt;0.001), MPV levels (9.99±0.79 vs. 9.04±0.7; p&amp;lt;0.001) and MPV/PLT ratio (0.041±0.07 vs. 0.037±0.006, p&amp;lt; 0.001) were found to be significantly higher in the PAD group than in the control group. Serum HDL levels (45.03±11.5 vs. 48.67±12.52 p=0.026) were significantly lower in the PAD group than in the control group. In multivariate analysis, age, MPV and MPV/PLT ratio were determined as independent predictors for peripheral arterial disease. Conclusion: In our study, we found that MPV and MPV/PLT ratio were independent predictors of peripheral artery disease.

The evaluation of vascular flow in clubfoot: a resistive index and peak systolic velocity study.

Resistive index (RI) and peak systolic velocity (PSV) are important Color doppler ultrasonography (CDU) parameters indicating the microcirculation and flow velocity in tissues. We aim to determine the changes in vascular flow characteristics in clubfoot after Ponseti treatment. There were three groups: the clubfoot group, the healthy group (the unaffected feet with unilateral deformities) and the control group. The Pirani severity scoring and CDU examinations of the foot were performed at initial admission and the 6th-month follow-up after Ponseti treatment. A total of 34 feet of 24 patients were included in the study. The mean age at initial treatment was 20.9 ± 22.5 days. The RI and PSV values of the clubfeet and the healthy group were similar. Resistive index values were significantly lower, and PSV values were significantly higher in the control group. After Ponseti treatment, only RI of the dorsalis pedis artery decreased, but PSV increased for all of the arteries. Recurrence of the deformity deteriorates the improvement in vascular development. Resistive index and PSV values were not related to the initial severity of the deformity. The RI values were higher, and PSV values were lower in clubfoot patients compared with the normal control group. Vascular pathology is a component of clubfoot, and treatment success improves vascular development. The improvement of microcirculation and blood flow velocity together was detected only in the dorsalis pedis artery. The effect of vascular flow change on prognosis was not detected.