Duplex-guided percutaneous transluminal balloon angioplasty of superficial femoral artery

The standard technique of balloon angioplasty of superficial femoral artery requires contrast arleriography and jluoroscopy. We attempted to perform this procedure with duplex guidance to avoid the use ofnephroloxic contrast material and eliminate radiation exposure. Materials and From October 2009 to December 2011, 48 patients [64.6% male] with a mean age of 68 +/- 8 years [range, 55-92 years] underwent balloon angioplasty of short [<4 cm in length], easily visualized superficial femoral artery stenotic/occluded lesions under duplex guidance. Diabetes, smoking, hypertension, renal insufficiency [serum creatinine level >L5 mg/dl], and hyperlipidemia were present in 33.3%, 66.7%, 41,7%, 54.2%, and 62,5% of patients, respectively. Disabling claudication was the indication far the procedure in 68.8% of cases, and critical limb ischemia was the indication in 31.2%. Based on color-coded duplex examination, patients were assigned into two groups. Group I included 30 cases [62.5%] with arterial stenoses, whereas Group II included 18 cases [37.5%] with arterial occlusions. The ipsilateral common femoral artery was cannulated under direct duplex visualization. Still under duplex guidance, a guidewire was directed into the superficial femoral artery, across the diseased segment, and parked at the tibioperoneal trunk, The diseased segment was then balloon-dilated. Balloon diameter and length were chosen according to arterial measurements obtained by duplex scan, Hemodynamically significant defects causing diameter reductions greater than 30% and peak systolic velocity ratios greater than 2 were stented with self-expandable stents under duplex guidance. Completion duplex examinations and ankle brachial indices were obtained routinely before hospital discharge. Whereas, the overall technical success rate was 95.8% [46/48 cases], it was 100% [30/30 cases] in Group I, and 88.9% [16/18 cases] in Group II. There was no statistically significant difference in technical success between the two groups [P value = 0.1]. Hemodynamically significant residual defects that required stenting were documented in 6 [13%] of the 46 successfully cannulated cases. There was no statistically significant difference regarding the need for stenting between the two groups [P value = 1]. After successful DGBA, the PSV [in 30 patients] decreased significantly from a mean of 419 +/- 27 cm/sec to 111 +/- 20 cm/sec [P value <0.0001], and the PSV ratio decreased significantly from a mean of 7.4 +/- 1.2 to 1,2 +/- 0,2 [P value <0,0001]. On the other hand, the ABI [in 46 patients] increased significantly from a mean of 0.5 +/- 0.1 to 0.9 +/- 0.1 [P value <0.0001]. The overall 6-month survival and limb salvage rates were 100%, The overall 6-month patency rate was 91.3% [42/46 cases]. There was no statistically significant difference regarding the patency rate between the two groups [P value = 0.1]. Duplex-guided balloon angioplasty and stent placement is a safe, effective alternative to the standard fluoroscopy guidance for the treatment of short, adequately visualized SFA stenotic/occluded lesions. It offers multiple advantages, including guidance of the arterial access, precise selection of the balloons and stents, and confirmation of the adequacy of the technique by reliable hemodynamic and imaging parameters

Relationship between lipid profiles, progesterone and postpartum fertility in buffaloes [with 3 tables and 9 figures]

Twenty normal parturient buffaloes, aged 4-8 years were used in this study to clarify any association between lipid profiles, progesterone and postpartum fertility in buffaloes. Based on the resumption of postpartum ovarian cyclicity, these animals were classified into three groups; buffaloes showing normal resumption of ovarian cyclicity at 65.18 +/- 19.90 days postpartum, buffaloes with delayed resumption of ovarian cyclicity at 138.33 +/- 16.50 days postpartum and buffaloes in anoestrus up to 210 days postpartum. The involution of the uterus averaged 35.4 +/- 7.6 days without any significant difference between the three groups. Highly significant [P<0.01] differences were recorded in the calving to conception interval-length between buffaloes with normal resumption of ovarian cyclicity and the others. A highly significant [P<0.0 1] negative correlation was recorded between the resumption of postpartum ovarian activity and serum levels of progesterone and total cholesterol. Also a negative correlation [P<0.01] was recorded between the calving to conception interval and these biochemical parameters. No association was found between resumption of ovarian cyclicity or calving to conception interval with serum triglycerides concentrations

Cavernous hemangioma of the maxilia [case report]

Intraosseous hemangioma of the facial bones is a rare disease and it occurs in the mandible more than in the maxilla. This paper is a report of a case of intraosseous cavernous hemangioma of the left anterior maxillary wall and presents the modality used for its treatment. Embolization of the nutrient arteries was first applied followed by left subtotal maxillectomy. Reconstruction with rib graft and temporalis fascia pedicled flap was resorted to as an augmentary procedure for the resultant postoperative defect. The patient was followed for one year to assess the final outcome of this therapeutic modality

outbreak of aldrin poisoning in heifers and buffalo

Nine 6-month old Friesian heifers and 10-month old female buffalo showed loss of appetite, fever, muscular tremors, constipation and then died within few weeks. Exposure to aldrin- sprayed pasture was reported. Encephalomalacia, perineural and perivascular edema, in addition to hemorrhage and perivascular cuffing had been detected in brain of the heifers and buffalo. Degenerative changes, coagulative necrosis, lymphocytic aggregations and hemorrhages were seen in the liver and kidneys of the heifers and buffalo. Depletion of lymphocytes was seen in lymphoid organs