Role of new magnetic resonance imaging modalities in diagnosis of orbital masses: a clinicopathologic correlation

To evaluate the role of diffusion-weighted magnetic resonance imaging [MRI] and proton magnetic resonance spectroscopy [MRS] in the diagnosis of different orbital masses and their advantages over conventional MRI. The study included 20 patients presenting with proptosis. Every patient was subjected to thorough clinical examination, conventional MRI [Tl weighted, T2 weighted, and postcontrast Tl weighted if needed,] diffusion-weighted MRI, and proton MRS. Orbitotomy was performed, the orbital mass was excised, and histopathological examination was performed. Diffusion-weighted MRI could differentiate between benign lesions and malignant tumors in 70% of cases; however, overlap occurred in 30% of cases with benign tumors showing restricted diffusion whereas proton MRS could differentiate between benign and malignant tumors in 90% of cases. Diffusion-weighted MRI and proton MRS can potentially increase the accuracy of diagnosis of orbital masses through in vivo tissue characterization. Magnetic resonance spectroscopy seems to be the more accurate modality

Vascular endothelial growth factor as an indicator of severity of diabetic retinopathy

To evaluate vascular endothelial growth factor [VEGF] as an indicator of severity in diabetic retinopathy. The study included 120 patients divided equally into 3 groups [proliferative diabetic retinopathy [PDR] group, non proliferative diabetic retinopathy [NPDR] group and non diabetics control group]. Vitreous and blood samples were collected from all patients. VEGF concentrations were determined using enzyme linked immuno-sorbent assay and correlated with retinopathy grading. Vitreous concentrations were statistically significant higher than serum concentrations in both retinopathy groups with strong positive correlation [r = 0.927 at p < 0.001 in PDR and r = 0.646 at p < 0.001 in NPDR]. Serum and vitreous VEGF concentrations in diabetics were statistically significant higher than control group [p<0.01]. Both increased with the progression of retinopathy. Very mild NPDR patients had the lowest vitreous concentration [mean = 20.33 ng / ml] but still higher than controls [mean = 4.53 ng / ml]. PDR patients with tractional detachment had the highest vitreous concentration [mean = 225.18 ng / ml]. VEGF concentrations were statistically significant higher in NPDR patients with maculopathy than NPDR patients without maculopathy. There is a strong direct positive correlation between VEGF concentrations and retinopathy grading

Relation of urinary prostaglandin E2 levels to uteroplacental blood flow and renal functions in preeclampsia

The objective of this study was to investigate the association between urinary prostaglandin E2 [PGE2] levels and uteroplacental blood flow and to test whether PGE2 contributes to the vasospasm and altered renal functions in pregnancies complicated by preeclampsia. Serum and urine samples of 63 pregnant women [29 preeclamptic and 34 normotensive] were investigated by means of PGE2 levels and urea, creatinine and creatinine clearance values. To all participants of the study, uteroplacental blood flow was assessed by uterine artery Doppler sonography flow patterns. Data from preeclamptic patients were compared with normotensive pregnancies as controls. Mean urinary PGE2 levels were significantly lower in preeclamptic patients than in normotensive women [2.67 +/- 0.65 vs. 4.35 +/- 0.89 pg/g creatinine, respectively, P < 0.001]. Preeclamptic patients had significantly higher serum urea and creatinine concentrations, and significantly lower creatinine clearance values compared to normal controls. Preeclamptic patients also showed significantly higher mean uterine artery resistance index [RI] values than controls. Correlation analysis revealed a significant inverse correlation between urinary PGE2 levels and uterine artery RI values [r = -0.84, P < 0.001]. Prostaglandin E2 [PGE2] is a relevant mediator of uteroplacental blood flow and its deficiency suggests a possible role in the vasospasm of preeclampsia. PGE2 deficiency is of relevance to preeclampsia by leading to reduced uteroplacental blood flow and altered renal functions