ABSTRACT
BACKGROUND AND OBJECTIVES: There is little information about the relationship between the Doppler flow of the ophthalmic artery (OA) and carotid and coronary atherosclerosis. The aim of the investigation was to assess the clinical usefulness of the Doppler flow of the OA to estimate the severity of carotid and coronary atherosclerosis. SUBJECTS AND METHODS: The study was a retrospective analysis of the findings in 140 patients (mean age: 60 years, male: 64%) who underwent coronary angiography (CA) for the evaluation of typical angina between July 2010 and October 2011 in our single center. The severity of coronary artery stenosis was based on the Gensini score (GS). Significant coronary artery disease (CAD) was defined as the obstruction of over 75% of the major coronary arteries confirmed with CA. The pulsed Doppler flow of the OA and carotid ultrasound were performed before CA. RESULTS: The mean systolic velocity/mean diastolic velocity (MSV/MDV), pulsatile index and resistance index in the Doppler flow of the OA were identified as significant and independent correlations with carotid intima-media thickness, and MSV/MDV was identified to have a significant and independent correlation with the GS. MSV/MDV >2.1 was the independent predictor for significant CAD {odds ratio (OR) 3.8, 95% confidence interval (CI) 1.5-9.7, p=0.005} and carotid plaque (OR 2.8, 95% CI 1.1-7.0, p=0.028), after adjustment for CAD-associated factors. CONCLUSION: The Doppler flow of the OA might be a useful predictor of the severity of carotid and coronary atherosclerosis.
Subject(s)
Humans , Male , Atherosclerosis , Carotid Arteries , Carotid Intima-Media Thickness , Coronary Angiography , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Ophthalmic Artery , Retrospective Studies , UltrasonographyABSTRACT
The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology and incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.
Subject(s)
Female , Humans , Empty Sella Syndrome , Hypercalcemia , Hyperparathyroidism , Incidence , Magnetic Resonance Imaging , Multiple Endocrine Neoplasia , Pancreatitis , Parathyroid Neoplasms , Pituitary Gland , Sella TurcicaABSTRACT
Behcet's disease (BD) is a rare multisystemic vasculitis characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Renal involvement in BD is more frequent than has been recognized. However, there have been a few reports of glomerulonephritis associated with BD in Korea. We report here a case of IgA nephropathy with nephrotic syndrome in a patient with BD. A 44-year-old woman with BD was admitted for generalized edema which had developed 1 month ago. Routine renal workup revealed heavy proteinuria and gross hematuria. Twenty-four hour urinary protein excretion was 9.8 g/day. Renal biopsy demonstrated IgA nephropathy. She was treated with oral prednisolone, colchicine and azathioprine. The edema and proteinuria gradually improved. Three months later, urine protein to creatinine ratio decreased to 1.8 and her renal function was well preserved.
Subject(s)
Adult , Female , Humans , Azathioprine , Biopsy , Colchicine , Creatinine , Edema , Glomerulonephritis , Glomerulonephritis, IGA , Hematuria , Immunoglobulin A , Immunoglobulins , Korea , Nephrotic Syndrome , Prednisolone , Proteinuria , Skin , Ulcer , Uveitis , VasculitisABSTRACT
Osteomyelitis (OM) of the clavicle is a rare complication of the central venous catheterization and has been reported infrequently in the literature. We report here a case of OM of the left clavicle complicating right subclavian vein catheterization performed for hemodialysis (HD). A 41-year-old male patient on HD for 3 months complained of pain and mass over the left sternoclavicular joint. Computerized tomography showed a demarcated soft tissue mass. Bone scan demonstrated increased tracer uptake in the left clavicle compatible with OM. The patient underwent surgical exploration with removal of the necrotic bone and he was treated with antibiotics including vancomycin. Afterward he remained well on HD. In conclusion, OM should be considered in any dialysis patient who develops pain and signs of inflammation in the sternoclavicular area after central venous catheterization for HD.