ABSTRACT
Background: Trans-catheter renal arterial embolization [RAE] has emerged as a possible alternative to surgery in the management of iatrogenic renal arterial injuries. Objective: To discuss the role of renal arterial embolization in patients with iatrogenically-induced renal arterial injuries
Methodology: All cases were done at the Interventional Radiology Unit, Ain Shams University Hospital
Results: Technical and Clinical success rates of the RAE reached 90% for each, with post procedural complications that only amounted up to 30%, half of which was the post embolization syndrome that presents as fever, leukocytosis and pain and is treated conservatively
Conclusion: Renal artery embolization has proven to be a safe, minimally invasive option in the treatment of iatrogenic renal arterial injuries achieving high technical and clinical success rates
ABSTRACT
Aim of the work: this study aimed to assess the role of ECG gated multidetector computed tomography in detection and characterization of congenital heart diseases
Patients and method: this study was carried out in the Radiology Department of Ain Shams University Hospitals. A total of 30 patients presented with clinically/echocardiographically known to have congenital heart disease. They were 17[56.7%] females and 13 [43.3%] males. Their age was ranged from 3 days -18 year old
Results: Regarding the cardiac abnormalities, we found good agreement between Echo and ECG gated MDCT as regard cardiac abnormalities with kappa value measuring 0.771. Regarding great vessels anomalies, we found overall good agreement between Echo and MDCT where k measuring 0.790. As regard extracardiac findings, lung changes that were seen in MDCT only in form of lung consolidation in three cases [10%] and one case of unilateral lung hypoplasia [3.3 %]
Conclusion: ECG gated MDCT is considered as an essential non-invasive diagnostic tool for the evaluation of congenital cardiac and extra cardiac great vessels. MDCT is complementary to the cardiac echocardiography especially in complex heart abnormalities
ABSTRACT
Chronic allograft nephropathy [CAN] is a devasting long-term complication of kidney transplantation that is responsible for a significant proportion of graft loss. Activin A, a member of the transforming growth factor-beta [TGF- beta] superfamily of proteins, has a pro-fibrotic activity. The biologic effects of activin A are countered by follistatin, which is a high affinity extracellular binding protein for activin A. To study serum activin A and follistatin levels in the post-renal transplant patients and their correlation to renal hemodynamics, graft function and survival. The study included 20 post-renal transplant patients [Group I] and 20 age and sex matched healthy subjects [Group II] as controls. Serum activin A and serum follistatin were measured by enzyme linked immunosorbent assay [ELISA]. Serum C-reactive protein [S.CRP] was measured by turbidimetry. Serum and urinary alkaline phosphatase [S.ALP, U.ALP] were measured by spectrophotometry. Renal henwdynamics were evaluated by duplex Doppler ultrasonography; resistive and pulsatility indices [RI, PI] were calculated. Ten patients were categorized as chronic allograft nephropathy [CAN; group Ia]. The other ten patients had a stable renal function [non-CAN; group Ib]. There was a statistically significant increase in serum activin A [S.activin A], S.ALP, S.CRP, RI and PI and a statistically significant decrease in U.ALP and follistarin/activin ratio in patients with CAN than healthy controls, versus a statistically significant difference only in S. activin A and follistatin/activin ratio between non-CAN and controls. There was no statistically significant differences in S. follistatin between the studied groups. In post-renal transplant patients, S.activin A showed a statistically significant positive correlation with S. creatinine, S.CRP, RI and PI versus a statistically significant negative correlation with creatinine clearance, U.ALP and follistatin/Activin ratio. U.ALP showed a statistically significant positive correlation with creatinine clearance versus a statistically significant negative correlation with S. creatinine, S. activin A, S.CRP, RI and PI. Enhanced activin A activity together with normal follistatin level and the decrease in follistatin/activin ratio in post-renal transplant patients, showed that there is a dysregulation of activin-follistatin axis with the increase of the unbound biologically active activin A with deterioration of renal function. Also, there is an increased activity of ongoing inflammation accompanied by impaired renal function among renal allograft recipients that led to enhanced renal fibrosis and a degree of tubular dysfunction