Is There a Significant Renal Sonographic Difference between HIV/AIDs Positives and Negatives? A Developing Country Perspective.

Background/Objectives: HIV/AIDS is a major health problem in the developing countries. It is a known cause of kidney failure especially in patients with HIV-Associated Nephropathy (HIVAN). Ultrasonography is a cheap and readily available imaging modality that is invaluable in evaluating the kidneys. Its value in pathological inference of HIV-associated renal diseases in developing countries is well known. Renal diseases in HIV/AIDS patients in developing countries are often underdiagnosed and often identified only at its end stage. In this study, we aim to identify, document and correlate the pre-intervention sonographic features of diseased kidneys of adult HIV/AIDS patients between the ages of 18 and 65 years. Methods: This study was conducted as a prospective & descriptive study to assess the sonographic features in kidneys of 219 HIV-seropositive adults aged between the ages of 18 and 65 years; matched (age & sex), with 219 controls. A 3.5-5.0 MHz curvilinear transducer on a mobile ‘ALOKA’ ultrasound machine was used in the study. Comparison of the findings between HIV-seropositive adults and the controls was done using the chi-square and student T-test analysis to determine any statistical significant difference. Results: Of 219 HIV+ patients studied, 149(68%) were females with an overall mean age of 38.36 years. The modal age group was the 30 – 39 years with a frequency of 94(42.9%). Observed significant features of HIVAN include nephromegaly, increased parenchymal echogenicity and decreased corticomedullary differentiation. Conclusion: The renal sonographic findings in HIV-seropositive research participants are similar to those from other studies within and outside Nigeria. Ultrasound can be a useful tool in the management and care of HIV/AIDS patients.

A Clinical analysis of sonographic and operation findings of peritoneal inclusion cyst / 대한산부인과학회지

OBJECTIVE: The aim of this study is to review 4 years' experience of peritoneal inclusion cysts at Kangnam St. Mary's Hospital. METHODS: A retrospective study of 50 cases of peritoneal inclusion cyst between April 1, 1999 and June 30, 2003 was carried out and then clinical feature, preoperative diagnostic findings, operative findings and recurrence were compared with previous reports. RESULTS: The mean age of patients was 40.2 years old and most of them were premenopausal. The majority (94%) of patients had history of laparotomy and most (70.2%) of them had history of total hysterectomy. The values of tumor makers such as CA125 and CA19-9 were normal in most of the patients. The peritoneal inclusion cysts usually generate on the left side of the pelvic cavity, size of them were often (59.6%) 5 to 10 cm and they usually (65.4%) have septum in ultrasonographic findings. They probably had pelvic adhesion or ovarian cyst with them in operative findings. Most of the recurrence occurred after only adhesiolysis was done. CONCLUSION: Because peritoneal inclusion cyst is benign and uncommon disease, its preoperative diagnosis rate was low. In our experience of 50 cases of peritoneal inclusion cyst, most of the patients have history of laparotomy and were premenopausal. When the ultrasonographic findings of cyst are 5 cm to 10 cm in size and have septum, they are likely to be peritoneal inclusion cyst. Their recurrence might be more common when adhesiolysis only was performed.

A case of Antenatally diagnosed Changing Sonographic Findings of a Twisted Fetal Ovarian Cyst / 대한산부인과학회지

Ovarian cysts are common incidental findings in term infants and, if unusually large, may result in dystocia, torsion, or rupture. We report the case in which serial sonographic examination revealed changing pattern of cystic ovarian mass from hypoechogenic to well defined multiseptated echogenic during pregnancy. Postnatal T2-weighted MR images revealed a multilocular with high signal density. After delivery a laparotomy was performed, and a twisted ovary measuring 6.7x5x4.5 cm was removed. Ovarian torsion was left-sided and had been almost autoamputated. The resected specimens were nontense, thin walled cysts, filled with hemorrhage like fluid. Histological examination demonstrated the presence of lymphangioma with widespread hemorrhage and necrosis. The neonate did well after the procedure.

Prenatal ultrasonographic findings of a case of multiple pterygium syndrome / 대한산부인과학회지

Multiple pterygium syndrome is an inherited condition characterized by joint pterygium and flexion contracture, in association with other abnormalities such as fetal hydrops, cystic hygroma, club foot, intrauterine growth retardation and hypoplastic lungs. It is usually inherited as an autosomal recessive trait, although X-linked recessive inheritance is also reported. The pathogenesis has been suggested to be early onset fetal akinesia, fragile collagen or generalized edema. Prenatal diagnosis of multiple pterygium syndrome is possible by demonstrating severe limb contractures, absence of fetal limb motion and progressive fetal edema in mid-pregnancy, but in case with a family history of this syndrome, ultrasound studies should be started in the first trimester. We have experienced a multiple pterygium syndrome with a history of recurrent fetal hydrops, so report on the prenatal sonographic findings of this case with brief review of literatures.