ABSTRACT
Pseudoaneurysm formation is a rare but potentially dev approximately astating complication of pancreatitis. It can be diag approximately nosed by using various imaging modalities including computer tomography, ultrasound, and angiography and should be entertained in any patient with a history of pancreatitis. We present the imaging findings in three patients with pseudoaneurysm formation secondary to pancreatitis who initially presented with gastrointestinal bleeding.
Subject(s)
Aneurysm, False/etiology , Gastrointestinal Hemorrhage/etiology , Pancreatitis/complications , Splenic Artery , Acute Disease , Aged , Aneurysm, False/diagnosis , Aneurysm, False/surgery , Angiography , Duodenal Ulcer/diagnosis , Duodenal Ulcer/etiology , Duodenum/blood supply , Fatal Outcome , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Humans , Male , Middle Aged , Pancreas/blood supply , Pancreatitis/diagnostic imaging , Splenectomy , Tomography, X-Ray Computed , Ultrasonography, Doppler, ColorABSTRACT
A patient with Menkes' kinky-hair disease was treated from an early age with copper histidinate. This patient did not display the progressive mental deterioration and early death typical of patients with Menkes' disease; on the contrary, his intellectual capabilities were above average for his age. The magnetic resonance imaging findings were unique, showing some tortuosity and elongation of the arteries but no evidence of cerebral atrophy, demyelination or subdural hygromas.
Subject(s)
Histidine/therapeutic use , Menkes Kinky Hair Syndrome/diagnostic imaging , Menkes Kinky Hair Syndrome/drug therapy , Organometallic Compounds/therapeutic use , Brain/diagnostic imaging , Brain/pathology , Child , Follow-Up Studies , Humans , Infant, Newborn , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Male , Menkes Kinky Hair Syndrome/pathology , Tomography, X-Ray ComputedABSTRACT
Furosemide causes both diuretic and non-diuretic changes in renal function. We compared responses to intravenous furosemide 0.5 mg.kg-1 in 38 subjects (30 males, 8 females) aged 18 to 30 with those in 14 subjects (9 males, 5 females) aged 50 and over. There were no consistent differences attributable to gender. Older persons showed greater natriuresis (47 percent in males and 26 percent in females) but their increment in plasma renin activity was markedly reduced. The urinary excretion of thromboxane B2 was elevated in older subjects (58 +/- 10 vs. 30 +/- 4 ng/4 h, p less than 0.05 for males; 48 +/- 7 vs. 29 +/- 4 ng/4 hr, p less than 0.05 for females) while that of 6-keto prostaglandin F1 alpha was not different. While differences in the diuretic response to furosemide may be due to pharmacokinetic differences, the non-diuretic response differences may reflect age related changes in renal prostaglandin synthesis.
Subject(s)
Aging/physiology , Furosemide/pharmacology , Adolescent , Adult , Aged , Aged, 80 and over , Blood Pressure/drug effects , Body Weight , Diuresis/drug effects , Female , Heart Rate/drug effects , Humans , Injections, Intravenous , Kidney/metabolism , Male , Middle Aged , Prostaglandins/biosynthesis , Prostaglandins/metabolism , Renin/blood , Thromboxane B2/bloodABSTRACT
It has been suggested that the nonsteroidal anti-inflammatory drug, sulindac, selectively spares renal prostaglandin synthesis. We compared the effect of placebo and sulindac 300 mg daily for one week on furosemide-stimulated renal prostaglandin synthesis in twelve healthy young men. Sulindac reduced serum thromboxane B2, a measure of platelet thromboxane A2 production, from 21 +/- 3.9 to 10.9 +/- 2.2 ng/ml (p less than 0.01) but had no effect on body weight, blood pressure or serum creatinine. Sulindac did, however, decrease the natriuretic effect of intravenous furosemide, and reduced the increment in plasma renin activity. The excretion rates of 6-keto-prostaglandin F1 alpha and thromboxane B2 in urine were reduced by 34 and 27% respectively (p less than 0.001 for both). The reduced excretion rate was particularly prominent in the first ten minutes after furosemide injection. While these decreases are less marked than those seen with indomethacin, the reduction in platelet thromboxane A2 production is also of lesser degree. We conclude that, in the dose used, sulindac is a less potent inhibitor of cyclo-oxygenase than indomethacin and has no selective renal sparing effect.
