Skin tissue cholesterol is not related to vascular occlusive disease.

The objective of the present study was to evaluate the role of skin tissue cholesterol (SkinTc) in predicting the presence of atherosclerosis. SkinTc concentrations were determined in 318 consecutive patients by using the non-invasive PREVU POC Skin Sterol Test. Additionally, a complete lipid status and cardiovascular risk profile according to the PROCAM and Framingham scores as well as an evaluation by carotid duplex sonography and ankle-brachial blood pressure index testing was obtained from all patients. SkinTc concentrations did not differ significantly among patients suffering from cerebrovascular disease (CVD) and peripheral arterial disease (PAD) compared to the corresponding control groups and among patients with a calculated cardiovascular risk > 10% in 10 years compared to patients with a risk < 10% (all p > 0.05). Additionally, SkinTc concentrations were not significantly higher in the 245 patients with at least one documented atherosclerotic disease compared with the remaining 73 patients without evidence of atherosclerosis. In conclusion, SkinTc concentrations determined by the PREVU POC Skin SterolTest are not related to the presence of CVD and PAD or to an elevated cardiovascular risk, indicating that this parameter cannot be used as a reliable indicator of atherosclerosis.

Endurance running acutely raises plasma osteoprotegerin and lowers plasma receptor activator of nuclear factor kappa B ligand.

Abstract The balance of the 2 cytokines, osteoprotegerin (OPG) and the receptor activator of nuclear factor kappa B ligand (soluble (s)RANKL), is known to have considerable influence on bone formation and degradation. Plasma concentrations of OPG and (s)RANKL were determined in a total of 31 long-distance runners before and immediately after running distances of either 15 or 42.195 km, respectively. In both groups of endurance runners, a significant decrease of sRANKL was observed during the run, the extent of which correlated to the running distance. Furthermore, OPG increased only in runners covering the marathon distance of 42.195 km. We hypothesize that the known positive effect of long-distance running on the skeletal mass may be mediated by the OPG/sRANKL system.

Prospective comparison of 3-dimensional volume rendered computerized tomography and conventional renal arteriography for surgical planning in patients undergoing laparoscopic donor nephrectomy.

PURPOSE: We prospectively assessed the accuracy of 3-dimensional (3-D) volume rendered computerized tomography (CT) and conventional renal arteriography to visualize renovascular anatomy in patients undergoing laparoscopic donor nephrectomy. MATERIALS AND METHODS: A total of 60 consecutive patients undergoing laparoscopic donor nephrectomy (left side in 46 and right side in 14) prospectively underwent 3-D CT and renal angiography. A short videotape of 3-D CT was prepared using volume rendering software that demonstrated the anatomical location, number, anomalies and spatial interrelationships of the renal arteries and veins. These 3-D videotapes and arteriogram findings were directly correlated with intraoperative surgical findings at laparoscopy and during ex vivo bench preparation of the harvested kidney. The perceived intraoperative value of 3D-CT to delineate renovascular anatomical detail was scored subjectively by the laparoscopic surgeon for each case on a 10-point scale of 0--completely inaccurate to 10--completely accurate. RESULTS: There were no complications related to the 3-D CT protocol and volume rendering was successful in all patients. Three-D CT accurately identified the number of renal arteries in 59 patients (98%). In 1 patient with 3 renal arteries 3-D CT and arteriogram each identified only 2. In the 46 patients undergoing left donor nephrectomy 3-D CT accurately identified the number of veins and venous anomalies in 45 (98%), including 2 with a circumaortic left renal vein. Another case of circumaortic vein was misdiagnosed as 2 renal veins. On the right side in 14 patients 3-D CT accurately identified the renal veins in 13 (94%) and missed 1 vein in a patient with 2 renal veins. Angiography correctly identified the number of renal veins in only 52 cases (87%). Furthermore, it misdiagnosed all 3 cases of circumaortic left renal vein. The laparoscopic surgeon believed that 3-D CT accurately identified the location and anatomical interrelationship of the renal vessels with precision. Mean subjective score +/- SEM was 8.5 +/- 1 for the arterial system, 8.6 +/- 1.1 for the venous system and 9.2 +/- 0.5 for any vascular anomalies. CONCLUSIONS: Three-D CT accurately identifies renal vascular anatomy in a manner that may facilitate renal hilar dissection during laparoscopic donor nephrectomy, especially during the initial surgeon experience. This imaging modality integrates essential information from angiography, venography and excretory urography into a single study, and it can obviate the need for more invasive vascular imaging in most cases.

Enhancement characteristics of papillary renal neoplasms revealed on triphasic helical CT of the kidneys.

OBJECTIVE: The purpose of this study was to determine whether renal tumor enhancement or heterogeneity on triphasic helical CT scans is predictive of the papillary cell subtype or nuclear grade of renal cell carcinoma. MATERIALS AND METHODS: We reviewed the CT scans of 90 consecutive patients with renal masses who had undergone triphasic renal helical CT before a complete or partial nephrectomy (12 with papillary renal cell carcinomas, 66 with nonpapillary renal cell carcinomas, and 12 with benign lesions). Three radiologists who were unaware of the patients' diagnoses retrospectively and independently measured the attenuation of each patient's tumor, abdominal aorta, and normal renal parenchyma on the scans obtained during all three phases. Ratios of tumor-to-aorta enhancement and tumor-to-normal renal parenchyma enhancement were calculated for both of the phases performed after contrast material had been administered. Tumor heterogeneity was calculated as the difference between the highest and lowest attenuation values divided by the value of the enhancement of the aorta. Values were correlated with cell type and nuclear grade found at surgical pathology. RESULTS: Low tumor-to-aorta enhancement and low tumor-to-normal renal parenchyma enhancement ratios on the vascular phase scans significantly correlated (p < 0.001) with papillary renal cell type carcinoma. Homogeneity and tumor-to-parenchyma enhancement ratios on the parenchymal phase scans also significantly correlated (p < 0.001) with papillary renal cell type carcinoma. Heterogeneity and tumor enhancement ratios did not correlate with the nuclear grade of the carcinoma. CONCLUSION: Papillary renal cell carcinomas are typically hypovascular and homogeneous. A high tumor-to-parenchyma enhancement ratio (> or = 25%) essentially excludes the possibility of a tumor being papillary renal cell carcinoma. A low tumor-to-aorta enhancement ratio or tumor-to-normal renal parenchyma enhancement ratio is more likely to indicate papillary renal cell carcinoma.