Amyloidosis in a patient with autosomal dominant polycystic kidney disease and tuberculosis: a case report.

Autosomal-dominant polycystic kidney disease is an inherited disorder characterized by the development and growth of cysts in the kidneys. Urinary protein excretion is generally less than 1 g/day, and the association of the nephrotic syndrome with this condition is considered rare. A 39-year-old man with autosomal-dominant polycystic kidney disease and nephrotic-range proteiuria is described. During admission, he had general edema and a diagnosis of pulmonary tuberculosis. The patient had hyperlipidemia, hypoalbuminemia, and 11.8 g/day proteinuria. The gingiva and rectum biopsies were performed in order to evaluate the etiology of nephrotic syndrome, and revealed AA amyloidosis thought to be secondary to pulmonary tuberculosis. We maintained the antituberculous treatment and began colchicine at a dose of 2 g/day and candesartan 8 mg/day. To our knowledge, this is the first autosomal-dominant polycystic kidney disease case with nephrotic syndrome due to amyloidosis secondary to pulmonary tuberculosis.

Anatomic and morphometric study of the arcade of Frohse in cadavers.

The most superior part of the superficial layer of the supinator muscle is named as the arcade of Frohse (AF). The deep branch of the radial nerve runs under this arch. The AF is reported to be the most common structure causing entrapment neuropathy of the deep branch of the radial nerve. The aim of our study was to reveal the anatomical properties and especially morphometric measurements of the AF in cadavers. This study was performed on 55 cadaver upper extremities. The AF was classified macroscopically as either tendinous or membranous. The width, length and thickness of the AF were measured as the dimensions of the AF. The "distance AF" between the lateral epicondyle of the humerus and the AF was measured. The "forearm length" between the lateral epicondyle of the humerus and the styloid process of the radius was measured. The distance AF was divided by the forearm length to find the "ratio AF". In 87% of the extremities the AF was tendinous, and in 13% it was membranous. The mean width, length and thickness of the AF were 10.13, 8.60 and 0.77 mm, respectively. The mean distance AF and forearm length were 46.23 and 233.17 mm, respectively. The mean ratio AF was 0.199 (approximately 1/5). These measurements of the dimensions of the AF may contribute to the anatomy of the AF. The surgeon may find the predicted distance AF of any upper extremity by dividing its forearm length by 5.

Morphometric study of the nerves entering into the coracobrachialis muscle.

The nerves entering into the coracobrachialis muscle are the musculocutaneous nerve (MC) and the nerve (usually consists of several thin branches) branches to the coracobrachialis. These thin branches enter the coracobrachialis proximal to the MC. The thin branches and the MC are susceptible to injury during coracoid process transfer. The purpose of this study is (1) to reveal the number and origin of the thin branches and (2) especially to report the morphometric information about the two distances between the coracoid process and the points where the first thin branch and the MC enter the coracobrachialis. These distances were named as the "distance T1" and the "distance D," respectively. Forty-two cadaver upper extremities were used and the distance between the coracoid process and the medial epicondyle of the humerus as the "arm length" was measured. The "ratio T1" was calculated by dividing the distance T1 by the arm length. The "ratio D" was calculated by dividing the distance D by the arm length. The number of the thin branches varied between one and four. In the most common type, there were two thin branches (45%). All of the thin branches originated from the MC. The mean distance T1, distance D and arm length were found as 41.5, 62 and 304.5 mm, respectively. The mean ratio T1 and ratio D were determined as 0.13 (approximately 1/8) and 0.20 (=1/5), respectively. The findings about the number and origin of the thin branches may contribute to the anatomy of the nerve to the coracobrachialis. The shoulder surgeon may calculate the predicted distance T1 and distance D of any upper extremity, dividing its arm length by eight and five, respectively.