Visibility of Different Intraorbital Foreign Bodies Using Plain Radiography, Computed Tomography, Magnetic Resonance Imaging, and Cone-Beam Computed Tomography: An In Vitro Study.

PURPOSE: The study sought to compare the usefulness of 4 imaging modalities in visualizing various intraorbital foreign bodies (IOFBs) in different sizes. METHODS: Six different materials including metal, wood, plastic, stone, glass. and graphite were cut in cylindrical shapes in 4 sizes (dimensions: 0.5, 1, 2, and 3 mm) and placed intraorbitally in the extraocular space of fresh sheep's head. Four skilled radiologists rated the visibility of the objects individually using plain radiography, spiral computed tomography (CT), magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) in accordance with a previously described grading system. RESULTS: Excluding wood, all embedded foreign bodies were best visualized in CT and CBCT images with almost equal accuracies. Wood could only be detected using MRI, and then only when fragments were more than 2 mm in size. There were 3 false-positive MRI reports, suggesting air bubbles as wood IOFBs. CONCLUSIONS: Because of lower cost and using less radiation in comparison with conventional CT, CBCT can be used as the initial imaging technique in cases with suspected IOFBs. Optimal imaging technique for wood IOFBs is yet to be defined.

Hepatic Artery and Portal Vein Doppler Indexes in Non-alcoholic Fatty Liver Disease Before and After Treatment to Prevent Unnecessary Health Care Costs.

BACKGROUND: We tested whether hepatic haemodynamics assessed by Doppler ultrasonography can be a predictor of response to therapy in patients with non-alcoholic fatty liver disease (NAFLD) to prevent further unnecessary diagnostic tests and interventions. METHODS: Forty eight consecutive patients affected by NAFLD, who refered to some clinics in Tabriz, Iran between 2009 and 2011 were included in the study. Response to therapy was assessed by decrease in liver enzyme levels. Three liver Doppler parameters (hepatic artery resistance index [RI], hepatic artery pulsatility index [PI] and portal vein waveform [PVW]) were analysed in all subjects who showed a decrease in liver function tests results. Wilcoxon and paired student's t-test were used for analysis. RESULTS: Forty eight subjects with NAFLD were included in the study during 21 months, out of which 22 (39.1% male - mean age: 37.6 ± 8.3) responded to the treatment and formed the basis of this study. Mean hepatic artery RI increased significantly from 0.60 ± 0.07 to 0.83 ± 0.27before and after treatment, however, there was no significant differences between hepatic artery PI or PVW. CONCLUSIONS: Increase in hepatic artery RI assessed by Doppler ultrasound may provide information on improvement of NAFLD in patients during the course of therapy.

The predictive role of histopathological findings in renal insufficiency and complete remission in a sample of Iranian adults with primary focal segmental glomerulosclerosis.

BACKGROUND: Primary focal segmental glomerulosclerosis (FSGS) is defined by the presence of proteinuria, often in nephrotic range and pathologically by segmental scars (SS). The aim of this study is to identify the possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis. METHODS: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patients' identities or outcomes. Patients were divided based on their histopathological findings and outcomes were compared among these groups. RESULTS: There were significant differences in the complete remission rate in subjects with and without mesangial hypercellularity (p < 0.05), and in patients with and without hyalinosis (p < 0.05). According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p < 0.05). Also multiple logistic regression analysis strongly suggests the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively. CONCLUSIONS: In the studied patients, presence of mesangial hypercellularity and hyalinosis has been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only mesangial hypercellularity and global scar were found to act as independent prognostic predictors of lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.

Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis.

To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS), we reviewed in a cross sectional study the pathological findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glomerular filtration rate (GFR), serum albumin, and the level of proteinuria. The mean level of serum creatinine was significantly higher in the biopsies' findings of synechiae (adhesions) in the Bowman's capsule, interstitial fibrosis, and global scars (P< 0.05), and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05). Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04), and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02). All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48%) of the group without renal insufficiency (P< 0.05). There was no significant difference between patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman's capsule in their biopsies.

Evaluation of iron status by serum ferritin level in Iranian carriers of beta thalassemia minor.

BACKGROUND: Conflicting data exists on iron metabolism in adults with beta thalassemia minor (BTM). The purpose of this study was to evaluate the serum ferritin (SF) levels in Iranian adults with BTM in order to determine the iron status in these subjects. METHODS: Eighty four (41 males, 43 females) Iranian adults with BTM and 102 (55 males, 47 females) healthy subjects as a control group were enrolled in the study. SF level was measured by immunoradiometric assay (IRMA). RESULTS: The mean SF concentration in the BTM group was 101.84+/-8.5 microg/L, which was higher than the mean SF in non-BTM subjects (67.98+/-5.4 microg/L, p=0.001). Comparing SF concentrations between BTM males and males in the control group showed that the SF level was significantly higher in BTM males (150.57+/-75.13 microg/L vs. 96.66+/-56.79 microg/L, p<0.001). Similar data was found for females (55.38+/-47.94 microg/L in the BTM group vs. 34.42+/-25.72 microg/L in the non-BTM group, p=0.01). CONCLUSION: This study showed that BTM may play a role in improving iron status in females with BTM. However in males, BTM can lead to iron overload. Therefore, we suggest determining the levels of SF in subjects with BTM, especially in males, to avoid harmful effects of iron overload in early stages of the disorder.