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Biomedical subjects

R Aigner

Publications and source records attributed to R Aigner.

At least 19 recordsLinked to original sources
PubMed2001

Vitamin E kinetics in smokers and nonsmokers.

Does cigarette smoking increase vitamin E utilization in vivo? A trial was carried out in 6 smokers and 5 nonsmokers of comparable ages and serum lipids. Subjects consumed 75 mg each d(3)-RRR and d(6)-all rac-alpha-tocopheryl acetates (natural and synthetic vitamin E, respectively) daily for 7 d with a standardized breakfast. Fasting blood samples were drawn on days -7, -6, -5, -4, -3, -2, -1, 0, 1, 2, 3, 4, 5, 6, 7, 9, 14, 21 (negative days indicate supplementation). In both groups, plasma d(3)-alpha-tocopherol concentrations were approximately double of d(6)-alpha-tocopherol. At day 0, the %d(3) alpha-tocopherols (d(3)-alpha-tocopherol/total-alpha-tocopherol x 100) were similar in both smokers and nonsmokers. Subsequently, there was a trend toward a faster exponential disappearance of the plasma %d(3) alpha-tocopherol in smokers compared with nonsmokers (0.30 +/- 0.04 compared with 0.24 +/- 0.05, p =.0565). The calculated %d(3) half-lives were 55.6 +/- 7.4 h in smokers and 72.1 +/- 17.3 h in nonsmokers (p =.0630). By day 21, the %d(3) in smokers had decreased to 1.4% +/- 0.3% while it was 2.2% +/- 0.7% (p =.0418) in the nonsmokers. These data suggest that smoking increases plasma vitamin E disappearance, but further studies are needed to confirm this finding and to assess its cause.

Adult↗
PubMed2001

Amplitude coded-colour Doppler sonography in paediatric renal disease.

The aim of our study was to assess the ability of amplitude coded-colour Doppler sonography (ACDS) to depict altered perfusion in paediatric renal disease in a prospective study. Colour Doppler sonography (CDS) and ACDS examinations were performed in 180 renal units (90 patients; age range newborn to 16 years) with unilateral or bilateral renal disease (e.g. reflux nephropathy, renal scars, end-stage renal disease, ureteropelvic junction obstruction, urinary tract infection, renal failure, haemolytic uraemic syndrome, nephrotic syndrome, systemic lupus erythematosus (LE), renal biopsy, congenital dysplasia, tumour/infiltration). The ACDS results were compared with scintigraphy or CT as well as to clinical findings. Amplitude colour-coded Doppler sonography accurately demonstrated normal vasculature in 49 of 51 healthy kidneys (= 96%); 3 healthy kidneys could not be evaluated due to motion/artefacts. In 39 of 43 kidneys with focally altered perfusion ACDS could be performed and correctly depicted focally impaired vasculature/perfusion in 35 kidneys (= 89.7%). Seventy-three of 83 kidneys with diffusely impaired perfusion could be evaluated by ACDS and altered pattern was correctly depicted in 58 kidneys (= 79.4%), with an overall percentage of agreement of 87.1%. Amplitude CDS appears to be useful in infants and children. Compared with CDS it improves visualisation of especially focally impaired vasculature/perfusion and should be considered a valuable adjunct to conventional investigations.

Adolescent↗
PubMed2001

Subcutaneous adipose tissue layers as a stable correlate of leptin in response to short term energy restriction in obese girls.

AIMS: We studied the relationship of subcutaneous adipose tissue layers (SAT-layers) measured at 15 specified body sites with leptin before and after a weight loss program for three weeks. SUBJECTS AND METHODS: In 70 obese girls, SAT-layers were measured by means of the optical device, lipometer. Fat mass (FM) was estimated by means of bioelectrical impedance. RESULTS: At the beginning of the study, all estimates of adiposity, insulin, and SAT-layers from the upper body (from 1-neck to 6-lateral chest) were correlated to leptin at a P-value of<0.0001. Percentage FM together with SAT-layer 4-upper back and insulin explained 75% of the variation in leptin (P<0.0001). After three weeks, estimates of adiposity and leptin were reduced (all P<0.0001). Most SAT-layers were reduced, but SAT-layers 8-lower abdomen and 9-lower back were significantly increased. Changes in leptin were best explained by initial leptin, but percentage change (Delta) in insulin, Delta SAT-layer 1-neck, and Delta SAT-layer 3-biceps contributed to the Delta leptin (adj. r(2)=0.47, P<0.0001). In the weight-reduced state, circulating leptin was best explained by three SAT-layers and insulin (adj. r(2)=0.67, P<0.0001). DISCUSSION: The results suggest that Delta changes in leptin are attributable to changes in the endocrine state and subcutaneous fat, and SAT-layers may serve as a stable correlate of leptin in the weight-reduced state.

Adipose Tissue↗
PubMed2001

Changes in serum interleukin-6 concentrations in obese children and adolescents during a weight reduction program.

OBJECTIVE: To investigate the effect of short term energy restriction combined with physical activity on serum concentrations of Interleukin-6 (IL-6) in obese children and adolescents. DESIGN: Longitudinal intervention study of 3.8-5 MJ daily with exercise. SUBJECTS: Forty-nine white obese children and adolescents (31 girls, age 11.9+/-1.8 y; 18 boys, age 11.6+/-1.7 y). MEASUREMENTS: Indexes of obesity, IL-6, leptin, estradiol, systolic and diastolic blood pressure, heart rate at baseline and after 3 weeks. RESULTS: All determined parameters decreased significantly during the 3 week program (IL-6: 3.9+/-4.7 vs 2.0+/-2.2 pg/ml; P<0.05). Body mass index (BMI) fat mass, percentage fat mass (indexes of obesity), and leptin were not related to IL-6 before the program. In contrast, IL-6 concentrations correlated significantly with indexes of obesity and leptin after weight loss. IL-6 concentrations did not correlate with estradiol, systolic and diastolic blood pressure, and heart rate. Changes in IL-6 concentrations correlated significantly with changes in BMI (r=0.25, P<0.05). CONCLUSION: An improved body composition induced by restriction of energy intake and increase in physical activity is associated with more favorable serum concentrations of IL-6 in obese children and adolescents.

Adolescent↗
PubMed2001

Interrelationship between estimates of adiposity and body fat distribution with metabolic and hemostatic parameters in obese children.

Adiposity in childhood is often associated with metabolic abnormalities and accompanied by a dysregulation of the coagulation and fibrinolytic systems. We studied the interrelationship of metabolic and hemostatic parameters and explored their relationship with measures of adiposity and fat distribution in obese children. In 34 obese boys (mean age, 11.7 years) and 57 obese girls (12.1 years), blood samples were determined for insulin, glucose, triglycerides, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and tissue-type plasminogen activator-antigen (tPA-Ag). Body composition was assessed by means of impedance. Waist (Wc) and hip circumference were measured. The thickness of subcutaneous adipose tissue-layers (SAT-layers) was measured at 15 different body sites (from 1-neck to 15-calf) by means of the optical device, Lipometer. Overall subcutaneous fatness (SAT) was calculated and SAT-distribution was estimated by means of factor analysis. Significant correlations were found between different measures of adiposity and Wc with metabolic parameters. Fibrinogen was mainly associated with upper body subcutaneous fatness (factor 1) in boys. In girls, hemostatic parameters were associated with nearly all measures of adiposity and also with factor 1 and SAT. Regression analysis showed that factor 1 together with PAI-1 (both P <.0001) contribute to fibrinogen (adjusted [adj], R(2) =.30). PAI-1 together with trigylcerides (both P <.0001) and age (P <.04) were main determinants for tPA-Ag (adj, R(2) =.41). tPA-Ag (P <.0001) together with glucose (P <.001, negative slope), fibrinogen (P <.001, negative slope), and percentage fat mass (%FM) (P <.01) contributed to PAI-1 (adj, R(2) =.54). These results favor the concept of an interrelationship between metabolic and hemostatic parameters resulting from increased adiposity, perhaps influenced by pubertal development of children. Although upper body subcutaneous fatness was found to be a main correlate of metabolic and hemostatic parameters, it remains to be investigated whether this type of subcutaneous fat distribution is involved in the expression of metabolic and hemostatic risk factors and participates in the dysregulation of the hemostatic system in the state of childhood obesity.

Adipose Tissue↗
PubMed2001

Determinants of homocysteine during weight reduction in obese children and adolescents.

Plasma homocysteine levels have been shown to be associated with indexes of obesity and insulin resistance in obese children and adolescents. We, therefore, investigated the contribution of changes in body composition, markers of insulin resistance, folate, and vitamin B(12) to changes in homocysteine during a weight reduction program in obese children and adolescents. Thirty-seven obese white girls (mean SD; age, 12 +/- 1.8 years, body mass index [BMI], 26.9 +/- 5.25) and 19 obese white boys (age, 11.9 +/- 1.7 years; BMI, 26.2 +/- 5.2) were investigated for body composition, fasting total plasma homocysteine (tHcy), insulin, C-peptide, folate, and vitamin B(12) before and after a 3-week weight reduction program including physical activities. During weight reduction BMI, fat mass (FM), percentage fat mass, insulin, and C-peptide decreased significantly, whereas homocysteine and vitamin B(12) showed a significant increase. Folate and lean body mass (LBM) remained unchanged. tHcy concentration before weight reduction was a function of age, folate, and C-peptide, whereas tHcy concentration after weight reduction was a function of folate and baseline LBM. Changes in tHcy during weight reduction correlated significantly with baseline LBM and were related inversely to changes in LBM during weight reduction. Children who increased LBM showed lower increases in tHcy compared with children who lost LBM. In multiple linear regression analysis, only baseline LBM contributed independently and significantly to changes in tHcy. Our study suggests that LBM has a significant impact on tHcy metabolism during weight reduction.

Adolescent↗
PubMed2001

The effects of changes in body mass and subcutaneous fat on the improvement in metabolic risk factors in obese children after short-term weight loss.

The pattern of subcutaneous fat (SAT) is related to metabolic risk factors in obese children. Because weight loss improves the risk-factor profile, we sought to determine whether changes in SAT or SAT-pattern contribute to the improvement in the risk-factor profile after 3 weeks of a low-calorie diet and physical activities. In 22 obese boys (mean age, 11.9 years) and 40 obese girls (mean age, 12 years), fat mass (by means of impedance) and fat distribution (waist and hip circumference) were assessed. The thickness of 15 different subcutaneous adipose tissue layers (SAT-layers) was measured using a Lipometer (Moeller Messtechnik, Graz, Austria). SAT and SAT-pattern (arm-SAT, trunk-SAT, leg-SAT) were calculated. Blood samples were taken for the determination of insulin, glucose, triglycerides, and cholesterol. After 3 weeks, fat mass, waist and hip circumference, SAT, arm-SAT, trunk-SAT (all P <.0001), and leg-SAT (P <.01) were reduced. Besides glucose, metabolic parameters were lowered (all P <.001) but changes in metabolic parameter were interrelated in boys and girls. Age- and sex-adjusted regression revealed that changes in body mass contributed to the variability in changes of insulin (adjusted R(2) =.15, P =.0015). For the change in triglycerides, changes in cholesterol together with subtle alterations in glucose and changes in leg-SAT were found to be the main determinants (adjusted R(2) =.587, P <.0001). The results indicate that the change in the atherogenic and metabolic risk factor profile is largely independent from the concomitant loss in SAT. The reduction in body mass explained only a small part of the variability in changes of insulin, but leg-SAT might participate in the lowering of triglycerides, especially in boys. The contribution of SAT-pattern to the risk factor profile is an issue that needs further investigation.

Adipose Tissue↗
PubMed2001

Effects of weight loss on leptin, sex hormones, and measures of adiposity in obese children.

Adipose tissue influences steroid conversion by paracrine and autocrine mechanisms. Leptin is secreted by adipocytes and influenced by sex hormones and adiposity. Short-term weight loss in the treatment of childhood obesity reduces leptin and adipose tissue. We therefore asked, Do alterations in sex hormones occur owing to weight loss? and can these alterations be explained by changes in fat mass or sc fat and are alterations in sex hormones directly related to the fall in leptin? Twenty obese boys and 40 obese girls were studied before and after 3 wk of low-calorie diet and physical activity. The weight loss program significantly lowered fat mass, abdominal fat distribution, sc fat (all p < 0.0001), leptin, insulin, and estradiol (all p < 0.0001) but not testosterone. Changes in leptin were related to changes in body mass and to changes in fat mass in boys. In girls, changes in leptin were related to changes in sc fatness and also to changes in insulin. In boys, the reduction in sc fat was positively correlated to changes in testosterone (r = 0.54; p < 0.01) and inversely related to the fall in estradiol (r = -0.41; p < 0.05). In girls, changes in testosterone (r = 0.33; p < 0.05) and in estradiol (r = 0.40; p < 0.01) were related to changes in insulin. Stepwise regression showed that initial leptin was the best determinant for the fall in leptin (adjusted R2 = 0.87; p < 0.0001). The results show that alterations in sex hormones are related to changes in certain fat depots in boys whereas in girls changes in insulin might participate in changes in sex hormones. A greater fall in leptin owing to short-term weight loss is not associated with greater alterations in sex hormones and initial leptin is the best determinant to explain the variability in changes in leptin. The possibility of sex differences in changes in sex hormones secondary to the reduction in fatness warrants further study.

Adipose Tissue↗
PubMed2001

The influence of weight loss on fibrinolytic and metabolic parameters in obese children and adolescents.

We studied i) whether short-term weight loss alters plasminogen activator inhibitor-1 antigen (PAI-1-Ag) and tissue-type plasminogen activator antigen (tPA-Ag) in obese children, and ii) whether changes in body composition and/or abdominal adiposity are responsible for changes in PAI-1 and tPA-Ag. 20 obese boys (mean age 11.9 yr) and 40 obese girls (mean age 12 yr) were studied before and after three weeks of low-caloric diet and physical activity. Body composition was assessed by means of bioelectrical impedance, and the waist-to-hip ratio (WHR) was measured. Blood samples were determined for insulin, glucose, triglycerides, PAI-1-Ag, tPA-Ag, and the fasting insulin resistance index (FIRI) was calculated. Boys had a greater WHR, higher levels of glucose, and a slightly greater FIRI than girls. Estimates of adiposity, insulin, and triglycerides were correlated with PAI-1 and tPA-Ag. WHR was significantly correlated with fibrinolytic parameters only in girls. Insulin and tPA-Ag contributed to PAI-1 (adj. R2 = 0.36, p <0.0001), whereas percentage fat mass and triglycerides contributed to tPA-Ag (adj. R2 = 0.469, p <0.0001). The weight loss program significantly reduced adiposity, abdominal adiposity, and lowered fibrinolytic and metabolic parameters. Initial levels of PAI-1 and changes in body mass contributed to the fall in PAI-1 (adj. R2 = 0.18, p = 0.0016) and initial levels of tPA-Ag contributed significantly to changes in tPA-Ag (adj. R2 = 0.57, p <0.0001). The results suggest that changes in fibrinolytic parameters are associated with the loss in body mass but can occur independently of a concomitant reduction in fatness. Although initial PAI-1 and tPA-Ag predict the changes of these fibrinolytic parameters, the results do not exclude the possibility that the improvement in metabolic state and changes in unmeasured parameters related to physical activity and low-caloric diet could have influenced our findings.

Abdomen↗
PubMed2000

Acute myelofibrosis: multifocal bone marrow infiltration detected by scintigraphy and magnetic resonance imaging.

Acute myelofibrosis is a rare, malignant hematological disorder of unknown etiology with an inevitably fatal outcome. Here we present the study of a 63-year-old Caucasian man with acute onset of pancytopenia. Repeated bone marrow biopsies showed dense fibrosis and hypoplastic hematopoiesis raising various differential diagnoses of malignant and nonmalignant conditions. Bone marrow scintigraphy and magnetic resonance imaging (MRI) showed areas suggesting neoplastic infiltration, mainly in both femurs and tibias. Histological examination of a surgical biopsy of the left tibia revealed acute megakaryoblastic leukemia. As the patient refused polychemotherapy, therapy with interferon gamma was initiated but discontinued prematurely because of intolerable side effects. The presented case therefore suggests that the combination of bone marrow scintigraphy and MRI is a valuable diagnostic tool in patients presenting with myelofibrosis of unknown origin.

Acute Disease↗
PubMed1998

Mild chronic anemia following heart transplantation: a syndrome with prognostic relevance?

The clinical relevance of mild chronic anemia in patients after heart transplantation (HTX) has not yet been demonstrated. Forty-five outpatients who had undergone HTX 2-99 months prior to investigation and who had not received blood transfusions or erythropoietin (EPO) before data acquisition were observed over a period of 37 months. Anemia was found in 36 of the 45 patients and was normocytic, normochromic, and slightly anisocytotic (coefficient of variation = 16 +/- 2, normal 11.5-14.5). Anemic patients showed elevated EPO levels, whereas in nonanemic patients EPO levels were normal. Survival after HTX differed significantly in anemic and nonanemic patients (P < 0.02), with 100% survival in the nonanemic and 85% in the anemic group. Chronic anemia in patients after HTX shows a typical pattern. Even when mild, anemia in patients after HTX seems to be of prognostic value and thus might be an indicator of chronic disorders.

Adolescent↗
PubMed1997

Comparison of hepaticoantrostomy and hepaticojejunostomy for biliary reconstruction after resection of a choledochal cyst.

Twelve infants operated upon for choledochal cyst (CC) are reviewed with emphasis on the operative technique of biliary tract reconstruction, incidence of cholangitis, postoperative hypergastrinemia, biliary excretion, and upper gastrointestinal (GI) motility in a follow-up of 24 to 35 months. In 7 patients biliary reconstruction was performed with a Roux-en-Y hepaticojejunostomy (HJ), and in 5 with a hepaticoantrostomy (HAST). In the HJ group 4 patients had recurrent episodes of cholangitis and intermittent diarrhea and serum gastrin levels were significantly elevated in 5. Hepatobiliary scintigraphy showed unobstructed excretion of labelled bile through bile ducts into the Roux-en-Y loop, but with significantly delayed emptying of bile into the distal jejunum in all patients. Gastric emptying and upper intestinal passage were normal. In the HAST group no episode of cholangitis occurred and serum gastrin levels were within the normal range. Scintigraphically, hepatobiliary excretion, and duodenojejunal passage of labelled bile was normal, except in 1 patient who developed a postoperative stenosis of the left hepatic duct. Upper GI contrast studies demonstrated normal gastric emptying without reflux into the biliary system. These results suggest that biliary reconstruction with HAST can be performed safely with a low incidence of complications HAST offers a more physiologic method of biliary reconstruction after resection of a CC that allows bile to drain directly into the duodenum.

Anastomosis, Roux-en-Y↗
PubMed1997

[Quantitative determination of left ventricular myocardial perfusion with electron beam computerized tomography].

Myocardial perfusion is one of the most important functional parameters of the heart. Presently various indirect methods are used to determine coronary blood flow or myocardial perfusion as inertgas-, thermodilution-, Doppler catheter- and radiopharmacological techniques. Electron-beam-computed-tomographical technology is able to perform CT data acquisition with a very short exposure time of 50 ms. Using this method it is not only possible to determine left ventricular volumes but also to measure myocardial perfusion in ml/100 g/min. The measurement of the left myocardial perfusion is performed using the short axis view. This position is obtained by moving the table 25 degrees to the patient's right and 15 degrees caudally. To determine the position of the left ventricle, a localization scan is obtained in multi-slice-mode using all for target-rings, thus obtaining 8 tomographic levels over 68 mm (each tomographic level having a slice thickness of 7 mm, with an interslice gap of 4 mm between each two adjacent tomographic levels). In this short axis position, using the multi slice flow mode with 3 target-rings and after administration of 50 ml of contrast medium intravenously with a flow of 3 ml/s, 6 tomographic levels are imaged. Each tomographic level is obtained 13 times at 80% of the R-R-interval at each 2 or 3 heart beat (ECG-gated). The left ventricular myocardial contrast enhancement is measured by drawing manually the outline of the left ventricular myocardium using time-density-software of the Imatron workstation. For calculation of the myocardial perfusion the so-called "slope method" is used and the results are expressed as the maximum slope of enhancement of the myocardium divided by the difference of the precontrast and peak CT-value in the left ventricle. The global myocardial perfusion is calculated as a mean of all evaluated tomographic levels. In this study left ventricular volumes as enddiastolic volume endsystolic volume and stroke volume were measured and ejection fraction and cardiac output calculated. The measurements were performed in the log axis view. This view is obtained by moving the table 15 degrees to the patients left in a horizontal position. In this long axis position 6 tomographic levels are imaged using the multi-slice-cine-mode with 3 target-rings after administration of 50 ml of contrast medium intravenously with a flow of 3 ml/s. Each tomographic level is obtained 13 times starting at 0% of the R-R-interval (ECG-triggering). The exposure time is 50 ms with an interscan time delay of 8 ms. In 9 studied patients of whom one had 3 significant coronary artery stenotic lesions (> 50%), 2 patients had each 2 non significant stenotic lesions (< 50%) and 6 revealed nearly normal coronary angiograms. The mean global myocardial perfusion was 70 ml/100 g/min (min.32 and max. 116 ml/100 g/min). This mean value of 70 ml/100 g/min is reflecting 5% of the cardiac output supposing that the mean heart weight of these patients was 300 g. In this study the mean of the left ventricular muscle mass determined by the use of EBCT was 130 g. A comparative evaluation of coronary angiographic findings in these patients with the measured myocardial perfusion values revealed, that is not sufficient to look only at the absolute values of the measured myocardial perfusion. Furthermore it seems to be necessary to interpret these perfusion values with respect to the calculated cardiac output. Additional studies of well defined patients groups are necessary to determine normal values of myocardial perfusion at rest in patients with and without coronary artery disease. This seems to be important as comparative analysis of myocardial scintigraphic and EBCT-studies is difficult because of methodical inherent differences. The results of this study suggest that despite the presence of some beam hardening artifacts it is possible to measure myocardial perfusion using EBCT in patients with suspected coronary artery disease in the

Aged↗
PubMed1997

The sonographically thickened wall of the upper urinary tract system: correlation with other imaging methods.

BACKGROUND: Sonographically detected, upper urinary tract wall thickening (UUTWT) was reported to occur in urinary tract infection, urinary tract stone disease, rejection after renal transplantation and vesico-ureteral reflux (VUR). A possible association with obstruction can be hypothesized. OBJECTIVE: The assessment of a potential relationship of UUTWT with VUR or obstruction in patients without one of the above-mentioned conditions. MATERIALS AND METHODS: We analyzed 38 patients (74 upper urinary tracts) with at least unilateral UUTWT and concomitant imaging studies such as voiding cystourethrography (VCU), intravenous urography (IVU) and diuretic renography (DR). RESULTS: At sonography 49 urinary tracts showed UUTWT. In 33, ipsilateral VUR could be demonstrated at VCU, 11 revealed obstruction at IVU and/or DR, and 4 showed non-obstructive pelvicalyceal dilatation at IVU and DR. In one patient, all imaging studies were normal. The positive predictive value of UUTWT for the presence of VUR was 67.4 % and for obstruction it was 22.5 %. Altogether, UUTWT indicated pathology in 98 % of urinary tracts. CONCLUSION: After exclusion of urinary tract infection, urinary stone disease and prior renal transplantation, the most common associated findings in UUTWT are VUR and obstruction. Therefore, VCU seems to be justified in all cases of UUTWT. Nonrefluxing systems should be further evaluated with DR and/or IVU for exclusion of obstruction.

Child↗
PubMed1997

[Corneal Langerhans cells. Behavior during storage in organ culture].

BACKGROUND: Corneal HLA-DR antigens are going to be lost during organ culture storage. This study investigated if this phenomenon is based on down-regulation of the HLA-DR antigen, or on a loss of the HLA-DR-positive corneal Langerhans cells (LCs). MATERIAL AND METHODS: Corneal LCs were stained in situ by the method of fluorescence-associated immunohistochemistry, and the organ culture mediums underwent flow cytometric analysis for HLA-DR-positive corneal LC at the end of the storage period. RESULTS: All stored corneas were negative for HLA-DR after 14 days and HLA-DR antigens could be detected in culture medium at the end of the storage time. CONCLUSION: Flow cytometry showed that organ culture storage leads to loss of HLA-DR-positive cells and not only to a loss of antigen presentation.

Antigen Presentation↗
PubMed1997

[Evaluation of renal vascularization using amplitude-coded Doppler ultrasound].

PURPOSE: To evaluate the benefit of "Colour Doppler Energy" (CDE) or "Power Doppler" applications in healthy kidneys and in renal disease including paediatric assessment. PATIENTS AND METHOD: Ten healthy volunteers (range: neonate to adults) were studied using conventional colour Doppler sonography (CDS) and CDE in order to evaluate the visibility of intrarenal vasculature. In addition, ten children and ten adults with known renal disease were evaluated. The findings were compared to clinical, scintigraphic and biopsy results. RESULTS: CDE showed far better visualisation of intrarenal vasculature than CDS. CDE demonstrated focal and diffuse reduced cortical perfusion with an overall accuracy of 95% and a sensitivity of 88%. In 7 healthy volunteers cortical vasculature was visualised throughout the kidney. In 3 infants incomplete visualisation was obtained because of motion artifacts. In the diseased kidneys, CDE findings correlated well with clinical findings, scintigraphy results and biopsy findings. CONCLUSION: CDE can be successfully applied to adults and infants demonstrating renal vasculature in healthy kidneys and in kidneys with focally or diffusely altered perfusion.

Adolescent↗
PubMed1996

Photoaccentuated erythroderma associated with CD4+ T lymphocytopenia: successful treatment with 5-methoxypsoralen and UVA, interferon alfa-2b, and extracorporeal photopheresis.

We describe a 53-year-old HIV-negative white man who had chronic CD4+ T lymphocytopenia and photoaccentuated erythroderma with lymphoma-like histologic changes. The erythroderma completely responded to 5-methoxypsoralen and UVA (PUVA), interferon alfa-2b, and extracorporeal photopheresis. During therapy opportunistic skin infections, including tinea corporis, warts, and disseminated molluscum contagiosum, developed. Although the patient met the current definition of idiopathic CD4+ T lymphocytopenia (ICTL), we cannot rule out the possibility that this peripheral CD4+ T lymphocytopenia resulted from sequestration of CD4+ T lymphocytes in erythrodermic skin.

5-Methoxypsoralen↗