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Isabella Guzzo, Federica Morolli, Francesca Diomedi Camassei, Antonina Piazza, Elvira Poggi, Luca Dello Strologo
BACKGROUND: Several cases of severe antibody-mediated rejection (AMR) secondary to antibodies against the angiotensin II type 1 receptor (AT1R-Ab) have been described with variable outcome. CASE-DIAGNOSIS/TREATMENT: We report the case of a 13-year-old boy whose first kidney transplant failed due to steroid-resistant acute cellular rejection, with the subsequent development of sensitization. He received a second kidney transplant which was complicated by early humoral rejection, with weakly positive staining for the complement degradation product C4d...
October 17, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Katsuhiro Mizutani, Takenori Akiyama, Masahiro Toda, Tokunori Kanazawa, Dai Kamamoto, Kazunari Yoshida
BACKGROUND: The endoscopic transclival approach is a method for reaching the anterior side of the brainstem. In making this approach, bleeding from the basilar plexus is often observed when cutting the dura overlying the clivus; controlling such bleeding is essential. CASE DESCRIPTION: We performed a transvenous embolization of the basilar plexus before making the transclival approach. After embolization, bleeding from the basilar plexus during the operation decreased considerably...
October 14, 2016: World Neurosurgery
Agnes Trautmann, Derek J Roebuck, Clare A McLaren, Eileen Brennan, Stephen D Marks, Kjell Tullus
OBJECTIVES: Renovascular disease (RVD) is found in about 10 % of secondary childhood hypertension. Digital subtraction angiography (DSA) is the gold standard to diagnose RVD. Non-invasive imaging methods like Doppler ultrasound (US), magnetic resonance angiography (MRA), and computed tomography angiography (CTA) are increasingly used. Our aim was to evaluate the role and accuracy of US, MRA, and CTA compared to DSA in diagnosing RVD in children. PATIENTS AND METHODS: A retrospective review of 127 children with suspected renovascular hypertension was performed in children referred to Great Ormond Street Hospital between 2006 and 2014 due to clinical suspicion of renovascular hypertension and/or findings on US and/or MRA or CTA...
October 17, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Toshinari Kawasaki, Kazumichi Yoshida, Takayuki Kikuchi, Akira Ishii, Yasushi Takagi, Susumu Miyamoto
BACKGROUND: Concerning traumatic aneurysms, those of the superficial temporal artery (STA) have been frequently reported in the literature, whereas those of the occipital artery (OA) are extremely rare. CASE DESCRIPTION: A 30-year-old man had been followed at another hospital for meningoencephalocele associated with his congenital occipital bone defect. He was admitted to our hospital with a chief complaint of neck swelling and pain during a football game. CT and MRI showed a hematoma in his right neck along with the meningoencephalocele...
October 11, 2016: World Neurosurgery
Chun Yang, Ceng Li, Mengsu Zeng, Xin Lu, Jingjing Li, Jiali Wang, Muhammad Umair Sami, Kai Xu
Non-CE MRA techniques (true steady-state free-precession, SSFP) have been used effectively for the selective visualization of the portal venous system and inferior vena cava. Budd-Chiari Syndrome (BCS) encompasses a number of conditions that cause the obstruction of the hepatic outflow tract from the small hepatic veins to the junction of the inferior vena cava (IVC) and right atrium. The purpose of this study was to diagnose BCS with IVC obstruction using respiratory triggered three-dimensional (3D) true SSFP with T-SLIP and compare to digital subtraction angiography (DSA)...
October 11, 2016: Magnetic Resonance Imaging
Jeffrey Ma, Anita Patel, Kathryn Tinckam
This review paper discusses the impact of de novo donor-specific antibodies (DSA) to donor HLA antigens in kidney transplantation and summarizes the benefits and challenges that exist with DSA monitoring. Post-transplant DSA is associated with worse allograft outcomes and its detection may precede or coincide with clinical, biochemical, and histologic allograft dysfunction. There are no absolute features of DSA testing results that perfectly discriminate between states of disease and health. In a state of antibody-associated graft dysfunction, removal or reduction in DSA may only provide clinical benefit for some...
September 2016: Advances in Chronic Kidney Disease
M Pereira, J Guerra, J Gonçalves, A Santana, C Nascimento, A G da Costa
Hyperacute rejection (HAR) is a rare event that can be prevented by crossmatch tests that detect anti-human leukocyte antigen antibodies against the donor. We present the case of a 43-year-old man who underwent a deceased-donor kidney transplantation with a negative complement-dependent cytotoxicity and a negative flow cytometry crossmatch. Luminex technology detected anti-DQ donor-specific antibodies (DSA) with a mean fluorescence intensity of 11,000. A single plasmapheresis session was carried out, followed by immunosuppression with immunoglobulin, antithymocyte globulin, tacrolimus, and methylprednisolone...
September 2016: Transplantation Proceedings
Eduardo Murias Quintana, Pedro Vega Valdés, Edison Morales Deza, Alberto Gil Garcia, Hugo Cuellar Saenz, Alba L Salgado Bernal, María Cadenas Rodríguez, Lorena Benavente Fernández, Montserrat González Delgado, Nuria Riesco Pérez, Davinia Larrosa Campo, Sergio Calleja Puerta
OBJECTIVE: The purpose of this study is to demonstrate our experience in endovascular reconstruction of carotid dissections using the Wingspan Stent System™ (Boston Scientific, Natick, MA, USA), a device we use because of its high radial force and its navigation in extreme curves. METHODS: We treated 11 consecutive patients with acute ischemic stroke due to carotid dissection with the Wingspan stent, in the cervical carotid artery. RESULTS: Functional evaluation revealed that 10 of the 11 patients were independent at 3 months post surgery and that the 11 stents used were found to be patent at the 6-month follow-up digital subtraction angiography (DSA)...
October 13, 2016: Interventional Neuroradiology
P García, M Huerfano, M Rodríguez, A Caicedo, F Berrío, C Gonzalez
BACKGROUND: Renal transplantation is the best treatment for end stage renal disease. Acute graft rejection is one of the main complications and may influence graft survival. OBJECTIVE: To determine the incidence and features of acute cellular rejection (ACR) episodes confirmed by biopsy. METHODS: We studied a cohort of 175 patients who underwent renal transplantation between 2004 and 2012 to determine the cumulative incidence of ACR confirmed by biopsy and to identify the associated risk factors using multivariate analysis...
2016: International Journal of Organ Transplantation Medicine
Jorge Malheiro, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Idalina Beirão, António Castro-Henriques, António Cabrita
Detrimental impact of preformed donor-specific antibodies (DSA) against human leukocyte antigens on outcomes after kidney transplantation remains controversial. We aimed to study DSA characteristics (strength and C1q-binding) that might distinguish harmful DSA from clinically irrelevant ones. We retrospectively studied 60 kidney-transplanted patients with preformed DSA detected by single antigen beads (SAB) assays (IgG and C1q kits). Patients were divided both by DSA strength (MFI < vs. ≥15000) and C1q-binding ability...
October 7, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Soliu O Ganiyu, Nihal Oturan, Stéphane Raffy, Marc Cretin, Roseline Esmilaire, Eric van Hullebusch, Giovanni Esposito, Mehmet A Oturan
Electrochemical degradation of aqueous solutions containing antibiotic amoxicillin (AMX) has been extensively studied in an undivided electrolytic cell using a sub-stoichiometric titanium oxide (Ti4O7) anode, elaborated by plasma deposition. Oxidative degradation of AMX by hydroxyl radicals was assessed as a function of applied current and was found to follow pseudo-first order kinetics. The use of carbon-felt cathode enhanced oxidation capacity of the process due to the generation of H2O2. Comparative studies at low current intensity using dimensional stable anode (DSA) and Pt anodes led to the lower mineralization efficiencies compared to Ti4O7 anode: 36 and 41% TOC removal for DSA and Pt respectively compared to 69% for Ti4O7 anode...
September 28, 2016: Water Research
Priya Verghese, Kristen Gillingham, Arthur Matas, Srinath Chinnakotla, Blanche Chavers
The association of blood transfusions with GS after pediatric KTx is unclear. We retrospectively analyzed blood transfusions post-KTx and subsequent outcomes. Between 1984 and 2013, 482 children (<18 years of age) underwent KTx at our center. Recipient demographics, outcomes and transfusion data were collected. Cox regression with post-KTx blood transfusion as a time-dependent covariate was performed to model the impact of blood transfusion on outcomes. Of the 208 (44%) that were transfused, 39% had transfusion <1 month post-KTx; 48% >12 months...
October 6, 2016: Pediatric Transplantation
André Giacomelli Leal, Leonardo Brancia Pagnan, Raphael Teruaki Kondo, José Aguiomar Foggiatto, Guilherme José Agnoletto, Ricardo Ramina
Methods: 3D biomodels were printed with flexible material (elastomer) using angiotomographic DICOM acquired images and compared to 3D digital subtraction angiography (DSA) images. Results: 3D biomodels represented the aneurysm angioarchitecture exactly, especially the neck and domus features. Conclusion: Elastomers 3D biomodels proved to be a trustworthy representation of the angiotomographic images and could be used to help surgical planning in IA treatment...
September 2016: Arquivos de Neuro-psiquiatria
Junhui Chen, Lei Chen, Chunlei Zhang, Jianqing He, Peipei Li, Jingxu Zhou, Jun Zhu, Yuhai Wang
Angiographically occult cerebrovascular malformation (AOVM) is a type of complex cerebrovascular malformation that is not visible on digital subtraction angiography (DSA). Vascular malformation coexisting with glioma is clinically rare, and glioma coexisting with AOVM is even more rare. To the best of our knowledge, the present study is the first to report glioma coexisting with AOVM in the literature. The present study reports a rare case of glioma coexisting with AOVM in a 30-year-old male patient. Computed tomography (CT) scan revealed calcification, hemorrhage and edema in the right frontal lobe...
October 2016: Oncology Letters
Xinxiang Zhao, Yanglin Zhang, Yong Sun, Lin Sun, Renhui Cai
The aim of the present study was to investigate the correlation between the degree of coronary artery stenosis determined by digital subtraction angiography (DSA) and infarcted segments detected by delayed enhancement magnetic resonance imaging (DE-MRI). DE-MRI and DSA were performed in 40 patients with coronary artery disease. The number of myocardial segments with infarction, the transmural extent of myocardial infarction, score of myocardial infarction by MRI, degree of coronary artery stenosis and Gensini score of the coronary artery were assessed...
October 2016: Experimental and Therapeutic Medicine
José M Arreola-Guerra, Natalia Castelán, Adrián de Santiago, Adriana Arvizu, Norma Gonzalez-Tableros, Mayra López, Isaac Salcedo, Mario Vilatobá, Julio Granados, Luis E Morales-Buenrostro, Josefina Alberú
The aim of the present study was to describe the association of positive flow cross match (FXM) and C1q-SAB. Methods. In this observational, cross-sectional, and comparative study, patients included had negative AHG-CDC-XM and donor specific antibodies (DSA) and were tested with FXM. All pretransplant sera were tested with C1q-SAB assay. Results. A total of 50 donor/recipient evaluations were conducted; half of them had at least one C1q+ Ab (n = 26, 52%). Ten patients (20.0%) had DSA C1q+ Ab. Twenty-five (50%) FXMs were positive...
2016: Journal of Transplantation
Yu-Ching Cheng, Hung-Chieh Chen, Chen-Hao Wu, Yi-Ying Wu, Ming-His Sun, Wen-Hsien Chen, Jyh-Wen Chai, Clayton Chi-Chang Chen
BACKGROUND: Traditional digital subtraction angiography (DSA) is currently the gold standard diagnostic method for the diagnosis and evaluation of cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (dAVF). OBJECTIVES: The aim of this study was to analyze different less invasive magnetic resonance angiography (MRA) images, time-resolved MRA (TR-MRA) and three-dimensional time-of-flight MRA (3D TOF MRA) to identify their diagnostic accuracy and to determine which approach is most similar to DSA...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Sophie Caillard, Camille Becmeur, Gabriela Gautier-Vargas, Jerome Olagne, Clotilde Muller, Noelle Cognard, Peggy Perrin, Laura Braun, Francoise Heibel, Francois Lefebre, Veronique Renner, Christian Gachet, Bruno Moulin, Anne Parissiadis
Donor-specific antibodies (DSA) increase the risk of allograft rejection and graft failure. They may be present before transplant or develop de novo after transplantation. Here, we studied the evolution of preformed DSA and their impact on graft outcome in kidney transplant recipients. Using the Luminex Single Antigen assay, we analyzed the sera on the day of transplantation of 239 patients who received a kidney transplant. Thirty-seven patients (15.5%) had pre-existing DSA detected the day of transplantation...
September 28, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Aqueel H Pabaney, Richard A Rammo, Rizwan A Tahir, Donald Seyfried
BACKGROUND: Arteriovenous Malformations (AVMs) are hypothesized to be static, congenital lesions developing as early as 4 weeks of fetal life. New literature has shown that AVMs may represent dynamic and reactive vascular lesions arising from cerebral infarction, inflammation, or trauma. A literature search reveals 17 previously reported cases of new AVM formation after previous negative imaging studies. This reactive development or "second hit" theory suggests that at a molecular level, growth factors may play a vital role in aberrant angiogenesis and maturation of an arterio-venous fistula into an AVM...
September 23, 2016: World Neurosurgery
Natalia Del Campo, Matteo Cesari, Marco Canevelli, Emiel O Hoogendijk, Matthieu Lilamand, Eirini Kelaiditi, Maria E Soto, Pierre-Jean Ousset, Michael W Weiner, Sandrine Andrieu, Bruno Vellas
OBJECTIVES: Recent evidence suggests that a substantial minority of people clinically diagnosed with probable Alzheimer disease (AD) in fact do not fulfill the neuropathological criteria for the disease. A clinical hallmark of these phenocopies of AD is that these individuals tend to remain cognitively stable for extended periods of time, in contrast to their peers with confirmed AD who show a progressive decline. We aimed to examine the prevalence of patients clinically diagnosed with mild-to-moderate AD who do not experience the expected clinically significant cognitive decline and identify markers easily available in routine medical practice predictive of a stable cognitive prognosis in this population...
October 1, 2016: Journal of the American Medical Directors Association
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