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AKI Ultrasound

Gabor Erdoes, Dominik E Uehlinger, Beatrice Kobel, Monika P Stucki, Roland Wiest, Frank Stueber, Niklaus Fankhauser, Stephan M Jakob, Joerg C Schefold
BACKGROUND: Microembolism is a frequent pathological event during extracorporeal renal replacement therapy (RRT). Some previous data indicate that microemboli are generated in patients who are undergoing RRT and that these may contribute to increased cerebrovascular and neurocognitive morbidity in patients with end-stage renal disease. The current trial aims to quantify the microembolic load and respective qualitative composition that effectively reaches the intracerebral circulation in critically ill patients treated with different RRT modalities for acute kidney injury (AKI)...
March 21, 2018: Trials
Takako Miyamae, Takuma Hara, Aki Hanaya, Yumi Tani, Takayuki Kishi, Hisashi Yamanaka
A 10-year-old girl manifested persistent fever, skin rash, leg pain, fatigue, and joint pain. Based on muscle weakness, elevated muscle-derived enzymes, magnetic resonance imaging, and skin biopsy results, the diagnosis was juvenile idiopathic inflammatory myopathies (JIIM). Chest CT was normal; the anti-melanoma differentiation-associated protein-5 (anti-MDA5) autoantibody was positive. Initial manifestations subsided after prednisolone (PSL) and methotrexate treatment. After the PSL dosage was decreased, the patient presented with metacarpophalangeal (MCP) joint pain and swelling in both index fingers, synovial fluid, and signals on power Doppler ultrasound...
2018: Case Reports in Rheumatology
Ayana Suzuki, Mitsuyoshi Hirokawa, Aki Ito, Nami Takada, Miyoko Higuchi, Toshitetsu Hayashi, Seiji Kuma, Tsutomu Daa, Akira Miyauchi
The pathogenesis of thyroid lymphoepithelial cysts is controversial, and two hypotheses have been proposed, namely derivation from branchial-derived remnants or from squamous metaplasia of the follicular cells. The aim of this study was to clarify the pathogenesis of thyroid lymphoepithelial cysts. We performed pathological and immunohistochemical examination of 21 thyroid lymphoepithelial cysts, 13 non-neoplastic squamous metaplasia samples without thyroid carcinoma, 13 solid cell nests, and 14 lateral cervical cysts...
March 14, 2018: Endocrine Journal
Tadatsugu Gamou, Kenji Sakata, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: To investigate the impact of stent deformity induced by final kissing balloon technique (KBT) for coronary bifurcation lesions on in-stent restenosis (ISR). BACKGROUND: In experimental models, the detrimental effects of KBT have been clearly demonstrated, but few data exists regarding the impact of proximal stent deformity induced by KBT on clinical outcomes. METHODS: We examined 370 coronary lesions where intravascular ultrasound (IVUS)-guided second-generation drug-eluting stent (DES) implantation for coronary bifurcation lesions was performed...
March 6, 2018: Journal of Interventional Cardiology
Junyi Wang, Xinjing Gao, Dong Wang, Zhiyong Wang, Zhibo Li, Dong Liu, Lei Xu
OBJECTIVE: To evaluate the diagnostic value of contrast-enhanced ultrasound in acute kidney injury (AKI) caused by sepsis. METHODS: The sepsis patients admitted to intensive care unit of Tianjin Third Central Hospital from January 2015 to June 2017 were enrolled. All of the patients were completed the 6-hour Bundle treatment and the bilateral renal contrast-enhanced ultrasound within 24 hours, and the peak signal intensity (PSI), peak intensity time (PIT), wash internal rate (WIR) and renal function parameters were measured at the same time...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Zondiwe Victor Mwanza, Mignon McCulloch, Mark Drayson, Timothy Plant, David V Milford, Gavin Dreyer
BACKGROUND: There is a paucity of data on paediatric kidney disease in developing countries such as Malawi. Descriptive research on kidney disease is essential to improving patient outcomes. METHODS: We conducted a cross-sectional study at a tertiary hospital in Malawi from 2012 to 2013. Children under 14 years with proteinuric kidney disease were enrolled from paediatric wards and outpatient clinics at Queen Elizabeth Central Hospital (QECH). Demographic, clinical and laboratory data were collected from patients at enrolment and at 3 months review at which point clinical status and disease outcome were ascertained...
January 31, 2018: BMC Nephrology
Aki Nykänen, Otso Arponen, Anna Sutela, Ritva Vanninen, Mazen Sudah
Background: This study aimed to evaluate the feasibility of contrast-enhanced ultrasound (CEUS) and CEUS-guided interventions in the diagnostics of MRI visible targeted US occult breast lesions. Patients and methods: This retrospective study examined 10 females with 10 occult, MRI only detected breast lesions between July 2014 and April 2017. Targeted second look US followed by CEUS with 2.4 ml of SonoVue® were performed for all of the lesions. After positive CEUS localization the same dose was repeated for confirmation and CEUS-guided interventions were performed...
December 2017: Radiology and Oncology
William Beaubien-Souligny, Roberto Eljaiek, Annik Fortier, Yoan Lamarche, Mark Liszkowski, Josée Bouchard, André Y Denault
OBJECTIVE: Venous congestion is a possible mechanism leading to acute kidney injury (AKI) following cardiac surgery. Portal vein flow pulsatility is an echographic marker of cardiogenic portal hypertension and might identify clinically significant organ congestion. This exploratory study aims to assess if the presence of portal flow pulsatility measured by transthoracic echography in the postsurgical intensive care unit is associated with AKI after cardiac surgery. DESIGN: Retrospective cohort study...
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Faizan Babar, Gurkeerat Singh, Mustafa Noor, Bruce Sabath
Early stage acute kidney injury (AKI) is an independent risk factor for an increase in mortality. Accurate assessment of volume status is a major challenge during the early stages of acute renal injury. Determining volume status based on the history and physical exam lacks accuracy. Urine sodium and free excretion of sodium (FENa) provide objective evidence of intravascular volume status when interpreted carefully and is helpful to delineate prerenal from intrinsic renal failure. In recent years point of care ultrasound has been used to assess volume status...
2017: Journal of Community Hospital Internal Medicine Perspectives
Rami Jambeih, Jean I Keddissi, Houssein A Youness
OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI were included. INTERVENTION: US-IVC was done on admission. The patients' management was done by the primary teams, who were unaware of the US-IVC findings...
2017: Critical Care Research and Practice
Kianoush B Kashani, Shennen A Mao, Sami Safadi, Bruce P Amiot, Jaime M Glorioso, John C Lieske, Scott L Nyberg, Xiaoming Zhang
BACKGROUND: Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. METHODS: We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elastography (USWE). We directly measured transcatheter KIP in three pigs at baseline and after bolus infusion of normal saline, norepinephrine, vasopressin, dopamine, and fenoldopam; infiltration of 2-L peritoneal dialysis solution in the intra-abdominal space; and venous, arterial, and ureteral clamping...
October 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
Fangyi Liu, Xiaoling Yu, Ping Liang, Zhigang Cheng, Zhiyu Han, Jie Yu
PURPOSE: To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for large hepatic cavernous haemangiomas (HCHs) with ablation of the feeding artery and aspiration of blood from haemangioma simultaneously. MATERIALS AND METHODS: From January 2011 to December 2016, 40 patients (29 females, 11male; average age 43.25 ± 7.65 years) with 42 giant hepatic haemangiomas (mean diameter 7.02 ± 1.55 cm, range 4.1-10.8 cm) were treated with image-guided percutaneous MWA with ablation of the feeding artery and aspiration of blood from haemangioma simultaneously...
October 30, 2017: International Journal of Hyperthermia
Mark D Okusa, Diane L Rosin, Kevin J Tracey
Neural pathways regulate immunity and inflammation via the inflammatory reflex and specific molecular targets can be modulated by stimulating neurons. Neuroimmunomodulation by nonpharmacological methods is emerging as a novel therapeutic strategy for inflammatory diseases, including kidney diseases and hypertension. Electrical stimulation of vagus neurons or treatment with pulsed ultrasound activates the cholinergic anti-inflammatory pathway (CAP) and protects mice from acute kidney injury (AKI). Direct innervation of the kidney, by afferent and efferent neurons, might have a role in modulating and responding to inflammation in various diseases, either locally or by providing feedback to regions of the central nervous system that are important in the inflammatory reflex pathway...
November 2017: Nature Reviews. Nephrology
Travis D Hull, Anupam Agarwal, Kenneth Hoyt
AKI and CKD are important clinical problems because they affect many patients and the associated diagnostic and treatment paradigms are imperfect. Ultrasound is a cost-effective, noninvasive, and simple imaging modality that offers a multitude of means to improve the diagnosis, monitoring, and treatment of both AKI and CKD, especially considering recent advances in this technique. Ultrasound alone can attenuate AKI and prevent CKD by stimulating the splenic cholinergic anti-inflammatory pathway. Additionally, microbubble contrast agents are improving the sensitivity and specificity of ultrasound for diagnosing kidney disease, especially when these agents are conjugated to ligand-specific mAbs or peptides, which make the dynamic assessment of disease progression and response to treatment possible...
December 2017: Journal of the American Society of Nephrology: JASN
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
November 2017: CEN Case Reports
Allen Young, Todd Crawford, Alejandro Suarez Pierre, J Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino
BACKGROUND: Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. METHODS: We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management...
September 2, 2017: Journal of Cardiothoracic Surgery
Masayuki Mori, Kenji Sakata, Junichiro Yokawa, Chiaki Nakanishi, Hirofumi Okada, Masaya Shimojima, Shohei Yoshida, Tsuyoshi Yoshimuta, Kenshi Hayashi, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: This study investigated the application of a novel enhanced device to retrieval of deployed stents in a porcine coronary model. BACKGROUND: Recurrence of in-stent restenosis and stent thrombosis still remains to be resolved. Under these conditions, it is sometimes necessary to retrieve malfunctional stents responsible for thrombosis. However, few data exist regarding the feasibility and safety of retrieval device use in previously deployed coronary stents...
December 2017: Journal of Interventional Cardiology
Wei Cao, Shuang Cui, Li Yang, Chunyi Wu, Jian Liu, Fang Yang, Youhua Liu, Jianping Bin, Fan Fan Hou
AIMS: Acute kidney injury (AKI) is increasingly recognized as a major risk factor leading to progression to chronic kidney disease (CKD). However, the diagnostic tools for predicting AKI to CKD progression are particularly lacking. Here, we tested the utility of contrast-enhanced ultrasound (CEUS) for predicting progression to CKD after AKI by using both mild (20-min) and severe (45-min) bilateral renal ischemia-reperfusion injury mice. RESULTS: Renal perfusion measured by CEUS reduced to 25% ± 7% and 14% ± 6% of the pre-ischemic levels in mild and severe AKI 1 h after ischemia (p < 0...
December 10, 2017: Antioxidants & Redox Signaling
Aki Pulkkinen, Jarkko J Leskinen, Aimo Tiihonen
Synthetic schlieren imaging, also known as background oriented schlieren imaging, is used to determine the acoustical field of a focused ultrasound transducer operating at 1.01 MHz frequency with peak pressure amplitude of 0.97 MPa. The measurement setup is composed of a commercial off-the-shelf digital single-lens reflex (DSLR) camera with an ordinary objective, a high power light-emitting diode driven in pulsating mode, water tank, ultrasound transducer, rotation stage, and driving electronics. Measurements are performed in tomographic fashion by rotating the ultrasound transducer within the water tank and photographing an imaged target behind the ultrasound field...
June 2017: Journal of the Acoustical Society of America
Shinji Tanaka, Tsuyoshi Inoue, John A Hossack, Mark D Okusa
Inflammation is broadly recognized as an important factor in the pathogenesis of acute kidney injury (AKI), but pharmacological approaches to alleviate inflammation in AKI have been without success in clinical trials. Neuromodulation by nonpharmacological methods is emerging as a novel therapeutic strategy to treat inflammatory diseases. Recently, our group and others have demonstrated that vagus nerve stimulation and pulsed ultrasound ameliorated inflammation via the cholinergic anti-inflammatory pathway (CAP) in various animal models, including renal ischemia-reperfusion injury...
2017: Nephron
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