BACKGROUND: To evaluate the performance of delayed contrast enhanced computed tomography (DCT) in characterizing renal masses. METHODS: Twenty-four patients with suspected renal masses or indeterminate renal masses on previous imaging studies were prospectively evaluated with preintravenous contrast imaging, conventional contrast-enhanced computed tomography (imaging initiated 2 min after intravenous contrast injection), and DCT (imaging initiated 13 min after injection of intravenous contrast). Only lesions larger than 1.0 cm were evaluated, with scanning parameters kept constant across the three scans. RESULTS: All pathologically confirmed renal cell carcinomas (n = 6) were detected on DCT using a threshold attenuation decrease of 10 Hounsfield units (HU). A significant decrease (p = 0.031) in attenuation occurred in renal cell carcinomas (mean = 29.6 +/- 23.6 HU) compared with the attenuation change (mean decrease = 1.1 +/- 7.1 HU), which occurred in non-neoplastic renal cysts (n = 34). Non-neoplastic renal cysts were correctly classified by DCT 32 of 34 times (94%). CONCLUSIONS: In this study, DCT distinguished renal cell carcinomas from non-neoplastic cysts in a vast majority of cases and may aid in characterizing incidentally discovered renal lesions on postcontrast CT.

Adenoma↗

PubMedDate not supplied

Effect of a low protein diet on the relationship of nonenzymatic glycation to altered renal structure and function in diabetes mellitus.

Renal functional parameters including creatinine clearance, urinary albumin excretion, basement membrane thickening, and levels of nonenzymatic glycation of glomerular basement membrane were studied in streptozotocin-induced diabetic rats and age-matched controls subjected to low protein diet. In addition, these parameters were also assessed in diabetic and streptozotocin injected nondiabetic animals fed a 24% protein diet, which served as "positive controls." While diabetic animals from both diet groups had similar elevated glycated hemoglobin levels and increased levels of nonenzymatic glycation of glomerular basement membrane, these were significantly elevated as compared to insulin treated diabetic (euglycemic), age-matched controls on an 8% protein diet, and streptozotocin injected nondiabetic animals from both diet groups. However, urinary albumin excretion and creatinine clearance levels were significantly elevated only in the 24% protein diet fed diabetics over values seen in the various groups of animals on 8% and controls on 24% protein diet. In contrast, there were no statistical differences among diabetic, euglycemic and control (8% and 24% protein) animals with respect to creatinine clearance, urinary albumin excretion, and glomerular basement membrane thickness. Taken together these data cast some doubt on the role of nonenzymatic glycation in the development of diabetic nephropathy. Moreover, hyperglycemia per se causes a compensatory increase in kidney size irrespective of protein intake; a low protein diet, however, inhibits the hyperfiltration commonly seen in early diabetic nephropathy. The authors, thus, hypothesize that a low protein diet, by preventing compensatory increase in blood flow to surviving nephrons, in some fashion protects these functional units from subsequent damage and possibly delays the onset of renal failure.

Albuminuria↗

PubMedDate not supplied

Manipulation of microcantilever oscillations.

Experimental observation of self-sustaining oscillations via a delayed feedback system is presented for a rectangular silicon microcantilever. The system is modeled as one and two-dimensional damped oscillator and the resulting delay differential equations are studied in frequency and time domain. The shortcomings of each model are outlined, and an improved formulation of the dynamics of the cantilever is presented.

Journal Article↗

PubMedDate not supplied

Computed tomography of renal lymphomatoid granulomatosis.

Lymphomatoid granulomatosis is an uncommon disease that primarily involves the lungs. Although renal involvement has been demonstrated to be common in autopsy series, the CT appearance has not been previously described. In this report a patient with verified pulmonary lymphomatoid granulomatosis was demonstrated to have bilateral, nodular renal masses by CT which regressed completely with treatment. Although not pathologically proven, this is presumed to represent renal involvement by lymphomatoid granulomatosis.

Humans↗

PubMedDate not supplied

Intravenous enzyme replacement therapy: better in home or hospital?

This article evaluates satisfaction with enzyme replacement therapy (ERT) at home and at hospital in adult patients with Fabry and Gaucher diseases. A questionnaire was developed and sent to 34 patients with Fabry disease who were receiving ERT with agalsidase alfa (Replagal) and to 49 patients with type I Gaucher disease who were receiving ERT with glucocerebrosidase (Cerezyme). Of the 45 returned questionnaires, 20 were from patients with Fabry disease and 25 from patients with Gaucher disease. Hospital treatment visits were reported as stressful by 18 patients (40%), whereas only 4 (9%) patients reported that home therapy was stressful. Both groups of patients adjusted well to receiving home-based therapy. Nearly all of the patients with Fabry disease (19 patients, 95%) and Gaucher disease (21 patients, 84%) preferred home-based therapy. Treatment in the home was reported as more comfortable, less stressful, more effective and had less impact on family life. Only 4 (9%) patients chose to continue receiving infusions in hospital. The majority of patients with Fabry disease and Gaucher disease found home-based therapy to be more convenient and less stressful than hospital-based therapy.

Adaptation, Psychological↗

PubMedDate not supplied