Lower limb high arterial flow induced by tenofovir and emtricitabine treatment.

Here, we describe a case of an HIV-infected patient with right lower limb oedema that appeared after initiation of tenofovir and emtricitabine treatment. The patient was fully investigated by serial heart and vessel echo-Doppler examination. Oedema of the lower limb was attributed to a transient drug-induced fivefold increase in peripheral artery flow, which was induced by a reduction in peripheral arterial resistance. The possible mechanisms of disease are discussed.

Infrainguinal bypass for peripheral arterial occlusive disease: when arms save legs.

OBJECTIVES: Determine if arm veins are good conduits for infrainguinal revascularisation and should be used when good quality saphenous vein is not available. DESIGN: Retrospective study. MATERIALS AND METHODS: We evaluated a consecutive series of infrainguinal bypass (IB) using arm vein conduits from March 2001 to December 2006.We selected arm vein by preoperative ultrasound mapping to identify suitable veins. We measured vein diameter and assessed vein wall quality. We followed patients with systematic duplex imaging at 1 week, 1, 3, 6 and 12 months, and annually thereafter. We treated significative stenoses found during the follow-up. RESULTS: We performed 56 infrainguinal revascularisation using arm vein conduits in 56 patients. Primary patency rates at 1, 2 and 3 years were 65%, 51% and 47%. Primary assisted patencies at 1, 2 and 3 years were 96%, 96% and 82%. Secondary patency rates at 1, 2 and 3 years were 92%, 88% and 88%. The three-year limb salvage rate was 88%. CONCLUSIONS: We conclude that infrainguinal bypass using arm vein for conduits gives good patency rates, if selected by a preoperative US mapping to use the best autogenous conduit available.

Movement evaluation of overerupted upper molars with absolute anchorage: An in-vitro study

Introduction: The overeruption of upper molars due to the premature loss of antagonist teeth can be treated with the help of miniscrews. The aim of this study was to evaluate the movement of a typodont molar according to the biomechanical approach used with miniscrews. Study design: The study was conducted with four plaster models filled with typodont wax. In each model we used one absolute anchorage on the palatal side and another on the buccal side in different positions, thus generating four different biomechanical systems. A force of 150 g was applied to each side of the resin tooth. Periapical radiographs were taken preintrusion and immediately after completion of the intrusion. Photographs were taken in both the sagittal and occlusal planes every 3 min. The radiographic films and photographs were measured and compared. Results: A vertical movement of the molar was observed in all the models, with system 4 showing the greatest movement. Rotation in the occlusal plane only occurred in system 2, while in system 1 there was a change in the axial axis of 37 degrees. Conclusions: The anchorage site and the combination of forces applied may determine the resulting tooth movement

Role of nuclear medicine during isolated limb perfusion

Aim:Isolated limb perfusion (ILP) is a technique consisting in administrating doses of chemotherapy up to 20 times higher than via systemic route in a limb affected by melanoma or sarcoma to maximise tumour reduction. ILP is performed in <50 centres worldwide and leads to partial or complete response, however without effect on overall survival. As an alternative to amputation, it improves patient quality of life. We report our >10-year single centre experience on the role of nuclear medicine in ILP. Material and method:From 2000 to 2012, we performed 77 ILP (45 women, 32 men; aged 62±16 years) for 49 melanoma (64%), 25 sarcoma (32%) and 3 others tumors (2 desmoid tumours and 1 aggressive fibromatosis) (3%). The affected limb vascularisation is isolated from the systemic circulation (SYS) using extracorporeal circulation, and chemotherapy (usually TNF and Melphalan) is administered. Peroperatively, limb isolation and eventual leakage from ILP to SYS are monitored by continuous measurement using a gamma-probe placed over the heart (150MBq of 99mTc-human serum albumin in ILP and 4MBq in SYS). The maximum acceptable leakage to the systemic circulation is 10% (maximum tolerated systemic TNF dose). Results:In total, 47 patients (61%) had positive leaks from the ILP to SYS of 4.1±14.5% (median 1% interquartile range 0.4% to 3.2%, range 0 to 100%) and 30 patients (39%) had negative leaks from the SYS to ILP of -0.9±1.2% (median -0.5%, interquartile range -0.8% to -0.2%, range -4.8% to -0.1%). In only 2 patients (2.6%), leaks >10% were observed leading to interrupting ILP. Conclusion:Nuclear Medicine has a crucial role for the safety and quality of ILP in monitoring leakage peroperatively and help deciding whether the procedure should be interrupted to minimize systemic toxicity.

Hind limb ischemia in rabbit model: T2-prepared versus time-of-flight MR angiography at 3 T.

PURPOSE: To prospectively compare various parameters of vessels imaged at 3 T by using time-of-flight (TOF) and T2-prepared magnetic resonance (MR) angiography in a rabbit model of hind limb ischemia. MATERIALS AND METHODS: Experiments were approved by the institutional animal care and use committee. Endovascular occlusion of the left superficial femoral artery was induced in 14 New Zealand white rabbits. After 2 weeks, MR angiography and conventional (x-ray) angiography were performed. Vessel sharpness was evaluated visually in the ischemic and nonischemic limbs, and the presence of small collateral vessels was evaluated in the ischemic limbs. Vessel sharpness was also quantified by evaluating the magnitude of signal intensity change at the vessel borders. RESULTS: The sharpness of vessels in the nonischemic limbs was similar between the TOF and the T2-prepared images. In the ischemic limbs, however, T2-prepared imaging, as compared with TOF imaging, generated higher vessel sharpness in arteries with diminished blood flow (mean vessel sharpness: 44% vs 30% for popliteal arteries, 45% vs 28% for saphenous arteries; P < .001 for both comparisons) and enabled better detection of small collateral vessels (93% vs 36% of vessels, P < .001). CONCLUSION: T2-prepared imaging can facilitate high-spatial-resolution MR angiography of small vessels with low blood flow and thus has potential as a tool for noninvasive evaluation of arteriogenic therapies, without use of contrast material. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2452062067/DC1.

Occurrence of Symphyla (Myriapoda) in the region of the Upper Solimões River, Amazonas, Brazil

The present work aimed at identifying the Symphyla species diversity and abundance in various land-use systems under different degrees of intensification in western Amazonia. This is the first inventory of Symphyla in primary and secondary forest, crops, agroforestry systems and pastures which was carried out in Benjamin Constant municipality, in the region of the Upper Solimões River, Brazil. Samples (n = 101) were collected using a metal corer, and the symphylan extraction was carried out using Berlese-Tullgren funnels. Two genera and three species of symphylans were encountered. Considering the diversity encountered in Amazonian inventories, with only four genera and five known species overall, the three species found in the present study are considered a reasonable representation of the regional diversity. Two of the Hanseniella species found have been known to cause plant damage.

09007-004 Upper Buffalo Creek Watershed Final Report

The main channel of Upper Buffalo Creek has been identified on Iowa's 303(d) List of Impaired Waters as having a biological impairment (i.e., greater than 50% decrease in mussel species) due to habitat modification, stream alteration, nutrients, and/or siltation. The Buchanan County SWCD has identified this as a priority watershed because mussel population decreases have been well documented to be directly associated with decreases in ecological value, recreational value, and overall water quality. The presence of a diverse and reproducing mussel population indicates that a healthy aquatic ecosystem is intact, which means good fishing, good water quality for wildlife, and assurance that water is safe for recreation. Dan Cohen, Buchanan Conservation Board Director, stated that "should water quality conditions improve, and fishing holes and habitat be enhanced, there is no doubt that many people would take advantage of the renewed recreational opportunities". This watershed contains two "threatened" species of mussels and five "sensitive" species of fish. The District feels that a watershed project will assist in implementing conservation practices that will greatly improve water quality and enhance biological and recreational venues.

Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser

Objectives: To compare upper lip frenulum reinsertion, bleeding, surgical time and surgical wound healing in frenectomies performed with the CO2 laser versus the Er, Cr:YSGG laser. Study design: A prospective study was carried out on 50 randomized pediatric patients who underwent rhomboidal resection of the upper lip frenulum with either the CO2 laser or the Er,Cr:YSGG laser. Twenty-five patients were assigned to each laser system. All patients were examined at 7, 14, 21 days and 4 months after the operation in order to assess the surgical wound healing. Results: Insertion of the frenulum, which was preoperatively located between the upper central incisors, migrated to the mucogingival junction as a result of using both laser systems in all patients. Only two patients required a single dose of 650 mg of paracetamol, one of either study group. CO2 laser registered improved intraoperative bleeding control results and shorter surgical times. On the other hand, the Er,Cr:YSGG laser achieved faster healing. Conclusions: Upper lip laser frenectomy is a simple technique that results in minimum or no postoperative swelling or pain, and which involves upper lip frenulum reinsertion at the mucogingival junction. The CO2 laser offers a bloodless field and shorter surgical times compared with the Er,Cr:YSGG laser. On the other hand, the Er,Cr:YSGG laser achieved faster wound healing.

06003-002 Upper Catfish Creek Watershed Final Report

Upper Catfish Creek is located in a 9,300-acre watershed that flows through two significant natural resources, Swiss Valley Park and Swiss Valley Nature Preserves, one of the largest nature preserves in the Midwest. According to DNR’s 2002 305(d) report, that portion of the creek within the park and preserve is classified as a Class B(CW) cold water stream of which a portion has naturally reproducing trout (one of only 30 in the state of Iowa with this capability). Urban sprawl is a real threat to the Upper Catfish Creek Watershed. Currently, 10% of the watershed is residential, but 27% is zoned residential or commercial. The watershed is near Dubuque city limits but the jurisdiction is in the county. Differing criteria for land development between city and county jurisdictions further entices developers to build in outlying areas. County leaders agree there is more that needs to be done and will work with municipalities on uniformity of regulations and follow-up measures. We propose to set up key urban conservation practice models that will address storm water runoff and water quality which can be learned about and viewed by city and county officials, engineers, developers, etc. This would be part of a larger initiative including an educational campaign, inter-jurisdictional planning, the development of a land use GIS database, and agricultural conservation practices. The successes coming out of and learned about this watershed will serve as a model to spread county-wide.

05044-016 Upper Miller Creek Watershed Final Report

A water quality resource concern has come to the forefront in the Upper Miller Creek watershed in Black Hawk County after five to seven inches of rain fell on the area on May 22nd and 23rd of 2004 and unprecedented amounts of soil and organic debris were washed from cultivated areas, clogging most culverts and roadside ditches. The quantity of soil deposited in ditches gave a good indication of the amounts that were transported into the stream. The estimated total cost to Black Hawk County for cleanup and repair within the road right-of-way was $345,000. There were undetermined environmental costs incurred when the incredibly high volumes of soil washed from the fields into Miller Creek which flows directly into the Cedar River that is identified by the Department of Natural Resources as an impaired water body. The Upper Miller Creek Watershed Project is an innovative, collaborative project intended to meet a specific need identified by a local steering committee made up of concerned community agencies and local landowners. Led by the Soil and Water Conservation District and the Black Hawk County Board of Supervisors, the Miller Creek Watershed Project seeks to reduce soil erosion, improve water quality, and reduce county road infrastructure cost by implementing conservation practices, reducing nutrient and pesticide use and improving wildlife habitat.