Two discreet areas of dystrophic calcification were noted within the interpolar region of the renal parenchyma and measured 6 and 3 mm. The patient was admitted and given intravenous normal saline with added potassium for treatment of hypercalcemia and hypokalemia, antiemetics, and a proton pump inhibitor. Over the course of 4 days, the patient’s creatinine declined to 4 mg/dl and serum calcium and potassium levels normalized. The patient was discharged.
Following discharge,
the patient was feeling well and the creatinine declined over 2 weeks to 2.3 mg/dl. Five weeks later, the creatinine was 1.6 mg/dl.
Two months after the initial presentation, repeat serum chemistries again revealed acute kidney injury with a creatinine of 5.4 mg/dl. At that time, the patient had a serum sodium of 134 mmol/l, potassium 2.9 mmol/l, chloride 75 mmol/l, CO(2) 44 mmol/l, calcium 12.8 mg/dl, and phosphorus 6.7 mg/dl. The patient reported no significant new symptoms although CUDC-907 cell line he did mention persistent ‘heartburn’. selleck products On his own, he had discontinued taking the proton pump inhibitor and restarted antacids, without relief of symptoms. Similarly, he reported having to ‘drink milk at night’ to help the symptoms. Physical examination
was unrevealing. Given the unclear etiology of the patient’s acute kidney injury, a renal biopsy was performed.”
“OBJECTIVE: To assess the value of an interactive visualization method for detecting the offending vessels in neurovascular compression syndrome
in patients with facial spasm and trigeminal neuralgia. Computer graphics models are created by fusion of fast imaging employing steady-state acquistion and magnetic resonance angiography.
METHODS: High-resolution magnetic resonance angiography and fast imaging employing steady acquisition were performed preoperatively in 17 patients with neurovascular compression syndromes (facial spasm, n = 10; trigeminal neuralgia, n = 7) using a 3.0-T magnetic resonance imaging scanner. Computer graphics models were created with computer software and observed interactively for detection of offending vessels by rotation, enlargement, reduction, and retraction on a graphic workstation. Two-dimensional images were reviewed by 2 radiologists blinded to the clinical details, and 2 neurosurgeons predicted the offending Doxacurium chloride vessel with the interactive visualization method before surgery predictions from the 2 imaging approaches were compared with surgical findings. The vessels identified during surgery were assumed to be the true offending vessels.
RESULTS: Offending vessels were identified correctly in 16 of 17 patients (94%) using the interactive visualization method and in 10 of 17 patients using 2-dimenstional images. These data demonstrrated a significant difference (P = 0.015 by Fishers exact method).
CONCLUSION: The interactive visualization method data corresponded well with surgical findings (surgical field offending vessels and nerves).