Hence, FGF23 measurements may be a sensitive early biomarker of d

Hence, FGF23 measurements may be a sensitive early biomarker of disordered phosphorus metabolism in patients with CKD and normal serum phosphate levels. Kidney International (2011) 79, 1370-1378; doi:10.1038/ki.2011.47; published online 9 March 2011″
“BACKGROUND: Giant perimedullary arteriovenous fistulas (GPMAVFs) located in the cervical region are a rare pathology with distinctive characteristics.

OBJECTIVE: To evaluate clinical presentation and different endovascular treatment options of cervical GPMAVFs see more and review previously published data in

the literature regarding cervical GPMAVFs.

METHODS: Six patients with cervical GPMAVFs were found in the spinal vascular malformations database of our group collected between 1990 and 2009. Endovascular techniques and treatment outcomes were evaluated and compared with other published series.

RESULTS: Clinical presentations were

progressive motor deficit (5 patients), hematomyelia (1 patient), meningeal syndrome (1 patient), and respiratory arrest and gait apraxia (1 patient). Three patients were treated by the transarterial approach. One patient was treated by the transvenous approach due to previous embolizations resulting in a proximal occlusion and preventing a safe transarterial approach. A transvenous approach was used in another patient due to complex arterial anatomy. In 1 patient, direct percutaneous puncture of the venous pouch was necessary because of previous

proximal occlusion of the arteries. All embolizations resulted in complete occlusions with clinical find more improvement, and there was no recanalization during a mean follow-up of 21 months.

CONCLUSION: Transarterial embolization of cervical GPMAVFs is safe and effective when it is done in highly experienced centers. Cervical GPMAVFs that cannot be accessed by the transarterial technique due to their complex angioarchitecture for can be treated by transvenous embolization or direct puncture of the venous pouch.”
“The sphingomyelin metabolite, sphingosylphosphorylcholinc (SPC) has been the subject of much recent interest and controversy. Studies have indicated that SPC naturally occurs in plasma and a constituent of lipoproteins. Synthesis is also increased in some pathological conditions. Research has demonstrated that SPC is a potentially important lipid mediator of cell type specific functions in major tissues, such as heart, blood vessels, skin, brain and immune system. These effects are regulated via a number of different intracellular signalling cascades, also dependent upon cell type. Initial reports identifying high affinity SPC receptors at first appeared to reinforce the physiological relevance of this sphingolipid. However, these studies have now been retracted. Some SPC effects have been shown be occur via plasma membrane receptors for the related sphingolipid, sphingosine I-phosphate (SIP).

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