In patients undergoing maintenance hemodialysis (HD). endothelial damage is readily caused by many factors including increased oxidative stress. Atherosclerosis, therefore, may have a greater incidence and progress more rapidly in HD patients than in the general population. The present study evaluated the endothelial function in HD patients and the effect of LDL apheresis (LDIA), one of treatments for peripheral arterial disease (PAD), on vasomotor function. Sixteen HD patients with PAD and 10 without PAD were enrolled in this study, and LDLA was performed in 8 of the 16 patients with PAD. Flow-mediated dilation (FMD) and glycerol-trinitrate-induced dilation (NMD) of the brachial artery were measured noninvasively with high-resolution ultrasound equipment, and are expressed here as the percentage changes from baseline (%FMD and %NMD, respectively). %FMD was significantly lower in patients with PAD than in patients without PAD (2.4 ± 3.9% versus 7.1 ± 3.4%. mean ± SD, p<0.005), but there was no significant difference in %NMD levels between the two groups. A series of LDLA treatments lead to a significant increase in %FMD (1.3 ± 1.7% versus 5.5 ± 2.2%, p<0.005) but not in %NMD. These data indicate that the ultrasound evaluation of endothelial function may be useful in assessing the progression of atherosclerosis in HD patients. This method can also be used to estimate the clinical effect of LDLA in HD patients with PAD.

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We evaluated internal echo intensity distribution in patients with malignant lymphomas. 25 patients (surface lymph nodes in 500 lesions) were studied. 12 cases (316 lesions) had diffuse type of Non-Hodgkin's lymphoma (NHL-D); 8, (102 lesions) follicular type of Non-Hodgkin's lymphoma (NHL-F); 5 (82 lesions), Hodgkins disease (HD). We calculated standard deviation (SD) using photo-analyzing software (Photoshop 5.0J^®, Adube inc, USA). Visual estimation was evaluated by two blind readers. NHL-D showed significantly lower SD than NHL-F and HD. Also, the lymph node intensities in patients with NHL-D tended to be homogeneous compare to in patients with NHL-F and HD by visual estimation. This result indicates that lymph node internal intensity in patients with NHL-D showed more homogeneous than NHL-F and HD. There were no significant differences in lymph node intensity distribution among several ultrasound systems we employed. Histopathological specimens in patients with NHL-D, showed massive and monotonous infiltration of lymphocytes without fibrosis, while NHL-F showed nodal expansion with remnant lymph node structure.The internal echo intensity is useful to estimate histopathological classification of malignant lymphoma.

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