Maturation and patency rates were determined by Kaplan Meier analysis. The following factors were analyzed: age, race, gender, body-mass index (BAU), fistula site, preoperative duplex vein diameter, diabetes, hyperlipidemia, HTN, prior Ro 61-8048 clinical trial central catheter placement, HIV, and history of IV drug abuse.
Results: From January 2003 to June 2007, 298 vascular access procedures were performed. One hundred ninety-five (65%) were initial
hemodialysis access procedures, among which a native AVF was created in 185 (95%); 158 patients with posterior radiocephalic AVF (PRCAVF, n = 24), wrist radiocephalic AVF (WRCAVF, n = 72), or brachiocephalic AVF (BCAVF, n = 62) had adequate follow-tip and were included in the analysis. PRCAVF, WRCAVF, and BCAVF had 54%, 66%, and 81% maturation rates, respectively. Both the type of fistula type (P = .032) and vein
size (P = .002) significantly affected maturation by univariate analysis. In contrast, by multivariate logistic regression analysis, vein diameter was the sole independent predictor of fistula functional maturation (P = .002).
Conclusion: In this series of 158 patients undergoing initial hemodialysis access creation, native AVF creation was performed in 95%. In contrast to previous reports, age, gender, diabetes, and BMI had no significant effect on functional maturation. By multivariate logistic regression analysis, vein diameter was the sole independent predictor of functional fistula maturation. (J Vase Surg 2009;49:1499-504.)”
“The hypothalamic paraventricular nucleus (PVN) and angiotensin II (AngII) play critical roles in cardiovascular and neurohumoral regulation ascribed in part DNA Synthesis inhibitor to vasopressin (VP) release. The AngII actions in the PVN are mediated largely through angiotensin II
type I (AT1) receptors. However, there is indirect evidence that the functionally elusive central angiotensin II type 2 (AT2) receptors are also mediators of AngII signaling Rolziracetam in the PVN. We used electron microscopic dual immunolabeling of antisera recognizing the AT2 receptor and VP to test the hypothesis that mouse PVN neurons expressing VP are among the cellular sites where this receptor has a subcellular distribution conducive to local activation. Immunoreactivity for the AT2 receptor was detected in somatodendritic profiles, of which similar to 60% of the somata and similar to 28% of the dendrites also contained VP. In comparison with somata and dendrites, axons, axon terminals, and glia less frequently contained the AT2 receptor. Somatic labeling for the AT2 receptor was often seen in the cytoplasm near the Golgi lamellae and other endomembrane structures implicated in receptor trafficking. AT2 receptor immunoreactivity in dendrites was commonly localized to cytoplasmic endomembranes, but was occasionally observed on extra- or peri-synaptic portions of the plasma membrane apposed by astrocytic processes or by unlabeled axon terminals.