Incidence of the retroaortic left renal vein in patients with varicocele.

OBJECTIVE: The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele. METHODS: The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery. RESULTS: The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively. CONCLUSIONS: In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.     

急性胰腺炎CT、B超、手术及临床对照研究

笔者分析了２４例急性胰腺炎的ＣＴ所见，并同Ｂ超、临床化验和剖腹探查结果进行了对照研究。表明：（１）急性胰腺炎的ＣＴ诊断优于Ｂ超，对胆源性胰腺炎Ｂ超对诊断有明确帮助。（２）急性胰腺炎时，ＣＴ表现与血淀粉酶浓度不一定成正比。（３）急性胰腺炎可累及门脉系统引起血管并发症。     

超声导向肝组织微波固化的实验研究

目的：探讨不同穿刺方案形成的肝组织微波凝固区的大小、形态，为临床治疗，特别是大肝癌的治疗，提供实践基础。方法：利用离体新鲜牛肝，比较ＵＭＣ－Ｉ型微波仪单针、两针及多针组合所形成凝固区的大小、形态。结果：单针穿刺可形成３．０ｃｍ×４．０ｃｍ头宽尾窄的滴水状凝固区。两针组合，距离在２．５～３．０ｃｍ之间造成的完全凝固区最大。不同穿刺方案，可形成８ｃｍ以下不同直径的球形凝固区。结论：适当的穿刺方案可使８ｃｍ以下的球形区域完全凝固     

TCD结合TCCD与DSA对脑动脉狭窄的一致性分析及对治疗方案的指导价值

目的 探究经颅多普勒超声(transcranial Doppler sonography, TCD)结合经颅彩色多普勒超声(transcranial color-coded duplex, TCCD)与数字减影血管造影(digital subtraction angiography, DSA)对脑动脉狭窄的一致性分析及对治疗方案的指导价值。方法 选取缺血性脑血管病患者100例,均行TCD、TCCD及DSA检查,以DSA检查结果作为“金标准”,分析脑动脉狭窄程度,观察不同狭窄程度患者TCD、TCCD超声表现,采用Kappa检验分析TCD结合TCCD诊断脑动脉狭窄程度与DSA检查结果的一致性,比较不同狭窄程度患者收缩期峰流速(systolic velocity, Vs)、平均峰流速(mean velocity, Vm)、搏动指数(pulsatility index, PI),采用Spearman相关系数模型分析Vm、PI与脑动脉狭窄程度的相关性,所有患者均行药物或手术治疗,比较不同治疗方法患者入院时、治疗后6个月Vs、Vm、PI。结果 100例缺血性脑血管病患者,轻度狭窄42例,中度狭窄3...     

Recurrent retroperitoneal cystic lymphangioma

Retroperitoneal cystic lymphangioma is a rare congenital malformation. The majority of lymphangiomas are present at birth and nearly all present before the age of two years. We report a case of giant cystic retroperitoneal lymphangioma in a patient who first presented with symptoms at the age of 7, underwent surgery, and who then suffered a recurrent mass 11 years later.     

Self-reported urogenital symptoms in postmenopausal women: Women's Health Initiative

OBJECTIVE: To examine the prevalence and correlates of self-reported urogenital symptoms (dryness, irritation or itching, discharge, dysuria) among postmenopausal women aged 50-79. DESIGN: A cross-sectional analysis based on n=98,705 women enrolled in the US-based Women's Health Initiative observational study and clinical trials. Urogenital symptoms, symptom severity (mild, moderate, severe), and all covariates were self-reported through questionnaires at enrollment. Prevalence rates of each urogenital symptom were examined and logistic regression was used to identify potential correlates. RESULTS: Prevalence rates for each symptom were: dryness, 27.0%; irritation or itching, 18.6%; discharge, 11.1%; and dysuria, 5.2%. Four factors were correlated with two or more symptoms: Hispanic ethnicity (adjusted odds ratio (AOR)=2.1-3.1 versus white women across all symptoms), obesity (AOR=2.2 severe discharge versus none, AOR=3.6 severe irritation/itching versus none), treated diabetes (pills or shots) compared to no diabetes (AOR=2.4 severe dysuria versus none, AOR=3.2 severe irritation/itching versus none), and vaginal cream HRT/ERT compared to those who never used HRT/ERT (AOR=4.4 severe dryness versus none, AOR=4.6 severe irritation/itching versus none). Factors not associated with the symptoms included sexual activity, age, years since menopause, current smoking, marital status, gravidity, and natural versus surgical menopause. CONCLUSIONS: This is the first report to document urogenital symptoms by race/ethnicity among an exclusively postmenopausal population. We found an elevated prevalence of urogenital symptoms among women who are Hispanic, obese, and/or diabetic. Confirmation of our findings in these subgroups, and, if confirmed, analysis on why these populations are at greater risk, are areas for future research.     

Metastatic Psammomatous Somatostatinoma of the Pancreas Causing Severe Ketoacidotic Diabetes Cured by Surgery

A case of somatostatin-producing pancreatic tumor associated with severe insulindependent diabetes mellitus and ketoacidotic coma is reported. The tumor, a 10-cm expansile mass arising from the pancreatic tail of a 70-yr-old woman, was first detected by ultrasonography, performed because of abdominal pain, and subsequently confirmed by computed tomography and fine-needle tumor aspiration. Pathologic investigation showed a predominatly solid-trabecular structure with scattered microacini and psammomatous bodies. A large proportion of tumor cells expressed somatostatin and/or calcitonin. Following resection of the primary tumor and three peripancreatic lymph nodes with metastases, the patient recovered rapidly from her diabetic syndrome and remained in substantially good health during a subsequent 8-yr follow-up period, without evidence of tumor recurrence.     

心理治疗在全程助产责任制中的应用

目的探村心理治疗封产科全程助产责任制分娩模式的影响。方法选择2002年3月至2004年9月在我院住院的初产妇1700例（均孕足月、单胎、无难产指征），随机分为治疗组和对照组两组，比较两组分娩方式、产程时间、产后出血。结果第一产程及总产程均短于对照组（P〈0．05），两组剖宫产率、阴道助产率、产后出血率比较均有显著差异（P〈0．05）。结论心理治疗应用于产科全程助产责任制，使产妇得到心理安慰和生理上的帮助，保障母婴健康，值得推广使用。     

Neu-Laxova syndrome: Prenatal ultrasonographic diagnosis,clinical and pathological studies,and new manifestations

A diagnosis of the Neu-Laxova syndrome (NLS) was made by ultrasonography at 32 wks of gestation. Ultrasonographic examination showed intrauterine growth retardation (IUGR), Dandy-Walker anomaly, choroid plexus cysts, receding forehead and microcephaly, bilateral cataract without prominent eyes, scalp edema with no generalized edema, retrognathia, curved penis, and flexion deformities of limbs. The findings in this case are consistent with NLS; however, they did not fit any of Curry's [1982] groups. Massive swelling of hands and feet were among the main manifestations in classic NLS cases. In the case presented herein, edema was noted only in the scalp. This might shed further light on the question of variability vs. heterogeneity in the NLS. This case shows the existing possibility of an early diagnosis of NLS and adds Dandy-Walker anomaly and choroid plexus cysts as new findings to this syndrome. © 1992 Wiley-Liss, Inc.     

Optimizing the embryo transfer technique

The technique of embryo transfer is very crucial and great attention and time should be given to this step. In order to optimize the embryo transfer technique, several precautions should be taken. The first and most important is to avoid the initiation of uterine contractility. This can be achieved by the use of soft catheters, gentle manipulation and by avoiding touching the fundus. Secondly, proper evaluation of the uterine cavity and utero-cervical angulation is very important, and can be achieved by performing dummy embryo transfer and by ultrasound evaluation of the utero-cervical angulation and uterine cavity length. Another important step is the removal of cervical mucus so that it does not stick to the catheter and inadvertently remove the embryo during catheter withdrawal. Finally, one has to be absolutely sure that the embryo transfer catheter has passed the internal cervical os and that the embryos are delivered gently inside the uterine cavity.