补肾通络方对去势大鼠阴茎细胞增殖的影响

目的　探讨补肾通络方能否诱导去势大鼠阴茎细胞增殖。　方法　 4 0只成年SD雄性大白鼠随机分为对照组、去势组、补肾通络方组及丙酸睾酮组。补肾通络方组、丙酸睾酮组术后 2周灌胃补肾通络方和肌注丙酸睾酮 ,并分别于治疗后 4d和 1周处死 ,最后处死对照组及去势组 ,取中段阴茎组织 ,用免疫组化技术 (SP法 )检测其细胞增殖情况。　结果　发现对照组阴茎组织中存在中等强度的细胞增殖 (35 0 7± 2 94 ) ,去势 2周后几乎无细胞增殖 (P <0 0 1) ,丙酸睾酮组、补肾通络方组治疗 4d和 1周后即诱导DNA合成 ,细胞增殖显著增多 (2 0 6 0± 2 6 6 ,19 6 2± 1 75 ,P <0 0 5 )。　结论　结果表明补肾通络方能诱导去势大鼠阴茎细胞增殖。     

雄激素对衰老大鼠阴茎组织转化生长因子β基因表达的影响

目的探讨雄激素对阴茎组织中TGF-βmRNA的调控作用。方法将30只雄性大鼠随机分为3组,衰老组、丙酸睾酮组与对照组（2个月龄大鼠）,其中丙酸睾酮组给予丙酸睾酮治疗,于24d取阴茎组织,用PCR检测其TGF-βmRNA的表达。结果衰老组TGF-βmRNA的表达较其他2组增强,而表现TGF-βmRNA减弱的组,由少到多依次排定为对照组、丙酸睾酮组及衰老组;对照组、丙酸睾酮组及衰老组其TGF-βmRNA内控量较少,与衰老组比较有显著性差异（P〈O．01）。结论雄激素可能通过调节TGF-βmRNA表达而在阴茎勃起中发挥重要作用。     

半导体激光体外照射大鼠睾丸间质细胞作用的初步观察

目的探讨低强度半导体激光照射对睾丸间质细胞分泌睾酮的作用。方法原代培养大鼠睾丸间质细胞,用放射免疫方法测定睾丸间质细胞的睾酮分泌量,用MTT法测定细胞增殖率。比较激光照射组与对照组之间睾丸分泌量与细胞增值率的差异。结果激光照射第5天后,睾丸间质细胞增殖活性明显高于对照组（P〈0．05）。激光照射后第1天睾酮分泌量显著高于对照组（P〈0．05）,第2天就恢复到接近对照组水平,第3天略低于对照组的睾酮分泌量。结论低强度半导体激光可促进睾丸间质细胞增殖,使睾酮分泌量短暂升高。     

低氧对雄性大鼠睾酮分泌及其合成相关蛋白和酶表达的影响

目的研究低氧对雄性大鼠睾酮分泌及其合成相关蛋白和酶表达的影响。方法36只雄性Wistar大鼠随机分为常氧、低氧5d、低氧15d和低氧30d组。运用放射免疫测定法和反转录聚合酶链式反应（RT—PCR）方法，研究了模拟海拔5000m高度低氧5d、15d、30d对雄性Wistar大鼠血中睾酮浓度的影响，以及对睾丸组织中睾酮合成相关的类固醇急性调节蛋白（StAR）、胆固醇侧链裂解酶（P450scc）以及313-羟甾脱氢酶（3β-HSD）mRNA表达的影响。结果模拟海拔5000m高度低氧15d，大鼠血中睾酮浓度显著高于常氧组（P〈0．05），低氧30d，大鼠血中睾酮浓度显著低于对照组（P〈0．05）；低氧不引起雄性大鼠睾丸组织StARmRNA表达改变；低氧15d、30d，大鼠睾丸组织P450scc mRNA和3β-HSDmRNA表达分别显著低于常氧组（P〈0．05）。结论慢性低氧抑制了睾酮的分泌，并抑制了睾丸组织睾酮合成相关酶P450scc mRNA和3β-HSD mRNA的表达。低氧15d大鼠血中睾酮浓度升高的机制需进一步研究。     

选择性雌激素受体调节剂雷诺昔酚对去势后大鼠骨密度及股骨生物力学的影响

目的：观察选择性雌激素受体调节剂（SERM）雷诺昔酚（raloxifene）对去势后大鼠骨密度及股骨生物力学的影响。方法：将5月龄未经产雌性二级SD大鼠24只，随机分为3组，每组8只：A组为假手术（SHAM）组；B组为去势（VOX）组；C组为去势＋雷诺昔酚（V0x＋RAL）组。C组大鼠术后第7d开始给药。术后16w处死各组大鼠，对各组大鼠骨密度（BMD）、骨生物力学指标进行检测，并进行骨组织形态学观察。结果：（1）去势组与对照组比较，去势组股骨近端、股骨干、腰椎BMD明显降低（P．〈0．01）；雷诺昔酚治疗组各部位BMD高于去势组（P〈0．05），但没有恢复到SHAM组水平（P〈0．05）；（2）与Sham组比较，去势组大鼠骨的股骨最大载荷、桡度、最大应力、弹性模量均明显下降（P〈0．05），雷诺昔酚治疗组上述指标高于去势组（P〈0．05），接近对照组水平。结论：去势后16w大鼠松质骨、皮质骨骨量、骨组织形态计量学及生物力学指标均明显下降。雷诺昔酚治疗后大鼠松质骨，皮质骨密度得到较好维持，雷诺昔酚对骨组织形态计量学及生物力学状况有显著改善作用，可减少和抑制骨质疏松性骨折的发生。     

补肾疏肝方治疗男性迟发性性腺功能减退症的临床研究

目的观察补肾疏肝方治疗男性迟发性性腺功能减退症的疗效。方法2003年2月～2007年6月男科门诊经雄激素部分缺乏问卷评分、血清睾酮（TT）测定筛选出雄激素部分缺乏症69例，平均年龄62．62岁，无器质性病变。36例作为治疗组予口服补肾疏肝方3个月，33例作为对照组未予特殊治疗。观察比较治疗前后雄激素部分缺乏评分和性激素的变化。结果治疗组治疗3个月雄激素部分缺乏评分总分和构成评分与治疗前比较明显改善（P〈0．01），治疗后3个月TT与治疗前比较明显改善（P〈0．01）。对照组雄激素部分缺乏评分总分和构成评分及性激素水平无明显变化（P〉0．05）。结论补肾疏肝方治疗男性迟发性性腺功能减退症安全、有效。     

血清性激素水平变化对子宫肌瘤影响临床观察

目的：探讨血清性激素水平变化与子宫肌瘤病因的关系，以及子宫切除手术对卵巢功能的影响。方法：对子宫肌瘤23例（术前组），于术前测定血清促卵泡生成素（FSH）、黄体生成素（LH）、垂体生乳素（PRL）、孕激素（P）、雄激素（T）及雌激素（B）水平；对子宫肌瘤术后57例（术后组），于术后2年测定性激素含量；将健康育龄妇女52例作为对照组。测定3组6项性激素水平的变化。结果：子宫肌瘤术前组和对照组比较，FSH、LH、PRL、T水平变化有显著差异（P〈0．05），P、B水平变化有显著差异（P〉0．05）。术前组和术后组比较，FSH、LH、PRL、T、B水平变化有显著差异（P〈0．05），P水平变化无显著差异（P〉0．05）。术后组和对照组比较，FSH、LH、PRL、T、B水平变化无显著差异（P〈0．05），P水平变化无显著差异（P〉0．05）。结论：子宫肌瘤的发生和发展可能与雌孕激素受体及雄激素有关；子宫切除术后卵巢远期功能下降。     

儿童期特发性男性乳腺发育的临床病理和免疫组化观察

目的：阐明儿童期特发性男性乳腺发育（CIE）的性质。方法：对37例儿童特发性乳腺进行临床病理学形态观察及免疫组化检测妊娠中特异β－1－糖蛋白（SP1）、癌胚抗原（CEA）、上皮膜抗原（EMA）和角蛋白（KT）的表达。结果：SP1、CEA、EMA、KT在CIG与正常乳腺中表达无显性差异（P＞0．05）。但与乳腺癌比较，上述指标SP1、CEA、KT在二中有高度显性差异（P＜0．01），EMA有显性差异（P＜0．05）。结论：上述结果提示CIG是一种近似正常的良性增加。     

维生素E对尾部悬吊大鼠雄性生殖损伤的防护作用

目的 研究维生素E（VE）对尾部悬吊大鼠雄性生殖损伤的防护作用。方法 选用性成熟期健康SD雄性大鼠30只，随机分为对照组、尾吊组、VE＋尾吊组3组。14d后观察各组大鼠的睾丸重量、形态，精子数量和质量以及血清激素含量。结果 与对照组相比，尾吊组大鼠睾丸重量、精子数量和质量以及血清睾酮含量均显著下降（P〈0．0．5）。VE可以显著改善这些指标（P〈0．05）。另外，尾吊组大鼠睾丸生精小管萎缩，间质水肿。生精上皮层数减少，细胞排列松散，生精小管腔内的精子数明显减少。VE＋尾吊组大鼠睾丸形态结构部分恢复正常，生精小管腔内的精子数量增多。结论 VE对尾部悬吊造成的大鼠雄性生殖损伤有防护作用。     

缬沙坦对兔动脉粥样硬化斑块中ACAT-1和PPARγy表达的影响

目的研究酰基辅酶A：胆固醇酰基转移酶-1（ACAT—1）和过氧化体增殖物激活型受体γ（PPAR-γ）在动脉粥样硬化斑块中的表达，以及血管紧张素Ⅱ1型受体拈抗剂缬沙坦对ACAT-1和PPAR-γ表达的影响。方法24只雄性日本大耳白兔随机分为对照组、缬沙坦干预组和高胆固醇饮食组，每组8只。喂养12周后，抽取静脉血检测血脂水平，并进行主动脉内膜／中膜比值测定，以RT-PCR和Western blotting方法检测各组主动脉ACAT-1、PPAR-γ mRNA及蛋白的表达。结果高胆固醇饮食组及缬沙坦干预组的血清胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）均无差别（P〉0．05），但均高于对照组（P〈0．01）。高胆固醇饮食组内膜和内膜／中膜厚度比值显著高于对照组和缬沙坦十预组（P〈0．01，P〈0．05），而缬沙坦干预组内膜和内膜／中膜厚度比值显著高于对照组（P〈0．01）。与对照组比较，高胆固醇饮食组和缬沙坦干预组ACAT-1、PPAR-γ mRNA和蛋白含量显著增加（P〈0．01或P〈0．05）；ACAT-1 γ-mRNA和蛋白在缬沙坦干预组的表达显著低于高胆同醇饮食组（P〈0．01或P〈0．05），而PPAR-γ mRNA和蛋白在缬沙坦干预组的表达显著高于高胆固醇饮食组（P〈0．05）。高胆固醇饮食组和缬沙坦干预组ACAT-1和PPAR-γ mRNA的表达呈明显负相关（P〈0．05）。结论缬沙坦可能通过上调PPAR-γ抑制ACAT-1的表达，从而起到抗动脉粥样硬化的作用。     

碳酸氢钠预处理对膝关节置换手术中松止血带后的血流动力学的影响

目的 观察TKA中松开止血带前,以碳酸氢钠输注预处理对血流动力学的影响。方法 60例ASA II-III拟择期在全身麻醉下行膝关节置换的患者随机分为碳酸氢钠组（BR组,n=30）和复方林格组（RL组,n=30）。两组患者常规全麻下接受手术,手术中使用气压止血带止血,在松开止血带前分别泵注（15 min）5%碳酸氢钠250 mL（BR组）和复方林格液250 mL（RL组）。输注完成后松开止血带,观察心率（heart rate,HR）,收缩压（systolic blood pressure,SBP）,舒张压（diastolic blood, pressure,DBP）,中心静脉压（central venous pressure,CVP）的变化,观察时间点：快速输注前（T1）,快速输注5 min（T2）,快速输注10 min（T3）,松开止血带后5 min（T4）,松开止血带后30 min（T5）。手术中使用间羟胺作为低血压调控药物。结果 （1）T1-T3 两组间血流动力学变化无统计学意义;（2）T4时,HR（P=0.046）,SBP（P=0.006）,DBP（P=0.02）改变情况均明显低于RL组（P<0.05）;和T3比较,T4时,两组患者的SBP,DBP以及CVP均出现了明显程度的改变。T5时,改变的血流动力学情况有所恢复;（2）BR组的间羟胺使用量明显低于LR组（P=0.018）。结论 在TKA中在松开止血带前,静脉注射碳酸氢钠进行预处理,能有效缓解松开止血带所引起的血流动力学变化。     

超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中的应用效果分析

目的探讨超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中的应用效果。方法回顾性分析2017年1月至2019年3月南阳市骨科医院收治的分别采用超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注麻醉行髋关节置换术的51例老年患者(设为研究组)与右美托咪定持续泵注复合全身麻醉行髋关节置换术的51例老年患者(设为对照组)的病历资料,对比观察两组患者的麻醉时间,手术时间,输血量,右美托咪定使用量及入室后(T0)、麻醉诱导后即刻(T1)、麻醉诱导后5 min(T2)、麻醉诱导后30 min(T3)、术毕(T4)时的心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO2),并采用视觉模拟评分法(visual analogue scale,VAS)评估患者术后2、4、8、12、24、48 h的疼痛程度。结果(1)两组患者麻醉时间、手术时间及输血量均无明显差异(P均>0.05),而研究组患者右美托咪定使用量明显少于对照组(t=9.612,P=0.000)。(2)T1、T2、T3、T4时,研究组患者HR及MAP均无明显变化(P均>0.05),而对照组患者HR及MAP均呈先降低后升高的趋势(F=12.560、4.643,P=0.000、0.001),且T1、T2、T3时研究组患者HR及MAP均明显高于对照组(HR:t=2.130、2.089、2.091,P=0.036、0.039、0.039;MAP:t=2.043、2.676、2.323,P=0.044、0.009、0.022),而T4时研究组患者HR及MAP均明显低于对照组(t=2.609、1.993,P=0.011、0.049);T1、T2、T3、T4时,两组患者SpO_2均无明显变化(P均>0.05),且各时间点两组患者SpO_2均无明显差异(P均>0.05)(3)术后2、4、8、12、24、48 h,两组患者VAS评分均呈先降低后升高再降低的趋势(F=85.860、32.650,P均=0.000),且术后2、4、8、12 h研究组患者VAS评分均明显低于对照组(t=14.380、12.540、11.490、15.960,P均=0.000),而术后24、48 h两组患者VAS评分无明显差异(P均>0.05)。结论超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注可有效维持老年髋关节置换术患者的麻醉药物用量,维持血流动力学稳定,降低疼痛程度,临床疗效更为显著。     

Quantitation of pharmacologically-induced penile erections: the value of radionuclide phallography in the objective evaluation of erectile haemodynamics

This study combines the pharmacologically-induced penile erection (PIPE) technique with radionuclide phallography (RNP) for the non-invasive study of penile haemodynamic changes during erection. Penile erections produced by the intracavernosal injections of two different vasoactive drugs, prostaglandin E1 (PGE1) and papaverine HCl (PPV) were assessed by quantitation of the dynamic RNP and parameters of erection were defined and compared. PGE1 intracavernosal injections were seen to elicit a better erectile response than PPV. Dynamic radionuclide phallography was performed using 99Tcm-labelled autologous RBCs in five normally potent volunteers, sixteen patients with psychogenic impotence, seven patients with vasculogenic impotence (three arteriogenic, four venous leakage) and one patient with neurogenic impotence. Physical parameters of erection including the penile length and circumference changes during erection and the erectile angle were compared with the indices of penile blood flow and volume derived through quantitation of the RNP. There was a close correlation between the penogram index (an index of penile blood volume) and penile circumference increase during erection (r = 0.77, p less than 10(-6). The erectile angle, a measure of penile rigidity, correlated strongly (r = 0.82, p less than 10(-6) with the flow index, a measure of penile blood volume. Patterns specific to various categories of impotence were observed and these aided in the diagnosis, especially in equivocal cases with a suboptimal clinical response to the intracavernosal injection. Quantitative RNP offers a non-invasive method which allows direct objective assessment of the erectile response providing several quantitative parameters for analysis.     

低T3综合征早产儿治疗的临床观察

目的探讨低T3综合征早产儿早期治疗的临床意义。方法将78例28～32周低T3综合征早产儿随机分为两组，治疗组给予甲状腺素替代治疗，观察两组临床情况、甲状腺素水平、神经系统发育情况的变化．应用t检验和χ^2检验进行比较。结果两组T3和FT3水平均随原发病的好转及年龄的增长逐渐恢复，生后4周时两组间有显著性差异（P〈0．05），生后6周时两组间无显著性差异（P〉0．05）。对两组患儿的体重恢复时间、黄疸持续时间、住院天数、静脉营养时间进行比较，两组间有显著性差异（P〈0．05）；而校正胎龄40周时的NABA评分及1岁时的CDCC测试无显著性差异（P〉0．05）。结论对低T3综合征早产儿进行早期干预治疗可以改善临床情况，促进早期恢复。     

Local staging of penile cancer using magnetic resonance imaging with pharmacologically induced penile erection

PURPOSE: This study was undertaken to compare the local staging of penile cancer by magnetic resonance imaging (MRI) combined with pharmacologically induced penile erection (PIPE), with clinical examination and pathology, and to verify whether MRI-PIPE led to changes in treatment planning in our cohort. MATERIALS AND METHODS: Thirteen patients with untreated penile cancer underwent local staging by clinical examination and MRI-PIPE obtained by intracavernosal injection of 10 mug prostaglandin E1. Transverse, sagittal and coronal T2-weighted and T1-weighted (before and after intravenous gadolinium injection) images were obtained with a four-channel phased-array coil. Tumours were treated according to stage, as defined by MRI-PIPE and clinical examination. Stage T1 tumours underwent laser ablation and stage T2 or T3 tumours partial or total penectomy. RESULTS: Twelve penile cancers were squamous cell carcinomas and one was a sarcoma. MRI-PIPE correctly staged 12 out of 13 patients, failing to detect one in situ carcinoma. Clinical examination correctly staged eight out of 13 patients, overstaging two patients (one Tis was overstaged as T1 and one T1 as T2) and understaging three patients (two T2 as T1 and one T3 as T2). CONCLUSION: MRI-PIPE performed better than the clinical examination and changed treatment planning in three patients.     

Quantitative T2 mapping of matrix-associated autologous chondrocyte transplantation at 3 Tesla: an in vivo cross-sectional study

OBJECTIVES: To evaluate magnetic resonance (MR) T2 mapping for characterization of cartilage repair tissue following matrix-associated autologous cartilage transplantation (MACT). MATERIALS AND METHODS: Fifteen patients were evaluated following MACT using a 3T MR scanner. Patients were categorized into 2 postoperative intervals: I: 3-13 months, II: 19-42 months. Mean T2 relaxation times calculated from multiple spin-echo sequence were determined in regions of interest (MACT and normal hyaline cartilage) and T2 line profiles through the repair tissue and control sites were acquired. RESULTS: Mean global T2 values of repair tissue in group I were significantly higher than at control sites (P < 0.05). Repair tissue in group II showed no significant difference to control sites. Repair tissue T2 line profiles normalized over time toward the control sites. CONCLUSIONS: T2 mapping allows visualization of cartilage repair tissue maturation. Global T2 repair tissue values approach that of control sites after more than 1.5 years, similar behavior is seen in the zonal organization.     

Cavernosography in conjunction with artificial erection for evaluation of venous leakage in impotent men

Twenty men with incomplete penile erection or inability to maintain an erection were evaluated to determine if venous leakage was a cause. Cavernosography was performed in conjunction with artificial erection induced by infusion of saline into the corpus cavernosa. Thirteen patients requiring higher than normal rates of saline infusion to achieve or maintain erection showed filling of superficial veins in the flaccid state as well as during erection. In five of the seven patients with normal saline requirements there was no filling of superficial veins, and two showed filling in the flaccid state only. Of the thirteen patients whose conditions were diagnosed as venous leakage, seven underwent surgical ligation of superficial veins and deep penile vein arterialization by a saphenous vein bypass graft between the superficial femoral artery and deep penile vein. All these patients had reduced saline requirements postoperatively. When cavernosography is performed in the flaccid state only, filling of superficial veins can occur normally; therefore, these studies should be performed with artificial erection.     

人工肱骨头假体置换与锁定板治疗复杂肱骨近端骨折的疗效对比

目的比较人工肱骨头假体置换与锁定板治疗复杂肱骨近端骨折的疗效。方法回顾性分析2013—2016年南通大学附属南京江北人民医院创伤关节外科收治的32例复杂肱骨近端骨折患者的临床资料,其中采取人工肱骨头假体置换治疗16例(置换组),采取锁定钢板内固定治疗16例(内固定组)。比较两组患者一般手术情况、临床疗效、术后4周时VAS评分及Constant-Murley评分。结果 (1)两组患者在手术时间、术中出血量及一次性手术费用比较方面差异无统计学意义(P0.05);(2)置换组Neer评分优良率为75.00%,内固定组Neer评分优良率为81.25%,两组比较差异无统计学意义(P0.05);(3)置换组VAS评分(2.14±0.52)分,内固定组VAS评分(2.37±0.61)分,两组比较差异无统计学意义(P0.05);(4)置换组Constant-Murley评分(65.28±13.04)分,内固定组Constant-Murley评分(61.44±11.62)分,两组比较差异无统计学意义(P0.05)。结论人工肱骨头假体置换与锁定板治疗复杂肱骨近端骨折的手术时间、术中出血量及手术花费无明显差异,术后疗效相近。术式的选择主要依赖骨折复杂程度和患者一般状况。     

Effect of bicycle racing saddle design on transcutaneous penile oxygen pressure

AIM: To determine the reliability of monitoring penile transcutaneous oxygen (tpO2) during cycling, and to assess the influence of seat design and cycling position on tpO2. METHODS: Experimental design: repeated measures analysis of the effects of seat design and riding position on tpO2 values. Participants: 31 male cyclists between the ages of 20 and 50 years participated. Subject inclusion criteria were: averaged=or>80 miles of road bicycling per week during the 2 months prior to enrollment in this study; no history of vascular disease, diabetes, or sexual dysfunction; and had an erection within 15 days prior to study. Measures: mean tpO2 values were calculated for seated and standing positions using 3 current bicycle seat designs. RESULTS: Test-retest reliability for seated cycling tpO2 values had an ICC (3,1) of 0.76 and mean absolute difference of 5.1 mmHg. Test-retest reliability for standing cycling tpO2 values had an ICC(3,1) of 0.88 and mean absolute difference of 7.23 mmHg. No interaction effect occurred between seat design and position. Seat design had no significant effect on tpO2 values. Seated cycling significantly reduced tpO2 levels compared with standing cycling (P<0.05). Mean percent decreases in tpO2 from standing to seated cycling were; Vetta 76%, Terry 73%, and Specialized 62%. CONCLUSION: The data suggest that penile tpO2 monitoring is reliable for use during cycling studies. None of the seats exhibited any significant ability to spare penile tpO2. The implications of decreased penile tpO2 over different time intervals on penile physiology remain to be investigated.     

Cystic fibrosis in adolescents and adults: fatty replacement of the pancreas--CT evaluation and functional correlation

PURPOSE: To compare the computed tomographic (CT) features of pancreatic fatty replacement in adolescents and adults with cystic fibrosis (CF) with those in control subjects and to correlate the degree of fatty replacement with the functional status of the pancreas. MATERIALS AND METHODS: CT scans in 15 patients with CF (group 1) and in 15 control subjects without CF (group 2) were evaluated for thickness and degree of pancreatic fatty replacement. Thickness was measured at four anatomic levels. The pattern of pancreatic fatty replacement was visually evaluated in four pancreatic regions. Images were semiquantitatively analyzed by two readers. The degree of fatty replacement was correlated with the functional status of the pancreas. RESULTS: In group 1, pancreatic glandular tissue was significantly thinner (P < .001) and the degree of fatty replacement was significantly greater in the four regions (P < .001) than those in group 2. In Group 1, no relationship was found between the degree of pancreatic fatty replacement and that of pancreatic endocrine dysfunction. A significant relationship was found between the degree of fatty replacement and that of pancreatic exocrine dysfunction (P < .001). CONCLUSION: In patients with CF, pancreatic glandular tissue is significantly reduced in size. Pancreatic fatty replacement is the most frequent pattern in older patients with CF and correlates with pancreatic exocrine dysfunction.