超声心动图对糖尿病心肌病的评价

目的:探讨超声心动图对糖尿病性心肌病的诊断价值.方法:通过观察35例2型糖尿病超声心动图与正常人对照,评价2型糖尿病患者左心室舒张功能的变化,探讨一种早期诊断糖尿病心肌病的检测方法.结论:通过对糖尿病患者应用超声心动图的检测可早期发现糖尿病性心肌病.     

超声心动图在评价小儿扩张型心肌病预后中的应用

目的:探讨超声心动图在评价小儿原发性扩张型心肌病预后中的作用。方法:对30例原发性扩张型心肌病患儿的超声心动图资料进行回顾分析和随访研究,分别比较存活组和死亡组的心脏超声测量指标。结果:两组(生存组和死亡组)LVEF有统计学差异(P=0.016),其它各项指标均无统计学差异。超声检测的二尖瓣病变和肺动脉瓣病变在两组间无统计学差异(P>0.05)。结论:LVEF值和三尖瓣病变程度可作为评价扩张型心肌病患儿临床预后的指标。     

超声心动图评价肥厚型心肌病的研究进展

肥厚型心肌病(HCM)是一种常见的遗传性心血管疾病,早期诊断和准确评估对于HCM的治疗和预后至关重要.本文对国内外关于HCM的超声心动图研究现状、各种新技术的临床应用及研究进展进行综述.     

腹腔镜胆囊切除术与开腹胆囊切除术对神经内分泌激素的影响

腹腔镜胆囊切除术与开腹胆囊切除术对神经内分泌激素的影响陈绍洋曾祥龙王庆德熊利泽董海龙本文观察腹腔镜胆囊切除术（ＬＣ）和开腹胆囊切除术（ＯＣ）病人围术期神经、内分泌激素的变化，旨在评估两种术式创伤程度和对代谢的影响。资料和方法２６例ＡＳＡⅠ～Ⅱ级，无明...     

超声内镜在胰腺神经内分泌肿瘤诊治中的价值

胰腺神经内分泌肿瘤（PNETs）定位诊断的准确性是决定病人手术成败和预后的关键。文献报道,超声内镜（EUS）对PNETs的定位诊断具有很高的敏感性,已成为术前定位诊断的重要手段。     

心脏移植术后超声心动图评价左心室功能

心脏移植术后超声心动图评价左心室功能张桂珍，高晖，韩玲，张卫峰，吴雅峰，张燕１９９２年３月２０日我们为１例１６岁，扩张型心肌病女病人原位心脏移植成功。至同年１０月１６日突然急性排异死亡期间，共进行心肌活检、同时作超声心动图监测１０次，现将结果报告分析...     

原发性睾丸神经内分泌癌1例的超声表现及文献复习

1临床资料 患者,男,61岁,因左侧阴囊逐渐长大1年余,于2007年7月12日人住我院泌尿外科.患者1年多前洗澡时偶然发现左侧阴囊内睾丸肿大.     

Echocardiographic evaluation of cardiac function after cancer chemotherapy

Progress in cancer therapy has led to improved prognosis of patients with cancer and thus to a continuous rise of cancer survivors. However, it has simultaneously increased cardiovascular morbidity and mortality rates due to direct and/or indirect side effects of anticancer treatment. Similar to the rapid rise of patients with adult congenital disease, the number of patients suffering or at risk of cardiotoxicity has been steeply increasing and getting an emerging issue. Among the many facets of chemotherapy-induced cardiovascular toxicity, this review attempts to summarize echocardiographic evaluation of cardiac function after cancer chemotherapy by reviewing the definition, risk factors, brief history, limitation of left ventricular ejection fraction and myocardial strain imaging, as well as the limitations of this technique.     

Echocardiographic evaluation of the evolutionary changes after heart transplantation

AIM: To undertake an evolutionary analysis of echocardiographic examinations carried out during follow-up of cardiac transplant patients. MATERIALS AND METHODS: The study included 193 consecutive patients transplanted between August 1998 and December 2004. We excluded pediatric, cardiopulmonary, and repeat transplants. Four echocardiographic examinations were analyzed per patient (first, second, third quarter and the last study carried out; average time from transplant: 1115 +/- 681 days). The total number of examinations was 772. The evaluated variables were thickness of walls and diameters of the cavities, systolic and diastolic functions, pericardial effusion, and number of rejections. RESULTS: The isovolumetric relaxation time showed reduced values during early echocardiography with subsequent increases during evolution (first echocardiogram: 92 +/- 16 vs final echocardiogram 101 +/- 16 ms; P < .0001). Right ventricular function showed initial deterioration with subsequent recovery (first echocardiogram: 16% vs final echocardiogram: 8%; P < .05); moreover, the existence of delayed malfunction of the right ventricle was correlated with a higher incidence of transplant rejection (P < .01). Pericardial effusion was initially present with a tendency to reduce over time (first echocardiogram: 58% vs final echocardiogram: 12%; P < .0001). There was no difference in the other variables. CONCLUSIONS: Cardiac transplant patients undergo evolutionary echocardiogram alterations that were mainly early and normalized as of the first quarter. The most usual changes in this period were restrictive isovolumetric behavior accompanied by some degree of depressed right ventricular function. Right ventricular malfunction during late evolution was correlated with a higher incidence of transplant rejection during follow-up.     

Echocardiographic evaluation in type 1 diabetic patients on waiting list for isolated pancreas or kidney-pancreas transplantation

Type 1 diabetic patients may display abnormalities of left ventricular geometry and systolic and diastolic function. Patients on the waiting list for solitary pancreas or kidney-pancreas transplantation were evaluated by Doppler echocardiography to assess left ventricular geometry and systolic and diastolic function, and correlate these parameters with clinical characteristics. We evaluated 78 patients including 45 men with an overall mean age of 39.5 +/- 7.2 years and a disease duration of 24 +/- 9.8 years. Among these 78 patients, 13 showed isolated retinopathy, 9 isolated arterial hypertension, 45 concomitant retinopathy and hypertension and overt nephropathy, while 11 were free of complications. The results of our study showed an increased left ventricular mass and abnormal diastolic function among patients with simultaneous target organ complications and with hypertension, as has been reported in many previous studies. In contrast study patients with no complications showed normal left ventricular structure and function. This finding conflicts with data from several reports in the medical literature in which diastolic impairment was present in type 1 diabetic patients at an early stage of disease and with no evident microvascular and macrovascular complications.     

Echocardiographic assessment of takotsubo cardiomyopathy: beyond apical ballooning

It has been >25 years since the first report of the takotsubo cardiomyopathy (TC). Although left ventriculography was originally used to depict its typical and impressive wall motion abnormality mimicking “takotsubo”, or octopus pot, echocardiography plays a pivotal role in detecting not only its left ventricular (LV) wall motion abnormality, apical ballooning, but also various other findings. First of all, apical ballooning is not an essential finding for TC anymore. Mid-ventricular LV asynergy with or without apical involvement is a basic pattern of the LV wall motion abnormality. Distribution and time course of the asynergy may be best detected by echocardiography and echo provides useful information to differentiate between TC and acute coronary syndrome or acute myocarditis. In addition to the wall motion assessment, echo detects complications of TC such as systolic anterior motion of the mitral leaflet with or without LV outflow obstruction, mitral regurgitation, LV thrombus, right ventricular (RV) involvement. In particular, RV involvement is not an uncommon finding and is associated with worse short-term as well as long-term prognosis. Finally, coronary flow measurements and speckle tracking by echo may offer additional and useful information about pathophysiology and prognosis of TC. In conclusion, echocardiography is a standard imaging modality for detecting various dynamic findings beyond apical ballooning in patients with TC.     

Modulation of growth hormone signal transduction in kidneys of streptozotocin-induced diabetic animals: effect of a growth hormone receptor antagonist

Growth hormone (GH) and IGFs have a long distinguished history in diabetes, with possible participation in the development of renal complications. The implicated effect of GH in diabetic end-stage organ damage may be mediated by growth hormone receptor (GHR) or postreceptor events in GH signal transduction. The present study investigates the effects of diabetes induced by streptozotocin (STZ) on renal GH signaling. Our results demonstrate that JAK2, insulin receptor substrate (IRS)-1, Shc, ERKs, and Akt are widely distributed in the kidney, and after GH treatment, there is a significant increase in phosphorylation of these proteins in STZ-induced diabetic rats compared with controls. Moreover, the GH-induced association of IRS-1/phosphatidylinositol 3-kinase, IRS-1/growth factor receptor bound 2 (Grb2), and Shc/Grb2 are increased in diabetic rats as well. Immunohistochemical studies show that GH-induced p-Akt and p-ERK activation is apparently more pronounced in the kidneys of diabetic rats. Administration of G120K-PEG, a GH antagonist, in diabetic mice shows inhibitory effects on diabetic renal enlargement and reverses the alterations in GH signal transduction observed in diabetic animals. The present study demonstrates a role for GH signaling in the pathogenesis of early diabetic renal changes and suggests that specific GHR blockade may present a new concept in the treatment of diabetic kidney disease.     

Prostate-specific antigen decline after gonadotropin-releasing hormone antagonist withdrawal in androgen-independent prostate cancer

A 66-year-old man with androgen-independent prostate cancer was treated with abarelix, a gonadotropin-releasing hormone antagonist, for 20 weeks in an experimental protocol. He did not respond to therapy, but his serum prostate-specific antigen level dropped from 15.8 ng/mL to a confirmed 0.8 ng/mL after abarelix was stopped. His prostate-specific antigen level did not return to greater than 15.8 ng/mL for 14 months. This is the first report of a withdrawal response after therapy with a gonadotropin-releasing hormone antagonist, a new class of agents for prostate cancer. Additional observations are needed to determine whether this is an isolated case or a harbinger of a more common phenomenon.     

Echocardiographic evaluation of left ventricular wall motion before and after heart transplantation.

Forty transplanted hearts were retrospectively investigated before, immediately after, and 15 +/- 12 months after heart transplantation by two-dimensional echocardiography for the presence and course of left ventricular myocardial wall motion abnormalities. Fourteen heart donors who were brain dead because of subarachnoid hemorrhage formed group 1 (mean age, 35 years); 21 heart donors who were brain dead because of head injury formed group 2 (mean age, 29 years), and five heart donors who were brain dead because of head injury with an additional chest trauma formed group 3 (mean age, 28 years). Myocardial wall motion was examined in six different myocardial segments (inferior, septal, anterior, posterior, posterolateral, apical) and was quantitatively assessed by a modified score index system (score index 0 = normal wall motion; score index 1 = diffuse hypokinesia). Overall, 27 of the 40 heart donors showed mild to severe (9 of the 40) wall motion abnormalities, which improved shortly after heart transplantation (score index: 0.36 vs 0.18, p < 0.01), and remained improved 15 months after heart transplantation (score index: 0.15). Among the different study groups, a significant improvement occurred in the myocardial wall motion score index on a short-term and long-term basis in all the groups, except for group 2, regarding the long-term follow-up. This study concluded that brain-dead, potential heart donors often reveal mild-to-severe left ventricular wall motion abnormalities, which are readily detected and semiquantitated by two-dimensional echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)     

Echocardiographic evaluation of potential cardiac transplant donors

Since the initiation of the UTAH Cardiac Transplant Program, echocardiography has been used to evaluate 74 potential donors including 65 of 71 hearts ultimately used for transplantation. Of these 65 donors, 46 had normal studies, nine had pericardial effusions, five had mild septal hypokinesia with otherwise normal function, four had equivocal mitral valve prolapse, and only one heart could not be visualized. All transplants were successful and all donor hearts exhibited satisfactory hemodynamic function immediately after transplantation, including the hearts that were mildly abnormal before transplantation. These hearts included 21 (29%) that could have been excluded by conventional screening criteria. Nine potential donor hearts with grossly abnormal echocardiograms were not used for transplantation, including eight hearts with severe hypokinesia and one heart with significant mitral and tricuspid regurgitation. Inspection or histologic analysis confirmed the presence of severe dysfunction or morphologic damage in those hearts subjected to these additional measures. We conclude that echocardiographic screening is a useful method of evaluating potential cardiac transplant donors. It can identify potential donors that would otherwise have been excluded and it can identify potential donors with severe cardiac dysfunction without the need for direct surgical inspection.