Ultrasonographic evaluation of knee joint cartilage in rheumatoid arthritis patients

The non-invasive methods used to study joint cartilage are restricted in their scope. No direct visualization of the joint cartilage is possible in conventional radiology and tomography and the decrease in joint space is only indirect evidence for joint destruction. CT is a radiologic method for direct visualization of joint cartilage but its diagnostic precision in the evaluation of early cartilage lesions is limited because it can not produce an image in a plane other than the transversal plane perpendicular to the direction of the main axis of the body and because it has limited spatial resolution. Other methods for direct visualization of joint cartilage are arthrography and arthroscopy which are little used in clinical practice because of their invasiveness and limited indications. MRI is a promising technique but its usage is limited by the high price and limited accessibility. Our object in the present study was to evaluate the significance of arthro-sonography in the diagnosis of early arthritic lesions of knee cartilage, based on the ultrasonographic assessment of the joint surface and cartilage thickness. Femoral cartilage was our choice for the study as there is statistically well documented high incidence of early arthritic changes in this area; moreover, the area is easily accessible for ultrasound evaluation using a scan perpendicular to the articular surface, incl. the cases with complete flexion of the knee joint, where the pressure areas of the condyles are apositioned to the tibial plateau. Using a 7.5 MHz transducer we managed to measure and document early arthritic changes in joint thickness and the contour of the joint surfaces before they can be detected using routine radiologic methods.     

Ultrasonographic gastric emptying in protein energy malnutrition: effect of type of meal and nutritional recovery

OBJECTIVE AND DESIGN: The earlier reports of disturbed gastric motility in protein energy malnutrition (PEM) point out to its possible contribution in the difficulties faced during nutritional rehabilitation. This study was thus designed to assess the ultrasonographic gastric emptying time (GET) using 20 ml/kg body weight of both liquid and semisolid meals, in 27 patients suffering from PEM as well as in 15 healthy matching infants to delineate any defect present, its degree in different types of PEM and the effect of nutritional rehabilitation. PATIENTS: The patients were recruited from the in-patient department of Children's Hospital, Ain Shams University, Cairo, Egypt. They were divided into three groups: 10 marasmic infants, 10 marasmic kwashiorkor (marasmic KWO) and seven kwashiorkor (KWO) cases. Ultrasonographic GET assessment was carried out within 72 h of admission and 30+/-7 days after nutritional rehabilitation. RESULTS: The gastric half-emptying time T(1/2) of both liquid and semisolid meals was markedly prolonged in patients with marasmus and marasmic KWO. It was more delayed for the semisolid than the liquid meals. This delay was reversible after nutritional rehabilitation of the patients, indicating that it was secondary to the malnourished status. On the other hand, T(1/2) of both liquid and semisolid meals showed no statistically significant delay in the KWO group and nutritional rehabilitation added no further to the results. CONCLUSION: PEM, especially marasmus and marasmic KWO, causes a delay in GET, which is reversible on nutritional recovery. This must be considered during nutritional rehabilitation of such patients to decrease the duration of their hospitalization and thus decrease the morbidity in PEM.     

异尖线虫病诊断与防治的相关研究

异尖线虫病是由异尖线虫第三期幼虫感染而引起的一种寄生虫病,可致使人产生急腹症、过敏症等临床症状,是我国禁止入境的二类寄生虫病.异尖线虫病呈世界性分布,目前病例报道主要集中于日本和西欧等国家.此文对该病的病原学、实验室检查、临床诊断及其防治等相关研究作了综述.     

异尖线虫病诊断与防治的相关研究

异尖线虫病是由异尖线虫第三期幼虫感染而引起的一种寄生虫病,可致使人产生急腹症、过敏症等临床症状,是我国禁止入境的二类寄生虫病.异尖线虫病呈世界性分布,目前病例报道主要集中于日本和西欧等国家.此文对该病的病原学、实验室检查、临床诊断及其防治等相关研究作了综述.     

胃癌常用化疗方案及其评价

胃癌化疗方案甚多且在不断变化中 ,这里仅就当前疗效较好 ,应用相对较广 ,有一定代表意义的扼要介绍 ,并酌情叙述其可供临床方案个体化时的药物与用法的变通1　ELF方案 (etoposide ,leucovorin ,fluorouracil) [1]足叶乙甙 (E .Vp16 ) 12 0mg m2 静脉点滴d1～ 3亚叶酸钙 (Lv .CF) 30 0mg m2 静脉点滴d1～ 3氟尿嘧啶 (5 -FU ,F) 5 0 0mg m2 静脉点滴d1～ 3每 3～ 4周重复 ,每次Lv于 5 -FU前先给药。评价 :本方案利用 3Lv与 5 -FU的生化调节作用加强了疗效。有效率在 5 0 %左右 ,毒副作用较小 ,对不同情况患者适用面较广。1 1　本方案…     

胃癌筛查的卫生经济学评价进展

我国是胃癌高发国家,而胃癌筛查对其早发现、早诊断及早治疗具有重要意义。目前的筛查手段包括胃镜筛查、血清学筛查、幽门螺杆菌筛查、上消化道钡餐筛查,然而何种筛查手段具有最佳成本效果并不明确。本文分析了国内外多种胃癌筛查的卫生经济学研究,以期为我国的胃癌筛查工作提供借鉴。目前几种筛查方法都符合成本效果原则,胃镜检查比消化道钡餐筛查有成本效果优势,幽门螺杆菌血清学筛查具有最佳成本优势。     

The radioallergosorbent test (RAST) for the serological diagnosis of human anisakiasis

The serum of patients with parasitologically confirmed and one patient with a clinically presumptive case of anisakiasis were tested by the radioallergosorbent test (RAST) and counter-electrophoresis (CEP) for IgE and IgG antibodies, respectively, using antigens prepared from larval (L3) stage Anisakis simplex and larval (L2) stage Toxocara canis. All sera were RAST-positive to the A. simplex antigen and RAST-negative to the T. canis antigen. All sera were CEP-negative to both antigens. The presence of a specific IgE antibody suggests that the RAST could serve as a useful technique for the serodiagnosis of anisakiasis in man.     

输尿管钙石的超声影像学研究

目的　探讨输尿管钙石形成的机制和超声检查的诊断价值。方法　使用凸阵探头 ,对 1 36例输尿管钙石患者进行超声检查 ,并与 CT、X线平片和静脉肾盂造影进行对比分析。结果　本组病例均有不同程度的腰部不适、肾绞痛和血尿等临床表现 ,超声检查表现为输尿管内径大于 4mm,在扩大的输尿管管腔内见有强回声的钙石病灶显示 ,可引起肾周水肿且输尿管钙石引起的肾周水肿以肾的上极和下极多见。结论　在一些地区输尿管钙石的形成可能与水的硬度有关。超声检查能清楚地显示输尿管内液区及钙石病灶并具有确诊价值 ,对临床有明显症状且高度怀疑输尿管钙石的患者应首选超声检查。     

病理性双胎妊娠的超声诊断

目的 探讨腹部超声在胎儿畸形尤其是病理性双胎妊娠中的诊断价值.方法 近两年产前超声检查9 982例,孕早期超声检查要注意观察绒毛膜囊数及羊膜囊数,孕中晚期注意观察胎盘数、双胎儿大小、形态、羊水量及脐血流的变化.结果 9 982例产前超声检查中单胎妊娠9 831例,单胎畸形458例,占妊娠总数的4.59%,占单胎妊娠的4.66%;双胎妊娠150例,病理性双胎32例,占妊娠总数的0.32%,占双胎的21.33%;三胎妊娠1例,占妊娠总数的0.01%.双胎病理性妊娠包括:①双胎之一消失或形成纸样儿17例,占病理性双胎的53.13%;②双胎宫内生长受限7例,占21.88%;③双胎输血综合征5例,占15.63%;④双胎之一无心畸形1例,占3.13%;⑤联体双胎2例,占6.25%.结论 腹部彩色多普勒超声检查是筛查胎儿畸形及病理性双胎妊娠的最佳选择,简便、易行、无创、重复性好.     

原发性输尿管肿瘤的超声诊断价值

目的：探讨原发性输尿管肿瘤的声像图特点。方法：回顾性分析经手术和病理证实的11例原发性输尿管肿瘤,对其大小、位置、声像图特点、肾积水程度及临床症状进行研究。结果：11例病灶中检出6例,位于输尿管上段1例,位于下段或末端5例,显示为高回声团块4例,显示为低回声团块2例,误诊为膀胱占位2例,因腹腔胀气严重,无法探及病灶的3例．11例均有肾积水。结论：原发性输尿管肿瘤声像图表现具有一定的特征,超声检查再结合其临床特点对其诊断与鉴别诊断具有重要价值。     

部分性葡萄胎的超声诊断

目的：探讨部分性葡萄胎的声像图特点,以提高部分性葡萄胎的诊断符合率。方法回顾性分析西安交通大学医学院第一附属医院2013年1月至2014年12月35例部分性葡萄胎患者(超声诊断29例,病理诊断6例)的病史、病理结果及超声声像图。结果29例超声诊断为部分性葡萄胎的患者,与病理结果相符合的有25例,其诊断符合率为86.2%(25/29);误诊病例4例,其中稽留流产2例,不全流产1例,肌瘤变性1例。6例病理诊断为部分性葡萄胎而超声漏诊的患者中,有3例超声诊断为稽留流产,1例诊断为不全流产,1例诊断为肌瘤变性,1例诊断为完全性葡萄胎。结论超声检查结合病史能够诊断绝大多数的部分性葡萄胎,但不典型的患者往往需结合病理以及实验室检查进行诊断。     

中孕期胎儿颅脑超声诊断价值

目的探讨中孕期胎儿颅脑超声表现，提高产前超声对胎儿颅脑正常结构及畸形的认识。方法观察12—40周胎儿颅内结构，测量双顶径(BPD)，侧脑室宽度(LVW)，后颅窝池宽度(CM)及颈部透明层(NT)或颈项软组织厚度(NF)。结果共检出颅脑异常18例．合并其他畸形9例，其中16—28周14例，均经出生或引产后证实。结论中孕期超声是胎儿颅脑结构产前检查的最佳时机。