Serum leptin concentration in patients after heart transplantation

Abstract:  Leptin is primarily produced by adipocytes but its receptors are expressed in a variety of tissues including the heart. Elevated plasma leptin levels predict acute myocardial infarction and it has been shown as acute phase reactant and a risk factor for coronary heart disease. The present study was undertaken to answer the question whether there exists a relationship or not, between serum leptin levels and grades of acute cellular rejection confirmed by elective endomyocardial biopsies in stable patients after orthotopic heart transplantation. We observed higher serum leptin levels compared with reference values, regardless of histopathologic biopsy findings studied. There was a positive correlation between serum leptin concentrations and body mass index, diastolic blood pressure, total cholesterol and low-density lipoprotein. The elevated leptin levels found in heart transplant recipients could be due to the result of steroid therapy. These results point the need for further studies to explain the leptin role in heart transplant recipients.     

Functional evaluation of anterior urethral strictures with combined antegrade and retrograde urethrography

The merits of radiological examination for functional evaluation of urethral strictures of the anterior male urethra were studied by comparing the results of combined retro- and antegrade urethrography with the patient's maximum urinary flow-rate. A correlation was found between stricture diameter and maximum flow-rate (r=0.67) and a still higher correlation between the ratio stricture diameter-prestenotic urethral diameter and the flow-rate (r=0.73). A low but significant (p less than 0.05) negative correlation was obtained between the prestenotic urethral diameter and the flow-rate (r=0.25).     

恶性梗阻性黄疸患者经ERCP后出血的危险因素分析及模型预测

目的:探讨恶性梗阻性黄疸(MOJ)患者经内镜逆行胰胆管造影术(ERCP)后出血的危险因素分析及模型预测。方法:回顾性分析2015年1月—2021年6月于西南医科大学附属三六三医院就诊的ERCP治疗的MOJ患者302例,收集患者一般临床资料,并对患者胰胆管生化指标进行检测。出院后对患者进行随访,依据随访患者ERCP术后是...     

女性排尿困难影像尿动力学评估

目的了解以排尿困难为主诉的女性患者影像尿动力学的临床意义及下尿路梗阻的鉴别诊断。方法采用影像尿动力学检查４４例患者。结果神经原性膀胱占５０％,其中逼尿肌反射低下３９％,逼尿肌反射亢进为１１％;下尿路梗阻占３６％,其中尿道远端狭窄２７％,原发膀胱颈梗阻９％;感觉性尿急３％;正常１１％。结论影像尿动力学检查能了解患者逼尿肌的功能状况,并能准确判断下尿路梗阻的解剖水平,为临床治疗的选择提供了可靠的依据。     

Urethral pressure profile and retrograde urethrography in diagnosis of urethral strictures.

In 20 male patients with urethral strictures, urethral pressure profile was compared with retrograde urethrography. There was good accordance between the two methods with only minor discrepancies in multiple or very distal strictures. Urethral profile did not provide more exact information than did urethrography.     

Serum prostate-specific antigen to predict the presence of bladder outlet obstruction in men with urinary symptoms

OBJECTIVE: To determine whether prostate specific antigen (PSA) level can usefully predict or exclude bladder outlet obstruction (BOO), in men with lower urinary tract symptoms (LUTS). PATIENTS AND METHODS: A cohort of men from 1996 to 1999 who had LUTS caused by BPH was evaluated by serum PSA and pressure-flow urodynamic studies, and a blinded comparison made. The settings were teaching hospitals in London, UK and L'Aquila, Italy. Men (302) were referred by primary-care practitioners with LUTS and a PSA of < 10 ng/mL. Regression analysis was used to predict the extent of BOO, and create likelihood ratios and predictive values for BOO according to the PSA value. RESULTS: PSA was significantly associated with BOO (P < 0.001; r2 0.07), with significant likelihood ratios altering the probability of BOO. If the PSA was > 4 ng/mL, mild or definite BOO was likely (89%), whereas if the PSA was <2 ng/mL, there was about a one-third chance each of no, mild and definite BOO. CONCLUSION: High PSA levels in patients with LUTS are significantly associated with BOO; low PSA levels mean that definite BOO is unlikely.     

Persistent symptoms of functional outlet obstruction after rectocele repair

BACKGROUND: Rectocele is frequently associated with constipation, but it is not known whether a causal relationship exists. OBJECTIVE: To determine the effect of rectocele repair on symptoms of constipation. METHOD: Thirty-five women (28-79 years) consecutively operated for rectocele repair (11 transanal approach and 24 transperineal) were included in the prospective study. Using a structured questionnaire, the following criteria for constipation were evaluated: (a) straining, (b) sensation of anal blockage, (c) sensation of incomplete evacuation, (d) manual manoeuvres to facilitate defecation, (e) stool consistency and (f) stool frequency. The evaluation was performed before and 1 year after rectocele repair. RESULTS: Before the operation all patients had two or more constipation criteria, including sensation of anal blockage. One year after the operation, the incidence of all symptoms significantly improved (from 3.9 +/- 0.2 to 1.9 +/- 0.3; P < 0.01). However, in 18 patients two or more criteria of constipation persisted, two patients presented one criterion, and only 15 patients became asymptomatic. Neither parity nor the type of surgical approach (endorectal vs transperineal) was related to the response to treatment. In eight patients who had a previous hysterectomy the result was significantly worse. CONCLUSION: In a considerable proportion of patients, constipation persists after rectocele repair, suggesting that these symptoms are related to an underlying dysfunction.     

Comparison between ultrasonography and retrograde urethrography for detection of prostatic utricle associated with hypospadias

Objectives. To evaluate the practical application and limitation of ultrasonography and retrograde urethrography in detecting prostatic utricle associated with hypospadias.Methods. Between 1995 and 1999, 80 patients with hypospadias, 1 month to 16 years of age (mean age 3 years, 6 months), underwent ultrasonography and retrograde urethrography to detect the prostatic utricle.Results. Of the 80 patients examined, the prostatic utricle was found in a total of 36 patients (45.0%) by ultrasonography and/or retrograde urethrography. Ultrasonography revealed the prostatic utricle in 27 (75%) of the 36 patients; in 6 of the 27, it was not detected by retrograde urethrography. Retrograde urethrography revealed the prostatic utricle in 30 (83%) of the 36 patients; in 9 of the 30, it was not visualized by ultrasonography. Retrograde urethrography was slightly more sensitive in detecting the prostatic utricle than was ultrasonography. In the remaining 44 patients, the prostatic utricle was not detected by either examination method.Conclusions. Although retrograde urethrography is considered the most useful method for detecting any degree of the prostatic utricle, we recommend routine ultrasonography because it is noninvasive, painless, and simple.     

结肠慢传输型便秘合并出口梗阻型便秘手术治疗7例疗效分析

目的 探讨结肠慢传输型便秘(slow transit constipation,STC)合并出口梗阻型便秘(outlet obstructive constipation,OCC)的手术治疗方法及疗效.方法 回顾性分析2008年9月至2010年9月诊治的7例混合型便秘的手术资料.其中5例采用结肠次全切除、逆蠕动盲肠直肠...     

The value of retrograde urethrography in the diagnosis of sub-urethral diverticula in women]

Urethral diverticulum in women is not a frequent disease. The diagnosis of this lesion is based on history and careful physical examination looking for a swelling on the anterior vaginal wall. A study of 15 cases is reported. The authors insist on investigations as a help to confirm and localise the diverticulum. A new technique of retrograde urethrography using a prehension cannula ("Bomelaer") is described. By this well tolerated and minimally invasive test, the visualisation of the urethral diverticulum was obtained in 14/15 patients. Associated with intravenous urography, it is certainly the most adapted strategy for diagnosis and management.     

Case of duplication of the urethra in an adult male, presenting with symptoms of bladder outlet obstruction

Duplication of the urethra is a rare congenital anomaly, usually found in children and adolescents. The authors present a rare case of urethral duplication, presenting in a 58-yr-old man, with symptoms of bladder outlet obstruction.