子宫肌瘤声象图诊断分析(附85例报告)

本文总结了我院Ｂ超检出并经手术病理证实的子宫肌瘤８５例。叙述了子宫肌瘤的声象图表现,病理结果与超声结果对照,超声诊断符合率为９２９６％。本组病例所见最大肌瘤为２５×２０×２１ｃｍ,最小肌瘤为１２×１５×１５ｃｍ,对子宫肌瘤的病因、病理、临床表现、声象图诊断价值及误诊原因进行了分析讨论。认为超声显象诊断子宫肌瘤迅速、可靠、诊断符合率高,是有价值的检查方法;对易误诊病例的声象图特点,尚需进一步探讨     

Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects

ObjectiveTo determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects.DesignParticipants underwent bilateral earplugging before completion of anthropometry, the author's developed questionnaire, the Hamilton Anxiety and Depression Inventory, pure tone audiometry (PTA), stapedial reflex thresholds (SRT), distortion products otoacoustic emissions input/output (DPOAE-I/O), and uncomfortable loudness levels (ULLs). Afterward, the participants were randomly divided into group A, starting at 8:00 a.m. and finishing at 8:00 p.m., and group B, starting at 4:00 p.m. and ending at 4:00 a.m. Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured.Study sampleThirty healthy volunteers.ResultsPTA was 2.68 and 3.33 dB HL in groups A and B, respectively, with no statistical difference between them. ULLs were significantly lower in group A compared to group B, with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B (p < 0.0001). A SRT shift was observed in group A, with no difference in group B, and a night shift in DPOAE-I/O in group B.ConclusionsReduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime; this may be due to increased central gain in the awake cortex.     

Preliminary experience with interactive guided brain biopsies using a vertically opened 0.5-T MR system

The purpose of our study was to evaluate the feasibility and accuracy of brain biopsies performed within a vertically opened MR system. We worked with the interventional 0.5-T MR “SIGNA SP” (General Electric Medical Systems, Milwaukee, Wis.) with an integrated tracking device “Flashpoint Position Encoder” (Image Guided Technologies, USA). As a holding device for this instrument we constructed a special frame. The whole system allows an exact adjustment of an optimum biopsy direction and guidance of the biopsy in a non-stereotactic, interactive mode in near real-time. As biopsy tools we used MR-compatible aspiration and specially made side-cut needles (Daum, Germany; E-Z-EM, USA). We performed a prospective diagnostic brain biopsy study in 18 patients. Guidance of the needle was carried out using gradient-echo single-slice technique. The sample was taken after controlling the exact position of the needle tip on spin-echo images. In 12 cases an exact neuropathological diagnosis was possible. In 6 cases of negative biopsy (4 aspiration biopsies) the samples were not representative. Our results demonstrate the feasibility of interactive MR-guided minimally invasive brain biopsies in an open MR system. The best results were achieved using cut needles for biopsies of contrast-enhancing lesions visible on T1-weighted gradient-echo guidance sequence. Received: 2 February 1998; Revision received: 13 July 1998; Accepted: 2 September 1998     

Plasma ionized magnesium in tubular disorders with and without total hypomagnesemia

 Selective electrodes have been designed for determining plasma ionized magnesium. In kidney disease the relationship between ionized and total circulating magnesium is often altered. Hence plasma ionized magnesium (ETH 7025 membrane) was determined in 25 patients with primary renal tubular disorders; 6 patients had total hypomagnesemia. Total plasma magnesium was never reduced in the remaining 19 patients. Plasma ionized magnesium values were low in the 6 patients with total hypomagnesemia. In 18 of the 19 patients without total hypomagnesemia plasma ionized magnesium values were not reduced. Ionized hypomagnesemia was noted in a patient with normal total plasma magnesium in the context of hypercalciuric nephrocalcinosis of unknown origin. The study demonstrates an excellent concordance between plasma total and ionized magnesium in tubular disorders associated with total hypomagnesemia and a good concordance in tubular disorders that are not linked with total hypomagnesemia. The determination of circulating ionized magnesium is of little value in the diagnostic work-up of the vast majority of renal tubular disorders. The determination might perhaps disclose latent hypomagnesemia in nephrocalcinosis of unknown cause. Received: 20 March 1998 / Revised: 28 May 1998 / Accepted: 29 May 1998     

A Review of the Diagnostic Methods Reported in the Journal of Autism and Developmental Disorders

This review summarizes subject selection and diagnostic procedures documented in the Journal of Autism and Developmental Disorders. One hundred forty-two empirical articles published between February 1993 and April 1997 were examined. Reviewers independently evaluated articles using a coding instrument developed by the authors. Results indicated that a majority of researchers reported the use of one or more standard diagnostic criteria in classifying their subjects. However, numerous studies did not report the methods by which the diagnostic criteria were quantified or applied. Additionally, there was a lack of clear specification of inclusion and exclusion criteria for comorbid disorders. Improving the documentation of diagnostic practices in research on autism will benefit researchers and practitioners.     

Invasive diagnosis and therapy—are they still reasonable in the age of sildenafil?

Diagnosis of erectile dysfunction is important because sildenafil may not be the proper therapy for patients with underlying major diseases such as coronary sclerosis, arteriosclerosis of the stroke vessels, depression, etc., where erectile dysfunction is just a symptom of the disease.     

Erectile dysfunction. Is an oral medication during the diagnostic pathway indicated?

For patients with erectile dysfunction oral medication seems to be the most comfortable form of application. This can also be seen in the expectations looking forward to Sildenafil and other drugs in development. We present a prospective examination with the oral medication of 100 mg acecarbamol, 30 mg extract of cortex quebracho and 33 mg tocopherol acetate (Afrodor) in 100 patients complaining secondary erectile dysfunction. The patients were treated unselected with 3 x 1 tablet/day during the diagnostic schedule. 14% of the patients were able to perform satisfying sexual intercourse after 4 weeks of medication and another 15% showed an increased libido. Therefore we suggest, that the application of an oral medication, might be useful, especially during the time of diagnostics. Especially for those patients who gain without invasive diagnostic tools as intracavernous injection.     

中心性浆液性脉络膜视网膜病变的光学相干断层扫描

目的 评价光学相干断层成像术(optical coherence tomography,OCT)对中心性浆液性脉络膜视网膜病变的诊断及追踪观察的临床使用价值。 方法 对30例(32只眼)中心性浆液性脉络膜视网膜病变患者分别进行检眼镜、荧光素眼底血管造影、OCT检查。部分病例进行定期的光学相干断层成像术复查。 结果 32只眼中心性浆液性脉络膜视网膜病变的OCT图像中,27只眼表现为单纯神经上皮层脱离,2只眼为单纯色素上皮层脱离,3只眼同时存在神经上皮层脱离和色素上皮层脱离。11只眼定期追踪观察的OCT均可动态地观察到液体的吸收和测量到神经上皮层脱离高度的减少。 结论 OCT是一种新的、无损伤性的、非接触性和定量的检查方法。能鉴别中心性浆液性脉络膜视网膜病变的神经上皮层脱离和色素上皮层脱离,并能进行定量的追踪观察。 (中华眼底病杂志, 1999, 15:131-134)     

特发性黄斑裂孔的光学相干断层扫描图像特征

目的 观察特发性黄斑裂孔的光学相干断层扫描(optical coherence tomography,OCT)图像的形态特征。 方法 对65例直接检眼镜或三面镜检查诊断为特发性黄斑裂孔的患者的70只患眼进行OCT、眼底彩色照相和/或荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查,结合临床特征对OCT图像进行分析。 结果 70只眼中,1,2,3,4期黄斑裂孔分别为11,12,36,11只眼。OCT图像特征1期者表现为黄斑中心凹变浅或消失,神经上皮层浅脱离,中心凹平均厚度为(324.55±139.92)μm;2期者为视网膜表层部分缺失伴小的视网膜组织全层缺损,裂孔的表面有一个可贴附的盖,裂孔平均孔径为(241.75±107.08)μm;3期者为神经上皮层全层缺损,游离盖或无盖,裂孔周围可伴有不同程度囊样水肿,裂孔孔径为(699.78±160.99)μm;4期者图像特征与3期相似,但伴黄斑区和视盘玻璃体后脱离,裂孔孔径(631.36±243.46)μm。 结论 OCT能直观、清晰地显示特发性黄斑裂孔的横截面形态特征,同时能精确地测量裂孔的大小。 (中华眼底病杂志, 1999, 15: 205-208)     

One-year prevalence and incidence of depression among first-year university students in Japan: a preliminary study

A structured interview was used to examine the 1-year incidence and prevalence of depression among 116 first-year university students. While 24 of the subjects (20.7%) met the Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) criteria for Major Depressive Episode (MDE), 62 (53.4%) met the Diagnostic and Statistical Manual of Mental Disorders 3rd ed. Revised (DSM-III-R) criteria for MDE, and 27 (23.3%) also met the Research Diagnostic Criteria (RDC) for Major Depressive Disorder (MDD) for the 12 months prior to the interview. Moreover, 23 of the subjects (19.8%) had onset of the DSM-IV criteria for MDE, 54 (46.6%) had onset of the DSM-III-R criteria for MDE, 24 (20.7%) had onset of the RDC for MDD, during the same time period. These high rates of depression may be explained by the students' difficulties in and by their readjustment after entering university.