Three-dimensional color Doppler sonography and uterine artery arteriography of fibroids: assessment of changes in vascularity before and after embolization.

OBJECTIVE: To assess the accuracy of three-dimensional color Doppler sonography and uterine artery arteriography in depicting changes in fibroid vascularity before and after embolization. METHODS: Preembolization and postembolization three-dimensional color Doppler sonography and selective uterine artery arteriography were retrospectively compared in 15 patients who underwent uterine artery embolization for treatment of symptomatic fibroids. Three-dimensional color Doppler sonography was performed by using a scanner with color power angiographic imaging capability. Vascularity was quantified by using an estimation of power-weighted pixel density as described by our group in previously published studies. Uterine artery arteriography was performed by using a standard selective microcatheter embolization technique. For purposes of comparison, fibroids were classified as either hypervascular or hypovascular relative to myometrial vascularity before and minutes to several hours after uterine artery embolization. Changes in fibroid vascularity (i.e., from hypervascular to hypovascular) as depicted by three-dimensional color Doppler sonography were compared with those shown on uterine artery arteriography and classified as being in agreement or disagreement. RESULTS: In 13 (87%) of 15 patients there was agreement; in 2 (13%) of 15 there was disagreement. In both cases of disagreement, three-dimensional color Doppler sonography showed collateral flow not depicted by uterine artery arteriography The mean reduction in quantitated vascularity after uterine artery embolization was 44% (range, 19%-78%). CONCLUSIONS: Three-dimensional color Doppler sonography accurately depicts fibroid vascularity and in some cases can reveal collateral flow not depicted by uterine artery arteriography.     

Monocrotaline-induced structural remodeling of the intra-acinar pulmonary arteries and pulmonary hypertension

Summary The monocrofaline-induced structural changes of small pulmonary arteries in rat and their relationship with pulmonary hypertension and right ventricular hypertrophy were observed by determining the right ventricular systolic pressure, and by light and electron microscope and morphometry. One to 38 days after last injection of monocrotaline (MCT), a medial thickening and lumen marrrowing of the circular muscular arteries (CMA), accompanying terminal (TB) and respiratory bronchioles (RB), were found. And there after the lumen of CMA, accompanying TB, became dilated, and its medial thickness (MT) decreased, whereas the histopathologic changes of the partially muscular arteries (PMA), accompanying RB, became severe, their MT increased continuously, and finally reached the peak value on Day 50. At the first day after last MCT treatment, inflammation and muscularization were found in PMA and nonmuscular arteries (NMA), and became more severe with the cause of disease. Therefore, the intra-acinar pulmonary arteries, both CMA and PMA, increased in number while the NMA decreased in number significantly because of the structural remodeling. Four days after MCT treatment, the right ventricular systolic pressure began to rise, and reached its peak value on Day 50. Eight days after MCT injection, right ventricular hypertrophy developed, and became most significant from Day 23 to Day 30. The results suggest that structural remodeling, i.e. muscularization, of intra-acinar pulmonary arteries plays an important role in the development of pulmonary hypertension and right ventricular hypertrophy.     

胱蛋白酶抑制剂C和内生肌酐清除率与肾脏病理变化的关系探讨

目的　了解血胱蛋白酶抑制剂 (cystatin)C和内生肌酐清除率 (Ccr)与肾脏病理变化的关系。 方法　选择 1999年 1月～ 2 0 0 3年 2月因各种肾脏疾病收治入院行肾穿刺活检术的患儿共 12 4例 ,入院后查血cys tatinC和Ccr ,并行肾穿刺活检术以了解肾脏病理变化 ,然后通过相关及多元线性回归分析了解血cystatinC和Ccr与肾脏病理变化的关系。结果　血cystatinC与肾脏病理变化的复相关系数 (R) =0 .6 91(P <0 .0 1) ,血cys tatinC与肾脏病理变化之间存在直线关系 ,其回归方程为Y =0 .6 0 5 +0 .30 7X1+0 .4 93X2 (F =5 5 .18,P <0 .0 1)。Ccr与肾脏病理变化的R =0 .4 0 5 (P <0 .0 1) ,Ccr与肾脏病理变化之间亦存在直线关系 (F =11.89,P<0 .0 1)。结论　血cystatinC比Ccr更能反映肾脏病理变化的严重程度。血cystatinC和Ccr均与肾间质的变化密切相关 ,尤以血cystatinC更敏感。因此 ,血cystatinC可作为判断肾脏疾病预后的重要参考指标 ,以及时了解肾脏病理变化采取有效的治疗。     

Asymptomatic renal abscess: Evaluation with gadolinium DTPA-enhanced MRI

Incidental detection of renal mass in a transplant patient is a diagnostic challenge. These patients are at risk for the development of neoplasms and, more commonly, infection with atypical organisms. Symptomatology may be lacking in either, and both conditions may present with similar symptoms. Magnetic resonance imaging (MRI) evaluation with gadolinium DTPA is helpful in the evaluation of asymptomatic renal mass, with enhancement effectively excluding simple and hemorrhagic cysts. Because the MRI appearances of renal cell neoplasm and renal abscess overlap, both must be considered in the differential diagnosis.     

复式脉冲低能量ESWL治疗肾结石769例报告

目的探讨复式脉冲HB-V型低能量体外冲击波碎石机治疗肾结石的治疗效果.方法采用复式脉冲HB-ESWL-VG型低能量碎石机治疗直径<2.0 cm的各类肾结石769例，治疗工作电压3～9 kV，平均冲击次数2 300次.结果肾盏结石总粉碎率为97.4%，其中上中盏结石复打率为13.1%，术后3个月排净率为89.4%，下盏结石复打率为17.3%，排净率为81.5%；肾盂结石粉碎率为98.3%，复打率为6.1%，术后3个月排净率为93.0%.结论复式脉冲低能量ESWL治疗肾结石具有治疗成功率高、复打率低、无严重并发症、副作用少之优点.     

Haemodynamic studies in early stroke

Summary We investigated prospectively a consecutive series of 81 patients suffering from acute middle cerebral artery (MCA) ischaemia by transcranial Doppler ultrasonography (TCD) within 24 h of the onset of symptoms. To monitor the haemodynamic changes follow-up recordings were carried out at short intervals during the next 2–3 weeks until stable haemodynamic status was achieved. In order to estimate the value of early TCD examinations in predicting the extent of brain damage seen later on, initial MCA flow reduction was correlated with infarction size and pattern on computed tomography. Fifty-three cases showed sufficient ultrasound penetration through the temporal bone. MCA flow asymmetries were recorded in 45 patients (85%); occlusion was observed in 17. Recanalization occurred in 11 patients followed by transient hyperaemia in 3, leaving residual stenosis in 2. Initial increase of flow velocities normalized within days or weeks in 7 out of 9 patients, while 2 developed residual MCA stenosis. Nineteen patients showed a considerable flow reduction on admission, which returned to normal in 9; transient hyperaemia was detected in 5 of these. Eight patients did not show any MCA flow asymmetry. Our study revealed very variable haemodynamic changes in acute stroke, which influenced further diagnostic and therapeutic management. The high rate of spontaneous recanalizations of MCA occlusions followed by transient hyperaemia in many cases has an important bearing on thrombolytic or theological therapy. Flow velocity differences could be related to infarction pattern rather than to infarction volume. Early MCA flow asymmetry recorded by TCD within the first 24 h could not reliably predict the extent of persistent brain damage or clinical outcome.     

支气管动脉灌注化疗联合直线加速器放射治疗Ⅲa期非小细胞肺癌

目的　研究支气管动脉灌注化疗联合直线加速器放射治疗Ⅲa期非小细胞肺癌 (NSCLC)的可行性及临床价值。方法　 76例NSCLC患者随机分成A、B 2组 ,A组先行 2次支气管动脉灌注化疗 (BAI) ,第 2次BAI 1～ 2周后再行直线加速器放射治疗 (RT) ;B组单纯行 2次BAI (对照组 )。结果　临床疗效 ,A组 (BAI RT)和B组 (BAI)分别为 89.47%和 60 .5 3% (Ρ <0 .0 1) ;1、3年生存率 ,A、B组分别为 81.5 8%、5 0 .0 0 %和 60 .5 3%、2 1.0 5 % ( 0 .0 1<Ρ <0 .0 5 )。结论　支气管动脉灌注化疗联合直线加速器放射治疗Ⅲa期非小细胞肺癌的临床疗效和患者 1、3年生存率均显著提高     

Donor conditions and graft survival - a retrospective study

In a retrospective study (one centre) the influence of donor and recipient factors were evaluated (n = 308). Head injury as the cause of death and anastomotic time less than 35 min were associated with a significantly better graft survival rate (P < 0.05). Although some of the donor factors influence graft survival, a stricter selection of grafts is not advisable, firstly because fewer kidneys would then be offered, and secondly because even comparatively bad graft survival rates are still better than dialysis.     

颈外动脉栓塞在耳鼻咽喉科的应用

在耳鼻咽喉科手术中应用颈外动脉栓塞法１０例，形成栓塞组，并把单纯颈外动脉结扎１０例作为对照组。结果表明：栓塞组较对照组术中出血量显著减少，有利于病灶彻底清除，因而有提高治愈率减少复发率的作用。掌握栓塞位置、栓塞剂用量和注射速度是防止并发症的关键。