Prenatal diagnosis of a complete mole coexisting with a dichorionic twin pregnancy: case report

A complete mole coexisting with dichorionic twins was diagnosed by the combined use of sonography and chorionic villus sampling at 10 weeks gestation. The pregnancy resulted in the death of one fetus at 31 weeks from presumed feto-maternal haemorrhage, while the other fetus survived in good condition. A summary of the available literature, combined with this report, reveals a total of seven pregnancies with twins and a coexistent complete mole. Only two out of 14 fetuses survived. Maternal complications included one case of pre-eclampsia and one persistent trophoblastic tumour. Accurate diagnosis of complete mole is possible by genetic analysis of chorionic villi obtained with standard transabdominal sampling. Twins with a coexistent complete mole will usually undergo miscarriage. However, fetal survival is possible and the maternal risks seem limited. A concomitance between gestational trophoblastic disease and the occurrence of feto-maternal haemorrhage is observed.     

The atopy patch test -- reproducibility and comparison of different evaluation methods

BACKGROUND: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging. METHODS: Fifty-two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape-stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re-tested 4-12 weeks later with the same allergens on their forearms. RESULTS: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT-positive and negative volunteers was 19 +/- 6 vs 15 +/- 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallergènes, was poor. Correlation of the results between the three evaluation methods was significant (P < or = 0.001). CONCLUSIONS: The low reproducibility rate of APT results and the poor inter-test-agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.     

Investigation and improved performance of optical fibre probes in laser Doppler blood flow measurement

Laser Doppler flowmetry with optical-fibre beam transmission is a sensitive fast and convenient method of measuring tissue blood flow. However, its sensitivity can also be a problem because of movement artefacts. This study applies some basic considerations of fibre optics and Rayleigh light scattering to the field of laser Doppler blood flow meters. Practical suggestions are given by which movement arterfacts can be reduced by choice of optical fibres, attention to probe geometry, cladding the fibres to reduce their movements and in the method of application. Experiments which test the normalisation circuitry of laser Doppler instruments are described and the effects of movement artefacts on the interpretation of the pulsatile component of laser Doppler records are also discussed. Probe and fibre line movements cause high-frequency intensity fluctuations due to speckle movement. The intensity fluctuations produce an apparent Doppler shift much greater than the Doppler shift produced by the relative movements of probe and tissue. It has been found that it is important to ensure that the fields of view of the illuminating and detecting fibres do not overlap at the skin surface and that probe contact with the skin surface should be maintained.     

癫癎患者脑血流速度改变与癫癎灶定侧的关系

目的 :探讨癫发作间期脑血流变化对癫灶定侧的价值。方法 :4 7例癫病人发作间期行经颅多普勒超声脑血流速度测定 ,并与临床、脑电图定位和MRI/CT病灶对比分析。结果 :根据临床症状确定病灶侧的 19例病人中 ,病灶侧脑血流速度改变 (升高和降低 )的比率显著高于双侧脑血流速度对称者 ;在脑电图确定病灶侧的 2 4例病人中 ,病灶侧脑血流速度升高比率显著高于脑血流速度降低和双侧脑血流速度对称者 ;在MRI确定病灶侧的 13例病人中 ,病灶侧脑血流速度增快 7例 ,减慢 2例 ,双侧血流速度对称 4例。结论 :癫病人一侧脑血流速度增高 ,高度提示癫病灶侧。     

经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值

目的：探讨经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值。方法：选取许昌中医院2020年1月至2022年1月期间收治的80例子宫腺肌瘤患者为研究对象,对上述患者实施经阴道彩色多普勒超声诊断,获得对应的诊断结果,随后将该结果和术后病理分析结果进行比较,最终得出诊断效果。结果：本研究80例子宫腺肌瘤患者中,经阴道彩色多普勒超声检出75例,漏诊或误诊5例,诊断准确率为93.75%;经阴道彩色多普勒检查诊断为子宫腺肌瘤的75例患者中,按照发病部位划分,有10例(13.33%)子宫腺肌瘤出现在子宫前壁区域,65例(86.67%)出现在子宫后壁部位;按照病情特点划分,有63例(84.00%)为单发子宫腺肌瘤,12例(16.00%)为子宫腺肌瘤合并子宫肌瘤。此外,75例患者中有3例患者并发卵巢内膜异位症。75例患者的子宫动脉血流阻力指数为0.75±0.05、搏动指数为1.37±0.04、舒张期峰值速度为(5.83±0.14)cm·s^-1、收缩期峰值速度为(71.74±0.25)cm·s^-1。结论：经阴道彩色多普勒超声可通过超声特征、血流分布、多普勒频谱特点,准...     

二维超声评价原发性肾病综合征预后的价值

目的　探讨二维超声对原发性肾病综合征预后的判断价值。方法　根据临床检查结果将 12 0例原发性肾病综合征患者分为 3组 ,并与二维超声检查结果进行相关性分析。结果　完全缓解组的肾脏超声检查结果与对照组比较无显著性差异 (P >0 .0 5 ) ,部分缓解组的肾脏超声检查结果与对照组比较有显著性差异 (P <0 .0 5 ) ,无效组的肾脏超声检查结果与对照组比较有非常显著性差异 (P <0 .0 1)。结论　二维超声检查原发性肾病综合征患者的肾脏无异常时预后良好 ,而肾脏缩小越明显 ,肾皮质回声越强 ,则预后越差。     

Polyorchidism in ultrasound examination: A case report

Polyorchidism is usually diagnosed incidentally when the patient undergoes imaging or surgery for some other reason. Although we are facing lack of evidence in different steps of diagnostic and therapeutic workup of these patients, this disorder is usually considered benign, not requiring any intervention. We report the case of a man complaining of a palpable mass in his scrotum. We evaluated the patient using ultrasound, MRI and serum tumour marker level measurement. The patient was finally diagnosed with polyorchidism (three testes). For the management, we recommended annual physical examination, US examination and serum tumour marker level measurement.     

Ultrasound-Guided Periprosthetic Biopsy in Failed Total Hip Arthroplasty: A Novel Approach to Test Infection in Patients With Dry Joints

BackgroundTo diagnose periprosthetic joint infection (PJI) preoperatively, ultrasound-guided joint aspiration (US-JA) may not be performed when effusion is minimal or absent. We aimed to report and investigate the diagnostic performance of ultrasound-guided periprosthetic biopsy (US-PB) of synovial tissue to obtain joint samples in patients without fluid around the implants.MethodsOne-hundred nine patients (55 men; mean age: 68 ± 13 years) with failed total hip arthroplasty (THA) who underwent revision surgery performed preoperative US-JA or US-PB to rule out PJI.ResultsSixty-nine of 109 patients had joint effusion and underwent US-JA, while the remaining 40 with dry joint required US-PB. Thirty-five of 109 patients (32.1%) had PJI, while 74/109 (67.9%) had aseptic THA failure. No immediate complications were observed in both groups. Technical success of US-PB was 100%, as the procedure was carried on as planned in all cases. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-JA were 52.2%, 97.8%, 92.3%, 80.3%, and 82.6%, while for US-PB, they were 41.7%, 100%, 100%, 80%, and 82.5%, respectively, with no significant difference (P = .779). Using the final diagnosis as reference standard, we observed a moderate agreement with both US-JA (k = 0.56) and US-PB (k = 0.50).ConclusionWe present a novel US-guided technique to biopsy periprosthetic synovial tissue of failed THA to rule out PJI. We found similar diagnostic performance as compared with traditional US-JA. This supports future larger studies on this procedure that might be applied in patients without joint effusion.     

How to perform high ultrasound examination of skin involvement among patients with systemic sclerosis – proposition of a unified protocol

IntroductionA fast and cheap method of skin assessment in systemic sclerosis (SSc) is an area of extensive research. Established in 1979, the Rodnan skin score is a palpation-based method used among clinicians. This method has some limitations, such as: examiner’s skills, subjective results, and no standardization. In the last few years researchers have been exploring ultrasound-based techniques as a possible tool for skin assessment among patients with SSc. The aim of the study is to develop a protocol of elastography-based skin imaging evaluation among patients with SSc.Material and methodsReview of the literature and own experience.ResultsProposition of elastography-based skin imaging protocol among patients with SSc.ConclusionsThe authors present a potential protocol of ultrasound-based examination of skin involvement among patients with SSc.