氯沙坦对维持性血透患者心血管保护作用的临床观察

目的 :观察氯沙坦对行维持性血透治疗的慢性肾功能衰竭 (CRF)患者心血管保护作用。方法 :6 0例维持性血透患者 (血肌酐≥ 70 0 μmol·L- 1 ) ,治疗组 (给予氯沙坦 5 0～ 10 0mg·d- 1 )及对照组 (给予非血管紧张素受体拮抗剂和非ACEI类降压药 )各 30例 ,记录用药前后各组患者血压 ,运用多普勒组织成像 (DTI)技术观察用药前后两组患者二尖瓣环峰值收缩速度 (VS)、收缩时间速度积分 (TVIS)、舒张早期速度 (VE)、舒张晚期速度 (VA)、VE VA 比值。结果 :治疗组及对照组患者治疗后血压均明显下降 ,二尖瓣环VS、TVIS、VE、VE VA ,则均明显上升 ;治疗组与对照组血压分别在治疗前、后相比并无明显差异 ;治疗前两组间二尖瓣环VS、TVIS、VE、VE VA 并无显著性差异 ,但在治疗12个月后 ,治疗组二尖瓣环VS、TVIS、VE、VE VA 则明显高于对照组。结论 :氯沙坦对行持续性血透的CRF患者具有良好的心脏保护作用 ,可有效改善其心功能 ,且不依赖于其降压作用     

经颅彩色多普勒对大脑血流动力学的研究

目的 :探讨认知过程中脑血流动力学的变化。方法 :应用经颅彩色多普勒对不同生理情况下大脑半球血流速度的变化进行监测。结果 :每项试验前后比较 ,血流速度的增加有显著差异 (P <0 0 1) ,语言试验血流速度增加偏侧在左半球 ,面视试验偏侧在右半球 ,光刺激试验时枕区血流速度最快。结论 :经颅多普勒能监测认知过程中半球血液动力学变化的差异     

眼动脉彩色多普勒血流频谱检测在甲亢诊断中的应用

采用ＣＤＦＩ对３４例初诊甲亢患者的眼动脉进行检测，３４例患者根据Ｔ３结果分为两组，同时１０位患者治疗前后的眼动脉血流速度对照。结果表明，甲亢患者的眼动脉血流速度高于正常人，但与Ｔ３值无相关。１０例患者的眼动脉血流速度随着Ｔ３、Ｔ４下降而恢复正常。结论：ＣＤＦＩ测定眼动脉血流频谱可用于甲亢的诊断和治疗观察。     

A study of factors governing fluid filtration in the diabetic foot

Abstract. The effect of lowering the foot on the factors governing fluid filtration in the foot were studied in 12 male insulin-dependent diabetic subjects and 10 controls. Toe skin blood flow, measured by laser Doppler flowmetry, was significantly higher during dependency in the diabetic group. In the control subjects, the colloid osmotic pressure of venous blood sampled from the foot rose to 47·7 mmHg (range 45·1–53·8) after 50 min of foot dependency. In the diabetic group, colloid osmotic pressure failed to rise to the same extent (median 36·7 mmHg; range 28·6–43·0; P < 0·001). Capillary pressure, measured directly by the Landis microinjection technique, was significantly higher in the diabetic group (85·3±1·7 ( n = 6) vs. 92·2±4·6 cm H₂O ( n = 6); P < 0·007), as was foot swelling rate determined by mercury strain gauge plethysmography (0·069±0·022 vs. 0·099±0·025 ml min^-1 100ml^-1; P < 0·02). These results suggest an impairment of the oedema-preventing mechanisms in diabetic subjects which may contribute to the risks of ulceration in the diabetic foot.     

Reduction in Internal Carotid Arterial Blood Flow Velocity in Children During Antiepileptic Drug Therapy with Clinical Dosages

Summary: We studied the effect of antiepileptic drugs (AEDs) on internal carotid artery (ICA) blood flow velocity, as an index of total cerebral blood flow (CBF). The subjects were 45 newly diagnosed children with febrile convulsion or epilepsy who were seizure-free for a period long enough not to affect the results. They had no neurologic deficit, received fixed monotherapy, and were examined by a noninvasive Doppler ultrasound method, in comparisonwith 13 age-matched normal volunteers with no AED. In 30 patients, the measurements were performed before and after AED administration [10 with phenobarbital (PB), 10 with carbamazepine (CBZ), and 10 with valproate (VPA)], and performed before and after AED discontinuation in the remaining 15 patients (all with PB). Normal volunteers underwent the two consecutive examinations with a mean interval equal to that of the entire patient group, and there was no difference in velocity values between the measurements. In patients receiving CBZ or VPA, a significant reduction was noted in blood flow velocity after drug administration. Although velocity values in the patients receiving PB did not change after drug administration, they were significantly increased after complete discontinuation. In the present study, a slight but significant reduction in CBF caused by AED administration at therapeutic doses in children was suggested.     

脐动脉血流速波、产前胎心监护及脐动脉血气分析与新生儿结局的对比研究

测定１１５例足月妊娠者（正常妊娠６２例，高危妊娠５３例）脐动脉血流速波（ＵｍＡＳ／Ｄ），同时作产前胎心电子监护（ＮＳＴ），其中３７例于分娩时抽取脐动脉血作血气分析。对上述三种方法预测新生儿结局的效果进行比较。结果表明：ＵｍＡＳ／Ｄ、脐动脉血的ｐＨ值较ＮＳＴ对新生儿结局不良有较好的预测性，异常ＵｒｎＡＳ／Ｄ与新生儿酸中毒有密切关系。     

Altered corticomotor representation in patients with Parkinson's disease.

In 6 patients with Parkinson's disease (PD) and 6 age-matched controls, transcranial magnetic stimulation was applied at 56 regions over the motor cortex and premotor cortex of each hemisphere, with the first dorsal interosseous (FDI) muscle of both hands activated at 15% maximum voluntary contraction during stimulation. For each site, motor evoked potential (MEP) landmarks were recovered, including MEP amplitude, MEP onset latency, and silent period duration. Scaled MEP amplitudes were used to construct individual cortical maps of the FDI muscles. The maps revealed an anterior displacement of the muscle representation in PD patients. This anterior shift over motor cortical areas may reflect increased contributions of corticocortical connections between motor cortex and premotor cortical areas, possibly enhanced by the visual feedback aspect of the task. These alterations may reflect adaptations to the impairments in striatocortical circuits in PD.     

Cortical Reorganization Allows for Motor Recovery after Crossed Cerebrocerebellar Atrophy

The authors report the case of a 33-year-old woman who exhibited, at the age of 17, a left-sided hemiplegia, which was followed by good motor recovery, though with a permanent deficit in fine finger movements. She had a widespread loss of neural tissue in the right hemisphere (crossed cerebrocerebellar atrophy), including (1) marked atrophy and thinning of the precentral and postcentral gyri; (2) widespread deep white matter destruction, including the corticospinal tract; and (3) crossed cerebellar atrophy. Except over the supplementary motor area (SMA), transcranial magnetic stimulation did not elicit motor evoked potentials in the affected hand. Nevertheless, during opening and closing of the affected hand, functional magnetic resonance imaging showed an activation of the lesioned primary sensorimotor cortex (SMC), as well as of the intact SMA and the parietal areas, but not of the ipsilateral motor areas. The authors speculate that recovery was achieved by a motor command generated in the SMC and the parietal cortex, passing through corticospinal axons originating in the SMA.     

Basic study on velocity-flow urodynamics using Doppler sonography: Simultaneous detection of cavitation and Doppler signals in an artificial urethral model

BACKGROUND: We have developed velocity-flow urodynamics using Doppler sonography based on the hypothesis that microbubbles formed in the urethra are responsible for Doppler signals. In order to confirm this hypothesis derived from Bernoulli's principle, we investigated the simultaneous detection of cavitation noise and Doppler signals in an experimental system. METHODS: An experimental circuit was built in which a stenosis was created using a glass or silicon tube with tap water used as the sample fluid. Doppler signals, pressure before and after the stenosis, flow rate, flow velocity and cavitation noise were measured. Direct detection of cavitation with a high-speed charged-coupled device (CCD) camera was conducted in the glass tube. The relationship between cross-sectional area and flow velocity in terms of the detection of Doppler signals was analyzed in the silicon tube study. RESULTS: In the glass tube study, a high-speed CCD camera clearly detected masses of microbubbles associated with cavitation. The range of flow rates creating cavitation completely corresponded with those producing Doppler signals detected by ultrasonography. A similar correlation was observed in the silicon tube study, which showed that a low flow velocity of 41.5 cm/sec through a stenosis with a cross-sectional area of 20 mm(2) created Doppler signals at a flow rate of 8.3 mL/sec. CONCLUSION: The results of the present study confirmed that microbubbles created in flowing urine are responsible for Doppler signals. Measurement of velocity-flow urodynamics has great potential to become a non-invasive and reliable alternative to conventional pressure- flow urodynamic studies.     

Primary and secondary malignancies of the penis: ultrasound features

Cancer of the penis is a rare neoplasm in developed countries but worldwide represents a significant health problem. In this study, the ultrasonographic features of primary and secondary malignant lesions of the penis are described. Squamous cell carcinoma usually presents as a hypoechoic lesion with heterogeneous appearance. Invasions of the corpora cavernosa and the corpus spongiosum are appreciable. B-cell lymphoma presents as a well-vascularized mass, a plaque, or ulcers in the penile skin. Penile metastases result from hematogenous or lymphatic spreading of distant tumors or, more frequently, as penile infiltration by tumors from adjacent organs. Diffuse corporeal or nodular involvement can result. 1Award-winning poster at the 10th European Symposium on Urogenital Radiology; Uppsala, Sweden, September 4•7, 2003.