Ultrasound vasography evaluation of radial arterial grafts used for coronary arterial bypass surgery

OBJECTIVES: For coronary bypass surgery, radial arteries are often used as bypass grafts. Some of these arteries however, have arteriosclerotic lesions. We attempted to evaluate the relationship between arteriosclerosis and vasodilation. METHODS: Prior to bypass surgery, 20 patients underwent ultrasound vasography to determine the condition of their radial and brachial arteries. Flow-mediated dilation, which is the same as endothelium-dependent vasodilation, was measured in the brachial artery of the nondominant arm by reactive hyperemia after 5-minute forearm ischemia. Vasodilation after application of a sublingual glyceryl trinitrate spray was also measured. RESULTS: During surgery, 4 of 20 radial arteries demonstrated calcification, and 3 of the 4 could be used by removing the calcified part. However, the other artery, which had extensive calcification that could not be detected by ultrasound vasography, was discarded. The amount of vasodilation seen after the administration of sublingual glyceryl trinitrate had no correlation with calcified grafts. Calcified radial arteries demonstrated significantly poor brachial artery vasodilation by an endothelial-dependent vasodilation test. CONCLUSIONS: Calcification in radial arteries can thus only be evaluated by flow-mediated dilation.     

人肌注部位肌内微血管构筑研究

目的：为医护人员科学合理选用肌肉注射部位提供依据。方法：采用解剖观察和血管内灌注颜料的方法,结合X线四肢血管造影片,显示小腿三头肌、臀大肌、肩三角肌及股外侧肌的血供和微血管构筑。结果：结果显示小腿三头肌和臀大肌微血管构筑较股外侧肌和肩三角肌更加密集丰富。结论：临床常用肌注部位肌肉血供和微血管构筑有差异,为临床合理选用肌注部位提供了科学依据。     

超声乳化白内障吸除术后缺血性视神经病变

目的：探讨超声乳化白内障吸除术后引起缺血性视神经病变的原因及治疗。方法：收集本院眼科经超声乳化白内障吸除术后发生缺血性视神经病变患者10例,经视野、眼底荧光血管造影检查确诊后,患者均使用扩张血管、皮质类固醇激素等药物进行治疗。结果：有2例（2/10,20%）患者视力恢复到1.0另有6例（6/10,60%）患者视力均有不同程度的提高;还有2例（2/10,20%）患者治疗后视力无明显提高。结论：由超声乳化白内障手术引起缺血性视神经病变,主要与患者本身存有血管性疾病和手术过程中,引起血管视神经缺血、缺氧有关;如及早发现,尽早使用激素、血管扩张剂等治疗,视力可有不同程度的提高。     

Vasography—Clinical and Experimental Investigations

Klinische und experimentelle Untersuchungen zur Deferentographie
Ausgehend von klinischen Beobachtungen nach Deferentographien wurden Experimente an 90 Ratten durchgeführt, um den Effekt verschiedener Kontrastmittel mit unterschiedlicher Konzentration und Zusammensetzung auf die Ductuswand zu prüfen.
Im Vergleich zu 3 Kontrollgruppen von je 10 Tieren (alleinige Laparotomie, alleinige Ductusligatur, Kochsalzinjektion) führten 6 verschiedene Kontrastmittel zu unterschiedlichem Schaden am Ductus deferens. Diese Veränderungen bestanden in Epithelschäden, Entzündung, zellulärer Infiltration, Wandfibrose, Septumformation und Fenestrierung im Ductuslumen sowie Ductusobliteration.
Entsprechend diesen experimentellen Ergebnissen sollten nur niedrigprozentige hydrophile Kontrastmittel zur Deferentographie beim Mann verwendet werden.     

Clinical study of azoospermia

This study evaluated how many patients with azoospermia might have fertility potential using assisted conception techniques. A total of 102 male patients with aioospermia were included in the study. Thirteen patients had sex chromosomal abnormalities. Testicular biopsy performed in the other 89 patients showed incomplete spermatogenesis in 47 of them whereas 42 had complete spermatogenesis. In the latter 42 patients, distal vasography demonstrated bilateral obstruction of the excurrent ducts in 14 patients whereas no distal obstruction of the ducts was found in 28. The 89 patients were divided into three groups according to the findings of testicular biopsy and distal vasography. In the 14 patients with both complete spermatogenesis and distal obstruction of the excurrent ducts, surgical procedures are applicable. The pathogenesis of the 28 patients with complete spermatogenesis but without distal obstruction of the ducts should be clarified for further treatment.     

Congenital agenesis of seminal vesicle

Congenital agenesis of the seminal vesicle （CASV） is frequently associated with congenital absence of the vas deferens （CAVD） or ipsilateral congenital vasoureteral communication. We reported two cases of a rare condition that the vas deferens open ectopically into Mullerian duct cyst associated with agenesis of the ipsilateral seminal vesicle. The diagnosis was confirmed by vasography. Transurethral unroofing of the Mullerian duct cyst was performed in both patients with favourable results, however, assisted reproductive technology （ART） was still necessary for them to father children.     

The effect of biological dyes and contrast media on the vas deferens in Long Evans rats

The conventional diagnostic procedure of vasography utilizes a contrast medium to evaluate the patency of the vas deferens. With the development of microsurgical reconstruction for obstructive azoospermia in the past two decades, intraoperative vasography with saline or biological dye injection has replaced the use of radiographic contrast media. However, there are few reports on the effect of biological dyes on the healthy vas deferens. Therefore, we used experimental vasography to evaluate histological changes and functional patency of the vas deferens after infusion with a contrast medium and biological dye.
Four groups of 10 Long Evans male rats were injected by vasopuncture with 1% methylene blue, 1% gentian violet and 38% Urografin or saline into the vas deferens. The animals were killed 30 days later, and the vasa deferentia were excised and examined for histological changes and for functional patency. Vasopuncture with saline injection induced minimal change both at the puncture site and in the distal vas deferens. In both the Urografin- and methylene blue-injected groups, inflammation at the puncture site was found in 20–22% of cases, and 10–11% of cases revealed functional obstruction of the vasal lumen. In the gentian violet-injected group, severe histological and obliterated changes were found in all cases. Leakage of the dye and contrast medium or the sperm reaction may be responsible for the inflammation; otherwise, methylene blue and urografin did not seem to be harmful to the vas deferens. Although gentian violet is a blue dye, as is methylene blue, it has marked destructive effects on the vas deferens. It is concluded that some biological dyes used for vasal injection can cause occlusion of the vasal lumen, while inflammatory responses can occur from placing a needle transmurally.     

输精管造影在射精管梗阻病因诊断中的作用探讨(附45例报告)(附编者按)

目的 对比分析细针穿刺输精管造影和经直肠B超(TRUS)对射精管梗阻性无精子症的诊断中作用,以期为探讨国人射精管梗阻性无精子症的最佳影像学诊断方法提供依据.方法 2005年7月至2007年7月间,对45例经精液分析和TRUS疑诊为双侧射精管梗阻(EDO)性无精子症的患者行开放性细针穿刺输精管造影检查.患者精液分析应具有典型的"四低"特点和(或)具有TRUS检查的典型EDO改变.结果 45例患者中,同时具有典型的精液分析"四低"特点和TRus检查改变的患者15例(33.33%),精液分析有"四低"特点而TRUS检查无典型改变者12例(26.67%),TRUS检查有典型改变而精液分析不具备"四低"特点者18例(40%).开放性细针穿刺输精管造影检查显示:双侧输精管起始段、附睾部梗阻患者19例,双侧输精管梗阻、发育不良患者15例,双侧射精管梗阻仅3例(6.67%),一侧输精管梗阻、一侧射精管梗阻患者2例,一侧输精管起始段及附睾部梗阻、一侧输精管梗阻或发育不良者6例.仅1例患者出现,是因造影后不遵医嘱过早活动出现阴囊血肿,保守治疗后自行吸收.结论 单纯依靠TRUS进行射精管梗阻诊断的价值有限,考虑与TRUS仪能显示静止的精囊、射精管情况有关.开放性细针穿刺输精管造影在梗阻性无精子症诊断中有重要作用.     

细针穿刺输精管造影对梗阻性无精子症的诊断作用

目的 探讨细针穿刺输精管造影对梗阻性无精子症梗阻部位的诊断和鉴别作用,分析其安全性和操作注意事项.方法 对2005年7月至2009年7月收治的拟诊为“梗阻性无精子症”的患者57例行精液分析、经直肠超声检查(TRUS)及开放性细针穿刺输精管造影检查.结果 57例梗阻性无精子症的患者分别行精液分析、TRUS和开放性细针穿刺...     

经皮输精管穿刺精道造影术的应用价值

目的 :提高精道疾病的诊断水平。　方法 :回顾我院 1 974年 1 1月～ 2 0 0 3年 1 2月成功施行精道造影 6 3例的资料。方法为局麻下经阴囊皮肤直接穿刺 ,输精管腔内注射造影剂后摄片。　结果 :精道异常的发现率为6 0 .3% ( 38/ 6 3)。其中不育症患者 8例 ( 33.3% ) ,分别为输精管双侧梗阻 2例 ,单侧梗阻 4例 ,精囊炎 1例 ,精囊发育不良 1例。血精症 1 7例 ( 80 .9% ) ,分别为精囊炎 1 3例 ,精囊囊肿 4例。慢性前列腺炎伴精道异常 1 1例 ( 6 8.8% ) ,分别为精囊炎 8例 ,精囊囊肿 1例 ,精囊多发性结石 1例 ,双侧输精管梗阻 1例。前列腺癌 2例。　结论 :精道造影对精道疾病诊断有重要价值