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Different hemodynamic responses by color doppler ultrasonography studies between sildenafil non-responders and responders

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Asian Journal of Andrology 2007年第1期9卷 129-133页

作者： Shih-Tsung Huang Ming-Li Hsieh Section of Andrology and Female Urology Division of Urology Department of Surgery Chang Gung MemorialHospital-Linkou Chang Gung University College of Medicine Taoyuan 333 Taiwan China

Aim： To determine if there are different penile hemodynamic patterns between sildenafil non-responders and responders by using color doppler ultrasonography. Methods： A total of 69 erectile dysfunction （ED） patients aged 22-79 years were enrolled into the present study. Thirty-eight （55.1%） men with ED who did not respond to four attempts of treatment with 100 mg sildenafil after re-education were classified as sildenafil non-responders. A com- bination of three vasodilator drugs, 1.25 mg papaverine, 0.4 mg phentolamine and 5 ug prostaglandin E1, was given by intracavernous injection before penile doppler ultrasonography was carried out. The erectile response to intracavernous injection and vascular parameters including peak systolic velocity （PSV）, resistance index （RI）, end diastolic velocity （EDV） and cavernosa artery diameter （CD） were measured and the results between sildenafil nonresponders and responders were compared. Results： No statistical difference in vascular parameters measured by doppler ultrasonography studies between non-responders and responders was noted. Sildenafil non-responders had a poorer penile rigidity response to intracavernous injection than responders （P 〈 0.05）. Among patients with adequate PSV （〉 30 cm/s） and abnormal EDV （〉 5 cm/s）, individuals in the non-responder group had fewer positive responses to intracavernous vasodilator injection than in the responder group （35.3% vs. 72.2%, P 〈 0.05）. Advanced age and comorbidity with diabetes mellitus were significantly associated with sildenafil non-response （P 〈 0.05）. Conclusion： Sildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.

关键词： color doppler ultrasonography erectile dysfunction impotence sildenafil citrate ultrasonography

Use of color doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

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World Journal of Gastroenterology 2005年第7期11卷 1018-1022页

作者： Hiroki Kawashima Yoshiki Hirooka Akihiro Itoh Senju Hashimoto Terutomo Itoh Kazuo Hara Akira Kanamori Naoki Ohmiya Yasumasa Niwa Hidemi Goto Department of Gastroenterology Department of Endoscopy

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was ***: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

关键词： color doppler ultrasonography Anomalous connection in pancreatobiliary disease Gallbladder cancer Gallbladder wall blood flow Endoscopic ultrasonography

Value of identifying and diagnosing mammary carcinoma and non-lactation mastitis lump by color doppler ultrasonography

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The Chinese-German Journal of Clinical Oncology 2008年第11期7卷 638-640页

作者： Guilong Jin Zhiwei Ding Yuxia Guo Xiangxiang Zhao Department of ultrasonography Dongyang People＇s Hospital Dongyang 322100 China

Objective: To evaluate the value of identifying and diagnosing mammary carcinoma and non-lactation mastitis lump (NLM) by multicolor doppler ultrasonography. Methods: We compared and analyzed the examination results of 69 cases of mammary carcinoma proved by surgical pathology and 22 cases of NLM before surgery by multicolor doppler ultra-sonography. Results: The detection rates of mammary carcinoma and NLM focus by ultrasonic examining were 100%. The shape, envelope, foul line, blood stream between sound and image of two diseases were similar. Of the two diseases, the representation with slight calcification in lump, lower echo in low echo, bloodstream distribution and resistance were different. Conclusion: By analyzing the sound and image representation of mammary lump, we find color doppler ultrasonography has significant value in identifying and diagnosing mammary carcinoma and non-lactation mastitis lump.

关键词： mammary carcinoma non-lactation mastitis lump (NLM) color doppler ultrasonography

color doppler sonography and angioscintigraphy in hepatic Hodgkin's lymphoma

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World Journal of Gastroenterology 2009年第26期15卷 3269-3275页

作者： Mirjana V Stojkovi Vera M Artiko Irena B Radoman Slavko J Knezevi Snezana M Luki Mirko D Kerkez Nebojsa S Leki Andrija A Anti Marinko M Zuvela Vitomir I Rankovi Milorad N Petrovi Dragana P obi Vladimir B Obradovi Institute for Digestive Diseases Clinical Center of Serbia Institute for Nuclear Medicine Clinical Center of Serbia Gastroenterology Department Clinical Center Podgorica Gastroenterology Department Clinical Center Kragujevac

AIM： To estimate the characteristics of color doppler findings and the results of hepatic radionuclide angiography （HRA） in secondary Hodgkin＇s hepatic lymphoma. METHODS： The research included patients with a diagnosis of Hodgkin＇s lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and color doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index （HPI） estimated by HRA was calculated. was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins （P 〉 0.05）. A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave （r = 390, P 〈 0.01）. HPI was significantly lower in patients with lymphomas than in controls （P 〈 0.05）, pointing out increased arterial perfusion in comparison to portal perfusion. CONCLUSION： color doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin＇s hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assesment of vascularisation of liver lesions.

关键词： color doppler ultrasonography Hodgkin's disease Lymphoma Liver Radionuclide angiography Velocity Hepatic artery Portal vein Blood flow Splenomegaly

Portalsystemic hemodynamic changes in chronic severe hepatitis B: An ultrasonographic study

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World Journal of Gastroenterology 2008年第5期14卷 795-799页

作者： Zhong-Zhen Su Hong Shan Wei-Min Ke Bing-Jun He Rong-Qin Zheng Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 Guangdong Province China Department of Radiology The Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 Guangdong Province China Department of Ultrasound The Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 Guangdong Province China

AIM： To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B. METHODS： Hemodynamic parameters included portal vein diameter （PVD）, portal vein peak velocity （PVPV）, portal vein volume （PW）, spleen length （SPL）, spleen vein diameter （SPVD）, spleen vein volume （SPW） and umbilical vein recanalization. They were measured by color doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with 51 normal controls, 61 patients with chronic hepatitis B, 46 patients with compensable cirrhosis, and 36 patients with decompensable cirrhosis. RESULTS： In the group of chronic severe hepatitis B, PVD （12.38 ± 1.23 mm） was significantly different from the normal control, compensable cirrhosis and decompensable cirrhosis groups （P = 0.000-0.026）, but not significantly different from the chronic hepatitis group. PVPV （16.15 ± 3.82 cm/s） dropped more significantly in the chronic severe hepatitis B group than the normal control, chronic hepatitis B and compensable cirrhosis groups （P = 0.000-0.011）. PW （667.53 ± 192.83 mL/min） dropped significantly as compared with the four comparison groups （P = 0.000-0.004）. SPL （120.42 ± 18.36 mm） and SPVD （7.52 ± 1.52 mm） were longer in the normal control and chronic hepatitis B groups （P = 0.000-0.009）, yet they were significantly shorter than those in the decompensable cirrhosis group （P = 0.000）. SPW （242.51 ± 137.70 mL/min） was also lower than the decompensable cirrhosis group （P = 0.000）. The umbilical vein recanalization rate （75%） was higher than the chronic hepatitis B and compensable cirrhosis groups. In the course of progression from chronic hepatitis to decompensable cirrhosis, PVD, SPL and SPVD gradually increased and showed significant differences between every two groups （P = 0.000-0.002）. CONCLUSION： Patients with chronic severe hepatitis B have a tendency to develop acute portal hypertension, resulting in significantly reduced portal vein perfusion, Observation of the portalsystemic h

关键词： color doppler ultrasonography Portalsystemic hemodynamics Chronic severe hepatitis B

Evaluation of the effects of combined endoscopic variceal ligation and splenectomy with pericardial devascularization on esophageal varices

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World Journal of Gastroenterology 2006年第42期12卷 6889-6892页

作者： Bo Liu Mei-Hai Deng Nan Lin Wei-Dong Pan Yun-Biao Ling Rui-Yun Xu Department of Hepatobiliary Surgery Third Affiliated Hospital Sun Yat-Sen University Guangzhou 510630 Guangdong Province China

AIM: To detect the hemodynamic alterations in collateral circulation before and after combined endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization by ultrasonography, and to evaluate their effect using hemodynamic parameters. METHODS: Forty-three patients with esophageal varices received combined EVL and splenectomy with pericardial devascularization for variceal eradication. The esophageal vein structures and azygos blood flow (AZBF) were detected by endoscopic ultrasonography and color doppler ultrasound. The recurrence and rebleeding of esophageal varices were followed up. RESULTS: Patients with moderate or severe varices in the esophageal wall and those with severe peri- esophageal collateral vein varices had improvements after treatment, while the percentage of patients with severe para-esophageal collateral vein varices decreased from 54.49% to 2.33%, and the percentage of patients with detectable perforating veins decreased from 79.07% to 4.65% (P color doppler flowmetry showed a significant decrease both in AZBF (43.00%, P < 0.05) and in diameter of the azygos vein (28.85%, P < 0.05), while the blood flow rate was unchanged. The recurrence rate of esophageal varices was 2.5% (1/40, mild), while no re-bleeding cases were recorded. CONCLUSION: EVL in combination with splenectomy with pericardial devascularization can block the collateral veins both inside and outside of the esophageal wall, and is more advantagious over splenectomy in combination with pericardial devascularization or EVL in preventing recurrence and re-bleeding of varices.

关键词： Esophageal varices Endoscopic ultrasound color doppler ultrasonography Endoscopic variceal ligation splenectomy with pericardial devascularization

Evaluation of penile hemodynamic status and adjustment of treatment alternatives in Peyronie's disease

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Asian Journal of Andrology 2002年第3期4卷 187-190页

作者： Tibet Erdogru Murat Savas Namik Yilmaz Mustafa Faruk Usta Turker Koksal Mutlu Ates Mehmet Baykara Department of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 TurkeyDepartment of Urology Akdeniz University Faculty of Medicine Kampus 07059 Turkey

Aim: Erectile dysfunction may be observed in up to 80% of patients with Peyronie's disease. An objective evaluation of the erectile function is attempted to work out in patients with Peyronie's disease. Methods: Penile deformity, sexual function and penile vascular status were analyzed in 123 patients with Peyronie's disease, who had not received any pertinent treatment. Results: Penile deformity, palpable plaque and pain on erection were seen in 112 (91%), 97(78.8%) and 27 (21.9%) of the 123 patients, respectively. Of the 76 patients evaluated by color doppler ultrasounography, veno-occlusive dysfunction as the vascular component for erectile dysfunction was found in 17 (22.3%), arterial insufficiency in 10(13.1%) and a mixed picture in 23 (30.2%). Conclusion: The documentation of penile erectile function and the determination of the vascular status using color doppler ultrasonography can guide the appropriate therapeutic choice.

关键词： Peyronie's disease sexual function penile vascular status color doppler ultrasonography

Relationship between Carotid Atherosclerosis and Cerebral Infarction

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Chinese Medical Sciences Journal 2010年第1期25卷 32-37页

作者： Guang-wen Li Guan-yi Zheng Jin-guo Li Xu-dong Sun Department of Geriatrics Union Hospital Fujian Medical University Fuzhou 350001 China

Objective To study the relationship between carotid atherosclerosis and cerebral infarction (CI). Methods Between November 2008 and March 2009,147 CI patients (CI group) and 48 patients with non-cerebrovascular diseases (control group) were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mm≤intima-media thickness (IMT) color doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups. Results In the CI group,36 (24.5%) patients had normal carotid intima,22 (15.0%) had thickened carotid intima,and 89 (60.5%) had carotid plaque. In the control group,22 (45.8%) patients had normal carotid intima,4 (8.3%) had thickened carotid intima,and 22 (45.8%) had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group (P=0.022). There was significant difference in the constitution of carotid plaque between the two groups (P=0.001); the CI group mainly had the soft plaque (55/89,61.8%),whereas the control group mainly had the hard plaque (17/22,77.3%). The first three common locations of carotid plaque in both groups were carotid bifurcation (CI group: 73.7%; control group: 64.1%),common carotid artery (CI group: 20.4%; control group: 25.6%),and internal carotid artery (CI group: 5.9%; control group: 10.3%). The location of carotid plaque between the two groups was not significantly different (P=0.438). There was no difference in the carotid inner diameter or resistance index between the two groups (P>0.05). Conclusions Carotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. T

关键词： carotid atherosclerosis cerebral infarction intima-media thickness color doppler ultrasonography

Dorsal hand reconstruction with radial artery perforator-based adipofascial flap

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Plastic and Aesthetic Research 2020年第5期7卷 15-25页

作者： Sho Yamakawa Kenji Hayashida Division of Plastic and Reconstructive Surgery Shimane University HospitalIzumoShimane 693-8501Japan

Reconstruction of dorsal hand soft tissue defects after severe injury is challenging for *** on the degree of defect,extensor tendon reconstruction may also be *** reconstruction methods are commonly performed to cover dorsal hand defects,such as skin grafting and distant,free,or local *** them,free vascularized flap transplantation is an ideal procedure because the major vessels that feed the local flap may have been damaged,and the affected limb can be reconstructed using a flow-through *** free flap surgery has advanced,few surgeons can choose this option due to its technical difficulty and *** the other hand,distant flaps have been commonly used for the reconstruction of dorsal hand defects,and local flaps,such as reverse forearm flaps and retrograde posterior interosseous flaps,do not require microvascular ***,they have some problems;distant flaps require at least two surgeries,reverse forearm flaps sacrifice major vessels and leave a scar at the donor site,and retrograde posterior interosseous flaps require meticulous dissection of the vascular *** radial artery perforator-based adipofascial flap is a versatile flap that is safe and easy to elevate without sacrificing the radial *** addition,elevating it as an adipofascial flap enables surgeons to avoid an unacceptable donor *** present two cases,demonstrating the usefulness of this pedicled perforator flap.

关键词： Perforator dorsal hand reconstruction adipofascial flap hand replantation color doppler ultrasonography