ABSTRACT
<p><b>OBJECTIVE</b>To discuss the diagnosis and therapy of chylous reflux and external chylous fistula.</p><p><b>METHODS</b>All of 6 patients were diagnosed with direct lymphagiography, lymphscintigraphy. Among them, 2 patients received CT after direct lymphagiography. Retroperitoneal lymphangiectomy plus lymph-vein shunting was performed in 5 patients, and retroperitoneal lymphangiectomy in 1 patient.</p><p><b>RESULTS</b>The 6 patients were followed up from 6 months to 6 years. In 5 patients, chylous cysts disappeared and chylous fistula closed, and in 1 patient, chylous fistula didn't cicatrize, and chyle still leak out from the scrotum.</p><p><b>CONCLUSIONS</b>Retroperitoneal lymphangiectomy plus lymph-vein shunting has curative effect on chylous external fistula of the lower extremity and genitalia, but it has the chance to not obstruct all paths of chylous reflex.</p>
Subject(s)
Humans , Chyle , FistulaABSTRACT
Ojective To study the diagnosis and treatment of upper extremity edema after radical mastectomy. Methods Diagnosis depended on B type ultrasoundgraphy, CT, lymphography, venography, biopsy and axilla exploration. Lymphaticovenous anastomosis (LVA) with microsurgery technology was used for the treatment of simple lymphoedema. Results In 40 cases of lymphoedma after radical mastectomy, 7 patients were diagnosed as metastasis of cancer. 3 patients were diagnosed obstrcution of lymphatic and vein. 30 patients with simple lymphedema were treated with LVA. Short term efficacy was observed in all patients.The efficacy at 3～12 years was 83.3%. Conclusion The diagnosis of upper limb edema after radical mastectomy is essential. Metastasis and obstruction of vein are the causes. Biopsy conducted under high frequency B type ultrasoundgraphy may be a good method for the diagnsosis of matastasis, but a few patients were diagnosed only by axilla exploration. LVA may be given first priority to the theraphy of lymphedema after radical mastectomy.
ABSTRACT
Blood glucose levels of 220 days were recorded in 85 type 2 diabetic patients for monitoring glycemia for 48-72 h each one by the continuous glucose monitoring system (CGMS). Frequencies of nocturnal hypoglycemia (blood glucose≤2. 8mmol/L) were estimated when bedtime blood glucose levels were≤4.4mmol/ L,≤5.0mmol/L,≤5. 6mmol/L,≤6.1mmol/L,≤6. 7mmol/L, or≤7. 2mmol/L respectively. Nocturnal hypoglycemia occurred in 39 nights of 220 days (17.7%) of 26 patients and their bedtime blood glucose level was (4.4?2.6)mmol/L with a range from 2. 2 to 12. 6 mmol/L. Using a cut-off of bedtime blood glucose at≤6. 7 mmol/L, area under the ROC curve was reached maximal value (0. 359?0. 046). The positive predictive value was 25% and the negative predictive value was 91. 7%. CCMS is a useful tool to detect unaware nocturnal hypoglycemia.