ABSTRACT
Forty-three men underwent varicocele scintigraphy to exclude underlying varicocele as a possible cause of decreased semen quality. The total acquisition time for each study amounted to as little as 200 seconds. In four cases retrograde blood flow was seen in the left internal spermatic vein, with subsequent clear visualization of the pampiniform plexus. In three of four of these patients, pregnancy ensued after therapeutic intervention. Seven patients showed only increased scrotal activity locally, in the absence of retrograde blood flow. The remaining 32 patients showed a normal blood flow pattern. The existence of spermatic vein reflux in varicocele-related infertility is thought to be a major factor in proper patient selection for therapeutic ligation or embolization of the internal spermatic vein. It is suggested that this simplified scintigraphic method may be useful in the detection of retrograde blood flow in patients with varicocele, especially in small or subclinical varicocele.
Subject(s)
Spermatic Cord/blood supply , Varicocele/diagnostic imaging , Adult , Analysis of Variance , Embolization, Therapeutic , Female , Humans , Infertility, Male/etiology , Infertility, Male/therapy , Ligation , Male , Patient Selection , Pregnancy , Radionuclide Imaging , Radiopharmaceuticals , Regional Blood Flow , Scrotum/blood supply , Scrotum/diagnostic imaging , Semen/physiology , Sodium Pertechnetate Tc 99m , Spermatic Cord/diagnostic imaging , Time Factors , Varicocele/complications , Varicocele/therapy , VeinsABSTRACT
In this report, a patient with known von Willebrand's disease is presented with severe thrombocytopenia developing during pregnancy, which at first was believed to be caused by immune thrombocytopenic purpura. For several reasons this first diagnosis had to be rejected, but subtyping of von Willebrand's disease pointed out that the patient suffered from type IIB, which, according to recent literature, can lead to platelet destruction in pregnancy. Early subtyping of von Willebrand's disease can have a major influence on the management of pregnancy.
Subject(s)
Blood Platelets/immunology , Pregnancy Complications, Hematologic , Thrombocytopenia/immunology , von Willebrand Diseases/complications , Adult , Autoantibodies/biosynthesis , Female , Humans , Immunoglobulin M/biosynthesis , Platelet Count , Prednisone/therapeutic use , Pregnancy , Thrombocytopenia/drug therapy , Thrombocytopenia/etiologyABSTRACT
A cardiotocograph with autocorrelation system, a simple telephone amplifier, a telephone handset with adjustable speaker volume and an adapted portable ultrasonic fetal heart detector can form a simple but effective system for long distance telemetry of the fetal heart rate from patients' homes using public telephone network. Especially the combination of supervision and direct communication with the patient during registration reduces the loss of signal to a minimum (4%), resulting in a high percentage of correctly transmitted fetal cardiograms.
