ABSTRACT
OBJECTIVE: To assess retrospectively the accuracy of colour-coded duplex sonography (CCDS) in distinguishing testicular torsion from epididymitis as the cause of acute testicular pain. PATIENTS AND METHODS: The results of CCDS were analysed for all 81 patients (mean age 27.2 years [6 weeks to 60 years]), admitted between 1.1.1995 and 30.6.1996 with the diagnosis of acute testicular pain. Testicular torsion was diagnosed when CCDS failed to detect perfusion in one testis. Regular arterial and venous perfusion of both testes excluded torsion. Epididymitis was diagnosed when hyperperfusion of the epididymis was demonstrated by CCDS. RESULTS: 20 of 22 cases of torsion, subsequently diagnosed at surgery, had been correctly diagnosed by CCDS (sensitivity 90.9%, specificity 98.3%). 55 patients had epididymitis, confirmed by the clinical course and follow-up having excluded torsion. Other causes (trauma, tumour, inguinal hernia) were found in the remainder of patients. CONCLUSION: With a positive predictive value of 95.2% and a negative one of 96.6% CCDS is a highly suitable method for recognizing or excluding testicular torsion and thus clarifying the cause of acute testicular pain.
Subject(s)
Epididymitis/diagnostic imaging , Pain/diagnosis , Spermatic Cord Torsion/diagnostic imaging , Testicular Diseases/diagnosis , Ultrasonography, Doppler, Color , Acute Disease , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Humans , Infant , Male , Middle Aged , Pain/etiology , Retrospective Studies , Sensitivity and Specificity , Testicular Diseases/diagnostic imagingSubject(s)
Delivery, Obstetric , Fetal Monitoring , Infant, Newborn/blood , Oxyhemoglobins/analysis , Scalp/blood supply , Capillaries , Female , Humans , Hyperbaric Oxygenation , Monitoring, Physiologic , Oxygen/blood , Pregnancy , Reference Values , Regional Blood Flow , Respiration, Artificial , Spectrophotometry/methodsSubject(s)
Mitochondria/metabolism , Oxygen Consumption , Pigments, Biological/analysis , Scattering, Radiation , Spectrum Analysis/methods , Animals , Electron Transport Complex IV/metabolism , Hemoglobins/metabolism , Light , Myocardium/metabolism , Myoglobin/metabolism , Spectrophotometry/methodsABSTRACT
The cellular oxygen supply in the isolated, hemoglobin-free perfused, working rat heart can be determined by measurements of myoglobin oxygenation. However, for a precise analysis of mitochondrial hypoxia and anoxia (pO2 < 0.01 Torr) redox-state of respiratory enzymes must be known. By use of the EMPHO (Frank et al. 1989) it is possible to perform a high speed spectrometry within very small tissue volumes. Because of the characteristic absorption spectra of oxygenated and deoxygenated myoglobin and of the oxidized and reduced cytochrome aa3 within the wavelength interval from 500 to 630 nm it is possible to isolate these two pigments from the remission spectra and to determine the oxygenation state of myoglobin and the redox-state of cytochrom aa3.
