Cost-effectiveness analysis of procalcitonin and lung ultrasonography guided antibiotic prescriptions in primary care.

Antimicrobial resistance comes with high morbidity and mortality burden, and ultimately high impact on healthcare and social costs. Efficient strategies are needed to limit antibiotic overuse. This paper investigates the cost-effectiveness of testing patients with lower respiratory tract infection with procalcitonin, either at the point-of-care only or combined with lung ultrasonography. These diagnostic tools help detect the presence of bacterial pneumonia, guiding prescription decisions. The clinical responses of these strategies were studied in the primary care setting. Evidence is needed on their cost-effectiveness. We used data from a cluster-randomized bi-centric clinical trial conducted in Switzerland and estimated patient-level costs using data on resource use to which we applied Swiss tariffs. Combining the incremental costs of the two strategies and the reduction in the 28-days antibiotic prescription rate (APR) compared to usual care, we calculated Incremental Cost-Effectiveness Ratios (ICER). We also used the Cost-Effectiveness Acceptability Curve as an analytical decision-making tool. The robustness of the findings is ensured by Probabilistic Sensitivity Analysis and scenario analysis. In the base case scenario, the ICER compared to usual care is $2.3 per percentage point (pp) reduction in APR for the procalcitonin group, and $4.4 for procalcitonin-ultrasound combined. Furthermore, we found that for a willingness to pay per patient of more than $2 per pp reduction in the APR, procalcitonin is the strategy with the highest probability to be cost-effective. Our findings suggest that testing patients with respiratory symptoms with procalcitonin to guide antibiotic prescription in the primary care setting represents good value for money.

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part VI, foot and ankle.

OBJECTIVES: Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musculoskeletal interventional procedures around this anatomical region. METHODS: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around foot and ankle in order to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper that was shared with all panel members for final approval. RESULTS: A list of 16 evidence-based statements on clinical indications for image-guided musculoskeletal interventional procedures in the foot and ankle were drafted after a literature review. The highest level of evidence was reported for four statements, all receiving 100% agreement. CONCLUSION: According to this consensus, image-guided interventions should not be considered a first-level approach for treating Achilles tendinopathy, while ultrasonography guidance is strongly recommended to improve the efficacy of interventional procedures for plantar fasciitis and Morton's neuroma, particularly using platelet-rich plasma and corticosteroids, respectively. KEY POINTS: • The expert panel of the ESSR listed 16 evidence-based statements on clinical indications of image-guided musculoskeletal interventional procedures in the foot and ankle. • Strong consensus was obtained for all statements. • The highest level of evidence was reached by four statements concerning the effectiveness of US-guided injections of corticosteroid for Morton's neuroma and PRP for plantar fasciitis.

Transient elastography in diagnosis of non-alcoholic fatty liver disease / 中华全科医师杂志

Clinical data of 113 patients with non-alcoholic fat liver disease (NAFLD) diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People's Hospital were retrospectively reviewed . Patients all underwent transient elastographic ( TE) examination and the values of fat attenuation index (FAI) were obtained.The hepatocyt fatty changes in pathological examination were scored as 0 (＜5%, n＝40), 1 (5%-33%,n ＝27), 2 (34% -66%,n ＝28) and 3 (＞66%, n ＝18).There were significant differences in AST , Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease .The areas under the ROC curve (AUCs) of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively.Logistic regression analysis showed that FAI was correlated with TG , TC and BMI.The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.

Ultrasound-Guided Bar Edge Labeling in the Perioperative Assessment of Nuss Bar Removal.

INTRODUCTION: Nuss bar removal after minimally invasive repair of pectus excavatum in patients where bar ends are not palpable, can be a challenging procedure for the surgeon; a blind dissection toward the bar edges may lead to intercostal vessels or deep intercostal muscle injuries. In this article, we describe a fast, repeatable, low-cost technique to detect bar edge and stabilizers. METHODS: A perioperative scan is performed by means of a portable ultrasonograph a few minutes before the operation. The bar edge stabilizer is detected as a hyperechogenic image with a concentric crescent while the bar edge is detected as a hyperechogenic dashed line with net edges. The scan is performed, and the actual projection on the skin of the metal plaque bulk is then labeled on the patient's chest by an ink marker. CONCLUSIONS: We believe that this method may improve morbidity, operative time, and consequently, hospitalization length and costs.

Comparative study of staging hepatic fibrosis between MR diffusion weighted imaging and ultrasound elastography in patients with chronic hepatitis B / 中华放射学杂志

Objective To compare the diagnostic value of DWI and ultrasound elastography(UE) in staging hepatic fibrosis in patients with chronic viral hepatitis B(CHB). Methods Fifteen healthy volunteers (control group) and 69 patients with CHB (disease duration more than 1 year) (patient group) were prospectively recruited. All of the subjects underwent DWI and UE experiments twice with the interval of less than 3 days. Liver ADC and shear wave velocity(SWV) values were obtained for subsequent analysis. Sixty?nine patients who had biopsy were grouped according to their pathological grading of fibrosis, from S0 to S4. One?way ANOVA was used to compare the ADC and SWV values between the five different fibrosis groups and control group. Spearman correlation analysis was used to analyze the correlations between the ADC and SWV values and those staging factors. Finally, receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of ADC and SWV values in discriminating different stages of hepatic fibrosis. Results Based on the pathological results, the 69 patients were reclassified to five subgroups with 11, 13, 12, 15 and 18 patients in the S0, S1, S2, S3 and S4 groups respectively. ADC values were(1.39±0.09)×10-3,(1.39±0.08)×10-3,(1.38±0.10)×10-3,(1.20±0.06)×10-3,(1.12±0.07)×10-3 and(1.01±0.07)×10-3mm2/s for the control group and stages S0 to S4 respectively.SWV values were(1.17±0.07),(1.16±0.08),(1.23±0.10),(1.48±0.14),(1.85±0.14)and(1.97±0.12)m/s for stages S0 to S4 and the control group respectively. Statistically significant differences were observed among them (P<0.01). Both ADC (r=-0.894,P<0.01) and SWV (r=0.904,P<0.01) values were highly correlated with the stages of liver fibrosis. The area under ROC(AUC) for predicting fibrosis stages (≥S1, ≥S2, ≥S3 and S4) with ADC values was 0.893, 0.991, 0.966 and 0.952 respectively. Accordingly, the AUC for SWV values were 0.937, 0.993, 0.994 and 0.914. Conclusions The two imaging methods of DWI and UE showed good and similar diagnostic performance in discriminating the different stages of hepatic fibrosis.

Testicular and epididymal ltrasonography in Santa Inês lambs raised in Brazil

The objective of this work was to study, through ultrasonographic evaluation, changes in testes and epididymides of clinically healthy, peripubertal and pubertal Santa Inês lambs raised in Brazil. Periodic e valuations of weight, biometric characteristics (scrotal circumference, width and length) and ultrasound examinatio ns of the testes and epididymides of 20 lambs were performed between 84 and 280 days old at intervals of 28 days. Scans were performed in the sagittal, transverse, frontal and oblique planes to evaluate the echotexture of the testicular parenchyma and mediastinum and the tail epididymis as well as the thickness and width of the mediastinum testis. The testicular parenchyma demonstrated a homogeneous echogenicity patter n ranging from low to moderate. The echogenicity of testicular parenchyma increased in direct proportion to animal age, being higher in pubertal lambs when compared to prepubertal at the same age. The mediastinum testis was observed in 100% of the evaluated animals, regardless of the scan plane used, and was classified as diffuse or moderately or highly echogenic. Echogenicity and the thickness of the mediastinum testis increased in direct proportion to animal age. The epididymal tail was presented in hypoechoic relation to the testicular parenchyma. Based on these results, it was concluded that ultrasound is useful tool for selection and morphophysiological evaluation of Santa Inês lambs on peripubertal and pubertal phases, when used in combination with other methods such as semen evaluation.

Evaluation of acoustic radiation force impulse imaging for the clinicopathological typing of renal fibrosis.

This study aimed to explore the assessment value of virtual touch quantization (VTQ) for the clinicopathological typing of renal fibrosis. The quantitative detection of 76 patients with nephropathy was performed using acoustic radiation force impulse imaging (ARFI). The extent of the renal fibrosis in each patient was confirmed using ultrasound-guided biopsy pathology. The VTQ values were compared with the degree of renal fibrosis in order to analyze the correlation between them. Patients were divided pathologically into four groups, as follows: non-fibrosis (n=14), mild fibrosis (n=40), moderate fibrosis (n=21) and severe fibrosis (n=1). Compared with the non-fibrosis group, the VTQ values of the mild and moderate fibrosis groups were significantly increased (P<0.01); however, there was no significant difference between the VTQ values of the mild and moderate fibrosis groups (P>0.05). According to the receiver operating characteristic (ROC) curve, a VTQ value of renal parenchyma of >1.67 m/sec was determined to be an indicator of renal fibrosis, with a sensitivity of 86.3% and a specificity of 83.3%. VTQ technology may be significant in the assessment of the extent of renal fibrosis.

Study on the correlation between fetal bowel dilatation and pregnancy outcomes / 中华医学超声杂志（电子版）

Objective To explore the ultrasonographic features of fetal gastrointestinal tract dilatation and associated abnormalities. Methods From July 2009 to June 2013, 118 cases of fetal bowel dilatation of detected by prenatal ultrasound in our hospital were followed up for their ultrasonographic changes and pregnancy outcomes. The features of fetal bowel dilatation with associated abnormalities and their impact on pregnancy outcomes were summarized. Results Among the 118 cases of fetuses, 101 cases had small bowel dilatation, including 4 cases with adverse pregnancy outcomes. One case had cleft lip and palate and was aborted during 25th week of pregnancy. The other 3 cases had continuous excess of amniotic lfuid and progressive widening of bowel, the average inner diameter of which was above 30.0 mm. In the 3 cases, 2 cases ended with intrauterine death during 34th week of pregnancy and 1 case ended with death at one week after birth. Among the 97 cases of pregnant women with good pregnancy outcomes, 66 cases (66/97) were solitary bowel dilatation, while the remaining 31 cases (31/97) were associated with abnormal soft markers, e.g., excess or decrease of amniotic lfuid, fetal echogenic bowel, fetal uronephrosis, short femur, single umbilical artery, fetal widened lateral ventricles and placenta overripe, etc. Among the 17 cases of colonic dilatation, 1 case had exessive amniotic lfuid and“double-leaf sign”clumps in abdomen during the second trimester and was proved to be anal atresia post partum, while the remaining 16 cases had the colonic dilatation which were found after 34th week of pregnancy and the widest inner diameter of colon was less than 30.0 mm associated with abnormal soft markers like excess or decrease of amniotic lfuid and fetal echogenic bowel, etc., and associated with good pregnancy outcomes. Conclusions Most fetuses with mild to moderate bowel dilatation had favorable outcomes. During ultrasonic examination, the degree and dynamic change of bowel dilatation shall be observed. If bowel dilatation or increment of amniotic fluid continues or worsens, greater risk of poor prognosis is indicated. The larger inner diameter of the small bowel, the greater risk of poor prognosis. If the fetus with bowel dilatation had echogenic bowel before, the risk of intestinal obstruction is comparatively lower. For the fetus suspected for colonic obstruction and anal atresia, it is more meaningful to observe the intestinal morphology and its changes.

The application of prenatal ultrasound in pregnancy with several kinds of pathogen infection / 中华医学超声杂志（电子版）

Objective To investigate the fetal ultrasonographic features in pregnancies with Toxoplasma (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Methods From January 2011 to March 2013, prenatal ultrasound examination was performed in 545 fetuses with mothers of speciifc positive IgM of TOX, RV, CMV and HSV, detected by enzyme-linked immune sorbent assay (ELISA) in Nanjing Medical University Affiliated Suzhou Hospital. Ultrasonographic features were summarized and pregnancy outcome was followed up in fetuses with abnormal ifndings. Results Among the 545 fetuses, 56 cases with abnormal sonographic ifndings:6 cases with central nervous systerm abnormalities (2 intracranial calcifications, 4 hydrocephaly);9 cases with digestive system abnormalities (1 intrahepatic calcifications, 8 echogenic bowel);2 cases with heart abnormalities (1 interventricular septal defect, 1 right heart enlargement);17 cases with abnormal amniotic fluid volume (16 polyhydramnios, 1 oligohydramnios);3 cases with placental abnormality (1 thick placenta, 2 placenta abnormal calciifcation);13 cases with urinary systerm abmormality appearing as renal sinus separation;and 6 cases with other systerm abnormalities (1 neck lymphatic hygroma, 1 single umbilical artery, 1 sacrococygeal teratoma and 3 intrauterine growth restriction);2 cases of complicated abnormalities. Conclusions Prenatal ultrasonography is signiifcant in detecting serious fetal malformations, such as hydrocephaly, heart abnormalities and characteristic ultrasound features such as intracranial calciifcations, echogenic bowel, placenta abnormal calciifcation complicated with TOX, RV, CMV and HSV infection, providing valuable information for further clinical treatment, such as induced labour.

The value of prenatal ultrasound examination in diagnosing twin reversed arterial perfusion sequence / 中华医学超声杂志（电子版）

Objective To explore the clinical significance of prenatal ultrasound examination in diagnosing twin reversed arterial perfusion sequence (TRAP). Methods This was a retrospective study on 5 cases of TRAP sequence conifrmed by prenatal ultrasound and clinical method. The clinical data and ultrasound images were analyzed. Cases were collected at Hubei Maternal and Child Health Hospital from 2001 January to 2013 February. Results Four-iffths of TRAP were not corrected diagnosed and another one was misdiagnosised as asymmetrical conjoined twins in early pregnancy. Five cases of TRAP were correctly diagnosed during the second trimester. Sonographic ifndings of ifve acardia without blood lfow were as follows:(1) All acardias had no blood perfusion in body and umbilical cord, were absence of the fetal head (acephalous) and heart (acaidia), without skin edema, and a linear object resemble as umbilical cord extend from umbilical region of acardia to plcenta could be seen. Four (case 2-5) had lower limbs or dysplasia of lower limbs (two had spine), and one (case 1) had an irregular mass with bone. (2) Four pump twins had no obvious abnormity, while one had two clubfeet (case 2). Three died in uterus, one underwent induced labor due to oligohydramnios and heart dysfunction, and another one survived. Prenatal ultrasound images were consistent with MRI, X-ray examination, autopsy and postnatal neonatal examination results. Conclusions Acardia without blood lfow which was generally misdiagnosed as single gestation in utero can be diagnosed according to the special disformity of acardia and the linear umbilical cord extend from umbilical region to placenta, besides, it still need to strengthen monitoring the pump twin even if there was no blood perfusion to acardia.

Correlation between ultrasound parameters and hormone level in patients with polycystic ovary and polycystic ovary syndrome / 中华全科医师杂志

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

Evaluation of colonoscopy in the diagnosis and treatment of rectal carcinoid tumors with diameter less than 1 cm in 21 patients.

The aim of this study was to evaluate colonoscopy in the diagnosis and treatment of rectal carcinoid tumors with diameter <1 cm. Elevated lesions with normal mucosal appearance under colonoscopy were identified. Endoscopic ultrasound (EUS) was performed in 16 patients. Lesions diagnosed as rectal carcinoid tumors were resected by endoscopic mucosal resection (EMR). The diagnosis of specimens by EMR was confirmed by pathological examination. Immunohistochemical staining was undertaken and follow-up data were collected. Twenty-two lesions were found among the 21 cases. The majority of these were located within 10 cm of the anal opening. Twenty two cases with rectal carcinoids were diagnosed by EUS under colonoscopy and all cases were verified by pathological examination. The resection rate was 95.5% (21/22). Of the lesions, six were mucosal and 10 were submucosal. Immunohistochemistry was undertaken for carcinoid tumors. Histological patterns of rectal carcinoids revealed solid nests or trabecular patterns. Eleven cases were synaptophysin (SYN)-positive, 8 cases were neurone-specific enolase (NSE)-positive and 5 cases were chromogranin A (CgA)-positive. Colonoscopy combined with EUS is effective in the diagnosis and determination of small rectal carcinoids. Endoscopic treatment is effective for small-sized tumors. Pathology and immunohistochemistry remain the diagnostic gold standard.

Atherosclerosis occurs in patients undergoing maintenance hemodialysis / 中国组织工程研究

BACKGROUND:Atherosclerosis is a common complication in diabetic nephropathy and hemodialysis patients. The effect of hemodialysis duration and other relative factors on the atherosclerosis of patients with diabetic nephropathy needs to be further observed and explored. OBJECTIVE:To observe the atherosclerosis in the patients with different hemodialysis durations, then to evaluate the effect of hemodialysis duration and other relative factors on atherosclerosis of patients with diabetic nephropathy. METHODS:The intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group, non-diabetic nephropathy hemodialysis group and end-stage renal disease non-hemodialysis group was detected with high-frequency ultrasonic testing, and the healthy volunteers were as the normal control group. The relationship between the intima-media thickness of the carotid artery in the hemodialysis patients and hemodialysis duration was analyzed, and the changes of insulin resistance in each group were compared. RESULTS AND CONCLUSION:Compared with the normal control group, the intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group and non-diabetic nephropathy hemodialysis group was increased (P0.05);the intima-media thickness of the carotid artery in the 60 months diabetic nephropathy hemodialysis group was higher than that in the 24 hours diabetic nephropathy hemodialysis group (P0.05). The homeostasis model of assessment-insulin resistance value in the 24 hours diabetic nephropathy hemodialysis group was slightly lower than that in the diabetic nephropathy non-emodialysis group (P<0.05), and the homeostasis model of assessment-insulin resistance value in the 60 months diabetic nephropathy hemodialysis group was significantly lower than that in the diabetic nephropathy non-emodialysis group (P<0.01). The development of atherosclerosis on diabetic nephropathy patients can be affected by hemodialysis to some extent. And the effect is correlated with the hemodialysis duration.

Effect of hypertension on intracranial and extracranial atherosclerotic lesions in patients with type 2 diabetes mellitus / 中国脑血管病杂志

Objective: To investigate the effect of hypertension on the process of carotid atherosclerotic lesions in patients with type 2 diabetes mellitus using ultrasound techniques. Methods: A total of 203 consecutive type 2 diabetic patients with hypertension were enrolled into the study. The patients were grouped according to the increased systolic blood pressure for 5 mm Hg as an observation unit. The hemodynamic parameters of intracranial and extracranial arteries in each group were measured by using color Doppler flow imaging (CDFI) and transcranial Doppler ultrasound (TCD) to identify the extent of vascular lesions. The correlations of systolic and diastolic blood pressure, age, hypertension, duration of diabetes with the detection rate of common carotid intimal medial thickness (CCA-IMT), carotid and intracranial arterial stenosis were analyzed. Results: Circled digit oneThe CCA-IMT in 203 patients was 0.62-1.36 mm (mean 1.04 ± 0.14 mm). The detection rate of intracranial arterial stenosis was 52.7%, in which the detection rate of stenosis rate ≥ 50% was 21.2%; the detection rate of extracranial carotid artery stenosis was 28.1%, in which the detection rate of stenosis rate ≥ 50% was 14.8%. The total detection rate of intracranial arterial stenosis and the detection rate of stenosis rate ≥ 50% were higher than extracranial carotid artery, in which there were significant differences in total detection rate of stenosis (P 0.05). Circled digit twoMultiple stepwise regression analysis showed that there was a linear relationship between the CCA-IMT and systolic blood pressure and age. For each increase of 5 mm Hg in systolic blood pressure, the CCA-IMT would increase 0.015 mm; for each increase of 1 year of age, the CCA-IMT would increase 0.008 mm. Circled digit threeThe total detection rate of intracranial artery stenosis showed a linear relationship with age. For each increase of 1 year of age, the total detection rate of stenosis increased 2.8%; the detection rate of ≥ 50% stenosis showed a linear relationship with systolic blood pressure. For each increase of 5 mm Hg in systolic blood pressure, the detection rate of stenosis increased 2%. Conclusion: the CCA-IMT increases with the increased blood pressure in hypertensive patients with type 2 diabetes. The progression of intracranial arterial stenosis in patients with diabetes mellitus promoted by hypertension is more apparent than carotid artery.

Evaluation of the effect of atorvastatin on preventing restenosis after vertebral artery stenting with color Doppler flow imaging / 中国脑血管病杂志

Objective: To evaluate the effect of atorvastatin on the prevention of restenosis after vertebral artery origin stenting with color Doppler flow imaging (CDFI). Methods: A total of 59 patients with complete clinical data underwent unilateral vertebral artery origin stenting were recruited in the study. The patients were divided into drug (n =29) and non-drug (n =30) groups according to whether they took atorvastatin (20 mg/d) or not. All the patients were detected by CDFI before and at 1, 6, and 12 months after stenting. The peak systolic velocity (PSV) at the proximal (PSVOS) and intervertebral segments of vertebral artery (PSVIV) were recorded and the ratio of PSVOS/PSVIV was calculated. Digital subtraction angiography (DSA) showed that the in-stent stenosis rate ≥50% was determined as postoperative restenosis. The incidence of restenosis and hemodynamic changes were compared between the two groups. Results: Circled digit oneThe restenosis rates of the drug and non-drug groups at 6 months after stenting were 20.7% (6/29) and 36.7% (11/30) respectively (P >0.05); the restenosis rate (50.0%) of the non-drug group(50%) was significantly higher than that of the drug group (20.7%) at 12 months after stenting (P < 0.05). Circled digit twoThe PSV OS and PSVOS/PSVIV of the patients in both groups at 1 month after stenting were improved more significantly than those before the procedure. PSVOS(187±18 cm/s, 179±20 cm/s) and PSVOS/PSVIV(3.93±0.59, 3.24±0.48) were relatively increased in the non-drug group at 6 months after the procedure, but there was no significant difference. PSVOS (209±21 cm/s, 159±16cm/s) and PSVOS/PSVIV (4.34±0.65, 2.86±0.36) in the non-drug group at 12 months after stenting were significantly higher than those in the drug group. There was significant difference between the two groups (P < 0.05). Conclusions: Atorvastatin can decrease the restenosis rate after vertebral artery stenting. With the prolonged time of drug treatment, it may affect the hemodynamic changes in the abnormal vessels.

Sonograms of Tuberculous Peritonitis / 中国医科大学学报

Objective To study the sonograms of tuberculous peritonitis and improve the diagnostic accuracy of this disease.Methods We retrispectively analyzed 138 cases of tuberculous peritonitis diagnosed by ultrasonically guided biopsy,postoperative pathology,and clinical manifestation.The characteristics of the sonograms were analyzed,including the amount and character of ascites,the changes in greater omentum,peritoneum,and mesenterium.the enlarged celiac lymph nodes,and the organ involvement.Results The sonograms of tuberculous peritonitis were characterized by thickening of greater omentum with different degrees of ascites,which usually presented cerebral fissure sign under high-frequency ultrasound,together with aggregation of intestines,thickening of peritoneum,enlarged celiac lymph nodes,hepatomegaly,splenomegaly,and pleural effusion.Conclusion Ultrasonography is of great clinical significance in the diagnosis of tuberculous peritonitis and the guidance of greater omentum biopsy.

Research of ultrasound combined with hemorheology on atherosclerosis in rabbits / 中华超声影像学杂志

Objective To assess the value of high-frequency color Doppler ultrasound technique combined with hemorheology in detecting early atherosclerosis and monitoring its progression.Methods Twenty-four white big ear rabbits were divided into two groups randomly.Group A (6 rabbits) was fed normal rabbit chow,while group B (18 rabbits) was fed high cholesterol diet and was divided into three subgroups: B1(6 rabbits) with high cholesterol diet for 4 weeks,B2(6 rabbits) for 8 weeks,B3(6 rabbits) for 12 weeks.Intima-media thickness (IMT),diameter of common carotid artery and hemorheology index were observed dynamically and compared with the findings of histological examination.Results IMT of common carotid artery increased gradually in group B at different phases of atherosclerosis.Diameter compensationally enlarged at the early stage,and then stenosed with the progression of atherosclerosis.RBC deformation index of group B began reducing in the second week,but blood viscosity,plasma viscosity,RBC aggregation index and rigidity index gradually increased from the fourth week( P

Research on carotid artery wall elasticity using echo-tracking in children / 中华超声影像学杂志

Objective To assess the wall elasticity of the common carotid artery using echo-tracking in healthy children and children with hyperlipidemia.Methods The study included 68 normal healthy children and 25 children with hyperlipidemia.All the subjects were 3-18 years old.They were divided into three groups according to ages 3-6 years old group,7-13 years old group and 14-18 years old group.Echo-tracking was used to measure the pressure-strain elastic modulus (E?),stiffness parameter(?)and arterial compliance (AC) of the common carotid artery.Results The average values of E? were different among the three age groups in normal healthy children (all P

CHANGES IN MUSCLE THICKNESS, PENNATION ANGLE AND FASCILE LENGTH WITH AGING / 体力科学

The influences of age on muscle architectural characteristics, i. e., muscle thickness, pennation angle, fascicle length, were studied in 121 men and 229 women aged 17 to 85 yrs. The subjects were divided into three age groups (younger : 17-39 yrs, middle-aged : 40-59 yrs, elderly : 60-85 yrs) for both genders. Muscle thickness and pennation angle of the vastus lateralis (VL), medial gastrocnemius (MG), and long head of triceps brachii (TB) muscles were measured using B-mode ultraso-nography, and fascicle length was estimated. In all age groups, men had significantly greater relative muscle thickness (to limb length) in VI, and TB than women, but not in MG. Relative muscle thickness of VL was significantly lower in elderly than in younger and middle-aged subjects. Ilowever, the corresponding differences in MG and TB were insignificant. The pennation angle of VL was significantly lower in elderly than in younger and middle-aged subjects, although there were no significant differences in pennation angles of MG and TB among the three groups. These results suggest that the decrease in thickness of vastus lateralis muscle with aging is significant, but not significant for medial gastrocnemius and triceps hrachii muscles.

A Significance of Fetal Choroid Plexus Cysts / 대한주산의학회잡지

OBJECTIVE: Choroid plexus cysts(CPCs) are commonly found at a routine ultrasonography. There is, however much debate as to their clinical significance. The aim of this study were to estimate the prevalence of CPCs associated with aneuploidy and to establish the guidelines for prenatal management and parental counseling. METHODS: Between January 1996 and December 2001, 10,917 women who underwent the secondtrimester USG at Asan Medical Center, of them CPCs were noted in 168 fetuses; there were 85 cases of isolated CPCs and 83 cases of the high risk group. All women whose fetuses were diagnosed as having CPCs underwent the targeted USG for survey of the detailed anatomy and followed with the repeat USG after 3-4weeks. We analysed the association of chromosomal abnormality and CPC, according to the size, bilaterality, and shape. RESULTS: The incidence of CPCs was 1.60%(175/10917). The gestational age of the first detection of CPCs was 21.0+/-3.8(mean+/-SD). In the isolated CPCs(85cases) all case except one resulted in normal karyotyping. In the high risk group(83cases), eighteen of trisomy 18, and two of trisomy 21 were detected. Almost all of them had other structural abnormalities on USG. The chromosomal abnormalities was significantly related with CPCs when CPCs are large(>or=10mm), bilateral, and irregular shape. CONCLUSION: The risk of chromosomal abnormalities is elevated when CPCs are associated with other structural abnormalities on USG. Therefore it is recommendable that the fetal chromosomal analysis to be performed, based on the presence of associated abnormal findings on USG, maternal age, and results of the double marker test.