[The application of full-length urethral preservation without anastomosis in single-port laparoscopic radical prostate cancer].

Objective: To preliminarily examine the feasibility and outcome of single-port laparoscopic radical prostatectomy with full-length urethral preservation (FLUP-SPRP). Method: This study was a prospective case series study. A total of 25 patients with prostate cancer who met the enrollment criteria and agreed to this surgical procedure from March 2022 to December 2022 were collected at the Department of Urology, the Second Affiliated Hospital of Nanjing Medical University. The age of the patients was (67.2±7.6) years (range: 61 to 76 years). This novel procedure was performed by an experienced surgeon who performed single hole radical prostatectomy skillfully. Patient urinary control, tumor control, and related surgical complications after surgery were regularly monitored. Postoperative urinary control was evaluated using the daily amount of urine pad, 0 to 1 piece of urine pad was to restore urinary control, and 0 to 1 piece of pad within 24 hours after catheter removal was immediate urinary control. Result: All prodecures were successfully completed without transit to open surgery. The surgical time was (128.4±22.4) minutes (range: 100 to 145 minutes), the intraoperative blood loss was (68.2±13.7) ml (range: 50 to 120 ml). The urethral injury occurred in 4 cases during surgery and was repaired by sutures. The urinary control recovery rates within 24 hours, 1 week, 4 weeks, and 7 weeks after surgery were 80.0%, 84.0%, 92.0% and 100%, respectively. Postoperative large section pathology revealed 1 case with a positive basal margin of the prostate and negative margins of all prostate glands around the urethra. Postoperative complications included urinary tract infection in 3 cases, urodynia in 2 cases, and acute urinary retention in 1 case. MRI follow-up 3 months after surgery showed normal anatomy of the bladder and urethra. The follow-up values of prostate specific antigen at 3 and 6 months after surgery were less than 0.1 µg/L. Conclusions: The preliminary results of this study indicate that the FLUP-SPRP procedure is safe and feasible. The early results of postoperative urinary control and oncology are as expected.

Value of dual-source computed tomography in evaluating left ventricular function in patients with coronary heart disease.

We aimed to assess parameters reflecting left ventricular function by dual-source computed tomography (DSCT) with echocardiography (ECG) as control. Fifty-eight patients with coronary heart disease (CHD) were recruited from January to June 2011; 29 CHD patients had type II diabetes. All patients were assessed by cardiac DSCT and ECG examination. DSCT and ECG correlated well for ejection fraction (EF) (r = 0.70), end-systolic volume (ESV) (r = 0.87), stroke volume (SV) (r = 0.83), and end-diastolic volume (EDV) (r = 0.90). The mean ESV and EDV values measured by the two methods in CHD patients with type II diabetes were higher than those in non-diabetic patients, whereas the mean EF was lower. DSCT is an accurate and practical method for assessing left ventricular function.

First trimester caesarean scar ectopic pregnancy evaluation using MRI.

AIM: To determine the features of caesarean scar ectopic pregnancy (CSP) by using magnetic resonance imaging (MRI) in the first trimester. MATERIALS AND METHODS: Thirty-nine women with CSP in the first trimester were initially selected and underwent transvaginal ultrasound and MRI examinations. Thirty-five patients with CSP were finally included in this study. RESULTS: The CSPs were categorized into three groups: type I, in which a thin-walled diverticulum is present at the caesarean section scar (CSS) defect and the gestational sac (GS) is embedded in the diverticulum; type II, in which a thin-walled diverticulum is present at the CSS defect and the GS is partially embedded in the diverticulum; type III, in which a niche is present in the CSS defect and the GS is mainly embedded in the isthmus. Types I, II, and III CSP occurred in 40, 46, and 14% of the women, respectively. There was no significant difference between the three types in the minimum thickness of the CSS defect. In types I and II, there was a positive correlation in the maximum inlet diameter of the CSS defect and the approximate area of the GS. CONCLUSION: Using MRI, most CSPs present as a diverticulum at the CSS defect, and the CSS defect becomes weaker with the growth of the GS. MRI showed detailed features of the CSP.

MR imaging findings of the intraspinal meningeal melanocytoma: correlation with histopathologic findings.

Our aim was to better understand and improve the accuracy of the preoperative diagnosis of intraspinal MM by a combined analysis of MR imaging and pathologic findings. All 5 patients had undergone unenhanced and contrast-enhanced MR imaging examinations. All tumor samples had immunohistochemical reactions to HMB-45, vimentin, S-100, EMA, and Leu-7 antibodies. All 5 cases were located in the intradural extramedullary compartment. Two cases had multifocal lesions, and 3 cases were solitary. Two cases showed homogeneously strong enhancement, and 3 cases showed moderate enhancement on contrast-enhanced T1WI. The tumor cells had positive reactions to HMB-45, vimentin, and S-100 antibodies. MR imaging plays an important role in the detection and diagnosis of intraspinal MM. Final diagnosis should be based on histopathology and IHC examinations.

[MRI analysis of non-traumatic multiple vertebral collapse in aged people].

OBJECTIVE: To evaluate the MRI in the differential diagnosis of acute non-traumatic vertebral collapse. METHODS: Sixty-eight cases were retrospected. All cases were studied with sagittal T1-weighted MR images, T2-weighted MR images, gadolinium-enhanced T1-weighted MR images, and axial T1-weighted MR images. Twelve of 68 were performed extra coronal T1-weighted MR images and 22 with additional axial gadolinium-enhanced T1-weighted images. RESULTS: The causes of vertebral collapse were: (1) osteoporosis (n = 31), their images showed retropulsion of bony fragments of collapsed vertebral body which kept the normal signal into the spinal canal as the distinctive sign; (2) metastatic tumor (n = 30), their images showed destructions of pedicles of vertebral and epidural mass as the distinctive sign, and hyperintense or mixed hyperintense signal on T2WI and enhanced T1WI of compressed vertebrae; and (3) multiple myeloma (n = 7), their images showed long T1WI and long T2WI, without destruction of pedicle and epidural mass in compressed vertebrae. CONCLUSION: MRI is useful to the differentiations of the non-traumatic vertebral collapse in aged.