Objective To retrospectively evaluate the effects of saline administration following contrast material injection, abdominal compression and two delay phase acquisition on image quality improvement of computed tomograp...Objective To retrospectively evaluate the effects of saline administration following contrast material injection, abdominal compression and two delay phase acquisition on image quality improvement of computed tomographic urography (CTU). Methods Medical records and informed consents of patients were obtained. In totally 122 patients (50 men, 72 women), two delay phase images with CTU were performed. Scans began simultaneously with a contrast bolus injection of 100 mL (300 mgI/mL) followed by a saline bolus injection of 100 mL at a rate of 5 mL/s. Two delay phase images were taken at 400 and 550 seconds for each patient. Examinations were taken by using abdominal compression or not. The distention and opacification of the urinary tract were evaluated by two interpreters together on transverse images and post-processing images. Effects of four techniques (saline administration and abdominal compression, saline administration only, compression only, and neither saline administration nor compression) and two delay phase acquisition on image quality improvement were analysed by using ANOVA and Chi-square test. Results Saline administration improved opacification (P<0.05) and increased overall image quality (P<0.01) of the intrarenal collecting system and proximal ureter. Abdominal compression (P<0.05) and delayed phase image acquisition of 550 seconds (P<0.01) all improved distention of the intrarenal collecting system and proximal ureter but did not improve opacification. No statistically significant effects on the distal ureter were found. However, there were more visualized distal ureteral segments with the longer imaging delay. Conclusion Saline administration, abdominal compression and longer imaging delays are all effective in improving image quality of 64-detector row CTU.展开更多
Background： Laparoendoscopic single-site surgery （LESS） may serve as a potential alternative to conventional laparoscopy and is developing quickly, but still in its infancy. The study is to present our two-year exp...Background： Laparoendoscopic single-site surgery （LESS） may serve as a potential alternative to conventional laparoscopy and is developing quickly, but still in its infancy. The study is to present our two-year experience in transumbilical LESS simple nephrectomy （LESS-SN） for non-functioning kidney, in an effort to evaluate its feasibility, clinical outcomes and potential advantages. Methods： From December 2008 to December 2010, a total of 11 patients with body mass index （BMI）≤30 underwent transumbilical TriPortTM LESS-SN by a single experienced urologist at our institution. The indications for nephrectomy included nonfunctioning kidney associated with ureteropelvic junction stricture （n=l）, ureteral calculi （n=6）, tuberculosis （n=3）, and ureteral stricture （n=l）. Patient demographics perioperative and follow-up data were prospectively collected and analyzed. Results： Ten procedures were successfully completed with one patient converted to open surgery due to uncontrollable bleeding. The mean operative time was 189.2 （ranging 100-320 min） with an estimated blood loss of 204.5 （ranging 50-1 000 ml）. There were two complications of bleeding （1- intra-, 1- post-）. The mean hospitalization after surgery was 7.9 d （ranging 4-17 d） With a regular follow-up of 1, 6, 12, and 24 months after surgery, all patients remained symptom-free with an intra-umbilical scar. Conclusion： Transumbilical LESS simple nephrectomy for nonfunctioning kidney can be accomplished with favorable surgical outcomes and a superiority of cosmesis. However, cases with chronic inflammation are not suitable for initial up-take and should only be attempted by the very experienced laparoscopist.展开更多
AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing whic...AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing which,endotherapy(ET;pancreatic sphincterotomy and stent placement)was done.The frequency of pain,its visual analogue score(VAS),quality of life(Qo L),serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET.Response was defined as at least 50%reduction in the severity of pain to below a score of 5.RESULTS Of the thirty nine patients analysed,21(53.9%)responded to DT and 18(46.1%)underwent ET.The VAS for pain(7.0±2.0 vs 1.3±2.5,P<0.001)and the number of days with pain per month decreased[1.0(1.0,2.0)vs 1.0(0.0,1.0),P<0.001],and the Qo L scores[55.0(44.0,66.0)vs 38.0(32.00,51.00),P<0.01]improved significantly during follow up.Similar significant improvements were seen in patients in the subgroups of DT and ET except for Qo L in ET.The serum C-peptide(P=0.001)and FE(P<0.001)levels improved significantly in the entire group and in the two subgroups of patients except for the C peptide levels in patients on DT.CONCLUSION A standardised protocol of DT,followed by ET decreased the intensity and frequency of pain in recurrent acute pancreatitis,enhanced Qo L and improved pancreatic function.展开更多
文摘Objective To retrospectively evaluate the effects of saline administration following contrast material injection, abdominal compression and two delay phase acquisition on image quality improvement of computed tomographic urography (CTU). Methods Medical records and informed consents of patients were obtained. In totally 122 patients (50 men, 72 women), two delay phase images with CTU were performed. Scans began simultaneously with a contrast bolus injection of 100 mL (300 mgI/mL) followed by a saline bolus injection of 100 mL at a rate of 5 mL/s. Two delay phase images were taken at 400 and 550 seconds for each patient. Examinations were taken by using abdominal compression or not. The distention and opacification of the urinary tract were evaluated by two interpreters together on transverse images and post-processing images. Effects of four techniques (saline administration and abdominal compression, saline administration only, compression only, and neither saline administration nor compression) and two delay phase acquisition on image quality improvement were analysed by using ANOVA and Chi-square test. Results Saline administration improved opacification (P<0.05) and increased overall image quality (P<0.01) of the intrarenal collecting system and proximal ureter. Abdominal compression (P<0.05) and delayed phase image acquisition of 550 seconds (P<0.01) all improved distention of the intrarenal collecting system and proximal ureter but did not improve opacification. No statistically significant effects on the distal ureter were found. However, there were more visualized distal ureteral segments with the longer imaging delay. Conclusion Saline administration, abdominal compression and longer imaging delays are all effective in improving image quality of 64-detector row CTU.
基金Supported by the Military Major Project for Clinical High-tech and Innovative Technology of China (2010gxjs057)the Municipal Hospitals’ Project for Emerging and Frontier Technology of Shanghai (SHDC12010115)the Project for the Key Discipline of Shanghai
文摘Background： Laparoendoscopic single-site surgery （LESS） may serve as a potential alternative to conventional laparoscopy and is developing quickly, but still in its infancy. The study is to present our two-year experience in transumbilical LESS simple nephrectomy （LESS-SN） for non-functioning kidney, in an effort to evaluate its feasibility, clinical outcomes and potential advantages. Methods： From December 2008 to December 2010, a total of 11 patients with body mass index （BMI）≤30 underwent transumbilical TriPortTM LESS-SN by a single experienced urologist at our institution. The indications for nephrectomy included nonfunctioning kidney associated with ureteropelvic junction stricture （n=l）, ureteral calculi （n=6）, tuberculosis （n=3）, and ureteral stricture （n=l）. Patient demographics perioperative and follow-up data were prospectively collected and analyzed. Results： Ten procedures were successfully completed with one patient converted to open surgery due to uncontrollable bleeding. The mean operative time was 189.2 （ranging 100-320 min） with an estimated blood loss of 204.5 （ranging 50-1 000 ml）. There were two complications of bleeding （1- intra-, 1- post-）. The mean hospitalization after surgery was 7.9 d （ranging 4-17 d） With a regular follow-up of 1, 6, 12, and 24 months after surgery, all patients remained symptom-free with an intra-umbilical scar. Conclusion： Transumbilical LESS simple nephrectomy for nonfunctioning kidney can be accomplished with favorable surgical outcomes and a superiority of cosmesis. However, cases with chronic inflammation are not suitable for initial up-take and should only be attempted by the very experienced laparoscopist.
文摘AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing which,endotherapy(ET;pancreatic sphincterotomy and stent placement)was done.The frequency of pain,its visual analogue score(VAS),quality of life(Qo L),serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET.Response was defined as at least 50%reduction in the severity of pain to below a score of 5.RESULTS Of the thirty nine patients analysed,21(53.9%)responded to DT and 18(46.1%)underwent ET.The VAS for pain(7.0±2.0 vs 1.3±2.5,P<0.001)and the number of days with pain per month decreased[1.0(1.0,2.0)vs 1.0(0.0,1.0),P<0.001],and the Qo L scores[55.0(44.0,66.0)vs 38.0(32.00,51.00),P<0.01]improved significantly during follow up.Similar significant improvements were seen in patients in the subgroups of DT and ET except for Qo L in ET.The serum C-peptide(P=0.001)and FE(P<0.001)levels improved significantly in the entire group and in the two subgroups of patients except for the C peptide levels in patients on DT.CONCLUSION A standardised protocol of DT,followed by ET decreased the intensity and frequency of pain in recurrent acute pancreatitis,enhanced Qo L and improved pancreatic function.
