BACKGROUND Varicocele embolization,a minimally invasive treatment for symptomatic varicoceles,carries a rare risk of complications like ureteral obstruction and hydronephrosis.This case report documents such a case to...BACKGROUND Varicocele embolization,a minimally invasive treatment for symptomatic varicoceles,carries a rare risk of complications like ureteral obstruction and hydronephrosis.This case report documents such a case to raise awareness of these potential complications and showcase minimally invasive surgical management as a successful solution.CASE SUMMARY A 35-year-old male presented with flank pain and hematuria following varicocele embolization.Imaging confirmed left ureteral obstruction and hydronephrosis.Laparoscopic ureterolysis successfully removed the embolization coil and repaired the ureter,resolving the patient's symptoms.Follow-up at six months and two years showed sustained improvement.CONCLUSION Minimally invasive surgery offers an effective treatment option for rare complications like ureteral obstruction arising from varicocele embolization.展开更多
Aiming at the problemthat the traditional short-circuit current calculationmethod is not applicable to Distributed Generation(DG)accessing the distribution network,the paper proposes a short-circuit current partitioni...Aiming at the problemthat the traditional short-circuit current calculationmethod is not applicable to Distributed Generation(DG)accessing the distribution network,the paper proposes a short-circuit current partitioning calculation method considering the degree of voltage drop at the grid-connected point of DG.Firstly,the output characteristics of DG in the process of low voltage ride through are analyzed,and the equivalent output model of DG in the fault state is obtained.Secondly,by studying the network voltage distribution law after fault in distribution networks under different DG penetration rates,the degree of voltage drop at the grid-connected point of DG is used as a partition index to partition the distribution network.Then,iterative computation is performed within each partition,and data are transferred between partitions through split nodes to realize the fast partition calculation of short-circuit current for high proportion DG access to distribution network,which solves the problems of long iteration time and large calculation error of traditional short-circuit current.Finally,a 62-node real distribution network model containing a high proportion of DG access is constructed onMATLAB/Simulink,and the simulation verifies the effectiveness of the short-circuit current partitioning calculation method proposed in the paper,and its calculation speed is improved by 48.35%compared with the global iteration method.展开更多
Dilated dysfunction involving multiple visceral organs has been reported in patients with systemic lupus erythematosus （SLE）. Chronic intestinal pseudoobstruction （CIPO） resulting from intestinal smooth muscle dam...Dilated dysfunction involving multiple visceral organs has been reported in patients with systemic lupus erythematosus （SLE）. Chronic intestinal pseudoobstruction （CIPO） resulting from intestinal smooth muscle damage has presented in conjunction with ureterohydronephrosis and, more rarely, biliary dilatation （megacholedochus）. While the molecular pathogenesis is largely unknown, observed histopathologic features include widespread myositis, myocyte necrosis in the intestinal muscularis propria with subsequent atrophy and fibrosis, preserved myenteric innervations and little vasculitis. High dose immunosuppression usually results in resolution of symptoms with recovery of smooth muscle function, indicative of an autoimmune etiology. We report a patient with SLE who presented with intestinal pseudo-obstruction, ureterohydronephrosis and megacholedochus, and present images that illustrate megaviscera simultaneously involving all 3 visceral organs. Since the co-manifestation of all 3 is unusual and has been reported only once previously, we have termed this rare clinical syndrome generalized megaviscera of lupus （GML）. Although the SLE disease-activity parameters responded to aggressive immunomodulative therapy in our patient, clinical evidence of peristaltic dysfunction persisted in all involved viscera. This is a variation from the favorable outcomes reported previously in SLE patients with GML and we attribute this poor clinical outcome to disease severity and, most importantly, delayed clinical presentation. Since inflammation followed by atrophy and fibrosis are key aspects in the pathogenesis and natural history of GML, the poor response in our patient who presented late in the clinical course may be the result of ＇burnt out＇ inflammation with irreversible end-stage fibrosis. Thus, early recognition and timely initiation of treatment may be the key to recover visceral peristaltic function in patients with GML.展开更多
Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fi...Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fibrosis. The aim of this study was to investigate whether morphological changes occur in the renal vasculature in hydronephrosis and the possible mechanisms involved. A model of complete unilateral ureteral obstruction（CUUO） was used. Experimental animals were divided into five groups： a normal control group（N） and groups of animals at 1st week（O1）, 2nd week（O2）, 4th week（O4） and 8th week（O8） after CUUO. Blood pressure was measured, renal arterial trees and glomeruli were assessed quantitatively, and renovascular three-dimensional reconstruction was performed on all groups. Glomerular ultrastructural changes were examined by transmission electron microscopy. The results showed that the systolic blood pressure was significantly increased in the obstructed groups（O1, O2, O4 and O8）. Three-dimensional reconstruction showed sparse arterial trees in the O8 group, and a tortuous and sometimes ruptured glomerular basement membrane was found in the O4 and O8 groups. Furthermore, epithelial media thickness and media/lumen ratio were increased, lumen diameters were decreased, and the cross-sectional area of the media was unaltered in the segmental renal artery, interlobar artery and afferent arterioles, respectively. In conclusion, renal arterial trees and glomeruli were dramatically altered following CUUO and the changes may be partially ascribed to vascular remodeling. Elucidation of the molecular mechanisms of renovascular morphological alterations will enable the development of potential therapeutic approaches for hydronephrosis.展开更多
文摘BACKGROUND Varicocele embolization,a minimally invasive treatment for symptomatic varicoceles,carries a rare risk of complications like ureteral obstruction and hydronephrosis.This case report documents such a case to raise awareness of these potential complications and showcase minimally invasive surgical management as a successful solution.CASE SUMMARY A 35-year-old male presented with flank pain and hematuria following varicocele embolization.Imaging confirmed left ureteral obstruction and hydronephrosis.Laparoscopic ureterolysis successfully removed the embolization coil and repaired the ureter,resolving the patient's symptoms.Follow-up at six months and two years showed sustained improvement.CONCLUSION Minimally invasive surgery offers an effective treatment option for rare complications like ureteral obstruction arising from varicocele embolization.
基金funded by the National Natural Science Foundation of China(52077004)Anhui Electric Power Company of the State Grid(52120021N00L).
文摘Aiming at the problemthat the traditional short-circuit current calculationmethod is not applicable to Distributed Generation(DG)accessing the distribution network,the paper proposes a short-circuit current partitioning calculation method considering the degree of voltage drop at the grid-connected point of DG.Firstly,the output characteristics of DG in the process of low voltage ride through are analyzed,and the equivalent output model of DG in the fault state is obtained.Secondly,by studying the network voltage distribution law after fault in distribution networks under different DG penetration rates,the degree of voltage drop at the grid-connected point of DG is used as a partition index to partition the distribution network.Then,iterative computation is performed within each partition,and data are transferred between partitions through split nodes to realize the fast partition calculation of short-circuit current for high proportion DG access to distribution network,which solves the problems of long iteration time and large calculation error of traditional short-circuit current.Finally,a 62-node real distribution network model containing a high proportion of DG access is constructed onMATLAB/Simulink,and the simulation verifies the effectiveness of the short-circuit current partitioning calculation method proposed in the paper,and its calculation speed is improved by 48.35%compared with the global iteration method.
基金Supported by NIH/T32 DK07202 (Ghosh P and Park FD)Ghosh P was additionally supported by the Research Scholar Award (American Gastroenterology Association FDN)the UCSD Digestive Diseases Research Development Center, U.S. PHS grant DK080506
文摘Dilated dysfunction involving multiple visceral organs has been reported in patients with systemic lupus erythematosus （SLE）. Chronic intestinal pseudoobstruction （CIPO） resulting from intestinal smooth muscle damage has presented in conjunction with ureterohydronephrosis and, more rarely, biliary dilatation （megacholedochus）. While the molecular pathogenesis is largely unknown, observed histopathologic features include widespread myositis, myocyte necrosis in the intestinal muscularis propria with subsequent atrophy and fibrosis, preserved myenteric innervations and little vasculitis. High dose immunosuppression usually results in resolution of symptoms with recovery of smooth muscle function, indicative of an autoimmune etiology. We report a patient with SLE who presented with intestinal pseudo-obstruction, ureterohydronephrosis and megacholedochus, and present images that illustrate megaviscera simultaneously involving all 3 visceral organs. Since the co-manifestation of all 3 is unusual and has been reported only once previously, we have termed this rare clinical syndrome generalized megaviscera of lupus （GML）. Although the SLE disease-activity parameters responded to aggressive immunomodulative therapy in our patient, clinical evidence of peristaltic dysfunction persisted in all involved viscera. This is a variation from the favorable outcomes reported previously in SLE patients with GML and we attribute this poor clinical outcome to disease severity and, most importantly, delayed clinical presentation. Since inflammation followed by atrophy and fibrosis are key aspects in the pathogenesis and natural history of GML, the poor response in our patient who presented late in the clinical course may be the result of ＇burnt out＇ inflammation with irreversible end-stage fibrosis. Thus, early recognition and timely initiation of treatment may be the key to recover visceral peristaltic function in patients with GML.
基金supported by the Natural Science Foundation of Hubei Province,China(No.2008CDA054)
文摘Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fibrosis. The aim of this study was to investigate whether morphological changes occur in the renal vasculature in hydronephrosis and the possible mechanisms involved. A model of complete unilateral ureteral obstruction（CUUO） was used. Experimental animals were divided into five groups： a normal control group（N） and groups of animals at 1st week（O1）, 2nd week（O2）, 4th week（O4） and 8th week（O8） after CUUO. Blood pressure was measured, renal arterial trees and glomeruli were assessed quantitatively, and renovascular three-dimensional reconstruction was performed on all groups. Glomerular ultrastructural changes were examined by transmission electron microscopy. The results showed that the systolic blood pressure was significantly increased in the obstructed groups（O1, O2, O4 and O8）. Three-dimensional reconstruction showed sparse arterial trees in the O8 group, and a tortuous and sometimes ruptured glomerular basement membrane was found in the O4 and O8 groups. Furthermore, epithelial media thickness and media/lumen ratio were increased, lumen diameters were decreased, and the cross-sectional area of the media was unaltered in the segmental renal artery, interlobar artery and afferent arterioles, respectively. In conclusion, renal arterial trees and glomeruli were dramatically altered following CUUO and the changes may be partially ascribed to vascular remodeling. Elucidation of the molecular mechanisms of renovascular morphological alterations will enable the development of potential therapeutic approaches for hydronephrosis.
