Transurethral bipolar plasma kinetic resection of ejaculatory duct for treatment of ejaculatory duct obstruction.

To evaluate the efficacy of transurethral bipolar plasma kinetic resection of ejaculatory duct for ejaculatory duct obstruction. The clinical information of 42 cases of ejaculatory duct obstruction was analyzed between July 2008 and June 2012. The diagnostic criteria included semen analysis, fructose and neutral α-glucosidase measurement in seminal plasma, transrectal ultrasonography, magnetic resonance imaging and vasography necessarily. Endoscopic procedure with bipolar plasma kinetic resection of ejaculatory duct was performed in all patients. Among these cases followed up 6 ≈ 24 months after operation, 38 patients (90.5%) had improved semen parameters, 23 azoospermic patients (60.5%) had sperm in the semen and 13 patients' wife (31%) achieved pregnancies in 42 cases of bipolar plasma kinetic resection of ejaculatory duct. Postoperative complications ensued as epididymitis in 1 case, watery ejaculate in 1, but no serious complication was observed. Bipolar plasma kinetic resection of ejaculatory duct appears to represent a promising endoscopic treatment alternative for ejaculatory duct obstruction patients, with high efficacy, less complications, quicker recovery and satisfactory follow-up parameters.

Microsurgical denervation of the spermatic cord for treatment of idiopathic chronic orchialgia.

A patient referred to our hospital, diagnosed with left idiopathic chronic orchialgia, was evaluated with a thorough medical and psychiatric history, physical examination, scrotal ultrasound and magnetic resonance imaging. Conservative management failed. The patient had temporary pain relief after undergoing outpatient cord block three times. Microsurgical denervation of the left spermatic cord was operated in March, 2011. A pain questionnaire was used to determine efficacy before and after operation, and complete pain relief was noted at one week after operation. The follow up period was 12 months, at the end of which the pain score was still zero. No complications, including testicular atrophy and hydrocele, occurred. Microsurgical denervation of the spermatic cord can be a minimally invasive, safe and effective management option for treatment of idiopathic chronic orchialgia.

[Magnetic resonance perfusion weighted imaging manifestation of late radiation-induced encephalopathy at temporal lobe].

BACKGROUND & OBJECTIVE: The imaging appearances of radiation-induced encephalopathy (REP) of nasopharyngeal carcinoma (NPC) patients were widely reported. As a new technique, magnetic resonance perfusion weighted imaging (MR PWI) is gradually applied to clinical study of REP. This study was designed to observe the characteristics of REP of NPC patients on MR PWI, and investigate its diagnostic value. METHODS: The MRI and MR PWI records of 26 volunteers and 19 NPC patients with 37 lesions of MRI-diagnosed temporal lobe REP were retrospectively analyzed. The MRI was performed 30 months to 9 years after radiation therapy for NPC. The imaging sequences included T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), MR PWI, and Gd-DTPA-contrasted T1WI. RESULTS: Unilateral temporal lobe was involved in 1 case of REP, and bilateral temporal lobes in 18 cases of REP. MR PWI revealed that in edema areas of REP, relative cerebral blood volume (rCBV) and relative cerebral blood flood (rCBF) were decreased, mean transit time (MTT), time to peak (TTP), and time of arrival (TO) were delayed simultaneously; in demolished blood-brain barrier areas of REP, rCBV and rCBF were normal, but MTT, TTP, and TO were delayed; no blood perfusion was observed in myelinopathy areas of REP. CONCLUSION: MR PWI can clearly reveal brain blood perfusion changes in various lesions of REP, and indicate that obvious malfunction of brain blood perfusion is occurred in REP.

[Proton spectroscopy findings of meningioma].

OBJECTIVE: To evaluate the characteristics of 1HMRSI and its diagnostic value on meningioma. METHODS: The findings of conventional MRI and of 1HMRSI from 11 cases of clinically proven meningiomas and from 12 normal volunteers were comparatively analyzed. The imaging sequences included T1-weighted imaging and T2-weighted imaging; additionally T1-weighted imaging with injection of the contrast agent of Gd-DTPA was performed in all meningioma cases. Two-dimensional phase encoding of proton magnetic resonance spectroscopic imaging (2D 1HMRSI) were obtained in all cases. RESULTS: On conventional pre-contrast MRI, the signals in 8 meningioma cases showed medium or faintly low intensities and in 3 cases showed mixed intensities on T1WI. On T2WI, the signals in 7 cases showed medium or faintly high intensities and in 4 cases showed mixed intensities. After injection of Gd-DTPA, the solid portion of tumors exhibited obvious enhancement in all meningioma cases. "Dural trail sign" was revealed in 7 cases. Peri-tumor edema was evident in 11 meningioma cases. Compared with control group, 1HMRSI of all meningiomas revealed different spectral peaks, including absent acetylaspartate (NAA), prominent choline (Cho), and reduced phosphocreatine (Pcr). The ratios of Cho/Pcr obviously increased. The peak of lactate (Lac) was visualized in 2 meningioma cases. CONCLUSION: Most cases of meningioma can be diagnosed with conventional magnetic resonance imaging (MRI). 1HMRSI can yield more informative findings about meningioma via the observed metabolic materials changes in tumor cells. So conventional MRI is the most important technology for diagnosing meningioma and 1HMRS combined with MRI can improve the diagnostic accuracy. 1HMRSI can be an important supplemental means in the diagnosis of meningiomas.

[Diagnostic value of MR diffusion tensor imaging on radiation-induced early brain injury of nasopharyngeal carcinoma after radiotherapy].

BACKGROUND & OBJECTIVE: MR diffusion tensor imaging (DTI), a new MRI technique, can observe water molecule diffusion non-invasively at molecular level. This study was to assess diagnostic value of DTI on post-radiotherapy brain injury by quantitatively analyzing diffuse features of water in bilateral temporal lobes alba of those nasopharyngeal carcinoma (NPC) patients with normal conventional MRI performances. METHODS: DTI was performed in 13 NPC patients with normal conventional MRI performances after radiotherapy, and 21 healthy controls. Isotropic apparent diffusion coefficient (ADCiso) and anisotropic index (AI) were measured in bilateral temporal lobes alba. RESULTS: ADCiso of patient group was (631.30+/-27.83) x 10(-6) mm2/s, while that of control group was (651.76+/-39.10) x 10(-6) mm2/s (P>0.05). Temporal lobes diffusion AI decreased significantly in patient group, mean fractional anisotropy (FA) was 0.405+/-0.042, mean relative anisotropy (RA) was 0.355+/-0.044, and mean 1 minus volume ratio (1-VR) was 0.192+/-0.042; while those in control group were 0.463+/-0.047, 0.418+/-0.052, and 0.257+/-0.055, respectively (P< 0.01). CONCLUSIONS: DTI can early detect subtle alba changes in NPC patients after radiotherapy, which conventional MRI failed to sense. AI is more sensitive than ADCiso, may better describe the diffuse features of water molecules, and evaluate the temporal lobes alba changes before and after NPC radiotherapy.

[Magnetic resonance imaging (MRI) findings of temporal lobe radiation encephalopathy].

BACKGROUND & OBJECTIVE: The imaging appearance of radiation encephalopathy (REP) was widely reported. However, there were few researches on imaging multiplicity of REP. The current study was designed to observe the morphological features of REP on magnetic resonance imaging(MRI) and to investigate its diagnostic value. METHODS: The MRI of 160 lesions with the diagnosis of temporal lobe REP on MRI was retrospectively analyzed in 104 patients with nasopharyngeal carcinoma (NPC). The MRI was performed after radiation therapy of NPC with an interval ranged from 8 months to 13 years. The imaging sequences included T1-weighted imaging and T2-weighted imaging additionally. T1-weighted imaging with injection of the contrast agent of Gd-DTPA was performed in 111 lesions and fluid attenuated inversion recovery (FLAIR) was obtained in 37 lesions, MR perfusion weighted imaging (PWI) was performed in 2 of them. RESULTS: Unilateral temporal lobe was involved in 48 cases of REP, bilateral temporal lobe in 56 cases of REP respectively, with totally 160 lesions founded. The REP in the white matter displayed hyper-intensity signal on T2-weighted imaging which could be homogenous, whereas area with heterogeneous hypo-intensity signal could be seen in 59 of them otherwise with hyper-intensity signal, and 91 lesions of white matter were associated with gray matter lesions with an appearance of hypo-intensity signal on T1-weighted imaging and hyper-intensity signal on T2-weighted imaging. In 111 lesions with the Gd-DTPA enhanced T1-weigthed imaging, 91 showed the enhancement of brain parencyma. Hemorrhage and hemosiderosis were found in 5 lesions of REP. CONCLUSION: REP in NPC has a multiplicity of the imaging features on MRI, in addition to the common involvement of white matter, including other relatively frequent findings, such as the involvement of gray matter, hemorrhage, hemosiderosis and blood-brain barrier destruction, those could be clearly revealed on MRI.

[Determination of the conversion of air oxidation of penicillin derivatives by high performance liquid chromatography].

In air oxidation of penicillin G p-methoxybenzyl ester (PGPMB) to its sulfoxides (PGPMBO), sol-gel technique was employed to encapsulate the catalyst Co (acac)3, by which the reaction was run under heterogeneous conditions. A reversed-phase high performance liquid chromatographic method was established for the determination of the conversion of this reaction. The analysis of PGPMBO was carried out on a C18 column (4.6 mm i.d. x 150 mm, 10 microm) with the mobile phase of methanol-water (85:15, V/V), at a flow rate of 1 mL min(-1) and with detection wavelength of 270 nm. The linearity of the calibration curve of PGPMBO was obtained over the range of 0.05 g x L(-1) - 0.40 g x L(-1) with a relative coefficient of 0.999 2. The highest conversion was 98.8%. The method can be applied to determine this conversion promptly in the reaction system.