Mahogany adds color to the evolving story of body weight regulation.
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Adrenocorticotropic Hormone↗
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Analysis of retrograde ejaculation using color Doppler ultrasonography before and after transurethral collagen injection.
Transurethral bladder neck collagen injection therapy was performed in a patient with retrograde ejaculation. The phenomenon of retrograde ejaculation and its correction after the therapy were clearly demonstrated by color Doppler ultrasonography. To our knowledge this is the first report showing successful observation of retrograde ejaculation using color Doppler ultrasonography.
Adult↗
Leukotrichia developed following application of intense pulsed light for hair removal.
BACKGROUND: Lasers and light sources are now used worldwide for permanent or prolonged hair removal. Patients now prefer lasers and light sources for hair removal because of their noninvasiveness and fewer reported side effects. OBJECTIVE: To study and report on leukotrichia that developed following application of intense pulsed light (IPL). METHODS: From February 9, 2001 to February 14, 2002 a total of 821 patients were treated for unwanted hair. The system used was a noncoherent IPL system, with a 650 nm flashlamp filter; the parameters used varied with different Fitzpatrick skin types. The patients were treated monthly, with the rate of hair loss, measured by hair counts, and possible side effects recorded. RESULTS: Twenty-nine of 821 patients treated developed leukotrichia. Thirteen patients had no white or gray hairs before IPL therapy; the remaining 16 patients, who had few white hairs before treatment reported accelerated development of new white hairs starting after the first or second IPL therapy. Restoration of hair color occurred in 9 patients and the remaining 20 patients had no improvement or worsening of the condition within the next 2-6 months. CONCLUSION: Temporary or permanent leukotrichia may develop following IPL and laser hair removal therapy. This finding may be explained by the difference in the thermal relaxation times of melanocytes and germinative cells. The light absorbed and the heat produced by melanin may be sufficient enough to destroy or impair the function of melanocytes but insufficient to damage the hair follicle cells.
Adolescent↗
Visualization of subsurface blood vessels by color Doppler optical coherence tomography in rats: before and after hemostatic therapy.
BACKGROUND: The ability to visualize subsurface blood vessels and measure flow may be useful in certain experimental and clinical settings. METHODS: Color Doppler optical coherence tomography was used to visualize and measure blood flow in subsurface vessels in vivo in a rat skin flap model. Local "hemostatic" interventions (epinephrine or sclerosant injection, heat probe, and laser) were then applied and imaging was repeated. The skin flap was evaluated histologically. RESULTS: Subsurface blood vessels were easily visualized in cross-section, and vessel diameter and bidirectional blood flow velocity were readily measured. Color Doppler optical coherence tomography demonstrated that flow was significantly reduced after epinephrine injection and became undetectable after the other interventions. This correlated with pathologic evidence of vessel damage in all interventions, except for epinephrine injection. Although vessel response was as predicted to most interventions, the response to epinephrine was only temporary, and limited application of heat alone from the heat probe halted flow without visually apparent surface injury. CONCLUSIONS: Color Doppler optical coherence tomography provides high-resolution, cross-sectional flow imaging in subsurface blood vessels. Color Doppler optical coherence tomography is potentially a better technique for the study of existing and new hemostatic intervention in the laboratory. Potential future clinical applications include monitoring of the response to hemostatic modalities.
Animals↗
Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection.
PURPOSE: To determine the usefulness of color Doppler ultrasound (US) in the evaluation of the response of hepatocellular carcinoma (HCC) to percutaneous ethanol injection (PEI). MATERIALS AND METHODS: Forty-one patients with 48 lesions 2-5 cm in diameter underwent color Doppler US before and after PEI. Computed tomography (CT), magnetic resonance (MR) imaging, and percutaneous biopsy were also performed to help establish the outcome of therapy. RESULTS: Before treatment, color signals with an arterial Doppler spectrum were seen in 44 of 48 lesions with a frequency shift of 0.51-4.11 kHz (mean, 1.65 kHz). After PEI, 37 of these lesions showed no color signal and were found to be necrotic at CT, MR imaging, and biopsy. In six of seven lesions containing residual tumor, pulsatile flow was still identified, although the frequency shift was significantly decreased (P = .01). CONCLUSION: Color Doppler US proved useful in the assessment of the therapeutic effect of PEI on HCC.
Aged↗
Transvaginal color Doppler sonographic evaluation of the uterus in postmenopausal women on daily raloxifene therapy.
OBJECTIVE: To evaluate the effect of raloxifene on the endometrium and the uterus by transvaginal color Doppler sonography. METHODS: The study group was composed of 34 asymptomatic postmenopausal women. All had been treated with raloxifene 60 mg/day for 6 months. The patients underwent transvaginal color Doppler sonography before starting raloxifene and after treatment. The uterus was scanned by transvaginal ultrasound to evaluate the pulsatility (PI) and resistance (RI) indices of both uterine arteries. The mean values for the uterine arteries were analyzed. RESULTS: The mean age of the women was 57.56 +/- 4.44 years (range 48-64 years), and mean number of years since the menopause was 8.67 +/- 5.44 (range 1-25 years). The mean endometrial thickness (3.62 +/- 1.13 vs. 3.59 +/- 0.95 mm) and uterine volume (40.67 +/- 18.36 vs. 38.05 +/- 19.47 ml) were not significantly different before starting treatment and after treatment (p > 0.05). The mean values of the PI (3.49 +/- 1.56 vs. 3.90 +/- 1.38) and RI (0.94 +/- 0.11 vs. 0.98 +/- 0.10) of the uterine arteries were not significantly different before starting treatment and after treatment (p > 0.05). CONCLUSION: Daily therapy with raloxifene did not stimulate the endometrium, the uterus or uterine blood flow.
Arteries↗
Change in parameters before and after alpha-1-blocker therapy for men with lower urinary tract symptoms using color doppler ultrasound urodynamics: possible application for prediction of clinical outcome.
INTRODUCTION: We previously developed a noninvasive video urodynamic study using color Doppler ultrasonography. We sought the best flow velocity-related parameter which would allow prediction of an improvement in lower urinary tract symptoms (LUTS) after alpha 1-blocker treatment. METHODS: Twenty-two men with benign prostatic hyperplasia who were treated with a nonselective alpha 1-blocker (urapidil) were included. Subjective symptoms were evaluated using the International Prostate Symptom Score (IPSS) before and after alpha 1-blocker treatment. We measured the flow velocities using a transperineal ultrasound technique in the distal prostatic urethra just proximal to the external urethral sphincter (V1) and in the sphincteric urethra (V2), and used them to obtain the velocity ratio (VR=V1/V2). The corresponding functional cross-sectional areas of the urethra at these two sites (A1 and A2) were calculated as Q(max)/V. All these parameters obtained by the velocity-flow urodynamics were compared before treatment and after 4 weeks. RESULTS: After treatment, V1 and VR were decreased, and A1 was increased. V2 correlated best with the change in IPSS before and after alpha 1-blocker therapy, with Spearman's rho of 0.584. All men with V2 exceeding 50 cm/s did not show an improvement in the LUTS. CONCLUSIONS: The maximum flow velocity at the sphincteric urethra (V2) can predict the subjective outcome of alpha 1-blocker treatment. The velocity-flow parameters changed after alpha 1-blocker treatment. We confirmed that the transperineal ultrasound urodynamic study is not only noninvasive but also informative.
Adrenergic alpha-Antagonists↗
Intrahepatic pseudoaneurysm: a complication following radio-frequency ablation therapy for hepatocellular carcinoma.
A 70-year-old male was admitted to hospital for a liver tumor. We diagnosed that hepatocellular carcinoma (HCC), 1.5 cm in diameter, by several examinations. We performed ultrasonically guided radio-frequency ablation (RFA). Ultrasonography (US) 9 days post-therapy revealed a cystic lesion 1.5 cm in diameter. Color Doppler US revealed color imaging throughout the lesion and dynamic computed tomography (CT) demonstrated an area of hyperattenuation. Intrahepatic pseudoaneurysm was diagnosed. On 14 days post-therapy, no color signals on color Doppler US or enhanced areas on CT were seen. We submit that pseudoaneurysm should be recognized as a complication of radio-frequency ablation.
Aged↗
Response to Fenster's "Group therapy as an effective treatment modality for people of color".
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Black or African American↗
[Entoptic phenomena in digitalis therapy].
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Color Perception↗
[Diseases and problems in the field of internal medicine. I. Current problems of sex-hormone therapy].
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Coloring Agents↗
Portal vein thrombosis associated with antiphospholipid syndrome: a case report.
We present a case of portal vein thrombosis associated with antiphospholipid syndrome (APS). The patient had an end-stage renal disease and underwent hemodialysis, and a portal thrombus was incidentally found in the main portal vein by color Doppler sonography. The patient is followed up now with long-term anticoagulant therapy. This experience suggests that color Doppler sonography be performed for patients with APS to improve their management.
Antiphospholipid Syndrome↗
Enrollment of drug abusers in HIV clinical trials: a public health imperative for communities of color.
There is an increasing appreciation of the impact of drug abuse on AIDS in the United States because of the pivotal role of injecting drug use in the prevalence of total AIDS cases and case reporting among ethnic/racial minorities, women, and children. While the participation of injecting drug users (IDUs) in HIV clinical trails has increased steadily, the IDU accrual rate lags unacceptably behind the IDU proportion of AIDS cases. The stigma of drug abuse, issues related to poverty, and the underrepresentation of communities of color are the major obstacles to IDU participation in HIV clinical research. It is critical to overcome these obstacles as the spectrum of HIV disease in IDUs requires the development of an IDU-relevant scientific agenda for HIV clinical trials. This, in turn, is crucial to the development of effective therapies for the treatment of HIV disease in IDUs. To the extent that these endeavors are successful, more relevant therapies to communities of color will be developed, as injecting drug use is disproportionately more prevalent in these communities.
Acquired Immunodeficiency Syndrome↗
Endometrial evaluation in postmenopausal breast cancer patients receiving tamoxifen: an ultrasound, color flow Doppler, hysteroscopic and histological study.
The purpose of this study was to evaluate the effect of tamoxifen therapy on the endometrium by transvaginal color Doppler sonography, hysteroscopy and endometrial sampling. The study group (tamoxifen group) was composed of 38 asymptomatic postmenopausal women. All had been treated with tamoxifen (20-30 mg/day) for breast cancer for at least 1 year. The patients of the tamoxifen group underwent transvaginal color Doppler sonography, hysteroscopy and, if necessary, endometrial biopsy. Thirty asymptomatic postmenopausal women (control group) and 25 asymptomatic postmenopausal breast cancer patients not on tamoxifen therapy (no-tamoxifen group) served as the control groups. The endometrium was scanned by transvaginal ultrasound to evaluate thickness, echotexture, border and intraluminal fluid. Color and pulsed Doppler were used to evaluate the pulsatility (PI) and resistance (RI) indices of the uterine and endometrial arteries when possible. The patients receiving tamoxifen had a significantly thicker endometrium compared to the control groups. Endometrial pathology was observed in 61% (23/38) of cases and an endometrial thickness of "> or =" 10 mm was always associated with an endometrial lesion. Nineteen benign endometrial polyps were found, most of them having a typical sonographic endometrial pattern with regular borders and small hypoechoic cystic areas which we define as polypoid. Four endometrial hyperplasias, one of these atypical were observed. There were no endometrial cancers. The mean PI and RI of the uterine arteries in the tamoxifen group were 2.04 +/- 0.77 and 0.82 +/- 0.1, respectively and were significantly lower than those of the control group (2.93 +/- 0.9 and 0.93 +/- 0.06) and the no-tamoxifen group (2.53 +/- 0.7 and 0.89 +/- 0.1). The blood velocity changes were very similar to those described in postmenopausal women receiving estrogen replacement therapy. A correlation between the time of beginning tamoxifen therapy after menopause and development of endometrial pathology was observed: in patients who started therapy many years after the onset of menopause, the risk of developing endometrial pathology was higher than in those who began therapy a few years after the onset of menopause. Patients receiving tamoxifen, particularly those who start therapy many years after the onset of menopause, should be closely monitored by transvaginal ultrasound and color Doppler imaging to detect endometrial lesions.
Aged↗
The Taylor Hyperpigmentation Scale: a new visual assessment tool for the evaluation of skin color and pigmentation.
The Taylor Hyperpigmentation Scale is a new visual scale developed to provide an inexpensive and convenient method to assess skin color and monitor the improvement of hyperpigmentation following therapy. The tool consists of 15 uniquely colored plastic cards spanning the full range of skin hues and is applicable to individuals with Fitzpatrick skin types I to VI. Each card contains 10 bands of increasingly darker gradations of skin hue that represent progressive levels of hyperpigmentation. This article describes the ongoing development of the Taylor Hyperpigmentation Scale and reports the results of a recent validation study of the use of this newly developed chart in individuals with skin of color. In the study, skin color and an area of hyperpigmentation in 30 subjects of white, African American, Asian, or Hispanic ancestry (approximately 5 from each of the 6 skin types) were evaluated by 10 investigators. The results of the study revealed significant variation among intraindividual and interindividual ratings by investigators of skin hue (P < .0001) and hyperpigmentation (P = .0008); however, most investigators rated the scale as useful and easy to use, and 60% stated they would use it in clinical practice to document the response of hyperpigmentation to therapeutic agents. A heuristic evaluation of the results of this study provided insight into essential considerations for the continued effort to develop a useful and simple scale for assessing skin color and pigmentation.
Adult↗
Training of color and form identification in cortical blindness: a case study.
A procedure was developed for retraining color and form identification in a multiply handicapped cortically blind adolescent girl who had sustained anoxic brain damage. Treatment involved systematic presentation of four different colored shapes with verbal feedback on performance. The trainer used a multiple choice procedure and traced the edge of the stimulus with a pointer. The patient attained near perfect performance with the four colored shapes in less than 10 sessions, while identification of visual and tactile stimulus materials not used in training remained essentially unchanged. Results suggest a specific effect of training on performance.
Adolescent↗
Modulation of coronary flow velocity reserve by gender, menstrual cycle and hormone replacement therapy.
OBJECTIVES: The purpose of this study was twofold: 1) to examine the relationship between menstrual cycle and coronary flow velocity reserve (CFVR) in young healthy women, and 2) to evaluate the effect of hormone replacement therapy by estrogen on CFVR in postmenopausal women, using transthoracic color Doppler echocardiography (TTCDE). BACKGROUND: Although the incidence of cardiovascular disease is lower in women before menopause compared with men, postmenopausal women have an incidence of coronary artery disease similar to that of men of the same age. This is mainly dependent upon estrogen deficiency. However, no clinical report has yet examined the effect of estrogen on CFVR, which is one index of coronary microcirculation. METHODS: We examined 15 male and both 15 premenopausal and 10 postmenopausal female healthy volunteers. We measured coronary flow velocity of the left anterior descending coronary artery at baseline and hyperemic conditions during adenosine triphosphate infusion by TTCDE and determined CFVR. Each premenopausal woman was studied two times (menstrual [M] and follicular [F] phases) in one menstrual cycle. Fifteen men were also studied at a time corresponding to women's menstrual cycle. The postmenopausal women were studied before and two hours after oral administration of conjugated estrogen (CE). RESULTS: Serum 17beta-estradiol level in premenopausal women increased in the F phase and decreased to the same levels as in men, as in the M phase and as in postmenopausal women (123 +/- 9 pg/ml vs. 28 +/- 6 pg/ml, 25 +/- 9 pg/ml and 19 +/- 11 pg/ml; p < 0.0001, respectively). The CFVR increased in the F phase compared with that in the M phase (4.8 +/- 0.4 vs. 3.7 +/- 0.8, p < 0.0001). We found that CFVR in men remained unchanged (3.7 +/- 0.6 vs. 3.8 +/- 0.5). After CE administration, CFVR increased compared with baseline in postmenopausal women (4.1 +/- 0.8 vs. 3.4 +/- 0.8, p < 0.005). CONCLUSIONS: In premenopausal women, CFVR determined by TTCDE varied during the menstrual cycle, and in postmenopausal women, CFVR increased after acute estrogen replacement.
Adult↗
Internal jugular and subclavian vein thrombosis caused by central venous catheters. Evaluation using Doppler blood flow imaging.
Thrombosis of the internal jugular vein and the subclavian vein is often caused by central venous catheters. Doppler blood flow imaging (duplex sonography and color flow imaging) is very useful to establish the diagnosis, as soon as signs of venous obstruction occur after placing a catheter. Twenty-six patients with clinically suspected thrombosis were examined; in 25 patients thrombosis of the internal jugular or subclavian vein was diagnosed. By means of duplex sonography and color flow imaging, the degree of venous obstruction can easily be determined. The efficiency of therapy can be controlled. With color flow imaging, blood flow direction and velocity can be visualized in color which provides global information about hemodynamics in a short time. Furthermore, color flow imaging is a suitable method to detect even small subcutaneous collaterals.
Catheterization, Central Venous↗