PURPOSE: To compare the efficacy and availability of foot pump and active ankle exercise for preventing deep vein thrombosis after total knee arthroplasty with hemodynamic evaluation using a color doppler duplex ultrasonography. MATERIALS AND METHODS: Thirty-six patients who underwent total knee arthroplasty between Oct. 2005 and Apr. 2006 were enrolled in this study. Retrospective analysis of 36 patients(Group 1 - foot pump after TKA, 18; Group 2-passive ankle exercise, 18) was conducted and all patients underwent color doppler duplex ultrasonography preoperatively and postoperative 7 to 14 days at femoral, popliteal and calf vein and the hemodynamic status was assessed. RESULTS: The mean baseline velocity was decreased postoperatively in both group, at all veins, but the mean peak velocity was increased only in Group. In Group 1, mean flow ratio was increased, but in Group 2, mean flow ratio was decreased except femoral vein. There were significant differences between Group 1 and Group 2(p<0.05). CONCLUSION: This study demonstrated that foot pump may be more effective than active ankle exercise in preventing postoperative deep vein thrombosis due to more increased venous flow rate and foot pump may be more compliable than active ankle exercise due to less painful, more convenient, so foot pump can be one of the available method for preventing DVT after total knee arthroplasty.
Ankle ; Arthroplasty* ; Femoral Vein ; Foot* ; Hemodynamics ; Humans ; Knee* ; Retrospective Studies ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex ; Veins ; Venous Thrombosis*

PURPOSE: Intracavernosal injection subsequent vibrotactile or audiovisual sexual stimulation (AVSS) have frequently been utilized to produce al maximal erectile response during penile Doppler ultrasonography. However, several studies have shown that erectile quality often decreases following the placement of the sonographic probe. We examined whether real-time AVSS with an eyeglasses-type monitor enhances quality during penile duplex color Doppler ultrasonography. PATIENTS AND METHODS: A total of 32 impotent patients underwent penile duplex color Doppler ultrasonography of the cavernosal arteries after intracavernosal injection of 10 to 20 microgram of prostaglandin E1 and subsequent manual stimulation. Real-time AVSS sas used when the patient failed to achieve a rigid erection or showed abnomal arterial blood flow. The clinical erectile response was assessed by visual inspection and palpation and graded from I to V. Peak blood flow velocities and resistance index of the both cavernosal arteries were monitored continuously. After AVSS, the sexual drive was assessed as grade I (poor), II (moderate), or III (good). RESULTS: After intracavernosal injection and genital stimulation, 3 patients (9%) had a Grade II erection, 2 (6%) a Grade III, 16 (50%) a Grade IV, and 11 (34%) a Grade V. During duplex ultrasonography, 4 patients (13%) had a Grade II erection, 7 (22%) a Grade III, 16 (50%) a Grade IV, and 5 (16%) an arade V. During real-time AVSS, 22 patients (69%) showed better drectile quality. Initial Doppler ultrasonographic scanning showed arteriogenic impotence in 9 patients (28%), veno-occlusive disease in 5 (16%), and mixed arteriogenic and venogenic impotence in 18 (25%), veno-occlusive in 9 (28%), and mixed type in 2 (6%). Therefore, the initial diagnosis turned to be different after AVSS in 26 patients (81%). The sexual drive was rated grade I in 9 (28%), grade II in 11(34%), and grade III in 12 (38%). CONCLUSION: Real-time AVSS with an eyeglasses-type monitor remarkably enhances the quality of pharmacologically induced erections. Such stimulation may be useful during penile color Doppler ultrasonography to help in making the ccorrect diagnosis of the cause of erectile dysfunction.
Alprostadil ; Arteries ; Blood Flow Velocity ; Diagnosis ; Erectile Dysfunction ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Palpation ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex*

PURPOSE: The purpose of this study was to validate the value of Duplex Color Doppler Ultrasonography (DDU) in post-operative deepvein thrombosis (DVT) after hip replacement surgery. MATERIALS AND METHODS: From September 1998 to June 2000, 138 cases (130 patients) were eligible for a minimal one-year follow-up.DDU was carried out between the 7th and 10th postoperative in all cases, patients wore a compressive stocking on the lower extremity. RESULTS: DVT occurred in five cases (4%), four cases occurred at 10th postoperative day and one case was occurred after one month. DVT occurred in the femoral vein in all cases. Three cases had clinical symptoms such as pain and localized edema. However, no case complained of systemic pulmonary symptoms. CONCLUSION: The incidence of DVT obtained from DDU after replacement hip surgery was very low (4%) with early mobilization and acompressive stocking. No case of DVT progressed to symptomatic pulmonary embolism. DDU was valuable for detecting DVT in the proximal thigh as a screening test.
Early Ambulation ; Edema ; Femoral Vein ; Hip* ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Pulmonary Embolism ; Thigh ; Thrombosis ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex ; Venous Thrombosis*

No abstract available.
Diagnosis* ; Female ; Impotence, Vasculogenic* ; Male ; Ultrasonography, Doppler, Duplex*

OBJECTIVE: To explore the diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging (CDFI) in primary bone tumor. METHODS: The hemodynamic parameters such as systolic maximum velocity (Vmax), diastolic minimum velocity (Vmin), resistance index (RI), and pulsatility index (PI) of intratumoral folw in 93 patients with primary bone tumors proved by histopathology were studied using 2-dimentional ultrasonography and CDFI techniques. RESULTS: The bone destruction periosteum response and soft tissue mass were essentially revealed with 2-dimentional ultrasonography techniques. The intratumoral flow features were clearly shown by CDFI. The Vmax and Vmin in malignant bone tumor were significantly higher than those in benign one (P < 0.01). RI and PI in malignant bone tumor were lower than those in benign one (P < 0.01). CONCLUSION Observing the features of bone tumor and hemodynamic parameters by 2-dimentional ultrasonography and CDFI has a great clinical value in diagnosing primary bone tumor and distinguishing the malignant and benign bone tumors.
Adolescent ; Adult ; Blood Flow Velocity ; Bone Neoplasms ; diagnostic imaging ; Female ; Giant Cell Tumor of Bone ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Osteosarcoma ; diagnostic imaging ; Ultrasonography, Doppler, Color ; methods ; Ultrasonography, Doppler, Duplex ; methods

The authors report a patient with a small traumatic cirsoid aneurysm of the scalp, diagnosed by duplex doppler ultrasonography. This 15-year-old boy was diagnosed as a cirsoid aneurysm by duplex doppler ultrasonogram which revealed an ovoid cystic lesion at left temporal area of scalp containing vascular flow mapping. The gross appearance showed an aneurysm with arteriovenous fistula, consisting of two feeding arteries and two draining veins. Total removal of mass was made and the histological examination revealed an aneurysm which showing irregular contour of inner surface and thickened fibrotic vascular wall without normal arterial layers. Noninvasive duplex doppler ultrasonography before surgical excision or direct puncture embolization of cirsoid aneurysms of the scalp could be recommended as an alternative management option.
Adolescent ; Aneurysm* ; Arteries ; Arteriovenous Fistula ; Humans ; Male ; Punctures ; Scalp* ; Ultrasonography ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Duplex ; Veins

PURPOSE: The aims of this study were to evaluate whether vardenafil, a phosphodiesterase type 5 inhibitor, may be used as a substitute for intracavernosal injection when assessing erectile dysfunction using penile duplex Doppler ultrasonography. MATERIALS AND METHODS: A total of 21 patients with erectile dysfunction underwent penile duplex Doppler ultrasonography after intracavernosal injection of 0.2 ml trimix. Each patient also underwent penile duplex Doppler ultrasonography after a 10-mg oral dose of vardenafil with audio-visual sexual stimulation. There was 1 week interval between each study. In both studies, peak systolic velocity, end-diastolic velocity, and resistive index were measured. Then ultrasonographic diagnoses of erectile dysfunction were classified as arteriogenic, veno-occlusive, and mixed-type. RESULTS: Doppler ultrasonography with trimix intracavernosal injection identified 8(38.1%), 1(4.8%), 10(47.6%), and 2(9.5%) patients with arteriogenic, veno-occlusive, mixed-type, and non-vasculogenic impotence, respectively. After vardenafil oral medication, 10(47.6%), 1(4.8%), and 10(47.6%) patients demonstrated arteriogenic, veno-occlusive, and mixed-type impotence, respectively. There was a difference in diagnosis in 23.8% of cases. CONCLUSIONS: Vardenafil oral administration with audio-visual sexual stimulation showed a similar hemodynamic result compared to trimix intracavernosal injection during penile duplex Doppler ultrasonography. However, there were some differences. These results suggest that vardenafil oral medication may be used as a substitute for intracavernosal injection when assessing erectile dysfunction using penile duplex Doppler ultrasonography. However, further investigation is needed.
Administration, Oral ; Diagnosis ; Erectile Dysfunction* ; Hemodynamics ; Humans ; Male ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Duplex* ; Vardenafil Dihydrochloride

PURPOSE: Female sexual dysfunction may have its origin in abnormal blood flow into the clitoris during sexual stimulation. There have been few studies to measure the clitoral blood flow by color duplex Doppler ultrasonography. The goal of this study was to evaluate the diagnostic values of clitoral color duplex Doppler ultrasonography with audiovisual sexual stimulation (AVSS). MATERIALS AND METHODS: Clitoral color duplex Doppler ultrasonography was performed during AVSS with glasses-type monitor. A total of fourteen women were included in the study; five premenopausal volunteers (mean age; 35, range; 24-50), five sexual arousal disorder patients (mean age; 38, range; 31-45) and four menopausal volunteers (mean age; 53, range; 47-56). Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of clitoral cavernosal arteries were measured during AVSS in each patients. RESULTS: In the premenopausal volunteer group, PSV of clitoral arteries (mean SD) showed 38.7 +/- 9.7cm/sec, EDV 14.9 +/- 3.2cm/sec, RI 0.59 +/- 0.04, respectively. PSV of clitoral arteries decreased to 27.3 9.6cm/sec in sexual arousal disorder group, 18.1 +/- 6.5cm/sec in menopausal group. PSV significantly decreased in menopausal group (p<0.05) compared to the premenopausal volunteer group, but RI did not be changed significantly. CONCLUSIONS: These results suggest that clitoral duplex Doppler ultrasonography with AVSS may be used to evaluate clitoral arterial function in the female sexual dysfunction patients. However, further studies are needed in a large group to define normal clitoral blood flow parameters.
Arteries ; Clitoris ; Female ; Humans ; Sexual Dysfunctions, Psychological ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Duplex* ; Volunteers

OBJECTIVE: We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. MATERIALS AND METHODS: We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for stenoocclusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. RESULTS: At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2; n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). CONCLUSION: We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint.
Aged ; Aged, 80 and over ; Alloys ; Angiography ; Arterial Occlusive Diseases/radiography/*therapy/ultrasonography ; Chi-Square Distribution ; Female ; Fluoroscopy ; Humans ; Korea ; Leg/blood supply ; Male ; Middle Aged ; Peripheral Vascular Diseases/radiography/*therapy/ultrasonography ; *Popliteal Artery ; Prosthesis Failure ; Retrospective Studies ; *Stents ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex ; Vascular Patency

PURPOSE: Retrograde flow is the main criterion for the diagnosis of varicocele, and the Duplex Doppler ultrasonographic values for retrograde flows are poorly defined. The purpose of this study is to assess a relationship between the palpated varicocele and pampiniform plexus diameter and the retrograde flow that was investigated with performing Duplex Doppler ultrasonography (DDU). MATERIALS AND METHODS: Physical examinations and DDU were performed to assess varicoceles in forty patients with left-sided varicocele and also in eight men who were without varicocele on their physical examination. During both normal respiration and the Valsalva's maneuver, the maximum diameters of the pampiniform plexus and the presence of the retrograde flow were measured by DDU. RESULTS: The highest mean venous diameter in the patients with clinical grade III varicocele was 2.7mm (2.4-3.6), and this was significantly higher than that in the patients with grade I (1.9mm) or with grade II varicocele (2.1mm) (p<0.05). While the difference of diameters between grade I and grade II was not significant, venous reflux was found in all degrees of the varicocele veins. Venous reflux during the Valsalva maneuver (type II flow pattern) was detected on the right side in one (8%) of 13 patients with grade II varicocele, and in three (21%) of 14 patients with grade III varicocele. The type III flow patterns, indicating augmenting of the reflux with an intra-abdominal pressure increase, were 46.1%, 69.2% and 100% for grade I, II and III, respectively. No venous reflux was found in the control group. CONCLUSIONS: The presence of retrograde flow may provide a more reliable indicator than does the spermatic vein diameter for the diagnosis of varicocele. When the palpability of the pampiniform plexus is questionable, Duplex Doppler ultrasound is indicated.
Diagnosis ; Humans ; Male ; Physical Examination ; Respiration ; Testis ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Valsalva Maneuver ; Varicocele* ; Veins