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41.
The role of anal/genital warts in HIV infection 总被引:1,自引:0,他引:1
42.
Laparoscopic Cholecystectomy for Acute Cholecystitis: Prospective Trial 总被引:23,自引:0,他引:23
Samuel Eldar Edmond Sabo Ernest Nash Jack Abrahamson Ibrahim Matter 《World journal of surgery》1997,21(5):540-545
p
< 0.00001) and for hydrops (28.5%) and empyema of the gallbladder
(28.5%) (
p
= 0.004). The difference in conversion
between the group with acute necrotizing (gangrenous) cholecystitis and
the two groups with hydrops and empyema of the gallbladder was not
statistically significant (
p
= 0.07). The complication
rates of acute cholecystitis, hydrops, empyema of the gallbladder, and
gangrenous cholecystitis were 9.0%, 9.5%, 14.0%, and 20.0%,
respectively (
p
= NS). Patients with an operative
delay of 96 hours or less from the onset of acute cholecystitis had a
conversion rate of 23%, whereas a delay of more than 96 hours was
associated with a conversion rate of 47% (
p
= 0.022).
The complication rate was 8.5% in the laparoscopic group and 27% in
the converted group (
p
= 0.013). Patients over 65
years of age, with a history of biliary disease, a nonpalpable
gallbladder, WBC count over 13,000/cc, and acute gangrenous
cholecystitis were independently associated with a high LC conversion
rate; male patients, finding large bile stones, serum bilirubin over
0.8 mg/dl, and WBC count over 13,000/cc were independently associated
with a high complication rate following laparoscopic surgery with or
without conversion. Generally, LC can be performed safely for acute
cholecystitis, with acceptably low conversion and complication rates.
Different forms of cholecystitis carry various conversion and
complication rates in selected cases. LC for acute cholecystitis should
be performed within 96 hours of the onset of disease. Predictors of
conversion and complications may be helpful when planning the
laparoscopic approach to acute cholecystitis. 相似文献
43.
Malcolm E. Richardson Samuel Menahem James L. Wilkinson 《International journal of cardiology》1991,30(3):351-353
In this report, we give details of two families in which fixed subaortic stenosis was found in more than one member. It is rare for this entity to show familial incidence. 相似文献
44.
In a homogeneous medium of soft tissue the radiation dose distribution due to a nonuniformly distributed beta source can be calculated by convolution of the beta dose point kernel of the nuclide with the source distribution. A possible extension of the technique to the calculation of the dose distribution in heterogeneous media involving relatively simple geometric interfaces requires the knowledge of the resulting perturbation to the beta point kernels in individual media. We simulated a soft-tissue-bone planar interface by a polystyrene (PST)-aluminum junction and measured the change in beta dose from the dose value in homogeneous PST due to a point source of 32P using 7LiF thermoluminescent dosimeters. With the point source at the interface, the dose rates at 0-31, 125-156, and 283-314 mg/cm2 separations from the interface were increased by (12 +/- 3)%, (8 +/- 2)%, and (3 +/- 2)%, respectively, compared with homogeneous PST. With the point source at a PST-air planar interface to simulate a soft-tissue-air junction, the dose rates at 0-31, 139-170, and 283-314 mg/cm2 from the interface were decreased by (25 +/- 4)%, (11 +/- 7)%, and (5 +/- 2)%, respectively. The changes in dose rates for these two interfaces have also been measured with degraded spectra of 32P. Comparison of the experimental data with Monte Carlo calculation for a point source and the two-group method of calculation for a plane source is also presented. 相似文献
45.
In a group of patients with breast lumps, diagnosis made by pre-operative aspiration cytology was compared with that obtained by histological section of excised specimens. Results showed that aspiration cytology correctly diagnosed 89% of malignant lesions and 92.6% of benign lesions based upon histological diagnosis. Cytological diagnosis of benign disease had a false negative rate of 6% while cytological diagnosis of malignant disease had a 2.7% false positive rate. Only 3.5% of cytologies returned an inadequate diagnosis. This study shows that aspiration cytology should be useful in allowing a better psychological preparation of patients before surgery as well as better utilization of operation theatre facilities. 相似文献
46.
Discrimination of well-differentiated pulmonary adenocarcinoma from reactive bronchioloalveolar epithelium can be difficult on routine histology, especially with small biopsies. Ancillary studies to help in this distinction are desirable. p63, a p53-homologous nuclear protein, is a marker of reserve cells of the bronchus and terminal lobular unit. In this study, 33 cases of adenocarcinoma (20 open lung and 13 transbronchial/percutaneous biopsies) and 43 cases of benign lungs with fibrosis and metaplasia (22 open lung and 21 transbronchial/percutaneous biopsies) were studied for nuclear p63 expression by immunohistochemistry (Dako, Carpinteria, CA, USA). Five additional cases each of atypical adenomatous hyperplasia and adenosquamous carcinoma and three cases of squamous carcinoma (all open lung biopsies) were also stained. The diagnostic categories of benign lung conditions were usual interstitial pneumonia, parenchymal scar, cryptogenic organizing pneumonia and diffuse alveolar damage. In neoplastic cases, p63 positivity was calculated as percentage of all tumor cells examined. In areas of normal lung, p63 decorated the reserve cells of large and small airways and occasional cells of the distal lobular unit. In fibrotic reactive processes, an interrupted but distinct pattern of nuclear staining was present in all cases, with staining of basal cells of the airways as well as bronchiolar- and squamous-metaplastic epithelium (43/43, 100%). p63 immunoreactivity was less uniform in areas of acute lung injury within these cases. One adenocarcinoma and two cases of atypical adenomatous hyperplasia showed strong immunoreactivity (>80%), while three adenocarcinomas highlighted only rare tumor nuclei (<5% of tumor cells). Morphologic areas where p63 immunostaining was not helpful included the junction of normal lung and lepidic growth of adenocarcinoma, and retrograde spread of adenocarcinoma into small airways. Our results highlight the differential expression of p63 across various bronchioloalveolar lesions. Moreover, p63 may be helpful in distinguishing reactive from neoplastic glandular proliferations in the lung. 相似文献
47.
Samuel E. Lynch DMD DMSc ; Stephen B. Trippel MD ; Richard D. Finkelman DDS PhD ; Rafael A. Hernandez DMD ; Christopher P. Kiritsy BA ; Harry N. Antoniades PhD 《Wound repair and regeneration》1994,2(3):182-190
The combination of insulin-like growth factor-I and platelet-derived growth factor-BB has previously been shown to stimulate healing of soft tissue wounds and the formation of bone and ligament around teeth. The purpose of the present study was to evaluate the effects of platelet-derived growth factor-BB and insulin-like growth factor-I individually and in combination on the healing of osseous wounds. Four standardized cortical wounds were created in each tibia of 11 adult Yucatan miniature pigs. The wounds in one tibia per animal were treated with either purified recombinant human insulin-like growth factor-I, platelet-derived growth factor-BB, or both in a methylcellulose gel. The wounds in each contralateral tibia received placebo gel alone. Coded serial sections of each wound were evaluated by computer-aided histomorphometry 21 days after surgery. The area and perimeter of the newly formed mineralized callus, the thickness of the total callus, and the percentage of mineralized tissue within the callus were significantly increased compared with the values of matched controls only in wounds treated with a combination of insulin-like growth factor-I and platelet-derived growth factor-BB. No significant differences in the measured parameters of callus formation were found in wounds treated with either insulin-like growth factor-I or platelet-derived growth factor-BB alone. Cartilage was present only in sites treated with insulin-like growth factor-I alone. These results suggest that the combination of platelet-derived growth factor-BB and insulin-like growth factor-I stimulates bone formation in wounds in long bones of adult animals and that these growth factors act via different pathways during the repair process. 相似文献
48.
49.
50.
Petra J. Jeffery Samuel Sostre L R. Scherer Wayne Kasecamp Edwaldo E. Camargo 《European journal of nuclear medicine and molecular imaging》1990,17(6-8):365-368
We report a case of massive cerebrospinal fluid (CSF) leakage where the tracer injected intra-thecally for radionuclide cisternography was later visualized in the bowel as well as the nasopharynx. We discuss the potential implications of this finding in patients with CSF leaks. A brief review of the diagnosis of CSF leaks is included. 相似文献