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991.
992.
"Seeing inside the body": MR imaging of gene expression 总被引:5,自引:0,他引:5
Högemann D Basilion JP 《European journal of nuclear medicine and molecular imaging》2002,29(3):400-408
The goal of this review is to describe the developments and recent advances that are enabling applications of magnetic resonance (MR) imaging for non-invasive imaging of gene expression. Guiding application of this technology has been the need to test, in vivo and in real time, hypotheses developed in multiple scientific fields. Advances made in the human genome project and our increasing understanding of the molecular basis of normal and disease physiology have defined questions that will only be answered when specific molecular imaging modalities are developed. In this review we will briefly summarize the salient features of MR imaging to provide the backdrop for a more detailed discussion of specific applications of MR imaging of gene expression. We will conclude with the insights gained from genomic approaches and how they might be exploited for MR imaging of gene expression in the future. 相似文献
993.
New frontiers in CT imaging of airway disease 总被引:7,自引:0,他引:7
Grenier PA Beigelman-Aubry C Fétita C Prêteux F Brauner MW Lenoir S 《European radiology》2002,12(5):1022-1044
Combining helical volumetric CT acquisition and thin-slice thickness during breath hold provides an accurate assessment of both focal and diffuse airway diseases. With multiple detector rows, compared with single-slice helical CT, multislice CT can cover a greater volume, during a simple breath hold, and with better longitudinal and in-plane spatial resolution and improved temporal resolution. The result in data set allows the generation of superior multiplanar and 3D images of the airways, including those obtained from techniques developed specifically for airway imaging, such as virtual bronchography and virtual bronchoscopy. Complementary CT evaluation at suspended or continuous full expiration is mandatory to detect air trapping that is a key finding for depicting an obstruction on the small airways. Indications for CT evaluation of the airways include: (a) detection of endobronchial lesions in patients with an unexplained hemoptysis; (b) evaluation of extent of tracheobronchial stenosis for planning treatment and follow-up; (c) detection of congenital airway anomalies revealed by hemoptysis or recurrent infection; (d) detection of postinfectious or postoperative airway fistula or dehiscence; and (e) diagnosis and assessment of extent of bronchiectasis and small airway disease. Improvement in image analysis technique and the use of spirometrically control of lung volume acquisition have made possible accurate and reproducible quantitative assessment of airway wall and lumen areas and lung density. This contributes to better insights in physiopathology of obstructive lung disease, particularly in chronic obstructive pulmonary disease and asthma. 相似文献
994.
Introduction Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease that presents with variable local manifestations.
We describe here the different management protocols based on the clinical presentation of these patients.
Methods A retrospective review of 20 histopathologic confirmed cases of IGM seen over a period of 10 years was performed.
Results The median age was 34 years (age range: 21–45 years). All were married, parous with history of breast feeding. Ill-defined
mass mimicking carcinoma was the commonest presentation (70%); however, with the presence of signs of inflammation like pain
(55%), redness (40%), and peau d’orange (40%), an inflammatory process appeared more likely. Axillary lymph node enlargement
was infrequently seen (40%). Radiologic findings (mammography and ultrasound) were nonspecific. Histopathology showed the
characteristic lobular distribution of granulomatous inflammation in all cases. Surgically, 7 patients had abscess drainage
with open biopsy, and 7 patients had lumpectomy. Six patients with diffuse breast involvement were diagnosed by core needle
biopsy only. Microbial cultures showed no growth. Antibiotics were given empirically when signs of inflammation where present.
Two patients needed further abscess drainage followed by persistent sinus excision 3–6 weeks later. The median follow-up was
24 months (range: 15–42 months). Seventeen patients (85%) were recurrence-free, and 3 patients (15%) were lost to follow-up.
Conclusions Management of IGM cases needs to be tailored according to the clinical presentation. Precise radiologic and pathologic data
interpretation by a multidisciplinary breast team will facilitate diagnosis and minimize unnecessary intervention. 相似文献
995.
Giacomo Pata Claudio Casella Ernesto Di Betta Luigi Grazioli Bruno Salerni 《World journal of surgery》2009,33(8):1611-1617
Background In hemodynamically stable patients after blunt pancreatic trauma, the main pancreatic duct (MPD) disruption (American Association
for the Surgery of Trauma [AAST] grade III-IV-V lesions) is usually treated surgically or by endoscopic stent placement, whereas
injuries without duct involvement (grade I-II) are liable to medical treatment. To date, no evidence has been reported regarding
nonoperative management (NoM) of grade III injuries. We aimed to evaluate the safety of extending medical management to include
cases of distal MPD involvement (grade III).
Patients and methods Data were collected on patients admitted after blunt pancreatic trauma between January 1999 and December 2007. Patients exhibiting
hemodynamic instability or hollow organ perforations were excluded from this study, as they were surgically managed. In all
remaining cases NoM was attempted. Antibiotic prophylaxis and early total enteral nutrition were routinely adopted. Grade
III patients received octreotide during hospitalization and for 6 months after discharge.
Results Eleven patients (2 with grade I injury, 3 with grade II injury, and 6 with grade III injury, all diagnosed by contrast-enhanced
helical CT) were included. Nonsurgical management was carried out in all of these patients. Among grade III patients, one
developed a peripancreatic abscess; another, a pancreatic fistula. Both were successfully treated nonoperatively. The average
length of hospital stay was similar in grade I-II and grade III patients. After a median follow-up of 57 months no mortality
or pancreatic sequelae had occurred.
Conclusions Under the aforementioned conditions, an attempt to extend NoM to include patients with AAST-grade III lesions can be justified. However, such a strategy demands
continuous patient monitoring, because should the case worsen, surgery might become necessary. 相似文献
996.
Emanuele Soricelli Giovanni Casella Mario Rizzello Benedetto Calì Giorgio Alessandri Nicola Basso 《Obesity surgery》2010,20(8):1149-1153
Background
The prevalence of gastroesophageal reflux disease (GERD) and/or hiatal hernia (HH) is significantly increased in morbidly obese patients. Laparoscopic bariatric procedures such as gastric banding (LGB) and Roux-en-Y gastric bypass have been shown to improve both obesity and reflux symptoms. The aim of this paper is to evaluate the effectiveness of laparoscopic sleeve gastrectomy (LSG) and hiatal hernia repair (HHR) for the treatment of obesity complicated by HH. 相似文献997.
A 60-year-old man, who suffered from advanced rectal cancer accompanied with liver metastasis, underwent an abdominoperineal
resection and a partial hepatectomy. He remained well until 4 months after surgery when he developed a biopsy-proven recurrent
intrapelvic mass and multiple liver tumors. At 6 months after surgery, the metastatic liver tumors grew larger and almost
completely occupied both lobes of the liver. However, 9 months after surgery, the liver tumors regressed remarkably and his
clinical condition improved without any specific treatment for cancer. Although he died of cancerous peritonitis 18 months
after surgery, the autopsy findings did not indicate any apparent regrowth of the liver tumors. To date, only one case report
of a spontaneous regression of a metastatic liver tumor from colorectal cancer has been published in the English literature.
We herein describe this rare case and discuss some of the reasons potentially responsible for the regression.
Received: July 16, 2001 / Accepted: March 5, 2002 相似文献
998.
Zsolt Balogh Cino Bendinelli Timothy Pollitt Rosemary A. Kozar Frederick A. Moore 《European journal of trauma and emergency surgery》2008,34(4):369-377
Postinjury abdominal compartment syndrome (ACS) has evolved during the 1980s together with the introduction of damage control
surgery (DCS) principles. DCS made it possible to salvage severely injured trauma patients who previously would have exsanguinated
due to uncontrollable coagulopathic bleeding. These patients had severe hemorrhagic shock; their abdomens were tightly packed
and had ongoing massive resuscitation. ACS is a lethal complication of the damage control patients. For today the pathophysiological
characteristics of ACS are described, the intra-abdominal pressure is measured on many intensive care units. Postinjury ACS
(primary and secondary) is one of the better characterized etiological types of ACS: risk factors, diagnostic criteria, independent
predictors and preventive strategies are all well documented. Since the mortality of full-blown postinjury ACS is still unacceptably
high and does not seem to improve with earlier decompression, prevention is the recommended strategy to decrease the morbidity
and mortality. Open abdomen is one of the important preventive strategies but it is not free from morbidity and mortality.
With aggressive open abdomen management in postinjury ACS these complications can be minimized. More importantly, timely hemorrhage
control and hemostatic resuscitation are the likely solutions for more efficient prevention of the postinjury ACS. 相似文献
999.
Kavin G. Shah Derry Rajan Jeffrey Nicastro Ernesto P. Molmenti Gene Coppa 《The Indian journal of surgery》2012,74(2):146-148
Bariatric surgery has been demonstrated to be an effective treatment for morbid obesity. The purpose of this study is to investigate
the incidence of pre- and post-operative deep venous thrombosis (DVT) in Lap-Band surgical patients. This study group comprised
56 consecutive patients who underwent Lap-Band surgery. Mean age and body mass index were 38 years (range: 18–64 years) and
50.9 kg/m2 (range: 53–74 kg/m2), respectively. All the patients were screened with duplex ultrasonography pre- and post-operatively. There were no iliac,
femoral, or popliteal vein thromboses detected at any given point of time. No patient had any clinical signs or symptoms of
DVT post-operatively. There were no observable differences attributable to DVT prophylaxis. This data suggest that in the
setting of chemical and mechanical prophylaxis, the incidence of DVT in patients undergoing Lap-Band surgery at an established
bariatric centre is minimal. 相似文献
1000.
Luigi Bonavina Davide Bona Greta Saino Claudio Clemente 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):653-656
Background Benign esophageal pseudoachalasia is a rare condition.
Discussion We report the case of a 70-year-old man who complained of severe dysphagia after laparoscopic Nissen fundoplication and crural
mesh repair performed for long-standing gastroesophageal reflux disease. Severe dysphagia and nocturnal aspiration developed
soon after the operation. A marked dilatation of the esophageal body and a manometric pattern resembling achalasia was documented.
Results Endoscopic balloon dilatation was ineffective. Five months after the initial operation, the patient underwent revisional laparoscopic
surgery that consisted of Nissen’s wrap takedown, enlargement of the hiatus with partial resection of the mesh, Heller myotomy,
and Dor fundoplication. After a 2-year follow-up, the patient is doing well and is free of symptoms. 相似文献