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91.
The thoracoscope as diagnostic tool for solid mediastinal masses 总被引:1,自引:0,他引:1
Background: Despite the accuracy of percutaneous biopsy of mediastinal masses under CT scan or sonographic control, there is still a need for surgical biopsy because of difficult location or because of insufficiency of the percutaneous biopsy, especially for those tumors requiring an immunological classification.
Methods: The thoracoscopic approach to mediastinal masses is an alternative to the usual surgical biopsies performed through thoracotomy, sternotomy, or anterior mediastinotomy. The procedure is performed under general anesthesia and one-lung ventilation.
Results: In a series of 47 cases, a histological diagnosis was obtained in 44 cases (93.6%). There was one hemorrhagic complication requiring thoracotomy (2.1%). The mean postoperative duration of stay was 3.2 days.
Conclusions: Thoracoscopy is the method of choice in case of failure or contraindication of percutaneous biopsy. There is still a role for mediastinoscopy in treating paratracheal lymph nodes. 相似文献
92.
Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation 总被引:1,自引:0,他引:1
MARY BOULTON JO GRIFFITHS† D. HALL† M. MCINTYRE† B. OLIVER† J. WOODWARD† 《Medical education》1984,18(4):269-274
This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved. 相似文献
93.
Pelvic neurilemmoma 总被引:2,自引:0,他引:2
F. T. Dénes M. Borelli V. P. Toledo G. M. de Gòes 《International urology and nephrology》1978,10(4):279-283
A rare case of benign pelvic neurilemmoma with bladder infiltration and ureteral obstruction is presented. This neurally originated tumor may occur anywhere in the body, but involvement of the urinary tract is rare. Management depends upon location and other clinical findings, and in this case, since complete removal was impossible, urinary derivation was employed as a palliative treatment. 相似文献
94.
Massari P Duro-Garcia V Girón F Hernández E Juárez F Castro C Toledo M;myPROMS LatAm Study Group 《Transplantation proceedings》2005,37(2):916-919
The immunosuppressant mycophenolate mofetil (MMF; CellCept) has greatly improved transplant recipients' clinical outcomes, but its efficacy may be limited by dose adjustments due to adverse events (AEs). An enteric-coated formulation of mycophenolate sodium (EC-MPS; myfortic), designed to improve gastrointestinal tolerability is now available. This Latin-American, prospective, multicenter, open-label, 6-month trial assessed the safety and tolerability of converting renal transplant recipients from MMF to EC-MPS. In total, 237 renal transplant recipients (stable > or = 3 months' posttransplant) receiving MMF (< or =1000 mg b.i.d.) were enrolled. Adults (n = 218) were converted to EC-MPS 720 mg b.i.d. (equimolar to MMF 1000 mg b.i.d.) even if they were initially receiving <1000 mg MMF b.i.d. (ie, 47 adults received a higher than equimolar dose of EC-MPS). Children (n = 19) were converted to EC-MPS 450 or 432 mg/m2 b.i.d. Patients also received cyclosporine microemulsion (Neoral) and corticosteroids. There were three acute rejections and no graft failures. The incidence of AEs was 59.9% (in those receiving a higher than equimolar EC-MPS dose it was 57.4%). In all, 22% of patients had gastrointestinal AEs, 37% had infections, and 4.8% had hematological AEs. Only 24 patients (10%) had an AE-related dose reduction. Seven of these patients had received higher than equimolar doses of EC-MPS. Patients can be safely converted from different doses of MMF to a standard dose of EC-MPS. The requirement for EC-MPS dose reduction to manage AEs was relatively low. Use of EC-MPS is a valid alternative for renal transplant recipients receiving maintenance MMF treatment. 相似文献
95.
de Aluja AS Villalobos NM Nava G Toledo A Martínez JJ Plancarte A Rodarte LF Fragoso G Sciutto E 《Vaccine》2005,23(31):4062-4069
The S3Pvac synthetic vaccine composed of three peptides (GK1, KETc1 and KETc12) effectively protect against pig cysticercosis. Preliminary results point to an additional cysticidal capacity induced by S3Pvac or GK1 immunization. Herein, clear evidences of the cysticidal effect of S3Pvac but not of GK1 are presented. S3Pvac immunization of already experimentally infected pigs induced a reduction in the parasite load, in the vesicular cysticerci and in their viability. It also substantially increases the percent of histological damaged cysticerci more importantly in muscles than in brains, with a concomitant reduction in the antibody levels. Thus, S3Pvac represents a powerful means of controlling cysticercosis infection in pigs. 相似文献
96.
Moretto EP Silva GH Toledo Filho JL Andreo JC Navarro Rde L Navarro JA 《Journal of applied oral science : revista FOB》2005,13(2):167-170
Anatomic knowledge on the zygomatic fossa is of primary importance to improve the regional anesthetic technique of the maxillary nerve. Few reports in the literature have addressed the trajectory of the maxillary nerve and its branches in this region; thus, this study aimed at presenting information about the trajectory of these nerves. Thirty human half-heads of both genders were fixed in 10% formalin and demineralized in 5% nitric acid, and the maxillary nerve was dissected since its origin on the pterygopalatine fossa until penetration into the inferior orbital fissure. It was observed that the maxillary nerve sends one to three posterior superior alveolar branches and tuberal descendent branches, which supply the soft tissue structures of the region. The posterior superior alveolar nerves are inferiorly oriented near the maxillary tuberosity, where they penetrate the alveolar canals with the posterior superior alveolar artery and send small nerve branches that continue in an extraosseous trajectory. This study found that nearly 2/3 of the trajectory of the maxillary nerve is located in the zygomatic region, with a short segment (1/3) in the pterygopalatine fossa. 相似文献
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