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Curtis W. Ollayos M.D. Jack Lichy M.D. Ph.D. Beverly W. Duncan M.Sc. Izzat S. Ali 《Gynecologic oncology》1996,63(3):388-391
Papillary squamous cell carcinoma (PSCC) of the uterine cervix is a rare variant of squamous cell carcinoma (SCC). It is characterized by a papillary architecture and markedly atypical epithelium. Invasion and metastasis have been reported. We report a case of PSCC in a 72-year-old woman who subsequently tested positive for HPV 16. To our knowledge, this is the first report of HPV typing in a case of PSCC. Our finding of a high-risk HPV type in PSCC may help explain why PSCC has been reported to have a clinical course similar to that of nonpapillary SCC. 相似文献
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Surgical Endoscopy - 相似文献
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Mohammad Bashar Izzat F.R.C.S. Tom Buckley F.F.I.C.A.N.Z.C.A. Kim S. Khaw F.R.C.A. Anthony P. C. Yim M.D. John E. Sanderson F.R.C.P. Gianni D. Angelini F.R.C.S. 《Echocardiography (Mount Kisco, N.Y.)》1985,2(2):136-140
Abstract Background: While the operative technique of left ventricular volume reduction (LVVR) is rapidly becoming standardized, the optimal perioperative management strategy is yet to be determined. We present our experience with the care of patients undergoing LVVR. Methods: LVVR was performed in 21 patients (mean age = 65.5 years) with congestive heart failure. Our management strategy was initially based on afterload reduction with sodium nitroprusside, but was later modified to include routine preoperative intra-aortic balloon support, normothermic cardiopulmonary bypass, antegrade intermittent warm blood cardioplegia, and postoperative support with phosphodiesterase-III inhibitors. Hernodynamic manipulations are aimed to attain systemic vascular resistance between 600 and 800 dyne/sec per cm-5 and the lowest mean blood pressure that is able to maintain satisfactory systemic perfusion. Postoperatively, aggressive antifailure medical therapy with a high dose of angiotensin converting enzyme inhibitors, nitrates, and diuretics was initiated early and maintained indefinitely. Results: Using this approach, postoperative progress was characterized by hemodynamic stability. IABP support was used for 59.6 ± 9 hours following surgery, and inotropic support for 103 ± 12 hours. In our series there were four (19%) in-hospital deaths, two of which were related to heart failure. Conclusion: The described approach is associated with an acceptable early outcome. However, further advances in myocardial protection methods and pharmacological and mechanical support techniques are necessary for a wider adoption of this procedure. 相似文献
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ObjectivesMultiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sourcesA total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked.MethodsA systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.ResultsThree studies were included. All included studies were small-scale case series (13–38 participants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study.ConclusionsBased on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials. 相似文献
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BACKGROUND: In the progress toward "off-pump" endoscopic coronary artery surgical procedures, new techniques for coronary artery anastomoses are being developed. One such approach is the use of nonpenetrating titanium clips. We evaluated the quality of anastomoses achieved using this technique in a porcine model of saphenous vein-carotid artery grafting using scanning electron microscopy. METHODS: Bilateral saphenous vein-carotid artery interposition grafts were implanted in 10 "white race" pigs, using the nonpenetrating clips in one side of the neck and conventional hand suturing on the opposite side. One week after operation, the grafts were harvested. RESULTS: All grafts were patent 7 days after operation, and 40 anastomoses underwent scanning electron microscopic study. In all samples, the luminal surfaces of both the carotid artery and vein graft were covered by a continuous layer of endothelial cells up to the anastomosis. Anastomotic sites in all clipped samples and most of the sutured anastomoses were completely endothelialized, and anastomotic clefts were indistinguishable. However, in 25% of sutured specimens, the suture material remained clearly visible inside the lumen of the vessel, and the subendothelial matrix remained exposed, with extensive fibrin, red blood cells, and platelet deposition on its surface. CONCLUSIONS: Because the endothelial coverage consistently appeared to be complete and the subendothelial matrix was not exposed, it is likely that the risk of early anastomotic thrombosis is reduced by using the nonpenetrating titanium clips. 相似文献
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Eric D. Hostetler Hong Fan Aniket D. Joshi Zhizhen Zeng Waisi Eng Liza Gantert Marie Holahan Xianjun Meng Patricia Miller Stacey O’Malley Mona Purcell Kerry Riffel Cristian Salinas Mangay Williams Bennett Ma Nicole Buist Sean M. Smith Paul J. Coleman Christopher D. Cox Brock A. Flores Izzat T. Raheem Jacquelynn J. Cook Jeffrey L. Evelhoch 《Molecular imaging and biology》2016,18(4):579-587