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61.
Ventilation parameters and arterial blood gases as a prediction of hypoplasia in congenital diaphragmatic hernia 总被引:1,自引:0,他引:1
Attempts to predict the degree of pulmonary hypoplasia associated with congenital diaphragmatic hernia have been made by evaluating the ventilation parameters and the arterial blood gasses of these patients. A CO2 index as a predictor of outcome, which correlates the PaCO2 with the ventilation index, was recently proposed. However, in this study the postductal PaO2 was a better predictor of survival. And the so-called "honeymoon period" was a better indicator of the efficacy of extracorporeal membrane oxygenation (ECMO) than the CO2 index. Nineteen patients were evaluated; 11 were treated with ECMO, and eight were not considered suitable for ECMO. 相似文献
62.
BACKGROUND: Chronic venous access devices (CVADs), placed for phlebotomy and the administration of medications and nutrition, require fluoroscopy to confirm correct catheter position. Long-term central venous catheters placed using an electromagnetic catheter locating system (EMCLS) could result in decreased radiation exposure and decreased cost without compromising accuracy of position. METHODS: Charts of patients who underwent placement of CVADs at University of New Mexico (UNM) Hospital or UNM Cancer Center were reviewed. Inclusion criteria included age >20 years and placement of a central CVAD utilizing fluoroscopy (group 1) or the EMCLS (group 2). Radiation exposure, complications, cost, and accuracy of placement were determined for each technique. RESULTS: Between June 1996 and June 1998, 196 patients underwent placement of CVADs. Complete data sets were available for 46 patients in each group. There were no statistically significant differences in age, gender, complications, or operating room times (P = 0.26). Fluoroscopy and EMCLS were equally accurate for the correct placement of the tip of the line (P = 0.12). Mean patient radiation exposure was EMCLS, 30 mRem, and fluoroscopy, 771 mRem. EMCLS significantly decreased cost (P = 0.025) when compared with fluoroscopic assisted catheter placement. CONCLUSIONS: The use of EMCLS for CVAD placement reduces radiation exposure and cost without compromising the accuracy of placement when compared with standard fluoroscopic-assisted placement. 相似文献
63.
A study was undertaken to analyse and compare the pelvic (S1) and the trunk (T12) oscillations during level and uphill walking and to provide kinematic baseline data of the lumbar region in incline walking for future comparisons with pathological gait patterns. An ultrasonic movement analysis device (Zebris(R) CMS 50) was used to obtain three-dimensional kinematic data for the pelvis and thorax. Data from treadmill walking at 0 and 10% incline of 22 adults were used for within subject analysis. Crosscorrelation values ranged from r=0.76 to 0.98 (P<0.001) demonstrating a strong degree of agreement between the temporal patterns of angular displacement of the trunk and pelvis in the sagittal, transverse and frontal plane in incline compared to level ambulation. However, Student's t-tests revealed significantly (P<0.01) higher amplitudes for thorax displacements in the frontal and transverse plane in uphill walking. No significant differences were detected for amplitude parameters of the pelvis. It could be stated that the phasic patterns in level walking are not different from that obtained for incline walking. It is concluded that incline ambulation exerts the major influences in the thoracic region by increasing amplitudes of axial rotations. 相似文献
64.
Vogt PR Ensner R Prêtre R Schmidli J Reuthebuch O Zünd G Turina MI 《Journal of cardiac surgery》1999,14(5):330-333
BACKGROUND: Radical resection using deep hypothermic circulatory arrest improves the survival of patients with transvenous intracardiac tumor extension of renal cell carcinomas. A less invasive surgical approach avoiding deep hypothermia, circulatory arrest, and cross-clamping of the aorta is presented. METHODS: Between 1987 and 1999, 12 patients (mean age 57+/-8 years) underwent resection of a renal cell carcinoma extending into the right atrium, right ventricle, or pulmonary arteries. After median sterno-laparotomy, normothermic cardiopulmonary bypass is used cannulating the ascending aorta, superior caval vein, and inferior caval vein below the renal veins. The tumor and the corresponding kidney are radically excised, including the renal vein. Tumor fragments from the inferior caval vein, the right heart, and pulmonary arteries are removed either on the fibrillating or beating heart. RESULTS: Operative mortality was 0%. Mean cardiopulmonary bypass time was 53+/-27 minutes (median 36; range 32-110 minutes). Mean blood loss per patient was 1200 mL. Mean duration of postoperative mechanical ventilation was 36+/-12 hours (median 36; range 30-77 hours), mean intensive care stay 5.5+/-5 days (median 3; range 1-48 days), and mean duration of hospitalization 22+/-12 days (median 21; range 10-58 days). All patients were discharged home. Patients with multiple tumor manifestations outside the cardiovascular systems died within 9 months after the operation. CONCLUSIONS: The use of normothermic cardiopulmonary bypass is a less invasive method for radical resection of renal cell carcinoma with intracardiac tumor extension. Radical resection does not improve survival in patients with multiple distant metastases. 相似文献
65.
66.
Baretton G Vogt M Diebold J Blasenbreu S Schneiderbanger K Lohrs U 《Oncology reports》1996,3(2):357-363
To get better insight into the role of numerical chromosome 17-aberrations and functional loss of the tumor suppressor gene TP53 during the early steps of colorectal carcinogenesis we analyzed paraffin-embedded tumor tissue from 58 colorectal adenomas with different histological features for p53-expression by immunohistology (IH; moAb DO1), #17-copy number by interphase-cytogenetics [nonradioactive in situ-hybridization (NISH) with a centromer-specific DNA-probe (D17Z1)], and DNA-ploidy by flow cytometry (FCM) with special emphasis on histopathological correlation. Seven adenomas (12%) showed nuclear p53-immunoreactivity. p53-expression was correlated with villous/tubulo-villous growth pattern (p=0.005) and grade of atypia (p=0.003) or dysplasia (p=0.0018). #17-aneusomy was present in 31% of the cases (29% deletions, 2% gains). In the FCM-analysis, 33% of the adenomas were DNA-non-diploid. p53-immunoreactivity correlated statistically significantly with FCM-non-diploidy (p=0.004) suggesting a role for the TP53-gene in the aneuploidization process. #17-deletions were associated to p53-immunoreactivity (p=0.046) but no correlation was found between FCM-ploidy and #17-copy number. As for loss of a tumor suppressor gene both alleles have to be affected, our data suggest a multistep process of TP53-inactivation. Whether the subgroup of adenomas with p53-expression might progress faster into invasive carcinoma than p53-negative cases remains to be tested. 相似文献
67.
M. M. Henrich K. Großmann W. Motz M. Vogt E. Vester M. Holschbach W. Hamkens G. Notohamiprodjo B. E. Strauer L. E. Feinendegen 《European journal of nuclear medicine and molecular imaging》1993,20(3):225-230
Radioiodine labelled 17-iodo-heptadecanoic acid (IHA) is used for non-invasive study of myocardial metabolism in coronary heart disease and cardiomyopathy. Yet in the interpretation of in vivo myocardial tracer kinetics, it is controversial whether the intracellular degradation of IHA or the removal of iodide across cellular membranes is the rate-limiting step in iodide release from the myocardium. In five patients undergoing coronary sinus catheterization, a mixture of about 40 kBq of [123I] NaI was injected into the left coronary artery. During the following 15-min period, frequent blood samples were taken from the aorta and the coronary sinus. In the aqueous phase of the venous blood, 14CO2 and inorganic 131I appeared nearly in parallel, with a peak time of 4–5 min. Moreover, as shown by the AV difference, there was no significant back diffusion of IHA and no significant non-specific deiodination detectable over the period of observation. There was myocardial retention of inorganic iodide (123I) injected into the left coronary artery. The data strongly support the premise that lipid turnover through -oxidation is the rate-limiting step in the externally measured release of iodide after IHA injection, provided that recirculating inorganic radioactive iodide is corrected for. In addition, 15 volunteers were studied using [11C]palmitic acid and [123I]IHA using PET and dynamic planar camera scintigraphy with iodide correction. There was no significant difference between the mean values of the elimination half-times, and also no significant correlation between half-times of both fatty acids for single individuals. 相似文献
68.
Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure. 总被引:7,自引:6,他引:1 下载免费PDF全文
Expired air carbon monoxide (CO) and serum thiocyanate (SCN) were used to asses exposure to cigarettes in 139 middle-aged men. Subjects who reported smoking cigarettes generally had CO levels exceeding 8ppm and SCN levels exceeding 100umol/L; non-smokers had lower levels. For both tests the mean concentration among men smoking more than one pack daily was three times that of non-smokers. The is a high correlation between the two tests (r=.571 for smokers), an association that was largely independent of the smaller correlations between either test and reported smoking frequency (r=.476 for CO; r=.479 for SCN). The ability to distinguish between individuals who reported "typical" smoking habits and non-smokers was best when the CO and SCN analyses were used together to take advantage of their separate sources of variance; it was 99 per cent when the two tests were mutually concordant (91 per cent of cases). The CO and SCN measurements allowed 16 individuals who reported light smoking habits to be categorized into high and low presumptive tobacco exposure groups. The two tests are inexpensive and suitable for use in epidemiologic and health care delivery programs. 相似文献
69.
Primary non-Hodgkin's lymphoma of the spinal cord 总被引:1,自引:0,他引:1
STUDY DESIGN: Case report. OBJECTIVE: To report a rare case of primary lymphoma of the spinal cord and to discuss therapeutic options. SUMMARY OF BACKGROUND DATA: Only few cases of primary spinal cord lymphomas are reported. Prognosis is often poor, and therapy is not yet established.METHODS: A primary lymphoplasmacytoid lymphoma of the thoracic cord in a 75-year-old woman was treated with focal radiotherapy (30 Gy) and three cycles of chemotherapy consisting of procarbazine, lomustine, and vincristine. RESULTS: Complete tumor response and partial recovery of neurologic symptoms were achieved. The patient was in complete remission at last follow-up (11 months after diagnosis). CONCLUSIONS: Primary spinal cord lymphomas should be considered in the differential diagnosis of spinal cord tumors, especially in older patients. Combination therapy with radiotherapy and chemotherapy may be superior to radiotherapy alone in these tumors. Rapid initiation of treatment is essential to achieve recovery of neurologic function. 相似文献
70.
First experience with gamma probe guided sentinel lymph node surgery in penile cancer 总被引:3,自引:0,他引:3
Wawroschek F Vogt H Bachter D Weckermann D Hamm M Harzmann R 《Urological research》2000,28(4):246-249
Because of the curative approach, the detection of lymph node metastases in squamous cell carcinoma (SCC) of the penis is
of significant clinical relevance. Sentinel lymph node (SLN) identification by means of lymphangiography has been proven to
be insufficiently safe. However, the high morbidity of inguinal lymphadenectomy and the considerable individual variability
regarding the location of lymph node metastases justify the necessity of a technique that enables the identification of SLNs.
Since 1998, SLNs have been intraoperatively identified and selectively dissected, after peritumoral injection of technetium-99m
nanocolloid and using lymphoscintigraphy, in three patients (one with malignant melanoma and two with SCC). At least one SLN
could be detected in each patient. The maximum surgical time was 30 min. There were no severe complications. Lymph node metastases
did not occur in any patient. Upon a mean follow-up of 10 months, all patients are currently free of tumor. Owing to the long-term
results of sentinel lymphadenectomy in malignant melanoma of other locations and our preliminary results with respect to penile
carcinoma, we consider the current method appropriate as the only primary operation for lymph node staging in early stages
and, in combination with modified inguinal lymphadenectomy, in locally advanced stages.
Received: 24 November 1999 / Accepted: 21 April 2000 相似文献