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11.
The chloride:phosphate ratio is of only limited value in aiding the clinician in the differential diagnosis of hypercalcemia. The use of thiazide diuretics may cause hypercalcemia with a chloride:phosphate ratio said to be consistent with a diagnosis of primary hyperparathyroidism. Parathormone assay remains the "gold standard" for definitive diagnosis of hyperparathyroidism. 相似文献
12.
Yanfang Li Menda LP Qiuliang WU Fuyuan Liu Jundong Li Jinglin Zou Yongwen Huang 《中国肿瘤临床(英文版)》2004,1(3):180-184
Objective Ovarian dysgerminoma is an uncommon ovarian malignancy, Its clinicai features are special and there are many factors affecting
its prognosis. If treated properly, the patient can be cured. Otherwise it may endanger the patient’s life. The aim of this
study is to investigate the clinical features and factors related to prognosis of ovarian dysgerminoma.
Methods Data from 57 patients with pure ovarian dysgerminoma were analyzed retrospectively. The patients were admitted to the Cancer
Center, Sun Yat-sen University from January 1.1964 to December 31, 2000.
Results The main clinical features were abdominal mass (56.1% ), abdominal pain (21.1% ), abdominal swelling (17.5%.), vaginal bleeding
(5.3% )and genital tract abnormalities (5.3%). Twenty-six patients had stage I diseases, 8 stage II.9 stage III.1 stage IV
and 13 recurrent and persistent diseases. The uterus was involved in 41.2% of patients with stage II -III diseases. Combined
modality was given to 52 cases and a single-method treatment to 5 cases. The total overall 5 and 10-year survival rates for
stages I-IV was 80.1 % and 70.0% respectively. The 5-year survival rate for stage I was 100%, stage II 55.2%. stage III 55.6%
and stage IV 0%; for recurrent and persistent diseases, 72.7%. The stage I group of 12 patients. received adnexectomy and
14 patients underwent hysterectomy and adnexa removal. There was no significant difference between the 5 and 10-year survival
rates (all 100%). Of the 23 patients in the stage I group to whom oniy chemotherapy was given after operation, 19 cases received
3 or more courses and were well without recurrence; 4 patients received only one course and one of them recurred 21 months
after the operation. In the group of stages II and III cases, the 5-year survival rate was 86.7% for those whose chemotherapy
courses were 3≥ 4 and 25.0% for patients who received less than 4 courses of chemotherapy (P<0.05).
Conclusions The prognosis of ovarian dysgerminoma is closely related to the disease stage and treatment modality. A fertility-preserving
operation can be considered in early -staged patients, but caution needs to be exercised in the middle to late staged cases.
Good results can be achieved with an operation-based combined modality in recurrent patients. 相似文献
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16.
The skeletal architecture of the DRUJ provides minimal inherent stability, as the sigmoid notch is shallow and its radius
of curvature is 50% greater than that of the ulnar head [Af Ekenstam F, Hagert CG. Anatomical studies on the geometry and
stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg 1985;19(1):17–25]. Due to its incongruent articulation,
the DRUJ relies strongly on the surrounding soft tissues for stability. The triangular fibrocartilage complex (TFCC) is generally
accepted as the major soft tissue stabilizer of the DRUJ of which the volar and dorsal radioulnar ligaments are the primary
components. Restoration of the radioulnar ligaments offers the best possibility to restore the normal DRUJ primary constraints
and kinematics. This article presents an update of the procedure developed by the senior author that anatomically reconstructs
the palmar and dorsal radioulnar ligaments at their anatomic origins and insertions. 相似文献
17.
Imaging bowel obstruction: a comparison between fast magnetic resonance imaging and helical computed tomography 总被引:5,自引:0,他引:5
AIM: To compare the accuracy of fast magnetic resonance (MR) imaging using the half-Fourier single shot turbo spin echo (HASTE) sequence with helical computed tomography (CT) in diagnosing bowel obstruction. MATERIALS AND METHODS: Prospective evaluation of 44 patients with clinical evidence of bowel obstruction was conducted using various investigations including HASTE MR and helical CT. MR was performed with a Siemens 1.5 Tesla MR Imaging System and CT was performed with one of two Siemens ARHP CT systems using helical technique. MR acquisition allowed data to be gathered in 6-10 minutes and no contrast media were administered. CT imaging consisted of consecutive helical CT through the abdomen and pelvis with oral and intravenous contrast medium used when indicated. Bowel dilation along with the presence and level of obstruction were determined. RESULTS: Twenty-eight patients had bowel obstruction confirmed at laparotomy or by radiographic assessment. Of these, 25 had small bowel obstruction and three had colonic obstructions. The obstruction was due to fibrous adhesions in nine patients, metastases or primary carcinoma in seven, Crohn's disease in four, hernias in two, and inflammation or abscess in two. Other causes of obstruction included lymphoma, intussusception and anastomotic stricture. The cause of obstruction was correctly diagnosed by CT in 71%, and by MR in 95% of cases. The sensitivity, specificity and accuracy for HASTE MR imaging was 95%, 100% and 96% respectively as compared to 71%, 71% and 71% for helical CT. CONCLUSION: Fast MR imaging using the HASTE sequence is more accurate than helical CT in diagnosing bowel obstruction. 相似文献
18.
The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or primary percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.
Pathophysiology
Changes in the definition of terms relating to the diagnosisof myocardial infarction (MI) have evolved by better understandingof the pathophysiology culminating in the new term of acutecoronary syndrome (ACS). Figure 1 illustrates the processesthat occur in the development of an acute coronary event. 相似文献
19.
Antisera with la Specificity Selected by Lymphocytes from Patients with Chronic Lymphocytic Leukemia
Sylvia D. Lawler P. J. Dewar Ivanka Mrazek Elizabeth H. Jones and A. B. Hockley 《Vox sanguinis》1978,34(4):200-207
Cells from patients with chronic lymphocytic leukaemia (CLL) have been used to screen the sera of pregnant women for antibodies specifc for B lymphocytes. The sera have been divided into groups showing Ig specificity: group I (UK 3) had a positive association with HLA-B8 and DW3, and group II (UK 2) with HLA-B7 and DW2. Groups III, IV and X were independent of each other and of HLA-A, B and C locus antigens. Certain sera with B-cell activity showed specific blocking activity in the mixed lymphocyte reaction (MLR), and this activity was dependent on the Ia sepcificities and DW specificities of cells used in the MLR. Some sera specifically blocked the responding cells, other the stimulating cells. 相似文献
20.