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31.
Isao Miyashiro MD Masahiro Hiratsuka MD Kentaro Kishi MD Ko Takachi MD Masahiko Yano MD Akemi Takenaka CT Yasuhiko Tomita MD Shingo Ishiguro MD 《Annals of surgical oncology》2013,20(2):542-546
Background
Reliable indicators that can intraoperatively determine the absence of nodal metastasis are in great demand to avoid unnecessary lymphadenectomy. However, little has been reported about the intraoperative diagnostic performance of sentinel node (SN) biopsy.Methods
Sentinel node biopsy by subserosal or submucosal injection of indocyanine green (ICG) was performed in 241 patients with American Joint Committee on Cancer tumor, node, metastasis staging system, 7th edition, clinical T1 (n = 190) and T2 (n = 51) gastric cancer by two experienced surgeons. All nodes that stained green (green node, GN), representing SNs, were excised before gastrectomy and were sliced into 2-mm sections for intraoperative histological examinations with hematoxylin and eosin staining. The sliced GNs were also examined simultaneously by imprint cytology.Results
The GNs were detectable in 240 patients (3.8 ± 2.4 nodes per patient; range 1–17 nodes; median 3 nodes), and the success rate of detection was 99.6 % (240 of 241). Of 240 patients with a successful detection, 29 were found to have lymph node (LN) metastases; 16 were diagnosed with LN metastases in both GNs and non-GNs, 12 in GNs alone, and 1 in non-GNs alone. The false-negative rate based on the SN concept was 3.4 % (1 of 29). However, two patients with cT1 gastric cancer were diagnosed as intraoperative GN negative but were later confirmed as GN positive by histological examinations of paraffin sections. As an intraoperative diagnosis, the false-negative rate was 10.3 % (3 of 29).Conclusions
Sentinel node biopsy using ICG could be performed intraoperatively within reasonable limits under certain conditions, such as multiplanes for detection, combination use of imprint cytology, and open surgery by experienced surgeons. 相似文献32.
Relapsed infant MLL‐rearranged acute lymphoblastic leukemia with additional genetic alterations
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运动性心律失常是指发生于机体剧烈运动期间或之后的心律失常。临床表现不一,从心悸、头晕、晕厥、心绞痛、急性心肌梗死和充血性心力衰竭,甚至到心脏性猝死。运动性心律失常可见于心肌缺血,如患有动脉粥样硬化性心脏病以及患有原发性或继发性心肌病的患者。然而,也可能发生在似乎健康的个体。在后一组人群中,运动性心律失常可以是良性的,但也可以是获得性(如药物诱发)或先天性(如先天性长QT综合征或致心律失常性右室发育不良)心电活动或结构的异常而呈恶性。这种潜在病理生理学机制的复杂性,使运动性心律失常的诊断和治疗成为临床医学上的… 相似文献
39.
Yihong Yang Gary H. Glover Peter van Gelderen Venkata S. Mattay Attanagoda K. S. Santha Roy H. Sexton Nick F. Ramsey Chrit T. W. Moonen Daniel R. Weinberger Joseph A. Frank Jeff H. Duyn 《Magnetic resonance in medicine》1996,36(4):620-626
A new method to perform rapid 3D fMRI in human brain is introduced and evaluated in normal subjects, on a standard clinical scanner at 1.5 Tesla. The method combines a highly stable gradient echo technique with a spiral scan method, to detect brain activation related changes in blood oxygenation with high sensitivity. A motor activation paradigm with a duration of less than 5 min, performed on 10 subjects, consistently showed significant changes in signal intensity in the area of the motor cortex. In all subjects, these changes survived high statistical thresholds. 相似文献
40.
Prediction of post-operative glomerular filtration rate after nephrectomy for renal malignancy. 总被引:2,自引:0,他引:2
The importance of a correct estimation of contralateral renal function in cases of renal malignancy is obvious, necessitating a conservative approach to tumour resection when function of the contralateral kidney is markedly reduced. The aim of the present study was to determine the accuracy of preoperative gamma camera renography and (51)Cr-EDTA clearance to predict the glomerular filtration rate (GFR) early and up to 6 months after nephrectomy for renal malignancy. Patients (n=40) underwent both gamma camera renography ((99m)TC-DTPA) and (51)Cr-EDTA clearance preoperatively, whereas (51)Cr-EDTA clearance was measured within 1 week and up to 6 months after nephrectomy. The single kidney GFR values of the contralateral kidneys were estimated preoperatively and then compared with the post-operative (51)Cr-EDTA clearance values. The predicted GFR values were lower compared with the measured post-operative (51)Cr-EDTA clearance values (45 +/- 2 vs. 54 +/- 3 ml min(-1) 1 week after nephrectomy and 53 +/- 3 ml min(-1) 6 months later, P<0.01, respectively). The difference between the measured and predicted GFR was larger in patients below the median age of 60 years (P<0.05) and confined to patients with a relative uptake of >30% by the tumour affected kidney. Prediction of post-operative GFR by non-invasive renal function tests performed prior to surgery for renal malignancy underestimate post-operative GFR when the function of the tumour affected kidney is preserved, indicating an adaptive GFR increase in these cases. 相似文献