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A 73-year-old lady, who underwent coronary artery bypass grafting eight months previously, presented with rigors and chest pain. The upper sternum was tender, swollen and erythematous, suggesting a retrosternal abscess. Radiological investigation supported the clinical diagnosis. Local infections following median sternotomy are uncommon, most being early and superficial. Late infections are very uncommon, and should suggest alternative pathology. Following open surgical drainage, histology showed the mass to be a poorly differentiated adenocarcinoma. The primary tumour was never found.  相似文献   
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Radiation dose reduction in CT of the pediatric pelvis   总被引:5,自引:0,他引:5  
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Glazer  GM; Aisen  AM; Francis  IR; Gyves  JW; Lande  I; Adler  DD 《Radiology》1985,155(2):417-420
Using a 0.35-T superconducting magnet and spin echo imaging, we prospectively evaluated 11 patients who had proved hepatic cavernous hemangioma. Magnetic resonance (MR) identified more lesions than either contrast-enhanced CT, or ultrasonography. The MR appearance was consistent; hemangiomas were homogeneous and generally isointense at short TR and TE intervals but were hyperintense at long TR intervals and greatly hyperintense at long TR and long TE intervals. However, the MR appearance of hemangioma was not specific; 2/14 other focal hepatic masses had similar features. The calculated relaxation times (T1, T2) were not useful in lesion characterization, although the intensity ratio of hemangioma to normal liver at the TR = 2.0 sec TE = 56 msec pulse sequence was useful in diagnosis since hemangiomas always had a ratio greater than 1.4.  相似文献   
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We compared responses of Chinese hamster ovary (CHO) cell lines stably transfected with human genes for the M1–M5 muscarinic receptor subtypes to several stimuli. While ATP brought about similar increases in the concentration of intracellular Ca2+ ions ([Ca2+]i) in the cell lines expressing all individual receptor subtypes, carbachol acted with much higher potency and efficacy on the cells expressing the M1, M3, and M5 receptor subtypes than on those expressing the M2 and M4 subtypes. The maximum [Ca2+]i responses to ATP corresponded to 41–75% of the maximum responses to carbachol in the cells expressing the M1, M3, and M5 receptor subtypes. The responses to ATP were strongly suppressed (> 75% decrease) by a preliminary administration of a maximally active concentration of carbachol in these three cell lines, whereas the responses to carbachol were less sensitive to the preliminary administration of a maximally active concentration of ATP (< 25% decrease). It appears likely that carbachol and ATP release Ca2+ ions from identical intracellular stores. Tetradecanoylphorbol acetate (TPA) strongly inhibited the responses of [Ca2+]i to both carbachol and ATP and enhanced the incorporation of [14C]choline into lipids in all five CHO cell lines investigated. On the other hand, the incorporation of [14C]choline into lipids was diminished by carbachol in the cell line expressing the M3 receptor subtype and unchanged in the other cell lines. This effect of carbachol was not dependent on the presence of extracellular Ca2+ ions and was not affected by TPA, which diminished the response of [Ca2+]i to muscarinic stimulation. It is suggested that it was due to muscarinic receptor-mediated activation of phospholipase D. Copyright © 1997 Elsevier Science Inc.  相似文献   
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Adrenal masses in oncologic patients: functional and morphologic evaluation   总被引:2,自引:0,他引:2  
Francis  IR; Smid  A; Gross  MD; Shapiro  B; Naylor  B; Glazer  GM 《Radiology》1988,166(2):353-356
The role of adrenocortical scintigraphy in the evaluation of unilateral adrenal masses detected with computed tomography (CT) in 28 oncologic patients with normal adrenal function was studied prospectively with the use of NP-59 (iodine-131-6-iodomethyl-19-norcholesterol). The diagnosis was proved by means of percutaneous fine-needle aspiration cytologic examination in 20 patients, surgical biopsy in one, and clinical and CT follow-up in seven. In 14 of the 28 patients, there was increased uptake of the NP-59 on the side of the adrenal mass detected at CT (concordant uptake). Thirteen of the 14 masses with concordant uptake were greater than 2 cm in diameter, and one was 1.5 cm; all were found to be adenomas. In 11 of 28 patients there was decreased uptake on the side of the mass detected at CT (discordant uptake). None of these 11 masses were adenomas; nine were metastases and two were adrenal cysts. Uptake was indeterminate (symmetric) in three patients, two of whom had adrenal adenomas and one an adrenal metastasis; each mass with indeterminate uptake was less than 2 cm in diameter.  相似文献   
69.
Ocular complications in renal transplant patients   总被引:2,自引:0,他引:2  
One hundred and seventy-six patients who received a renal transplant between 1982 and 1988 were examined for ocular complications of steroid therapy. Posterior subcapsular cataracts (PSC) were present in 60 patients (34.1%). Patients were classified into three groups (HS, LS, NoS) depending on their maintenance immunosuppression therapy. The HS group received high doses of steroids after renal transplantation. LS had low steroid doses, and NoS had no steroids. The incidence of PSC was 21 of 38 in HS (55.3%), 33 of 117 in LS (28.2%), and 1 of 16 in NoS (6.2%). The difference between HS and LS was statistically significant (x2= 8.1, P < 0.01). Grading the severity of PSC (PSC 0, PSC +, PSC > ++) showed a significant correlation between the degree of PSC and the steroid therapy. In the HS group, five patients had PSC +, and 16 had PSC > ++ (76%), compared to 19 patients with PSC +,14 patients with PSC > ++ (42%) in the LS group (x2= 4.6; P < 0.05). There was no correlation between the incidence of PSC and use of steroids for more than three months before dialysis. Comparison with the results of our earlier series (1973 -1981)1 using high doses of steroids showed a similar incidence of PSC with HS (40.7% Series 1; 55.3% Series 2) but a lower incidence with LS and NoS.  相似文献   
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