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Gupta NP Goel R Hemal AK Dogra PN Seth A Aron M Kumar R Ansari MS 《International urology and nephrology》2004,36(3):353-358
Introduction: Clinical results of radical cystectomy performed on elderly bladder cancer patients over 70 years old were assessed to determine whether age is one of the critical points for the application of this type of surgery. Materials: From January 1992 to December 2002, 41 radical cystectomy performed in septuagenarian population were compared with 197 performed in patients less than 70 years of age. Results: The early and late complication rate for septuagenarians was 29.7% and 12%, compared with 26.9% and 9.6% for patients younger than 70 years respectively. The overall mortality rate for septuagenarians was 4.9%, compared with 8.6% for patients younger than 70 years. There was no significant difference between the two groups with regard to pathologic stage or length of hospital stay. The 5-year overall survival rate for septuagenarians was 53% compared with 59% for patients younger than 70 years. Conclusions: When indicated after adequate preoperative assessment and optimization of the patient, radical cystectomy is a safe procedure in the septuagenarians and patient should not be denied surgery dependent on chronologic age. 相似文献
14.
Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an acute life-threatening
emergency. The following case describes one such patient with an emphasis on the CT findings in these cases.
Electronic Publication 相似文献
15.
Bangkim Chandra Khangembam Sellam Karunanithi Punit Sharma Sudhir Suman Kc Rajeev Kumar Pramod Kumar Julka Rakesh Kumar Chandrasekhar Bal 《Neuroradiology》2014,56(10):893-902
Introduction
We assessed the validity of “perfusion-metabolism coupling” hypothesis in recurrent glioma with 13N-ammonia (13N-NH3) PET/CT and 18F-fluorodeoxyglucose (18F-FDG) PET/CT.Methods
Fifty-six consecutive patients (age, 38.8?±?12.1 years; 62.5 % males) with histologically proven and previously treated glioma presenting with clinical suspicion of recurrence were prospectively enrolled and evaluated with 13N-NH3 PET/CT and 18F-FDG PET/CT. PET/CT images were evaluated both qualitatively and semiquantitatively. Tumor to white matter uptake ratio (T/W) and tumor to gray matter uptake ratio (T/G) were calculated and analyzed for both the modalities. A combination of clinico-radiological follow-up, repeated imaging, and biopsy (when available) were considered as the reference standard.Results
Based on the reference standard, 27/56 patients had recurrence. 13N-NH3 PET/CT and 18F-FDG PET/CT were concordant in 55/56 patients. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 13N-NH3PET/CT were 77.8, 86.2, 84.0, 80.7, and 82.1 %, respectively, and for 18F-FDG PET/CT were 77.8, 89.7, 87.5, 81.2, and 83.9 %, respectively. There was excellent agreement between results of 13N-NH3 PET/CT and 18F-FDG PET/CT (??=?0.964; P?0.001). The performances of 13N-NH3 PET/CT and 18F-FDG PET/CT were not significantly different between high-grade and low-grade glioma (P?=?1.000). A strong positive correlation was noted between the uptake ratios derived on the two modalities (ρ?=?0.866, P?0.001 for T/W; ρ?=?0.918, P?0.001 for T/G).Conclusion
A combination of 13N-NH3 PET/CT and 18F-FDG PET/CT demonstrates that perfusion and metabolism are coupled in recurrent gliomas. These tracers target two different but interrelated aspects of the same pathologic process and can be used as surrogates for each other. 相似文献16.
The Role of TGF‐β in the Association Between Primary Graft Dysfunction and Bronchiolitis Obliterans Syndrome 下载免费PDF全文
A. DerHovanessian S. S. Weigt V. Palchevskiy M. Y. Shino D. M. Sayah A. L. Gregson P. W. Noble S. M. Palmer M. C. Fishbein B. M. Kubak A. Ardehali D. J. Ross R. Saggar J. P. Lynch III R. M. Elashoff J. A. Belperio 《American journal of transplantation》2016,16(2):640-649
Primary graft dysfunction (PGD) is a possible risk factor for bronchiolitis obliterans syndrome (BOS) following lung transplantation; however, the mechanism for any such association is poorly understood. Based on the association of TGF‐β with acute and chronic inflammatory disorders, we hypothesized that it might play a role in the continuum between PGD and BOS. Thus, the association between PGD and BOS was assessed in a single‐center cohort of lung transplant recipients. Bronchoalveolar lavage fluid concentrations of TGF‐β and procollagen collected within 24 h of transplantation were compared across the spectrum of PGD, and incorporated into Cox models of BOS. Immunohistochemistry localized expression of TGF‐β and its receptor in early lung biopsies posttransplant. We found an association between PGD and BOS in both bilateral and single lung recipients with a hazard ratio of 3.07 (95% CI 1.76–5.38) for the most severe form of PGD. TGF‐β and procollagen concentrations were elevated during PGD (p < 0.01), and associated with increased rates of BOS. Expression of TGF‐β and its receptor localized to allograft infiltrating mononuclear and stromal cells, and the airway epithelium. These findings validate the association between PGD and the subsequent development of BOS, and suggest that this association may be mediated by receptor/TGF‐β biology. 相似文献
17.
Randeep Kashyap Parvez Mantry Rajeev Sharma Manoj K. Maloo Saman Safadjou Yanjie Qi Ashok Jain Benedict Maliakkal Charlotte Ryan Mark Orloff 《Journal of gastrointestinal surgery》2009,13(8):1480-1486
Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to end-stage liver disease
(ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live
donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease
recurrence for LDLT and DDLT for ESLD secondary to PSC.
Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC.
Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007,
was done. Patients were divided into two groups based on donor status. Group 1 (n = 14) patients received grafts from living donors, while group 2 (n = 44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed.
Recurrence was confirmed based on radiological and histological criteria.
Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one
patient in LDLT group and nine patients in DDLT group. One patient (7%) among LDLT and six patients (14%) among DDLT died.
The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p = 0.60; graft survival, p = 0.24).
Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be
higher in patients undergoing LDLT. 相似文献
18.
Gupta NP Kumar R Tandon S 《Journal of laparoendoscopic & advanced surgical techniques. Part A》2005,15(4):405-407
Laparoscopic adrenalectomy for pheochromocytoma and laparoscopic dismembered pyeloplasty are both technically difficult procedures. We describe the case of a 61-year-old female patient who presented with a right adrenal pheochromocytoma and bilateral pelvi-ureteric junction obstruction with renal failure who underwent a successful simultaneous transperitoneal laparoscopic adrenalectomy and pyeloplasty. 相似文献
19.
Rajeev B. Ahuja Sameek Bhattacharya Ashish Rai 《Burns : journal of the International Society for Burn Injuries》2009
The incidence of severe burn is extremely high in the Low and Middle Income Countries with an estimated 90% of the world incidence of which 50% is in South East Asia. Through an earlier analysis of 11,196 burn admission over 8 years (1993–2000—Phase I) to our burn unit we established the endemic nature of the injury [Ahuja RB, Bhattacharya S. An analysis of 11,196 burn admissions and evaluation of conservative management techniques. Burns 2002;28:555–61]. A continued analysis of 5566 burn admissions over the next 7 years (2001–2007—Phase II) and its comparison with the Phase I reveals a significant change in the epidemiological profile. The average yearly admissions have fallen by 43.14%, from 1399.5 patients in Phase I to 795.14 patients in Phase II. This fall in average yearly admissions is predominant in the age group 16–35 years (52.61% decline) and 36–55 years (46.51% decline). The overall female to male ratio has also changed from 1.26:1 to 0.91:1. However, the overall mean %TBSA burn has reduced only mildly from 49.12% TBSA in Phase I to 44.39% in Phase II. During Phase II there was also a significant decline of 46.93% and 56.25% in the yearly admission of flame and scald burn respectively. Non-intentional incidents still remain the main mode of injury accounting for 87.12% in Phase I and 89.89% in Phase II. But, the yearly admissions of non-intentional burns fell from 1219.25 in Phase I to 714.71 in Phase II, which is a significant drop of 41.38%. Kitchen continues to dominate as the main location for flame incidents, but the yearly admission rate from kitchen accidents dropped from 897.5 patients in Phase I to 368.43 patients in Phase II. At the same time, liquefied petroleum gas (LPG) leaks which accounted for only 0.72% of all kitchen accidents in Phase I rose to 10.74% in Phase II. Another redeeming feature is the reduction in overall mortality from 51.8% in Phase I to 40.20% in Phase II. Interestingly, a very significant negative correlation exists (being significant at 0.01 level—2 tailed) between burn admissions and the yearly per-capita income of Delhi, from 1993 to 2005, to prove that the incidence and profile of burns directly reflects the economic development of the society. We see this as the first long term study from a burn unit of a developing country to directly reflect this association of burn incidence and its changing profile with economic prosperity. 相似文献
20.
Genitourinary tuberculosis is an important cause of morbidity in developing and developed countries. We describe a case of extensive genitourinary tuberculosis in which there was complete destruction of the right kidney, stricture of the entire left ureter and an autocystectomized bladder. He presented in azotemia with urinary incontinence and was managed by right nephroureterectomy, ileal replacement of left ureter and ileal neobladder after a preliminary nephrostomy and antituberculous chemotherapy. 相似文献