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101.
Endocrine tumours of the pancreas, also known as islet cell tumours, are neuroendocrine tumours arising from the pancreatic islets. Pancreatic endocrine tumours are uncommon and no endocrine surgeon has vast experience with them. Patients with these rare tumours present either with a specific syndrome or with symptoms related to the malignant nature of the tumours. In addition, an increasing number of ‘pancreatic incidentalomas’ with no obvious function have been detected by abdominal computerized tomography. Diagnosis relies on a high index of clinical suspicion and is based on the demonstration of elevated serum levels of the secretory products concerned. Therapeutic strategy depends on the exact localization of the primary tumor and the presence or absence of metastasis, and is designed to control the tumoral process as well as ameliorate the syndrome associated with it. The present review highlights the clinical presentation, diagnosis, localization and therapeutic principles in the management of pancreatic endocrine tumours. 相似文献
102.
A case of mucinous cystic ovarian tumor with mural nodules of anaplastic carcinoma in a 30-year-old woman is described. The carcinomatous components within the nodules showed strong immunopositivity for cytokeratin and carcinoembryonic antigen, and ultrastructurally they displayed epithelial and glandular differentiation. Omental metastasis had already developed in the patient, and she received postoperative adjuvant chemotherapy consisting of cyclophosphamide and cis-platinum. No sign of recurrence was evident 4 months after the operation. The literature is reviewed and the importance of adjuvant chemotherapy in the postoperative management of such patients highlighted. The salient pathologic features differentiating mural nodules of anaplastic carcinoma and true sarcoma from prognostically favorable sarcoma-like nodules are presented. 相似文献
103.
104.
Mo LR Chang KK Wang CH Yau MP Yang TM 《Journal of Hepato-Biliary-Pancreatic Surgery》2002,9(2):191-195
Preoperative endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) prior to laparoscopic
cholecystectomy (LC) are the most common methods for the diagnosis and treatment of patients with cholecystocholedocholithiasis.
We evaluated the selection criteria for preoperative ERCP examination and the results of endoscopic-laparoscopic treatment
of patients with choledocholithiasis. Between January 1993 and December 1998, 1630 patients with symptomatic cholelithiasis
were admitted for surgical intervention. Preoperative ERCP was performed in 247 patients according to the selection criteria.
The criteria to perform ERCP were dilated common bile duct (CBD; more than 8 mm), abnormal serum liver test results, and a
recent history of pancreatitis. Endoscopic sphincterotomy (ES) was performed if CBD stones were found during the procedure.
LC was then carried out within 3 days after ES. Of the 247 patients selected for preoperative ERCP, CBD stones were confirmed
in 146 patients (59.1%). ES was successful in 141 patients, and stone clearance was achieved in 133 patients, resulting in
a 94.3% success rate. Eight patients (5.5%) had complications after endoscopic intervention, all of which resolved uneventfully.
Open operative procedures were carried out in a total of 31 patients. Overall, 115 patients were successfully treated by this
endoscopic laparoscopic sequence. The length of hospital stay in these groups was significantly lower than that for patients
in whom an open method was employed. Preoperative ES combined with LC is a safe and effective therapy for cholecystocholedocholithiasis,
and the criteria that we used for the selection of patients seem to be appropriate.
Received: July 4, 2000 / Accepted: October 12, 2000 相似文献
105.
Reyes L Tinworth KD Li KM Yau DF Waters KA 《Pharmacology, biochemistry, and behavior》2002,73(3):521-528
Piglets are popular for studies of respiratory and cardiovascular function, but opioid analgesics are contraindicated in these studies because of central nervous system depression. We evaluated two nonopioid analgesics for postoperative pain relief following implantation of a central arterial catheter via an inguinal incision. Animals were randomly assigned to paracetamol-treated (n=8, rectal suppositories, 100 mg/kg) meloxicam-treated (n=8, 1 mg/kg meloxicam via the catheter) or untreated control group (n=8, placebo suppositories and normal saline). Additional controls received paracetamol or meloxicam, without pain (n=6 for both groups). Behavioral and physiological assessments, and blood sampling were undertaken at nine timed intervals until 24 h after surgery. Multifactorial numerical rating scale (NRS), behavioral and physiological pain scores (PPS) decreased over time for all groups (P<.001). On NRS and behavioral criteria, meloxicam was significantly better than paracetamol (P<.001), and both were better than control (p<.001 for each). Physiological parameters discriminated between the control and analgesia-treated groups, but not between paracetamol and meloxicam. Preliminary pharmacokinetics, determined by isocratic high-performance liquid chromatography (HPLC), revealed no difference in the half-life of paracetamol (2.5+/-0.3 h) vs. meloxicam (3.4+/-0.4 h). Paracetamol and meloxicam provided effective postoperative analgesia in piglets, with meloxicam superior to paracetamol on behavioral criteria. 相似文献
106.
Bolan CD Carter CS Wesley RA Yau YY Barrett AJ Childs RW Read EJ Leitman SF 《British journal of haematology》2003,120(5):801-807
We report cell kinetics, yields and donation experiences of 20 demographically matched allogeneic peripheral blood stem cell (PBSC) donors who were prospectively assigned to undergo either a single 25 l or two consecutive daily 15 l (15 l x 2) apheresis procedures. Procedures were performed using prophylactic intravenous calcium administration after standard granulocyte colony-stimulating factor (GCSF) mobilization (10 microg/kg/d). Central line placements (two each), initial CD34 cell counts (0.077 vs 0.078 x 10(9)/l) and yields (7.9 vs 8.1 x 10(8) CD34 cells) were similar in the two groups; however, 25 l donors spent significantly less time both in the clinic (7.5 vs 10.8 h) and with central venous catheters in place (8.5 vs 29.5 h) than 15 l x 2 donors. End-procedure platelet counts were below 100 x 10(9)/l in one out of 10 25 l donors versus five out of 10 in 15 l x 2 donors (41%vs 53% mean decrease in platelet counts, P = 0.02). PBSC collection efficiency increased by 37% after 15 l of the 25-l volume had been processed, compared with no significant change during 15 l x 2 procedures. Results similar to these prospective findings were also observed in CD34 yields, symptoms and platelet counts in additional 25 l and 15 l procedures performed during the same period and evaluated retrospectively. This study indicates that a single 25-l apheresis procedure results in similar yields and symptoms, but less donor thrombocytopenia and inconvenience than two consecutive daily 15-l procedures. 相似文献
107.
108.
The use of dental amalgam as a restorative material has long been a contentious issue because of its elemental mercury component. While microleakage of mercury from amalgam has been conclusively confirmed over the past 30 years intensive research has failed to identify deleterious health outcomes. Mercury, as with other metals entering the body tissues, appears to be tolerated at low levels. Nevertheless, a contrary opinion is held by some professional and lay groups who advocate a zero tolerance for inhaled or ingested elemental mercury. They identify dental amalgam as an aetiological factor for neurological conditions such as chronic fatigue syndrome, multiple sclerosis and Alzheimer's disease resulting from chronic mercury poisoning. Epidemiological and clinical evidence of widespread chronic mercury toxicity associated with a body burden of amalgam has consistently failed to be established even in populations with a high prevalence of dental amalgam restorations. On current evidence, international consensus heavily supports the statement that amalgam does not constitute a health risk to patients. However, exposure to volatile free mercury in dental clinics should be controlled to eliminate occupational risk. This paper provides a general review of the current situation and issues. It offers a consensus viewpoint for practitioners and lay people in reaching an informed decision on dental amalgam restorations. 相似文献
109.
Sun H Tsunenari T Yau KW Nathans J 《Proceedings of the National Academy of Sciences of the United States of America》2002,99(6):4008-4013
Vitelliform macular dystrophy (VMD/Best disease; MIM*153700) is an early-onset autosomal dominant disorder in which accumulation of lipofuscin-like material within and beneath the retinal pigment epithelium is associated with a progressive loss of central vision. Bestrophin, the protein product of the VMD gene, has four predicted transmembrane domains. There are multiple bestrophin homologues in the human, Drosophila, and Caenorhabditis elegans genomes, but no function has previously been ascribed to these proteins, and they show no detectable homology to other proteins of known function. Using heterologous expression, we show here that human, Drosophila, and C. elegans bestrophins form oligomeric chloride channels, and that human bestrophin is sensitive to intracellular calcium. Each of 15 missense mutations asscociated with VMD greatly reduces or abolishes the membrane current. Four of these mutant bestrophins were coexpressed with the wild type and each dominantly inhibited the wild-type membrane current, consistent with the dominant nature of the disease. These experiments establish the existence of a new chloride channel family and VMD as a channelopathy. 相似文献
110.
Narendra Nath Datta Safi‐Ur Rehman Kwong‐Yau Chan Kin‐Wai Chan Christopher Yee‐Fat Poon John Ching‐Kwong Kwok 《Surgical Practice》2002,6(3):87-90
Two cases of interhemispheric subdural haematoma are presented. None of the patients had any neurological deficit on admission. They developed progressive neurological deficits within a day or two. Surgical treatment was by a large convexity craniectomy and a wide opening of the dura. The dura was left open in one case and primary duroplasty was done in the other. No deliberate attempt was made to remove the interhemispheric clot. Both patients made a quick and complete recovery by this simple procedure. Cranioplasty was carried out subsequently. Chinese Abstract
Volume 6 , Issue 3 August 2002
Pages 87-90 相似文献