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11.
《Journal of pediatric surgery》2023,58(6):1090-1094
BackgroundThe purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO).MethodsAfter IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography.ResultsAmong 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030).ConclusionsIn this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families.Level of EvidenceDiagnostic Study, Level III. 相似文献
12.
13.
Kimberly B. Glazer Kendrin R. Sonneville Nadia Micali Sonja A. Swanson Ross Crosby Nicholas J. Horton Kamryn T. Eddy Alison E. Field 《The Journal of adolescent health》2019,64(2):165-171
Purpose
To quantify eating disorder (ED) stability and diagnostic transition among a community-based sample of adolescents and young adult females in the United States.Methods
Using 11 prospective assessments from 9,031 U.S. females ages 9–15 years at baseline of the Growing Up Today Study, we classified cases of the following EDs involving bingeing and purging: bulimia nervosa (BN), binge ED, purging disorder (PD), and subthreshold variants defined by less frequent (monthly vs. weekly) bingeing and purging behaviors. We measured number of years symptomatic and probability of maintaining symptoms, crossing to another diagnosis, or resolving symptoms across consecutive surveys.Results
Study lifetime disorder prevalence was 2.1% for BN and roughly 6% each for binge ED and PD. Most cases reported symptoms during only one survey year. Twenty-six percent of cases crossed between diagnoses during follow-up. Among participants meeting full threshold diagnostic criteria, transition from BN was most prevalent, crossing most frequently from BN to PD (12.9% of BN cases). Within each disorder phenotype, 20%–40% of cases moved between subthreshold and full threshold criteria across consecutive surveys.Conclusions
Diagnostic crossover is not rare among adolescent and young adult females with an ED. Transition patterns from BN to PD add support for considering these classifications in the same diagnostic category of disorders that involve purging. The prevalence of crossover between monthly and weekly symptom frequency suggests that a continuum or staging approach may increase utility of ED classification for prognostic and therapeutic intervention. 相似文献14.
趾蹼血管分型的临床认识 总被引:2,自引:2,他引:0
目的分析120例足趾移植再造手指病例,对趾蹼间的血管形态和交通情况进行观察,并阐述其临床意义。方法临床观察120例156侧趾蹼,对第一跖骨背动脉和第一趾底动脉在趾蹼间的走向、口径以及两者的交通支情况进行记录并进行分型。结果按孙博的分型方法:Ⅰ型72侧,占46.2%;Ⅱ型57侧,占36.5%;Ⅱ型7侧,占4.5%;Ⅳ型3侧,占1.9%;Ⅴ型15侧,占9.6%;另有2侧(占1.3%)第一跖骨背血管口径〉1mm,虽发出趾背动脉供养蹲趾胫侧和第二趾腓侧,但在趾蹼内与趾底血管无吻合,故称之为孙博Ⅵ型。结论(1)从解剖形态看应增加孙博Ⅵ型较全面;(2)从临床实用角度出发,趾蹼间血管可以简单分为三型:Ⅰ型交通支口径在0.5mm以上。Ⅱ型交通支在0.5mm以下。Ⅲ型无交通;(3)手术中采用第一套或第二套供血系统,首先要看趾蹼间血管的交通支,即按本组的分型属Ⅰ型采用第一套供血系统,Ⅱ、Ⅲ型采用第二套供血系统。 相似文献
15.
Tadashi Teshirogi M.D. Hiroeki Hosoi M.D. Yukashi Ohki M.D. Toshio Kagoshima M.D. 《Pediatrics international》1987,29(3):335-339
Residual pancreatic B-cell function was investigated in children with diabetes mellitus in whom classification of the type of disease was difficult at the first visit. Intravenous glucagon tests were performed at the first visit and subsequently, the C-peptide responses compared. Based on our data on a limited number of patients, we propose C-peptide concentrations of 3.0 to 3.5 ng/ml at the peak or at 6 min after injection of glucagon, as the critical level which distinguishes non-insulin dependent from insulin-dependent diabetes mellitus. However, the degree of obesity, clinical stage and other factors also need to be considered in the classification of diabetes mellitus. 相似文献
16.
耿波 《中华医学图书情报杂志》2005,15(1):46-47
针对当前的医学文献检索课中忽略期刊论文分类标引教学的问题,总结了几点教学实践,分别从期刊论文分类标引准确的重要性、期刊论文分类标引的步骤及原则、医学期刊论文分类标引的注意事项几个方面进行阐述. 相似文献
17.
Pathophysiological aspects of brain edema 总被引:16,自引:0,他引:16
Igor Klatzo 《Acta neuropathologica》1987,72(3):236-239
Summary Two mayor types of brain edema, related to two different pathomechanisms, can be recognized: 1)cytotoxic type-where the main feature is the swelling of cellular elements of brain parenchyma and 2)vasogenic type-where an increased vascular permeability leading to accumulation of edema fluid inthe extracellular spaces plays the principal role. In this type of edema, there is a close interrelationship between extravasation of serum proteins and retention of water in the brain tissue. In theischemic brain edema both cytotoxic and vasogenic mechanisms are involved. A biphasic opening of the blood-brain barrier, associated with vasogenic edema, is observed following release of major cerebral artery occlusion. The first opening of the barrier is related to a reactive hyperemia which follows promptly recirculation. The second opening, recognizable after a delay, is associated with a severe ischemic brain tissue injury.Dedicated to Prof. F. Seitelberger on the occasion of his seventieth birthday 相似文献
18.
目的为规范各类颜面凹陷畸形的临床治疗提供参考性建议。方法根据凹陷部位支撑组织的异常或被覆组织的异常情况。临床上将凹陷畸形分为三型:Ⅰ型为骨性凹陷畸形,包括先天性发育不良。后天性局部骨组织缺损、错位或塌陷;Ⅱ型为软组织凹陷畸形。包括局部软组织萎缩、缺损或黏连;Ⅲ型为复合性凹陷畸形。骨与软组织同时存在萎缩、缺损或较严重的塌陷。并依照此分型分别采用游离皮瓣、肌皮瓣或带蒂肌皮瓣填充法。局部组织瓣填充法。带蒂组织瓣加医用材料混合填充法,游离脂肪颗粒填充法。HA人工骨填充法。硅胶假体填充法。有机玻璃填充法,奥美定填充法。复杂凹陷畸形的综合治疗整复方法。为216例患者修复颜面凹陷畸形。结果随访216例患者6个月至5年,未发现严重并发症,外观效果满意。结论此颜面凹陷畸形的临床分型简单、合理。便于临床对颜面凹陷畸形的整复。具有一定的实用价值。 相似文献
19.
A. P. Dei Tos Paola Dal Cin 《Virchows Archiv : an international journal of pathology》1997,431(2):83-94
Soft tissue tumours represent a heterogeneous group of mesenchymal lesions, and their classification is the subject of continuous
debate. Chromosome analysis, molecular cytogenetics and molecular assays may become increasingly useful in diagnosis, and
this review summarises advances in the cytogenetic characterisation and classification of soft tissue tumours. Among the group
of fibrous lesions, superficial fibromatosis exhibits trisomy 8. This genomic change is also observed in desmoid fibromatosis
in association with trisomy 20. Trisomy 11 is the most frequently observed chromosomal aberration in congenital fibrosarcoma.
Dermatofibrosarcoma protuberans and giant cell fibroblastoma share a translocation t(17;22), which supports the concept of
the existence of a common differentiation pathway. Adipose tissue tumours is the group in which integration of genetics and
pathology has been most fruitful. Ordinary lipomas cytogenetically show an abnormal karyotype in about half the cases. Genomic
changes of the 11q13 region are observed in hibernoma. Lipoblastoma exhibits a specific 8q rearrangement in 8q11-q13. Loss
of material from the region 16q13-qter and 13q deletions are observed in spindle cell/pleomorphic lipomas. The well-differentiated
liposarcoma/atypical lipoma group is characterised karyotypically by the presence of one extra ring and/or extra giant chromosome
marker. Myxoid and round cell liposarcoma share the same characteristic chromosome change: t(12;16)(q13;p11) in most cases.
In the group of smooth muscle lesions most data are derived from uterine leiomyomas, which can be subclassified cytogenetically
into seven different types. Half of all leiomyomas are chromosomally normal; the other half have one of six possible consistent
chromosome changes. Alveolar rhabdomyosarcoma is characterised cytogenetically by two variant translocations t(2;13)(q35;q14)
and t(1;13)(p36;q14). Among tenosynovial tumours, the localised type of giant cell tumour of tendon sheath exhibits two different
karyotypic changes. One involves 1p11 in a translocation with chromosome 2 or with another chromosome. A second type involves
16q24. Synovial sarcoma is characterised cytogenetically by a translocation occurring between chromosome 18 and presumably
two adjacent loci on the X chromosome. In neural tumours, abnormalities of chromosome 22 have been reported in benign schwannomas
and perineuriomas. Malignant peripheral nerve sheath tumours exist in two main forms: sporadic and associated with the NF-1
syndrome. Karyotypes are very complex, but chromosomes 17q and 22q are very often involved. Clear cell sarcoma is characterised
cytogenetically and molecularly by a translocation t(12;22)(q13;q12). The Ewing’s sarcoma/peripheral neuroectodermal tumour
category shows a central karyotypic anomaly represented by the translocation t(11;22). The two variants t(21;22) and t(7;22)
are found in some cases. Among cartilaginous lesion, the most frequently described anomaly is the t(9;22)(q22;q12) in extraskeletal
myxoid chondrosarcoma. Intra-abdominal desmoplastic small round cell tumour is characterised by a t(11;22)(p13;q12).
Received: 5 February 1997 / Accepted: 24 February 1997 相似文献
20.
Summary
Malignant lymphomas can be subdivided into Hodgkin's disease and low- or high-grade non-Hodgkin's lymphoma (NHL). The principal
therapeutic options are polychemotherapy and radiotherapy. Besides the histological classification, staging of the disease
with particular regard to risk factors is an essential prerequisite for the therapeutic decision. Diagnostic imaging modalities
such as computer tomography, magnetic resonance imaging, and ultrasonography have improved the accuracy of clinical staging
such that invasive pathological staging is only necessary in exceptional cases. A novel therapeutic approach is high-dose
chemotherapy with autologous haematopoietic stem-cell support. This treatment improves the survival of patients with relapsed
high-grade NHL. The place of high-dose therapy as the primary therapeutic option in malignant lymphoma is now being assessed
in prospective studies following encouraging results from single-centre studies, including those involving the treatment of
low-grade lymphoma. The effects of antibodies directed against lymphatic cells are currently being examined in experimental
treatments. An assessment of the viability and rate of proliferation of lymphoma tissue on completion of therapy using sensitive
radiological and nuclear medical methods is an important aim for the future.
Eingegangen am 5. November 1996 Angenommen am 12. November 1996 相似文献