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71.
Francis J Podbielski Heron E Rodriguez Andrew M Brown Matthew J Blecha Mario R Salazar Mark M Connolly 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2004,8(3):213-216
Management of an indeterminate pulmonary nodule is a diagnostic challenge that commonly confronts primary care physicians and specialists. Patients often present with this radiographic finding in the course of an unrelated medical evaluation. We examined our institution's experience with percutaneous biopsy of lung nodules to determine the impact of this procedure on overall patient care. Although significant complications are uncommon, the expedience of percutaneous lung biopsy often supplants a surgical opinion prior to initiation of therapy without added diagnostic benefit or cost-savings. Hence, we caution practitioners to use this technique as an adjunct to diagnosis and not a substitute for multidisciplinary care. 相似文献
72.
星形细胞瘤瘤周水肿区立体定向活检组织的超微结构研究 总被引:1,自引:0,他引:1
目的探讨星形细胞瘤瘤周脑水肿的发生机制。方法对15例星形细胞瘤瘤周脑水肿的宽度进行分级:一级0~20mm、二级21~40mm、三级〉40mm。结合CT平扫及增强扫描的影像,应用立体定向技术,对15例星形细胞瘤瘤体、瘤周水肿区及正常脑组织的活检标本进行电镜观察比较。结果CT增强扫描可强化,瘤周脑水肿明显的病人,其瘤体及瘤周水肿区毛细血管超微结构均有不同程度的改变。毛细血管的分布和结构变化,影响着瘤周水肿区的形态,瘤体毛细血管的明显异常,出现于大范围瘤周水肿区的病例。CT增强扫描无强化,瘤周脑水肿不明显的病人,毛细血管超微结构与正常脑组织相似。结论伴有明显瘤周脑水肿的星形细胞瘤,其瘤体及瘤周水肿区毛细血管超微结构均有不同程度的改变,而瘤周水肿的产生,是瘤体及瘤周水肿区毛细血管超微结构改变共同作用的结果。 相似文献
73.
The value of different resistance parameters in distinguishing biopsy-proved dysfunction of renal allografts 总被引:3,自引:2,他引:1
Frauchiger B.; Bock A.; Eichlisberger R.; Landmann J.; Thiel G.; Mihatsch M. J.; Jager K. 《Nephrology, dialysis, transplantation》1995,10(4):527-532
The data concerning the value of duplex sonography in diagnosingparenchymatous renal allograft dysfunction are controversial.Most early studies did not take into consideration the manyfactors influencing resistance parameters. We therefore performeda prospective, biopsy-controlled study with exclusion of allknown sources of error regarding resistance parameters. Furthermorewe investigated the value of a new resistance parameter, thesystolic deceleration percentage. Forty-seven duplex sonographicstudies were performed on 43 patients (30 male, 13 female, medianage 47 years, range 770). Fourteen studies were doneon normally functioning grafts (control group) an average of33 days after transplantation. Thirty-three studies were performedon dysfunctional grafts immediately prior to biopsy. Graftswhich had been transplanted more than a year previously or withvascular findings or any other clinical or sonographic pathologyprobably explaining function deterioration were excluded. Inall patients, the resistive index (RI), pulsatility index (PI)and systolic deceleration percentage (DP) were calculated inthe main renal artery and in the interlobar artery. Of the 33grafts with dysfunction, nine had vascular rejection (VR), 11interstitial rejection (IR), 11 cyclosporin A toxicity (CAT)and two other histologies (OR). The mean RI in normal grafts(NO) was 0.71±0.06 in the main artery and 0.68±0.06in the interlobar artery, in VR 0.86±0.12 and 0.80±0.18,in IR 0.72±0.05 and 0.70±0.07, in CAT 0.67±0.06and 0.65±0.07 and in OR 0.64±0.07 and 0.60±0.01.For PI, the values were 1.45±0.23 and 1.41±0.28(NO), 3.5±2.13 and 2.92±2.16 (VR), 1.55±0.26and 1.46±0.33 (IR), 1.32±0.25 and 1.27±0.26(CAT) and 1.30±0.34 and 1.13±0.04 (OR). For DPwe calculated 28±5% and 29±6% (NO), 43±14%and 36±6% (VR), 29±9% and 27±9% (IR), 31±8%and 32±7% (CAT ) and 32±4% and 28±3% (OR).The sensitivity/specificity for VR with a cutoff mean+2 SD was0.44/1 for RI, 0.55/0.97 for PI and 0.33/0.89 for DP. It wasconcluded that:(1) despite the high selection of our patientgroup, diagnostic accuracy of duplex sonography for diagnosingparenchymatous function disorder in renal allograft remainsinsufficient; (2) in vascular rejection only, the resistanceparameters differ significantly from the values of normal allografts;(3) the higher the cutoff of resistance parameters, the betterthe specificity and the worse the sensitivity for diagnosingvascular rejection; (4) of all investigated resistance parameters,the RI is the most practical due to a simple measurement technique. 相似文献
74.
T-cell infiltration was detected by immunohistochemistry in only 2 of 10 sural nerve biopsies from patients with Guillain-Barré syndrome (GBS). The number of endoneurial macrophages, identified by the monoclonal antibody MAC 387, was increased, compared with the number in 10 cases of axonal neuropathy. Macrophage-associated demyelination was identified in 7 and axonal degeneration in 8 cases. Cytomegalovirus (CMV) genome was not detected with the polymerase chain reaction. 相似文献
75.
76.
J. B. DILAWARI N. NAGPAL Y. K. CHAWLA U. KAUR J. VERMA H. BALI K. M. DAS S. SURI 《Journal of gastroenterology and hepatology》1993,8(2):202-205
Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature. 相似文献
77.
Kentaro Yamashita Hiroyuki Tsukuda Yasuyo Mizukami Jun Ito Shigeo Ikuta Yoshihiro Kondo Hiroshi Kinoshita Yasunori Fujisawa Kohzoh Imai 《Journal of gastroenterology》1997,32(5):684-688
A case of hepatic infarction with portal thrombosis is reported. A 63-year-old woman with liver cirrhosis and esophageal varices
was admitted for treatment of the esophagel varices. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy
(EIS) were performed. Two months later, she experienced right hypochondralgia and right flank pain. Serum transaminase levels
were suddenly elevated, and computed tomography scans of the liver showed multiple small nodular lesions. Her condition worsened,
and she died of hepatic failure. Autopsy revealed splenic and portal vein thrombosis, multiple hepatic infarction, and evidence
of chronic pancreatitis. We believe that liver cirrhosis and chronic pancreatitis were the main risk factors for the portal
thrombosis, and the treatment for esophageal varices appeared to have triggered the thrombosis. The hepatic infarction was
caused by the portal thrombosis. 相似文献
78.
Takakura Yoshinobu Fujita Takuya Hashida Mitsuru Sezaki Hitoshi 《Pharmaceutical research》1990,7(4):339-346
As part of the strategy for the design of macromolecular carriers for drug targeting, the disposition characteristics of macromolecules were studied in mice bearing tumors that served as target tissues. Eight kinds of macromolecules including four polysaccharides and four proteins with different molecular weights and electric charges were used; tissue distribution and tumor localization after intravenous injection were studied. Pharmacokinetic analysis revealed that the tissue radioactivity uptake rate index calculated in terms of clearance was different among the tested compounds; especially, the urinary radioactivity excretion clearances and the total hepatic radioactivity uptake clearances varied widely. Compounds with low molecular weights (approximately 10 kD) or positive charges showed lower tumor radioactivity accumulation; radioactivity was rapidly eliminated from the plasma via rapid urinary excretion or extensive hepatic uptake, respectively. On the other hand, large and negatively charged compounds, carboxymethyl dextran, bovine serum albumin, and mouse immunoglobulin G, showed higher radioactivity accumulation in the tumor (calculated total amounts were 15.6, 10.8, and 20.8% of the dose, respectively) and prolonged retention in the circulation. These results demonstrated that the total systemic exposure rather than the uptake rate index was correlated with total tumor uptake. Molecular weight and electric charge of the macromolecules significantly affected their disposition characteristics and, consequently, determined radioactivity accumulation in the tumor. It was concluded that a drug–carrier complex designed for systemic tumor targeting should be polyanionic in nature and larger than 70,000 in molecular weight. 相似文献
79.
M. R. Angi F. Forattini M. Chilosi A. Cipriani G. De Caro G. Semenzato 《International ophthalmology》1990,14(1):1-11
Summary Sarcoidosis is a multisystem disease characterized by enhanced immune responses at sites of involvement. To elucidate the immunopathogenesis of ophthalmic lesions, cell infiltrates in biopsies from conjunctiva and other tissues involved (lungs, lymph nodes, skin) were studied in 26 patients with active sarcoidosis in order to define the surface phenotype and the distribution of cells in granulomatous lesions. Biopsy specimens were also stained for detection of immunoglobulins, complement and fibrinogen deposits. The data demonstrate a lymphocytes/macrophages interaction in the central core of granulomatous areas as the crucial event that initiates the maintains the state of inflammation: at all sites of disease activity is present a compartmentalization of T-cells expressing a helper-related phenotype which account for the great majority of infiltrating cells both in the early lesions (aggregate of macrophages surrounded by lymphocytic infiltrate) and in well-organized sarcoid granulomata. The presence of plasma cells and immunoglobulin deposits may represent an epiphenomenon in line with the helper infiltration, suggesting a local hyper-reactivity of the B-cells immune system. This study suggests some immunopathogenetic mechanisms leading to the formation and growth of conjunctival sarcoid granulomata. 相似文献
80.
对10例经手术证实的肝包虫囊肿(又称细粒棘球蚴病)的磁共振成像(MRI)进行分析,认为其特征性表现为:囊壁呈光滑厚薄均一的低信号的包膜,在T2加权像上显示更加清楚;母囊内有数个大小不等的子囊,整个病灶呈多房性似玫瑰花状。本文对肝包虫囊肿与肝内其它囊性占位病变的鉴别诊断进行了探讨。 相似文献