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81.
P. Dervanian L. Macé T.A. Folliguet A. di Virgilio J.M. Grinda J.F. Fuzellier B. De Geeter P. Morville J.Y. Neveux 《Pediatric cardiology》1998,19(4):369-373
The prognosis of Marfan syndrome in both adult and pediatric patients is primarily related to the cardiovascular complications.
In infantile Marfan syndrome, although involvement of the mitral valve is the most frequently encountered cardiovascular lesion,
the aortic root can be more worrisome because of its excessive dilatation, leading to aortic insufficiency or dissection.
If the role of elective surgery is relatively well defined for adult patients, it is still debated during childhood. We report
two patients, aged 22 months and 5 years, each presenting an aortic root aneurysm related to Marfan syndrome, and each treated
with the Bentall procedure without specific age-related mortality or morbidity. These two patients experienced normal growth
and were free of any complication for a follow-up period of 8 and 2 years, respectively. More than an absolute value of the
aortic root dimension, it is the conjunction of the rate of progression of the aortic root dilatation, the degree and the
duration of the aortic valve regurgitation, and its resulting left ventricular dysfunction that must be taken into consideration
in choosing the surgical option. 相似文献
82.
83.
The aim of this study was to investigate the usefulness of contrast-enhanced harmonic power Doppler ultrasound (US) for the
detection of residual viable hepatocellular carcinoma (HCC) after treatment with transcatheter arterial chemoembolization
(TACE). Forty-seven patients with 68 HCC lesions 1.8–9.5 cm in diameter (mean ± SD 4.3 ± 1.7 cm) underwent contrast-enhanced
power Doppler US, in the harmonic mode, before and after treatment with TACE. Unenhanced spiral CT and contrast-enhanced dynamic
MR imaging were also performed to help establish the outcome of therapy. Before treatment, intratumoral blood flow signals
were detected at contrast-enhanced harmonic power Doppler US in 65 (95 %) of 68 lesions. After TACE, flow signals were no
longer detectable in 22 of these 65 lesions, which showed complete response at spiral CT and dynamic MR imaging. In 38 (88
%) of the 43 lesions with partial response, intratumoral flow signals were still identified at contrast-enhanced harmonic
power Doppler US. Twenty-eight of these 38 lesions underwent additional treatment with percutaneous ethanol injection (PEI)
using contrast-enhanced harmonic power Doppler US guidance. Complete response was seen after PEI in 23 of 28 lesions. Contrast-enhanced
harmonic power Doppler US proved useful for assessing the therapeutic effect of TACE on HCC and for guiding additional treatment
with PEI in cases of partial response.
Received: 25 January 2000; Revised: 21 April 2000; Accepted: 25 April 2000 相似文献
84.
目的 探讨甲状腺乳头状微小癌的临床特征、诊断和治疗方法。方法 回顾性分析1986~2004年间收治并经病理证实的28例甲状腺乳头状微小癌患者的临床资料。结果 因甲状腺良性病变手术而发现微小癌18例,另有10例术前怀疑为癌,经活检发现微小癌。颈部淋巴转移6例。腺叶多发结节转移的发生率显著高于单发结节。结论 术前触诊、B超检查、术中探查及冰冻组织切片对提高甲状腺乳头状微小癌的诊断非常重要。根据病情选择不同的切除范围,疗效是同样的。 相似文献
85.
PURPOSE: Although the intracarotid amobarbital procedure (IAP) or Wada test is useful in lateralizing seizure focus in patients with temporal lobe epilepsy (TLE), the results of the IAP memory test are frequently nonlateralizing. An insufficient suppression of the medial temporal region contralateral to the seizure focus may contribute to the failure of lateralization. We tried to correlate IAP memory results with the functional changes in the contralateral medial temporal region as measured by single photon emission computed tomography (SPECT) during IAP. METHODS: We performed a (99m)technetium-(Tc) hexamethylene-propylene-amine-oxime (HMPAO) brain SPECT in 19 medial TLE patients during a contralateral IAP (sodium amobarbital injected contralateral to the seizure focus). Regional cerebral blood flow (rCBF) was measured in the contralateral medial temporal region. The amount of decrease in the rCBF was calculated by subtracting the previous measurement from the one obtained with the interictal SPECT. RESULTS: Ten (53%) patients passed and nine (47%) failed the contralateral IAP. The mean percentage decrease in rCBF was 5.3+/-5.3%. There was a significant negative correlation between a decrease in the rCBF and the IAP memory-retention score by Spearman correlation (p = -0.53: p<0.021). Patients with smaller decreases in rCBF (<5%) more frequently passed the contralateral IAP memory test than did those with larger decreases (80 vs. 22%; p<0.023). CONCLUSIONS: We suggest that an insufficient suppression of the contralateral medial temporal function is partly responsible for nonlateralizing IAP memory tests. An IAP-SPECT may be useful in interpreting IAP memory tests for the lateralization of seizure focus in TLE patients. 相似文献
86.
Objective
To compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied.Materials and Methods
Stents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared.Results
Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0.62).Conclusion
For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed. 相似文献87.
非虚假设非中心法及其临床应用 总被引:4,自引:0,他引:4
目的本文提出一种非虚假设非中心法,并说明其临床应用.方法以非虚假设取代虚假设将经典非中心法加以扩展,以Monte Carlo方法展示其行为.结果当最小临床承认差量取零时,它还原为经典方法.其观测功效与预定功效吻合.结论这种方法适用于以治疗-对照差临床意义研究或临床等效性为目的临床试验的设计. 相似文献
88.
89.
应用吻合器治疗重度痔疮10例体会 总被引:1,自引:0,他引:1
目的 :探讨吻合器痔疮环状切除的临床应用 ,总结其适应证、方法和疗效以及安全性和适用性。方法 :应用美国强生公司 33mm吻合器 (PPH)对 10例Ⅲ度、Ⅳ度环行脱垂性内痔进行手术治疗。结果 :手术时间平均 2 0min ,术后平均住院时间 4d。 97%的患者对手术效果满意。 3例术后 5d内有血便 ,经对症处理后好转。 5例出现肛门疼痛、大便不适伴水肿。 2例出现尿潴留 ,给予导尿处理 ,0 .5a随访无大便失禁、肛门狭窄的发生。结论 :PPH治疗痔疮具有比传统手术安全有效、手术简单、手术时间短、术后痛苦少、恢复快及并发症少的优点。但由于病例少 ,临床经验尚待进一步积累和总结 相似文献
90.
解脲脲原体感染者与其正常携带者在量值间的区分研究 总被引:12,自引:1,他引:12
目的 探讨解脲脲原体 (UU)感染者与其正常携带者数量的相关性。方法 以UU液体培养阳性为基础 ,选择 <2 4h ,2 4h~ ,4 8h~ ,72h~ ,96~ 1 2 0h培养阳性的标本进行培养鉴定药敏定量一步法和荧光聚合酶链反应 (PCR)定量测定。结果 液体培养≤ 4 8h阳性 2 6人 ,其中荧光PCR定量值≥ 1 0 6拷贝 2 2人 (84 .6 2 % ) ;>4 8h阳性 39人 ,荧光PCR定量值 <1 0 6拷贝 35人 (89.74 % )。培养鉴定药敏定量一步法≤ 4 8h培养阳性组与 >4 8h培养阳性组荧光PCR定量值比较 ,P <0 .0 5 ;>4 8~ 1 2 0h培养阳性组荧光PCR定量值比较 ,P >0 .0 5。结论 培养鉴定药敏定量一步法培养≤ 4 8h阳性或荧光PCR定量值≥ 1 0 6拷贝可作为界定感染者标准 ,培养 >4 8h阳性或荧光PCR测定值 <1 0 6拷贝可作为正常携带。培养鉴定药敏定量一步法可作为临床判断患者是否需要接受抗菌药物治疗的标准方法 相似文献