Proportional analysis of the kidney arterial segments

Summary The proportional area of each renal arterial segment was analyzed in 49 polyester resin corrosion endocasts of the renal vasculature. We defined a segmental artery as a primary or secondary branch of the renal artery that could be isolated outside the hilum. We found kidneys with five arterial segments in 30 of 49 casts (61.2% of cases) and kidneys with four arterial segments in 19 of 49 casts (38.8%). To enable the evaluation of the proportional areas of the autonomous segments (by using the point-counting planimetry method), each arterial segmental branch was injected with different-colored resin. The superior segment (apical) was present in 36 of 49 casts (73.5% of cases) and had a median proportional area of 13.02%. The anterosuperior and anteroinferior segments were present in 30 of 40 casts (61.2% of cases) and had median proportional areas of 21.36% and 17.18%, respectively. The anterior segment was present in 19 of 49 casts (38.8% of cases; when the mid-kidney anterior surface received only one segmental artery) and had a median proportional area of 28.44%. The inferior segment was present in 100% of cases and had a median proportional area of 22.65%. The posterior segment was also present in 100% of cases and was the segment with the greatest median proportional area (33.76%).     

International differences in health care costs in Europe and the United States: Do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?

The aim of this study was to assess whether potential differences in costs for diagnostic procedures and treatment of pulmonary embolism (PE) among European and U. S. hospitals alter the optimal cost-effective diagnostic strategy for PE. A standardized questionnaire was used to obtain cost data for the diagnosis and treatment of PE in participating European and U. S. hospitals. Costs for diagnostic tests and treatment of PE were then calculated in a standardized manner for all participating hospitals, from the hospital perspective. Costs were used in an existing cost-effectiveness analysis (CEA) model to determine the most cost-effective diagnostic strategy in participating hospitals. There were considerable differences in costs for diagnostic and therapeutic procedures for PE among the participating centers. These differences, however, did not affect the most cost-effective strategy based on incremental cost-effectiveness. In all hospitals the most cost-effective strategy appeared to be ultrasound followed by helical CT. International differences in cost of diagnostic and therapeutic procedures certainly exist and should be considered before applying a published CEA. Nevertheless, despite these cost differences, the diagnostic strategy for PE of ultrasound followed by helical CT appears most cost-effective. Received: 3 December 1998; Accepted: 31 December 1998     

早期胃癌的常规钡餐检查方法及征象分析

目的：通过各种常规钡餐方法的比较及早期胃癌（ＥＧＣ）的征象分析,提高常规钡餐造影对早期胃癌的检出率,方法：对４４例手术及病理证实的早期胃癌进行回顾性研究,重点对溃疡进行研究,并与３２例胃镜或手术病例证实的良性溃疡对照,结果：ＥＣＧ病例中Ｘ线发现异常的总阳性率９５．５％,采用双对比像,粘膜像,充盈像,压迫像的阳性率分别为９０．９％,８１．８％,５４．５％,５６．８％,对病变及周围粘膜均能清晰显示并能     

肝癌的介入放射学治疗（附40例分析）

目的：观察肝动脉灌注＋栓塞治疗肝癌的疗效及生存率。方法：经确诊的原发性肝癌25例,转移性肝癌15例均采取动脉灌注治疗,后行碘化油乳剂或悬混剂＋明胶海绵栓塞。结果：1年的生存率48％,2年的生存率为38％,CR为55％,PR为38．2％,PD为6．8％,结论：肝癌的（TAI）＋栓塞（TAE）治疗为肝癌的有效治疗手段之一。     

髓质海绵肾X线诊断12例

目的：提高对髓质海绵肾Ｘ线表现的认识。方法：报告１２例髓质海绵肾的Ｘ线平片和ＩＶＰ所见,并作文献复习。结果：本病的Ｘ线平片和ＩＶＰ均有特征性改变。结论：Ｘ线平片和ＩＶＰ是诊断髓质海绵肾的首选方法。     

The septal arteries in the differential diagnosis of constrictive pericarditis

Angiographic study of the motion of the septal and left marginal arteries was performed in patients with restriction in ventricular diastolic filling in order to separate patients with constrictive pericarditis from those with restrictive cardiomyopathy. Twelve patients with constrictive pericarditis (group I) and 10 patients with restrictive cardiomyopathy (group II) were evaluated and compared with 21 patients with normal coronary angiograms (group III). The displacement of the septal arteries (23 +/- 2.04 mm) was abnormally exaggerated in group I and normal (9 +/- 0.81 mm) in groups II and III. The displacement of the left marginal arteries as seen by the "corrugating index" was similar in all groups. We conclude that study of the displacement of the septal arteries is a useful angiographic sign that helps to separate constrictive pericarditis from restrictive cardiomyopathy and normals.     

甲状腺动脉栓塞治疗难治性甲状腺机能亢进

目的 探讨经导管甲状腺动脉栓塞治疗难治性甲状腺机能亢进的方法及疗效。方法 使用高压消毒后明胶海绵、聚乙烯醇(PVA)微球栓塞甲状腺上动脉及下动脉。结果 13例病人甲状腺动脉栓塞成功，颈围缩小，11例T3、T4降至正常，2例轻废增高。结论 经导管甲状腺动脉栓塞治疗难治性甲状腺机能亢进可作为内外科治疗及^131I治疗替代疗法，只要正确掌握操作方法，是安全有效的。     

经PCS区域动脉灌注健择和5-氟尿嘧啶治疗中晚期胰腺癌的疗效观察

 目的　评价经PCS区域动脉灌注健择和 5 氟尿嘧啶治疗中晚期胰腺癌的疗效和安全性。方法　 36例中晚期胰腺癌患者分为 2组 ,16例行经PCS区域动脉灌注化疗 (B组 ) ,另 2 0例行外周静脉全身化疗 (A组 )。结果　B组临床受益反应有效率为 75 .0 % (12 / 16 ) ,A组为 4 5 .0 % (9/ 2 0 ) (P <0 .0 5 ) ,A组和B组 6个月、1年生存率和中位生存期分别为 35 .0 %、15 .0 %、6 .8个月和 6 8.7%、37.5 %、11.4个月 ,P<0 .0 5。结论　经PCS区域动脉灌注化疗较外周静脉化疗能提高中晚期胰腺癌的临床受益反应、改善生活质量 ,提高远期生存率。     

小肠双重造影对小肠肿瘤的诊断价值

 目的　探讨各种类型小肠肿瘤的小肠造影表现及双重造影的诊断价值。方法　回顾性分析 5 3例小肠肿瘤的双重造影表现。结果　病变 1.0× 1.2cm～ 17× 19cm ,<6cm的病变 2 6例。小肠平滑肌肿瘤主要表现为充盈缺损。小肠淋巴瘤病变范围广 ,主要表现为多发结节状充盈缺损 ,伴肠管狭窄及扩张。小肠腺癌主要表现为肠管不规则狭窄 ,肠壁僵硬破坏 ,显示“果核征”。小肠转移瘤主要表现为多发压迹 ,肠管粘连固定。结论　小肠双重造影是目前诊断小肠肿瘤最有价值的方法之一。     

肢体动脉阻塞性疾病的介入溶栓治疗

目的探讨栓子内溶栓治疗肢体动脉急、慢性阻塞性疾病的方法和效果。方法12例血管造影证实为肢体动脉阻塞者,将导管和溶栓导丝插入血栓内,以4000U/min尿激酶(UK)灌注直至血栓溶解。结果病程<3d者6例,血管全部再通,UK平均用量67万U;病程>2个月者6例,血管再通5例,UK平均用量106万U,1例无效者病程4.2年。术中术后无严重并发症。结论栓子内溶栓安全有效,是治疗肢体动脉急、慢性阻塞性疾病的优先选择的方法。