A 17-year-old man presented with signs of peritonitis. Laparotomy revealed gangrene of the stomach without obvious cause. The patient underwent total gastrectomy with esophago-jejunal anastomosis with formation of jejunal pouch. Bacterial culture of the peritoneal fluid grew Strept. pyogenes and E. coli. The patient was discharged on day 21 after a stormy postoperative course. 相似文献
BACKGROUND: Amalgam tattoos result from deposition of metallic particles (eg, silver, mercury, copper, zinc, and tin) into the oral mucosa. Their clinical and histologic appearance is similar to that of decorative tattoos. OBJECTIVE: To describe the successful use of a Q-switched alexandrite laser for removal of an amalgam tattoo. MATERIALS AND METHODS: An amalgam tattoo on the buccal mucosa and gingiva was treated with a QS 755 nm alexandrite laser. Three treatments were delivered at 8-week time intervals (average fluence = 6.8 J/cm2). RESULTS: Significant lightening of the tattoo was achieved after each of the three treatments without adverse sequelae. CONCLUSION: Q-switched alexandrite laser irradiation can safely and effectively eradicate amalgam tattoos. 相似文献
Background: This study investigated whether a tensioning headband that applies up to 20 mmHg pressure over a forehead pulse oximetry sensor could improve arterial hemoglobin oxygen saturation reading accuracy in presence of venous pooling and pulsations at the forehead site.
Methods: Healthy volunteers were studied breathing room air in supine and various levels of negative incline (Trendelenburg position) using the forehead sensor with the headband adjusted to its maximum and minimum recommended pressure limits. Saturation readings obtained from the forehead sensor with the subjects supine and the headband in place were used as a baseline to compare the effects of negative incline on reading accuracy when using and not using the headband. Occurrences of false low-saturation readings detected by forehead sensors were compared with those from digit sensors.
Results: No difference was observed between saturation readings obtained from the forehead sensor in supine and negative incline positions when the headband was applied. Forehead sensor readings obtained while subjects were inclined and the headband was not used were significantly lower (P < 0.05) than the supine readings. There was no statistically significant difference between the digit and forehead sensor in reporting false low-saturation readings when the headband was applied, regardless of body incline. 相似文献
Between 1970 and 1990, 104 patients with squamous cell carcinoma (SCC) of the tonsil were treated. The median age was 58 years and 80% of patients were males. Distribution among clinical stages was: stage I, 19 patients; stage II, 12 patients; stage III, 23 patients; and stage IV, 48 patients. More than 70% of patients had initial radiotherapy as definitive treatment irrespective of stage, reflecting the treatment philosophy over much of this period. The overall survival rate was 26% at 5 years, with survival being significantly affected by T stage, clinical stage and age. Clinical node status did not significantly affect survival rates. Good local control of T1N0 cancers was achieved with radiotherapy alone, but patients with more advanced cancers did poorly. We have now moved away from a non-selective policy and use initial surgery combined with postoperative radiotherapy in most patients, reserving radiotherapy alone for mainly early tonsil cancers. 相似文献
Cytokine-producing cells in gut-associated lymphoid tissues of rhesus macaques with chronic enterocolitis were studied. The confocal microscopy technique that we developed enables simultaneous in situ visualization of multiple extra- and/or intracellular antigens at a resolution higher than that allowed by light or epifluorescence microscopy. The presence of interleukin-6 (IL-6)-, tumor necrosis factor alpha (TNF-alpha)-, and IL-1-alpha-producing cells was focally intense in the colon lamina propria of the affected animals. The IL-1-alpha-producing cells were T lymphocytes (CD3+), while the TNF-alpha-producing cells were both macrophages (CD68+/HAM56+/LN5+) and T lymphocytes (CD3+). The IL-6-producing cells within the colon consisted of T lymphocytes and macrophages. The amount of IL-6-producing cells seen in macaques with enterocolitis was significantly higher (P<0.001) than that seen in the healthy control animal, while TNF-alpha- and IL-1-alpha-producing cells were seen only in macaques with enterocolitis. Most of the T lymphocytes that produced cytokines were detected in the lamina propria, while the macrophages were most prominent in highly inflamed regions of the lamina propria. Taken together, our findings indicate that there might be immunological similarity between chronic enterocolitis of rhesus macaques and humans, suggesting the potential use of the nonhuman primate model for the validation of novel therapies. 相似文献
Atypical adenomatous hyperplasia (AAH) is considered to be a precursor lesion of the lung adenocarcinoma. Several genetic abnormalities have been reported in AAH associated with adenocarcinoma, but little is known about AAH associated with benign lung lesions. To address this we compared the molecular characteristics of AAH present in benign conditions to those coexisting with carcinoma. Seven cases of AAH from resected non-neoplastic lungs (AAH-B) and 12 cases from lungs resected for primary lung carcinoma (AAH-M) were analyzed for loss of heterozygosity (LOH) using 21 polymorphic microsatellite markers situated in proximity to known tumor suppressor genes on chromosomes 3p, 5q, 7p, 9p, 10q, and 17p. Direct DNA sequencing for K-ras mutation was also performed. There was a broad range of LOH in both groups. No LOH was identified in 3 cases (25%) of AAH-M, but all cases of AAH-B showed LOH (P=0.26). Six cases (50%) of AAH-M and 3 cases (43%) of AAH-B showed loss at 1 marker (P=0.99). LOH at 2 or more markers was identified in 3 (25%) cases of AAH-M and 4 (57%) cases of AAH-B (P=0.32). LOH was most frequently detected on chromosomes 3p and 10q in both groups. The difference in overall fractional allelic loss between the 2 groups did not reach statistical significance. K-ras mutations were not identified in either group. Our results showed a significant overlap in LOH patterns between AAH with or without coexistent lung malignancy. Therefore, AAH may represent a smoking induced low-grade neoplastic lesion that may be a precursor lesion of only a subset of invasive lung adenocarcinoma. 相似文献