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Dr Gerald A. Maccioli MD Daniel R. Kuni MS George Silvay MD PhD John M. Evans MB Jerry M. Calkins MD PhD Joel A. Kaplan MD 《Journal of clinical monitoring and computing》1988,4(4):247-255
A multiple-center study was performed to determine the relationship between lower esophageal contractility, clinical signs, and anesthetic concentration as expressed by minimum alveolar concentration (MAC). One hundred four American Society of Anesthesiologists Class I through III patients were exposed to isoflurane (with and without nitrous oxide) or halothane in concentrations of 0.5, 1.0, and 1.5 MAC. Heart rate and systolic blood pressure were continuously monitored. Both the amplitude and frequency of spontaneous and provoked lower esophageal contractions were measured in situ by using a 24-F probe equipped with provoking and measuring balloons. Combined results demonstrated statistically significant correlations (P<0.001) between lower esophageal contractility and MAC. Spontaneous lower esophageal contractions decreased from 1.10±0.12 (SEM) contractions per minute (0.5 MAC) to 0.42±0.05 (1 MAC) to 0.18±0.05 (1.5 MAC). Provoked lower esophageal contractility values decreased from 45±4 mm Hg (0.5 MAC) to 29±3 (1 MAC) to 19±2 (1.5 MAC). Heart rate changes did not correlate with MAC, and systolic blood pressure correlated in only one of three centers. Intracenter and intercenter analyses failed to demonstrate a significant relationship between lower esophageal contractility and heart rate or systolic blood pressure. No intracenter differences in either amplitude or frequency of lower esophageal contractions were observed, despite differences in volatile agents, induction techniques and agents, patient populations, and duration of anesthesia. Our studies indicate that lower esophageal contractility may be an indicator of anesthetic depth as reflected by MAC, but further studies are needed to quantify the effects of surgical stimulus, intravenous anesthetics, vasodilators, anticholinergics, calcium channel blockers, beta-adrenergic agonists, and the presence of a nasogastric tube. 相似文献
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T Kokubo Y Ohtomo J Iseki T Toyoda S Kondo F Hattori K Itoh K Kojima 《Radiation Medicine》1986,4(4):124-126
The case of a 38-year-old man with an exogastric leiomyoblastoma is reported. CT and ultrasound examinations revealed a large mass in the left hypochondrium that had both solid and cystic components. These findings mimicked those of cystadenoma of the pancreas. Because of intraperitoneal hemorrhage in the preoperative course, emergency laparotomy was performed. A large tumor was found to arise from the greater curvature of the stomach. The diagnosis was confirmed histologically. 相似文献
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Five cases of localized cystic dilatation of a side branch of the main pancreatic duct due to a new entity ("ductectatic" mucinous cystadenoma and cystadenocarcinoma) are reported. The dilated duct was widely covered by epithelium indistinguishable from that of mucinous cystadenoma (n = 4) or cystadenocarcinoma (n = 1) of the pancreas. All lesions were located in the uncinate process and were about 3 cm in size. On computed tomographic scans and sonograms, lesions were difficult to distinguish from simple cyst of the pancreas unless lobulated or irregular margins were demonstrated. Endoscopic retrograde pancreatography (ERP) or operative pancreatography clearly demonstrated characteristic findings: localized, prominent cystic dilatation of a side branch of the main pancreatic duct with grape-like clusters or pear-shaped pools of contrast material associated with filling defects of various sizes. When a cystic lesion is noted in the uncinate process of the pancreas, ERP is mandatory to confirm or rule out this potentially or overtly malignant disease. 相似文献
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Inoue Y Katayama N Yoshioka N Yoshikawa K Kashima M Shimizu T Tsukune Y Ohtomo K 《Annals of nuclear medicine》1999,13(6):453-456
The aim of this study was to evaluate breast parenchymal activity on scintimammography with bone-seeking agents and 99mTc-MIBI. Scintimammography was performed with bone-seeking agents in 61 patients and with 99mTc-MIBI in 33 patients. Activity in the breast parenchyma contralateral to the suspected lesion was visually assessed by two independent observers. Increased breast parenchymal activity was shown in 19 of 61 patients examined with bone-seeking agents, while it was demonstrated in only two of 33 patients examined with 99mTc-MIBI. Breast parenchymal activity of bone-seeking agents was higher in patients aged 50 years or younger than in those older than 50. Increased parenchymal activity of bone-seeking agents may disturb visualization of primary breast cancer especially in relatively young patients. Low parenchymal activity is suggested to be a favorable characteristic of 99mTc-MIBI as a scintimammographic agent. 相似文献
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