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Spleen sizing by ultrasound in polycythaemia and thrombocythaemia: comparison with SPECT 总被引:3,自引:1,他引:2
M. Messinezy L. M. MacDonald T. O. Nunan N. B. Westwood S. Chinn & T. C. Pearson 《British journal of haematology》1997,98(1):103-107
Detection of non-palpable early splenic enlargement may aid diagnosis of primary polycythaemia (PP) and primary thrombocythaemia (PT). In this study linear spleen sizing by ultrasound has been compared with spleen volume estimation by single photon emission computerized tomography (SPECT) in 26 patients. Spleen length by ultrasound correlated well with SPECT volume estimation.
Ultrasound spleen length was also measured in 60 normal control subjects where the upper limit of the 95% reference range was 11.6 cm. Changes in spleen length with both age and body weight were substantial and overshadowed the imperfect reproducibility of this method. Therefore, interpretation of an individual's measured spleen length should be in relation to that predicted for adults of the same age and weight, particularly at the extremes of the younger, heavier patients and also the older, lighter patients.
Ultrasound spleen lengths of different patient groups (21 PP, 26 PT, 17 idiopathic erythrocytosis, 12 secondary polycythaemia, nine apparent polycythaemia) were compared both using the measured overall reference range and the differences from the values predicted for their age and weight. The comparison showed that almost all patients with PP whose spleens were not palpable had spleen lengths greater than the upper limit for the normal control group, but separation from the other patient groups was incomplete.
Detection of non-palpable splenomegaly by ultrasound length should remain a 'minor' criterion amongst the 'proposed modified diagnostic criteria' of PP. 相似文献
Ultrasound spleen length was also measured in 60 normal control subjects where the upper limit of the 95% reference range was 11.6 cm. Changes in spleen length with both age and body weight were substantial and overshadowed the imperfect reproducibility of this method. Therefore, interpretation of an individual's measured spleen length should be in relation to that predicted for adults of the same age and weight, particularly at the extremes of the younger, heavier patients and also the older, lighter patients.
Ultrasound spleen lengths of different patient groups (21 PP, 26 PT, 17 idiopathic erythrocytosis, 12 secondary polycythaemia, nine apparent polycythaemia) were compared both using the measured overall reference range and the differences from the values predicted for their age and weight. The comparison showed that almost all patients with PP whose spleens were not palpable had spleen lengths greater than the upper limit for the normal control group, but separation from the other patient groups was incomplete.
Detection of non-palpable splenomegaly by ultrasound length should remain a 'minor' criterion amongst the 'proposed modified diagnostic criteria' of PP. 相似文献
4.
Frederic T. Pender 《Journal of human nutrition and dietetics》1989,2(6):423-427
The study described tested the hypothesis that increasing amounts of dietary fibre (DF) in the diet of patients on haemodialysis (HD) may achieve positive clinical benefit without adversely affecting serum potassium and plasma phosphate. The current diet of 20 home HD patients was supplemented with 15g unprocessed wheat bran incorporated into three 'bran muffins' eaten daily for a trial period of 28 days. During this period patients reported an improvement in bowel habit. Serum potassium decreased slightly but not significantly ( P =0.242) but there was a significant rise in plasma phosphate ( P =0.004). These findings suggest that when increasing DF in devising HD dietary regimes, plasma phosphate is possibly the more sensitive biochemical variable following introduction of wheat bran. 相似文献
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目的通过是否进行腭咽肌肉重建的两组腭裂修复术后患者鼻咽内窥镜的比较观察,了解腭咽部肌肉重建术后腭咽闭合状况的改变。方法将41例腭裂术后患者,按照在腭裂修复时是否进行腭咽肌肉重建分为重建组(22例)和非重建组(19例),以鼻咽纤维内窥镜记录静态和发音时腭咽闭合运动状况,对两组患者腭咽闭合运动类型和状况进行比较。结果重建组静态腭咽腔形态较非重建组明显缩小,各壁光滑丰满,未见软腭鼻腔面V型缺损畸形;动态时以环状闭合为主。非重建组静态腭咽腔形态较大,可见软腭鼻腔面V型缺损畸形;动态时以冠状闭合为主。经比较重建组腭咽闭合良好率(90.91%)明显优于非重建组(37.31%)。结论鼻咽内窥镜观察证实腭咽肌肉重建腭裂修复术后腭咽闭合功能恢复明显优于非重建组。腭裂修复术时重建腭咽肌肉有助于缩小腭咽腔和更易于达到良好的腭咽闭合状态。 相似文献
7.
Lee L. Q. Pu 《European journal of plastic surgery》2007,30(1):19-24
A soleus flap as a local reconstructive option for soft-tissue coverage of a tibial wound in the distal third of the leg has
never been well recognized. In a 2-year period, seven patients underwent reconstruction of a less extensive tibial wound (4 × 3
to 10 × 4 cm) in the distal third of the leg after orthopedic trauma with the laterally extended medial hemisoleus flap. The
flap was elevated with emphasis on the preservation of the most distal perforators from the posterior tibial vessels to the
flap as possible while allowing adequate rotation of the flap to cover the exposed tibia and/or hardware and on the possible
preservation of foot planter flexion by reconstruction of the proximal Achilles’ tendon. In this series, there was no total
or partial flap loss. All patients healed their tibial wounds primarily with reliable soft-tissue coverage, evidenced fracture
healing, and good cosmetic outcome during follow-up. Thus, the laterally extended medial hemisoleus flap described by the
author can be a reliable option for soft-tissue coverage of a less extensive tibial wound in the distal third of the leg.
It offers a more cost-effective approach for managing this unique problem and can be performed by most reconstructive surgeons
without microsurgical expertise. 相似文献
8.
Several single agonist/antagonist primary muscle spindle afferents were simultaneously recorded in chloralose anaesthetized cats. It was shown that their dynamic and static sensitivity to sinusoidal muscle stretches could be increased or decreased via the fusimotor system by extension and flexion of the contralateral hind limb as well as by stretch of ipsilateral muscles and stimulation of ipsilateral skin nerves. The results seem to support the hypothesis that the primary muscle spindle afferents convey complex multisensory messages to the central nervous system (CNS). 相似文献
9.
The calculation of the extent of the ring scotoma around positive lenses, as conventionally taught to students of clinical optics, indicates that the scotoma is of a significant size. Using knife-edge lenses this study shows that the calculations are invalid due to the finite size of the eye's entrance pupil and in many instances the scotoma is shown not to exist. The effect noticed in clinical practice is probably largely due to the frame and the edging techniques used which add to the refractive scotoma which is present with high powered lenses, large apertures and/or small pupil sizes. 相似文献
10.
A 37-year-old Italian male developed a myocardial infarct with subsequent ventricular fibrillation. He was defibrillated
seven times with up to 360 Joules. Thirteen days later the patient died of recurrent myocardial infarct due to thrombotic
occlusion of the left circumflex coronary artery. At autopsy, necrosis of the right pectoralis muscle was observed. Electroporation
is the pathogenetic mechanism of skeletal muscle damage due to multiple defibrillations with high energy levels.
Received: 8 January 1998 Accepted: 15 April 1998 相似文献