diseases of the pituitary

... increase in the development of en-dometrial carcinoma Thus, although the overall benefits may outweigh the risks, tients taking tamoxifen should be aware of the risk and the symp-toms of endometrial ... to totally suppress the endometrium The endometrium must prefer-be thoroughly sampled at 6 month intervals to ascertain the suc-cess of therapy Regardless of the severity of adenomatous plasia, ... in any of the followingways: within the endometrium as a surface growth (e.g., into thecervical canal), into the myometrium to the peritoneum and para-metrium, via the uterine tube to the ovaries,

Ngày tải lên: 05/08/2014, 16:20

... system The confluence takes place at the right of the hilus of the liver, anterior to the portal venous bifurcation and overlying the origin of the right branch of the portal vein (Fig 1.5) The biliary ... aspect of the portal vein, the posterior aspect of the pancreas, between the aorta and the inferior vena cava, and the left aspect of the aorta under the left renal extrin-fi bers from the left ... distributed to the gallbladder through the hepatic plexus The duct of Luschka The duct of Luschka is a small bile duct, running in the bed of the gallbladder, outside the wall It is present in 50% of individuals

Ngày tải lên: 09/08/2014, 14:22

... cells, further resembling autoimmune hepatitis A high index of suspicion on the part of the gastroenterologist and the pathologist is often necessary to make the diagnosis of PSC in the pediatric ... Fibropolycystic diseases Cystic diseases of the liver may be broadly divided into the categories of infectious cystic lesions, which are of course not cysts as they lack an epithelial lining, and true epithelial ... cholesta-The size of ductal remnants in the porta hepatis at the time of hepatoportoenterostomy is considered by some tors to be an indicator of the likelihood of restoration investiga-of bile

Ngày tải lên: 09/08/2014, 14:22

... has the advantage of high spatial resolution, which allows depiction of both the lumen and the wall of the bile ducts, but has the disadvantage of imaging only in the axial plane This is offset ... profound segmental atrophy, particularly in the anterior segment of the right hepatic lobe and the medial segment of the left hepatic lobe Furthermore, there are often enlarged lymph nodes in the ... in the diagnosis of sis, especially when the diameter of the stones is less than the thickness of the CT “slices.” Although the specificity of CT for detecting choledocholithiasis is over 95%, the

Ngày tải lên: 09/08/2014, 14:22

... by the PTC needle The suspected presence of blood clots requires repeating the cholangiogram in several days The lytic prop-erties of bile and the passing of clots through the drainage catheter ... [48] The shortest route from the skin to gallbladder usually requires passage of the catheter through 1 cm of liver tissue Passing the needle through the window of liver tissue also stabilizes the ... for the patient The risk of vascular injury during percutaneous biliary terventions is greatest in the central portion of the liver, where the vascular structures are the greatest in caliber Therefore,

Ngày tải lên: 09/08/2014, 14:22

... of more than four segments of the liver Figure 8.8 The liver is pulled up and the ligamentum teres downwards The duct of S III can be approached by dissecting the left part of the base of the ... permission from the Journal of the American College of Surgeons.) junction of the aberrant duct with the hepatic duct may be identical to that of the junction of the cystic duct with the hepatic ... ob-Figure 9.2 The triangle of Calot Dissection of the tissue until the base of the liver bed is exposed When the triangle of Calot is dissected free, the two structures entering the gallbladder

Ngày tải lên: 09/08/2014, 14:22

... the first 36 to 72 hours from the onset of symptoms With the introduction of laparoscopic cholecystectomy at the beginning of the 1990s the question of timing arose again At the beginning of the ... those of the brown pigment type, are therefore thought to form anywhere in the biliary tree, very often in the intrahepatic portion of the bili-ary tree; they probably constitute the majority of ... attacks of mild acute cholecystitis, caused by transient obstruction of the cystic duct by stones, lead to the development of a chronic in-flammation of the wall of the gallbladder Besides the repara-tive

Ngày tải lên: 09/08/2014, 14:22

... al The role of radiation therapy in cancer of the extra-hepatic biliary system: an analy-sis of thirteen patients and a review of the literature of the effec-tiveness of surgery, chemotherapy ... disease • Name the classification of cystic diseases of the biliary tract • Understand the premalignant nature of cystic diseases of the biliary tract • Understand the role of liver resection for biliary ... lesions of the intra- and extrahepatic bile ducts How-ever, because of the assumed role of the intrahepatic biliary epithelium in the origin of the noncommunicating liver cysts, this group of cystic

Ngày tải lên: 09/08/2014, 14:22

... required. The major criticism of the theories of colonic toxins caus- ing PSC comes from studies looking at the natural history of the disorder. It has been demonstrated that the severity of the ... 6.3/100,000) than women. The same study confirmed the findings that 73% of cases have IBD, most of them ulcerative colitis [12]. One of the reasons why the prevalence of this disease ap- pears ... understanding of the pathophysiology of primary sclerosing cholangitis (PSC), the progression of disease and eventual outcomes become logical • To present the various options of therapy — their advantages,

Ngày tải lên: 09/08/2014, 14:22

... different diseases in the future Mechanisms for hepatic bile formation The cellular organization of the liver combined with the unique endothelial structure of the sinusoids are ideally suit-ed for the ... effl ux of molecules by the hepatocytes as well as their biliary excretion into the canaliculus, the most proximal portion of the biliary system 355 [1–4] The hepatocytes, like other epithelial ... regulation of its own synthesis, by indirectly reducing the expression of CYP 7A1, the rate-limiting enzyme for the synthesis of primary bile acids in the neutral pathway [42,47] FXR induces the expression

Ngày tải lên: 09/08/2014, 14:22

... pentoxyfilline The use of steroids in children has been limited because of the known deleterious effects on growth and the lack of proven effi cacy in altering the course of the disease Trials ... structures that eventually bud off and migrate to the center of the portal tract to become the interlobular bile ducts The ductal plate cells around the periphery of the portal tract normally involute, ... some degree of failure of the normal formation of the inter- lobular bile ducts, and results in a characteristic portal tract lesion consisting of persistence of some remnant of the ductal plate

Ngày tải lên: 09/08/2014, 14:22

... of the ampulla of Vater, 644 Cystic tumours of the pancreas, 644 Endocrine tumours of the pancreas, 644 Benign lesions of the gallbladder, 647 Carcinoma of the gallbladder, 647 Other tumours, ... cyst, 591 Other cysts, 591 Congenital anomalies of the biliary tract, 592 Absence of the gallbladder, 592 Congenital adhesions to the gallbladder, 594 Floating gallbladder and torsion of the gallbladder, ... Anatomy of the biliary tract, 3 Development of the liver and bile ducts, 4 Anatomical abnormalities of the liver, 4 Sinusoidal membrane traffic, 16 Bile duct epithelial cells, 16 2 Assessment of Liver

Ngày tải lên: 10/08/2014, 15:20

... palms) The hands are warm and the palms bright red in colour,especially the hypothenar and thenar eminences andpulps of the fingers (fig 6.12) Islets of erythema may befound at the bases of the fingers ... rhosis They are more common in cirrhosis of the alco-holic and if the patient is in the active, reproductivephase of life In the male, the changes are towards femi-nization In the female, the changes ... (fig 4.6) The cells are of all types and varying maturity The distribution of cells may reflect the type of underlying sinusoidal endothelial cell [4] There are many reticulum cells and these may

Ngày tải lên: 10/08/2014, 15:20

... veins of the caval system Deviation of blood into these chan-nels leads to varicosities in the submucous layer of the lower end of the oesophagus and fundus of the stomach (b) At the anus, the ... and the splenic vein just posterior to the head of the pancreas at about the level of the second lumbar vertebra It extends slightly to the right of the mid-line for a distance of 5.5–8 cm to the ... attempting to bypass the block and return blood towards the liver These enter the portal vein in the porta hepatis beyond the block They include theveins at the hilum, venae comitantes of the portal veinand

Ngày tải lên: 10/08/2014, 15:20

... on chromosome 2. The structure of the gene is complex (fig. 12.4) [5, 11, 36]. Exons 2–5 at the 3¢ end are constant components of all isoforms of UGT. To complete the gene, one of several first ... cholangioles or canals of Hering (fig 13.3) These are found largely in the portal zones of the liver The ductule passes into the interlobular... the biliary canaliculus is the most important ... This is done by the paradoxical pulse, the venous pulse, the calcified pericardium, the echocardiogram, the electrocardio- gram and by cardiac catheterization. Treatment is that of the cardiac condition.

Ngày tải lên: 10/08/2014, 15:20

... passage from the mother to the neonate The infection is usually not via the umbilical vein, but from the mother at the time of birth and during close contact afterwards The chance of transmission ... serum IgG anti-HDV is found There may be a window period between thedisappearance of one and the detection of the other Loss of IgM anti-HDV confirms the resolution of HDV tion, whereas persistence ... million are in the USA and 5 million in Western Europe HCV accounts for 20% of cases of acute hepatitis, 70% of cases of chronic hepatitis, 40% of cases of end-stage cirrhosis, 60% of cases of hepato-cellular

Ngày tải lên: 10/08/2014, 15:20

... related to the severity of theliver disease [72] The extent of the nutritional defectdepends on the type of alcoholic, whether of low socio-economic status where protein-calorie malnutritionoften ... decreasing with the reduction in the content of active ingredients The oestrogen is the important agent, although the progestin may augment the effect The drugs interact with the biliary apparatus ... years, should be warned of the possibility of adenoma development If adenoma is diagnosed, the woman must be warned of the possibility of rupture and the significance of any unexplained right

Ngày tải lên: 10/08/2014, 15:20

... abscess of liver Note the elevated right diaphragm with overlying reaction in the lung field. Trang 7An abscess in the left lobe of the liver may show a crescentic deformity of the lesser curve of the ... fever, often with a rash (erythema of Milan), occur about 9 days after starting therapy This is part of the Herxheimer reaction The mechanism of the jaundice is unclear References 1 Case Records of ... Chemotherapy aims to relieve symptoms and prevent further deposition of the eggs which will produce further fibrosis If egg excretion is stopped, the life cycle of the parasite is blocked Chemotherapy

Ngày tải lên: 10/08/2014, 15:20

... of the ventral wall of the primitive foregut just cranial to the yolk sac Two solid buds of cells form the right and left lobes of the liver while the original elon-gated diverticulum forms the ... if the bilirubin is greater than twice the upper limit of normal be-cause of failure of efficient secretion of contrast by the liver Oral cholecystography is of value in showing lesions of the ... develop as an outgrowth from the hepatic diverticu-lum of the foregut This type is often found with other anomalies of the biliary passages Type II is the failure of the gallbladder to vacuolize

Ngày tải lên: 10/08/2014, 15:20

... adjacent to the tumour [36]. Spread of the tumour Direct extension in the wall of the bile duct and infiltra-tion through the head of the pancreas is common with the acinar although not with the ampullary ... depends on the clinical state of the patient and the staging of the tumour derived from radiological imaging Difficulties in removal arise because of the inaccessibility of the pancreas on the pos- ... is the same as those having the classical proce- dure The continuity of the biliary passages is restored by anastomosis of the common bile duct with the jejunum Pancreatico-jejunostomy drains the

Ngày tải lên: 10/08/2014, 15:20