DISEASES OF THE UTERUS doc
... 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
Diseases of the Gallbladder and Bile Ducts - part 3 pdf
... 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
Diseases of the Gallbladder and Bile Ducts - part 4 pot
... 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 ... biliary tree can be drained directly into the stomach This is done by transhepatic perforation of the left lobe of the liver into the lesser curvature of the stomach using fluoroscopic, endoscopic, ... [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
Ngày tải lên: 09/08/2014, 14:22
Diseases of the Gallbladder and Bile Ducts - part 5 potx
... from the 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 ... [36,44–48] (see below) At the time of reconstruction there is often evidence of dissection on the left side of the common duct, even to the point of exposure of the portal vein [12] ... the sheath of the right portal pedicle, the cystic plate must be detached from the anterior surface of the sheath of the right portal pedicle The rationale of the dissection
Ngày tải lên: 09/08/2014, 14:22
Diseases of the Gallbladder and Bile Ducts - part 6 pptx
... 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 ... after the beginning of symptoms, while “delayed” operation ranged from 6 to 12 weeks after the onset of symptoms The pooled rate of overall mortality was 0.2% in the early and 1.6% in the delayed
Ngày tải lên: 09/08/2014, 14:22
Diseases of the Gallbladder and Bile Ducts - part 7 pdf
... 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
Diseases of the Gallbladder and Bile Ducts - part 8 pptx
... 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
Diseases of the Gallbladder and Bile Ducts - part 9 potx
... these widely 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 ... of the distal ducts and patency of the gallbladder. .. nearer to the portal plate excluding the gallbladder, and the fundus of the gallbladder is approximated to the ... dissection at the hilum of the liver In this way, the gallbladder and bile duct act as the conduit through which bile may flow into the duodenum Theoretically, the presence of a
Ngày tải lên: 09/08/2014, 14:22
Diseases of the Gallbladder and Bile Ducts - part 10 ppsx
... 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
Diseases of the Liver and Biliary System - part 1 potx
... 16) These make up 6–8% of the total endothelial cell surface, and there are more in the centrilobular zone of the sinusoid than the peri-portal area... normal human liver, of ... lined throughout by endothelium Tissue fluid seeps through the endothelium into the lymph vessels The branch of the hepatic... Effect of age on liver protein synthesis and degradation ... needle Note the nail in the shaft of the needle [30] oblique and slightly convex towards the outside The needle is... depends on the acinar location of damage [28] The liver
Ngày tải lên: 10/08/2014, 15:20
Diseases of the Liver and Biliary System - part 2 pot
... 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
Diseases of the Liver and Biliary System - part 3 potx
... 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
Diseases of the Liver and Biliary System - part 4 docx
... 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
Diseases of the Liver and Biliary System - part 5 pot
... anti-HDV is found There may be a window period between the disappearance of one and the detection of the other Loss of. .. 18.1) [26] The viral genome is composed of a 5 non-coding ... single-stranded DNA virus of the circoviridiae family. It is found in the blood of about 1% of US blood donors [1]. The prevalence depends on methodology, particularly the sets of primers used for ... 17.12 Efficacy of hepatitis B vaccine Results of a doubleblind trial of the efficacy of hepatitis B vaccine in 1083 homosexual men Distribution of infections in recipients of (a) placebo
Ngày tải lên: 10/08/2014, 15:20
Diseases of the Liver and Biliary System - part 6 pps
... 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
Diseases of the Liver and Biliary System - part 8 ppt
... abscess of liver. Note the elevated right diaphragm with overlying reaction in the lung field. An abscess in the left lobe of the liver may show a crescentic deformity of the lesser curve of the stomach. ... widening of the intercostal spaces. The liver shadow may be enlarged with a raised immobile right diaphragm. The abscess commonly causes a bulge in the antero-medial part of the right diaphragm. The ... Malaria [1] In the erythrocytic stage, the parasite is engulfed by reticulo-endothelial cells The liver suffers from the general effects of the toxaemia and pyrexia [2] The Liver
Ngày tải lên: 10/08/2014, 15:20
Diseases of the Liver and Biliary System - part 9 pptx
... 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
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