Assuntos
Antivirais/uso terapêutico , Crioglobulinemia/tratamento farmacológico , Glomerulonefrite Membranosa/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Síndrome Nefrótica/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Idoso , Crioglobulinemia/complicações , Glomerulonefrite Membranosa/complicações , Hepatite C Crônica/complicações , Humanos , Interferon alfa-2 , Linfoma de Zona Marginal Tipo Células B/complicações , Masculino , Síndrome Nefrótica/complicações , Proteínas Recombinantes/uso terapêutico , Neoplasias Gástricas/complicaçõesRESUMO
The association of a monoclonal gammopathy (MG) with a B cell non-Hodgkin's lymphoma (NHL) is a well-known phenomenon. It has been recognized in many subtypes of primary gastrointestinal lymphoma but its association with primary colonic mantle cell lymphoma has never been yet described. We report a 65-year-old man who presented with an exudative ascites and constipation. Serum electrophoresis showed a monoclonal peak in the gamma region of 45g/L and immunoelectrophoresis confirmed the presence of monoclonal gammopathy of IgM kappa type. Bone marrow aspirate was normal. Radiologic and endoscopic investigations evidenced a primary colonic mantle cell lymphoma. Although the association of an MG with an NHL and, in particular, to a primitive digestive location appears a rare phenomenon, endoscopic investigations in patients with MG appears legitimate in the presence of any digestive sign.
Assuntos
Neoplasias do Colo/complicações , Linfoma de Célula do Manto/complicações , Paraproteinemias/complicações , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Murinos , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Colo/patologia , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/patologia , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Seguimentos , Humanos , Imunoeletroforese , Linfoma de Célula do Manto/diagnóstico por imagem , Linfoma de Célula do Manto/tratamento farmacológico , Linfoma de Célula do Manto/patologia , Masculino , Estadiamento de Neoplasias , Paraproteinemias/diagnóstico , Prednisona/uso terapêutico , Radiografia Abdominal , Rituximab , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vincristina/uso terapêuticoRESUMO
This paper discusses the importance of stress-induced contributions to the photo-induced birefringence observed in fiber Bragg gratings. Optical tomography measurements are performed in exposed and unexposed fibers to extract the stress profiles induced by UV-writing of fiber Bragg gratings for various exposure levels. A photoelastic analysis and a high-order isoparametric finite elements method are then used to calculate the birefringence caused by stress profile modifications. The results are compared to the birefringence directly measured by spectral analysis of a chirped fiber grating with multiple phase-shifts. We can therefore estimate the fraction of the photo-induced birefringence due to stress-induced anisotropy following UV exposure.
Assuntos
Tecnologia de Fibra Óptica/instrumentação , Modelos Teóricos , Óptica e Fotônica/instrumentação , Refratometria/instrumentação , Anisotropia , Birrefringência , Simulação por Computador , Elasticidade/efeitos da radiação , Desenho de Equipamento , Análise de Falha de Equipamento , Luz , Fibras Ópticas , Espalhamento de Radiação , Estresse Mecânico , Raios UltravioletaRESUMO
OBJECTIVE: To study effect of injection rate on spinal blockade and haemodynamic of spinal bupivacaine for Caesarean section. STUDY DESIGN: Prospective and randomized. PATIENTS AND METHODS: Sixty ASA I-II patients scheduled for elective Caesarean section were randomized to receive either fast (20 seconds, group R, n=30) or slow (60 seconds, group L, n=30) spinal injection of 10 mg of hyperbaric bupivacaine 0.5% associated with 25 microg of fentanyl and 100 microg of morphine. Sensory and motor blockade and haemodynamic parameters were recorded. RESULTS: Profiles of sensory and motor block were similar in both groups. Variations of arterial blood pressure and total dose of ephedrine were not different between R and L groups. However, the number of patient with systolic blood pressure lower than 100 mmHg were significantly lower in L group than in R group (p=0.04). Incidences of adverse effects were similar in both groups. CONCLUSION: Result of the present study suggests that a slow rate of injection would induce lower incidence of hypotension induced by spinal bupivacaine for Caesarean section.
Assuntos
Raquianestesia , Anestésicos Locais , Bupivacaína , Cesárea , Hipotensão/induzido quimicamente , Hipotensão/epidemiologia , Adjuvantes Anestésicos , Adulto , Pressão Sanguínea/efeitos dos fármacos , Método Duplo-Cego , Efedrina/administração & dosagem , Efedrina/uso terapêutico , Feminino , Fentanila , Hemodinâmica/efeitos dos fármacos , Humanos , Morfina , Neurônios Motores/efeitos dos fármacos , Bloqueio Nervoso , Neurônios Aferentes/efeitos dos fármacos , Gravidez , Estudos Prospectivos , Vasoconstritores/administração & dosagem , Vasoconstritores/uso terapêuticoRESUMO
INTRODUCTION: Alagille syndrome is a multisystem autosomal disorder. The main clinical features are chronic cholestasis due to paucity of intrahepatic bile ducts, which can progress to cirrhosis and liver failure. PRESENTATION OF CASE: A 15 year-old girl with Alagille syndrome was referred for liver transplantation. She developed severe cirrhosis with refractory ascites. In the pre-transplant evaluation, imaging studies disclosed liver atrophy with a high density pseudotumor in the segment 4, raising the possibility of a hepatocellular carcinoma. However, behavior of the lesion was highly suggestive of focal compensatory hyperplasia surrounded by an atrophic liver. The patient was registered on the waiting list. DISCUSSION: Hepatic lesions have been described in Alagille syndrome in isolated case reports, and most of these have been reported to be hepatocellular carcinoma. However, they can be related to an area of focal compensatory hyperplasia in severe cirrhosis. These findings may also explain why progression of liver disease occurs only in 15% of patients. CONCLUSION: The presence of a large hepatic nodule Alagille syndrome can be benign in these patients also predisposed to hepatocellular carcinoma. Therefore, cautious evaluation with magnetic resonance imaging study before liver transplantation is mandatory.
RESUMO
The effective index change and form birefringence are calculated in UV-exposed fibers using a high-order vectorial finite element method. The birefringence is compared in optical fibers with and without photosensitive inner cladding.
RESUMO
The ejection fraction and fractional shortening are parameters of left ventricular function dependent on the conditions of load. They are not perfect indices of myocardial contractility. The study of the relationships between stress and diameter and fractional shortening and stress in end-systole provides a better means of assessing the contractile state of the myocardium. The relationships between end-systolic stress-diameter and end-systolic stress-fractional shortening were studied non-invasively in 10 normal subjects (Group I) and 7 patients with severe dilated cardiomyopathy (Group II). End-systolic longitudinal stress of the left ventricle was calculated from Grossman's formula by coupling automatic measurement of blood pressure (cuff method) with simultaneous M mode recordings guided by 2D echocardiography. The line of regression of end-systolic stress-end-systolic diameter was determined in all cases from a series of 14 points obtained after sublingual administration of 10 mg of isosorbide dinitrate. The line of regression of fractional shortening-end-systolic stress was established in both groups by using the values observed under basal conditions and at the peak of action of the isosorbide dinitrate. The following results obtained: Under basal conditions, patients in Group II had greater end-diastolic diameters (69 +/- 8 vs 49 +/- 4 cm, p less than 0.01), greater end-systolic diameters (61 +/- 8 vs 33 +/- 4 mm, p less than 0.001) and higher end-systolic stress (140 +/- 54 vs 67 +/- 13 10(3) dyn/cm2, p less than 0.001). Fractional shortening was lower in Group II than in Group I (12 +/- 5 vs 33 +/- 5%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Cardiomiopatia Dilatada/fisiopatologia , Contração Miocárdica , Adulto , Pressão Sanguínea/efeitos dos fármacos , Ecocardiografia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Septos Cardíacos/patologia , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/patologia , Ventrículos do Coração/fisiopatologia , Hemodinâmica/efeitos dos fármacos , Humanos , Dinitrato de Isossorbida/farmacologia , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/efeitos dos fármacos , Volume Sistólico , SístoleRESUMO
Esophageal cancer has a bad prognosis because of late diagnosis. The rate of Survival is very low. Palliative treatment is frequently made. The aim of the treatment is to allow feeding, and treat some complications likes breathing troubles. We report two cases of esotracheal fistulae secondary to esophageal cancer. The esophageal fistula was successfully treated by esotracheal prosthesis.
Assuntos
Neoplasias Esofágicas/complicações , Implantação de Prótese , Fístula Traqueoesofágica/cirurgia , Adulto , Idoso , Feminino , Humanos , Cuidados Paliativos , Fístula Traqueoesofágica/etiologiaRESUMO
The duplicity of the way biliaire main is a rare abnormality. We report two observations revealed by episodes of angiocholite. The degrades cholangiopancreatography endoscopy allowed to wear diagnosis and to practise a therapeutic gesture.
Assuntos
Ductos Biliares/patologia , Colangiopancreatografia Retrógrada Endoscópica , Idoso , Ductos Biliares/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , MasculinoRESUMO
Menetrier's disease is an uncommon reason of hypertrophic gastropathy. The diagnosis is suspected when clinic, endoscopic and radiologic criteria are associated and is confirmed by histologic features which are a cryptric hyperplasia atrophy of gland of the fundus and an hypertrophy of the mucosa. The main complications of this disease are neoplasia and cachexia. The treatment of Menetrier's disease is first medical. Chirurgical treatment is indicated when bleeding or neoplasia occurred. In this paper, we report the case of patient who is 41 years old which, in spite of some therapeutic problems is in conformity with literature.
Assuntos
Caquexia/etiologia , Mucosa Gástrica/patologia , Gastrite Hipertrófica/patologia , Adulto , Gastrite Hipertrófica/complicações , Gastrite Hipertrófica/cirurgia , Hemorragia Gastrointestinal/etiologia , Humanos , Hipertrofia , Masculino , Neoplasias Gástricas/etiologiaRESUMO
Ocytocin and vasopressin are two nonapeptides of the hypo thalamo-Post-hypophysary system. They are isolated and purified from dromedary post-hyphophysis, freshly collected in the meat centers of the south of Tunisia. The use of three chromatographies steps were found to be essential in obtaining high Pure hormones. These steps cousist in a sephadex G25 gel filtration and two successive High performance liquid chromatographies: H.P.L.C. The analysis of the two hormones by thin layer chromatography and Radioimmunoassays, and the identification of the amino-acid composition demonstrate that camel vasopressin is a 8 arginin vasopressin but ocytocin is identic to the other hormones isolated from different animal species.
Assuntos
Camelus/fisiologia , Sistema Hipotálamo-Hipofisário/fisiologia , Ocitocina/análise , Vasopressinas/análise , Aminoácidos/análise , Animais , Cromatografia em Gel , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Fina , RadioimunoensaioAssuntos
Ductos Biliares/anormalidades , Doença de Caroli/complicações , Ductos Pancreáticos/anormalidades , Adulto , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/cirurgia , Colangiografia , Colangiopancreatografia Retrógrada Endoscópica , Anormalidades Congênitas/epidemiologia , Feminino , Humanos , Incidência , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/cirurgia , UltrassonografiaRESUMO
The authors report 34 cases of anterior ischemic optic neuropathy, in 31 patients with one complete etiological examination. The modes of revelation, the symptoms and the results of the etiological inquest are related.