917 resultados para Bilateral balanced occlusion


Relevância:

20.00% 20.00%

Publicador:

Resumo:

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relevância:

20.00% 20.00%

Publicador:

Resumo:

OBJECTIVE: To estimate the response in lung growth and vascularity after fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia in the prediction of neonatal survival.METHODS: Between January 2006 and December 2010, fetal lung parameters (observed-to-expected lung-to-head ratio; observed-to-expected lung volume; and contralateral lung vascularization index) were evaluated before fetal tracheal occlusion and were evaluated longitudinally every 2 weeks in 72 fetuses with severe isolated congenital diaphragmatic hernia. Thirty-five fetuses underwent fetal endoscopic tracheal occlusion and 37 cases did not.RESULTS: Survival rate was significantly higher in the fetal endoscopic tracheal occlusion group (54.3%) than in the no fetal endoscopic tracheal occlusion group (5.4%, P<.01). Fetal endoscopic tracheal occlusion resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with fetuses that did not go to the fetal intervention (increase of the observed-to-expected lung-to-head ratio, observed-to-expected total lung volume, and contralateral pulmonary vascularization index 56.2% compared with 0.3%, 37.9% compared with 0.1%, and 98.6% compared with 0.0%, respectively; P<.01). Receiver operating characteristic curves indicated that the observed-to-expected total fetal lung volume was the single best predictor of neonatal survival before fetal endoscopic tracheal occlusion (cutoff 0.23, area under the curve [AUC] 0.88, relative risk 5.3, 95% confidence interval [CI] 1.4-19.7). However, the contralateral lung vascularization index at 4 weeks after fetal endoscopic tracheal occlusion was more accurate in the prediction of neonatal outcome (cutoff 24.0%, AUC 0.98, relative risk 9.9, 95% CI 1.5-66.9) with the combination of observed-to-expected lung volumes and contralateral lung vascularization index at 4 weeks being the best predictor of outcome (AUC 0.98, relative risk 16.6, 95% CI 2.5-112.3).CONCLUSION: Fetal endoscopic tracheal occlusion improves survival rate by increasing the lung size and pulmonary vascularity in fetuses with severe congenital diaphragmatic hernia. The pulmonary response after fetal endoscopic tracheal occlusion can be used to predict neonatal survival. (Obstet Gynecol 2012; 119: 93-101) DOI: 10.1097/AOG.0b013e31823d3aea

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Um reprodutor bovino, Bos indicus, com varicocele bilateral detectado por palpação e ultra-sonografia foi acompanhado por um período de 24 meses quanto à biometria testicular, valores espermáticos e concentração de testosterona comparados entre as estações do ano e outros animais da mesma espécie. As alterações morfológicas dos defeitos maiores e menores não variaram entre o touro com a patologia e os demais touros, no entanto, durante o verão o touro com varicocele apresentou maior percentual de defeitos totais se comparado aos demais touros da mesma espécie (49,86%±6,9 e 27,91%±2,9). O animal apresentou maior percentual de defeitos maiores no verão se comparado às outras estações do ano. Os achados de necrópsia confirmaram o diagnóstico clínico. Pode-se concluir que esta patologia, caracterizada por trombose nos vasos do cordão espermático, comprometeu a termoregulação determinando degeneração testicular severa. O aumento das concentrações de testosterona sérica sugerem a diminuição da retenção de esteroides nos testículos pelo plexo pampiniforme, a produção espermática estava anormal.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

We describe a case of X monosomy associated with a maternally inherited t(13;14) Robertsonian translocation in a girl with Turner syndrome. The girl's X chromosome was demonstrated to be maternally inherited, ruling out the hypothesis that the translocation exerted an interchromosomal effect on the origin of the monosomy. Chromosomes 13 and 14 showed biparental inheritance.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

CONTEXTO: O esvaziamento cervical que acompanha a ressecção da lesão primária no tratamento dos tumores malignos das vias aerodigestivas superiores possibilita o surgimento de complicações inerentes a ela ou ao prolongamento do tempo cirúrgico, aumentando os riscos para o paciente. Entre as complicações que podem ocorrer está a amaurose, de incidência rara. RELATO do CASO: Um paciente submetido a laringectomia total e esvaziamento cervical seletivo à esquerda e radical modificado à direita, que evoluiu com amaurose, provavelmente decorrente de hipotensão intra-operatória, com contribuição dos Diabetes Mellitus descompensado e trombose da veia jugular interna à direita. Discutem as possíveis causas, os fatores de risco e os cuidados que devem ser tomados para evitar essa rara, mas tão debilitante complicação.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Epithelial cells from involuting rat ventral prostate (VP) express Matrilysin (MMP-7) mRNA. Herein, we investigated by immunohistochemistry the NIMP-7 protein location and its association with tissue changes following castration in the VP. Normal and castrated adult male Wistar rats were sacrificed at different times after surgery. VP was examined by immunocytochemistry and immunoprecipitation. Castration promoted a shrinking of prostate ducts with an extensive stromal remodeling. In the VP from normal rats, MMP-7 immunoreactivity was found in epithelial secretory granules. Three days after castration, immunostaining for MMP-7 was found in both the epithelial secretory granules and in the stroma just below the epithelium, mainly at the distal ductal tips. At seven and 21 days after castration, the immunostaining for MMP-7 was found only in the stromal space. Immunoprecipitation confirmed the specificity of the primary antibody by rescuing a pro-enzyme form (28 kDa) in the prostate extracts. The present results suggest that MMP-7 participates in the epithelial-stromal interface remodeling of the ventral prostate during the involution achieved by castration, probably in the degradation of components of the epithelial basement membrane. (c) 2007 International Federation for Cell Biology. Published by Elsevier Ltd. All rights reserved.