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  • 1
    ISSN: 1437-9813
    Keywords: Key words Congenital diaphragmatic hernia ; Hypoplastic lung ; Bromodeoxyuridine (BrdU) ; Antenatal glucocorticoids ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The aim of this study was to investigate the effect of antenatal glucocorticoid therapy on smooth-muscle-cell (SMC) DNA synthesis in the pulmonary arteries (PA) in a nitrofen-induced congenital diaphragmatic hernia (CDH) rat model following nitrofen administration on day 9.5 of gestation. Antenatal dexamethasone (DEX) was given intraperitoneally on days 18.5 and 19.5 of gestation. Bromodeoxyuridine (BrdU) was injected via a jugular vein into the dam 1 h before the fetuses were killed by cesarean section at term. The fetuses were divided into three groups: group I (n = 10): normal controls; group II (n = 10): nitrofen-induced CDH; group III (n = 10): nitrofen-induced CDH with antenatal DEX treatment. Immunostaining of the lungs with anti-BrdU antibody was obtained by a standard avidin-biotin complex method. The number of immunopositive cells in the PA media and adventitia were counted using an image analyzer and analyzed statistically. The number of BrdU-immunopositive cells in the media was significantly increased in group II (16.83 ± 3.01) compared to groups I (9.16 ± 2.20) and III (6.83 ± 1.70) (P 〈 0.01). There was no significant difference between groups I and III. The number of BrdU-immunopositive cells in the adventitia was not significantly different between the three groups. Antenatal DEX treatment inhibits SMC DNA synthesis in PA media in CDH lungs. This may be a possible mechanism by which antenatal DEX prevents structural PA changes in nitrofen-induced CDH in rats.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: staging ; CT-scan ; lung cancer ; bone scan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to evaluate the role of CT scan and bone scan in staging patients with non-small-cell lung cancer presumably indicated for surgery, 70 consecutive patients who underwent thoracotomy were reviewed. Most of them received mediastinal and multi-organ (brain, liver and adrenal) CT scans and a bone scan. In the most recent 40 of the 70 patients, CT findings of the mediastinal lymph nodes were compared to the pathology following complete sampling. The overall accuracy of the mediastinal CT was 60.0 per cent (12 true positive and 12 true negative), but the negative predictable value was 12/(12+3) or 80.0 per cent, whereas 3 were false negatives though they showed an acceptable postoperative course. Sixteen out of 21 patients with one, or at the most, three enlarged nodes detected on CT also did well postoperatively and retrospectively, were considered not to have required mediastinoscopy. A group of patients showing no, or at the most, three enlarged mediastinal lymph nodes on CT may be considered as candidates for surgery even without mediastinoscopy. Multi-organ survey by means of CT was believed cost-ineffective and omittable. Bone scan however, retrospectively detected three true positives among 20 patients with a positive uptake, so that it cannot be omitted out of hand, though further examination of this point is required.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: dumbbell neurogenic tumor ; mediastinal tumor ; hour-glass tumor ; laminectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Of a total thirteen patients who underwent surgery for a neurogenic tumor in the posterior mediastinum 4 (30.8 per cent) presented with dumbbell type development of the tumor. Along with a comparatively greater incidence in the number of cases of dumbbell neurogenic tumors in the posterior mediastinum, resection has also recently become more popular, necessitating the establishment of a standard operative approach for this type of tumor. We successfully removed dumbbell neurogenic tumor from the posterior mediastinum in our 3 most recent casesvia a dorsal approach by virtue of a laminectomy and resection of a small portion of the neighbouring rib root without opening the parietal pleura at all. These three aptients were a 14 year old female, a 54 year old male and a 68 year old female, respectively, and the largest diameter in cm and level of origin of the tumors were 5.5 at Th 1 in case 1, 3.0 at Th 2 in case 2 and 3.7 at Th 11 in case 3. The operative approach described herein was easy to perform, felt secure and was less invasive and better tolerated by the patients than the thoractomy approach. Avoiding a thoractomy in such cases has many advantages to enumerate, but does not seem to have been clearly aimed at by others to date. We therefore propose our technique as a standard approach for dumbbell neurogenic tumors in the posterior mediastinum.
    Type of Medium: Electronic Resource
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