diseases of the thyroid and parathyroid glands

... a nodular mass at the angle of the jaw The masses gradually increase in size and number and form sinuses that open onto the face and neck Although infection is often seen in the jaw area, Actinomyces ... in the host following the fly bite The sandfly inoculates the host with the organisms in the promastigote stage Once the organisms are inoculated, they are phagocytized by host macrophages The ... spread of the organism from the initial site of infection The ulcers often become secondarily infected with bacteria The mucosal lesions can involve the oral mucosa, pharynx, lacrimal glands, ...

Ngày tải lên: 19/02/2014, 08:20

... vein, and the celiac axis The inferior pathway of nodes along the cystic duct, anterior and lateral aspect of the portal vein, the posterior aspect of the pancreas, between the aorta and the inferior ... the round ligament and umbilical fissure The right lobe is further divided by the gallbladder fossa into the right hemiliver to the right of the gallbladder and the quadrate lobe to the left 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 confluence...

Ngày tải lên: 09/08/2014, 14:22

... examination They can Chapter 3: Epidemiology of diseases of the bile ducts and gallbladder be distinguished from stones by their fixed position in the gallbladder and by the lack of an acoustic ... jejunum, and amount of gas in the second portion of the duodenum An oral contrast agent has been introduced in the past that both displaces and absorbs gas in the lumen of the stomach, duodenum, and ... (especially the first and second portions of the duodenum and the hepatic flexure of the colon) The attenuation of bile may be increased in patients with sludge, or several hours to days after the intravascular...

Ngày tải lên: 09/08/2014, 14:22

... 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 ... includes the rnucosa, the fibromuscularis, and the fibrous layer of the serosa The outer hyperechoic layer corresponds to the subserosal fatty tissue, the serosa, and the interface echo between the ... Involvement of the main trunk of the portal vein Involvement of both branches of the portal vein or bilateral involvement of the hepatic artery and portal vein Vascular involvement on one side of the...

Ngày tải lên: 09/08/2014, 14:22

... al The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and ... approaches for the biliary tree and gallbladder by irradiation They further characterized the injury as “vacuolation, swelling, and necrosis of the epithelial cells of the ducts, and by a slow and atypical ... absorption of the majority of their energy at the end of their track range, the so-called Bragg peak The dose unit of charged particles is the Gray Equivalent (GyE) Figure 7.2 demonstrates the energy...

Ngày tải lên: 09/08/2014, 14:22

... 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] Sometimes one clip is placed on the ... sheath of the main right portal pedicle Therefore, to find the bile duct within the sheath of the right portal pedicle, the cystic plate must be detached from the anterior surface of the sheath of the ... classical injuries The deceptive flaring appearance is caused by the separation of the cystic and common hepatic ducts or the side of the common hepatic duct and the side of the gallbladder Note...

Ngày tải lên: 09/08/2014, 14:22

... intravenously and will normally be taken up by the liver and then the gallbladder Uptake by the liver and excretion into the duodenum without filling of the gallbladder is indicative for occlusion of the ... addition, they not definitively manage the biliary disease [75] Morbidity and mortality The morbidity and mortality are mostly determined by the presence of comorbid diseases of the patient and the ... treatment the gallstone disimpacts and falls back into the gallbladder, which allows emptying of the gallbladder, resulting in reduction of the inflammation The theoretical aim of fasting is to rest the...

Ngày tải lên: 09/08/2014, 14:22

... resection of the gallbladder fossa includes which segments of the liver? a I and IVb b IVb and V c V and VIII d IVb and VIII The term “extended cholecystectomy” may encompass a resection of all of the ... Understand the various types of genetic background in polycystic liver disease • Name the classification of cystic diseases of the biliary tract • Understand the premalignant nature of cystic diseases ... diagnosis of acute cholangitis The choice between ERCP and PTC depends on the availability of local expertise and the nature and level of biliary obstruction Both imaging can define the extent of ductal...

Ngày tải lên: 09/08/2014, 14:22

... dilatation of the bile ducts is easily visualized, and the location of the biliary stenosis can be determined At the same time, the patency of the main hepatic artery and portal vein and their branches ... Further investigation to delineate the role of these peptides in the etiology of PSC is required The major criticism of the theories of colonic toxins causing PSC comes from studies looking at the ... histology, there was progression of disease in out of 10 patients on placebo and but in only 11 out of 20 on therapy The incidence of side-effects was relatively low and included paresthesias and hypertrichosis,...

Ngày tải lên: 09/08/2014, 14:22

... atresia) and that the proximal ducts dilate in response to obstruction [32] The operative strategy required will depend on the age of the child, the size of the ducts, and the location of the perforation ... 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 ... tracer, suggests the diagnosis of Alagille’s [66] The diagnosis is made on the basis of the signs and symptoms, the typical facies, associated findings in the eyes and heart, and on the liver biopsy...

Ngày tải lên: 09/08/2014, 14:22

... reflects some degree of failure of the normal formation of the interlobular bile ducts, and results in a characteristic portal tract lesion consisting of persistence of some remnant of the ductal plate ... affecting the liver in a number of ways, and often is associated with renal disease of varying severity First described in 1962 [165], the most important features of the disease and the complications ... little to address the fundamental problem of portal hypertension and may exacerbate the bleeding from varices in the stomach and esophagus One of the more intriguing aspects of CHF is the association...

Ngày tải lên: 09/08/2014, 14:22

... to the skin into the liver substance and extracted This is the quick part of the procedure The tip of the needle is now placed on sterile paper and some of the remaining saline flushed through the ... to a compartment of uncoupling of receptor and ligand (CURL) The receptor and ligand separate The receptor returns to sinusoidal plasma membrane and the ligand enters a lysosome and is degraded ... 636 Other causes, 636 Summary, 636 36 Diseases of the Ampulla of Vater and Pancreas, 639 Peri-ampullary carcinoma, 639 Benign villous adenoma of the ampulla of Vater, 644 Cystic tumours of the...

Ngày tải lên: 10/08/2014, 15:20

... especially the hypothenar and thenar eminences and pulps of the fingers (fig 6.12) Islets of erythema may be found at the bases of the fingers The soles of the feet may be similarly affected The mottling ... diameter and is not obliterated by pressure Venous stars are seen on the dorsum of the foot, legs, back and on the lower border of the ribs Palmar erythema (liver palms) The hands are warm and the ... benzodiazepines and barbiturates (fig 7.9) The binding of any of these ligands opens a chloride channel and after the influx of chloride there is hyperpolarization of the postsynaptic membrane, and neuroinhibition...

Ngày tải lên: 10/08/2014, 15:20

... veins of the caval system Deviation of blood into these channels leads to varicosities in the submucous layer of the lower end of the oesophagus and fundus of the stomach (b) At the anus, the superior ... by the union of the superior mesenteric vein 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 ... bypass the block and return blood towards the liver These enter the portal vein in the porta hepatis beyond the block They include the veins at the hilum, venae comitantes of the portal vein and...

Ngày tải lên: 10/08/2014, 15:20

... with other variations of the A(TA)nTAA allele have also shown elevated serum total bilirubin levels, including the alleles 5/6, 5/7 and 7/8 [5] In Asians and the Japanese, the frequency of the ... continuity with the space of Disse Disruption of the tight junction leads to free passage of solute and larger molecules into the canaliculus with loss of the osmotic gradient and cholestasis ... one another to form septal bile ducts and so on until the two main hepatic ducts emerge from the right and left lobes of the liver at the porta hepatis Small bile ducts distal to the canals of Hering...

Ngày tải lên: 10/08/2014, 15:20

... serum IgG anti-HDV is found There may be a window period between the disappearance of one and the detection of the other Loss of IgM anti-HDV confirms the resolution of HDV infection, whereas persistence ... both as monotherapy, and, on the basis of recently completed large trials, in combination with ribavirin The cost and availability makes all these treatments out of reach of the millions of sufferers ... Diagram of the virion of hepatitis B (HBV: Dane particle) The core contains DNA polymerase, double-stranded DNA, core antigen and ‘e’ antigen The surface consists of HBsAg Spheres and tubules of HBsAg...

Ngày tải lên: 10/08/2014, 15:20

... lipids synthesized in the liver itself The origin depends upon the dose of ethanol ingested and the lipid content of the diet After an acute, isolated ingestion of a large dose of ethanol the fatty ... related to the severity of the liver disease [72] The extent of the nutritional defect depends on the type of alcoholic, whether of low socioeconomic status where protein-calorie malnutrition often ... is the fourth commonest cause of death in adult males The prevalence of alcoholic liver disease depends largely on religious and other customs and on the relation between the cost of alcohol and...

Ngày tải lên: 10/08/2014, 15:20

... the liver parenchyma The lesions produced are single or multiple and of variable size The amoebic abscess is usually about the size of an orange The most frequent site is in the right lobe, often ... abscess in the left lobe of the liver may show a crescentic deformity of the lesser curve of the stomach US is the most useful (fig 29.7) CT shows the abscess with a somewhat irregular edge and low ... penicillin Jaundice, chills and fever, often with a rash (erythema of Milan), occur about days after starting therapy This is part of the Herxheimer reaction The mechanism of the jaundice is unclear...

Ngày tải lên: 10/08/2014, 15:20

... laterally over the gallbladder down to the duodenum, to the hepatic flexure of the colon and even to the right lobe of the liver, perhaps closing the foramen of Winslow In a milder form, a band of tissue ... leaks and residual duct stones Endoscopic biliary endoprostheses After catheterization of the ampulla and demonstration of the stricture by contrast, a guide-wire is passed through the catheter and ... recognized Type I is the failure of the gallbladder and cystic duct to develop as an outgrowth from the hepatic diverticulum of the foregut This type is often found with other anomalies of the biliary...

Ngày tải lên: 10/08/2014, 15:20

... 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 posterior ... which there is no acceptable, alternative therapy The patient and the family must understand the magnitude of the undertaking and be prepared to face the difficult early postoperative period and ... pooling in the lower part of the body and splanchnic congestion The cannulae are placed in the inferior vena cava (via the femoral vein) and the portal vein, and run to the subclavian vein The veno-venous...

Ngày tải lên: 10/08/2014, 15:20