surgical disorders of the liver and bile ducts and portal hypertension
DISORDERS OF THE VULVA AND VAGINA pps
... to the cervical and vaginal mucosa When these are removed, slight oozing occurs There may be both erythema and edema of the vulva and vagina The discharge with Candida infection has a pH of 4–5 ... acne, and symptoms are soreness and local swelling, edema, CHAPTER 20 DISORDERS OF THE VULVA AND VAGINA 581 cellulitis, and suppuration of the groin Involvement of apocrine glands establishes the ... in origin Nonetheless, cancer of the vulva may arise also from the urethra, glandular elements of the vulva, or mucosa of the lower third of the vagina Vulvar cancers are intraepithelial or invasive...
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Diseases of the Liver and Biliary System - part 1 potx
... 645 Other causes of extrinsic pressure on the common bile duct, 645 37 Tumours of the Gallbladder and Bile Ducts, 647 Benign lesions of the gallbladder, 647 Carcinoma of the gallbladder, 647 Other ... 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 ... receptor and ligand are transferred 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...
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Diseases of the Liver and Biliary System - part 2 pot
... 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 ... Microscopically, the leukaemic infiltration involves only the portal tracts — the normal site of lymphoid tissue in the liver The portal areas are enlarged and contain both mature and immature cells of the...
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Diseases of the Liver and Biliary System - part 3 potx
... 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 haemorrhoidal vein of the ... changes depend on the cause of the portal hypertension The height of the portal venous pressure correlates poorly with the apparent degree of cirrhosis and in particular of fibrosis There is a much ... uncertain whether the hyperdynamic circulation is the cause or the consequence of the portal hypertension or both It is related to the severity of liver failure Cardiac output increases and there is...
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Diseases of the Liver and Biliary System - part 4 docx
... 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 ... passes into the interlobular bile duct which is the rst bile channel to be accompanied by a branch of the hepatic artery and portal vein These are also found in the portal triad These channels ... cirrhosis results in portal hypertension and splenomegaly The intestinal contents are bulky and greasy; the more complete the cholestasis, the paler the stools The kidneys are swollen and bile stained...
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Diseases of the Liver and Biliary System - part 5 pot
... 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 ... introspection by the patient Antiviral therapy The aim is to control infectivity, eradicate the virus and prevent the development of cirrhosis However, permanent loss of HBeAg and HBV DNA are unusual and...
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Diseases of the Liver and Biliary System - part 6 pps
... 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 ... redox state of the liver The hydrogen generated replaces fatty acid as a fuel and is followed by triglyceride accumulation and fatty liver The redox state of the liver changes, protein synthesis is ... dilatation and irregularity of the pancreatic duct and smooth constriction of the common bile duct as it passes behind the inflamed pancreas Alcohol and the Liver 100 90 80 % Survival sis of complicating...
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Diseases of the Liver and Biliary System - part 8 ppt
... throughout the world except in New Zealand, Australia and some parts of the west Pacific The Borrelia multiply in the liver, invading liver cells and causing focal necrosis Just before the crisis the ... been found in the liver of man The tissue stage of human malaria is confined to the liver cells Pathology The liver shows reticulo-endothelial proliferation, both of Kupffer cells and in zone Focal, ... 627 Liver flukes Cysts are consumed and larvae develop in the duodenum and eventually reach the bile ducts The flukes probably invade the liver through its peritoneal coat and are carried via the...
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Diseases of the Liver and Biliary System - part 9 pptx
... lesions of the liver and bile ducts are increasingly being diagnosed This can be related to the improved methods of imaging the liver and bile ducts, and of liver biopsy Application of such methods ... mechanism through the amount of bile salts and cholesterol reaching the liver from the gut Bile acid synthesis is decreased by administration of bile salts and increased by interruption of the entero-hepatic ... between the junction of the main right and left hepatic ducts and the entry of the cystic duct Floating gallbladder (fig 35.1c) It may, however, join the cystic duct, the gallbladder or the common bile...
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Diseases of the Liver and Biliary System - part 10 docx
... usually used The left lobe of the donor liver is excised and the right lobe anastomosed to the portal vein, inferior vena cava and aorta of the recipient The donor liver hypertrophies and the recipient’s ... into the liver They cause complete obstruction of the extra-hepatic bile ducts with intra-hepatic biliary dilatation and enlargement of the liver The gallbladder is collapsed and flaccid If the ... 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...
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Báo cáo y học: "Vasopressin in vasodilatory shock: hemodynamic stabilization at the cost of the liver and the kidney" doc
... infusion The study by Krejci and colleagues therefore raises the question of whether AVP compares favorably with catecholamines In a complementary investigation the same group compared the regional ... Krejci and colleagues confirm that the unrestricted use of even ‘low-dose’ AVP may result in ‘overconstriction’, in particular in the hepato-splanchnic region and the kidney Furthermore, the authors’ ... activation of the inducible isoform of nitric oxide synthase) probably did not assume major importance Finally, as the authors themselves acknowledge, although labelled ‘low dose’, the infusion...
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Diseases of the Gallbladder and Bile Ducts - part 1 pdf
... 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 ... Anatomy and physiology of the biliary tree and gallbladder James Toouli and Mayank Bhandari OBJECTIVES • Describe the anatomy of the liver and biliary tract • Highlight the surgical anatomy of the liver ... surrounds the branches of the portal vein [7] These ducts increase in caliber and possess smooth muscle fibers within their wall as they reach the hilus of the liver Furthermore, as they become...
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Diseases of the Gallbladder and Bile Ducts - part 2 potx
... ductopenia The portal triads are often small and inconspicuous and lack a significant inflammatory infiltrate The degree of portal fibrosis is Chapter 2: Pathology of the intrahepatic and extrahepatic bile ... extrahepatic bile ducts and gallbladder 41 Figure 2.16 Paucity of intrahepatic bile ducts Most portal triads are devoid of interlobular bile ducts in this example of Alagille’s syndrome The portal tract ... Tumor confined to the bile duct histologically T2 Tumor invades beyond the wall of the bile duct T3 Tumor invades the liver, gallbladder, pancreas and/ or unilateral branches of the portal vein or...
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Diseases of the Gallbladder and Bile Ducts - part 3 pdf
... enhancement and thickening of the wall of the extrahepatic bile ducts, and increased enhancement of the periphery of the liver during the hepatic arterial phase Cystic dilatation of the bile duct Congenital ... 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 liver ... visualize the bile ducts at their extremes (i.e the peripheral intrahepatic ducts at one end and the distal common bile duct at the other), the central intrahepatic ducts and especially the common...
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Diseases of the Gallbladder and Bile Ducts - part 4 pot
... 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 ... 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 ... of patients have an aberrant common bile duct from the left hemiliver to the right bile duct In another 6% of the cases an aberrant bile duct originates from the posterior right side of the liver...
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Diseases of the Gallbladder and Bile Ducts - part 5 potx
... to the anterior surface of 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 ... when the portion of occluded liver is small or if the injury was remote and the liver has atrophied When the injury is recent and the portion of liver affected is large (e.g the whole right hemiliver) ... exposing the ducts of segment II Careful release of the clamp allows identification of the vessels, which are selectively ligated The branches of the portal vein run in close proximity to the bile ducts...
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Diseases of the Gallbladder and Bile Ducts - part 6 pptx
... 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 ... 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 decade, acute ... sequestration of bile acids in the gallbladder, reducing the amount of bile salts available for cholesterol solubilization [23] usually in excess of 40% Bilirubin is secreted by the liver into the bile...
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Diseases of the Gallbladder and Bile Ducts - part 7 pdf
... nature of cystic diseases of the biliary tract • Understand the role of liver resection for biliary cystadenoma and cystadenocarcinoma Introduction Cystic lesions of the bile ducts and liver can ... Further investigations demonstrate fusiform cystic dilatations of the common bile duct with thickening of the bile duct wall and extension of the cystic abnormalities into the left lobe of the liver ... 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...
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Diseases of the Gallbladder and Bile Ducts - part 8 pptx
... confluence of the left and right main hepatic bile ducts (perihilar: 67% of the cases) [11] The tumor has a tendency to spread along the bile ducts and perineural sheets Distant metastases are rare and ... segment VI of the liver b compression of the right portal vein c enlargement of the perihilar lymph nodes d encasement of the main hepatic artery in the hilar mass 5.3 A PTC is placed and the cholangiography ... demonstrates occlusion of the bile duct bifurcation with narrowing of the right common bile duct The best surgical option for the patient is a resection of the extrahepatic bile duct and hepaticojejunostomy...
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Diseases of the Gallbladder and Bile Ducts - part 9 potx
... atresia of the gallbladder and all external bile ducts Variants include atresia of the proximal hepatic ducts with patency of the gallbladder and distal duct, or atresia of the distal ducts and patency ... 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 ... 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...
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Tìm thêm: khảo sát các chuẩn giảng dạy tiếng nhật từ góc độ lí thuyết và thực tiễn khảo sát chương trình đào tạo gắn với các giáo trình cụ thể xác định thời lượng học về mặt lí thuyết và thực tế tiến hành xây dựng chương trình đào tạo dành cho đối tượng không chuyên ngữ tại việt nam điều tra đối với đối tượng giảng viên và đối tượng quản lí khảo sát các chương trình đào tạo theo những bộ giáo trình tiêu biểu nội dung cụ thể cho từng kĩ năng ở từng cấp độ xác định mức độ đáp ứng về văn hoá và chuyên môn trong ct phát huy những thành tựu công nghệ mới nhất được áp dụng vào công tác dạy và học ngoại ngữ mở máy động cơ lồng sóc mở máy động cơ rôto dây quấn hệ số công suất cosp fi p2 đặc tuyến mômen quay m fi p2 đặc tuyến tốc độ rôto n fi p2 động cơ điện không đồng bộ một pha sự cần thiết phải đầu tư xây dựng nhà máy thông tin liên lạc và các dịch vụ phần 3 giới thiệu nguyên liệu chỉ tiêu chất lượng theo chất lượng phẩm chất sản phẩm khô từ gạo của bộ y tế năm 2008 chỉ tiêu chất lượng 9 tr 25