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外科医生和病理医生对胸腺恶性肿瘤切除标本的处理方法和程序 被引量:2
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作者 付浩 中国胸腺瘤协作组全体成员 +6 位作者 Frank C.Detterbeck Cesar Moran James Huang Saul Suster Garrett Walsh Lawrence Kaiser Mark Wick 《中国肺癌杂志》 CAS 北大核心 2014年第2期95-103,共9页
胸腺恶性肿瘤发病率低,临床病例分散,需要结合多中心经验才能进行良好的研究,但由于在诸多方面没有统一标准,使得研究与研究之间的可比性差。其中外科医生和病理医生对胸腺恶性肿瘤切除标本的处理是统一标准中至关重要的部分。针对... 胸腺恶性肿瘤发病率低,临床病例分散,需要结合多中心经验才能进行良好的研究,但由于在诸多方面没有统一标准,使得研究与研究之间的可比性差。其中外科医生和病理医生对胸腺恶性肿瘤切除标本的处理是统一标准中至关重要的部分。针对目前胸腺瘤的常用手术方式胸骨劈开根治性R0切除术的标本处理作如下规定,包括切除胸腺瘤及周围的受累结构说明如何处理手术切除标本。活检或细胞学标本的处理另文描述[1]。本文首先由国际胸腺肿瘤协作组织(International hTymic Malignacy Interest Group, ITMIG)中病理医生和外科医生组成的小组回顾相关文献形成初步建议[2,3],交扩展组审议提炼后分发给ITMIG成员进讨论,再将ITMIG成员回馈的建议和几个大中心试点的情况进行提炼,最终形成的建议经ITMIG批准并被采用。因此,既强调证据又代表ITMIG成员的广泛共识。 展开更多
关键词 手术切除标本 恶性肿瘤 病理医生 外科医生 胸腺瘤 程序 统一标准 细胞学标本
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Impact of Revascularization on the Distal to Proximal Pressure Ratio in Case of Multiple Coronary Stenoses
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作者 Amédéo Anselmi Hervé Corbineau +1 位作者 Jean-Philippe Verhoye Agnès Drochon 《Journal of Biomedical Science and Engineering》 2021年第3期142-175,共34页
<em>Objective</em>: In order to take a decision about the revascularization approach to be adopted, it is of fundamental importance to determine whether coronary artery stenoses induce ischemia or not. An ... <em>Objective</em>: In order to take a decision about the revascularization approach to be adopted, it is of fundamental importance to determine whether coronary artery stenoses induce ischemia or not. An index, named (Fractional Flow Reserve), based on pressure measurements has been proposed to this aim and is usually interpreted in terms of flows. The objective of this work is to compute simultaneously pressures and flow rates in the coronary network of patients with three-vessel disease, in order to study more precisely the relationship between these two quantities. <em>Approach</em>: 22 patients have been included in the study. Some pressure and flow rate measurements were collected during by-pass surgery. These clinical data allow determining parameters for a patient’s specific model, based on the electric/hydraulic analogy. Collateral pathways are included in the model, as well as the severity of the disease and the impact of revascularization. <em>Main Results</em>: For patients with stenoses on LAD, LCx, LMCA and occlusion of the RCA, the flow rate delivered to the right territory is of course a function of the aortic pressure, the left stenoses severity, and the pressure distal to the thrombosis. But it mainly depends on the capillary and collateral resistances, and on the proportion between them. Abnormal microvascular hemodynamics, may be present in patients with non-hemodynamic significant lesions as assessed by the pressure ratio. Complete revascularization with the 3 grafts is demonstrated to be fully justified. The direction of collateral flows may be reversed, depending on the pressure gradient. In any case, they remain low and become negligible when the 3 grafts are operating. <em>Significance</em>: Surgical decision based only on pressure measurements may miss some real hemodynamic problems due to the considered stenosis. This risk is even greater in case of serial stenoses. 展开更多
关键词 Coronary Three-Vessel Disease Hydrodynamic Impact of Stenoses By-Pass Grafting Fractional Flow Reserve Collateral Flow Analog Electric Model Flow and Pressure Simulations
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