Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated after a period of collapse. The syndrome of re-expansion pulmonary edema is associated with variable degrees of hypotension and hypoxemia. In its extreme form, it may result in cardiac arrest and death. The initial cause of uninflated pulmonary parenchyma described with re-expansion pulmonary edema has typically been either a large undrained pleural effusion or a pneumothorax. The authors describe a patient in whom re-expansion pulmonary edema developed when inadvertent puncture of large emphysematous bullae released previously atelectatic lung.

Introduction: There are no validated strategies in the teaching of ultrasound as a diagnostic tool in undergraduate medicine students. Given the role that ultrasound plays in the diagnostic capacity of any clinician is currently undeniable, a teaching method is proposed based on the demonstration of the association between the histopathology of a large vessel vasculitis and the characteristic ultrasound finding, known as the «halo sign». Methods: The teaching strategy was imparted by means of a 10-minute video presentation. Twenty-one final-year students from a single medical school participated in a concordance study and a validation test, identifying images corresponding to the halo sign in 120 different cases. The overall sensitivity, specificity and likelihood ratio of the students were also determined. Results: The overall concordance test had a kappa coefficient of 0.749 (SD: 0.11). The kappa concordance was 0.76 with dynamic images, and 0.84 with cross-sectional slices. The overall sensitivity was 89.7%, and the positive predictive value was 92.3%. The likelihood ratio achieved was 7.28. Conclusions: It has been shown that the application of this pedagogical method is useful in teaching the identification of an ultrasound sign to medical students. This study also suggests conditions that could be useful to improve between-observer agreement in both teaching scenarios and multiple observer scientific studies. / Revisión por pares

No description available.

This study investigated the morphologic differences of the giant vacuoles (GVs) in the inner wall endothelium of Schlemm’s canal (SC) in human eyes perfused at either 30 mmHg or 7 mmHg (physiologic pressure in enucleated eyes) using serial block-face scanning electron microscopy (SBF-SEM) paired with three-dimensional reconstruction software. Two normal human eyes were perfused at 30 mmHg with fluorescent tracers to mark regions of active and inactive flow, followed by perfusion-fixation. Tissue wedges (n = 6) of trabecular meshwork including SC from high-, low-, and non-flow areas of each eye (determined by tracer distribution) were dissected and processed for SBF-SEM. Four types of GVs were identified: Type I GVs which lack both a basal opening and an Ipore; Type II GVs which have a basal opening but lack an I-pore; Type III GVs which have an I-pore but lack a basal opening; and Type IV GVs which possess both a basal opening and an I-pore. Types and spans of GVs were collected from the SBF-SEM images, and volumes of GVs from a random subset were measured using 3D reconstruction. Results were compared with findings from an earlier study conducted with two eyes perfused at 7 mmHg and prepared in the same manner (Soares, 2022). In total, 19,047 SBF-SEM images were analyzed between 7 mmHg (n = 9586) and 30 mmHg (n = 9461) using Reconstruct. Statistical analysis comparing data between the two pressures was performed using R. There were more GVs found at 30 mmHg (n = 1541) when compared with 7 mmHg (n = 1312), and there were more Type IV GVs at 30 mmHg when compared with 7 mmHg. Type IV GVs occurred most frequently in high-flow areas at both pressures. GVs with I-pores were greater in size (both span and volume) than GVs without I-pores in all flow areas at both pressures. Type IV GVs were larger than Type II GVs which were larger than Type I GVs at both pressures. The span of GVs without I-pores was significantly greater at 7 mmHg. However, there was no significant difference between the volumes of GVs with or without I-pores between the two pressures. The result that GVs with I-pores were larger in size than GVs without I-pores at all conditions appears to support the theory that GV size is an important contributing factor to I-pore formation. The differences in span but not volume of GVs without I-pores between two pressures suggest that GVs at high pressure may be more convex in shape and may protrude further into SC, a situation which could contribute to thinning of the cellular membrane of GVs. Finally, the result that more Type IV GVs were found in high-flow areas at both pressures implies that the changing percentage of Type IV GVs likely plays a role in regulating segmental flow. / 2025-02-26T00:00:00Z

No description available.

京都大学 / 新制・論文博士 / 博士(理学) / 乙第13596号 / 論理博第1581号 / 新制||理||1722(附属図書館) / 京都大学大学院理学研究科物理学・宇宙物理学専攻 / (主査)教授 永江 知文, 教授 田島 治, 准教授 金田 佳子 / 学位規則第4条第2項該当 / Doctor of Science / Kyoto University / DGAM

京都大学 / 新制・課程博士 / 博士(理学) / 甲第25148号 / 理博第5055号 / 新制||理||1721(附属図書館) / 京都大学大学院理学研究科生物科学専攻 / (主査)教授 緒方 博之, 教授 望月 敦史, 教授 西山 朋子 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

El Tumor de Células Gigantes es un tumor de comportamiento localmente agresivo y que asienta a nivel óseo próximo a las articulaciones en pacientes jóvenes. La larga trayectoria en el tratamiento de los tumores óseos en el Hospital Universitario Virgen de la Arrixaca y la controversia actual en el diagnóstico y tratamiento de este tumor nos llevó a realizar esta Memoria. Todos los pacientes de la serie fueron sometidos a una completa anamnesis y exploración física y se cuantificaron los intervalos transcurridos desde la aparición de los síntomas, momento de consulta, diagnóstico y tratamiento. Se valora las técnicas diagnósticas empleadas, así como el tratamiento quirúrgico bien mediante procedimiento intralesional o resección amplia y las técnicas de reconstrucción. Se estudia la integración de los aloinjertos estructurales mediante la escala ISOLS y la integración del aloinjerto triturado mediante la escala VIIT. También se valora los resultados funcionales mediante la escala EFCOM. / Giant cell tumor is a locally aggressive bone tumor and it is located in the end of the long bones near of joints in young patients. The long history in the treatment of bone tumors at the Hospital Universitario Virgen de la Arrixaca and the current controversy in the diagnosis and treatment of this tumor led us to this report. All patients in the series underwent a complete history and physical examination and quantified the interval since the onset of symptoms, time of consultation, diagnosis and treatment. It assesses the diagnostic techniques used and the surgical procedure or by intralesional or wide resection and reconstruction techniques. We study the integration of structural allografts by ISOLS scale and integration of crushed allografts by the VIIT scale. It also assesses the functional results by EFCOM scale.

No description available.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 118-131).