智慧人生

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(2005-06-03 06:22:09)

UltrasonographyUltrasoundhasfoundincreasedapplicationtothelowergenitourinarytract.Itresultsinminimaldiscomfort;givesa3-dimensionalappreciationoftheshape,size,andvolumeoforgansanddisease;andcanprovidedirectintervention.Varioustransducersareavailable;high-megahertztransducersarerequiredforsuperficialstructures(forexample,scrotalstructures)toassesstesticulardisease(includingtumorsandtorsion),whilelow...[阅读全文]
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(2005-06-03 06:19:45)

DiagnosticClinicalApplicationsQuantitativeLuminalMeasurementsAbroadspectrumoftherapeuticdecisionshingeonassessmentofcoronaryluminaldimensions.Accordingly,indiagnosticandinterventionalpractice,quantitationofvasculardimensionsrepresentsacommonclinicalapplicationofintravascularultrasound.Recently,acommitteeoftheAmericanCollegeofCardiologyandtheEuropeanSocietyofCardiologydefinedstandardsfortheacquisit...[阅读全文]
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(2005-06-03 06:15:44)

CoronaryIntravascularUltrasoundImaging:IntroductionAftermorethanadecadeofcontinuousdevelopment,coronaryintravascularultrasoundhasachievedgeneralacceptanceasanessentialelementinallcontemporarycatheterizationlaboratories.Althoughangiographycontinuestoserveastheprimaryimagingmodalityusedtoassesstheanatomyofcoronaryarterydisease,intravascularultrasoundrepresentsanimportantalternativemethodforexaminati...[阅读全文]
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(2005-06-03 06:09:29)

EssentialsofDiagnosisRiskfactorsincludedelayedchildbearing,positivefamilyhistoryofbreastcancerorgeneticmutations(BRCA1,BRCA2),andpersonalhistoryofbreastcancerorsometypesofmammarydysplasia.Mostwomenwithbreastcancerdonothaveidentifiableriskfactors.Earlyfindings:Single,nontender,firmtohardmasswithill-definedmargins;mammographicabnormalitiesandnopalpablemass.Laterfindings:Skinornippleretraction;axilla...[阅读全文]
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(2005-06-03 06:05:22)

EssentialsofDiagnosisPainful,oftenmultiple,usuallybilateralmassesinthebreast.Rapidfluctuationinthesizeofthemassesiscommon.Frequently,painoccursorincreasesandsizeincreasesduringpremenstrualphaseofcycle.Mostcommonageis30–50.Rareinpostmenopausalwomennotreceivinghormonalreplacement.GeneralConsiderationsThisdisorderisthemostfrequentlesionofthebreast.Itiscommoninwomen30–50yearsofagebutrareinpostmenopa...[阅读全文]
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(2005-06-03 06:00:30)

BenignProstaticHyperplasia(BPH)Incidence&EpidemiologyBPHisthemostcommonbenigntumorinmen,anditsincidenceisage-related.TheprevalenceofhistologicBPHinautopsystudiesrisesfromapproximately20%inmenaged41–50,to50%inmenaged51–60,andtoover90%inmenolderthan80.Althoughclinicalevidenceofdiseaseoccurslesscommonly,symptomsofprostaticobstructionarealsoage-related.Atage55,approximately25%ofmenreportobstruct...[阅读全文]
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(2005-06-03 05:51:16)

EssentialsofDiagnosisTotalserumcholesterolgreaterthan200mg/dLontwosamplesatleast2weeksapartLDLcholesterolgreaterthan100mg/dLHDLcholesterollessthan40mg/dLTriglyceridesgreaterthan200mg/dLGeneralConsiderationsInrecentyears,agreatdealofemphasishasbeenplacedontherelationshipbetweenelevatedserumcholesterollevels—especiallylow-densitylipoproteincholesterollow-densitylipoproteincholesterolcomplex(LDL-C)—...[阅读全文]
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(2005-06-03 05:47:29)

PhysicalFindingsPhysicalExaminationThephysicalexaminationislessimportantthanthehistoryinpatientswithischemicheartdisease,butitisofcriticalvalueinpatientswithcongenitalandvalvularheartdisease.Inthelattertwocategories,thephysiciancanoftenmakespecificanatomicandetiologicdiagnosesbasedonthephysicalexamination.Certainabnormalmurmursandheartsoundsarespecificforstructuralabnormalitiesoftheheart.Thephysic...[阅读全文]
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(2005-06-03 05:45:17)

SonographyBasicPrinciplesSoundisthemechanicalpropagationofpressurechanges,orwaves,throughadeformablemedium.Awavefrequencyofonecycle/second(cps)iscalledahertz(Hz).Soundfrequenciesgreaterthan20kHzarebeyondtherangeofhumanhearingandarecalledultrasound.Medicalsonographyusesultrasoundtoproduceimages(Figures6–22,6–23,6–24,6–25,6–26,and6–27).Thefrequenciescommonlyusedinmedicalsonographyarebetween3.5...[阅读全文]
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(2005-06-03 05:43:02)
Appendix17–3.RecommendationsforIntracoronaryPhysiologicMeasurements(DopplerUltrasound,FFR)ClassINoneClassIIaLevelofEvidence1.Assessmentofthephysiologiceffectsofintermediatecoronarystenosis(30to70percentluminalnarrowing)inpatientswithanginalsymptoms.CoronarypressureorDopplervelocimetrymayalsobeusefulasanalternativetoperformingnoninvasivefunctionaltesting(e.g.,whe...[阅读全文]
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