Treatment of the acute severe pulmonary embolism using endovascular methods

Purpose: To present a single-centre experience with endovascular treatment of patients with severe symptoms secondary to acute pulmonary embolism (PE). Material and methods: Twenty-five patients were treated due to contraindications or deficient effects of systemic thrombolytic therapy. The patients were treated with a combination of fragmentation and aspiration, only aspiration, or only fragmentation, and with catheter-directed thrombolytic therapy. Results: The saturation was improved following treatment in all patients, except in one where the procedure could not be completed. There were no immediate or late procedure-related complications. Conclusions: Endovascular treatment of severe PE is a safe and efficient option in patients with failing effect or contraindication to systemic thrombolysis

Att skildra sin historia - En diskursanalys av franska politikers bild av Frankrikes roll som kolonisatör sett ur ett postkolonialteoretiskt och mångkulturellt perspektiv

The aftermath of colonization, culture diversity and the recognition of the own identity - living in a country which has the role of a former colonizer has got consequences in the multicultural French society. These consequences can be seen studying the politics, the education and the history of that country. In this bachelor thesis I discuss the aftermath of French colonization with a focus on how the French cultural identity can be explained in defining colonialism in French lawmaking. The aim is to understand the definition of the own cultural identity from a postcolonial perspective and what meaning the multicultural society has for this definition. This is an issue which can be seen in politics as well as in everyday life, and to make an understanding of it, I study how French politicians are representing their country's role as a former colonizer in a postcolonial era. By adopting a discourse analysis to this theme, studying a debate of the law which aims to recognize the French colonial role in North Africa during the colonial rule with a focus on Algeria, I try to understand how influential politicians in France have the power to explain the French role as colonizer, as well as the power to defend the cultural identity of their country, in teaching new generations about the history of French colonialism

Response of the Esophageal Epithelium to Concomitant Cis-Dichlorodiammineplatinum(II) and Radiation Treatment. An Electron Microscopic Study in Rabbits

The rabbit esophageal mucosa was irradiated with daily fractions of 2 Gy up to an accumulated dose of 20 Gy (total dose 2, 6, 10. 16 or 20 Gy). Fifteen to forty-five minutes before the start of each irradiation 0.3 mg Cis-dichlorodiammineplatinum (cis-DDP, cisplatinum) was given by intraperitoneal injection to each rabbit. Examinations were carried out 1-10 days after each fractionation schedule, when specimens were taken for morphological investigations. Scanning electron microscope (SEM) examination showed a gradual development of damage with cell loss and structural disarrangement of the microridges and whorls on the surface. However, with further treatment the esophageal mucosa exposed to cis-DDP and radiation normalized faster and more complete compared to the esophageal part exposed to cis-DDP alone. The difference may depend on an accelerated proliferation in the part of the trachea that is exposed to a combined treatment

Hasan di Tiros dagbok - Den narrativa konstruktionen av en fiendebild

Hasan di Tiro och organisationen Acheh Sumatra National Liberation Front (ASNLF) har varit den drivande kraften i kampen för ett självständigt Acheh, som sedan 1949 varit en del av Indonesien. Deras främsta argument är att när den forna nederländska kolonin upplöstes överläts Acheh till den konstruerade nationen Indonesien, ett land utan några som helst historiska eller kulturella band med Acheh. Syftet med denna uppsats är att utföra en narrativanalys på den dagbok Hasan di Tiro skrev 1976-79 mitt under den pågående frihetskampen. Vi analyserar vilka kognitiva och ideologiska uppfattningar som ligger till grund för konstruktionen av en achehnesisk fiendebild, samt hur di Tiro refererar till Indonesien som "den Andre" i sin narrativa diskurs. Vår analys visar att fiendebilden om Indonesien bygger på en stark förankring i Achehs historiska uppfattning från kolonialtiden, samt på ett resonemang där fienden avhumaniseras och sätts i en underlägsen position i kontrast till den egna identiteten

The Influence of 5-Fluorouracil on the Endothelium in Small Arteries. An Electron Microscopic Study in Rabbits

5-Fluorouracil (5-FU) is a widely used antineoplastic agent. 5-FU induced cardiotoxicity is a still relatively unknown side-effect of this drug. This phenomenon could be due to a direct cytotoxic effect on the endothelial cells. We tested this hypothesis in an experimental study in rabbits, by scanning or transmission electron microscopic evaluation of endothelium in small arteries (the central artery of the ear) after in vivo treatment with 5-FU. Both local and systemic effects of 5-FU on endothelium were studied 15, 30, 60 and 120 minutes after intra-arterial or intraperitoneal treatment. Perfusion fixation at physiological pressure and temperature was used in order to minimize damage to the endothelium during the preparation procedure. Eighteen rabbits weighing 2.5-3.0 kg were used, and 6 animals served as controls. The following parameters were evaluated: vessel wall and endothelial cell contraction, cell edema, cytolysis, occurrence of denuded areas, platelet adhesion/aggregation and fibrin formation. For the description of each parameter a scale of negative points was used. Irreversible cell damage was observed in 5-FU treated animals: disruption of the endothelial sheet and patchy exposure of the subendothelium, sometimes as a focus for thrombus formation. Our findings support the hypothesis that the thrombogenic effect of 5-FU secondary to its direct cytotoxic effect on endothelium might be one of the pathophysiological mechanisms behind 5-FU induced cardiotoxicity

The Appearance of Endothelium in Small Arteries After Treatment with 5-Fluorouracil. An Electron Microscopic Study of Late Effects in Rabbits

Cardiotoxicity is an unexplained toxic manifestation of 5-fluorouracil (5-FU). Its possible mechanism could be a direct cytotoxic effect on the vascular endothelium. We have tested this hypothesis in an experimental study in rabbits, using scanning and transmission electron microscopic evaluation of endothelium in small arteries (the central artery of the ear). The perfusion fixation method at physiological pressure and temperature was used. Both local and systemic effects of 5-FU on endothelium were studied 1, 3, 7, 14 and 30 days after in vivo treatment with 5-FU. Fifteen rabbits were used and five additional animals served as controls. The following parameters were evaluated: vessel wall and endothelial cell contraction, cell oedema, cytolysis, occurrence of denuded areas, platelet adhesion/aggregation and fibrin formation. For the description of each parameter, a scale of negative points (0.0-3.0) was used. We found severe cell damage with accompanying thrombus formation. The findings support the hypothesis that the thrombogenic effect of 5-FU, secondary to its direct cytotoxic effect on endothelium, is the pathophysiological mechanism behind 5-FU cardiotoxicity

Scanning Electron Microscopy of Human Esophageal Mucosa in Patients with Carcinoma of the Esophagus

Specimens taken at surgery from 15 patients with carcinoma of the esophagus were examined with scanning electron microscopy. Nine patients were treated with chemotherapy (cisplatin + 5-fluorouracil), surgery and radiotherapy; one received preoperative radiotherapy only; and the remaining five primary surgery only. Scanning electron microscopy was performed on specimens of both tumor tissue and the mucosa at least 5 cm from the tumor. In adjacent non-tumor tissue, damage due to treatment was observed in the form of changes in microridges and increased cell loss. In tumor tissue, the degree of damage was correlated to tumor response to treatment. For patients with no residual tumor after treatment, the ultrastructure was normalized with a low tumor score, while for patients with residual tumor, the score was high

Conformation of Adjacent Self-expanding Stents: A Cross-Sectional In Vitro Study

We examined the proximal conformation of three commonly used self-expanding stents when the stents were deployed adjacent to one another in a tubular model, simulating a “kissing” stent technique. The stent pairs were evaluated by computed tomogrphy to determine the cross-sectional area excluded by the stents within the model. The mean areas associated with each stent pair were compared and significance evaluated by a t -test. A statistically significant difference was found when the area excluded by adjacent Wallstents was compared with both the Luminexx and SMART stents ( p < 0.001 and p < 0.002, respectively). The difference in the area excluded and differences in conformation might play a role in the lower patencies that have been observed in “kissing” stent series.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41328/1/270_2005_Article_33.pd

Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area

Brunner's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunner's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunner's gland hyperplasia. The final diagnosis was the coexistence of Brunner's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunner's gland hyperplasia is reviewed