Objective: We hypothesized that histopathology predicts survival without cardiac transplantation in patients with biopsy- proven myocarditis. Background: The role of endomyocardial biopsy in diagnosing myocarditis rem...
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Objective: We hypothesized that histopathology predicts survival without cardiac transplantation in patients with biopsy- proven myocarditis. Background: The role of endomyocardial biopsy in diagnosing myocarditis remains controversial. Histopathology has been integrated with clinical and hemodynamic features to predict prognosis. However, the influence of histopathology on survival >5 years has not been explored. Methods: We retrospectively identified 112 consecutive patients with histopathologic confirmation of myocarditis. We examined these patients’ clinical presentation, hemodynamic assessment, hospital course, and treatment. We selected 14 variables that might influence survival without cardiac transplantation. Results: A total of 62(55% ) of 112 patients had lymphocytic myocarditis; 88(79% ) and 63(56% ) were alive without cardiac transplantation at 1 and 5 years, respectively. Median follow- up was a mean 95.5 months and median 74.5 months. Among the 55 with complete data of the 14 candidate predictor variables, age, sex, and clinical presentation with congestive heart failure and ventricular(ventricular tachycardia or fibrillation) or atrial arrhythmias(atrial fibrillation or flutter) did not predict the study end point of death or need for transplantation. In univariate analysis, pulmonary capillary wedge pressure ≥ 15 mm Hg significantly predicted the study end point. In multivariate analysis, pulmonary capillary wedge pressure ≥ 15 mm Hg and histopathology of lymphocytic, granulomatous, or giant cell myocarditis each significantly predicted mortality or transplant(P=.047, P=.013, and P=.054, respectively) on cumulative survival without cardiac transplantation. Conclusions: Histopathology predicts long- term survival in patients with myocarditis. Clinical presentation, including presentation with congestive heart failure, ventricular tachycardia/ ventricular fibrillation, or atrial fibrillation/atrial flutter, does not predict survival without transplanta
AIM: To evaluate spiral computed tomography (CT) including virtual gastroscopy for diagnosis of gastric carcinoma in comparison with upper gastrointestinal series (UGI),fiberoptic gastroscopy (FG) and ***: Sixty patie...
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AIM: To evaluate spiral computed tomography (CT) including virtual gastroscopy for diagnosis of gastric carcinoma in comparison with upper gastrointestinal series (UGI),fiberoptic gastroscopy (FG) and ***: Sixty patients with histologically proven gastric carcinoma (54 advanced and 6 early) were included in this study. The results of spiral CT were compared with those of UGI and FG. Two observers blindly evaluated images of spiral CT and UGI and video recording of FG with consensus in terms of diagnostic confidence with a five-point *** of lesion detection, Borrmann′s classification of spiral CT, UGI and FG, as well as the accuracy of TNM staging of spiral CT were determined by comparing them to surgical and histological ***: The lesion detection rate was 98 % (59/60),95 % (57/60) and 98 % (59/60) for spiral CT, UGI and FG,respectively. There were no statistical differences in the detection sensitivity among the three techniques (P>0.05).For the sensitivity in Borrmann′s classification, spiral CT was higher than that of UGI (P=0.025) and similar to that of FG (P>0.05). The accuracy of spiral CT in staging the gastric carcinoma was 76.7 %. Six cases of early gastric carcinoma were all detected by spiral CT as well as ***: Spiral CT is equivalent to UGI and FG in the detection of gastric carcinoma, and superior to UGI but similar to FG in the Borrmann′s classification of advanced gastric carcinoma. Spiral CT is more valuable than FG in the staging of gastric carcinoma.
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