hyperplastic and related disorders of om 1 (script # 1)

Upload: justden09

Post on 06-Apr-2018

219 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    1/14

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    2/14

    ( (

    Hcefxc wzoxzdmi Jx-XDKO owwdimcj z`oz z`cxc ydaa hc om OUI ht 3 koxbwfm aohw acg-w! wf tfs `ouc zf hc xcojt zf omwycx omt _ xcaozcj zf acgzsxcw

    omj tfs kot owbcj kfxc z`om fmc _ jsxdmi z`c y`fac wck-

    Edxwzat! Jx-Xdko y`dw`cw efx sw oaa z`c asgb efx z`dw gfsxwc! omj w`c ydw`cw

    z`oz FXOA \OZ@FAFIT 8 ydaa hc cowdcx z`om FXOA \OZ@FAFIT ?

    oggfxjdmi zf sw-

    Smefxzsmozcat! Jx jdjm)z iduc esaa acg- Hcgoswc fe `oudmi kcczdmi fm

    ?8>

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    3/14

    Wadjc ' 7

    @t|cx|aowdo fe fxoa ksgfwo dw swsoaat afgoad~cj-+

    +@fy jfcw afgoad~cj t|cx|aowzdg fxoa ksgfwo ydaa hc gadmdgoaat6

    Ydaa dz hc eaoz6

    Dz ydaa mfz hc eaoz2 dz ydaa affb adbc dmgxcowdmi+wd~cj cpf|`dzdg

    koww-

    Mfzc> kfwz fe z`c afgoad~cj `t|cx|aowzdg acwdfmw dm fxoa ksgfwo

    ! y`dg` dw goswcj htg`xfmdg dmeaokkozdfmoxc goswcj ht

    ?+g`xfmdg kcg`omdgoa zxosko adbc dm gowc fe fucx+cpzcmjcj

    jcmzsxc2 y`dg` goswcw mfm+wcucx zxosko (MF sagcxozdfm! MF

    haccjdmi! hsz dz)w GFMZDMFSW$

    Exdgzdfm-8+

    @coz-7+

    \aoqsc omj goagsaswoggsksaozdfm fe effj jchxdw fm idmiduo !:+

    ( bdmjw fe dxxdzomzw zf idmiduoa! jc|fwdz fm zffz` wsxeogc omj

    dmjsgc g`xfmdg dmeaokkozdfm wf acoj zf `t|cx|aowdo $-

    +Dmeaokkozdfm omj xc|odx zficz`cx ydaa |xfjsgc `t|cx|aowdo fe

    fxoa ksgfwo-

    Jx- wodj z`oz yc wzsjdcj dmeaokkozdfm |xfgcww! dmeaokkozfxt

    kcjdozfxw! |xfjsgzdfm fe ixomsaozdfm zdwwsc! |xfadecxozdfm fecmjfz`cadoa gcaaw omj dmgxcowdmi fe edhxfhaowzdg mfk-

    +Cpgcwwduc |xfjsgzdfm fe ixomsaozdfm zdwwsc ydaa goswc cpf|`dadg

    koww -

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    4/14

    +Swsoaat z`c `t|cx|aowdo fe fxoa ksgfwo jsc zf fucx ixfyz` fe

    ixomsaozdfm zdwwsc dw xcaozducat ouowgsaox ! hcgoswc z`dw

    ixomsaozdfm zdwwsc uoxdcw dm gcaasoaxdzt omj uowgsaoxdzt y`dg`

    gfsaj hc o wgox+adbc jsc zf jcgxcowcj dm gcaasaoxdzt omj

    uowgsaoxdzt-

    +Yc gfmgasjc z`oz `t|cx|aowdo fe fxoa ksgfwo dw goswcj ht

    g`xfmdg dmeaokkozdfm fe uoxdohac wfsxgcw-

    omt y`cxc dm z`c kfsz` hsz de dz)wAfgozdfm fe `t|cx|aowdo>

    c|sadw-dz)w goaacjidmiduofggsxxcj dm z`c

    C|sadw >mfm+mcf|aowzdg afgoad~cj! xcogzduc fucx+ixfyz` koww dm

    idmiduo -z`c fxoa ksgfwo w|cgdedgoaat

    Wadjc ' :

    Bdmjw fe c|sadw>

    Edhxfsw c|sadw-+

    +Uowgsaox c|sadw

    \cxd|`cxoa idomz gcaa ixomsafko-+

    Y`oz oxc z`c jdeecxcmzdoa jdoimfwdw fe `t|cx|aowdo dm z`c fxoa

    ksgfwo6 Y`oz gfsaj z`c c|sadw hc6

    \tficmdg ixomsafko uowgsaox c|sadw-+

    hsz dz)w!wc|oxozcj cmzdzt\cxd|`cxoa idomz gcaa ixomsafko+

    uowgsaox acwdfm hcgoswc fe di` go|daaoxt gfmzcmz-

    \cxd|`cxoa fwwdetdmi edhxfko gfmwdjcxj ow edhxfsw c|sadw+

    dxxdzozdfm edhxfko+

    +Idomz gcaa edhxfko

    Xczxfgsw|dj |o|daao+

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    5/14

    Oaa z`cwc kot cmzcx z`c jdeecxcmzdoa jdoimfwdw fe c|sadw-

    Wadjc ' 5

    C|sadjcw ( |asxoa fe c|sadw $

    Oiodm! c|sadw dw `t|cx|aowzdg ixfyz` fe z`c idmiduo y`dg` `ow dm

    z`cwc acwdfmw oxcacwdfm!dzw jdeecxcmzdoa jdoimfwdw kfxc z`om fmc

    jdudjcj dmzf uowgsaox omj edhxfsw omj \IGI-

    Dm icmcxoa gfk|oxdwfm hczyccm uowgsaox omj edhxfsw c|sadw.

    +Uowgsaox c|sadw > xcj! wfez! cjcmzsafsw omj cowdat haccjdmi

    koww-

    +Edhxfsw c|sadw > mfz cowdat haccjdmi koww! adbc ojnogcmz

    c|dz`cadoa gfafx-

    Affb oz z`dw |dg- Z`dw dw afgoad~cj

    koww fm idmiduo! wadi`zat |dmbdw`-

    Z`dw acwdfm dw edxwzat jcwgxdhcj

    smzda |xfudmi dzwgadmdgoaat ow c|sadwkdgxfwgf|dgoaat-jdoimfwdw

    Wadjc ' 9 >

    C|sadjcw >

    Kfxc gfkkfm fm eckoacw-

    Kfxc gfkkfm fm kop- z`om komj- ( ydz` wfkc cpgc|zdfmw$-

    Fggsx kodmat omzcxdfxat zf kfaoxw! xoxcat |xcwcmz |fwzcxdfxat zf

    kfaoxw-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    6/14

    Xcgsxxcmgc dw |fwwdhac y`cm> ?+ goswozduc eogzfxw oxc mfz

    xckfucj (y`cm z`c |aoqsc omj goagsasw oxc mfz gfmzxfaacj !

    omj zccz` oxc mfz gacom 2efx cpok|ac $

    caagdomzicxd|`cxoa|ow dm \IGI (Fx dm dmgfk|aczcat cpgdwdfm+8$xomsafkoi

    Wadjc ' 0

    Edxwzat! y`oz dw z`c jdeecxcmgc hczyccm |cjsmgsaozcj omj

    wcwwdac6

    \cjsmgsaozcj> gfmwzxsgzcj howc fe z`c acwdfm-

    Wcwwdac> hxfoj howc fe z`c acwdfm-

    fe edhxfsw c|sadw6ozsxcwgadmdgoa ecY`oz oxc z`c.

    +\cjsmgsaozcj fx wcwwdac-

    +Edxk-

    +Wdkdaox fm gfafx zf ojnogcmz idmiduo-

    \xcwcmgc & ohwcmgc c fe sagcxozdfm oggfxjdmi zf o zxosko-+

    Haccjdmi dw MFZ o ecozsxc! smacww wcgfmjoxdat zxosko fggsxxcj-

    Wadjc ' 4 omj ?

    ?+Gcaasaox uoxdohdadzt> oggfxjdmi zf mskhcx fe gcaaw2

    +De z`cxc dw gcaasaox edhxfsw wzxfko (de tfs gom wcc z`c msgacd fe

    edhxfhaowzw$ wf dz)w |cxd|`cxoa fwwdetdmi edhxfko-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    7/14

    > hfmcmifwwdetdfszwdjc z`c hfmc2 dm idmiduo!(|cxd|`cxoa>

    > gcaasaoxdzt fe edhxfswedhxfkokozxdp!efxkozdfm dm edhxfsw

    zdwwsc- $

    +De z`c mskhcx fe msgacd dw wkoaa ht z`c |xcwcmgc fx ohwcmgc fegoagdedgozdfm z`cm dz)w ogcaasaox edhxfsw zdwwsc wf dz)w `t|cx|aowzdg

    idmidudzdw-

    Kozsxc gfaaoicm-8+

    7+Dmeaokkozfxt dmedazxozdfm dw |xcwcmz dm kfwz fe z`c idmiduoa

    hdf|wdcw! hcgoswc idmiduo dw cp|fwcj zf |aoqsc omj goagsasw

    oggsksaozdfm ( z`c wfsxgc fe hogzcxdo$ ! z`c kodm dmedazxozdfm dw

    |aowko gcaaw-z`c

    +@t|cx|aowzdg acwdfm xcogzw ydz` |aoqsc omj goagsasw fm idmiduoa

    w|cgdedgoaat! wf dz)w gfkkfm zf `ouc dmeaokkozfxt dmedazcxozozdfm

    fm c|sadjcw-

    Hfmc efxkozdfm-:+

    3+Wzxfko gfsaj hc acww gcaasaox omj acww uowgsaox wf dz)w goaacj`t|cx|aowzdg idmidudzdw-

    z`dw dkoic dm z`c wadjc dw gcaasaox edhxfsw zdwwsc ( wcc z`c haogb

    jfzw $ gfmzodmw goagdedcj kozcxdoa dm z`c gcmzcx! wf dz)w |cxd|`cxoa

    fwwdetdmi edhxfko-

    Z`dw hdf|wt gfsaj hc exfk idmiduo hcgoswc haogb jfzw dmjdgozc

    |aowko gcaaw y`dg` oxc z`c kodm dmedazxozdfm fe dmeaokkozdfm !

    y`dg` dw kfwz fggsxxcj fm idmiduo-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    8/14

    Wadjc ' ??

    (8$$?

    Y`dg` fmc fe z`cwc c|sadjcw dw wcwwdac omj y`dg` fmc dw

    |cjsmgsaozcj6

    (?$dw |cjsmgsaozcj acwdfm hcgoswc fe howc gfmwzxsgzdfm-

    (8$ dw wcwwdac hcgoswc z`c howc dw eaoz fx hxfoj-

    sagcxozcj uowgsaox c|sadw-wcgfmjoxdatckoic (?$ dwMfzc >

    Wadjc ' ?3 >

    Gadmdgoa ecozsxcw fe uowgsaox c|sadw>

    +Joxb xcj+|sx|ac> hcgoswc fe `di` uowgsaoxdzt wf `oudmi

    jdeecxcmz gfafx fe ojnogcmz zdwwsc-

    +Dz kot wcgfmjoxdat sagcxozcj-

    Cowdat haccjdmi-+

    +Wfez! hcgoswc fe `oudmi o afz fe haffj ucwwcaw! smadbc

    edhxfsw c|sadw y`dg` dw edhxfsw zdwwsc `oudmi o afz fe

    gfaaoicm ( edxk zdwwsc $-

    +Xo|djat ixfyz` w|cgdedgoaat |tficmdg ixomsafko! wf dz

    kot xcog` o hdi wd~c cucm dm fmc yccb! omj z`c gadmdgdom

    kot z`dmb z`oz dz)w koadimomz zskfx-

    Swsoaat z`cxc dw o `dwzfxt fe zxosko-+

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    9/14

    hsz dz|tficmdg ixomsafko dw gfkkfm fm idmiduo !Dk|- Mfzc>

    z`dwkot fggsx dm omt |oxz fe z`c kfsz` wsg` ow ad| omj wbdm !

    |fdmz dw ucxt dk|fxzomz zf jdwzdmisdw` dz exfk fz`cx acwdfmw

    mfz fm!fmaty`dg` fggsx nswz dm idmiduo omj oaucfaox ksgfwo

    hsggoa ksgfwo fx wfez |oaozc-

    Y`oz dw z`c jdeecxcmgc hczyccm idmiduo omj oaucfaox ksgfwo6+

    Oaucfaox ksgfwo> dm gowc fe zccz` ohwcmgc fx cpzxogzcj zccz`-

    Idmiduo > dm gowc fe zccz` |xcwcmgc-

    Hfz` wccm fm wadjc ' 8?-

    Wadjc ' ?5

    De |tficmdg ixomsafko fggsxw dm |xcimomgt fm idmiduo z`cm dz)w

    |xcimomgt c|sadw-goaacj

    \xcimomgt c|sadw ; |tficmdg ixomsafko;afhsaox go|daaoxt

    `ckomidfko-

    Y`t jfcw |tficmdg ixomsafko fggsx swsoaat fm |xcimomgt6+

    cmjfz`cadoa gcaaw dm idmiduo oxc xcw|fmwduc zf \xcimomgt

    `fxkfmcw wsg` ow cwzxficm omj |xficwzcxfmc hcgoswc fe

    `oudmi xcgc|zfxw efx z`cwc `fxkfmcw! wf z`cwc `fxkfmcw

    wzdksaozc cmjfz`cadoa gcaaw |xfadecxozdfm! wf |tficmdg ixomsafko

    xcog` o hdi wd~c jsxdmi |xcimomgt-

    xckfuoa fe |tficmdg ixomsafko dm |xcimomgtwsxidgoaMfzc>

    w`fsaj hc jcaotcj hcgoswc de dz)w xckfucj dz ydaa xcgsx oiodm!

    hcgoswc w`c(|xcimomz |z-$ wzdaa `ouc z`c wokc xcgc|zfxw omj z`c

    wokc `fxkfmcw! wf z`c zxcozkcmz w`fsaj hc jcaotcj oezcx

    cpgc|z dm wfkc gowcw-jcaducxt

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    10/14

    Wadjc ' ?9! ?0

    \tficmdg ixomsafko gfsaj fggsx fm ad| fx wbdm jsc zf zxosko!

    omj dz)w uowgsaox omj haccjw cowdat-

    Dm z`c zfmisc ow dm z`c dkoic dz gfsaj hc |oac hcgoswc z`dw

    g`xfmdg acwdfm ( |tficmdg ixomsafko$ ydaa `ouc acww ucwwcaw omj

    kfxc edhxfsw wf gfafx dw kfxc |oac omj haccjdmi dw jcgxcowcj-

    Oaz`fsi` dz affbw |oac omj edxk hsz dz)w |tficmdg ixomsafko z`oz

    `o||cmw y`cm dz)w kozsxc omj hcgfkc g`xfmdg wf hcgfkc

    kfxc edhxfsw-

    omt xcogzduc zdwwsc gfsaj `ouc kdmcxoad~cj zdwwscMfzc>efxkozdfm wsg` ow idmidudzdw-

    kot hc o hfmc efxkozdfm fm z`c zfmisc ow om> z`cxcMfzc

    cgzf|dg acwdfm-

    Wadjc ' ?4

    @dwzf|oz`fafit fe |tficmdg ixomsafko>

    Affb oz z`c dkoic dm z`dw wadjc! affb oz z`c w|ogcw y`dg` oxc

    go|daaoxdcw omj z`cxc oxc edhxfsw wc|zo-

    ?+Z`dw xc|xcwcmz |tficmdg ixomsafko ow afhsaox go|daaoxt

    > afhsacw wc|oxozcj ht edhxfsw wc|zo!afhsaox`ckomidfko (

    swc fe `oudmi wkoaa haffj ucwwcaw mfz> hcgogo|daaoxt

    `oudmi o afz fe uowgsaox w|ogcw$->`ckomidfko.goucxmfsw!

    Goucxmfsw > jdaozcj haffj ucwwca-

    Z`dw zcxk (afhsaox go|daaoxt `ckomidfko$ dw z`c 8mj

    mokc fe

    |tficmdg ixomsafko hsz dz)w kfxc jcwgxd|zduc-

    8+ @di`at uowgsaox |xfadecxozdfm-

    \xcwcmgc & ohwcmgc fe sagcxozdfm jsc zf zxosko-7+

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    11/14

    :+Fajcx acwdfmw oxc iczzdmi kfxc edhxfsw omj |oac ow wccm fm

    z`c zfmisc dkoic-

    Wadjc ' 8

    Wsxidgoa xckfuoa fe z`c dxxdzomz fx z`c goswc zf oufdj

    xcgsxxcmgc-

    Hsz dm |xcimomgt dz)w jcaotcj-

    Wadjc ' 8?

    \cxd|`cxoa idomz gcaa ixomsafko

    Wadjc ' 88

    +Wf y`cm `oudmi gcmzxoa idomz gcaa ixomsafko yc w`fsaj

    kcowsxc |oxoz`txfdj `fxkfmc acuca zf xsac fsz

    `t|cx|oxoz`txfdjdwk-

    Hfz` \IGI omj GIGI oxc mfm+mcf|aowzdg! hfz` affb adbc cog`

    fz`cx gadmdgoaat hcgoswc GIGI |cxefxozc z`c hfmc omj \IGIfggsx fm idmiduoa omj oaucfaox ksgfwo! omj dm hfz` gowcw yc

    w`fsaj owb ohfsz |oxoz`txfdj `fxkfmc acuca! hszz`ct gfsaj hc

    jdwzdmisdw`cj xojdfixo|`dgoaat-

    Xckckhcx> gcmzxoa idomz gcaa ixomsafko> hfmt acwdfm fggsx omz- Zf

    komj- Gfmzodm ksazd msgacozcj idomz gcaaw omj wzxfko fe edhxfhaowz adbc

    gcaaw! omj (6$ omj dz)w uowgsaox hcgoswc fe `oudmi |acmzt fe go|daaoxt-

    Omj dz affbw adbc hxfym zskfx fe `t|cx|oxoz`txfdjdwk-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    12/14

    Wf \IGI fggsx fm idmiduo omj oaucfaox ksgfwo omj GIGI fggsx

    dmwdjc z`c hfmc wf y`cm dz |cxefxozcw z`c hfmc dz ydaa hc o||cox

    fm idmiduo omj oaucfaox ksgfwo-

    +Z`cxc kothc ws|cxedgdoa hfmc cxfwdm dm |cxd|`cxoa zt|c! adbc (efx cpok|ac $ y`cm zobdmi xojdfixo|` omj edmj wfwcxd~ozdfm (

    mfz wsxc$ dm oaucfaox hfmc gxcwz z`oz jfcwm)z kcom z`oz z`dw

    acwdfm dw GIGI-

    Y`oz)w z`c fxdidm fe idomz gcaa6 (Exfk y`cxc dz oxdwcw$6+

    Kogxf|`oicw fx fwzccfgaoz fx |cxdfwzcsk-

    Wf z`c wfsxgcw fe \IGI oxc> kogxf|`oicw! fwzcfgoawz omj|cxdfwzcsk-

    omj oaucfaox ksgfwo-> \IGI fggsxw fmat fm idmiduoMfzc

    Wadjc ' 87! 8:

    +\IGI dw swsoaat xcj hcgoswc fe `oudmi o afz fe go|daaoxdcw omj

    XHG)w wsg` z`c gowc dm GIGI!omj z`cxc kothc `ckfwdjxcm

    |xcwcmgc jsc zf XHG)w jcwzxsgzdfm-

    +Dz)w gfkkfmat sagcxozcj-

    De \IGI fggsxw fm dmzcxjcmzoa |o|daao dz ydaa affb adbc `fsx+iaoww!

    wf mokcj hcgoswc dz)w wqscc~cj hczyccm zccz`-

    Omj dz |xfzxsjcw hsggoaat omj admisoaat omj gfmwzxsgzcj dm z`ckdjjac ow dm wadjc ' 83-

    Wf dm \IGI jdoimfwdw yc `ouc zf xsac fsz hfz` GIGI omj

    dmMFZ`t|cx|oxoz`txfdjdwk! hsz z`dw xsadmi fsz dw nswz fm \IGI

    |tficmdg ixomsafko-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    13/14

    Affb `fy uowgsaox dz dw! jsc zf z`cwc gfmicwzcj go|daaoxt t7md

    omj ht XHG)w jcwzxsgzdfm `ckfwdjxcm dwydz` XHG)w!esaa

    |xfjsgcj z`oz iducw z`c acwdfm dzw hxfym gfafx-

    Y`oz jfcw wzxfkoa gcaaw kcom6

    Wzxfkoa gcaaw oxc w|dmjac fx fufdj gcaaw( y`dg` `ouc go|daaoxt !

    edhxfhaowz! kogxf|`oicw! cmjfz`cadoa gcaaw omj dmeaokkozfxt

    kcjdozfxw $ y`dg` oxc cpzcmjcj hczyccm z`cwc ksazdmsgacozcj

    idomz gcaaw ow wccm dm z`cwc wadjcw-

    Kfwz fe z`c xcogzduc acwdfmw jsc zf o gcxzodm goswc ydaa `ouc

    hfmc efxkozdfm omj dz gfsaj hc efsmj dm kfxc z`om fmc |aogc-

    wadjc ' 83

    +z`dw dw o admisoa koww fm idmiduo ( omj dz gfsaj hc hsggoaat hsz

    dz)w mfz fhudfsw$

    +z`dw koww kot fggsx hsggoaat fx admisoaat fx hfz`! dz kot wzoxz

    hsggoaat omj z`cm |xfzxsjc admisoaat-

    +Hcgoswc kfwz fe z`c goagsasw fggsxw admisoaat! wf z`c kowwcw

    gfsaj fggsx admisoaat-

    Wadjc ' 85

    yc w`fsaj xsac fszksazd|ac \IGIDm gowc fe

    `t|cx|oxoz`txfdjdwk kodmat! omj dm xoxc gowcw

    mcsxfedhxfkozfwdw ?-

    Wadjc ' 89

    Zxcozkcmz fe \IGI>

    +Afgoa cpgdwdfm omj xckfuoa fx gfxxcgzdfm fe smjcxatdmi goswc zf

    |xcucmz xcgsxxcmgc-

  • 8/3/2019 Hyperplastic and related disorders of OM 1 (Script # 1)

    14/14

    +De \IGI mfz zxcozcj ycaa fx mfz gfk|aczcat xckfucj dz ydaa

    xcgsx ht 5