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81.
Shuichi Adachi Ken Kawamura Shouji Yoshida Kazuo Takemoto 《International archives of occupational and environmental health》1992,63(8):553-557
Summary We compared the potential of asbestos and man-made fibers to attack DNA by the determination of the yield of 8-hydroxy-2-deoxyguanosine (8-OH-dGuo) under several in vitro conditions. Asbestos induced 6.6–99.8 of 8-OH-dGuo per 105 dGuo in calf thymus DNA after 20 h of incubation, while the levels of 8-OH-dGuo in man-made fibers were low (3.6–9.4). The amounts of 8-OH-dGuo were strongly stimulated by the addition of H2O2 in asbestos, but not in man-made fibers. However, the yield of 8-OH-dGuo was induced more than that with asbestos by the further addition of FeSO4 in attapulgite, fiberglass, potassium titanate whisker, and metaphosphate polymer. The addition of ethylene diamine tetraacetic acid (EDTA) promoted the induction of 8-OH-dGuo with asbestos and H2O2. The effects of mannitol (known as a hydroxy radical scavenger) were not dramatic on 8-OH-dGuo induction by all fibers except fiberglass and basic magnesium sulfate whisker, which induced higher amounts after mannitol addition than in these fibers and H2O2. Therefore, it was suggested that asbestos could damage DNA, resulting in 8-OH-dGuo as a cause of point mutation, and also several types of manmade fibers had similar effects to asbestos under certain conditions. 相似文献
82.
83.
目的 研究颈分区性清扫术在头颈部鳞状细胞癌 (简称鳞癌 )治疗中的效果。方法 回顾性分析 1997年 1月~ 2 0 0 1年 12月在中国医学科学院肿瘤医院接受分区性清扫术的头颈部鳞癌患者 12 3例 ,其中喉癌 77例、口腔癌 2 9例、口咽癌 2例、下咽癌 15例。分区性清扫术后发现淋巴结病理阴性 (pN0 ) 99例 ,淋巴结病理阳性 (pN + ) 2 4例。随访时间中位数为 2 5个月。结果 10 1例cN0患者行分区性清扫术后发现pN + 14例 ( 13 9% ) ;2 2例cN +患者行分区性清扫术后发现pN + 10例( 4 5 5 % )。 15 7侧分区性清扫标本中共发现 5 2枚阳性淋巴结 ,其在颈部的分布如下 :Ⅰ区 2 5 % ,Ⅱ区4 8% ,Ⅲ区 2 5 % ,Ⅳ区 2 %。根据Kaplan Meier方法计算 5年颈部复发率 ,pN0患者为 5 87% ( 95 %可信区间 0 8% ,10 9% ) ,pN +患者为 9 2 % ( 95 %可信区间 0 0 % ,2 1 5 % )。结论 颈分区性清扫术从微创观念出发 ,只要选择恰当 ,对于头颈部鳞癌患者可以取得与传统颈清扫术相当的效果。更重要的是保留了患者的功能和外观 ,提高了生活质量 相似文献
84.
85.
目的 观察比较乳腺癌根治术后曲马多PCIA与吗啡PCEA临床镇痛效果及副作用。方法 乳腺癌根治术后病人 12 0例。随机分两组 :T组 (PCIA组 ) ,M组 (PCEA组 )。PCA设备 :2ml/h持续输注 ,单次PCA剂量 0 .5ml,锁定时间 15min。术后 6 ,12 ,2 4 ,4 8小时观察病人药物用量、镇静镇痛评分 ,满意水平及副作用。结果 T组 4 8小时Tramadol用量 (90 8.2± 5 9.7)mg ,按键次数 (6±1.5 )次 ;M组Mor phine(4 .8± 0 )mg ,按键次数 (0 )次。镇痛效果 :VAS及SS评分无显著性差异 ,优良率 >98%。副作用 :T组病人恶心、呕吐发生率明显低于M组 (P <0 .0 1)。结论 曲马多PCIA与吗啡PCEA镇痛效果确切 ,但在副反应方面曲马多PCIA相对较少 相似文献
86.
[目的]探讨连续间置空肠代胃消化道重建术在全胃切除后的应用价值.[方法]对2000年1月至2002年3月间26例全胃切除连续间置空肠代胃术的临床资料进行分析.[结果]全组病人无手术死亡和吻合口瘘发生.随访12个月至25个月,平均17.4个月.其中钡餐检查11例,代胃容量均在300ml以上,排空时间为30min~120 mm.术后6个月、12个月出现反流性食管炎分别为6例和2例.与术前相比,术后生活质量有所提高.[结论]连续间置空肠代胃术是全胃切除消化道重建的理想术式,手术操作简便省时,可取得较好的生活质量. 相似文献
87.
Hideki Nagano Shigekazu Ohyama Yoshihiro Sakamoto Keiichiro Ohta Toshiharu Yamaguchi Tetsuichiro Muto Akio Yamaguchi 《Gastric cancer》2004,7(1):54-59
Background Pylorus-preserving gastrectomy (PPG) and transverse gastrectomy (TrG) have been accepted as function-preserving procedures for node-negative early gastric cancer. It is believed that a better quality of life is guaranteed after PPG or TrG compared to that after distal subtotal gastrectomy (DSG) with Billroth type-I reconstruction. However, objective evaluations of the gastric remnant following gastrectomy have not been widely reported, and the real advantages and disadvantages of PPG or TrG over DSG remain unclear. Moreover, the risk of secondary cancer after PPG or TrG is uncertain.Methods Between 1991 and 2000, 834 DSGs were carried out in our institute for preoperatively diagnosed patients with early gastric cancer. The degree of residual gastritis and the amount of diet residue in the gastric remnant were evaluated by annual gastrointestinal endoscopic investigations prospectively for 72 patients after PPG, 95 patients after TrG, and 60 patients after DSG. These analyses were performed using the RGB classification (residue, gastritis, bile). The incidence of disease greater than or equal to grade 2 was calculated, and the time trends of the incidence for each procedure were also studied for 3 years after gastrectomy. In addition, secondary cancer cases in the gastric remnant mucosa were checked for each procedure during this period, and the incidence of secondary cancer after each operation was calculated.Results The incidence of gastritis, of grade 2 or more, found in the gastric remnant was significantly lower after PPG (1.4%) and TrG (2.1%) than after DSG (43.3%). However, the incidence of moderate or greater residue in the gastric remnant, grade 2 or more, was significantly higher after PPG (45.8%) and TrG (40.0%) than after DSG (11.7%). The analysis of time trends of gastritis and diet residue reflected the significant advantage or disadvantage for each procedure 1 year after surgery. The analysis also included these factors without consideration of elapsed time following surgery. Two patients after PPG (2.8%) and three patients after TrG (3.2%) developed secondary cancer in the gastric remnant. No DSG-treated patient showed new cancer genesis in the remaining stomach.Conclusion PPG and TrG have the advantage over DSG in preventing postoperative gastritis in the gastric remnant. On the other hand, moderate or greater diet residue in the gastric remnant is more common after PPG or TrG than after DSG. For the risk of carcinogenesis in the remnant gastric mucosa, we could not conclude that there was any apparent difference between these range-limited gastrectomies and conventional DSG. Further study is necessary to determine the significant advantages and disadvantages of using PPG or TrG. 相似文献
88.
Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures 总被引:7,自引:0,他引:7
Shinya Adachi Satoshi Inagawa Tsuyoshi Enomoto Eiji Shinozaki Tatsuya Oda Toru Kawamoto 《Gastric cancer》2003,6(1):0024-0029
Background:
Many reconstruction procedures have been developed in efforts to resolve patients' complaints after total gastrectomy. However,
there have been few reports of longterm comparisons between reconstruction procedures, especially with regard to the prevention
of duodenal food passage. This study was undertaken to compare the longterm subjective and functional results among Roux-en-Y
esophagojejunostomy (R-Y), R-Y with pouch (P-Y), and jejunal interposition with pouch (P-I) after total gastrectomy.
Methods:
Consecutive patients requiring curative total gastrectomy were enrolled in this prospective study by the envelope method.
Results:
Hospital stay was longer following a P-I than an R-Y or a P-Y. Over 50% of R-Y patients complained of heartburn, and 20%
of R-Y patients showed dumping syndrome throughout the postoperative period, with this rate being significantly different
from rates in the other two groups. P-Y patients complained of early satiety in the late postoperative period, while P-I patients
complained of early satiety in the early postoperative period. The nutritional index in P-I patients was higher than those
in patients with the other two procedures. Gastrointestinal and hepatobiliary dual scintigraphy (GHDS) showed that the rate
of bile reflux with an R-Y was relatively high after surgery. Food reflux with a P-Y was increased (9.4% to 11.1%), but with
a P-I food reflux was decreased at 3 years after surgery (13.3% to 9.9%). Patients with a P-Y had a faster recovery of body,
weight in the early postoperative period; however, at 5 years after operation, body weight recovery with a P-I was greatest.
Conclusion:
Reconstruction should be performed with pouch formation after total gastrectomy with curative intent.
Received: March 7, 2002 / Accepted: September 26, 2002
Acknowledgments This study was partly supported by the University of Tsukuba Research Project.
Offprint requests to: S. Adachi 相似文献
89.
本文复习了我院72例改良根治术治疗的乳腺癌患者,与同时期Halsted根治术73例作比较。MRM组5年、10年生存率分别为81.04%和50.59%,RM组分别为75.57%和55.33%。经统计学处理,两组无显著性差异(P>0.05)。同时对腋淋巴结清除数目与局部复发率分别进行比较,两组也无显著差异。作者认为对可手术的乳腺癌,除非肿瘤累及胸大肌或腋淋巴结转移较大而影响手术操作外,MRM为可行术式。 相似文献
90.
报告因骨疡型及胆脂瘤型中耳炎而行乳突根治术的1112例中并发弥漫性浆液性迷路炎4例,发生率为0.36%,听力损失严重,经抗炎治疗,尽快施行乳突根治术,配合应用扩张血管,皮质激素,神经营养药物等治疗,获得良好效果,认为本病一经确诊后应尽快施行手术,这样不仅能解除骨疡型及胆脂瘤型中耳炎的危险性,而且还尽可能地挽救患耳的听力,尤其对两侧耳重度听力损失者意义更大。 相似文献