大肠癌淋巴结转移与nm23-H1和p53的相关性研究

研究ｎｍ２３－Ｈ１和Ｐ５３在原发性大肠癌中的表达及其与淋巴结转移的关系。方法 应用免疫经Ｓ－Ｐ法检测６３例大肠示本中ｎｍ２３－Ｈ１和ｐ５３基因的表达。结果 ６３例大肠癌标本中ｎｍ２３－Ｈ１低表达３７例，其中转移组２２例，非转移组１５例。Ｐ５３阳性表达３３例，转移组２１例，非转移组１２例。     

人胰腺癌细胞nm23 mRNA的表达与其转移潜能的关系

目的　研究人胰腺癌细胞中ｎｍ２３ ｍＲＮＡ的表达与其转移潜能的关系。 方法　在建立不同转移潜能的人胰腺癌ＪＦ３０５ 单克隆细胞亚系的基础上,应用定量逆转录多聚酶链式反应技术（ＲＴＰＣＲ）检测不同转移潜能的人胰腺癌ＪＦ３０５ 单克隆细胞亚系细胞中ｎｍ２３ ｍＲＮＡ 的表达。 结果　ｎｍ２３Ｈ１ 基因ｍＲＮＡ在低转移潜能的ＪＦ３０５Ｃ细胞系中的表达（１－９０ ±０－０９）明显高于其在高转移潜能的ＪＦ３０５Ａ 细胞系中的表达（１－６３±０－１０,Ｐ＜ ０－０１）;ｎｍ２３Ｈ２ 基因ｍＲＮＡ的表达,在高、低转移潜能的细胞亚系间差异无显著意义（０－７９ ±０－１０ ,０－７７±０－０６,Ｐ＞０－０５）。 结论　ｎｍ２３ 基因,主要是ｎｍ２３Ｈ１ 基因,在人胰腺癌中起转移抑制作用     

转移抑制基因nm23—H1在人非小细胞肺癌中的表达研究

目的探讨ｎｍ２３－Ｈ１基因表达产物的表达水平与肺癌发生、发展和转移的关系。方法应用免疫组织化学法研究人非小细胞肺癌细胞中ｎｍ２３－Ｈ１基因表达产物的表达水平。结果ｎｍ２３－Ｈ１在肺癌组织中的表达水平（５４．０３％）明显低于癌旁正常肺组织（７３．４８％，Ｐ＜０．０１）。有淋巴结转移的原发癌ｎｍ２３－Ｈ１表达水平明显低于无淋巴结转移的原发癌（Ｐ＜０．０１）；转移癌组织表达水平明显低于原发癌组织（Ｐ＜０．０１）；低分化肺癌明显低于中－高分化肺癌（Ｐ＜０．０１）。结论ｎｍ２３－Ｈ１基因可能参与肺癌的发生、发展和转移过程的调控，ｎｍ２３－Ｈ１基因表达水平降低，预示肺癌的转移和预后不良。     

转移抑制基因nm23在膀胱移行细胞癌中的表达及意义

目的：探讨转移抑制基因ｎｍ２３与膀胱移行细胞癌转移之间的关系。方法：应用Ｎｏｒｔｈ－ｅｒｎ ｂｌｏｔ技术分析１２例膀胱移行细胞癌和６例肉眼未见异常的癌旁膀胱粘膜ｎｍ２３－Ｈ１和ｎｍ２３－Ｈ２基因的表达。结果：膀胱移行细胞组ｎｍ２３－Ｈ１ｍＲＮＡ表达水平较癌旁膀胱粘膜组显著升高,有盆腔淋巴结转移的膀胱移行细胞癌组的ｎｍ２３－Ｈ１ｍＲＮＡ表达显著高于无盆腔淋巴结转移组（Ｐ〈０．０５）,而ｎｍ２３－Ｈ２     

肝细胞癌DNA异倍体及nm23-H1、C-erb B-2和p53癌基因蛋白表达的临床意义

目的 探讨肝细胞癌ＤＮＡ异倍体、ｎｍ２３－Ｈ１、Ｃ－ｅｒｂＢ－２和Ｐ５３癌基因蛋白表达与肝细胞癌侵袭性的关系及其临床意义。方法采用ＤＮＡ图像分析系统定量测定５２例肝癌２的肝癌细胞的ＤＮＡ含量,用免疫组化方法检测癌基因蛋白在肝癌中的表达。结果ＤＮＡ异倍体在≤５ｃｍ肝癌组为５０．０％,在〉５ｃｍ肝癌为８２．１％;ＤＮＡ异倍体与肝癌肝内转移及合并癌栓有关。肝癌伴有肝内转移者的ｎｍ２３－Ｈ１阳性率是明显     

膀胱移行细胞癌nm23—H1和nm23—H2基因表达的检测及临床意义

目的 探讨ｎｍ２３基因与膀胱移行细胞癌转移之间的关系。方法 应用Ｎｏｒｔｈｅｒｎ ｂｌｏｔ技术分析１２例膀胱移行细胞癌和６例膀胱粘膜ｎｍ２３－Ｈ１和ｎｍ２３－Ｈ２的基因表达。结果 膀胱癌标本ｎｍ２３－Ｈ１ ｍＲＮＡ表达水平较膀胱粘膜显著升高，有盆腔淋巴结转移膀胱癌标本的ｎｍ２３－Ｈ１ ｍＲＮＡ表达显著高于无转移组（Ｐ〈０．０５），而ｎｍ２３－Ｈ２ ｍＲＮＡ在各组间的表达无显著性差异。结论 ｎｍ２３     

nm23-H1 cDNA克隆的构建及其mRNA表达与肝癌转移的关系

目的 构建转移抑制基因ｎｍ２３－Ｈ１ｃＤＮＡ克隆，初步分析其ｍＲＮＡ表达与肝内转移，门静脉形成癌栓，ＴＮＭ分期等临床病理特征的关系。方法 利用ＲＴ－ＰＣＲ技术扩增ｎｍ２３－Ｈｄ１ｃＤＮＡ片段，并亚克隆入ｐＢｌｕｅｓｃｒｉｐｔⅡＳＫ（－）质粒，借助Ｎｏｒｔｈｅｒｎｂｌｏｔ方法，检测１０例肝细胞癌及癌旁肝组织ｎｍ２３－Ｈ１基因ｍＲＮＡ表达水平。结果 ｎｍ２３－Ｈ１ｍＲＮＡ低表达，诱发肝细胞癌伴肝内转移     

nm23-H1 基因产物表达与胃癌生物学行为及淋巴结转移规律的关系

目的探讨ｎｍ２３Ｈ１基因表达与胃癌生物学行为及淋巴结转移规律的关系。方法应用免疫组织化学方法观察了ｎｍ２３Ｈ１基因产物／核苷二磷酸激酶（ｎｍ２３／ＮＤＰＫ）在７５例胃癌组织中的表达。结果胃癌ｎｍ２３／ＤＮＰＫ表达阳性率为５９％，在浸透浆膜（Ｔ３、Ｔ４），淋巴结转移５个以上及Ⅱ站以远者，Ⅲ、Ⅳ期和伴腹膜转移的胃癌中表达明显减低（Ｐ＜００５）。在不同大体类型、分化程度和生长方式的胃癌中，ｎｍ２３Ｈ１表达差异无显著意义（Ｐ＞００５）。ｎｍ２３Ｈ１阳性组和阴性组５年生存率分别为６１％和３５％，二者差异有显著意义（Ｐ＜００５）。结论ｎｍ２３Ｈ１基因表达与胃癌浸润转移和预后有关，对评估淋巴结转移程度可能有重要意义     

乳腺癌中nm23—H1mRNA及其蛋白低表达的研究

目的：为探讨ｎｍ２３－Ｈ１ｍＲＮＡ及其蛋白低表达之间相关性及与乳腺癌生物学行为的关系。方法；应用ＲＴ／ＰＣＲ及免疫组化方法对５８例乳腺癌中ｎｍ２３－Ｈ１ｍＲＮＡ及其蛋白的表达进行检测。结果：分别为４４．８％，４８．２％的乳腺癌伴有ｎｍ２３－Ｈ１ｍＲＮＡ或该基因编码蛋白的低表达，ｎｍ２３－Ｈ１ｍＲＮＡ与其蛋白表达蛋有相关性，但并不完全吻合。低水平的ｎｍ２３－Ｈ１ｍＲＮＡ或其蛋白与乳癌淋巴结转移呈显著     

逆转录聚合酶链反应技术检测人肝癌nm23-H1基因mRNA表达

为探讨人肝癌中肿瘤转移抑制基因ｎｍ２３－Ｈ１的ｍＲＮＡ表达状况,设计特异性引物,应用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）技术检测分析了２０例人肝癌组织及相应癌旁肝组织中ｎｍ２３－Ｈ１基因的ｍＲＮＡ表达。结果 特异性引物能成功扩增ｎｍ２３－Ｈ１基因的几乎整个编码序列：２０例肝癌及癌旁肝组织的ＲＴ－ＰＣＲ结果均为阳性,ｎｍ２３－Ｈ１基因ｍＲＮＡ未发生表达缺失或较大变异现象,由此表明,本实验建立的ＲＴ－Ｐ     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Immunomodulation in Transplantation with Photopheresis

Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.