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111.
Morten Wøjdemann M.D. Pernille Traberg Flemming Stadil DM.Sci Berit Sternby Ph.D. Steen Larsen DM.Sci Linda Hilsted DM.Sci Ole Olsen DM.Sci 《The American journal of gastroenterology》1998,93(2):244-248
Objective : Gastric lipase and gastric acid are secreted simultaneously. The aim of this study was to investigate whether the acid interferes with the lipase secretion. The secretion of human gastric lipase was studied during blockade of gastric acid secretion and modified sham feeding to estimate the impact of these conditions on both gastric lipase enzyme activity and immunoreactivity. Methods : Eight healthy volunteers were intubated with a nasogastric tube. We examined gastric aspirates for the amount and activity of lipase secretion during basal conditions, after blockade of acid secretion with a proton pump inhibitor (omeprazole i.v. infusion), and in response to sham feeding (chewing gum) during the blockade. Results : The amount of secreted gastric lipase was unaffected by blockade of acid secretion and increased significantly after sham feeding (169.9 ± 35.7 g/15 min to 348.1 ± 79.2 g/15 min; p < 0.01 ). Likewise, the output of enzyme activity increased after sham feeding (0.63 ± 0.09 kU/15 min to 1.52 ± 0.36 kU/15 min; p < 0.03 ). The concentration of enzyme activity remained unchanged by blockade of acid secretion, whereas the output of enzyme activity was decreased, probably because of reduced volume secretion or denaturation and conformational changes of the enzyme. Plasma concentrations of gastrin increased in response to blockade of acid secretion (basal 9.6 ± 1.4 pmol/L to 13.3 ± 2.9 pmol/L; p < 0.02 ). Conclusions : Gastric acid secretion is not a prerequisite for gastric lipase secretion. Lipase enzyme activity, though, is sensitive to anacidic conditions. 相似文献
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Vladimír Džavík MD FSCAI Upendra Kaul MD DM FSCAI Guilio Guagliumi MD Bernard Chevalier MD Peter C. Smits MD Marrianne Stuteville BSC Dong Li MSC Krishnankutty Sudhir MD PhD Eberhard Grube MD FSCAI 《Catheterization and cardiovascular interventions》2013,82(3):E163-E172
The aim of this analysis was to analyze outcomes of patients undergoing Xience V EES treatment of bifurcation lesions, a subset in which treatment is particularly challenging. The SPIRIT V Study provided an evaluation of the Xience V everolimus eluting stent (EES) performance in complex patient and lesion population. The SPIRIT V Single Arm Study enrolled 2700 patients with de novo coronary artery lesions suitable to be optimally treated with a maximum of four planned Xience V EES. Lesion evaluation was by visual assessment. The outcomes of the 492 patients undergoing Xience V EES stenting of ≥1 bifurcation lesion were compared to those with no bifurcation lesion treated. Compared to those without bifurcation treatment, patients with bifurcation treatment were more likely to have multi‐vessel disease (49% vs 40%), left main treatment (3.1% vs 0.9%), more lesions treated (1.5 vs 1.3), calcification (36.4% vs 27.5%), and ostial (17.1% vs 8.2%) and angulated lesions (29.3% vs 21.1%), all P < 0.001. The 30‐day composite rate of death, myocardial infarction (MI), target vessel revascularization (TVR) was 4.3% in patients with bifurcation PCI and 2.2% in those with non‐bifurcation PCI (P = 0.017). At 2 years, this composite event rate was 11.3% and 10.0% in these two groups, respectively (P = 0.403). Rates of cardiac death, MI, target lesion revascularization (TLR), TVR, and ARC defined definite or probable stent thrombosis (0.4% vs 0.9%, P = 0.402) were not significantly different between the two groups. Despite greater patient and lesion complexity, treatment of patients with bifurcation lesions using the Xience V EES in the SPIRIT V prospective Single Arm Study was safe and effective, with low overall event rates that were similar to those without bifurcation lesion treatment. © 2013 Wiley Periodicals, Inc. 相似文献
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In countries with intermediate or high endemicity for chronic hepatitis B virus (HBV) infection, exacerbations of chronic
hepatitis B (CHB) are common. We studied the clinical, biochemical, and virologic characteristics of patients first presenting
clinically with features of acute icteric hepatitis B, to identify features that might differentiate between acute viral hepatitis
B (AVHB) from first episode of exacerbation of chronic hepatitis (ECHB). We retrospectively analyzed 79 patients (mean age
35.4 ± 14 years; M:F = 60:19) who first presented clinically as AVHB, within 4 weeks of onset of symptoms. Patients who on
follow-up cleared HBsAg and/or did not develop any clinical, radiologic, or histologic evidence of chronic liver disease (CLD)
were categorized as AVHB (group 1). Patients who had persistence of HBsAg and developed clinical, biochemical, radiologic,
or histologic evidence of chronic liver disease were categorized as ECHB (group 2). Forty-nine patients were in group 1 and
30 in group 2. The 2 groups were comparable with respect to prodrome, onset of jaundice, serum bilirubin, ALT, prothrombin
time prolongation, serum albumin, and A/G ratio. Among group 1 patients, 78% had IgM anti-HBc positive in titers > 1:1000;
in group 2, there were negative or positive in titers < 1:1000 in 70% patients (P < .001). Forty-seven of 49 (95.9%) patients in group 1 had HBV-DNA levels < 0.5 pg/mL, whereas 26 of 30 (86.73%) patients
in group 2 had levels > 0.5 pg/mL (P ≤ .001). Quantitative HBV DNA and IgM anti-HBc titers at initial presentation can differentiate patients with a true episode
of acute hepatitis B from patients with first episode of symptomatic exacerbation of chronic hepatitis B. Clinical and biochemical
features do not help in differentiating the two. 相似文献
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Cees DM Ruijs Bregje D Onwuteaka-Philipsen Gerrit van der Wal Ad JFM Kerkhof 《BMC palliative care》2009,8(1):16-10