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991.
Ham Young Min Song Hae Seong Kwon Jeong Eun Jeon Hyelin Baek Hyun Jin Kim Chang Won Yoon Weon-Jong Choung Eui Su Kang Se Chan 《Journal of natural medicines》2019,73(1):34-46
Journal of Natural Medicines - Atherosclerosis is a major cause of coronary heart disease. As a result of the development of atherosclerotic lesions, the walls of blood vessels become thicker and... 相似文献
992.
Myong Ki Baeg Myung-Gyu Choi Seong Jin Moon Chul-Hyun Lim Jin Su Kim Yu Kyung Cho Jae Myung Park In Seok Lee Sang Woo Kim Kyu Yong Choi 《Digestive diseases and sciences》2014,59(9):2243-2248
Background
The maximal effect of proton pump inhibitors (PPI) is reported to take 5 days. However, most current protocols start PPI on the day of gastric endoscopic submucosal dissection (ESD).Aims
We aimed to evaluate the benefit of 5 days pretreatment with oral PPI before ESD to prevent bleeding.Methods
This was a prospective randomized controlled trial. Patients were administered oral rabeprazole 20 mg or placebo twice daily for 5 days before ESD. Intravenous pantoprazole 40 mg was administered 2 h before ESD and at postprocedure day 1, and then oral rabeprazole 20 mg was administered once daily. Follow-up endoscopy was performed on days 1 and 30. Forty-eight-hour measurement of intragastric pH was performed in 26 patients. The primary endpoint was major bleeding related to ESD.Results
One-hundred and twenty patients were enrolled. Of these, 45 in the pretreatment and 53 in the placebo group were analyzed. Each group had three cases of major bleeding. There were no significant differences in the ulcer healing rate. Intragastric pH percentage times greater than 4, 5, and 6 were 86.61 ± 19.45 %, 83.30 ± 22.06 %, and 76.86 ± 25.35 %, respectively, in the pretreatment and 85.54 ± 19.45 %, 84.08 ± 27.11 %, and 81.53 ± 27.81 %, respectively, in the placebo group, without significant differences.Conclusions
Preprocedural administration of rabeprazole offers no additional benefit over postprocedural administration alone in preventing major bleeding after gastric ESD. 相似文献993.
Impact of Atherosclerosis Detection by Carotid Ultrasound on Physician Behavior and Risk‐Factor Management in Asymptomatic Hypertensive Subjects
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994.
Jennifer A. Cuthbert Sami Arslanlar Jay Yepuri Marc Montrose Chul W. Ahn Jessica P. Shah 《Digestive diseases and sciences》2014,59(7):1594-1602
Background
No study has evaluated current scoring systems for their accuracy in predicting short and long-term outcome of alcoholic hepatitis in a US population.Methods
We reviewed electronic records for patients with alcoholic liver disease (ALD) admitted to Parkland Memorial Hospital between January 2002 and August 2005. Data and outcomes for 148 of 1,761 admissions meeting pre-defined criteria were collected. The discriminant function (DF) was revised (INRdf) to account for changes in prothrombin time reagents that could potentially affect identification of risk using the previous DF threshold of >32. Admission and theoretical peak scores were calculated by use of the Model for End-stage Liver Disease (MELD). Analysis models compared five different scoring systems.Results
INRdf was closely correlated with the old DF (r 2 = 0.95). Multivariate analysis of the data showed that survival for 28 days was significantly associated with a scoring system using a combination of age, bilirubin, coagulation status, and creatinine (p < 0.001), and an elevated ammonia result within two days of admission (p = 0.012). When peak values for MELD were included, they were the most significant predictor of short-term mortality (p < 0.001), followed by INRdf (p = 0.006).Conclusion
On admission, two scoring systems that identify a subset of patients with severe alcoholic liver disease are able to predict >50 % mortality at four weeks and >80 % mortality at six months without specific treatment. 相似文献995.
Jong Chan Lee Jong Ho Moon Hyun Jong Choi Dong Choon Kim Moon Han Choi Tae Hoon Lee Sang-Woo Cha Young Deok Cho Sang-Heum Park Sun-Joo Kim 《Digestive diseases and sciences》2014,59(6):1302-1306
Background
Endoscopic papillary large balloon dilation (EPLBD) after an endoscopic sphincterotomy (EST) is an option for endoscopic removal of large common bile duct (CBD) stones. However, risks or fear of severe adverse events remain.Aims
Our aim was to compare the safety and efficacy of delayed EPLBD after EST with concurrent EST and EPLBD in patients with acute cholangitis by large CBD stones.Patients and Methods
A total of sixty-eight patients with acute cholangitis from large CBD stones were enrolled in this prospective observational study. Thirty-five patients underwent concurrent EST and EPLBD at the same session (group A). Thirty-three patients underwent only EST at the first session, and EPLBD with stone removal was performed during a second session (group B). The complete stone removal rate and adverse events rate were analyzed.Results
Both groups resulted in similar outcomes in terms of overall successful stone removal (100 % in both groups) and the use of additional lithotripsy (22.9 % in group A and 24.2 % in group B). Six patients (17.1 %) in group A had procedural-related adverse events including one patient with death by perforation, one with significant bleeding, and four with pancreatitis, including one moderate grade. However, there was no procedure-related complication in group B (p < 0.05).Conclusions
Delayed EPLBD after EST may reduce complications associated with EPLBD and extraction of large bile duct stones in patients with acute cholangitis. 相似文献996.
Joon Bum Kim Byung Kwon Chong Sung-Ho Jung Suk Jung Choo Cheol Hyun Chung Jae Won Lee 《International journal of cardiology》2014
Background
The risks and benefits of a concomitant Maze procedure for patients with LV dysfunction undergoing major cardiac surgery have not yet been elucidated. This study aimed to evaluate the clinical impacts of the Maze procedure in patients with atrial fibrillation and left ventricular (LV) dysfunction.Methods
Between January 1999 and March 2011, a total of 139 patients (mean age 52.7 ± 12.3 years, 54 females) with valvular atrial fibrillation (AF) and an LV ejection fraction (EF) of 40% or less underwent open heart surgery with (n = 77) or without (n = 62) a concomitant Maze procedure. We compared adverse outcomes (death and composite of death, thromboembolic events and congestive heart failure [CHF]) during a median follow-up period of 66.0 months (inter-quartile range, 27.5–106.9 months).Results
Adverse events occurred in 41 patients, including 36 deaths, seven thromboembolic events and eight hospitalizations due to CHF. After adjustment for baseline profiles with the use of propensity scores and inverse probability weighting, patients who had the Maze procedure were at lower risks of death (hazard ratio, 0.39; 95% confidence interval, 0.16–0.93; P = 0.033) and composite adverse outcomes (hazard ratio, 0.28; 95% confidence interval, 0.14–0.57; P = 0.017) than those not undergoing the Maze procedure. Furthermore, the Maze procedure resulted in superior functional status (P < 0.001) and reduced the need for long-term anticoagulation therapy (67.1% vs. 91.2%, P = 0.001).Conclusion
Performing the Maze procedure on patients with valvular AF and LV dysfunction reduced serious adverse outcomes and the need for long-term anticoagulation therapy when compared to cardiac surgery alone without the Maze procedure. 相似文献997.
Si Eun Hwang Keisuke Hieda Ji Hyun Kim Gen Murakami Shinichi Abe Akio Matsubara Baik Hwan Cho 《International journal of colorectal disease》2014,29(7):783-791
Purpose and methods
To identify site-dependent and individual differences in neuronal nitric oxide synthase (nNOS)-positive nerves of the myenteric plexus, we examined full-thickness walls of the stomach, pylorus, duodenum, ileum, colon, and rectum in 7 male and 8 female cadavers (mean ages, 80 and 87 years, respectively).Results
The areas occupied by nNOS-positive nerve fibers in the myenteric plexus were fragmentary and overlapped with areas occupied by vasoactive intestinal polypeptide-positive fibers. The nNOS-positive fiber-containing areas per 1-mm length of intermuscular space tended to be larger at more anal sites, with positive areas four times greater in the rectum than in the stomach. Interindividual differences in rectal areas were extremely large, ranging from 0.017 mm2 in one 80-year-old man to 0.067 mm2 in another 80-year-old man. Similarly, the numbers of nNOS-positive ganglion cell bodies per 1-mm length in the rectum ranged from 4 to 28. These areas and numbers were weakly correlated (r?=?0.62; p?=?0.02). Interindividual differences in the rectum appeared not to depend on either age or gender.Conclusions
Anatomic studies using donated cadavers carried the advantage of obtaining any parts of intestine within an individual, in contrast to surgically removed specimens. We speculated excess control of evacuation with laxatives as one of causes of atrophy of the rectal myenteric plexus. 相似文献998.
Doyoung Kwon Yeon‐Mi Lim Jung‐Taek Kwon Ilseob Shim Eunji Kim Doo‐Hee Lee Byung‐Il Yoon Pilje Kim Hyun‐Mi Kim 《Environmental toxicology》2019,34(5):561-572
Benzalkonium chloride (BAC) is a widely used disinfectant/preservative, and respiratory exposure to this compound has been reported to be highly toxic. Spray‐form household products have been known to contain BAC together with triethylene glycol (TEG) in their solutions. The purpose of this study was to estimate the toxicity of BAC and TEG mixtures to pulmonary organs using in vitro and in vivo experiments. Human alveolar epithelial (A549) cells incubated with BAC (1‐10 μg/mL) for 24 hours showed significant cytotoxicity, while TEG (up to 1000 μg/mL) did not affect cell viability. However, TEG in combination with BAC aggravated cell damage and inhibited colony formation as compared to BAC alone. TEG also exacerbated BAC‐promoted production of reactive oxygen species (ROS) and reduction of glutathione (GSH) level in A549 cells. However, pretreatment of the cells with N‐acetylcysteine (NAC) alleviated the cytotoxicity, indicating oxidative stress could be a mechanism of the toxicity. Quantification of intracellular BAC by LC/MS/MS showed that cellular distribution/absorption of BAC was enhanced in A549 cells when it was exposed together with TEG. Intratracheal instillation of BAC (400 μg/kg) in rats was toxic to the pulmonary tissues while that of TEG (up to 1000 μg/kg) did not show any harmful effect. A combination of nontoxic doses of BAC (200 μg/kg) and TEG (1000 μg/kg) promoted significant lung injury in rats, as shown by increased protein content and lactate dehydrogenase (LDH) activity in bronchoalveolar lavage fluids (BALF). Moreover, BAC/TEG mixture recruited inflammatory cells, polymorphonuclear leukocytes (PMNs), in terminal bronchioles and elevated cytokine levels, tumor necrosis factor α (TNF‐α), and interleukin 6 (IL‐6) in BALF. These results suggest that TEG can potentiate BAC‐induced pulmonary toxicity and inflammation, and thus respiratory exposure to the air mist from spray‐form products containing this chemical combination is potentially harmful to humans. 相似文献
999.
In upper gastrointestinal bleeding (UGIB), scoring systems using multiple variables were developed to predict patient outcomes. We evaluated serum C-reactive protein (CRP) for simple prediction of patient mortality after acute non-variceal UGIB.The associated factors for 30-day mortality was investigated by regression analysis in patients with acute non-variceal UGIB (N = 1232). The area under the receiver operating characteristics (AUROC) curve was analyzed with serum CRP in these patients and a prospective cohort (N = 435). The discriminant validity of serum CRP was compared to other prognostic scoring systems by means of AUROC curve analysis.Serum CRP was significantly higher in the expired than survived patients (median, 4.53 vs 0.49; P < .001). The odds ratio of serum CRP was 4.18 (2.10–9.27) in multivariate analysis. The odds ratio of high serum CRP was higher than Rockall score (4.15 vs 1.29), AIMS65 (3.55 vs 1.71) and Glasgow-Blatchford score (4.32 vs 1.08) in multivariate analyses. The AUROC of serum CRP at bleeding was 0.78 for 30-day mortality (P < .001). In the validation set, serum CRP was also significantly higher in the expired than survived patients, of which AUROC was 0.73 (P < .001). In predicting 30-day mortality, the AUROC with serum CRP was not inferior to that of other scoring systems.Serum CRP at bleeding can be simply used to identify the patients with high mortality after acute non-variceal UGIB. 相似文献
1000.
Even though chronic abdominal pain is 1 of the most common reasons for hospital visits, diagnostic testing is often time-consuming and treatment is inadequate. Abdominal myofascial pain syndrome (AMPS) is usually not included as a differential diagnosis, but it should be considered in cases of chronic abdominal pain. The purpose of this study was to investigate the clinical characteristics of AMPS and to assess the effect of sonography-guided trigger point injections (TPI).A total of 100 patients with AMPS from 2012 to 2018 were retrospectively evaluated for clinical characteristics and TPI effects. AMPS was diagnosed using Srinivasan and Greenbaum''s criteria, and the TPIs were performed at intervals of 2 to 4 weeks. The Visual Analog Scale (VAS) ratio was calculated by subtracting the final VAS from the initial VAS score and dividing it by the initial VAS score after injections, and the patients were divided into 4 groups: non-responders, mild, moderate, and good responders.The median duration of pain was 12 months, and the median number of hospital visits before TPI was 2. Of the 100 patients, 66 (66%) were categorized as good responders, 11 (11%) as moderate responders, 7 (6.9%) as mild responders, and 16 (15.7%) as non-responders. When the initial and final VAS scores were compared, the sonography-guided injections were found to be effective in alleviating pain (P < .001). Moreover, patients who received the injections 2 or more times tended to have more significant pain reduction than those who received a single injection (P < .001).Patients with AMPS suffer from long-term pain and undergo many hospital visits and diagnostic tests. TPI with lidocaine can be an effective and safe treatment for patients with chronic AMPS. 相似文献