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101.
Laparoscopic cholecystectomy and intraoperative endoscopic sphincterotomy in the treatment of cholecysto-choledocholithiasis. 总被引:3,自引:0,他引:3
N Basso G Pizzuto D Surgo A Materia G Silecchia A Fantini F Fiocca P Trentino 《Gastrointestinal endoscopy》1999,50(4):532-535
BACKGROUND: A single-stage minimally invasive procedure would be optimal for management of cholecysto-choledocholithiasis. Two alternative strategies are available: management by laparoscopy alone or a combined laparoscopic-endoscopic approach. This study evaluates the results of the latter procedure. METHODS: From June 1993 to September 1997, 1400 patients with symptomatic biliary stone disease were evaluated for laparoscopic cholecystectomy. Intraoperative cholangiography was performed on the basis of a preoperative suspicion of bile duct stones; bile duct stone treatment was by intraoperative endoscopic retrograde sphincterotomy. RESULTS: Intraoperative cholangiography was performed because of a preoperative suspicion of a bile duct abnormality in 141 of 1400 patients (10%) undergoing laparoscopic cholecystectomy because of biliary stone disease. Of those 141 patients, 54 (38.3%) presented with pathologic findings (bile duct stone [52] and papillary stenosis [2]); all 54 underwent intraoperative endoscopic sphincterotomy. Complete clearance of the ductal stones was achieved in 43 patients (82.7%) by intraoperative sphincterotomy, and in 9 patients by an additional postoperative endoscopic procedure. Laparoscopic cholecystectomy was carried out in all cases. There were no conversions to an open operation. Postoperative course in the uncomplicated cases was comparable to that for laparoscopic cholecystectomy alone. The postoperative complication rate was 5.6% and mortality 1.8%. Mean hospital stay was 3.3 days (range 2 to 16). At a mean 38 months follow-up, no complications related to the laparoscopic-endoscopic procedure were observed. CONCLUSION: The intraoperative combined laparoscopic-endoscopic approach seems to be a feasible and effective management of cholecysto-choledocholithiasis, saving patients a subsequent invasive procedure. 相似文献
102.
Rivas P Górgolas M Gimena B Sousa J Fernández-Guerrero ML 《Scandinavian journal of infectious diseases》2005,37(5):373-374
We present a 68-y-old female who had undergone aortocoronary bypass and developed Staphylococcus aureus sternal osteomyelitis. Despite prolonged therapy with different antibiotics and several local debridements and drainage, the wound remained open and suppurative. Only after sternectomy and wide excision of infected costal cartilage was the diagnosis of sternal tuberculosis made, 24 months later. This case illustrates the necessity of a high degree of suspicion to diagnose this very rare entity which coexists with more common causes of sternal osteomyelitis. 相似文献
103.
G. Silecchia M.D. N. Perrotta M.D. G. Giraudo M.D. M. Salval M.D. U. Parini M.D. F. Feliciotti M.D. E. Lezoche M.D. M. Morino M.D. G. Melotti M.D. M. Carlini M.D. P. Rosato M.D. N. Basso M.D. 《Diseases of the colon and rectum》2002,45(9):1172-1177
PURPOSE: The purpose of the present study was to evaluate prospectively the abdominal wall recurrence rate after laparoscopic resection for colorectal cancer, to analyze the impact of the learning curve on abdominal wall recurrence, and to assess the outcome of those patients.
METHODS: The Italian Registry of Laparoscopic Colorectal Surgery database was analyzed to obtain data on cancer patients with abdominal wall recurrence, concomitant local or distant metastases, and interval between initial surgery and diagnosis of trocar site or minilaparotomy recurrences. The records of the initial procedures and the technique of specimen removal were reviewed.
RESULTS: From January 1992 to July 2000, 2,583 patients (1,753 cases of carcinomas and 830 cases of benign diseases) were recorded. The malignant lesions were located on the right colon in 19 percent, the left colon in 48.8 percent, and rectum in 32.2 percent. Sixteen patients with histologic evidence of colorectal adenocarcinoma recurrences at the abdominal wall were observed (0.9 percent). Ten patients presented an advanced stage (III for 7 patients and IV for 3 patients). Eleven cases occurred during the learning curve period (the first 50 consecutive cases). The median survival time after abdominal wall recurrence diagnosis was 16 (range, 12–60) months. By July 2000 only two patients were alive.
CONCLUSIONS: The results of the Italian prospective Registry of Laparoscopic Colorectal Surgery confirm that the incidence of abdominal wall recurrences is similar to that reported in open studies (<1 percent). Most abdominal wall recurrences occurred in the learning curve period, suggesting that surgical experience may play a role in the development of this outcome. The prognosis of these patients is very poor. 相似文献
104.
Human alloantigen-specific anergic cells induced by a combination of CTLA4-Ig and CsA maintain anti-leukemia and anti-viral cytotoxic responses 总被引:4,自引:0,他引:4
Comoli P Locatelli F Moretta A Montagna D Calcaterra V Cometa A Basso S Zecca M Maccario R 《Bone marrow transplantation》2001,27(12):1263-1273
The success of allogeneic hematopoietic stem cell transplantation from HLA-disparate donors depends on the development of new strategies for graft-versus-host disease prevention able to target specifically donor antihost alloreactivity, while preserving GVL and antiviral immune surveillance. Recent experimental and clinical work has shown the feasibility of an approach based on induction of anergy to host alloantigens through blockade of B7/CD28 costimulatory signal in donor T cells, but data on the impact of this strategy on the recovery of the immune system are still lacking. We devised an ex vivo method for induction of host alloantigen-specific unresponsiveness based on treatment with the B7/CD28 blocking agent CTLA4-Ig associated with CsA. We then proceeded to assess the maintenance of an effective immune response towards viral pathogens and tumor cells after CTLA4-Ig/CsA treatment, by measuring the frequency of CTL precursors directed against CMV- and EBV-infected targets, and against autologous leukemic blasts. We demonstrated that (1) CTLA4-Ig and CsA can act synergistically in inducing a state of unresponsiveness to alloantigens; (2) the number of leukemia-reactive, EBV-specific and CMV-specific CTLp is not impaired by CTLA4-Ig/CsA treatment. Our data provide the first direct in vitro evidence that it is possible to preserve antiviral and antileukemia effector cells after blockade of CD28/B7 interaction during MLR. 相似文献
105.
Yujuan Wang Beatriz E. Marciano Defen Shen Rachel J. Bishop Stanley Park Steven M. Holland Chi-Chao Chan 《Journal of clinical immunology》2013,33(5):917-924
Purpose
Chronic granulomatous disease (CGD) is an inherited disorder characterized by defects in phagocyte-derived nicotinamide adenine dinucleotide phosphate oxidase. It is typically diagnosed in childhood and leads to severe, recurrent bacterial or fungal infections. Chorioretinal lesions are the most common ocular manifestation. We sought to determine whether there are infectious agents in CGD-associated chorioretinopathy.Methods
Medical records and ocular histopathology from CGD cases from January 1983 to January 2012 at the National Institutes of Health were retrospectively reviewed. Chorioretinal cells from normal and lesional tissues of the same eye were microdissected. Primers for Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia sp., and a panbacterial 16S ribosomal DNA were used for polymerase chain reaction.Results
Seventeen CGD patients had ocular tissues (16 autopsied cases and 1 chorioretinal biopsy) examined. Of these 17, 8 demonstrated CGD-associated chorioretinal lesions in at least one eye on histopathology. Of these 8, 7 showed amplification of 16S ribosomal DNA within the lesion; of these 7, two also amplified S. epidermidis and one P. aeruginosa. One had no bacterial DNA amplified. Importantly, no microbial DNA was amplified from the normal, non-lesional ocular tissues of these 8 cases. Furthermore, only 1 of the 9 eyes without chorioretinopathy had amplified Burkholderia DNA, that patient had a history of Burkholderia infection.Conclusions
We detected bacterial DNA in 7 of 8 (88 %) cases with CGD-associated chorioretinopathy and only in 1 normal ocular tissue of 17 CGD cases. Bacterial infection may play a role in the pathogenesis of CGD-associated chorioretinal lesions. 相似文献106.
Navas-Sánchez Francisco J. Fernández-Pena Alberto Martín de Blas Daniel Alemán-Gómez Yasser Marcos-Vidal Luís Guzmán-de-Villoria Juan A. Fernández-García Pilar Romero Julia Catalina Irene Lillo Laura Muñoz-Blanco José L. Ordoñez-Ugalde Andrés Quintáns Beatriz Pardo Julio Sobrido María-Jesús Carmona Susanna Grandas Francisco Desco Manuel 《Journal of neurology》2021,268(7):2429-2440
Journal of Neurology - SPG4 is an autosomal dominant pure form of hereditary spastic paraplegia (HSP) caused by mutations in the SPAST gene. HSP is considered an upper motor neuron disorder... 相似文献
107.
Ane Murueta‐Goyena Rocío Del Pino Marta Galds Begoa Arana Marian Acera Mar Carmona‐Abelln Tamara Fernndez‐Valle Beatriz Tijero Olaia Lucas‐Jimnez Natalia Ojeda Naroa Ibarretxe‐Bilbao Javier Pea Jesus Cortes Unai Ayala Maitane Barrenechea Juan Carlos Gmez‐Esteban Iigo Gabilondo 《Annals of neurology》2021,89(1):165-176
108.
Luis Velázquez-Pérez DSc Roberto Rodriguez-Labrada PhD Yasmani González-Garcés BSc Eduardo Arrufat-Pie MD Reidenis Torres-Vega BSc Jacqueline Medrano-Montero PhD Beatriz Ramirez-Bautista MD Yaimeé Vazquez-Mojena MSc Georg Auburger MD Fay Horak PhD Ulf Ziemann PhD Christopher M. Gomez PhD 《Movement disorders》2021,36(2):471-480
109.
Braz Aline Mrcia Marques Winckler Fernanda Cristina Binelli Larissa Sarri Chimeno Luis Guilherme Lopes Lia Beatriz Mantovani Lima Rodrigo Santos Simes Rafael Plana Grotto Rejane Maria Tommasini Golim Marjorie de Assis Silva Giovanni Faria 《Clinical and experimental medicine》2021,21(4):587-597
Clinical and Experimental Medicine - Cirrhotic patients with chronic hepatitis C should be monitored for the evaluation of liver function and screening of hepatocellular carcinoma even after... 相似文献
110.
Takahama Jr Ademar de Sousa Vitoria Iaros Tanaka Elisa Emi Ono Evelise Ito Fernanda Akemi Nakanishi Costa Priscila Paganini Pedriali Maria Beatriz Bergonse Pereira de Lima Heliton Gustavo Fornazieri Marco Aurélio Correia Leticia Sassaki Cardoso Lucienne Tibery Queiroz de Maio Carrilho Claudia Maria Dantas 《Clinical oral investigations》2021,25(3):1217-1222
Clinical Oral Investigations - This a cross-sectional study to evaluate the association between oral health findings and ventilator-associated pneumonia (VAP) among critically ill patients in... 相似文献