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31.
Correlation between T cell phenotypes, especially activated T cells expressing early (EA1) and late (HLA-DR) activation antigens and clinical features were investigated in 22 patients with systemic lupus erythematosus (SLE) of childhood onset. Percentages of T cells expressing EA1 and HLA-DR in 22 patients with SLE were significantly higher than those in controls. Comparison of T cell phenotypes between patients with active and inactive SLE showed that eight patients with active disease had significantly increased percentages of HLA-DR positive T cells than 14 with inactive disease (P<0.01). Serial examinations showed that the percentages of HLA-DR positive T cells were decreased after therapy in seven with active non-renal or active non-renal and renal diseases but not in one with only active renal disease. A possible significance of T cells expressing EA1 and HLA-DR in the management of patients with SLE is discussed.Abbreviations HLA-DR human leukocyte antigens-DR - SLE systemic lupus erythematosus  相似文献   
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Epidemiologic Survey of Children with End-Stage Renal Disease   总被引:1,自引:0,他引:1  
We performed an epidemiologic study on the basis of a questionnaire survey of 162 children with end-stage renal disease (ESRD). Sixty-nine (43%) of our 162 children, including 25 detected at mass screening of urine, were found by chance hematuria and/or proteinuria. The three major causes of ESRD in our children were chronic glomerulonephritis (CGN) in 56, congenital anomalies of the urinary tract in 30, and nephrotic syndrome (NS) in 27. The renal pathology in 39 children with CGN or NS was focal glomerular sclerosis in 15, diffuse mesangial GN in 7, IgA GN in 5, membranoproliferative GN in 3, membranous GN in 3, and unclassified in 6. Forms of dialysis initiated were hemodialysis in 91 children, continuous ambulatory peritoneal dialysis (PD) in 66, and intermittent PD in 5. Renal transplantation was performed on 38 children, and the graft and the patient survival rates were 76% and 89%, respectively. The survival rate of our 162 children for a mean follow-up of 8.1 years was 77%. In conclusion, an integrated program of maintenance dialysis and transplantation provides a favorable life for children with ESRD.  相似文献   
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Objectives Several studies have reported that the secretory immunoglobulin A (S-IgA) concentration in saliva is an indicator of psychological stress. The aim of this study was to clarify the relationship between S-IgA and the stress from academic examinations. Methods S-IgA levels in 10 medical student volunteers from the second year course between May 4 and July 13, 2000 were examined using the ELISA method. Results There was a tendency for S-IgA in saliva to be higher on the day before academic examinations and during them, and lower on the days between these examinations. Conclusions It may be possible to use this measurement to monitor psychological stress in students and workers. Second year medical student in the year 2000.  相似文献   
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Background. There is still a possibility that mild hypothermictherapy may be useful as a neuroprotective tool during the intraoperativeperiod, although the mechanism of cerebral protection by mildhypothermia is not well understood. We hypothesized that mildhypothermia may be protective against cerebral ischaemia byinhibiting post-ischaemia apoptosis. In this study, we usedserum-deprived PC12 cells as the neuronal apoptotic model andexamined the direct effects of mild and moderate hypothermia. Methods. Apoptosis was induced by depriving the cell culturemedium of serum, which is one of the most representative methodsto induce apoptosis, but not necrosis, in PC12 cells. Effectsof mild (35 and 33°C) and moderate (31 and 29°C) hypothermiaon apoptosis were evaluated. Cytotoxicity (lactate dehydogenaseleakage) and the percentage of apoptotic cells (calculated byflow cytometry with propidium iodide) were evaluated 4 daysafter induction of apoptosis. As a control, cells without inductionof apoptosis were incubated under the same conditions as theapoptosis group. Results. Without induction at 37°C, cytotoxicity and thepercentage of apoptotic cells were over 60 and 90%, respectively.At each temperature examined below 35°C, significant decreasesin cytotoxicity and the percentage of apoptotic cells were observed.Mean cytotoxicity at 31 and 29°C was 50.2 (SD 4.2)% and47.9 (4.4)%, respectively. The percentage of apoptotic cellsat 31 and 29°C was 42.5 (7.4)% and 36.5 (7.3)%, respectively.In the control group, cytotoxicity and the percentage of apoptoticcells were significantly higher at 29°C than at 37°C. Conclusions. Mild and moderate hypothermia (29–35°C)inhibited apoptosis, although hypothermia below 30°C mayinduce apoptosis in intact cells. Br J Anaesth 2002; 89: 301–5  相似文献   
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Management of cholelithiasis in combination with cardiovascular surgery   总被引:1,自引:0,他引:1  
A retrospective review of the perioperative management of patients with cardiovascular surgical disorders and cholelithiasis was conducted, and the surgical strategies employed are discussed. Between 1988 and 1998, 18 patients having cardiovascular surgical disorders underwent cholecystectomy. These patients were divided into three groups: group I, given a one-stage operation (n = 9); group II, given a two-stage operation (n = 3); and group III, given cholecystectomy during follow-up after cardiovascular surgery (n = 6). In group I, a median laparotomy was adopted for patients with an abdominal aortic aneurysm (AAA) to allow both disorders to be treated through the same incision, whereas a right subcostal approach was employed to separate the incisions for patients who underwent cardiac operations. In group II, one patient underwent cholecystectomy before cardiac surgery, and two patients underwent cholecystectomy for postoperative cholecystitis after cardiovascular operations. One patient from group II and all from group III were on preoperative anticoagulant therapy, two of whom underwent laparoscopic cholecystectomy. No fatal complications such as prosthetic infection, intraperitoneal hemorrhage, or cerebral attack were encountered. In conclusion, we consider that performing cholecystectomy during AAA repair may be safe and prevents the risk of postoperative cholecystitis; it is preferable to treat cholelithiasis coexisting with cardiac disorders concomitantly with or before cardiac operations; and laparoscopic cholecystectomy can be safely performed under anticoagulant therapy. Received: March 1, 1999 / Accepted: March 24, 2000  相似文献   
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This case is about a male in his 50's. In May 2004, he consulted a nearby doctor with abdominal pain and was pointed out a huge mass in the liver. He was diagnosed as hepatocellular carcinoma over 10 cm in diameter with chronic hepatitis type B. Because the tumor concurred with intra-hepatic metastasis along with lymph node metastasis, we planned transhepatic arterial embolization (TAE) as a first choice of treatment and performed twice. However, because of the tail inside part of the tumor was supplied from the gastroduodenal artery (GDA) and right gastroepiploic artery (RGEA) which were nutrient arteries, an effective TAE was impossible. The enhancement lesion that seemed viable was shown by enhanced CT. Therefore, a wrapping therapy (surgical decollateralization+silicon membrane sheeting) was performed under laparotomy for the purpose of cutting off blood supply to the part of the viable lesion in August of the same year. The tail inside part of the tumor that seemed viable fell into necrosis by wrapping alone, and the serum PIVKA-II level decreased within normal limit. As of ten months after the treatment, the patient is still alive without aggravation.  相似文献   
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A 54-year-old woman complained of dyspnea, due to complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma, was transferred to our department about two months after curative resection (with preoperative chemotherapy for T4 cancer) in July 2004. She suddenly developed a severe shortness of breath with anxiety, and arterial blood gas analysis revealed a PaO2 of 25 mmHg (FiO2 1.0). The presence of pulmonary embolism was diagnosed by pulmonary perfusion scintigraphy. Thrombolytic therapy with urokinase was started to keep the air way. Fogarty catheter and bronchoscopic Nd-YAG laser treatment was performed. After that, an expandable metallic stent (EMS) was placed at the site of obstruction without any troubles, and there was a striking improvement in her condition of respiration and atelectasis. The radiation therapy was initiated and completed safely. The tumor lesion had disappeared on CT scan after the radiation therapy (a total dose of 50 Gy). We experienced a case that could be rescued from an advanced respiratory failure caused by one side air way obstruction and another side's blood circulation disorder.  相似文献   
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