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61.
Bum Soon Choi Mi Jung Shin Suk Joon Shin Young Soo Kim Yeong Jin Choi Yong-Soo Kim In Sung Moon Suk Young Kim Yong Bok Koh Byung Kee Bang Chul Woo Yang 《American journal of transplantation》2005,5(6):1354-1360
We report here our 10-year experience of a biopsy performed at day 14 after transplantation in 304 patients with stable graft function. The factors that may have influenced subclinical rejection were analyzed according to histology. The incidence of subclinical rejection was 13.2%. Addition of mycophenolate mofetile (MMF) as a primary immunosuppressant significantly decreased the incidence of subclinical rejection compared with patients without such treatment (odds ratio, 0.23; p < 0.05). On the other hand, HLA-DR antigen mismatch (odds ratio, 2.39) and unrelated donor (odds ratio, 2.10) were also significantly associated with decreased subclinical rejection (p < 0.05). The incidence of acute rejection in patients with normal findings was lower than in those with borderline changes or subclinical rejection (0.23 +/- 0.05 vs. 0.48 +/- 0.07 and 0.60 +/- 0.11, respectively; p < 0.05). The graft survival rates in patients with subclinical rejection were lower than in patients with normal or borderline changes at 1 (88.4% vs. 97.9% and 99.1%; p < 0.05), 5 (77.8% vs. 96.2% and 95.9%; p < 0.05) and 10 (62.3% vs. 96.2% and 93.7%; p < 0.05) years. Thus, a protocol biopsy performed on day 14 after transplantation is useful for predicting graft survival. Triple therapy including MMF, related donor and HLA-DR antigen match are important factors for reducing subclinical rejection in living-donor renal transplantation. 相似文献
62.
Treatment of congenital cystic adenomatoid malformation-does resection in the early postnatal period increase surgical risk? 总被引:1,自引:0,他引:1
Young Tae Kim Jun Sung Kim June Dong Park Chang Hyun Kang Sook Whan Sung Joo Hyun Kim 《European journal of cardio-thoracic surgery》2005,27(4):658-661
OBJECTIVE: The recent development of fetal ultrasonography has allowed for an increasing number of prenatal diagnoses for congenital cystic adenomatoid malformation (CCAM). However, the appropriate surgical timing of these patients has not been studied as of yet. The aim of this study is to suggest a safe strategy for the treatment of CCAM by identifying the relationship between the timing of surgery and postoperative outcome. METHODS: Between 1987 and 2003, 40 patients (28 males, 12 females) underwent surgical resection for CCAM. The mean age was 38.6+/-9.1 (2 days-13 years) months. CCAM was diagnosed by prenatal ultrasonography in eight patients. Early operations were performed in four out of the eight. Operation was deferred until 2-12 months of age for the remaining four patients. RESULTS: Type I CCAM was found in 20 patients, type II in 20 and no patient exhibited type III. Five patients had associated pectus excavatum anomaly. There were no cases of operative mortality. Seventeen minor postoperative complications developed in 16 patients (40.0%): prolonged chest tube drain in 10, wound infection in 4, and 1 case of pneumonia, empyema and pleural space, respectively. The average hospital stay was 11.8 (6-29) days. During the mean follow-up period of 67.5 months, one patient died of accidental aspiration 7 months after operation during the postoperative recovery course of Ravich operation for pectus excavatum. The remaining patients reported doing well with normal physical activity. All five patients who underwent surgery at the age of under 1 month did not exhibit increased postoperative morbidity. CONCLUSIONS: We concluded that surgery for CCAM could be safely performed in all age groups with satisfactory long-term outcomes. It is suggested that early elective surgical correction can be recommended for a patient whose diagnosis was made in utero. 相似文献
63.
Mahmut Koç Ömer Yoldaş Yusuf Alper Kılıç Erdal Göçmen Tamer Ertan Hayrettin Dizen Mesut Tez 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):581-585
Background and aims The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic
ulcer referred to an academic department of general surgery in a tertiary reference center.
Patients and methods Seventy-five consecutive patients (Male/female ratio = 64:11; mean age, 44 years; range, 16–85) with perforated peptic ulcer
disease were investigated. Disease severity scores and mortality predictions were calculated using the collected data during
admission. Discrimination and calibration characteristics of each system, namely, the acute physiology and chronic health
evaluation II and III, the simplified acute physiology score II, and the mortality probability models (MPM) II, were determined
by using the area under receiver operating characteristics curve and the Hosmer–Lemeshow goodness-of-fit test, respectively.
Results Among the 75 patients included, there were eight (10.6%) mortalities. All systems had a reliable power of discrimination and
calibration. Among the systems tested, MPM II was the best performing as far as discrimination and calibration characteristics
were considered. The parameters of MPM II system that were related to systemic perfusion of the patient were significantly
positive in patients who died compared to those who survived.
Conclusions MPM II that predicted mortality at admission is better than the other systems in predicting mortality. Results also indicate
the importance of maintenance of systemic perfusion of the patient at the early phases of peptic ulcer perforation. 相似文献
64.
65.
66.
Kaan Kirali Nihan Kayalar Tuncer Ko?ak Cevat Yakut 《European journal of cardio-thoracic surgery》2005,27(5):923-924
Many approaches for minimally invasive coronary bypass surgery are available and to further decrease the invasiveness, coronary artery bypass grafting has been performed under high thoracic epidural anesthesia without endotracheal intubation in the last years. Less invasive approach to coronary artery bypass graft operations is possible through combination of the high thoracic epidural anesthesia and a reversed-J sternotomy, and coronary revascularization can be accomplished without any additional technical difficulties and with a good exposure of both the left anterior descending artery and the left internal thoracic artery. This technique is less traumatic for patients and provides practical better oxygenation and shorter hospital stay. 相似文献
67.
Ei Tae Kim Lee Hoo Kim Jung Il Lee Hee Seung Chin 《Japanese journal of ophthalmology》2009,53(6):598-602
Background
To assess the nature, incidence, and risk factors of retinopathy associated with pegylated interferon and ribavirin combination therapy in chronic hepatitis C patients. 相似文献68.
Chien-Huang Lin Feng-Nien Ko Hisahi Ishii Tsutomu Ishikawa Ih-Sheng Chen Che-Ming Teng H.-P. Kuo 《Naunyn-Schmiedeberg's archives of pharmacology》1997,355(2):210-216
We investigated the effects of a novel platelet-activating factor (PAF) receptor antagonist, CIS-19 [cis-2-(3, 4-dimethoxyphenyl)-6-isopropoxy-7-methoxy-1-(N-methylformamido)-1,
2, 3, 4-tetrahydronaphthalene], on PAF-, histamine-, substance P- and antigen-induced bronchoconstriction and microvascular
leakage, as well as PAF- and antigen-induced bronchial hyperreactivity to methacholine in urethane-anesthetized guinea-pigs.
Administration of CIS-19 (0.5–5 mg/kg, i.v.) inhibited the increase in lung resistance induced by PAF (30 ng/kg, i.v.) in
a dose-dependent manner, but failed to inhibit the increase induced by histamine (30 μg/kg, i.v.) or substance P (6.5 μg/kg,
i.v.). CIS-19 (5 mg/kg, i.v.) did not inhibit the increase in lung resistance induced by ovalbumin (2 mg/kg, i.v.) in actively
sensitized guinea-pigs. PAF (30 ng/kg, i.v.)-induced microvascular leakage, measured by the extravasation of Evans blue dye,
was dose-dependently inhibited by CIS-19 (0.5–5 mg/kg, i.v.) in the trachea, main bronchi and intrapulmonary airways, but
it did not affect histamine (30 μg/kg, i.v.)- or substance P (6.5 μg/kg, i.v.)-induced microvascular leakage at all airway
levels. CIS-19 (2.5 and 5 mg/kg) did not affect ovalbumin (2 mg/kg, i.v.)-induced microvascular leakage in all airway levels
in actively sensitized guinea-pigs. CIS-19 (2.5 and 5 mg/kg, i.v.) significantly inhibited PAF-induced enhancement of the
bronchial response to methacholine, but had no effect on ovalbumin (0.05 mg/kg, i.v.)-induced bronchial hyperreactivity in
actively sensitized guinea-pigs. It is concluded that CIS-19 is a potent PAF receptor antagonist which inhibits PAF- but not
antigen-induced bronchoconstriction, microvascular leakage and bronchial hyperreactivity. These results suggest that PAF plays
little or no role in early airway responses following antigen challenge.
Received: 29 April 1996 / Accepted: 10 October 1996 相似文献
69.
The biomechanical and morphological changes in the medial collateral ligament of the rabbit after immobilization and remobilization 总被引:10,自引:0,他引:10
S L Woo M A Gomez T J Sites P O Newton C A Orlando W H Akeson 《The Journal of bone and joint surgery. American volume》1987,69(8):1200-1211
The effects of immobilization and remobilization on the biomechanical and morphological properties of the femur-medial collateral ligament-tibia complex and each of its components were investigated in the rabbit. Specimens that had been obtained after periods of unilateral immobilization of the knee and remobilization were evaluated for structural properties. In addition, the mechanical properties of the substance of the medial collateral ligament and the histological characteristics of both the substance of the ligament and its sites of insertion were evaluated. After immobilization, there were significant reductions in the ultimate load and energy-absorbing capabilities of the bone-ligament complex, and an increased number of failures occurred by tibial avulsion. The tissue of the medial collateral ligament also became less stiff as a result of immobilization. Histologically, the femoral and tibial insertion sites showed increased osteoclastic activity, resorption of bone, and disruption of the normal attachment of the bone to the ligament. With remobilization, the ultimate load and energy-absorbing capabilities of the bone-ligament complex improved but did not return to normal. Failure by tibial avulsion became less frequent, and the stress-strain characteristics of the medial collateral ligament returned to normal. Histologically, the sites of insertion of the ligament also showed evidence of recovery. 相似文献
70.
Jae Sue Choi Han Suk Young Jong Cheol Park Jin-Ho Choi Won Sick Woo 《Archives of pharmacal research》1986,9(4):233-236
The flavonoids isolated from the leaves ofRhododendron brachycarpum, were identified as quercetin, avicularin, quercitrin and hyperin. 相似文献