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111.
McCullough JA Evoy D Sweeney KJ Meyers C Ravi N Keeling N Byrne PJ Reynolds JV 《Irish journal of medical science》2003,172(3):132-135
Background Gastric carcinoma is a significant cause of death in Ireland. Surgery offers the best option of cure, but the five-year survival
following resection remains dismal at 10–15%. Experience from Japan and from some Western units suggest that an extended (D2)
lymphadenectomy in association with gastrectomy increases the prospect of cure, but concern about the morbidity and mortality
of this operation and lack of evidence from randomised studies has limited its acceptance.
Aims This study reports the experience of a specialist upper gastrointestinal unit with D2 gastrectomy in a four-year audit.
Methods Sixty-two resections were performed for gastric cancer. Results Nineteen patients were deemed unsuitable for the D2 procedure
and underwent a more limited lymphadenectomy (DO or D1). Forty-three patients underwent D2 resection, 12 with an oesophagogastrectomy,
22 with total gastrectomy and nine with a sub-total distal resection. Eight patients undergoing D2 resection had extended
resections, five with splenectomy and three with a distal pancreatectomy. Post-operative complications occurred in 31% of
patients. Thirty-day and 90-day mortality were zero. Median survival was 822 days in the D2 group (range 120–1,320).
Conclusions These results show that a D2 gastrectomy can be performed with a low morbidity and mortality and a median survival of greater
than two years. 相似文献
112.
113.
Mediastinal masses: alternative approaches to CT-guided needle biopsy 总被引:10,自引:1,他引:10
114.
山苍子水提物柠檬醛抗哮喘作用的实验研究 总被引:5,自引:0,他引:5
目的:研究山苍子水提物柠檬醛的抗哮喘作用及其机理。方法:通过豚鼠氯化乙酰胆碱-磷酸组胺喷雾致喘法、小鼠浓氨水喷雾引咳法、小鼠酚红排泻法观察柠檬醛的平喘、镇咳、祛痰作用,通过观察张力变化研究柠檬醛对豚鼠离体气管环张力的影响及乙酰胆碱对气管收缩的抑制作用。结果:柠檬醛能明显延长氯化乙酰胆碱-磷酸组胺喷雾引起的豚鼠哮喘潜伏期,能延长浓氨水喷雾诱发小鼠咳嗽反应潜伏期,明显减少咳嗽次数。能增加小鼠呼吸道酚红排泌量,能抑制乙酰胆碱对豚鼠离体气管平滑肌的收缩作用,使乙酰胆碱所致气管平滑肌量效曲线右移。结论:柠檬醛气雾剂具有一定的平喘、镇咳和祛痰作用,具有良好的支气管解痉作用。 相似文献
115.
James R Bell Antonia JA Raaijmakers Johannes V Janssens Lea MD Delbridge 《Clinical and experimental pharmacology & physiology》2015,42(12):1327-1332
Control of cardiomyocyte cytosolic Ca2+ levels is crucial in determining inotropic status and ischemia/reperfusion stress response. Responsive to fluctuations in cellular Ca2+, Ca2+/calmodulin‐dependent protein kinase II (CaMKII) is a serine/threonine kinase integral to the processes regulating cardiomyocyte Ca2+ channels/transporters. CaMKII is primarily expressed either in the δB or δC splice variant forms, which may mediate differential influences on cardiomyocyte function and pathological response mechanisms. Increases in myocyte Ca2+ levels promote the binding of a Ca2+/calmodulin complex to CaMKII, to activate the kinase. Activity is also maintained through a series of post‐translational modifications within a critical region of the regulatory domain of the protein. Recent data indicate that the post‐translational modification status of CaMKIIδB/δC variants may have an important influence on reperfusion outcomes. This study provided the first evidence that the specific type of CaMKII post‐translational modification has a role in determining target selectivity of downstream Ca2+ transporters. The study was also able to demonstrate that the phosphorylated form of CaMKII closely co‐localizes with CaMKIIδB in the nuclear/myofilament fraction, contrasting with a co‐enrichment of oxidized CaMKII in the membrane fraction with CaMKIIδC. It has also been possible to conclude that a hyper‐phosphorylation of CaMKII (Thr287) in reperfused hearts represents a hyper‐activation of the CaMKIIδB, which exerts anti‐arrhythmic actions through an enhanced capacity to selectively increase sarcoplasmic reticulum Ca2+ uptake and maintain cytosolic Ca2+ levels. This suggests that suppression of global CaMKIIδ may not be an efficacious approach to developing optimal pharmacological interventions for the vulnerable heart. 相似文献
116.
117.
Clift RA; Buckner CD; Thomas ED; Bensinger WI; Bowden R; Bryant E; Deeg HJ; Doney KC; Fisher LD; Hansen JA 《Blood》1994,84(6):2036-2043
A prospective randomized study was conducted comparing two conditioning regimens for the treatment of patients with chronic myeloid leukemia in chronic phase by marrow transplantation from HLA identical siblings. Sixty-nine patients received 60 mg/kg of cyclophosphamide on each of 2 successive days followed by 6 fractions of total body irradiation each of 2.0 Gy (CY-TBI), and 73 patients received 16 mg/kg of busulfan delivered over 4 days followed by 60 mg/kg CY on each of 2 successive days (BU-CY). There was no significant difference between the CY-TBI and the BU-CY groups in the 3-year probabilities of survival (0.80 for both), relapse (0.13 for both), or event-free survival (CY-TBI, 0.68; BU-CY, 0.71) or in speed of engraftment or incidence of venocclusive disease of the liver. The 4-year probabilities of survival and event- free survival for patients transplanted within 1 year of diagnosis were 0.86 and 0.72, respectively, for each group. Significantly more patients in the CY-TBI group experienced major creatinine elevations. There was significantly more acute graft-versus-host disease in the CY- TBI group. Fever days, positive blood cultures, hospitalizations, and inpatient hospital days were significantly more common in the CY-TBI group than in the BU-CY group. In conclusion, the BU-CY regimen was better tolerated than, and associated with survival and relapse probabilities that compare favorably with, the CY-TBI regimen. 相似文献
118.
119.
Burwinkel B; Maichele AJ; Aagenaes O; Bakker HD; Lerner A; Shin YS; Strachan JA; Kilimann MW 《Human molecular genetics》1997,6(7):1109-1115
Glycogen storage disease due to phosphorylase kinase deficiency occurs in
several variants that differ in mode of inheritance and tissue-
specificity. This heterogeneity is suspected to be largely due to mutations
affecting different subunits and isoforms of phosphorylase kinase. The gene
of the ubiquitously expressed beta subunit, PHKB, was a candidate for
involvement in autosomally transmitted phosphorylase kinase deficiency of
liver and muscle. To identify such mutations, the complete PHKB coding
sequence was amplified by RT-PCR of RNA isolated from blood samples of
patients and analyzed by direct sequencing of PCR products. The
characterization of mutations was complemented by PCR of genomic DNA. In
one female and four male patients, we identified five independent nonsense
mutations (Y418ter; R428ter; Y974H+E975ter; Q656ter in two cases), one
single-base insertion in codon N421, one splice-site mutation affecting
exon 31, and a large deletion involving the loss of exon 8. Although these
severe translation-disrupting mutations occur in constitutively expressed
sequences of the only known beta subunit gene of phosphorylase kinase,
PHKB, they are associated with a surprisingly mild clinical phenotype,
affecting virtually only the liver, and relatively high residual enzyme
activity of approximately 10%.
相似文献
120.
Surgery remains the treatment of choice for massive and recurrent hemoptysis. In some instances, however, immediate surgical intervention is contraindicated. In these situations, bronchial artery embolization (BAE) has proved to be a successful definitive treatment for non-surgical candidates and a palliative therapy in patients requiring hemodynamic stabilization prior to surgery. The most serious complication of BAE is spinal cord ischemia. This relates directly to the potential anastomotic connections between the bronchial circulation and the anterior spinal artery. Somatosensory evoked potentials (SSEPs) have been used in the past to monitor spinal cord ischemia during procedures that threaten the vascularity of the spinal cord. The authors report two cases in which SSEPs were employed to monitor spinal cord ischemia during bronchial artery embolization. 相似文献