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91.
Isaac Samuel M.D. Mark A. Yorek Ph.D. Asgar Zaheer Ph.D. Rory A. Fisher Ph.D. 《Journal of gastrointestinal surgery》2006,10(7):950-959
Using a unique surgical model (the donor rat model), we showed previously that duodenal replacement of bile-pancreatic juice,
obtained fresh from a donor rat, ameliorates ligation-induced acute pancreatitis. We hypothesize that bile-pancreatic juice
exclusion from gut exacerbates Akt/nuclear factor-kB (NF-kB) pathway activation and induces chemokine production in ligation-induced acute pancreatitis. We compared rats with bile-pancreatic
duct ligation to those with duodenal bile-pancreatic juice replacement fresh from a donor rat beginning immediately before
duct ligation. Sham control rats had ducts dissected but not ligated. Rats were killed 1 or 3 hours after operation (n=7/group).
Akt activation (immunoblotting, immune-complex kinase assay, and ELISA), inhibitory protein I-kB (I-kB) activation (immunoblotting), and production of chemokines MCP-1 and RANTES (ELISA) were measured in pancreatic homogenates.
NF-kB was quantitated in nuclear fractions using electrophoretic mobility shift assay. Duct ligation produced significant increases
in pancreatic Akt, IkB, and NF-kB activation and production of MCP-1 and RANTES. Activation of the Akt/NF-kB pathway and increased MCP-1 and RANTES production in response to duct ligation were significantly reduced by bile-pancreatic
juice replacement (ANOVA, P<0.05). Bile-pancreatic juice exclusion stimulates Akt/NF-kB pathway activation and increases chemokine production in ligation-induced acute pancreatitis.
Presented at the annual meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 16, 2005 (poster). 相似文献
92.
Kimberly A. Varker Edward W. Martin Dori Klemanski Bryan Palmer Manisha H. Shah Mark Bloomston 《Journal of gastrointestinal surgery》2007,11(12):1680-1685
Background
Transarterial chemoemobolization (TACE) is commonly used to treat metastatic carcinoid tumors; however, the management of
progressive disease is less clear. We sought to determine if patients with disease progression after TACE would benefit from
repeat TACE.
Methods
The records of 27 patients undergoing repeat TACE for radiologic or symptomatic progression after TACE for metastatic carcinoid
were reviewed and compared to 122 undergoing first TACE. Overall and progression-free survivals were estimated by the Kaplan–Meier
method.
Results
Mean disease-free interval after first TACE was 11.8 months. Radiologic response was observed in 61% compared to 82% after
first TACE (p = 0.058); hormone response in 64% compared to 80% (p = 0.159); and symptomatic response in 77% compared to 92% (p = 0.053). The complication rate after repeat TACE was lower than after first TACE (p = 0.03). Median overall survival was similar after repeat (28.1 months) and first TACE (33.3 months) (p = 0.53). Progression-free survival was shorter after repeat TACE but not significantly so. No factor examined could predict
survival after repeat TACE.
Conclusion
Repeat TACE for patients with hepatic carcinoid metastases failing first TACE or having evidence of disease progression is
safe and offers a viable treatment option.
Presented at the 48th Annual Meeting of The Society for Surgery of the Alimentary Tract, Washington, DC, May, 2007. 相似文献
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Background
Chronic plantar heel pain (CPHP) is one of the most common musculoskeletal disorders of the foot, yet its aetiology is poorly understood. The purpose of this study was to examine the association between CPHP and a number of commonly hypothesised causative factors. 相似文献97.
Mark A. Trimble Salvador Borges-Neto Stuart Smallhelser Ji Chen Emily F. Honeycutt Linda K. Shaw Jaekyeong Heo Robert A. Pagnanelli E. Lindsey Tauxe Ernest V. Garcia Fabio Esteves Frank Seghatol-Eslami G. Neal Kay Ami E. Iskandrian 《Journal of nuclear cardiology》2007,14(3):298-307
Background Cardiac resynchronization therapy (CRT) is approved for the treatment of patients with advanced systolic heart failure and
evidence of dyssynchrony on electrocardiograms. However, a significant percentage of patients do not demonstrate improvement
with CRT. Echocardiographic techniques have been used for more accurate determination of dyssynchrony. Single photon emission
computed tomography (SPECT) myocardial perfusion imaging has not previously been used to evaluate cardiac dyssynchrony. The
objective of this study is to evaluate mechanical dyssynchrony as described by phase analysis of gated SPECT images in patients
with left ventricular dysfunction, conduction delays, and ventricular paced rhythms.
Methods and Results A novel count-based method is used to extract regional systolic wall thickening amplitude and phase from gated SPECT images.
Five indices describing the phase dispersion of the onset of mechanical contraction are determined: peak phase, phase SD,
bandwidth, skewness, and kurtosis. These indices were determined in consecutive patients with left ventricular dysfunction
(n=120), left bundle branch block (n=33), right bundle branch block (n=19), and ventricular paced rhythms (n=23) and were
compared with normal control subjects (n=157). Phase SD, bandwidth, skewness, and kurtosis were significantly different between
patients with left ventricular dysfunction, left bundle branch block, right bundle branch block, and ventricular paced rhythms
and normal control subjects (all P<.001) Peak phase was significantly different between patients with right ventricular paced rhythms and normal control subjects
(P=.001).
Conclusions A novel SPECT technique for describing left ventricular mechanical dyssyn-chrony has been developed and may prove useful in
the evaluation of patients for CRT.
This study was funded in part by a research grant from the Medtronic-Duke Strategic Alliance, of which Dr Borges-Neto is the
primary investigator. 相似文献
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Mathematical modelling of the spatio-temporal response of cytotoxic T-lymphocytes to a solid tumour.
Anastasios Matzavinos Mark A J Chaplain Vladimir A Kuznetsov 《Mathematical medicine and biology》2004,21(1):1-34
In this paper a mathematical model describing the growth of a solid tumour in the presence of an immune system response is presented. In particular, attention is focused upon the attack of tumour cells by so-called tumour-infiltrating cytotoxic lymphocytes (TICLs), in a small, multicellular tumour, without necrosis and at some stage prior to (tumour-induced) angiogenesis. At this stage the immune cells and the tumour cells are considered to be in a state of dynamic equilibrium--cancer dormancy--a phenomenon which has been observed in primary tumours, micrometastases and residual disease after ablation of the primary tumour. Nonetheless, the precise biochemical and cellular mechanisms by which TICLs control cancer dormancy are still poorly understood from a biological and immunological point of view. Therefore we focus on the analysis of the spatio-temporal dynamics of tumour cells, immune cells and chemokines in an immunogenic tumour. The lymphocytes are assumed to migrate into the growing solid tumour and interact with the tumour cells in such a way that lymphocyte-tumour cell complexes are formed. These complexes result in either the death of the tumour cells (the normal situation) or the inactivation (sometimes even the death) of the lymphocytes. The migration of the TICLs is determined by a combination of random motility and chemotaxis in response to the presence of chemokines. The resulting system of four nonlinear partial differential equations (TICLs, tumour cells, complexes and chemokines) is analysed and numerical simulations are presented. We consider two different tumour geometries--multi-layered cell growth and multi-cellular spheroid growth. The numerical simulations demonstrate the existence of cell distributions that are quasi-stationary in time and heterogeneous in space. A linear stability analysis of the underlying (spatially homogeneous) ordinary differential equation (ODE) kinetics coupled with a numerical investigation of the ODE system reveals the existence of a stable limit cycle. This is verified further when a subsequent bifurcation analysis is undertaken using a numerical continuation package. These results then explain the complex heterogeneous spatio-temporal dynamics observed in the partial differential equation (PDE) system. Our approach may lead to a deeper understanding of the phenomenon of cancer dormancy and may be helpful in the future development of more effective anti-cancer vaccines. 相似文献
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