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951.
R. Parker Ward MD Mouaz H. Al-Mallah MD Gabriel B. Grossman MD PhD Christopher L. Hansen MD Robert C. Hendel MD Todd C. Kerwin MD Benjamin D. McCallister Jr MD Rupa Mehta MD Donna M. Polk MD MPH Peter L. Tilkemeier MD Aseem Vashist MD Kim Allan Williams MD David G. Wolinsky MD Edward P. Ficaro PhD 《Journal of nuclear cardiology》2007,14(6):911-e38
952.
Everson L. A. Artifon Airton Z. Rodrigues Sergio Marques Bhawna Halwan Paulo Sakai Claudio Bresciani Atul Kumar 《Journal of gastrointestinal surgery》2007,11(12):1686-1691
Background Exploratory laparoscopy is commonly undertaken in patients with highly suspicious biliary and pancreatic lesions to facilitate
diagnosis and staging cancer is present. If an unresectable tumor is identified, a second endoscopic procedure may be required
do deploy a self-expandable metal stent (SEMS) for palliation. As endoscopic retrograde cholangio pancreatography (ERCP) may
be unsuccessful in up to 20% of patients, we evaluated the feasibility and safety of deployment of self-expandable metal stents
at the same time as the initial laparoscopy.
Patients and Methods A total of 23 eligible patients (8 male and 15 female) with malignant obstruction of the common bile duct underwent deployment
of SEMS at laparoscopy. Primary outcome measure was the successful laparoscopic deployment of stent and secondary outcome
measure was complications rates.
Results Indications for stent deployment were unresectable pancreatic cancer in 18, cholangiocarcinoma in two, neuroendocrine tumor
in one and ampullary adenocarcinoma in two patients. The median age was 73 years (range 49–93). Twenty-two of 23 stents were
deployed successfully: 17 stents were deployed transcystically and five via a choledochotomy. Median times for laparoscopic
exploration and SEMS deployment were 165 min (range 105–230) and 20 min (range 10–50), respectively. Pre- and post-procedures
median total bilirubin were 9.4 mg/dl (range 5.4–17.5) and 4.0 (range 2.6–7.1). The median size of the pancreatic mass was
3 cm (range 2–5 cm) and that of the common bile duct (CBD) from 9.2 mm (range 7.2–17.4). The mean duration of laparoscopy
was 170 min (range 120–230 min) and that for stent deployment 23 min (range 10–50 min). Complications included bleeding, obstruction,
and wound infection. Bleeding occurred on day 7 in two patients and on day 30 in one patient; bleeding occurred at the gastrojejunal
anastomosis site and was successfully treated with endoscopic hemostasis. A total of three stent obstructions were identified:
one each at 60, 90, and 120 days follow-up. All complications were successfully managed endoscopically. There were a total
of seven deaths, six as a result of progressive cancer and one of surgical wound infection and ensuing complications.
Conclusion This study demonstrates that laparoscopic deployment of self-expandable metal bile duct stents is feasible and safe. This
option appears to be a reasonable option in patients with inoperable malignant obstruction of the distal common bile duct. 相似文献
953.
Pierpaolo Sileri Vito Maria Stolfi Giampiero Palmieri Alessandra Mele Alessandro Falchetti Sara Di Carlo Achille Lucio Gaspari 《Journal of gastrointestinal surgery》2007,11(12):1662-1668
Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective
audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.
Macroscopic appearance of the specimen (shape, size, and depth) was recorded. Microscopically, the presence of columnar, transitional,
and squamous epithelium, the involvement of circular/longitudinal smooth muscle, and features of mucosal prolapse were assessed.
Clinical outcome was evaluated by a validated questionnaire. Postoperative pain, secretion, and bleeding durations were 12.7 +/− 10.6,
5.6 +/− 9.6, and 6.3 +/− 8.4 days. Patient’s return to work averaged 16.7 +/− 10.7 days. Fissure, skin tags, and anal strictures
were observed in 23.4%. Seven patients experienced pain for a significantly longer period of time. All specimens contained
columnar mucosa, but 29.8% contained columnar and transitional epithelium and 12.8% contained columnar, anal transitional,
and stratified squamous epithelium. Smooth muscle was observed in 62.7%. Pain was significantly increased if transitional
epithelium was present in the specimen. No correlation or differences were observed if smooth muscle was present, although
postoperative bleeding was more frequent. Hemorrhoidopexy is safe and effective. The specimen should always be sent for pathology
examination. Only columnar epithelium should be present and, although the presence of smooth muscle does not influence the
outcome in terms of functional results, its presence may play a role in postoperative bleeding.
Presented as poster at the Digestive Disease Week, May 2007, Washington, USA 相似文献
954.
Virginia L Willour Peter P Zandi Judith A Badner Jo Steele Kuangyi Miao Victor Lopez Dean F MacKinnon Francis M Mondimore Barbara Schweizer Melvin G McInnis Erin B Miller J Raymond Depaulo Elliot S Gershon Francis J McMahon James B Potash 《Neuropsychopharmacology》2007,61(5):725-727
BACKGROUND: We are interested in identifying susceptibility genes that predispose subjects to attempted suicide. METHODS: We conducted a secondary analysis of genome-wide linkage data from 162 bipolar pedigrees that incorporated attempted suicide as a clinical covariate. RESULTS: The strongest covariate-based linkage signal was seen on 2p12 at marker D2S1777. The logarithm of odds (LOD) score at marker D2S1777 rose from 1.56 to 3.82 after inclusion of the suicide covariate, resulting in significant chromosome-wide empirically derived p-values for the overall linkage finding (p = .01) and for the change in LOD score after the inclusion of the covariate (p = .02). CONCLUSIONS: The finding on chromosome 2 replicates results from two previous studies of attempted suicide in pedigrees with alcohol dependence and in pedigrees with recurrent early-onset depression. Combined, these three studies provide compelling evidence for a locus influencing attempted suicide on 2p12. 相似文献
955.
Status,challenges and facilitators of consumer involvement in Australian health and medical research
Background
The emergent international practice of involving consumers in health research is driven, in part, by the growing share of health research that can only be applied in and emerge from knowledge that is shaped by human values and societal contexts. This is the first investigation of its kind to identify the current prevalence, challenges, enabling factors and range of approaches to consumer involvement in health and medical research in Australia. 相似文献956.
Background
Cancer cells recurrently develop into acquired resistance to the administered drugs. The iatrogenic mechanisms of induced chemotherapy-resistance remain elusive and the degree of drug resistance did not exclusively correlate with reductions of drug accumulation, suggesting that drug resistance may involve additional mechanisms. Our aim is to define the potential targets, that makes drug-sensitive MCF-7 breast cancer cells turn to drug-resistant, for the anti-cancer drug development against drug resistant breast cancer cells. 相似文献957.
958.
Background
Despite considerable knowledge about musculoskeletal disorders (MSD) and physical, psychosocial and individual risk factors there is limited knowledge about physical activity as a factor in preventing MSD. In addition, studies of physical activity are often limited to either leisure activity or physical activity at work. Studies among military personnel on the association between physical activity at work and at leisure and MSD are lacking. This study was conducted to find the prevalence of MSD among personnel in the Royal Norwegian Navy and to assess the association between physical activity at work and at leisure and MSD. 相似文献959.
Oluseun A Sowemimo Steven M Yood John Courtney Jessie Moore Miriam Huang Rebecca Ross Ursula McMillian Peter Ojo Randolph B Reinhold 《Surgery for obesity and related diseases》2007,3(1):73-7; discussion 77
BACKGROUND: To study the mortality among morbidly obese patients qualifying for bariatric surgery. Mortality from bariatric surgery for morbid obesity has been widely reported; however, little is known about the mortality in morbidly obese patients who defer surgery. METHODS: Consecutive patients evaluated for bariatric surgery with an initial encounter between 1997 and 2004 were identified. The Social Security Death Index and office records were used to identify mortality through 2006. We conducted telephone interviews to determine whether the 305 patients who did not undergo bariatric surgery at our institution had undergone the surgery elsewhere. Using Cox proportional hazards models, we compared the mortality in patients undergoing surgery with that of those who did not. To evaluate bias resulting from missing data, we conducted analyses assuming that all patients with missing data had (1) undergone surgery and (2) not undergone surgery. RESULTS: A total of 908 patients underwent bariatric surgery (880 patients at our institution and 28 patients elsewhere). A total of 112 patients did not undergo surgery. Data regarding surgery on 165 patients could not be obtained. The mortality in those patients who did not undergo surgery was 14.3% compared with 2.9% for those who did undergo surgery. Adjusting for age, gender, and body mass index, patients who had undergone surgery had an 82% reduction in mortality (hazard ratio 0.18, 95% confidence interval 0.09-0.35, P <.0001). Sensitivity analysis, assuming that all patients with missing data received surgery resulted in an 85% mortality reduction (P <.001) and assuming that patients did not receive surgery resulted in a 50% mortality reduction (P = .04). CONCLUSIONS: Mortality among morbidly obese patients without surgery was 14.3% during the study period. Surgical intervention offered a 50%-85% mortality reduction benefit. 相似文献
960.
Characterization of a functional promoter polymorphism of the human tryptophan hydroxylase 2 gene in serotonergic raphe neurons. 总被引:2,自引:0,他引:2