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排序方式: 共有771条查询结果,搜索用时 15 毫秒
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2.
Erkki Lotspeich Markus Schoene Heinz Gerngroß Roland Schmidt Reinhard Steinmann Marco Ramadani Susanne Gansauge 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):559-566
Introduction Postoperative treatment for colorectal cancer depends on tumor stage as defined by the International Union Against Cancer
(UICC). Adjuvant chemotherapy is not recommended in patients without lymph node involvement (UICC stages I and II). As many
as 20–30% of these patients, however, will develop recurrence.
Aims and objectives We conducted this study to determine the presence of disseminated tumor cells in the lymph nodes by quantitative real-time
polymerase chain reaction (QRT-PCR) for cytokeratin 20 (CK20) in an attempt to provide supplementary information compared
to histopathological findings.
Materials and methods Using a standard QRT-PCR assay, we examined primary tumors and 391 lymph nodes from 31 patients with completely resected colorectal
cancer.
Results Of the 31 primary tumors, 29 were positive for CK20 by QRT-PCR.
Discussion An examination of the lymph nodes from the 29 patients with CK20-positive primary tumors revealed that 35 (92.1% sensitivity)
of the 38 histopathologically positive lymph nodes and 54 (16.7%) of the 324 histopathologically negative lymph nodes were
positive by molecular analysis. CK20 expression was detected in 10 (100%) of 10 patients with a histopathologically positive
lymph node status (pN1). In 9 (47.4%) of 19 patients with negative histopathological results (pN0), we detected a CK20 mRNA
signal in at least one lymph node. Whereas eight patients with histopathologically negative lymph nodes could be upstaged
on the basis of the molecular findings, no patient would be downstaged.
Conclusion Our results suggest that QRT-PCR for CK20 is a useful tool for the quantitative detection of micrometastases in the regional
lymph nodes. We introduce a standardized procedure that integrates a molecular diagnostic technique in the clinical staging. 相似文献
3.
R. I. Parker 《Intensivmedizin und Notfallmedizin》1997,34(1):24-32
Summary Excessive bleeding frequently complicates the care of critically-ill patients. Except in the case of trauma or in patients
with known coagulopathies (e.g., hemophilia), the bleeding is generally not directly related to the illness that results in
admission to the intensive care unit. In general, the causes of the bleeding can be divided into 3 categories: consumptive
coagulopathies (e.g., DIC), bleeding related to ``hepatic issues' (i.e., liver dysfunction, vitamin K deficiency), and iatrogenic
causes. This review will discuss the more common causes of bleeding in the critically-ill patient and outline diagnostic and
treatment approaches for these patients. New experimental data linking activation of the coagulation and inflammatory systems
with the development of multisystem organ failure is briefly discussed.
Received: 8 November 1996 Accepted: 18 November 1996 相似文献
4.
F. Carmassi M. Morale F. De Negri M. Carrai 《Journal of molecular medicine (Berlin, Germany)》1995,73(2):89-93
Patients with liver failure can present both thrombotic and hemorragic complications because of the deficiency in coagulation factors and inhibitors (protein C and S, antithrombin III) and impairment of fibrinolytic balance. Here we report the case of a 63-year-old man with liver cirrhosis, recurrent thrombosis, and features of low-grade consumption coagulopathy, showing severe antithrombin III deficiency (about 30% of normal values). Treatment with antithrombin III (2000 U/day) and low doses of heparin (5000 U b.i.d.) was successful in modulating the coagulation system toward an antithrombotic effect. After discharge from hospital the ambulatory treatment with antithrombin III concentrates (2000 U twice a week) allowed the attainment of antithrombin III activity of about 60% and prevented the patient from recurrence of venous thrombosis.Abbreviations
AT-III
Antithrombin III
-
DIC
Disseminated intravascular coagulation
-
TAT complexes
Thrombin-antithrombin III complexes
-
PAI-1
Plasminogen activator inhibitor-1 相似文献
5.
Rosenzweig SD Schäffer AA Ding L Sullivan R Enyedi B Yim JJ Cook JL Musser JM Holland SM 《Clinical immunology (Orlando, Fla.)》2004,112(1):113-119
Different polymorphisms have been described in the minimal promoter region (MPR) of the interferon-gamma receptor 1 (IFNGR1), a molecule that plays a critical role in mycobacterial control. We sequenced the IFNGR1 MPR from African American, Caucasian and Korean controls, and from mycobacteria-infected patients. Six different single nucleotide polymorphisms (SNPs) were detected in the IFNGR1 MPR. The three ethnic groups showed different SNP distribution patterns, but no significant differences were detected between mycobacterial cases and controls. Two polymorphisms were found in all populations (G-611A, T-56C). We cloned the four allelic variants (var) of haplotype G-611A/T-56C into a luciferase reporter vector and determined their promoter activity. Polymorphisms at position -611 had a stronger effect on the promoter activity than those at position -56, and constructs carrying G-611 produced a stronger promoter activity than -611A constructs. The IFNGR1 MPR is a polymorphic region with at least two SNPs influencing its activity, but these are not associated with increased mycobacterial susceptibility. 相似文献
6.
P. Harten H. H. Euler E. Wolf G. Delling H. Löffler 《Journal of molecular medicine (Berlin, Germany)》1994,72(11):878-882
Histoplasma infections in Europe are rare, and acute disseminated histoplasmosis has only been observed in immunocompromised persons. We describe a case of acute disseminated histoplasmosis in a young, nonimmunocompromised European woman. The probable source of infection was Sri Lanka or the Maldives. At presentation she was severely ill with fever, lymphadenopathy, anemia, thrombocytopenia, hepatosplenomegaly, and polyserositis. Histologically, myelofibrosis and osteosclerosis were observed with extramedullary hematopoiesis. Histoplasma capsulatum yeasts were detected in bone marrow trephine biopsy by methenamine silver staining. Treatment with conventional and liposomal amphotericin B and subsequent itraconazole led to rapid and complete recovery.Abbreviations He
Histoplasma capsulatum
- AIDS
acquired immunodeficiency syndrome
- HIV
human immunodeficiency virus 相似文献
7.
《Journal of microbiology, immunology, and infection》2023,56(1):172-181
ObjectivesWe described a case of Strongyloides hyperinfection syndrome, reported a case series, and reviewed published cases of strongyloidiasis in Taiwan.MethodsConfirmed cases of strongyloidiasis at the National Taiwan University Hospital (NTUH) and NTUH Hsin-Chu Branch from 1988 to 2020 were identified in the medical record database. Literature search was carried out through Pubmed, Google Scholar, and Index to Taiwan Periodical Literature System to identify published cases of strongyloidiasis in Taiwan from 1979 to 2020. Data pertaining to the demographics, underlying medical conditions, clinical manifestations, laboratory findings, and outcomes were extracted.ResultsA total of 117 cases of strongyloidiasis were identified, including 20 previously unpublished cases from the two hospitals and 97 published cases in the literature. Overall, 85 (73%) were male and the mean age was 64 years (range, 6–95 years). Classical symptoms such as diarrhea, cough, and skin rash were only observed in 43%, 37%, and 18% of the patients, respectively, whereas eosinophilia at presentation was only found in 48%. Strongyloides hyperinfection syndrome and disseminated strongyloidiasis were identified in 41 (35%) and 4 (3%) patients, respectively. Four (3%) patients had concurrent meningitis. In univariable analysis, being older and having pre-existing chronic obstructive pulmonary disease or asthma were associated with hyperinfection or dissemination (p = 0.024 and 0.003, respectively). The mortality rate was 43% among those with hyperinfection or disseminated infection.ConclusionsStrongyloidiasis can cause serious complications and mortality. Efforts to diagnose strongyloidiasis early are urgently needed to improve the outcome of patients with strongyloidiasis in Taiwan. 相似文献
8.
大剂量糖皮质激素联合抗蛇毒血清治疗竹叶青蛇伤致DIC的疗效 总被引:3,自引:0,他引:3
目的观察大剂量糖皮质激素联合抗蛇毒血清在治疗竹叶青蛇伤致DIC中的疗效。方法57例竹叶青蛇伤致DIC患者按单盲随机法分为两组,对照组28例,治疗组29例。对照组予常规综合治疗+抗蝮蛇血清;治疗组在对照组基础上加用甲基强的松龙1000m g/d,观察两组疗效及凝血酶原时间(PT)、纤维蛋白原(Fg)和血小板(PLT)的恢复时间。结果治疗组总有效率96.6%,对照组总有效率75.0%,两者差异有显著性(P<0.05);治疗组PT、Fg、PLT与对照组比较,有显著性差异(P<0.05)。结论大剂量糖皮质激素联合抗蛇毒血清治疗竹叶青蛇伤致DIC可明显缩短凝血指标恢复时间及提高疗效。可以对竹叶青蛇毒起较好的中和作用,取得满意的临床治疗效果。 相似文献
9.
10.
目的:研究细胞外信号调节激酶1/2(ERK1/2)抑制剂PD98059对大鼠内毒素弥散性血管内凝血(DIC)多器官损伤的保护作用。方法:Sprague-Dawley(SD)大鼠随机分为对照组、DIC组及抑制剂组。DIC组通过腹腔注射6mg/kg脂多糖(LPS)建立内毒素DIC模型,抑制剂组腹腔注射6mg/kg LPS和10mg/kg PD98059。5h后取血,利用全自动血凝仪及生化仪检测活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、乳酸脱氢酶(LDH)、碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素(BUN)及肌酐(Cr)等指标;并留取心肝肾组织,光镜下观察其形态学变化。结果:与对照组相比:DIC组APTT、LDH、ALP、ALT、AST、BUN及Cr均延长或升高(P<0.01),FIB较对照组降低(P<0.01),心、肝、肾组织病理学检查均有明显的血管扩张充血;PD98059预防性用药后,除Cr外各指标均有明显改善(P<0.01),心、肝、肾组织血管充血减轻。结论:ERK1/2抑制剂PD98059能够减轻内毒素DIC时的多器官损伤,其机制与ERK1/2信号通路的抑制有关。 相似文献