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991.
Experimental studies demonstrated a severe cardiac load of the CO2 pneumoperitoneum caused by an accelerated after- and a decreased preload. Patients displaying cardiovascular risks are therefore
often rejected from laparoscopic surgery. Hence, the pathophysiological changes and the intraoperative risk of the CO2 pneumoperitoneum in high-risk cardiopulmonary patients (NYHA II–III, n= 15) undergoing laparoscopic cholecystectomy are described. The changes in cardiac after- and preload seem to be due to the
elevated intraabdominal pressure rather than transperitoneally resorbed CO2 and are reversible by desufflation. In one patient conversion to open operation had to be performed because of a severe drop
in cardiac output and right ventricle ejection fraction. Mixed oxygen saturation was predicting intraoperative worsening in
this case. The described pathophysiological changes may seem to be well tolerated even in high-risk cardiac patients. Monitoring
of hemodynamics should include an arterial catheter line and blood gas analyses. Pharmacologic interventions or pressureless
laparoscopic procedures might not be necessary as long as laparoscopic cholecystectomy is performed.
Received: 13 December 1996/Accepted: 8 January 1997 相似文献
992.
P. Kiviskk W. Tian S. Fredrikson H. Link M. Sderstrm 《European journal of neurology》1997,4(5):460-467
Beta-interferon (IFN-β) is a promising treatment in multiple sclerosis (MS), reducing the exacerbation rate and MRI lesion burden, as well as the disease progression in relapsing-remitting MS. IFN-β was originally defined by its antiviral effects, but the interest has recently been focused on its immunomodulatory properties. Myelin basic protein (MBP) is one of several autoantigens considered to be the target for autoaggressive immune responses, which eventually might lead to the development of MS. To study in-vitro effects of IFN-β1b on MBP induced cytokine expression, mRNA for the Th1 cytokines IFN-γ and TNF-α, the Th2 related IL-4 and IL-6, the cytolytic perforin and the immune response downregulating TGF-β was measured with in situ hybridization after culture of blood mononuclear cells (MNC) in the presence and absence of MBP. Numbers of cells expressing IFN-γ, TNF-α, perforin and IL-4 mRNA were significantly suppressed after culture with 10 U/ml IFN-β1b. No such effect was seen on MBP induced IL-6 or TGF-β mRNA expression. These observations suggest that one of the major effects of IFN-β1b is the induction of a shift in the cytokine mRNA profile towards a more immunosuppressive pattern. In parallel in vitro tests, the control substance dexametasone (40 μg/ml) reduced the numbers of cells expressing mRNA for all cytokines under study with the exception of TGF-β, to an extent equal to or even more pronounced than IFN-β1b. 相似文献
993.
Seiji Yano Shoichiro Sumi Yoshinori Nio Tatsuro Ooishi Yasunari Kawabata Yoshimitsu Minari Katsuhiro Tamura 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):340-345
A case of insulinoma is reported in a patient in whom selective arterial calcium injection (SACI) tests were performed both
to confirm tumor localization before surgery and to confirm complete tumor removal during surgery. An 18-year-old woman with
hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body demonstrated by celiac arteriography. In a preoperative
SACI test, calcium was injected into the splenic artery (SpA), gastroduodenal artery (GDA), and superior mesenteric artery
(SMA). Serum immunoreactive insulin (IRI) and proinsulin levels were measured in hepatic venous samples. IRI was markedly
increased after the injection of calcium into the GDA and SMA, while there was no response in IRI levels when calcium was
injected into the SpA. Therefore, no occult insulinoma was revealed in the distal area fed by the SpA, although the presence
of insulinoma was uncertain in the proximal pancreas. In the intraoperative SACI test, calcium was injected into the celiac
artery. Insulin (determined by enzyme immunoassay) and proinsulin levels were measured in portal venous samples before and
after resection of the tumor. After resection, these levels decreased in response to the calcium stimuli, confirming complete
removal of the insulinoma. The SACI test was helpful to localize the insulinoma and was useful to confirm the complete removal
of the tumor. 相似文献
994.
Yoshimasa Mori Masakazu Takayasu Yoshio Suzuki Masato Shibuya Jun Yoshida Hiroyoshi Hidaka 《European journal of pharmacology》1997,320(2-3):183-186
The vasodilator effects of C-type natriuretic peptide (CNP) were investigated in isolated rat cerebral arterioles. CNP caused dose-dependent vasodilation, maximally by 10.0±2.2% at 10−6 M. The median effective concentration (EC50) was 5.2×10−10 M. In contrast, atrial natriuretic peptide and B-type natriuretic peptide, other members of the natriuretic peptide family, produced little or no vasodilation. Pretreatment with methylene blue (10−4 M) abolished CNP-induced vasodilation, whereas pretreatment with NG-monomethyl--arginine or indomethacin did not inhibit vasodilation. Thus, CNP is suggested to cause significant vasodilation in cerebral arterioles via a cyclic guanosine monophosphate-dependent mechanism. © 1997 Elsevier Science B.V. All rights reserved. 相似文献
995.
J. Mäurer A. Kendzia H. Gerlach D. Pappert J. Hierholzer K. J. Falke R. Felix 《Intensive care medicine》1998,24(11):1152-1156
Objective: To determine whether the quality of infiltrations in chest radiographs can accurately predict the histological extent of
fibrotic change in patients with acute respiratory distress syndrome (ARDS). Design: Retrospective clinical investigation. Setting: Intensive care unit (ICU) of a university teaching hospital. Patients and methods: Of 47 patients treated with extracorporeal membrane oxygenation (ECMO) for severe ARDS over a 5-year period, 23 patients
underwent open lung biopsy at thoracotomy for treatment, mostly of pneumothorax. Chest films obtained by portable chest roentgenography
preceding the operation were reviewed retrospectively and compared to the histomorphological results of the lung specimen.
Results: Chest radiographs displayed mixed alveolar-reticular opacification in 60.2 %, alveolar patterns in 22.9 % and reticular
opacities in 10.5 %. In 0.4 % there were no infiltrates, 6 % could not be evaluated because of insufficient quality. There
was no relevant difference between the right and left lungs. Subdividing patients into two groups according to the histological
results of either absent or mild (1) or severe (2) lung fibrosis, we found an alveolar haziness in 12.3 % in group 1 compared
with 28.2 % in group 2, while reticular characteristics were identified in 13 % and 11 %, respectively. Conclusions: The most common opacity in chest radiographs of patients with severe ARDS treated with ECMO is mixed alveolar-reticular
opacification. Severe lung fibrosis is not positively correlated with a reticular radiographic pattern. ECMO does not lead
to specific radiological changes in conventional radiograms, contrary to clinical findings that treatment with ECMO might
induce pleural or pulmonic haemorrhage, especially in the earlier days when systemic heparinization had to be used instead
of the heparin-coated tube-surfacing.
Received: 24 November 1997 Accepted: 20 July 1998 相似文献
996.
997.
合成了3-取代苯基-5-取代-1,2,4-(口恶)二唑类化合物50个,经感染棘球蚴的小鼠初筛,部分化合物对棘球蚴有不同程度的作用,化合物13、28和30对棘球蚴的囊重抑制率分别为70、75.6和71.6%,其中化合物13对棘球蚴的生发层有损害作用。 相似文献
998.
电针对沙鼠急性脑缺血再灌注后神经原损伤的保护作用 总被引:9,自引:0,他引:9
本实验利用沙鼠急性脑缺血再灌注模型,研究电针对脑缺血及再灌注各期脑电活动的影响及组织病理学的改变。结果表明:缺血10mln,脑电幅度受到严重抑制,甚至变平坦,总功率大大下降,再灌注后总功率难以恢复,在120min时仅恢复到缺血前的27.39±11.31%,以后即不再进一步恢复,电针组动物缺血10min再灌注后,脑电的恢复明显比对照组快,120min时恢复至缺血前的71.45±16.46%(P<0.01),240min时继续恢复至缺血前的75.27±18.43%。同时电针能明显减轻缺血10min后再灌注24小时的神经原缺血性损伤。结果提示:电针对急性脑缺血引起的神经原损伤具有保护作用,并能促进脑功能的恢复。 相似文献
999.
1000.
胃癌组织COX-2的表达及其与细胞增殖和凋亡的关系 总被引:8,自引:1,他引:7
目的 :探讨环氧化酶 - 2 (cyclooxygenase - 2 ,COX - 2 )在胃癌组织中的表达与癌细胞增殖和凋亡的关系。 方法 :采用免疫组织化学的方法检测 4 3例胃癌患者COX - 2和增殖细胞核抗原 (PCNA)的表达 ,用TUNEL法检测原位细胞凋亡的情况。分别计算细胞增殖指数 (MI)和凋亡指数 (AI)。结果 :胃癌组织COX - 2表达的阳性率为 6 0 .4 7% ,明显高于对照组 (P <0 .0 1)。COX - 2的高表达与胃癌淋巴结的转移和临床分期有关 ,与肿瘤大小、浸润深度、分化程度均无关。COX - 2阳性胃癌组中MI高于COX - 2阴性胃癌组 ,而AI却低于COX - 2阴性胃癌组 (P均 <0 .0 1)。结论 :COX - 2的过度表达可促进胃癌细胞增殖、抑制细胞凋亡 ,在胃癌的发生、发展过程中起着重要的作用。 相似文献