Dialytic ultrafiltration with haemofilter was performed in 16 patients with malignant ascites refractory to treatment with sodium restriction, diuretic and systemic chemotherapy. A continuous flow of ascitic fluid at a rate of 300–400 ml/min through a haemofilter was maintained by a blood pump. The protein-rich ascitic fluid was re-infused into the peritoneal cavity with sodium and water removed. An average of 5.2 1 of filtrate was removed over a mean interval of 3.5 h. Bleomycin (60 mg) was administered intraperitoneally following the procedure. Complete response was observed in six patients (37.25%) and partial response occurred in four (25%). The remaining patients showed no response. Complications of the dialytic ultrafiltration procedure and toxicity of intraperitoneal administration of bleomycin were minimal. The technique of dialytic ultrafiltration is simple, safe and cost-effective and could be used as an adjuvant therapy for intraperitoneal chemotherapy. 相似文献
Recent data suggest that vitamin D3 may be capable of immunoregulation after it is converted to an active metabolite, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). The effect of vitamin D3 and 1,25(OH)2D3 on human natural killer (NK) cells and their activation by interferon (IFN) and interleukin 2 (IL-2) was investigated. Vitamin D3 and 1,25(OH)2D3 inhibited NK cytotoxicity in a dose-dependent manner. Pretreatment of non-adherent (NA) cells at 37 degrees C for 18 h with the vitamins also led to inhibition of NK activity. Both the inhibition of NK lysis and pretreatment of NA cells were dependent on the concentrations of fetal calf serum (FCS) in the medium. The inhibition of NK activity was less effective in the presence of 10% FCS than with 1% FCS. Vitamin D3 inhibited both IFN and IL-2 activation of NK activity. However, increasing doses of IL-2 were able to abrogate the inhibition caused by vitamin D3. Vitamin D3 was able to inhibit NK activity of phytohaemagglutinin and IL-2-activated cells, and also inhibit the proliferation and lymphokine-activated killer activity induced by IL-2. NA cells pretreated with vitamin D3 did not respond well to IL-2. NA cells pretreated with low doses of IL-2 were sensitive to inhibition by vitamin D3 while those pretreated with high doses of IL-2 were not. The data presented suggest that vitamin D3 and 1,25(OH)2D3 inhibit NK activity and LAK cellular differentiation. 相似文献
OBJECTIVE: Hereditary non‐polyposis colorectal cancer (HNPCC) syndrome is the most common cause of hereditary colorectal cancer with an early age of onset. Microsatellite instability (MSI) and germline mutation in one of the DNA mismatch repair (MMR) genes are found in the majority of HNPCC families and provide an opportunity for genetic diagnosis and prophylactic screening. The MMR gene mutation spectrum may vary across different populations and be influenced by founder mutations that prevail in specific ethnic groups. China is a big and ancient nation with enormous genetic diversity, which is especially notable between the northern and southern Chinese populations. A MMR gene mutation database for the southern Chinese population based in Hong Kong has been previously established. This study compares the MMR gene mutation spectrum and the MSI of HNPCC between the northern and southern Chinese populations. METHODS: Twenty‐five HNPCC families from northern China were systematically analyzed. The MSI analysis was performed using five loci in the USA National Cancer Institute (NCI) panel (D2S123, D5S346, BAT‐25, BAT‐26 and BAT‐40) by PCR from the tumor and normal tissue. MSH2, MSH6 and MLH1 were performed using immunohistochemical staining. Two founder mutations of MSH2 and MLH1 were examined by PCR base analyses using primers flanking the two deletion sites (c.1452_1455delAATG in MSH2 and 1.8 kb deletion involving exon 11 of MLH1) . RESULTS: Of the 25 families collected, 19 met Bethesda guideline (BG) 1 and six met BG3. Twenty‐two (15.7%) were extra‐colonic cancers with gastric cancer (in seven patients) being the most common cancer type. Of the 25 tumors analyzed, 21 (84%) were high level microsatellite instability (MSI‐H) and four (16%) were microsatellite stable (MSS). Eighteen (86%) of the 21 MSI‐H tumors showed loss of either the MLH1 or the MSH2 protein. Three MSI‐H tumors and all four MSS tumors showed no loss of expression of the three MMR proteins. Out of the 21 patients with MSI‐H tumors, 12 (57%) showed pathogenic germline mutations in either MLH1 (n = 8) or MSH2 (n = 4). Overall, three novel mutations (in patients H22, H17 and H29) have been identified. One of them, c.503_4insA, caused a frameshift mutation in the MLH1 gene. The other two were found in the MSH2 gene, including a frameshift (c.899_890insAT) and a splice junction (IVS7‐1G→A, SA of Exon 8) mutation. CONCLUSIONS: The results suggest a distinctly different mutation spectrum of MMR genes between northern and southern Chinese populations and call for a systematic, nationwide study to facilitate the design of a MMR gene mutation detection strategy tailored for individual populations in China. 相似文献
Root migration occurs after most third molar coronectomy and a portion may be exposed in the oral cavity. This study compared the root migration rate, surgical morbidities after third molar coronectomy with or without adjunctive guided bone regeneration (GBR).
Methods
A split-mouth randomized clinical trial was conducted on patients with bilateral lower third molars close to the inferior alveolar nerve. One side of the lower third molars was randomized to receive coronectomy with adjunctive GBR (study group) and the other side received coronectomy alone (control group). The cases were followed up for 2 years. Root migration, root exposure rate, surgical morbidities, and adjacent second molar periodontal regeneration were analyzed.
Results
Forty-eight subjects (19 males, 29 females) with a mean age of 2.6 years (SD 5.8 years) were recruited. There was no root exposure in the review period. There were no statistical differences in pain and infection rate between the two groups at all time-points. The root migration was significantly less in the study group than the control group from 3 months onwards, and migrated only 1 mm (SD 1.3 mm) in 2 years (versus 3.5 mm (S.D.1.9 mm) in the control group). There were no differences in the periodontal attachment regeneration between the two groups.
Conclusions
Root migration in coronectomy with adjunctive GBR was less when compared with coronectomy alone, and with similar surgical morbidities and periodontal regeneration of adjacent second molars.
Clinical relevance
Minimal root migration occurred in coronectomy with adjunctive GBR. The chance of long-term (3 years or more) root exposure and the need of subsequent second operation to remove the exposed root would be reduced.