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1.
Ragnhild B. Wijma Marloes Emous Merel van den Broek Anke Laskewitz Anneke C. Muller Kobold André P. van Beek 《Surgery for obesity and related diseases》2019,15(1):73-81
Background
Early dumping is a poorly defined and incompletely understood complication after Roux-en-Y gastric (RYGB).Objective
We performed a mixed-meal tolerance test in patients after RYGB to address the prevalence of early dumping and to gain further insight into its pathophysiology.Setting
The study was conducted in a regional hospital in the northern part of the Netherlands.Methods
From a random sample of patients who underwent primary RYGB between 2008 and 2011, 46 patients completed the mixed-meal tolerance test. The dumping severity score for early dumping was assessed every 30 minutes. A sum score at 30 or 60 minutes of ≥5 and an incremental score of ≥3 points were defined as indicating a high suspicion of early dumping. Blood samples were collected at baseline, every 10 minutes during the first half hour, and at 60 minutes after the start.Results
The prevalence of a high suspicion of early dumping was 26%. No differences were seen for absolute hematocrit value, inactive glucagon-like peptide-1, and vasoactive intestinal peptide between patients with or without early dumping. Patients at high suspicion of early dumping had higher levels of active glucagon-like peptide-1 and peptide YY.Conclusion
The prevalence of complaints at high suspicion of early dumping in a random population of patients after RYGB is 26% in response to a mixed-meal tolerance test. Postprandial increases in both glucagon-like peptide-1 and peptide YY are associated with symptoms of early dumping, suggesting gut L-cell overactivity in this syndrome. 相似文献2.
Jenny Andersson Barbro Linderholm Jonas Bergh Goran Elmberger 《Applied immunohistochemistry & molecular morphology》2004,12(1):14-20
We have studied the intratumor HER-2/neu heterogeneity in 78 consecutive and population-based primary invasive breast carcinomas. Within the invasive component, heterogeneity was detected in only 1 of 78 tumors. In 48 tumors (62%), we found both in situ and invasive components in analyzed tissue sections. Twelve of these 48 tumors had a difference of at least 2 arbitrary units in the in situ compared with the invasive part of the tumor with regard to the HER-2/neu status analyzed by HercepTest (immunohistochemistry). Eight of these 12 tumors were reanalyzed with fluorescent in situ hybridization and immunohistochemistry with and without a new Automated Cellular Imaging System. In this limited material, immunohistochemistry in combination with the Automated Cellular Imaging System seemed to have a better correlation with fluorescent in situ hybridization than immunostaining analyzed manually. In conclusion, HER-2/neu expression is not seldom heterogeneous in invasive compared with in situ components within a tumor. This finding should be considered in the choice of evaluation method. To avoid heterogeneity as a confounding factor in HER-2/neu analyses, detection methods such as immunohistochemistry and fluorescent in situ hybridization, which can provide evaluation in a preserved tissue architecture, should be used. Perhaps the intratumor HER-2/neu heterogeneity can explain some of the unexpected failures of trastuzumab therapy. 相似文献
3.
Johanna Albert Leif Kindlund Barbro Nilvér Waldemar Gożdzik 《Central European Journal of Medicine》2006,1(2):162-171
Abstract: Background: The laryngeal mask airway (LMA) can be used in general anaesthesia without neuromuscular block. The
laryngeal tube (LT) is a new airway device with similar airway features as LMA. LT is provided with a distal cuff to prevent
regurgitation. In this study we compared the LMA and LT concerning patient and user aspects.
Methods: Sixty patients with ASA (American Society of Anestesiologists) score 1–2 scheduled for minor surgery were randomized
to be ventilated either through LMA or LT. After insertion, the number of insertion attempts, and “positioning” and “airway-assessment”
was evaluated. The patients reported on “sore throat” after 30 and 60 minutes and the day after anaesthesia.
Results: Gender and mean age were equal in both groups. The first insertion attempt was successful in 25 of 28 patients randomised
to LMA and in 23 of 27 patients randomised to LT. LMA was evaluated to be easier in “positioning” whereas no difference in
“sore throat” was reported.
Conclusion: We found no difference between the LMA and the LT in terms user and patient friendliness and safety. 相似文献
4.
The aim of this study was to examine whether esophageal dysphagia can be described as a handicap and to grade the severity
of handicap as the discrepancy between the subject's own eating goals and his or her eating disability. The severity of the
disability-goal-handicap (DGH) regarding dysphagia was expressed on a scale ranging from 0 to 48 points. Nineteen patients
with dysphagia of differing causes were selected from a patient register at a laboratory for diagnostic procedures of the
esophagus. The severity of handicap for the 19 patients was, on average, 33 points (range, 20–44). The DGH score correlated
significantly with the patients' own evaluation of the severity of their dysphagia (p=0.008). The DGH scores did not differ markedly based on patient's sex, age, or cause of dysphagia. Patients who were operated
upon because of dysphagia had significantly more points on the DGH scale prior to operation than patients who were not (p=0.001). Denial of dysphagia (N=18), concealment of dysphagia (N=18), and lack of confirmation by the patient's physician
(N=15) were common but did not influence the severity of handicap as assessed by the DGH scale. It was shown that dysphagia
affects all aspects of life as expressed by reduction in self-esteem (N=13), security (N=16), work capacity (N=8), exercise
(N=7), and leisure time (N=6). Esophageal dysphagia may therefore be regarded as a handicap when assessed using the DGH code
described in this study. 相似文献
5.
Antti Tynys Tapio Saarinen Kimmo Hakala Tuulamari Helaja Tiina Vanne Petri Lehmus Barbro Lfgren 《Macromolecular chemistry and physics.》2005,206(10):1043-1056
Summary: Ethylene–propylene (EP) copolymerisations were performed with two sterically different metallocenes activated by methylaluminoxane (MAO) in an attempt to better understand the effect of catalyst structure on termination reactions and polymer microstructure. The metallocene precursors under investigation were rac‐dimethylsilylbis(2‐methyl‐4‐phenyl‐1‐indenyl)zirconium dichloride ( 1 ) and a more sterically hindered counterpart rac‐dimethylsilylbis(2‐isopropyl‐4‐[3,5‐dimethylphenyl]indenyl) zirconium dichloride ( 2 ). For both catalyst systems, the most common termination mechanism was chain transfer to aluminium. In addition, for polymer samples polymerised with 1 /MAO, chain growth was terminated by chain transfer to Zr metal in propylene‐rich polymerisations and by chain transfer to ethylene monomer in ethylene‐rich polymerisations. The steric hindrance of 2 was able to suppress the chain transfer to the ethylene monomer, and chain transfer to Zr metal was also found in the ethylene‐rich polymerisations. The greater steric hindrance of 2 also affected the EP copolymer microstructure: regioregularity in the propylene‐rich copolymers was greater and isotacticity less with 2 /MAO than with 1 /MAO.
6.
Susceptibility to beta-lactam antibiotics and production of beta-lactamase inBacteroides fragilis 总被引:1,自引:0,他引:1
Barbro Olsson Kathrine Dornbusch Carl-Erik Nord 《Medical microbiology and immunology》1977,163(3):183-194
Using the agar dilution technique, 231 strains of Bacteroides fragilis, isolated during a 2-year period from human infections, were identified at subspecies level and were tested for susceptibility to 13 beta-lactam antibiotics. The penicillins were benzylpenicillin, ampicillin, carbenicillin, cloxacillin, and the recently described penicillin derivatives cyclacillin, ticarcillin, and PC-904. The following cephalosporin derivatives were tested: cephaloridine, cephalothin, cephalexin, cefamandole and cefuroxime. The cephamycin C derivative cefoxitin was also included in the study. Cefoxitin was the most effective drug tested since more than 80% of the strains were inhibited by 8 microgram/ml or less, and no strain had a minimal inhibitory concentration (MIC) of more than 64 microgram/ml. There was no marked difference in sensitivity among the subspecies with exception of subspecies vulgatus, which was slightly more sensitive to all antibiotics tested. The size of the inoculum was an important factor for obtaining reproducible results in the sensitivity tests. Increased inocula resulted in markedly higher MICs for cephaloridine and cefuroxime. Production of beta-lactamase was performed on all isolates by a chromogenic cephalosporin substrate and about 90% of the strains were found to be beta-lactamase producers. 相似文献
7.
The objective of the present study was to assess the relationship between the amount of lactate accumulated during complete ischaemia and the ensuing changes in extra- and intracellular pH (pHe and pHi, respectively). The preischaemic plasma glucose concentration of anaesthetized rats was varied by administration of glucose or insulin, pHe was determined in neocortex with ion-sensitive microelectrodes, and tissue lactate and CO2 contents were measured, tissue CO2 tension being known from separate experiments. The experiments were carried out in both normocapnic [arterial CO2 tension (PaCO2) approximately 40 mm Hg] and hypercapnic (PaCO2 approximately 80 mm Hg) animals. Irrespective of the preischaemic CO2 tension, DeltapHe was linearly related to tissue lactate content. Depending on the preischaemic glucose concentration, DeltapHe varied from <0.4 to >1.4 units. The results thus fail to confirm previous results that the changes in pHe describe two plateau functions (DeltapHe approximately 0.5 and 1.1, respectively), with a transition zone at tissue lactate contents of 17 - 20 mmol kg-1. Changes in pHi given in this study are based on the assumption of a uniform intracellular space. The pHi changed from a normal value of approximately 7.0 to 6.5, 6.1 and 5.8 at tissue lactate contents of 10, 20 and 30 mmol kg-1. The intrinsic (non-bicarbonate) buffer capacity, derived from these figures, was 23 mmol kg-1 pH-1. Some differences in pH and in HCO3- concentration between extra- and intracellular fluids persisted in the ischaemic tissue. These differences were probably caused by a persisting membrane potential in the ischaemic cells. 相似文献
8.
Ohrvall U Eriksson B Juhlin C Karacagil S Rastad J Hellman P Akerström G 《World journal of surgery》2000,24(11):1402-1408
With adequate medical management the midgut carcinoid tumor generally is an indolent malignancy associated with substantial
life expectancy and appreciable life quality, even in the presence of liver metastases and significant tumor burden. Abdominal
complications may occur in this entity of carcinoids owing to entrapment of intestines and encasement of mesenteric vessels
by mesenteric metastases and associated marked mesenteric fibrosis. This may be the cause of abdominal pain, disabling diarrhea,
weight loss to the extent of malnutrition, and eventually the risk of death with acute or chronic intestinal obstruction or
intestinal gangrene. Operative removal of the mesentericointestinal lesion is often indicated to prevent or treat these complications
but may be technically difficult when mesenteric metastases extend in the vicinity of major vessels in the mesenteric root.
At laparotomy 56 patients with advanced midgut carcinoids underwent removal of the mesenteric tumor with a method for preserving
the mesenteric vessels. This was feasible by mobilizing and releasing the right colon and mesenteric root from posterior adhesions,
identifying the mesenteric artery below the pancreas, and free-dissecting this artery on the tumor capsule in the mobilized
mesentery. Dissection was successful even with tumors initially judged inoperable unless tumor growth completely surrounded
the mesenteric vessels or extended retroperitoneally. One patient was subjected to distal intestinal artery bypass. Symptom
relief was been substantial and often of long duration after mesenteric tumor removal in patients who prior to surgery often
had threatening intestinal ischemia. Patients with advanced midgut carcinoids may benefit markedly from dissectional removal
of mesenteric tumors, which (conceivably better than conventional wedge resection) preserves the length of the remaining intestine. 相似文献
9.
10.
Wågström E Akesson A Van Rooijen M Larson B Bremme K 《Acta obstetricia et gynecologica Scandinavica》2007,86(8):957-962
BACKGROUND: We assessed whether recombinant human erythropoietin (rhEPO) enhances a rise in haemoglobin concentration in postpartum anaemia compared to intravenous iron alone. DESIGN: Some 60 patients with haemoglobin values 相似文献