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1.
Eitaro Ito Akihiro Takai Yoshinori Imai Hiromi Otani Yoshihiro Onishi Yosuke Yamamoto Kohei Ogawa Taiji Tohyama Shunichi Fukuhara Yasutsugu Takada 《Surgery》2019,165(2):353-359
Background
Controversy continues as to whether single-incision laparoscopic cholecystectomy, with the somewhat larger incision at the umbilicus, may lead to a worse postoperative quality of life and more pain compared with the more classic 4-port laparoscopic cholecystectomy. The aim of this study was to compare single-incision and 4-port laparoscopic cholecystectomy from the perspective of quality of life.Methods
This study was a multicenter, parallel-group, open-label, randomized clinical trial. A total of 120 patients who were scheduled to undergo elective cholecystectomy were randomly assigned 1:1 into the single-incision laparoscopic cholecystectomy or the 4-port laparoscopic cholecystectomy group and then assessed continuously for 2 weeks during the postoperative period. The primary outcome was quality of life, defined as the time to resume normal daily activities. Postoperative pain was also assessed. To explore the heterogeneity of treatment effects, we assessed the interactions of sex, age, and working status on recovery time.Results
A total of 58 patients in the single-incision group and 53 in the 4-port group (n?=?111, 47 male, mean age 57 years) were analyzed. The mean time to resume daily activities was 10.2 days and 8.8 days, respectively, for single-incision and 4-port laparoscopic cholecystectomy (95% confidence interval –0.4 to 3.2, P?=?.12). Similarly, the time to relief from postoperative pain did not differ significantly between the groups. Statistically insignificant but qualitative interactions were noted; in the subgroups of women, full-time workers, and patients younger than 60 years, recovery tended to be slower after single-incision laparoscopic cholecystectomy.Conclusion
Postoperative quality of life did not differ substantially between single-incision laparoscopic cholecystectomy and 4-port laparoscopic cholecystectomy. Patients younger than 60 years, women, and full-time workers tended to have a somewhat slower recovery after single-incision laparoscopic cholecystectomy. 相似文献2.
Induction of endothelium-dependent relaxation in the rat aorta by IRL 1620, a novel and selective agonist at the endothelin ETB receptor. 总被引:3,自引:2,他引:1
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H. Karaki S. A. Sudjarwo M. Hori M. Takai Y. Urade T. Okada 《British journal of pharmacology》1993,109(2):486-490
1. The effects of a novel and selective agonist at the endothelin ETB receptor, IRL 1620 (Suc-[Glu9, Ala11,15] endothelin-1 (8-21)), were examined in the isolated aorta of the rat. 2. IRL 1620 (1-300 nM) changed neither the resting tone nor the cytosolic Ca2+ level ([Ca2+]i) of the aorta without endothelium. In the presence of endothelium, however, IRL 1620 increased endothelial [Ca2+]i with little effect on the muscle tone. In the absence of external Ca2+, IRL 1620 still induced a transient increase in endothelial [Ca2+]i. 3. Noradrenaline (100 nM) increased both muscle [Ca2+]i and tension. IRL 1620 (1-300 nM) relaxed the muscle with an increase in endothelial [Ca2+]i only in the presence of endothelium. An inhibitor of nitric oxide synthase, 100 microM NG-monomethyl-L-arginine, inhibited the relaxant effect of IRL 1620 but not the increase in endothelial [Ca2+]i. 4. In resting and noradrenaline-stimulated aorta, the effects of IRL 1620 were inhibited by a selective antagonist of the ETB receptor, IRL 1038 (0.3-3 microM), although a selective antagonist of the ETA receptor, BQ-123 (3 microM), was ineffective. Verapamil (10 microM) did not alter the effects of IRL 1620. 5. A muscarinic receptor agonist, carbachol (1 microM), also induced endothelium-dependent relaxation with an increase in endothelial [Ca2+]i. However, the effects of carbachol were not inhibited by the ETB antagonist, IRL 1038 (3 microM).(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
3.
Abstract: Juvenile xanthogranuloma is a benign histiocytic skin disorder encountered primarily in infancy and childhood. Approximately 0.4% of cases exhibit ocular manifestations, which can result in glaucoma and blindness. We present a case of a 7-month-old male with unilateral glaucoma associated with Juvenile xanthogranuloma, and emphasize the importance of an ocular screening in patients with Juvenile xanthogranuloma, especially those with periocular lesions. 相似文献
4.
目的探讨5-羟色胺(5-HT)受体激动剂对猫脊髓损伤后膀胱过度活动的影响。方法雌性猫18只,其中正常假手术组5只,脊髓损伤组13只。术后6~8周,氯醛糖麻醉下,在猫颈动脉及膀胱内置管,连接压力感受器,记录诱发膀胱收缩的膀胱容量阈值、膀胱容量、剩余尿量、排尿量和血压。静脉注入5-HT1A受体激动剂8-OH-DPAT(0.3~30μg/kg)或5-HT1B/1D受体激动剂GR-46611(0.03~300μg/kg),得到剂量-效应曲线后再给予5HT1A受体抑制剂WAY-100635(300μg/kg),比较给药前后各项指标变化。结果正常猫使用8-OH-DPAT后,膀胱容量阈值、膀胱容量、剩尿量均有增加趋势,但差异无统计学意义;8-OH-DPAT和GR-46611均能使脊髓损伤猫的膀胱容量阈值、膀胱容量、剩余尿量增加,且效应随着剂量增加而增加,差异有统计学意义。WAY-100635能抵消8-OH-DPAT的作用,但对GR-46611无影响。结论5-HT1A和5-HT1B/1D受体激动剂能改善慢性脊髓损伤后的膀胱过度活动,增加膀胱容量。 相似文献
5.
64排螺旋CT冠状动脉造影与DSA的对照研究 总被引:1,自引:0,他引:1
目的:通过和冠脉造影对比,评价64排螺旋CT冠状动脉成像在冠状动脉狭窄中的临床应用价值。方法:28例患者同时行64排螺旋CT冠状动脉成像和有创性冠脉造影检查,依据AHA17段分段法,评价所有有效节段,并将两者进行对比。结果:冠脉造影显示阴性病例占7.1%(2例),单只病变占21.4%(6例),多支病变占71.4%(20例)。按节段分析,CT检出冠脉狭窄的敏感度,特异度,阳性预测值和阴性预测值分别为91.1%,94.6%,90.0和95.3%。结论:64排螺旋CT冠状动脉成像和传统的冠脉造影检查对检出正常冠脉节段以及狭窄节段具有很好的一致性。 相似文献
6.
7.
大鼠心肌缺血再灌注时心肌细胞凋亡caspase-3活性变化规律及药物对其影响 总被引:3,自引:2,他引:1
目的 探讨大鼠心肌缺血再灌注 (Ischemiareperfusion ,IR)不同时相的心肌细胞凋亡、caspase 3活性变化规律及caspase 3抑制剂Ac DEVD CHO的影响。方法 Wistar大鼠 12 2只 ,设立IR组 ,IR +Ac DEVD CHO组和假手术对照组并分设缺血 3 0min后再灌注 1、3、6、12、2 4h 5个时相点 ;以缺口末端标记法 (TUNEL)标记凋亡细胞 ,用荧光分析法检测caspase 3活性 ,行TTC染色测定心肌梗死范围。结果 心肌细胞凋亡与caspase 3活性随心肌再灌注不同时相而变化 ,心肌细胞凋亡指数 (Apoptosisindex ,AI)与caspase 3活性于再灌注 12h最高 [AI :( 3 4 83± 9 3 5 ) % ;caspase 3活性 :( 1 3 4±0 2 ) ] ,其后基本维持在平台状态 ;心肌梗死范围随IR时间逐渐增加 ,至 2 4h仍未见下降趋势 ,三者间呈显著正相关 (P <0 0 5 )。IR +Ac DEVD CHO组上述指标虽也明显增高 ,但比IR组明显减小 (P <0 0 5 )。结论 Caspase 3激活及心肌细胞凋亡参与了心肌缺血再灌注损伤过程 ,Ac DEVD CHO减轻心肌缺血再灌注损伤可能部分与其抑制心肌细胞凋亡有关。 相似文献
8.
Kanta Kishi Michiko Muramatsu Denan Jin Keiichi Furubayashi Shinji Takai Hiroshi Tamai Mizuo Miyazaki 《Hypertension research》2007,30(1):77-83
Chymase is known to generate angiotensin II in the vascular wall. In this study we investigated a novel role for chymase other than angiotensin II production in vascular proliferation after balloon injury. Chymase promoted the migration of vascular smooth muscle cells in the matrix-coated invasion chambers and activated promatrix metalloproteinase-2 obtained from the culture medium of vascular smooth muscle cells. Two weeks after balloon injury, significant neointimal formation was found in dog carotid arteries. After injury, active matrix metalloproteinase-2 was increased in parallel with the augmentation of chymase activity that was seen in the proliferating region of the vascular wall. The oral administration of NK3201 (1 mg/kg per day), a chymase inhibitor, prevented neointimal formation and significantly suppressed both active matrix metalloproteinase-2 and chymase activities 2 weeks after injury. These results suggest that chymase inhibitors can prevent the development of intimal hyperplasia via the inhibition of matrix metalloproteinase-2 activation in balloon-injured arteries. 相似文献
9.
陕西省健康人群脊髓灰质炎免疫屏障的评价 总被引:8,自引:2,他引:6
为了对陕西省近 10年脊髓灰质炎 (脊灰 )的免疫状况做出科学的评价 ,在地理特点不同、经济发展程度各异的 3个地区采集 0~ 39岁健康人群血标本 86 6份测定脊灰抗体。脊灰Ⅰ、Ⅱ、Ⅲ型中和抗体阳性率分别为96 88%、98 0 4%、92 73%,几何平均滴度 (GMT)分别为 1∶2 5 9 30、1∶10 3 6 9、1∶5 2 6 9。表明通过口服脊灰疫苗的常规免疫和强化免疫 ,陕西省健康人群对脊灰已形成牢固的免疫屏障。 相似文献
10.