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排序方式: 共有503条查询结果,搜索用时 15 毫秒
1.
Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation 总被引:2,自引:2,他引:0
Nicolaus Lingens Eva Dobos Klaus Witte Christopher Busch Björn Lemmer Günther Klaus Karl Schärer 《Pediatric nephrology (Berlin, Germany)》1997,11(1):23-26
Ambulatory blood pressure monitoring was applied in 27 pediatric patients aged 6.3 – 24.3 (median 15.0) years who had been
transplanted 1.5 – 8.4 years previously. Daytime values were compared with the mean of 10 concomitant casual blood pressure
recordings. At the time of the study, antihypertensive drugs were given to 17 patients. Inulin clearance ranged from 18 to
116 (median 66) ml/min per 1.73 m2. Ambulatory blood pressure monitoring confirmed hypertension or normotension determined by casual blood pressure measurements
in 63% of patients. The physiological nocturnal dip in blood pressure was attenuated or reversed in 8 of 27 patients. It was
reduced in all 3 patients with renal artery stenosis of the graft, in 3 of 4 patients with chronic rejection, in the only
patient with recurrent focal segmental glomerulosclerosis, and in 1 of 6 patients with past acute rejection. The dipping was
not related to inulin clearance. In conclusion, casual blood pressure measurements do not accurately reflect blood pressure
in pediatric patients transplanted more than 1.5 years previously. A reduced nocturnal dip in blood pressure may indicate
an underlying renovascular or renoparenchymal pathology. Ambulatory blood pressure monitoring should regularly be applied
in patients with renal transplants.
Received May 23, 1995; received in revised form June 18, 1996; accepted June 20, 1996 相似文献
2.
Between 1980 and 1993, 680 patients with non-Hodgkin's lymphomas (NHL) and Hodgkin's disese (HD) were studied by ultrasonography. In 210 patients a total of 254 extranodular abdominal lymphoma inflitrates were diagnosed. Infiltrates were confirmed histologically in 118 patients and through the clinical course and follow-up studies in 92 patients. Lymphoma infiltrates were seen most frequently in the spleen (N = 101), the gastrointestinal tract (n=70), the liver (n = 47), the kidneys (n = 17) and other organs (n = 19). The sonographic features of lymphomatous infiltrates in different extranodal sites are described, and possible correlations between lymphoma subtypes and sonographic texture characteristics are investigated. Different infiltration patterns of lymphoma subtypes could be indentical in liver and spleen. High-grade NHLs most frequently showed large-nodular lesions, whereas low-grade NHLs and HD showed a tendency towards small-nodular or diffuse lesions. The role of ultrasonography in the clinical management of lymphoma pateins is discussed.Correspondece to: C. Görg 相似文献
3.
The first of two experiments with laboratory rats demonstrated that oral estrogen (17 alpha-ethinylestradiol) can remain in the albumen of eggs at room temperature for up to 8 days with undiminished capacity to produce conditioned taste aversion. The second experiment showed that estrogen remains potent in the yolk of eggs for at least 4 days. There is now greater assurance that egg prey placed into the field will induce reliable CTA among mammalian predators. Community ecologists interested in such processes as competitive release and the responses of prey populations to reduced predation upon their eggs can selectively factor predation out of field experiments without the need for physically excluding predators. Wildlife biologists interested in reducing predation upon the eggs of endangered species now have greater assurance that estrogen-treated egg baits will suppress predation in a more cost-effective manner and with less likelihood of discrimination between treated eggs and those of endangered species. 相似文献
4.
Michael G Kiehl Ludwig Kraut Rainer Schwerdtfeger Bernd Hertenstein Mats Remberger Nicolaus Kroeger Mathias Stelljes Martin Bornhaeuser Hans Martin Christoph Scheid Arnold Ganser Axel R Zander Joachim Kienast Gerhard Ehninger Dieter Hoelzer Volker Diehl Axel A Fauser Olle Ringden 《Journal of clinical oncology》2004,22(14):2816-2825
PURPOSE: The role of unrelated allogeneic stem-cell transplantation in acute lymphoblastic leukemia (ALL) patients is still not clear, and only limited data are available from the literature. We analyzed factors affecting clinical outcome of ALL patients receiving a related or unrelated stem-cell graft from matched donors. PATIENTS AND METHODS: The total study population was 264 adult patients receiving a myeloablative allogeneic stem-cell transplant for ALL at nine bone marrow transplantation centers between 1990 and 2002. Of these, 221 patients receiving a matched related or unrelated graft were analyzed. One hundred forty-eight patients received transplantation in complete remission; 62 patients were in relapse; and 11 patients were refractory to chemotherapy before transplant. Fifty percent of patients received bone marrow, and 50% received peripheral blood stem cell from a human leukocyte antigen-identical related (n = 103), or matched unrelated (n = 118) donor. RESULTS: Disease-free survival (DFS) at 5 years was 28%, with 76 patients (34%) still alive (2.2 to 103 months post-transplantation), and 145 deceased (65 relapses, transplant-related mortality, 45%). We observed an advantage regarding DFS in favor of patients receiving transplantation during their first complete remission (CR) in comparison with patients receiving transplantation in or after second CR (P =.014) or who relapsed (P <.001). We observed a clear trend toward improved survival in favor of B-lineage ALL patients compared with T-lineage ALL patients (P =.052), and Philadelphia chromosome-positive patients had no poorer outcome than Philadelphia chromosome-negative patients. Total-body irradiation-based conditioning improved DFS in comparison with busulfan (P =.041). CONCLUSION: Myeloablative matched related or matched unrelated allogeneic hematopoietic stem-cell transplantation in ALL patients should be performed in first CR. 相似文献
5.
Kröger N Einsele H Wolff D Casper J Freund M Derigs G Wandt H Schäfer-Eckart K Wittkowsky G Schmitz N Krüger W Zabelina T Renges H Ayuk F Krüll A Zander A;German Study-group Multiple Myeloma 《Bone marrow transplantation》2003,31(11):973-979
We investigated toxicity and efficacy of in vivo T-cell depletion with anti-thymocyte globulin (ATG) as part of an intensified myeloablative conditioning regimen followed by allogeneic stem cell transplantation in patients with advanced multiple myeloma. The conditioning regimen consisted of modified total body irradiation, busulfan and cyclophosphamide (n=15) or in the case of prior dose-limiting radiotherapy of busulfan and cyclophosphamide (n=3). The median age was 44 years (range, 29-53) and the median time from diagnosis to transplant was 12 months (range, 6-144). Grade II-IV acute graft-versus-host disease (GvHD) occurred in six patients (35%). Severe grade III/IV GvHD developed in one patient (6%). Three patients died of therapy-related causes (17%). A complete remission (CR) with negative immunofixation after allogeneic transplantation was seen in eight of the evaluable patients (53%). After a median follow-up of 41 months (range, 8-84), the estimated overall survival at 6 years for all patients is 77% (CI 95%: 58-96%). The estimated progression-free survival at 6 years for all patients is 31% (CI 95%: 2-59%) and 46% (CI 95%: 9-83%) for patients with CR. In vivo T-cell depletion with ATG resulted in a low rate of severe GvHD with low treatment-related mortality, and a substantial number of long-term survivors. 相似文献
6.
U Meckler W F Caspary T Clement P Herzog B Lembcke B Limberg A el Mouaaouy G Nippel P Reuss W B Schwerk 《Zeitschrift für Gastroenterologie》1991,29(7):355-359
Sonography is adding a new dimension to diagnosis of Crohn's disease: the analysis of the transmural and peri-intestinal manifestations of the chronic inflammation. Distortions in the structure of intestinal wall are recognizable, the impact on transport of intestinal content can be judged, penetration of inflammation into the bowel surrounding as fistula, abscess, mesenteriitis und peritonitis is safely seen. Differential diagnosis on a strictly sonographic basis is difficult. The paper represents the results of an expert meeting held at the University of Frankfurt/M. 相似文献
7.
Nicolaus Reifart Marie-Claude Morice Sigmund Silber Edouard Benit K E Hauptmann Eduardo de Sousa John Webb Upendra Kaul Charles Chan Leif Thuesen Giulio Guagliumi Michael Cobaugh Keith Dawkins 《Catheterization and cardiovascular interventions》2004,62(1):18-25
This study should clarify whether the gold-coated NIROYAL stent is equivalent to the stainless steel NIR stent. Patients were randomized to either NIR stent (n = 298) or a NIROYAL stent (n = 305). The primary endpoint was the minimum lumen diameter of the target lesion at 6 months postprocedure. Secondary endpoints focused on clinical events. At 30 days, adverse events were similar in both groups. At 6 months, the minimal lumen diameter was 1.83/1.64 mm (P < 0.001; 95% CI = 0.08-0.30) and the angiographic restenosis rate was 20.6%/37.7% (P < 0.001; 95% CI = -24.7 to -9.3) for NIR/NIROYAL. The 6-month MACE rates were NIR 7.4% and NIROYAL 10.5% (95% CI = -7.7 to 1.4). Compared to stainless steel stent, the NIROYAL stent demonstrated a smaller minimal lumen diameter, a higher late loss (i.e., higher neointimal hyperplasia in spite of a significantly better initial gain), with higher restenosis and similar MACE rates at 6 months. 相似文献
8.
Schmid C Labopin M Nagler A Niederwieser D Castagna L Tabrizi R Stadler M Kuball J Cornelissen J Vorlicek J Socié G Falda M Vindeløv L Ljungman P Jackson G Kröger N Rank A Polge E Rocha V Mohty M;Acute Leukaemia Working Party of the European Group for Blood Marrow Transplantation 《Blood》2012,119(6):1599-1606
Because information on management and outcome of AML relapse after allogeneic hematopoietic stem cell transplantation (HSCT) with reduced intensity conditioning (RIC) is scarce, a retrospective registry study was performed by the Acute Leukemia Working Party of EBMT. Among 2815 RIC transplants performed for AML in complete remission (CR) between 1999 and 2008, cumulative incidence of relapse was 32% ± 1%. Relapsed patients (263) were included into a detailed analysis of risk factors for overall survival (OS) and building of a prognostic score. CR was reinduced in 32%; remission duration after transplantation was the only prognostic factor for response (P = .003). Estimated 2-year OS from relapse was 14%, thereby resembling results of AML relapse after standard conditioning. Among variables available at the time of relapse, remission after HSCT > 5 months (hazard ratio [HR] = 0.50, 95% confidence interval [CI], 0.37-0.67, P < .001), bone marrow blasts less than 27% (HR = 0.53, 95% CI, 0.40-0.72, P < .001), and absence of acute GVHD after HSCT (HR = 0.67, 95% CI, 0.49-0.93, P = .017) were associated with better OS. Based on these factors, 3 prognostic groups could be discriminated, showing OS of 32% ± 7%, 19% ± 4%, and 4% ± 2% at 2 years (P < .0001). Long-term survival was achieved almost exclusively after successful induction of CR by cytoreductive therapy, followed either by donor lymphocyte infusion or second HSCT for consolidation. 相似文献
9.
Allogeneic hematopoietic stem-cell transplantation is a potentially curative therapy for various hematologic diseases. An essential component of this procedure is the pre-transplant conditioning regimen, which should facilitate engraftment and reduce or eliminate tumor cells. The recognition of the substantial association of a graft-versus- tumor effect and the high toxicity of the commonly used conditioning regimen led to the introduction of more differentiated intensity strategies, with the aim of making hematopoietic stem-cell transplantation less toxic and safer, and thus more applicable to broader populations such as older or unfit patients. In general, prospective and retrospective studies suggest a correlation between increasing intensity and nonrelapse mortality and an inverse correlation with relapse incidence. In this review, we will summarize traditional and updated definitions for conditioning intensity strategies and the landscape of comparative prospective and retrospective studies, which may help to find the balance between the risk of non-relapse mortality and relapse. We will try to underscore the caveats regarding these definitions and analyses, by missing complex differences between intensity and toxicity as well as the broad influences of other factors in the transplantation procedure. We will summarize evidence regarding several confounders which may influence decisions when selecting the intensity of the conditioning regimen for any given patient, according to the individual risk of relapse and non-relapse mortality. 相似文献
10.
Kröger N Sayer HG Schwerdtfeger R Kiehl M Nagler A Renges H Zabelina T Fehse B Ayuk F Wittkowsky G Schmitz N Zander AR 《Blood》2002,100(12):3919-3924
We investigated the feasibility of unrelated stem cell transplantation in 21 patients with advanced stage II/III multiple myeloma after a reduced-intensity conditioning regimen consisting of fludarabine (150 mg/m(2)), melphalan (100-140 mg/m(2)), and antithymocyte globulin (ATG; 10 mg/kg on 3 days). The median patient age was 50 years (range, 32-61 years). All patients had received at least one prior autologous transplantation, in 9 cases as part of an autologous-allogeneic tandem protocol. No graft failure was observed. At day 40 complete donor chimerism was detected in all patients. Grade II to IV acute graft-versus-host disease (GVHD) was seen in 8 patients (38%), and severe grade III/IV GVHD was observed in 4 patients (19%). Six patients (37%) developed chronic GVHD, but only 2 patients (12%) experienced extensive chronic GVHD. The estimated probability of nonrelapse mortality at day 100 was 10% and at 1 year was 26%. After allografting, 40% of the patients achieved a complete remission, and 50% achieved a partial remission, resulting in an overall response rate of 90%. After a median follow-up of 13 months, the 2-year estimated overall and progression-free survival rates are 74% (95% CI, 54%-94%) and 53% (95% CI, 29%-87%), respectively. A shorter progression-free survival was seen in patients who already experienced relapse to prior autograft (26% versus 86%, P =.04). Dose-reduced conditioning with pretransplantation ATG followed by unrelated stem cell transplantation provides durable engraftment and donor chimerism, reduces substantially the risk of transplant-related organ toxicity, and induces high remission rates. 相似文献