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Hong Chee Chew Arjun Iyer Mark Connellan Sarah Scheuer Jeanette Villanueva Ling Gao Mark Hicks Michelle Harkness Claudio Soto Andrew Dinale Priya Nair Alasdair Watson Emily Granger Paul Jansz Kavitha Muthiah Andrew Jabbour Eugene Kotlyar Anne Keogh Kumud Dhital 《Journal of the American College of Cardiology》2019,73(12):1447-1459
Background
Transplantation of hearts retrieved from donation after circulatory death (DCD) donors is an evolving clinical practice.Objectives
The purpose of this study is to provide an update on the authors’ Australian clinical program and discuss lessons learned since performing the world’s first series of distantly procured DCD heart transplants.Methods
The authors report their experience of 23 DCD heart transplants from 45 DCD donor referrals since 2014. Donor details were collected using electronic donor records (Donate Life, Australia) and all recipient details were collected from clinical notes and electronic databases at St. Vincent’s Hospital.Results
Hearts were retrieved from 33 of 45 DCD donors. A total of 12 donors did not progress to circulatory arrest within the pre-specified timeframe. Eight hearts failed to meet viability criteria during normothermic machine perfusion, and 2 hearts were declined due to machine malfunction. A total of 23 hearts were transplanted between July 2014 and April 2018. All recipients had successful implantation, with mechanical circulatory support utilized in 9 cases. One case requiring extracorporeal membrane oxygenation subsequently died on the sixth post-operative day, representing a mortality of 4.4% over 4 years with a total follow-up period of 15,500 days for the entire cohort. All surviving recipients had normal cardiac function on echocardiogram and no evidence of acute rejection on discharge. All surviving patients remain in New York Heart Association functional class I with normal biventricular function.Conclusions
DCD heart transplant outcomes are excellent. Despite a higher requirement for mechanical circulatory support for delayed graft function, primarily in recipients with ventricular assist device support, overall survival and rejection episodes are comparable to outcomes from contemporary brain-dead donors. 相似文献2.
于力 《军医进修学院学报》1999,20(3):170-172
目的:克隆白血病相关基因及白血病相关基因甲基化的临床意义。方法:应用新的分子克隆技术RLGS及SouthernBlot技术自急性髓细胞白血病(AML)骨髓标本中克隆白血病相关基因对该基因的甲基化进行检测。结果:克隆到一个长度为221bp因NotⅠ酶切位点甲基化所致的DNA片段,序列分析结果表明其来源于急性白血病相关基因(WIT-1基因)第二外显子,WIT-1基因甲基化发生率在原发难治性AML中明显 相似文献
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Deletion of WT1 and WIT1 Genes and Loss of Heterozygosity on Chromosome 11p in Wilms Tumors in Japan
Yasuhiko Kaneko Osamu Takeda Chieko Homma Nobuo Maseki Hiroyuki Miyoshi Yukiko Tsunematsu Bryan G. Williams Grady F. Saunders Masaharu Sakurai 《Cancer science》1993,84(6):616-624
Six of 39 sporadic Wilms tumors had gross homozygous or hemizygous WT1 and WIT1 deletions. Two Wilms tumor-aniridia-genitourinary abnormalities-mental retardation syndrome patients had total hemizygous WT1 and WIT1 deletions in both constitutional and nonsporadic type tumor cells. Four of the 8 tumors with WT1 and WIT1 deletions showed loss of constitutional heterozygosity (LOH) for markers limited to the 11p13 region. Seven of 19 Wilms tumors with neither WT1 nor WIT1 deletions also had LOH on 11p; 4 in the 11p15–11p13 region, one in the 11p15 and possibly also 11p13 regions, and two solely in the 11lp15 region. Thus, 15 of the 41 Wilms tumors (37%) had WT1 and WIT1 deletions or LOH on 11p, and only 2 of the 27 tumors whose nonneoplastic normal tissues were available for study showed LOH limited to the 11p15 region. None of the 7 non-Wilms childhood renal tumors showed WT1 or WIT1 deletions, or LOH on 11p. These data suggest that Japanese Wilms tumors may be characterized by a higher incidence of the gross WT1 deletion and a lower incidence of LOH limited to the 11p15 region than the Caucasian counterparts. These moleculargenetic features may be contributing to the lower incidence of Wilms tumors in Japanese children than in Caucasian ones. 相似文献
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Andrea Mari Simone Morselli Francesco Sessa Riccardo Campi Fabrizio Di Maida Isabella Greco Giampaolo Siena Agostino Tuccio Gianni Vittori Sergio Serni Marco Carini Andrea Minervini 《European journal of surgical oncology》2018,44(6):853-858
Purpose
To evaluate the surgical and functional outcomes of a matched-paired series of on-clamp vs off-clamp endoscopic robot-assisted simple enucleation (ERASE) and standardized renorraphy in a tertiary referral institution, to search for predictors of functional drop after surgery and to investigate the influence of off-clamp technique in patients presenting these characteristics.Materials and methods
A matched-pair comparison of 120 on-clamp vs 120 off-clamp over 491 patients treated with ERASE was performed. Perioperative and functional outcomes were compared between groups.Results
Patients treated with on-clamp and off-clamp technique had comparable complication and positive surgical margin rate. The off-clamp group had a significantly lower eGFR drop compared to the on-clamp group at 3rd postoperative day (POD) (1% vs 7%, p = 0.0001) and at 30th POD (2.5% vs 9%, p = 0.01) from baseline. This difference lost its statistical significance at 6th month and at last follow-up (median 40 months). At multivariable analysis the Charlson comorbidity index (OR 2.06, p < 0.0001), uncontrolled type 2 diabetes mellitus (OR 4.13, p < 0.001) were independent predictive factors of a >15% eGFR drop from baseline to last follow-up. In a subanalysis over 64 comorbid patients, those patients who underwent off-clamp ERASE had a significantly lower eGFR drop compared to the comorbid counterpart during the whole follow-up.Conclusions
The off-clamp ERASE is a safe surgical technique with a significantly lower renal function drop compared to on-clamp ERASE in the early perioperative time. Patients with comorbidity might represent a subgroup of patients having a functional benefit after off-clamp RAPN even in the long-term period. 相似文献8.
Recent evidence shows that event-related (upper) alpha desynchronization (ERD) is related to cognitive performance. Several studies observed a positive, some a negative relationship. The latter finding, interpreted in terms of the neural efficiency hypothesis, suggests that good performance is associated with a more 'efficient', smaller extent of cortical activation. Other studies found that ERD increases with semantic processing demands and that this increase is larger for good performers. Studies supporting the neural efficiency hypothesis used tasks that do not specifically require semantic processing. Thus, we assume that the lack of semantic processing demands may at least in part be responsible for the reduced ERD. In the present study we measured ERD during a difficult verbal-semantic task. The findings demonstrate that during semantic processing, more intelligent (as compared to less intelligent) subjects exhibited a significantly larger upper alpha ERD over the left hemisphere. We conclude that more intelligent subjects exhibit a more extensive activation in a semantic processing system and suggest that divergent findings regarding the neural efficiency hypotheses are due to task specific differences in semantic processing demands. 相似文献
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