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1.
The purpose of this study was to elucidate the clinicopathological significance of p53 overexpression in elderly patients with colorectal cancer. p53 positivity for elderly patients and control was 41% and 57%, respectively. There was a significant difference between these two groups. Regarding the rate of hematogenic metastases, there was no significant difference between patients with positive for p53 and negative for p53 in the elderly group (44% vs 39%), on the other hand, there was a significant difference between patients with positive for p53 and negative for p53 in the control group (70% vs 48%). Regarding prognosis, there was no significant difference between patients with positive for p53 and negative for p53 in the elderly group (73.3% vs 72%), on the other hand, there was a significant difference between patients with positive for p53 and negative for p53 in the control group (51.2% vs 68.7%). These results suggest that the significance of p53 overexpression was negligible in elderly patients with colorectal cancer.  相似文献   

2.
BACKGROUND: A single-institution experience with completion pneumonectomy was analyzed to assess operative mortality and late outcome. METHODS: A consecutive series of 138 completion pneumonectomies from 1975 to 1995 was reviewed, and compared with single-stage pneumonectomies performed during the same period. RESULTS: Hospital mortality was 13.8%, including 4 intraoperative and 15 postoperative deaths. Hospital mortality was the same for lung cancer (13.2%) as for benign disease (15.5%). It was 37.5% if an early complication of the primary operation was the indication (p = 0.01). If infection of the pleural space was the indication for completion pneumonectomy, hospital mortality was 23.3% (p > 0.05). In 760 single-stage pneumonectomies hospital mortality was 8.7% (p > 0.05). Five-year actuarial survival after completion pneumonectomy was 42.5% for all patients, 32.3% for those with lung cancer, and 58.8% for those with benign disease. CONCLUSIONS: Hospital mortality for completion pneumonectomy was the same for malignant as for benign indications. It was significantly higher if completion pneumonectomy was done for an early complication of the primary operation. Results at long term of lung cancer patients were the same for single-stage pneumonectomy and completion pneumonectomy.  相似文献   

3.
OBJECTIVE: To assess, under field conditions, whether a hand-held electrical conductivity (EC) meter could be used to detect subclinical mastitis caused by pathogens most commonly associated with mastitis in dairy cows. ANIMALS: 425 lactating cows on 15 dairies in Costa Rica. PROCEDURE: Immediately prior to milking, milk samples from each quarter were tested, using a hand-held EC meter. A milk sample from the quarter with the highest score was submitted for bacteriologic culture. Results of bacteriologic culture were compared with highest absolute EC score for each cow and with differential EC score (ie, difference between the highest and lowest absolute EC scores for the 4 quarters of each cow). RESULTS: Absolute EC score for cows with subclinical mastitis was significantly higher than that for cows without subclinical mastitis, and absolute EC score was significantly associated with detection of subclinical mastitis. If absolute EC score > or = 7 was considered indicative of subclinical mastitis, sensitivity was 0.43, specificity was 0.83, predictive value of a positive result was 0.39, and predictive value of a negative result was 0.85. Differential EC score for cows with mastitis was significantly higher than that for cows without subclinical mastitis. If differential EC score > or = 2 was considered indicative of subclinical mastitis, sensitivity was 0.53, specificity was 0.77, predictive value of a positive result was 0.37, and predictive value of a negative result was 0.87. CLINICAL IMPLICATIONS: A hand-held EC meter may be used to screen cows for subclinical mastitis.  相似文献   

4.
The purpose of this study was to examine intratester, intertester, and interdevice reliability of range of motion measurements of the elbow and forearm. Elbow flexion and extension and forearm pronation and supination were measured on 38 subjects with elbow, forearm, or wrist disease by 5 testers. Standardized test methods and a randomized order of testing were used to test groups of patients with universal standard goniometers, a computerized goniometer, and a mechanical rotation measuring device. Intratester reliability was high for all 3 measuring devices. Meaningful changes in intratester range of motion measurements taken with a universal goniometer occur with 95% confidence if they are greater than 6 degrees for flexion, 7 degrees for extension, 8 degrees for pronation, and 8 degrees for supination. Intertester reliability was high for flexion and extension measurements with the computerized goniometer and moderate for flexion and extension measurements with the universal goniometer. Meaningful change in interobserver range of motion measurements was expected if the change was greater than 4 degrees for flexion and 6 degrees for extension with the computerized goniometer compared with 10 degrees and 10 degrees, respectively, if the universal goniometer was used. Intertester reliability was high for pronation and supination with all 3 devices. Meaningful change in forearm rotation is characterized by a minimum of 10 degrees for pronation and 11 degrees for supination with the universal goniometer. Reliable measurements of elbow and forearm arm movement are obtainable regardless of the level of experience when standardized methods are used. Measurement error was least for repeated measurements taken by the same tester with the same instrument and most when different instruments were used.  相似文献   

5.
OBJECTIVE: The aim of the study was to test the hypothesis that different types of gender-related personality attributes are associated with a past history of different types of childhood maltreatment. METHOD: A survey was administered to 1,060 male soldiers and 305 female soldiers in the U.S. Army. The survey instrument included the Extended Personal Attributes Questionnaire (EPAQ) which is a self-assessment instrument of personality characteristics associated with gender, and includes measures of positive masculinity (self-assertive/instrumental traits), positive femininity (expressive/interpersonal traits), negative masculinity (hyper masculine/macho traits), and negative femininity (subordination of self to others). The survey instrument also included the Childhood Trauma Questionnaire (CTQ), which contains scales measuring sexual abuse, physical-emotional abuse, physical neglect, and emotional neglect, and four questions on childhood sexual abuse developed for a national survey of U.S. adults. RESULTS: Negative masculinity was predicted by male gender, younger age, and childhood physical-emotional abuse. Negative femininity was predicted by physical-emotional abuse and sexual abuse. The relationship to sexual abuse was mainly evident for males. Positive femininity was positively correlated with sexual abuse for females and negatively correlated with sexual abuse for males. Positive masculinity was negatively correlated with emotional neglect for males but not for females. Positive femininity was negatively correlated with emotional neglect for both genders. CONCLUSIONS: Childhood abuse was associated with the presence of negative gender-related attributes; childhood neglect was associated with absence of positive gender-related attributes. Childhood physical abuse was associated with negative masculine attributes in both genders. Childhood sexual abuse was associated with positive feminine attributes in females, and negative feminine attributes in males. The finding for females is counterintuitive, and is discussed in the light of the clinical literature on certain types of adaptation to incest.  相似文献   

6.
Hundred non-hospitalized smokers with an average consumption of 20 cigarettes per day were treated with an alcoholic extract of Avena sativa for disaccustoming. The study was double blind. By using query-sheets personal contact was excluded. The first result was a placebo-effect of 35% for disaccustoming of smokers and no statistically significant effect of the extract of Avena sativa. The second result was a difference of disaccustoming between light and heavy smokers. It was shown, that the rate of disaccustoming was higher for light smokers than for smokers with a high consumption of cigarettes.  相似文献   

7.
Unilateral whole lung lavage (UWLL) was performed four times in a patient with pulmonary alveolar proteinosis. PaO2 was 94 Torr even under ventilation with 100% O2. Because of the difficulty in providing adequate arterial oxygenation, extracorporeal membrane oxygenation (ECMO) was indispensable in accomplishing the first right UWLL. During the second left UWLL, the left lung was ventilated with nitrogen (N2) and an attempt was made to predict the lowest PaO2 occurring during lavage in order to establish criteria for the use of ECMO during UWLL. When both lungs were ventilated with 100%. O2, PaO2 rose to 150 Torr. PaO2 fell to 65 Torr after ventilation of the left lung with N2 while the right lung was ventilated with 100% O2 for 7 minutes. The N2 was replaced with 100% O2 and ventilation was continued for another 10 minutes to wash the N2 out of the left lung. When the tracheal tube in the left lung was clamped for 7 minutes for degassing, PaO2 fell to 59 Torr. Subsequently 1,200 ml of physiological saline was injected into the left lung, and PaO2 rose to 155 Torr. A 6 Torr difference was found between the value of PaO2 under ventilation with N2 and that of degassing, but this difference was not statistically significant. The lowest PaO2 occurring during UWLL was considered to be predictable if the unilateral lung was ventilated with N2.  相似文献   

8.
PURPOSE: The analysis of the nucleolar organizer regions (AgNORs) was performed in patients with acute myelogenous leukemia (AML) to verify the role of cell proliferation in predicting complete remission (CR) and survival. MATERIALS AND METHODS: Bone marrow biopsies from 40 adult patients with AML were stained with the argyrophilic method. The mean AgNOR number (AgNOR count) was calculated for each case. After induction therapy, patients who achieved CR received intensive consolidation; two underwent autologous and four allogeneic bone marrow transplantations (BMT). RESULTS: The mean AgNOR count for the whole series was 6.6 (SD = 1.35); it was higher in CR patients than in resistant ones (P = .02). The median duration of CR was 26 months for patients with an AgNOR count greater than 6.6, but only 6 months for those with lower counts (P = .01). Sixteen patients who achieved a CR relapsed and 14 reached a second CR; the median duration of second CR was 16 months for patients with AgNOR count greater than 6.6, but only 5 months for those with lower counts (P = .01). The median survival time for the whole series was 14 months, with 30% of patients alive and in continuous CR at 103 months. Survival was longer for patients with an AgNOR count greater than 6.6 (33 months) than for those with lower counts (6 months; P = .0009). In multivariate analysis, when CR was excluded from the model, AgNOR count appeared as an independent prognostic variable (P = .005). CONCLUSION: AgNOR analysis is a suitable method to assess cell proliferation in bone marrow biopsies and can predict CR, remission duration, and survival in AML patients.  相似文献   

9.
OBJECTIVE: There were two aims of this study. The first was to evaluate the application of helical computed tomography of the thorax (HCTT) for the diagnosis of blunt aortic injury (BAI). The second was to evaluate the efficacy of beta-blockers with or without nitroprusside in preventing aortic rupture. SUMMARY BACKGROUND DATA: Aortography has been the standard for diagnosing BAI for the past 4 decades. Conventional chest CT has not proven to be of significant value. Helical CT scanning is faster and has higher resolution than conventional CT. Retrospective studies have suggested the efficacy of antihypertensives in preventing aortic rupture. METHODS: A prospective study comparing HCTT to aortography in the diagnosis of BAI was performed. A protocol of beta-blockers with or without nitroprusside was also examined for efficacy in preventing rupture before aortic repair and in allowing delayed repair in patients with significant associated injuries. RESULTS: Over a period of 4 years, 494 patients were studied. BAI was diagnosed in 71 patients. Sensitivity was 100% for HCTT versus 92% for aortography. Specificity was 83% for HCTT versus 99% for aortography. Accuracy was 86% for HCTT versus 97% for aortography. Positive predictive value was 50% for HCTT versus 97% for aortography. Negative predictive value was 100% for HCTT versus 97% for aortography. No patient had spontaneous rupture in this study. CONCLUSIONS: HCTT is sensitive for diagnosing intimal injuries and pseudoaneurysms. Patients without direct HCTT evidence of BAI require no further evaluation. Aortography can be reserved for indeterminate HCTT scans. Early diagnosis with HCTT and presumptive treatment with the antihypertensive regimen eliminated in-hospital aortic rupture.  相似文献   

10.
Isoflurane and halothane were compared in two similar groups of 100 patients each. Isoflurane compared favorably with halothane in producing adequate anesthesia in all our patients. Induction period was a little stormy when there was direct induction with isoflurane. Maintenance was excellent and recovery was good. Mean concentration necessary to induce anesthesia was 3.07% with isoflurane and 2.56% with halothane. Mean maintenance with isoflurane was 1.39%, compared to 1.40% with halothane. Less curare was required for relaxation when used with isoflurane than with halothane. This difference was not seen with pancuronium (Pavulon). Patient recovery was faster with isoflurane than with halothane. Incidence of delirium and shivering in the recovery period was similar for both agents. Incidence of nausea and vomiting was greater with isoflurane. Other clinical and biochemical postoperative comparisons did not show any significant differences between the two agents.  相似文献   

11.
INTRODUCTION: A population-based cross-sectional study was conducted in Pelotas, Southern Brazil, with the objective of determining the prevalence of obesity and identify associated, variables as this condition increased markedly in the country between 1974 and 1989. MATERIAL AND METHODS: One thousand and thirty-five adults between 20 and 69 years of age were studied. Obesity was defined as a Body Mass Index--BMI--equal to or over 30 Kg/square meter). The multivariate analyses took into account the hierarchical model of the variables associated with obesity for both men and women. RESULTS: The prevalence for the overall population was of 21% (CI 18-23). It was higher among women--25% (CI 22-29) than for men--15% (CI 12-18). Socioeconomic status was positively associated with obesity among men, whereas the opposite situation was reported for women, with those belonging to the poorest social strata presenting increased BMI. Reported obesity in their parents was associated with increased BMI in the subjects, and this association remained statistically significant even after compensating for the effect of possible confounding variables. Self-reported diabetes and arterial hypertension doubled the risk of obesity, whereas non-smoking was associated with obesity only among women. Variables which were not associated with obesity after adjusting for confounders were alcohol consumption, marital status and parity. Women having more daily meals were less prone to obesity, even after controlling for confounders, and this association was not quite significant for men (p = 0.07). CONCLUSIONS: The prevalence of obesity was higher among women, and important differences in risk factors were noticed when the population was considered by sex.  相似文献   

12.
The sinus node function was evaluated by rapid atrial pacing in 35 aged patients (mean age 78.2 years) including 10 aged controls, 12 cases with various degrees of AV block, 6 with bradycardia-tachycardia syndrome (BTS), and 7 with sinus bradyarrhythmia (SB). AV block was further divided into A-H block (7 cases) and H-V block (5 cases) by His bundle electrogram which was simultaneously recorded with 3 leads of surface electrocardiogram. Sinus node recovery time (SRT) was measured and its maximum value (SRTmax) was selected from SRTs obtained after pacing with various rates and durations in each patient. SRTmax was also expressed as percentage of the control P-P interval (%SRTmax). For patients in whom the study was repeated 3 to 8 months later, %SRTmax was reproducible in 9 of 14 instances. Prolongation of SRT was not always observed as the rate and/or duration of pacing was increased. SRTmax and %SRTmax were 1,363 +/- 188 msec and 147 +/- 19% (mean +/- SD), respectively, for aged controls, 1,597 +/- 442 msec and 156 +/- 31% for patients with AV block, 2,087 +/- 1,315 msec and 203 +/- 132% for those with BTS, and 3,069 +/- 1,287 msec and 247 +/- 115% for those with SB. SRTmax exceeding the range for aged controls was noted in 4 of 7 cases (57%) with A-H block, 2 of 6 (33%) with BTS, and 5 of 7 (71%) with SB; normal SRT was not infrequently observed in patients with sick sinus syndrome, especially in those with BTS. Analysis of 10 consecutive atrial cycles following cessation of pacing revealed that in 8 cases the first P-P interval (SRT) was followed by longer ones in some occasions (secondary suppression). It was observed almost exclusively in patients with sick sinus syndrome. The possibility of this phenomenon to reflect another feature of sinus node abnormality was discussed.  相似文献   

13.
A method for the determination of total phenylephrine (free plus conjugated) in human serum was developed using column-switching high-performance liquid chromatography (HPLC) with fluorescence detection. After serum was deproteinized with acetonitrile, the conjugated phenylephrine was hydrolyzed with diluted hydrochloric acid. The solution was evaporated to dryness. The reconstituted residue was analyzed with HPLC using a heart-cut technique. Good recoveries of the analytes from spiked human serum samples were obtained with small coefficients of variation. A good linear response was obtained for the concentration range 5-500 ng/ml. The lower limit of quantitation for phenylephrine in human serum was 5 ng/ml. The method was applied to the determination of phenylephrine in human serum after oral administration of phenylephrine hydrochloride.  相似文献   

14.
Nine male patients with separate primary cancers of the esophagus and head and neck (pharynx, larynx) presented with a mean age of 56 years (41-69). They included 7 pharyngeal cancer patients and 2 laryngeal ones. Esophageal cancer was discovered synchronously in 6 patients and metachronously in 3 (1, 4, and 11 years later, respectively). The head and neck cancer was stage-I in one patient, stage-II in 4 and stage-IV in 4. The esophageal cancer was cervical in 2, thoracic in 6 and abdominal in 1. It was early cancer (stage-0) in 6 patients and advanced (stage-IV) in 3. The esophageal cancer was more advanced in the metachronous group, while it was early in the synchronous group. Since the head and neck cancer was advanced, all patients underwent a total laryngectomy for their head and neck cancers. As for esophageal surgery, a transhiatal esophagectomy was, in principle, performed for early cancers while a total thoracic esophagectomy was done for advanced cancers. For the reconstruction of the esophagus, a gastric tube was used. Four patients are still alive with a mean survival time of 25 months, whereas five died of cancer recurrence of either type a mean of 19 months after surgery. As compared with the survival rates of the patients with esophageal cancer alone, the 5-year survival rate was 18.2% for patients with double cancers in this series and 27.9% for those with esophageal cancer alone.  相似文献   

15.
OBJECTIVE: To determine whether sex of fetus, sire, month of conception, or year of foaling was associated with duration of gestation in mares. DESIGN: Epidemiologic retrospective cohort study. ANIMALS: 500 foalings for 296 Standardbred mares. PROCEDURE: Data for reproductive events from 1986 to 1992 were analyzed. Analyses were conducted to determine whether duration of gestation was associated with sex of fetus, sire, month of conception, or year of foaling. RESULTS: Mean duration of gestation was 343.3 days and was significantly greater for colt fetuses (344.4 days) than for filly fetuses (342.2 days). Sire was associated with duration of gestation; gestation after mating with certain sires was consistently less than 340 days in duration, whereas duration after mating with other sires was consistently more than 350 days. Duration of gestation was associated with month of conception, decreasing by about 2.5 d/mo for mares conceiving later during the breeding season. CLINICAL IMPLICATIONS: Duration of gestation is affected by mating to specific sires and by month of conception. Stallions associated with exceptionally prolonged gestations might be used to breed mares early in the breeding season, whereas stallions associated with shorter gestations might be desirable for mares bred later in the breeding season. Preparations for impending parturition should be more effective and efficient with improved information on expected date of parturition.  相似文献   

16.
An audit was undertaken to determine case compliance with prenatal testing and investigation of infants for toxoplasma infection. Subsequently, the effect of enhanced reference unit Intervention was studied. The proportion of cases of toxoplasma infection associated with pregnancy completing an investigation programme was calculated. The effect of continued and short-term additional intervention was assessed and reasons for failure to comply were sought. The status of the child was established in 30% of cases when acute maternal toxoplasma infection was detected. Continuous reference unit intervention significantly improved case compliance to 45% over a 3-year period, but the effect was lost when the additional measures were withdrawn. Failure to complete the investigation procedure was associated with loss of patient-clinician contact and clinician/laboratory error. Enhanced intervention did not result in a significant improvement in compliance with the investigation programme for babies with clinical abnormality. The benefits of testing for toxoplasma infection associated with pregnancy are limited by failure to complete necessary investigations.  相似文献   

17.
An 81 year old man with severe ischemic heart disease and left ventricular dysfunction was scheduled for a subtotal gastrectomy for his advanced gastric cancer. His cardiac function was so poor that we performed minimally invasive coronary artery bypass grafting (MIDCAB; coronary artery bypass grafting without cardiopulmonary bypass for LAD through a small left thoracotomy), just before the abdominal operation. Anesthesia was induced and maintained with fentanyl, vecuronium and sevoflurane. To control heart rate below 60 bpm during local coronary occlusion for bypass grafting, edrophonium 5 mg was administered just before the occlusion. During the bypass grafting procedure, the patient's heart rate was maintained at 50-60 bpm and his hemodynamic profile slightly declined but was permissible. After bypass grafting, his cardiac performance was improved with low dose dobutamine. Subsequently subtotal gastrectomy was carried out. His postoperative course was uneventful. Combined MIDCAB and abdominal operation may be beneficial for selected patients with severe ischemic heart disease.  相似文献   

18.
BACKGROUND: It has been suggested that desmoplastic melanoma (DM) and desmoplastic neurotropic melanoma (DNM) are associated with worse prognoses and higher local recurrence rates than other forms of melanoma. In the current study, a large series of patients with DM and DNM treated at a tertiary referral center was reviewed. METHODS: For 190 patients with DM and 90 patients with DNM accrued over a 10-year period, clinical features were recorded and all available histopathology was reviewed. The associations between clinical and pathologic variables, biologic behavior, and eventual outcome were analyzed. RESULTS: The male-to-female ratio was 1.75:1 and the median patient age 61 years. The median tumor thickness was 2.5 mm, and 44% of cases were amelanotic. Five-year survival was 75%. Significant predictors of overall survival were a high mitotic rate (P=0.003) and tumor thickness (P=0.011). All the DNMs exceeded 1.5 mm in thickness and were graded as Clark's level IV or V. There was a significant increase in local recurrence when neurotropism was present (P < 0.001). The rate of local recurrence was not higher for DM than for other cutaneous melanomas. CONCLUSIONS: There was no statistically significant difference in survival for patients with DM and those with DNM, and overall survival for both was similar to that for patients with other cutaneous melanomas. However, there was a lower rate of regional lymph node metastasis at initial presentation and as the first recurrence for both DM and DNM. The local recurrence rate was higher when the surgical clearance margin was <1 cm and when neurotropism was present.  相似文献   

19.
通过采用不同的样品处理方法,对电感耦合等离子体原子发射光谱法(ICP-AES)测定重晶石中碳酸钡和硫酸钡含量的方法进行了探讨。采用不同浓度醋酸对纯硫酸钡进行溶解试验,结果表明,采用1.7mol/L醋酸常温溶解1h,硫酸钡的溶出率与用水进行溶解时保持一致。因而采用以下流程对样品中碳酸钡进行测定:采用水溶解样品,并用ICP-AES对样品溶液中钡进行测定,得到样品中水溶性钡的含量;采用1.7mol/L醋酸溶解样品,并用ICP-AES对样品溶液中钡进行测定,得到样品中水溶性钡、以碳酸钡形式存在的钡的含量总和;将后者减去前者可得到以碳酸钡形式存在的钡的含量,再进一步换算为碳酸钡含量,实现了ICPAES对重晶石中碳酸钡含量的测定。采用1.0mol/L盐酸加热煮沸30min处理样品,可有效溶解氯化钡、碳酸钡等含钡杂质,而采用1.0mol/L盐酸对纯硫酸钡的溶解试验表明,1.0mol/L盐酸对硫酸钡的溶出率为0.090%,与重晶石样品中硫酸钡质量分数(大于10%)相比可忽略不计。因而采用以下流程对样品中硫酸钡进行测定:样品经1.0mol/L盐酸处理后,过滤,采用过氧化钠熔融-碳酸钠溶液浸提的方法处理沉淀,并采用ICP-AES对浸取液中钡进行测定,可得到以硫酸钡形式存在的钡的含量,将其换算为硫酸钡含量,实现了ICP-AES对重晶石样品中硫酸钡含量的测定。考虑到重晶石样品中碳酸钡的含量较低而硫酸钡的含量较高,分别选择灵敏度最高的Ba 455.403nm谱线和灵敏度较低的Ba 230.424nm谱线为分析谱线对二者进行测定,其对应钡的校准曲线线性相关系数分别为0.999 1~0.999 9和0.999 5~1.000 0。按照实验方法测定重晶石样品中碳酸钡和硫酸钡,碳酸钡方法检出限为0.001%,硫酸钡方法检出限为0.003%;碳酸钡和硫酸钡测定结果的相对标准偏差(RSD,n=12)分别不大于21%和1.0%。实验方法用于样品中碳酸钡测定并加入碳酸钡进行加标回收试验,其回收率为90%~110%。实验方法用于测定重晶石矿石成分分析标准物质中硫酸钡,测定值与认定值相吻合。  相似文献   

20.
Goal orientation was hypothesized to moderate the relationship between quantitative workload and frustration. Based on data from 460 graduate students, two forms of goal orientation moderated this relationship. Specifically, it was found that workload was positively related to frustration for people with high levels of avoiding goal orientation, but not for those with low levels of avoiding goal orientation. In addition, it was found that the positive effect of workload on frustration was weaker for people with high levels of mastery goal orientation than for those with low levels of mastery goal orientation. Both theoretical and practical implications of the current findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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