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BACKGROUND: Endoscopic sclerotherapy (ST), widely used as treatment of bleeding esophageal varices, might cause motility disturbances of the esophagus as well as mucosal damage. We performed this study to evaluate the long-term effects of repeated sclerotherapy on esophageal motility and mucosa. METHODS: Ten patients with liver cirrhosis and bleeding esophageal varices treated with repeated ST were evaluated after the last ST, median 52 months, by esophageal manometry and gastroscopy where forceps biopsies were taken. RESULTS: We found a significant difference in the distal esophageal sphincter intraabdominal length. The distal esophageal sphincter pressure was somewhat lower in the ST group although the difference did not reach statistical significance. There was infiltration of neutrophil leukocytes in biopsies from four patients and normal findings in the rest. CONCLUSIONS: Long-term follow-up evaluation showed statistically longer distal esophageal intraabdominal length in the ST group. No mucosal alterations were found at the histopathological investigation.  相似文献   
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  总被引:1,自引:0,他引:1  
BACKGROUND: Factors determining the outcome of operative correction of valvular abnormalities combined with coronary artery bypass grafting are still incompletely defined. METHODS: Determinants of early and late (more than 90 days) deaths and event-free survival were studied for combined valve operations and coronary artery bypass grafting in 741 patients using multivariate analysis. RESULTS: Ninety-day survival probability was 89% (95% confidence interval, 87% to 92%). Preoperative risk factors for early death were age, female sex, renal failure, New York Heart Association class IV or V, and mitral insufficiency. The operative risk factor was the duration of aortic cross-clamping. Five- and 10-year survival probabilities were 74% (95% confidence interval, 71% to 78%) and 43% (95% confidence interval, 36% to 50%), respectively. Preoperative risk factors for late death were age, preoperative renal failure, New York Heart Association class IV or V, vessel disease, and nonsinus rhythm. Five- and 10-year event-free survival probabilities were 57% (95% confidence interval, 53% to 61%) and 23% (95% confidence interval, 17% to 28%), respectively. Preoperative risk factors for non-event-free survival were age, female sex, reduced left ventricular function, mitral regurgitation, and pacemaker rhythm. CONCLUSION: The demographic factors of age and female sex; the comorbid condition of renal failure; the cardiac conditions of advanced New York Heart Association class, left ventricular function, mitral regurgitation, vessel disease, and cardiac rhythm; and the operative condition of ischemia time are the most important predictors of clinical outcome after combined valve operations and coronary artery bypass grafting.  相似文献   
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Nine healthy subjects (age 31 +/- 4 yr) exercised with and without expiratory-flow limitation (maximal flow approximately 1 l/s). We monitored flow, end-tidal PCO2, esophageal (Pes) and gastric pressures, changes in end-expiratory lung volume, and perception (sensation) of difficulty in breathing. Subjects cycled at increasing intensity (+25 W/30 s) until symptom limitation. During the flow-limited run, exercise performance was limited in all subjects by maximum sensation. Sensation was equally determined by inspiratory and expiratory pressure changes. In both runs, 90% of the variance in sensation could be explained by the Pes swings (difference between peak inspiratory and peak expiratory Pes). End-tidal PCO2 did not explain any variance in sensation in the control run and added only 3% to the explained variance in the flow-limited run. We conclude that in healthy subjects, during normal as well as expiratory flow-limited exercise, the pleural pressure generation of the expiratory muscles is equally related to the perception of difficulty in breathing as that of the inspiratory muscles.  相似文献   
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Two commercial epoxy resins, MY750 and MY720, were cured over a range of cure temperatures with a series of novel curing agents based on modified imidazoles. A combination of techniques, including dynamic viscometry, proton nuclear magnetic resonance spectroscopy, differential scanning calorimetry, high performance and gel permeation chromatography, were used to analyse the reaction mixture. It appears that for a given formulation and given resin, the viscosity behaviour near gelation is different for different cure temperatures and the mechanism appears to be dependent not only on the nature of the imidazole curing agent, but also on the cure temperature. Higher temperature cure appears to lead to the formation of a less ‘homogeneous’ reaction mixture at the gel point, containing oligomeric chain lengths of higher polydispersity, whereas in the lower temperature cure, oligomers of a smaller range of chain lengths are present.  相似文献   
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Summary The thermal cure of a monofunctional maleimide N-(4-phenoxy)-phenylmaleimid (1) was examined using differential scanning calorimetry (DSC). The analogous bis-maleimide bis-(4-maleimidophenyl)ether (2) was also analyzed in the same manner for comparison. Polymerization kinetics derived from scanning DSC measurements showed an order of reaction varying between n=1 and 2 for (1), compared to an order of reaction between n=2 and 3 (by multiple linear regression analysis) for (2). The overall enthalpy of polymerization (Ho) for N-(4-phenoxy)-phenylmaleimide (94kJ/mole) agrees well with that obtained for maleimide itself (89kJ/mole) using conventional calorimetric techniques indicating that polymerization appears complete within the timescale of the experiment. In contrast the analogous BMI displays a markedly lower overall polymerization enthalpy (ca. 66kJ/mole) indicating an apparent conversion of only 37%.  相似文献   
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The microstructure of aluminum (Al) solution-doped soot layers in modified chemical vapor deposition fabrication of silica-based optical fibers has been studied. It is shown that such Al doping is predominantly determined by deposition temperature. Radial and longitudinal Al doping distributions have been investigated in soot layers, in fully sintered glass layers, and in collapsed preforms. Formation mechanisms are discussed.  相似文献   
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