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131.
BACKGROUND: Recently, investigators have reported the use of endoscopic myotomy in the treatment of esophageal achalasia. As with the open operation, considerable disagreement exists regarding the appropriate length of the myotomy and the need for a concomitant antireflux procedure. METHODS: Patients presenting with symptomatic achalasia between 1993 and 1997 were included in this prospective study. Preoperative studies included barium upper gastrointestinal study, endoscopy, and esophageal manometry. Laparoscopic myotomy was completed in all 20 patients; 18 had concomitant Toupet fundoplication. RESULTS: Operative times ranged from 95 to 345 minutes (mean 216). Blood loss ranged from 50 to 300 cc (mean 100 cc). There were 7 minor complications (5 mucosal injuries repaired laparoscopically, 1 bile leak and 1 splenic capsular tear). Nine patients began a liquid diet on the first day postoperatively; 19 were tolerating liquids by postoperative day 3. Hospital stay ranged from 2 to 20 days (mean 5). Eighteen patients had complete relief of dysphagia, with less than one reflux episode per month. One individual continues to have mild persistent solid food dysphagia. Another patient initially did well but subsequently developed mild recurrent dysphagia and reflux. One patient required laparoscopic take-down of the wrap because of recurrent dysphagia and now has no problems swallowing, but does complain of mild reflux. Two other patients also have mild reflux, 1 of whom did not undergo fundoplication. CONCLUSIONS: Laparoscopic Heller myotomy can be performed safely with excellent results in patients with achalasia. Adding a partial fundoplication appears to help control postoperative symptoms of reflux. This procedure should be considered the procedure of choice in patients with symptomatic esophageal achalasia. 相似文献
132.
Hemiballism is a rare hyperkinetic disorder which is characterized by irregular vigorous rotatory movements of the limbs of one side of the body. The disabling and exhausting movements with their high risk of severe injuries require an acute drug treatment. However, there are no common guidelines for the treatment of this disorder. Therefore we reviewed the available literature to establish a concept for a rational symptomatic drug treatment. Furthermore, own observations in 6 patients with hemiballism of different origins are reported. 相似文献
133.
H.U. Khan K.M. Agrawal M. Anwar S.P. Nautiyal B.S. Rawat 《Petroleum Science and Technology》1998,16(1):145-166
Lubricating oil base stocks differ greatly in their chemical composition and consequently in their physical properties and applications. Influence of waxes and various hydrocarbon type constituents viz saturates and aromatic components on the viscosity and shear stress as a function of temperature in different lube oil base stocks has been studied in the present paper. 相似文献
134.
135.
Motivated by the fact that time delays in a practical direct-sequence code-division multiple-access (DS-CDMA) system can never be perfectly estimated, an improved minimum-mean squared-error (MMSE)-based receiver is proposed and analyzed. Via the simple assumption of a probability distribution for the delay estimation errors, the proposed receiver can achieve a performance superior to that of the conventional MMSE (CMMSE) receiver. The performances of this improved receiver and the CMMSE receiver are compared in terms of the mean squared error (MSE), probability of error, and asymptotic multiuser efficiency (AME). As the original definition of AME does not consider mismatched channels, the behavior of three single-user receivers bearing imperfect delay estimation is also investigated. These single-user receivers are employed to define a more appropriate AME. Finally, an efficient update mechanism to accommodate dynamic channel statistics, and thus practical implementation, is proposed 相似文献
136.
An "Occam algorithm" learning model maintains a tentative hypothesis consistent with past observations and, when a new observation is inconsistent with the current hypothesis, updates to the next-simplest hypothesis consistent with all observations. In previous work, observations were assumed to be stochastically independent. This paper initiates study of such models under weaker Markovian assumptions on the observations, In the special case where the sequence of hypotheses satisfies a monotonicity condition, it is shown that the number of mistakes in classifying the first t observations is O(√t log 1/πi), where πi is the stationary probability of the initial state, i, of the Markov chain. 相似文献
137.
It was found, that To?pa Peat Preparation (TPP) administered to healthy volunteers in doses of 100-300 mg/day during 14 days evoked the stimulation of the phagocytic and bactericidal activity of the granulocytes. The dose of 600 mg/day causes only a transient and insignificant increase of phagocytic and bactericidal properties of the granulocytes. 相似文献
138.
J Karjalainen A Kanervo ML V?is?nen B Forsblom E Sarkiala H Jousimies-Somer 《Canadian Metallurgical Quarterly》1993,6(2-3):207-212
A total of 259 Gram-negative Porphyromonas-like rods isolated from subgingival plaque samples of 16 family-owned dogs with naturally occurring periodontitis were characterized phenotypically by biochemical reactions, metabolic end products and enzymatic activities (API-ZYMTM, RoscoTM). Four distinct groups were found. Group A isolates (63) were asaccharolytic, lipase negative, trypsin positive and produced phenylacetic acid (PAA) from peptone-yeast extract glucose broth. Unlike P. gingivalis strains they were catalase positive. Group B isolates (42) differed from those of group A by a positive lipase reaction and from those of group D by failing to ferment sugars. Group C isolates (88) were asaccharolytic and did not produce PAA. They were alpha-fucosidase, N-acetyl-beta-glucosaminidase (beta-NAG) and trypsin negative, resembling P. endodontalis, but unlike human isolates, they were catalase positive. Subgroup C.1 isolates (6) differed from those of parent group C by producing minor amounts of PAA, and subgroup C.2 isolates (12) were beta-NAG positive. Group D isolates (46) were weakly fermentative, lipase, catalase and trypsin positive, and produced PAA. They resembled the B (P.) salivosus type strain which, in our hands, fermented weakly glucose, lactose and mannose. Two isolates could not be assigned to any of the previous groups. 相似文献
139.
I Frías MT Caldeira JR Pérez-Casti?eira JP Navarro-Avi?ó FA Culia?ez-Maciá O Kuppinger H Stransky M Pagés A Hager R Serrano 《Canadian Metallurgical Quarterly》1996,8(9):1533-1544
The plasma membrane (PM) H(+)-ATPase has been proposed to play important transport and regulatory roles in plant physiology, including its participation in auxin-induced acidification in coleoptile segments. This enzyme is encoded by a family of genes differing in tissue distribution, regulation, and expression level. A major expressed isoform of the maize PM H(+)-ATPase (MHA2) has been characterized. RNA gel blot analysis indicated that MHA2 is expressed in all maize organs, with highest levels being in the roots. In situ hybridization of sections from maize seedlings indicated enriched expression of MHA2 in stomatal guard cells, phloem cells, and root epidermal cells. MHA2 mRNA was induced threefold when nonvascular parts of the coleoptile segments were treated with auxin. This induction correlates with auxin-triggered proton extrusion by the same part of the segments. The PM H(+)-ATPase in the vascular bundies does not contribute significantly to auxin-induced acidification, is not regulated by auxin, and masks the auxin effect in extracts of whole coleoptile segments. We conclude that auxin-induced acidification in coleoptile segments most often occurs in the nonvascular tissue and is mediated, at least in part, by increased levels of MHA2. 相似文献
140.