There are evidence indicating that endoscopic retrograde cholangiopancreatography with sphincterotomy (ERCP+S) reduces the rate of complications in patients with severe acute biliary pancreatitis (ABP). The aim of this study was to analyze our experience in the treatment of severe ABP with ERCP+S and compare the evolution of the patients treated early (3 days or less following admission) with those treated late (after the 3rd day). A retrospective review of the clinical histories of the 16 patients with severe ABP treated with ERCP+S over the last two years is presented, analyzing their clinical features on admission and evolution. Biliary stones or biliary sludge was observed in 11 cases (69%). Nine patients had undergone early, and 7 late, ERCP+S. The patients of the latter group presented a greater number of complications during evolution than the former group (43% vs 0%; p = 0.025). The mortality of the patients of the late ERCP+S was also greater although without statistical significance (28.6% vs 0%; p = 0.15). No complication secondary to ERCP+S was detected. These findings confirm the fact that ERCP+S performed early in severe ABP significantly reduces the number of complications and is associated with a lower mortality. 相似文献
Comparative genomic hybridization (CGH) was used to detect copy number changes of DNA sequences in the Ewing family of tumours (ET). We analysed 20 samples from 17 patients. Fifteen tumours (75%) showed copy number changes. Gains of DNA sequences were much more frequent than losses, the majority of the gains affecting whole chromosomes or whole chromosome arms. Recurrent findings included copy number increases for chromosomes 8 (seven out of 20 samples; 35%), 1q (five samples; 25%) and 12 (five samples; 25%). The minimal common regions of these gains were the whole chromosomes 8 and 12, and 1q21-22. High-level amplifications affected 8q13-24, 1q and 1q21-22, each once. Southern blot analysis of the specimen with high-level amplification at 1q21-22 showed an amplification of FLG and SPRR3, both mapped to this region. All cases with a gain of chromosome 12 simultaneously showed a gain of chromosome 8. Comparison of CGH findings with cytogenetic analysis of the same tumours and previous cytogenetic reports of ET showed, in general, concordant results. In conclusion, our findings confirm that secondary changes, which may have prognostic significance in ET, are trisomy 8, trisomy 12 and a gain of DNA sequences in 1q. 相似文献
A modified natural surfactant was administered to a patient with life-threatening adult respiratory distress syndrome caused by viral pneumonia. Subsequently, there was a marked improvement in gas exchange. In order to assess the mechanism for improved oxygenation, computed tomography of the lungs was done. Quantitative analysis of the scans taken before and after surfactant administration indicates that improvement in gas exchange was largely due to the expansion of underinflated and collapsed lung areas. Although this is a single case report, it provides insight into the possible beneficial effect of instilled surfactant in severe respiratory distress from viral pneumonia. 相似文献
Overproduction of proteinase A by recombinant Saccharomyces cerevisiae was investigated by cultivations in a cell-recycling bioreactor. Membrane filtration was used to separate cells from the broth. Recycling ratios and dilution rates were varied and the effect on enzyme production was studied both experimentally and by computer simulations. Experiments and simulations showed that cell mass and product concentration were enhanced by high ratios of recycling. Additional simulations showed that the proteinase A concentration decreased drastically at high dilution rates and the optimal volumetric productivities were at high dilution rates just below washout and at high ratios of recycling. Cell-recycling fermentation gave much higher volumetric productivities and stable product concentrations in contrast to simple continuous fermentation. 相似文献
For new developments such as plasma surface technologies, it is first necessary to prove their scientific possibilities and limits. Therefore it is mainly questions of process understanding and process handling, quality of the substrate and coating as well as its interactions which are considered and discussed.
To use these technologies in industry it is also necessary to consider ecological aspects as well as economic and marketing aspects. For a scientist at first these aspects are not as important.
An overview of different economic aspects of the application of plasma surface technologies is presented by considering the following: investment and running costs of plants; costs of process development for special applications; comparison of different technologies; certainty and reproducibility of the coating technologies; cost and profit balance of coated work pieces; costs of marketing.
Recently, the importance of the ecological aspects of industrial technologies has increased greatly. In most cases these questions are closely linked to the economic aspects. Nearly all ecological problems can be solved and handled, but the costs for this are increasing greatly. Although the laws currently differ in different countries, in future the laws everywhere will become more strict. The main concerns of the application and handling of a plasma assisted process are for example the use or production of toxic media, security of plants for the staff and for the environment, and handling of used coated material. 相似文献
A cross-sectional study was performed to obtain risk factors for hepatitis B disease, HBsAg carriers and immunised personnel, among 2470 workers in a general hospital in Madrid, Spain. The data obtained were analyzed with multiple logistic regression to obtain beta coefficients for variables. The results of the analysis show that being a nurse or being regularly exposed to blood are the most important risk factors for hepatitis B acquisition. The length of time working at the same job activity was also a risk factor. The resulting beta coefficients allow the construction for a hepatitis non-immunised, HBsAg carrier and immunised HBV status, which can select subjects for a hepatitis B vaccination program. 相似文献
The adsorption of sulphate ions on Zn and Al was studied in 0.5 M NaClO4 supporting electrolyte at various pH values in the range of pH=2-7 by radiotracer techniques. It was found in both cases that the adsorption of sulphate passes over maximum in the pH range studied.The phenomena observed are interpreted by the assumption that the main component of the overall process is anion adsorption on the protonated oxides/hydroxides formed as a result of corrosion. At low pH values the steady state coverage with respect to these products should be very low owing to their dissolution; consequently the extent of anion adsorption induced must also be very low. At higher pH values where no protonation occurs the adsorption of anions decreases significantly. 相似文献
The changes to the chemical senses of taste and smell that accompany ageing are widely documented, and there has been some evidence that these changes may influence food preferences of the older consumer. However, little is known about the loss of function of the residual senses of texture and chemical irritant perception and how such losses influence food preferences. A consumer panel comprising a young (20–35 years) and an older (>65 years) age cohort was recruited and sensory tests were conducted to determine perceived intensity, preferences and the possibility of cross modal interaction between the sensory modalities of chemical irritation and texture. Liquid, semi-solid and solid food systems were studied to enable comparisons to be drawn. Older consumers were less capable of discriminating between chemical irritation and texture stimuli, indicating loss of sensory function, but there was indication that higher levels of chemical irritation were preferred among older consumers in some texture types. 相似文献