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  • 1
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cystatins are protein inhibitors of cysteine proteinases, which are believed to play an important role in the pathogenesis of periodontal disease. In this study, we report a new sensitive method for the quantitative analysis of cystatin activity in a small amount of crude sample such as gingival crevicular fluid. Cystatin activity in the crude sample was determined by using active site-titrated papain, which is a cysteine proteinase from the plant Carica papaya. Crude samples usually contain endogenous cysteine proteinases. These competed with the added papain for the active sites of the cystatins. The cystatin-cysteine proteinase complex was able to be dissociated by the addition of papain. This competition and dissociation could interfere with the determination of cystatin activity, since some of the cysteine proteinases, such as cathepsin B, hydrolyzed the specific substrate for papain during titration with the papain. In order to exclude this interference and measure total cystatin activity, the crude sample must be alkalinized (pH 11.0) for 5 min at 4°C followed by 10 min at 40°C before titration with papain. The minimum detectable amount of cystatins was 20 fmol/ assay when it was calculated per mole of papain inhibitory sites. Using this method, significant levels of cystatin activity were detected in all the samples of gingival crevicular fluid taken from periodontal disease patients. These results suggest that cystatins could regulate the cysteine proteinases in gingival crevicular fluid and that this new method could be useful to clarify the role of cystatins in the pathogenesis of periodontal disease.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-9813
    Keywords: Key words Prenatal diagnosis ; Meconium peritonitis ; Meconium ascites ; Intestinal atresia ; Fetal ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To clarify the relationship between clinical features in utero and postnatal prognosis, 20 fetuses who underwent ultrasonic (US) evaluation for meconium peritonitis (MP) over a 17-year period were reviewed. According to final US findings in utero, patients were classified into three types. Type I (massive meconium ascites) was noted is 5 cases, type II (giant pseudocyst) in 4, and the other 11 were classified as type III (calcification and/or small pseudocyst). Abdominal calcifications were identified in only 5 cases (2 type I, 1 type II, 2 type III). Seven fetuses who had associated polyhydramnios (1 Type I, 1 Type II, 2 Type III) and fetal hydrops (3 Type II) were delivered before 36 weeks' gestation. Cardiopulmonary resuscitation at birth was required in 9 cases (5 type I, 4 type II) who underwent abdominal drainage before delivery and/or immediately after birth. Although dilatation of the intestine was identified in 10 fetuses (2 type II, 8 Type III), 18 had intestinal atresia and 2 had fecal obstruction of the distal ileum. Four infants (2 type I, 1 type II, 1 type III) died of respiratory failure and postoperative complications. These results indicated that careful fetal US may be useful for perinatal management of MP.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1437-9813
    Keywords: Caliceal diverticulum ; Hydronephrosis ; Pyeloureteral junction obstruction ; Prenatal diagnosis ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Caliceal diverticula (CD) are rarely associated with hydronephrosis (HN), and prenatal diagnosis of CD has not been reported. We present a case of neonatal CD associated with HN that was detected before birth. This rare association should be borne in mind in the differential diagnosis of cystic renal lesions.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-9813
    Keywords: Congenital diaphragmatic hernia ; Lung hypoplasia ; Fetal ultrasonography ; High-frequency oscillation ventilation ; Extracorporeal membrane exygenation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The outcome of fetuses with diaphragmatic hernia (CDH) has been reported to be related to the severity of lung hypoplasia. As an index of pulmonary hypoplasia, we attempted to measure the lung-thorax transverse area ratio (L/T) using ultrasonic echography in eight fetuses with left-sided CDH. Two cases with L/T more than 0.28 (controls: 0.52±0.04) were transported postnatally and recovered after early operation without episodes of persistent fetal circulation. Elective surgical repair was performed in six infants immediately after cesarean delivery at 35–37 weeks' gestation. In three cases with L/T between 0.21 and 0.24 who recovered with no complications, surgical reduction of the abdominal organs improved arterial blood gases and high-frequency oscillation ventilation (HFOV) was fully effective for respiratory management. In three with L/T between 0.11 and 0.17, extracorporeal membrane oxygenation (ECMO) was required from the 1st to the 12th postoperative day despite HFOV. Although two infants died of combined cardiovascular anomalies and airway bleeding caused by prolonged HFOV, respectively, one infant with minimal L/T survived. Measurement of L/T may help to predict the outcome of fetuses with CDH and to determine the indications for various treatments including immediate operation after cesarean delivery, HFOV, and ECMO.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1437-9813
    Keywords: Meconium peritonitis ; Giant cystic type ; Hydrops fetalis ; Prenatal diagnosis ; Perinatal management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of giant cystic meconium peritonitis associated with hydrops fetalis is reported. An excellent outcome was obtained by surgical intervention following prenatal diagnosis and adequate perinatal management.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1437-9813
    Keywords: Key words Congenital diaphragmatic hernia ; Identical twins ; Prenatal diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors present a pair of identical twins with congenital diaphragmatic hernia (CDH) diagnosed prenatally, who underwent successful surgical repair. They were diagnosed as having CDH at 32 weeks' gestation and showed respiratory distress soon after cesarean section at 33 weeks' gestation. Both survived after scheduled perinatal management followed by surgery, for which the prenatal diagnosis of CDH was valuable.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1437-9813
    Keywords: Diaphragmatic eventration ; Diaphragmatic hernia ; Phrenic palsy ; Prenatal diagnosis ; Fetal ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A rare prenatal case of congenital diaphragmatic eventration is reported. Fixed elevation of the right hemidiaphragm since the early fetal period suggests irreversibility of the eventration. A rationale for early surgical plication in symptomatic congenital eventration is proposed.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 24 (2000), S. 1498-1502 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A developing child, with a high metabolic rate and low body stores of nutrients, is susceptible to metabolic disturbances due to surgical stress. For perioperative nutritional care of infants, the distinct physiologic features of their body fluids must be carefully considered. The postoperative metabolic response is the same as that in adults, but in children this response is more rapid. Based on the urinary excretion of 3-methylhistidine in infants, the postoperative degradation of muscle protein is thought to be twice the preoperative level. This transient increase during the early postoperative period was not suppressed by increased amino acid intake, and energy intake was sufficient. To prevent postoperative metabolic complications, the energy intake of glucose or fat should correspond to the patient—s requirements, and excess carbohydrate should be avoided. The quantity and quality of the amino acid formula used must be carefully evaluated.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 369-371 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate whether the ambulatory level premorbid or at discharge reflected the survival rate better. Ambulatory level was retrospectively evaluated as a postoperative indicator of survival rate following operative treatment in 301 consecutive patients over 65 years old. All of the patients were followed up for a mean of 62 months. The postoperative ambulatory level at discharge reliably reflected the survival rate in the elderly after hip fracture, better than the premorbid ambulatory level. It is confirmed that the planning of the operation and rehabilitation to maintain the premorbid ambulatory level after hip fracture might be critical.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1436-2813
    Keywords: bowel transplantation ; cyclosporin A ; blood transfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pre-transplant blood transfusions are given as a means of desensitization to reduce the required dose of cyclosporin A (CsA). In this study, the effect of pretransplant blood transfusion on host survival and T-cell function against alloantigen were investigated. Male Lewis rats (RT11) were used as the recipients in all experiments, and male DA rats (RT1a) were used as the blood and small bowel donors, and as a source of allogeneic stimulator cells. Male BUF rats (RT1b) were used as donors of third party blood, and of allo-stimulator cells in a delayed-type hypersensitivity (DTH) response. In our experimental design, Lewis rats were divided into the following groups according to the type of administration: (1) a donor-specific blood transfusion (DST) 8 days preoperatively and a concurrent 5-day course of CsA at 10 mg/kg per day; (2) a nonspecific third party blood transfusion (NST) and CsA at 10 mg/kg per day from day 8 to day 4 preoperatively; (3) CsA alone from day 8 to day 4 preoperatively; (4) DST alone 8 days preoperatively; or (5) no treatment, being the control group. Postoperative treatment consisted of CsA at 2.5 mg/kg per day for 30 days. Rats conditioned with NST plus CsA, CsA alone, DST alone, and the untreated control rats survived for 7.2 ±1.2, 9.0 ± 2.2, 6.8 ± 0.4, and 7.4 ± 1.6 days, respectively. In contrast, the five rats conditioned with DST plus CsA survived for 100 days or more. This study demonstrates that long-term survival of a small bowel allograft can be achieved by host-conditioning with a combined treatment of DST and low-dose CsA.
    Type of Medium: Electronic Resource
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