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  • 1
    Electronic Resource
    Electronic Resource
    Electroconcentration by using countercurrent due to pressurized flow and electrophoretic mobility (1993)
    s.l. : American Chemical Society
    Analytical chemistry 65 (1993), S. 2882-2886 
    Details
    ISSN: 1520-6882
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1021/ac00068a027
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  • 2
    Electronic Resource
    Electronic Resource
    The NF-κB binding site is essential for transcriptional activation of the IL-15 gene (1998)
    Springer
    Immunogenetics 48 (1998), S. 1-7 
    Details
    ISSN: 1432-1211
    Keywords: Key words Interleukin-15 ; Gene transcription ; Macrophage ; NF-κB ; LPS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract  We cloned the 5’ upstream region of IL-15 genomic DNA and examined promoter activity in macrophages stimulated with lipopolysaccharide(LPS). The 1.2 kilobase (kb) fragment of the 5’ upstream region contained binding elements for LPS-inducible transcription factors such as NFIL-6 or NF-κB. Determined by luciferase assay following transient transfection in the J774A.1 macrophage cell line, the 1.2 kb of the 5’ upstream region exhibited high promoter activity in response to LPS, while promoter activity was significantly reduced by the 5’ deletion of 313 base pairs containing the NF-κB binding motif. Nuclear protein prepared from LPS-stimulated macrophages formed a complex with the NF-κB binding sequence of the IL-15 promoter. Taken together, the binding of nuclear protein to the NF-κB binding site is required for transcriptional activation of the IL-15 gene in LPS-stimulated macrophages.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002510050393
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  • 3
    Electronic Resource
    Electronic Resource
    Manometric Findings of the Upper Esophageal Sphincter in Esophageal Achalasia (1998)
    Springer
    Molecular medicine 22 (1998), S. 1043-1047 
    Details
    ISSN: 1076-1551
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Pharyngeal and upper esophageal sphincter (UES) manometry was performed in 15 patients with esophageal achalasia and compared with that in 10 healthy controls. Neither the pharyngeal contraction pressure nor the UES resting pressure were significantly different between the two groups, although the UES residual pressure in patients with achalasia was significantly increased compared with that in controls. Pneumatic dilatation of the lower esophageal sphincter (LES) was performed in these patients. After successful LES dilatation, the increased UES residual pressure in patients with esophageal achalasia decreased significantly. Our results suggest that UES relaxation in patients with esophageal achalasia is incomplete compared with that in healthy adults. This UES abnormality is not a primary defect but a secondary phenomenon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900514
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  • 4
    Electronic Resource
    Electronic Resource
    NAK is an IκB kinase-activating kinase (2000)
    [s.l.] : Macmillian Magazines Ltd.
    Nature 404 (2000), S. 778-782 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Phosphorylation of IκB by the IκB kinase (IKK) complex is a critical step leading to IκB degradation and activation of transcription factor NF-κB. The IKK complex contains two catalytic subunits, IKKα and IKKβ, the latter being indispensable for ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/35008109
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  • 5
    Electronic Resource
    Electronic Resource
    Treatment Strategy for Mucin-producing Intrahepatic Cholangiocarcinoma: Value of Percutaneous Transhepatic Biliary Drainage and Cholangioscopy (1999)
    Springer
    World journal of surgery 23 (1999), S. 1038-1044 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Intrahepatic cholangiocarcinomas that secrete macroscopically excessive mucin into the biliary system are rare, and few of the previously reported cases have achieved a curative resection. We defined these tumors as “mucin-producing intrahepatic cholangiocarcinomas” and clarify the optimal preoperative and surgical management for them. Eleven patients with mucin-producing intrahepatic cholangiocarcinomas underwent surgical resection in our department. The clinical, radiologic, surgical, and pathologic findings were studied. The clinical presentation of the 11 patients included repeated abdominal pain, jaundice, and fever. Conventional cholangiographies, such as percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography, could not offer precise information about tumor location and extension because of abundant mucin in the biliary system. Using percutaneous transhepatic biliary drainage (PTBD) and percutaneous transhepatic cholangioscopy (PTCS), we were able to drain the mucin and determine precisely the cancer extension into intrahepatic segmental bile ducts. Based on these findings, various types of liver resection with or without extrahepatic bile duct resection were planned, and 10 patients obtained curative resection. The cumulative 5-year survival rate after curative resection was 78%. In patients with mucin-producing intrahepatic cholangiocarcinoma, PTBD and PTCS are important for evaluating the cancer extension. Rational surgery based on accurate preoperative diagnosis improved the prognosis of patients with this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900620
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  • 6
    Electronic Resource
    Electronic Resource
    Doppler analysis of hepatic blood flow predicts liver dysfunction after major hepatectomy (1994)
    Springer
    World journal of surgery 18 (1994), S. 143-149 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Chez 17 patients consécutifs ayant eu une résection hépatique majeure, dont neuf en même temps qu'une résection intestinale ou de la tête du pancréas, on a mesuré le débit sanguin de l'artère hépatique. Dans cette étude, les patients ont été classés en deux groupes selon leur taux de bilirubinémie: chez 7 patients (groupe A) la bilirubinémie était supérieure à 7 mg/dl pendant plus d'une semaine en période postopératoire, alors que chez 10 patients, elle ne l'était pas. Pendant deux semaines après la résection, la vitesse du flux hépatique veineux et l'indexe de résistance (IR) dans l'artère hépatique ont été mesurés de façon intermittente en utilisant un Doppleréchographie couleur. Le volume hépatique a été estimé selon les données de la tomodensitométrie. Des différences significatives concernant la vitesse du flux sanguin porte et de l'IR ont été notées entre les deux groupes à partir du troisième jour. Dans le groupe A, la vitesse du flux prote est devenue inférieure aux valeurs préopératoires alors que l'IR a dépassé 0.75. En revanche, la vitesse du flux porte était élevée alors que l'IR de l'artère hépatique était bas dans les résections du groupe B. Dans les deux groupes, l'IR était corrélé de façon significative avec le taux de bilirubine totale (r=0.74, p〈0.0001) et le taux de croissance du foie restant était proportionnel à la vitesse moyenne du flux porte postopératoire (r=0.70, p=0.016). Nous concluons que la mesure de la vitesse du flux porte et de l'IR de l'artère hépatique sont utiles pour prédire l'insuffisance hépatique postopératoire et la régénération hépatique après résection hépatique majeure.
    Abstract: Resumen Se investigó el flujo sanguíneo hepático postoperatorio en 17 pacientes consecutivos sometidos a resección hepática mayor; 9 de ellos tuvieron también resecciones combinadas del tracto gastrointestinal y/o la cabeza del páncreas. Los pacientes fueron clasificados en dos grupos según el nivel sérico postoperatorio de bilirrubina total: el grupo A quedó constituído por 7 pacientes con niveles 〉7 mg/dl por más de una semana postoperatoria, y el grupo B por 10 pacientes que no cumplieron tal criterio. En las dos semanas siguientes a la cirugía se hicieron determinaciones intermitentes, mediante ultrasonografia Doppler a color, de la velocidad del flujo sanguineo portal, del indice de resistencia (RI) de la arteria hepática, calculado a partir del cambio en las variaciones de la frecuencia de Doppler, y la velocidad del flujo venoso hepático. Se determinó el volumen hepático por tomografía computadorizada con el fin de proveer la restauración. Se hallaron diferencias significativas en la velocidad del flujo venoso portal y en el RI de la arteria hepática entre los dos grupos a partir del tercer día postoperatorio. En el grupo A la velocidad del flujo venoso portal descendió por debajo del valor preoperatorio y el RI de la arteria hepática ascendió por encima de 0.75. En contraste, el grupo B exhibió alta velocidad del flujo venoso portal y bajo RI de la arteria hepática. En ambos grupos el RI se correlacionó en forma significativa con el nivel sérico de bilirrubina total (r=0.74, p〈0.0001) y la rata de crecimiento del hígado remanente apareció proporcional al valor postoperatorio de la velocidad del flujo venoso portal (r=0.70, p=0.016). Nuestra conclusión es que la medición de la velocidad del flujo venoso portal y del RI de la arteria hepática pueden ser de utilidad en la predicción de disfunción hepática postoperatoria y de regeneración hepática luego de una resección hepática mayor.
    Notes: Abstract In 17 consecutive patients who underwent major hepatic resection, 9 of whom with combined resection of the gastrointestinal tract or the pancreatic head (or both), postoperative hepatic blood flow was investigated. In this study, the patients were classified into two groups according to their postoperative serum total bilirubin level: Group A comprised 7 patients with the level higher than 7 mg/dl for more than 1 week postoperatively, and group B comprised 10 patients who did not meet this criterion. For 2 weeks after surgery, the portal blood flow velocity, the hepatic artery resistive index (RI) calculated from the changes in Doppler frequency shifts, and the hepatic venous blood flow velocity were measured intermittently using color Doppler ultrasonography. Liver volume was assessed by computed tomography to provide the restoration. Significant differences in portal blood flow velocity and hepatic artery RI were noted between the two groups from the third postoperative day. In group A the portal blood flow velocity decreased below the preoperative value, and the hepatic artery RI increased above 0.75. In contrast, group B showed high portal blood flow velocity and low hepatic artery RI. In both groups the RI correlated significantly with the total bilirubin level (r=0.74; p〈0.0001), and the growth rate of the remnant liver was proportional to the mean postoperative portal blood flow velocity (r=0.70; p=0.016). We concluded that measurement of the portal blood flow velocity and hepatic artery RI can be useful for predicting postoperative liver dysfunction and liver regeneration after major hepatic resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00348207
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  • 7
    Electronic Resource
    Electronic Resource
    Patterns of Intestinal Motility Recovery during the Early Stage following Abdominal Surgery: Clinical and Manometric Study (1997)
    Springer
    World journal of surgery 21 (1997), S. 806-810 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate the pattern of recovery of intestinal motility using manometric and clinical assessment in the postoperative ileus following abdominal surgery. We reviewed the charts of 18 patients who underwent partial colectomy for colon cancer (group A, without vagotomy) and compared them to those of 15 patients who underwent gastrectomy with truncal vagotomy and reconstruction by the Billroth I technique (group B, with vagotomy). A three-lumen catheter was inserted via the nose into the proximal jejunum for drainage of intestinal fluids and to record intestinal motility at laparotomy. The first appearance of a burst activity following a silent period and a migrating motor complex (MMC) was at 3.8 hours (mean) and 16.4 hours, respectively, in group A, and at 2.5 and 14.3 hours, respectively, in group B. The first audible bowel sounds and the time of feeling abdominal fullness and passage of flatus was at 34.8, 47.5, and 62.9 hours (group A), and at 43.0, 53.8, and 77.9 hours (group B), respectively. The peak volume of nasointestinal drainage was recorded at 16 to 24 hours in group A and 40 to 48 hours in group B ( p 〈 0.05). As measured by manometric examination, an MMC reappeared within a few hours after surgery. Physiologic postoperative ileus was ended when MMCs extended throughout the gastrointestinal (GI) tract with forwarding GI fluids.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900310
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  • 8
    Electronic Resource
    Electronic Resource
    Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus (1990)
    Springer
    World journal of surgery 14 (1990), S. 535-543 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé De 1979 à 1989 la résection chirurgicale a été effectuée chez 55 des 66 patients ayant un cancer du hile hépatique après diminué l'ictère par drainage biliaire transhépatique percutané (DBTP). La cholangiographie sélective par DBTP a défini avec exactitude le site anatomique—l'étendue de l'obstruction dans chaque canal hépatique segmentaire intéressé. La cholangioscopie transhépatique percutanée a été pratiquée par le trajet du drainage après avoir remplacé le cathéter de drainage par un cathéter F15. On a réalisé ainsi une cholangiographie hypersélective et effectué des biopsies pour établir le diagnostic définitif, préciser l'étendue histologique de la tumeur et décéler toutes les variations anatomiques des canaux hépatiques segmentaires se jettant dans le hile. Pour 46 (69.7%) patients sur 66, la résection curative a été possible. Parmi eux, 45 ont eu différents types de segmentectomies hépatiques intéressant le lobe caudé avec un taux de morbidité de 41.3% et un taux de mortalité opératoire de 6.4%. Quatorze (31.1%) patients avec des lésions avancées ont eu à la fois résection de la veine porte et hépatectomie. L'envahissement histologique des branches caudales a été confirmé chez 44 des 45 patients qui ont eu une résection du lobe caudé. Le taux de survie à 3 ans pour les 43 patients survivants à l'excision curative était de 55.1% et le taux de survie à 5 ans était de 40.5%. Les 11 patients qui avaient une tumeur avancée non résécable sont morts dans les 9 mois. Le type de résection curative devrait être décidée d'après les données préopératoires sur l'étendue du cancer dans chaque canal hépatique; le traitment comporte la résection du lobe caudé associée à la plus petite segmentectomie hépatique nécessaire possible.
    Abstract: Resumen Entre 1979 y 1989 se realizó resección quirúrgica en 55 de 66 pacientes con carcinoma del hilio hepático después de mejorar la ictericia mediante el drenaje biliar percutáneo transhepático (DBPT). Se efectuó colangiografía selectiva a través del DBPT con el objeto de definir con precisión la ubicación anatómica, así como la extensión de la lesión obstructiva en los canales hepáticos segmentarios. Se realizó colangioscopia percutánea transhepática a través del tracto de la DBPT después de reemplazar el catéter de drenaje por un catéter French No. 15 para hacer colangiografía superselectiva y biopsia para establecer el diagnóstico definitivo de la extensión histológica del tumor, así como visualizar cualquiera variatión de los canales hepáticos segmentarios que vienen a unirse en el hilio hepático. En 46 (69.7%) de 66 pacientes fue posible la resección curativa. Cuarenta y cinco de éstos fueron sometidos a diferentes tipos de segmentectomía hepática con lobectomía caudada con una tasa de morbilidad de 41.3% y una tasa de mortalidad operatoria de 6.4%. Catorce (31.1%) casos avanzados fueron sometidos a resección combinada de la vena porta junto con la hepatectomía. Se confirmó invasión tumoral en las ramas caudadas en 44 de 45 pacientes en quienes se practicó resección del lóbulo caudado. La sobrevida de 3 años de los pacientes que sobrevivieron la resección curativa due 55.1% y la supervivencia a 5 años fue de 40.5%. Todos los 11 pacientes que exhibieron tumor avanzado no resecable murieron dentro de los primeros 9 meses. La resección curativa debe ser diseñada de acuerdo con los hallazgos preoperatorios relativos a la extensión del cáncer en cada conducto segmentario y la resección del lóbulo caudado debería ser efectuada junto con tan mínima segmentectomía hepática como sea posible.
    Notes: Abstract From 1979 through 1989, surgical resection was performed in 55 of 66 patients with carcinoma of the hepatic hilus after improving jaundice by percutaneous transhepatic biliary drainage (PTBD). Selective cholangiography through PTBD was done to define precisely the anatomical location—extent of the obstructing lesion in each segmental hepatic duct. Percutaneous transhepatic cholangioscopy was performed through the sinus tract of PTBD after replacing the drainage catheter with a 15 French catheter for superselective cholangiography and biopsy to make the definitive diagnosis of the histological extent of the tumor and any variation of each segmentai hepatic duct that joins the hepatic hilus. In 46 (69.7%) of 66 patients, curative resection was possible. Forty-five of these underwent various types of hepatic segmentectomy with caudate lobectomy for a morbidity rate of 41.3% and an operative mortality rate of 6.4%. Fourteen (31.1%) advanced cases underwent combined resection of the portal vein together with hepatectomy. Microscopic tumor involvement in the caudate branches was confirmed in 44 of 45 patients who underwent caudate lobe resection. The 3-year survival rate for all 43 patients surviving the curative excision was 55.1% and the 5-year survival rate was 40.5%. All 11 patients who had an unresectable advanced tumor died within 9 months. Curative resection should be designed according to the preoperative findings of the extent of cancer in each segmental duct, and caudate lobe resection should be performed together with the smallest necessary hepatic segmentectomy possible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01658686
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  • 9
    Electronic Resource
    Electronic Resource
    Clinicopathologic factors influencing survival of patients with bile duct carcinoma: Multivariate statistical analysis (1993)
    Springer
    World journal of surgery 17 (1993), S. 653-657 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Afin d'évaluer l'influence de facteurs clinicopathologiques sur la survie, on a analysé les résultats observés chez 70 patients ayant un cancer des voies biliaires. L'analyse monofactorielle a permis d'identifier 10 facteurs pronostiques influençant la survie: site de la tumeur primitive (p=0.01), envahissement du pancréas (p=0.005), envahissement du duodénum (p=0.005), envahissement vasculaire macro ou microscopique (p=0.009 et p=0.04, respectivement), envahissement périneural (p= 0.02), envahissement lymphatique (p=0.04), envahissement ganglionnaire (p=0.02), le type histologique (p=0.02) et la profondeur de l'envahissement (p=0.04). Par l'analyse multifactorielle selon la méthode pas à pas de Cox, les deux facteurs ayant la valeur pronostique la plus importante étaient l'envahissement pancréatique et périneural. Le sexe et l'âge du patient, la taille et l'aspect macroscopique de la tumeur, l'infiltration hépatique, l'envahissement de la séreuse, la marge de sécurité de la résection ainsi que les disséminations péritonéale et hépatique n'influencaient pas significativement le pronostic.
    Abstract: Resumen Con el propósito de evaluar el impacto de los diferentes factores clinicopatológicos sobre la supervivencia, se realizó un análisis computadorizado en 70 pacientes sometidos a resección por carcinoma de la vía biliar. El análisis univariable de la supervivencia global aplicado a la totalidad de los pacientes identificó diez factores asociados con un desenlace significativo: la ubicación de la lesión primaria (P=0.01), la invasión pancreática (P=0.05), la invasión duodenal (P=0.005), la invasión vascular tanto macroscópica como microscópica (P=0.009 y P =0.04), la invasión périneural (P=0.02), la invasión de vasos linfáticos (P=0.04), las metastasis a los ganglios linfáticos (P=0.02), el tipo histológico (P=0.02) y la profundidad de la invasión cancerosa (P=0.04). Sin embargo, al tomar en cuenta el efecto interactivo de tales factores, se seleccionaron la invasión pancreática y la invasión périneural como los dos principales factores de pronóstico en un análisis multivariable utilizando el modelo de Cox de riesgos proporcionales escalonados. En tanto que la edad, sexo, tamaño del tumor, tipo macroscópico de la lesión, infiltración hepática, invasión de la serosa, márgenes de resección, diseminación peritoneal y metastasis hepáticas no resultaron asociadas con el pronóstico en forma significativa.
    Notes: Abstract To evaluate the influence of various clinicopathologic factors on survival, a computer analysis was performed on 70 patients who underwent resection for bile duct carcinoma. Univariate analysis of overall survival involving all the patients identified 10 factors that were associated with a significant outcome: location of primary lesion (p=0.01), pancreatic invasion (p=0.004), duodenal invasion (p=0.005), macroscopic and microscopic vascular involvement (tp=0.009 andp=0.04), perineural invasion (p=0.02), lymphatic vessel involvement (p=0.04), lymph node metastasis (p=0.02), histologictype (p=0.02), and depth of cancer invasion (p=0.04). However, when the interactive effects of these factors were taken into account, the pancreatic invasion and perineural invasion were selected as the two most significant prognostic factors in a multivariate analysis using the Cox stepwise proportional hazards model. The age, sex, size of the tumor, macroscopic type of lesions, hepatic infiltration, serosal invasion, resected surgical margin at the proximal and distal ends, exposed surgical margin, peritoneal dissemination, and hepatic metastasis were not significantly associated with prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01659134
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  • 10
    Electronic Resource
    Electronic Resource
    Percutaneous transhepatic portal embolization using newly devised catheters: Preliminary report (1993)
    Springer
    World journal of surgery 17 (1993), S. 520-523 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé On présente deux types de cathéter à ballonnet, de 5.5 F, destinés à améliorer l'embolisation porte préopératoire par voie percutanée transhépatique, en vue d'une résection hépatique étendue. Avec ces cathéters, on peut aborder le foie homolatéral à l'embolisation et Femboliser avec une colle à base de fibrine mélangée à du lipiodol. Cette approche semble plus sûre et fiable que l'approche traditionnelle controlatérale, pour les raisons suivantes: ponction du lobe hépatique et du système porte à réséquer, possibilité d'embolisation simultanée des branches portes antérieures, gauche et droite avec une seule ponction et possibilité d'enlever rapidement la gaine du cathéter après l'embolisation.
    Abstract: Resumen Dos diferentes catéteres de balón de triple lumen fueron diseñados para mejorar la embolización portal transhepática percutánea como manejo postoperatorio en pacientes sometidos a resecciones hepáticas extensas. Con estos catéteres se logra un aproche ipsilateral para la embolización a través de una rama portal del hígado utilizando pegante de fibrina mezclado con Lipiodol como material embólico. Este aproche, que ha demonstrado ser más seguro y confiable que el aproche contralateral tradicional, se realiza así: primero, se punciona la rama portal que va a ser resecada; segundo, se practica la embolización portal anterior izquierda y derecha simultáneamente a través de punción portal única; tercero, la vaina del catéter puede ser removida sin que sea necesario tratamiento adicional alguno.
    Notes: Abstract Two 5.5 French triple-lumen balloon catheters were devised to improve percutaneous transhepatic portal embolization (PTPE) as preoperative management of patients undergoing extensive liver resection. Using these catheters, an ipsilateral approach for embolization is achieved through a portal branch of the liver using fibrin glue mixed with Lipiodol as the embolic material. This approach proved safer and more reliable than the traditional contralateral approach: (1) The portal branch to be resected is punctured; (2) the left and right anterior portal embolization is conducted simultaneously through a single portal puncture; and (3) the catheter sheath can consequentially be removed soon after PTPE without requiring further treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01655112
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