Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 92
Filtrar
Mais filtros

Bases de dados
País/Região como assunto
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Rhinology ; 61(6): 552-560, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37690065

RESUMO

BACKGROUND: Olfactory dysfunctions (OD) and taste dysfunctions (TD) are widely recognized as characteristic symptoms of COVID-19; however, the frequency and mode of occurrence has varied depending on the viral mutation. The prevalence and characteristics of OD/TD in Japan have not been definitively investigated. The purpose of this study is to assess the prevalence of OD/TD in Japan during the Alpha variant epidemic, and measure symptom prolongation at 6 months and 1 year later following initial infection. METHODS: Patients treated for COVID-19 between February to May 2021 were evaluated for OD/TD symptoms and provided with a QOL questionnaire. Olfactory tests and taste tests were performed using Open Essence and Taste Strips, respectively. RESULTS: Among the 251 COVID-19 patients who participated, 119 underwent both olfactory and taste tests. Prevalence of subjective OD and TD at the time of survey was 57.8% and 40.2%, respectively. After 12 months, the prevalence fell to 5.8% for OD and 3.5% for TD. Among the OD/TD patients, 36.6% experienced parosmia, and 55.4% experienced parageusia. Prevalence of parosmia and parageusia was higher at 6 and 12 months than at the time of survey. Patients with long-lasting disease reported qualitative dysfunctions and scored significantly higher in food-related QOL problems. Most patients who were aware of their hyposmia had low scores on the olfactory test (83.1%). In contrast, only 26.7% of patients who were aware of their hypogeusia had low scores on the taste test. CONCLUSIONS: The prevalence of COVID-19-related OD and TD at the time of survey was 57.8% and 40.2%, respectively. Subjective symptoms of OD and TD persisted for one year in 5.8% and 3.5% of patients, respectively. More than half of the patients with OD or TD complained of qualitative dysfunction and a decrease in their QOL related to eating and drinking. Most patients with TD did not have true TD, but rather developed flavour disorders associated with OD. This conclusion is supported by the finding that patients with subjective OD had low scores on the olfactory test, whereas most patients with subjective TD had normal scores on the taste test.


Assuntos
COVID-19 , Transtornos do Olfato , Humanos , COVID-19/complicações , SARS-CoV-2 , Paladar , Disgeusia , Qualidade de Vida , Olfato , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/etiologia , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , Transtornos do Olfato/diagnóstico
2.
Faraday Discuss ; 189: 291-315, 2016 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-27112235

RESUMO

A detailed source apportionment of size-resolved aerosol particles in the area of Leipzig, Germany, was performed. Sampling took place at four sites (traffic, traffic/residential, urban background, regional background) in parallel during summer 2013 and the winters 2013/14/15. Twenty-one samples were taken per season with a 5-stage Berner impactor and analysed for particulate mass, inorganic ions, organic and elemental carbon, water-soluble organic carbon, trace metals, and a wide range of organic species. The compositional data were used to estimate source contributions to particulate matter (PM) in quasi-ultrafine (up to 140 nm), accumulation mode, and coarse size ranges using Positive Matrix Factorisation (PMF) receptor modelling. Traffic (exhaust and general traffic emissions), coal combustion, biomass combustion, photochemistry, general secondary formation, cooking, fungal spores, urban dust, fresh sea/road salt, and aged sea salt were all found to contribute to different extents to observed PM concentrations. PMF derived estimates agreed reasonably with estimates from established macrotracer approaches. Quasi-ultrafine PM originated mainly from traffic (20-50%) and photochemistry (30-50%) in summer, while it was dominated by solid fuel (mainly biomass) combustion in winter (50-70%). Tentatively identified cooking aerosol contributed up to 36% on average at the residential site. For accumulation mode particles, two secondary sources typically contributed 40-90% to particle mass. In winter, biomass and coal combustion contributions were up to ca. 25% and 45%, respectively. Main sources of coarse particles were diverse and included nearly all PMF-resolved ones depending on season and air mass origin. For PM10, traffic (typically 20-40% at kerbside sites), secondary formation (30-60%), biomass combustion (10-15% in winter), and coal combustion (30-40% in winter with eastern air mass inflow) were the main quantified sources. At the residential site, contributions from biomass combustion derived up to 60% from local emissions. Coal combustion as a significant source was only present during eastern air mass inflow and showed very similar concentrations at all sites, indicating the importance of trans-boundary air pollution transport in the study area. Overall, nearly half of the PM10 mass was attributed to urban sources by a simple subtractive approach with highest reduction potentials of up to 80% for local (urban) mitigation measures in ultrafine and coarse particles. Local increments of elemental carbon have decreased by about 50% as compared to the year 2000, corroborating results from a former study on the positive effects of a low emission zone, implemented in Leipzig in 2011.

3.
J Appl Microbiol ; 120(2): 487-97, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26642191

RESUMO

AIMS: Molecular epidemiological techniques, such as pulsed-field gel electrophoresis (PFGE), or multilocus sequence typing (MLST) have facilitated our understanding of the transmission routes of nosocomial infections by Pseudomonas aeruginosa. However, they are time consuming and technically demanding. To perform molecular epidemiological analysis in a standard microbiology laboratory, we aimed to develop a simpler and effective molecular epidemiological technique based on the open-reading frame (ORF) distribution patterns detected by PCR, which we call PCR-based ORF typing (POT). METHODS AND RESULTS: Ten ORFs from genomic islets, five ORFs from genomic islands, and the metallo-ß-lactamases (MBLs) blaIMP and blaVIM were selected by comparing the whole-genome sequences of different Ps. aeruginosa strains (PAO1, PA7, UCBPP-PA14 and LESB58). These 17 ORFs were detected, along with a Ps. aeruginosa marker, using 9-plex and 10-plex PCR systems. The genotypes in the POT were compared to those obtained by using PFGE and MLST. CONCLUSIONS: Using the POT method, molecular epidemiological analyses of Ps. aeruginosa can be completed in 4 h. SIGNIFICANCE AND IMPACT OF THE STUDY: Since this method is very easy to perform, even in standard clinical laboratories, it could be a valuable tool for monitoring daily infection control measures.


Assuntos
Infecção Hospitalar/microbiologia , Epidemiologia Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Proteínas de Bactérias/genética , Infecção Hospitalar/epidemiologia , Ilhas Genômicas , Genótipo , Humanos , Dados de Sequência Molecular , Fases de Leitura Aberta , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/genética , beta-Lactamases/genética
4.
Eur J Clin Microbiol Infect Dis ; 31(6): 1095-100, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21968723

RESUMO

The purpose of this investigation was to control the post-outbreak prevalence of vancomycin-resistant enterococci (VRE) in the affected Kyoto region. The study period was from 2005 to 2010. Faecal samples were subjected to VRE screening, and vancomycin resistance genes were detected by polymerase chain reaction (PCR). The genotype was determined by pulsed-field gel electrophoresis (PFGE) of genomic DNA digested with SmaI and by multilocus sequence typing (MLST). A VRE control programme was established in 2006, consisting of a laboratory-based faecal VRE screening system, annual surveillance of hospital inpatients and the promotion of adequate infection control measures. vanA-Enterococcus faecium, vanB-E. faecium and vanB-E. faecalis were detected at 35, 12 and 5 hospitals, respectively. Genotype analysis revealed that all of the vancomycin-resistant E. faecium isolates obtained since 2005 belonged to ST78, and that clonally related vanB-E. faecalis of ST64 had spread to three hospitals. The rate of faecal VRE carriage among the patients enrolled in the annual surveillance increased until 2007, when it reached 24 (1.2%) of the 2,035 enrolled patients. The rate began to decrease in 2008 and, by 2010, reached a low of 4 (0.17%) of the 2,408 enrolled patients. While VRE did spread within the Kyoto region, the VRE control programme succeeded in controlling the overall VRE spread.


Assuntos
Infecção Hospitalar/epidemiologia , Enterococcus faecalis/isolamento & purificação , Enterococcus faecium/isolamento & purificação , Infecções por Bactérias Gram-Positivas/epidemiologia , Controle de Infecções/métodos , Resistência a Vancomicina , Antibacterianos/farmacologia , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Infecção Hospitalar/microbiologia , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecium/efeitos dos fármacos , Fezes/microbiologia , Genótipo , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Japão/epidemiologia , Testes de Sensibilidade Microbiana/métodos , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Reação em Cadeia da Polimerase/métodos , Vancomicina/farmacologia
5.
Lupus ; 20(8): 792-800, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21562022

RESUMO

Our aim was to analyze the performance of an interferon-gamma release assay, QuantiFERON-TB Gold (QFT-2G), for diagnosing Mycobacterium tuberculosis (MTB) infection in patients with systemic lupus erythematosus (SLE). We performed the QFT-2G and tuberculin skin test (TST) in 71 SLE patients. The QFT-2G results of 279 patients with other connective tissue diseases (CTD) and 35 healthy controls were analyzed. Of the 71 SLE patients, two (2.8%) were positive and 46 (64.8%) were negative by QFT-2G. All SLE patients had no evidence of active MTB infection, apart from one. QFT-2G produced a significantly higher number of indeterminate results in patients with SLE (23/71, 32.4%) compared with those with other CTD (5.7%) or healthy controls (0%) (p < 0.0001 and p < 0.0001). Decreased lymphocyte counts and high SLEDAI scores in SLE patients were shown to be risk factors for indeterminate results by multivariate analysis (p = 0.02 and p = 0.04). Among all patients with CTD, SLE itself and lymphocytopenia were found to be independent risks for indeterminate results (p = 0.00000625 and p = 0.000107). In conclusion, QFT-2G may have more potential to assist in the diagnosis of active and latent MTB infection than TST in SLE patients. However, because of the high frequency of indeterminate results, caution must be used when interpreting the results of QFT-2G among SLE patients, especially those who have parallel or subsequent flares.


Assuntos
Interferon gama/imunologia , Interferon gama/metabolismo , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/microbiologia , Mycobacterium tuberculosis/imunologia , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Tuberculose/imunologia , Adulto Jovem
6.
Epidemiol Infect ; 139(3): 430-6, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20513252

RESUMO

Following an outbreak of vanA-positive Enterococcus faecium in 2005 in Kyoto prefecture, regional surveillance of vancomycin-resistant enterococci (VRE) was initiated. This revealed vanA- or vanB-positive Enterococcus gallinarum in multiple facilities. Eighty-eight vanA-positive E. gallinarum faecal carriers from 12 facilities and ten vanB-positive E. gallinarum faecal carriers from eight facilities were found. Pulsed-field gel electrophoresis profiles of the first isolate from each facility showed that 11 of the 12 vanA isolates and three of the eight vanB-positive E. gallinarum isolates belonged to a single clone. This study confirms the clonal spread of vanA- or vanB-positive E. gallinarum in a region and underlines the importance of surveillance of VRE for the presence of vancomycin resistance determinants.


Assuntos
Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases/genética , Portador Sadio/epidemiologia , Infecção Hospitalar/epidemiologia , Enterococcus/genética , Infecções por Bactérias Gram-Positivas/epidemiologia , Resistência a Vancomicina , Técnicas de Tipagem Bacteriana , Portador Sadio/microbiologia , Análise por Conglomerados , Infecção Hospitalar/microbiologia , Eletroforese em Gel de Campo Pulsado , Enterococcus/efeitos dos fármacos , Enterococcus/isolamento & purificação , Fezes/microbiologia , Genótipo , Infecções por Bactérias Gram-Positivas/microbiologia , Hospitais , Humanos , Japão/epidemiologia , Assistência de Longa Duração , Epidemiologia Molecular , Tipagem Molecular , Casas de Saúde
7.
Clin Exp Obstet Gynecol ; 37(3): 226-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21077531

RESUMO

BACKGROUND: Toxic shock syndrome caused by group A streptococci (GAS) is rare around the time of delivery, but it may predispose pregnant women to a life-threatening condition. CASE: A 32-year-old primigravida at 21 weeks of gestation was taken to our hospital with acute severe abdominal pain following fever. On admission the fetus was found to be dead, and intrauterine fetal demise due to placental abruption was suspected. An emergency cesarean section found no sign of placental abruption. Soon after the surgery, the patient went into shock but was successfully treated with intensive care. Although repeated blood cultures failed to detect microorganisms, the patient was positive for streptococcal pyrogenic toxin A, which is a superantigen of GAS. CONCLUSION: Once GAS infection is suspected, regardless of negative blood cultures, supportive care in the intensive care unit is mandatory.


Assuntos
Morte Fetal/microbiologia , Complicações Infecciosas na Gravidez/diagnóstico , Choque Séptico/diagnóstico , Infecções Estreptocócicas/diagnóstico , Adulto , Feminino , Humanos , Gravidez , Streptococcus pyogenes
8.
Aliment Pharmacol Ther ; 20 Suppl 1: 39-47, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15298604

RESUMO

BACKGROUND: Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents. AIM: We aimed to study differences between H. pylori strains isolated before and after eradication failure. METHODS: We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed-field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method. RESULTS: Eradication therapy failed in 12 patients (14%); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole-sensitive to -resistant, one changed from clarithromycin- and metronidazole-sensitive to -resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin- and metronidazole-sensitive to -resistant. CONCLUSION: Eradication of H. pylori by first-line therapy is an important goal in the treatment of H. pylori-positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.


Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Infecções por Helicobacter/genética , Helicobacter pylori/genética , Adulto , Amoxicilina/uso terapêutico , Antiulcerosos/uso terapêutico , Claritromicina/uso terapêutico , Impressões Digitais de DNA/métodos , DNA Bacteriano/análise , Quimioterapia Combinada/uso terapêutico , Eletroforese em Gel de Campo Pulsado/métodos , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Omeprazol/uso terapêutico , Reação em Cadeia da Polimerase/métodos , Resultado do Tratamento
9.
J Smooth Muscle Res ; 36(2): 57-67, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10983593

RESUMO

We searched the effect of the muscular valve on the management of short bowel syndrome. The motility of the remnant intestine with a special muscular valve after 80% massive distal small bowel resection (MSBR) was evaluated in conscious dogs. The valve (muscular ring) was made by the autointestinal muscle layer holding vascular pedicle. Interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gauge force transducers 2-4 weeks after the surgery, and data of this group (Group I) were compared to the motility in dogs after MSBR without valve construction (Group II) and in controls (Control). Results; Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) in Group I occurred at longer intervals than in Control and almost similarly to those in Group II. MMCs arising from the duodenum were often interrupted before the jejunum above the valve and the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment including that from the duodenum to the proximal jejunum, and to the jejunum above the anastomosis. Transit time in MSBR group (I and II) from the duodenum to the terminal ileum was extremely shorter than in Control, but there were no differences between in Groups I and II. The duration of the postprandial period without duodenal MMCs in Group I was significantly prolonged than in Control, but was shorter than that in Group II. The muscular valve was frequently activated, and the jejunum covered with the valve was contracted frequently which synchronized with the valve activity. It seemed the valve worked as sphincter. However, intestinal obstruction was not occurred through the jejunum covered by the valve. In conclusion, changes in gut motility after MSBR with the valve construction compensate for the shortened intestine and maintain the bowel content earlier postoperatively in comparison with the MSBR alone, and also contribute to the adaptive increase in the remnant intestinal absorption.


Assuntos
Motilidade Gastrointestinal/fisiologia , Intestino Delgado/fisiologia , Músculo Liso/fisiologia , Animais , Cães , Intestino Delgado/patologia , Contração Muscular/fisiologia
10.
J Smooth Muscle Res ; 36(4): 117-26, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11286295

RESUMO

Effects of trimebutine maleate (TM) on intestinal motility in short bowel syndrome (SBS) were studied in conscious canines in both acute and chronic phases following 80% massive distal small bowel resection (MSBR). TM was administered orally to beagles with MSBR or as controls in the postprandial and fasting states, and given simultaneously with meals. Intestinal motility was measured using bipolar electrodes for approximately 1 month after the electrodes were implanted in each beagle and the data compared between treatment groups. When TM was given with meals, the postprandial period without duodenal migrating myoelectric (or motor) complexes (MMCs) was shorter than in those given meals only. When TM was given in the postprandial state in short bowel beagles, the initial duodenal MMCs occurred earlier, i.e. the postprandial period was shorter. Diarrhea did not occur in these beagles. When TM was given in the fasting state, duodenal MMCs occurred and propagated to the distal intestine. In conclusion, oral TM administration can produce a more appropriate intestinal condition for the next food intake and make enteral nutrition possible even in the acute phase after MSBR. Such feeding can be carried out without overloading gut function as a result of the modulation of gastrointestinal motility by TM.


Assuntos
Motilidade Gastrointestinal/efeitos dos fármacos , Trimebutina/farmacologia , Anastomose Cirúrgica , Animais , Modelos Animais de Doenças , Cães , Duodeno/efeitos dos fármacos , Duodeno/inervação , Duodeno/fisiologia , Jejum , Fármacos Gastrointestinais/farmacologia , Íleo/efeitos dos fármacos , Íleo/fisiologia , Jejuno/efeitos dos fármacos , Jejuno/fisiologia , Jejuno/cirurgia , Complexo Mioelétrico Migratório/fisiologia , Período Pós-Prandial , Valores de Referência , Síndrome do Intestino Curto/fisiopatologia
11.
J Infect ; 46(4): 215-20, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12799146

RESUMO

OBJECTIVES: To study whether NRAMP1 gene polymorphisms in a Japanese population affect susceptibility to tuberculosis and clinical features of tuberculosis. METHODS: Polymerase chain reaction and restriction fragment-length polymorphism analyses were used to type NRAMP1 polymorphisms in 95 patients with pulmonary tuberculosis and 90 controls. Clinical features of patients also were investigated. RESULTS: No association was seen between susceptibility to tuberculosis and NRAMP1 polymorphisms. Patients with the D543N A allele were significantly more likely than others to develop a cavitary lesion; by logistic regression analysis with adjustment for gender, age, and presence of diabetes, the odds ratio in patients with an A allele was 5.16 (95% confidence interval, 1.30-20.45). CONCLUSIONS: Genetic variation in the human NRAMP1 gene may be associated with cavitation in patients with tuberculosis.


Assuntos
Proteínas de Transporte de Cátions/genética , Polimorfismo Genético , Tuberculose Pulmonar/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Variação Genética , Genótipo , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Fatores de Risco
12.
Talanta ; 28(8): 551-6, 1981 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18962956

RESUMO

The sorption behaviour of several metal ions on five kinds of poly(4- or 2-vinylpyridine) resins, cross-linked with divinylbenzene, and with different surface properties, are examined. All the resins proposed sorb some metal ions effectively in a similar manner by anion-exchange, while the sorption of metal ions by complex formation with the pyridine moiety is strongly affected by the surface properties of the resins. A macroreticular poly(4-vinylpyridine) resin shows high affinity for copper and nickel ions in acetate buffer. Sodium chloride and/or methanol added to the working solutions influence the sorption capacities for metal ions. This resin was applied to the separation of copper/cobalt and nickel/cobalt and the concentration of copper from sea-water by a column operation.

13.
J Pediatr Surg ; 29(10): 1335-8, 1994 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7807320

RESUMO

To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Intestino Delgado/fisiologia , Jejuno/cirurgia , Complexo Mioelétrico Migratório , Peristaltismo , Anastomose Cirúrgica , Animais , Cães , Motilidade Gastrointestinal , Intestino Delgado/cirurgia , Jejuno/fisiologia
14.
J Pediatr Surg ; 26(7): 834-7, 1991 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1895194

RESUMO

Flow cytometric DNA content analyses were performed on samples of 54 patients with neuroblastoma. DNA aneuploidy was detected in 55.6% of the 54 patients. A high incidence of DNA aneuploidy was observed in patients with prognostically favorable variables such as age (less than 1 year), clinical stage (I, II, or IVs), and primary site (extraadrenal sites). DNA aneuploidy was predominant in surviving patients, even in those with unfavorable variables. In patients 1 year old or more, the survival rate among those with DNA aneuploidy was 58.8% compared with 28.6% in patients with diploidy. Likewise, in patients with advanced stage (III or IV) neuroblastoma, the survival rate among those with DNA aneuploidy was 63.2% compared with 30.4% in patients with DNA diploidy. It is concluded that DNA content analysis is of value in predicting the prognosis of patients with neuroblastoma.


Assuntos
Neoplasias das Glândulas Suprarrenais/genética , Aneuploidia , DNA de Neoplasias/análise , Diploide , Ganglioneuroma/genética , Neuroblastoma/genética , Neoplasias das Glândulas Suprarrenais/mortalidade , Neoplasias das Glândulas Suprarrenais/patologia , Criança , Pré-Escolar , DNA de Neoplasias/genética , Citometria de Fluxo , Ganglioneuroma/mortalidade , Ganglioneuroma/patologia , Humanos , Lactente , Estadiamento de Neoplasias , Neuroblastoma/mortalidade , Neuroblastoma/patologia , Prognóstico
15.
J Pediatr Surg ; 27(6): 686-90, 1992 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1501023

RESUMO

To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.


Assuntos
Motilidade Gastrointestinal/fisiologia , Intestino Delgado/fisiologia , Jejuno/cirurgia , Anastomose Cirúrgica , Animais , Cães , Duodeno/fisiologia , Duodeno/cirurgia , Eletrodos Implantados , Eletromiografia , Intestino Delgado/cirurgia , Jejuno/fisiologia , Contração Muscular , Complexo Mioelétrico Migratório
16.
J Pediatr Surg ; 35(4): 545-9, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10770378

RESUMO

BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) was assessed in the diagnosis of cholestatic liver disease in infants. METHODS: ERCP was performed in 50 infants who had prolonged cholestasis. Their ages ranged from 25 to 274 days (mean, 69 days), and their weight ranged from 2.6 to 6.7 kg (mean, 4.7 kg). Incomplete visualization of the biliary tree or visualization of only the pancreatic duct was followed by exploratory laparotomy. In those in whom the biliary tree was visualized completely, the caliber of the bile duct was compared with that of the pancreatic duct. RESULTS: ERCP was completed in 43 patients (success rate, 86%) without complications. In the 7 patients in whom ERCP failed, 6 had biliary atresia (BA) diagnosed by exploratory laparotomy. The other patient had congenital biliary dilatation (CBD). In 29 of the 43 patients, the biliary tree was seen partially or only the pancreatic duct was visualized. These patients had BA diagnosed by laparotomy. Complete visualization of the biliary tree was obtained in 14 patients. Of these, 9 had neonatal hepatitis (NH), 2 had a paucity of intrahepatic bile ducts (PIBLD), and 3 had CBD. In all of the patients with NH, cholestasis improved spontaneously. The 2 patients with PIBLD had biopsy-proven disease. The caliber of the bile duct was larger than that of the pancreatic duct in NH. This relationship was not observed in PIBLD. CONCLUSIONS: ERCP is safe in infants. It is useful in the diagnosis of prolonged cholestasis.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Colestase/diagnóstico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Ductos Pancreáticos/diagnóstico por imagem
17.
Nagoya J Med Sci ; 63(3-4): 123-8, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11201986

RESUMO

An 8-year-old girl died of sepsis due to staphylococcal infection one year and 8 months after Bacille Calmette-Guerin (BCG) revaccination. Two months after the vaccination in accordance with the school health program, she was hospitalized with a high fever, skin rash over the face and lower limbs, and leukopenia. Her clinical and laboratory pictures were not compatible with those of any established type of immunodeficiency. The polymerase chain reaction (PCR) test for M. tuberculosis complex was positive for bone marrow, pleural fluid, and peripheral blood. The strain recovered from a mycobacterial culture of the blood was identical to the BCG strains with which the patient was vaccinated, based on restriction fragment length polymorphism (RFLP) and a pulse-field gel electrophoresis (PFGE) analyses of DNA. She developed finally a lung abscess due to staphylococcal septicemia, which was the direct cause of her death.


Assuntos
Vacina BCG/efeitos adversos , Mycobacterium bovis , Tuberculose/etiologia , Criança , Evolução Fatal , Feminino , Humanos , Mycobacterium bovis/genética , Mycobacterium bovis/isolamento & purificação , Mycobacterium bovis/patogenicidade , Sepse/etiologia , Infecções Estafilocócicas/etiologia
18.
Eur J Pediatr Surg ; 9(3): 142-5, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10427488

RESUMO

Our results of treatment for pediatric hepatoblastoma are presented with special emphasis on pulmonary metastasis. The pulmonary metastasis rate of hepatoblastoma was 44% (11/25). In 19 patients with resected hepatoblastomas, the 5-year survival rate without pulmonary metastasis was 90% (9/10); while with pulmonary metastasis it was 22% (2/9). Six patients with unresected hepatoblastomas all died within 4 months regardless of chemotherapy and/or metastasis. To improve survival in patients with hepatoblastoma, preoperative or postoperative chemotherapy was thought to be essential for tumors extending over 2 hepatic segments and having predictable factors for pulmonary metastasis (large size or histological evidence of capsular invasion). A long-term multidisciplinary approach including hepatic lobectomy, current multiagent chemotherapy (including CDDP, THP-ADR), and partial pulmonary resection for localized lung areas with metastases would ultimately be needed.


Assuntos
Hepatoblastoma/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Criança , Pré-Escolar , Terapia Combinada , Feminino , Hepatoblastoma/tratamento farmacológico , Hepatoblastoma/mortalidade , Hepatoblastoma/cirurgia , Humanos , Lactente , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Masculino , Equipe de Assistência ao Paciente , Pneumonectomia , Taxa de Sobrevida
19.
Eur J Pediatr Surg ; 9(3): 158-62, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10427491

RESUMO

A series of 19 cases of sacrococcygeal teratoma (SCT) with follow-up of 5 to 25 years is presented. Twelve patients were neonates, age 0 to 26 days (5 immature teratomas and 7 mature teratomas, representing 3, 6, 2, and 1 Altman's type I, II, III, and IV tumors, respectively), four were infants, age 1 to 6 months (all mature teratomas, representing 1, 1, and 2 Altman's type I, II, and IV tumors), and 3 were children, age 1 to 4 years (all malignant teratomas, all Altman's IV tumors). Eight babies were delivered by elective caesarean section (CS). Though the mean gestational age at CS was 34.3 weeks in our series, we now believe that CS often must be performed earlier, depending on a tumor size or fetal condition. Eleven neonates and 4 infants were operated upon using a sacral approach in 10 and an abdominosacral approach in 5, and all survived. However, 4 patients had neurogenic bladder and were treated by urinary catheterization or vesicostomy for 2 to 5 years after surgery. Postoperative urogenital sequelae are seen in patients with a large tumor, urethral compression, urinary retention, or edema of the lower body. Malignant tumors usually had metastasized by the time of diagnosis, but the prognosis for outcome has been improved following surgery and combination chemotherapy.


Assuntos
Cóccix/cirurgia , Sacro/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Teratoma/cirurgia , Adolescente , Adulto , Cesárea , Quimioterapia Adjuvante , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias/etiologia , Neoplasias da Coluna Vertebral/tratamento farmacológico , Neoplasias da Coluna Vertebral/patologia , Teratoma/tratamento farmacológico , Teratoma/patologia , Resultado do Tratamento
20.
J Vet Med Sci ; 63(1): 31-5, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11217059

RESUMO

Spermatogenesis and acrosomal formation in the greater Japanese shrew mole, Urotrichus talpoides, were studied by light microscopy. On the basis of acrosomal changes, morphology of spermatid head, nuclear shape, appearance of meiotic figures, location of spermatid and period of spermiation, the cycle of the seminiferous epithelium was classified into 12 stages, and developing spermatids could be divided into 15 steps. The mean relative frequencies of stages from I to XII were 10.9, 8.7, 9.8, 7.3, 8.5, 10.3, 12.5, 8.7, 5.8, 5.4, 5.1 and 7.1%, respectively. Similar to the case in the musk shrew, the spermatid nucleus of the greater Japanese shrew mole remained in the middle region of the seminiferous epithelium and only the acrosome extended towards the basement membrane. The elongation of the acrosome, however, was not prominent. The proacrosomal vesicle first appeared in stage II and then one large and round granule was seen in stage III. The acrosomal vesicle became flattened on the surface of the nucleus in stage IV. Spreading of the acrosomic system has been recognized from stage VII. In stage VII, spermiation occurred. In stage IX, the spermatid nucleus began to elongate. Elongation and condensation of the nucleus were clearly observed in stage X. In stage XII, pachytene spermatocytes divided into diplotene spermatocytes. In stage XII, meiotic figures and secondary spermatocytes were observed.


Assuntos
Toupeiras/fisiologia , Túbulos Seminíferos/citologia , Túbulos Seminíferos/fisiologia , Espermatogênese , Espermatozoides/fisiologia , Acrossomo/ultraestrutura , Animais , Núcleo Celular/ultraestrutura , Células Epiteliais/citologia , Células Epiteliais/fisiologia , Masculino , Especificidade da Espécie , Espermátides/citologia , Espermátides/fisiologia , Espermatozoides/citologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA