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1.
J Fish Dis ; 41(7): 1077-1092, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29542825

RESUMEN

The effect of dietary ß-glucan on the bacterial community in the gut of common carp (Cyprinus carpio) was examined after oral application of Aeromonas hydrophila. Carp received either feed supplemented with 1% MacroGard® , a ß-1,3/1,6-glucan, or a ß-glucan-free diet. Fourteen days after feeding, half of the carp from each group were intubated with 109 colony-forming units (CFU) of a pathogenic strain of A. hydrophila. Gut samples were taken 12 hr to 7 days after application and analysed using microbiological and molecular biological techniques (NGS, RT-PCR-DGGE). The reaction of the mucosa and the microbiota to an A. hydrophila intubation differed in carp fed with ß-glucan compared to carp from the control group. In ß-glucan fed carp, the total bacterial amount was lower but the number of bacterial species was higher. Bacterial composition was different for carp from both treatment groups. The number of mucin filled goblet cells was reduced in carp fed the ß-glucan diet. Mucus was obviously released from the goblet cells and was probably washed out of the gut together with high numbers of bacteria. This might be protective against pathogenic bacteria and, therefore, feeding with ß-glucan may provide protection against infections of the gut in carp.


Asunto(s)
Carpas/inmunología , Carpas/microbiología , Enfermedades de los Peces/inmunología , Microbioma Gastrointestinal/efectos de los fármacos , Glucanos/metabolismo , Mucosa Intestinal/inmunología , Aeromonas hydrophila/fisiología , Alimentación Animal/análisis , Animales , Carpas/metabolismo , Dieta/veterinaria , Suplementos Dietéticos/análisis , Glucanos/administración & dosificación , Infecciones por Bacterias Gramnegativas/inmunología
4.
J Fish Dis ; 41(3): 463-468, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29064105

RESUMEN

Hungary is an important carp producer with intensive trading relationships with farms in other carp-producing areas in Europe. Carp in Europe were recently found infected with carp edema virus (CEV), a poxvirus which causes the koi sleepy disease (KSD) syndrome. Moribund carp were collected from 17 fish farms and angling ponds in different regions of Hungary. Histological analysis of gills from these carp revealed a proliferation of the interlamellar epithelium and an infiltration by eosinophilic cells. In 13 of 17 of these carp, CEV DNA was detected by qPCR and in seven fish more than 1 × 104 copies of virus-specific DNA sequences per 250 ng of DNA, which could be considered as clinically relevant and a cause of disease. A phylogenetic analysis of the sequences revealed that all three genogroups of CEV were present in Hungarian common carp with genogroup I being most abundant. These results support the hypothesis of a prolonged presence of CEV in European carp populations and suggest that previous outbreaks of KSD were not recorded or misdiagnosed. Hence, a testing of carp and koi for infection with CEV should be included into disease surveillance programmes to prevent further spreading of this disease.


Asunto(s)
Carpas , Enfermedades de los Peces/patología , Infecciones por Poxviridae/veterinaria , Poxviridae/fisiología , Animales , ADN Viral/análisis , Enfermedades de los Peces/virología , Genotipo , Hungría , Filogenia , Poxviridae/genética , Infecciones por Poxviridae/patología , Infecciones por Poxviridae/virología , Análisis de Secuencia de ADN
5.
Dis Aquat Organ ; 126(2): 155-166, 2017 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-29044045

RESUMEN

Carp edema virus disease (CEVD), also known as koi sleepy disease, is caused by a poxvirus associated with outbreaks of clinical disease in koi and common carp Cyprinus carpio. Originally characterised in Japan in the 1970s, international trade in koi has led to the spread of CEV, although the first recognised outbreak of the disease outside of Japan was not reported until 1996 in the USA. In Europe, the disease was first recognised in 2009 and, as detection and diagnosis have improved, more EU member states have reported CEV associated with disease outbreaks. Although the structure of the CEV genome is not yet elucidated, molecular epidemiology studies have suggested distinct geographical populations of CEV infecting both koi and common carp. Detection and identification of cases of CEVD in common carp were unreliable using the original PCR primers. New primers for conventional and quantitative PCR (qPCR) have been designed that improve detection, and their sequences are provided in this paper. The qPCR primers have successfully detected CEV DNA in archive material from investigations of unexplained carp mortalities conducted >15 yr ago. Improvement in disease management and control is possible, and the principles of biosecurity, good health management and disease surveillance, applied to koi herpesvirus disease, can be equally applied to CEVD. However, further research studies are needed to fill the knowledge gaps in the disease pathogenesis and epidemiology that, currently, prevent an accurate assessment of the likely impact of CEVD on European koi and common carp aquaculture and on wild carp stocks.


Asunto(s)
Carpas/virología , Enfermedades de los Peces/virología , Infecciones por Poxviridae/veterinaria , Poxviridae/aislamiento & purificación , Animales , Europa (Continente)/epidemiología , Enfermedades de los Peces/epidemiología , Poxviridae/genética , Infecciones por Poxviridae/epidemiología , Infecciones por Poxviridae/virología
6.
J Anim Sci ; 95(7): 3173-3183, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28727099

RESUMEN

Masculinized females, named sex-reversed females (SRF), have a male phenotype but retain the female genotype (XX) and all spermatozoa produced in their testes carry the X chromosome. Masculinization of females leads to incomplete testicular development and the production of lower-quality semen. The mechanism of masculinization is unknown at present. Therefore, the aim of our study was to identify differentially abundant proteins in testicular semen of normal males and SRF using a difference in-gel electrophoresis approach. Masculinization seemed to not lead to significant changes in the testicular seminal plasma proteome, but did have an impact on the proteome of SRF and normal male sperm. We identified 26 proteins enriched ( < 0.05) in testicular male spermatozoa compared to SRF. A total of 28 proteins were also found to be differentially expressed ( < 0.05) in testicular SRF sperm in comparison to normal males. Bioinformatic analysis highlighted pathways associated with energy production for normal male spermatozoa and pathways related to protein remodeling for SRF sperm. Normal male spermatozoa seemed to be equipped with proteins participating in diverse metabolic pathways, focusing on producing the energy required for sperm movement. On the other hand, SRF spermatozoa were characterized by the enhanced expression of proteins associated with cytoskeletal structures and those related to remodeling, which could indicate that spermatogenesis and spermiogenesis are not fully accomplished. These results can be the basis for further research on the molecular mechanisms of masculinization and toward the development of a method for separating X and Y fish sperm.


Asunto(s)
Regulación de la Expresión Génica/fisiología , Oncorhynchus mykiss/genética , Oncorhynchus mykiss/fisiología , Semen/metabolismo , Espermatozoides/fisiología , Animales , Femenino , Regulación de la Expresión Génica/genética , Cariotipo , Masculino , Proteoma/metabolismo , Proteómica/métodos , Análisis de Semen , Caracteres Sexuales , Procesos de Determinación del Sexo , Motilidad Espermática , Espermatogénesis , Testículo/metabolismo
7.
HLA ; 90(2): 102-105, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28470865

RESUMEN

FoxP3 and Vav1 are known to be involved in the development of regulatory T cells. Two polymorphic sites in the FoxP3 promoter (rs3761548 and a (GT) n -dinucleotide repeat) and 2 single nucleotide polymorphisms in intron 1 of the Vav1 gene (rs2546133 and rs2617822) have been shown to correlate with gene expression levels. We investigated a potential impact of FoxP3 and Vav1 genetic variants on kidney allograft failure using samples and data of the Collaborative Transplant Study. A cohort of 384 kidney transplant patients was tested. We found no significant association of FoxP3 promoter rs3761548 or (GT) n repeat length with presumed immunological graft failure. The genotype frequencies of Vav1 intron polymorphisms did not significantly differ between patients with graft failure and matched controls.


Asunto(s)
Factores de Transcripción Forkhead/genética , Genotipo , Supervivencia de Injerto/genética , Trasplante de Riñón , Polimorfismo de Nucleótido Simple , Proteínas Proto-Oncogénicas c-vav/genética , Adulto , Aloinjertos , Femenino , Factores de Transcripción Forkhead/inmunología , Supervivencia de Injerto/inmunología , Humanos , Intrones , Masculino , Persona de Mediana Edad , Regiones Promotoras Genéticas , Proteínas Proto-Oncogénicas c-vav/inmunología
8.
J Fish Dis ; 40(11): 1695-1706, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28452055

RESUMEN

The Schlei fjord in northern Germany is the recipient water of a comprehensive eel, Anguilla anguilla (L.), stocking programme. Since 2015, stocked eels become alizarin red S marked, but to date no control mechanism is implemented in this stock enhancement measure to prevent anthropogenic spreading of diseases. Consequentially, it was possible that farmed stocking cohorts of 2015 and 2016 (in total ca. 1040 kg) were subsequently tested positive for anguillid herpesvirus 1 (AngHV 1). For this study, 100 eels [total length (TL) 24.3-72.9 cm, age ca. 1-6 years] were caught in 2016 and investigated with regard to AngHV 1 infection, parasite load (Anguillicoloides crassus) and body conditions. 68% of the eels were found to be virus positive while larger specimens were more often infected. In addition, a fitted generalized linear model (area under the curve = 0.741) demonstrated that an increase in individual TL is accompanied with an increased risk of clinically relevant virus loads. Anguillicoloides crassus turned out to be an important stressor for eels, because parasite and virus load revealed a significant positive correlation. The results of this study evidently show the urgent need of a disease containment strategy for eel stocking programmes.


Asunto(s)
Anguilla , Dracunculoidea/fisiología , Enfermedades de los Peces/epidemiología , Infecciones por Herpesviridae/veterinaria , Herpesviridae/fisiología , Infecciones por Spirurida/veterinaria , Animales , Femenino , Enfermedades de los Peces/parasitología , Enfermedades de los Peces/virología , Alemania/epidemiología , Infecciones por Herpesviridae/epidemiología , Infecciones por Herpesviridae/virología , Masculino , Carga de Parásitos/veterinaria , Prevalencia , Infecciones por Spirurida/epidemiología , Infecciones por Spirurida/parasitología , Carga Viral/veterinaria
9.
Water Sci Technol ; 75(5-6): 1204-1210, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28272049

RESUMEN

A 'membrane-denitrification' reactor (MDR) was developed and tested in a semi-technical recirculation aquaculture system in comparison to a double - without MDR - as reference system. The MDR consisted of a reactor with an ultrafiltration membrane unit for removal of micro-particles (e.g. sludge flocs, bacteria and parasites). Specific carrier material provided surfaces for biofilm growth in a fluidized bed reactor with ethanol as carbon source for denitrification. The continuous motion of these carriers cleaned the membrane surface. With online and laboratory measurements of water parameters and operational data the feasibility of the concept was verified. An advantage is that no chemicals are needed to clean the membranes. Examinations of the fish and water analyses proved an MDR can positively influence cortisol, as a stress marker, and the microflora of the aquatic system.


Asunto(s)
Acuicultura/instrumentación , Acuicultura/métodos , Reactores Biológicos/microbiología , Desnitrificación , Material Particulado/aislamiento & purificación , Animales , Peces , Membranas Artificiales , Nefelometría y Turbidimetría , Nitratos/análisis , Nitritos/análisis , Permeabilidad , Presión , Aguas del Alcantarillado/microbiología
12.
Pol J Vet Sci ; 17(4): 733-5, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25638991

RESUMEN

A Cyprinid herpesvirus 3 infection of carp induces a disease which causes substantial losses in carp culture. Here we present the use of a possible strategy for the management of the virus infection RNA interference based on small interfering RNAs. As a result of in vitro studies, we found that a mixture of short interfering RNAs specific for viral DNA enzyme synthesis and capsid proteins of the CyHV-3 can be a potential inhibitor of virus replication in fibroblastic cells. This gives the basis for the development of a combinatorial RNA interference strategy to treat CyHV-3 infections.


Asunto(s)
Proteínas de la Cápside/metabolismo , Fibroblastos/virología , Herpesviridae/fisiología , Interferencia de ARN/fisiología , ARN Interferente Pequeño/genética , Animales , Proteínas de la Cápside/genética , Muerte Celular , Línea Celular , Fibroblastos/fisiología , Peces , Regulación Viral de la Expresión Génica , Herpesviridae/genética , Replicación Viral
13.
Tissue Antigens ; 82(6): 410-5, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24134411

RESUMEN

Mannose-binding lectin (MBL) is a major component of the lectin pathway of complement activation. High and low MBL levels have been associated with susceptibility and severity of a variety of infectious and autoimmune diseases. Several single-nucleotide polymorphisms (SNPs) in the promoter region and exon 1 of the MBL2 gene are responsible for variations in serum MBL levels. We developed a sequence-based typing method for allele-specific MBL2 genotyping and measured serum MBL protein levels in 24 German blood donors. We identified the common MBL2 haplotypes including five promoter polymorphisms in linkage with the Q allele and correlated serum MBL levels with the respective genotypes. The genotyping method presented here could provide a basis for confirmatory studies in larger cohorts.


Asunto(s)
Enfermedades Autoinmunes/inmunología , Infecciones/inmunología , Lectina de Unión a Manosa/genética , Análisis de Secuencia de ADN/métodos , Enfermedades Autoinmunes/genética , Lectina de Unión a Manosa de la Vía del Complemento/genética , Exones/genética , Femenino , Estudios de Asociación Genética , Genotipo , Alemania , Humanos , Infecciones/genética , Desequilibrio de Ligamiento , Masculino , Lectina de Unión a Manosa/sangre , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas/genética
14.
Am J Transplant ; 13(4): 1063-1068, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23398855

RESUMEN

Natural killer (NK) cell function can be modulated by the killer cell immunoglobulin-like receptors (KIR) which interact with human leukocyte antigen (HLA) class I molecules on target cells. KIR-ligand mismatching has recently been shown by van Bergen et al. (American Journal of Transplantation 2011; 11(9): 1959-1964) to be a significant risk factor for long-term graft loss in HLA-A, -B and -DR compatible kidney transplants. To verify this potentially important finding, we performed genotyping of 608 deceased-donor kidney graft recipients and their HLA-A, -B and -DR compatible donors for KIR and HLA, using samples and clinical data provided by the Collaborative Transplant Study. Graft survival of KIR-ligand-matched and -mismatched transplants was compared. We found no impact of KIR-ligand mismatching on 10-year graft survival in HLA-A, -B, -DR compatible kidney transplants. Further analysis did not reveal a significant effect of recipient activating/inhibitory KIR or KIR genotypes on graft survival. Our data do not support the concept that KIR-HLA matching might serve as a tool to improve long-term renal allograft survival.


Asunto(s)
Antígenos de Histocompatibilidad Clase I/genética , Trasplante de Riñón/métodos , Receptores KIR/metabolismo , Insuficiencia Renal/inmunología , Adolescente , Adulto , Anciano , Estudios de Cohortes , Femenino , Genotipo , Supervivencia de Injerto , Prueba de Histocompatibilidad , Humanos , Ligandos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Insuficiencia Renal/cirugía , Factores de Riesgo , Factores de Tiempo , Adulto Joven
15.
J Comp Pathol ; 149(1): 94-102, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23218409

RESUMEN

Streptococcus iniae is an invasive pathogen causing meningitis and other lesions in various fish species. Furthermore, S. iniae is an emerging zoonotic agent that causes cellulitis in man. The aims of this study were to establish an intraperitoneal infection model for S. iniae in Nile tilapia (Oreochromis niloticus) and to develop a new histopathological scoring system to reflect the degree and extent of inflammation as well as the presence of necrosis in the brain and eye. Intraperitoneal administration of 10(6) colony-forming units (CFU) led to 80% mortality and numerous fish developing clinical signs of central nervous system dysfunction. Microscopical examination of four regions of the brain (olfactory bulb, cerebellum, cerebrum and optical lobe) and the eye revealed the presence of lymphohistiocytic leptomeningitis, meningoencephalitis and endophthalmitis. Lesions were dominated by macrophages that often contained intracellular bacteria. Necrosis was recorded in some cases. Bacteriological screening revealed that multiple organs, including brain and eye, were infected with S. iniae and S. iniae colonized the scales and gills in high number. S. iniae was detected in tank water during the first week post infection, suggesting that infected tilapia might shed up to 3 × 10(7) CFU of S. iniae within 24 h. A multiplex polymerase chain reaction allowed confirmation of the challenge strain by detection of the virulence factors simA, scpI, cpsD, pgi, pgm and sagA.


Asunto(s)
Modelos Animales de Enfermedad , Meningoencefalitis/microbiología , Infecciones Estreptocócicas/patología , Tilapia/microbiología , Animales , Encéfalo/patología , Ojo/patología , Humanos , Meningoencefalitis/patología , Infecciones Estreptocócicas/microbiología
16.
Rozhl Chir ; 88(12): 704-7, 2009 Dec.
Artículo en Checo | MEDLINE | ID: mdl-20662433

RESUMEN

Blunt injury of the carotid artery is uncommon but serious injury with high mortality and morbidity. The symptomatology may be inconspicuous, in other case a neurological deficit is present. The cause is mainly head hyperexstension and rotation, basal scull fracture, compression, blunt stroke. The diagnosis is usually confirmed by CT scan, CT angiography, MRI. In the therapy in present prevail heparin anticoagulation and endovascular stent implantation in some cases.


Asunto(s)
Traumatismos de las Arterias Carótidas/diagnóstico , Heridas no Penetrantes/diagnóstico , Accidentes de Tránsito , Adulto , Traumatismos de las Arterias Carótidas/cirugía , Arteria Carótida Interna , Femenino , Humanos , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/cirugía
17.
J Hazard Mater ; 160(2-3): 514-20, 2008 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-18455302

RESUMEN

In this paper, the authors deal with the problem of processing various types of waste generated by leather industry, with special emphasis to chrome-tanned waste. The agent that makes this waste potentially hazardous is hexavalent chromium. Its compounds can have negative effects on human health and some CrVI salts are considered carcinogens. The authors present the risks of spontaneous oxidization of CrIII to CrVI in the open-air dumps as well as the possible risks of wearing bad quality shoes, in which the chromium content is not controlled. There are several ways of handling primary leather waste, but no satisfactory technology has been developed for the secondary waste (manipulation waste, e.g. leather scraps and used leather products). In this contribution, a new three-step hybrid technology of processing manipulation waste is presented and tested under laboratory, pilot-scale and industrial conditions. The filtrate can be used as a good quality NPK fertilizer. The solid product, titanium-chromium sludge, can serve as an inorganic pigment in glass and ceramic industry. Further, the authors propose selective collection of used leather products (e.g. old shoes), the hydrolysable parts of which can be also processed by the new hybrid technology.


Asunto(s)
Residuos Industriales/efectos adversos , Curtiembre , Contaminantes Químicos del Agua/efectos adversos , Contaminación Química del Agua/efectos adversos , Contaminación Química del Agua/prevención & control , Cromo/química , Cromo/toxicidad , Femenino , Filtración , Humanos , Neoplasias Renales/mortalidad , Proyectos Piloto , Eliminación de Residuos , Neoplasias de la Vejiga Urinaria/mortalidad
18.
Oncogene ; 25(24): 3365-74, 2006 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-16462769

RESUMEN

Photodynamic therapy is a promising antitumor treatment modality approved for the management of both early and advanced tumors. The mechanisms of its antitumor action include generation of singlet oxygen and reactive oxygen species that directly damage tumor cells and tumor vasculature. A number of mechanisms seem to be involved in the protective responses to PDT that include activation of transcription factors, heat shock proteins, antioxidant enzymes and antiapoptotic pathways. Elucidation of these mechanisms might result in the design of more effective combination strategies to improve the antitumor efficacy of PDT. Using DNA microarray analysis to identify stress-related genes induced by Photofrin-mediated PDT in colon adenocarcinoma C-26 cells, we observed a marked induction of heme oxygenase-1 (HO-1). Induction of HO-1 with hemin or stable transfection of C-26 with a plasmid vector encoding HO-1 increased resistance of tumor cells to PDT-mediated cytotoxicity. On the other hand, zinc (II) protoporphyrin IX, an HO-1 inhibitor, markedly augmented PDT-mediated cytotoxicity towards C-26 and human ovarian carcinoma MDAH2774 cells. Neither bilirubin, biliverdin nor carbon monoxide, direct products of HO-1 catalysed heme degradation, was responsible for cytoprotection. Importantly, desferrioxamine, a potent iron chelator significantly potentiated cytotoxic effects of PDT. Altogether our results indicate that HO-1 is involved in an important protective mechanism against PDT-mediated phototoxicity and administration of HO-1 inhibitors might be an effective way to potentiate antitumor effectiveness of PDT.


Asunto(s)
Hemo-Oxigenasa 1/fisiología , Fotoquimioterapia/efectos adversos , Animales , Monóxido de Carbono/química , Monóxido de Carbono/farmacología , Quelantes/farmacología , Éter de Dihematoporfirina/química , Hemo/química , Hemo-Oxigenasa 1/metabolismo , Humanos , Hierro/farmacología , Ratones , Neoplasias/patología , Análisis de Secuencia por Matrices de Oligonucleótidos , Oxígeno/metabolismo , Especies Reactivas de Oxígeno
19.
Photodiagnosis Photodyn Ther ; 3(2): 132-3, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25049105

RESUMEN

In dermatology PDT has been proven to be effective in the treatment of actinic keratoses, basal cell carcinomas (BCC), Bowen's disease, superficial squamous cell carcinomas (SCC).

20.
Endoscopy ; 34(8): 624-7, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12173082

RESUMEN

BACKGROUND AND STUDY AIMS: The use of endoscopic therapy in combination with lithotripsy techniques has become increasingly common in patients with complicated common bile duct stones. In many units, although this is controversial, cholecystectomy is then performed, because of possible subsequent cholecystitis and recurrence of choledocholithiasis. The aim of this study was to investigate whether gallbladder status influences the long-term outcome in patients after extracorporeal shockwave lithotripsy (ESWL) of common bile duct stones. PATIENTS AND METHODS: Recruited for the study were 120 patients with an average age of 68 years (range 28 - 86). They were selected from 137 consecutive patients who presented to our department between January 1989 and June 1996 with complicated common bile duct stones, and in whom ESWL was necessary to achieve complete clearance of stones. Follow-up data were obtained from the patients and their general practitioners. RESULTS: The mean duration of follow-up was 4 years (range 3 - 9). A total of 37 patients had their gallbladder in situ (group A), while 83 had undergone cholecystectomy. Of these 83 patients, 27 had had a cholecystectomy after ESWL (group B), whereas 56 patients had already had the gallbladder removed when choledocholithiasis was diagnosed (group C). During follow-up, 36 patients (30 %) experienced some biliary symptoms. There were no significant differences in the incidence of recurrent biliary symptoms between the three groups. Re-exploration of the bile duct by endoscopic retrograde cholangiopancreatography (ERCP) revealed 28 cases of recurrent bile duct stones. Recurrence developed more often in groups B and C, who had undergone cholecystectomy, without reaching statistical significance ( P = 0.077). In patients with an intact gallbladder (group A), there was no difference in the rate of recurrent biliary symptoms or stones between the patients with or without cholecystolithiasis. Operations were necessary in 28 patients; in only ten was this for biliary reasons. CONCLUSION: The intact gallbladder is not a risk factor for recurrent biliary complications after ESWL of common bile duct stones; therefore, as far as patients with complicated bile duct stones which require additional lithotripsy techniques are concerned, elective cholecystectomy after endoscopic clearance of the bile duct no longer seems appropriate.


Asunto(s)
Colecistectomía , Cálculos Biliares/terapia , Litotricia/métodos , Adulto , Anciano , Anciano de 80 o más Años , Colangiopancreatografia Retrógrada Endoscópica , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Factores de Riesgo , Resultado del Tratamiento
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