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1.
Endoscopy ; 41(2): 166-74, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19214899

RESUMEN

Traditionally abdominal abscesses have been treated with either surgical or radiologically guided percutaneous drainage. Surgical drainage procedures may be associated with considerable morbidity and mortality, and serious complications may also arise from percutaneous drainage. Endoscopic ultrasound (EUS)-guided drainage of well-demarcated abdominal abscesses, with adjunctive endoscopic debridement in the presence of solid necrotic debris, has been shown to be feasible and safe. This multicenter review summarizes the current status of the EUS-guided approach, describes the available and emerging techniques, and highlights the indications, limitations, and safety issues.


Asunto(s)
Absceso Abdominal/cirugía , Drenaje/métodos , Endosonografía , Absceso Abdominal/patología , Desbridamiento/instrumentación , Desbridamiento/métodos , Drenaje/instrumentación , Endoscopios , Humanos , Necrosis/microbiología , Necrosis/cirugía
2.
Endoscopy ; 40(9): 739-45, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18698533

RESUMEN

BACKGROUND AND STUDY AIMS: Magnetic resonance cholangiopancreatography (MRCP) is a less-invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis of primary sclerosing cholangitis (PSC). This study evaluated the diagnostic accuracy of MRCP in PSC compared with ERCP, and assessed the diagnostic accuracy of different T2w sequences. PATIENTS AND METHODS: 95 patients (69 PSC, 26 controls) were evaluated using both ERCP and MRCP. Exclusion criteria included secondary sclerosing cholangitis and contraindications to MRCP. The diagnosis of PSC was confirmed in 69 patients based on ERCP as the reference gold standard. MRCP was performed using a 1.5 Tesla MR unit, using breath hold, coronal and transverse half-Fourier acquisition single-shot turbo spin-echo (HASTE), coronal-oblique, fat-suppressed half-Fourier rapid acquisition with relaxation enhancement (RARE), and coronal-oblique, fat-suppressed, multisection, thin-section HASTE (TS-HASTE) sequences. The MRCP morphological criteria of PSC were evaluated and compared with ERCP. RESULTS: The sensitivity, specificity, and diagnostic accuracy were 86%, 77%, and 83%, respectively, using the MRCP-RARE sequence, and increased further to 93%, 77%, and 88%, respectively, by the inclusion of follow-up MRCP in 52 patients, performed at 6-12-month intervals. HASTE and TS-HASTE sequences showed significantly lower diagnostic accuracy but provided additional morphologic information. CONCLUSIONS: MRCP can diagnose PSC but has difficulties in early PSC and in cirrhosis, and in the differentiation of cholangiocarcinoma, Caroli's disease, and secondary sclerosing cholangitis. A positive MRCP would negate some diagnostic ERCP studies but a negative MRCP would not obviate the need for ERCP.


Asunto(s)
Pancreatocolangiografía por Resonancia Magnética , Colangitis Esclerosante/diagnóstico , Adolescente , Adulto , Anciano , Neoplasias de los Conductos Biliares/diagnóstico , Enfermedad de Caroli/diagnóstico , Colangiocarcinoma/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Pancreatocolangiografía por Resonancia Magnética/efectos adversos , Diagnóstico Diferencial , Errores Diagnósticos , Reacciones Falso Positivas , Femenino , Humanos , Aumento de la Imagen/métodos , Cirrosis Hepática/diagnóstico , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Seudoquiste Pancreático/etiología , Pancreatitis/etiología , Estudios Retrospectivos , Sensibilidad y Especificidad
3.
Cancer Res ; 61(10): 3853-7, 2001 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-11358795

RESUMEN

We used a murine tumor progression model for the evaluation of potential proliferation markers using positron emission tomography (PET). 5-[(18)F]-2'-deoxyuridine ([(18)F]FdUrd) was synthesized with >98% radiochemical purity and investigated in a pancreatic cancer model, transforming growth factor alpha transgenic mice crossbred to p53 deficient mice. Thymidylate synthase was increased already in premalignant lesions, whereas thymidine kinase 1 mRNA levels were up-regulated 4-fold in the pancreatic cancer specimen of these mice. PET imaging was performed after injection of 1 MBq of [(18)F]FdUrd and 1 MBq of [(18)F]fluoro-deoxyglucose. Animals with pancreatic cancer displayed focal uptake of both tracers. The [(18)F]FdUrd uptake ratio closely correlated with the proliferation index as evaluated in morphometric and fluorescence-activated cell sorter analysis. These results indicate the potential of our tumor model for the evaluation of PET tracers and suggest [(18)F]FdUrd as a tracer for the assessment of proliferation in vivo.


Asunto(s)
Floxuridina , Neoplasias Pancreáticas/diagnóstico por imagen , Radiofármacos , Animales , División Celular/fisiología , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Floxuridina/síntesis química , Floxuridina/farmacocinética , Fluorodesoxiglucosa F18 , Genes p53/genética , Ratones , Ratones Transgénicos , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patología , ARN Mensajero/biosíntesis , ARN Mensajero/genética , Cintigrafía , Radiofármacos/síntesis química , Radiofármacos/farmacocinética , Timidina Quinasa/biosíntesis , Timidina Quinasa/genética , Timidilato Sintasa/biosíntesis , Timidilato Sintasa/genética , Factor de Crecimiento Transformador alfa/genética , Regulación hacia Arriba
4.
Medicine (Baltimore) ; 94(43): e1941, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26512623

RESUMEN

Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse.Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course.Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P < 0.001, Wilcoxon), and for correct classification of relevance of the lesions from 5.0 (IQR 3) to 7.0 (IQR 3) (P < 0.001), respectively. Improvement was not dependent on experience, profession, SBCE system, or course setting. Previous experience in SBCE was associated with higher baseline scores for correct diagnosis (P < 0.001; Kruskal-Wallis). Additionally, independent nonparametric partial correlation with experience in gastroscopy (rho 0.33) and colonoscopy (rho 0.27) was observed (P < 0.001).A simple ET-CET demonstrated significant improvement of diagnostic skills on completion of formal basic SBCE courses with hands-on training, regardless of preexisting experience, profession, and course setting. Baseline scores for correct diagnoses show a plateau after interpretation of 25 SBCE before courses, supporting this number as a compromise for credentialing. Experience in flexible endoscopy may be useful before attending an SBCE course.


Asunto(s)
Endoscopía Capsular/educación , Evaluación Educacional/métodos , Endoscopía Capsular/normas , Competencia Clínica , Europa (Continente) , Humanos , Intestino Delgado , Estudios Prospectivos
5.
Stroke ; 35(9): 2064-8, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15297630

RESUMEN

BACKGROUND AND PURPOSE: A locus containing the elastin gene has been linked to familial intracranial aneurysms in 2 distinct populations. We investigated the association of single-nucleotide polymorphisms (SNPs) and haplotypes of SNPs in the elastin gene with the occurrence of subarachnoid hemorrhage (SAH) from sporadic aneurysms in the Netherlands. METHODS: We genotyped 167 SAH patients and 167 matching controls for 18 exonic and intronic SNPs in the elastin gene. A Bonferroni correction was applied for multiple comparisons with all novel associations, with a correction factor derived from the number of SNPs tested (P value after Bonferroni correction [P(corr)]). RESULTS: SAH was statistically significant associated with an SNP in exon 22 of the elastin gene (minor allele frequency was 0.000 in patients and 0.028 in controls; odds ratio [OR], 0.0; 95% CI, 0.0 to 0.7; P=0.004; P(corr)=0.05) and possibly with an SNP in intron 5 (minor allele frequency was 0.062 in patients and 0.128 in controls; OR, 0.5; 95% CI, 0.2 to 0.8; P=0.007; P(corr)=0.08). Haplotypes of intron 5/exon 22 (P(corr)=0.002), intron 4/exon 22 (P(corr)=0.02), and intron 4/intron 5/exon 22 (P=9.0x10(-9)) were also associated with aneurysmal SAH. CONCLUSIONS: Variants and haplotypes within the elastin gene are associated with the risk of sporadic SAH in Dutch patients. Gradual increase of statistical power with the inclusion of 2 or 3 SNPs in the studied haplotypes supports the validity of our conclusion that the elastin gene is a susceptibility locus for SAH.


Asunto(s)
Elastina/genética , Haplotipos/genética , Aneurisma Intracraneal/genética , Polimorfismo de Nucleótido Simple , Hemorragia Subaracnoidea/genética , Alelos , Estudios de Cohortes , Elastina/química , Exones/genética , Frecuencia de los Genes , Heterogeneidad Genética , Predisposición Genética a la Enfermedad , Humanos , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/epidemiología , Intrones/genética , Desequilibrio de Ligamiento , Países Bajos/epidemiología , Estructura Terciaria de Proteína , Hemorragia Subaracnoidea/complicaciones , Hemorragia Subaracnoidea/epidemiología
6.
J Nucl Med ; 41(3): 531-7, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10716329

RESUMEN

UNLABELLED: A new concept is the intensification of preparative regimens for patients with advanced leukemia using monoclonal antibodies (MAbs) with an affinity for beta emitter-labeled bone marrow. 188Re is a high-energy beta emitter that has therapeutic promise. Our first aim was to clarify whether the therapeutic application of 188Re-MAb against nonspecific cross-reacting antigen 95 (NCA-95) can be predicted from biokinetic data derived from 99mTc-labeled NCA-95. Our second aim was to show that a radiation absorbed dose of > or =12 Gy in the bone marrow can be achieved using 188Re-MAb. METHODS: Dosimetric data were obtained for both radiotracers from multiple planar whole-body scans (double-head gamma camera), blood samples, and urine measurements from 12 patients with advanced leukemia. Radiation absorbed doses were calculated using MIRDOSE 3 software. RESULTS: Radiation absorbed doses to bone marrow, liver, spleen, lung, and kidney were 2.24, 0.50, 1.93, 0.05, and 0.90 mGy/MBq, respectively, using 99mTc-MAb and 1.45, 0.43, 1.32, 0.07, and 0.71 mGy/MBq, respectively, using 188Re-MAb. These differences were statistically significant for bone marrow, spleen, and kidney. The main differences were less accumulation of 188Re-MAb in bone marrow (31%+/-13% compared with 52%+/-13%) and faster elimination through urine (25%+/-3% compared with 15%+/-5% after 24 h). On the basis of these data, a mean marrow dose of 14+/-7 Gy was achieved in 12 patients suffering from leukemia after application of approximately 10+/-2 GBq 188Re-MAb. CONCLUSION: Myeloablative radiation absorbed doses can easily be achieved using 188Re-MAb. 99mTc- and 188Re-MAb showed similar whole-body distributions. However, direct prediction of radiation absorbed doses from the 99mTc-MAb, assuming identical biokinetic behavior, is not valid for the 188Re-MAb in a single patient. Therefore, individual dosimetry using 188Re-MAb is needed to calculate therapeutic activity.


Asunto(s)
Moléculas de Adhesión Celular , Trasplante de Células Madre Hematopoyéticas , Radioinmunoterapia , Acondicionamiento Pretrasplante , Adulto , Anticuerpos Monoclonales/farmacocinética , Anticuerpos Monoclonales/uso terapéutico , Antígenos de Neoplasias/inmunología , Femenino , Humanos , Leucemia/radioterapia , Masculino , Glicoproteínas de Membrana/inmunología , Persona de Mediana Edad , Fantasmas de Imagen , Radiometría , Renio/farmacocinética , Renio/uso terapéutico , Tecnecio/farmacocinética , Tecnecio/uso terapéutico , Distribución Tisular
7.
Biochem Pharmacol ; 55(6): 883-8, 1998 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-9586961

RESUMEN

The effect of the Aconitum alkaloids aconitine, 3-acetylaconitine, lappaconitine, and N-desacetyllappaconitine to inhibit [3H]noradrenaline uptake was investigated in rat hippocampal synaptosomes. Aconitine and 3-acetylaconitine, which are known to activate sodium channels, had comparable inhibitory potencies and yielded Ki (inhibitor constant) values of 230 +/- 66 nM and 316 +/- 96 nM, respectively. In contrast, lappaconitine and N-desacetyllappaconitine failed to inhibit [3H]noradrenaline uptake. When either lappaconitine or N-desacetyllappaconitine was applied in combination with aconitine, [3H]noradrenaline uptake was not affected. The sodium channel blocker tetrodotoxin enhanced [3H]noradrenaline uptake, whereas uptake was completely blocked in sodium-free incubation medium. The inhibitory action of aconitine and 3-acetylaconitine on [3H]noradrenaline uptake was blocked by addition of tetrodotoxin. Patch clamp studies performed on cultured rat hippocampal neurons revealed an inhibitory action of lappaconitine and N-desacetyllappaconitine on whole cell sodium currents. It is concluded that the blockade of [3H]noradrenaline uptake evoked by aconitine and 3-acetylaconitine is mediated indirectly by an increased sodium concentration in the synaptosomes.


Asunto(s)
Aconitina/farmacología , Hipocampo/efectos de los fármacos , Norepinefrina/metabolismo , Plantas Medicinales , Aconitina/análogos & derivados , Animales , Técnicas In Vitro , Masculino , Técnicas de Placa-Clamp , Células Piramidales/efectos de los fármacos , Ensayo de Unión Radioligante , Ratas , Ratas Wistar , Relación Estructura-Actividad , Sinaptosomas/efectos de los fármacos , Tritio
8.
Ann Thorac Surg ; 72(5): 1645-9, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11722059

RESUMEN

BACKGROUND: Minimally invasive surgical techniques in pediatric cardiac surgery have evolved throughout the last 10 years. Advantages of minimally invasive procedures include excellent cosmetic results and superior postoperative outcome. However, safety of minimally invasive techniques has to be proven. METHODS: In 21 female infants and children, a right anterolateral thoracotomy was performed. Mean age was 7.1 years (0.5 to 16.6 years) and mean body weight was 20.8 kg (8.3 to 56 kg). The following defects were repaired: atrial septum defect type II (n = 14); partial atrioventricular septum defect (n = 3); partial anomalous pulmonary venous connection (n = 2); ventricular septum defect (n = 2); mitral valve insufficiency (n = 1); and resection of an embolized atrial septum defect occluder (n = 1). In two cases, aortic cross-clamping was performed by using a transthoracic clamp. In 5 patients, femoral cannulation was performed. Skin incisions were limited to 4 to 7 cm. RESULTS: There was no operative or late mortality. Mean operation time, bypass time, and aortic cross-clamp time were 138 (95 to 275), 72 (32 to 179), and 35 (12 to 120) minutes, respectively. Mean postoperative mechanical ventilation time, mean intensive care unit stay, and mean hospital stay were 3.9 hours (1 to 12 hours), 1.4 days (1 to 3 days), and 12 days (8 to 18 days), respectively. Postoperative complications included hemorrhage in 1 patient requiring surgical intervention. Mean follow-up period was 13.3 months (1 to 36 months). All patients were in New York Heart Association class I postoperatively. Trivial mitral insufficiency was evident in 1 patient operated for partial atrioventricular septum defect. CONCLUSIONS: A small right anterolateral thoracotomy as a minimally invasive technique in pediatric cardiac surgery is a safe and suitable alternative in the operative management of simple congenital heart defects. Cosmetic results are superior, however, improved postoperative outcome has to be proven.


Asunto(s)
Cardiopatías Congénitas/cirugía , Toracotomía/métodos , Adolescente , Niño , Preescolar , Diseño de Equipo , Femenino , Estudios de Seguimiento , Humanos , Lactante , Procedimientos Quirúrgicos Mínimamente Invasivos , Estudios Retrospectivos , Toracotomía/instrumentación
9.
Rofo ; 175(2): 203-10, 2003 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-12584620

RESUMEN

PURPOSE: Evaluation of MR-cholangiopancreaticography (MRCP) for the diagnosis of primary sclerosing cholangitis (PSC) in correlation with endoscopic retrograde cholangiopancreaticography (ERCP) and in comparison to the diagnostic accuracy of various T2-weighted sequences. METHODS AND MATERIALS: Fifty-five patients (34 males, 21 females; mean age 40 years, range 16 to 65 years) with suspected PSC were examined in a 1.5 T MR unit (Magnetom Vision, Siemens, Erlangen), using breath-hold transverse and coronal HASTE, paracoronal RARE and thin-sliced HASTE (TS-HASTE) sequences. Applying a five-point-scale, two blinded investigators assessed the image quality for ROC analysis. Morphologic criteria of PSC were documented and correlated with ERCP, which served as the gold standard, and sensitivity, specificity and diagnostic accuracy were calculated. RESULTS: PSC was confirmed in 40 of 55 patients (ERCP 55 of 55, liver biopsy 37 of 55), with concomitant chronic ulcerative colitis in 27 and Crohn's disease in 6 of the 40 patients. Qualitative analysis of the image quality showed no significant difference between RARE, HASTE and thin-sliced HASTE sequences (3.4/3.5/3.2). The RARE sequence had the highest sensitivity (97 %), specificity (64 %) and accuracy (84 %) for the detection of PSC. The difference between HASTE and thin-sliced HASTE was statistically significant (p < 0.01). Of the 40 patients with confirmed PSC, 29 were followed by MRI and 3 underwent a liver transplantation within the follow-up period. A Klatskin tumor, which was misdiagnosed by MRCP, was diagnosed by brush biopsy in 1 of the 40 patients. Interobserver variability was adequate to good (kappa 0.4 to 0.7), depending on the chosen sequence. CONCLUSION: MRCP seems to be a reliable non-invasive imaging method to diagnose and follow PSC. The RARE sequence showed the highest diagnostic accuracy of the T2-weighted sequences.


Asunto(s)
Colangiografía , Colangiopancreatografia Retrógrada Endoscópica , Colangitis Esclerosante/diagnóstico , Imagen por Resonancia Magnética , Adolescente , Adulto , Anciano , Neoplasias de los Conductos Biliares/diagnóstico , Conductos Biliares Extrahepáticos/patología , Conductos Biliares Intrahepáticos/patología , Colitis Ulcerosa/diagnóstico , Enfermedad de Crohn/diagnóstico , Femenino , Análisis de Fourier , Conducto Hepático Común/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Tumor de Klatskin/diagnóstico , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad
10.
Chirurg ; 65(5): 413-7, 1994 May.
Artículo en Alemán | MEDLINE | ID: mdl-8050293

RESUMEN

Endoscopically, approximately 85% of all bile duct stones can be removed immediately after successful papillotomy. For the remaining cases, complete clearance of the bile duct is achieved by lithotripsy techniques. Due to the lower risks, endoscopic treatment is preferable.


Asunto(s)
Colecistectomía Laparoscópica/instrumentación , Cálculos Biliares/terapia , Litotricia/instrumentación , Esfinterotomía Endoscópica/instrumentación , Humanos , Resultado del Tratamiento
11.
Z Gastroenterol ; 45(3): 245-9, 2007 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-17357954

RESUMEN

UNLABELLED: Angiodysplasia are common in patients over the age of 60. Heyde syndrome describes the coincidence of aortic valve stenosis and gastrointestinal bleeding from angiodysplasia. We describe one characteristic case of aortic valve stenosis and gastrointestinal bleeding from angiodysplasia which subsided after replacement with an aortic valve bioprosthesis. We review the current literature and discuss the actual explanation approaches for this phenomenon. CONCLUSION: There seems to be a clear indication for valve replacement in the case of aortic valve-stenosis and gastrointestinal bleeding due to angiodysplasia.


Asunto(s)
Estenosis de la Válvula Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/cirugía , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/prevención & control , Prótesis Valvulares Cardíacas , Anciano , Femenino , Humanos , Prevención Secundaria , Síndrome , Resultado del Tratamiento
12.
Endoscopy ; 38(10): 1029-31, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17058169

RESUMEN

BACKGROUND AND STUDY AIM: Endoscopic mucosal resection (EMR) is a less invasive alternative treatment strategy to surgery for intramucosal esophageal squamous cell carcinoma (SCC). This study described our initial experience with the newly introduced Duette Multiband Mucosectomy Kit (Cook Ireland Ltd, Limerick, Ireland) for the treatment of extensive early esophageal SCC. PATIENTS AND METHODS: Five patients with extensive early esophageal SCC, covering at least half of the circumference of the esophageal wall and measuring a mean of 2.8 cm longitudinally, underwent EMR after EUS staging. RESULTS: EMR was successfully completed in one session in five patients. Post-EMR stricture occurred in four patients but was successfully treated with bougienage. One patient did not return for follow-up after bougienage and died from ischemic heart disease 3 months later. For the remaining four patients, there was no recurrence over a mean follow up of 14.7 months. CONCLUSION: This new device obviates the need for repeated insertion of the endoscope during the process of ligation and resection and thus facilitates EMR of extensive SCC.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Endoscopía Gastrointestinal/métodos , Neoplasias Esofágicas/cirugía , Mucosa Intestinal/cirugía , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/patología , Femenino , Estudios de Seguimiento , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
13.
Endoscopy ; 38(12): 1235-40, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17163325

RESUMEN

BACKGROUND AND STUDY AIMS: Precut is a well-known technique that is used if repeated attempts at common bile duct (CBD) cannulation fail. Opinions on the complication rate of precut are conflicting, however. The aim of the present study was to compare the efficacy and complication rate of precut used as a primary method of CBD access with the efficacy and safety of the conventional technique. PATIENTS AND METHODS: During the 19-month study period, consecutive patients who were scheduled for first-time endoscopic sphincterotomy (ES) for a variety of biliary disorders were randomized into two groups: patients in group A underwent conventional wire-guided biliary cannulation followed by ES (with precut being performed only when this failed); in patients in group B precut was used as a primary technique to gain biliary access, followed by wire-guided ES. We used a specially designed, modified Erlangen type of sphincterotome for precutting. RESULTS: A total of 291 patients (100 men, 191 women; mean +/- SD age 65 +/- 17.5 years) were recruited: 146 patients were assigned to group A (conventional approach) and 145 to group B (primary precut approach). The indications for ES were comparable in the two groups. In group A, wire-guided cannulation of the CBD failed in 42 patients. Secondary precut was successful in 41 of these patients, leading to an overall success rate of 99.3 %. In group B, the ES success rate using primary precut was 100 % at the first attempt. The mean time to successful deep CBD cannulation was 8.3 +/- 2.1 minutes in group A and 6.9 +/- 1.8 minutes in group B ( P < 0.001). The incidence of mild to moderate pancreatitis was similar in the two groups (2.9 % in group A vs. 2.1 % in group B, P > 0.05). Mild bleeding occurred in only one patient (from group A) and this was controlled by epinephrine injection. None of the study patients developed severe pancreatitis or perforation. CONCLUSIONS: In experienced hands, an approach using primary precut appears to be at least as successful and safe as a conventional approach using guide-wire-based CBD cannulation followed by ES, and might also be a quicker method.


Asunto(s)
Conductos Biliares/cirugía , Esfinterotomía Endoscópica/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cateterismo/efectos adversos , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Esfinterotomía Endoscópica/efectos adversos , Resultado del Tratamiento
14.
Planta Med ; 53(4): 311-4, 1987 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17269035

RESUMEN

The main topics of this brief overview of the cryopreservation of plant cell cultures are (a) the principles behind Cryopreservation procedures as a basis from which the appropriate method for various different cultures can be developed, and (b) the question of how far the characteristics of cell strains are preserved during the freeze-thaw cycle. Of all the species successfully cryopreserved to date, only seven have been investigated with regard to their biochemical capacities. In all these cases the cultures have been shown to retain their growth patterns and biochemical traits. Furthermore, results are available which indicate that this is also valid for long-term storage. Some details are presented on the accumulation of natural products and the biotransformation of cardenolides in frozen-thawed cell cultures. On the other hand, before it is possible to recommend universally applicable cryopreservation protocols, we must better understand the cellular events which determine the freeze-tolerance of plant cell cultures.

15.
Z Naturforsch C Biosci ; 34(3-4): 253-8, 1979.
Artículo en Inglés | MEDLINE | ID: mdl-156469

RESUMEN

Actively dividing callus cells of higher plants (Petroselinum crispum, Daucus carota, Acer pseudoplatanus) were used to detect the primary gene product of rDNA in vivo. Parsley and carrot cells were labelled with [32P]orthophosphate. Under non-denaturing conditions, in both cases only one high molecular weight rRNA precursor was present on polyacrylamide gels. Its molecular weight did not exceed 2.5 x 10(6) dalton. Under denaturing conditions, 2.0--2.1 x 10(6) dalton were determined on formamide gels. This rRNA precursor was already present after a labelling period of 5--10 min. In parsley cells labelled mature rRNA (25S and 18S) arrived in the cytoplasm 45 min after onset of incubation. In Acer pseudoplatanus incubated with [3H]uridine two rapidly labelled components did emerge from polyacrylamide gels without formamide; their molecular weights were 2.3 and 3.2--3.4 x 10(6) dalton. After electrophoresis in formamide, the larger component disappeared, thus indicating that it would be an intermolecular aggregate of different RNAs. From these results we have no evidence for the existence of rRNA precursors exceeding the molecular weight of 2.5 x 10(6) dalton.


Asunto(s)
Plantas/metabolismo , ARN Ribosómico/biosíntesis , Células Cultivadas , Cicloheximida/farmacología , Formamidas/farmacología , Cinética , Peso Molecular , Fosfatos , Plantas/efectos de los fármacos , Especificidad de la Especie , Transcripción Genética/efectos de los fármacos
16.
Planta ; 106(2): 141-8, 1972 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-24477955

RESUMEN

A rapidly labelled rRNA precursor can be detected in callus cells of Petroselinum sativum grown on a liquid synthetic medium. Its molecular weight has been calculated to be 2.3×10(6). This value agrees with that of the rRNA precursor from other plant material. In order to follow the synthesis and processing of rRNA in time and to correlate single steps in this process with cell organelles it was necessary to obtain pure fractions of nuclei and ribosomes. The isolation method for nuclei is given in detail. The nucleic acids are separated on polyacrylamide gels of low acrylamide concentration. Pulse-chase experiments show that the rRNA precursor is split into two fragments within the nucleus: an 18S and a 25S component. The 18S RNA leaves the nucleus rapidly. It is already found quantitatively in the ribosomal fraction after 30-60 min chase. At that time the 25S RNA is still within the nucleus; it appears much later in the ribosomes. Since the increase in ribosomal label occurs simultaneously with the decrease in nuclear label, it is concluded that there is no degradation of 18S RNA within the nucleus. Apparently there are two distinct transport mechanisms with different kinetics for the two RNA components.

17.
Planta ; 97(3): 224-9, 1971 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-24493242

RESUMEN

The effect of α-amanitin on the synthesis of AMP-rich RNA has been investigated. After incubation of freely suspended callus cells of parsley with the toxin and pulse labelling (30 min) with (32)P-orthophosphate, the high AMP content of the RNA component eluted from MAK columns behind the 25 S-RNA disappears. The base ratio of this RNA becomes ribosomal (CMP 20.1, AMP 26.5, GMP 28.4, UMP 25.0). Polyacrylamide gel electrophoresis of the high molecular RNA shows that radioactivity is incorporated only into the 32 S-RNA. At higher α-amanitin concentrations the total nucleic acid synthesis is reduced. In this case only the high molecular RNA (32 S-RNA) is produced.

18.
Planta ; 135(3): 313-8, 1977 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24420100

RESUMEN

Callus cells of Daucus carota L. have different phenylpropanoid pathways depending on the medium composition. Cells propagated on a medium with gibberellic acid do not accumulate cyanidin but incorporate [(14)C]phenylalanine into chlorogenic acid at a high rate. Cells grown on a medium free of gibberellic acid accumulate cyanidin in very large amounts. We here describe partial purification of hydroxycinnamate: CoA ligase, and its properties in these two cell lines. The enzymes extracted from the two cell populations had different substrate specifities: for that from anthocyanin-containing cells, p-coumaric acid was the best substrate, and caffeic acid and ferulic acid were also activated. With enzyme from anthocyanin-free cells, the lowest Km values were obtained for caffeic acid, while ferulic acid had higher values, and p-coumaric acid was nearly inactive. The enzyme did not separate into isoenzymes during purification. Only on polyacrylamide gels the partially purified enzyme from anthocyanin-containing cells separated into three peaks, and that from anthocyanin-free cells, into only two peaks. This difference is discussed in the context of the lack of activity with p-coumaric acid in anthocyanin-free cells.

19.
Z Naturforsch C Biosci ; 30(2): 213-8, 1975.
Artículo en Inglés | MEDLINE | ID: mdl-125967

RESUMEN

In freely suspended cells of parsley (Petroselinum crispum) protein synthesis is inhibited nearly totally by 5 mug/ml cycloheximide within 10 min. This very low dose has a slight effect on the rRNA synthesis too. During an incubation period of 60 min with [32P] orthophosphate in the presence of the inhibitor (5 mug/ml) at least 65-70% mature rRNA are synthesized compared with the control. After 120 min the synthesis is progressively reduced to 60-65%, and after 240 min to 30-40%. Cycloheximide causes a delay of the prn addition to the 2.3 X 10(6) daltons RNA, normally detectable in pulse experiments, two further precursor molecules do emerge which undernormal circumstances apparently are shortlived. Their molecular weights are 2.0 X 10(6) and 0.9 X 10(6) daltons. The pulse-chase technique and cell fractionation into nuclear and ribosomal parts enables us to demonstrate a rapid transfer of labelled 18S and 25S RNA during a 15 min chase treatment to the mature cytoplasmic ribosomes. Under these conditions no differential transport of the two components takes place. The cells possess a pool of proteins. Therefore the formation of RNP-particles or ribosomes respectively and the transport from the nucleus to the cytoplasm are indipendent from protein synthesis for some time.


Asunto(s)
Cicloheximida/farmacología , Proteínas de Plantas/biosíntesis , ARN Ribosómico/metabolismo , Ribosomas/metabolismo , Transporte Biológico Activo , Núcleo Celular/metabolismo , Fosfatos/metabolismo , Proteínas Ribosómicas/metabolismo , Ribosomas/efectos de los fármacos
20.
Planta ; 117(1): 75-81, 1974 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-24458301

RESUMEN

Two celllines from Daucus carota callus were tested for phenylalanine ammonia-lyase activity. The white callus (DCw) has only 15% of the enzyme activity of the blue callus (DCb). The enzyme activity reaches a maximum value after a cultivation period of 21 days, whereas the maximum in anthocyanin content is reached after 28 days. We can demonstrate here a good correlation between one of the enzymes and the end product of the anthocyanin biosynthesis.The crude extract from DCw cells has no inhibitory effect on the enzyme from DCb-cells. Gibberellic acid A3, a component of the culture medium for DCw cells, does not act as an inhibitor on the partially purified enzyme. The procedure of purification and the characteristics of phenylalanine ammonia-lyase from the callus of Daucus carota are described.

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