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1.
Blood Cancer J ; 7(4): e559, 2017 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-28452984

RESUMO

Although tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of chronic myeloid leukemia (CML), the ability of TKIs to eradicate CML remains uncertain and patients must continue TKI therapy for indefinite periods. In this study, we performed whole-exome sequencing to identify somatic mutations in 24 patients with newly diagnosed chronic phase CML who were registered in the JALSG CML212 study. We identified 191 somatic mutations other than the BCR-ABL1 fusion gene (median 8, range 1-17). Age, hemoglobin concentration and white blood cell counts were correlated with the number of mutations. Patients with mutations ⩾6 showed higher rate of achieving major molecular response than those<6 (P=0.0381). Mutations in epigenetic regulator, ASXL1, TET2, TET3, KDM1A and MSH6 were found in 25% of patients. TET2 or TET3, AKT1 and RUNX1 were mutated in one patient each. ASXL1 was mutated within exon 12 in three cases. Mutated genes were significantly enriched with cell signaling and cell division pathways. Furthermore, DNA copy number analysis showed that 2 of 24 patients had uniparental disomy of chromosome 1p or 3q, which disappeared major molecular response was achieved. These mutations may play significant roles in CML pathogenesis in addition to the strong driver mutation BCR-ABL1.


Assuntos
Proteínas de Ligação a DNA/genética , Dioxigenases/genética , Histona Desmetilases/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Proteínas Proto-Oncogênicas/genética , Proteínas Repressoras/genética , Fatores Etários , Variações do Número de Cópias de DNA/genética , Resistencia a Medicamentos Antineoplásicos/genética , Epigênese Genética/genética , Feminino , Proteínas de Fusão bcr-abl/genética , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Contagem de Leucócitos , Masculino , Mutação , Inibidores de Proteínas Quinases/administração & dosagem , Transdução de Sinais , Sequenciamento do Exoma
2.
Leukemia ; 31(4): 861-871, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27694924

RESUMO

Somatic inactivating mutations in epigenetic regulators are frequently found in combination in myelodysplastic syndrome (MDS). However, the mechanisms by which combinatory mutations in epigenetic regulators promote the development of MDS remain unknown. Here we performed epigenomic profiling of hematopoietic progenitors in MDS mice hypomorphic for Tet2 following the loss of the polycomb-group gene Ezh2 (Tet2KD/KDEzh2Δ/Δ). Aberrant DNA methylation propagated in a sequential manner from a Tet2-insufficient state to advanced MDS with deletion of Ezh2. Hyper-differentially methylated regions (hyper-DMRs) in Tet2KD/KDEzh2Δ/Δ MDS hematopoietic stem/progenitor cells were largely distinct from those in each single mutant and correlated with transcriptional repression. Although Tet2 hypomorph was responsible for enhancer hypermethylation, the loss of Ezh2 induced hyper-DMRs that were enriched for CpG islands of polycomb targets. Notably, Ezh2 targets largely lost the H3K27me3 mark while acquiring a significantly higher level of DNA methylation than Ezh1 targets that retained the mark. These findings indicate that Ezh2 targets are the major targets of the epigenetic switch in MDS with Ezh2 insufficiency. Our results provide a detailed trail for the epigenetic drift in a well-defined MDS model and demonstrate that the combined dysfunction of epigenetic regulators cooperatively remodels the epigenome in the pathogenesis of MDS.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Proteína Potenciadora do Homólogo 2 de Zeste/metabolismo , Epigênese Genética , Regulação da Expressão Gênica , Síndromes Mielodisplásicas/genética , Síndromes Mielodisplásicas/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Animais , Sequência de Bases , Sítios de Ligação , Ilhas de CpG , Metilação de DNA , Proteínas de Ligação a DNA/genética , Dioxigenases , Modelos Animais de Doenças , Elementos Facilitadores Genéticos , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Hematopoese/genética , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Membro 2 do Grupo A da Subfamília 4 de Receptores Nucleares/genética , Membro 2 do Grupo A da Subfamília 4 de Receptores Nucleares/metabolismo , Motivos de Nucleotídeos , Ligação Proteica , Proteínas Proto-Oncogênicas/genética , Proteínas Repressoras/metabolismo , Fatores de Transcrição/metabolismo
5.
Indian J Nephrol ; 21(4): 264-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22022087

RESUMO

We evaluated important nontraditional cardiovascular risk factors, endothelial function and oxidative stress (OS) among stable peritoneal dialysis (PD) patients. Their association with carotid intimal medial thickness (CIMT) was also assessed. Thirty-eight adult patients (13 diabetics, 20 males) on PD for >6 months and 15 age and sex-matched controls were studied. Duration of dialysis (DOD), residual urine output (UO), weekly Kt/V urea, detailed biochemical and lipid profile were noted. OS was measured by serum concentration of antioxidants; vitamin C and ferric reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid-reactive substances (TBARS). High-resolution ultrasonography was used to determine CIMT and flow-mediated dilatation of brachial artery [endothelium-dependent dilatation (EDD)] and dilatation subsequent to nitrate spray [endothelium-independent dilatation (EID)]. Mean age, DOD, UO and Kt/V of study population were 49.3 ± 11.6 years, 19.4 ± 11.8 months, 508.2 ± 422.9 ml/day and 1.73 ± 0.24, respectively. As compared to controls PD patients had higher CIMT (0.46 ± 0.05 vs 0.50 ± 0.07 mm, P = 0.003) and TBARS (1.5 ± 0.4 vs 5.1 ± 2.3 nM/ml, P < 0.001) but lower Vitamin C (1.7 ± 0.3 vs 0.6 ± 0.2 mg%, P < 0.001), FRAP (990.8 ± 78.1 vs 328.7 ± 183.5 µM/L, P < 0.001) and EDD (26.2 ± 5.4 vs 9.8 ± 4.6 %, P < 0.001). TBARS correlated positively with DOD and negatively with hemoglobin. Vitamin C and FRAP correlated positively with serum albumin. EDD correlated positively with UO, Kt/V and hemoglobin. CIMT correlated negatively with Kt/V and hemoglobin. Among themselves CIMT correlated negatively with EDD and vitamin C. EDD correlated positively with vitamin C, while FRAP correlated positively with vitamin C and negatively with TBARS. PD patients have higher OS, poorer endothelial function and higher structural atherosclerosis. These parameters are closely linked to each other, hemoglobin, DOD, residual UO, serum albumin and small solute clearances.

9.
Trop Gastroenterol ; 24(3): 120-3, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14978983

RESUMO

Pancreatic involvement is considered to be the hallmark of malnutrition-related diabetes mellitus (MRDM). Of the 2 subgroups of the disease, fibrocalculous pancreatic diabetes (FCPD) is characterized by pancreatic calcification. The nature of pancreatic abnormalities in MRDM have not been studied extensively in Indian patients. The present study was designed to compare pancreatic abnormalities (exocrine and endocrine) including endoscopic retrograde pancreaticography in patients with FCPD and protein deficient pancreatic diabetes (PDPD), in relation to controls. Ten patients each of FCPD and PDPD were studied with regard to clinical features, biochemical exocrine and endocrine pancreatic responses, C-peptide response, islet cell antibody, and pancreatographic changes. Five normal pancreatograms were taken as control. Clinical and biochemical features in patient with FCPD and PDPD were as follows: pain in 8 and 2 patients, respectively; the mean duration of diabetes was similar in both groups (62.28 +/- 71.92 months V. 72 +/- 50.9 months); and faecal fat excretion and insulin requirements were comparable in both groups. The main pancreatic duct was dilated in 6 of 10 patient with FCPD and only 1 of 10 with PDPD on ultrasonography. On pancreatography the duct was dilated in 9 of 10 patients with FCPD and only 1 of 10 patients with PDPD. The number of side branches was reduced in all cases with MRDM; in those with FCPD, these were stunted and dilated while in PDPD side branches are thin and spastic. We conclude that pancreatic ductal changes involving the main duct and side branches are more frequent in patients with FCPD as compared to those with PDPD.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Diabetes Mellitus/etiologia , Diabetes Mellitus/fisiopatologia , Pancreatopatias/etiologia , Pancreatopatias/fisiopatologia , Desnutrição Proteico-Calórica/complicações , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Diabetes Mellitus/sangue , Humanos , Pancreatopatias/sangue , Ductos Pancreáticos/patologia
10.
Trop Gastroenterol ; 24(3): 152-6, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14978994

RESUMO

Laparoscopic fundoplication is rapidly becoming the surgical procedure of choice in western countries for the management of gastro-oesophageal reflux disease (GERD). Experience with this technique is limited in India. Most operations continue to be performed through the traditional open technique, thus denying the advantage of a minimal invasive approach to patients. This study was done to evaluate the feasibility and short term results of laparoscopic Nissen fundoplication. Between June 2000 and March 2002, a total of 10 patients with GERD refractory to medical therapy or requiring daily treatment underwent laparoscopic Nissen fundoplication. Preoperative evaluation included scoring of symptoms, oesophagogastroduodenoscopy, barium swallow and nuclear scan. The intraoperative and post-operative course of the patients was recorded. At 3 months post-surgery, patients were re-evaluated using pre-operative symptom scores and investigations to assess the benefit of and complications associated with surgery. Laparoscopic nissen fundoplication was successfully completed in all the patients. Follow up ranged from 3 to 18 months with a mean of 5.9 months. The mean symptom score decreased from 10.1 pre-operatively to 1.7 (p value < 0.001). Eight out of 9 patients (88%) had endoscopic resolution of oesophagitis. Seven patients (70%) were off medication following surgery while the remaining 3 (30%) were taking medication intermittently. Overall, 80% of the patients were satisfied with the surgery. One patient required re-exploration due to bleeding from a short gastric vessel. The most frequent post-operative complication was temporary dysphagia in 60% of patients, which improved with conservative management over 2 to 3 weeks. We concluded that laparoscopic Nissen fundoplication is a safe and effective procedure to treat patients with GERD.


Assuntos
Fundoplicatura , Refluxo Gastroesofágico/cirurgia , Laparoscopia , Adulto , Feminino , Fundoplicatura/métodos , Humanos , Índia/epidemiologia , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Resultado do Tratamento
11.
Trop Gastroenterol ; 23(4): 167-9, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12833701

RESUMO

Chronic Calcific Pancreatitis of Tropics is a disease of unknown aetiology and is characterised by chronic pancreatitis with calcification in young persons who present with pain, diabetes, and/or steatorrhoea. ERCP performed on 42 patients with this condition revealed changes compatible with chronic pancreatitis. These changes were however, more marked and somewhat different from those seen in the alcoholic chronic pancreatitis. Cystic dilatation, tortuosity, and obstruction of the main pancreatic duct were similar to that in alcoholic pancreatitis. The features of CCPT that were different from those of latter, were large pancreatic calculi, absence of strictures/stenosis and absence of irregularity of the ductal wall. The calculi were predominantly in the head region of the pancreas causing maximal dilatation of the main pancreatic duct in the head of pancreas. The secondary branches were stunted, short and scanty but revealed a lower grade of changes, than the changes documented in the main pancreatic duct. The pancreatic ductal changes in CCPT seems to be different from that seen in chronic alcoholic pancreatitis and may be due to the difference in the pathophysiology of the underlying disease.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Pancreatite/diagnóstico por imagem , Adolescente , Adulto , Idoso , Calcinose/diagnóstico por imagem , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos/diagnóstico por imagem
12.
Nat Neurosci ; 4(5): 507-12, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11319559

RESUMO

Glucose-responsive (GR) neurons in the hypothalamus are thought to be critical in glucose homeostasis, but it is not known how they function in this context. Kir6.2 is the pore-forming subunit of K(ATP) channels in many cell types, including pancreatic beta-cells and heart. Here we show the complete absence of both functional ATP-sensitive K+ (K(ATP)) channels and glucose responsiveness in the neurons of the ventromedial hypothalamus (VMH) in Kir6.2-/- mice. Although pancreatic alpha-cells were functional in Kir6.2-/-, the mice exhibited a severe defect in glucagon secretion in response to systemic hypoglycemia. In addition, they showed a complete loss of glucagon secretion, together with reduced food intake in response to neuroglycopenia. Thus, our results demonstrate that KATP channels are important in glucose sensing in VMH GR neurons, and are essential for the maintenance of glucose homeostasis.


Assuntos
Glucose/metabolismo , Homeostase/fisiologia , Hipotálamo/fisiologia , Canais de Potássio Corretores do Fluxo de Internalização , Canais de Potássio/fisiologia , Transportadores de Cassetes de Ligação de ATP , Animais , Glicemia/metabolismo , Catecolaminas/metabolismo , Ingestão de Alimentos/fisiologia , Eletrofisiologia , Epinefrina/metabolismo , Epinefrina/farmacologia , Glucagon/metabolismo , Glucagon/farmacologia , Hormônios/farmacologia , Hipoglicemia/genética , Hipoglicemia/metabolismo , Técnicas In Vitro , Canais KATP , Camundongos , Camundongos Knockout , Canais de Potássio/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa
13.
J Gastroenterol Hepatol ; 14(7): 705-8, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10440216

RESUMO

BACKGROUND: Malnutrition-related diabetes mellitus is a distinct clinical entity subdivided into protein-deficient diabetes mellitus (PDDM) and fibrocalculus pancreatic diabetes (FCPD). Whereas FCPD has obvious pancreatitis manifested by pancreatic duct calculi, the evidence for involvement of the pancreas in PDDM is limited to the presence of ketosis-resistant hyperglycaemia. METHODS: We studied 10 patients with PDDM biochemically and radiologically. Endoscopic retrograde cholangiopancreatography was performed to determine if they had any evidence of chronic pancreatitis. RESULTS: Their mean faecal chymotrypsin level was low (13.2+/-5.72 microg/g), as was their basal c-peptide value (0.35+/-0.15 mmol/L). Islet cell antibodies were not detected in any of these patients. Ultrasound examination revealed pancreatic atrophy. In two patients, however, the pancreas was bulky. The ERCP showed generalized thinning of the pancreatic duct, measuring 2.4+/-0.06mm in the head, 2.01+/-0.08 mm in the body and 1.02 +/- 0.03 mm in tail region; side branches were seen but they were too sparse and thin. CONCLUSIONS: The significance of these changes is not clear, but they may represent an ongoing pancreatic disease and may, indeed, be the earliest changes of chronic pancreatitis.


Assuntos
Diabetes Mellitus/etiologia , Pancreatite/complicações , Deficiência de Proteína/complicações , Adolescente , Adulto , Criança , Colangiopancreatografia Retrógrada Endoscópica , Doença Crônica , Feminino , Humanos , Masculino , Pâncreas/diagnóstico por imagem , Ductos Pancreáticos/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Ultrassonografia
14.
Asia Pac J Clin Nutr ; 8(1): 19-23, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24393731

RESUMO

The nutritional status of patients with chronic pancreatitis was assessed in 76 consecutive patients (63 males, mean age 35 ± 10 years; 13 females, mean age 40 ± 16 years) attending the pancreas clinic of a tertiary care hospital in India. A food frequency questionnaire was used to elicit information regarding dietary intake of food items. Nutrient intake was calculated using the 24 h recall method on a subsample of 20 patients. Anthropometric measurements were taken and haemoglobin and serum albumin were estimated. Thirty patients (45%) had made dietary modifications after they were diagnosed as having chronic pancreatitis. These changes in diet included a decrease in fat, spices and/or quantity of food consumed. Analysis of the qualitative data revealed that the majority of patients were taking wheat, lentils, vegetables, fruits, milk, curd, sugar and oils on a daily basis. The mean energy intake was 1750 ± 375 kcal in males and 1180 ± 246 kcal in females, which turned out to be 37% lower than the Recommended Dietary Allowances (RDA), both in males and females. Alhough most patients (86%) were in the normal range of Body Mass Index (BMI), 67% of the patients reported weight loss after onset of the disease. Biochemical parameters studied were in the normal range: haemoglobin 12.26 ± 1.99 gm% and albumin 4.05 ± 0.89 g/100 mL. We concluded that in patients with chronic pancreatitis, malnutrition occurs mainly due to a low intake of calories and protein as a result of dietary modification for symptomatic relief and pancreatic insufficiency. However, nutritional parameters such as haemoglobin and serum albumin are fairly well maintained.

15.
Trop Gastroenterol ; 19(2): 70-1, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9752757

RESUMO

Eighty five children were evaluated endoscopically for recurrent lower gastrointestinal (GI) bleeding. The male: female ratio was 2.4:1 with a mean age of 6 years (range 8 months to 2 years). After adequate bowel preparation endoscopic evaluation was done using olympus CF 101 colonoscope. Sedation was given only in two patients. Full length colonoscopy had been done in 16 cases only, to look for extent of disease in 8 cases and to ascertain site of bleeding when no lesion could be seen on sigmoidoscopy. Juvenile polyps were seen in 40 cases, amoebic ulcer in 20, solitary rectal ulcer in 4 and polyposis syndrome in 5 cases. Sigmoidoscopy alone could establish the diagnose in 76 cases. We conclude that flexible sigmoidoscopy alone is safe and adequate in ascertaining the cause of prolonged recurrent lower GI bleeding.


Assuntos
Hemorragia Gastrointestinal/epidemiologia , Criança , Colite/complicações , Colite/parasitologia , Pólipos do Colo/complicações , Colonoscopia , Disenteria Amebiana/complicações , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Índia/epidemiologia , Masculino , Reto , Sigmoidoscopia
16.
Trop Gastroenterol ; 19(1): 32-3, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9641033

RESUMO

The use of flexible endoscopes had made removal of foreign bodies in the upper gastrointestinal tract easier and safer. We describe our experience of 49 cases of foreign bodies of the upper gastrointestinal tract. Majority (67%) of the patients were children and only 4 patients (8%) were above 45 years of age. The most common foreign bodies encountered were coins (25), fruit stones (4) and dentures (3). In 29 patients foreign bodies were lodged in the oesophagus and in 15 cases in the stomach. Forty one patients were considered for endoscopic removal of the foreign bodies and 40 could be managed successfully. There were no procedure related complications. We conclude that endoscopic removal of the foreign bodies of the upper gastrointestinal tract is a safe and effective technique.


Assuntos
Esôfago , Corpos Estranhos/terapia , Intestino Delgado , Estômago , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade
17.
J Hepatol ; 26(2): 293-7, 1997 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9059949

RESUMO

BACKGROUND/AIMS: Erythropoietin-independent endogenous growth of erythroid colony from bone marrow cells has been shown in many patients with Budd Chiari syndrome in earlier studies. In another report, increased megakaryocyte colony growth has also been documented in this disease. However, defects in granulocyte-macrophage cell lines in Budd Chiari syndrome have yet to be reported in the literature. METHODS: Both in vitro erythroid and granulocyte-macrophage colony cultures from peripheral blood mononuclear cells with and without erythropoietin or granulocyte-macrophage colony stimulating factor, respectively, were studied in 32 patients with Budd Chiari syndrome, along with 20 normal healthy controls and ten patient controls with portal hypertension (five patients each with noncirrhotic portal fibrosis and liver cirrhosis). In 18 patients the occlusion was only in the inferior vena cava, in five patients only in hepatic veins, and in nine patients both inferior vena cava and hepatic veins were blocked. RESULT: Endogenous erythroid or granulocyte-macrophage colony growth was not observed in any of the normal healthy controls or in patient controls with portal hypertension. However, 22 of the 32 (68.8%) patients showed endogenous erythroid colony growth. Moreover, four of them also showed endogenous growth of granulocyte-macrophage colony, not previously reported in Budd Chiari syndrome. CONCLUSION: It may be inferred that stem cell defects affecting all three hemopoietic cell lines (erythroid, megakaryocyte and granulocyte-macrophage) occur in Budd Chiari syndrome, which may be the primary defect responsible for the pro-thrombotic state causing venous thrombosis in them.


Assuntos
Síndrome de Budd-Chiari/fisiopatologia , Células-Tronco Hematopoéticas/fisiologia , Síndrome de Budd-Chiari/etiologia , Eritropoese , Humanos , Hipertensão Portal/fisiopatologia
19.
J Clin Gastroenterol ; 22(1): 23-7, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8776090

RESUMO

Dietary intake and plasma lipids were estimated in 200 patients with gallstones and 98 control subjects from a hospital in Northern India and were matched for age, sex, and social class. The intake of total calories and carbohydrates and the plasma triglyceride values were higher in all gallstone patients as compared with controls (p < 0.05 and p < 0.01, respectively). The dietary intake of refined carbohydrates was higher than in controls, but only in the female patients with gallstones (35.6 +/- 32.9 g/day compared with 24.5 +/- 11.8 g/day; p < 0.001). By contrast, the male patients with gallstones had an increased intake of fat (patients 79.0 +/- 38.1 g/day vs. controls 60.2 +/- 24.3 g/day; p < 0.05) and had increased plasma cholesterol values (patients 166.4 +/- 54.2 mg/dl vs. controls 140.3 +/- 32.8 mg/dl; p < 0.01). Such sex differences in the dietary intake and plasma lipid values may form a special feature of gallstone disease in Northern India and should be studied further.


Assuntos
Colelitíase/etiologia , Dieta , Adulto , Fatores Etários , Estudos de Casos e Controles , Colelitíase/sangue , Feminino , Humanos , Índia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
20.
Eur J Haematol ; 55(5): 294-301, 1995 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7493675

RESUMO

Morphologic characteristics of circulating platelets were studied in 20 patients with primary Budd-Chiari syndrome (BCS) without any known etiology, using transmission electron microscopy (TEM). Significant platelet ultrastructural changes were observed in all the patients (in 10-->90% platelets) as compared to 20 normal healthy controls (in up to 4% of their platelets). The prominent changes in the platelets were paucity or absence of alpha granules, hypertrophy of the open canalicular systems (OCS) and clumping and fusion of the granules and other organelles in the centre of platelets. Some other changes observed in platelets were dilated channels of OCS, pseudopodial protrusion of cytoplasm and presence of prominent masses of glycogen particles. Platelets from 20 normal controls processed along with the patients' platelets showed only a few such abnormalities. Most of these changes observed in patients' platelets were akin to the changes observed in platelets undergoing activation. Assay of plasma beta-thromboglobulin showed significantly higher levels in all the patients (p < 0.001) further confirming on-going in vivo platelet activation with morphologic changes most likely reflecting the thrombotic process present in BCS patients.


Assuntos
Plaquetas/ultraestrutura , Síndrome de Budd-Chiari/sangue , Adolescente , Adulto , Feminino , Glicogênio/sangue , Humanos , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Ativação Plaquetária , beta-Tromboglobulina/metabolismo
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