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Safety and feasibility of thoracoscopic pericardial window in recurrent pericardial effusion - A single-centre experience. 胸腔镜心包开窗治疗复发性心包积液的安全性和可行性 - 单中心经验。
IF 0.8 Pub Date : 2024-01-01 Epub Date: 2022-10-31 DOI: 10.4103/jmas.jmas_144_22
Mohan Venkatesh Pulle, Manish Bansal, Belal Bin Asaf, Harsh Vardhan Puri, Sukhram Bishnoi, Arvind Kumar

Background: This study aimed to report the surgical outcomes and also evaluating the safety and feasibility of thoracoscopic pericardial window (PW) for recurrent pericardial effusion.

Materials and methods: This was a retrospective analysis of eight cases of recurrent pericardial effusion, managed by thoracoscopic method in a tertiary-level thoracic surgery centre over 5 years. A detailed analysis of all perioperative variables, including complications, was carried out.

Results: A total of eight patients underwent thoracoscopic PW during the study period. Males (87.5%) were predominant in the cohort. The median age was 54 years (range: 28-78 years). The median duration of symptoms was 2 months (range: 1-3 months). Tuberculosis (50%), malignancy (37.5%) and chronic kidney disease (12.5%) were the causes of recurrent effusion. All patients underwent thoracoscopic procedure with no conversions. The median operative time was 45 min (range: 40-70 min). The median effusion volume drained was 500 ± 100 ml. The median hospital stay was 3 days (range: 2-4 days) with no post-procedural complications. All the patients had complete resolution of symptoms. No recurrence was noted in the median follow-up period of 28 months (range: 6-60 months).

Conclusions: Thoracoscopic PW is a safe and feasible minimally invasive option in the management of recurrent pericardial effusion in selected patients. Surgical fitness, haemodynamic status and estimated survival (in malignant effusion) should be considered before the procedure.

背景:本研究旨在报告手术结果,并评估胸腔镜心包开窗术(PW)治疗复发性心包积液的安全性和可行性:本研究旨在报告胸腔镜心包开窗术(PW)治疗复发性心包积液的手术效果,并评估其安全性和可行性:这是一项回顾性分析,研究对象是一家三级胸外科中心5年来用胸腔镜方法治疗的8例复发性心包积液患者。对包括并发症在内的所有围手术期变量进行了详细分析:研究期间共有8名患者接受了胸腔镜PW手术。男性占多数(87.5%)。中位年龄为 54 岁(28-78 岁)。症状持续时间的中位数为 2 个月(范围:1-3 个月)。肺结核(50%)、恶性肿瘤(37.5%)和慢性肾病(12.5%)是导致反复流脓的原因。所有患者均接受了胸腔镜手术,无一例转院。手术时间中位数为 45 分钟(40-70 分钟不等)。排出的中位积液量为 500 ± 100 毫升。中位住院时间为 3 天(2-4 天不等),无术后并发症。所有患者的症状均已完全缓解。中位随访期为 28 个月(6-60 个月),无复发:结论:胸腔镜 PW 是治疗复发性心包积液的一种安全可行的微创方法。手术前应考虑手术适应性、血液动力学状态和估计存活率(恶性积液)。
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引用次数: 0
Management of NF2-associated vestibular schwannomas in children and young adults: influence of surgery and clinical factors on tumor volume and growth rate. 儿童和青少年NF2相关前庭裂神经瘤的治疗:手术和临床因素对肿瘤体积和生长速度的影响。
IF 2.1 Pub Date : 2019-08-23 Print Date: 2019-11-01 DOI: 10.3171/2019.6.PEDS1947
Isabel Gugel, Florian Grimm, Christian Teuber, Lan Kluwe, Victor-Felix Mautner, Marcos Tatagiba, Martin Ulrich Schuhmann

Objective: The authors' aim was to evaluate the tumor volume and growth rate of neurofibromatosis type 2 (NF2)-associated vestibular schwannomas (VSs) and the clinical factors or type of mutations before and after surgery in children and adults younger than 25 years at the time of diagnosis.

Methods: A total of 579 volumetric measurements were performed in 46 operated tumors in 28 NF2 patients, using thin-slice (< 3 mm) T1-weighted contrast-enhanced MRI. The follow-up period ranged from 21 to 167 months (mean 75 months). Growth rate was calculated using a multilinear regression model. Mutation analysis of the NF2 gene was performed in 25 patients.

Results: Surgery significantly (p = 0.013) slowed the VS growth rate from 0.69 ± 1.30 cm3/yr to 0.23 ± 0.42 cm3/yr. Factors significantly associated with a higher growth rate of VSs were increasing patient age (p < 0.0005), tumor volume (p = 0.006), tumor size (p = 0.001), and constitutional truncating mutations in the NF2 gene (p = 0.018). VS growth rates tended to be higher in patients with spinal ependymomas and in right-sided tumors and lower in the presence of peripheral schwannomas; however, no statistical significance was achieved.

Conclusions: Decompression of the internal auditory canal with various degrees of tumor resection decreases the postoperative tumor growth rate in children and young adults with NF2-associated VS. Patients with potential risk factors for accelerated growth (e.g., large volume, truncating mutations) and with increasing age should be monitored more closely before and after surgery.

研究目的作者的目的是评估神经纤维瘤病2型(NF2)相关前庭分裂瘤(VSs)的肿瘤体积和生长速度,以及诊断时年龄小于25岁的儿童和成人手术前后的临床因素或突变类型:使用薄切片(< 3 mm)T1加权对比增强磁共振成像对28名NF2患者的46个手术肿瘤进行了579次体积测量。随访时间为 21 至 167 个月(平均 75 个月)。生长率通过多线性回归模型计算得出。对25名患者进行了NF2基因突变分析:结果:手术明显(p = 0.013)降低了 VS 的生长速度,从 0.69 ± 1.30 cm3/年降至 0.23 ± 0.42 cm3/年。与VS生长率较高明显相关的因素包括患者年龄增加(p < 0.0005)、肿瘤体积增大(p = 0.006)、肿瘤大小增大(p = 0.001)以及NF2基因中的宪法截断突变(p = 0.018)。脊髓上皮瘤患者和右侧肿瘤患者的VS生长率往往较高,而外周裂隙瘤患者的VS生长率较低;但没有统计学意义:有加速生长潜在危险因素(如体积大、截断突变)和年龄增大的患者在手术前后应更密切地监测。
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引用次数: 0
The influence of rat and frog liver enzymes on the hydrolysis of ortho and pyrophosphoric esters of thiamine 大鼠和青蛙肝酶对硫胺素邻苯二甲酸酯和焦磷酸酯水解的影响
Pub Date : 1965-08-01 DOI: 10.1002/JCP.1030660111
Rina Singer-Altbeker, A. Ber
Homogenates of rat and frog liver were incubated with ThDP and ThMP at different pHs. The products of hydrolysis were identified by paper chromatography. In experiments carried out at pH 9 with ThDP as substrate in the presence of rat liver, the spot corresponding to Th did not appear on the chromatogram. This was in contrast with parallel experiments with frog liver. ThMP from commercial source behaved differently toward enzymatic decomposition than ThMP originating from hydrolysis of ThDP. Attempts have been made to explain these differences.
大鼠和青蛙肝脏匀浆分别用不同ph的ThDP和ThMP孵育。水解产物经纸层析鉴定。在pH为9,ThDP为底物,有大鼠肝脏存在的实验中,色谱上没有出现Th对应的斑点。这与青蛙肝脏的平行实验形成对比。来自商业来源的ThMP与来自ThDP水解的ThMP在酶分解方面表现不同。人们曾试图解释这些差异。
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引用次数: 1
The attachment of glycolytic enzymes to muscle ultrastructure 糖酵解酶在肌肉超微结构上的附着
Pub Date : 1965-08-01 DOI: 10.1002/JCP.1030660108
W. R. Amberson, F. Roisen, A. C. Bauer
The glycolytic enzymes, lactic dehydrogenase and aldolase, usually thought to be freely dissolved in the sarcoplasmic matrix, are in good part attached to the muscle ultrastructure. This attachment becomes manifest when the enzyme activities and specific activities of the press juices of whole skeletal muscles (rabbit) are compared with those of minced muscles, all obtained by ultracentrifugation of the tissues at 40,000 xpm for 16 to 20 hours. Mincing causes a great increase in the activities, associated with a rise in the volume and protein concentration of the press juices. We interpret these increases to be due to the solution in the matrix of enzymes previously attached to the ultrastructure. The same conclusion is reached by a different method, which we call “washing the ultrastructure.” It consists in multiple centrifugations of whole skeletal muscles, and removal of press juices, alternating with periods of imbibition of a buffer (0.1 M phosphate at pH 7.5) too dilute to dissolve out the fibrous proteins. During the imbibitions enzymes diffuse out into the buffer not imbibed, which becomes an extract. After four centrifugation-imbibition sequences in as many days nearly all of the fluid matrix has been replaced by buffer. Enzyme activities fall steeply in press juices and extracts until nearly all freely dissolved enzymes have been washed away. Homogenates of the pressed muscles then show activities which are about half of those found in the homogenates of unpressed control muscles. We conclude that the enzymes found in the homogenates of the pressed muscles have previously been attached to the ultrastructure. Similar experiments with heart muscle indicate that nearly all of these enzymes are normally attached to the ultrastructure. Press juices contain only traces of activity, even after the heart has been minced. A fraction of the enzymes is slowly detached during the centrifugation-imbibition sequences, appearing mainly in the extracts.
糖酵解酶、乳酸脱氢酶和醛缩酶,通常被认为是自由溶解在肌浆基质中的,大部分附着在肌肉的超微结构上。当将整个骨骼肌(兔)的压榨液与切碎的肌肉的压榨液的酶活性和比活性进行比较时,这种附着性就变得明显了,所有这些都是通过在40000 xpm的条件下对组织进行16至20小时的超离心得到的。切碎会使活性大大增加,与压榨汁的体积和蛋白质浓度的增加有关。我们将这些增加解释为由于先前附着在超微结构上的酶基质中的溶液。同样的结论可以通过另一种不同的方法得到,我们称之为“清洗超微结构”。它包括对整个骨骼肌进行多次离心,去除榨出的汁液,交替吸吸缓冲液(0.1 M磷酸盐,pH值为7.5),缓冲液太稀,无法溶解出纤维蛋白。在吸收过程中,酶扩散到缓冲液中,而缓冲液没有被吸收,就变成了提取物。在连续4次离心吸吸后,几乎所有的流体基质都被缓冲液所取代。在榨汁和提取物中,酶的活性急剧下降,直到几乎所有自由溶解的酶都被冲走。受压肌肉的匀浆体显示出的活动大约是未受压对照肌肉匀浆体的一半。我们得出结论,在挤压肌肉的匀浆中发现的酶先前已经附着在超微结构上。类似的心肌实验表明,几乎所有这些酶通常都附着在心肌的超微结构上。即使在心脏被切碎之后,榨出的汁液也只含有活动的痕迹。一部分酶在离心吸胀过程中缓慢分离,主要出现在提取物中。
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引用次数: 49
PHYSICAL CHANGES AND MUTAGENESIS. 物理变化和诱变。
R B Setlow
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引用次数: 0
CHANGES IN PATTERNS OF NUCLEIC ACID AND PROTEIN SYNTHESIS CAUSED BY A PURINE ANALOGUE. 嘌呤类似物引起的核酸和蛋白质合成模式的变化
H Chantrenne
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引用次数: 0
REACTION OF SOME MUTAGENIC AND CARCINOGENIC COMPOUNDS WITH NUCLEIC ACIDS. 一些致突变和致癌化合物与核酸的反应。
P Brookes, P D Lawley
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引用次数: 0
ORIGIN AND NATURE OF SPONTANEOUS MUTATIONS IN MEIOTIC ORGANISMS. 减数分裂生物中自发突变的起源和性质。
G E Magni
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引用次数: 0
ACRIDINE MUTAGENS AND DNA STRUCTURE. 吖啶诱变剂和DNA结构。
L S Lerman
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引用次数: 0
STUDIES ON THE MOLECULAR MECHANISM OF HYDROCARBON CARCINOGENESIS. 碳氢化合物致癌的分子机制研究。
C Heidelberger
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引用次数: 0
期刊
Journal of Cellular and Comparative Physiology
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