RESUMEN
The research was performed on 15 non embalmed bodies and 32 abdominal complexes of adult individuals. The comparative study of variant anatomy of splenic ligaments and architectonics of arteries passing through them was carried out to substantiate the mobilization of splenopancreatic complex. Anatomical and angiographic restudied were carried out using preparation, morphometry, injection of gastric, pancreatic and splenic vascular bed with red lead suspension. It was established that the form and sizes of splenic ligaments and their interrelation with the branches of the splenic artery were variable. The minimal and maximal sizes of gastrolienal, phrenicosplenic and splenocolic ligaments differed 2-3 times. In most cases, spleen was fixed in abdominal cavity by many short ligaments. It was shown that architectonics and topography of main branches of spleen artery were determined by morphometric characteristics of the spleen proper and its ligaments. The knowledge of splenic ligament variant anatomy allows a new perspective to approach to substantiate different methods of the mobilization of spleno-pancreatic complex during surgical operations on organs of the upper part of the peritoneal cavity and organ-preserving surgery of the spleen.
Asunto(s)
Ligamentos/anatomía & histología , Bazo/anatomía & histología , Bazo/irrigación sanguínea , Arteria Esplénica/anatomía & histología , Adulto , Femenino , Humanos , MasculinoRESUMEN
A comparative study of the effect of the combination of Nissen fundoplication, different variants of splenectomy ligation of left gastric artery on stomach wall arterial bed blood fillability was carried out on 40 human corpses in 6 research series. The red lead paint suspension was used for the injection of arterial bed. It was shown that combination of Nissen operation andligation of stomach short arteries during splenectomy and left gastric artery trunk in its intraligamental part resulted in the impairment of the stomach wall blood supply. In the gastric fundus area avascular zones measuring from 2.5 x 3.0 to 5.0 x 10.0 cm and larger, were detected. The stomach wall of the given areas is potentially prone to necrosis. Avascular zones in the stomach wall were not observed when short gastric arteries were preserved.
Asunto(s)
Arterias/patología , Fundoplicación/efectos adversos , Esplenectomía/efectos adversos , Estómago/irrigación sanguínea , Adulto , Anciano , Arterias/fisiología , Arterias/cirugía , Estudios de Casos y Controles , Humanos , Persona de Mediana Edad , Estómago/patología , Estómago/cirugíaRESUMEN
OBJECTIVE: To determine the frequency of and risk factors for major adverse drug reactions (MADRs) associated with anti-tuberculosis treatment at a tuberculosis (TB) referral hospital in the Republic of Korea. METHODS: Data from an ongoing natural history cohort study were analyzed for permanent regimen changes due to adverse drug reactions and confirmed by chart review. RESULTS: Among 655 subjects, there were 132 MADRs in 112 (17%) subjects. The most common MADRs were gastrointestinal (n = 53), musculoskeletal (n = 22), psychiatric (n = 10), visual (n = 9) and peripheral neuropathic (n = 8). MADRs were more frequent in subjects being treated with second-line regimens (16%) compared to first-line regimens (2.5%). Drugs frequently associated with MADRs were amikacin (3/10, 30%), linezolid (8/29, 28%), para-aminosalicylic acid (47/192, 24%), pyrazinamide (31/528, 5.8%), macrolides (2/44, 4.5%) and cycloserine (12/272, 4.4%). Fluoroquinolones accounted for a single MADR (1/377, 0.003%), despite widespread usage. In multivariate analysis, infection with multi- or extensively drug-resistant disease and previous history of anti-tuberculosis treatment were risk factors for MADR, with adjusted hazard ratios of respectively 2.2 (P = 0.02) and 1.6 (P = 0.04). CONCLUSION: MADRs are common during anti-tuberculosis chemotherapy in this population, occurring in more than one in six subjects. New and less toxic agents to treat drug-resistant TB are urgently needed.
Asunto(s)
Antituberculosos/efectos adversos , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis/tratamiento farmacológico , Adulto , Anciano , Antituberculosos/uso terapéutico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , República de Corea , Factores de Riesgo , Resultado del Tratamiento , Adulto JovenRESUMEN
[Rh(bpy)2(chrysi)]3+ is a novel, sterically bulky DNA intercalator that has been designed to bind specifically in the destabilized regions near DNA base mismatches and, upon photoactivation, to cleave the DNA backbone. Here the molecule is shown to be both a general and remarkably specific mismatch recognition agent. Specific DNA cleavage is observed at over 80% of mismatch sites in all the possible single base pair sequence contexts around the mispaired bases. Moreover, the complex is highly site-specific; it is shown to recognize and photocleave at a single base mismatch in a 2725 base pair linearized plasmid heteroduplex. Sterically demanding intercalators such as [Rh(bpy)2(chrysi)]3+ may have application both in mutation detection systems and as mismatch-specific chemotherapeutic agents.