Nicolaisenlevin7445

Sporadic conventional colon adenomas are microscopically built of 2 intertwined compartments one on top, harboring the dysplastic tissue that defines their histo-biomolecular attributes, and the other below, composed of non-dysplastic crypts with corrupted shapes (CCS). The CCS of 306 colon adenomas revealed asymmetric, haphazardly-distributed proliferating cell-domains (PC). In contrast, the PC-domains in normal controls were symmetric, being limited to the lower thirds of the crypts. In 28% out of 501 sporadic conventional adenomas, foci of p53-upregulated dysplastic tissue were found. The CCS in 30% of 108 sporadic adenomas showed p53-upregulated single cells, suggesting mounting somatic mutations. No p53-upregulated cells were found in the crypts of controls. In polypoid adenomas, the mucosa of the stalk without dysplastic tissue on top disclosed CCS with asymmetrical PC-domains and single p53-upregulated cells. The latter observations suggested that CCS had developed prior to and not after the growth of the dysplastic tissue on top. CCS were also found below colon adenomas in carcinogen-treated rats. It is concluded that the 2 intertwined histo-biological compartments of sporadic conventional colon adenomas are probably interdependent components. These findings may open new directions aimed to uncover the link between the normal colonic mucosa and the histogenesis of, conventional adenomas.in English, Turkish Amaç Sirotik hastalarda sık görülen bir komplikasyon olan hepatopulmoner sendromun (HPS) tanısı halen tartışmaya açıktır. Bu çalışmada, makroagregat albümin akciğer perfüzyon sintigrafisi (99mTc-MAA akciğer sintigrafisi) kullanılarak sirotik hastalarda klinik bulgularla HPS’nin ilişkisi araştırılmıştır. Ayrıca, HPS’nin saptanmasında 99mTc-MAA akciğer sintigrafisi ile kontrast ekokardiyografi (KE) karşılaştırılmıştır. Yöntem Bu çalışmada, sirozlu 27 hastada 99mTc-MAA akciğer sintigrafisi ve KE karşılaştırıldı ve HPS sıklığı değerlendirildi. Ayrıca HPS’nin sıklığı ile diğer değişkenler arasındaki ilişki araştırıldı. Bulgular 99mTc-MAA akciğer sintigrafisi 13 sirozlu hastada (%48,1) HPS’nin varlığını gösterirken, KE 5 sirozlu hastada (%18,51) gösterdi. HPS hastaların %40,74’inde (11/27) hafif, sadece 2 hastada şiddetliydi. Cinsiyet, hastalık süresi, hastalık geçmişi, akciğer semptomları ve Child skoru ile HPS arasında herhangi bir ilişki yoktu (p>0,05). find more Hemodinamik indeksler, arteriyel kan gazı analizi ve laboratuvar indeksleri açısından HPS’li hastalar ve HPS’li olmayan hastalar arasında fark görülmedi (p>0,05). Sirotik hastalarda değerlendirilen koagülasyon faktörleri arasında, sadece HPS ve protrombin zamanı arasında anlamlı bir korelasyon bulundu (p less then 0,05). Sonuç 99mTc-MAA akciğer sintigrafisi ile çok sayıda sirozlu hastada HPS’nin özellikle hafif formu saptandı. Teknik kolaylığı ve objektif kantitatif bilgi edinme olasılığı nedeniyle, 99mTc-MAA akciğer sintigrafisi HPS’nin değerlendirilmesinde diğer tanı yöntemlerini tamamlayıcı olabilir, ancak ek çalışmalara ihtiyaç vardır.Background The significance of ambulatory blood pressure (ABP) in Korean patients with chronic kidney disease (CKD) in relation to renal outcome or death remains unclear. We investigated the role of ABP in predicting end-stage renal disease or death in patients with CKD. Methods We enrolled 387 patients with hypertension and CKD who underwent ABP monitoring and were followed for 1 year. Data on clinical parameters and outcomes from August 2014 to May 2018 were retrospectively collected. The composite endpoint was end-stage renal disease or death. Patients were grouped according to the mean ABP. Results There were 66 endpoint events, 52 end-stage renal disease cases, and 15 mortalities. Among all patients, one developed end-stage renal disease and died. Mean ABP in the systolic and diastolic phases were risk factors for the development of composite outcome with hazard ratios of 1.03 (95% confidence interval [CI], 1.01-1.04; P less then 0.001) and 1.04 (95% CI, 1.02-1.07; P = 0.001) for every 1 mmHg increase in BP, respectively. Patients with mean ABP between 125/75 and 130/80 mmHg had a 2.56-fold higher risk for the development of composite outcome (95% CI, 0.72-9.12; P = 0.147) as compared to those with mean ABP ≤ 125/75 mmHg. Patients with mean ABP ≥ 130/80 mmHg had a 4.79-fold higher risk (95% CI, 1.68-13.70; P = 0.003) compared to those with mean ABP ≤ 125/75 mmHg. Office blood pressure (OBP) was not a risk factor for the composite outcome when adjusted for covariates. Conclusion In contrast to OBP, ABP was a significant risk factor for end-stage renal disease or death in CKD patients.BACKGROUND The aim of this study was to evaluate the safety and performance of the sinus-SuperFlex-635 self-expandable nitinol stent (Optimed GmbH) for the treatment of steno-occlusive lesions in the superficial femoral artery (SFA) and proximal popliteal artery (PPA). METHODS The prospective, multicenter, observational HERO study recruited 117 eligible patients (83 men; mean age 69.4±9.7y) from 7 centers in Belgium. RESULTS A total of 129 stents were successfully deployed in 121 lesions in 117 patients (100%). The patients presented with symptomatic ≥50% stenosis or chronic total occlusion (CTO) (30.6%). Mean lesion length was 71.4±56.3 mm. Moderate to severe calcification was present in 82.6% of the lesions. Acute lesion success ( less then 30% residual stenosis) was achieved in 96.0%. There were no in-hospital serious adverse events. Duplex ultrasound-driven primary patency at 12 months was recorded in 84 of 107 (78.5%) lesions. The overall target lesion revascularization (TLR) rate was 8.4% at 12 months; the target extremity revascularization (TER) rate was 4.7%. Clinical assessment at 12 months demonstrated improvement by at least 1 Rutherford class, without the need for TLR (i.e. primary sustained clinical improvement) in 83.9% of patients and with the need for TLR in 90.6% of patients (i.e. secondary sustained clinical improvement). CONCLUSIONS Based on the high primary patency, low stent fracture rate and significant clinical improvement, combined with refined stent design and long stent availability, the sinus-SuperFlex-635 self-expandable nitinol stent proves its value in the treatment of complex femoropopliteal lesions.