AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ). METH...AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ). METHODS: Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled. Patients were classified as GEJ group (SEMS across GEJ, 18 patients) and non-GEJ group (SEMS above GEJ, 30 patients) according to SEMS position. Double layered (outer uncovered and inner covered stent) esophageal stents were placed. RESULTS: The SEMS insertion and the clinical improvement were achieved in all patients in both groups. Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group. Tumor overgrowth occurred in five and eight patients, respectively, food impaction occurred in one patient in each group, and stent migration occurred in one and no patient, respectively. There were no significant differences between the two groups. Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients, P = 0.036) and was controlled by proton pump inhibitor. Aspiration pneumonia occurred in zero and five patients, respectively, and tracheoesophageal fistula occurred in zero and two patients, respectively. CONCLUSION: Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction. Double-layered SEMS provide acceptable complications, especially migration, although reflux esophagitis is more common in the GEJ group.展开更多
The inhibition ability of 4-amino-5-phenyl-4H-1, 2, 4-trizole-3-thiol （APTT）, ethylenediaminetetra-acetic acid （EDTA） and thiourea （TU） for mild steel corrosion in 1.0 moFL HC1 solution at 30 ℃ was investigated...The inhibition ability of 4-amino-5-phenyl-4H-1, 2, 4-trizole-3-thiol （APTT）, ethylenediaminetetra-acetic acid （EDTA） and thiourea （TU） for mild steel corrosion in 1.0 moFL HC1 solution at 30 ℃ was investigated. Tafel polarization and electrochemical impedance spectroscopy （EIS） were used to investigate the influence of these organic compounds as corrosion inhibitors of mild steel in 1.0 mol/L HC1 solution at 30 ℃. The inhibition mechanism was discussed in terms of Langrnuir isotherm model. Results obtained from Tafel polarization and impedance measurements are in a good agreement. The inhibition efficiency increases with the increase of the inhibitor concentration. The adsorption of the inhibitors on the mild steel surface follows Langmuir adsorption isotherm and the free energy of adsorption AGads indicates that the adsorption of APTT, EDTA, and TU molecules is a spontaneous process and a typical chemisorption.展开更多
Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of e...Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function （ejection fraction 〈 45%） who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.展开更多
基金Supported by A grant from the Korea Healthcare Technology R and D Project, Ministry for Health, Welfare and Family Affairs, South Korea, No. A091047
文摘AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ). METHODS: Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled. Patients were classified as GEJ group (SEMS across GEJ, 18 patients) and non-GEJ group (SEMS above GEJ, 30 patients) according to SEMS position. Double layered (outer uncovered and inner covered stent) esophageal stents were placed. RESULTS: The SEMS insertion and the clinical improvement were achieved in all patients in both groups. Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group. Tumor overgrowth occurred in five and eight patients, respectively, food impaction occurred in one patient in each group, and stent migration occurred in one and no patient, respectively. There were no significant differences between the two groups. Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients, P = 0.036) and was controlled by proton pump inhibitor. Aspiration pneumonia occurred in zero and five patients, respectively, and tracheoesophageal fistula occurred in zero and two patients, respectively. CONCLUSION: Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction. Double-layered SEMS provide acceptable complications, especially migration, although reflux esophagitis is more common in the GEJ group.
基金Project(UKM-GUP-BTT-07-25-170) supported by Universiti Kebangsaan Malaysia
文摘The inhibition ability of 4-amino-5-phenyl-4H-1, 2, 4-trizole-3-thiol （APTT）, ethylenediaminetetra-acetic acid （EDTA） and thiourea （TU） for mild steel corrosion in 1.0 moFL HC1 solution at 30 ℃ was investigated. Tafel polarization and electrochemical impedance spectroscopy （EIS） were used to investigate the influence of these organic compounds as corrosion inhibitors of mild steel in 1.0 mol/L HC1 solution at 30 ℃. The inhibition mechanism was discussed in terms of Langrnuir isotherm model. Results obtained from Tafel polarization and impedance measurements are in a good agreement. The inhibition efficiency increases with the increase of the inhibitor concentration. The adsorption of the inhibitors on the mild steel surface follows Langmuir adsorption isotherm and the free energy of adsorption AGads indicates that the adsorption of APTT, EDTA, and TU molecules is a spontaneous process and a typical chemisorption.
文摘Background Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. Methods The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function （ejection fraction 〈 45%） who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Results Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Conclusions Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.
