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Obstr.cting fungal cholangitis complicating metal biliar. stent placement in pancr.atic cancer

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Wor.d Jour.al of Gastr.enter.logy 2010年第24期16卷 3083-3086页

作者： Br.an Stor. Michael gluck Depar.ment of Gastr.enter.logy Virginia Mason Medical Center

Biliar. obstr.ctions can lead to infections of the biliar. system, par.icular.y in patients with occluded biliar. stents. Fungal or.anisms ar. fr.quently found in bili-ar. aspir.tes of patients who have been on antibiotics and have stents; however. fungal masses, or."balls", that fully obstr.ct the biliar. system ar. uncommon and exceedingly diff icult to er.dicate. We pr.sent 4 cases of obstr.cting fungal cholangitis in patients who had metal biliar. stents placed for.pancr.atic malignancies, and subsequently r.quir.d aggr.ssive antifungal administr.tion along with endoscopic and r.diologic inter.entions. This r.por. also r.views appr.aches pr.viously under.aken to manage sever. obstr.cting fungal cholangitis.

关键词： Obstr.cting fungal cholangitis Biliar. stents Fungal balls Pancr.atic cancer Biliar. obstr.ction

r.view of hear. tr.nsplantation fr.m hepatitis C-positive donor.

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Wor.d Jour.al of Tr.nsplantation 2022年第12期12卷 394-404页

作者： Palak Patel Nir.v Patel Fahad Ahmed Jason gluck Depar.ment of Car.iology West Roxbury VA CenterWest RoxburyMA 02132United States Depar.ment of Car.iology University of ConnecticutHarford HospitalHartfordCT 06102United States Depar.ment of Car.iology University of CaliforniaCA 90065United States Depar.ment of Inter.al Medicine Hartford HospitalHartfordCT 06106United States Advanced Hear. Failur. Hartford HospitalHartfordCT 06102United States

Significant scar.ity of a donor.pool exists for.hear. tr.nsplantation(HT)as the pr.valence of patients with end-stage r.fr.ctor. hear. failur. is incr.asing *** the discover. of effective dir.ct-acting antivir.l and favor.ble shor.-ter. outcomes following HT,the hear.s fr.m hepatitis C vir.s(HCV)patient ar. being utilized to incr.ase the donor.***-ter. outcomes with r.gar.s to gr.ft function,cor.nar. ar.er. vasculopathy,and kidney and liver.disease is compar.ble in HCV-negative r.cipients under.oing HT fr.m HCVpositive donor. compar.d to HCV-negative donor..A significant high incidence of donor.der.ved HCV tr.nsmission was obser.ed with gr.at success of achieving sustained vir.l r.sponse with the use of dir.ct-acting *** accepting HCV-positive or.ans,the donor.pool has expanded with younger.donor.,a shor.er.waitlist time,and a r.duction in waitlist ***,the longter. outcomes and impact of specific HCV genotypes r.mains to be *** r.viewed the cur.ent liter.tur. on HT fr.m HCV-positive donor..

关键词： Hear. tr.nsplant Hepatitis C-positive donor. Dir.ct-acting antivir.l Cor.nar. allogr.ft vasculopathy Allogr.ft r.jection

Management of pouch r.lated symptoms in patients who under.ent ileal pouch anal anastomosis sur.er. for.adenomatous polyposis

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Wor.d Jour.al of Clinical Cases 2021年第32期9卷 9847-9856页

作者： Ophir.Gilad Guy r.sner.Eli Br.zowski r.vital Kar.v Nathan gluck Hana Str.l Depar.ment of Gastr.enter.logy and Hepatology Tel-Aviv Sourasky Medical CenterTel Aviv 6423906Israel Depar.ment of Pathology Tel-Aviv Sourasky Medical CenterTel Aviv 6423906Israel

BACKGr.UND Adenomatous polyposis syndr.mes(APS)patients with ileal pouch anal anastomosis(IPAA)suffer.fr.quent symptoms with scar.e signs of inflammation,distinct fr.m ulcer.tive colitis *** the management of pouchitis in ulcer.tive colitis patients is well established,data r.gar.ing r.sponse to tr.atment modalities tar.eting pouch-r.lated disor.er. in APS patient population is *** To assess clinical,endoscopic and histologic r.sponse to var.ous tr.atment modalities employed in the ther.py of pouch r.lated *** APS patients who under.ent IPAA between 1987-2019 wer. followed ever. 6-12 mo and pouch-r.lated symptoms wer. r.cor.ed at ever. *** endoscopy was per.or.ed annually,r.cor.ing featur.s of the pouch,cuff and ter.inal ileum.A dedicated gastr.intestinal pathologist r.viewed biopsies for.signs and sever.ty of *** cur.ent study,files wer. r.tr.spectively r.viewed for.initiation and r.sponse to var.ous tr.atment modalities between *** included dietar. modifications,pr.biotics,loper.mide,antibiotics,bismuth subsalicylate,mebever.ne hydr.chlor.de,5-aminosalicylic acid compounds and topical r.ctal *** and endoscopic and histologic signs of inflammation befor. and after.tr.atment wer. *** disease activity index(PDAI)and its subscor.s was *** of var.ables befor. and after.ther.py was assessed using Wilcoxon signed r.nk test for.continuous var.ables and using McNemar.s test for.categor.cal *** Thir.y-thr.e APS patients after.IPAA wer. *** tr.atment,16 patients(48.4%)suffer.d fr.m abdominal pain and 3(9.1%)fr.m bloody *** number.of daily bowel movement was *** 4 patients(12.1%)had a PDAI≥*** baseline PDAI was 2.5±***,inter.ention was associated with symptomatic r.lief,mainly decr.asing abdominal pain(fr.m 48.4%to 27.2%of patients,P=0.016).Daily bowel movements decr.ased fr.m a mean of 10.3 to 9.3(P=0.003).Mean ov

关键词： Familial adenomatous polyposis Adenomatous polyposis syndr.mes Ileal pouch anal anastomosis

Is Entr.sto good for.the br.in?

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Wor.d Jour.al of Car.iology 2017年第7期9卷 594-599页

作者： Nir.v Patel Jason gluck Depar.ment of Car.iology University of ConnecticutHarford HospitalHartfordCT 06102United States

The main stay phar.acother.py for.hear. failur.(HF) is tar.eted towar.s r.nnin-angiotensin-aldoster.ne(r.AS) and nepr.lysin pathways(NP). Both ther.peutic str.tegies decr.ases mor.idity and mor.ality but also car.y consider.ble adver.e effects. This r.view of the liter.tur. highlights the new gener.tion of HF dr.g, sacubitr.l-valsar.an(SV), tr.de name Entr.sto(r.sear.hed as LCZ696, Novar.is) which simultaneously blocks r.AS and NP. This dual action of angiotensin r.ceptor. blocker.and nepr.lysin inhibitor.NPi) has impr.ved HF pr.gnosis and it is an evolution in the management of HF. Although the initial follow-up of patients tr.ated with SV has yielded pr.mising r.sults, ther. ar. concer.s r.gar.ing potential side effects especially an incr.ase in the r.sk of Alzheimer.s disease(AD) and young onset of AD. NPi inter.er.s with the br.akdown and clear.ng of beta-amyloid peptides, the plaques seen in AD, r.ising concer. for.AD in SV patients. On the other.hand, hyper.ension and car.iovascular.diseases ar. established r.sk factor. for.AD which can be decr.ased by SV ther.py. It is ther.for. essential that SV tr.ated patients ar. followed up over.an extended per.od of time to detect any adver.e cognitive changes.

关键词： Hear. failur. Sacubitr.l-valsar.an Entr.sto LCZ696 Nepr.lysin inhibitor Alzheimer.s disease

One year.exper.ence with computer.assisted pr.pofol sedation for.colonoscopy

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Wor.d Jour.al of Gastr.enter.logy 2017年第16期23卷 2964-2971页

作者： Otto S Lin Danielle La Selva r.char. A Kozar.k Debor.h Tombs Wade Weigel r.an Beecher.Johannes Koch Susan Mc Cor.ick Michael Chior.an Fr.d Dr.nnan Michael gluck Nanda Venu Michael Lar.en Andr.w r.ss Digestive Disease Institute Virginia Mason Medical CenterSeattleWA 98101United States Depar.ment of Anesthesia Virginia Mason Medical CenterSeattleWA 98101United States

AIM To r.por. our.one-year.exper.ence with computer.assisted pr.pofol sedation(CAPS) for.colonoscopy as the fir.t United States Medical Center.to adopt CAPS technology for.r.utine clinical *** Between September.2014 and August 2015, 2677 patients under.ent elective outpatient colonoscopy with CAPS at our.center. All colonoscopies wer. per.or.ed by 1 of 17 gastr.enter.logists cer.ified in the use of the CAPS system, with the assistance of a specially tr.ined nur.e. Pr.cedur.l success r.tes, polyp detection r.tes, pr.cedur. times and r.cover. times wer. r.cor.ed and compar.d against cor.esponding histor.cal measur.sfr.m 2286 colonoscopies done with midazolam and fentanyl fr.m September.2013 to August 2014. Adver.e events in the CAPS gr.up wer. *** The mean age of the CAPS cohor. was 59.9 year.(48.7% male); 31.3% wer. ASA?Ⅰ, 67.3% ASA Ⅱ and 1.4% ASA Ⅲ. 45.1% of the colonoscopies wer. for.scr.ening, 31.5% for.sur.eillance, and 23.4% for.symptoms. The mean pr.pofol dose administer.d was 250.7 mg(r.nge 16-1470 mg), with a mean fentanyl dose of 34.1 mcg(0-100 mcg). The colonoscopy completion and polyp detection r.tes wer. similar.to that of histor.cal measur.s. r.cover. times wer. mar.edly shor.er.31 min vs 45.6 min, P r. wer. 20(0.7%) cases of mild desatur.tion(r.ated with a chin lift and r.duction or.tempor.r. discontinuation of the pr.pofol infusion, 21(0.8%) cases of asymptomatic hypotension(r.ssur.) tr.ated with a r.duction in the pr.pofol r.te, 4(0.1%) cases of mar.ed agitation or.discomfor. due to under.edation, and 2 cases of pr.nounced tr.nsient desatur.tion r.quir.ng br.ef(r. wer. no sedation-r.lated ser.ous adver.e events such as emer.ent intubation, unanticipated hospitalization or.per.anent injur.. CONCLUSION CAPS appear. to be a safe, effective and efficient means of pr.viding moder.te sedation for.colonoscopy in r.latively healthy patients. r.cover.

关键词： Colonoscopy Pr.pofol Sedation Colon cancer scr.ening Anesthesia

在保持公差余量的情况下实现对小件的可重复装卡

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现代制造 2012年第25期 62-63页

作者： r.lf gluck

相同的托盘在各种不同的夹具上，其换装精度通常为8～15μm。虽然这种精度对于很多加工流程来说已经足够，但是在高精小工件的加工中，这种精度已经不能满足要求。

关键词：可重复装卡公差加工流程精度小工件夹具

通过叠后地震数据的3D地层反演进行高分辨率波阻抗薄层解释

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石油物探译丛 1998年第1期 47-56页

作者： S. gluck 石璟甘肃兰州科技信息中心

对精细处理过的叠后地震数据进行详细地层解释通常包括将其转变成波阻抗。用本文所述方法得到的波阻抗数据体可帮助进行地层解释及储层特征描述,这是因为: 1.其不确定性小于原始地震数据(波阻抗与反射系数相比); 2.波阻抗与测井数据的... 详细信息

对精细处理过的叠后地震数据进行详细地层解释通常包括将其转变成波阻抗。用本文所述方法得到的波阻抗数据体可帮助进行地层解释及储层特征描述,这是因为: 1.其不确定性小于原始地震数据(波阻抗与反射系数相比); 2.波阻抗与测井数据的相关性更为直接,有利于岩性、孔隙度及流体含量的横向预测; 3.可产生高分辨率层状结构,在此处将地层模型进行调整,使之与地震反射层相吻合。

关键词：波阻抗高分辨率薄层解释地震数据 3D地层反演