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Laparoscopic Liver Resection: A Tool to Improve Outcomes in Obese Patients Requiring Liver Resection

Open Journal of Gastroenterology 2022年第12期12卷 347-360页

作者： Asmita Chopra michael devries Rachel Mullins Roberta Redfern Kerri Ann Simo Department of Surgery University of Toledo School of Medicine Toledo Ohio Promedica Health System Toledo Hospital Toledo Ohio

Introduction: Obesity is associated with an increased risk of fatty liver disease, predisposing to liver fibrosis and cirrhosis, as well as increased occurrence of hepatocellular carcinoma. Obesity is intuitively considered a risk factor for increased post-hepatectomy morbidity and mortality. Nevertheless, peer-reviewed literature reveals significant heterogeneity between different cohorts contributing to varying conclusions. Outcomes in this cohort for Laparoscopic Liver Resection (LLR), especially in non-academic settings remain under-evaluated. The current study evaluated outcomes of LLR in obese patients, in a community health system. Methods: A retrospective analysis of all patients undergoing LLR at the flagship hospital in the community health system, between 2013 and 2020, was performed. Classified into two groups based on Body Mass Index (BMI): obese (BMI > 30 kg/m2) vs non-obese (BMI Results: 90 patients underwent LLR during the 7-year period;obese = 38 and non-obese = 52. No statistically significant differences were noted between obese and non-obese cohorts, in baseline characteristics including age (53.1 ± 15.1 vs 56.8 ± 11.6 years), female gender (60.5% vs 53.8%), and ASA grade (3.13 ± 0.53 vs 3.02 ± 0.54) (all p > 0.05). Univariate analysis showed no statistically significant differences between obese and non-obese groups, comparing estimated blood loss [300 (100 - 500) vs. 200 (100 - 462.5) cc], operative time [177 (125 - 215) vs. 150.9 (111 - 207) minutes], bile leak (2.6% vs. 4.1%), post-operative bleeding (2.6% vs. 4.1%), infection (0% vs. 4.1%), cardiorespiratory complication (10.5% vs 12.2%), conversion rate (5.3% vs 5.8%), length of stay [4 (3 - 5) vs. 4 (2 - 5) days], 90-day reoperation (0% vs. 2%) and 90-day readmission (2.6% vs. 4.1%) (p > 0.05). Multivariate analysis showed no association between obesity and composite complication rate (p = 0.97), after adjusting for alcohol abuse, neoadjuvant therapy, and prior liver surgery. Co

关键词： Liver Resection Laparoscopic Obesity Surgical Outcomes Minimally-Invasive

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Multilocus Sequence Analysis of Root Nodule Bacteria Associated with <i>Lupinus</i>spp. and <i>Glycine max</i>

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Advances in Microbiology 2017年第11期7卷 790-812页

作者： Dilshan H. Beligala Helen J. michaels michael devries Vipaporn Phuntumart Department of Biological Sciences Bowling Green State University Bowling Green OH USA

Lupinus is known to form endophytic associations with both nodulating and non-nodulating bacteria. In this study, multilocus sequence analysis (MLSA) was used to analyze phylogenetic relationships among root nodule bacteria associated with Lupinus and soybean. Out of 17 bacterial strains analyzed, 13 strains isolated from root nodules of Lupinus spp. were obtained from the National Rhizobium Germplasm Resource Collection, USDA. Additionally, two strains of root-nodule bacteria isolated each from native lupinus and domestic soybean were examined. Sequences of the 16S rRNA gene and three house-keeping genes (atpD, dnaK and glnII) were used. All the reference genes were retrieved from the existing complete genome sequences only. The clustering of 12 of the strains was consistent among single and concatenated gene trees, but not USDA strains 3044, 3048, 3504, 3715, and 3060. According to the concatenated phylogeny, we suggest that USDA 3040, 3042, 3044, 3048, 3051, 3060, 3504, 3709 and 3715 are Bradyrhizobium, USDA 3063 and 3717 are Mesorhizobium, USDA 3043 is Burkholderia and USDA 3057a is Microvirga. The two strains isolated from native lupines in this study are Burkholderia and Rhizobium, whereas the two from domestic soybean are Bradyrhizobium. This study emphasizes the robustness of MLSA, the diversity of bacterial species that are capable of nodulating lupine and the substantial capability of Burkholderia spp. to colonize lupine root nodules.

关键词： Multilocus Sequence Analysis Nodule Bacteria Phylogeny Lupinus Burkholderia

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Integrated Multidisciplinary Management of Alcoholassociated Liver Disease

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Journal of Clinical and Translational Hepatology 2023年第6期11卷 1404-1412页

作者： Malia Holbeck Hannah Statz devries Ashwani K.Singal Addiction Medicine Avera McKennan University HospitalUniversity of South DakotaSioux FallsSDUSA Psychiatry Avera McKennan University HospitalUniversity of South DakotaSioux FallsSDUSA Transplant Hepatology Avera McKennan University HospitalUniversity of South DakotaSioux FallsSDUSA

Alcohol-associated liver disease(ALD)is one of the most common liver diseases and indications for liver transplantation(LT).Alcohol use disorder(AUD),a frequent accompaniment in ALD patients,may also be associated with psychiatric comorbidities such as depression and *** of ALD at an earlier stage,and treatment of AUD may help prevent progression to advanced stage of ALD such as cirrhosis and alcoholic *** for alcohol use and AUD treatment in ALD patients is often not performed due to several barriers at the level of patients,clinicians,and administrative *** review details the integrated multidisciplinary care model especially on the specific role of the hepatologist,psychiatrist,addiction counselor,and social worker in providing complete management for the dual pathology of liver disease and of *** assessment,pharmacological and behavioral therapies,and recommended assessments for follow-up care by the respective specialists is *** provide perspective along with the literature support,with the goal of providing team based comprehensive care of patients with ALD.

关键词： Alcohol Cirrhosis Liver transplant Depression Anxiety Multidisciplinary

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Percutaneous coronary interventions in the elderly:a 10-year experience in Northern New England

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Journal of Geriatric Cardiology 2005年第1期2卷 17-22页

作者： David J.Malenka James T.devries Samuel J.Shubrooks for the Northern New England Cardiovascular Disease Study Group Section of Cardiology Dartmouth-Hitchcock Medical Center LebanonNH Center for the Evaluative Clinical Sciences Dartmouth Medical SchoolHanoverNHUSA for the Northern New England Cardiovascular Disease Study Group Section of Cardiology Dartmouth-Hitchcock Medical Center LebanonNHUSA for the Northern New England Cardiovascular Disease Study Group Division of Cardiology Beth Israel-Deaconess Medical Center BostonMAUSA Jr

Background There is a paucity of information available for clinical decision making applying to the elderly patient population. Therefore, data of percutaneous coronary interventions (PCI) including demographic information on the elderly patients, procedural practices, and outcomes are needed. Objectives and Methods From consecutive PCIs of participating institutions, demographics data, clinical, angiographic success and adverse clinical outcomes were collected. Standard statistical methods were used to compare crude differences in patient and procedural characteristics across age groups. Results At baseline, the prevalence of comorbid conditions ( renal failure and heart failure) increased with age. Unstable angina or a non-ST elevation MI were the most common indications for PCI across all age groups. Fewer patients ≥ 80 years old were undergoing primary PCI and older patients were somewhat less likely to receive a Ⅱb/Ⅲa receptor blocker. Slightly more patients ≥ 80 years old underwent a 2-vessel PCI ( consistent with them having more multivessel disease) and these patients were more likely to have an intervention on a Type C lesion. Compared to patients ＜ 50 years old, those aged ≥ 70 years old had a significantly increased risk of death, MI, stroke, or vascular complications at the access site. Conclusions This study suggests increasing age is associated with increasing risk for an adverse outcome following PCI. This is in part attributable to case-mix but likely, also related to the changing physiology of aging. Despite the increased risk of the procedure, the clinical success rate for PCI is quite high and makes it a reasonable alternative for the treatment of CAD in the elderly.

关键词： coronary artery disease elderly percutaneous coronary intervention

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Patterns of in-hospital mortality and bleeding complications following PCI for very elderly patients： insights from the Dartmouth Dynamic Registry

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Journal of Geriatric Cardiology 2018年第2期15卷 131-136页

作者： Shawn X Li Hannah I Chaudry Jiyong Lee Theodore B Curran Vishesh Kumar Kendrew K Wong Bruce W Andrus James T devries Dartmouth Geisel School of Medicine Hanover NH USA Department of Internal Medicine Dartmouth-Hitcheock Medical Center Lebanon NH USA Section of Cardiovascular Medicine Dartmouth-Hitchcock Medical Center Lebanon NH USA

Background Very elderly patients （age 〉 85 years） are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention （PCI）. However, the relationship between bleeding and mortality in the very elderly is unknown. Methods Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center. Incidence of bleeding during the index PCI admission （bleeding requiring transfusion, access site hematoma 〉 5 cm, pseudoaneurysm, and retroperitoneal bleed） and in-hospital mortality were reported for four age groups （〈 65 years, 65-74 years, 75-84 years, and ≥ 85 years）. The mortality of patients who suffered bleeding complications and those who did not was calculated and multivariate analysis was performed for in-hospital mortality. Lastly, known predictors of bleeding were compared between patients age 〈 85 years and age ≥85 years. Results Of 17,378 patients studied, 1019 （5.9%） experienced bleeding and 369 （2.1%） died in-hospital following PCI. Incidence of bleeding and in-hospital mortality increased monotonically with increasing age （mortality： 0.94%, 2.27%, 4.24% and 4.58%; bleeding： 3.96%, 6.62%, 10.68% and 13.99% for ages 〈 65, 65-4, 75-84 and ≥ 85 years, respectively）. On multivariate analysis, bleeding was associated with increased mortality for all age groups except patients age ≥85 years [odds ratio （95% CI）： age 〈 65 years, 3.65 （1.99-6.74）; age 65-74 years, 2.83 （1.62-4.94）; age 75-84 years, 3.86 （2.56-5.82）, age ≥ 85 years 1.39 （0.49-3.95）]. Conclusions Bleeding and mortality following PCI increase with increasing age. For the very elderly, despite high rates of bleeding, bleeding is no longer predictive of in-hospital mortality following PCI.

关键词： Complications In-hospital mortality Percutaneous coronary intervention The elderly

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Why High-Speed Railway Stations Continue China's Leapfrog Urbanization:Institutional Parameters of Urban Development

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China City Planning Review 2013年第1期22卷 49-59页

作者： Guowen DAI Willem Salet Jochem devries Program group of Urban Planning Department of Human GeographyPlanning and International Development StudiesFaculty of Social ScienceUniversity of Amsterdam Urban and Regional Planning Program leader of the Group of Urban PlanningDepartment of Human GeographyPlanning and International Development StudiesFaculty of Social ScienceUniversity of Amsterdam Urban and Regional Planning Program group of Urban PlanningDepartment of Human GeographyPlanning and International Development StudiesFaculty of SocialScienceUniversity of Amsterdam

An ambitious program of High-Speed Railway (HSR) is under construction in China and already soon the network will overtake its counterparts in Europe. Reflecting on experiences in Europe, the authors explore the conditions for place making qualities of six new HSR station areas in China. The superb inter-city connectivity of the new infrastructure nodes raises a lot of expectations about the economic and social potential of the station areas, but the experiences in Europe thus far are very differentiated. With regards to the attraction of economic activities usually the existing differences between different economic regions are reproduced rather than shaping completely new conditions. Also the expectations of developing completely new integrated urban centers around stations in the urban periphery are rather ambitious. The paper questions the planning responses to HSR development in Chinese cities and investigates the institutional conditions that frame these responses. The authors explore how the plans for Chinese HSR station development account for their objectives and reflect on the potential of the station area planning by investigating the institutional parameters of urban development.

关键词： High-Speed Railway (HSR) urban mega project institutional parameters spatial re-configuration urbanization in China

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喹乙醇对大鼠的光毒性

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中国兽药杂志 1990年第4期24卷 51-53页

作者： H.devries 徐士新

喹乙醇为喹啉二氮氧化物类衍生物,同类其它衍生物有卡巴氧和西吖氧。1971年至1973年,喹多辛被用作饲料添加剂,具有抗菌和促生长作用。不久,一些衍生物被合成并用于相同目的。但是,有证明喹多辛引起饲养员的永久性光敏性皮炎。

关键词：喹乙醇大鼠光毒性

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Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus

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World Journal of Diabetes 2021年第6期12卷 868-882页

作者： Leon de Wit Anna B Zijlmans Doortje Rademaker Christiana A Naaktgeboren J Hans devries Arie Franx Rebecca C Painter Bas B van Rijn Department of Obstetrics and Gynaecology University Medical Center UtrechtUtrecht 3584 EANetherlands Department of Obstetrics and Gynaecology Gelderse Vallei HospitalEde 6716 RPNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers-Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Gynaecology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Endocrinology Amsterdam University Medical Centers–Location AMCAmsterdam 1105 AZNetherlands Department of Obstetrics and Fetal Medicine Erasmus MC Sophia Children HospitalRotterdam 3015 GDNetherlands

BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus(GDM)are still a subject of debate,mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly *** To estimate the impact of the World Health Organization(WHO)2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy *** We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically *** were categorized into four groups:non-GDM by both criteria,GDM by WHO 1999 only(excluded from GDM),GDM by WHO 2013 only(newly diagnosed)and GDM by both *** compared maternal characteristics,pregnancy outcomes and likelihood ratios for adverse pregnancy *** Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%,from 19.3%to 32.4%.Discordant diagnoses occurred in 21.3%;4.1%would no longer be labelled as GDM,and 17.2%were newly *** to the non-GDM group,women newly diagnosed were older,had higher rates of obesity,higher diastolic blood pressure and higher rates of caesarean *** infants were more often delivered preterm,large-for-gestational-age and were at higher risk of a 5 min Apgar score<*** excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group,except for higher rates of shoulder dystocia(4.3%vs 1.3%,P=0.015).Positive likelihood ratios for adverse outcomes in all groups were generally low,ranging from 0.54 to *** Applying the WHO 2013 criteria would result in a substantial increase in GDM *** diagnosed women are at increased risk for pregnancy adverse *** risk,however,seems to be lower than those identified by the

关键词： Diagnostic criteria Gestational diabetes Glucose tolerance test Incidence Pregnancy outcome

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南极eelpout(Lycodichthys dearborni)多聚体Ⅲ型抗冻蛋白基因的克隆及进化分析

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Acta Genetica Sinica 2005年第8期32卷 789-794页

作者：於静 Chi Hing C.Cheng Arthur L.devries 陈良标中国科学院遗传与发育生物学研究所 Department of Animal Biology University of IllinoisUrbana IL 61801USA

冰冻海洋中生存的南极eelpout(Lycodichthysdearborni)体内能合成高浓度的Ⅲ型抗冻蛋白(AFPⅢ)。为了寻找新的AFPⅢ基因,构建了***肝脏cDNA文库。通过斑点杂交筛选此文库,发现一个2.87kb 的cDNA克隆,LD12。序列分析采用DNAssist2.0和Clu... 详细信息

冰冻海洋中生存的南极eelpout(Lycodichthysdearborni)体内能合成高浓度的Ⅲ型抗冻蛋白(AFPⅢ)。为了寻找新的AFPⅢ基因,构建了***肝脏cDNA文库。通过斑点杂交筛选此文库,发现一个2.87kb 的cDNA克隆,LD12。序列分析采用DNAssist2.0和ClustalX1.8软件。结果显示,LD12分子由12个串联重复的片段构成,每一个片段编码一个61个氨基酸(aa)的Ⅲ型抗冻蛋白分子和一个9aa的连接子。这是第一次在合成AFPⅢ的极地鱼类中发现这样的多聚蛋白结构基因。有趣的是,组成、结构和起源都不相同的抗冻糖蛋白AF GP,其基因也呈现类似的多聚蛋白结构的现象。因此,这种独特的多聚基因结构可能是鱼类基因组在适应极端寒冷的环境中采取的一种普遍方式。

关键词：南极eel pout Ⅲ型抗冻蛋白串联重复多聚体蛋白基因基因家族进化

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机械刺激和电刺激引出的单突触反射与年龄的关系

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神经损伤与功能重建 1987年第1期 23-25页

作者： devries HA 郭敏

文献报告,随年龄组的增加,临床检查跟腱反射(T)消失者增多。Milne 和Willa-mson 报道在63～69岁年龄组中,20%的男性和37%的女性跟腱反射消失,并随年龄增加此百分比增大。用电诊断的方法辅助临床诊断发现,踝反射的消失率随年龄增加而稳... 详细信息

文献报告,随年龄组的增加,临床检查跟腱反射(T)消失者增多。Milne 和Willa-mson 报道在63～69岁年龄组中,20%的男性和37%的女性跟腱反射消失,并随年龄增加此百分比增大。用电诊断的方法辅助临床诊断发现,踝反射的消失率随年龄增加而稳定地增长,70～79岁的年龄组中,42%的女性和36%的男性踝反射消失。Baist 等用39例年龄在18～81岁的正常人记录了踝反射所引出的肌肉动作电位,发现在反射变化和年龄之间只有一很小的、无显著性的相关。

关键词：运动系统动作电位反射锤差异有显著性肌梭体力活动老年人机械刺激突触

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