Abstract:
OBJECTIVE:Mycophenolate mofetil (MM) is a new immunosuppressive agent that reversibly inhibits guanine nucleotide synthesis and DNA replication. Its activity is highly selective for T and B lymphocytes. Two open-label multicenter trials of MM in renal transplantation have been performed. This report summarizes the results from one center involved in these two trials. METHODS AND RESULTS:The initial trial of MM was an open-label dose-ranging trial in primary cadaveric renal transplantation. Mycophenolate mofetil was included in the maintenance immunosuppression regimen from the day after transplantation. Of the 21 patients enrolled in this trial, one (5%) was withdrawn for side effects. There was one graft loss due to recurrent renal disease and two patients were withdrawn for difficulty with follow-up. Mean follow-up is 26 months, and patient and graft survival at 2 years are 100 and 95% respectively. The second trial was designed to study the efficacy of mycophenolate in reversing refractory renal allograft rejection. Patients enrolled in the trial had biopsy-proven acute rejection and had previously received at least one course of high-dose corticosteroids and/or OKT3. Of the 26 patients enrolled in this trial, one (4%) was withdrawn for side effects. There were two deaths. Mean follow-up is 20 months, and patient and graft survival at 12 months was 91 and 54%. The incidence of infections in the two groups was 38% and there were no deaths in either group attributable to infection. CONCLUSIONS:The results of these two studies indicate that mycophenolate mofetil could be administered safely to renal allograft recipients for periods up to 2 years. It appears to be effective in reversing acute rejection in a high percentage of patients refractory to other forms of therapy.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Deierhoi MH,Kauffman RS,Hudson SL,Barber WH,Curtis JJ,Julian BA,Gaston RS,Laskow DA,Diethelm AGdoi
10.1097/00000658-199305010-00007subject
Has Abstractpub_date
1993-05-01 00:00:00pages
476-82; discussion 482-4issue
5eissn
0003-4932issn
1528-1140journal_volume
217pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND:Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS:The...
journal_title:Annals of surgery
pub_type: 杂志文章,实务指引
doi:10.1097/SLA.0000000000003580
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To evaluate perioperative statin treatment, to explore the rapidly increasing body of literature on the pleiotropic effects of statins, and to suggest a rational strategy of perioperative risk reduction. SUMMARY OF BACKGROUND DATA:Vascular, cerebrovascular, and cardiovascular complications are all too common...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181492c0d
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA:The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS:Using health administrative data, all adults who survived to discharge after major burn ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002722
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA:Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of con...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003075
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:Comparison of short- and long-term effects after laparoscopic Heller myotomy (LHM) and endoscopic balloon dilation (EBD) considering the need for retreatment. BACKGROUND:Previously published studies have indicated that LHM is the most effective treatment for Achalasia. In contrast to that a recent randomized...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000000212
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA:Professional societies provided ad-hoc guidance at the outset of the COVID-19 pan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004029
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The role of adjuvant chemoradiation in esophageal cancer has been underestimated in the literature. This study was undertaken to determine whether adjuvant chemoradiation improves survival compared with surgery alone. METHODS:Data of 1095 esophageal squamous cell carcinoma (ESCC) patients, including 679 in ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001410
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. BACKGROUND:Volume-outcome relationships led to the centralization of esophageal cancer surgery. METHODS:Hospital Episode Statistics data were used to identify patients admitted to hospitals wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002387
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to identify a set of microRNAs (miRNAs) as prognostic molecular biomarkers for the progression of Barrett esophagus (BE) to esophageal adenocarcinoma (EAC) to rationalize the surveillance programs in patients with BE. BACKGROUND:Histological dysplasia is currently used as the main bi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826ddba6
更新日期:2013-05-01 00:00:00
abstract::: Since their discovery, neutrophil extracellular traps (NETs) have been implicated in a broad array of functions, both beneficial and detrimental to the host. Indeed, NETs have roles in infection, sepsis, wound healing, thrombotic disease, and cancer propagation, all of which are directly implicated in the care of su...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000003586
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE AND SUMMARY BACKGROUND DATA:Sentinel lymph node (LN) sampling, a technique widely used to manage breast cancer and melanoma, seeks to select LNs that accurately predict regional node status and can be extensively examined to identify nodal metastatic disease not detected by standard histopathological staging....
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.sla.0000140753.41357.20
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:The goal of this scoping review was to summarize the literature on facilitators and barriers to surgical practice change. This information can inform research to implement best practices and evaluate new surgical innovations. BACKGROUND:In an era of accelerated innovations, surgeons face the difficult decisi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004355
更新日期:2020-08-26 00:00:00
abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00
abstract::The importance of prostacyclin (PGI2) and thromboxane (Tx) medication of depressed cardiac performance during abdominal aortic aneurysm operative surgery was studied by contrasting the effects of 650 mg aspirin administered 12 hours before operation to that of a placebo. In 11 patients who received a placebo, the stab...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-198111000-00008
更新日期:1981-11-01 00:00:00
abstract:OBJECTIVE:We sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons. SUMMARY BACKGROUND DATA:Multiple disciplines utilize coaching for continuous professional development; however, coaching is not routinely employed for practicing surgeons. METHODS:Peer-nominated surgeons ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002341
更新日期:2018-05-01 00:00:00
abstract::Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation vessels and the poplitea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198312000-00017
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:The authors examined the natural history of choledochal cysts in adults treated surgically. BACKGROUND:An initial diagnosis of choledochal cyst is uncommon in adults. The recommended treatment is excision, rather than bypass, to achieve effective biliary drainage and because of the risk of cancer. METHODS:A...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199508000-00004
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on fasting and meal-stimulated release of the gut hormones ghrelin, pancreatic polypeptide (PP), peptide-YY (PYY), glucagon-like peptide-1 (GLP-1), and amylin and of the adipocytokine leptin. BACKGROUND:Mounting evidence suggests that the mechan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826e1846
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. METHODS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207c24f
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to test the hypothesis that cardiac mucosa, carditis, and specialized intestinal metaplasia at an endoscopically normal-appearing cardia are manifestations of gastroesophageal reflux disease. SUMMARY BACKGROUND DATA:In the absence of esophageal mucosal injury, the diagnosis of ga...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199710000-00013
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200211000-00004
更新日期:2002-11-01 00:00:00
abstract::The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00013
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:To investigate the pattern of nodal metastasis, morbidity, recurrence rates of papillary thyroid carcinoma (PTC), and parathyroid hormone (PTH) responses following neck dissection (ND) plus total thyroidectomy (TT). SUMMARY BACKGROUND DATA:While hypoparathyroidism develops after TT plus ND, little is known o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000250451.59685.67
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe contemporary management and in-hospital mortality associated with blunt thoracic aortic intimal tears (IT) within the American College of Surgeons Trauma Quality Improvement Program. SUMMARY BACKGROUND DATA:The evidence basis for nonoperative expectant management of traumatic IT of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004415
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003162
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in chil...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001094
更新日期:2015-12-01 00:00:00
abstract::Forty-nine patients with chronic ulcerative colitis refractory to medical therapy and four with multiple polyposis have undergone total colectomy, mucosal protectomy, and endorectal ileal pull-through with ileoanal anastomosis at the UCLA Medical Center during the past 12 years (mean age, 19.4 years). Thirty-eight pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198402000-00003
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:Our aim was to evaluate recurrence patterns of surgically resected PDAC patients with negative (pN0) or positive (pN1) lymph nodes. SUMMARY BACKGROUND DATA:Pancreatic ductal adenocarcinoma (PDAC) is predicted to become the second leading cause of cancer death by 2030. This is mostly due to early local and di...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003123
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To study the incidence of gastroesophageal reflux (GER)related complications after correction of esophageal atresia (EA). SUMMARY BACKGROUND DATA:The association of EA and GER in children is well known. However, little is known about the prevalence of GER and its potential complications in adults who have un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094303.07910.05
更新日期:2003-11-01 00:00:00