Results: We found significant differences in their ASA scores (p ( 0.001): the majority of patients in the younger group scored ASA I (93 %), while most of the patients in the older group scored ASA II or III (72 %). In the youngergroup there were significantly more Lauren diffuse-type carcinomas (63 % versus 36 %; P = 0.007), total gastrectomies (79 % versus 55 %; P = 0.003), and harvested lymph nodes (26 19 versus 21 14; P = 0.02). There were no statistically significant differences in curative resections (86 % versus 85 %), TNM stage distribution and in the rate of perioperative surgical and non-surgical morbidity and mortality. Actuarial 5-year survival rates for the younger and the older groups were 43.8 % and 34.1 % respectively (P = 0.05). Actuarial 10-year survival rates for the younger and the older groups were 37 % and 23.7 % respectively (P = 0.05). The factors associated with adverse 5-year survival in multivariate analysis were higher TNM UICC stage, non-curative resection, higher ASA scores, and N2-3 lymph node metastases. Conclusions: Differences in the ASA scores between the two groups were expected. A second feature was the predominance of the Lauren diffuse type in the younger group. A higher portion of total gastrectomies and harvested lymphnodes were the consequences of the more aggressive surgical approach in younger patients. Survival was better in the younger group of patients, although the outcome is probably more related to stage of the disease at diagnosis than to age.
COBISS.SI-ID: 27863001
Previous animal and human studies have suggested that total plasma sulfide plays a role in the pathophysiology of shock. This study's aim was to determine the value of total plasma sulfide as a marker of shock severity in nonsurgical adult patients admitted to the ICU. Forty-one patients, with various types of shock (septic, cardiogenic, obstructive, and hypovolemic), were included in the study, with an average total plasma sulfide concentration of 23.2 +/- 26.3 microM. Survivors (of shock) had lower total plasma sulfide concentrations than nonsurvivors (13.0 +/- 26.3 vs. 31.9 +/- 31.5 microM; P = 0.02). Total plasma sulfide correlated with dose of administered norepinephrine (R linear = 0.829; P = 0.001) and with Acute Physiology and Chronic Health Evaluation II (APACHE II) score (R cubic = 0.767; P = 0.001). Area under the receiver operating characteristic for total plasma sulfide as a predictor of ICU mortality was 0.739 (confidence interval,0.587-0.892; P = 0.009). Even after correcting for APACHE II score and lactate values, total plasma sulfide correlated with mortality (odds ratio, 1.058; 95% confidence interval, 1.001-1.118; P = 0.045). The study provides evidence that, in nonsurgical adult ICU patients admitted because of any type of shock, total plasma sulfide correlates with administered norepinephrine dose at admission, severity of disease (APACHE II score )/=30 points), and survival outcome.
COBISS.SI-ID: 28925401
Many stress conditions are accompanied by skeletal muscle dysfunction and regeneration, which is essentially a recapitulation of the embryonic development. However, regeneration usually occurs under conditions of hypothalamus-pituitary-adrenal gland axis activation and therefore increased glucocorticoid (GC) levels. Glucocorticoid receptor (GR), the main determinantof cellular responsiveness to GCs, exists in two isoforms (GRalpha and GRbeta) in humans. While the role of GRalpha is well characterized, GRbetaremains an elusive player in GC signalling. To elucidate basic characteristics of GC signaling in the regenerating human skeletal muscle we assessed GRalpha and GRbeta expression pattern in cultured human myoblasts andmyotubes and their response to 24-hour dexamethasone (DEX) treatment. Therewas no difference in GRalpha mRNA and protein expression or DEX-mediated GRalpha down-regulation in myoblasts and myotubes. GRbeta mRNA level was very low in myoblasts and remained unaffected by differentiation and/or DEX. GRbeta protein could not be detected. These results indicate that response to GCs is established very early during human skeletal muscle regeneration and that it remains practically unchanged before innervation is established. Very low GRbeta mRNA expression and inability to detect GRbeta protein suggests that GRbeta is not a major player in the early stages of human skeletal muscle regeneration.
COBISS.SI-ID: 28908505