Within a collaborative project of 14 transplant centers, prospective recipients of cadaver kidney grafts were randomized to receive either three pretransplant transfusions or transplants without transfusions. RESULTS; The graft survival rate was significantly higher in the 205 transfusion recipients than in the 218 patients who did not receive transfusions (at 1 year: 90+/-2% vs. 82+/-3%, P=0.020; at 5 years: 79+/-3% vs. 70+/-4%, P=0.025). Cox regression analysis showed that this effect was independent of age, gender, underlying disease, prophylaxis with antilymphocyte antibodies, and preformed lymphocytotoxins. CONCLUSIONS; Transfusion pretreatment improves the outcome of cadaver kidney transplants even with the use of modern immunosuppressive regimens.
The data for 77 patients with colorectal cancer who underwent emergency surgery for acute intestinal obstruction (57 patients) or perforation (20 patients) within 24 h of admission were evaluated. The patients were older and had more advanced disease than patients undergoing elective surgery for colorectal cancer. Emergency surgery for carcinoma of the right colon consisted of primary resection in 95 per cent of cases and was followed by a 28 per cent mortality rate. Perforated tumours of the left colon and rectum were managed by primary resection in 82 per cent of cases with a 22 per cent mortality rate. In contrast, obstructing tumours of the left colon and rectum were treated by primary resection in 38 per cent of cases with a 6 per cent mortality rate, and by primary decompression in 62 per cent of cases with a 25 per cent mortality rate. The overall postoperative mortality rate was 23 per cent and increased with advanced tumour disease, perforation and peritonitis. Cardiac decompensation and intraabdominal sepsis were the major causes of death. Although the long-term survival rate following emergency surgery was worse than after elective surgery, improvements in outcome should be achieved by better management of the initial emergency situation.
Excitation functions AN (p lab , Θc.m.) of the analyzing power in elastic proton-proton scattering have been measured in an internal target experiment at the Cooler Synchrotron COSY with an unpolarized proton beam and a polarized atomic hydrogen target. Data were taken continuously during the acceleration and deceleration for proton kinetic energies T lab (momenta p lab ) between 0.45 and 2.5 GeV (1.0 and 3.3 GeV/c) and scattering angles 30 • ≤ Θc.m. ≤ 90 • . The results provide excitation functions and angular distributions of high precision and internal consistency. The data can be used as calibration standard between 0.45 and 2.5 GeV. They have significant impact on phase shift solutions, in particular on the spin triplet phase shifts between 1.0 and 1.8 GeV. PACS. 25.40.Cm Elastic proton scattering -13.75.Cs Nucleon-nucleon interactions -24.70.+s Polarization phenomena in reactions -21.30.-x Nuclear forces
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