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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Role of β-microseminoprotein from prostate cancer initiationto recurrence: A mini-review显示文摘Medline/Pubmed articles relevant to this topic were considered using the search terms ?-microseminoprotein, MSMB, prostate secretory protein of 94 amino acids and PSP94. Full articles were retrieved when the abstract was considered relevant. In addition, other data related to this topic including our own are discussed. Summary of fi ndings-?-microseminoprotein(MSMB) is increasingly being considered as a marker for prostatecancer, as reduced levels have been associated with the disease. Here we review various aspects of this protein including its biological and physiological variants, binding proteins and immune modulation; its importance as a marker for biochemical recurrence of prostate cancer; prostate cancer related splice variants and its therapeutic utility. Two of the most important properties of MSMB are related to anticancer functions and immune modulation. Predominant expression of two(short and full-length) splice variants of MSMB has been observed from normal prostate and several other tissues. In benign prostate hyperplasia the short isoform is dominant, constituting 98% of this isoform, whereas in prostate cancer 96% constitute the fulllength isoform. The MSMB promoter single nucleotide polymorphism rs10993994 with the C allele functions as an activated cyclic adenosine monophosphate response element binding protein binding site. This C variant of rs10993994 could be responsible for the production of splice variants under variable conditions. MSMB has binding motifs to a few known proteins including immunoglobulin G and several Cysteine-rich secretory proteins family proteins. MSMB bound to these proteins is considered as immune modulating. Use of MSMB as a urinary marker for detecting aggressive prostate cancers that could resist radiation and surgical treatments, seems possible, but needs further investigation. The ratio of MSMB splice variants could also be a possible approach in understanding prostate cancers, with higher ratios indicating severe disease. | Nishi Karunasinghe Karen Bishop Pamela Murray Yuanye Xu Megan Goudie Lance Ng Shuotun Zhu Dug Yeo Han Lynnette R Ferguson Jonathan Masters Benji Benjamin Michael Holmes | 2014 | World Journal of Clinical Urology2014，3，1： | 2 |
| 3 | Rapid-infiltration research at Flushing Meadous project, Arizona显示文摘 | Bouwer H Rice R C Lance J C Gilbert R G | 1980 | Journal Water Pollution Control Federation1980，52，： | 2 |
| 4 | Viral pneumonia显示文摘 | Olli Ruuskanen Elina Lahti Lance C Jennings David R Murdoch | 2011 | 2011 (9773)2011，，9773： | 2 |
| 5 | Rapid-infiltration research at Flushing Mead-onus project, Arizona显示文摘 | Bouwer H Rice R C Lance J C | 1980 | Journal Water Pollu- tion Control Federation1980，52，： | 1 |
| 6 | Rapid infiltra- tion research at flushing meadows project, Arizona 显示文摘 | Bouwer H Rice R C Lance J C | 1980 | Journal Water Pollution Control Federation1980，，52： | 1 |
| 7 | Recognizes veterinary shortage in public health 显示文摘 | JESSUP D A KARESH W B LANCE W R | 2005 | J Am Vet bled Assoc2005，227，3： | 1 |
| 8 | A review and synthesis of the measurement invariance literature:suggestions,practices,and recommendations for Organizational Research显示文摘 | Vandenberg R J Lance C E | | 0，，01： | 1 |
| 9 | Experimental studies on the role of backfill and pipeline characteristics in the application of acoustic leak location to underground pipelines 显示文摘 | Amanda M C Lance E R | 1997 | Review of Progress in Quantitative Nondestructive Evaluation1997，16，： | 1 |
| 10 | Experimental studies on the role of backfill and pipeline characteristics in the application of acoustic leak location to under around pipelines显示文摘 | Clark M Amanda Rewerts Lance E Robbers Ron R | 1997 | Review of Progress in Quantitative Non-destructive Evaluation1997，16，4： | 1 |
| 11 | Segmentation of multiple salient closed contours from real images 显示文摘 | Shyjan Mahamud Lance R Williams Karvel K Thornber | 2003 | IEEE Transactions on Pattern Analysis and Machine Intelligence2003，25，4： | 1 |
| 12 | Assessment Center Exercise Factors Represent Cross-situational Specificity,not Method Bias显示文摘 | Lance C E Newbolt W H Gatewood R D | 2000 | Human Performance2000，13，4： | 1 |
| 13 | Hounsfield unit density accurately predicts ESWL success显示文摘 | Maqnuson W J Tomera K M Lance R S | 2005 | Alaska Med2005，47，2： | 1 |
| 14 | Comparison of different methods of obtaining orthostatie vital signs 显示文摘 | Lance R Link ME Padua M | 2000 | Clin Nurs Res2000，9，： | 1 |
| 15 | Detection and treatment of multiple canals in mandibular premolars 显示文摘 | England M C Hartwell G R Lance J R | 1991 | JEndod1991，17，4： | 1 |
| 16 | Renovation of wastewater by soil columns flooded with primary effluent 显示文摘 | LANCE J C RICE R C GILBERT R G | 1980 | Water Environmental Federation1980，，2： | 1 |
| 17 | Genetic models for quantitatively inherited endosperm characters 显示文摘 | Bogyo T P Lance R C | 1998 | Heredity1998，60，： | 1 |
| 18 | Variation inplasma lipids during the reproductive cycle of male and femaledesert tortoises,Gopherus agassizii 显示文摘 | LANCE V A PLACE A R GRUMBLES J S | 2002 | Journal of ExperimentalZoology2002，293，7： | 1 |
| 19 | The importance of protein Z to the quality of barley and malt for brewing显示文摘 | Evans D E Macleod L C Lance R C M | 1995 | Proc Congr Eur Brew Cony1995，25，： | 1 |
| 20 | The association be- tween telomerase, p53 and clinical staging in eolorectal cancer 显示文摘 | BROWN T ALDOUS W LANCE R | 1998 | Am J Surg1998，175，5： | 1 |
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