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1.
目的探讨硫化氢对低氧性肺动脉高压大鼠细胞因子的调节作用。方法将Wistar大鼠22只随机分为3组。对照组(8只),低氧组(7只),低氧+硫氢化钠(NaHS)组(7只),测定3组大鼠肺动脉平均压(mPAP),观测肺血管结构变化,并用免疫组织化学方法研究α-平滑肌肌动蛋白(-αSM-actin)、弹力蛋白、转化生长因子β(TGF-β)和结缔组织生长因子(CTGF)在肺动脉平滑肌细胞的表达含量。结果低氧组的mPAP明显高于对照组和低氧+NaHS组;低氧组肌型动脉、部分肌型动脉百分比明显高于对照组和低氧+NaHS组,非肌型动脉百分比明显低于对照组和低氧+NaHS组;低氧组肺中、小型肺动脉平滑肌细胞-αSM-actin、弹力蛋白和TGF-β表达含量分别明显高于对照组和低氧+NaHS组;对照组、低氧+NaHS组以及低氧组肺中、小型肺动脉平滑肌细胞CTGF表达含量依次增高,但3组之间无显著差异。结论硫化氢可能通过调节低氧性肺动脉高压大鼠肺小血管肌性动脉TGF-β的表达,进而抑制细胞外基质成分之一的弹力蛋白合成,参与低氧性肺动脉高压的形成。  相似文献   

2.
目的:探讨17β-雌二醇(E2)对低氧性肺动脉高压(HPH)的保护作用是否通过下调微小核糖核酸(mi RNA)-21(mi R-21)表达进而抑制肺动脉平滑肌细胞(PASMC)增殖而实现。方法:(1)动物水平:32只健康雌性SD大鼠行卵巢切除术后随机分入常氧组、常氧+E2组、低氧组、低氧+E2组,每组8只。两个E2干预组大鼠每日皮下注射E2 20μg/kg,余组大鼠皮下注射等量生理盐水。两个低氧组大鼠在低氧环境下饲养,两个常氧组大鼠呼吸正常空气,连续饲养8周建立HPH模型。观察各组大鼠肺血管形态、平均肺动脉压(mPAP)及右心室肥厚指数(RVHI)变化,用实时聚合酶链式反应(PCR)及免疫印迹法测定肺动脉中mi R-21、增殖细胞核抗体(PCNA)表达变化。(2)细胞水平:将体外培养的人PASMC随机分为3组:常氧组、低氧组、低氧+E2组,24 h后用四甲基偶氮唑蓝比色法检测各组细胞增殖情况,用实时PCR及免疫印迹法检测细胞中mi R-21和PCNA表达变化。结果:(1)动物水平:低氧组较常氧组肺小动脉厚度和RVHI均明显增加,m PAP升高,肺动脉中mi R-21及PCNA表达明显上升(P均0.01);常氧+E2组上述指标较常氧组无明显变化(P均0.05);低氧+E2组上述三项指标明显低于低氧组(P均0.01)。(2)细胞水平:与常氧组相比,低氧组细胞增殖明显,mi R-21和PCNA表达明显上升(P均0.01);与低氧组相比,低氧+E2组细胞增殖程度明显减轻,mi R-21和PCNA表达明显下降(P均0.01)。结论:E2能够改善HPH大鼠肺血管重构、肺动脉压力、右心室肥厚程度,其保护作用可能是通过下调mi R-21和PCNA表达从而抑制PASMC增殖而实现的。  相似文献   

3.
目的通过观察低氧致大鼠肺动脉平滑肌细胞丝氨酸/苏氨酸蛋白激酶2蛋白表达水平变化与低氧致肺动脉平滑肌细胞增殖的关系,探讨丝氨酸/苏氨酸蛋白激酶2在低氧肺血管重建中的调控作用。方法组织块法培养肺动脉平滑肌细胞,采用蛋白印迹技术检测蛋白表达水平,采用甲基噻唑基四唑法、氚—胸腺嘧啶核苷掺入法检测肺动脉平滑肌细胞增殖。结果低氧刺激肺动脉平滑肌细胞不断增殖,常氧下氚—胸腺嘧啶核苷掺入检测值为0.372±0.059,随着低氧处理时间的延长氚—胸腺嘧啶核苷掺入检测值不断升高,其中低氧12 h达到0.703±0.100,与常氧组比较差异显著;常氧下甲基噻唑基四唑检测值为8374.39±545.31,随着低氧处理时间的延长,甲基噻唑基四唑检测值不断升高,低氧24 h达到11208.35±678.82,与常氧组比较差异显著。各组均检测出丝氨酸/苏氨酸蛋白激酶2蛋白的表达,图像定量分析显示各组蛋白表达与细胞增殖改变密切相关。结论丝氨酸/苏氨酸蛋白激酶2信号通路可能在低氧肺动脉高压中调节肺动脉平滑肌细胞增殖。  相似文献   

4.
目的 探讨长期雾化吸入单硝酸异山梨醇酯(ISMN)对COPD大鼠的肺动脉压力和肺血管结构的作用及其机制.方法 24只健康雄性Wistar大鼠随机分为对照组(n=11)、COPD模型组(n=6)、吸入组(n=7).对模型组和吸入组以熏烟、寒冷刺激4 w,结合两次气管内注入脂多糖(LPS)的多因素刺激制作大鼠慢性阻塞性肺疾病模型.对照组、模型组大鼠雾化吸入生理盐水;吸入组雾化吸入ISMN,每日一次,每次10 min,共吸3 w.检测右心室肥厚,测定肺系数、肺湿重/肺干重、肺含水率,观测肺血管显微及肺组织结构变化,用免疫组织化学法检测大鼠肺动脉人类尾加压素Ⅱ(hUII)的表达.结果 COPD组大鼠右心室 /左心室+室间隔重量比值[RV/(LV+S)]明显高于对照组(P<0.01),且COPD组大鼠肺小血管肌化程度明显增强(P<0.01),中、小型肺肌型动脉相对厚度(RMT)和中膜面积(RMA)增加,肺动脉内皮细胞和平滑肌细胞hUII表达明显增强.吸入组大鼠 RV/(LV+S)高于对照组(P<0.01),但与COPD组比较差异无显著性.吸入组大鼠肺小血管肌化程度明显改善,肺血管重建缓解,小型肺肌型动脉RMT及小型肺动脉内皮细胞和平滑肌细胞hUⅡ减少.结论 长期雾化吸入ISMN可缓解COPD所致肺动脉高压和肺血管结构的重建,其对肺动脉内皮细胞和平滑肌细胞 hUⅡ表达的抑制作用可能参与肺血管的重建和肺动脉高压的调节.  相似文献   

5.
张园  杨敬平  张卿 《临床肺科杂志》2014,(12):2138-2142
目的研究H2S对大鼠低氧性肺动脉高压及凋亡相关基因BaxmRNA、Bcl-2mRNA表达的影响,探讨其在低氧性肺动脉高压发病中的作用。方法将30只雄性Wistar大鼠随机分为三组:常氧对照组、低氧组及低氧+Na HS组(腹腔注射Na HS并进行低氧处理)。常压间歇低氧法建立大鼠低氧性肺动脉高压模型,右心导管法检测平均肺动脉压(m PAP);分别称量大鼠右心室(RV)和左心室加室间隔(LV+S)的质量,计算出右心室肥厚指数RV/(LV+S);HE及弹力纤维+VG染色光镜下观察肺血管形态及肺小动脉平滑肌结构,弹力纤维、肌纤维及胶原纤维增生情况;RT-PCR方法检测BaxmRNA、Bcl-2mRNA在肺组织中的表达。结果 1低氧各组较对照组体重明显减轻(P0.05),但低氧+Na HS组明显高于低氧组(P0.05),造模前各组大鼠体重无差别(P0.05)。2低氧各组较对照组m PAP明显升高(P0.05)、RV/(LV+S)明显增加(P0.05)。低氧+Na HS组较低氧组m PAP明显降低(P0.05),RV/(LV+S)明显减少(P0.05)。3光镜下观察,对照组肺动脉管壁较薄,薄厚均匀,管腔较大。内弹力膜呈平缓波浪状,管壁层次结构清晰;低氧组肺小动脉平滑肌增生,胶原纤维增多,管壁增厚,管腔狭窄。内弹力膜增厚,外膜胶原纤维增生、沉积,外弹力膜也增厚,内外弹力板间距离均增宽;中膜平滑肌细胞也增生明显,管壁增厚,管腔明显变小,管周水肿。低氧+Na HS组较低氧组上述表现有所缓减。4低氧各组较对照组肺组织BaxmRNA表达均显著降低,Bcl-2 mRNA表达均显著增加(P0.05)。低氧+Na HS组较低氧组肺组织BaxmRNA表达显著升高,Bcl-2mRNA表达明显降低(P0.05),低氧+Na HS组较对照组大鼠肺组织BaxmRNA、Bcl-2 mRNA表达无统计学差异(P0.05).结论 H2S可以调节低氧性肺动脉高压细胞大鼠肺组织凋亡相关基因BaxmRNA、Bcl-2mRNA的表达,缓解低氧性肺血管重建,对低氧性肺动脉高压的发病起到保护作用。  相似文献   

6.
目的观察骨形态发生蛋白4(BMP4)mRNA在低氧性肺动脉高压大鼠肺血管中的表达及其与低氧性肺动脉高压形成的关系。方法将20只雄性SD大鼠随机分为对照组和低氧组,常压低氧3周建立大鼠肺动脉高压模型,以导管法测定平均肺动脉压(mPAP),分离并分别称量大鼠右心室(RV)和左心室加室间隔(LV+S),计算出右心室肥厚指数RV/(LV+S)。采用图像分析法测定和计算出肺小动脉管壁厚度指标即管壁厚度占外径的百分比(WT%)和管壁面积占总面积的百分比(WA%),并采用原位杂交方法检测大鼠肺小动脉管壁BMP4 mRNA的表达水平。结果①对照组mPAP为(16.47±1.11)mm Hg,低氧组大鼠为(29.01±0.86)mm Hg,较对照组明显升高(P〈0.01)。低氧组RV/(LV+S)为(31.13±2.57)%,对照组仅为(23.12±1.38)%(P〈0.01)。②对照组肺小动脉厚度指标为[WT%:(12.63±0.92)%;WA%:(45.24±1.98)%],而低氧组则明显升高,分别为[WT%:(26.06±1.86)%;WA%:(76.07±5.44)%](P均〈0.01)。③对照组和低氧组大鼠肺小动脉BMP4 mRNA的染色强度分别为(0.16±0.01)、(0.27±0.03),低氧组BMP4 mRNA表达明显增加(P〈0.01)。结论低氧大鼠肺血管BMP4 mRNA表达明显增加,BMP4可能在低氧性肺动脉高压的形成中具有重要作用。  相似文献   

7.
目的探讨慢性阻塞性肺疾病(COPD)患者肺动脉高压及肺血管重塑的机制。方法将患者分为非COPD非肺动脉高压组(A组)、COPD非肺动脉高压组(B组)和COPD并肺动脉高压组(C组),应用免疫组织化学方法检测肺动脉平滑肌细胞增殖细胞核抗原(PCNA),用原位缺口末端DNA碎片标记技术检测肺动脉平滑肌细胞凋亡。结果A组肺小动脉管壁较薄,管腔较大;B组管壁厚度增加,管腔变窄,其程度介于A组和C组之间;C组肺小动脉管壁明显增厚,管腔明显变窄,平滑肌细胞增生肥大,呈现明显的肺血管重塑现象;图像分析结果表明。B组及C组管壁厚度占外径的百分比(WT%)和血管壁横断面积占血管总面积的百分比(WA%)分别为(20±4)和(35±5)%、(28±5)和(50±6)%,明显高于A组的(16±3)和(25±3)%。C组与B组相比,WT%及WA%明显增高。3组肺小动脉壁平滑肌细胞均存在一定比例的增殖与凋亡,B组和C组肺小动脉平滑肌细胞增殖指数(PI)为(19±5)和(38±7)%,明显高于A组的(8±2)%;两组凋亡指数为(4.5±1.3)和(3.1±1.3)%,均明显低于A组的(6.9±1.9)%;B组肺动脉平滑肌细胞增殖指数低于C组,而凋亡指数高于C组。C组及B组氧分压与肺动脉平滑肌细胞增殖指数成负相关(r=-0.519,P=0.003),与肺动脉平滑肌细胞凋亡指数成正相关(r=0.441,P=0.015)。结论肺动脉平滑肌细胞增殖增加和凋亡减少。由此引起增殖与凋亡失衡是COPD患者肺血管重塑及发生肺动脉高压的主要机制;缺氧是引起肺动脉平滑肌细胞增殖增加和凋亡减少的主要原因之一。  相似文献   

8.
阿托伐他汀对高脂兔肺血管重构及平滑肌增殖肌化的影响   总被引:1,自引:0,他引:1  
蒋凌志  吴尚洁 《内科》2008,3(4):489-491
目的探讨阿托伐他汀对高脂兔肺动脉组织形态学、平滑肌增殖和肺小动脉肌化的影响。方法15只3月龄新西兰雄性兔随机分成对照组、高脂组及阿托伐他汀干预组,对肺组织石蜡切片进行α-平滑肌肌动蛋白、增殖细胞核抗原免疫组化检查及HE染色,观察阿托伐他汀对肺血管重构的影响。结果高脂组出现明显的肺血管重构;阿托伐他汀干预组肺动脉中膜厚度、小动脉肌化比例、中膜平滑肌细胞增殖指数均明显低于高脂组。结论阿托伐他汀可以抑制高脂兔肺动脉平滑肌细胞增殖及肺小动脉肌化,改善肺血管重构。  相似文献   

9.
目的观察Gax基因对低氧性肺动脉内皮细胞(PAECs)增殖和低氧诱导因子-1α(HIF-1α)基因表达的影响,为进一步研究Gax基因调节低氧性肺动脉高压(HPH)的作用与机制奠定基础。方法取大鼠肺动脉,用酶消化法获取PAECs并进行原代培养;PAECs分4组:未转染常氧对照组(常氧组)、未转染低氧处理组(低氧组)、Ad—SGal转染再行低氧处理组(Ad—SGal+低氧组)、Ad—Gax转染再行低氧处理组(Ad—Gax+低氧组)。分别在常氧(21%O2)和低氧(2.5%O2)1h、3h、6h和12h各时相点,采用3H-胸腺嘧啶核苷(3H-TdR)掺入法检测PAECs增殖;使用RT—PCR和Weatern blot方法分别检测PAECs中HIF-1α mRNA和蛋白表达水平。结果①PAECs的3H-TdR掺入量:与常氧组同时相点比较,低氧组和Ad—pGaJ+低氧组均显著升高(P均〈0.01),在低氧6h达最大值;Ad.Gax+低氧组与常氧组同时相点比较均显著升高(P均〈0.01),但与低氧组比较却均明显降低(P〈0.01、P〈0.05),到低氧6h降幅最大;②在低氧处理6h,与常氧组比较,低氧组和Ad—BGal+低氧组HIF-1α mRNA和蛋白表达均明显上调;与低氧组或Ad—BGal+低氧组比较,Ad—Gax+低氧组HIF-1α mRNA和蛋白表达皆显著下调,差异有统计学意义(P〈0.05、P〈0.01)。低氧早期内皮细胞异常增殖加速,而此时增强Gax基因的表达可抑制细胞的异常增殖;随着低氧时间的不断延长,细胞增殖受到抑制,而此时增强内皮细胞中Gax基因表达却又促进细胞增殖,以此来维持细胞的数量。结论Gax基因对维持内皮细胞数量的稳态具有双向调节作用。增强Gax基因的表达能下调低氧诱导的HIF-1α mRNA和蛋白表达,这可能与Gax基因抑制低氧性内皮细胞异常增殖的机制相关。  相似文献   

10.
低氧对肺血管周细胞增殖及分化的影响   总被引:6,自引:1,他引:5  
目的研究低氧对肺血管周细胞增殖及分化的影响,探讨低氧性肺动脉高压时无肌型肺动脉肌化的细胞来源。方法实验分为4组:直接低氧组(H组),常氧组(N组),低氧内皮细胞条件培养液组(HECCM组),常氧内皮细胞条件培养液组(NECCM组)。应用细胞培养、3H胸腺嘧啶核苷(3HTdR)、免疫细胞化学、图像分析等技术,研究低氧对肺血管周细胞3HTdR的掺入量、增殖细胞核抗原(PCNA)、α平滑肌肌动蛋白(αSMActin)表达的影响。结果H组周细胞3HTdR的掺入量、PCNA及αSMActin的表达量分别是N组的2.16倍(P<0.01)、1.16倍(P<0.01)及1.11倍(P<0.05),HECCM组周细胞3HTdR的掺入量、PCNA及αSMActin的表达量分别是NECCM组的1.8倍(P<0.01)、1.15倍(P<0.01)及1.12倍(P<0.05)。结论低氧可直接或刺激内皮细胞分泌某些细胞因子促进肺血管周细胞增殖、并向平滑肌样细胞分化。肺血管周细胞的增殖、向平滑肌样细胞分化是低氧性肺动脉高压无肌细动脉肌化的重要细胞来源  相似文献   

11.
Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.  相似文献   

12.
The immunoneuroendocrine role of melatonin   总被引:19,自引:0,他引:19  
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.  相似文献   

13.
Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm2) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.  相似文献   

14.
15.
Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.  相似文献   

16.
Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.  相似文献   

17.
Microbiology of human immunodeficiency virus anorectal disease   总被引:3,自引:3,他引:0  
PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.  相似文献   

18.
Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.  相似文献   

19.
Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.  相似文献   

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