电视辅助胸腔镜外科

１概述 电视辅助胸腔镜外科（Ｖｉｄｅｏ—ａｓｓｉｓｔｅｄ ＴｈｏｒａｃｉｃＳｕｒｇｅｒｙ,ＶＡＴＳ）是内镜外科在设备和手术器械不断发展的基础上产生的“微侵入”外科技术。如腹腔镜技术在外科的应用一样,９０年代以来,ＶＡＴＳ在胸外科领域也得到蓬勃发展。 ＶＡＴＳ的出现改变了胸腔内镜技术的面貌。早在１９１０年,瑞士内科医师Ｊａｃｏｂｅｕｓ首先把膀胱镜技术移植到胸腔内,用于诊断胸膜病灶以及应用到治疗肺结核的胸膜粘连术和肺萎陷疗法。开辟了内镜诊断、治疗胸部疾病的先例［１］。以后,在２０世纪三四十年代,逐渐发…     

Alpha(4)beta(7)/alpha(4)beta(1) dual integrin antagonists block alpha(4)beta(7)-dependent adhesion under shear flow

The alpha(4) integrin, alpha(4)beta(7), plays an important role in recruiting circulating lymphocytes to the gastrointestinal tract, where its ligand mucosal addressin cell adhesion molecule-1 (MAdCAM-1) is preferentially expressed on high endothelial venules (HEVs). Dual antagonists of alpha(4)beta(1) and alpha(4)beta(7), N-(2,6-dichlorobenzoyl)-(L)-4-(2',6'-bis-methoxyphenyl)phenylalanine (TR14035) and N-(N-[(3,5-dichlorobenzene)sulfonyl]-2-(R)-methylpropyl)-(D)-phenylalanine (compound 1), were tested for their ability to block the binding of alpha(4)beta(7)-expressing cells to soluble ligand in suspension and under in vitro and in vivo shear flow. Compound 1 and TR14035 blocked the binding of human alpha(4)beta(7) to an (125)I-MAdCAM-Ig fusion protein with IC(50) values of 2.93 and 0.75 nM, respectively. Both compounds inhibited binding of soluble ligands to alpha(4)beta(1) or alpha(4)beta(7) on cells of human or rodent origin with similar potency. Under shear flow in vitro, TR14035 and compound 1 blocked binding of human alpha(4)beta(7)-expressing RPMI-8866 cells or murine mesenteric lymph node lymphocytes to MAdCAM-Ig with IC(50) values of 0.1 and 1 microM, respectively. Intravital microscopy was used to quantitate alpha(4)-dependent adhesion of fluorescent murine lymphocytes in Peyer's patch HEVs. When cells were prestimulated with 2 mM Mn(2+) to activate alpha(4)beta(7) binding to ligand, anti-alpha(4) monoclonal antibody (mAb) [10 mg/kg (mpk) i.v.] blocked adhesion by 95%, and anti-beta(1) mAb did not block adhesion, demonstrating that this interaction was dependent on alpha(4)beta(7). TR14035 blocked adhesion to HEVs [ED(50) of 0.01-0.1 mpk i.v.], and compound 1 blocked adhesion by 47% at 10 mpk i.v. Thus, alpha(4)beta(7)/alpha(4)beta(1) antagonists blocked alpha(4)beta(7)-dependent adhesion of lymphocytes to HEVs under both in vitro and in vivo shear flow.     

(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU)

(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU, Brivudin, Zostex, Zerpex, Zonavir), now more than 20 years after its discovery, still stands out as a highly potent and selective inhibitor of herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) infections. It has been used in the topical treatment of herpetic keratitis and recurrent herpes labialis and the systemic (oral) treatment of herpes zoster (zona, shingles). The high selectivity of BVDU towards HSV-1 and VZV depends primarily on a specific phosphorylation of BVDU to its 5'-diphosphate (DP) by the virus-encoded thymidine kinase (TK). After further phosphorylation (by cellular enzymes), to the 5'-triphosphate (TP), the compound interferes as a competitive inhibitor/alternate substrate with the viral DNA polymerase. The specific phosphorylation by the HSV- and VZV-induced TK also explains the marked cytostatic activity of BVDU against tumor cells that have been transduced by the viral TK genes. This finding offers considerable potential in a combined gene therapy/chemotherapy approach for cancer. To the extent that BVDU or its analogues (i.e., BVaraU) are degraded (by thymidine phosphorylase) to (E)-5-(2-bromovinyl)uracil (BVU), they may potentiate the anticancer potency, as well as toxicity, of 5-fluorouracil. This ensues from the direct inactivating effect of BVU on dihydropyrimidine dehydrogenase, the enzyme that initiates the degradative pathway of 5-fluorouracil. The prime determinant in the unique behavior of BVDU is its (E)-5-(2-bromovinyl) substituent. Numerous BVDU analogues have been described that, when equipped with this particular pharmacophore, demonstrate an activity spectrum characteristic of BVDU, including selective anti-VZV activity.     

真空负压吸引在乳腺癌改良根治术后应用的研究

目的 ：探讨Drainobag真空负压引流瓶在乳腺癌根治术后的应用效果。方法：对66 例在我科施行乳腺癌改良根治术的患者,术后随机分为两组,对照组(33 例)选择持续墙式中心负压吸引引流,改进组(33例)应用Drainobag真空负压引流瓶引流,对两组术后第一天引流量、置管时间、皮下积液、皮瓣坏死和术后住院时间进行比较。结果：改进组术后第一天引流量、置管时间、皮下积液、皮瓣坏死率和术后住院时间均明显低于对照组(Ｐ＜0.05)。结论：应用Drainobag真空负压引流瓶引流效果好,能有效预防术后并发症的发生,缩短了住院时间,增强了病人的自信心。     

Alendronate (Fosamax) and risedronate (Actonel) revisited

A 10-year study of daily oral alendronate (Fosamax) and a 7-year study of daily oral risedronate (Actonel) indicate that both drugs maintained increases in bone mineral density (BMD) and decreases in markers of bone remodeling throughout the study period. Both drugs are now more commonly taken once weekly. Available data are insufficient to compare fracture rates with alendronate and risedronate, and fracture rates are considered the most important endpoint in osteoporosis studies. Recent reports of severe pain and jaw osteonecrosis with these drugs are disturbing.     

Morphological Distinction of Cyanodermatium (Hydrococcaceae) and Radaisia (Hyellaceae) of Chroococcales (Cyanoprokaryota)

Radaisia gomontiana Sauvageau has been studied for their morphology from the material collected from natural habitat and from cultures. The continuous collections of the organism from nature did not show any sign of baeocyte formation. However, in the seventeenth collection, after 2 months growth in a water body, it did reveal the formation of baeocytes only for 2 days, whereas under culture conditions, stages of baeocyte and monocyte formation were recorded as distinct features. The organism is identified as Radaisia (Hyellaceae) when baeocytes are observed. Its vegetative stage which is recognized as Cyanodermatium (Hydrococcaceae).     

Douleur(s) d’archive(s)

Sans résumé Texte présenté au colloque ?Douleur et Mémoire? à Paris, novembre 1997.     

Artificial corneal implants (keratoprostheses) (author's transl)

The history of keratoprosthetics and the pioneer work of Cardona et al. is described and the technical improvements in this method over the past two decades are reviewed. In addition, the results achieved in 17 personal cases are recorded. Visual acuity was definitely improved in 7 cases, transient improvement was obtained in 5 cases, 3 patients retained poor vision, and 2 cases showed deterioration. Implantation of artificial keratoprostheses is still at a pioneer stage and further progress can be expected in this field.     

Poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) (Pluronic)/poly(epsilon-caprolactone) (PCL) amphiphilic block copolymeric nanospheres. I. Preparation and characterization.

Amphiphilic block copolymers based on PEO-PPO-PEO block copolymer (Pluronic) and poly(epsilon-caprolactone) were synthesized by bulk polymerization. The structural analysis of Pluronic/PCL block copolymer was carried out using FT-IR, 1H NMR, GPC, WAXD, DSC and TGA measurements. To prepare copolymeric nanospheres with a micellar structure, Pluronic/PCL amphiphilic block copolymers were dialyzed against water. The size and size distribution of Pluronic/PCL block copolymeric nanospheres were examined by dynamic light scattering measurement. They showed an average diameter of 116 to 196 nm depending on the type of copolymer. All the nanosphere samples exhibited a narrow size distribution. The critical micelle concentrations of Pluronic/PCL amphiphilic block copolymers determined by fluorescence spectroscopy were lower than that of common low molecular weight surfactants. We confirmed the formation of stable copolymeric nanospheres through the solution behavior of amphiphilic block copolymer in selective solvents.     

Sandostatin (octreotide)--drug and neurotransmitter (experimental study)

Sandostatin (octreotide), a synthetic analogue of somatostatin that is a hormone and neurotransmitter of pain conduction, has been developed. The drug has been widely used in gastroenterological care; however, its role as a neurotransmitter has been little studied. The authors performed experimental studies to evaluate the effects of octreotide on the nociceptive sensitivity of animals (the intravenous dose being 1 mg/kg) and on the actinociceptive activity of fentanyl (the intraperitoneal doses, 125 and 250 micrograms/kg). The study has demonstrated that octreotide in a dose of 1 mg/kg causes a steady-state hyperalgesic effect. A combination of octreotide and fentanyl in the above diseases substantially reduces the analgesic activity of the latter just 15 min after injection, which should be borne in mind in applying the above agents in clinical practice.