Usage of long-term steroid therapy

This report will discuss the different aspects of long-term steroid therapy. The five major areas of interest are indications for treatment, complications, withdraw, monitoring, and surgical adjustment of dosage.     

MDMA produces stimulant-like conditioned locomotor activity

Daily administration of a drug in a distinctive environment establishes contingencies that support Pavlovian conditioning. Environmental cues that are paired with the drug injection and that predict the onset of drug action can become conditioned stimuli. Ultimately, the conditioned stimuli come to predict the availability of drug and develop the potential to engender conditioned drug responses. Various psychostimulant drugs can produce conditioned locotnotion when tested in the presence of environmental cues that were repeatedly associated with the drug experience. The ability of amphetamine and cocaine to produce conditioned locomotion was demonstrated in the present study. Stimulant-like properties of methylenedioxymethamphetamine (MDMA) have been reported in locomotor paradigms, drug discrimination procedures, and human subjective questionnaires. MDMA (5 mg/kg), paired for 5 days to a distinct environment signalled by the presence of a distinct odor, produced enhanced locomotion during a test probe with the odor alone indicating that MDMA can also produce conditioned locomotion. The observation that the stimulus properties of MDMA can also become associated with environmental cues supports the hypothesis that some of the behavioral effects of MDMA resemble those of other classical psychostimulants such as amphetamine and cocaine.This is publication number 5732BCR from the Research Institute of Scripps Clinic     

Tumor-specific efficacy of transforming growth factor-beta RI inhibition in Eker rats.

PURPOSE: Transforming growth factor beta (TGF-beta), which generally stimulates the growth of mesenchymally derived cells but inhibits the growth of epithelial cells, has been proposed as a possible target for cancer therapy. However, concerns have been raised that whereas inhibition of TGF-beta signaling could be efficacious for lesions in which TGF-beta promotes tumor development and/or progression, systemic pharmacologic blockade of this signaling pathway could also promote the growth of epithelial lesions. EXPERIMENTAL DESIGN: We examined the effect of a TGF-beta inhibitor on mesenchymal (leiomyoma) and epithelial (renal cell carcinoma) tumors in Eker rats, which are genetically predisposed to develop these tumors with a high frequency. RESULTS: Blockade of TGF-beta signaling with the ALK5/type I TGF-beta R kinase inhibitor, SB-525334, was efficacious for uterine leiomyoma; significantly decreasing tumor incidence and multiplicity, and reducing the size of these mesenchymal tumors. However, SB-525334 was also mitogenic and antiapoptotic for epithelial cells in the kidney and exacerbated the growth of epithelial lesions present in the kidneys of these animals. CONCLUSION: Although pharmacologic inhibition of TGF-beta signaling with SB-525334 may be efficacious for mesenchymal tumors, inhibition of this signaling pathway seems to promote the development of epithelial tumors.     

腹部外科常见感染性疾病的病原菌及药敏试验研究

为了了解本地区本医院腹部外科感染性疾病病原菌的构成比和药物敏感率的变化,指导临床用药,我们采用美国BD公司生产的6B和7D两种增菌瓶采集标本和培养细菌,并用该公司生产的生化板和药敏板,对1994～1996年269例常见的普外科感染性疾病患者的手术标本进行前瞻性的细菌培养和药敏试验研究.     

Magnetic Resonance Imaging of Corticobasal Degeneration

Corticobasal degeneration (CBD) is an adult–onset, progressive parkinsonian syndrome with strikingly asymmetrical features, and signs and symptoms referable to both cerebral cortex and basal ganglia. Although once considered rare, it is now recognized with increasing frequency during life. Eight patients with clinically diagnosed CBD and 8 age– and sex–matched patients with Parkinson's disease underwent high–field–strength magnetic resonance imaging (MRI) of the brain. MRIs were graded by a blinded neuroradiologist using a semiquantitative (0–3) scale. MRI of patients with CBD revealed significantly greater T2–weighted signal hypointensity in the putamena and globi pallidi, and ventricular enlargement. When specifically sought, asymmetrical cortical atrophy was identified in 5 of 8 CBD patients. Increased T2–weighted lenticular signal hypointensity, ventricular enlargement, and asymmetrical cortical atrophy are supportive MRI findings of CBD.     

"Bicycle kickstand" phenomenon: prolonged erections associated with antipsychotic agents

The purpose of this paper is to draw attention to the ability of some antipsychotic agents to produce sustained erection short of priapism. They appear to have this effect consistently over time in some individuals. The effect is rapidly reversible on discontinuation of the drug, and appears to be dose-dependent. In one of our patients, the "active metabolite" of that same drug could not duplicate the effect. Prevalence and mechanism require clarification. If even a small proportion of patients with the sustained erection phenomenon are found to progress to priapism, this would have profound ramifications. If this phenomenon could be confidently predicted or safely and readily implemented, the benefits for some patients with impotence or premature ejaculation might be considerable. Given all the potential adverse side effects of antipsychotics, it should be appreciated that the potential direct effects on male sexual function are not always adverse.     

Reconstruction of axillary burn contractures with the latissimus dorsi fasciocutaneous flap

Standard management of axillary burn contractures has been scar release and the use of skin grafts, despite the common problem of incomplete graft take, prolonged splinting, extended physical therapy, and recurrent contractures. A recent development in plastic surgery has been the "super flap" or fasciocutaneous flap. A series of axillary burn contractures released with the latissimus dorsi fasciocutaneous flap has been reported by Tolhurst. Our series of ten patients confirms that the latissimus dorsi fasciocutaneous flap is the treatment of choice for the release of severe axillary burn contractures.     

Indoor air pollution.

This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leading to immune responses, such as house dust mites, cockroaches, fungi, animal dander, and urine; biologic agents associated with infection such as Legionella and tuberculosis; formaldehyde; and volatile organic compounds. An approach to assessing building-related illness and "tight building" syndrome is presented. Finally, the article reviews recent data on hospital-related asthma and exposures to potential respiratory hazards such as antineoplastic agents, anesthetic gases, and ethylene oxide.