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21.
Hans D de Boer Jan van Egmond Jacques J Driessen Leo HD Booij 《Neuropsychiatric Disease and Treatment》2007,3(5):539-544
Steroidal neuromuscular blocking agents (NMBAs), such as rocuronium, are widely used in clinical anesthesia and emergency medicine to facilitate endotracheal intubation and artificial ventilation and to allow surgical access to body cavities. Reversal of neuromuscular blockade is important for the acceleration of patient recovery and prevention of postoperative residual neuromuscular blockade and reduces the incidence of severe morbidity and mortality associated with anesthesia management. Sugammadex is the first selective relaxant binding agent (SRBA) and has been designed to reverse the steroidal neuromuscular blocking drug rocuronium. Encapsulation of the rocuronium molecule by sugammadex results in a rapid decrease in free rocuronium in the plasma and subsequently at the nicotinic receptor at the motor endplate. After encapsulation, rocuronium is not available to bind to the nicotinic receptor in the neuromuscular junction. This promotes the liberation of acetylcholine receptors, and muscle activity reappears. This new concept of reversal of neuromuscular block induced by rocuronium (or vecuronium) led to impressive results in animal and phase 1 and 2 studies. Sugammadex is currently in phase 3 clinical studies and may be commercially available by 2008. 相似文献
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Regulation of spontaneous activity and oscillatory spike firing in rat midbrain dopamine neurons recorded in vitro 总被引:2,自引:0,他引:2
A A Grace 《Synapse (New York, N.Y.)》1991,7(3):221-234
Intracellular recordings were obtained from identified dopamine (DA) neurons in rat midbrain slices maintained in vitro. DA neuron membranes exhibited pronounced instantaneous and time-dependent anomalous rectification that showed evidence of maximal activation at average membrane potentials of -63 and -78 mV, respectively. Action potentials were followed by prominent afterhyperpolarizations (AHP) that consisted of two components. The fast component showed evidence of inactivation at -63 mV independent of the initial membrane potential, whereas the longer-duration, later component increased in amplitude at hyperpolarized potentials. Unlike DA neurons recorded in vivo, there was no evidence of spike frequency adaptation or summation of AHPs with prolonged depolarization-induced spike trains. Spontaneous spike discharge occurred via an endogenous pacemaker potential that was dependent on both TTX-sensitive and cobalt-sensitive processes. Hyperpolarizing prepulses could activate rebound pacemaker discharge, but this rebound activity was progressively blocked with larger-amplitude hyperpolarizing prepulses. DA neurons recorded in the anesthetized animal, freely moving animal, and in vitro preparations have been shown to exist in two states of activity: 1) spontaneously discharging action potentials or 2) hyperpolarized, quiescent, and nonfiring. Furthermore, although it is rare to find DA neurons in the untreated animal in transitional states of activity, quiescent neurons can be activated by stimuli that place a demand on the DA system. The evidence presented here is consistent with the hypothesis that the special combination of membrane properties of DA neurons contribute to the segregation of their activity into active or inactive states. 相似文献
26.
De Leo V; Morgante G; Lanzetta D; D'Antona D; Bertieri RS 《Human reproduction (Oxford, England)》1997,12(2):357-360
We report the results of administration of danazol after suspension of
gonadotrophin-releasing hormone analogue (GnRHa) therapy for uterine
myomas. A total of 21 women with uterine myomas was treated with 100 mg
danazol for 6 months after GnRHa therapy. Uterine volume and endocrine
status were monitored monthly by ultrasound and assay of plasma
gonadotrophins, oestradiol and progesterone. The results show a rebound of
uterine volume about 30% less than in controls at the end of danazol
therapy. Menstrual cyclicity returned after 65 +/- 3 days in 16 subjects
and five patients remained amenorrhoeic. Hormone assays confirmed renewed
ovarian function in the women whose menstrual periods returned. Bone
mineral content was substantially reduced during GnRHa treatment but
improved significantly during danazol therapy even in the women who
remained amenorrhoeic. These results show the utility of danazol in
prolonging the therapeutic effects of GnRHa. The mechanism by which danazol
inhibits rebound of uterine volume may be due to its antiprogesterone
effects on uterine myomas.
相似文献
27.
A dosage study of the effect of the 21-aminosteroid U74006F on chronic cerebral vasospasm in a primate model 总被引:1,自引:0,他引:1
The efficacy of the 21-aminosteroid U74006F was investigated using different dosages in a restricted, randomized, placebo-controlled trial. Forty cynomolgous monkeys were divided into five groups of eight. There were two groups given treatment with placebos, one being saline and the other the vehicle in which U74006F was delivered. There were three U74006F treatment dosage groups: 0.3, 1.0, and 3.0 mg/kg. Each monkey underwent baseline cerebral angiography followed by right-sided craniectomy and subarachnoid placement of a clot around the middle cerebral artery (MCA). Treatment was administered intravenously every 8 hours for 6 days. Seven days after experimental subarachnoid hemorrhage, angiography was repeated, and the animals were killed. In both saline or vehicle placebo treatment groups, significant vasospasm (VSP) occurred on the clot side in the extradural internal carotid artery (C3), the intradural internal carotid artery, the precommunicating segment of the anterior cerebral artery (A1,) and the MCA (P less than 0.01). After U74006F treatment, significantly less VSP developed in the A1 on the clot side (0.3 mg/kg U74006F treatment group) and the MCA (all U74006F treatment groups, P less than 0.05). When the percentages of change from the baseline for the vessel diameters on the clot side were compared, VSP was attenuated in the A1 (P less than 0.05) and MCA (P less than 0.001) of all U74006F treatment groups as compared with the placebo treatment groups. Only 0.3 mg/kg of U74006F significantly prevented VSP in C3 (P less than 0.01). Although the 0.3 mg/kg dosage appeared to have the most favorable effect, no significant differences were observed among the three dosage groups. Electron microscopy of the MCA on the clot side in the animals treated with U74006F still showed luminal convolutions and morphological changes in the endothelial cells. These changes appeared less prominent in those MCAs with milder VSP. If these results in primates are applicable to humans, U74006F would be useful in reducing VSP after aneurysmal subarachnoid hemorrhage. 相似文献
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Andrea DiMartini Lubna Javed Sarah Russell Mary Amanda Dew Mary Grace Fitzgerald Ashok Jain John Fung 《Liver transplantation》2005,11(6):679-683
Alcohol and tobacco use commonly co-occur, with at least 90% of those with an alcohol problem also using tobacco. Thus, 3 years ago when we discovered higher rate of late deaths due to lung and oropharyngeal cancer in patients who had received a transplant for alcoholic liver disease (ALD), we hypothesized that these patients were continuing to expose themselves to tobacco after liver transplantation (post-LTX) and that this behavior was increasing their risk for cancer. We subsequently began a prospective investigation of post-LTX tobacco use in patients having undergone LTX for ALD (n = 172). For 33 recipients we had data starting from our first assessment at 3 months post-LTX and for this subgroup we report on the details of the timing of tobacco use resumption and the redevelopment of nicotine addiction. We found that on average more than 40% are smoking across all time periods. ALD recipients resume smoking early post-LTX, increase their consumption over time, and quickly become tobacco dependent. These data highlight an underrecognized serious health risk for these patients and demonstrate our need for more stringent clinical monitoring and intervention for tobacco use in the pre- and post-LTX periods. 相似文献