Peripheral opioid analgesia: Clinical applications

Peripheral opioid analgesia is undoubtedly of clinical relevance, especially considering that systemic opioid therapy often is hampered by central side effects. Despite some clinical studies that do not show peripheral opioid-mediated pain control, mostly because of methodologic shortcomings, studies evaluating inflammatory pain conditions show clear evidence and the number and the sites of applications are increasing. The intention of this paper is to give insight into the recent experience with the clinical applications of peripheral opioid analgesia.     

Dextran 70 administration after trauma-hemorrhagic shock does not impair cellular immune functions

: Although the effects of the colloid dextran 70 on induction of anaphylactoid reactions or reticulo-endothelial phagocytosis have been examined previously, its effects on specific cell-mediated immunity after trauma-hemorrhage shock remain unknown.

: Nonheparinized C3H/HeN mice underwent a laparotomy, were bled, and then maintained at a blood pressure of 35 mm Hg for 60 minutes. Then they were resuscitated with either 4 × the shed blood volume as lactated Ringer's solution (LRS) or 2 × LRS + 1 × dextran 70. Control mice underwent all operative protocols but were neither hemorrhaged, nor resuscitated. At 2 or 24 hours posthemorrhage, serum, splenocytes (SPL), and peritoneal macrophages (pMø, splenic Mo (sMø) were obtained. Bioassays were used to determine interleukin-2 (IL-2), IL-3, IL-6, and SPL proliferation.

: Trauma-hemorrhage markedly depressed lymphokine release, splenocyte proliferation, and IL-6 release at 2 hours after the insult. The combination of LRS + dextran did not restore lymphocyte functions, but also did not further suppress them. The release of IL-6 by pMø and sMø at 2 and 24 hours after dextran infusion and serum IL-6 remained at the same level as in LRS-treated animals.

: The combination of LRS and colloid dextran 70 does not adversely affect ex vivo cell-mediated immune functions during the first 24 hours after its administration after trauma-hemorrhage. Thus, from the immunological standpoint, dextran is a safe resuscitation adjunct.     

High intensity focused ultrasound as noninvasive therapy for multilocal renal cell carcinoma: case study and review of the literature

PURPOSE: Noninvasive tumor ablation can be achieved by extracorporeally induced high intensity focused ultrasound. Clinical high intensity focused ultrasound performed to date for renal tumors have only been experimental in nature. We present specific details on a patient with renal cell carcinoma who underwent high intensity focused ultrasound with curative intent and long-term followup examinations. MATERIALS AND METHODS: Ultrasound waves were generated by a cylindrical piezoelectric element focused by a paraboloid reflector. High intensity focused ultrasound was applied to 3 tumors in 3 sessions with the patient under general anesthesia or sedation analgesia, followed by magnetic resonance imaging for 6 months. RESULTS: After treatment magnetic resonance imaging showed necrosis in the 2 tumors in the lower kidney pole within 17 and 48 days, respectively. The necrotic tumor area shrank thereafter within 6 months. The tumor in the upper pole was not affected by treatment due to absorption of the ultrasound energy by the interposed ribs. General anesthesia was required to apply high energy levels of focused ultrasound. Absorption of high intensity focused ultrasound in the tissue induced sharply demarcated thermonecrosis. For 50 years patients have been treated with high intensity focused ultrasound for different indications, focusing on the brain, eyes, prostate, liver and bladder. For the kidney experimental but only few clinical studies indicate sufficient tissue ablation. CONCLUSIONS: In our case contactless noninvasive application of high intensity focused ultrasound to 2 renal carcinomas achieved thermal ablation. When high intensity focused ultrasound energy was coupled correctly, no lesions occurred outside of the target area. Successful high intensity focused ultrasound application depended on optimum energy coupling, a sufficiently high ultrasound energy level and general anesthesia.     

GC盒不是人胰岛素基因启动子中关键顺式作用元件

目的 鉴定人胰岛素基因启动子中的GC盒(-348～-338)是否是启动子中的关键顺式作用元件.方法 用PCR克隆人胰岛素基因启动子,构建由人胰岛素基因启动子驱动的分泌型碱性磷酸酶(SEAP)报告质粒,并对报告质粒中人胰岛素基因启动子中的GC盒进行删除和突变.将报告质粒转染到β细胞系βTC3中,测定细胞培养液上清中SEAP的活性强度,进而判定GC盒与人胰岛素基因启动子转录活性的关系.结果 删除和突变人胰岛素启动子中的GC盒不能显著改变胰岛素基因启动子在β细胞中的转录活性.结论 人胰岛素基因启动子中GC盒不是一个关键顺式作用元件.     

Reuse of silver-palladium ceramic metal

The effect of various percentages of reused silver-palladium alloy on the bond strength of porcelain was considered. All-new metal and once-cast alloy with the addition of 50% new metal produced the highest bond values. Once-cast alloy with less than 50% new metal produced bond strength values that were significantly lower. When using this silver-palladium alloy, 50% new alloy should be added to each casting button, and buttons with questionable casting history should not be used.     

Ultrasound Bone Fracture Sensing and Data Communication: Experimental Results in a Pig Limb Sample

Approximately 6.3 million fractures occur each year in the United States alone. Accurately monitoring the progression of fracture healing is essential to be able to advise patients when it is safe to return to normal activity. The most common method used to confirm and monitor fracture healing is the acquisition of multiple radiographic images over the many months required for healing. This imaging method uses large expensive equipment and exposes patients to high levels of ionizing radiation. In the study described here, we tested another technology for monitoring fracture healing that could minimize the need for multiple radiographic images. We tested a piezoelectric transducer fixed to the surface of a bone that uses electromechanical impedance spectroscopy to measure simulated fractures and transmits the measurement data to an acoustic receiver located externally on the skin surface.