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81.
An in vitro is described that attempts to detect patients with a potential for adverse systemic reactions to contrast material. This test involves measuring the rate of conversion of prekallikrein to kallikrein under certain standard conditions. In a preliminary retrospective study, the test could be used to identify such patients with a sensitivity of 88%, a specificity of 82%, and a predictive value of 79%. 相似文献
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Endonasal transsphenoidal removal of tuberculum sellae meningiomas: technical note 总被引:12,自引:0,他引:12
OBJECTIVE: Tuberculum sellae meningiomas traditionally have been removed through a transcranial approach. More recently, the sublabial transsphenoidal approach has been used to remove such tumors. Here, we describe use of the direct endonasal transsphenoidal approach for removal of suprasellar meningiomas. METHODS: Three women, aged 32, 34, and 55 years, each sought treatment for visual loss and headaches. In each patient, magnetic resonance imaging (MRI) showed a suprasellar mass causing optic chiasmal and optic nerve compression (average size, 2 x 2 cm). All three patients underwent tumor removal via an endonasal approach with the operating microscope. Suprasellar exposure was facilitated by removal of the posterior planum sphenoidale. Ultrasound was used to help define tumor location before dural opening. The extent of tumor removal was verified with angled endoscopes in all patients, and with intraoperative MRI in one patient. The surgical dural and bony defects were repaired in all patients with abdominal fat, titanium mesh, and 2 to 3 days of cerebrospinal fluid lumbar drainage. Nasal packing was not used. RESULTS: There were no postoperative cerebrospinal fluid leaks or meningitis. One patient required a reoperation 2 weeks after surgery to reduce the size of her fat graft, which was causing optic nerve compression; within 24 hours, her vision rapidly improved. At 3 months after surgery, all three patients had normal vision, no new endocrinopathy, and no residual tumor on MRI. At 10 months after surgery, one patient had a small asymptomatic tumor regrowth seen on MRI. CONCLUSION: The endonasal approach with the operating microscope appears to be an effective minimally invasive method for removing relatively small midline tuberculum sellae meningiomas. Intraoperative ultrasound, the micro-Doppler probe, and angled endoscopes are useful adjuncts for safely and completely removing such tumors. Longer follow-up is needed to monitor for tumor recurrence in these patients. 相似文献
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Pharmacokinetic and pharmacodynamic evaluation of a novel proton pump inhibitor, YH1885, in healthy volunteers 总被引:4,自引:0,他引:4
Yu KS Bae KS Shon JH Cho JY Yi SY Chung JY Lim HS Jang IJ Shin SG Song KS Moon BS 《Journal of clinical pharmacology》2004,44(1):73-82
To evaluate the pharmacokinetic and pharmacodynamic characteristics of YH1885, a novel proton pump inhibitor, a single-blind, randomized, placebo-controlled, dose-rising, parallel-group study was conducted in 46 healthy volunteers. The volunteers were randomly allocated to single dose groups of 60 mg, 100 mg, 150 mg, 200 mg, and 300 mg (6 subjects per dose, including 2 placebos) or to multiple-dose groups of 150 mg and 300 mg (once-daily dosing for 7 days; 8 subjects per dose, including 2 placebos). The multiple-dose study was conducted separately after the single-dose study. YH1885 was administered orally after overnight fasting. Serial blood samples, urine samples, and pharmacodynamic measurements were taken. Drug concentrations in plasma and urine were determined by liquid chromatography/mass spectrometry (LC/MS). Pharmacodynamic changes were evaluated by ambulatory intragastric pH monitoring and by serial measurements of serum gastrin concentrations. Assessments of safety and tolerability also were made. Plasma concentrations of YH1885 reached peak levels 1.3 to 2.5 hours after single-dose administration and then declined monoexponentially with a terminal half-life (t(1/2)) of 2.2 to 2.4 hours in dosage groups up to 200 mg in the single-dose study. YH1885 showed linear pharmacokinetic characteristics, and little accumulation occurred after multiple administrations. The parent drug was not detected in urine. Dose-related pharmacological effects were obvious for dose groups of 150 mg and higher in the single-dose study. The mean intragastric pH and the percentage of time at pH>4 were significantly increased. The onset of drug effect was rapid, and maximal effects were observed on the first day of administration during multiple dosing. Serum gastrin levels also showed rapid increases during dosing but with a weak dose-effect relationship. Neither serious nor dose-limiting adverse effects were observed. YH1885 was found to be safe and well tolerated and effectively inhibited acid secretion with dose-dependent increases in intragastric pH. The acid-suppressing efficacy of YH1885 needs to be further evaluated in patients with gastric acid-related diseases. 相似文献
86.
Miller A Hall CS Buchanan RW Buckley PF Chiles JA Conley RR Crismon ML Ereshefsky L Essock SM Finnerty M Marder SR Miller DD McEvoy JP Rush AJ Saeed SA Schooler NR Shon SP Stroup S Tarin-Godoy B 《The Journal of clinical psychiatry》2004,65(4):500-508
BACKGROUND: The Texas Medication Algorithm Project (TMAP) has been a public-academic collaboration in which guidelines for medication treatment of schizophrenia, bipolar disorder, and major depressive disorder were used in selected public outpatient clinics in Texas. Subsequently, these algorithms were implemented throughout Texas and are being used in other states. Guidelines require updating when significant new evidence emerges; the antipsychotic algorithm for schizophrenia was last updated in 1999. This article reports the recommendations developed in 2002 and 2003 by a group of experts, clinicians, and administrators. METHOD: A conference in January 2002 began the update process. Before the conference, experts in the pharmacologic treatment of schizophrenia, clinicians, and administrators reviewed literature topics and prepared presentations. Topics included ziprasidone's inclusion in the algorithm, the number of antipsychotics tried before clozapine, and the role of first generation antipsychotics. Data were rated according to Agency for Healthcare Research and Quality criteria. After discussing the presentations, conference attendees arrived at consensus recommendations. Consideration of aripiprazole's inclusion was subsequently handled by electronic communications. RESULTS: The antipsychotic algorithm for schizophrenia was updated to include ziprasidone and aripiprazole among the first-line agents. Relative to the prior algorithm, the number of stages before clozapine was reduced. First generation antipsychotics were included but not as first-line choices. For patients refusing or not responding to clozapine and clozapine augmentation, preference was given to trying monotherapy with another antipsychotic before resorting to antipsychotic combinations. CONCLUSION: Consensus on algorithm revisions was achieved, but only further well-controlled research will answer many key questions about sequence and type of medication treatments of schizophrenia. 相似文献
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Excel97在药物分析中的应用 总被引:1,自引:0,他引:1
目的:在药物分析中,电子表格软件MicrosoftExce197for Windows。方法:利用Excel的数据处理功能,进行药物的图表绘制、数据计算和统计处理,回归分析,特别是计算分析,并可建立分析数据库。结果和结论:Excel操作简单,功能强大,数据分析工作直观。 相似文献
89.
目的:比较国产辛伐他汀与进口辛伐他汀治疗原发性高胆固醇血症的疗效及安全性。方法:采用开放区组随机对照、多中心的临床设计。150例高胆 固醇血症病人分为验证组(50例)、对照组(48例)和开放组(52例),剂量均为每晚顿服10mg,服药8周。结果:验证组与对照组服药前后比较,血清总胆 固醇(TC)分别降低26.36%和28.3%,低密度脂蛋白胆固醇(LDL-C)分别降低33.17%和35.51%;验 相似文献
90.
Diet and cancer prevention: the fiber first diet 总被引:3,自引:0,他引:3
Diet can play a major role in cancer prevention. The international
differences in cancer incidence are largely accounted for by lifestyle
practices that include nutrition, exercise, and alcohol and tobacco use.
About 50% of cancer incidence and 35% of cancer mortality in the U.S.,
represented by cancers of the breast, prostate, pancreas, ovary,
endometrium, and colon, are associated with Western dietary habits. Cancer
of the stomach, currently a major disease in the Far East, relates to
distinct, specific nutritional elements such as excessive salt intake. For
these cancers, information is available on possible initiating genotoxic
factors, promoting elements, and prophylactic agents. In general, the
typical diet in the United States contains low levels of the potent
carcinogenic agents, heterocyclic amines, formed during the cooking of
meats. It provides only about half the potent appropriate fiber intake and
is high in calories. About twice as many calories as would be desirable
come from fat, certain kinds of which enhance the development of cancers.
Other foods with functional properties, such as soy products and tea, can
be beneficial. To achieve reduction in risk of certain cancers, diet must
be optimized, primarily to reduce caloric intake and the fat component. The
latter should be 20% or less of total caloric intake and fiber should be
increased to 25- 35 g per day for adults. One approach to achieving these
goals is the Fiber First Diet, a diet designed around adequate fiber intake
from grains, especially cereals, vegetables, legumes, and fruits, which
thereby reduces both calorie and fat intake. Such dietary improvements will
not only reduce cancer and other chronic disease risks, but will contribute
to a healthy life to an advanced age. A corollary benefit is a lower cost
of medical care.
相似文献