Adhesion formation is a major source of postoperative morbidity and
mortality. In this study, the ability of a variety of lazaroid formulations
[the antioxidant 21-aminosteroid PNU74006F (tirilazad) and the
non-steroidal 2-methylaminochroman derivative PNU83,836E] to reduce i.p.
adhesion formation in three rabbit models was examined. In initial studies,
PNU83836E was administered via Alzet miniosmotic pump to the site of
injury. In the sidewall and double uterine horn models, PNU83,836E was
administered via Alzet miniosmotic pump for the entire postoperative
interval. In the sidewall model, there was a dose- dependent reduction in
the area of the sidewall injury that was involved in adhesions. In the
double uterine horn model, PNU83,836E was administered via Alzet
miniosmotic pump to the area of injury for 1, 2, 3 or 7 days.
Administration for as little as 24 h after surgery significantly reduced
the extent of adhesion formation and the reduction was increased if it was
administered for longer. Further studies were conducted in which various
lazaroid formulations were administered as a bolus at the end of surgery.
In both the sidewall and double uterine horn models, administration of
either PNU83,386E (in citrate buffer) or PNU74006F (in cyclodextrin or
lipid emulsion vehicles) at the end of surgery reduced adhesion formation.
Administration of a bolus of PNU74006F 10 min prior to initiation of
surgery with or without additional treatment at the end of surgery further
increased its efficacy in the reduction of adhesion formation.
Administration of a minimum of 1.5 mg before and after surgery (3 mg total)
was required for maximal efficacy. These studies demonstrate that pre- and
postoperative administration of either a steroidal (PNU74006F) or
non-steroidal (PNU83,836E) lazaroid intraperitoneally reduced the formation
and reformation of postoperative adhesions in three animal models.
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Renal transplantation has become a treatment of choice for patients with end stage renal disease. A successful transplant is the result of a combination of several factors acting synergistically, such as the degree of HLA compatibility between donor and the recipient, pretransplant blood transfusions, the recipient''s state of immunoreactivity and sensitization, immunosuppressive therapy given in post operative period etc. Donor selection appears to be the most critical factor for the long term success of the organ graft. In this brief review, some of the important parameters of donor selection in renal transplantation are highlighted.KEY WORDS: Histocompatibility (HLA) matching, Cross match, Sensitization相似文献
Acute catatonic syndromes occurring in the context of various medical and neuropsychiatric conditions, including schizophrenia,
have been shown to respond well to benzodiazepines (BZD). However, there have been no studies specifically designed to address
the BZD treatment response of persistent catatonic states. Eighteen patients with clinically stable chronic schizophrenia,
who also displayed enduring catatonic features, underwent a 12-week long, random assignment, double-blind, placebo-controlled
cross-over trial with lorazepam (6 mg/day). A comprehensive assessment, including the subjects’ clinical and motor (catatonic
as well as drug-induced movement disorders) condition, was performed at baseline and four weekly intervals thereafter. Pre-existing
medication was kept constant throughout the study. Lorazepam had no effect on the subjects’catatonic signs and symptoms, suggesting
that acute and chronic catatonic syndromes associated with schizophrenic illness might have a different neurobiological basis.
Received: 25 May 1998/Final version: 22 September 1998 相似文献
Emergency and elective embolotherapy of various systemic arteries in 64 patients was carried out at a tertiary centre of Armed Forces. Specific indications were haemoptysis (n=43), preoperative (n=18), haematuria (n=1), epistaxis (n=1) and chemoembolization (n=1). The procedures were performed with gelfoam pellets (n=46), gelfoam pellets and absolute alcohol (n=1), polyvinyl alcohol particles (PVA) (n=14), steel coils (n=2) and Adriamycin-in-oil emulsion (n=1). Embolotherapy resulted in complete haemostasis in 37 (82.2%) out of 45 cases of haemorrhage. In eight cases (17.8%), it resulted in significant improvement. Complete haemostasis was achieved in both cases of haematuria and epistaxis. Pre-operative embolotherapy resulted in considerable reduction of peroperative blood loss in all the cases. Chemoembolization of Hepatocellular carcinoma resulted in partial regression of the tumour. The purpose of this study was to assess the efficacy, safety and reliability of vascular embolotherapy for control of life threatening haemorrhage and preoperative reduction of lesions.KEY WORDS: Embolization, Embolotherapy, Haemorrhage相似文献
Traumatic brain injury (TBI) was shown to lead to the development of cerebral microbleeds (CMBs), which are associated with long term cognitive decline and gait disturbances in patients. The elderly is one of the most vulnerable parts of the population to suffer TBI. Importantly, ageing is known to exacerbate microvascular fragility and to promote the formation of CMBs. In this overview, the effect of ageing is discussed on the development and characteristics of TBI-related CMBs, with special emphasis on CMBs associated with mild TBI. Four cases of TBI-related CMBs are described to illustrate the concept that ageing exacerbates the deleterious microvascular effects of TBI and that similar brain trauma may induce more CMBs in old patients than in young ones. Recommendations are made for future prospective studies to establish the mechanistic effects of ageing on the formation of CMBs after TBI, and to determine long-term consequences of CMBs on clinically relevant outcome measures including cognitive performance, gait and balance function.
Background: No study has examined ketamine users’ psychiatric morbidity using structured diagnostic instruments. The aim of this study was thus to determine the psychiatric comorbidity of community-based ketamine users using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), Axis I Disorders (SCID). Methods: A convenience sample of 200 frequent ketamine users was recruited from community organizations in Hong Kong. Participants were screened with the Severity of Dependence Scale (SDS), Beck Depression Inventory (BDI), Anxiety subscale of the Hospital Anxiety Depression Scale (HADSA), and SCID psychotic symptoms. Those who scored above the threshold (cutoff point of 8/9 on the BDI and 4/5 on HADSA) or displayed evidence of psychotic symptoms were referred for a structured clinical interview conducted by a psychiatrist. Results: One hundred and seventy participants scored above the cutoff point on 1 or more of the scales, and 115 participants attended the SCID interview. Fifty-one of these 115 participants received a psychiatric diagnosis of 1 or more comorbidities for the month preceding the interview. Mood disorders accounted for 80.4% of the diagnoses, anxiety disorders for 33.3%, and psychotic disorders for 7.8%. Conclusions: Female gender and history of psychiatric/psychological clinic attendance were significantly associated with comorbid psychiatric disorders, whereas ketamine dependence had a borderline association. 相似文献
OBJECTIVE: To examine whether promoter polymorphisms associated with
variation in interleukin-10 (IL-10) production are relevant to the
development of rheumatoid arthritis (RA) or Felty's syndrome (FS). METHODS:
DNA was obtained from 44 FS patients, 117 RA patients and 295 controls. The
promoter region between -533 and - 1120 was amplified by polymerase chain
reaction, and polymorphisms detected by restriction enzyme digest or
sequence-specific oligonucleotide probing. RESULTS: We found no significant
difference in allele or haplotype frequencies between the groups.
CONCLUSION: There is no association between FS or RA and these recently
identified IL-10 promoter polymorphisms. Other genetic or environmental
factors could explain the alterations in IL-10 levels seen in these
conditions.
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