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61.
RAL Dampney Y. Hirooka PD Potts GA Head 《Clinical and experimental pharmacology & physiology》1996,23(Z3):105-111
- 1 It was first shown several years ago that the rostral part of the ventrolateral medulla (VLM) contains a high density of receptor binding sites for angiotensin II (AngII). In the present paper we briefly review recent studies aimed at determining the actions of both exogenous and endogenous angiotensin peptides in the rostral VLM, as well as their specific sites of action.
- 2 The results of these studies have shown that angiotensin peptides can excite pressor and sympathoexcitatory neurons in the rostral VLM, but do not appear to affect non-cardiovascular neurons in this region.
- 3 It is known that pressor neurons in the rostral VLM include both catecholamine and non-catecholamine neurons. There is evidence that, at least in conscious rabbits, both of these types of neurons are activated by AngII. The specific endogenous angiotensin peptide or peptides that affect pressor neurons in the rostral VLM have not yet been definitively identified.
- 4 It is also possible that different angiotensin peptides may have different effects on pressor neurons in the rostral VLM, mediated by different receptors. Further studies will be needed to define these different functions as well as the specific receptors and cellular mechanisms that subserve them.
62.
Prof. Dr. A. A. Fauser Prof. Dr. G. Dölken Prof. Dr. K. J. Bross Dr. J. Schmid Dr. med. Eva Lang PD Dr. F. Sörgel 《Infection》1991,19(3):195-200
Summary We evaluated teicoplanin for suspected gram-positive infections after inadequate response to initial empiric beta-lactam and aminoglycoside combination therapy. All 20 patients included in this study received either an allogeneic (8 patients) or an autologous (12 patients) bone marrow transplant for acute myeloid leucaemia (AML), non-Hodgkin's-lymphoma (NHL, high grade) or other malignant diseases. All patients developing primary septicaemia of unknown origin (18 patients) or catheter-related septicaemia (2 patients) were treated with 400 mg teicoplanin, administered i.v. once daily in combination with a cephalosporin and an aminoglycoside (ceftazidime 2 g i.v., t.i.d.; netilmicin 400 mg once daily). All patients responded to therapy, 19 patients were clinically cured and one patient improved under therapy. The therapeutic regimen was well tolerated; only one adverse drug reaction was observed. We did not observe any delayed take or prolonged neutropenia or thrombocytopenia with this therapeutic regimen when our patients were compared to other bone marrow transplant patients (who did not receive this antimicrobial therapy). Our results suggest that teicoplanin is a potentially effective and well tolerated antimicrobial agent in bone marrow transplant patients with infections not responding primarily to beta-lactams and aminoglycosides.
Teicoplanin in Kombination mit -Laktamen und Aminoglykosiden bei Knochenmarktransplantatempfängern mit schwerer Sepsis
Zusammenfassung Wir untersuchten Teicoplanin bei vermuteten grampositiven Infektionen nach ungenügendem Ansprechen auf die anfängliche Kombinationstherapie von -Laktam-Antibiotika und Aminoglykosiden. Alle 20 in dieser Studie erfaßten Patienten wurden entweder allogen (8 Patienten) oder autolog (12 Patienten) transplantiert mit folgenden Grundkrankheiten: akute myeloische Leukämie (AML), Non-Hodgkin-Lymphom (NHL) oder andere maligne Erkrankungen. Alle Patienten, die eine primäre Septikämie unbekannten Ursprungs entwickelten (18 Patienten) oder unter einer Katheter-bedingten Septikämie (2 Patienten) litten, wurden mit 400 mg Teicoplanin behandelt. Die Verabreichung von Teicoplanin erfolgte einmal täglich intravenös in Kombination mit einem Cephalosporin und einem Aminoglykosid (Ceftazidim 2 g i.v., 3 ×/die, Netilmicin 400 mg, 1 ×/die). Alle behandelten Patienten sprachen auf diese Therapie an. 19 Patienten wurden klinische geheilt, ein Patient besserte sich unter dieser Therapie. Die Kombinationstherapie wurde gut vertragen, unerwünschte Arzneimittelwirkungen traten während der Studie nicht auf. Wir beobachteten kein verzögertes Angehen des Knochenmarks oder eine Verlängerung der Thrombozytopenie unter dieser Behandlung im Vergleich zu anderen knochenmarktransplantierten Patienten, die diese antimikrobielle Behandlung nicht erhielten. Unsere Ergebnisse zeigen, daß Teicoplanin ein wirksames und gut verträgliches Antibiotikum für knochenmarktransplantierte Patienten ist, die primär nicht auf die Kombinationstherapie mit -Laktam-Antibiotika und Aminoglykosiden ansprechen.相似文献
63.
P M Sanfelippo E R Giuliani G K Danielson R B Wallace J R Pluth D C McGoon 《The Journal of thoracic and cardiovascular surgery》1976,71(3):441-445
The total experience (154 patients) with ball-valve (Starr-Edwards) replacement of the tricuspid valve, alone and in combination, through Dec. 31, 1971, at the Mayo Clinic is reviewed. The early mortality rate with isolated tricuspid replacement was twice that for tricuspid replacement combined with replacement of other valves. Among patients receiving three valves, those with "functional' tricuspid insufficiency and those who were in New York Heart Association (N.Y.H.A.) Class IV preoperatively had a higher early mortality rate. The early mortality rate for the total group was 28%. Of those surviving tricuspid plus mitral valve replacement, 70% were alive at 3 years; at latest follow-up, 94% of those surviving were functionally improved. Of those surviving triple valve replacement, 56% were alive at 3 years; at latest follow-up, 93% of those surviving were functionally improved. Previous cardiac surgery with residual tricuspid valve dysfunction and severe disability, as judged by N.Y.H.A. class, influenced the outcome adversely. The experience reported here provides a standard against which never prostheses can be compared. 相似文献
64.
MJ Stevens PD Stricker J Saalfeld PC Brenner R Kooner GFA O'Neill PJ Duval RS Jagavkar P Cross J Martland 《Journal of Medical Imaging and Radiation Oncology》2003,47(2):152-160
Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate‐ and high‐risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate‐specific antigen progression‐free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability. 相似文献
65.
Technical advances in pediatric laparoscopy have had a beneficial impact on splenectomy 总被引:2,自引:0,他引:2
Danielson PD Shaul DB Phillips JD Stein JE Anderson KD 《Journal of pediatric surgery》2000,35(11):1578-1581
PURPOSE: The aim of this study was to demonstrate the effects of recent technical advances on the safety and benefits of pediatric laparoscopic splenectomy. METHODS: A retrospective review was conducted of patients undergoing laparoscopic splenectomy from January 1998 to January 2000. Technical advances utilized during this period included the harmonic scalpel, a specialized flexible hilar retractor, a larger, wire-rimmed specimen bag, and lateral patient positioning. RESULTS: Laparoscopic splenectomy was performed successfully on 18 patients aged 3 to 17 years (median, 9). The indications were hereditary spherocytosis (n = 10), idiopathic thrombocytopenic purpura (n = 5), and other (n = 3). Eight patients had concomitant procedures including cholecystectomy (n = 3), resection of an accessory spleen (n = 3), and other (n = 2). The median operating time, including the concomitant procedures, was 125 minutes (range, 70 to 235). Patients tolerated a regular diet on median postoperative day 1 (range, 1 to 3), and 16 were discharged home on or before postoperative day 2. None of the patients required blood product transfusion or conversion to an open technique. There were no complications, and all patients had returned to usual activity by 2 weeks. CONCLUSION: With recent technological advances, the laparoscopic approach has become easy to perform, safe, and should be considered the procedure of choice for pediatric splenectomy. 相似文献
66.
Tyrosinemia type I is an autosomal recessive inherited defect of tyrosine metabolism. The underlying cause is a defect of fumarylacetoacetate hydrolase. The disease affects the liver (acute liver failure, liver cirrhosis, hepatocellular cancer), the kidney (tubulopathy with hypophosphatemic rickets), and the peripheral nervous system (paresthesia, vegetative symptoms, progressive paralysis). Beside the hypertyrosinemia the diagnosis can be made on the basis of urinary excretion of a pathological metabolite of the tyrosine metabolism (succinylacetone). Therapeutic options are a regulated phenylalanine/tyrosine diet, a very effective drug therapy (NTBC) that has been available for several years, and in cases of acute liver failure or end-stage liver cirrhosis a liver transplantation. 相似文献
67.
Ohne Zusammenfassung 相似文献
68.
PD Dr. F. Bahlmann 《Der Gyn?kologe》2004,37(8):725-736
In monochorionic twin pregnancies, the risk of developing a twin to twin transfusion syndrome is between 15 and 20%. Using high-resolution ultrasound machines, sonographic images demonstrate the detailed features of placental development. The lambda sign was established for the diagnosis of dichorionic placenta and the T sign for monochorionic placenta at the end of the first trimester. Other sonographic findings of the twin to twin transfusion syndrome are monochorionicity, same sex, polyhydramnios, permanently filled bladder in the recipient, and oligo/anhydramnios of the donor with a slightly filled or empty bladder. Fetoscopic laser treatment has become an accepted procedure to coagulate the placental anastomoses. This development is supported by actual studies about psycho- and neuromotoric development in early childhood, which shows a lower rate of disabled children in the group receiving laser therapy in comparison to the group undergoing amnioreduction. Twin pregnancies complicated by twin to twin transfusion syndrome should be treated in specialized prenatal centers. 相似文献
69.
PD Dr. T. Moser N. Strenzke A. Meyer A. Lesinski-Schiedat T. Lenarz D. Beutner A. Foerst R. Lang-Roth H. von Wedel M. Walger M. Gross A. Keilmann A. Limberger T. Steffens J. Strutz 《HNO》2006,54(11):833-841
Pathological auditory brainstem responses (lack of responses, elevated thresholds and perturbed waveforms) in combination with present otoacoustic emissions are typical audiometric findings in patients with a hearing impairment that particularly affects speech comprehension or complete deafness. This heterogenous group of disorders first described as “auditory neuropathy” includes dysfunction of peripheral synaptic coding of sound by inner hair cells (synaptopathy) and/or of the generation and propagation of action potentials in the auditory nerve (neuropathy). This joint statement provides prevailing background information as well as recommendations on diagnosis and treatment. The statement focuses on the handling in the german language area but also refers to current international statements. 相似文献
70.
Minimally invasive diagnostic procedures for the breast under mammography, ultrasound, and magnetic resonance guidance have led to a higher specificity of imaging techniques and a decrease in open biopsy of the breast. The percutaneous approach is more cost and time effective and reduces morbidity compared with open biopsy. The “Step-3-guideline for early breast cancer detection in Germany” represents the first national guidelines for a nationwide, quality assured, early breast cancer detection program, including recommendations for minimally invasive breast diagnostics. Indications for ultrasound guided vacuum biopsy of the breast are summarized in the “Consensus on the use and technique of vacuum-assisted sonographic breast biopsy” by the Study Group on Minimally Invasive Breast Interventions (AG MiMi) of the German Society of Senology (DGS). 相似文献