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2.
TRA Lane HM Moore IJ Franklin AH Davies 《Annals of the Royal College of Surgeons of England》2015,97(2):e18-e20
The endovenous revolution has accelerated the development of new techniques and devices for the treatment of varicose veins. The ClariVein® mechanochemical ablation device offers tumescentless treatment with a rotating ablation tip that can theoretically become stuck in tissue. We present the first report of retrograde stripping of the small saphenous vein without anaesthesia following attempted use of the ClariVein® device, without adverse sequelae. 相似文献
3.
PAG Torrie A Leonidou IJ Harding G Wynne Jones MJ Hutchinson IW Nelson 《Annals of the Royal College of Surgeons of England》2013,95(8):604-608
Introduction
The purpose of this study was to investigate the significance of the inflammatory markers on admission in the isolation of a causative pathogen in patients with spinal infection. Spinal infection is treated frequently at spinal units and can encompass a broad range of clinical entities. Its diagnosis is often delayed because of the difficulty of identifying the responsible pathogen.Methods
Patients with spinal infection treated in our institution over a period of eight years were identified and their notes studied retrospectively. Admission C-reactive protein (CRP), white cell count (WCC) as well as co-morbidities and mode of pathogen identification were recorded. Overall, 96 patients were included in the study.Results
The CRP levels on admission were correlated significantly with the overall potential for isolation of a pathogen (p<0.0001) and positive biopsy cultures (p=0.0016). Admission WCC levels were associated significantly with the overall potential for isolation of a pathogen (p=0.0003) and positive biopsy cultures (p=0.0023). Both CRP and WCC levels were significantly negatively correlated with the duration of the preceding symptoms (p=0.0003 and p<0.0001 respectively). Delay in presentation was significantly negatively correlated with organism isolation (p=0.0001). Multivariate analyses identified the delay in presentation as the strongest independent variable for organism isolation (p=0.014) in cases of spontaneous spinal infection when compared with the admission CRP level (p=0.031) and WCC (p=0.056).Conclusions
In spontaneous spinal infection, delay in presentation is the strongest independent variable for organism isolation. High inflammatory marker levels on admission are a useful prognostic marker for the overall potential of isolating a causative organism either by blood cultures or by biopsy in patients with negative blood cultures. Furthermore, the admission inflammatory marker levels allow for treating surgeons to counsel their patients of the likelihood of achieving a positive microbiological yield from biopsy. 相似文献4.
IJ Griffin TJ Cole KA Duncan AS Hollman MDC Donaldson 《Acta paediatrica (Oslo, Norway : 1992)》1995,84(5):544-549
Recently produced reference curves for various ultrasound dimensions were used to retrospectively assess 67 pelvic ultrasound scans carried out at the initial presentation in girls with sexual precocity. At presentation the group with precocious puberty had significantly increased uterine lengths and ovarian volumes compared with the normal population, and a significantly increased fundal–cervical ratio. Ovarian volume was also significantly increased in thelarche and thelarche variant. The fundal–cervical ratio was significantly increased in thelarche variant. There was considerable overlap between individuals with sexual precocity and normal subjects. The ultrasound findings that best discriminated early or precocious puberty from other forms of sexual precocity were the presence of a midline endometrial echo, and a uterine length above the 97th centile for age. An entirely normal pelvic ultrasound at presentation did not rule out the possibility of precocious puberty. 相似文献
5.
Development of IL-5 receptor antagonists 总被引:3,自引:0,他引:3
A wealth of both clinical and pre-clinical data has strongly implicated the eosinophil in the pathogenesis of asthma, highlighting this cell type as a potential target for novel anti-inflammatory approaches to asthma therapy. The Th2 lymphocyte derived cytokine Interleukin-5 (IL-5) has emerged as the key regulator of eosinophil production, thus identifying IL-5 as the principal molecular target for therapeutic intervention. This review highlights both the pharmaceutical approaches, and the major challenges, to the identification of small molecule and protein antagonists of the IL-5 receptor. Using examples of known inhibitors we discuss their current status and highlight the major development hurdles in progressing these molecules into the market place. 相似文献
6.
Inhaled corticosteroids are highly effective agents for the treatment of asthma and chronic obstructive pulmonary disease. Although local delivery to the lung has led to significant progress towards minimising side effects associated with systemic exposure, additional opportunities exist for further enhancement of the therapeutic index. Recent developments in the molecular and structural understanding of corticosteroid biology have made it increasingly clear that novel corticosteroids with intrinsically different pharmacology can be designed. 相似文献
7.
Madauss KP Deng SJ Austin RJ Lambert MH McLay I Pritchard J Short SA Stewart EL Uings IJ Williams SP 《Journal of medicinal chemistry》2004,47(13):3381-3387
Although progesterone, the natural ligand of the progesterone receptor (PR), has a hydrogen atom at the 17alpha position, other potent steroid agonists such as norethindrone and mometasone furoate have larger substituents at this position that are accommodated by the PR ligand binding pocket. Crystallographic analysis of PR ligand binding domain complexes clearly demonstrated that these moieties were accommodated by local shifts of the protein main chain and by adoption of alternative side chain rotamer conformations of ligand-proximal amino acids. These conformational changes imparted a ligand-specific volume to the binding pocket, from 490 A3 in the metribolone complex to 520 A3 in the norethindrone complex, 565 A3 in the progesterone complex, and 730 A3 in the mometasone furoate complex. Despite these marked alterations in binding pocket volume, critical interactions essential for establishment of an active AF2 conformation were maintained. 相似文献
8.
Cefalu WT; Wagner JD; Bell-Farrow AD; Edwards IJ; Terry JG; Weindruch R; Kemnitz JW 《Toxicological sciences》1999,52(2):49-55
Caloric restriction (CR) has been observed to retard aging processes and
extend the maximum life span in rodents. In an effort to evaluate the
effect of this nutritional intervention on physiologic variables in higher
species, several nonhuman primate trials are ongoing. In particular, a
study evaluating the independent effect of CR on the extent of
atherosclerosis was initiated in 1993 in 32 adult cynomolgus monkeys.
Therefore, the trial was designed to achieve identical cholesterol intake
after animals were randomized to a control group or a calorie-restricted
group (30% reduction from baseline caloric intake). The animals were
routinely evaluated for glycated proteins, plasma insulin and glucose
levels, insulin sensitivity, and specific measures for abdominal fat
distribution by CT scans over a 4-year interval. The results from 4 years
of intervention demonstrate that CR improves cardiovascular risk factors
(such as visceral fat accumulation) and improves insulin sensitivity. In
contrast to other primate studies with normolipidemic animals, CR had no
independent effects on plasma lipid levels and composition in the presence
of equivalent amounts of dietary cholesterol intake. Preliminary analysis
of atherosclerotic lesion extent in the abdominal aorta has failed to
demonstrate differences between control animals and CR animals. Follow- up
studies are being conducted to determine the effect of CR on
atherosclerosis extent in coronary and carotid arteries.
相似文献
9.
IJ Webb ; CE Eickhoff ; AD Elias ; LJ Ayash ; CA Wheeler ; GN Schwartz ; GD Demetri ; KC Anderson 《Transfusion》1996,36(2):160-167
BACKGROUND: Peripheral blood progenitor cells (PBPCs) are commonly collected and used to reconstitute hematopoiesis after high-dose chemotherapy. However, strategies for optimal collection and assessment of leukapheresis components are not standardized. STUDY DESIGN and METHODS: Hematopoietic progenitor cell assays were performed on 369 leukapheresis components collected from 95 patients who had received doxorubicin-based chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF). Precollection patient hematologic values, leukapheresis collection values, component hematopoietic progenitor cell assays, and patient outcome measures were summarized. The kinetics of mononuclear cell (MNC) and PBPC mobilization were assessed among four patient groups. RESULTS: Patient group was a significant predictor of the peripheral blood MNC count on the day of collection (p<0.0001), and that value was a significant predictor of granulocyte-macrophage– colony-forming unit (CFU-GM) yield (p<0.0001). This relationship between the peripheral blood MNC count on the day of collection and CFU- GM yield differed according to patient group (p<0.0001). CFU-GM made up a larger fraction of peripheral blood MNCs collected from patients who received chemotherapy plus G-CSF than collected from those who received G-CSF alone. Moreover, the peripheral blood MNC count and the corresponding CFU-GM yield increased significantly on consecutive days of collection in patient groups receiving chemotherapy and G-CSF but were unchanged or decreased in patients receiving G-CSF alone. CONCLUSION: The relationship between peripheral blood MNC count and leukapheresis component CFU-GM yield differed significantly between patients who received chemotherapy and G-CSF and those who received G- CSF alone for the mobilization of PBPCs. Patient peripheral blood MNC count and component CFU-GM yield are useful for both assessing and suggesting revisions to PBPC mobilization and collection strategies. 相似文献
10.