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Post-transplantation diabetes is better controlled after conversion from prednisone to deflazacort: a prospective trial in renal transplants 总被引:2,自引:0,他引:2
Yu Seun Kim Myoung Soo Kim Soon Il Kim Seung Kil Lim Ho Yung Lee Dae Suk Han Kiil Park 《Transplant international》1997,10(3):197-201
It is well known that long-term use of steroids plays a decisive role in the development of glucose intolerance and diabetes
mellitus (DM). Deflazacort, an oxazoline derivative of prednisolone, has been introduced as a potential substitute for conventional
steroids in order to ameliorate glucose intolerance. We initiated a randomized study of conversion from prednisone to deflazacort
in kidney transplantation (Tx) recipients presenting with pre-Tx or post-Tx DM to ascertain whether or not the switch to deflazacort
would ameliorate the diabetic state. Forty-two recipients in the conversion group were compared with 40 patients on prednisone
(the control group) in a prospective manner. The dose reduction of insulin or oral blood glucose-lowering agents, the adequacy
of glucose control, and the development of side effects were the criteria for evaluating outcome. In the conversion group,
patients were switched to deflazacort at a dose ratio of 6 mg deflazacort to 5 mg prednisone. During the mean follow-up period
of 13.2 months, neither graft dysfunction nor acute rejection developed in the conversion group. Improvement in blood glucose
control in the conversion group was noted. When the conversion group was stratified into pre- or post-Tx DM, promising effects
were clearly evident in the post-Tx DM patients. More than 50 % dose reduction of blood glucose-lowering agents was possible
in 42.3 % of post-Tx DM patients. In conclusion, it was readily possible to control blood glucose better in post-Tx DM recipients
without seriously affecting the immunosuppressive activity after conversion to deflazacort.
Received: 20 August 1996 Received after revision: 25 November 1996 Accepted: 6 December 1996 相似文献
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Bum Soon Choi Mi Jung Shin Suk Joon Shin Young Soo Kim Yeong Jin Choi Yong-Soo Kim In Sung Moon Suk Young Kim Yong Bok Koh Byung Kee Bang Chul Woo Yang 《American journal of transplantation》2005,5(6):1354-1360
We report here our 10-year experience of a biopsy performed at day 14 after transplantation in 304 patients with stable graft function. The factors that may have influenced subclinical rejection were analyzed according to histology. The incidence of subclinical rejection was 13.2%. Addition of mycophenolate mofetile (MMF) as a primary immunosuppressant significantly decreased the incidence of subclinical rejection compared with patients without such treatment (odds ratio, 0.23; p < 0.05). On the other hand, HLA-DR antigen mismatch (odds ratio, 2.39) and unrelated donor (odds ratio, 2.10) were also significantly associated with decreased subclinical rejection (p < 0.05). The incidence of acute rejection in patients with normal findings was lower than in those with borderline changes or subclinical rejection (0.23 +/- 0.05 vs. 0.48 +/- 0.07 and 0.60 +/- 0.11, respectively; p < 0.05). The graft survival rates in patients with subclinical rejection were lower than in patients with normal or borderline changes at 1 (88.4% vs. 97.9% and 99.1%; p < 0.05), 5 (77.8% vs. 96.2% and 95.9%; p < 0.05) and 10 (62.3% vs. 96.2% and 93.7%; p < 0.05) years. Thus, a protocol biopsy performed on day 14 after transplantation is useful for predicting graft survival. Triple therapy including MMF, related donor and HLA-DR antigen match are important factors for reducing subclinical rejection in living-donor renal transplantation. 相似文献
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Hy De Lee Euy Young Soh Hoon Sang Chi Byong Ro Kim Kyong Sik Lee Kyung Soon Song Hyun Joo Jung 《Surgery today》1990,20(2):180-185
The relationship between primary tumor proliferative activity and clinical and pathologic characteristics was analyzed in
relation to menopausal status in 32 patients with malignant or benign breast disease. The thymidine labeling index (TLI) showed
significantly higher median values in the cancer patients (3.48 per cent) than in the patients with benign diseases (1.02
per cent). TLI was not significantly affected by delayed incubation at room temperature for about 1 hour. In the breast cancer
patients, TLI did not significantly correlate to tumor size, the presence of axillary lymph node metastasis or pathologic
nuclear grading. The only significant difference was limited to the breast cancer patients without axillary lymph node metastasis
in relation to menopausal status; the TLI in the premenopausal patients (5.10 per cent) was significantly higher (p<0.05)
than that in the postmenopausal patients (2.28 per cent). These data thus suggest that among premenopausal patients without
axillary lymph node metastasis, those with a high TLI could be potential candidates for adjuvant chemotherapy. 相似文献
8.
Perforation of the large bowel during colonoscopy in Singapore 总被引:1,自引:0,他引:1
The management of seven patients with colonoscopy-related perforations is described. This study demonstrates the need for an early laparotomy. A high index of suspicion is required to reach an early diagnosis. Patients with no preexisting medical problems who underwent early surgery recovered with little morbidity. In elderly patients (greater than 75 years), colonoscopic perforation can be fatal. Endoscopy should be performed with special care in such patients. 相似文献
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Oh SH Kim JK Song KS Noh SM Ghil SH Yuk SH Lee JH 《Journal of biomedical materials research. Part A》2005,72(3):306-316
Sol-gel transition temperature-controllable Pluronic F127/F68 mixtures including mildly crosslinked alginate and nonsteroidal anti-inflammatory drug (ibuprofen) were prepared to evaluate their potential as tissue adhesion barrier gels. The sol-gel transition temperatures of the Pluronic mixtures could be controlled by adjusting F127/F68 ratio and polymer concentration. The mildly crosslinked alginate with still flow property provided the residence stability of Pluronic mixture gels in the body. Ibuprofen was loaded in Pluronic mixtures to reduce inflammatory response in the body and, thus, to prevent tissue adhesion. The gelation temperatures of the Pluronic mixtures were not affected by the alginate but lowered by the addition of ibuprofen. The in vitro drug release behavior and in vivo peritoneal tissue adhesion of the Pluronic mixtures with the sol-gel transition just below body temperatures were investigated. The drug release behavior from the ibuprofen (1 wt%)-loaded Pluronic mixture gels at 37 degrees C was examined using a membrane-less dissolution model. The drug in the mixture gels was released continuously up to about 45-65% of the total loading amount during the first 7 days. For in vivo evaluation of tissue anti-adhesion potential, the Pluronic mixtures with/without drug were coated on the peritoneal wall defects of rats and their tissue adhesion extents and tissue reactions (inflammatory response, granulation tissue formation, and toxicity in organs) were compared. It was observed that ibuprofen has a positive effect for the peritoneal tissue anti-adhesion. The Pluronic F127/F68/alginate/ibuprofen mixture gel (25 wt% of F127/F68 [7/3], 1 wt% ibuprofen) was highly effective for the prevention of peritoneal tissue adhesion and showed a relatively low inflammatory response and non-toxicity, and thus can be a good candidate material as a coatable or injectable tissue adhesion barrier gel. 相似文献