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1.
2.
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
3.
Identification of a Klebsiella pneumoniae strain associated with nosocomial urinary tract infection. 下载免费PDF全文
K S Kil R O Darouiche R A Hull M D Mansouri D M Musher 《Journal of clinical microbiology》1997,35(9):2370-2374
To differentiate between relapse of infection and reinfection of the urinary tract due to Klebsiella pneumoniae, 33 K. pneumoniae isolates collected from 20 patients with spinal cord injury (SCI) over 2 years were typed by genomic fingerprinting by repetitive-element PCR. Clinical isolates obtained from the same patients with recurrent episodes of urinary tract infection (UTI) revealed identical genomic fingerprints indicating relapse of UTI due to K. pneumoniae, despite appropriate antibiotic therapy. Seventeen isolates obtained from 8 of the 20 SCI patients shared a common genotype, termed RD6. Among non-SCI patients residing in other nursing units, the RD6 genotype was found in 5 of 10 patients with K. pneumoniae UTI but in only 1 of 20 patients with K. pneumoniae infection that did not involve the urinary tract, suggesting a strong association of this genotype with UTI. All RD6 isolates exhibited strong adherence (> or =50 adherent bacteria per cell) to HEp-2 cells, whereas other K. pneumoniae isolates generally did not adhere to or adhered very weakly to HEp-2 cells (< or =5 adherent bacteria per cell). Adherence was inhibited either by 4% D-mannose or by anti-type 1 fimbrial rabbit serum. These results suggest that the capacity of K. pneumoniae RD6 isolates to cause UTI may be mediated by its striking adherence to mammalian cells. 相似文献
4.
J. K. Kang Sang Won Lee Min Woo Baik Byung Chul Son Yong Kil Hong Chul Ku Jung Keon Hee Ryu 《Child's nervous system》1998,14(7):297-301
Accurate assessment and replacement of blood loss and fluid–electrolyte deficit during craniosynostosis repair is difficult
owing to patient size and the diversity of surgical technique. Forty-three patients undergoing primary craniosynostosis repair
over a 10-year period were studied retrospectively to determine blood loss and fluid deficit and to assess blood transfusion
practices during both intraoperative and postoperative periods. Blood loss was calculated on the basis of estimated red cell
mass (ERCM) and fluid-electrolyte imbalance was investigated with blood samplings. Blood transfusion was considered appropriate
if the postoperative or posttransfusion ERCM was within 12% of the preoperative value. Estimated fluid requirement (EFR) was
used in 4 ml kg–1 h–1 except for neonates. Intraoperatively, 80% of all patients were appropriately managed with respect to blood transfusion and
EFR. Postoperatively only 20% of the patients receiving transfusions were transfused appropriately. In 23.3% of these patients
(10/43) unexpected respiratory distress developed immediately after their recovery from the anesthesia. With the measurement
of estimated blood volume and allowable blood loss, appropriate transfusion could be achieved for the successful treatment
of the primary craniosynostosis.
Received: 16 February 1998 相似文献
5.
Ten (E)-and (Z)-isomers of 2-phenylcyclopropylamine (PCA), 1-Me-PCA, 2-Me-PCA, N-Me-PCA, and N, N-diMe-PCA and fifteeno
−, m−, p− isomers of (E)-PCA with substituents of Me, Cl, F, OMe, OH were synthesized in this laboratory and tested for the inhibition of rat brain
mitochondrial MAO-A and MAO-B. The effects of substituents, their positions, and stereochemistry on the inhibition were assessed
for the compounds with substituents at cyclopropyl and amino groups and QSAR analyses were performed using the potency data
of ring-substituted compounds. The best correlated QSAR equations are as follows: pI50=0.804 Π2 Blo−1.069 Blm+0.334 Lp−1.709 HDp+7.897 (r=0.945, s=0.211, F=16.691, p=0.000) for the inhibition of MAO-A; pI50=1.815 π-0.825 Π2 R+0.900 Es2+0.869 Es3+0.796 Es4−0.992 HDp+0.562 HAo+3.893 (r=0.982, s=0.178, F=23.351, p=0.000) for the inhibition of MAO-B. Based on the potency difference
between stereoisomers of cyclopropylamine-modified compounds and on QSAR results, it is proposed that the active sites of
MAO-A are composed of one deep hydrophobic cavity near para position, two hydrophobic cavities interacting with Me group,
a hydrophobic area accomodating phenyl and cyclopropyl backbone, steric boundaries, a hydrogen-acceptor site near para position,
and an amino group binding site and that in addition to the same two hydrophobic cavities, hydrophobic area, steric boundaries,
hydrogen-acceptor site, and amino group binding site, another steric boundary near para position and a hydrogen donating site
near ortho position constitute active sites of MAO-B. 相似文献
6.
Anulus fibrosus in bulging intervertebral disks 总被引:1,自引:0,他引:1
In this investigation the association of radial tears of the anulus fibrosus and bulging of the intervertebral disk was studied. An index of disk bulging was measured in sagittal anatomic sections in 149 lumbar disks from 31 cadavers. The indexes of disk bulging were correlated with stages of disk development and the presence of an annular tear. The largest disk-bulging indexes were always associated with radial tears of the anulus. Eighty-four percent of the disks with radial tears had disk-bulging indexes greater than 2.5 mm. Most normal adult disks had an index of less than 2.5 mm. The results challenge the concept that the anulus fibrosus is intact in bulging disks, although ruptured in herniated disks. 相似文献
7.
Guk-Hee Suh Hyun Gyun Son Young-Su Ju Kyeong Hyeong Jcho Byeong Kil Yeon Young Min Shin Baik Seok Kee Sung-Ku Choi 《The American journal of geriatric psychiatry》2004,12(5):509-516
OBJECTIVE: Behavioral disturbances in dementia are extremely prominent and distressful, and often result in serious physical, social, and economic consequences. The authors compared the efficacy and tolerability of risperidone and haloperidol in the treatment of behavioral and psychological symptoms of dementia (BPSD) in institutionalized elderly Korean patients with Alzheimer disease, vascular dementia, or mixed dementia. METHODS: This was an 18-week double-blind, crossover study involving 120 patients who were randomly assigned to receive flexible doses (0.5-1.5 mg/day) of risperidone or haloperidol. BPSD were assessed using the Korean version of the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD-K), the Korean version of the Cohen-Mansfield Agitation Inventory (CMAI-K), and the Clinical Global Impression of Change scale (CGI-C). Safety and tolerability assessments included the Extrapyramidal Symptom Rating Scale and the incidence of adverse events. RESULTS: Both risperidone and haloperidol were efficacious in alleviating BPSD. However, when receiving risperidone, patients showed significantly greater improvement than when receiving haloperidol in the total and subscale scores of the BEHAVE-AD-K, the total and subscale scores of the CMAI-K, and the scores on the CGI-C scale. Also, risperidone had an additional benefit on aggressiveness and anxieties/phobias. The risk of antipsychotic-induced parkinsonism throughout this study was significantly lower with risperidone than with haloperidol. CONCLUSION: Risperidone had a favorable efficacy and tolerability profile compared with haloperidol in the treatment of BPSD in this patient population. 相似文献
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Two new nitro analogs of tranylcypromine, (E)-2-(p-nitrophenyl)cyclopropylamine ((E)-p-NTCP) and (E)-2-(m-nitrophenyl)cyclopropylamine ((E)-m-NTCP) were synthesized in order to examine the effect of aromatic nitro substitution on the MAO-inhibitory activity of 2-phenylcyclopropylamines. The compounds were obtained by treatingt-butyl (E)-2-(p-nitrophenyl) cyclopropanecarbamate andt-butyl (E)-2-(m-nitrophenyl)cyclopropanecarbamate withp-toluenesulfonic acid in CH3CN. Inhibitions of rat brain mitochondrial MAO-A and B by the compounds were examined using serotonin and benzylamine as the substrate at bothin vitro andex vivo levels. It was found fromin vitro measurements that(E)-p-NTCP at 6.0×10?5M elicited merely 22.5% inhibition against MAO-B without any effect on MAO-A. In contrast,(E)-m-NTCP showed fair degrees of inhibitions of MAO-A and B with IC50 values, 2.5×10?7M and 1.4×10?6M, respectively. It was also noted from(E)-m-NTCP thatm-nitro substitution caused a shift of selectivity of the inhibition toward MAO-A. According toex vivo measurements at 1.5, 3, 6, and 12 hr following the administration of a dose of 0.015 mmol/kg, i.p. to the rats, the inhibition percents of MAO-A by(E)-m-NTCP were 58.6, 63.7 63.6, and 46.6%, slightly lower than those observed by tranylcypromine. Whereas,(E)-p-NTCP at the same dose level did not show significant inhibitions against both MAO-A and MAO-B. Possible reasons for the difference in potencies between(E)-m-NTCP and(E)-p-NTCP were sought in relation to differing electron withdrawing effects ofm-andp-substituents which will influence electron density of the side chain amino functions and the partitions. 相似文献