[Comparative study of the effectiveness of 9,3"-di-O-acetyl midecamycin (MOM) and josamycin (JM) against acute tonsillitis by double blind method].
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The author gives a short review and the development of sterilization techniques. According to data from the literature and his limited experience, he concludes that to the Yugoslav population of women minilaparotomy with Pomeroy and Uchida occlusion techniques, as well as the laparoscopic approach with electrocoagulation or the application of clips and rings can be used. Vaginal approach should be reserved only for exceptional cases. Ljubljana.
Two cases are presented in whom full-thickness defects of the abdominal wall were repaired by combined groin-tensor fasciae latae flaps nourished only by the superficial circumflex iliac artery. The dissection of the flap is simple and it will probably cover even the upper parts of the flank.
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OBJECTIVES: This study was designed to evaluate the efficacy of local versus systemic treatment of thrombosis with various antithrombotic drugs. BACKGROUND: Local use of low dose antithrombotic drugs has been proposed as being effective and safe. METHODS: Heparin (30 U/kg), an antithrombin agent (argatroban, 0.05 mg/kg body weight) or a defibrinogenating drug (batroxobin, 0.05 U/kg) was locally infused into one side of the canine iliac artery after injury by balloon inflation. The other side was injured as a control. The efficacy of systemic delivery of high dose (heparin [300 U/kg] and argatroban [0.5 mg/kg]) and low dose drugs was also assessed. RESULTS: Sixty minutes after local treatment in 22 dogs, no thrombotic stenosis was observed by angiography in locally treated arteries (p < 0.005 vs. mean thrombotic stenosis of 27% in control segments for heparin, 25.3% in control segments for argatroban and 32% in control segments for batroxobin). Angioscopy demonstrated the same trend. In locally treated arteries, thrombus weight was significantly lower in the treated than control side. In the systemic high dose group (n = 10), angiographic thrombotic stenosis was < 5% after high dose drug delivery (p < 0.05 vs. control segments, 37.4% for heparin, 43% for argatroban). In another 10 dogs, low dose systemic delivery was not effective in inhibiting thrombus formation. Activated partial thromboplastin time and fibrinogen levels did not change with local treatment. CONCLUSIONS: Compared with systemic administration of antithrombotic drugs, local treatment is a safer and more effective method of preventing thrombosis.
Purpose: To study whether the glistening on implanted acrylic intraocular lenses increases or not.Method: 1. Prospective study: We studied the glistening on 49 implanted acrylic intraocular lenses, particularly the time of appearance and increase after glistening appeared. 2. Experiment: We kept an intraocular lens immersed in saline solution at 50 degrees centigrade for 2 hours and then moved this lens into saline solution at 35 degrees centigrade, and observed this lens during immersion.Results: 1. Prospective study: Glistening was present in 28 eyes (57%), and appeared from 2 to 16 months postoperatively. A few months after appearance it become stable and did not increase further. 2. Experiment: On the 10th day after observation, we could see glistening on the lenses. The points of glistening were 10 µm or less in size, and did not change during 60 days of observation.Conclusion: The glistening in acrylic intraocular lenses seemed to become stable a few months after appearance. This our experimental method is useful, because it gives us glistening similar to clinical cases in a short time.
BACKGROUND AND STUDY AIMS: Complete resection of small carcinoid tumors of the rectum is difficult during endoscopic polypectomy, because these tumors are often located in the submucosal layer of the rectal wall. To completely remove these tumors, we have used aspiration lumpectomy. In this study, we evaluated its clinical usefulness in comparison with strip biopsy. PATIENTS AND METHODS: We performed strip biopsy (December 1996 through March 2000) or aspiration lumpectomy (April 2000 through February 2003) in a consecutive series of patients with rectal carcinoid tumor. Eight carcinoid tumors in eight patients were resected by strip biopsy, and eight tumors in eight patients were resected by aspiration lumpectomy. RESULTS: The rate of complete removal of carcinoid tumors with aspiration lumpectomy (100 %) was significantly higher (P < 0.05) than that with strip biopsy (37.5 %). CONCLUSIONS: Endoscopic resection with aspiration lumpectomy is a useful and safe method for resection of small carcinoid tumors of the rectum.
Interstitial heating and brachytherapy are often combined in the treatment of cancer. In such instances, a needle-type internal electrode is inserted into the RALS (remotely controlled afterloading system) catheter instead of a radioactive source. A problem with this approach, however, is that the temperature distribution pattern generated by the inserted electrode varies at any given target region in each heating treatment, which makes it difficult to accurately replicate the heating treatment protocol. This variation is suspected to be caused by non-uniformity in the small gap between the internal electrode and the inner surface of the surrounding catheter, causing electric currents to flow between the electrode and the heating material, which differs from procedure to procedure. To solve this problem, the gap was filled with water of high permittivity, and the temperature distribution was investigated using phantoms. With this method, a stable and reproducible temperature rise distribution was obtained in the phantom experiment.
BACKGROUND: Glomerular capillary injuries result in proteinuria, previously reported to be a risk factor for renal allograft dysfunction. According to the Banff 97 Working Classification of Renal Allograft Pathology, 'double contours' in glomerular capillary loops (GC-DC) were suggested to be most specific for chronic transplant glomerulopathy. Tenascin-C (TN), a component of extracellular matrix, is known to be overexpressed in various conditions. METHODS: TN immunostaining was performed by the labeled streptavidin biotin method. The correlations between glomerular capillary TN (GC-TN) and proteinuria, and between GC-DC and GC-TN, were studied in 27 biopsies showing chronic allograft nephropathy (CAN) lesions. In 14 patients (serum creatinine <2.0 mg/dl at biopsy), graft outcome was studied. Graft function 3 years after biopsy was classified as stable or deteriorated; the term 'deteriorated' was used if serum creatinine had increased 20% over baseline, or if the patient required dialysis. RESULTS: In CAN, GC-TN correlated with GC-DC. Proteinuria in patients with intense GC-TN tended to increase during 1 year after biopsy. In graft outcome analysis, GC-TN was significantly lower in stable grafts than in deteriorated ones. Furthermore, all 3 patients demonstrating weak GC-TN without GC-DC returned to dialysis. CONCLUSION: TN immunostaining is a sensitive method to detect glomerular capillary injury with a predictive value for renal allograft dysfunction.
Proliferation of vascular smooth muscle cells (VSMC) stimulated by oxidative stresses and reactive oxygen species (ROS) may play a pivotal role in the pathogenesis of atherosclerosis. Antiatherosclerotic effects of angiotensin II receptor blockers, angiotensin converting enzyme inhibitors, HMG CoA reductase inhibitors, calcium channel blocker and epalrestat were studied with an in vitro guinea-pig basilar artery smooth muscle cell (GBa-SM3) culture system over 3 days incubated with 0 to 10% of fetal bovine serum. Results demonstrated that simvastatin (0.1 mM), fluvastatin (0.3 mM), amlodipine (0.2 mM) and epalrestat (1 mM) elicited significant (p < 0.05 or 0.01) antiproliferative effects, whereas losartan (1 mM), valsartan (1 mM), enalapril (0.1 mM), captopril (1 mM), trandolapril (0.01 mM), pravastatin (0.7 mM) did not. In conclusion, the present in vitro VSMC culture system may serve as a comprehensive screening method for pleiotropic effects of commonly used therapeutic agents.
The submucosally embedded in situ appendix guarantees an ideal continence mechanism in patients with ileocecal urinary reservoirs. To date this modification of the Mainz pouch technique was performed successfully in 10 patients between September 1990 and October 1992. Pouch capacity ranged from 350 ml to 900 ml (mean: 565 ml), frequency of intermittent self-catheterization ranged from 3 to 7 times per day (mean: 4.4-5.4 times) and complete urinary continence without difficulty of self-catheterization was obtained in eight patients. Two patients with stomal stenosis needed to indwell a catheter. The follow up periods ranged from 3 to 24 months (mean: 14.7 months). The main advantages of appendix stoma technique are shorter operation time, a short ileal segment, no risk of nipple gliding or prolapse, no need for staples, thereby decreasing significantly the risk of stone formation, and facilitating easy catheterization. This method seemed to be valuable for continent urinary reservoir assuring patients of high quality of life.
PURPOSE: To study whether the glistening on implanted acrylic intracular lenses increases or not. METHOD: 1. Prospective study: We studied the glistening on 49 implanted acrylic intraocular lenses, particularly the time of appearance and increase after glistening appeared. 2. EXPERIMENT: We kept an intraocular lens immersed in saline solution at 50 degrees centigrade for two hours and then moved this lens into saline solution at 35 degrees centigrade, and observed this lens during immersion. RESULTS: 1. Prospective study: Glistening was present in 28 eyes (57%), and appeared from 2 to 16 months postoperatively. A few months after appearance it become stable and did not increase further. 2. EXPERIMENT: On the 10th day after observation, we could see glistening on the lenses. The points of glistening were 10 microns or less in size, and did not change during 60 days of observation. CONCLUSION: The glistening in acrylic intraocular lenses seemed to become stable a few months after appearance. This our experimental method is useful, because it gives us glistening similar to clinical cases in a short time.
One hundred healthy parturients scheduled for elective cesarean section were studied prospectively. Fifty patients received spinal anesthesia with 12mg of hyperbaric tetracaine and were defined as the spinal group. Other fifty patients received epidural anesthesia with 300mg of lidocaine and were defined as the epidural group. A half of patients in each group were given 1,000ml of Ringer's lactate immediately before the regional anesthesia (prehydrated). Rapid hydration was not given to another half of them (non-prehydrated). In the spinal group, ephedrine administration was needed significantly less frequently for prehydrated patients than for non-prehydrated ones. And the mean dose of this drug for prehydrated patients was significantly less than that for non-prehydrated ones. In the epidural group, though prehydration tended to prevent maternal hypotension, neither rate of ephedrine administration nor mean doses of this drug showed any significant difference between prehydrated and non-prehydrated patients. Prehydration did not improve significantly neither acid-base balances of umbilical arterial and venous blood nor Apgar scores of the neonates in either group. We conclude that massive fluid load is not indispensable immediately before the regional anesthesia for the parturient. Furthermore, because this method is not reliable, its advantages and disadvantages including the possibility of enhancing pulmonary edema should be evaluated.
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Human phosphoglyceric acid mutase is a dimer comprising M-, B- and MB-type isozymes composed from the combination of the muscle-specific (M) and non-muscle-specific (B) subunits. Human DNAs coding M and B subunits were, respectively, reconstructed at their 5' regions without changing amino acid sequences, and expressed directly in Escherichia coli under the control of the trp promoter. M- and B-type isozymes were over-produced in the bacterial cytoplasm as soluble, active forms, which have been purified and characterized. MB-type was synthesized in vitro by recombining M- and B-type. All three recombinant isozymes thus obtained showed the same properties as the naturally-occurring ones with respect to the properties tested. Polyclonal IgGs specific to the M-type, B-type and MB-type were prepared from rabbits immunized with M- and B-type, using columns bound with M- and B-type. A method for the immunoassay of MB-type which is specifically present in cardiac muscle, is now under development.
BACKGROUND: In spinal surgery, repair of the dura is difficult when it is torn or fragile or is ossified as in cases with ossification of posterior longitudinal ligament. We report our experience with a nonsuture dural repair technique in patients undergoing spinal surgery; it uses a dura substitute composed of polyglycolic acid (PGA) mesh and fibrin glue. Here, we report the efficacy and safety of nonsuture duroplasty using PGA mesh and fibrin glue (PGA-fibrin sheet). METHODS: The artificial dura mater is composed of a PGA-fibrin sheet. The dural defect is covered with a patch sprayed with fibrin glue without suturing to the dura mater. We first evaluated this technique in an experimental study by performing water leakage tests. Between May 2001 and January 2005, we used it in 160 spinal surgeries that required intraoperative dura repair. RESULTS: Our preliminary tests showed that the threshold for water pressure without leakage was 161 +/- 42 and 96.5 +/- 32 mm Hg when the unsprayed margin around the perimeter of the patch was 5 and 2 mm, respectively. Of the 160 operated patients, 10 (6.3%) experienced subcutaneous cerebrospinal fluid (CSF) leakage. Of these, 6 required a second operation; in the other 4, the CSF collection diminished spontaneously. There were no other complications such as allergic reaction, adhesion, or infection. CONCLUSION: In combination with CSF diversion, the PGA-fibrin sheet is a viable alternative method for dural repair in spinal surgery.