摘要:

The authors measured plasma metalloproteinase (MMP)-9 and corresponding monocyte mRNA in 20 patients with septic shock. Plasma MMP-9 concentrations and monocyte MMP-9 mRNA levels were significantly higher in the 10 nonsurviving patients with septic shock than in 10 surviving patients and 25 normal controls. Hemoperfusion using polymyxin B immobilized on fibers (PMX-F), a reportedly effective treatment for septic shock, was studied for effects on MMP-9 in the patients. Increases in plasma MMP-9 concentrations and corresponding monocyte mRNA levels were attenuated significantly by PMX-F treatment in both nonsurviving and surviving patients. These data suggest that plasma MMP-9 concentrations and monocyte MMP-9 mRNA levels may be useful prognostic markers in septic shock, and that PMX-F treatment affects MMP-9.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Background:The authors have previously demonstrated abnormalities in glucose and insulin metabolism in nondiabetic black American (BA) adults versus white American (WA) adults. Whether similar glucoregulatory alterations extend to BA adolescents remain unknown. In addition, obesity, a known risk factor for insulin resistance and hyperinsulinemia, occurs in a greater proportion of BA adults and children when compared to WA. The objective of the present study was to examine the differential effects of obesity on glucose homeostasis in BA and WA adolescents.Methods:We examined glucose homeostasis in BA and WA adolescents using oral glucose tolerance test (OGTT), intravenous glucose tolerance test (IVGTT), and [6,6-2H2]-glucose infusion. The study consisted of four age-, sex-, and pubertal stage-matched groups: 15 lean BA, 29 lean WA, 7 obese BA, and 9 obese WA.Results:Both obese groups had significantly increased insulin and C-peptide area under the curve (AUC) during OGTT and IVGTT when compared to their same-race lean counterparts. During OGTT, obese BA demonstrated greater insulin and C-peptide when compared to obese WA. During IVGTT, first- and second-phase insulin were significantly greater in obese BA versus obese WA.Conclusion:In summary, BA adolescents demonstrated insulin resistance which is markedly exaggerated in the face of obesity when compared to WA adolescents, implying a differential impact for obesity on glucose homeostasis that is unique to the obese BA adolescent group. In conclusion, there is a need for early aggressive weight management in obese BA adolescents.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Lung branching morphogenesis is the process by which the embryonic lung undergoes repetitive branching to form the bronchial tree. This process occurs during the pseudoglandular stage of lung development and requires epithelial-mesenchymal interactions. Coinciding with lung branching morphogenesis is the appearance of parabronchial smooth muscle cells (PSMCs) and the accumulation of extracellular matrices (ECMs) around the developing airways. The authors previously reported in preliminary form that heparin prevents the branching of murine lung explants (Roman et al., Am Rev Respir Dis. 1991;143:A401); this article corroborates those early observations and expands them by demonstrating that heparin results in disruption of PSMC distribution and abnormal organization of ECMs around the developing airways. These changes were associated with inhibition of lung branching morphogenesis in the absence of effects on cell proliferation. The data provide further support for the role of ECMs in lung branching morphogenesis, and points to PSMCs as potential players in this process.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A total of 57 strains ofShigella(36S sonnei, 21S flexneri), isolated from children with acute diarrheal disease who presented for treatment at the Andes University Hospital, Mérida, Venezuela, from June 1993 to June 1995, were tested for their susceptibility to trimethoprim, sulfamethoxazole, ampicillin, cefamandole, ceftriaxone, streptomycin, fleroxacin, and nalidixic acid, by the agar dilution method. Twenty-seven strains (75%) ofS sonneiand eight strains ofS flexneri(38.1%) isolates showed high-level resistance to trimethoprim (MIC90> 1024 µg/mL), which was also associated with other resistance patterns. The most common resistant phenotype associated with trimethoprim-resistance amongS sonneiisolated was sulfamethoxazole-streptomycin (63%); amongS flexneriisolates, it was sulfamethoxazole-ampicillin-streptomycin (87.5%). Individual resistance was only observed for ampicillin, mainly in four isolates ofS flexneri, and in one isolate ofS sonnei. Most Shigellastrains were resistant to three or more antimicrobial agents. These results confirmed that multiresistant strains ofShigellaare present in Mérida, and emphasize the importance to maintain these under surveillance in order to assess local susceptibility patterns and empiric therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Amiodarone is a benzofuran derivative with a chemical structure similar to thyroxine. Originally introduced to treat angina pectoris, amiodarone was found to have antiarrhythmic properties, and in 1985, was approved in the United States for treatment of life-threatening ventricular arrhythmias. It is now used for various ventricular and supraventricular arrhythmias refractory to conventional first-line medications, and as a result, side effects have been observed with increased frequency. The most severe and potentially life-threatening of these side effects is the development of pulmonary toxicity. Typically, amiodarone pulmonary toxicity (APT) is manifested by acute pneumonitis and chronic fibrosis. Amiodarone-associated hemoptysis (AAH) is a rare occurrence. The authors describe a case of AAH successfully treated with cessation of drug and steroid therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Plasma proteins, especially albumin, account for much of the normal anion gap. The relationship between globulins and the anion gap has not received much attention except for reports of a narrowing of the gap associated with certain monoclonal immunoglobulin G gammopathies. The author presents a patient with polyclonal gammopathy, the magnitude of which correlated strongly and positively with the anion gap, along with data from 400 patients attending a renal hypertension clinic, which show a significant positive correlation between the anion gap and total globulins. These results indicate that both albumin and globulin concentrations should be taken into account when attempting to explain abnormalities or changes in the magnitude of the gap.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors observed a long-lasting response to uninterrupted vinorelbine treatment in a 72-year-old patient with a stage IIIB unresectable non-small cell carcinoma. The progressive tumor mass reduction was assessed by computed tomographic scans over a 2-year period. In the literature, data of randomized trials confirm that the appeal of single-agent vinorelbine therapy in elderly patients is also good for the patient's quality of life during treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Influenza A is associated with leukopenia, although it is not reported to cause isolated thrombocytopenia, anemia, or pancytopenia. The authors report three pediatric patients with transient cytopenias associated with influenza A infection, all of whom had evidence for influenza A infection by direct immunofluorescence from nasopharyngeal aspirates. In all patients, cytopenias were transient and improved as their viral symptoms resolved. All patients improved spontaneously. This is the first report of transient pancytopenia, anemia, or thrombocytopenia associated with influenza A infection. Given the high frequency of influenza A infections during the winter months, it is important to recognize the associated hematologic findings.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Herpes simplex virus (HSV) hepatitis is a rare complication of HSV infection with a high reported mortality rate in untreated patients. The authors present a case of HSV hepatitis in a 26-year-old female with focal proliferative lupus nephropathy who was status post one cycle of pulse high-dose (1 gm/m2) cyclophosphamide. Treatment with parenteral acyclovir was successful. A meta analysis of well-documented cases of HSV hepatitis treated with acyclovir, excluding those that omit initial serum concentrations of hepatic transaminases, suggests that the early administration of parenteral acyclovir may have been instrumental in the achievement of a successful outcome, and that a patient's serum levels of hepatic transaminases at the time of treatment initiation may predict outcome. This is the first reported case of successful parenteral acyclovir treatment of HSV hepatitis in a patient with lupus nephritis who has recently undergone cyclophosphamide immunosuppression, and includes a meta analysis to examine the hypothesis that initial markers of hepatic injury may predict outcome of acyclovir treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1998

数据来源: OVID