摘要:

Ketoconazole, an oral antifungal imidazole, has been effective in some refractory cases of psoriasis, particularly those with scalp involvement, perhaps because of suppression ofPityrosporum ovale. To assess an ancillary immunologically mediated role for ketoconazole, its effects were evaluated on psoriatic patients' lymphocyte function. Ketoconazole in vitro markedly inhibitedPityrosporumantigen-induced lymphocyte blastogenesis as indicated by impairment of celular tritiated thymidine uptake. Ketoconazole likewise inhibited lymphocyte uptake of other pyrimidine nucleosides by both normal and psoriatic lymphocytes. Neither imidazole or an investigational trazole antifungal (Bay n7133) inhibited the uptake. Thus, ketoconazole potentially could affect psoriasis in seborrheic areas of skin by a direct antigungal action or indirectly by suppressing fungal antigeninduced lymphocyte-mediated immune responses affecting the skin.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The authors evaluated the transport kinetics of insulin and inulin administered intraperitoneally to six diabetic patients undergoing continuous ambulatory peritoneal dialysis. The mass transfer coefficients (MTC) calculated from dialysate to blood for 1.5% and 4.25% dextrose dialysate were (ml/min): insulin 2.9 ± 0.9, 2.0 ± 0.5; inulin 3.3 ± 1.4; 2.9 ± 1.7, respectively. The MTC for inulin caluclated from blood to dialysate was 2.0 ± 0.7 ml/min. Because insulin disappears from the peritoneal cavity at a rate similar to inulin, it suggests that insulin transport can be defined by diffusion. The derived MTC values for glucose were not altered by the addition of intraperitoneal insulin. The derived MTCs for eight diabetic to thirteen nondiabetic patients were compaed. The MTC dorived for urea was less among the diabetics (16.6 ± 2.2 vs. 24.6 ± 2.6 p < 0.05), but there were no differences for creatinine, uric acid, glucose, inulin, and protein. The derived values were found to be normally distributed and patients in the upper quartile for one solute were generally in the upper quartile for other solutes.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The aminopyrine breath test (APBT) was used to study patients with chronic congestive heart failure before and after treatment with two chemically similar intropic agents, amrinone (AR) and milrinone (MR), to determine their effects on hepatic microsomal function. Liver chemistries and cardiac indices were meansured and correlated with the 2-hour APBT score in 11 patients with chronic congestive heart failure (5 treated with AR, 6 with MR) and five healthy control subjects. Despite normal or near-normal liver chemistries, patients with chronic congestive heart failure demonstrated overall depressed hepatic microsomal oxidative function. Patients with severe congestive heart failure had a lower mean pretreatment APBT score (AR = 3.05 ± 1.02, MR = 5.38 ± 3.09) when compared with healthy controls (10.02 ± 1.02). However, the APBT score for each individual could not be predicted from the cardiac index. Although the mean cardiac index increased significantly in both the AR and the MR treated patients by 26.14% ± 15.28 (p < 0.01) and 40.0% ± 42.27 (p < 0.025), respectively, compared with protreatment values, the mean APBT score fell by 62.02% ± 22.5 (p < 0.005) in the former and increased by 38.35% ± 25.69 (p < 0.01) in the patients receiving MR. This discordance between the effects of AR and MR suggests possible differences in the effects of the two drugs on hepatic microsomal function.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Changes in arterial and hepatic venous blood ketone bodies were investigated following transcatheter hepatic artery embolization (THAE) in patients with hepatocellular carcinoma. Acetoacetaie/ β-hydroxybuty-rate ration (ketone body ratio) in arterial blood was positively correlated with those of hepatic venous blood (r = 0.960, p < 0.001), which reflects the mitochondrial redox potential in the embolized lobe. Nine cirrhotic patients were classified into three groups according to the changes in arterial blood ketone body ratio following THAE: Type A without decrease to below 0.7; Type B with a transient decrease to below 0.7, followed by its restoration within 5 hours; and Type C with decrease to below 0.7 without recovery within 5 hours. There were no serious complications in Type A and B patients. By contrast, severe sepsis and hepatic failure developed in Type C patients, possibly due to the extended embolization of both lobes. It is suggests that THAE can be successfully performed even in severely cirrhotic patients, as long as the embolized area is restricted to one lobe. In addition, changes in arterial blood ketone body ratios can give early information about the likely consequences of the THAE procedure just performed.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The term “isolated asymptomatic hematuria,” as it relates to both gross and microscopic hematuria, is defined; and the pros and cons of detection techniques used to localize the source of the hematuria are discussed. An algorithm is provided to optimize detection of structural defects and intrinsic renal disease in an effort to avoid subjecting the patient with this difficult-to-diagnose problem to unnecessary invasive tests. Although invasive tests should be performed where deemed necessary in the clinician's aggressive search to detect any structural abnormality, controversial areas of teh evaluation of these patients are addressed. To justify various branch points of the algorithm, a discussion of both renal cell carcinoma and primary renal hematuria is proffered.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Quadriplegia as a presenting syndrome in a case of primary hyperparathyrodism is reported. The clinical picture was misdiagnosed as a space-occupying lesion in the cervical spinal canal, for which an unnecessary laminectomy was performed. The neurologic deficits disappeared following the removal of a parathyroid adenoma. The neurologic presentations of hyperparathyroidism are reviewed and discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Three patients with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) during the course of disseminated Herpes Varicella-Zoster (HVZ) virus infections are reported. In one patient and two previously reported patients, SIADH occurred at or shortly after admission, prior to antiviral drug therapy. In two patients and one previously reported patient, SIADH began or hyponatremia worsened after vidarabine therapy was begun. Therefore, SIADH may occur during the course of untreated, disseminated HVZ infection. However, the relatively high fluid volume required to dilute vidarabine may play a role in the development of the clinical and laboratory manifestations of SIADH, in patients receiving the drug. Physicians should avoid excess fluid intake and monitor serum sodium carefully when caring for patients with disseminated HVZ infections. Doses of vidarabine greater than 10 mg/kg/day may increase the likelihood of SIADH. Acyclovir therapy was not associated with worsening of hypotonic hyponatremia in our patients.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Closed-chest trauma in a young man was followed by rupture of a right ventricular papillary muscle and bifascicular block. This produced signs and symptoms of tricuspid regurgitation and recurrent syncope. Treatment by valve replacement and pacemaker implantation was successful. Review of 30 cases of traumatic tricuspid regurgitation reveals that this patient had characteristic findings: adult onset of isolated tricuspid regurgitation, a history of trauma, right bundle branch block, and cardiomegaly without signs of left ventricular failure. In addition, right atrial hypertension of longstanding may produce cyanosis because of right-left shunting through a patent foramen ovale.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A patient with clinical Stage IV Hodgkin's disease of the nodular sclerosis type demonstrated all features of the syndrome of inappropriate secretion of antidiuretic hormone. Electroencephalogram, radiography of the skull, and computerized tomography of the brain and cardiac, renal, thyroid, and adrenal function tests were all normal. It is suggested that the patient presents a rare case of Hodgkin's disease with inappropriate secretion of antidiuretic hormone.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The association ofStreptococcus bovissepticemia with abnominal neoplasms has been well-documented. The case of a man who presented with vertebral osteomyelitis due toS. bovisis reported; he was subsequently found to have bacteremia and colonic polyps. It is recommended that patients who present with localized as well as generalizedS. bovisinfections undergo yearly colonoscopy.

ISSN:0002-9629    

出版商:OVID    

年代:1986

数据来源: OVID