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1.
Neurol Res ; 19(2): 169-73, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9175147

RESUMO

Blood pressure usually is reduced in patients with hypertensive intracerebral hemorrhage for the prevention of the expansion of the hematoma and recurrent hemorrhage in acute stage. However, disturbed autoregulation of cerebral circulation is expected, and decreased cerebral blood flow (CBF) caused by excessive hypotension has been pointed out. There are different mechanisms of action in hypotensives, thereby the influence of hypotension on CBF in patients with the thalamic hemorrhage was investigated using nitroglycerin (TNG), diltiazem hydrochloride (DH) and trimethaphan camsilate (TC). Average CBF in a hemisphere on the hematoma side, the hemisphere without hematoma, and around the hematoma showed a slight decline after administration of TNG or DH. However, CBF declined more, after TC than DH. DH and TNG are preferable in descending order to control blood pressure of patients with intracerebral hemorrhage in the acute stages in view of a smaller decline in CBF.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/fisiopatologia , Circulação Cerebrovascular/efeitos dos fármacos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Adulto , Idoso , Pressão Sanguínea , Diltiazem/uso terapêutico , Hematoma/etiologia , Hematoma/fisiopatologia , Humanos , Hipertensão/fisiopatologia , Pessoa de Meia-Idade , Nitroglicerina/uso terapêutico , Doenças Talâmicas/etiologia , Doenças Talâmicas/fisiopatologia , Trimetafano/uso terapêutico
2.
J Bone Joint Surg Am ; 67(3): 439-45, 1985 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-3882718

RESUMO

Ten patients with an amputated thumb had reconstruction by a free wrap-around flap taken from the big toe, including the nail, and an iliac-bone graft as the core of the reconstruction. The long-term results showed that a better replica of the thumb was achieved. The results were quite satisfactory both cosmetically and functionally, but there were some new problems: resorption of the bone graft, bulging of the pulp, skin atrophy at the base of the thumb, and deformity of the nail in a few patients. Modifications of the flap design and of the shape of the bone graft eliminated these problems nearly entirely.


Assuntos
Amputação Traumática/cirurgia , Transplante Ósseo , Hallux , Retalhos Cirúrgicos , Polegar/lesões , Adulto , Reabsorção Óssea/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Ílio/transplante , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Radiografia , Polegar/cirurgia
3.
J Bone Joint Surg Br ; 80(1): 117-20, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9460966

RESUMO

One pattern of injury to the brachial plexus shows recovery of the fifth and sixth cervical nerves but little else. These patients have useful shoulders and functional elbow flexion, but elbow and wrist extension is weak or absent. Their hand function is negligible. We restored hand function in three such patients using free functioning muscle transfer for finger flexion and transfer of the sensory rami of the intercostal nerve to the ulnar nerve for sensation. Supplementary operations to restore elbow and wrist extension were necessary in one patient.


Assuntos
Plexo Braquial/lesões , Mãos/fisiopatologia , Músculo Esquelético/transplante , Paresia/cirurgia , Adulto , Feminino , Humanos , Masculino , Procedimentos de Cirurgia Plástica/métodos
4.
Plast Reconstr Surg ; 104(6): 1679-87, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10541169

RESUMO

Limb-sparing surgery is the preferred approach in the management of patients with high-grade soft-tissue sarcomas when local disease can be completely resected. However, conventional treatment focuses only on restoration of basic functions to the remnant limb. Lost functions are not restored to normal, leaving the patient with variable degrees of functional disabilities. This in turn may necessitate further massive reconstructive procedures. Transferred reinnervated free muscles were used to reconstruct functions lost after radical resection of malignant soft-tissue sarcoma of the extremities in 17 patients. The long-term functional outcome included survival of transplanted muscle, speed of neural recovery, and muscle strength and disabilities. All muscles survived. Postoperative follow-up ranged from 27 to 106 months. All muscles except those in a 75-year-old patient were successfully reinnervated. Powerful strength and almost normal limb functions were obtained. Functional scoring of the patients according to the rating system of the Musculoskeletal Tumor Society was 87 percent for the lower extremity and 93 percent for the upper extremity. All patients are presently disease-free. Use of the reinnervated free-muscle transfer in limb-sparing surgery after resection of soft-tissue sarcoma in the extremity may be indicated in the young adult when radical excision of the tumor will result in severe motor functional loss, provided adequate clearance can be obtained and that there is no presence of distant metastasis.


Assuntos
Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Retalhos Cirúrgicos/inervação , Adolescente , Adulto , Idoso , Amputação Cirúrgica , Criança , Extremidades/cirurgia , Feminino , Humanos , Contração Isométrica/fisiologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Regeneração Nervosa/fisiologia , Complicações Pós-Operatórias/fisiopatologia , Prognóstico , Resultado do Tratamento
5.
Plast Reconstr Surg ; 91(4): 597-605; discussion 606-7, 1993 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8446712

RESUMO

The effects of 4 weeks of cyclosporin A (7 mg/kg per day) (CyA) on the survival of vascularized osteochondral grafts between rat strains [DA (donor) and Lewis (recipient)] and the presence and significance of host immune tolerance and graft antigen modulation after cessation of immunosuppression have been examined. Isografts (n = 12) survived without apparent abnormality for 8 weeks but showed signs of wasting after longer periods; unprotected allografts (n = 5) were rejected within 2 weeks. After 4 weeks of CyA, allografts remained healthy for at least 12 weeks but then deteriorated (n = 40). Antigen modulation was examined by graft removal at various intervals after cessation of CyA and reimplantation into a naive recipient (n = 14). All were rejected rapidly. Host tolerance was examined by graft removal at various periods after cessation of CyA and reimplantation of a fresh allograft (n = 15). Some of the second grafts survived at least 4 weeks without immunosuppression. The findings indicate development of incomplete host tolerance but no antigenic modulation of the graft.


Assuntos
Transplante Ósseo/imunologia , Cartilagem/transplante , Ciclosporina/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto/imunologia , Tolerância Imunológica/imunologia , Animais , Terapia de Imunossupressão , Ratos , Ratos Endogâmicos Lew , Fatores de Tempo , Transplante Homólogo , Transplante Isogênico
6.
Hand Clin ; 15(4): 757-67, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10563274

RESUMO

Recent interest in reconstruction of the upper limb following brachial plexus injuries has focused on the restoration of prehension following complete avulsion of the brachial plexus. The authors use free muscle transfers for reconstruction of the upper limb to resolve the difficult problems in complete avulsion of the brachial plexus. This article describes the authors' updated technique--the double free muscle procedure. Reconstruction of prehension to achieve independent voluntary finger and elbow flexion and extension by the use of double free muscle and multiple nerve transfers following complete avulsion of the brachial plexus (nerve roots C5 to T1) is presented. The procedure involves transferring the first free muscle, neurotized by the spinal accessory nerve for elbow flexion and finger extension, a second free muscle transfer reinnervated by the fifth and sixth intercostal nerves for finger flexion, and neurotization of the triceps brachii via its motor nerve by the third and fourth intercostal motor nerves to extend and stabilize the elbow. Restoration of hand sensibility is obtained via the suturing of sensory rami from the intercostal nerves to the median nerve. Secondary reconstruction, including arthrodesis of the carpometacarpal joint of the thumb and glenohumeral joint, and tenolysis of the transferred muscle and distal tendons, improve the functional outcome. Based on the long-term result, selection of the patient, donor muscle, and donor motor nerve were indicated. Most patients were able to achieve prehensile functions such as holding a can and lifting a heavy box. This double free muscle transfer has provided prehension for patients with complete avulsion of the brachial plexus and has given them new hope to be able to use their otherwise useless limbs.


Assuntos
Braço/cirurgia , Plexo Braquial/lesões , Músculo Esquelético/transplante , Adulto , Plexo Braquial/cirurgia , Humanos , Nervos Intercostais/cirurgia , Masculino , Seleção de Pacientes , Procedimentos de Cirurgia Plástica , Ferimentos e Lesões/cirurgia
7.
Hiroshima J Med Sci ; 45(2): 57-62, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8810132

RESUMO

The purpose of this study was to identify the patients with decreased methotrexate (MTX) clearance as early as possible after the start of high-dose methotrexate (HD-MTX) infusion. Fifty-six patients (age: 18 approximately 83 years) received a HD-MTX infusion (dosage: 1.9 approximately 3.8 g/m2) for 6 h. These patients were retrospectively divided into a low-clearance group and a high-clearance group based on the serum MTX concentration at 48 h (1 microM). Six out of the 56 patients showed decreased MTX clearance. The MTX concentrations in the low-clearance group were significantly higher than those in the high-clearance group even in earlier sampling times than at 48 h. The average MTX concentrations were 330 microM at 6 h, 72 microM at 12 h, and 16 microM at 24 h in the low-clearance group, and those in the high-clearance group were 210 microM, 18 microM, and 1.0 microM, respectively. The estimated elimination half-lives (t1/2) at 6 approximately 12 h and 12 approximately 24 h after the start of the infusion were also significantly longer in the low-clearance group (2.8 vs. 1.7 h and 5.0 vs. 2.8 h, respectively). Therefore, we proposed convenient criteria based on the mean + 1 S.D. of the high-clearance group: the concentration > 270 microM at 6 h and > 32 microM at 12 h; the t1/2 value > 2.1 h at 6-12 h. All 6 patients were recognized as belonging to the low-clearance group at an early stage after HD-MTX infusion by using our proposed criteria. These results indicate that patients with decreased MTX clearance could be identified within the first 12 h after the start of HD-MTX infusion. The factors influencing the prolonged elimination of MTX were also investigated. A significant decrease in renal function on day 2 was observed in the low-clearance group. The MTX level at 12 h and the estimated t1/2 values were significantly correlated with BUN, Scr and Clcr on the 2nd day after HD-MTX therapy, suggesting that an alteration in renal function occurs within 12 h of the HD-MTX infusion. The prolonged elimination of MTX could be attributable to this decrease in renal function.


Assuntos
Antimetabólitos Antineoplásicos/farmacocinética , Leucemia/tratamento farmacológico , Linfoma/tratamento farmacológico , Metotrexato/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/administração & dosagem , Humanos , Infusões Intravenosas , Rim/fisiopatologia , Taxa de Depuração Metabólica , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
8.
No Shinkei Geka ; 29(11): 1049-54, 2001 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-11758312

RESUMO

Capillary hemangiomas are the most common tumor of the neck and head in children. Intracranial capillary hemangioma without generalized neuro-cutaneous hemangiomatosis is extremely rare, with only one report in the literature. We report a case of intracranial capillary hemangioma originating from the temporal base. An 8-year-old boy presented with a severe headache and nausea. A CT scan showed a low-density area in the left temporal lobe and an iso-density mass at the temporal base. This mass was enhanced by contrast medium. The mass lesion appeared as an iso-intensity area on T1-weighted MR images and as a high-intensity area on T2-weighted MR images, and the mass was enhanced almost uniformly by gadoliniumdiethylene triaminepenta-acetic acid. Cerebral angiography showed abnormal staining fed by the anterior temporal artery. An operation was performed, and all of the tumor with the dura attached was removed. The histological diagnosis was capillary hemangioma. The tumor consisted of a proliferation of capillary vessels lined by a single layer of endothelial cells. In this paper, we review the clinical features, neuro-imaging findings and proposed etiology of capillary hemangioma.


Assuntos
Neoplasias Encefálicas , Hemangioma Capilar , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Artérias Carótidas/diagnóstico por imagem , Criança , Hemangioma Capilar/diagnóstico , Hemangioma Capilar/patologia , Hemangioma Capilar/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
9.
Microsurgery ; 5(1): 31-5, 1984.
Artigo em Inglês | MEDLINE | ID: mdl-6708799

RESUMO

The relationship between ischemic interval and bone union in reimplantation of digits was studied clinically and experimentally. In 32 reimplanted digits, the cases in which the bone union delayed had a longer ischemic interval. In experimental study of rats, bone union of the group of which ischemic interval was 12 hours was definitively delayed in comparison with that of the control group.


Assuntos
Dedos/cirurgia , Isquemia/complicações , Reimplante , Cicatrização , Adulto , Amputação Traumática/cirurgia , Animais , Traumatismos dos Dedos/cirurgia , Dedos/irrigação sanguínea , Dedos/fisiopatologia , Humanos , Masculino , Microcirurgia , Pessoa de Meia-Idade , Ratos , Ratos Endogâmicos , Estudos Retrospectivos , Fatores de Tempo
10.
J Hand Surg Am ; 9(5): 740-9, 1984 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-6491224

RESUMO

An alumina ceramic hinge-type finger prosthesis, composed of alumina ceramics and high-density polyethylene, is described. Biomaterial evaluations, including flexion-extension tolerance, stretching, twisting, extraction tests, and histologic examinations of affinity for bone, demonstrated that this implant has characteristics superior to those of previous finger implants. Eighteen proximal interphalangeal joints and 13 metacarpophalangeal joints have been replaced with this alumina ceramic finger implant. Follow-up studies (12 to 31 months) have been most encouraging with satisfactory functional recovery and no fracture or dislocation of the implants.


Assuntos
Articulações dos Dedos/cirurgia , Prótese Articular , Adulto , Idoso , Alumínio , Fenômenos Biomecânicos , Cerâmica , Estudos de Avaliação como Assunto , Humanos , Prótese Articular/normas , Masculino , Articulação Metacarpofalângica/cirurgia , Pessoa de Meia-Idade , Polietilenos , Desenho de Prótese , Resistência à Tração
12.
Microsurgery ; 5(2): 90-4, 1984.
Artigo em Inglês | MEDLINE | ID: mdl-6748938

RESUMO

An automatic milking apparatus composed of a finger attachment and a pump to push out the air was devised in order to perform the forced drainage from replanted digits with insufficient venous drainage. Seven replanted digits with insufficient venous drainage after replantation were applied, and remarkable improvement was found in five digits. An interesting case is reported in which a replanted digit without venous anastomosis survived as a consequence of applying the milking apparatus. The advantages of our milking apparatus are also discussed.


Assuntos
Drenagem/instrumentação , Traumatismos dos Dedos/cirurgia , Dedos/irrigação sanguínea , Reimplante , Amputação Traumática/cirurgia , Drenagem/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Veias
13.
Microsurgery ; 15(9): 663-70, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7845198

RESUMO

To study the healing mechanism of vascularized bone allografts under short-term as well as long-term immunosuppression with cyclosporin A, experimental vascularized intercalary bone allograft transplantation was carried out between inbred rats using the tibiofibula graft model. Bone scintigram and radiographs were used as an indicator for early detection of rejection after transplantation and bone union. In vascularized bone allografts under long-term immunosuppression with cyclosporin A, early bone union and continuous incorporation were similar to that observed in vascularized bone autograft transplantation. When administration of cyclosporin A was discontinued before completion of bone union, the graft was rejected and bone union was delayed. Apparent swelling on the operated limb associated with a decrease in bone scintigram uptake suggested the occurrence of rejection of the allograft. Vascularized bone allograft transplantation is useful for reconstruction of massive bone defects only if immunosuppressants are used and maintained at least until bone union is obtained.


Assuntos
Transplante Ósseo/métodos , Ciclosporina/uso terapêutico , Fíbula/transplante , Rejeição de Enxerto/imunologia , Terapia de Imunossupressão , Tíbia/transplante , Cicatrização/fisiologia , Animais , Transplante Ósseo/imunologia , Rejeição de Enxerto/diagnóstico , Masculino , Microcirurgia , Ratos , Ratos Endogâmicos Lew , Ratos Endogâmicos , Medronato de Tecnécio Tc 99m/análogos & derivados , Fatores de Tempo , Transplante Homólogo
14.
J Hand Surg Am ; 12(5 Pt 1): 677-84, 1987 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3655224

RESUMO

A technique of harvesting a free vascularized sural nerve graft based on either the cutaneous branch of the peroneal artery or the muscular perforating branch of the posterior tibial artery is described. Anatomic dissections with dye injection studies confirmed the reliability of this blood supply to a 25 cm long segment of the sural nerve. The sural nerve can be sectioned into as many as four segments while safely maintaining each segment's vascularity through intact fascia. A skin monitor can be elevated with the nerve to monitor vascular patency. The free vascularized sural nerve was used to reconstruct 16 nerve defects in the upper extremity. All 13 skin monitors elevated have survived. Early follow-up (range, 2 to 31 months) has shown encouraging clinical recovery. Although our preliminary results are difficult to compare with other series, this technique appears promising in clinical circumstances when interfascicular nerve grafting is indicated but the recipient bed is heavily scarred and poorly vascularized.


Assuntos
Nervos Espinhais/transplante , Nervo Sural/transplante , Retalhos Cirúrgicos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Sural/anatomia & histologia , Grau de Desobstrução Vascular
15.
J Hand Surg Am ; 17(4): 670-6, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1321181

RESUMO

Long-term results of a randomized series of 27 vascularized and 22 conventional sural nerve grafts in patients with comparable upper extremity injuries are reported. Recovery speed and outcome depended on (1) whether or not there was an overlying skin defect, (2) how the defect was closed, and (3) which nerve was injured and at what level. Generally, a vascularized nerve graft is indicated when the nerve gap is more than 6 cm and is associated with a massive skin defect or the graft is performed after reimplantation. Otherwise, results achieved with a conventional graft are equally good.


Assuntos
Doenças do Sistema Nervoso Periférico/cirurgia , Nervo Sural/transplante , Adolescente , Adulto , Axila/inervação , Humanos , Nervo Mediano/cirurgia , Nervo Radial/cirurgia , Retalhos Cirúrgicos , Transplante Autólogo/métodos , Nervo Ulnar/cirurgia
16.
J Hand Surg Am ; 16(5): 796-803, 1991 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-1940155

RESUMO

Simultaneous reconstruction of elbow and finger function with free muscle and nerve transfers after complete avulsion of the brachial plexus (nerve roots C5 to T1) and its long-term results are presented. The basic procedure combined free or vascular pedicle latissimus dorsi muscle transfer with reinnervation by the spinal accessory nerve to obtain elbow and finger flexion, intercostal nerve transfer of the radial nerve to activate elbow and wrist extensors, and suture of the supraclavicular nerve or intercostal sensory rami to the median nerve to restore hand sensibility. Six patients had some or all of these procedures. Postoperative follow-up ranged from 2 to 5 years. Elbow function was restored completely, and some finger flexion was achieved in all cases, although a dynamic splint was necessary to straighten the digits. Patients have continued to improve in grasp power and finger control. This procedure appears to be promising for the restoration of basic hand function in severely handicapped patients.


Assuntos
Plexo Braquial/lesões , Articulação do Cotovelo/fisiologia , Articulações dos Dedos/fisiologia , Transferência de Nervo , Retalhos Cirúrgicos/métodos , Nervo Acessório/cirurgia , Adulto , Mãos/inervação , Humanos , Nervos Intercostais/cirurgia , Masculino , Nervo Mediano/cirurgia , Nervo Radial/cirurgia , Amplitude de Movimento Articular/fisiologia
17.
J Hand Surg Am ; 21(3): 381-6, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8724465

RESUMO

Twenty-one patients with complete brachial plexus palsy due to the avulsion of multiple cervical nerve roots underwent motor and sensory reconstruction. Of these, 15 patients who had been followed for at least 2 years were included in the present study. Sensory reconstruction was performed by nerve graft or nerve crossing to the median nerve. The donor nerves included the supraclavicular nerve in 10 patients, the intercostal nerve in 3, and the C5 nerve root in the first 2 patients. Limited sensibility in the median nerve distribution of the hand was restored in 12 patients, and the results were classified as S2+ in 2, S2 in 4, S1 in 6, and S0 in 3, according to the S0 to S4 grading system. No moving two-point discrimination was restored in any case. While the best recovery obtained was only at the S2+ level, even this limited sensibility was useful for otherwise completely anesthetic patients.


Assuntos
Plexo Braquial/lesões , Mãos/inervação , Hipestesia/cirurgia , Transferência de Nervo/métodos , Nervos Periféricos/transplante , Raízes Nervosas Espinhais/lesões , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Microcirurgia/métodos , Músculo Esquelético/inervação , Exame Neurológico , Complicações Pós-Operatórias/etiologia , Raízes Nervosas Espinhais/cirurgia , Resultado do Tratamento
18.
J Hand Surg Am ; 20(3): 408-14, 1995 May.
Artigo em Inglês | MEDLINE | ID: mdl-7642917

RESUMO

Restoration of finger flexion and extension as well as elbow flexion and extension with a double free-muscle and multiple nerve transfers following complete avulsion of the brachial plexus (nerve roots C5 to T1) is reported. The procedure combines (1) free-muscle transfer with reinnervation by the spinal accessory nerve to achieve elbow flexion and finger extension, (2) free-muscle transfer with reinnervation by the fifth and sixth intercostal nerves to restore finger flexion, (3) third and fourth intercostal motor nerve transfer to the triceps brachi to extend and stabilize the elbow, (4) nerve transfer of the supraclavicular nerve or nerve transfer of the sensory rami of the intercostal nerves to the median nerve to restore hand sensibility, and (5) glenohumeral arthrodesis. Seven of 10 patients recovered elbow function and finger flexion and extension. Five patients reported use of their hand in activities of daily living.


Assuntos
Plexo Braquial/lesões , Dedos/fisiopatologia , Músculo Esquelético/transplante , Adolescente , Adulto , Articulação do Cotovelo/fisiopatologia , Eletromiografia , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Transferência de Nervo , Amplitude de Movimento Articular , Reoperação , Resultado do Tratamento
19.
Neurosurg Rev ; 18(4): 237-45, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8927239

RESUMO

In patients with hypertensive intracerebral hemorrhage, changes in regional cerebral blood flow (rCBF) following drug-induced blood pressure reduction were examined by SPECT. METHODS. The subjects were 68 patients with hypertensive intracerebral hemorrhage. The site of cerebral hemorrhage was the thalamus in 28 patients, and the putamen in 40 patients. RCBF was measured by SPECT using the 133Xe inhalation method. To reduce blood pressure, trimethaphan camsilate (an autonomic ganglion blocker) and diltiazem hydrochloride (a calcium antagonist) were used. RESULTS. 1. In the acute period, mean CBF declined as the mean arterial blood pressure declined by more than 20% in both the putaminal and the thalamic hemorrhage group (p < 0.01). 2. During the chronic period, a greater reduction in blood pressure was needed to induce mean CBF reduction. 3. Neither of the two drugs significantly reduced the mean arterial blood pressure, but the group receiving trimethaphan demonstrated a 7.9 approximately 7.5% decreased in CBF, group while the receiving diltiazem showed a 2.2 approximately 2.4% decrease (p < 0.05). CONCLUSIONS. In patients with hypertensive intracerebral hemorrhage, a 20% or more drug-induced decrease in blood pressure resulted in a decrease in mean CBF. During the acute period of intracerebral hemorrhage, blood pressure showed reduced by 20%. Clinically, diltiazem was more effective than trimethaphan.


Assuntos
Hemorragia Cerebral/diagnóstico por imagem , Homeostase , Hipertensão/diagnóstico por imagem , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Hemorragia Cerebral/fisiopatologia , Circulação Cerebrovascular/efeitos dos fármacos , Diltiazem/farmacologia , Humanos , Hipertensão/fisiopatologia , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão de Fóton Único , Trimetafano/farmacologia
20.
J Immunol ; 163(12): 6355-9, 1999 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-10586023

RESUMO

It has been proposed that Ig gene rearrangement in the peritoneal cavity (Pc) B-1 cells might be involved in autoantibody generation. To study possible secondary B cell maturation, we prepared mice carrying a target integration of gfp gene into a rag1 locus (rag1/gfp mice). The GFP+ cells express rag1 mRNA and are undergoing Ig gene rearrangement. RAG1 expression was studied in Pc B-1 cells to detect cells during the stage of Ig gene rearrangement. In contrast to previous reports, Pc B-1 cells did not show RAG1 expression in adolescent or elderly mice. RAG1 expression was not induced in Pc B-1 cells in vivo after stimulation by oral or i.p. administration of LPS. Our results suggest that RAG1 expression in Pc B-1 cells is inhibited for a long period under normal condition and that this suppression is an essential state which maintains allelic exclusion of Ig genes.


Assuntos
Linfócitos B/metabolismo , DNA Nucleotidiltransferases/deficiência , DNA Nucleotidiltransferases/genética , Regulação da Expressão Gênica/imunologia , Genes RAG-1/imunologia , Proteínas de Homeodomínio/genética , Integrases , Proteínas Luminescentes/genética , Animais , Cruzamentos Genéticos , DNA Nucleotidiltransferases/biossíntese , Vetores Genéticos/síntese química , Vetores Genéticos/metabolismo , Proteínas de Fluorescência Verde , Proteínas de Homeodomínio/biossíntese , Camundongos , Camundongos Mutantes , Mutagênese Insercional , Peritônio/citologia , RNA Mensageiro/biossíntese , Recombinases , Transdução de Sinais/genética , Transdução de Sinais/imunologia
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