[Assessment of Feasibility of Early Ambulation and Food-intake on the Operative Day after Lung Resection].

To decrease the risk of morbidity, we have started an early ambulation and food-intake program conducted on the same day as pulmonary resection. This protocol was developed with consideration of the characteristics of lung surgery and conducted through an interdisciplinary team-approach. The assessment of feasibility and clinical effectiveness of this protocol was evaluated in 64 consecutive patients. No apparent adverse effect relating to this protocol was recorded. Fifty-five of 64 patients( 80%) were able to accomplish ambulation to the up-right standing position. Thirty-four of 64 patients( 53%) were able to consume more than half the amount of their hospital supper. No patients, including 5 patients who had had a past-history of postoperative delirium after their previous surgery, developed postoperative delirium after conducting this protocol. This protocol, which consisted of extraordinary early ambulation and food-intake on the operative day, was done safely and is expected to have some benefit as a postoperative management protocol for lung surgery.

A possible mechanism for the decrease in serum thyroxine level by a 2,3,7,8-tetrachlorodibenzo-p-dioxin-like polychlorinated biphenyl congener, 3,3',4,4',5-pentachlorobiphenyl in mice.

Serum total thyroxine (T(4)) and free T(4) levels were markedly decreased 7 days after treatment with 3,3',4,4',5-pentachlorobiphenyl (CB126) (2.5 mg/kg i.p.) in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-sensitive C57BL/6 mice but not in TCDD-resistant DBA/2 mice. At the same time, the level and activity of hepatic T(4)-UDP-glucuronosyltransferase (T(4)-UGT) were significantly increased in C57BL/6 mice but not in DBA/2 mice. Furthermore, the amounts of biliary [(125)I]T(4) and [(125)I]T(4) glucuronide after injection of [(125)I]T(4) were increased by CB126 pretreatment in C57BL/6 mice but not in DBA/2 mice. Clearance of [(125)I]T(4) from serum was also promoted by CB126 pretreatment in C57BL/6 mice but not in DBA/2 mice. On the other hand, no significant changes in the steady-state volumes of distribution of [(125)I]T(4) and in the concentration ratio (K(p) value) of the liver to serum by CB126 pretreatment were observed in either strain of mice. Because liver weight was increased by CB126 pretreatment in C57BL/6 mice but not in DBA/2 mice, hepatic total [(125)I]T(4) was increased only in C57BL/6 mice. The present findings indicate that CB126-mediated decrease in serum T(4) occurs through the increase in hepatic T(4)-UGT and the enhanced accumulation of hepatic T(4) along with development of liver hypertrophy.

4-Hydroxy-2,2',3,4',5,5',6-heptachlorobiphenyl-mediated decrease in serum thyroxine level in mice occurs through increase in accumulation of thyroxine in the liver.

4-Hydroxy-2,2',3,4',5,5',6-heptachlorobiphenyl (4-OH-CB187) was selected as a major hydroxylated polychlorinated biphenyl metabolite detected from serum of wildlife and humans and was examined for its effect on level of serum thyroid hormone in mice. Four days after treatment of C57BL/6 and DBA/2 mice with 4-OH-CB187 (1.0 mg/kg), the serum total thyroxine (T(4)) and free T(4) levels were decreased in both strains of mice. On the other hand, no significant changes in the level and activity of the T(4)-UDP-glucuronosyltransferases, including UGT1a and UGT1a1, by the 4-OH-CB187 treatment were observed in either strain of mice. No 4-OH-CB187-mediated change in level of serum thyroid-stimulating hormone was observed in either strain of mice. Binding levels of [(125)I]T(4) to serum proteins after administration of [(125)I]T(4) were significantly changed in 4-OH-CB187-pretreated mice: a decrease in the level of serum [(125)I]T(4)-transthyretin (TTR) complex and an increase in the binding level of [(125)I]T(4) to serum albumin and thyroxine binding protein in both strains of mice. Clearance from serum of T(4) was promoted by 4-OH-CB187 pretreatment in both C57BL/6 and DBA/2 mice, and the levels of T(4) in several tissues, especially the liver, were increased. In addition, 4-OH-CB187-mediated decreases in serum total T(4) and free T(4) levels were observed in wild-type and TTR-heterozygous mice but not in TTR-deficient mice. The present findings show that 4-OH-CB187 shows a definite ability to decrease serum T(4) level and further indicate that the 4-OH-CB187-induced decrease would occur through increase in accumulation of T(4) in the liver.

Hiperprolactinemia: possivel emprego do piribedil (ET-495) no diagnóstico diferencial em relaçäo a prolactinas / Hyperprolactinemia: possible use of piribedyl (ET-495) in the differential diagnosis related to prolactins

O diagnóstico sindrômico das hiperprolactinemias em si näo traz tantas dificuldades. A principal dificuldade consiste em discriminar as de origem tumoral e as de origem funcional em indivíduos com sela túrcica radiologicamente normal após ter afastado nestes, o uso de drogas que aumentam a secreçäo de PRL. Atualmente, várias substâncias vem sendo utilizadas nestes tipos de pacientes no sentido de detectar indiretamente um possível microadenoma através da sua atuaçäo farmacodinâmica sobre as células prolactínicas da hipófise. O piribedil (ET 495), um potente agente dopaminérgico foi testado em 30 indivíduos divididos em três grupos: normal, hiperprolactinemia puerperal e hiperprolactinemia tumoral. Foi entäo evidenciado queda de PRL superior a 50% em relaçäo aos valores iniciais em dois primeiros grupos. Já em grupo tumoral este índice foi inferior a 50%, além de observar um comportamento irregular de prolactinemia durante o teste. Sugere o autor que a substância poderia faze parte como um elemento no diagnóstico diferencial das hiperprolactinemias tumora e funcional, mencionando também a possibilidade de utilizaçäo do piribedil no tratamento de algumas hiperprolactinemias sensíveis as substâncias dopaminérgicas tendo em vista a sua prolongada açäo, poucos efeitos colaterais e baixo custo