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Results of treatment of 397 patients with acute pancreatitis are analyzed. Use of fresh-frozen and cryosupernatant plasma, heparin and protease inhibitors provide more effective elimination of disseminated intravascular blood coagulation syndrome, disorders of microcirculation that permits to improve results of treatment.
Comparative results of roentgenologic and ultrasonic investigation (USI) of distractional regenerate during performance of bifocal substitution of long bone defect in 185 patients with chronic osteomyelitis were analyzed. Predominance of USI on early stages of the regenerate formation were noted. Application of USI in early terms had allowed to reveal opportunely the disorders of the regenerate formation and to eliminate them using correction of the distraction pace or the method, proposed by the author.
Acute hemorrhage is a main cause of reduction of blood oxygen capacity. The main aim of correction of sequels of acute hemorrhage is to maintain effective gas exchange by restoring central circulation and microcirculation, the rate of diuresis, by normalizing water-salt exchange, to eliminate anemia, hypoproteinemia, and acute blood coagulability disorders. The values of oxygen budget with calculated oxygen delivery and consumption and those of hemoglobin and hematocrit which are of great value only after recovery of circulating blood volume are considered to be major indications for hemotransfusion. A relationship is established between the extraction and uptake of oxygen and its delivery. The concept of the critical level of oxygen delivery is considered, ways of correcting oxygen indebtedness are presented. Alternatives to the use of hemotransfusions by employing the solutions of modified hemoglobulin and perfluorocarbon-containing emulsions are under consideration. A possible algorithm of aid rendering in acute hemorrhage is given.
Attachment loss through advanced periodontitis results in tooth mobility, and then loss of teeth. To prevent progression it is needed to eliminate any exciting agent and correct functional disorders in consequence of disease. Regeneration of periodontium is impossible and mastication is difficult because of tooth mobility. Long-term maintenance of mobile teeth is doubtful. We have to prevent the extraction of these teeth to stabilise them by a splint made of material that is inexpensive, reparable, provides sufficient support for the artificial tooth. Fiber-Reinforced Composite (FRC) fulfills the above requirements. In their case-reports the authors demonstrate the practical application of splinting with FRC materials. In these cases the FRC splints are not only periodontal splints but they act as orthodontic retainers or supports for an artificial tooth.
In its more severe form heparin induced thrombocytopenia (HIT) is a rare immune mediated complication of heparin administration that potentially has catastrophic results, and significant mortality. In view of the severity of this condition it is important for the clinician to maintain a high index of suspicion and get alerted to the HIT syndrome by the precocity of platelet count decrease in any patient group, and especially in those previously exposed to heparin. We report on a 72-year-old woman who developed HIT syndrome that was complicated by recurrent arterial thromboses after receiving postoperative antithrombotic prophylaxis with tinzaparin, a low molecular weight heparin. The patient was successfully treated with iloprost (Ilomedin, iloprost tromethamine, Schering) a stable prostacyclin analogue, at the acute phase of the syndrome, followed by long-term treatment with clopidogrel (Plavix, clopidogrel bisulfate, Sanofi) an inhibitor of adenosine diphosphate (ADP) receptor. Although direct thrombin inhibitors have been proven to be effective for the treatment of HIT thrombosis, they do not completely eliminate the morbidity and mortality of this disorder. Our case report suggests that antithrombotic treatment by targeting of the activated platelets with a potent platelet inhibitor during the acute phase of type II HIT syndrome followed by long-term administration of oral anticoagulation may be an additional, safe and effective therapeutic alternative that merits to be systematically studied.
Many studies have made on the physiological significance of the periodontium in relation to oral functions. But, although its importance to oral functions has been pointed out, few investigations have been carried out on the periodontal pressoreceptive information system. To help rectify this situation, as a link in investigations of soft-food textures, the author attempted to determine how a sense of pressure was perceived when loads gradually increasing from very small were applied to the tooth surface. In addition, the author attempted to clarify the way the periodontium discerns differences between initial and secondary loadings in a range of small loads between the touch sensation and the pressure sensation. Subjects were 10 males with sound, natural dentition and no disorders in mandibular functions. In order to eliminate intervention from pressoreceptors in the masticatory muscles and the mandibular joints, the upper first premolar was chosen as the test tooth. Small loads were applied in 2 directions: parallel to the first premolar vertical axis (vertical) and from the lingual to the buccal sides parallel to the occlusal plane (horizontal). For vertical loading, the mesial pit on the occlusal surface was chosen as the loading point. The middle point on the lingual surface was chosen as loading point for horizontal loading. First, loading on the tooth surface was gradually increased to obtain (1) threshold value for touch sensation; that is, minimal load required to incite a touch sensation, and (2) critical value for pressure sensation; that is, minimal load required to incite the pressure sensation subsequent to the touch sensation. Each subject was requested to press a hand switch in the moment he experienced the sensation of being touched and then again when, during increases of load, the touch sensation changed to the pressure sensation. The loading device was built into an electric strain gauge. Loads were increased gradually from 0 g to 60 g, with an increase ratio of about 10 g/sec. Loading wave and switching signal were simultaneously recorded on an oscillograph. Second, in order to determine the ability to discriminate small loads, with the same loading device, initial load was applied to the tooth. This load served as control. As soon as the load was sensed, it was removed. Then the secondary (testing) load was applied. Subjects were requested to say whether the secondary load was larger, smaller than or same as the initial one.(ABSTRACT TRUNCATED AT 400 WORDS)
The effect of common multimodality therapy, histaglobulin course therapy was studied in 55 patients with exacerbation of chronic atrophic gastritis with secretory insufficiency and absolute hypohistaminemia. Histaglobulin enhanced the elimination of the pain syndrome and dyspeptic disorders, reduced the period of treatment in hospital, promoted the disappearance of acute phase changes in gastric mucosa, stimulated secretory and motor stomach function, and normalized histamine metabolism in the body.
In this paper the authors report on two term-birth newborn infants who were exposed to long-term maternal treatment with benzodiazepines. They emphasize the free interval before the onset of respiratory pauses in these newborns, since triazolam is classified as belonging to the class of benzodiazepines with ultra-rapid elimination and especially the severity of these disorders.
Histologically hypersensitivity angiitis produces necrotising inflammation of the small arterial and venous blood vessels. In most cases the inflammatory infiltrate presents leucocytoclasia i.e. nuclear leucocytic detritus. Unlike polyarteritis nodosa, hypersensitivity angiitis does not affect the medium sized arteries though its lesions are produced at the same stage of development. At skin level, the postcapillary venules are the vessels most often affected. Fibrinoid necrosis of the glomerular loops of the kidney may arise and is often accompanied by epithelial crescents. Aetiologically, a variety of agents--bacteria, viruses, drugs, toxic substances--have been held responsible for the disease, though very often the cause cannot be identified. The most widely based on the finding of immunocomplexes, though other immunological disorders might be involved. Treatment involves the elimination of the antigen held responsible, the suppression of the immune response, the removal of circulating immunocomplexes and the use of anti-inflammatory drugs.
In experiments on C57 Bl mice the effects of growth and metastatic proliferation of Lewis lung carcinoma inoculated intramuscularly on metabolism and kinin activity have been studied during the application of pharmacologic agents (parmidin, cellulose sulphate, unithiol). Causing a weak inhibition of the primary tumour growth, parmidin if administered repeatedly in given doses, inhibits partially metastatic process, which is manifested in an essential decrease of the quantity, size and weight of lung metastases. Parmidin also inhibits an adverse effect of cellulose sulphate and unithiol on metastatic process. It is believed that the action of parmidin is of an indirect character and is mainly associated with the elimination of the kinin component of microcirculatory disorders in the lungs.
The overproduction of parathyroid hormone as caused by a simple hyperplasia or an adenoma leads to pathological changes in various organs which are termed primary hyperparathyroidism. The blood phosphates increase in case of long-standing disturbances of the metabolism, e.g. chronic renal insufficiency. In this way and due to other causes, the production of parathyroid hormone is increased. The resultant clinical picture is termed secondary hyperparathyroidism. Both forms are associated with osseous changes also in the maxillofacial skeleton. Tertiary hyperparathyroidism may develop from secondary hyperparathyroidism if the metabolic disorder in the renal form cannot be eliminated by kidney transplantation and if the process in the parathyroid becomes independent (autonomous hyperparathyroidism). Besides these three forms, there are two others, quaternary hyperparathyroidism and quinary hyperparathyroidism, which are described.
Histological examination of the various specimens taken during an exploratory laparotomy for Hodgkin's disease revealed the presence of epithelioid cells in 56 cases out of a total of 235 patients (i.e. 23.8 p. 100). These cells were disseminated throughout the lymphoid tissue or grouped in clumps, in plaques or, more rarely, as true follicles. They were found either in contact with Hodgkin's lesions or at a distance in organs free of disease. They were found in Lukes-Rye histological types 1, 2 and, above all, 3. Their significance remains unknown. The most likely hypotheses would appear to be those of a response to the accumulation of substances to be eliminated (tumour antigens?) or those of a disorder in cellular immunity.
The authors studied the ability of neuroleptics to eliminate the amphetamine-induced (5 mg/kg) disorders of the transformation of the defense response trajectory in rats kept in a U-shaped maze. Haloperidol (0.1 mg/kg) and clozapine (2 mg/kg) similarly normalized the animals' behavior but differently affected the motor automatisms typical for amphetamine stereotypy. Metoclopramide (1 mg/kg) reduced the external manifestations of amphetamint stereotypy but did not abolish the disorders in the defense response. It is likely that the ability of the neuroleptics to produce an antiamphetamine action in experimental defense response with multiple transformation of the responses might characterize specific properties of the drugs belonging to the class under discussion.
The structural and metabolic indicators of the function of the end secretory divisions, intercalary ducts, and salivary tubes of the salivary gland were assayed in white rats aged 20 1/2 months. This age period is characterized by the occurrence of noticeable changes in the reproductive tract and of spontaneous tumors in different organs. Abnormalities of transport processes followed by an insignificant variation in intracellular metabolism indicate that reconstitution of the salivary glands accompanied by profound shifts in endocrine regulation is a secondary process, a consequence of a systemic injury to the microcirculatory bed. Disorders seen in the processes of secretion elimination and reduced activity of lysosomal enzymes are likely to be the triggering mechanism of the occurrence of the delayed phase of storing secretory granules observed during the development of metabolic sialoses.
The main pharmacokinetic and pharmacodynamic features of althesin are described. Though relatively new, this steroid is now widely employed in anaesthesiological practice. From the pharmacological standpoint, the high therapeutic index of althesin, the fact that its metabolic fate is known, its rapid elimination, and the prompt, complete awakening of patients when it is used mean that it can be reliably employed in all forms of surgery and on all types of patient. The absolute contraindications coincide with those preventing the employment of general anaesthesia in any form, while the relative contraindications, i.e. those involving particular care in its administration, are linked to the presence of diseases interfering with its mechanism and elimination, the existence of allergy, or cardiovascular disorders of a fairly substantial nature. Althesin, in fact, while not responsible for frank cardiovascular changes, cannot be regarded as entirely innocuous. In other words, it is subject to the same limitations as the barbituric and non-barbituric drugs commonly employed in the i.v. induction of anaesthesia.
Mechanisms of elimination of pollutants from the lungs are described. Factors which might produce deleterious effects on elimination of pollutants are listed. Changes of mucociliatry clearance and phagocytosis under the influence of general atmospheric pollutants, cigarette smoke, pharmacologic preparations, immunologic system, occupational exposures, and other effects are presented.
Hirschsprung's disease (HD) or congenital aganglionosis usually presents with involvement of the rectosigmoid, except for a small percentage of the ultrashort segment cases in which dysfunction is limited to the area of the anal sphincter. However, the diagnostic criteria for ultrashort segment HD are the subject of some controversy. The reported case illustrates the gross and microscopic anatomy of a documented case of ultrashort segment HD and helps define the proper biopsy technique and confirm previously established criteria for accurate diagnosis. It is suggested that modification of criteria to allow up to a 4-cm segment of aganglionosis for the diagnosis of ultrashort segment HD would eliminate some of the current ambiguity. Functional disorders of the and sphincter should be considered separately.
Preliminary data indicate that the use of a morphometric model, an expert system with standardized questions, and an evaluation of snoring can be effective tools for diagnosing upper-airway sleep-disordered breathing (UASDB) in many cases. This eliminates the need for many sleep recordings.