The effect of implantation of polyvinilidine spinal plates was studied when placed on spinous processes of 11 mixed breed dogs and when placed within the thoracolumbar musculature of 12 male white rats. Specimens were also obtained from soft tissues adjacent to polyvinilidine plates 2 to 3 months after clinical surgery to repair spinal subluxations in three dogs. A similar pattern of dense, organized fibrous tissue interspersed with focal congregations of lymphocytes, plasma cells, and multinucleated giant cells was observed in the dog experiment, rat experiment, and in all clinical cases.
View Article and Find Full Text PDFA kinin-directed monoclonal antibody to kininogens has been developed by the fusion of murine myeloma cells with mouse splenocytes immunized with bradykinin-conjugated hemocyanin. The hybrid cells were screened by an enzyme-linked immunosorbent assay (ELISA) and a radioimmunoassay (RIA) for the secretion of antibodies to bradykinin. Ascitic fluids were produced and purified by a bradykinin-agarose affinity column.
View Article and Find Full Text PDFThe argon laser was used to treat 220 patients with port-wine stains with moderate efficacy and few complications although perfect cosmetic results were rarely achieved. Primary failure of the argon laser to produce permanent blanching graded good or excellent was the most important factor limiting the final cosmetic results whilst severe scarring was rare (less than 2%). In order to improve the efficacy of this treatment, a randomized controlled study of different parameters of laser treatment was undertaken in test patches of port-wine stains in 50 patients.
View Article and Find Full Text PDFAnecdotal comments in the literature suggest that spinous fracture many weeks after application of polyvinilidine plates to the dorsal spinous processes of dogs may be due to associated adverse vascular changes. This study was undertaken to evaluate that hypothesis. Large size Lubra plates were cut to the appropriate length and applied to the dorsal spines of vertebrae L3 and L4.
View Article and Find Full Text PDFPalliative treatment of malignant dysphagia aims to optimise swallowing for the maximum time possible with the minimum of general distress to these seriously ill patients. Thirty four patients considered unsuitable for surgery because of advanced malignancy, other major pathology or in whom previous surgery had been unsuccessful were treated endoscopically with the Nd YAG laser. Significant improvement was achieved in 29 (85%).
View Article and Find Full Text PDFWe have detected tissue kallikrein and kallikrein mRNA in various brain regions with a kallikrein direct RIA and with nucleic acid hybridization using a kallikrein cDNA probe. In the direct RIA, rat urinary kallikrein-like activity was found in the pituitary and pineal glands, hypothalamus, cerebral cortex, cerebellum, and brain stem. Pituitary and pineal gland kallikrein concentrations were significantly higher than those in other regions.
View Article and Find Full Text PDFThis article reviews the pathophysiology and management of bleeding peptic ulcer. Ulcers bleed when and because they erode into a blood vessel, and bleed massively when they erode into a medium- or large-sized artery. Focal pathology at the bleeding point (such as arteritis, aneurysmal dilatation or recanalized thrombus) contributes to the timing and clinical pattern of ulcer bleeding.
View Article and Find Full Text PDFSeventeen patients with cancers of the rectum or distal sigmoid and considered inoperable because of old age, severe concomitant disease or advanced stage of malignancy, were treated endoscopically with the Nd YAG laser. Symptoms included rectal bleeding, obstruction, diarrhoea and incontinence. Significant improvement was achieved in 15 (88 per cent) and there were no complications.
View Article and Find Full Text PDFThe efficacy of Nd-YAG laser photocoagulation in the endoscopic control of haemorrhage from peptic ulcers was shown in a controlled trial. 527 patients admitted consecutively with acute upper gastrointestinal haemorrhage underwent urgent endoscopy. Peptic ulcers were seen in 260.
View Article and Find Full Text PDFAn unselected consecutive series of 826 patients admitted for acute upper gastrointestinal bleeding underwent urgent endoscopy. Peptic ulcers were found in 402 (49%). Of the 329 ulcer craters that could be fully examined, visible vessels were identified in 156 (47%), other stigmata of recent hemorrhage in 66, and no stigmata of recent hemorrhage in 107.
View Article and Find Full Text PDFUlcers with stigmata of recent hemorrhage (SRH) but without evidence of active bleeding (Forrest 11 bleeding) are a common endoscopic finding in patients with upper gastrointestinal bleeding. This study considers the problem of identifying patients in this group at risk of further bleeding and death. The high incidence of rebleeding in patients with visible vessel and the low incidence in patients with other SRH or no SRH suggest that endoscopic therapy in the absence of active bleeding is best limited to patients with visible vessels in ulcers that have recently bled.
View Article and Find Full Text PDFVascular anomalies of the gastrointestinal tract are an important source of both acute and chronic blood loss. They present difficult management problems as they are often multiple, involving more than one part of the gastrointestinal tract, and may give rise to bleeds of increasing frequency and severity over a period of many years. We present the results of endoscopic argon and Nd YAG laser treatment of 18 patients with documented recurrent, severe haemorrhage from vascular lesions of the upper gastrointestinal tract with follow up of up to five years.
View Article and Find Full Text PDFSeveral inexpensive endoscopic methods of electrocoagulation have been advocated for treatment of gastrointestinal haemorrhage. We compared four types of electrode: dry monopolar - Cameron Miller (M), liquid monopolar - Storz (L), bipolar - Bicap ACMI (B), and heater probe - Seattle (H). The electrical and thermal properties of these probes were studied using computerised monitoring of energy deposition and their efficacy and safety was tested in a randomised study in 140 experimental canine gastric ulcers.
View Article and Find Full Text PDFPalliative treatment of upper gastrointestinal tract obstruction was undertaken by endoscopic laser therapy in 6 patients with carcinoma of the oesophagus or stomach. All had dysphagia for solids on admission and were considered unsuitable for surgery or radiotherapy. Three were in sites unsuitable for placement of an endoscopic prosthesis.
View Article and Find Full Text PDFThe drawbacks of monopolar electrocoagulation in the control of gastrointestinal bleeding include tissue adherence, unpredictable energy deposition, and a high incidence of tissue damage. Introduction of a conductive interfacial film of liquid between the monopolar electrode and the bleeding point during electrocoagulation may overcome these drawbacks. A prospective, controlled study was undertaken to evaluate the efficacy and safety of a monopolar electrode in liquid and dry modes when used to coagulate experimental canine bleeding ulcers.
View Article and Find Full Text PDFThere has been growing confidence in the ability of therapeutic endoscopy to control bleeding from the upper gastrointestinal tract. This chapter attempts to review the recently published data on this topic, concentrating on sclerotherapy for variceal bleeding, laser photocoagulation and electrocoagulation for bleeding peptic ulcers, with particular emphasis on the results of published controlled trials which are essential for demonstration of clinical benefit.
View Article and Find Full Text PDFTissue changes produced in the dog stomach by exposure to a Nd YAG laser varied from mild mucosal oedema to cell vaporisation. Intermediate degrees of damage caused a marked inflammatory response leading to extensive fibrosis in the submucosa and muscularis propria. The true extent of tissue damage was not apparent immediately, and treated mucosa that initially appeared intact sometimes sloughed several days later to leave an ulcer.
View Article and Find Full Text PDF1 The ability of a series of 17 isatogen derivatives to relax smooth muscle, inhibit adenosine 5'-diphosphate (ADP)-stimulated respiration in isolated mitochondria and to antagonize the inhibitory effects of adenosine 5'-triphosphate (ATP) on smooth muscle was measured. 2 Substitution in the 4- and 7-positions of the A-ring gave compounds that were strong inhibitors of mitochondrial ATP synthesis and potent, non-specific smooth muscle relaxants. The compounds also possessed ATP-receptor blocking activity.
View Article and Find Full Text PDFLaser treatment in carcinoma of the bronchus is essentially palliative and is suitable for only a few patients. Patients selected for laser treatment must have predominantly endobronchial growth with normal bronchial anatomy still identifiable and symptoms due to the obstruction or to haemoptysis. A total of 34 patients with carcinoma of the bronchus were treated with argon gas or neodynium yttrium aluminium garnet crystal lasers.
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