Consenso latinoamericano sobre la importancia de un sistema de gestión de datos microbiológicos para apoyar el programa de optimización de uso de antimicrobianos (PROA): Recomendaciones basadas en la evidencia. Parte 1 / Latin American consensus on the importance of a microbiological data management system to support antimicrobial use optimization program (PROA): Evidence-based recommendations. Part 1

La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en el cual el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In Part I, recommendations on the use of a computerized microbiological data management system in clinical practice, data and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In Part II, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Antimicrobial stewardship: Attitudes, perceptions, and practices of healthcare workers in a pediatric tertiary hospital

Objectives@#This study aims to determine the healthcare workers’ (HCWs) attitudes, perceptions, and practices regarding Antimicrobial Stewardship (AMS) at the Philippine Children's Medical Center (PCMC).@*Materials and Methods@#This cross-sectional study employed a validated online survey. @*Results@#The study included 288 healthcare workers, predominantly female (77.35% ) and aged 31-40 years (47.74%), with physicians being the largest professional group (57.14%). HCWs had positive attitudes toward AMS. They perceived moderate to high antimicrobial resistance (AMR) levels in different contexts but believed the hospital had lower AMR levels than the country. HCWs agreed that AMR impacts antimicrobial choices, patient outcomes, and safety. Contributors to AMR were prescribing inappropriate antimicrobials, unnecessary prescriptions, poor patient adherence, and inadequate infection control measures. HCWs, except medical technologists, were aware of the Antimicrobial Stewardship Program (ASP) and its interventions. Only nurses and pharmacists were aware of the hospital policies against AMR. Barriers to AMS implementation include inadequate training in antimicrobial use, lack of infectious disease/ microbiology services, lack of electronic medication management services, and personnel shortages. HCWs had high self-reported AMS practices, but a practice gap in single-dose surgical antibiotic prophylaxis was identified, with low physician adherence (50.6%).@*Conclusion@#This study revealed positive attitudes and high self-reported AMS practices among HCWs. They also perceived moderate to high AMR in different contexts but believed that the hospital has lower AMR levels than the country. Addressing the identified barriers to implementation and practice gaps is crucial for achieving antimicrobial stewardship goals.

Establishing Climatic Change on Rainfall Trend, Variation and Change Point Pattern in Benin City, Nigeria

This study examined the effect of changing climate for thirty-six years (1982-2017) on 24-hourly annual maximum time series (AMS) rainfall data for Benin City. The results show the existence of a trend, variation in magnitude, and change point dates. Trend analysis was performed using Mann-Kendall (MK) test and Sen’s slope estimator (SSE) applied to obtain the trend magnitude. A statistically significant trend was found for Benin City at a 5% level of significance. The MK |Z| statistic varied from 2.0710 to 2.1550 for IMD and 2.0844 to 2.0995 for MCIMD downscaling models, which were both greater than the critical Z-value of 1.96. The SSE gave the magnitude of the trend variation rate due to climate change at 24-hour duration as 1.008 mm/year (10.08 mm/decade) and 1.1376 mm/year (11.376 mm/decade) for the IMD and MCIMD models, respectively. Also, the trend change point analysis was conducted using the distribution-free cumulative sum test (CUSUM) and the sequential Mann-Kendall test (SQMK) which has rainfall pattern definite change point date for Benin City as 2005 from where continued a positive trend which intensified through the year 2015. Thus, proving the existence of increasing changing climatic condition for the study area.

Mountaineering And Altitude Sickness: A Study of AMS Prevalence among Climbers of Mount Kinabalu, Malaysia

@#Introduction: Adventure tourism has become one of Malaysia’s most attractive tourism demands, and mountain climbing is rapidly becoming a popular recreational sport. Exploring mountain adventures offers a dynamic experience, preserving this fascinating activity, yet the climbers are exposed to the risk of altitude sickness, such as Acute Mountain Sickness (AMS). This study aimed to evaluate the prevalence of AMS and investigate the effects of high-altitude sickness on the climber profile associated with climbing at Mount Kinabalu, Malaysia. Methods:. The Lake Louise acute mountain sickness LLS score questionnaire collected 95 climber’s data at four different altitudes. SPO2 and Pulse rate was (PR) measured using a finger pulse oximeter. In a cohort study, AMS was measured on day one at 1866m (1st station), 3622m (2nd station), and day two at 3810m (3rd station), and 4095m (4th station). Results: At the altitude of 1866 (Timpohon Gate), the prevalence of AMS was 0%, 30% at 3622m (Laban Rata), 34.7% at 3810m (Sayat-Sayat), and 37.9% at 4095m (Low’s Peak). The overall prevalence of AMS was 37.9% and the majority of AMS cases were moderate in severity and the LLS score is significant with Pulse Rate and peripheral capillary oxygen saturation (SPO2). Conclusion: Concisely, this finding has triggered a need for consideration from multi agencies to enhance mountaineering guidance, especially for beginners or inexperienced hikers, for a suitable package for climbing attempts to reduce the incidence of AMS among Mount Kinabalu climbers.

Extracellular vesicle activities regulating macrophage- and tissue-mediated injury and repair responses

Macrophages are typically identified as classically activated (M1) macrophages and alternatively activated (M2) macrophages, which respectively exhibit pro- and anti-inflammatory phenotypes, and the balance between these two subtypes plays a critical role in the regulation of tissue inflammation, injury, and repair processes. Recent studies indicate that tissue cells and macrophages interact

Copro-prevalence of Fasciola hepatica in Chilean breed horses in the province of Concepción, Chile / Copro-prevalência de Fasciola hepatica em equinos de raça chilena na província de Concepción, Chile

Abstract The aim of this research was to assess the copro-prevalence of Fasciola hepatica in owned Chilean breed horses (Equus caballus) residing in the province of Concepción, Chile. The study was carried out throughout October 2017. Samples were taken from all (100%) Chilean breed horse (124 specimens; 45 females and 79 males, aged between 7 months and 24 years old) from the Concepción province. A rectal stool sample was obtained from each animal. This was analyzed using the Army Medical School method (AMS III) technique to detect F. hepatica eggs. Information about the horse's age, sex, previous fasciolicide application, and an assessment of body condition was also obtained. Fisher tests were carried out to analyze the results. Ten horses (8.06%) were positive for the presence of F. hepatica eggs. No significant difference of copro-prevalence was found between age (young 8.47%, old 7.69%), sex (female 11.1%, male 6.33%), the previous application of fasciolicide (dewormed 10%, not dewormed 7.89%), or body condition (low condition 11.1%, high condition 0.7%) categories (Fisher tests: P>0.05 in all cases). The results of this study suggest that Chilean breed horses constitute part of the reservoir of F. hepatica for both ruminant populations and humans in the Concepción province.

Resumo O objetivo desta pesquisa foi avaliar a coproprevalência de Fasciola hepatica em equinos chilenos (Equus caballus), residentes na província de Concepción, região de Bío-Bío, Chile. O estudo foi realizado durante o mês de outubro de 2017. Foram coletadas amostras de todos os equinos estabulados (124 espécimes; 45 fêmeas e 79 machos, com idades entre 7 meses e 24 anos) da província de Concepción. Uma amostra de fezes transretal foi obtida de cada animal, analisada no Laboratório "Dr. Luis Rubilar", da Universidad de Concepción, usando-se a técnica AMS III, para detectar a presença de ovos de F. hepatica. O diagnóstico fecal foi complementado com informações sobre a idade do animal, sexo, aplicação prévia de fasciolicida e uma avaliação da condição corporal. Testes de Fisher foram realizados para analisar os resultados. Dos 124 equinos, 10 (8,06%) foram positivos para ovos de F. hepatica. Não foi encontrada associação significativa entre idade, sexo, aplicação prévia de fasciolicida ou condição corporal com a presença de ovos. Um cavalo tratado com triclabendazol foi positivo para ovos de F. hepatica.

Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study / 대한배뇨장애요실금학회지

PURPOSE: The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter. METHODS: A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project. RESULTS: Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4–5.5 cm). CONCLUSIONS: Apart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5–5.5 cm.

Study on the Effect of Porcine Placental Extract Ingestion on Symptoms of Late-onset Hypogonadism Syndrome in Middle-aged and Elderly Men / 日本補完代替医療学会誌

Purpose: An open-label, single-arm study was conducted to evaluate the effectiveness of porcine placental extract (PPE) ingestion to improve late-onset hypogonadism (LOH) syndrome symptoms. In addition, we reported the safety of continuous PPE ingestion in biochemistry tests.Materials and Methods: Test food containing PPE was given daily to healthy male subjects with an Aging Males’ Symptoms (AMS) score of ≥27, who were assessed as having LOH syndrome. AMS score, blood hormone level, and other parameters were measured before the start of PPE ingestion, Week 4, and Week 8. And adverse events that occurred during the ingestion period were accumulated.Results: Excluding one subject who withdrew from the study due to an adverse event unrelated to the test food, 14 subjects were included in the analysis. In terms of AMS score, no improvement was observed at Week 4, whereas a significant improvement was observed at Week 8. AMS scores were further categorized into three subscales (psychological, somatic, and sexual) and analyzed. The results showed a significant improvement from baseline in somatic scores at Week 8. Meanwhile, no significant change in sexual hormone levels was observed. At Week 8, improvements from baseline were observed in renal function and LDL cholesterol level. There were no adverse events related to the test food.Conclusion: The study demonstrated that 8-week PPE ingestion in middle-aged and elderly men can improve LOH syndrome symptoms while having little effect on sexual hormone secretion.

Occurrence of high altitude cerebral edema (hace) and high altitude pulmonary edema (HAPO) simultaneously at 12000 ft: a rare phenomen

High altitude cerebral edema (HACE) and High altitude pulmonary edema (HAPO) are the most dreaded complications related to high altitude. Authors managed a case of HACE and HAPO simultaneously set at unusually low height (1200 ft) in a patient. The altitude was not too much to develop these comorbidities as studied earlier. Relationship with altitude was immaterial in our case. However, rapid ascent without proper acclimatisation, young and tender age, male sex and smoking were associated contributing factors. He was managed with standard protocol and descent to lower altitude.

Predictive Factors In Successful Completion Of Laparoscopic Cholecystectomy In Acute Cholecystitis.

Background: Laparoscopic Cholecystectomy in acute Cholecystitis is the established treatment of choice for the management of acute Cholecystitis. The conversion rate and morbidity is higher in Laparoscopic Cholecystectomy done in acute Cholecystitis. Aims and Objectives: To identify certain preoperative criteria for the selection of patients in acute Cholecystitis that can undergo laparoscopic Cholecystectomy, so that there is decrease in the conversion rate to open procedure and decrease in the complications. Methods: A Prospective interventional study was conducted in the Department of General Surgery, Moolchand Medcity, New Delhi, on 50 patients with acute Cholecystitis from September 2009 to September 2010. Data was analyzed using standard statistical software SPSS. Chi-square test was used for statistical analysis of qualitative data. Results: There were 4 males and 46 female patients with a mean age of 37. 74 years (range 18 to 65 years). There was no significant variation in intraoperative severity (IOS) pattern of acute Cholecystitis across the various age groups (p=0. 532). Males had significantly higher IOS grades of acute Cholecystitis as (p=0. 000). Among patients with varying IOS of acute Cholecystitis, there was significant difference in mean values of duration of symptoms before surgery (p=0.006), TLC at admission (adm.) (p=0.037) and at 24 hours of adm. (p=0.016) and serum AMS at adm. (p=0.005). The difference in mean serum ALP at adm. (p=0. 0171), at 24 hours of adm. (p=0. 137) and at 48 hours of adm. (p=0. 151), and mean values of TLC (p=0. 052) at 48 hours of adm. were insignificant across the various IOS grades of acute cholecystitis. There was no significant variation in histopathological severity (HPS) pattern of acute cholecystitis across the various age groups (p=0.826). Males had significantly higher HPS grades of acute Cholecystitis compared to females (p=0.042). Among patients with varying HPS of acute cholecystitis, there was no significant difference in mean duration of symptoms before surgery (p=0. 065). The difference in mean values of TLC at adm. (p=0.001), at 24 hours of adm. (p=0.001) and 48 hours of adm. (p=0.003); serum ALP at adm. (p=0.001), at 24 hours of adm.(p=0.001) and at 48 hours of adm.(p=0.022) was very significant across the various HPS grades of acute cholecystitis. The IOS (p=0.035) and HPS (p=0.032) of acute cholecystitis was significantly less with successful early lap Chole than with failed procedure. There was no significant difference in success versus failure rates of early Lap Chole across the age distribution of the patients (p=0. 153); mean values of duration of symptoms before surgery (p=0.971); TLC at adm. (p=0.422), at 24 hours of adm. (p=0.990) and at 48 hours of adm. (p=0. 478); serum ALP at adm. (p=0.113), at 24 hours of adm. (p=0.135) and at 48 hours of adm.(p= 0. 238). Male patients had significantly higher failure rate of early Lap Chole (p=0.022). Patients with failed early Lap Chole had a significantly longer mean duration of surgery (p=0. 032) and postoperative hospital stay (p=0.028) than those undergoing a successful procedure. Conclusion: Acute Cholecystitis is much more common in females. Severity of inflammation (intraoperative/ histopathological) in acute Cholecystitis is associated with higher failure/conversion rate of early laparoscopic Cholecystectomy because of dense pericholecystic adhesions, and has longer duration of surgery and postoperative hospital stay. This has a positive relation with male sex and TLC(IOS and TLC at 48 hrs of adm. , however had insignificant relation in our study ), while as no relation with age (at least up to 65 years) and mean duration of symptoms before surgery (if surgery is done within 1.5-4 days of onset of symptoms).

Study on myocardium and brain damage in rats by simulating high altitude / 药学实践杂志

Objective To investigate the effect of hypoxia with cold on the heart and brain damage in rats by simulating 6 000 m high altitude at different exposure time,established a rat model of acute mountain sickness for the related mechanism studies.Methods 32 healthy male Wistar rats were randomly divided into normal control group,hypoxia with cold 1 d,3 d and 5 d group,8 rats in each group.The normal control group was kept in the plain environment(1 500 m)without any treat-ment.The other three groups were placed in large hypobaric hypoxia chamber to simulate 6 000 m altitude with different ex-posed times.HE staining was used to observe the pathological changes of heart and brain tissue.The changes of biochemical indexes were measured to evaluate the damage of heart and brain tissue at different hypoxia times.Results HE staining showed that hypoxia with cold induced rat heart and brain damage with different degrees.The myocardial tissue damage was in-creased with exposure time.The most serious brain damage happened in day 3.Compared with the normal control group,the content of MDA and LD in the myocardial tissue of hypoxia rats were significantly increased(P<0.05 or P<0.01)with pro-longed time,while the contents of GSH,T-SOD and the activity of Na+K+-ATPase were reduced(P<0.05 or P<0.01). The content of MDA in brain tissue was significantly increased at day 1 and day 3(P<0.05 or P<0.01).LD content was sig-nificantly increased(P<0.05)with time.The content of GSH,the activity of T-SOD and Na+K+-ATPase were significantly reduced in day 3(P<0.05).Conclusion Simulating an altitude of 6 000 m caused obvious damage on the heart and brain tis-sues of rats.The degree of damage was related to the exposure time to hypoxia with cold.The decrease of body′s antioxidant capacity,the increase of free radicals and energy metabolism disorders are important factors leading to heart and brain injury.

Research progress on prevention and treatment of acute mountain sickness / 药学实践杂志

Acute mountain sickness (AMS ) is a self-limiting medical condition characterized by headache ,nausea ,fa-tigue ,dizziness ,and insomnia .AMS usually occurs after rapid ascent to high altitudes in non-altitude acclimatized individuals . Extensive studies have been done on AMS ,but knowledge on the mechanism ,prevention and treatment are still limited .It will help the prevention and treatment of AMS with deep understanding of its risk factors and mechanisms .In this article ,we sys-tematically reviewed the diagnosis ,risk factors ,developing mechanisms ,preventions and treatments of AMS .

Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures / 亚洲男科学杂志(英文版)

Implantation of an inflatable penile prosthesis (IPP) is a well-established definitive solution for erectile dysfunction when conservative treatments fail. Penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness (P50 and P100) and International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation (median age 61 years) and completed 6 months follow-up, 36 (80%) completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months (P = 0.033). P100 was also significantly increased at 6 and 12 months, with a mean 10% increase (1.3 ± 0.4 cm) from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain (P = 0.0001) and for overall satisfaction (P = 0.002); however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation.

Evaluation of Scatter Reduction Effect of the Aft-Multiple-Slit (AMS) System Using MC Simulation / 대한방사선종양학회지

PURPOSE: We designed the aft-multiple-slit (AMS) system to reduce scatter in cone-beam computed tomography (CBCT). As a preliminary study, we performed a Monte Carlo N-Particle Transport Code (MCNP) simulation to verify the effectiveness of this system. MATERIALS AND METHODS: The MCNPX code was used to build the AMS geometry. An AMS is an equi-angled arc to consider beam divergence. The scatter-reduced projection images were compared with the primary images only and the primary plus scatter radiation images with and without AMS to evaluate the effectiveness of scatter reduction. To obtain the full 2 dimensional (2D) projection image, the whole AMS system was moved to obtain closed septa of the AMS after the first image acquisition. RESULTS: The primary radiation with and without AMS is identical to all the slit widths, but the profiles of the primary plus scattered radiation varied according to the slit widths in the 2D projection image. The average scatter reduction factors were 29%, 15%, 9%, and 8% when the slit widths were 5 mm, 10 mm, 15 mm, and 20 mm, respectively. CONCLUSION: We have evaluated the scatter reduction effect of the AMS in CBCT imaging using the Monte Carlo (MC) simulations. A preliminary study based on the MCNP simulations showed a mount of scatter reduction with the proposed system.

The Efficacy of Transdermal Testosterone(Testogel(R)) in Late Onset Hypogonadism Patients: Changes in Serum Testosterone Level and Symptom Scores Based on Aging Males' Symptoms Scale / 대한남성과학회지

PURPOSE: This study was done to assess the effects of Transdermal testosterone gel(Testogel(R)) in late onset hypogonadism (LOH) patients and the correlation of AMS(aging males' symptoms) scale with serum testosterone concentration. MATERIALS AND METHODS: We reviewed 73 medical records of LOH patients with low serum testosterone level (<3.5 ng/ml) who had been prescribed 1% Testogel(R) 5 g for over 3 months. The changes in serum testosterone level and AMS scores after application of Testogel(R) were statistically analyzed. RESULTS: Mean age and duration of therapy were 56.0+/-11.1 years and 195.4+/-102.9 days, respectively. Compared to before treatment, Testogel(R) significantly increased the level of serum total testosterone, free testosterone, and bioavailable testosterone at 3, 6, and 9 months after treatment, and there were no significant differences in each of these parameters at the 3 time points. Testogel(R) also significantly improved AMS scores related to sexual dysfunction, somatic function, and psychological function at 3, 6, and 9 months. Among various parameters, serum total testosterone level was highly correlated with the AMS score (r=0.422, p<0.01). The more severe the complaints were before treatment, the greater the relative improvement. There were no severe systemic adverse reactions in any patients. CONCLUSIONS: Testogel(R) effectively elevated serum testosterone level and improved AMS scores. The improvement of AMS score was correlated with serum total testosterone concentration. Treatment was more effective in patients with more severe symptoms. Large prospective studies are needed to identify the long-term effects of Testogel(R) in LOH patients.

Detection of Donor Specific Anti-HLA Antibodies Using Antibody Monitoring System / 대한이식학회지

PURPOSE: The antibody monitoring system (AMS, GTI Inc.) is a solid phase ELISA crossmatch test for the detection of IgG antibody to the donor-specific solubilized HLA class I and class II antigens. The objective of this study was to compare the results of AMS assay with donor specific anti-HLA IgG antibodies (DS-HLA Abs), as determined by ELISA-PRA and flowcytometric crossmatch test (FCXM). METHODS: A total of 132 sera were tested for the presence of DS-HLA Abs by ELISA-EIA, FCXM and AMS assay. RESULTS: DS-HLA Abs were determined in 41 serum samples by an ELISA-PRA panel and FCXM. There was a significant degree of concordance (84.8%) between the results from the FCXM and AMS (P<0.001). The sensitivity, specificity, the positive predictive value and the negative predictive value of AMS assay to detect DS-HLA Abs was 90.2%, 93.4%, 86.0%, 95.5%, respectively. The AMS is a simple, objective test and it has several advantages over the cell-based crossmatch test such as elimination of non-HLA antibody reactivity, elimination of the non-donor specific antibody reactivity, no need for viable cells, and the donor's HLA antigens can be prepared in advance. CONCLUSION: This study suggests that AMS may be useful as a supportive crossmatch test or as a monitoring test after transplantation for detecting class I and/or class II DS-HLA Abs.

The role of TNF-? in the establishment and development of model of pancreatic cancer / 中国普通外科杂志

Objective To establish a model of pancreatic cancer(PC)in SD rats,and to study the changs of serum levels of AMS and TNF-? and the significances.Methods Dimethylbenzanthracene(DMBA)was directly implanted into pancreatic parenchyma of SD rats(experimental group,group A),and in the process of establishing PC,weekly TSA by 1P was done in intervention group(group B).The tumor development of rats executed within 3～5 months in Group A and Group B were observed by HE staining and gross examination.Meanwhile,the rats in the sham operation group(Group C)were executed at 5 months.The levels of serum AMS were detected by autobiochemical assay apparatus,and the levels of serurn TNF-? were determined by ELISA.Results(1)The incidence of pancreatic cancer in Group A within 3～5 months was 48.7%(18/37),including 17 cases of pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in Group B was 33.3%(12/36),including 11 pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The maximal diameter of tumor mass in Group A was higher than that in Group B((P

The distribution and degradation of albumin microspheres injected into jugular external artery / 实用口腔医学杂志

Objective: To evaluate the distribution and degradatio n of albumin microspheres (AMS) with average diameter of 56.3 ?m injected into jugular external artery.Methods: 125 I labeled AMS we re injected into rabbit's jugular external artery. The radioactive amount of loc al tissue and internal organs was measured. 760 ml/L urografin angiography was e mployed to observe the re opening of embolized vessels after AMS infusion of e xternal jugular artery in 5 dogs. Results: The AMS was mai nly concentrated in the target area (92.23%) after injection. The micro artery was obviously embolized by AMS and re opened in 7～9 days. Conclusio n : The AMS can be used as the drug bearer with delayed releasing eff ection.

Mechanical reliability of AMS hydraulic penile prostheses

The mechanical reliability of AMS hydraulic penile prostheses implanted in 203 patients from April 1985 to June 1995 were evaluated. AMS Hydroflex prosthesis showed the highest incidence of mechanical failure (18.8%; 6/32 patients) during a mean follow-up period of 94.5 (64-117) months. Mean functioning time of the prostheses until malfunction was 50 (0-100) months. Bilateral fractures at junction of rear reservior and inflation chamber were found in 3 patients. AMS Dynaflex had a failure rate of 2.4% (2/85 patients) for an average of 35.3 (1-59) months. One patient showed complete fracture of silicone ball covering the proximal end of rear reservior onto which rear tip extenders are snapped. Regarding 3-piece inflatable prosthesis, AMS 700, AMS 700CX and AMS Ultrex had failure rates of 11.1% (1/9 patients), 10.5% (2/19 patients) and 4.0% (1/25 patients) during a mean follow-up period of 116.4 (103-125), 79.0 (60-94) and 44.4 (22-57) months, respectively. The verified causes of the mechanical failures were a tiny rupture of the cylinder in one case of AMS 700, an incomplete fracture of input tube in one case of AMS 700CX and a pump malfunction in one case of Ultrex. However, none of 33 cases of AMS 700CXM showed mechanical failure for an average of 21.3 (2-43) months. Therefore, AMS 700CXM and Ultrex seem to be very reliable, and the reliability of AMS Dynaflex was much higher than that of AMS Hydroflex. However, the long-term reliability of these devices needs more time to be determined.

Ten years of experience with various penile prosthesis in Korean

Currently there are more than 10 types of penile prosthesis available, ranging from the very simple to the very sophisticated. We review our experiences with various penile prosthesis, with particular regard to the complication rate. From Dec. 1983 to Jul. 1993, we implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisplinary diagnostic approaches. The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9.5 mm to 13 mm, mostly 9.5 mm (52.9%). The length of implanted prosthesis were from 10 cm to 20 cm, mostly 16 approximately 18 cm (68.8%). Cases with uneven diameters or lengths were 20 (6.8%). The int aoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In those 4 patients reimplantations were successful. More than 99% (290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size.