Advances in the research of HIV-1 envelope glycoprotein gp120 inhibitors / 药学学报

From the process of human immunodeficiency virus-1 (HIV-1) invading cells, the combination of gp120 and CD4 is the first step for HIV-1 to invade cells. Interfering with this process can prevent HIV from recognizing target cells and inhibit virus replication. Therefore, HIV-1 gp120 is an important part of the HIV-1 life cycle. Fostesavir, a phosphatate prodrug derived from the gp120 inhibitor BMS-626529 modified by the prodrug strategy, was approved for the treatment of adult patients with multidrug resistant HIV-1 infection by the US FDA and the European Medicines Agency in 2020 and 2021, respectively. In this review, we focus on the research progress of small molecule inhibitors targeting the interaction of gp120-CD4 from the perspective of medicinal chemistry, in order to provide reference for the subsequent research of gp120 inhibitors.

Evaluation of the effect of melatonin in patients with Burning mouth syndrome: a double-blind, placebo-controlled randomized clinical trial

Abstract The present study was carried out to evaluate the effect of Melatonin and Placebo in the patient with the Burning mouth (BMs). This double-blind, placebo-controlled randomized clinical trial study was carried out on 30 patients who were suffering from BMS. During this period patients were divided into 2 study and control groups. The study group used four 3 mg Melatonin daily and the control group received a placebo. Then the severity of the burning sensation was measured by the physician Sleep quality was measured using the VAS scale using the Petersburg questionnaire. Data in the application Enter SPSS 20 and then using T test or equivalent Nonparametric was analyzed, mean sleep score and mean severity of oral irritation before and after treatment in two the group was evaluated using T-test Independent. Level significance was considered 0.05. The results of the present study show that the use of melatonin and a placebo in patients with BMS reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study severity of burning was 4.93±2.56 after treatment in the study group and 6.93±2.12 in the control group, which was statistically significant (P =0.036). No significant difference was observed between the two groups in the sleep quality score (P-value = 0.43). Using Melatonin can be a reliable way to treat pain for which there is no standard treatment to date. Although evidence suggests an association between sleep disorders and BMS, melatonin was not superior to a placebo in reducing BMS-induced burning in the present study. Identification of stressors and the ways to struggle with them, further studies with larger samples and higher oral doses, extended follow-up periods and control of psychological factors, and measurement of body mass index that may affect pharmacokinetics are recommended.

Fostemsavir, a Drug with Novel Mechanism for the Treatment of HIV-1 Infection

HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.

Antagonism of Protease-Activated Receptor 4 Protects Against Traumatic Brain Injury by Suppressing Neuroinflammation via Inhibition of Tab2/NF-κB Signaling / 神经科学通报·英文版

Traumatic brain injury (TBI) triggers the activation of the endogenous coagulation mechanism, and a large amount of thrombin is released to curb uncontrollable bleeding through thrombin receptors, also known as protease-activated receptors (PARs). However, thrombin is one of the most critical factors in secondary brain injury. Thus, the PARs may be effective targets against hemorrhagic brain injury. Since the PAR1 antagonist has an increased bleeding risk in clinical practice, PAR4 blockade has been suggested as a more promising treatment. Here, we explored the expression pattern of PAR4 in the brain of mice after TBI, and explored the effect and possible mechanism of BMS-986120 (BMS), a novel selective and reversible PAR4 antagonist on secondary brain injury. Treatment with BMS protected against TBI in mice. mRNA-seq analysis, Western blot, and qRT-PCR verification in vitro showed that BMS significantly inhibited thrombin-induced inflammation in astrocytes, and suggested that the Tab2/ERK/NF-κB signaling pathway plays a key role in this process. Our findings provide reliable evidence that blocking PAR4 is a safe and effective intervention for TBI, and suggest that BMS has a potential clinical application in the management of TBI.

Inhibitory effect and apoptosis induction of MST1R inhibitor BMS-777607 on proliferation of breast cancer MCF-7 cells / 吉林大学学报(医学版)

Objective: To investigate the effects of macrophage stimulating 1 receptor (MST1R ) inhibitor BMS-777607 on the proliferation and apoptosis of the breast cancer MCF-7 cells, and to elucidate the mechanisms. Methods: The breast cancer MCF-7 cells treated with different concentrations of BMS777607 were divided into control group (0/xmol • L BMS-777607 group) and 0. 5, 1.0» 2.0, 5. 0, 10.0. 15. 0. and 20.0/xmol • L BMS-777607 groups. MTT method was used to detect the proliferation rates of the MCF-7 cells in various groups, and clone formation assay was used to detect the survival rates of the MCF-7 cells in various groups; EDU imaging and EDU flow cytometry methods were used to detect the proliferation rates of the MCF-7 cells in various groups, and Hoechst33342 staining was used to detect the apoptotic morphology of the MCF-7 cells in various groups; flow cytometry was used to detect the apoptotic rates of the MCF-7 cells in various groups∗ and Western blotting method was used to detect the expression levels of ERK, p-ERK, Akt, p-Akt, PARP, Cleaved PARP, Bax, Caspase-3, Cleaved Caspase-3, Caspase-9 and Cleaved Caspase-9 proteins in the MCF-7 cells in various groups. Results: The MTT results showed that compared with control group, the proliferation rates of the MCF-7 cells in 5 and 10/imol • L BMS-777607 groups were increased (P<0. 05 or P<0.01). The clone formation assay results showed that compared with control group, the survival rates of the MCF-7 cells in 5 and 20/imol • L IiMS-777607 groups were increased (P<0. 05 or P

Mechanism Study on Electroacupuncture in Reconstructing the Neurologic Function in Mice after Spinal Cord Injury / 上海针灸杂志

Objective To observe the effect of electroacupuncture at thoracic Jiaji points (EX-B 2) on the Behavior Measurement Scale (BMS) score, and expressions of nestin and glial fibrillary acidic protein (GFAP) in spinal cord in mice after spinal cord injury, and to explore the action mechanism of electroacupuncture in protecting nerves and recovering motor function.Method Ninety-six female C57BL/6 mice were randomized into a sham operation group, a spinal cord injury group, an electroacupuncture group, and an acupuncture group, 24 mice in each group. Except for the sham operation group, spinal cord injury at T9 level was induced in the other three groups. The electroacupuncture group was intervened by electroacupuncture at Jiaji points (EX-B 2) of T7 and T11, and the acupuncture group received manual acupuncture at the same acupoints. The intervention was conducted 15 min each time, once a day, with 1 d interval every 5 d, for a total of 28 d. The BMS score was evaluated respectively after 3 d, 7 d, 14 d, and 28 d intervention. Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the expression ofnestin in spinal cord, and immunofluorescence and Western blotting were used to detect the expression of GFAP in spinal cord.Result Respectively 14 d and 28 d after spinal cord injury, the main and auxiliary scores of BMS in the acupuncture group were significantly higher than those in the spinal cord injury group (P<0.05); 28 d after spinal cord injury, the main and auxiliary scores of BMS in the acupuncture group were significantly higher than those in the spinal cord injury group (P<0.05) and the auxiliary BMS score in the electroacupuncture group was significantly higher than that in the acupuncture group (P<0.05). Respectively 3 d, 7 d, and 14 d after spinal cord injury, the contents of nestin in the electroacupuncture group were obviously increased and significantly different from those in the spinal cord injury group (P<0.05). The nestin content of the acupuncture group was significantly higher than that of the spinal cord injury group 7 d and 14 d after spinal cord injury (P<0.05). The expression of GFAP in the electro-acupuncture group was significantly higher than that in the spinal cord injury group 3 d and 7 d after spinal cord injury (P<0.05); the inhibitions on the immunoreactivity of GFAP in the electroacupuncture group and acupuncture group were more significant than the inhibition in the spinal cord injury group 28 d after the injury (P<0.05).Conclusion Electroacupuncture at Jiaji points (EX-B 2) can promote the recovery of motor function after spinal cord injury, which is related to the enhancement of the expressions of nestin and GFAP within 7 d after the injury, and the two expressions are in a positive correlation. In the early stage of treatment, electroacupuncture can boost the activity of astrocytes to act as neural stem cells and inhibit the immunoreactivity of GFAP in the later stage to benefit the reconstruction of neurologic function.

P2X3 receptor expression in lingual nerve fibres of patients with burning mouth syndrome / 实用口腔医学杂志

Patients with burning mouth syndrom(BMS,n =12)and patients with wisdom tooth removal(controls,n =9)were included. Immunohistochemistry and image analysis were used to quantify P2X3 receptor expression in lingual nerve fibres.A pain history and score were recorded on a visual analogue scale(VAS)prior to obtaining a lingual biopsy.The value of P2X3 receptor positive fibres in BMS and control subjects was 0.56 ±0.29 and 0.15 ±0.06 respectively(P <0.001).There was no significant correlation between P2X3 and VAS scores(R2 =0.012).Increased P2X3 may play a role in BMS but not correlated with the VAS score.

Pharmacological intervention of HIV-1 maturation

Despite significant advances in antiretroviral therapy, increasing drug resistance and toxicities observed among many of the current approved human immunodeficiency virus (HIV) drugs indicate a need for discovery and development of potent and safe antivirals with a novel mechanism of action. Maturation inhibitors (MIs) represent one such new class of HIV therapies. MIs inhibit a late step in the HIV-1 Gag processing cascade, causing defective core condensation and the release of non-infectious virus particles from infected cells, thus blocking the spread of the infection to new cells. Clinical proof-of-concept for the MIs was established with betulinic acid derived bevirimat, the prototype HIV-1 MI. Despite the discontinuation of its further clinical development in 2010 due to a lack of uniform patient response caused by naturally occurring drug resistance Gag polymorphisms, several second-generation MIs with improved activity against viruses exhibiting Gag polymorphism mediated resistance have been recently discovered and are under clinical evaluation in HIV/AID patients. In this review, current understanding of HIV-1 MIs is described and recent progress made toward elucidating the mechanism of action, target identification and development of second-generation MIs is reviewed.

BMS-345541 regulates repair of DNA double-strand breaks induced by VP-16 in acute myeloid leukemia cells / 中国药理学通报

Aim To investigate the effect of BMS- 345541 on the repair of DNA DSBs induced by VP-16 in AML cells and its possible mechanism. Methods The effects of BMS-345541 on the sensitivity of AML cells to VP-16 were determined by MTT. Flow cytome-try ( FCM) was applied to test the level of DNA dam-age, cell cycle progression and apoptosis in AML cells. High content analysis ( HCA) was used to verify the amount ofγ-H2AX,p-ATM,RAD51 in AML cells. Results BMS-345541 could significantly inhibit the proliferation of AML cells induced by VP-16 . BMS- ＜br> 345541 increased the amount of RAD51 foci and p-ATM foci in AML cells treated with VP-16 after 6 hours , which led to increased numbers of cells in the G2/M phases of the cell cycle,then induced apoptotic cell death. Conclusion BMS-345541 sensitizes AML cells to VP-16 via selective inhibition of homologous recombinational repair of DNA double-strand breaks.

Change in expression of interleukin-17 in C57 mice’s spinal cord injury area / 国际药学研究杂志

Objective: To investigate the mechanism of expression of interlenkin (IL)-17 in C57 mice’s spinal cord clamp area, and to provide new targets for clinical treatment of spinal cord injury (SCI). Methods: Male C57BL/6 mice were randomly divided into three groups. In the spinal cord injury group, mice were made into spinal cord clamp model. In the sham surgery group, the dura was cut without injuring the spinal cord. The IL-17 neutralizing antibody group received IL-17 neutralizing antibody injection through the cadual vein at 1 hour after the spinal cord clamp . Mouse scale for locomotion(BMS) was applied to evaluate the mice’s behavior change of hindlimb in 1-7 days, the real time fluorescent quantitative PCR was used to detect the change in the expression of spinal cord injury district TNF-α mRNA each time, HE staining was conducted to detect the morphological changes of spinal cord injury of the sham surgery group, the spinal cord injury group and the IL-17 neutralizing antibody group at the 7th days. Results: After spinal cord injury, the mice’s BMS score were 9 in the sham surgery group; in the model of spinal cord injury group, the mice’s BMS score were 0 on the 1st day, and 2.9 on the 7th day. In the IL-17 neutralizing antibody group, the mice’s BMS score were 0 on the 1st day, and 3.5 on the 7th day. The expression of IL-17 mRNA in the injury area peaked at the 3rd hour, which showed statistical difference when compared with sham surgery group (P0.05), and the expression of IL-17 mRNA reduced the lowest levels on the 7th day. The 7th day following spinal cord injury, mice’s spinal cord tissue was complete normal in the sham surgery group. In the spinal cord injury group, a large number of mice’s nerve cells were necrotic, a lot of cells formed vacuolated. In the IL-17 neutralizing antibody group, part of mice’s nuclear neurons were shrinking, cells formed vacuolated, but part of cells remained morphologically complete. Conclusion: IL-17 is involved in secondary immune inflammatory process of spinal cord injury, it may be targets for intervention in the treatment of spinal cord injury.

Antidepressant-induced Burning Mouth Syndrome: A Unique Case

Burning Mouth Syndrome (BMS) is defined as a chronic orofacial pain syndrome, without evidence of mucosal lesions and other clinical signs of disease or laboratory abnormalities. Patients with BMS complain of burning pain in the mouth, xerostomia and taste disturbances. It is more common among women and the median age of occurrence is about 60 years. BMS may be primary or secondary to other diseases. The mainstay in the treatment of BMS includes antidepressants, benzodiazepines, and anticonvulsants. A few cases of BMS caused due to medication have been reported. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. This is a case report of a patient on antidepressants who developed symptoms of BMS thereby causing a dilemma in management.

Change in expression of interleukin-17 in C57 mice′s spinal cord injury area / 国际药学研究杂志

Objective To investigate the mechanism of expression of interlenkin (IL)-17 in C57 mice′s spinal cord clamp area,and to provide new targets for clinical treatment of spinal cord injury (SCI). Methods Male C57BL/6 mice were randomly divided into three groups. In the spinal cord injury group,mice were made into spinal cord clamp model. In the sham surgery group, the dura was cut without injuring the spinal cord. The IL-17 neutralizing antibody group received IL-17 neutralizing antibody injection through the cadual vein at 1 hour after the spinal cord clamp . Mouse scale for locomotion (BMS)was applied to evaluate the mice's behavior change of hindlimb in 1-7 days,the real time fluorescent quantitative PCR was used to detect the change in the expression of spinal cord injury district TNF-αmRNA each time,HE staining was conducted to detect the morphological changes of spinal cord injury of the sham surgery group,the spinal cord injury group and the IL-17 neutralizing antibody group at the 7th days. Results After spinal cord injury,the mice's BMS score were 9 in the sham surgery group;in the model of spinal cord injury group,the mice's BMS score were 0 on the 1st day,and 2.9 on the 7th day. In the IL-17 neutralizing antibody group,the mice's BMS score were 0 on the 1st day,and 3.5 on the 7th day. The expression of IL-17 mRNA in the injury area peaked at the 3rd hour,which showed statistical difference when compared with sham surgery group (P0.05),and the expression of IL-17 mRNA reduced the lowest levels on the 7th day. The 7th day following spinal cord injury,mice's spinal cord tissue was complete normal in the sham surgery group. In the spinal cord injury group,a large number of mice's nerve cells were necrotic, a lot of cells formed vacuolated. In the IL-17 neutralizing antibody group, part of mice's nuclear neurons were shrinking, cells formed vacuolated, but part of cells remained morphologically complete. Conclusion IL-17 is involved in secondary immune inflammatory process of spinal cord injury, it may be targets for intervention in the treatment of spinal cord injury.

Changes and curative effect of serum cell cytokine of burning mouth syndrome(BMS) patients before and after medical treatment / 中国基层医药

Objective To discuss changes and curative effect of serum interleukin-2 and 6 and tumor necrosis factor-α (TNF-α) of burning mouth syndrome (BMS) patients before and after medical treatment.Methods 50 cases of BMS patients were selected as case group,and who were given Clonazepam tablets (2mg) and Fluoxetine capsules (20 mg) one time daily for 4 weeks.Observe and compare the changes of serum IL-2 and 6,and TNF-αof patients in two groups before and after 4 weeks' medical treatment,and proceeded with the clinical curative effect observation.Moreover,30 cases of healthy subjects who just took the physical examination in medical examination center(MEC) at that moment was the control group.Results The serum IL-2 and IL-6,and TNF-αlevels of patients in case group before medical treatment was obviously higher than those in control group (t =4.31,2.97,3.84,all P ＜0.01).After 4 weeks' medical treatment,serum IL-2 and IL-6,and TNF-αlevels of patients had obviously declined than before (t =2.88,2.34,3.21,P ＜ 0.05 or P ＜ 0.01).After 4 weeks' medical treatment,there were 6 cured cases,14 cases with significant effect,and 24 cases with curative effect,and the total clinical efficiency reaches 88.0％ (44/50).Conclusion BMS patients have abnormal elevation of serum IL-2 and 6,and TNF-α,which may be the sensitive serological indicators of the early diagnosis of BMS.The changes of serum IL-2 and IL-6,and TNF-α levels may be the index of follow-up curative effect and prognosis observation.

Burning Mouth Syndrome / 대한이비인후과학회지

Burning mouth syndrome (BMS) is defined as a chronic pain condition, characterized symptomatically by a generalized or localized burning sensation in the oral cavity without any specific mucosal lesion. Although this is not a rare disease, the etiology and effective treatment are not well established yet. Various drugs have been used in attempting to manage BMS, but there is insufficient evidence to show the effect of them. The goal of this article is to review about diagnosis, treatment, and updates current knowledge of BMS along with our experiences. Although randomized controlled studies are required to establish the treatment for patients suffering from this chronic and painful syndrome, the authors hope that this document will encourage otolaryngologist to approach to this challenging disease without fear and contribute to a better therapeutic management.

Controversies in the use & implementation of drug-eluting stent technology.

The introduction of drug eluting stents has resulted in dramatic reductions in the rates of restenosis and the need for repeat revascularization. In the last several years, concern has been raised regarding the long-term safety of this technology, particularly in the area of late restenosis and stent thrombosis. The development of newer anti-restenotic drug coatings, biodegradable polymers and even completely bioabsorbable stents offer the potential to address these limitations. Additional questions that have recently come to the forefront include the optimal duration of dual antiplatelet therapy, the use of platelet reactivity assays and genetic testing and drug eluting stent use in the treatment of acute myocardial infarction. This article will attempt to address these and other areas of controversy in the use and implementation of drug eluting stents.

A study to evaluate the clinical outcome of drug-eluting vs. bare-metal stents for acute coronary syndrome patients during commercial use in real setting.

Background: This study compared clinical outcome of Drug Eluting Stents (DES) versus Bare Metal Stents (BMS) in coronary arteries in patients with Acute Coronary Syndromes. Methods: A retrospective, observational study was carried out in an inpatient setting of the private tertiary care hospital. Patients with >18 years, diagnosed for Acute Coronary Syndromes (ACS), required intervention in coronary artery with implantation of Drug Eluting Stents (DES) or Bare Metal Stents (BMS) were recruited in the study. The data had been collected from file or database of the hospital. All subjects were followed for major adverse cardiac event. Results: A total of 202 patients who underwent percutaneous coronary intervention (PCI) were enrolled into DES group (n=101) and BMS group (n=101). All patients were followed up at 1 month, 3 months, 6 months & 12 months for Major Adverse Cardiac Events (MACE). Clinical outcomes during 12 months were compared between DES group & BMS group. Overall MACE rates were reported non-significantly high in BMS group patients (14.85%) compare to DES group patients (8.91%) (p=0.458). However, DES group had lower rates of death (0.99% vs 1.98%, p=0.57), rate of MI (3.96% vs 4.95% p=0.73), rate of revascularization (1.98% vs 3.96% p=0.42) & rate of sub acute thrombosis (1.98% vs 3.96% p=0.42) and higher rate of bleeding (1.98% vs 0.99% p=0.57) compare to cohort-II. Conclusions: The use of DES in the setting of Acute Coronary Syndrome is associated with lower Major Adverse Cardiac Event (MACE) rate compared to BMS without compromising the overall safety over the course of one-year follow-up. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials.

Effective connectivity between superior temporal gyrus and Heschl’s gyrus during white noise listening: linear versus non-linear models

Purpose: This fMRI study is about modelling the effective connectivity between Heschl’s gyrus (HG) and the superior temporal gyrus (STG) in human primary auditory cortices. Materials & methods: Ten healthy male participants were required to listen to white noise stimuli during functional magnetic resonance imaging (fMRI) scans. Statistical parametric mapping (SPM) was used to generate individual and group brain activation maps. For input region determination, two intrinsic connectivity models comprising bilateral HG and STG were constructed using dynamic causal modelling (DCM). The models were estimated and inferred using DCM while Bayesian Model Selection (BMS) for group studies was used for model comparison and selection. Based on the winning model, six linear and six non-linear causal models were derived and were again estimated, inferred, and compared to obtain a model that best represents the effective connectivity between HG and the STG, balancing accuracy and complexity. Results: Group results indicated significant asymmetrical activation (puncorr < 0.001) in bilateral HG and STG. Model comparison results showed strong evidence of STG as the input centre. The winning model is preferred by 6 out of 10 participants. The results were supported by BMS results for group studies with the expected posterior probability,r = 0.7830 and exceedance probability, φ = 0.9823. One-sample t-tests performed on connection values obtained from the winning model indicated that the valid connections for the winning model are the unidirectional parallel connections from STG to bilateral HG (p < 0.05). Subsequent model comparison between linear and non-linear models using BMS prefers non-linear connection (r = 0.9160, φ = 1.000) from which the connectivity between STG and the ipsi- and contralateral HG is gated by the activity in STG itself. Conclusion: We are able to demonstrate that the effective connectivity between HG and STG while listening to white noise for the respective participants can be explained by a non-linear dynamic causal model with the activity in STG influencing the STG-HG connectivity non-linearly.

Evaluating myocardial function of a cardiomyopathy rabbit model following bone marrow stromal cell transplantation by tissue Doppler echocardiography / 中国组织工程研究

BACKGROUND: Tissue Doppler echocardiography (TDE) has been proved to evaluate general and local function of heart but less reported on adriamycin-induced cardiomyopathy following bone marrow stromal cell (BMS) transplantation.OBJECTIVE: To evaluate myocardial function of an adriamycin-induced cardiomyopathy rabbit model following BMS transplantation using TDE.DESIGN, TIME AND SETTING: A randomized animal control study was performed at Laboratory of Ultrasound, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from September 2002 to December 2003.MATERIALS: A total of 28 male adult Japanese rabbits weighing (2.0+0.2) kg were used in this study. Adriamycin was used to induce cardiomyopathy model in 20 rabbits.METHODS: Twenty-eight male Japanese rabbits were randomly divided into three groups: cell transplantation group (n=10),PBS group (n=10), and sham operation group (n=8). BMSs were isolated from cell transplantation group at the 8th day. On the 12th week, cells were labeled with 4, 6-diamidino-2-phenylindole (DAPI), and then epicardial directly injected into the myocardium of the same rabbits in thoracotomy surgery. Non-cell only culture fluid PBS was injected in PBS group. Sham operation group underwent thoracotomy surgery with the same volume of saline injection.MAIN OUTCOME MEASURES: Left ventricular function was assessed by conventional and tissue Doppler echocardiography before and 4 weeks after surgery. Histological examination including apotisis study and DAPI fluorescent were assessed after sacrificed.from (4.0+1.1) cm/s to (5.3+1.2) cm/s (P ＜ 0.05) around the inject site, but the improvement of global myocardial function was not found by conventional echocardiography. In PBS and sham operation group there were no differences in global and myocardium at 4 weeks after transplantation. Histological findings showed that the injury of the myocardium around the injection site was relieved with less apoptosis.

Application of BMS(TM) Avoids a Defunctioning Colostomy in the Treatment of Fournier's Gangrene

PURPOSE: Recently developed BMS(TM) (Zassi Bowel Management System(TM): Hollister Inc., Illinois, USA) can provide effective nonsurgical fecal diversion without the risks associated with colostomy creation and subsequent closure. Our aim is to evaluate the effectiveness of the BMS in diverting feces from the perianal wide surgical wound in patients with Fournier's gangrene. METHODS: BMS(TM) was applied in five patients (male: 2, median age; 44) with Fournier's gangrene from January 2000 to September 2001. The treatments consist of three times a day wound dressing after wide surgical debridement and intravenous antibiotic therapy. For evacuation of feces, twice daily warm saline irrigation was administered via BMS(TM) or low daily doses of polyethylene glycol solutions were orally taken in. An endoscopic and anorectal manometric study was done to evaluate possible mucosal complications and anorectal functional changes. RESULTS: The average duration of the BMS application was 41 (range, 22~63) days. The result of a manometric study after immediate removal of the BMS(TM) showed a decreased mean resting pressure (range: 22~36 mmHg) and a decreased mean squeezing pressure (range: 32~39 mmHg). After 3 days, the sphincter pressure had improved markedly: mean resting pressures of 38, 45, 60, and 63 mmHg and mean squeezing pressure of 78, 89, 91, and 101 mmHg respectively. Fecal incontience was not noted in any patient. Other possible mucosal complications were not noted. There were no mortalit. CONCLUSIONS: BMS(TM) application in Fournier's gangrene patients after surgery successfully avoids a defunctioning colostomy. Furthermore, no significant complications were noted over a prolonged period up to 63 days.