ABSTRACT
Methylprednisolone sodium succinate (MPSS) was given to 50% of patients undergoing coronary artery bypass graft in a 50-patient double-blind clinical study to ascertain the beneficial effects of this glucocorticoid in decreasing ischemic injury to the heart. MPSS (1 gm) was given intravenously at the start of cardiopulmonary bypass and another gram was given during the course of the open-heart procedure. Steroid-treated patients demonstrated a favorable response compared to placebo-treated controls in a variety of physiologic variables: Bypass graft flow rates measured prior to operative closure were 51-62% greater; urine output in the first 24 postoperative hours was 67% higher; fewer abnormalities were found in both chest x-ray and microbiology results. Thus, methylprednisolone sodium succinate treated patients exhibited more favorable trends for all critical variables measured.
Subject(s)
Cardiopulmonary Bypass , Methylprednisolone/therapeutic use , Postoperative Complications/prevention & control , Blood Pressure/drug effects , Body Temperature/drug effects , Clinical Trials as Topic , Coronary Circulation/drug effects , Double-Blind Method , Female , Humans , Kidney/drug effects , Male , Mitochondria, Heart/drug effectsABSTRACT
The urinary excretion of nonesterified cholesterol (NEC) in 170 women with cervical and endometrial carcinomas has been investigated. Control patients (236) included: 1) women with other types of (benign and/or malignant diseases of the pelvic organs; 2) patients with non-steroid-related neoplasms; 3) patients with benign and/or malignant breast diseases other than carcinoma; and 4) patients with a variety of non-neoplastic diseases. NEC was determined by a gas-liquid chromatographic procedure. The range of NEC excretion for clinically healthy normal women (64) was previously established by this method. NEC hyperexcretion was defined as any NEC value over 1.5 mg/24 hours. The results showed NEC hyperexcretion in 65 of 68 women with active carcinoma of the cervix, including 13 patients with carcinoma in situ, and in 42 of 45 women with active carcinoma of the endometrium. In contrast, a normal excretion of NEC occurred in all the patients (77) of the first and second control groups, in 39 (80%) of the 48 patients of the third control group (high-risk group), and in 101 of the 111 patients of the fourth control group. Sequential studies performed in patients with uterine carcinomas have demonstrated an almost perfect correlation between the NEC excretion and the clinical status of the patient following surgical and/or radiation therapy. Of 57 patients (31 cervix and 26 endometrium) in which the NEC studies were started after treatment was instituted, 53 have normal NEC excretion in the multiple determination performed to date. Presently these patients have no clinical, chemical, or radiologic evidence of cancer. It is concluded that urinary NEC determination can be used as an additional diagnostic biochemical test to detect active carcinoma of the steroid-producing glands and their main target organs, and that in women with uterine carcinomas, the test can be used as an objective laboratory method to monitor the course of the disease and the response of the patient to therapy.
