We initially conducted a multicenter, randomized trial (n ¼ 43), and subsequently a questionnaire study (n ¼ 209) of participating hospitals, to evaluate whether infused fresh frozen plasma (FFP) could prevent the occurrence of hepatic veno-occlusive disease (VOD) after stem cell transplantation (SCT). Forty-three patients were divided into two groups: 23 receiving FFP infusions and 20 not receiving it. VOD developed in three patients not receiving FFP. Plasma von Willebrand factor (VWF) antigen levels were lower at days 0, 7 and 28 after SCT in patients receiving FFP than in those not receiving it, whereas plasma ADAMTS13 activity (ADAMTS13:AC) did not differ between them. Plasma VWF multimer (VWFM) was demonstrated to be defective in the highBintermediate VWFM during the early post-SCT phase, but there was a significant increase in high VWFM just before VOD onset. This suggests that a relative enzyme-tosubstrate (ADAMTS13/high-VWFM) imbalance is involved in the pathogenesis of VOD. To strengthen this hypothesis, the incidence of VOD was apparently lower in patients receiving FFP infusions than in those not receiving it (0/23 vs 3/20) in the randomized trial. Further, the results combined with the subsequent questionnaire study (0/36 vs 11/173) clearly showed the incidence to be statistically significant (0/59 vs 14/193, P ¼ 0.033).
HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation.
Conjunctival cultures were obtained from 488 patients undergoing cataract extraction. Bacterial isolation rates from the lids and conjunctiva were 84.6 and 36.7, respectively. Propionibacterium acnes was the only anaerobic organism identified. A significantly lower incidence of P. acnes was observed in the eyes after preoperative conjunctival irrigation using povidone-iodine solution (9%) compared with those using benzetonium chloride solution (30%). Topical use of ofloxacin and cefmenoxime for 1 or 2 days preoperatively, and irrigation of the conjunctival sac with a 16-fold-diluted povidone-iodine solution for at least 30 s immediately prior to cataract surgery are recommended.
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