Our data suggest that PPAR-gamma is present in keloid fibroblasts and PPAR-gamma activation inhibits TGF-beta1-induced collagen type I expression at least in part by decreasing collagen synthesis. PPAR-gamma may be a promising therapeutic target for keloids.
ABSTRACT. We examined the protective effects of Ginkgo biloba extract (EGb761) postconditioning on myocardial ischemia reperfusion injury in rabbits. Four groups of 8 white rabbits were allocated to: pseudo surgery group: the left coronary was lined without blocking for 160 min after thoracotomy; ischemia and reperfusion group (IR): the left anterior descending coronary artery was blocked for 40 min and reperfused for 120 min; ischemic postconditioning group: the left anterior descending artery was ligated for 40 min, reopened for 30 s and ligated for 30 s, repeated three times, and then reperfused for 120 min; EGb761 postconditioning group (E): 100 mg/kg EGb761 was injected into a vein while the left coronary artery was opened for 1 min. The reperfusion took 120 min. Internal carotid arterial blood in each group was collected for cTnI measurement at five times: 20 min before occlusion of the left coronary artery, 20 min after left coronary artery occlusion, 40 min after left coronary artery occlusion, 1 h after myocardial reperfusion, and 2 h after myocardial reperfusion. Superoxide dismutase (SOD), malondialdehyde (MDA) in the centrifuged blood and myocardial infarction area were measured at the end of reperfusion. We found that the serum cTnI concentrations in the E group during reperfusion decreased significantly compared with those in the IR group. The infarction area was significantly lower in the E group than that in the IR group. The SOD activity in the E group was increased compared with that in the IR group; the MDA content decreased significantly in the E group compared with that in the IR group. We conclude that G. biloba extract postconditioning had myocardial protection effects by reducing the generation of oxygen-free radicals and increasing the antioxidant capacity of the myocardial cells.
OBJECTIVES: To estimate differences in adjusted hospital length of stay (LOS) between linezolid and vancomycin using multivariate survival analysis. Linezolid's bioequivalent IV and oral formulations may enable earlier hospital discharge compared to vancomycin treatment. METHODS: 460 hospitalized patients with suspected/confirmed methicillin‐resistant Staphylococcus infections were treated with either linezolid (LZD) or vancomycin (VAN) in a randomized controlled trial. Covariate imbalances between treatment groups were tested using t‐tests and chi‐square tests. Multivariate Cox proportional hazards and several parametric models for LOS were tested for best fit using the Akaike Information Criteria and log‐likelihood ratio statistics. The Cox proportional hazards assumption was rejected (p < .05); log‐logistic survival models fit best. The log‐logistic estimates are used to create two alternative adjusted survivorship functions, one based on individual corrections to LOS (Individual correction), and the other based on means of the predicted survivorship function for each individual (Mean survivorship). Adjusted LOS at quartiles of % discharged for each function was compared with unadjusted LOS using Kaplan‐Meier method. RESULTS: Hospital unit type at randomization and number of comorbidities both differed significantly between groups and significantly affected LOS. With covariate controls in the log‐logistic model, linezolid treatment significantly reduced LOS (p = .04). Adjusted/unadjusted LOS at quartiles of % discharged were:
CONCLUSIONS: When adjusted for covariate differences, median LOS for linezolid patients was at least 2 days shorter than for vancomycin patients. Other differences in the LOS distribution are evident and may be important to decision‐makers but off‐median estimates may be sensitive to the adjustment method used. Methodologic considerations are explored further.
%
discharged
Adjusted LOS (days) Unadjusted LOS
Individual correction Mean survivorship Kaplan‐Meier
LZDVANLZDVANLZDVAN25610696850 (median)14161316141575262828292929
The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) is a predictive scoring system for post-operative morbidity. The present study assessed the value of POSSUM in predicting post-operative morbidity following pancreaticoduodenectomy (PD). POSSUM scores were prospectively calculated for 265 consecutive cases of PD performed between 2005 and 2007. Expected morbidity was estimated based on POSSUM scores and was compared with observed morbidity. Patients were also stratified into one of four groups based on their individual POSSUM scores and subsequent risk of morbidity. Mean expected morbidity was 43.81% (116 cases) and mean observed morbidity was 39.62% (105 cases) (no statistically significant difference). It is concluded that the POSSUM scoring system has high value for predicting the risk of morbidity in PD patients.
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