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DIMETHYL-SULFOXIDE THERAPY IN BRONCHIOLITIS

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 1975年第JAN27期243卷 460-467页

作者： ZUNIGA, A BURDACH, R RUBIO, S MANUEL ARRIARAN CHILDRENS HOSP DEPT OTORHINOLARYNGOL & BRONCHOPULM DIS SANTIAGO CHILE

The action of a medicinal spray that contains anti-inflammatory and bacterio-static drugs integrated with the penetrating and potentiating agent DMSO has been evaluated clinically in 60 infants with acute respiratory obstruction. A dose of 2 ml of this spray is applied in the posterior pharynx and the tonsil region; 1 to 4 applications are made, according to the clinical evolution of the case. Two groups were chosen at random; 60 patients were paired off, and one of each pair received the treatment with DMSO spray. All the patients received ampicillin (50-100 mg/kg body weight). The following clinical results were observed. First there was an immediate recovery, after an average lapse of 30 min; improvement of sensorial involvement was observed in 80% of the cases, reduction of the intercostal retraction in 75%, reduction of polypnea in 76%, and transformation of the obstructive syndrome into a catarrhal syndrome in 80% (with fluidification of the secretions, which were expelled more easily by the upper air tracts). There was also a deferred or maintenance effect, which evaluated in comparsion with the control group that received similar treatment except for the nebulizations with DMSO spray. A sequential design, based on whether or not it was necessary to use the croupette, demonstrated the superiority of the DMSO spray over the control treatment in the bronchiolar process; in the group treated with DMSO spray it was not necessary to use the croupette. The sequential design based on the effect of this therapy on the general condition and the tabulated clinical factors permitted the inference that the therapeutic responses are more favorable in the group treated with DMSO spray than in the control group. In the sequential design, the line of significance is cut at the fifteenth pair (an error of 0.05 and P equals 0.95%). Since the application is easy, there are no toxic side effects and in view of the favorable results in the clinical evolution of the acute respirat

关键词：气雾剂气道阻塞/药物疗法氨苄西林/治疗应用支气管疾病/药物疗法细支气管炎病毒性/并发症细支气管炎病毒性/药物疗法细支气管炎病毒性/病理生理学二甲亚砜/投药和剂量二甲亚砜/副作用二甲亚砜/治疗应用复方合剂儿童学龄前人类婴儿婴儿新生男(雄)性

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HSV-1-induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy, proptosis, and optic nerve involvement

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OPHTHALMOLOGY 2000年第2期107卷 397-401页

作者： Tornerup, NR Fomsgaard, A Nielsen, NV Univ Copenhagen Rigshosp Eye Clin DK-2100 Copenhagen Denmark State Serum Inst Dept Virol Copenhagen Denmark

Objective: To present a unique case in which orbital inflammation, proptosis, and optic neuritis were the initial symptoms of acute retinal necrosis (ARN), The clinical presentation of ARN, as well as the currently recommended diagnostic procedures and guidelines for medical treatment of ARN, are summarized. Design: Interventional case report. Testing: Polymerase chain reaction (PCR) techniques were made on the vitreous for cytomegalovirus, Epstein-Barr virus, herpes simplex virus (HSV), varicella tester virus, and toxoplasmosis, A full laboratory evaluation was made together with HLA-typing and serologic tests measuring convalescent titers for HSV and other micro-organisms. Magnetic resonance imaging scan, computed tomography (CT) scan, and fluorescein angiographic examination were performed. The patient was treated with acyclovir and oral prednisone. Main Outcome Measures: The patient was evaluated for initial and final visual acuity and for degree of proptosis, periocular edema, and vitreitis. Results: The first symptoms and signs of ARN were eye pain, headache, proptosis, and a swollen optic nerve on CT scan, Other than increased C-reactive protein, all blood samples were normal. PCR was positive for HSV-type I in two separate vitreous biopsies. The patient had the strongly ARN-related specificity HLA-DQ7. Conclusions: This is the first report of HSV-induced ARN presenting with inflammatory orbitopathy and optic neuritis, Polymerase chain reaction for HSV-1 was positive more than 4 weeks after debut of symptoms, which is a new finding. The combination of severe vitreitis and retinal whitening, with or without proptosis, should alert the clinician to the possibility of herpes infection and treatment with intravenous acyclovir started promptly. (C) 2000 by the American Academy of Ophthalmology.

关键词：阿昔洛韦/治疗应用抗体病毒/分析 DNA 病毒/分析突眼/诊断突眼/药物疗法突眼/病因学眼感染病毒性/诊断眼感染病毒性/药物疗法眼感染病毒性/病因学荧光素血管造影术单纯疱疹/并发症单纯疱疹/诊断单纯疱疹/药物疗法疱疹病毒1型人/遗传学疱疹病毒1型人/免疫学疱疹病毒1型人/分离和提纯磁共振成像视神经炎/诊断视神经炎/药物疗法视神经炎/病因学眼眶假瘤/诊断眼眶假瘤/药物疗法眼眶假瘤/病因学聚合酶链反应泼尼松龙/治疗应用视网膜坏死综合征急性/诊断视网膜坏死综合征急性/药物疗法视网膜坏死综合征急性/病因学体层摄影术 X线计算机玻璃体/病毒学成年人女(雌)性人类

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Acute follicular conjunctivitis caused by adenovirus type 34

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第6期128卷 680-686页

作者： Uchio, E Matsuura, N Takeuchi, S Itoh, N Ishiko, H Aoki, K Ohno, S Yokohama City Univ Sch Med Dept Ophthalmol Kanazawa Ku Yokohama Kanagawa 2360004 Japan Mitsubishi Kagaku Bioclin Labs Inc Itabashi Ku Tokyo Japan Aoki Eye Clin Shiroishi Ku Sapporo Hokkaido Japan

PURPOSE: Adenovirus type 34 belongs to adenovirus subgenus B. The prototype virus of adenovirus 34 was isolated from a renal transplant recipient. However, no case of acute conjunctivitis caused by adenovirus 34 has been reported. Recently, we encountered two cases of acute follicular conjunctivitis in which adenovirus 34 was isolated. METHODS: The clinical isolates were identified by the standard neutralization test. The sequences of seven hypervariable regions in the hexon protein of these cases were compared with those of several prototype strains of adenovirus subgenus B. RESULTS: The cases were middle aged, 34 and 41 years old, and male, and they exhibited moderate conjunctivitis with upper respiratory tract symptoms. Isolates from cell culture were identified as adenovirus 34 by NT. The mean homology rate (percentage of total number of coincident amino acids in the total length of amino acids in seven hypervariable regions) between clinical isolates and the adenovirus 34 prototype was 96.5%;in contrast, those between clinical isolates and the prototypes of adenovirus ii, adenovirus 14, and adenovirus 35 were 55.6%, 66.7%, and 57.9%, respectively. The results of conventional serotyping by neutralization test were confirmed by these values. CONCLUSIONS: These results indicate that adenovirus 34 may induce acute conjunctivitis in immunocompetent subjects and that special attention should be paid to adenovirus 34 as a causative agent for adenoviral conjunctivitis. (C) 1999 by Elsevier Science Inc. All rights reserved.

关键词：腺病毒人/分类腺病毒人/遗传学腺病毒人/分离和提纯消炎药非甾类/治疗应用结膜/病理学结膜/病毒学结膜炎病毒性/药物疗法结膜炎病毒性/病因学结膜炎病毒性/病理学结膜炎病毒性/病毒学 DNA引物/化学 DNA 病毒/分析聚合酶链反应成年人人类男(雄)性

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Decreased macular leukocyte velocity in human immunodeficiency virus-infected individuals

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第5期132卷 711-719页

作者： Lim, MC Cumberland, WG Minassian, SL Ransome, SS Cornish, MJ Terry, BG Holland, GN Univ Calif Los Angeles Sch Med Jules Stein Eye InstOcular Inflammatory Dis Ctr So Calif HIV Eye Consortium Los Angeles CA 90095 USA Univ Calif Los Angeles Sch Med Dept Ophthalmol Los Angeles CA 90095 USA Univ Calif Los Angeles Sch Publ Hlth UCLA AIDS Inst Los Angeles CA 90024 USA Univ Calif Los Angeles Sch Publ Hlth Dept Biostat Los Angeles CA 90024 USA Community Eye Med Pasadena CA USA

PURPOSE: To determine whether human immunodeficiency virus (HIV)-infected individuals have decreased macular capillary blood flow in vivo. DESIGN: Case control study. METHODS: Macular leukocyte velocity and perceived leukocyte density were determined in 41 HIV-infected individuals without cytomegalovirus retinitis and 31 HIV-negative control subjects using the blue field simulation technique (BFS-2000, Oculix, Inc., Jenkintown, PA). Velocity and density measurements for HIV,infected individuals were compared to current and lowest previous CD4+ T-lymphocyte counts, HIV RNA blood levels, and blood leukocyte counts. RESULTS: Mean macular leukocyte velocity was lower in HIV-infected individuals than in controls (P = 0.0006). No correlations were identified between velocity measurements and the following factors in HIV-infected individuals: current or lowest previous CD4+ T-lymphocyte count;or HIV RNA blood level. Mean perceived leukocyte density in HIV-infected individuals was lower than in controls (P = 0.003), but was not correlated with blood leukocyte count in HIV-infected individuals. No relationships were identified between macular leukocyte velocity and duration of medication use or duration of elevated CD4+ T-lymphocyte count in patients receiving potent antiretroviral therapy. CONCLUSIONS: Reduced macular leukocyte velocity may have important implications for understanding the retinal microvasculopathy of HIV disease, the pathogenesis of opportunistic retinal infections, and visual dysfunction in HIV-infected individuals who do not have opportunistic retinal infections. We found no evidence that macular leukocyte velocity increased with immune reconstitution. (C) 2001 by Elsevier Science Inc. All rights reserved.

关键词：抗病毒药/治疗应用血流速度 CD4淋巴细胞计数毛细血管病例对照研究眼感染病毒性/药物疗法眼感染病毒性/病理生理学 HIV感染/药物疗法 HIV感染/病理生理学 HIV-1/遗传学白细胞计数白细胞/生理学 RNA 病毒/血液视网膜疾病/药物疗法视网膜疾病/病理生理学视网膜血管/药物作用视网膜血管/病理生理学视觉内视成年人人类

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Treatment of viral diseases of the cornea and external eye

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PROGRESS IN RETINAL AND EYE RESEARCH 2000年第1期19卷 69-85页

作者： Kaufman, HE Louisiana State Univ Med Ctr Sch Med LSU Eye CtrDept Ophthalmol New Orleans LA 70112 USA

Ocular virus infections remain an important cause of corneal and external disease. Herpes simplex. the most important, is easily treated when ii is confined to the epithelium. New studies indicate that herpetic stromal disease and iritis are effectively treated with a combination of corticosteroid and antiviral without additional risk. Recurrences of ocular herpetic disease can be reduced with acyclovir given orally;the benefit seems to be greatest in patients who have had at feast one episode of stromal keratitis. Herpes tester can be treated with either acyclovir or famciclovir, but to be effective, treatment must be initiated within 72 hours of onset. Early treatment reduces the risk of post-herpetic neuralgia and may reduce the risk of ocular complications. Adenovirus infection (epidemic keratoconjunctivitis) is often spread by the ophthalmologist. New medications such as cidofovir appear to be effective against the adenoviruses in non-human systems and may have some effect in man, although previously, drugs that appeared to have an effect in vitro have proven to be ineffective in the clinical setting. (C) 1999 Elsevier Science Ltd. All rights reserved.

关键词：腺病毒感染人/药物疗法抗病毒药/治疗应用角膜疾病/药物疗法角膜疾病/病毒学眼感染病毒性/药物疗法疱疹带状眼部/药物疗法角膜炎疱疹性/药物疗法沙眼/药物疗法动物人类

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The pharmacologic mechanism by which inhaled epinephrine reduces airway obstruction in respiratory syncytial virus-associated bronchiolitis

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JOURNAL OF PEDIATRICS 2000年第5期136卷 699-700页

作者： Barr, FE Patel, NR Newth, CJL Vanderbilt Univ Ctr Med Vanderbilt Childrens Hosp Div Pediat Crit Care & Anesthesia Nashville TN 37232 USA Univ So Calif Childrens Hosp Los Angeles Div Pediat Crit Care Los Angeles CA USA

Inhaled racemic epinephrine relieves airway obstruction in patients with respiratory syncytial virus bronchiolitis. The contribution of alpha- versus beta- adrenoreceptor stimulation toward this clinical effect is unknown. We describe an infant treated with propranolol for supraventricular tachycardia in whom respiratory syncytial virus bronchiolitis developed. Inhaled racemic epinephrine improved his respiratory symptoms, whereas nebulized albuterol did not.

关键词：投药吸入肾上腺素能激动剂/投药和剂量肾上腺素能激动剂/药理学肾上腺素能β受体拮抗剂/治疗应用细支气管炎病毒性/药物疗法支气管扩张药/投药和剂量支气管扩张药/药理学肾上腺素/投药和剂量肾上腺素/药理学普萘洛尔/治疗应用呼吸道合胞体病毒感染/药物疗法心动过速室上性/药物疗法人类婴儿男(雄)性

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Chronic verrucous varicella tester virus skin lesions: clinical, histological, molecular and therapeutic aspects

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CLINICAL AND EXPERIMENTAL DERMATOLOGY 1999年第5期24卷 346-353页

作者： Nikkels, AF Snoeck, R Rentier, B Pierard, GE Univ Liege Dept Dermatopathol B-4000 Liege Belgium Univ Liege Rega Inst B-4000 Liege Belgium

The outbreak of HIV infection introduced a new phenomenon in varicella tester virus (VZV) pathology namely the long-standing wart-like skin lesions that are frequently associated with resistance to thymidine kinase (TK)-dependent antiviral agents. This paper reviews the clinical, histological, and molecular aspects and the therapeutic management of these verrucous lesions. The majority of lesions are characterized by chronically evolving, unique or multiple wart-like cutaneous lesions. The main histopathological features include hyperkeratosis, verruciform acanthosis and VZV-induced cytopathic changes with scant or absent cytolysis of infected keratinocytes. The mechanism that establishes the chronic nature of the lesions appears to be associated with a particular pattern of VZV gene expression exhibiting reduced or nondetectable gE and gB synthesis. Drug resistance to TK-dependent antiviral agents is a result of nonfunctional or deficient viral TK. This necessitates alternative therapeutic management using antiviral agents that target the viral DNA polymerase.

关键词：阿昔洛韦/治疗应用抗病毒药/治疗应用抗药性微生物膦甲酸/治疗应用 HIV感染/并发症疱疹病毒3型人皮肤疾病病毒性/诊断皮肤疾病病毒性/药物疗法皮肤疾病病毒性/病理学人类

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Intravitreal administration of antisense oligonucleotides: Potential of liposomal delivery

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PROGRESS IN RETINAL AND EYE RESEARCH 2000年第2期19卷 131-147页

作者： Bochot, A Couvreur, P Fattal, E Univ Paris 11 Ctr Etud Pharmaceut Lab Physicochim UMR CNRS 8612 F-92296 Chatenay Malabry France

Antisense oligonucleotides are short synthetic fragments of genes that are able to inhibit gene expression after being internalized by cells. They can therefore be used as antiviral compounds particularly, for the treatment of ocular viral infections (i.e. Herpes simplex virus or Cytomegalovirus, CMV). Antisense oligonucleotides are however poorly stable in biological fluids and their intracellular penetration is limited. Although oligonucleotides are now currently used in therapeutics for the treatment of CMV by intravitreal injection (Vitravene(R)), their main drawbacks impose to repeat the number of administrations which can be very harmful and damaging. A system that is able to permit a protection of oligonucleotides against degradation and their slow delivery into the vitreous would be more favorable for improving patient compliance. The use of liposomes for intravitreal administration can be very promising since these lipid vesicles are able to protect oligonucleotides against degradation by nucleases and they allow to increase the retention time of many drugs in the vitreous. In this review, the potentialities of liposomes far the intravitreal delivery of oligonucleotides will be discussed. (C) 2000 Elsevier Science Ltd. All rights reserved.

关键词：投药局部迟效制剂/药代动力学药物释放系统眼感染病毒性/药物疗法脂质体/药代动力学寡核苷酸类反义/投药和剂量寡核苷酸类反义/毒性粒子大小病人依从玻璃体动物人类

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Immunomodulatory therapy in the management of viral infections in patients with HIV infection

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JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY 2000年第1期43卷 S27-S30页

作者： Conant, MA Univ Calif San Francisco Med Ctr San Francisco CA 94143 USA

Human immunodeficiency virus (HIV) causes disease by infecting lymphocytes and progressively destroying critical regulatory and effector cells of the immune system, leaving patients vulnerable to a number of bacterial, fungal, and viral infections. Facial herpes (herpes simplex virus-1 [HSV-1]), genital herpes (HSV-2), herpes tester (varicella tester virus), oral hairy leukoplakia (Epstein-Barr virus), Kaposi's sarcoma (HHV-8), molluscum contagiosum, condyloma acuminata (human papillomavirus [HPV-6, HPV-11]), plantar warts (HPV-1), and facial warts and flat warts (HPV-5) are some of the cutaneous viral diseases most commonly seen in HIV-infected patients. Two immunomodulatory agents, imiquimod (Aldara), shown to be safe and effective in the management of genital warts, and alitretinoin gel, shown to be safe and effective in the treatment of Kaposi's sarcoma, may offer a new therapeutic approach to treatment of cutaneous viral diseases. There is a strong scientific rationale to suggest that imiquimod and alitretinoin gel may be useful in the treatment of a variety of cutaneous viral diseases that have been shown to respond to immunomodulatory drugs. This represents a new approach in the therapeutic treatment paradigm for treatment of cutaneous viral diseases at their site of infection.

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Coxsackievirus B4 as a cause of adult chorioretinitis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第3期127卷 347-349页

作者： Kadrmas, EF Buzney, SM Retina Specialists Boston Boston MA USA

PURPOSE: To describe the clinical manifestation and course of chorioretinitis presumed to be secondary to coxsackievirus infection in an adult. METHOD: Case report documented by fundus photography and fluorescein angiography. RESULTS: Ophthalmoscopic examination of a symptomatic 34-year-old woman showed several cream-colored parafoveal spots at the level of the retinal pigment epithelium and similar, multiple confluent spots in the midperiphery of both eyes. Titers for coxsackievirus B4 demonstrated a fourfold rise between acute and convalescent sera. CONCLUSION: Coxsackievirus B4 is apparently a rare cause of chorioretinitis but nevertheless should be considered in the appropriate clinical setting. (C) 1999 by Elsevier Science Inc. All rights reserved.

关键词：投药口服脉络膜视网膜炎/药物疗法脉络膜视网膜炎/病毒学柯萨奇病毒感染/并发症柯萨奇病毒感染/药物疗法肠道病毒B型人眼感染病毒性/药物疗法眼感染病毒性/病因学荧光素血管造影术眼底泼尼松/投药和剂量泼尼松/治疗应用成年人女(雌)性人类

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