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Molecular aspects of endotoxins relevant to their biological functions

NEPHROLOGY DIALYSIS TRANSPLANTATION 1999年第4期14卷 853-860页

作者： Haeffner-Cavaillon, N Carreno, MP Aussel, L Caroff, M Hop Broussais INSERM U430 F-75674 Paris France CNRS ERS571 Orsay France

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Hyaluronic acid-based agents do not affect anastomotic strength in the rat colon, in either the presence or absence of bacterial peritonitis

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BRITISH JOURNAL OF SURGERY 2000年第9期87卷 1222-1228页

作者： Reijnen, MMPJ de Man, BM Hendriks, T Postma, VA Meis, JFGM van Goor, H Univ Nijmegen Hosp Dept Surg NL-6500 HB Nijmegen Netherlands Univ Nijmegen Hosp Dept Med Microbiol NL-6500 HB Nijmegen Netherlands

Background: Hyaluronic acid (HA) agents reduce postsurgical adhesion formation. The effect of their perioperative administration on early anastomotic healing is unknown. This study investigated the influence of two HA-containing agents on the development of strength in colonic anastomosis during the first postoperative week, both in normal rats and in rats with bacterial peritonitis. Methods: In 90 male Wistar rats a 1-cm segment was resected from the descending colon and an end-to-end anastomosis was constructed. In 108 rats a bacterial peritonitis was induced using caecal ligation and puncture (CLP). Some 24 h after CLP the abdomen was reopened, the caecum was taken out and, after resection of a 1-cm segment, an anastomosis was made. Animals in both groups were randomized to receive either an HA-carboxymethylcellulose (CMC) bioresorbable membrane, 0.4 per cent HA solution or no treatment. One-third of each group was killed at day 1, 3 and 7 after operation. Cultures were taken from the abdominal cavity for microbiological analysis in half of the animals. Subsequently, both bursting pressure and breaking strength were determined as parameters for anastomotic strength. Results: No differences in anastomotic bursting pressure or breaking strength were found between the experimental groups and their controls. In addition, there was no significant difference in the number of bacteria cultured from the abdominal cavity between rats treated with HA and controls. Conclusion: Neither HA-CMC bioresorbable membrane nor 0.4 per cent HA solution interferes with the development of early anastomotic strength in the colon, and can therefore be safely used to prevent intra-abdominal adhesion formation after performing bowel anastomosis.

关键词：佐剂免疫/治疗应用吻合术外科细菌感染/并发症细菌感染/病理生理学透明质酸/治疗应用腹膜炎/并发症腹膜炎/病理生理学压力大鼠 Wistar 外科伤口裂开/病理生理学外科伤口裂开/预防和控制伤口愈合/药物作用动物男(雄)性大鼠

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Spontaneous bacterial peritonitis: Keys to management

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HOSPITAL PRACTICE 2000年第5期35卷 87-+页

作者： Hillebrand, DJ Runyon, BA Loma Linda Univ Sch Med Inst Transplantat Loma Linda CA 92350 USA

Infection of ascitic fluid in patients with cirrhosis can be rapidly fatal. Survival after the initial episode has improved dramatically in recent years, largely because of earlier diagnosis, better-defined diagnostic criteria, and the widespread use of paracentesis and empiric antibiotic therapy. Antibiotic use may prevent recurrences. Despite these advances, the long-term outlook is grim for most patients.

关键词：氨基糖苷类腹水液/微生物学细菌感染/并发症细菌感染/诊断细菌感染/药物疗法细菌感染/病理生理学肝硬化/微生物学腹膜炎/并发症腹膜炎/诊断腹膜炎/药物疗法腹膜炎/微生物学腹膜炎/病理生理学预后危险因素老年人女(雌)性人类男(雄)性

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Clinical and in vitro evaluation of membrane humidifier that does not require addition of water

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RESPIRATORY MEDICINE 2000年第1期94卷 71-75页

作者： Burioka, N Takano, K Chikumi, H Suyama, H Sako, T Sasaki, T Tottori Univ Fac Med Dept Internal Med 3 Yonago Tottori 683 Japan Sanyo Elect Ind Co Ltd Okayama Japan

It is well known that conventional bubbling humidifiers are capable of producing micro-aerosols contaminated with bacteria. We developed a unique humidifier, named a membrane humidifier, that does not require an external water supply. This new system obtains moisture from room air. We investigated the clinical and in vitro evaluation of the membrane humidifier. Ten patients with chronic pulmonary disease participated in the study. We evaluated the partial pressure of oxygen in arterial blood (PaO2) of 10 patients who used the new device. We conducted an in vitro study to determine whether the device could prevent the bacterial contamination of humidified-oxygen. We passed compressed air contaminated with Pseudomonas aeruginosa outside the hollow fibres of the membrane humidifier, and the humidified-oxygen passed inside the hollow fibres was sampled into nutrient broth periodically for 10 days. We also compared the relative humidity of oxygen humidified by a membrane humidifier with that of oxygen humidified by a bubbling humidifier. There was no significant difference between measured PaO2 while breathing oxygen humidified using a membrane humidifier and that while breathing oxygen humidified using a bubbling humidifier. Cultures of the humidified-oxygen passed through the hollow fibres were negative for bacteria. The membrane humidifier could produce good humidification. The new device appeared to prevent bacterial contamination, and may help to reduce the risk of infection in patients at hospital and home.

关键词：细菌感染/病理生理学细菌感染/传播设备污染评价研究用力呼气量/生理学湿度肺疾病阻塞性/微生物学肺疾病阻塞性/病理生理学肺疾病阻塞性/治疗危险因素水老年人女(雌)性人类男(雄)性

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The relationship between infection, inflammation, and cardiovascular disease: an overview.

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Annals of periodontology / the American Academy of Periodontology 2001年第1期6卷 1-8页

作者： Lowe, G.D. Department of Medicine University of Glasgow Scotland United States

Atherosclerotic plaques were likened histologically to healing inflammatory lesions by Russell Ross, who proposed a "response to injury" hypothesis for their formation. More recently, intraplaque inflammation has been postulated to play a role in thinning of the fibrous cap, plaque rupture, and superadded thrombosis. Potential causes for vascular injury include mechanical stress, smoke exposure, hypercholesterolemia, hyperhomocysteinemia, and chronic infection (direct, or indirect). Blood levels of inflammatory markers (e.g., C-reactive protein [CRP];serum amyloid A [SAA];fibrinogen;plasma viscosity;erythrocyte sedimentation rate [ESR];leukocyte count, low serum albumin) have been associated with vascular risk factors and with prevalent and incident atherothrombotic cardiovascular disease (CVD) (coronary heart disease, [CHD];stroke;and peripheral arterial disease). More recently, cytokines (e.g., interleukin-6 [IL-6]) and soluble adhesion molecules (e.g., intercellular adhesion molecule-1, vascular cell adhesion molecule-1) have been associated with both risk factors and disease;and offer potential therapeutic targets for nonspecific "anti-inflammatory" treatment of arterial disease. Infections associated with arterial disease include specific infections (Chlamydia pneumoniae, Helicobacter pylori) and nonspecific infections (periodontal infections, respiratory tract infections). Recent meta-analyses have shown that associations of serum markers of C. pneumoniae and H. pylori with arterial disease, risk factors, or potential intermediary mechanisms for disease are weaker than was first suggested by early reports. Likewise, further studies and meta-analyses are required to evaluate the epidemiologic relationships of CVD to periodontal infection and disease and to chronic pulmonary infections and disease. The weaker the associations between chronic infections and CVD, the larger is the size of randomized controlled trials required to establish (or exclude) a preventive

关键词：抗菌药/治疗应用动脉硬化/病理生理学细菌感染/并发症细菌感染/病理生理学生物学标记/血液血液凝固因子/生理学血蛋白质类/生物合成心血管疾病/病因学心血管疾病/病理生理学心血管疾病/预防和控制细胞黏附分子/血液化学预防慢性病细胞因子类/血液高胆固醇血症/并发症高同种半胱氨酸血症/并发症炎症/病理生理学炎症介导素类/血液白细胞介素类/血液牙周疾病/并发症呼吸道感染/并发症危险因素血栓形成/病理生理学人类

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Surgical management of orofacial infections.

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Atlas of the oral and maxillofacial surgery clinics of North America 2000年第1期8卷 77-100页

作者： Flynn, T.R. Harvard School of Dental Medicine Boston Massachusetts United States

This overview of the surgical management of orofacial odontogenic infections is designed as a practical guide for the oral and maxillofacial surgeon. Fortunately, the incidence of serious odontogenic infections is decreasing. This decreased frequency, however, necessitates diligent study and mental preparation in advance of the emergent situations in which such cases present.

关键词：抗菌药/治疗应用细菌感染/分类细菌感染/病理生理学细菌感染/外科学引流术/仪器和设备引流术/方法面部/外科学病灶感染牙/分类病灶感染牙/病理生理学病灶感染牙/外科学免疫减弱宿主灌洗口腔疾病/分类口腔疾病/微生物学口腔疾病/病理生理学口腔疾病/外科学颈/外科学病人医疗护理计划呼吸人类

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The association between periodontal diseases and cardiovascular diseases: a state-of-the-science review.

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Annals of periodontology / the American Academy of Periodontology 2001年第1期6卷 9-15页

作者： Beck, J.D. Offenbacher, S. Comprehensive Center for Inflammatory Disorders Center for Oral and Systemic Diseases University of North Carolina Chapel Hill North Carolina United States

Early case-control and cross-sectional studies demonstrating associations between chronic periodontitis and cardiovascular disease (CVD) were quickly followed by secondary analyses of data available from existing longitudinal studies, which indicated that individuals with periodontitis, as determined by clinical measures, were at greater risk for CVD events. Many of these studies contained large numbers of subjects and were adjusted for traditional risk factors. Within the last 18 months, one case-control study and one longitudinal study have reported finding positive associations that were not statistically significant. The earlier studies stimulated a number of studies focused on identifying potential biological mechanisms that might underlie this association. While still early in that process, such studies have implicated a systemic role for oral microorganisms and for the quality and quantity of the host inflammatory response as key biologic processes that may underlie the association of CVD with the clinical manifestation of periodontitis. It is a positive development when changes in our knowledge regarding biologic mechanisms result in reevaluation of past studies, and this reevaluation leads to new studies that incorporate the design elements demanded by this new knowledge. In that spirit, we conclude that all longitudinal studies reported to date can be characterized as follows: none were initially designed to actually test the association of interest;almost all were restricted to clinical measures of periodontitis to index the exposure and lacked measures of infectious burden and host response;and they used a variety of cardiovascular clinical events to index the outcome and did not include subclinical measures of atherosclerosis. In addition, the longitudinal studies that failed to show a significant association between periodontitis and CVD used the least sensitive and crudest clinical measures of periodontal disease. Based upon the current state-of-the-s

关键词：动脉硬化/病因学细菌感染/并发症细菌感染/免疫学细菌感染/病理生理学心血管疾病/病因学病例对照研究慢性病横断面研究流行病学分子随访研究炎症/病理生理学炎症介导素类/分析纵向研究牙周炎/并发症牙周炎/免疫学牙周炎/微生物学危险因素敏感性与特异性统计数据人类

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Update on otitis media. Part 1. Epidemiology and pathophysiology.

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American pharmacy 1992年第12期NS32卷 27-31页

作者： Sagraves, R. Maish, W. Kameshka, A.

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Periodontitis and diabetes interrelationships: role of inflammation.

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Annals of periodontology / the American Academy of Periodontology 2001年第1期6卷 125-137页

作者： Iacopino, A.M. Division of Prosthodontics Marquette University School of Dentistry Milwaukee Wisconsin United States

Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life. One of these complications is periodontal disease (periodontitis). Periodontitis is much more than a localized oral infection. Recent data indicate that periodontitis may cause changes in systemic physiology. The interrelationships between periodontitis and diabetes provide an example of systemic disease predisposing to oral infection, and once that infection is established, the oral infection exacerbates systemic disease. In this case, it may also be possible for the oral infection to predispose to systemic disease. In order to understand the cellular/molecular mechanisms responsible for such a cyclical association, one must identify common physiological changes associated with diabetes and periodontitis that produce a synergy when the conditions coexist. A potential mechanistic link involves the broad axis of inflammation, specifically immune cell phenotype, serum lipid levels, and tissue homeostasis. Diabetes-induced changes in immune cell function produce an inflammatory immune cell phenotype (upregulation of proinflammatory cytokines from monocytes/polymorphonuclear leukocytes and downregulation of growth factors from macrophages). This predisposes to chronic inflammation, progressive tissue breakdown, and diminished tissue repair capacity. Periodontal tissues frequently manifest these changes because they are constantly wounded by substances emanating from bacterial biofilms. Diabetic patients are prone to elevated low density lipoprotein cholesterol and triglycerides (LDL/TRG) even when blood glucose levels are well controlled. This is significant, as recent studies demonstrate that hyperlipidemia may be one of the factors associated with diabetes-induced immune cell alterations. Recent human studies have established a relationship between high serum lipid levels and periodontitis. Some evidence now suggests that periodontitis itself may lea

关键词：菌血症/免疫学菌血症/病理生理学细菌感染/免疫学细菌感染/病理生理学生物膜血糖/分析胆固醇 LDL/血液糖尿病并发症糖尿病/免疫学糖尿病/病理生理学疾病易感性减量调节内毒素血症/免疫学内毒素血症/病理生理学生长物质/免疫学内环境稳定/生理学高脂血症/免疫学高脂血症/病理生理学炎症/免疫学炎症/病理生理学炎症介导素类/免疫学胰岛素抗药性/生理学白细胞介素8/免疫学胰岛/病理生理学牙周炎/并发症牙周炎/免疫学牙周炎/微生物学牙周炎/病理生理学表型危险因素甘油三酯类/血液肿瘤坏死因子α/免疫学增量调节伤口愈合人类

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Treatment of periodontal disease and control of diabetes: an assessment of the evidence and need for future research.

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Annals of periodontology / the American Academy of Periodontology 2001年第1期6卷 138-145页

作者： Grossi, S.G. Periodontal Disease Research Center Department of Oral Biology School of Dental Medicine The University at Buffalo Buffalo New York United States

Evidence points to an increased cytokine response in type 2 diabetes, especially the proinflammatory cytokines interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha. Genetics, age, and, nutrition are important signals for this increased response and as reported more recently, infections and inflammation. Persistent elevation of IL-1 beta, IL-6, and TNF-alpha in the diabetic state have an effect on the liver, stimulate the release of acute-phase proteins, produce the characteristic dysregulation of lipid metabolism associated with type 2 diabetes, and have effects on pancreatic beta cells as well. In addition, TNF-alpha, a potent inhibitor of the tyrosine kinase activity of the insulin receptor, has been implicated as an etiologic factor for insulin resistance. Collectively, the evidence supports a role for cytokine elevation in the pathophysiology and metabolic abnormalities associated with diabetes. Periodontitis is an infection that is twice as prevalent in diabetic individuals compared to non-diabetics. Porphyromonas gingivalis, one of the microorganisms responsible for this infection, is able to invade endothelial cells and is a potent signal for monocyte and macrophage activation. Thus, once established in the diabetic host, this chronic infection complicates diabetes control and increases the occurrence and severity of microvascular and macrovascular complications. Unlike treatment of acute infections, modalities of treatment for chronic infections are a matter of debate. Evidence indicates that mechanical removal of subgingival infection does not result in complete elimination of periodontal infection and consequently there is no effect on diabetes control measured as reduction in glycated hemoglobin. On the other hand, studies incorporating systemic antibiotics as adjuncts to mechanical debridement result in a reduction of P. gingivalis to nondetectable levels and a concomitant reduction in glycated hemoglobin, independent of the hypoglycemic

关键词：急相蛋白质类/代谢年龄因素抗菌药/治疗应用细菌感染/病理生理学拟杆菌科感染/病理生理学趋化作用/生理学糖尿病/病理生理学糖尿病/预防和控制预测血红蛋白A 糖基化/分析炎症/病理生理学炎症介导素类/生理学胰岛素抗药性/生理学白细胞介素1/生理学白细胞介素6/生理学胰岛/病理生理学脂类代谢营养生理学/生理学牙周疾病/微生物学牙周疾病/病理生理学牙周疾病/治疗紫单胞菌龈/生理学研究/发展趋势肿瘤坏死因子α/生理学人类

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