Verhandelingen - Koninklijke Academie voor Geneeskunde van België
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Verh. K. Acad. Geneeskd. Belg. · Jan 1997
ReviewPlatelet-vessel wall interactions in thrombosis and restenosis role of von Willebrand factor.
As a consequence of vessel wall injury, subendothelial matrix and collagen fibers are exposed to the flowing blood. Circulating platelets adhere to these structures and initiate arrest of blood flow. Subendothelial von Willebrand Factor (vWF) plays an important role in mediating platelet adhesion to the injured site, at least in the arterial circulation, characterized by sufficiently elevated shear forces to allow a critical conformation change in vWF, enabling an interaction between the vWF domain A1 and the vWF receptor on the platelet, the GPIb/IX complex. ⋯ In vivo anti-thrombotic studies in the hamster showed that the vWF antagonist aurin tricarboxylc acid was a more potent inhibitor of arterial thrombosis than of venous thrombosis, confirming the in vivo role of vWF during thrombus formation. Following vessel wall damage and thrombus formation, the neointima that formed in the hamster carotid artery developed more rapidly than in other models, and its formation partially responded to reported inhibitors of restenosis. The combination of cardiovascular drugs with complementary modes of action, such as G4120 (inhibitor of platelet GPIIb/IIIa and smooth muscle cell alpha(v) beta(3)) and quinapril (potent vascular ACE inhibitor) prevented neointima formation to about 70%, i.e. better than with any treatment separately.
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Verh. K. Acad. Geneeskd. Belg. · Jan 1994
Present views of the surgical treatment of non-small cell lung cancer.
There is consensus regarding a pretreatment minimal staging protocol for non-small cell lung cancer. We adopted the new TNM-classification and staging system. For the preoperative mediastinal exploration CT scan (with contrast) and mediastinoscopy are complemental explorations. ⋯ When a second or third primary lung cancer appears, reoperation is the treatment of choice in the absence of metastases or other contraindications. In most cases a complete curative resection is possible. Pulmonary resections have to be complete, but as conservative as possible, eventually with broncho- and angioplasty.
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Verh. K. Acad. Geneeskd. Belg. · Jan 1993
Pharmacological influences on cardiopulmonary arrest-related brain damage in the rat.
The aim of the present work was to evaluate the protective properties of the calcium-entry blocker nimodipine against brain damage induced by cardiopulmonary arrest in a rat model. We studied first the effect of nimodipine administered in a blind and randomized fashion and started 5 min after the restoration of spontaneous circulation. Our experiments showed no improvement of survival, and nimodipine did not improve the neurological outcome in the animals surviving after 7 days. ⋯ Our results could, however, not confirm this beneficial effect. We conclude that in the rat there is no cerebroprotective effect of the calcium-entry blocker nimodipine on global brain ischemia as present during cardiopulmonary arrest. On the contrary, we even observed adverse effects, especially when high doses are used and/or when the drug is given during resuscitation attempts.
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Destructive operations are the oldest type of bloody operation in obstetrics and possibly in the (written) history of Medicine. The name "embryotomy" is already mentioned in the hippocratic literature. The indication and technique of this "two-tempi" operation (embryotomy or reduction of the fetus and embryulcia or extraction of the reduced foetus) were thoroughly mentioned, described and coded for the first time by Soranos of Ephesos. ⋯ The author elucidates the many--medical and ethical--aspects relating to embryotomy, which has been practised till after W. W. II.
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Verh. K. Acad. Geneeskd. Belg. · Jan 1991
Historical Article[Cocaine and pain control in childbirth].
Without absolutely any pain, women can live through the whole process of birth-giving thanks to the discovery of cocaine (1860) and the work of surgeons and obstetricians, who invented a whole range of locoregional methods, and the chemists who delivered them safe substitutes for cocaine. It was, as a matter of fact, a long way to go, but the final result was surely worth the effort.