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SURGICAL TECHNOLOGY INTERNATIONAL V.
$175.00
STI V contains 54 articles with color illustrations.
Universal Medical Press, Inc.
San Francisco, 1996, ISBN: 0-9643425-4-5
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Transplantation
Mycophenolate Mofetil: Clinical Update
Carlton J. Young, M.D., University of Arizona School of Medicine, Tucson, AZ; Hans W. Sollinger, M.D., Ph.D., University of Wisconsin School of Medicine, Madison, WI
Since active clinical transplantation became a reality, physicians have been in constant conflict with the body's immunologic defenses. Steroids and azathioprine were the mainstay of immunosuppressive therapy for many years. During these years, graft survival was modest, with survival rates of 50% or less at one year for cadaver transplants. After the introduction of cyclosporine A in 1983, renal cadaver graft survival rates increased to 60-75%. Since that time, other immunosuppressive agents such as OKT3 and better patient management have increased 1-year graft survival rates well above 80%. Nevertheless, present immunosuppressive regimens remain toxic, nonspecific, and render the patient at increased risk of infection and lymphoproliferative disorders. Presently there exists no "magic bullet" that can render the immune system incapable of rejecting a graft while allowing the patient continued defense against infection. However, a new drug, mycophenolate mofetil (MMF; CellCept®;RS-6144-3) comes surprisingly close to this concept by ernpha- sizing a unique mechanism of action.
Orthotopic Liver Transplantation in U.S. Veterans under Primary Tacrolimus Immunosupression
Timothy Gayowski, M.D., F.R.C.S.(C.), F.A.C.S; Ignazio R. Marino, M.D., F.A.C.S.; Nina Singh, M.D.,; Howard R. Doyle, M.D.; Marilyn M. Wagener, M.P.H.; Satoru Todo, M.D.; John J. Fung, M.D., Ph.D.; Thomas E. Starzl, M.D., Ph.D.; Pittsburgh Transplantation Institute and the Vetrans Administration Medical Center, Pittsburgh, Pennsylvania
The evolution and refinement of surgical techniques, perioperative patient care, and immunosuppression have established orthotopic liver transplantation (OLTX) as a highly successful therapeutic modality for patients with end-stage liver disease. In February 1989, Tacrolimus (Prograf®, formerly FK 506) was first used successfully at the University of Pittsburgh Medical Center to treat patients with rejection refractory to cyclosporine-based immunosuppression. Clinical trials utilizing Tacrolimus in solid organ transplantation followed, and in April of 1994 it was approved for use by the
Regulation of the Anti-Allograft Response by Targeting the CD2 Antigen: A Potential Strategy for the Creation of Transplant Tolerance
Sandip Kapur, M.D., The New York Hospital-Cornell University Medical Center; Vijay Sharma, Ph.D., Ashwani Khanna, Ph.D., Baogui Li, Ph.D., Karen Sokol, M.D., The Rogosin Institute; Manikkam Suthanthiran, M.D., The Rogosin Institute and The New York Hospital Cornell University Medical Center, New York, NY
Activated T cells playa central role in the rejection of histoincompatible organ allografts. Studies of transmembrane signaling requirements of T cells, by identifying molecular and cellular mechanisms of T-cell activation, can lead to rational therapeutic strategies for the regulation of the anti-allograft response. A clear consensus exists that the primary signal for T-cell activation is generated as a consequence of the interactions among the T-cell receptor for antigen (TCR)I cluster designation 3 (CD3) complex and the antigenic peptide presented in the context of major histocompatibility complex (MHC) proteins expressed on the surface of the antigen-presenting cells (APCs). The TCR/CD3-dependent signaling is necessary but insufficient in itself to fully activate normal human primary (quiescent) T cells, and additional costimulatory signals are required for full activatiori.