RESUMO
We tested the hypothesis that an all-out-effort 200-m front-crawl swim trial affects competitive swimmers' shoulder joint position sense. On Day 1, we measured shoulder joint position sense before and after the swim trial, and on Day 2 before and after 2 min of seated rest. On both days, shoulder joint position sense was measured in the seated position using electromagnetic movement sensors in a position-matching paradigm. An investigator abducted participants' left (reference) shoulder joint in the frontal plane to test angles of 90°, 135°, and 180°. Participants then actively abducted the right (indicator) shoulder joint to match the position of the left, reference arm. After the 200-m all-out front-crawl swim trial, the indicator relative to the reference angle differed by 4.4° toward adduction at the 180° (vertical) testing position (P<0.05). Variation in absolute matching error was 3.2° or 2.2 times greater after swim compared with the no-swim control trial. An all-out 200-m front-crawl swim trial can selectively increase competitive swimmers' shoulder joint position sense error and increase variation in matching error in horizontal arm position.
Assuntos
Braço/fisiologia , Articulação do Ombro/fisiologia , Natação/fisiologia , Fenômenos Biomecânicos , Humanos , Masculino , Movimento , Adulto JovemRESUMO
Oral appliances (OAs) have demonstrated efficacy in treating obstructive sleep apnea (OSA), but many different OA devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of OAs that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or CPAP. A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (AHI), lowest SpO2 , arousal index, Epworth Sleepiness Scale (ESS), the SF-36 Health Survey. We performed this meta-analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Five studies remained eligible after applying the exclusion criteria. Comparing OA and control appliance, OA significantly reduced the weighted mean difference (WMD) in both AHI and the arousal index (favouring OA, AHI: -7.05 events h(-1) ; 95% CI, -12.07 to -2.03; P = 0.006, arousal index: -6.95 events h(-1) ; 95% CI, -11.75 to -2.15; P = 0.005). OAs were significantly less effective at reducing the WMD in AHI and improving lowest SpO2 and SF-36 than CPAP, (favouring OA, AHI: 6.11 events h(-1) ; 95% CI, 3.24 to 8.98; P = 0.0001, lowest SpO2 : -2.52%; 95% CI, -4.81 to -0.23; P = 0.03, SF-36: -1.80; 95% CI, -3.17 to -042; P = 0.01). Apnea Hypopnea Index and arousal index were significantly improved by OA relative to the untreated disease. Apnea Hypopnea Index, lowest SpO2 and SF-36 were significantly better with CPAP than with OA. The results of this study suggested that OAs improve OSA compared with untreated. CPAP appears to be more effective in improving OSA than OAs.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Mandíbula , Boca , Aparelhos Ortodônticos , Apneia Obstrutiva do Sono/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do TratamentoRESUMO
PURPOSE: Stress urinary incontinence (UI) often develops after radical prostatectomy for prostate cancer, and in those patients with moderate-to-severe stress UI an artificial urinary sphincter (AUS) is implanted. Inguinal hernias (IHs) often occur after radical prostatectomy. As the prevalence of AUS implantation increases, it is possible to encounter patients with IHs undergoing AUS implantation (IHA). This study investigated our treatment and discussed an appropriate approach for IHAs. METHODS: We retrospectively investigated patients who underwent IH repair with AUS implantation at our hospital from January 2018 to March 2023. We classified IHAs into Types A-D based on the positions of the IHs and AUS devices (the positions of the control pump, pressure-regulating balloon, and connecting tube). The hernia and control pump were ipsilateral in Types A and B, whereas the hernia and pressure-regulating balloon were ipsilateral in Types A and C. RESULTS: This study included 12 IHs of 11 patients. The median patient age was 77 years. We conducted open repair in nine patients with all types and laparoscopic repair in two patients with Type B. The median operation times for unilateral and bilateral repairs were 96 and 182 min, respectively. There were no complications with AUS or hernia surgeries. CONCLUSION: IHA has its own characteristics, and multidisciplinary knowledge thereof will help surgeons safely perform IH surgery.
Assuntos
Hérnia Inguinal , Herniorrafia , Prostatectomia , Esfíncter Urinário Artificial , Humanos , Masculino , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Idoso , Estudos Retrospectivos , Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Incontinência Urinária por Estresse/cirurgia , Complicações Pós-Operatórias/etiologia , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Neoplasias da Próstata/cirurgiaRESUMO
This study examined the aspect of the regulation of velum movement in the transition from the oral to pharyngeal phases of swallowing in relation to changes in the swallowing volume and viscosity by means of measurment of levator veli palatini muscle activity. The subjects were nine normal adults, ranging in age from 24 to 30 years. The swallowing volume was set at 1/4, 1/2 and 1 volume of the optimum volume of green tea for swallowing determined in each subject, and the viscosity was adjusted to 0, 2·0 and 4·6 Pa·s by mixing with thickener. Nine test foods were prepared in total. The electromyographic activity of the levator veli palatini muscle was monitored using bipolar hooked wire electrodes. The levator veli palatini muscle activity was defined as the integrated electromyographic wave. The mean in swallowing each test food was determined in each subject. The levator veli palatini muscle activity increased with the swallowing volume for all subjects (P < 0·05) and decreased inversely with the viscosity for six subjects (P < 0·05), but no change with the increase in the viscosity was noted for three subjects. This study clarified the aspect of the regulation of velar movement with regard to the involvement of the levator veli palatini muscle in swallowing activity with changes in the swallowing volume and viscosity.
Assuntos
Deglutição/fisiologia , Músculos Palatinos/fisiologia , Palato Mole/fisiologia , Adulto , Eletromiografia , Feminino , Humanos , Técnicas In Vitro , Masculino , Fatores de Tempo , Viscosidade , Adulto JovemRESUMO
The hyoid bone moves during swallowing due to contraction of suprahyoid muscles, which are critical components of normal swallowing function. It has been reported that the muscle force and shortening velocity decline gradually with age. Reduced hyoid velocities may delay the sealing of the laryngeal vestibule and opening of the cricopharyngeal muscle. We hypothesised that the hyoid velocity could be a factor influencing aspiration. This study evaluated effects of bolus volume changes on the hyoid distance and velocity in normal swallowing. The subjects were 21 healthy young adults. Lateral projection videofluorography was recorded while each subject swallowed 2·5, 5·0, 10 and 20 mL of liquid barium. We evaluated the maximum hyoid distance (Max d), anterior and superior distance (Max ad, Max sd). And, we evaluated the maximum velocity (Max v), anterior and superior velocity (Max av, Max sv). Two-way anova test revealed that Max d, Max ad and Max sd for different bolus volumes are not significantly different. But, two-way anova test showed statistically significant difference in Max v, Max av and Max sv among different bolus volume (P < 0·01). Tukey's test showed that there are significant differences in Max v between 2·5 and 20 mL, 5·0 and 20 mL, 10 and 20 mL, and 2·5 and 10 mL swallowing. And, Tukey's test showed significant differences in Max av and Max sv between 2·5 and 20 mL, 5·0 and 20 mL, and 10 and 20 mL swallowing. It is possible that a larger bolus volume requires greater maximum hyoid velocity. We plan to study hyoid velocity in elderly subjects and in those with dysphagia.
Assuntos
Deglutição/fisiologia , Osso Hioide/fisiologia , Movimento/fisiologia , Adulto , Análise de Variância , Bário , Feminino , Fluoroscopia/métodos , Humanos , Osso Hioide/anatomia & histologia , Masculino , Gravação em Vídeo , Adulto JovemRESUMO
Quantitative trait loci (QTLs) for resistance to rice blast offer a potential source of durable disease resistance in rice. However, few QTLs have been validated in progeny testing, on account of their small phenotypic effects. To understand the genetic basis for QTL-mediated resistance to blast, we dissected a resistance QTL, qBR4-2, using advanced backcross progeny derived from a chromosome segment substitution line in which a 30- to 34-Mb region of chromosome 4 from the resistant cultivar Owarihatamochi was substituted into the genetic background of the highly susceptible Aichiasahi. The analysis resolved qBR4-2 into three loci, designated qBR4-2a, qBR4-2b, and qBR4-2c. The sequences of qBR4-2a and qBR4-2b, which lie 181 kb apart from each other and measure, 113 and 32 kb, respectively, appear to encode proteins with a putative nucleotide-binding site (NBS) and leucine-rich repeats (LRRs). Sequence analysis of the donor allele of qBR4-2a, the region with the largest effect among the three, revealed sequence variations in the NBS-LRR region. The effect of qBR4-2c was smallest among the three, but its combination with the donor alleles of qBR4-2a and qBR4-2b significantly enhanced blast resistance. qBR4-2 comprises three tightly linked QTLs that control blast resistance in a complex manner, and thus gene pyramiding or haplotype selection is the recommended strategy for improving QTL-mediated resistance to blast disease through the use of this chromosomal region.
Assuntos
Cromossomos de Plantas/genética , Genes de Plantas , Oryza/genética , Doenças das Plantas/genética , Alelos , Mapeamento Cromossômico , Cruzamentos Genéticos , Resistência à Doença/genética , Ligação Genética , Oryza/imunologia , Doenças das Plantas/imunologia , Doenças das Plantas/microbiologia , Análise de Sequência de DNARESUMO
Disuse atrophy of swallowing-related organs is suspected when decreased swallowing frequency is seen in the elderly. However, swallowing frequency has not been examined in elderly people during daily life. We developed a swallowing frequency meter containing a laryngeal microphone that does not restrict the subject's ability to perform daily activities. In this study, the utility of the meter was assessed. Experiment 1: The ability of the meter to detect swallowing was examined. The subject was instructed to swallow saliva or foods at a voluntarily pace. During these procedures, swallowing events were simultaneously recorded by the meter, self-enumeration and videofluorography. As a result, all of the swallowing events identified by the meter coincided with the swallowing events identified by self-enumeration and videofluorography. Experiment 2: Swallowing sounds display various patterns both between and within individuals. Therefore, we examined the concordance rate between the number of swallowing events counted by the meter and that counted by self-enumeration in 15 subjects over a longer period than in experiment 1. The concordance rates calculated by two examiners between the meter and self-enumeration were 96·8 ± 4·5% and 98·9 ± 3·3% at rest and 95·2 ± 4·5% and 96·1 ± 4·1% during meals, respectively. Our findings indicate that this meter is useful for measuring the frequency of swallowing during daily situations.
Assuntos
Deglutição/fisiologia , Laringe , Monitorização Ambulatorial/instrumentação , Som , Adulto , Feminino , Fluoroscopia/métodos , Humanos , MP3-Player , Masculino , Reprodutibilidade dos Testes , Autorrelato , Gravação em Vídeo , Adulto JovemRESUMO
BACKGROUND: There is no standard treatment available for gastric cancer patients whose sole 'non-curative factor' is positivecytological findings in peritoneal washings (CFPW). The aim of this study was to examine the safety, pharmacokinetics and efficacy for free intraperitoneal cancer cells of intraperitoneal chemotherapy with paclitaxel after gastrectomy with en bloc D2 lymph node dissection in cases of gastric cancer with positive CFPW. METHODS: Ten patients with gastric cancer who underwent gastrectomy and systemic lymphadenectomy with D2 dissection, without any other non-curative factors besides positive CFPW, were treated with early postoperative intraperitoneal paclitaxel. Intra-chemotherapeutic toxicity and operative complications were measured using NCI-CTC version 3.0. Intraperitoneal and plasma paclitaxel concentrations were measured using a high-performance liquid chromatographic assay. RESULTS: Grade 3/4 toxic effects included anemia (20%) and neutropenia (10%) that required no treatment. Operative complications were, for example, superficial surgical site infections (10%) that were treated with antibiotics. No viable cancer cells were observed in the intra-abdominal fluid 24 h after intraperitoneal administration of paclitaxel. The intraperitoneal/plasma area under the drug concentration-time curve ratio was 2,003.3:1. CONCLUSION: Intraperitoneal chemotherapy with paclitaxel is a safe and effective treatment modality for free intraperitoneal cancer cells.
Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/administração & dosagem , Neoplasias Gástricas/tratamento farmacológico , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Antineoplásicos/farmacocinética , Antineoplásicos/toxicidade , Protocolos de Quimioterapia Combinada Antineoplásica , Feminino , Humanos , Infusões Parenterais , Masculino , Pessoa de Meia-Idade , Cavidade Peritoneal/patologia , Lavagem Peritoneal , Estudos Prospectivos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgiaRESUMO
Immunization of C57BL/6 (B6) mice with FBL, a Friend murine leukemia virus (F-MuLV), induces both tumor-specific cytolytic CD8+ (CTL) and lymphokine-producing CD4+ Th that are effective in adoptive therapy of B6 mice bearing disseminated FBL leukemia. The current study evaluated the F-MuLV antigenic determinants expressed on FBL that are recognized by FBL-reactive CD8+ and CD4+ T cells. To identify the specificity of the FBL-reactive CD8+ CTL, Fisher rat embryo fibroblast (FRE) cells transfected with plasmids encoding F-MuLV gag or envelope (env) gene products plus the class I-restricting element Db were utilized. FBL-reactive CTL recognized FRE target cells transfected with the F-MuLV gag-encoded gene products, but failed to recognize targets expressing F-MuLV env. Attempts to generate env-specific CD8+ CTL by immunization with a recombinant vaccinia virus containing an inserted F-MuLV env gene were unsuccessful, despite the generation of a cytolytic response to vaccinia epitopes, implying that B6 mice fail to generate CD8+ CTL to env determinants. By contrast, CD4+ Th clones recognized FRE target cells transfected with env and not gag genes, and immunization with the recombinant vaccinia virus induced an env-specific CD4+ T cell response. These data show that in a Friend retrovirus-induced tumor model in which tumor rejection can be mediated by either CTL or Th, antigens derived from discrete retroviral proteins are predominantly responsible for activation of each T cell subset.
Assuntos
Antígenos Virais/imunologia , Linfócitos T CD4-Positivos/imunologia , Vírus da Leucemia Murina de Friend/imunologia , Linfócitos T Citotóxicos/imunologia , Linfócitos T Auxiliares-Indutores/imunologia , Animais , Antígenos Virais/genética , Clonagem Molecular , Citotoxicidade Imunológica , Produtos do Gene gag , Antígenos de Histocompatibilidade Classe II/imunologia , Técnicas In Vitro , Ativação Linfocitária , Camundongos , Proteínas dos Retroviridae/genética , Proteínas dos Retroviridae/imunologia , Transfecção , Proteínas do Envelope Viral/imunologiaRESUMO
A rare case of a 31-year-old woman is reported who had massive intraperitoneal bleeding caused by ovarian hemorrhage as the first manifestation of acute leukemia. Preoperative laboratory findings revealed severe anemia (Hb 6.6 g/dl) and thrombocytopenia (1.5 x 10(4)/mm(3)) but normal leukocyte count (3.9 x 10(3)/mm(3)). After surgery, blast cells were found in her peripheral blood and she was diagnosed with M0 type acute myeloid leukemia. In addition, histopathology revealed infiltration of leukemic cells in the resected ovary.
Assuntos
Hemoperitônio/etiologia , Leucemia Mieloide Aguda/patologia , Neoplasias Ovarianas/secundário , Adulto , Feminino , Humanos , Neoplasias Ovarianas/cirurgiaRESUMO
The purpose of this study was to evaluate the utility of a novel organ dysfunction assessment score developed for patients with severe traumatic brain injury during therapeutic brain hypothermia. The Brain Hypothermia Organ Dysfunction Assessment (BHODA) score is calculated through the combined assessment of 6 indices: central nervous system (CNS) function, respiratory function, cardiovascular function, hepatosplanchnic circulation, coagulation, and metabolism. The CNS, hepatosplanchnic circulation, and metabolic indices were based on measurements of cerebral perfusion pressure, gastric tonometry, and blood glucose, respectively. Thirty-nine patients with severe closed head injuries (scores of 3 to 8 on the Glasgow Coma Scale) were enrolled. Seven patients (18%) died during hospitalization. Outcome was favorable in 20 patients and unfavorable in 19. The BHODA score proved useful in describing sequences of complications during therapeutic brain hypothermia. A total maximum BHODA score of more than 13 points corresponded to a mortality of 70%. In a multivariate model, the total maximum BHODA score was independently associated with neurological outcome (odds ratio for unfavorable neurological outcome, 2.590: 95% confidence interval, 1.260, 5.327). In conclusion, the BHODA score can help assess multiple organ dysfunction/failure during therapeutic hypothermia and may be useful for predicting outcome.
Assuntos
Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/terapia , Hipotermia Induzida/métodos , Monitorização Fisiológica/métodos , Insuficiência de Múltiplos Órgãos/classificação , Insuficiência de Múltiplos Órgãos/diagnóstico , Avaliação de Resultados em Cuidados de Saúde/métodos , Índices de Gravidade do Trauma , Adolescente , Adulto , Idoso , Traumatismos Craniocerebrais/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/prevenção & controle , Prognóstico , Resultado do TratamentoRESUMO
Dimethyl sulfoxide (DMSO) is widely used as a solvent for other drugs, i.e., for the protein kinase C activator phorbol 12-myristate 13-acetate (PMA) and the V1a receptor-antagonist SR49059, to reduce brain edema. We studied the effect of DMSO on blood-brain barrier (BBB) integrity following middle cerebral artery occlusion (MCAO) and the consequences on brain edema development. Male Sprague-Dawley rats were randomly assigned to sham procedure or infusion of 1% DMSO, PMA (230 microg/kg in 1% DMSO), or SR49059 (1 mg/kg in 1% DMSO) followed by MCAO (each group n = 10). After a 2-hour period of ischemia and 2 hours reperfusion, the animals were sacrificed for assessment of brain water content, sodium, and potassium concentration. BBB integrity was assessed by Evans blue extravasation. Statistical analysis was performed by ANOVA followed by a Tukey post hoc test. Low-dose DMSO treatment following MCAO significantly opened the BBB on the ischemic side (p < 0.037). PMA and SR49059 did not have any additional effect on BBB compromise compared to DMSO (p = 1.000, p < 0.957, respectively). We conclude that DMSO as a vehicle for drug administration may increase the drug concentration into the extracellular space, but since BBB permeability is increased, it may also provide an avenue for development of vasogenic edema.
Assuntos
Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/fisiopatologia , Edema Encefálico/fisiopatologia , Dimetil Sulfóxido/administração & dosagem , Infarto da Artéria Cerebral Média/fisiopatologia , Animais , Edema Encefálico/etiologia , Relação Dose-Resposta a Droga , Infarto da Artéria Cerebral Média/complicações , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
OBJECTIVE: To evaluate hemodynamics in patients with severe traumatic brain injury (TBI) after cerebral perfusion pressure (CPP) management using cerebrospinal fluid (CSF) drainage. METHODS: Twenty-six patients with TBI (Glasgow Coma Score = 8 or less) were investigated. Mean arterial blood pressure, CPP, cardiac index (CI), systemic vascular resistance index (SVRI), and central venous pressure were measured. The patients were divided into 2 groups after craniotomy: the intraparenchymal ICP (IP-ICP) monitoring group (n = 14) and ventricular ICP (V-ICP) monitoring group (n = 12). Patient hemodynamics were investigated on the second hospital day to identify differences. Measurements indicated a target CPP above 70 mmHg and a central venous pressure of 8 10 mmHg in both groups. Mannitol administration (IP-ICP group) or CSF drainage (V-ICP group) was performed whenever the CPP remained below 70 mmHg. RESULTS: High SVRI and low CI (p < 0.05) were observed in the IP-ICP group. The V-ICP group exhibited a reduction in the total fluid infusion volume of crystalloid (p < 0.01) and a reduction in the frequency of hypotensive episodes after the mannitol infusion. CONCLUSIONS: CPP management using CSF drainage decreases the total infusion volume of crystalloid and may reduce the risk of aggravated brain edema after excess fluid resuscitation.
Assuntos
Pressão Sanguínea , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/terapia , Encéfalo/irrigação sanguínea , Drenagem , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/terapia , Velocidade do Fluxo Sanguíneo , Encéfalo/fisiopatologia , Circulação Cerebrovascular , Humanos , Prognóstico , Índices de Gravidade do Trauma , Resultado do TratamentoRESUMO
OBJECTIVES: To investigate the clinical characteristics of contralateral intracranial hematoma (ICH) after traumatic brain injury. METHODS: The subjects included 149 patients with traumatic ICH treated by hematoma evacuation. The patients were retrospectively divided into a bilateral ICH (B-ICH) group and unilateral ICH (U-ICH) group after craniotomy using brain CT scans for comparison of the following parameters: complicated expanded brain bulk from the cranial window, hypotension during craniotomy, and outcome. RESULTS: Post-craniotomy brain CT scans revealed U-ICH in 106 patients and B-ICH in 43 patients. Average Glasgow Coma Scale on arrival did not differ between the groups, but a higher proportion of patients in the B-ICH group deteriorated after admission (p = 0.02). The B-ICH patients also exhibited a significantly higher rate of expanded brain bulk from the cranial window (p < 0.05). No significant difference was observed between the groups with hypotension during craniotomy. The B-ICH group exhibited a lower rate of favorable outcome (p < 0.05) and higher mortality (p < 0.05). CONCLUSION: The B-ICH patients had a worse outcome than the U-ICH patients. Contralateral ICH was difficult to forecast based on pre- and intraoperative clinical conditions. Subdural hematoma or contusional ICH was frequently observed as a contralateral ICH.
Assuntos
Lesões Encefálicas/epidemiologia , Lesões Encefálicas/cirurgia , Craniotomia/estatística & dados numéricos , Descompressão Cirúrgica/estatística & dados numéricos , Hemorragia Intracraniana Traumática/epidemiologia , Hemorragia Intracraniana Traumática/cirurgia , Avaliação de Resultados em Cuidados de Saúde/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/diagnóstico por imagem , Criança , Feminino , Humanos , Hemorragia Intracraniana Traumática/diagnóstico por imagem , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Radiografia , Medição de Risco/métodos , Fatores de Risco , Resultado do TratamentoRESUMO
OBJECTIVE: A gradient between the jugular vein temperature and core body temperature has been reported in animal and clinical studies; however, the pathophysiological meaning of this phenomenon remains unclear. This study was conducted to identify the temperature gradient between the jugular vein and pulmonary artery in comatose patients after cardiopulmonary resuscitation. MATERIALS AND METHODS: The temperatures of the jugular vein and pulmonary artery were measured in 19 patients at 6 and 24 hours after cardiopulmonary resuscitation. Jugular venous blood saturation (SjO2; %) was also measured concomitantly. The patients were divided into 2 groups: high SjO2 (SjO2 > 75%: H-group; n = 10) and normal SjO2 (SjO2 < or = 75%: N-group; n = 9). The temperature gradient was calculated by subtracting the temperature of the pulmonary artery from that of the jugular vein (jugular - pulmonary = dT degrees C). Statistical significance was defined as p < 0.05. RESULTS: dT was significantly lower in the H-group than in the N-group at 6 hours (0.120 +/- 0.011: mean +/- SD vs. 0.389 +/- 0.036: p = 0.0012) and 24 hours (0.090 +/- 0.005 vs. 0.256 +/- 0.030: p = 0.0136) after cardiopulmonary resuscitation. CONCLUSION: The temperature gradient between the jugular vein and pulmonary artery was significantly lower in patients with high SjO2 after cardiopulmonary resuscitation. This temperature gradient may be reflected in brain oxygen metabolism.
Assuntos
Temperatura Corporal , Encéfalo/metabolismo , Reanimação Cardiopulmonar , Coma/fisiopatologia , Veias Jugulares/fisiopatologia , Oxigênio/metabolismo , Artéria Pulmonar/fisiopatologia , Encéfalo/irrigação sanguínea , Feminino , Parada Cardíaca/fisiopatologia , Parada Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Activating transcription factor-2 (ATF-2) is a transcription factor that binds to cAMP response element (CRE). ATF-2 contains two functional domains, an N-terminal transactivation domain and a C-terminal DNA-binding domain. The DNA-binding domain contains the basic leucine zipper (bZip) motif. Here, the three-dimensional structure of the transactivation domain of ATF-2 has been determined by NMR. The transactivation domain consists of two subdomains: the structure of an N-terminal half (N-subdomain) is well determined, while a C-terminal half (C-subdomain) takes a highly flexible and disordered structure. The architecture of the N-subdomain is very similar to that of the well-known zinc finger motif found in DNA-binding domains, consisting of an antiparallel beta-sheet and an alpha-helix. The zinc atom is tetrahedrally coordinated to two cysteine residues and two histidine residues. Amino acids that form the hydrophobic core in all of the DNA-binding zinc fingers are well conserved in the N-subdomain of the transactivation domain, whereas some amino acids that are responsible for binding to the phosphate backbone of DNA in the DNA-binding zinc fingers are substituted with other amino acids. The flexible C-subdomain, which contains two threonine residues that the stress-activated protein kinases phosphorylate, is likely to undergo a conformational change by specific binding to a target protein.
Assuntos
Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/química , Fatores de Transcrição/química , Fator 2 Ativador da Transcrição , Sequência de Aminoácidos , Sítios de Ligação/genética , Dicroísmo Circular , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/genética , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , DNA/metabolismo , Humanos , Técnicas In Vitro , Espectroscopia de Ressonância Magnética , Modelos Moleculares , Dados de Sequência Molecular , Conformação Proteica , Estrutura Secundária de Proteína , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Homologia de Sequência de Aminoácidos , Soluções , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Ativação Transcricional , Dedos de Zinco/genéticaRESUMO
The current study examined sera from 160 colon cancer patients and 60 normal individuals to determine whether antibody to mutated p21 ras protein was present. Studies focused on the aspartic acid substitution at amino acid position 12 (denoted D12), one of the most common mutations in colon adenocarcinoma. IgA antibodies directed against mutated p21 ras-D12 protein were detected in 51 (32%) of 160 colon cancer patients, but only in 1 (2.5%) of 40 normal individuals. The greater incidence of antibody in cancer patients provides presumptive evidence that immunization to the ras proteins occurred as a result of the malignancy. Examination of sera for antibody reactivity to wild-type p21 ras protein (denoted p21 ras-G12) as well as p21 ras proteins bearing the D12, V12, S12, or L61 mutations showed that antibody detected was largely to normal segments of the p21 ras protein. Epitope mapping, using peptide neutralization assays with mutated or normal ras peptides as competitors, demonstrated that in 10 (67%) of 15 sera examined the antibody reactivity to p21 ras-G12 protein was neutralized by peptides near the carboxyl terminus of p21 ras protein, but not by peptides spanning the specific point mutation region. Antibody reactivities correlated with peripheral blood lymphocyte count, but did not correlate with patient age, sex, histology, stage, tumor locus, lymph node metastasis, or serum carcinoembryonic antigen.
Assuntos
Anticorpos Antineoplásicos/sangue , Neoplasias do Colo/imunologia , Imunoglobulina A/sangue , Mutação/imunologia , Proteínas de Neoplasias/imunologia , Proteínas Proto-Oncogênicas p21(ras)/imunologia , Reações Antígeno-Anticorpo/imunologia , Neoplasias do Colo/sangue , Humanos , Proteínas de Neoplasias/genética , Fragmentos de Peptídeos/imunologia , Proteínas Proto-Oncogênicas p21(ras)/genéticaRESUMO
Previous studies have demonstrated that i.v. presensitization of C57BL/6 (B6) mice with class I H-2-disparate B6-C-H-2bml (bml) spleen cells induced potent suppression of anti-bml CD8+ T cell-mediated responses in vitro as well as suppression of the allograft response. The present study analyzes the population of donor bml cells required for suppression of the generation of the cellular subsets involved in the in vitro and in vivo immune responses. Anti-bml CD8+ helper T cell (proliferative/IL-2-producing) activities were almost completely eliminated by i.v. inoculation of bml whole blood or various (T or B cell) fractions of spleen cells. However, anti-bml CD8+ cytotoxic T lymphocyte capacity was significantly reduced by i.v. sensitization with bml T cell-containing, but not with T cell-depleted splenic fractions. In B6 mice receiving bml skin grafts following i.v. sensitization with T-depleted bml spleen cells, marginal Th activity was induced. However, the CTL response was equal to that observed in unsensitized mice, and allograft survival was not prolonged. Prolongation of bml graft survival was achieved by i.v. presensitization with bml T cell fraction, indicating that bml T cells were a requirement for suppression of graft rejection in the B6-bml combination. In contrast, in the B6-C-H-2bml2 (bml2) combination in which CD4+ T cells are responding to bml2 alloantigens, only the B cell fraction was capable of prolonging bm12 graft survival. These results indicate that functionally and phenotypically different subsets of alloantigen-reactive T cells are rendered unresponsive by i.v. presensitization with distinct fractions of donor lymphoid cells.
Assuntos
Tolerância Imunológica , Terapia de Imunossupressão , Subpopulações de Linfócitos T/imunologia , Animais , Linfócitos B/imunologia , Células Cultivadas , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Interleucina-2/biossíntese , Isoantígenos , Teste de Cultura Mista de Linfócitos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Transplante de Pele/imunologia , Baço/imunologia , Baço/transplante , Linfócitos T Citotóxicos/imunologiaRESUMO
The hepatic extraction ratios (EH) of 5-fluorouracil (FUra) in rats were studied to clarify the disposition of FUra in the liver. The EH of FUra in rats at infusion rates ranging from 0.375 to 3 mg/kg/min decreased from 0.750 to 0.225. The EH of values of tegafur, a pro-drug of FUra, were 0.076 to 0.103 over the range of infusion rates, 0.577 to 4.616 mg/kg/min, and were much lower than those of FUra. The EH of FUra at an infusion rate of 0.375 mg/kg/min combined with uracil (0.323 mg/kg/min) was 0.646, which was significantly lower than that of FUra alone, 0.750 (P < 0.001). The EH of FUra combined with interleukin-2 (IL-2) at an infusion rate of 7500 U/kg/min was significantly higher than that of FUra alone (P < 0.01). The dose dependence of the EH of FUra and the effects of uracil and IL-2 on the EH of FUra corresponded with clinical findings. These results suggest that this experimental model in rats may be useful for predicting the clinical pharmacokinetics and efficacy of FUra. We also studied the effect of IL-2 on the EH of mitomycin C (MMC). The EH of MMC combined with IL-2 was higher than that of MMC alone, but the difference was not significant.