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1.
Diabetologia ; 54(11): 2953-62, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21833587

RESUMO

AIMS/HYPOTHESIS: The activation of platelet-derived growth factor receptor-ß (PDGFR-ß) signalling is increased in the glomeruli and tubules of diabetic animals. In this study, we examined the role of PDGFR-ß signalling during the development of diabetic nephropathy. METHODS: We recently generated pancreatic beta cell-specific Ca(2+)/calmodulin-dependent protein kinase IIα (Thr286Asp) transgenic mice (CaMKIIα mice), which show very high plasma glucose levels up to 55.5 mmol/l and exhibit the features of diabetic nephropathy. These mice were crossed with conditional knockout mice in which Pdgfr-ß (also known as Pdgfrb) was deleted postnatally. The effect of the deletion of the Pdgfr-ß gene on diabetic nephropathy in CaMKIIα mice was evaluated at 10 and 16 weeks of age. RESULTS: The plasma glucose concentrations and HbA(1c) levels were elevated in the CaMKIIα mice from 4 weeks of age. Variables indicative of diabetic nephropathy, such as an increased urinary albumin/creatinine ratio, kidney weight/body weight ratio and mesangial area/glomerular area ratio, were observed at 16 weeks of age. The postnatal deletion of the Pdgfr-ß gene significantly decreased the urinary albumin/creatinine ratio and mesangial area/glomerular area ratio without affecting the plasma glucose concentration. Furthermore, the increased oxidative stress in the kidneys of the CaMKIIα mice as shown by the increased urinary 8-hydroxydeoxyguanosine (8-OHdG) excretion and the increased expression of NAD(P)H oxidase 4 (NOX4), glutathione peroxidase 1 (GPX1) and manganese superoxide dismutase (MnSOD) was decreased by Pdgfr-ß gene deletion. CONCLUSIONS/INTERPRETATION: The activation of PDGFR-ß signalling contributes to the progress of diabetic nephropathy, with an increase in oxidative stress and mesangial expansion in CaMKIIα mice.


Assuntos
Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/fisiologia , Nefropatias Diabéticas/fisiopatologia , Receptor beta de Fator de Crescimento Derivado de Plaquetas/fisiologia , Substituição de Aminoácidos , Animais , Biomarcadores/sangue , Biomarcadores/metabolismo , Biomarcadores/urina , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Cruzamentos Genéticos , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/patologia , Progressão da Doença , Mesângio Glomerular/patologia , Células Secretoras de Insulina/metabolismo , Rim/metabolismo , Rim/patologia , Rim/fisiopatologia , Masculino , Células Mesangiais/metabolismo , Células Mesangiais/patologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Proteínas Mutantes/fisiologia , Estresse Oxidativo , Oxirredutases/metabolismo , Receptor beta de Fator de Crescimento Derivado de Plaquetas/genética , Transdução de Sinais
2.
J Appl Physiol (1985) ; 107(1): 112-20, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19443741

RESUMO

Studying the responsiveness of specific central nervous system pathways to electrical or magnetic stimulation can provide important information regarding fatigue processes in the central nervous system. We investigated the changes in corticospinal responsiveness during a sustained submaximal contraction of the triceps surae. Comparisons were made between the size of motor-evoked potentials (MEPs) elicited by motor cortical stimulation and cervicomedullary motor-evoked potentials (CMEPs) elicited by magnetic stimulation of the descending tracts to determine the site of any change in corticospinal responsiveness. Participants maintained an isometric contraction of triceps surae at 30% of maximal voluntary contraction (MVC) for as long as possible on two occasions. Stimulation was applied to the motor cortex or the cervicomedullary junction at 1-min intervals during contraction until task failure. Peripheral nerve stimulation was also applied to evoke maximal M waves (M(max)) and a superimposed twitch. Additionally, MEPs and CMEPs were evoked during brief contractions at 80%, 90%, and 100% of MVC as a nonfatigue control. During the sustained contractions, MEP amplitude increased significantly in soleus (113%) and medial gastrocnemius (108%) muscles and, at task failure, matched MEP amplitude in the prefatigue MVC ( approximately 20-25% M(max)). In contrast, CMEP amplitude increased significantly in medial gastrocnemius (51%), but not in soleus (63%) muscle and, at task failure, was significantly smaller than during prefatigue MVC (5-6% M(max) vs. 11-13% M(max)). The data indicate that cortical processes contribute substantially to the increase in corticospinal responsiveness during sustained submaximal contraction of triceps surae.


Assuntos
Potencial Evocado Motor/fisiologia , Contração Isométrica/fisiologia , Córtex Motor/fisiologia , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Tratos Piramidais/fisiologia , Adulto , Estimulação Elétrica/métodos , Eletromiografia , Feminino , Humanos , Extremidade Inferior , Masculino , Estimulação Magnética Transcraniana/métodos
3.
Science ; 286(5444): 1543-5, 1999 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-10567256

RESUMO

A general approach is presented for creating polymer gels that can recognize and capture a target molecule by multiple-point interaction and that can reversibly change their affinity to the target by more than one order of magnitude. The polymers consist of majority monomers that make the gel reversibly swell and shrink and minority monomers that constitute multiple-point adsorption centers for the target molecule. Multiple-point interaction is experimentally proven by power laws found between the affinity and the concentration of the adsorbing monomers within the gels.


Assuntos
Cloreto de Amônio/química , Sulfonatos de Arila/química , Géis/química , Metacrilatos/química , Polímeros/química , Adsorção , Cloretos/química , Espectrometria de Fluorescência , Espectrofotometria Ultravioleta , Temperatura
4.
J Appl Physiol (1985) ; 105(5): 1527-32, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18787089

RESUMO

This study investigated corticospinal-evoked responses in lower limb muscles during voluntary contractions at varying strengths. Similar investigations have been made on upper limb muscles, where evoked responses have been shown to increase up to approximately 50% of maximal force and then decline. We elicited motor-evoked potentials (MEPs) and cervicomedullary motor-evoked potentials (CMEPs) in the soleus (Sol) and medial gastrocnemius (MG) muscles using magnetic stimulation over the motor cortex and cervicomedullary junction during voluntary plantar flexions with the torque ranging from 0 to 100% of a maximal voluntary contraction. Differences between the MEP and CMEP were also investigated to assess whether any changes were occurring at the cortical or spinal levels. In both Sol and MG, MEP and CMEP amplitudes [normalized to maximal M wave (Mmax)] showed an increase, followed by a plateau, over the greater part of the contraction range with responses increasing from approximately 0.2 to approximately 6% of Mmax for Sol and from approximately 0.3 to approximately 10% of Mmax for MG. Because both MEPs and CMEPs changed in a similar manner, the observed increase and lack of decrease at high force levels are likely related to underlying changes occurring at the spinal level. The evoked responses in the Sol and MG increase over a greater range of contraction strengths than for upper limb muscles, probably due to differences in the pattern of motor unit recruitment and rate coding for these muscles and the strength of the corticospinal input.


Assuntos
Córtex Motor/fisiologia , Contração Muscular , Força Muscular , Músculo Esquelético/inervação , Tratos Piramidais/fisiologia , Adulto , Estimulação Elétrica , Eletromiografia , Potencial Evocado Motor , Feminino , Humanos , Extremidade Inferior , Masculino , Recrutamento Neurofisiológico , Fatores de Tempo , Torque , Estimulação Magnética Transcraniana , Volição , Adulto Jovem
5.
Exp Brain Res ; 185(4): 699-707, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17989963

RESUMO

To determine whether the soleus (SOL) H-reflex is modulated during shortening contractions in a manner that has been observed for isometric contractions, SOL H-reflexes and M-waves were elicited via percutaneous electrical stimulation to the tibial nerve at an intensity that evoked an H-reflex at 50% of its maximum in 11 healthy subjects. Paired electrical stimuli were delivered as the ankle angle passed through 90 degrees at an interval of 400 ms while the subject performed shortening contractions at levels of plantar flexion torque ranging between 2 and 30% of that during a maximal voluntary contraction (MVC). H-reflexes were also recorded during the performance of isomeric contractions of plantar flexors at similar levels of plantar flexion torque and at the same joint angle (muscle length) in an additional five healthy subjects. Correlations were examined between the peak-to-peak amplitude of the first H-reflexes, M-waves and plantar flexion torques in both protocols. It was revealed that no significant correlation was found between the SOL H-reflex and increasing plantar flexion torque during shortening contractions (rho = -0.07, P = 0.15), while a strong positive correlation was observed for the isometric conditions (rho = 0.99, P < 0.01). No significant change was observed in the SOL M-wave for either contraction type. Furthermore, the H-reflexes elicited via paired stimuli with the same background activity in voluntary shortening contractions showed almost identical amplitudes, suggesting that the level of homosynaptic post-activation depression did not change in response to the varying levels of activation in voluntary shortening contractions. Therefore, the lack of increase in the H-reflex during shortening contractions at increasing intensities is possibly due to a centrally regulated increase in presynaptic inhibition. Such a downward modulation of the reflex suggests that Ia-excitatory input onto the SOL motoneurone pool needs to be reduced during the performance of shortening contractions.


Assuntos
Pé/fisiologia , Reflexo H/fisiologia , Contração Muscular/fisiologia , Esforço Físico/fisiologia , Adulto , Vias Aferentes/fisiologia , Feminino , Humanos , Masculino
6.
Water Sci Technol ; 53(11): 251-60, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16862797

RESUMO

An expanded-bed anaerobic reactor with granular activated carbon (GAC) medium has been developed to treat wastewaters that contain a high concentration of inhibitory and/or refractory organic compounds as well as readily degradable organic compounds. The process is characterised by a combination of two removal mechanisms; adsorption on GAC and biological degradation by microorganisms grown on GAC. Applicability of the reactor to treatment of phenol, chloroacetaldehyde (CAA), pentachlorophenol (PCP) and tetrachloroethylene (PCE) was discussed based on experimental data. All chemicals focused on here were removed well and stably at a removal efficiency of more than 98% even during starting operation and shock load operation. Chemicals in influent that exceeded biological degradation capacity was initially adsorbed on GAC and then gradually degraded, and hence the adsorptive capacity of GAC was regenerated biologically. These results proved that a biological activated carbon anaerobic reactor was effective for treatment of wastewater containing hazardous chemicals, especially for strongly absorbable chemicals, as well as readily degradable organic compounds at high concentration.


Assuntos
Biodegradação Ambiental , Carbono/química , Substâncias Perigosas/análise , Fenóis/química , Eliminação de Resíduos Líquidos/métodos , Acetaldeído/análogos & derivados , Acetaldeído/análise , Adsorção , Bactérias Anaeróbias , Reatores Biológicos , Pentaclorofenol/análise , Tetracloroetileno/análise , Fatores de Tempo , Purificação da Água
7.
Kyobu Geka ; 59(6): 487-90, 2006 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-16780070

RESUMO

A 71-year-old woman was found to have an abnormal shadow on a chest X-ray. Fifteen years earlier she had undergone a subtotal thyroidectomy for thyroid cancer without any lymph node metastasis. Chest computed tomography (CT) revealed a mediastinal tumor with full of blood stream. Since the positron emission tomography (PET) disclosed an increased uptake of fluoro-2-deoxy-D-glucose (FDG) in the tumor, a malignant lymphatic tumor was therefore suspected. An immunohistological examination of biopsy specimens taken by thoracoscopic procedure demonstrated tumor to be lymph node metastasis of the previous thyroid cancer. After a tumor resection by means of a thoracotomy and total thyroidectomy, the patient was scheduled to receive radioiodine therapy. The previously reported cases are also herein reviewed.


Assuntos
Carcinoma Papilar/secundário , Linfonodos/patologia , Metástase Linfática/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Idoso , Carcinoma Papilar/cirurgia , Feminino , Fluordesoxiglucose F18 , Humanos , Excisão de Linfonodo , Metástase Linfática/patologia , Mediastino , Proteínas Nucleares/análise , Tomografia por Emissão de Pósitrons , Período Pós-Operatório , Neoplasias da Glândula Tireoide/cirurgia , Fator Nuclear 1 de Tireoide , Fatores de Transcrição/análise
8.
Biochim Biophys Acta ; 1550(2): 164-74, 2001 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-11755205

RESUMO

The AT motif-binding factor 1 (ATBF1)-A is a large transcription factor containing four homeodomains and 23 zinc finger motifs. It has a number of motifs involved in transcriptional regulation, and in addition, several motifs found in enzymes, such as ATPases and helicases. In this study, we examined whether ATPase activity is associated with the ATBF1-A molecule. A 263-amino acid segment of the ATBF1-A molecule, termed AHZ, which contains the ATPase A-motif, homeodomain IV and zinc finger 21, was expressed in Escherichia coli in the form of glutathione S-transferase fusion protein and analyzed for ATPase activity. We found that AHZ was able to hydrolyze ATP with K(m) 10.6 microM and K(cat) 0.055 min(-1) at 5 mM Mg(2+) and pH 7.75. AHZ retained bacterial DNA and removal of the DNA resulted in 70% decrease in ATPase activity. The addition of double- or single-stranded DNAs restored 70-75% ATPase activity and that of RNA restored 50-55% activity. Site-directed mutagenesis of the A-motif resulted in 34% reduction of ATPase activity with no significant loss of bound DNA. In contrast, mutation of homeodomain IV and zinc finger 21 resulted in 90 and 80% reduction of ATPase, respectively, with the loss of the ability to bind to DNA and RNA. These results show that ATBF1 has at least one enzyme activity in addition to regulation of DNA transcription. The ATPase activity associated with ATBF1-A is DNA/RNA-dependent and unique in that it requires both homeodomain and zinc finger motifs.


Assuntos
Adenosina Trifosfatases/metabolismo , Proteínas de Homeodomínio/química , Dedos de Zinco , Adenosina Trifosfatases/química , Adenosina Trifosfatases/genética , Trifosfato de Adenosina/química , Sequência de Aminoácidos , Sequência de Bases , DNA/farmacologia , DNA Bacteriano/química , Escherichia coli/genética , Escherichia coli/metabolismo , Proteínas de Homeodomínio/genética , Dados de Sequência Molecular , Mutagênese Sítio-Dirigida , Fragmentos de Peptídeos/química , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/metabolismo , Plasmídeos , RNA/farmacologia , Proteínas Recombinantes de Fusão/metabolismo , Especificidade por Substrato
9.
FEBS Lett ; 410(2-3): 313-8, 1997 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-9237653

RESUMO

Methylglyoxal (MG), an endogenous metabolite that increases in diabetes, is a common intermediate in nonenzymatic glycation (Maillard reaction) in vivo. Here we describe the immunochemical approach to the detection of MG adducts in proteins in vitro and in atherosclerotic lesions of human aorta in vivo. The reaction of protein (bovine serum albumin) with MG led to selective loss of arginine and lysine residues, accompanied by the formation of 5-methylimidazolone (N delta-(5-methylimidazolon-2-yl)ornithine) and imidazolysine (1,3-di-lysino-4-methylimidazole) derivatives, respectively. The anti-5-methylimidazolone antibody was prepared by immunizing rabbits with a MG-keyhole limpet hemocyanin conjugate and purifying the serum on an affinity gel prepared by covalent attachment of the 5-methylimidazolone derivative. The antibody cross-reacted with the proteins treated with not only MG but trioses, such as hydroxyacetone, dihydroxyacetone, and glyceraldehyde. The immunohistochemical analysis revealed that atherosclerotic lesions of human aorta contained 5-methylimidazolone derivatives whose distributions were identical to those of advanced glycation end products (AGEs) detected by the anti-AGE antibody.


Assuntos
Imidazóis/análise , Reação de Maillard , Aldeído Pirúvico/metabolismo , Soroalbumina Bovina/metabolismo , Animais , Anticorpos/metabolismo , Aorta/metabolismo , Arginina , Arteriosclerose/metabolismo , Hemocianinas/imunologia , Humanos , Imidazóis/metabolismo , Lisina , Estrutura Molecular , Coelhos
10.
J Pediatr Surg ; 27(5): 623-5, 1992 May.
Artigo em Inglês | MEDLINE | ID: mdl-1625135

RESUMO

At 35 weeks 6 days of gestational age, ultrasound evaluation of the fetal abdomen showed a mixed cystic mass in the superior pole of the left kidney. The mass was suspected to be an adrenal hemorrhage or neuroblastoma. The diagnosis was fetal neuroblastoma. Differential diagnosis enabled the fetal neuroblastoma to be distinguished from adrenal hemorrhage. The parameters of diagnosis of fetal neuroblastoma include no specific ultrasonographic pattern, lack of palpability, and no tumor markers. However, certain features do characterize fetal neuroblastoma, such as little metastases, complete resection at operation, and excellent prognosis. In cases of suspected neuroblastoma, a laparotomy performed as soon as possible is generally regarded as the best course of treatment. Nonetheless, biological analyses of the tumor may prove in the future to be necessary for determining whether or not laparotomy is the best treatment.


Assuntos
Doenças das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Doenças Fetais/diagnóstico , Hemorragia/diagnóstico , Neuroblastoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Adulto , Diagnóstico Diferencial , Feminino , Doenças Fetais/patologia , Doenças Fetais/cirurgia , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Neuroblastoma/patologia , Neuroblastoma/cirurgia , Gravidez , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal , Urografia
11.
Auris Nasus Larynx ; 14(3): 165-70, 1987.
Artigo em Inglês | MEDLINE | ID: mdl-3451735

RESUMO

A case of acoustic neuroma presenting with sudden and fluctuating hearing loss is reported. The patient was a 38-year-old Japanese woman who noticed a sudden onset of hearing loss and tinnitus in the right ear. With a provisional diagnosis of sudden deafness, she was subjected to conservative therapy, including steroid hormone. The hearing started to recover and reached a normal level 2 months after the treatment. Meanwhile, the results of an ABR and plain skull X-rays aroused a suspicion of acoustic neuroma. She was operated on via a middle cranial fossa approach and an acoustic neuroma occupying the internal auditory meatus was removed.


Assuntos
Perda Auditiva Súbita/etiologia , Perda Auditiva/etiologia , Neuroma Acústico/complicações , Doença Aguda , Adulto , Audiometria , Diagnóstico Diferencial , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva Súbita/diagnóstico , Humanos , Neuroma Acústico/diagnóstico , Neuroma Acústico/cirurgia , Pneumorradiografia , Recidiva , Tomografia Computadorizada por Raios X
12.
Nippon Ganka Gakkai Zasshi ; 99(3): 302-7, 1995 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-7732921

RESUMO

The existence and pathophysiological role of glycosaminoglycans in the tear fluid in humans was investigated using quantitative analyses of hyaluronic acid and chondroitin sulfate in the tear fluid. The subjects were 42 eyes of 31 normal controls, 9 eyes of 9 patients with superficial punctate keratitis (SPK), and 13 eyes of 13 patients with epithelial defect. After an instillation of 100 microliters saline solution in the conjunctival sac, as much tear fluid as possible was collected from the lower cul-de-sac. The glycosaminoglycans in the tears were then treated with chondroitinase ABC to make fractions of unsaturated disaccharides. The quantities of disaccharides were determined by high-performance liquid chromatography. Concentrations were expressed as nanomoles of unsaturated disaccharides per protein in the tears. The concentrations of hyaluronic acid and chondroitin sulfate in the normal controls were 0.07 +/- 0.12(n mol/mg protein) and 6.91 +/- 3.63 (n mol/mg protein), respectively. The mean concentration of hyaluronic acid was significantly higher in patients with epithelial erosion than in normal controls, whereas the mean concentration of chondroitin sulfate was significantly lower in patients with epithelial erosion than in normal controls. There was no significant difference in the concentration of glycosaminoglycans between the patients with SPK and normal controls. The results of our study suggest that glycosaminoglycans are synthesized and endogenously secreted into the tear fluids and, especially in the case of hyaluronic acid, may play an important role in corneal epithelial wound healing in patients with epithelial erosion.


Assuntos
Doenças da Córnea/metabolismo , Glicosaminoglicanos/metabolismo , Lágrimas/metabolismo , Adulto , Idoso , Sulfatos de Condroitina/metabolismo , Doenças da Córnea/patologia , Epitélio/patologia , Humanos , Ácido Hialurônico/metabolismo , Pessoa de Meia-Idade
13.
Nippon Ganka Gakkai Zasshi ; 98(11): 1049-55, 1994 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-7825495

RESUMO

We performed quantitative analyses of glycosaminoglycans in the tear fluids in a rabbit wound healing model. We ablated rabbit corneal epithelium with trephine and spatula, and sampled tear fluids before the epithelial ablation, and at 3, 24, 48, and 72 hours after it. After an instillation of 200 microliters saline solution in the conjunctival sac, as much tear fluid as possible was collected from the lower cul-del-sac. The glycosaminoglycans in the tears were then treated with chondoroitinase ABC to make fractions of disaccharides. The quantities of disaccharides were determined with high-performance liquid chromatography as weight per unit protein in the tears. The concentrations of delta Di-HA in the tear fluids at 3 and 24 hours were significantly higher than those before the treatment and returned to the initial value at 72 hours after making the epithelial wound. Among the disaccharides of chondroitin sulfate, delta Di-0S and delta Di-6S showed a significant increase at 3 hours after the treatment but delta Di-4S did not show any significant variation. The results suggest that the glycosaminoglycans in the rabbit tear fluids may play an important role in the corneal epithelial wound healing process.


Assuntos
Lesões da Córnea , Glicosaminoglicanos/análise , Lágrimas/química , Animais , Epitélio/lesões , Feminino , Glicosaminoglicanos/química , Coelhos , Cicatrização
14.
Nippon Ganka Gakkai Zasshi ; 97(10): 1179-84, 1993 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-8256670

RESUMO

We describe a new membrane filter (PORETEC) technique for processing cytopathologic fluid specimens. This procedure provides excellent cytologic preparations because there is no background staining and only a small amount of fluid specimen is necessary, as there is little cell loss. We compared the number of cells collected by the membrane filter technique with that collected by cytocentrifugation using conjunctival brush cytology specimens from 6 subjects. The number of cells obtained by the new method was significantly higher than that obtained by the cytocentrifugation technique. This method was very useful for ocular fluid specimens such as aqueous humor, vitreous specimens, and scrapings from the cornea and conjunctiva. We showed some examples of these specimens including immunocytochemical staining done by this method. We confirm that this is valuable for diagnostic cytopathologic study of various fluid specimens in ophthalmology.


Assuntos
Oftalmopatias/diagnóstico , Técnicas de Preparação Histocitológica , Adulto , Idoso , Humor Aquoso/citologia , Contagem de Células , Túnica Conjuntiva/citologia , Oftalmopatias/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Corpo Vítreo/citologia
15.
Kyobu Geka ; 57(3): 211-3, 2004 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-15035076

RESUMO

A 71-year-old man with congestive heart failure due to acute myocardial infarction was referred to our hospital. He was under the support of mechanical ventilation and the intraaortic balloon pumping (IABP) and coronary angiogram revealed the thromboembolism of the obtuse marginal artery. We completed the revascularization by the direct percutaneous coronary intervention. However, grade II mitral valve regurgitation and heart failure were worsening. Mitral valvuloplasty and the modified maze procedure through the partial lower sternotomy were performed. He is still in good condition 4 years later. Ischemic mitral valve regurgitation due to the coronary thromboembolism is very rare. Careful follow-up on the grade of ischemic mitral valve regurgitation is necessary even after the early coronary recanalization. The surgical approach of the partial sternotomy should be used in such a case of acute mitral valve regurgitation.


Assuntos
Trombose Coronária/complicações , Insuficiência da Valva Mitral/etiologia , Doença Aguda , Idoso , Angioplastia Coronária com Balão , Procedimentos Cirúrgicos Cardíacos/métodos , Trombose Coronária/terapia , Seguimentos , Humanos , Masculino , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Esterno/cirurgia , Resultado do Tratamento
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