RESUMEN
Extracorporeal cardiopulmonary resuscitation (E-CPR) has attracted interest in the area of resuscitation, with its utilization in refractory cardiac arrest having recently increased. However, E-CPR has a high complication rate of approximately 30% and life-threatening complications can occur. We present a case who experienced an acute aortic dissection caused by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Specifically, the aortic dissection was caused by an adjustment in the position of return cannula.
Asunto(s)
Disección Aórtica/etiología , Oxigenación por Membrana Extracorpórea/efectos adversos , Anciano , Oxigenación por Membrana Extracorpórea/métodos , Oxigenación por Membrana Extracorpórea/estadística & datos numéricos , Humanos , Masculino , Tomografía Computarizada por Rayos X/métodosRESUMEN
BACKGROUND Patients with coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 can rapidly progress to acute respiratory distress syndrome (ARDS). Because clinical diagnosis of ARDS includes several diseases, understanding the characteristics of COVID-19-related ARDS is necessary for precise treatment. We report 2 patients with ARDS due to COVID-19-associated pneumonia. CASE REPORT Case 1 involved a 72-year-old Japanese man who presented with respiratory distress and fever. Computed tomography (CT) revealed subpleural ground-glass opacities (GGOs) and consolidation. Six days after symptom onset, reverse transcription-polymerase chain reaction (RT-PCR) testing confirmed the diagnosis of COVID-19-associated pneumonia. He was intubated and received veno-venous extracorporeal membrane oxygenation (ECMO) 8 days after symptom onset. Follow-up CT revealed large diffuse areas with a crazy-paving pattern and consolidation, which indicated progression of COVID-19-associated pneumonia. Following treatment with antiviral medications and supportive measures, the patient was weaned off ECMO after 20 days. Case 2 involved a 70-year-old Asian man residing in Canada who presented with cough, malaise, nausea, vomiting, and fever. COVID-19-associated pneumonia was diagnosed based on a positive result from RT-PCR testing. The patient was then transferred to the intensive care unit and intubated 8 days after symptom onset. Follow-up CT showed that while the initial subpleural GGOs had improved, diffuse GGOs appeared, similar to those observed upon diffuse alveolar damage. He was administered systemic steroid therapy for ARDS and extubated after 6 days. CONCLUSIONS Because the pattern of symptom exacerbation in COVID-19-associated pneumonia cases seems inconsistent, individual treatment management, especially the CT-based treatment strategy, is crucial.
Asunto(s)
Infecciones por Coronavirus/terapia , Oxigenación por Membrana Extracorpórea/métodos , Unidades de Cuidados Intensivos , Pulmón/diagnóstico por imagen , Neumonía Viral/terapia , Síndrome de Dificultad Respiratoria/terapia , Navíos , Viaje , Anciano , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Humanos , Masculino , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/etiología , SARS-CoV-2 , Tomografía Computarizada por Rayos X/métodosRESUMEN
Reactive oxygen species (ROS) have been implicated in the pathogenesis of temporomandibular disorders. In the present study, we provide the first evidence of ROS generation in the synovial fluid from human temporomandibular disorder patients, as shown by electron spin resonance (ESR) and spin trapping. Three distinct ESR spectra of DMPO spin adducts were observed in the synovial fluid. They corresponded to three free radical species: hydroxyl radical (HO(*)), hydrogen radical (H(*)), and carbon-center radical (R(*)). Among them, the 5,5-dimethyl-1-pyrroline-N-oxide (DMPO)-OH spectrum was the most prominent, suggesting that HO(*) was dominantly generated in the synovial fluid from temporomandibular disorder patients. Desferrioxamine (DFO), an iron chelator, strongly depressed the DMPO-OH signal intensity in the synovial fluid from patients with temporomandibular disorders. We successfully demonstrated ROS-induced oxidative stress in the synovial fluid from temporomandibular disorder patients. ROS generation in the temporomandibular joint could lead to exacerbation of inflammation and activation of cartilage matrix degrading enzymes that proceed to degenerative change of the temporomandibular joint. Thus, iron-dependent generation of HO( *) might have a crucial role in the pathogenesis of temporomandibular disorders.
Asunto(s)
Especies Reactivas de Oxígeno/metabolismo , Líquido Sinovial/metabolismo , Trastornos de la Articulación Temporomandibular/metabolismo , Adolescente , Adulto , Deferoxamina/farmacología , Espectroscopía de Resonancia por Spin del Electrón , Femenino , Humanos , Radical Hidroxilo/metabolismo , Masculino , Persona de Mediana Edad , Marcadores de Spin , Superóxido Dismutasa/metabolismo , Trastornos de la Articulación Temporomandibular/etiologíaRESUMEN
In this study, we gave the soybean powder-added food pellets (soybean pellets) to investigate anti-anxious effects of soybean in male mice. Twenty eight days after feeding control pellets or soybean pellets, we observed the behavioral changes in the elevated plus maze. There was no significant difference on the time spent in the open arms (%) between mice fed the control and soybean pellets. When we administered m-chlorophenylpiperazine (m-CPP, 2.5 mg/kg, i.p.) to mice, the mice fed control pellets showed the decrease in the time spent in the open arms, suggesting that anxiety-like behavior was induced by m-CPP. On the other hand, we could not observe the m-CPP-induced anxiety-like behavior in mice fed soybean pellets in this test. These results suggest that soybean pellets may attenuate anxiety-like behavior in mice.
Asunto(s)
Alimentación Animal , Ansiedad/inducido químicamente , Ansiedad/prevención & control , Glycine max , Aprendizaje por Laberinto/efectos de los fármacos , Piperazinas/farmacología , Agonistas de Receptores de Serotonina/farmacología , Animales , Modelos Animales de Enfermedad , Masculino , Ratones , Ratones Endogámicos ICRRESUMEN
Inverted ductal papilloma (IDP) is a type of ductal papilloma arising in ducts of minor salivary glands. Very few cases, and no cases in Japan, have been reported. Reported herein is a case of IDP with a review of the literature. The patient was a 49-year-old man presenting with a lump in the right buccal mucosa of the premolar area of the mandible. The tumor was excised en bloc after a biopsy diagnosis of IDP. On the surface of the covering epithelium, an opening was seen to be filled with mucinous material. On cut surface the opening led to the tumor cavity. The major portion of the tumor parenchyma was made up of papillary proliferation of basaloid squamous cells. Some crypts, microcysts, and mucous cells were seen. There were no findings suggestive of a malignant tumor. The patient's postoperative course was uneventful and there has been no recurrence after 1 year's follow up. Immunohistochemical analysis of the present case supports the hypothesis that IDP originates from squamous metaplasia and proliferation of minor salivary gland duct cells.