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1.
Plant Biol (Stuttg) ; 23(6): 1149-1156, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34396655

RESUMEN

Pecan (Carya illinoinensis) is sensitive to Zn, which is involved in basic physiological and biochemical processes. To explore the growth and physiology of pecan in response to Zn application, we used 1-year-old annual grafted seedlings (Pawnee) and applied four concentrations of Zn fertilizer (0.05, 0.10, 0.20 and 0.40 g·plant-1 ); a control (CK; no Zn fertilization) was also included. The growth characteristics, anatomical structure of the leaves and photosynthesis were assessed. Compared with the CK, photosynthesis and chlorophyll (Chl) fluorescence parameters, leaf area and leaf structure significantly increased at Zn concentrations of 0.05 and 0.10 g·plant-1 . In addition, growth of pecan at the seedling stage increased in response to moderate Zn application. In contrast, treatment with 0.20 and 0.40 g·Zn·plant-1 dramatically decreased these physiological indices and inhibited pecan growth. The results show that moderate soil Zn application promotes pecan growth and development by increasing photosynthesis. However excess Zn concentrations were not conducive to seedling growth. The concentration of 0.1 g·Zn·plant-1 was best when considering long-term soil Zn applications, providing a theoretical foundation for microelement management of pecan.


Asunto(s)
Carya , Clorofila , Fotosíntesis , Hojas de la Planta , Plantones , Zinc/farmacología
2.
Neuropharmacology ; 40(8): 1073-83, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11406199

RESUMEN

To understand the cellular and molecular mechanisms by which neurotensin (NT) induces an analgesic effect in the nucleus raphe magnus (NRM), whole-cell patch-clamp recordings were performed to investigate the electrophysiological effects of NT on acutely dissociated NRM neurons. Two subtypes of neurons, primary serotonergic and secondary non-serotonergic cells, were identified from acutely isolated NRM neurons. During current-clamp recordings, NT depolarized NRM serotonergic neurons and evoked action potentials. Voltage-clamp recordings showed that NT excited serotonergic neurons by enhancing a voltage-insensitive and non-selective cationic conductance. Both SR48692, a selective antagonist of subtype 1 neurotensin receptor (NTR-1), and SR 142948A, a non-selective antagonist of NTR-1 and subtype 2 neurotensin receptor (NTR-2), failed to prevent neurotensin from exciting NRM serotonergic neurons. NT-evoked cationic current was inhibited by the intracellular administration of GDP-beta-S. NT failed to induce cationic currents after dialyzing serotonergic neurons with the anti-G(alphaq/11) antibody. Cellular Ca(2+) imaging study using fura-2 showed that NT induced the calcium release from the intracellular store. NT-evoked current was blocked after the internal perfusion of heparin, an IP(3) receptor antagonist, or BAPTA, a fast Ca(2+) chelator. It is concluded that neurotensin enhancement of the cationic conductance of NRM serotonergic neurons is mediated by a novel subtype of neurotensin receptors. The coupling mechanism via G(alphaq/11) proteins is likely to involve the generation of IP(3), and subsequent IP(3)-evoked Ca(2+) release from intracellular stores results in activating the non-selective cationic conductance.


Asunto(s)
Adamantano/análogos & derivados , Canales Iónicos/fisiología , Neuronas/efectos de los fármacos , Neurotensina/farmacología , Núcleos del Rafe/efectos de los fármacos , Serotonina/fisiología , Adamantano/farmacología , Animales , Calcio/metabolismo , Canales de Calcio/fisiología , Guanosina Difosfato/análogos & derivados , Guanosina Difosfato/farmacología , Imidazoles/farmacología , Receptores de Inositol 1,4,5-Trifosfato , Neuronas/fisiología , Pirazoles/farmacología , Quinolinas/farmacología , Núcleos del Rafe/fisiología , Ratas , Ratas Sprague-Dawley , Receptores Citoplasmáticos y Nucleares/fisiología , Receptores de Neurotensina/antagonistas & inhibidores , Receptores de Neurotensina/fisiología , Tionucleótidos/farmacología
3.
Shock ; 11(3): 187-92, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10188771

RESUMEN

Based on simultaneous power spectral analysis of systemic arterial pressure (SAP) and central venous pressure (CVP) signals in rats anesthetized with pentobarbital sodium, we assessed the hypotheses that subtle changes in the SAP spectrum exist during hemorrhagic shock, and that the CVP spectrum is a feasible index for central blood volume during acute graded blood loss. During Stage I hemorrhagic shock seen after reduction in 10% of total blood volume (TBV), there was a significant increase in the power of both the very low frequency (VLF, 0-.25 Hz) and low frequency (LF, .25-.8 Hz) components, along with a moderate decrease in the very high frequency (VHF, 5-9 Hz) component, of SAP signals. Substantial reduction in VLF, LF, and VHF components in the SAP spectrum occurred after a blood loss of 25% of TBV (Stage II), which persisted during Stage III hemorrhagic shock when the withdrawn blood reached 50% of TBV and the mean SAP maintained at 40 mm Hg. The depressed SAP-VLF and SAP-LF components sustained the period of spontaneous recovery and subsequent retransfusion of shed blood, although the power of SAP-VHF component gradually elevated during these two periods. The power of the high-frequency (HF, .8-2.4 Hz) component of SAP signals increased discernibly only during Stage III, became significant on spontaneous recovery, and declined during retransfusion. Although CVP and CVP-VHF component progressively declined, the power of the CVP-HF component manifested a gradual increase that was significantly and reversely correlated with the reduction in TBV. We conclude that differential changes in individual components of the SAP spectrum occur during hemorrhagic shock, and that the CVP-HF component may be a reliable indicator for central blood volume during acute graded blood loss.


Asunto(s)
Hemorragia/diagnóstico , Procesamiento de Señales Asistido por Computador , Algoritmos , Anestesia , Animales , Arterias/fisiopatología , Determinación de la Presión Sanguínea , Transfusión Sanguínea , Presión Venosa Central , Electrocardiografía/métodos , Hemorragia/fisiopatología , Hemorragia/terapia , Masculino , Ratas , Ratas Sprague-Dawley , Choque Hemorrágico/diagnóstico , Choque Hemorrágico/fisiopatología , Choque Hemorrágico/terapia , Transductores
4.
Chest ; 110(6): 1603-7, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8989084

RESUMEN

OBJECTIVES: Video-assisted endoscopic techniques had been applied in the surgical correction of patent ductus arteriosus, vascular ring, or coronary artery disease. However, it has been used only recently in the correction of reoperative mitral valve lesions. DESIGN: Video-assisted cardiac operations were performed on four patients who had received surgical interventions on their mitral valves and needed emergent reoperation. PATIENTS: Four patients (3 men and 1 woman) received emergency surgery from September to December 1995 for thrombosis of mechanical mitral prosthesis (2 patients) and severe mitral regurgitation with previously failed mitral valve repair (2 patients). Six previous operations had been performed on these mitral valves. Patient ages ranged from 26.7 to 68.1 years (mean, 47.3 years). Preoperatively, acute pulmonary edema occurred in two patients, cerebral emboli occurred in one patient, and sepsis was found in one patient. Mechanical ventilatory support was used in two patients before operation. INTERVENTION: The operations were performed through right anterior minithoracotomy, guided by video-assisted endoscopic techniques with femoro-femoral extracorporeal circulation. The operative procedures were thrombectomy of mitral prosthesis in two patients, mitral valve repair in one patient, and mitral valve replacement in one patient. RESULTS: The duration of extracorporeal circulation was 166 to 320 min (222 +/- 67 min) and the operation time was 4.6 to 6.8 h (6.1 +/- 1.0 h). All patients recovered from the operations rapidly with uneventful postoperative courses except 1 patient who had sepsis preoperatively and died 2 months later. CONCLUSION: Our experience demonstrates that video-assisted cardiac surgery is technically feasible and could be performed in reoperation of the mitral valve.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Endoscopía/métodos , Válvula Mitral/cirugía , Adulto , Anciano , Femenino , Prótesis Valvulares Cardíacas , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Insuficiencia de la Válvula Mitral/cirugía , Complicaciones Posoperatorias , Reoperación , Trombosis/cirugía , Grabación en Video
5.
J Thorac Cardiovasc Surg ; 108(5): 969-74, 1994 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-7967682

RESUMEN

Hypothermic circulatory arrest is commonly used to facilitate repair of complex congenital heart defects and aortic lesions and for complex neurosurgical procedures. However, extended periods of circulatory arrest may impair cerebral metabolism and cause ischemic injury. Retrograde cerebral perfusion has been applied recently in aortic surgery to protect the brain. From January 1991 to December 1993, 29 patients underwent emergency operations to repair acute type A aortic dissection with the aid of hypothermic circulatory arrest. Six patients received hypothermic circulatory arrest without retrograde cerebral perfusion with a rectal temperature of 16.4 degrees +/- 0.9 degrees C (mean +/- standard error of the mean, group 1). Retrograde cerebral perfusion during hypothermic circulatory arrest was performed in 15 patients with a rectal temperature of 15.9 degrees +/- 0.5 degrees C (group 2) and in eight patients with a rectal temperature of 21.7 degrees +/- 0.8 degrees C (group 3). The hypothermic circulatory arrest times were 25 +/- 4, 42 +/- 4, and 63 +/- 6 minutes, respectively (p < 0.05). The cardiopulmonary bypass times were 173 +/- 5, 184 +/- 7, and 143 +/- 6 minutes, respectively (p < 0.05). All patients survived the operation and regained consciousness with no neurologic defects. Follow-up (mean 23.2, 14.5, and 5.1 months, respectively) was complete in all patients except one. This patient, from group 2, was killed in a road traffic accident 12 months after the operation. Our experience suggests that retrograde cerebral perfusion can effectively protect the brain from ischemic injury and extend the safe period of hypothermic circulatory arrest. With the aid of retrograde cerebral perfusion, prolonged circulatory arrest can probably be performed safely with moderate hypothermia.


Asunto(s)
Aneurisma de la Aorta/cirugía , Disección Aórtica/cirugía , Isquemia Encefálica/prevención & control , Paro Cardíaco Inducido , Perfusión , Adulto , Anciano , Anciano de 80 o más Años , Puente Cardiopulmonar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perfusión/métodos , Factores de Tiempo
6.
Peptides ; 21(2): 205-10, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10764946

RESUMEN

Neuropeptide FF (NPFF), an endogenous opioid-related neuromodulater, has been reported to show significant effects on the cardiovascular system, namely elevation of arterial blood pressure (BP) and heart rate (HR) in rats. In the present study, we synthesized two novel NPFF analogs, PFRFamide (putative NPFF agonist) and PFR(Tic)amide (putative NPFF antagonist), and examined their cardiovascular effect on BP and HR in anesthetized rats. The arterial mean BP and HR were measured by way of direct femoral artery catheterization. The data showed that PFRFamide increased BP in a dose-dependent manner, while PFR(Tic)amide decreased BP dose-dependently. These results revealed the possibility of PFRFamide and PFR(Tic)amide to be NPFF agonist and antagonist (or inverse agonist), respectively. These two NPFF analogs may possess potential in new drug design, and the NPFF system could be very important in mammalian cardiovascular function.


Asunto(s)
Sistema Cardiovascular/efectos de los fármacos , Neuropéptidos/farmacología , Oligopéptidos/agonistas , Oligopéptidos/antagonistas & inhibidores , Tetrahidroisoquinolinas , Amidas/síntesis química , Animales , Presión Sanguínea/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Diseño de Fármacos , Frecuencia Cardíaca/efectos de los fármacos , Masculino , Péptidos/síntesis química , Ratas , Ratas Sprague-Dawley
7.
Peptides ; 20(10): 1211-7, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10573293

RESUMEN

Neuropeptide FF (NPFF) has been reported to be an endogenous anti-opioid peptide that has significant effects on morphine tolerance and dependence. In the present study, we examined the chronic effects of NPFF and its synthetic analogs: the putative agonist, PFRFamide, and the putative antagonists, dansyl-PQRamide and PFR(Tic)amide on naloxone-precipitated morphine withdrawal syndromes in rats. After a 5-day co-administration with morphine [5 mg/kg, intraperitoneally (i.p.), twice per day (b.i.d.)] and the tested peptide [intracerebroventricularly (i.c.v.) or i.p., b.i.d.], naloxone (4 mg/kg, i.p.) was given systemically to evaluate the severity of the morphine withdrawal syndromes. Our results revealed that NPFF significantly potentiated the overall morphine withdrawal syndromes and, on the contrary, dansyl-PQRamide attenuated these syndromes. These results clearly indicate that modulation of the NPFF system in the mammalian central nervous system has significant effects on opiate dependence. In addition, morphine withdrawal syndromes could be practically applied as a valid parameter to functionally characterize the putative NPFF agonists and antagonists.


Asunto(s)
Morfina/efectos adversos , Antagonistas de Narcóticos/farmacología , Neuropéptidos/farmacología , Oligopéptidos/farmacología , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Tetrahidroisoquinolinas , Animales , Estructura Molecular , Naloxona , Neuropéptidos/administración & dosificación , Neuropéptidos/química , Oligopéptidos/agonistas , Oligopéptidos/antagonistas & inhibidores , Ratas , Ratas Sprague-Dawley
8.
Peptides ; 23(3): 489-96, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11835998

RESUMEN

Neuropeptide FF (NPFF) is an endogenous anti-opioid peptide. NPFF could potentiate the naloxone-precipitated morphine withdrawal syndromes in morphine-dependent rats, indicating the possible involvement of the endogenous NPFF system in opioid analgesia and dependence. The present study was performed to examine the effects of dansyl-PQRamide (dns-PQRa), a putative NPFF antagonist, on conditioned place preference (CPP), in addition, its interaction with the opioid system. Two CPP experiments were conducted. First, rats were treated with dns-PQRa (4-13 mg/kg, i.p.) and paired with the non-preferred compartment while the vehicle was paired with the preferred compartment. Second, similar to experiment 1 except naloxone (1 mg/kg, i.p.) was given 10 min prior to each dns-PQRa administration. The post-drug place preference was examined after 4 alternative pairings. Another group of animals after repetitive dns-PQRa treatments were analyzed for levels of neurotransmitters in discrete brain areas. Dns-PQRa (4-13 mg/kg, i.p.) induced a significant dose-dependent CPP. The dns-PQRa-induced CPP was completely blocked by pretreatment with 1 mg/kg i.p. naloxone, while naloxone alone did not induce any place aversion. The chronic dns-PQRa-treated (13 mg/kg, i.p., b.i.d.) rats caused a significant increase in 3,4-dihydroxyphenylacetic acid and 5-hydroxyindoleacetic acid in the olfactory tubercle compared to the vehicle-treated controls. There was also an increase in the turnover of serotonin in the olfactory tubercle, nucleus accumbens and medial prefrontal cortex. These results suggest that blockade of the NPFF system produces rewarding, possibly via an inhibition of the anti-opioid action of NPFF. These results also reveal a close relationship between NPFF, drug rewarding and the dopaminergic and serotoninergic neurons in the mesolimbic system.


Asunto(s)
Neuropéptidos/farmacología , Corteza Prefrontal/efectos de los fármacos , Receptores de Neuropéptido/antagonistas & inhibidores , Animales , Ácido Aspártico/metabolismo , Condicionamiento Psicológico/efectos de los fármacos , Interacciones Farmacológicas , Ácido Glutámico/metabolismo , Masculino , Modelos Animales , Naloxona/farmacología , Antagonistas de Narcóticos/farmacología , Corteza Prefrontal/metabolismo , Ratas , Ratas Sprague-Dawley , Receptores de Neuropéptido/metabolismo , Ácido gamma-Aminobutírico/metabolismo
9.
Ann Thorac Surg ; 68(1): 40-5, 1999 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10421112

RESUMEN

BACKGROUND: Minimally invasive surgical approaches have been applied recently in the management of valvular heart disease. In this report, we reviewed our preliminary experience of minimally invasive aortic valve replacement. METHODS: Eighteen patients were operated on by means of an "I" ministernotomy, and 16 patients were operated on by means of a full median sternotomy during the same period. There was no difference between these two groups in term of age, sex, and preoperative left ventricular ejection fraction. In patients of the ministernotomy group, the operations were approached through an "I" median sternal split, from the second to the fifth intercostal space, 8 to 10 cm in length, with transverse division. Cardiopulmonary bypass was established through aorto-right atrial cannulation with aortic cross-clamping and antegrade or retrograde delivery of blood cardioplegia. RESULTS: Under direct vision, aortic valve replacement was performed successfully in patients of both groups. The duration of cardiopulmonary bypass time and aortic cross-clamp time was significantly longer in the ministernotomy group than in the full sternotomy group. However, the length of incision, duration of endotracheal intubation, intensive care unit stay, pain score, postoperative length of stay, and return to normal activity interval were significantly shorter and lower in patients of the ministernotomy group than in those of the full sternotomy group. All patients recovered from the operation rapidly. Follow-up was complete in all patients with no late complications. Echocardiographic examination showed good function of aortic prostheses. CONCLUSIONS: Our experience demonstrates that the "I" ministernotomy provides good exposure, reduced wound pain, enhanced recovery, shortened hospital stay, and good cosmetic healing. It may be a good alternative for surgical correction of aortic valve lesions.


Asunto(s)
Válvula Aórtica/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Esternón/cirugía , Adulto , Anciano , Puente Cardiopulmonar , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Complicaciones Posoperatorias
10.
Ann Thorac Surg ; 65(3): 846-7, 1998 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-9527234

RESUMEN

Low cardiac output after open heart operations in neonates and infants carries a high mortality. Delayed sternal closure may be life-saving but may prolong hospital stay and increase costs. To circumvent these issues, we shaped homograft bone and interposed it between the sternal edges to allow primary wound closure in 2 pediatric patients. Midterm results are satisfactory.


Asunto(s)
Trasplante Óseo/métodos , Procedimientos Quirúrgicos Cardíacos/métodos , Stents , Esternón/cirugía , Preescolar , Femenino , Cardiopatías Congénitas/cirugía , Humanos , Lactante , Recién Nacido , Trasplante Homólogo
11.
Ann Thorac Surg ; 65(2): 407-12, 1998 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9485237

RESUMEN

BACKGROUND: Minimal access surgical techniques in coronary artery bypass grafting have been used mainly in the management of single-vessel disease. METHODS: Fifteen patients, 11 men and 4 women with a mean age of 64.1 years (range, 35.7 to 78.0 years), underwent operation for triple-vessel disease using minimal access techniques. The procedures were performed through a limited left parasternal thoracotomy using femorofemoral extracorporeal circulation. The myocardium was protected by the antegrade infusion of cold blood cardioplegic solution while the aorta was cross-clamped. RESULTS: Under direct vision, the left saphenous vein grafts were connected sequentially to the diagonal branch, obtuse marginal branch, and posterior descending branch, and the left internal thoracic artery graft was anastomosed to the left anterior descending artery in each patient. The mean aortic cross-clamp time was 86 +/- 17 minutes (range, 67 to 125 minutes). The mean duration of extracorporeal circulation was 112 +/- 22 minutes (range, 82 to 162 minutes). The postoperative course was uneventful in all patients. Follow-up was complete in all patients at a mean of 7.4 months (range, 6.0 to 8.5 months), and there were no late deaths or angina. Coronary angiography in 8 patients showed patent grafts. CONCLUSIONS: Our experience demonstrates that minimal access surgical techniques in coronary artery bypass grafting are technically feasible and may be an alternative approach in the surgical revascularization of triple-vessel disease.


Asunto(s)
Puente de Arteria Coronaria/métodos , Adulto , Anciano , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/patología , Enfermedad Coronaria/cirugía , Ecocardiografía Transesofágica , Circulación Extracorporea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Monitoreo Intraoperatorio , Vena Safena/trasplante
12.
Ann Thorac Surg ; 65(1): 165-9; discussion 169-70, 1998 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9456111

RESUMEN

BACKGROUND: Minimally invasive cardiac surgical techniques recently have been applied in the management of a variety of intracardiac lesions. METHODS: Fourteen patients (6 boys and 8 girls; age, 8.9 +/- 5.5 years; body weight, 29.0 +/- 13.5 kg) were operated on using minimally invasive cardiac surgical techniques for the closure of a ventricular septal defect (subarterial in 11 patients and perimembranous in 3 patients). The operations were performed through a left anterior minithoracotomy and were guided by video-assisted endoscopic techniques under femorofemoral cardiopulmonary bypass. The myocardium was protected by continuous coronary perfusion with hypothermic fibrillatory arrest. The right ventricular outflow tract was entered after pericardiotomy was performed. RESULTS: Closure of the defect (directly in 4 patients and by patch in 10 patients) was performed successfully in all patients. A right ventricular outflow tract obstruction and ruptured sinus of Valsalva aneurysm also were repaired in 1 patient each. The duration of cardiopulmonary bypass was 41 +/- 10 minutes (range, 28 to 100 minutes) and the total operative time was 2.2 +/- 0.8 hours (range, 1.3 to 3.5 hours). All the patients recovered rapidly from their operation and had an uneventful postoperative course. Follow-up (mean, 6.2 months; range, 6 to 9 months) was complete in all patients. There were no late deaths. Transthoracic echocardiographic examination showed no residual shunt and no aortic regurgitation in all patients. CONCLUSIONS: Our experience demonstrates that minimally invasive cardiac surgical techniques are technically feasible and an alternative option for the repair of a ventricular septal defect.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Endoscopía/métodos , Defectos del Tabique Interventricular/cirugía , Puente Cardiopulmonar , Niño , Ecocardiografía , Femenino , Humanos , Masculino , Factores de Tiempo , Resultado del Tratamiento
13.
Ann Thorac Surg ; 63(1): 175-8; discussion 178-9, 1997 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8993261

RESUMEN

BACKGROUND: Patent ductus arteriosus (PDA) is a frequent congenital heart disease encountered in premature neonates, infants, and children. Video-assisted endoscopic techniques have been used in PDA interruption since 1993. Almost all the experiences are in pediatric patients. Applications in adults with PDA have been limited. METHODS: We report our experience of video-assisted thoracoscopic surgical ligation of PDA in adults. From August 1995 to January 1996, 60 patients with PDA were operated on with a video-assisted thoracoscopic technique. Twelve adults were identified with mean age of 30 years (range, 20 to 57 years). With the patient under general anesthesia and double-lumen endotracheal intubation, two 5-mm holes were made in the left lateral chest wall. Another 4-cm incision was made in the left third intercostal space for manipulation, dissection, and ligation. Conventional surgical instruments were used except an endoscopic grasper and an endoscopic tube that connected to a video camera. The surgical procedure was viewed on a video screen. Transesophageal echocardiography was used for monitoring during PDA ligation. RESULTS: All patients had successful ligation of the PDA. There was no surgical mortality, but there was one morbidity; transient recurrent nerve injury, which recovered 3 months later. Ten patients were extubated in operative room and 2 patients were extubated 2 hours after the operation. Tube thoracostomy was performed in the first 2 cases; it was omitted thereafter. No patients needed narcotic to control chest pain. Postoperative follow-up by echocardiography showed faint ductal flow in 1 patient without any murmur. All patients were discharged within 3 days after the operation. CONCLUSIONS: Our experience suggests that with refinement of instruments and surgical technique, video-assisted thoracoscopic surgical ligation can be safely applied not only in pediatric patients, but also in adults with PDA.


Asunto(s)
Conducto Arterioso Permeable/cirugía , Endoscopía/métodos , Adulto , Anestesia General , Femenino , Humanos , Intubación Intratraqueal , Ligadura/métodos , Masculino , Toracoscopía , Grabación en Video
14.
Ann Thorac Surg ; 62(3): 697-701, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8783995

RESUMEN

BACKGROUND: Video-assisted endoscopy has been applied in the management of a variety of intrathoracic vascular lesions. Here we report its use in the correction of intracardiac congenital defects. METHODS: Eight patients (3 male and 5 female) underwent operation for closure of an atrial septal defect. The patients ranged in age from 2.0 to 60.9 years (mean, 19.2 +/- 19.0 years). The patients weighed 11 to 66 kg (mean, 41.3 +/- 23.5 kg). The ratio of pulmonary blood flow to systemic blood flow ranged from 2.0 to 6.0 (mean, 3.4 +/- 1.3). The mean pulmonary artery pressure was 19.7 +/- 4.0 mm Hg (range, 13 to 24 mm Hg). The operations were performed through a right anterior minithoracotomy and guided by video-assisted endoscopic techniques under femorofemoral or femoral-right atrial extracorporeal circulation. The aorta was not cross-clamped, and the myocardium was protected by continuous coronary perfusion with hypothermic fibrillatory arrest (rectal temperature, 22.0 degrees +/- 2.0 degrees C). Transesophageal echocardiographic monitoring was maintained during the operations. The right atrium was entered after pericardiotomy. Primary closure of the defect was performed successfully in all patients. Conventional nondisposable instruments were used for dissection, grasping, suturing, and hemostasis. RESULTS: The durations of extracorporeal circulation and operation ranged from 47 to 126 minutes (mean, 80 +/- 31 minutes) and from 2.2 to 4.5 hours (mean, 3.1 +/- 0.8), respectively. All patients recovered from the operation rapidly with an uneventful postoperative course. CONCLUSIONS: Our experience demonstrates that video-assisted cardiac surgery is technically feasible and can be used with excellent results for the repair of congenital heart defects in general.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Endoscopía , Defectos del Tabique Interatrial/cirugía , Grabación en Video , Adolescente , Adulto , Niño , Preescolar , Ecocardiografía Transesofágica , Femenino , Defectos del Tabique Interatrial/diagnóstico por imagen , Defectos del Tabique Interatrial/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Complicaciones Posoperatorias , Factores de Tiempo
15.
Ann Thorac Surg ; 61(6): 1781-6; discussion 1786-7, 1996 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-8651784

RESUMEN

BACKGROUND: Video-assisted endoscopy has been applied frequently in the management of a variety of surgical diseases. However, it has rarely been applied in mitral valve surgery. METHODS: We report 2 patients who received emergency operations for thrombosis of a mitral prosthesis (patient 1, a 68-year-old man) and acute mitral regurgitation due to rupture of anterior chordae (patient 2, a 75-year-old woman). They both had severe congestive heart failure. Cardiogenic shock was noted in patient 2. The mitral valve was approached through a right anterior minithoracotomy with the aid of an endoscope by means of projected images on the video monitor under femorofemoral cardiopulmonary bypass. The aorta was not cross-clamped, and the myocardium was protected by continuous coronary perfusion with hypothermic fibrillatory arrest. The left atrium was entered posterior to the interatrial groove. Thrombectomy and mitral valve repair were performed successfully. RESULTS: The duration of extracorporeal circulation was 204 and 147 minutes, respectively. Both patients recovered from the operation rapidly with uneventful postoperative courses. CONCLUSIONS: Our preliminary results suggest that video-assisted endoscopic cardiac surgery is technically feasible and could be performed in the milieu of open heart surgery.


Asunto(s)
Endoscopía , Insuficiencia Cardíaca/cirugía , Válvula Mitral/cirugía , Toracoscopía , Grabación en Video , Anciano , Puente Cardiopulmonar , Cuerdas Tendinosas/patología , Urgencias Médicas , Estudios de Factibilidad , Femenino , Paro Cardíaco Inducido , Rotura Cardíaca/complicaciones , Prótesis Valvulares Cardíacas/efectos adversos , Humanos , Hipotermia Inducida , Masculino , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Mitral/cirugía , Rotura Espontánea , Choque Cardiogénico/cirugía , Toracotomía , Trombectomía
16.
Ann Thorac Surg ; 63(4): 1113-7, 1997 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-9124915

RESUMEN

BACKGROUND: Hypothermic fibrillatory arrest without aortic cross-clamping is a technique for quieting the heart during coronary artery bypass grafting. This report reviews the preliminary results with this technique in 4 patients having video-assisted coronary artery bypass grafting. METHODS: Four male patients 28.5 to 64.5 years old (mean age, 45.4 years) underwent operation for unstable angina. With video-assisted techniques, coronary artery bypass grafting was performed through a left anterior minithoracotomy with femoral-femoral cardiopulmonary bypass without cross-clamping the aorta. The myocardium was protected by continuous coronary perfusion during hypothermic fibrillatory arrest. RESULTS: A left internal thoracic artery graft was anastomosed to the left anterior descending coronary artery in each patient. The posterior descending branch of the right coronary artery was grafted with a pedicled right gastroepiploic artery in 1 patient. The duration of cardiopulmonary bypass was 72 to 127 minutes (mean duration, 92 +/- 21 minutes). The postoperative course of each patient was uneventful. Follow-up (range, 3.9 to 5.8 months; mean follow-up, 4.9 months) was complete for all patients. There were no late deaths. Coronary angiography showed patent grafts. All patients were in New York Heart Association functional class I or II (mean class, 1.25). CONCLUSIONS: Hypothermic fibrillatory arrest is a simple and effective method of quieting the heart, thereby providing a motionless operative field for video-assisted coronary artery bypass grafting.


Asunto(s)
Puente de Arteria Coronaria/métodos , Endoscopía/métodos , Paro Cardíaco Inducido/métodos , Toracotomía/métodos , Adulto , Cateterismo Cardíaco/métodos , Puente de Arteria Coronaria/instrumentación , Vasos Coronarios/cirugía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Arterias Torácicas/cirugía
17.
Neurosci Lett ; 184(3): 212-5, 1995 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-7715849

RESUMEN

We evaluated the pharmacokinetics and regional distribution of propofol in the brain and spinal cord during propofol anesthesia in Sprague-Dawley rats, using high-performance liquid chromatographic determination of propofol concentration in brain, whole blood and plasma. We found that the concentration of propofol in the brain increased and decreased expeditiously during and after a 15-min and 30-min period of i.v. infusion of an anesthetic dose (60 mg/kg per h) of propofol. Furthermore, propofol was evenly distributed in the brain and spinal cord during infusion, with a significant inter-individual variation. Upon the establishment of anesthesia 15 and 30 min following intravenous infusion of propofol, the concentration of propofol in the brain, whole blood and plasma was respectively 15.7 +/- 1.9 and 39.4 +/- 2.7 micrograms/g, 4.5 +/- 1.2 and 13.6 +/- 1.3 micrograms/ml and 1.8 +/- 0.5 and 5.1 +/- 0.9 micrograms/ml (mean +/- SEM, n = 6 or 7). These high brain/blood and brain/plasma ratios during anesthesia suggest that propofol manifests a pharmacokinetic profile that is different from at least thiopental.


Asunto(s)
Encéfalo/metabolismo , Propofol/farmacocinética , Médula Espinal/metabolismo , Anestesia , Animales , Cromatografía Líquida de Alta Presión , Inyecciones Intravenosas , Masculino , Concentración Osmolar , Ratas , Ratas Sprague-Dawley , Distribución Tisular
18.
Neurosci Lett ; 153(2): 161-4, 1993 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-8327191

RESUMEN

Based on the tail-flick response to noxious thermal stimuli, we determined in the present study that the minimal effective antinociceptive dose of propofol in adult, male Sprague-Dawley rats, given in an intravenous bolus manner, was 10 mg/kg. Simultaneous power spectral analysis of the electroencephalographic (EEG) and systemic arterial pressure signals further revealed a concomitant transient suppression of the EEG activity, primarily in the theta and sigma bands, alongside minor hypotensive and negative inotropic and chronotropic actions, but with maintained vasomotor tone. These alterations followed a time course that paralleled the plasma concentration of propofol in the arterial blood, as detected by high-performance liquid chromatography.


Asunto(s)
Anestesia Intravenosa , Electroencefalografía/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Propofol , Animales , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Inyecciones Intravenosas , Masculino , Contracción Miocárdica/efectos de los fármacos , Dimensión del Dolor/efectos de los fármacos , Propofol/sangre , Propofol/farmacocinética , Ratas , Ratas Sprague-Dawley
19.
Neurosci Lett ; 160(2): 205-8, 1993 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-8247355

RESUMEN

Based on the tail-flick response to noxious thermal stimuli, we determined in the present study that effective antinociception could be achieved in adult male Sprague-Dawley rats 15 min after intravenous infusion of propofol at 60 mg/kg/h. Simultaneous power spectral analysis of the electroencephalographic (EEG) and systemic arterial pressure signals further revealed a concomitant depression of the activity of all EEG frequency bands (delta, theta, alpha, beta), alongside hypotension, negative inotropic and chronotropic actions, and attenuated baroreceptor reflex and vasomotor activity. These effects were congruent with a plasma concentration of propofol in the arterial blood of 1.70 +/- 0.13 micrograms/ml, as determined by high-performance liquid chromatography.


Asunto(s)
Electroencefalografía/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Propofol/administración & dosificación , Propofol/farmacología , Anestesia , Animales , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Infusiones Intravenosas , Masculino , Dolor/fisiopatología , Ratas , Ratas Sprague-Dawley
20.
Life Sci ; 64(10): PL111-6, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10096440

RESUMEN

To understand whether chronic inflammation alters the development of morphine tolerance, the tail-flick test was used to evaluate the analgesic effect of morphine (75 mg tablet, s.c.) in the arthritic rats at the day 9-12 after the inoculation with Freund's adjuvant. Spinal cord monoamines and amino acid neurotransmitters were concomitantly measured. Chronic inflammation attenuated the antinociceptive effect of morphine as tolerance developed faster in the arthritic rats compared to the vehicle-treated controls. In addition, ratio of 5-hydroxyindole-3-acetic acid/5-hydroxytryptamine (5-HIAA/5-HT) increased in the lumbar spinal cord of arthritic rats without any change in the concentrations of norepinephrine, glutamate, aspartate or GABA. Interestingly, increased serotonin turnover in the spinal cord was observed in both control and arthritic rats 24 hours after morphine treatment. Overall, the results suggest a significant role of serotonin up-regulation in the spinal cord during chronic pain and the development of morphine tolerance.


Asunto(s)
Analgésicos Opioides/farmacología , Artritis Experimental/inmunología , Artritis Experimental/metabolismo , Morfina/farmacología , Serotonina/metabolismo , Médula Espinal/metabolismo , Analgésicos Opioides/uso terapéutico , Animales , Enfermedad Crónica , Tolerancia a Medicamentos , Extremidades/patología , Ácido Hidroxiindolacético/metabolismo , Masculino , Morfina/uso terapéutico , Neurotransmisores/metabolismo , Norepinefrina/metabolismo , Dolor/tratamiento farmacológico , Dimensión del Dolor/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Médula Espinal/efectos de los fármacos , Factores de Tiempo , Regulación hacia Arriba
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