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1.
Eur J Pain ; 22(3): 501-510, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29034546

RESUMO

BACKGROUND: Endometriosis is a gynaecological disease exhibiting severe pelvic pain, but the mechanism of pain production remains unknown. Bradykinin (BK) is known as an inflammatory mediator, and shows elevated levels in inflammatory diseases such as rheumatoid arthritis. In the present study, we evaluated whether BK is involved in endometriosis-related pain. METHODS: Endometriotic lesions were used for immunohistochemistry. Primary cultures of endometriotic stromal cells (ESC) were stimulated with IL-1ß and/or BK. Quantitative RT-PCR was used to evaluate the mRNA expressions of BK receptors (BKR) and endothelin-1 in ESC. The concentration of endothelin-1 in cystic fluid of endometrioma or non-endometrioma was measured with ELISA. The conditioned medium of ESC stimulated with IL-1ß and/or BK was injected intraplantarly in mice, and evaluated whether pain-related licking behaviour was elicited. RESULTS: The expressions of BK and BKR in endometriotic lesions were observed by immunohistochemistry. In vitro experiments showed that IL-1ß induced BKR-B1 and B2 on ESC. Activation of these receptors by BK significantly induced endothelin-1 expression in ESC, which was negated completely by HOE-140, a BKR-B2 antagonist. The cystic fluid of endometrioma contained higher amount of endothelin-1 compared to non-endometrioma. Intraplantar injection of the conditioned medium of ESC treated with IL-1ß and BK significantly induced licking behaviour, which was suppressed with BQ-123, an endothelin type-A receptor antagonist. CONCLUSIONS: The present study demonstrated the presence and the function of the BK axis in endometriosis, and established a potential new therapy target for endometriosis-related pain. SIGNIFICANCE: The present study demonstrated (1) the presence and the function of the BK system in endometriosis, (2) activation of BKR induced endothelin-1 in endometriotic lesion and (3) blocking endothelin-1 was effective to decrease pain.


Assuntos
Bradicinina/metabolismo , Endometriose/metabolismo , Endotelina-1/metabolismo , Dor/metabolismo , Receptores da Bradicinina/metabolismo , Células Estromais/metabolismo , Animais , Comportamento Animal/efeitos dos fármacos , Bradicinina/análogos & derivados , Bradicinina/farmacologia , Antagonistas de Receptor B2 da Bradicinina/farmacologia , Estudos de Casos e Controles , Células Cultivadas , Meios de Cultivo Condicionados/farmacologia , Líquido Cístico/metabolismo , Endotelina-1/efeitos dos fármacos , Endotelina-1/genética , Endotelina-1/farmacologia , Feminino , Humanos , Interleucina-1beta/farmacologia , Camundongos , Doenças Ovarianas/metabolismo , Doenças Peritoneais/metabolismo , RNA Mensageiro/metabolismo , Receptores da Bradicinina/efeitos dos fármacos , Receptores da Bradicinina/genética , Células Estromais/efeitos dos fármacos
3.
Am J Transplant ; 15(7): 1805-16, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25766876

RESUMO

Cytomegalovirus accelerates transplant vascular sclerosis (TVS) and chronic rejection (CR) in solid organ transplants; however, the mechanisms involved are unclear. We determined the efficacy of a CMV vaccine in preventing CMV-accelerated rat cardiac allograft rejection in naïve recipients of CMV+ donor hearts. F344 donor rats were infected with RCMV 5 days prior to heterotopic cardiac transplantation into CMV-naïve or H2 O2 -inactivated RCMV-vaccinated Lewis recipients. Recipients of RCMV-infected donor hearts rejected at POD59, whereas vaccinated recipients exhibited a significantly prolonged time to rejection-POD97, similar to recipients of uninfected donor hearts (POD108). Although all of the donor hearts were preinfected, the vaccinated recipients had lower graft and PBMC viral loads at POD 7 compared to unvaccinated controls. Adoptive T cell and passive antibody transfers from vaccinated Lewis rats into naïve recipients demonstrate that both T-cell and B-cell arms of the adaptive immune response provide protection against CMV-accelerated rejection. Similar findings were obtained when testing three different adjuvants in passive transfer experiments. We have determined that the timing of the vaccine prior to transplantation and the specific adjuvant play critical roles in mediating anti-viral responses and promoting graft survival. CMV vaccination prior to transplantation may effectively increase graft survival.


Assuntos
Infecções por Citomegalovirus/prevenção & controle , Vacinas contra Citomegalovirus/administração & dosagem , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto/imunologia , Transplante de Coração/efeitos adversos , Muromegalovirus/imunologia , Aloenxertos , Animais , Western Blotting , Infecções por Citomegalovirus/imunologia , Infecções por Citomegalovirus/microbiologia , Ensaio de Imunoadsorção Enzimática , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/patologia , Reação em Cadeia da Polimerase , Ratos , Ratos Endogâmicos F344 , Ratos Endogâmicos Lew , Doadores de Tecidos , Transplantados
4.
Br J Anaesth ; 113(3): 491-500, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24838806

RESUMO

BACKGROUND: We wanted to demonstrate the feasibility of a novel computer-assisted ventilator alarm system, the support system for care of mechanically ventilated patients (SCMVP), to detect gas leaks and provide graphical information on the site of the leak in a manikin model. METHODS: We tested six leakage scenarios. Four scenarios were applied to both the respiratory circuits with the SCMVP and without the SCMVP (conventional system), and two scenarios were each specific to one of the systems. Fifteen registered nurses were asked to manage three scenarios each (two mutual and one system-specific scenario). Time to identify the site of the leak was measured and compared between the two systems. RESULTS: The SCMVP showed significantly shorter time for troubleshooting in one of the four mutual scenarios and shorter accumulated time for troubleshooting in the four mutual scenarios [18.0 (range, 14.5-19.5) and 48.5 (9.0-180.0) s, respectively] compared with the conventional system [76.0 (47.0-133.8) and 82.5 (16.0-180.0) s, respectively]. In the mutual scenarios, SCMVP resulted in significantly more frequent incidences of successful troubleshooting within 30 s and less frequent incidences of troubleshooting requiring >180 s [43.3% (13/30) and 6.7% (2/30), respectively] compared with the conventional system [13.3% (4/30) and 30% (9/30), respectively]. CONCLUSIONS: The SCMVP can facilitate rapid and successful recognition of the site of leak in a respiratory circuit in a simulation environment.


Assuntos
Alarmes Clínicos , Tomada de Decisões Assistida por Computador , Segurança do Paciente , Respiração Artificial/instrumentação , Respiração Artificial/métodos , Simulação por Computador , Computadores , Apresentação de Dados , Desenho de Equipamento , Falha de Equipamento , Estudos de Viabilidade , Humanos , Manequins , Modelos Organizacionais , Enfermeiras e Enfermeiros , Projetos Piloto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Fatores de Tempo
5.
Neurogastroenterol Motil ; 26(7): 950-61, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24766295

RESUMO

BACKGROUND: Rikkunshito, a standardized Japanese herbal medicine, is thought to accelerate gastric emptying and relieve dyspepsia, although no large-scale, randomized, placebo-controlled trials of rikkunshito have been conducted. This study aimed to determine the efficacy and safety of rikkunshito for treating functional dyspepsia (FD). METHODS: FD patients received 2.5 g rikkunshito or placebo three times a day for 8 weeks in this multicenter, randomized, placebo-controlled, parallel-group trial. The primary end point was the proportion of responders at 8 weeks after starting test drug, determined by global patient assessment (GPA). The improvement in four major dyspepsia symptoms severity scale was also evaluated. In addition, plasma ghrelin levels were investigated before and after treatment. KEY RESULTS: Two hundred forty-seven patients were randomly assigned. In the eighth week, the rikkunshito group had more GPA responders (33.6%) than the placebo (23.8%), although this did not reach statistical significance (p = 0.09). Epigastric pain was significantly improved (p = 0.04) and postprandial fullness tended to improve (p = 0.06) in the rikkunshito group at week 8. Rikkunshito was relatively more effective among Helicobacter pylori-infected participants (rikkunshito: 40.0% vs placebo: 20.5%, p = 0.07), and seemed less effective among H. pylori-uninfected participants (rikkunshito: 29.3% vs placebo: 25.6%, p = 0.72). Among H. pylori-positive individuals, acyl ghrelin levels were improved just in rikkunshito group. There were no severe adverse events in both groups. CONCLUSIONS & INFERENCES: Administration of rikkunshito for 8 weeks reduced dyspepsia, particularly symptoms of epigastric pain and postprandial fullness. (UMIN Clinical Trials Registry, Number UMIN000003954).


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Dispepsia/tratamento farmacológico , Dor/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Dispepsia/sangue , Feminino , Grelina/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do Tratamento , Adulto Jovem
6.
Neuroscience ; 237: 151-60, 2013 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-23396087

RESUMO

General anesthesia is occasionally associated with postoperative complications such as sleep disorder, drowsiness, or mood alterations. Hippocampal acetylcholine (ACh), the extracellular level of which increases during the dark (active) phase and decreases during the light (rest) phase in rats, is thought to be associated with locomotor activity and be crucial for learning and memory. Propofol, an intravenous anesthetic, is known to shift the circadian rhythms of physiological parameters including locomotor activity and body temperature in both rodents and humans, while the effects of volatile anesthetics on the circadian rhythm largely remain unclear. The present study examined the effects of isoflurane anesthesia on the diurnal changes in hippocampal ACh release and locomotor activity in rats. Rats were divided into three groups: a light-phase anesthesia group (LA group), a dark-phase anesthesia group (DA group), and a control group. They were exposed to a 12-h light/12-h dark environment and anesthetized with 1.4% isoflurane for 4h during the middle of the light phase (LA group) and dark phase (DA group). Simultaneous measurement of hippocampal ACh by microdialysis and locomotor activity were done for 60h under free-moving conditions. Hippocampal ACh release and locomotor activity showed a clear circadian rhythm. In the DA group, but not in the LA group, the diurnal variation in ACh release was significantly disturbed and a more than 2-h phase-advance in locomotor activity was observed. There was a significant correlation between hippocampal ACh release and locomotor activity, and isoflurane anesthesia disrupted it even after anesthesia was discontinued. This study revealed that the levels and circadian rhythms of hippocampal ACh release and locomotor activity were more sensitive to isoflurane anesthesia when it was administered during the active phase. Our findings suggest that anesthesia exerts differential effects on the regulation of circadian rhythms depending on the circadian phase.


Assuntos
Acetilcolina/metabolismo , Anestésicos Inalatórios/farmacologia , Ritmo Circadiano/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Isoflurano/farmacologia , Atividade Motora/efeitos dos fármacos , Análise de Variância , Animais , Ritmo Circadiano/fisiologia , Relação Dose-Resposta a Droga , Masculino , Microdiálise , Ratos , Ratos Wistar , Estatística como Assunto
7.
Rev Sci Instrum ; 82(7): 076104, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21806238

RESUMO

We have developed a laser Doppler velocimeter (LDV) for measuring velocity distributions in blood vessels. We converted a transmission-based LDV into a reflection-based LDV to make it suitable for clinical applications. The velocity distribution image of a serpentine flow channel obtained could be qualitatively explained by the numerical results. Finally, we evaluated the system by using it to measure injection of blood into a glass tube by a syringe pump. The results obtained demonstrate that erythrocytes can be used as seeding particles for the reflection-type micro multipoint LDV. The results obtained are useful as basic data for clinical applications.


Assuntos
Vasos Sanguíneos/fisiologia , Fluxometria por Laser-Doppler/instrumentação , Animais , Hemorreologia , Masculino , Camundongos , Microcirculação , Imagem Molecular
8.
Appl Radiat Isot ; 69(12): 1713-6, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21354804

RESUMO

Clear cell sarcoma (CCS), a rare malignant tumor with a predilection for young adults, is of poor prognosis. Recently however, boron neutron capture therapy (BNCT) with the use of p-borono-L-phenylalanine (BPA) for malignant melanoma has provided good results. CCS also produces melanin; therefore, the uptake of BPA is the key to the application of BNCT to CCS. We describe, for the first time, the high accumulation of boron in CCS and the CCS tumor-bearing animal model generated for BNCT studies.


Assuntos
Compostos de Boro/farmacocinética , Terapia por Captura de Nêutron de Boro , Fenilalanina/análogos & derivados , Sarcoma de Células Claras/metabolismo , Animais , Linhagem Celular Tumoral , Humanos , Técnicas In Vitro , Melanoma Experimental/metabolismo , Microscopia Eletrônica , Fenilalanina/farmacocinética
9.
Appl Radiat Isot ; 69(12): 1721-4, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21367607

RESUMO

Clear cell sarcoma (CCS) is a rare melanocytic malignant tumor with a poor prognosis. Our previous study demonstrated that in vitro cultured CCS cells have the ability to highly uptake l-BPA and thus boron neutron capture therapy could be a new option for CCS treatment. This paper proved that a remarkably high accumulation of (10)B (45-74 ppm) in tumor was obtained even in a CCS-bearing animal with a well-controlled biodistribution followed by intravenous administration of L-BPA-fructose complex (500 mg BPA/kg).


Assuntos
Compostos de Boro/farmacocinética , Terapia por Captura de Nêutron de Boro , Fenilalanina/análogos & derivados , Sarcoma de Células Claras/radioterapia , Adolescente , Animais , Linhagem Celular Tumoral , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Fenilalanina/farmacocinética , Sarcoma de Células Claras/metabolismo , Distribuição Tecidual
10.
Am J Transplant ; 11(1): 45-55, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21199347

RESUMO

Human cytomegalovirus (HCMV) infection is associated with the acceleration of transplant vascular sclerosis (TVS) and chronic allograft rejection (CR). HCMV-negative recipients of latently HCMV infected donor grafts are at highest risk for developing CMV disease. Using a rat heart transplant CR model, we have previously shown that acute rat CMV (RCMV) infection following transplantation significantly accelerates both TVS and CR. Here, we report that RCMV-naïve recipients of heart allografts from latently RCMV-infected donors undergo acceleration of CR with similar kinetics as acutely infected recipients. In contrast to acutely infected recipients, treatment of recipients of latently infected donor hearts with ganciclovir did not prevent CR or TVS. We observed the formation of tertiary lymphoid structures (TLOs) containing macrophages and T cells in latently infected hearts prior to transplantation but not in uninfected rats. Moreover, pathway analysis of gene expression data from allografts from latently infected donors indicated an early and sustained production of TLO-associated genes compared to allografts from uninfected donors. We conclude that RCMV-induced TLO formation and alteration of donor tissue T cell profiles prior to transplantation in part mediate the ganciclovir-insensitive rejection of latently infected donor allografts transplanted into naïve recipients by providing a scaffold for immune activation.


Assuntos
Infecções por Citomegalovirus/imunologia , Transplante de Coração/imunologia , Animais , Arteriosclerose/complicações , Arteriosclerose/imunologia , Citomegalovirus/fisiologia , Ganciclovir/uso terapêutico , Rejeição de Enxerto/imunologia , Humanos , Tecido Linfoide/fisiologia , Ratos , Ratos Endogâmicos F344 , Ratos Endogâmicos Lew
11.
Gene Ther ; 16(12): 1383-94, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19759563

RESUMO

In this study, we describe a novel self-contained, nonviral vector system for the rapid development of tetracycline (Tet)-inducible transgene expression systems in mammalian cell lines. To avoid multiple rounds of clonal selection for the establishment of stably transfected cell clones, as is necessary with conventional systems, we constructed a multicomplementary DNA(cDNA) expression vector that enables both one-step targeted genomic integration and conditional induction of transgene expression. This vector system consists of several modules including a Tet-inducible promoter directing the expression of a transgene and two Tet repressor expression units placed in tandem on a single vector. The cell clones, generated using a one-step phiC31 integrase-mediated chromosomal integration of the multi-cDNA expression construct, showed a stable and robust expression with high induction rates upon addition of doxycycline inducer in five different cell lines tested. By using this system, we show c-Src-induced cell transformation and anticancer cell therapy for this transformation in cultured fibroblast cells. The results show a rapid production and accumulation of target protein on addition of the inducer starting from extremely low background levels and reduction to background levels in a matter of days after the inducer was withdrawn from the culture medium.


Assuntos
Regulação da Expressão Gênica , Vetores Genéticos , Tetraciclina/farmacologia , Transgenes , Linhagem Celular , Linhagem Celular Transformada , DNA Complementar , Técnicas de Transferência de Genes , Humanos
12.
Acta Neurochir Suppl ; 103: 83-6, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18496950

RESUMO

BACKGROUND: We introduce less invasive technique for superficial temporal to middle cerebral artery (STA-MCA) anastomosis, and also described an innovative technique to preoperatively identify the recipient artery using three dimensional CT angiography (3D CTA). Objective. In a period of 28 months between January 2004 and April 2006, 39 EC-IC bypass were performed for hemodynamic compromised patients (including 9 patients with Moyamoya disease) using less invasive technique. METHODS: Operative technique is as follows: 1) A parietal or frontal branch of STA and cortical arteries could be identified on the original images of 3D CTA. The most suitable segment of both the artery provided as donor and recipient arteries for EC-IC bypass. The distance between the afore-mentioned segment of donor artery (STA) and the superior border of the helix were calculated. 2) A 5 cm linear skin incision on the STA, the center of which was the point measured on preoperative 3D CTA, was made. The temporal muscle was divided in the same fashion, and a 3 cm small craniotomy was made. The recipient artery could be identified on the center of the craniotomy. End-to-side anastomosis was performed in the usual way. RESULTS: Operation times were 115-172 min (mean 154 min) and intraoperative blood loss was 20-60 ml (mean 38 ml). All bypasses were patent on the post-operative 3D CTA. CONCLUSIONS: This technique for EC-IC bypass was less invasive and cosmetically excellent. 3D CTA provides useful information for planning of the less invasive EC-IC bypass.


Assuntos
Revascularização Cerebral/métodos , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/cirurgia , Microcirurgia/métodos , Transtornos Cerebrovasculares/fisiopatologia , Humanos , Angiografia por Ressonância Magnética/métodos , Estudos Retrospectivos , Tomografia Computadorizada de Emissão de Fóton Único
13.
Am J Transplant ; 8(2): 277-87, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18093265

RESUMO

Human cytomegalovirus (HCMV) accelerates transplant vascular sclerosis (TVS), a consequence of angiogenesis (AG) and wound repair (WR). While HCMV can be localized to TVS lesions, the low number of infected cells suggests a global effect on target tissues. We used microarray analysis followed by real-time-polymerase chain reaction (RT-PCR) in an RCMV-accelerated TVS rat cardiac transplant model to determine whether CMV activates host WR and AG factors. Dysregulated cellular genes in allografts from RCMV-infected recipients were compared to those from uninfected recipients and native hearts. We demonstrated that RCMV upregulates the genes involved in WR and AG, which was highest during the critical time of TVS acceleration (21-28 days). Using a standard in vitro AG assay, virus and serum-free supernatants collected at 48 h postinfection significantly induced endothelial cell (EC) migration, branching and tubule formation compared to supernatants from mock-infected cells. Supernatants from ultraviolet (UV)-inactivated RCMV-infected cells failed to induce AG, indicating that virus replication is required. Upregulation of WR and AG genes occurs during the critical period of CMV-accelerated TVS. Targeting these genes may prevent this process and improve allograft survival.


Assuntos
Doença da Artéria Coronariana/complicações , Infecções por Citomegalovirus/complicações , Transplante de Coração/fisiologia , Neovascularização Fisiológica , Cicatrização , Animais , Doença da Artéria Coronariana/virologia , Citomegalovirus , Modelos Animais de Doenças , Genoma , Masculino , Metaloproteinases da Matriz/genética , Análise de Sequência com Séries de Oligonucleotídeos , Ratos , Ratos Endogâmicos F344 , Ratos Endogâmicos Lew , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transplante Homólogo
14.
Neuroscience ; 150(2): 459-66, 2007 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-17997045

RESUMO

We investigated using the mice role of nitric oxide synthase (NOS) in the spinal dorsal horn in herpetic and postherpetic pain, especially allodynia, which was induced by transdermal inoculation of the hind paw with herpes simplex virus type-1 (HSV-1). The virus inoculation induced NOS2 expression in the lumbar dorsal horn of mice with herpetic allodynia, but not postherpetic allodynia. There were no substantial alternations in the expression level of NOS1 at the herpetic and postherpetic stages. Herpetic allodynia was significantly inhibited by i.p. administration of the selective NOS2 inhibitor S-methylisothiourea, but not the selective NOS1 inhibitor 7-nitroindazole. NOS2 expression was observed around HSV-1 antigen-immunoreactive cells. On the other hand, postherpetic allodynia was significantly inhibited by i.p. administration of 7-nitroindazole, but not S-methylisothiourea. The activity of reduced nicotinamide adenine dinucleotide phosphate diaphorase, an index of NOS1 activity, significantly increased in the laminae I and II of the lumbar dorsal horn of mice with postherpetic allodynia, but not mice without postherpetic allodynia. The expression level of NOS1 mRNA in the dorsal root ganglia was similar between mice with and without postherpetic allodynia. The results suggest that herpetic and postherpetic allodynia is mediated by nitric oxide in the dorsal horn and that NOS2 and NOS1 are responsible for herpetic and postherpetic allodynia, respectively. It may be worth testing the effects of NOS2 and NOS1 inhibitors on herpetic pain and postherpetic neuralgia in human subjects, respectively.


Assuntos
Gânglios Espinais/enzimologia , Neuralgia Pós-Herpética/enzimologia , Neuralgia Pós-Herpética/fisiopatologia , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo I/metabolismo , Óxido Nítrico/biossíntese , Células do Corno Posterior/enzimologia , Animais , Di-Hidrolipoamida Desidrogenase/metabolismo , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Feminino , Gânglios Espinais/fisiopatologia , Gânglios Espinais/virologia , Herpesvirus Humano 1/fisiologia , Hiperalgesia/enzimologia , Hiperalgesia/fisiopatologia , Hiperalgesia/virologia , Indazóis/farmacologia , Isotiurônio/análogos & derivados , Isotiurônio/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico Sintase Tipo I/antagonistas & inibidores , Óxido Nítrico Sintase Tipo I/genética , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/genética , Nociceptores/enzimologia , Nociceptores/fisiopatologia , Nociceptores/virologia , Células do Corno Posterior/fisiopatologia , Células do Corno Posterior/virologia , RNA Mensageiro/metabolismo , Regulação para Cima/fisiologia
15.
Interv Neuroradiol ; 13 Suppl 1: 68-72, 2007 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-20566080

RESUMO

SUMMARY: The present series provides a balanced overview of the treatment of aneurysms in surgical clipping and coil embolization. Between January 2004 and March 2006, 76 consecutive patients with cerebral aneurysms underwent endovascular embolization and/or surgical clipping. Of these, 42 patients suffered an aneurysmal subarachnoid hemorrhage (SAH), while the remaining 34 patients had nonruptured cerebral aneurysms. Of the 23 surgically treated patients, 17 (73.9%) achieved a favorable outcome. Of the 19 patients who underwent endovascular embolization, 12 (63.2%) achieved a favorable outcome. Three patients (15.8%) who underwent endovascular embolization needed to undergo re-treatments, while no re-treatment was needed in the surgically treated patients. Of the 34 nonruptured aneurysms, 12 (35.3%) were treated using surgical clipping, while 22 (64.7%) underwent endovascular embolization. The complication rates of the two treatment modalities demonstrated no significant difference. A combined microsurgical-endovascular team approach is thus considered to provide the most effective means to achieve favorable outcomes for patients with cerebral aneurysms.

16.
Transplant Proc ; 38(10): 3214-20, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17175227

RESUMO

BACKGROUND: Studies have shown that rat cytomegalovirus (RCMV) infection accelerates transplant vascular sclerosis (TVS) in rat heart and small bowel allotransplants. In these models, RCMV-accelerated TVS results from increased graft infiltration of inflammatory cells through up-regulation of chemokine expression. The aim of this study was to determine if RCMV infection accelerates renal transplant chronic allograft nephropathy (CAN), and the role of chemokines in this process. METHODS: F344 kidneys were transplanted into Lewis recipients with and without RCMV infection. To monitor CAN, serum creatinine (Cr) levels were measured starting at 4 weeks posttransplantation. At 7 and 21 days, and at terminal rejection, grafts were examined for histologic changes, inflammatory cell infiltrates, viral load, and chemokine expression profiles. RESULTS: By week 8, serum Cr showed significant elevation (P < .01) in the RCMV-infected group vs uninfected group, and remained significantly elevated through the end of the study. RCMV+ renal allografts had significant inflammatory cell infiltration and increased CAN at postoperative day (POD) 28. The CC chemokines RANTES, MCP-1, and MIP-1alpha, and the CXC chemokine IP-10 were up-regulated in RCMV-infected vs uninfected allografts. IP-10 was significantly up-regulated early in the process, whereas RANTES and MCP-1 were induced at a later time. CONCLUSIONS: RCMV infection accelerates CAN, with associated graft inflammatory infiltrates, which is paralleled by an increase in expression of CC and CXC chemokines. Our findings suggest that the early induction of IP-10 in the infected allografts promotes alterations in T-cell and monocyte migration to the graft, which initiates accelerated inflammatory and fibrotic changes associated with CAN.


Assuntos
Quimiocinas/biossíntese , Infecções por Citomegalovirus/imunologia , Citomegalovirus/patogenicidade , Transplante de Rim/patologia , Animais , Imuno-Histoquímica , Modelos Animais , Ratos , Ratos Endogâmicos F344 , Ratos Endogâmicos Lew , Transplante Homólogo
17.
Acta Anaesthesiol Scand ; 50(5): 568-71, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16643226

RESUMO

BACKGROUND: Propofol is a widely used intravenous anesthetic although its injection pain is a common and unpleasant problem. Long-/medium-chain triglyceride (LCT/MCT) propofol has been introduced, as its low free propofol content is expected to reduce injection pain compared with LCT propofol. Target controlled infusion (TCI) differs from conventional induction in the initial infusion pattern. During induction using TCI, we investigated injection pain caused by two propofol solutions with different triglyceride compositions. METHODS: Fifty patients, ASA I-II, with adequate communicative ability, were randomly assigned to two groups. TCI was conducted with Diprifusor for LCT and with BeComSim (custom-made software) for LCT/MCT. The target blood concentration was set at 4 microg/ml for both groups. At 30, 60, and 120 s after the infusion, patients were asked questions regarding the severity of pain on a 0-10 pain score. The total dose of propofol and the time required to induce anesthesia were also investigated. RESULTS: The LCT/MCT propofol group had a larger number of pain-free patients and showed lower severity of pain than the LCT group [the number of pain-free patients being 11 and 3, respectively (P < 0.05), and median maximum pain being 0 and 4.5, respectively (P < 0.01)]. The dose and time required for induction were not significantly different between the groups (dose of 84 +/- 27 and 80 +/- 24 mg, respectively, and time of 119 +/- 60 and 107 +/- 55 s, respectively). CONCLUSION: Our study showed that the frequency and severity of pain during TCI induction with propofol could be significantly reduced using LCT/MCT propofol rather than LCT propofol.


Assuntos
Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/efeitos adversos , Dor/etiologia , Propofol/administração & dosagem , Propofol/efeitos adversos , Triglicerídeos , Adulto , Idoso , Anestesia Intravenosa , Química Farmacêutica , Relação Dose-Resposta a Droga , Excipientes , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Medição da Dor/efeitos dos fármacos
18.
Neuroscience ; 137(2): 573-81, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16289884

RESUMO

ATP-sensitive K channels are widely expressed in cytoplasmic membranes of neurons, and they couple cell metabolism to excitability. They are thought to be involved in neuroprotection against cell damage during hypoxia, ischemia and excitotoxicity by hyperpolarizing neurons and reducing excitability. Although barbiturates are often used in patients with brain ischemia, the effects of these agents on neuronal ATP-sensitive K channels have not been clarified. We studied the effects of thiopental and pentobarbital on surface ATP-sensitive K channels in principal neurons of rat substantia nigra pars compacta. Whole cell voltage- and current-clamp recordings were made using rat midbrain slices. ATP-sensitive K channels were activated by intracellular dialysis with an ATP-free pipette solution during perfusion with a glucose-free solution. When the pipette solution contained 4mM ATP and the perfusing solution contained 25 mM glucose, the membrane current at -60 mV remained stable. When intracellular ATP was depleted, hyperpolarization and an outward current developed slowly. Although thiopental did not affect the membrane current in the presence of ATP and glucose, it reversibly inhibited the hyperpolarization and outward current induced by intracellular ATP depletion at 100 and 300 microM. Thiopental reduced the ATP depletion-induced outward current by 4.7%, 36.7% and 87% at 30, 100 and 300 microM, respectively. The high dose of pentobarbital also exhibited similar effects on ATP-sensitive K channels. These results suggest that barbiturates at high concentrations but not at clinically relevant concentrations inhibit ATP-sensitive K channels activated by intracellular ATP depletion in rat substantia nigra.


Assuntos
Barbitúricos/farmacologia , Neurônios/efeitos dos fármacos , Canais de Potássio Corretores do Fluxo de Internalização/efeitos dos fármacos , Potássio/metabolismo , Substância Negra/efeitos dos fármacos , Trifosfato de Adenosina/metabolismo , Trifosfato de Adenosina/farmacologia , Animais , Animais Recém-Nascidos , Dano Encefálico Crônico/tratamento farmacológico , Dano Encefálico Crônico/fisiopatologia , Dano Encefálico Crônico/prevenção & controle , Membrana Celular/efeitos dos fármacos , Membrana Celular/metabolismo , Relação Dose-Resposta a Droga , Hipnóticos e Sedativos/farmacologia , Líquido Intracelular/efeitos dos fármacos , Líquido Intracelular/metabolismo , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Inibição Neural/efeitos dos fármacos , Inibição Neural/fisiologia , Neurônios/metabolismo , Fármacos Neuroprotetores/farmacologia , Técnicas de Cultura de Órgãos , Técnicas de Patch-Clamp , Pentobarbital/farmacologia , Canais de Potássio Corretores do Fluxo de Internalização/metabolismo , Ratos , Ratos Sprague-Dawley , Substância Negra/metabolismo , Tiopental/farmacologia
19.
Br J Anaesth ; 95(6): 803-10, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16227338

RESUMO

BACKGROUND: Ketamine has been reported to exert anti-inflammatory effects on macrophages stimulated with lipopolysaccharide (LPS) in vitro and in vivo. Several studies have reported conflicting results regarding the effects of propofol on cytokine production from immune cells. However, there have been no reports of the effects of these agents on inflammatory responses in glial cells. We investigated the effects of ketamine and propofol on LPS-induced production of nitric oxide, tumour necrosis factor-alpha (TNF-alpha) and prostaglandin E(2) (PGE(2)) from primary cultures of rat glial cells in vitro. METHODS: Glial cells were stimulated with LPS in the absence and presence of various concentrations of ketamine (30-1000 microM) or propofol (30 and 300 microM). Nitric oxide released into the culture media was determined by measuring nitrite using the Griess reaction, and concentrations of TNF-alpha and PGE(2) were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Ketamine reduced LPS-induced TNF-alpha production without significant inhibition of nitrite release in mixed glial cells, astrocyte cultures and microglial cultures. Ketamine also inhibited LPS-induced production of PGE(2) in astrocyte cultures. In contrast, propofol had no effect on LPS-induced nitrite or TNF-alpha production in mixed glial cells. CONCLUSIONS: The data demonstrate that ketamine inhibited some of the inflammatory responses of both astrocytes and microglial cells treated with LPS without causing major change in nitric oxide release. Propofol had no effect on the production of nitric oxide or TNF-alpha from LPS-stimulated glial cells.


Assuntos
Mediadores da Inflamação/metabolismo , Ketamina/farmacologia , Lipopolissacarídeos/farmacologia , Neuroglia/efeitos dos fármacos , Propofol/farmacologia , Anestésicos Dissociativos/farmacologia , Anestésicos Intravenosos/farmacologia , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/metabolismo , Células Cultivadas , Dinoprostona/biossíntese , Relação Dose-Resposta a Droga , Lipopolissacarídeos/antagonistas & inibidores , Microglia/efeitos dos fármacos , Microglia/metabolismo , Neuroglia/metabolismo , Óxido Nítrico/biossíntese , Ratos , Ratos Wistar , Fator de Necrose Tumoral alfa/biossíntese
20.
Br J Anaesth ; 93(5): 737-9, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15347603

RESUMO

BACKGROUND: The aim of this study was to examine ethanol-consumption-related changes in the effects of propofol on rat hippocampal acetylcholine (ACh) release. METHODS: Male Sprague-Dawley rats received a solution of ethanol (20% v/v) for 24 weeks while controls received tap water. The effects of propofol were examined by in vivo microdialysis, with ACh release from the hippocampal regions determined by high-performance liquid chromatography with electrochemical detection (HPLC-ECD). RESULTS: Propofol 50 mg kg(-1) i.p. significantly decreased basal hippocampal ACh release in ethanol-treated and control rats by 50.4 (sem 4.7)% and 38.3 (11.1)%, respectively. Propofol 100 mg kg(-1) i.p. significantly decreased basal hippocampal ACh release in ethanol-treated and control rats by 67.5 (3.7)% and 55.9 (7.4)%, respectively. The reduction in hippocampal ACh release induced by 50 or 100 mg kg(-1) i.p. propofol was not significantly different between ethanol-treated and control rats. There was no significant difference in the duration of sleep between the two groups. CONCLUSIONS: These results demonstrate that chronic ethanol consumption does not augment the inhibitory actions of propofol on rat hippocampal ACh release. These findings appear to be inconsistent with the notion that chronic ethanol intake enhances the propofol-induced inhibition of the hippocampal cholinergic system and related mental dysfunction.


Assuntos
Acetilcolina/metabolismo , Anestésicos Intravenosos/farmacologia , Etanol/farmacologia , Hipocampo/efeitos dos fármacos , Propofol/farmacologia , Alcoolismo/metabolismo , Animais , Cromatografia Líquida de Alta Pressão , Modelos Animais de Doenças , Hipocampo/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley
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