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1.
Cureus ; 16(6): e61522, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38957242

RESUMO

Purpose The purpose of this study was to investigate the effect of dexmedetomidine (DEX) on hypotension-induced neuronal damage in a chronic cerebral hypoperfusion (CCH) model of rats, an established model of cerebral white matter lesions (WML) in humans, which is prevalent in the elderly and closely related to cognitive decline. Methods The CCH model rats were randomly assigned to one of four groups: normotension + no DEX (NN) group (n = 6), normotension + DEX (ND) group (n = 6), hypotension + no DEX (HN) group (n = 6), or hypotension + DEX (HD) group (n = 6). Under isoflurane anesthesia, mean arterial blood pressure was maintained at or above 80 mmHg (normotension) or below 60 mmHg (hypotension) for a duration of two hours. The DEX groups received 50 µg of DEX intraperitoneally. Two weeks later, the Y-maze test and, after preparing brain slices, immunohistochemical staining were performed using antibodies against neuronal nuclei (NeuN), microtubule-associated protein 2 (MAP2), glial fibrillary acidic protein (GFAP), and Ionized calcium-binding adapter molecule 1 (Iba1). Results Behavioral observations showed no significant differences among the groups. Significant reductions of both NeuN-positive cells and the MAP2-positive area were found in the hippocampal CA1 in the HN group compared with NN and ND groups, but not in the HD group. GFAP and Iba-1-positive areas were significantly increased in the HN group, but not in the HD group. Conclusion DEX significantly ameliorated hypotension-induced neuronal damage and both astroglial and microglial activation in the CA1 region of CCH rats.

2.
Cureus ; 16(4): e58340, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38752064

RESUMO

PURPOSE: Hypotension is common during anesthesia induction. However, minimal hemodynamic effects of remimazolam anesthesia have been reported. We hypothesized that remimazolam would have weaker hemodynamic effects than would propofol. To test this, we simultaneously evaluated the hemodynamics using the estimated continuous cardiac output (esCCO) system and heart rate variability (HRV) during anesthesia induction. METHODS: This was a single-center, observational, retrospective study of patients undergoing dental surgery under general anesthesia between 2020 and 2022. Seventy patients were divided into two groups: remimazolam (R group; n=34) and propofol (P group; n=36). The information obtained from the anesthesia records, patient information, esCCO system parameters, and HRV were integrated and analyzed. The percentages of various parameters were set to 100% for the pre-induction phase as the baseline. RESULTS: The %MAP (noninvasive mean arterial blood pressure) decreased over a narrower range in the R compared to the P group (-17.8% (-26.3%, -11.9%) vs. -22.6% (-32.9%, -17.0%); P=0.039). The %HR (heart rate) increased significantly in the R group and decreased in the P group (+10.7% (+6.5%, +18.6%) vs. -6.5% (-14.5%, +8.4%); P<0.01). The %SVesCCO (stroke volume calculated using the esCCO system) decreased significantly in both groups, but the R group showed a smaller difference compared to the P group (- 5.1% (-7.7%, -2.1%) vs. -10.0% (-13.8%, -5.6%); P<0.01). The rates of change in %LF nu (normalized unit of low frequency) and %HF nu (normalized unit of high frequency) were lower for the R than for the P group, although the difference was not significant (+6.8% (-14.5%, 32.4%) vs. +9.2% (-7.2%, +59.7%), P=0.30; +7.9% (-51.0%, +66.9%) vs. +22.8% (-26.1%, +61.6%), P=0.57). CONCLUSION: Remimazolam demonstrated a lower MAP reduction rate than propofol. A compensatory increase in HR occurred with a decrease in stroke volume. However, the HR increase was not attributable to the autonomic nervous system.

3.
Sci Rep ; 13(1): 17074, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37816802

RESUMO

Remimazolam, an ultrashort-acting benzodiazepine, allows for rapid and reliable arousal. Rapid awakening using remimazolam may be beneficial in transcatheter aortic valve replacement (TAVR), as it allows rapid detection of neurologic deficits. The purpose of this study was to compare arousal time and outcomes between monitored anesthesia care (MAC) with remimazolam and remifentanil and conventional MAC with dexmedetomidine, propofol, and remifentanil. This study was a single center retrospective study. All TAVR cases performed under MAC (MAC-TAVR) at our institution between 2019 and 2021 were included. Patients were classified by anesthesia method into remimazolam and dexmedetomidine groups. Among 258 MAC-TAVR patients, 253 were enrolled. After propensity score matching, 76 patients were assigned to each group. The time from end of drug-administration to arousal [20.0 (16.0, 24.0) min vs. 38.5 (30.0, 56.3) min, p < 0.0001] and the time from attempted-arousal to arousal [1.0 (1.0, 1.0) min vs. 12.5 (3.0, 26.8) min, p < 0.0001] were significantly shorter in the remimazolam group. There was no significant difference in the length of ICU stay [2.0 (2.0, 2.0) days vs. 2.0 (2.0, 2.0) days, p = 0.157] and postoperative hospital stay [6.0 (4.0, 9.0) days vs. 5.0 (4.0, 8.0) days, p = 0.262].Trial registration: Clinical trial number: R03-123, Registry URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000051635 Registration number: UMIN000045195, Principal investigator's name: Atsuhiro Kitaura, Date of registration: 20 August 2021.


Assuntos
Estenose da Valva Aórtica , Dexmedetomidina , Substituição da Valva Aórtica Transcateter , Humanos , Anestesia Geral/métodos , Estenose da Valva Aórtica/cirurgia , Benzodiazepinas/uso terapêutico , Remifentanil , Estudos Retrospectivos , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
4.
Am J Case Rep ; 23: e938609, 2022 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-36523136

RESUMO

BACKGROUND Prevention of lethal arrhythmias in congenital long QT syndrome type 1 (LQT1) requires avoidance of sympathoexcitation, drugs that prolong QT, and electrolyte abnormalities. However, it is often difficult to avoid all these risks in the perioperative period of open heart surgery. Herein, we report hypokalemia-induced cardiac arrest in a postoperative cardiac patient with LQT1 on catecholamine. CASE REPORT A 79-year-old woman underwent surgical aortic valve replacement for severe aortic stenosis. Although the initial plan was not to use catecholamine, catecholamine was used in the Postoperative Intensive Care Unit with attention to QT interval and electrolytes due to heart failure caused by postoperative bleeding. Serum potassium levels were controlled above 4.5 mEq/L, and no arrhythmic events occurred. On postoperative day 4, the patient was started on insulin owing to hyperglycemia. Cardiac arrest occurred after the first insulin dose; the implantable cardioverter defibrillator was activated, and the patient's own heartbeat resumed. Subsequent examination revealed that a marked decrease in serum potassium level had occurred after insulin administration. The electrocardiogram showed obvious QT prolongation and ventricular fibrillation following R on T. Thereafter, under strict potassium management, there was no recurrence of cardiac arrest events. CONCLUSIONS A patient with LQT1 who underwent open heart surgery developed ventricular fibrillation after Torsades de Pointes, probably due to hypokalemia after insulin administration in addition to catecholamine. It is important to check serum potassium levels to avoid the onset of Torsades de Pointes in patients with long QT syndrome. In addition, the impact of insulin administration was reaffirmed.


Assuntos
Parada Cardíaca , Hipopotassemia , Insulinas , Síndrome do QT Longo , Síndrome de Romano-Ward , Torsades de Pointes , Feminino , Humanos , Idoso , Torsades de Pointes/etiologia , Torsades de Pointes/diagnóstico , Hipopotassemia/complicações , Fibrilação Ventricular/complicações , Valva Aórtica , Catecolaminas , Síndrome do QT Longo/diagnóstico , Eletrocardiografia , Parada Cardíaca/complicações , Arritmias Cardíacas/complicações , Potássio , Insulinas/efeitos adversos
5.
JA Clin Rep ; 8(1): 60, 2022 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-35931870
6.
JA Clin Rep ; 8(1): 38, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648295

RESUMO

BACKGROUND: Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is characterized by cardiac depression, respiratory failure, myopathy, and anesthesia for affected patients is challenging. Although several anesthetics have been safely employed, there are no reports on remimazolam used in those patients. CASE PRESENTATION: A 47-year-old male with MELAS syndrome was diagnosed with mitral regurgitation and scheduled for transcatheter mitral valve repair under general anesthesia. Anesthesia was induced with remimazolam and remifentanil (0.3 µg/kg/min). Remimazolam was administered at 12 mg/kg/h until loss of consciousness for approximately 1 min. Anesthesia was maintained with 1.1-1.2 mg/kg/h of remimazolam and 0.1 µg/kg/min of remifentanil without circulatory collapse or severe metabolic acidosis. The tracheal tube was removed in the operating room. CONCLUSION: Remimazolam may be a new option for anesthesia for MELAS syndrome patients with depressed heart function.

7.
Viruses ; 14(4)2022 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-35458563

RESUMO

Tissue and subcellular localization and its changes upon cell activation of virus-restricting APOBEC3 at protein levels are important to understanding physiological functions of this cytidine deaminase, but have not been thoroughly analyzed in vivo. To precisely follow the possible activation-induced changes in expression levels of APOBEC3 protein in different mouse tissues and cell populations, genome editing was utilized to establish knock-in mice that express APOBEC3 protein with an in-frame FLAG tag. Flow cytometry and immunohistochemical analyses were performed prior to and after an immunological stimulation. Cultured B cells expressed higher levels of APOBEC3 protein than T cells. All differentiation and activation stages of freshly prepared B cells expressed significant levels of APOBEC3 protein, but germinal center cells possessed the highest levels of APOBEC3 protein localized in their cytoplasm. Upon immunological stimulation with sheep red blood cells in vivo, germinal center cells with high levels of APOBEC3 protein expression increased in their number, but FLAG-specific fluorescence intensity in each cell did not change. T cells, even those in germinal centers, did not express significant levels of APOBEC3 protein. Thus, mouse APOBEC3 protein is expressed at distinctively high levels in germinal center B cells. Antigenic stimulation did not affect expression levels of cellular APOBEC3 protein despite increased numbers of germinal center cells.


Assuntos
Linfócitos B , Citidina Desaminase , Centro Germinativo , Infecções por HIV , Animais , Antirretrovirais , Citidina Desaminase/genética , Camundongos , Proteínas , Ovinos
8.
Membranes (Basel) ; 11(7)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34209426

RESUMO

We successfully demonstrated the effect of a membrane reactor for methanol synthesis to improve one-pass CO2 conversion. An Si-rich LTA membrane for dehydration from a methanol synthesis reaction field was synthesized by the seed-assisted hydrothermal synthesis method. The H2O permselective performance of the membrane showed 1.5 × 10-6 mol m-2 s-1 Pa-1 as H2O permeance and around 2000 as selectivity of H2O/MeOH at 473 K. From the results of membrane reactor tests, the CO2 conversion of the membrane reactor was higher than that of the conventional packed-bed reactor under the all of experimental conditions. Especially, at 4 MPa of reaction pressure, the conversion using the membrane reactor was around 60%. In the case of using a packed-bed reactor, the conversion was 20% under the same conditions. In addition, the calculated and experimental conversion were in good agreement in both the case of the membrane reactor and packed-bed reactor.

9.
Membranes (Basel) ; 11(5)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946729

RESUMO

Methylcyclohexane-toluene system is one of the most promising methods for hydrogen transport/storage. The methylcyclohexane dehydrogenation can be exceeded by the equilibrium conversion using membrane reactor. However, the modularization of the membrane reactor and manufacturing longer silica membranes than 100 mm are little developed. Herein, we have developed silica membrane with practical length by a counter-diffusion chemical vapor deposition method, and membrane reactor module bundled multiple silica membranes. The developed 500 mm-length silica membrane had high hydrogen permselective performance (H2 permeance > 1 × 10-6 mol m-2 s-1 Pa-1, H2/SF6 selectivity > 10,000). In addition, we successfully demonstrated effective methylcyclohexane dehydrogenation using a flange-type membrane reactor module, which was installed with 6 silica membranes. The results indicated that conversion of methylcyclohexane was around 85% at 573 K, whereas the equilibrium conversion was 42%.

10.
Am J Case Rep ; 22: e927756, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33737506

RESUMO

BACKGROUND Brugada syndrome is a potentially fatal cardiac arrhythmia characterized by incomplete right bundle-branch block (RBB) and characteristic ST-segment elevation in the anterior electrocardiogram (ECG) leads. This report is of a case of type 2 Brugada syndrome, and discusses the importance of preoperative history and ECG evaluation. CASE REPORT A 32-year-old man was scheduled for tympanoplasty. His preoperative ECG revealed saddleback-type J waves in V2 (>2 mm) and ST increase (>1 mm) detected 1 week before elective surgery, but the ECG 1 year before showed normal. He had no notable past history. Anesthesia was induced with remifentanil and propofol, and maintained with sevoflurane in combination with remifentanil. Routine monitoring of vital signs was supplemented with V2 monitoring on the ECG. The heart rate was maintained at above 60 beats/min using ephedrine. The course of the operation was uneventful. CONCLUSIONS We managed anesthesia for a patient with a type 2 Brugada syndrome ECG without events, probably because he had no notable past history such as syncope. Type 2 and type 3 Brugada syndrome ECGs are difficult to recognize, and patients with them are considered to be less risky than a patient with a type I ECG. However, as Brugada syndrome ECG is dynamic and changeable, a type 2 or 3 Brugada syndrome ECG can change to a type I ECG under some conditions, and thus should not be overlooked, and the patient's past history or symptoms, such as syncope, should be carefully investigated.


Assuntos
Síndrome de Brugada , Adulto , Arritmias Cardíacas , Síndrome de Brugada/diagnóstico , Bloqueio de Ramo , Eletrocardiografia , Humanos , Masculino , Timpanoplastia
11.
PLoS One ; 16(1): e0245957, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33493233

RESUMO

Hyperglycaemia provides a suitable environment for infections and the mechanisms of glucose toxicity include the formation of advanced glycation end-products (AGEs), which comprise non-enzymatically glycosylated proteins, lipids, and nucleic acid amino groups. Among AGE-associated phenotypes, glycolaldehyde-derived toxic AGE (AGE-3) is involved in the pathogenesis of diabetic complications. Internalisation of endotoxin by various cell types contributes to innate immune responses against bacterial infection. An endotoxin derived from Gram-negative bacteria, lipopolysaccharide (LPS), was reported to enhance its own uptake by RAW264.7 mouse macrophage-like cells, and an LPS binding protein, CD14, was involved in the LPS uptake. The LPS uptake induced the activation of RAW264.7 leading to the production of chemokine CXC motif ligand (CXCL) 10, which promotes T helper cell type 1 responses. Previously, we reported that AGE-3 was internalised into RAW264.7 cells through scavenger receptor-1 Class A. We hypothesized that AGEs uptake interrupt LPS uptake and impair innate immune response to LPS in RAW264.7 cells. In the present study, we found that AGE-3 attenuated CD14 expression, LPS uptake, and CXCL10 production, which was concentration-dependent, whereas LPS did not affect AGE uptake. AGEs were reported to stimulate the receptor for AGEs and Toll-like receptor 4, which cause inflammatory reactions. We found that inhibitors for RAGE, but not Toll-like receptor 4, restored the AGE-induced suppression of CD14 expression, LPS uptake, and CXCL10 production. These results indicate that the receptor for the AGE-initiated pathway partially impairs the immune response in diabetes patients.


Assuntos
Produtos Finais de Glicação Avançada/farmacologia , Lipopolissacarídeos/farmacologia , Macrófagos/metabolismo , Animais , Sobrevivência Celular/efeitos dos fármacos , Quimiocina CXCL10/metabolismo , Receptores de Lipopolissacarídeos/metabolismo , Macrófagos/efeitos dos fármacos , Camundongos , Células RAW 264.7 , Receptor 4 Toll-Like/metabolismo
12.
J Clin Pharm Ther ; 46(2): 433-439, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33098128

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Propofol is the most commonly used intravenous anaesthetic worldwide and is considered to be safe for all ages. However, there have been some reports that propofol induces severe atrioventricular (AV) blocks in humans and some studies demonstrated that propofol suppressed the cardiac conduction system in animals. A precise mechanism by which the block is induced has not been elucidated yet in humans. The objective of this study was to investigate the effects of propofol on the cardiac conduction system and the cardiac autonomic nervous balance in children. METHODS: We enrolled 23 paediatric patients (age: 6-15 years; males: 16, females: 7) who were scheduled to undergo radiofrequency catheter ablation (RFCA) under general anaesthesia. Anaesthesia was induced with 2 mg/kg propofol and 0.5 µg/kg/min remifentanil, and tracheal intubation was performed with the aid of 1 mg/kg rocuronium. Anaesthesia was maintained with 5-7 mg/kg/h propofol and 0.2 µg/kg/min remifentanil during the RFCA. After the completion of the RFCA, anaesthesia was further maintained with 5 mg/kg/h propofol and 0.2 µg/kg/min remifentanil for at least 10 min (LC: low propofol concentration state), followed by the injection of 2 mg/kg propofol and the infusion of 10 mg/kg/h propofol for 10 min (HC: high propofol concentration state). The sinus node recovery time (SNRT), sinoatrial conduction time (SACT), atrial-His (AH) interval and the His-ventricular (HV) interval were measured at the end of both the LC and HC. Cardiac autonomic regulation was simultaneously assessed based on heart rate variability. RESULTS AND DISCUSSION: Propofol significantly suppressed intrinsic cardiac HV conduction, but did not affect the SNRT, SACT or the AH interval. As HV blocks, which occur below the His bundle, are often life-threatening, the HV conduction delay may be a cause of severe AV blocks induced by propofol. Propofol directly suppressed parasympathetic nerve activity, and sympathetic nerve activity was also suppressed. WHAT IS NEW AND CONCLUSION: These results indicate that propofol suppresses the HV conduction and might help to elucidate the mechanism by which propofol causes lethal AV blocks.


Assuntos
Anestésicos Intravenosos/farmacologia , Sistema de Condução Cardíaco/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Propofol/farmacologia , Adolescente , Anestésicos Intravenosos/administração & dosagem , Ablação por Cateter/métodos , Criança , Feminino , Humanos , Masculino , Propofol/administração & dosagem , Remifentanil/uso terapêutico
13.
PLoS One ; 15(11): e0241591, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147268

RESUMO

BACKGROUND: Severe aortic stenosis (AS) is increasing in the aging society and is a serious condition for anesthetic management. However, approximately one-third of patients with severe AS are asymptomatic. Echocardiography is the most reliable method to detect AS, but it takes time and is costly. METHODS: Data were obtained retrospectively from patients who underwent surgery and preoperative transthoracic echocardiography (TTE). LVH on ECG was determined by voltage criteria (Sv1 + Rv5 or 6 ≥3.5 mV) and/or the strain pattern in V5 and V6. Severe AS was defined as a mean transaortic pressure gradient ≥40 mmHg or aortic valve area ≤1.0 cm2 by TTE. RESULTS: Data for 470 patients aged 28-94 years old were obtained. One hundred and twenty-six patients had severe AS. LVH on ECG by voltage criteria alone was detected in 182 patients, LVH by strain pattern alone was detected in 80 patients and LVH by both was detected in 55 patients. Multivariable logistic analysis revealed that LVH by the strain pattern or voltage criteria, diabetes mellitus, and age were significantly associated with severe AS. The AUC for the ROC curve for LVH by voltage criteria alone was 0.675 and the cut-off value was 3.84 mm V, and the AUC for the ROC for age was 0.675 and the cut-off value was 74 years old. CONCLUSION: Our study suggests that patients who are 74 years old or over with LVH on ECG, especially those with DM, should undergo preoperative TTE in order to detect severe AS.


Assuntos
Estenose da Valva Aórtica/diagnóstico , Doenças Assintomáticas , Eletrocardiografia , Hipertrofia Ventricular Esquerda/diagnóstico , Cuidados Pré-Operatórios/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia/efeitos adversos , Estenose da Valva Aórtica/complicações , Feminino , Humanos , Hipertrofia Ventricular Esquerda/etiologia , Japão , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Procedimentos Cirúrgicos Operatórios/efeitos adversos
14.
JA Clin Rep ; 6(1): 72, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32939699

RESUMO

BACKGROUND: In a patient with very long-chain acyl-Coenzyme A dehydrogenase (VLCAD) deficiency, metabolism of fatty acids is impaired and a supply of alternative energy is limited when glucose level is insufficient on starvation. CASE PRESENTATION: A 37-year-old woman with VLCAD deficiency was diagnosed with an ovarian cyst and was scheduled for laparoscopic ovarian cystectomy. Glucose was administered intravenously with the start of fasting. Anesthesia was induced with remifentanil, midazolam, and thiamylal, maintained with desflurane and remifentanil. Body temperature was maintained at 36.2-36.7 °C. During anesthesia, hypoglycemia did not occur, creatine kinase levels were in the normal range, and myoglobinuria was not detected. No shivering was observed after extubation. CONCLUSIONS: Glucose was administered to avoid perioperative hypoglycemia. Body temperature was controlled to avoid shivering, which would otherwise increase skeletal muscle energy needs. Blood creatine kinase did not increase, and myoglobinuria was not detected; thus, rhabdomyolysis was unlikely to develop.

15.
Sci Rep ; 10(1): 3735, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-32111926

RESUMO

Elevation of the levels of reactive oxygen species (ROS) is a major tissue-degenerative phenomenon involved in aging and aging-related diseases. The detailed mechanisms underlying aging-related ROS generation remain unclear. Presently, the expression of microRNA (miR)-142-5p was significantly upregulated in bone marrow mesenchymal stem cells (BMMSCs) of aged mice. Overexpression of miR-142 and subsequent observation revealed that miR-142 involved ROS accumulation through the disruption of selective autophagy for peroxisomes (pexophagy). Mechanistically, attenuation of acetyltransferase Ep300 triggered the upregulation of miR-142 in aged BMMSCs, and miR-142 targeted endothelial PAS domain protein 1 (Epas1) was identified as a regulatory protein of pexophagy. These findings support a novel molecular mechanism relating aging-associated ROS generation and organelle degradation in BMMSCs, and suggest a potential therapeutic target for aging-associated disorders that are accompanied by stem cell degeneration.


Assuntos
Autofagia , Células da Medula Óssea/metabolismo , Senescência Celular , Células-Tronco Mesenquimais/metabolismo , MicroRNAs/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Células da Medula Óssea/citologia , Masculino , Células-Tronco Mesenquimais/citologia , Camundongos , MicroRNAs/genética , Peroxissomos/genética , Peroxissomos/metabolismo
16.
Spine Surg Relat Res ; 4(1): 95-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32039306

RESUMO

INTRODUCTION: Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. However, although there are various therapeutic options for CSF leak, there is currently no optimal technique, and the choice of therapy often depends on the surgeon's cumulative experience. The aim of this study was to describe the successful treatment of CSF leakage using blood injection therapy along the drain removal tract. TECHNICAL NOTE: We enrolled 7 consecutive patients who underwent lumbar surgery at our institute. The surgeries performed included decompression in two patients (one microendoscopic surgery), fusion in four, and an epidural cyst resection in one. After finding a CSF leak, we injected about 10 ml of blood from the patient into the drain tract. CSF leak did not recur after the blood injection in any of the seven patients. Following just one day of bed rest, the symptoms of intracranial hypotension disappeared with no instances of worsened symptoms of back pain, lower limb pain or fever. CONCLUSIONS: We propose this route of blood injection therapy as a novel method for the treatment of CSF leak after lumbar surgery.

17.
Biochem Biophys Res Commun ; 523(3): 707-712, 2020 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-31948758

RESUMO

Removal of dysfunctional mitochondria is essential step to maintain normal cell physiology, and selective autophagy in mitochondria, called mitophagy, plays a critical role in quality control of mitochondria. While in several diseases and aging, disturbed mitophagy has been observed. In stem cells, accumulation of damaged mitochondria can lead to deterioration of stem cell properties. Here, we focused on miR-155-5p (miR-155), one of the most prominent miRNAs in inflammatory and aged tissues, and found that miR-155 disturbed mitophagy in mesenchymal stem cells (MSCs). As a molecular mechanism of miR-155-mediated mitophagy suppression, we found that BCL2 associated athanogene 5 (BAG5) is a direct target of miR-155. Reduction of BAG5 resulted in destabilization of PTEN-induced kinase (PINK1) and consequently disrupted mitophagy. Our study suggests a novel mechanism connecting aging and aging-associated inflammation with mitochondrial dysfunction in stem cells through a miRNA-mediated mechanism.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Células-Tronco Mesenquimais/metabolismo , MicroRNAs/genética , Mitofagia , Proteínas Quinases/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Envelhecimento , Animais , Linhagem Celular , Células Cultivadas , Regulação para Baixo , Humanos , Masculino , Células-Tronco Mesenquimais/citologia , Camundongos Endogâmicos C57BL , MicroRNAs/metabolismo , Mapas de Interação de Proteínas , Proteínas Quinases/metabolismo , Regulação para Cima
18.
Membranes (Basel) ; 9(12)2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31817466

RESUMO

The effect of carbonic anhydrase (CA) on the separation performance of thin poly(amidoamine) (PAMAM) dendrimer/poly(ethylene glycol) (PEG) hybrid membranes was investigated. CA, a type of enzyme, was used to promote CO2 hydration and dehydration reactions and to assess whether these reactions were the rate-limiting step in CO2 permeation through the membrane. The relationship between the membrane thickness and the CO2 permeance was evaluated in CO2/H2 or CO2/He separation using PAMAM/PEG hybrid membranes (thickness: 10-100 µm) with and without CA. Without CA, the CO2 permeance of PAMAM/PEG hybrid membranes was not inversely proportional to the membrane thickness. On the other hand, with CA, the CO2 permeance was inversely proportional to the membrane thickness. It was implied that, without CA, the rate-limiting step of CO2 transport was either the CO2 hydration reaction at the feed side or the CO2 dehydration reaction at the permeate side. On the other hand, with CA addition, the rate-limiting step of CO2 transport was diffusion, and CO2 permeance could be increased without sacrificing the selectivity by reducing membrane thickness. The effect of the position of CA (i.e., on the surface and/or reverse surface) on CO2 separation performance was investigated to evaluate which reaction was the rate-limiting step of CO2 permeation through the membrane. It was suggested that the rate-limiting step of CO2 permeation was CO2 dehydration reaction at the permeate side.

19.
Membranes (Basel) ; 9(11)2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31671562

RESUMO

Water gas shift reaction of carbon monoxide (CO) with membrane reactors should be a promising method for hydrogen mass-production because of its high CO conversion, high hydrogen purity and low carbon dioxide emission. For developing such membrane reactors, we need hydrogen permselective membranes with high hydrogen permeance with order of 10-6 mol m-2 s-1 Pa-1 at 573 K and high steam durability. In this study, we have optimized the kind of substrates, precursors, vapor concentration, and chemical vapor deposition (CVD) time using the counter-diffusion CVD method for developing such membranes. The developed membrane prepared from hexamethyldisiloxane has a hydrogen permeance of 1.29 × 10-6 mol m-2 s-1 Pa-1 at 573 K and high steam durability. We also conducted water gas shift reactions with membrane reactors installed the developed silica membranes. The results indicated that reactions proceed efficiently with the conversion around 95-97%, hydrogen purity around 94%, and hydrogen recovery around 60% at space velocity (SV) 7000.

20.
Langmuir ; 35(30): 9825-9830, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31293166

RESUMO

By utilizing water transport phenomena between two different water-in-oil (W/O) emulsion droplets through continuous oil phase, we developed a novel method of aqueous two-phase system (ATPS) formation in small droplets prepared by Shirasu porous glass (SPG) membrane emulsification technique. When we mixed W/O emulsion droplets containing poly(ethylene glycol) (PEG) and dextran (DEX) at concentrations below the threshold of the phase separation, with droplets containing other solutes at high concentrations, water extraction from the droplets containing PEG and DEX to those containing the other solutes occurred, owing to the osmotic pressure difference. This effect increased the concentrations of PEG and DEX in the droplets above the phase separation threshold. We demonstrated the feasibility of the preparation method by varying the pore sizes of the SPG membranes, the solutes, and their concentrations. Only when the concentration of the solute was high enough to extract sufficient amounts of water did the homogeneous disperse phase consisting of PEG and DEX in droplets turn into a PEG-rich phase and DEX-rich phase, showing ATPS. This result was irrespective of the solute itself and pore size of the SPG membrane. In particular, we successfully demonstrated monodisperse ATPS droplets with diameters of approximately 10 µm under a certain condition.

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