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1.
Osteoporos Int ; 25(7): 1945-51, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24760244

RESUMO

UNLABELLED: Treatment effects over 2 years of teriparatide vs. ibandronate in postmenopausal women with osteoporosis were compared using lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). Teriparatide induced larger increases in BMD and TBS compared to ibandronate, suggesting a more pronounced effect on bone microarchitecture of the bone anabolic drug. INTRODUCTION: The trabecular bone score (TBS) is an index of bone microarchitecture, independent of bone mineral density (BMD), calculated from anteroposterior spine dual X-ray absorptiometry (DXA) scans. The potential role of TBS for monitoring treatment response with bone-active substances is not established. The aim of this study was to compare the effects of recombinant human 1-34 parathyroid hormone (teriparatide) and the bisphosphonate ibandronate (IBN), on lumbar spine (LS) BMD and TBS in postmenopausal women with osteoporosis. METHODS: Two patient groups with matched age, body mass index (BMI), and baseline LS BMD, treated with either daily subcutaneous teriparatide (N = 65) or quarterly intravenous IBN (N = 122) during 2 years and with available LS BMD measurements at baseline and 2 years after treatment initiation were compared. RESULTS: Baseline characteristics (overall mean ± SD) were similar between groups in terms of age 67.9 ± 7.4 years, body mass index 23.8 ± 3.8 kg/m(2), BMD L1-L4 0.741 ± 0.100 g/cm(2), and TBS 1.208 ± 0.100. Over 24 months, teriparatide induced a significantly larger increase in LS BMD and TBS than IBN (+7.6 % ± 6.3 vs. +2.9 % ± 3.3 and +4.3 % ± 6.6 vs. +0.3 % ± 4.1, respectively; P < 0.0001 for both). LS BMD and TBS were only weakly correlated at baseline (r (2) = 0.04) with no correlation between the changes in BMD and TBS over 24 months. CONCLUSIONS: In postmenopausal women with osteoporosis, a 2-year treatment with teriparatide led to a significantly larger increase in LS BMD and TBS than IBN, suggesting that teriparatide had more pronounced effects on bone microarchitecture than IBN.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Difosfonatos/uso terapêutico , Osteoporose Pós-Menopausa/tratamento farmacológico , Teriparatida/uso terapêutico , Absorciometria de Fóton/métodos , Idoso , Conservadores da Densidade Óssea/farmacologia , Difosfonatos/farmacologia , Avaliação de Medicamentos/métodos , Feminino , Humanos , Ácido Ibandrônico , Injeções Intravenosas , Injeções Subcutâneas , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/fisiopatologia , Estudos Retrospectivos , Teriparatida/farmacologia , Resultado do Tratamento
2.
Ultraschall Med ; 33(3): 245-50, 2012 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-22532081

RESUMO

AIM: In this explorative study it should be evaluated how the introduction of non invasive first trimester diagnosis (nuchal translucency measurement, Combined Test, first trimester ultrasound screening) has influenced the indications and cytogenetic results of chorion villi samplings. MATERIALS AND METHODS: Between 1989 and 2008 3337 pregnancies with CVS between 11 and 14 weeks of gestation were examined retrospectively. They were divided in two groups: CVS 1989 - 2001 before introduction of non invasive first trimester diagnosis (n = 1698) and CVS 2002 - 2008 after introducing non invasive testing at the end of 2001 (n = 1639). In both groups the indications for CVS (maternal age, sonographic findings, past history, maternal anxiety, and abnormal results of the Combined Test only in the second group) and the cytogenetic results were evaluated. RESULTS: In the first group (1989 - 2001, n = 1698) 85,6% (n = 1454) of all CVS were performed because of maternal age and only 3% (n = 51) due to sonographic findings. In the second group (2002 - 2008, n = 1639) there was a distinct increase of sonographic findings leading to CVS (33,9%, n = 555) with a clear decrease of maternal age to 37,9% (n = 621). Abnormal cytogenetic results were found in 10,5% (n = 172) in the second group, in the first group only in 4,5% (n = 76), respectively. The parameter with the highest rate of chromosomal disorders was fetal hydrops (66,1%), follwed by hygroma colli (48,2%), malformations (12,9%) and increased nuchal translucency (11,2%). Regarding maternal age alone the rate of abnormal chromosomes was 3,1%. CONCLUSIONS: It could be shown that non invasive first trimester diagnosis has lead to a more specific indication for invasive fetal testing (sonographic findings 33,9 vs. 3%, maternal age 37,9 vs. 85,6%) with a higher rate of chromosomal disorder in this group (10,5 vs. 4,5%).


Assuntos
Amostra da Vilosidade Coriônica , Anormalidades Congênitas/diagnóstico por imagem , Medição da Translucência Nucal , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal , Adulto , Aberrações Cromossômicas , Anormalidades Congênitas/genética , Anormalidades Congênitas/prevenção & controle , Feminino , Humanos , Recém-Nascido , Linfangioma Cístico/diagnóstico por imagem , Idade Materna , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade
3.
Pathologe ; 32(1): 40-6, 2011 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-21170535

RESUMO

The Jena Institute of Pathology has been serving as a consultation and reference center for soft tissue tumors in Germany since 1978. The present study provides an overview of the clinicopathological data from a two-year period and an update on diagnostics and research. Retrospectively, 7043 cases sent to the institute in the years 2006 and 2007 were analyzed. The majority of cases (>77.7%) were soft tissue tumors, of which 49% were categorized as malignant, 11.4% as intermediate, 35% as benign and 4.6% as tumors of uncertain biological potential. Neoplasms with fibroblastic differentiation were the most frequent. The mean age of patients with a sarcoma was 63 years. The molecular pathological analysis of soft tissue tumors has attained a major role in diagnosis. This is further advanced at the Jena institute in the context of a German Federal Ministry of Education and Research (BMBF) project for molecular sarcoma diagnosis with the aim of developing and validating DNA probes for in situ hybridization detection of translocations and their associated chromosomal breaks on the one hand, and DNA chips for the detection of fusion transcripts on the other. Research projects relate to the analysis of specific biomarkers in large tumor collectives and the pathomechanisms in several sarcoma entities.


Assuntos
Sistema de Registros , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Adulto , Idoso , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/patologia , Aberrações Cromossômicas , Estudos Transversais , Sondas de DNA , Feminino , Predisposição Genética para Doença/genética , Alemanha , Humanos , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Análise de Sequência com Séries de Oligonucleotídeos , Pesquisa , Estudos Retrospectivos , Sarcoma/classificação , Sarcoma/epidemiologia , Sarcoma/genética , Neoplasias de Tecidos Moles/classificação , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/genética , Translocação Genética/genética
4.
Acta Theriol (Warsz) ; 56(1): 1-12, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21350595

RESUMO

European red deer are known to show a conspicuous phylogeographic pattern with three distinct mtDNA lineages (western, eastern and North-African/Sardinian). The western lineage, believed to be indicative of a southwestern glacial refuge in Iberia and southern France, nowadays covers large areas of the continent including the British Isles, Scandinavia and parts of central Europe, while the eastern lineage is primarily found in southeast-central Europe, the Carpathians and the Balkans. However, large parts of central Europe and the whole northeast of the continent were not covered by previous analyses. To close this gap, we produced mtDNA control region sequences from more than 500 red deer from Denmark, Germany, Poland, Lithuania, Belarus, Ukraine and western Russia and combined our data with sequences available from earlier studies to an overall sample size of almost 1,100. Our results show that the western lineage extends far into the European east and is prominent in all eastern countries except for the Polish Carpathians, Ukraine and Russia where only eastern haplotypes occurred. While the latter may actually reflect the natural northward expansion of the eastern lineage after the last ice age, the present distribution of the western lineage in eastern Europe may in large parts be artificial and a result of translocations and reintroduction of red deer into areas where the species became extinct in historical times.

5.
J Cell Biol ; 152(2): 325-34, 2001 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-11266449

RESUMO

Male "viable motheaten" (me(v)) mice, with a naturally occurring mutation in the gene of the SH2 domain protein tyrosine phosphatase SHP-1, are sterile. Known defects in sperm maturation in these mice correlate with an impaired differentiation of the epididymis, which has similarities to the phenotype of mice with a targeted inactivation of the Ros receptor tyrosine kinase. Ros and SHP-1 are coexpressed in epididymal epithelium, and elevated phosphorylation of Ros in the epididymis of me(v) mice suggests that Ros signaling is under control of SHP-1 in vivo. Phosphorylated Ros strongly and directly associates with SHP-1 in yeast two-hybrid, glutathione S-transferase pull-down, and coimmunoprecipitation experiments. Strong binding of SHP-1 to Ros is selective compared to six other receptor tyrosine kinases. The interaction is mediated by the SHP-1 NH(2)-terminal SH2 domain and Ros phosphotyrosine 2267. Overexpression of SHP-1 results in Ros dephosphorylation and effectively downregulates Ros-dependent proliferation and transformation. We propose that SHP-1 is an important downstream regulator of Ros signaling.


Assuntos
Células Epiteliais/fisiologia , Proteínas Tirosina Fosfatases/genética , Proteínas Tirosina Fosfatases/metabolismo , Proteínas Tirosina Quinases/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Receptores Proteína Tirosina Quinases , Receptor trkA/fisiologia , Transdução de Sinais/fisiologia , Células 3T3 , Animais , Linhagem Celular , Epididimo/citologia , Células Epiteliais/citologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Camundongos , Camundongos Knockout , Camundongos Mutantes , Proteína Tirosina Fosfatase não Receptora Tipo 6 , Proteínas Tirosina Fosfatases/química , Proteínas Proto-Oncogênicas/deficiência , Proteínas Proto-Oncogênicas/genética , Receptor trkA/genética , Proteínas Recombinantes de Fusão/metabolismo , Transfecção , Domínios de Homologia de src
6.
Biochem Genet ; 47(3-4): 241-50, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19169806

RESUMO

We analyzed 121 golden jackals (Canis aureus) from six sample sites in Serbia with regard to genetic variability and differentiation as revealed by mitochondrial control region sequences and eight nuclear microsatellite loci. There was no variation at all in the mtDNA sequences, and nuclear variability was very low (average observed and expected heterozygosity of 0.29 and 0.34, respectively). This is in line with the considerable recent range expansion of this species in the Balkans and indicates a strong founder effect in the recently established Serbian population. We did not find evidence of differentiation between the northeastern jackals and those from the plain of Srem or those in between. F-statistics and Bayesian Structure analyses, however, were indicative of a low degree of overall differentiation in the Serbian population. A vagrant Austrian jackal that was also analyzed was genetically indistinguishable from its Serbian conspecifics.


Assuntos
DNA Mitocondrial/genética , Efeito Fundador , Chacais/genética , Repetições de Microssatélites/genética , Animais , Teorema de Bayes , Variação Genética , Geografia , Sérvia
7.
IEEE Trans Med Imaging ; 38(2): 649-656, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30188818

RESUMO

X-ray grating interferometry is a powerful emerging tool in biomedical imaging, providing access to three complementary image modalities. In addition to the conventional attenuation modality, interferometry provides a phase modality, which visualizes soft tissue structures, and a dark-field modality, which relates to the number and size of sub-resolution scattering objects. A particularly strong dark-field signal originates from the alveoli or air sacs in the lung. Dark-field lung radiographs in animal models have already shown increased sensitivity in diagnosing lung diseases, such as lung cancer or emphysema, compared to conventional X-ray chest radiography. However, to date, X-ray dark-field lung imaging has either averaged information over several breaths or has been captured during a breath hold. In this paper, we demonstrate the first time-resolved dark-field imaging of a breath cycle in a mechanically ventilated mouse, in vivo, which was obtained using a grating interferometer. We achieved a time resolution of 0.1 s, visualizing the changes in the dark-field, phase, and attenuation images during inhalation and exhalation. These measurements show that the dark-field signal depends on the air volume and, hence, the alveolar dimensions of the lung. Conducting this type of scan with animal disease models would help to locate the optimum breath point for single-image diagnostic dark-field imaging and could indicate if the changes in the dark-field signal during breath provide a diagnostically useful complementary measure.


Assuntos
Interferometria/métodos , Pulmão/diagnóstico por imagem , Radiografia Torácica/métodos , Animais , Feminino , Processamento de Imagem Assistida por Computador , Pneumopatias/diagnóstico por imagem , Camundongos , Camundongos Endogâmicos C57BL , Respiração Artificial
8.
PLoS One ; 12(8): e0180137, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28767659

RESUMO

For hares (Lepus spp., Leporidae, Lagomorpha, Mammalia) from Ethiopia no conclusive molecular phylogenetic data are available. To provide a first molecular phylogenetic model for the Abyssinian Hare (Lepus habessinicus), the Ethiopian Hare (L. fagani), and the Ethiopian Highland Hare (L. starcki) and their evolutionary relationships to hares from Africa, Eurasia, and North America, we phylogenetically analysed mitochondrial ATPase subunit 6 (ATP6; n = 153 / 416bp) and nuclear transferrin (TF; n = 155 / 434bp) sequences of phenotypically determined individuals. For the hares from Ethiopia, genotype composition at twelve microsatellite loci (n = 107) was used to explore both interspecific gene pool separation and levels of current hybridization, as has been observed in some other Lepus species. For phylogenetic analyses ATP6 and TF sequences of Lepus species from South and North Africa (L. capensis, L. saxatilis), the Anatolian peninsula and Europe (L. europaeus, L. timidus) were also produced and additional TF sequences of 18 Lepus species retrieved from GenBank were included as well. Median joining networks, neighbour joining, maximum likelihood analyses, as well as Bayesian inference resulted in similar models of evolution of the three species from Ethiopia for the ATP6 and TF sequences, respectively. The Ethiopian species are, however, not monophyletic, with signatures of contemporary uni- and bidirectional mitochondrial introgression and/ or shared ancestral polymorphism. Lepus habessinicus carries mtDNA distinct from South African L. capensis and North African L. capensis sensu lato; that finding is not in line with earlier suggestions of its conspecificity with L. capensis. Lepus starcki has mtDNA distinct from L. capensis and L. europaeus, which is not in line with earlier suggestions to include it either in L. capensis or L. europaeus. Lepus fagani shares mitochondrial haplotypes with the other two species from Ethiopia, despite its distinct phenotypic and microsatellite differences; moreover, it is not represented by a species-specific mitochondrial haplogroup, suggesting considerable mitochondrial capture by the other species from Ethiopia or species from other parts of Africa. Both mitochondrial and nuclear sequences indicate close phylogenetic relationships among all three Lepus species from Ethiopia, with L. fagani being surprisingly tightly connected to L. habessinicus. TF sequences suggest close evolutionary relationships between the three Ethiopian species and Cape hares from South and North Africa; they further suggest that hares from Ethiopia hold a position ancestral to many Eurasian and North American species.


Assuntos
Evolução Biológica , DNA/genética , Lebres/classificação , Lebres/genética , Animais , Teorema de Bayes , DNA/química , DNA Mitocondrial/química , DNA Mitocondrial/genética , DNA Mitocondrial/isolamento & purificação , DNA Mitocondrial/metabolismo , Etiópia , Variação Genética , Genótipo , Haplótipos , Hibridização Genética , Repetições de Microssatélites/genética , ATPases Mitocondriais Próton-Translocadoras/genética , Fenótipo , Filogenia , Polimorfismo Genético , Densidade Demográfica , Análise de Sequência de DNA , Transferrina/genética
9.
Eur J Surg Oncol ; 31(5): 512-20, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15878259

RESUMO

AIMS: To investigate the role of hospital volume and individual hospitals on long term outcomes (local recurrence and survival) of rectal cancer patients. METHODS: One thousand thirty-eight patients with rectal cancer were diagnosed between 1996 and 1998. From these, we analysed 884 patients with a resected invasive primary rectal cancer. Median follow-up was 5.7 years. The impact of hospital volume (<10, 10-30 and >30 rectal cancer patients annually) on local recurrence and survival was examined in a Cox model. Differences between the four largest clinics in the high volume group were also investigated. RESULTS: In the multivariate model predicting survival the following variables were significant: UICC stage, grade, age, local recurrence, and (neo-) adjuvant therapy treatment. In the multivariate model predicting local recurrence UICC stage, tumour localisation, and neoadjuvant therapy treatment were significant variables. Hospital volume was not a significant factor for survival or local recurrence. Within the high volume category one hospital showed significantly worse local recurrence rates than all other hospitals, but no survival difference could be seen between the four largest hospitals of the high volume group. CONCLUSIONS: This analysis of a rectal cancer population found that hospital volume did not determine survival or local recurrence. Detailed clinical data with long term follow-up from cancer registries are vital to demonstrate the quality of routine care.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Procedimentos Cirúrgicos do Sistema Digestório/normas , Hospitais/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Neoplasias Retais/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Modelos de Riscos Proporcionais , Análise de Sobrevida
10.
Eur J Ophthalmol ; 15(5): 627-37, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16167294

RESUMO

PURPOSE: To pre p a re and explore new solutions of semifluorinated alkane in silicone oil, which have a specific gravity slightly higher than silicone oil and vitreous fluid (referred to in the following as heavier-than-water silicone oils (HWSs), and to investigate, in vitro, whether HWSs can be used to plug retina holes, while allowing dehydration of the subretinal space. METHODS: HWS solutions were pre p a red with silicone oil 5000 and perfluorohexyloctane (F6H8). The stability was investigated under different conditions. The viscosity was determined by means of a capillary viscometer. The surface and interface tension were measured using the ring method. RESULTS: HWSs are insoluble in an aqueous medium. Densiron(R)68 (HWS 1.06) is a transparent homogeneous liquid which is slightly heavier (1.06 g/cm3) than water and has a refractive index close to that of vitreous liquid. Densiron68 (HWS 1.06) has a low viscosity (1480 mPas) and interface tension (40.82 mN/m), making it an effective tamponade in the surgical treatment of an inferior detached retina. In addition, the interfaces between Densiron68 and other perfluorocarbon liquids are clearly visible. However, the interface layer between Densiron68 and water is not clear. Finally, all HWSs are stable over the long term at ambient temperatures, as well as physically and thermally resistant. CONCLUSIONS. Due to its physiochemical properties, Densiron68 could meet the requirements for a heavier-than-water tamponade.


Assuntos
Dimetilpolisiloxanos/química , Fluorocarbonos/química , Óleos de Silicone/química , Silicones/química , Adulto , Animais , Dimetilpolisiloxanos/toxicidade , Drenagem , Combinação de Medicamentos , Estabilidade de Medicamentos , Fluorocarbonos/toxicidade , Humanos , Células L/efeitos dos fármacos , Camundongos , Soluções Oftálmicas/química , Soluções Oftálmicas/toxicidade , Epitélio Pigmentado Ocular/efeitos dos fármacos , Refratometria , Óleos de Silicone/toxicidade , Silicones/toxicidade , Gravidade Específica , Tensão Superficial , Viscosidade
11.
Eur J Hum Genet ; 9(3): 226-30, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11313763

RESUMO

A clinical evaluation and Cx26 mutation analysis was performed in 92 consecutive patients with sensorineural hearing loss in order to delineate the spectrum of genetically caused hearing loss. Among patients of Austrian origin, 53% were classified with hereditary hearing loss. Cx26 mutations were found in 26% of NSHL patients (40% of familial vs 18% of sporadic cases). The mutation 35delG accounted for 52.8% of all presumed GJB2 disease alleles. The second most frequent mutation was L90P (16.7%) having been reported with a prevalence of 0.7-3.5% in other populations. Three novel mutations were found. The novel mutation, R143Q, was associated with dominant high-frequency hearing loss. Pseudodominant transmission of NSHL was seen in four families with Cx26 mutations. A mutation 35delG carrier rate of 0.9% was observed among 672 controls from West-Austria. Cx26 mutations were found associated with mild to profound, and with asymmetric hearing impairment.


Assuntos
Conexinas/genética , Perda Auditiva Neurossensorial/genética , Mutação , Áustria , Conexina 26 , Feminino , Humanos , Masculino , Linhagem
12.
Shock ; 15(2): 143-50, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11220643

RESUMO

The purpose of this preliminary study was to investigate the advantages of the time-frequency analysis through the Continuous Wavelet Transform (CWT) compared to classical Fourier analysis using the Fast Fourier Transform (FFT) in arterial pressure signals from anesthetized mongrel dogs before and during standardized hemorrhages. Systemic arterial pressure pulsations were recorded using catheter-tip manometers. CWT and FFT were applied to arterial pressure pulsations to obtain module coefficients of this transformation and its associated contours during the evolution of progressive hemorrhages, in amounts of 15, 34, and 66% of the estimated total blood volume. This mathematical analysis enabled us to identify the evolution of the frequency components of aortic valve functions, heart dynamics, respiratory influences, and vasomotor activities. Furthermore, we isolated the modulating signal of amplitude modulation phenomenon present in the arterial pressure records, as described in previous papers, being the heart rate carrier frequency. The CWT is a very sensitive and reliable procedure to analyze (time-frequency) the oscillatory phenomena in two dimensions, and to provide more information than the FFT. This new analytical procedure may provide new insights in the study of shock pathophysiology.


Assuntos
Determinação da Pressão Arterial/métodos , Hemorragia/fisiopatologia , Processamento de Imagem Assistida por Computador/métodos , Animais , Cães , Feminino , Análise de Fourier , Masculino
13.
J Cancer Res Clin Oncol ; 110(3): 225-9, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-3841127

RESUMO

The status of lymphocyte subpopulations in splenectomized (Sx) stomach cancer patients (SCa-patients), assessed by monoclonal antibodies, has not been evaluated so far. Therefore subsets of peripheral white blood cells were monitored prior to and following surgical treatment in gastrectomized (Gx) and Sx (n = 64) as well as in non-Sx patients (n = 39). Postoperative surgical complications were more frequent in the Sx group. However, the 2-year survival rate of this group was higher than in non-Sx patients. Lymphocytes were significantly decreased in both groups of patients during the early postoperative period. Monocytes and polymorphonuclear cells (PMN) increased correspondingly. A significant loss of lymphocytes and their subsets in Sx patients was observed during the 1st-3rd postoperative days as compared to the Gx only patients. The OKT4/OKT8 ratios did not differ in either group of patients, whereas the OKT3+anti-B-Ly2 ratio was significantly increased in Sx patients 1 to 3 days postoperatively.


Assuntos
Linfócitos/imunologia , Neoplasias Gástricas/imunologia , Anticorpos Monoclonais , Feminino , Gastrectomia , Humanos , Contagem de Leucócitos , Linfócitos/classificação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Esplenectomia , Neoplasias Gástricas/cirurgia
14.
Surgery ; 103(4): 440-4, 1988 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-3353857

RESUMO

In a prospective study microvascular reactivity was examined in 12 patients with septic conditions by means of the provocation of reactive hyperemia (RH) for evaluation of microcirculatory function. Data were compared with data from 10 nonseptic, postsurgical patients. At the time of the initial measurement, an adequate hyperemic response could be produced in all patients. In the further course of the disease, in nine of the 12 patients severe multiple organ failure developed. In spite of sufficient values for arterial blood pressure, oxygenation, and the clotting system, RH was absent in these patients (8 +/- 2 days after the initial measurement). Subsequently, seven of these nine patients died (4 +/- 2 days after the onset of microvascular nonreactivity). Until death, RH was absent in each patient, and at this time therapy-resistant hypoxemia, hypotension, and severe disturbances of the clotting system were present. In the two surviving patients RH was restored completely. These results indicate that (1) the septic state per se is not necessarily combined with impaired microvascular reactivity (rather, the absence of RH may be a sign of generally poor clinical conditions); (2) the absence of RH is not related to therapy-resistant hypotension, hypoxia, and severe clotting disorders but precedes these changes; and (3) provocation of RH may be of clinical use for early detection of microcirculatory malfunction in high-risk patients.


Assuntos
Hiperemia/fisiopatologia , Infecções/fisiopatologia , Microcirculação , Fatores Etários , Idoso , Antebraço/irrigação sanguínea , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Prognóstico , Resistência Vascular
15.
Metabolism ; 37(2): 185-90, 1988 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3123876

RESUMO

The systemic effect of low-dose bradykinin infusion on total body glucose production and arterial substrate concentrations was examined during D5W infusion (1.0 mg/kg/min) in five normal-weight postsurgical subjects and compared to the response in four saline infused control patients, well matched for age, weight, and degree of postoperative stress. The primed-constant infusion of 6,6-d2-glucose was used to determine the rate of endogenous glucose production. After a basal period of 90 minutes, subjects in the study group were infused with bradykinin at increasing rates of 2.0 and 4.0 micrograms/kg/h, each infusion rate lasting for 90 minutes, whereas in controls corresponding amounts of saline were given. After 75 minutes of bradykinin, endogenous glucose production was significantly reduced as compared to basal values (1.63 +/- 0.21 mg/kg/min, P less than .0125 v 2.20 +/- 0.35 basal). This was accompanied by a significant reduction in arterial concentrations of glucose, lactate, pyruvate, and alanine. Corresponding concentrations of insulin, glucagon, glycerol, free fatty acids, and ketone bodies, as well as mean arterial blood pressure and heart rate was not affected by bradykinin. In the control group no significant changes in substrate and hormone concentrations, or the rate of glucose production were observed. The higher bradykinin infusion rate did not further affect substrate metabolism or systemic hemodynamics. These results demonstrate the inhibitory effect of low-dose bradykinin on glucose production in surgically stressed patients. The stimulation of hepatic prostaglandin synthesis by bradykinin may explain the results since prostaglandins are known to exert an inhibitory effect on hormone stimulated gluconeogenesis and glycogenolysis in liver tissue.


Assuntos
Bradicinina/farmacologia , Glucose/biossíntese , Estresse Fisiológico/metabolismo , Adulto , Inibidores de Ciclo-Oxigenase , Gluconeogênese , Humanos , Fígado/metabolismo , Procedimentos Cirúrgicos Operatórios
16.
Arch Surg ; 119(10): 1125-32, 1984 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-6477095

RESUMO

We studied the hormonal millieu and possibility of altered thyroid function in 25 patients in a surgical intensive care unit (ICU) who had severe life-threatening illnesses. Sixteen patients had septic complications and nine patients had multiple-system injuries. On admission to the ICU, serial measurements were begun of thyroxine (T4), triiodothyronine (T3), T4-binding globulin, thyrotropin (thyroid-stimulating hormone [TSH]), corticotropin (adrenocorticotropic hormone [ACTH]), cortisol, prolactin, human growth hormone, catecholamine, insulin and glucose, lactate, retinol-binding protein, prealbumin, and transferrin levels. All patients initially had low normal levels of T4 (4.5 +/- 2 micrograms/dL) and T3 (55 +/- 26 ng/dL), with normal TSH levels (2.3 +/- 2.3 microU/mL) (the "low T3 syndrome"). The 11 surviving patients had their levels increase to normal before leaving the ICU (T4, 7.0 +/- 2.1 micrograms/dL; T3, 110 +/- 48 ng/dL; and TSH, no change). The 14 patients who died showed further decreases before death (T4, 2.6 +/- 2.1 micrograms/dL; T3, 30.6 +/- 23.5 ng/dL; and TSH, 0.9 +/- 0.7 microU/mL). The corticotropin, cortisol, prolactin, and growth hormone levels were normal throughout the study. Catecholamine levels were high initially and decreased in surviving patients. Epinephrine levels increased greatly in nonsurvivors before death, and the norepinephrine-epinephrine ratio decreased from 5.7:1 to 2:1. After protirelin (thyroid-releasing hormone [TRH]) stimulation, the TSH level increased either minimally or not at all in six patients who eventually died. This indicates hypothalamic-pituitary dysregulation or suppression, and altered release and/or peripheral metabolism of T4. Whether this represents a deficiency of thyroid hormone for cell and organ function remains to be established.


Assuntos
Doença/sangue , Hormônios/sangue , Ferimentos e Lesões/sangue , Adolescente , Adulto , Idoso , Humanos , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Prognóstico , Radioimunoensaio , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
17.
Arch Surg ; 122(7): 765-71, 1987 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3297000

RESUMO

To evaluate the effect of the glucose-induced insulin release on peripheral substrate metabolism, we studied muscle metabolism in seven patients after elective surgery and in four healthy volunteers combining the forearm and the euglycemic glucose clamp technique (insulin infusion, 0.2 mU/kg per minute). Arterial and deep venous concentrations of substrates and hormones were determined in the basal period and during steady state of the infusion period. After 90 minutes of insulin infusion, the whole-body glucose infusion rate was significantly lower in patients who had elective surgery, although plasma insulin concentrations were comparable. In both groups this was related to a reduced supply of free fatty acids and ketones in muscle. In controls the resulting lack of substrates in muscle appeared to be compensated by an enhanced uptake of glucose, not seen in the patients who had elective surgery. Surprisingly, as indicated by the significantly reduced lactate production (-0.15 +/- 0.05 vs -0.62 +/- 0.32 mumol/100 g per minute basal), in this group the glucose taken up was oxidized aerobically to a greater extent. However, the total resulting energy gain was small. Thus, a peripheral energy deficit might arise favoring increased oxidation of amino acids. To avoid this undesired side effect, only those substrates should be administered that minimize pancreatic insulin release.


Assuntos
Abdome/cirurgia , Glucose/administração & dosagem , Músculos/metabolismo , Acetoacetatos/sangue , Adulto , Glicemia/análise , Metabolismo Energético , Ácidos Graxos não Esterificados/sangue , Feminino , Antebraço/irrigação sanguínea , Glucose/uso terapêutico , Glicólise , Humanos , Insulina/administração & dosagem , Insulina/sangue , Lactatos/sangue , Masculino , Cuidados Pós-Operatórios
18.
Ann Thorac Surg ; 66(6 Suppl): S249-54, 1998 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9930458

RESUMO

BACKGROUND: New anticalcificant treatments have been developed because tissue calcification is a major contributing factor for bioprosthetic valve failure. METHODS: Aortic valve leaflet and aortic root tissue samples from stentless bioprostheses treated with No-React (Biocor, Belo Horizonte, Brazil), AOA (Medtronic freestyle, Minneapolis, MN), and BiLinx (St. Jude Medical, St. Paul, MN) were compared to a control group by subcutaneous implantation in 60 male weanling Sprague-Dawley rats. RESULTS: Calcium levels were in the range of 0.3 to 2.2 mg/g dry tissue at 3 and 12 weeks in all three treated aortic valve leaflet implants. The BiLinx treatment proved anticalcificant effectiveness on aortic root samples as well. There were statistically significant differences for valve leaflet tissue samples: No-React = AOA < BiLinx < < Control and for aortic root tissue samples: BiLinx < < AOA < Control = No-React. CONCLUSION: Calcification of aortic valve leaflets was significantly reduced by all new anticalcificant treatments. Inhibition of cellular calcification (BiLinx) resulted in additional reduction of aortic root calcification. Maximum anticalcificant properties upon both leaflet and aortic root is important as these are considered a functional unit in stentless bioprostheses.


Assuntos
Valva Aórtica , Bioprótese , Calcinose/prevenção & controle , Próteses Valvulares Cardíacas , Alumínio/farmacologia , Animais , Valva Aórtica/efeitos dos fármacos , Valva Aórtica/patologia , Cálcio/análise , Modelos Animais de Doenças , Durapatita/química , Etanol/farmacologia , Fixadores/farmacologia , Glutaral/farmacologia , Masculino , Ácidos Oleicos/farmacologia , Desenho de Prótese , Falha de Prótese , Ratos , Ratos Sprague-Dawley , Espectrofotometria , Tensoativos/farmacologia
19.
C R Biol ; 326 Suppl 1: S37-42, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-14558447

RESUMO

Allozyme, microsatellite and mtDNA (RFLP and sequence) data of European red deer populations were examined as to their capability of indicating anthropogenic influences such as the keeping of animals in enclosures, selective hunting for trophies translocation of specimens to improve trophy quality and habitat fragmentation. Deer in enclosures revealed considerable deviations of allele frequencies from isolation-by-distance expectations but no remarkable loss of genetic diversity. Particular allozyme genotypes were associated with antler morphology, and selective hunting was shown to alter allele frequencies in the expected direction. Habitat fragmentation is reflected by various kinds of genetic markers but due to the lack of information on population histories no unequivocal evidence on particular human activities could be obtained.


Assuntos
DNA Mitocondrial/genética , Cervos/genética , Meio Ambiente , Variação Genética , Criação de Animais Domésticos , Animais , DNA Mitocondrial/química , Europa (Continente) , Humanos , Isoenzimas/genética , Itália , Comportamento Predatório
20.
Clin Nutr ; 1(4): 251-7, 1983 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16829388

RESUMO

The substrate metabolism of skeletal muscle has been studied by the forearm technique in 23 patients after abdominal operation. The data were compared to those of 55 healthy volunteers after an overnight fast. While the uptake of glucose into forearm muscle tissue was increased in relation to its elevated arterial concentration, its rate of oxidation was clearly reduced and the muscle extraction of ketone bodies was increased. Simultaneously, the production of lactate was doubled and the output of glycerol and alanine significantly enhanced. From these data one may conclude that 3 hours after abdominal surgery the energy requirements of skeletal muscle tissue are adequately met by the substrates provided that glucose sparing occurs in association with a rising arterial concentration of KB, and that the release of alanine is accelerated in spite of abundant caloric supply.

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