RESUMEN
AIM: To calculate the quantitative liver-portal vein contrast ratio (Q-LPC) cut-off value based on tumour detectability by using receiver operating characteristic (ROC) curves. MATERIALS AND METHODS: Seventy-four patients with tumours (46 men and 28 women; age, 71 ± 8.1 years), who underwent liver magnetic resonance imaging (MRI) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) were enrolled. Some patients were found to have multiple tumours. In total, 102 tumour images were evaluated for quantitative liver-spleen contrast ratio (Q-LSC) and Q-LPC 10 minutes after the administration of Gd-EOB-DTPA. Q-LPC and Q-LSC were compared to assess the cut-off values and usefulness. The ROC curve was evaluated using the method for continuously distributed test results, with a free scale of 50 mm. A score of ≥30 out of 50 points was considered good. Cut-off values of Q-LPC and Q-LSC were then calculated. The areas under the ROC curve (AUCs) were also examined and compared. RESULTS: The AUC-ROC for Q-LPC was 0.858 (95% confidence interval [CI], 0.783-0.933). The cut-off value was determined to be at 1.462. Sensitivity was 0.747, and specificity was 0.852 at the cut-off value. The AUC-ROC for Q-LSC was 0.710 (95% CI, 0.597-0.822). The cut-off value was at 1.543, the sensitivity was 0.560, and the specificity was 0.778 at the cut-off value. A significant difference was noted between the AUCs (p=0.0016). CONCLUSION: Q-LPC can be used for hepatobiliary phase MRI evaluation.
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Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Anciano , Medios de Contraste , Femenino , Gadolinio DTPA , Humanos , Masculino , Sensibilidad y EspecificidadRESUMEN
AIM: To evaluate the hepatobiliary phase (HBP) of liver magnetic resonance imaging (MRI) using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid, and report a visual criterion based on the portal vein (PV), which can be used as a substitute for the quantitative liver-spleen contrast ratio (Q-LSC). MATERIALS AND METHODS: In HBP images of 167 patients, a visual criterion was established based on the sufficient contrast between the liver parenchyma (LP) and PV. The Q-LSC was calculated for patients to assess whether the cut-off value of 1.5 was exceeded. The correlation between the signal intensities in the PV and tumours were determined and comparisons were made. The contrast between LP and the tumour was visually assessed with scores ranging from 1 to 3 defined as poor, fair, and good, respectively. The correlation between Q-LSC and quantitative liver-PV contrast ratio (Q-LPC) was also assessed. RESULTS: The Q-LSC was <1.5 in all patients who did not meet the visual criterion. There was a strong correlation between the signal intensities in the PV and tumours (r=0.72), and no significant differences (p=0.99) were found between the signal intensities in PV and tumours by Wilcoxon's signed-rank test. Significant differences of all the combinations were found using Steel-Dwass multiple comparisons in the visual assessments of contrasts between LP and tumour. The correlation between Q-LSC and Q-LPC was strong (r=0.82). CONCLUSIONS: The visual criterion based on the PV was suitable for the assessment of HBP images as a substitute for Q-LSC.
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Medios de Contraste/farmacocinética , Gadolinio DTPA/farmacocinética , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Vena Porta/diagnóstico por imagen , Anciano , Femenino , Humanos , Pruebas de Función Hepática , Masculino , Estudios RetrospectivosRESUMEN
Wnt/Wingless directs many cell fates during development. Wnt/Wingless signaling increases the amount of beta-catenin/Armadillo, which in turn activates gene transcription. Here the Drosophila protein D-Axin was shown to interact with Armadillo and D-APC. Mutation of d-axin resulted in the accumulation of cytoplasmic Armadillo and one of the Wingless target gene products, Distal-less. Ectopic expression of d-axin inhibited Wingless signaling. Hence, D-Axin negatively regulates Wingless signaling by down-regulating the level of Armadillo. These results establish the importance of the Axin family of proteins in Wnt/Wingless signaling in Drosophila.
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Proteínas Adaptadoras Transductoras de Señales , Proteínas Portadoras/metabolismo , Proteínas de Drosophila , Drosophila/embriología , Proteínas/metabolismo , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Represoras , Transducción de Señal , Transactivadores , Factores de Transcripción , Proteína de la Poliposis Adenomatosa del Colon , Animales , Proteínas del Dominio Armadillo , Proteína Axina , Tipificación del Cuerpo , Proteínas Portadoras/química , Proteínas Portadoras/genética , Mapeo Cromosómico , Citoplasma/metabolismo , Proteínas del Citoesqueleto/metabolismo , Regulación hacia Abajo , Drosophila/genética , Drosophila/metabolismo , Embrión no Mamífero/metabolismo , Extremidades/embriología , Regulación del Desarrollo de la Expresión Génica , Genes de Insecto , Proteínas de Homeodominio/genética , Proteínas de Homeodominio/metabolismo , Hibridación in Situ , Proteínas de Insectos/genética , Proteínas de Insectos/metabolismo , Datos de Secuencia Molecular , Mutación , Fenotipo , Proteínas/química , Proteínas/genética , Proteínas Recombinantes de Fusión/metabolismo , Alas de Animales/embriología , Alas de Animales/metabolismo , Proteína Wnt1RESUMEN
Serum PGI2 stabilizing factor (PSF) was purified from human serum to a single protein with a molecular weight of 28,000 D by SDS-PAGE. Analyses of NH2-terminal sequence (32 residues), COOH-terminal sequence (3 residues) and the composition of amino acids disclosed its homology with human apolipoprotein A-I (Apo A-I), a major apolipoprotein of HDL. Apolipoprotein A-II, C-I, C-II, C-III, D and E, as well as LDL, and VLDL did not possess this activity. The alpha-helix structure of Apo A-I is necessary for the binding of PGI2. HDL and nascent HDL reconstituted from Apo A-I and phospholipid significantly prolonged the half-life of PGI2. PGI2 stabilization by HDL and Apo A-I may be an important protective action against the accumulation of platelet thrombi at sites of vascular damage. The beneficial effect of HDL in the prevention of coronary artery disease may be partly due to this action.
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Apolipoproteínas A/sangre , Epoprostenol/sangre , Secuencia de Aminoácidos , Apolipoproteínas A/aislamiento & purificación , Apolipoproteínas A/fisiología , Estabilidad de Medicamentos , Semivida , Humanos , Lipoproteínas HDL/sangre , Masculino , Datos de Secuencia Molecular , Albúmina Sérica/aislamiento & purificación , Albúmina Sérica/fisiologíaRESUMEN
Transforming growth factor beta (TGF-beta)-activated kinase 1 (TAK1) is a member of the MAPKKK superfamily and has been characterized as a component of the TGF-beta/bone morphogenetic protein signaling pathway. TAK1 function has been extensively studied in cultured cells, but its in vivo function is not fully understood. In this study, we isolated a Drosophila homolog of TAK1 (dTAK1) which contains an extensively conserved NH(2)-terminal kinase domain and a partially conserved COOH-terminal domain. To learn about possible endogenous roles of TAK1 during animal development, we generated transgenic flies which express dTAK1 or the mouse TAK1 (mTAK1) gene in the fly visual system. Ectopic activation of TAK1 signaling leads to a small eye phenotype, and genetic analysis reveals that this phenotype is a result of ectopically induced apoptosis. Genetic and biochemical analyses also indicate that the c-Jun amino-terminal kinase (JNK) signaling pathway is specifically activated by TAK1 signaling. Expression of a dominant negative form of dTAK during embryonic development resulted in various embryonic cuticle defects including dorsal open phenotypes. Our results strongly suggest that in Drosophila melanogaster, TAK1 functions as a MAPKKK in the JNK signaling pathway and participates in such diverse roles as control of cell shape and regulation of apoptosis.
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Proteínas de Drosophila/fisiología , Drosophila/embriología , Quinasas Quinasa Quinasa PAM/fisiología , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Transducción de Señal , Secuencia de Aminoácidos , Animales , Animales Modificados Genéticamente , Apoptosis , Proteínas de Drosophila/genética , Ojo/embriología , Genes Dominantes , Proteínas Quinasas JNK Activadas por Mitógenos , Quinasas Quinasa Quinasa PAM/genética , Ratones , Microscopía Electrónica de Rastreo , Datos de Secuencia Molecular , Fenotipo , Fosforilación , Filogenia , Plásmidos , Homología de Secuencia de Aminoácido , Factor de Crecimiento Transformador beta/metabolismoRESUMEN
BACKGROUND: The measurement of serum concentrations of cardiac troponin T (TnT) is a simple, useful method to detect myocyte injury that may be repeated multiple times to follow patients without interobserver variability. METHODS AND RESULTS: Multiple measurements of TnT with a second-generation assay were performed in 60 patients with dilated cardiomyopathy confirmed by coronary angiography and endomyocardial biopsy between April 1996 and December 1999. Three evolutionary patterns of TnT concentrations were identified. Thirty-three patients had concentrations of TnT <0.02 ng/mL throughout the follow-up period (group 1). The remaining 27 patients had high initial serum concentrations of TnT (>/=0.02 ng/mL). In 10 of these 27 patients, TnT decreased to <0.02 ng/mL during follow-up (group 2), whereas 17 had persistently high serum TnT concentrations despite being conventionally treated for chronic congestive heart failure (group 3). Although the initial echocardiographic left ventricular diastolic dimension (LVDd) and left ventricular ejection fraction (LVEF) were not significantly different among the 3 groups, follow-up echocardiography showed significantly decreased LVDd and increased LVEF in group 1 (each P:<0.01) and group 2 (each P:<0.05) compared with increased LVDd and decreased LVEF in group 3 (each P:<0.05). The cardiac event-free rate was significantly lower in group 3 than in groups 1 and 2 (each P:<0.001), and the survival rate was lower in group 3 than in group 1 (P:<0.05). CONCLUSIONS: Persistently increased TnT concentrations in dilated cardiomyopathy suggest ongoing subclinical myocyte degeneration associated with deterioration of the patients' clinical status.
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Cardiomiopatía Dilatada/sangre , Troponina T/sangre , Biopsia , Cardiomiopatía Dilatada/tratamiento farmacológico , Cardiomiopatía Dilatada/patología , Angiografía Coronaria , Ecocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Miocardio/patología , Pronóstico , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
To investigate whether thromboxane A2 is responsible for the initiation of vasospastic angina pectoris, thromboxane B2 levels were measured in the great cardiac vein and the arterial blood of 12 patients with clinically and angiographically proved vasospastic angina and therapeutic trials were performed with selective thromboxane A2 synthetase inhibitor OKY-046, an imidazole derivative. During ergonovine-provoked (11 cases) and spontaneous (1 case) anginal attacks, great cardiac vein thromboxane B2 increased from 121 +/- 27 to 430 +/- 382 pg/ml (p less than 0.05, n = 12), arterial thromboxane B2 increased from 93 +/- 18 to 122 +/- 33 pg/ml (NS, n = 12) and thromboxane B2 production increased from 3.18 +/- 1.88 to 25.16 +/- 22.32 ng/min (p less than 0.05, n = 6). Subsequently, OKY-046, 400 mg/day orally, was administered to 7 of the 12 patients, while a continuous electrocardiogram was recorded on a dual channel Holter monitor during a 3 day placebo period and the 3 day OKY-046 regimen. Although peripheral plasma thromboxane B2 levels decreased significantly from 98 +/- 15 to 12 +/- 8 and 28 +/- 10 pg/ml (1 and 6 hours after ingestion, respectively) (p less than 0.05 for both), 6-keto-prostaglandin F1 alpha production in serum increased significantly from 0.48 +/- 0.22 to 2.3 +/- 0.72 (1 hour) and 1.8 +/- 0.46 ng/ml (6 hours) (p less than 0.05 for both) during OKY-046 administration.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Acrilatos/farmacología , Angina Pectoris Variable/enzimología , Metacrilatos/farmacología , Tromboxano B2/sangre , Tromboxano-A Sintasa/antagonistas & inhibidores , Administración Oral , Adulto , Anciano , Angina Pectoris Variable/sangre , Angina Pectoris Variable/tratamiento farmacológico , Aorta/metabolismo , Cateterismo Cardíaco , Vasos Coronarios/metabolismo , Electrocardiografía , Humanos , Masculino , Metacrilatos/administración & dosificación , Persona de Mediana EdadRESUMEN
Myocardial metabolism was assessed in 20 patients with acute anterior myocardial infarction using lactate uptake (defined as (aortic lactate - great cardiac venous lactate)/aortic lactate X 100) as an index. The regional ejection fraction of the anterior wall was obtained from left ventriculography. There was a linear relation between lactate uptake and regional ejection fraction (r = 0.79, p less than 0.001). Four patients without total occlusion in the infarct vessel had a higher lactate uptake (19.6 +/- 6.7 versus 4.2 +/- 13.4%, p less than 0.05) and regional ejection fraction (26.3 +/- 7.9 versus 14.9 +/- 7.0%, p less than 0.05) than did 16 patients with total occlusion. The latter group of patients underwent intracoronary infusion of urokinase, which resulted in reperfusion in 13 patients. Lactate uptake before urokinase infusion (sample I), just after reperfusion (sample II), 30 minutes after reperfusion (sample III) and 4 weeks after reperfusion (sample IV) was 5.7 +/- 13.2, -13.9 +/- 14.7, 2.9 +/- 15.2 and 20.2 +/- 11.0%, respectively (sample I versus II and II versus III, p less than 0.01; sample I versus IV and III versus IV, p less than 0.05). The decrease in lactate uptake immediately after reperfusion, which was accompanied by an increase in creatine kinase-MB isoenzyme release into the blood, was considered to be the result of a "washout" effect. Lactate uptake was ameliorated 4 weeks later, accompanied by an improvement (from 15.1 +/- 7.1 to 23.4 +/- 7.2%, p less than 0.01) in the regional ejection fraction. It is concluded that the degree of asynergy was closely related to the extent of metabolic deterioration in myocardial infarction.
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Ventrículos Cardíacos/fisiopatología , Lactatos/metabolismo , Infarto del Miocardio/metabolismo , Miocardio/metabolismo , Enfermedad Aguda , Adulto , Anciano , Circulación Colateral , Angiografía Coronaria , Circulación Coronaria , Vasos Coronarios/fisiopatología , Creatina Quinasa/sangre , Femenino , Humanos , Isoenzimas , Masculino , Persona de Mediana Edad , Infarto del Miocardio/tratamiento farmacológico , Infarto del Miocardio/fisiopatología , Volumen Sistólico , Activador de Plasminógeno de Tipo Uroquinasa/administración & dosificaciónRESUMEN
The quantitative relations between serum creatine kinase-MB isoenzyme (CK-MB) release and the final infarct size estimated by myocardial emission computed tomography with thallium-201 was assessed in 37 patients with a first acute transmural myocardial infarction who underwent intracoronary thrombolysis using urokinase 4.6 +/- 1.9 hours after the onset of symptoms. Serial CK-MB determinations were used to calculate the accumulated release of CK-MB (sigma CK-MB). Myocardial emission tomography with thallium-201 was performed 4 weeks after the onset, and infarct volume was measured from reconstructed tomographic images by computerized planimetry. The results are presented for two groups of patients: 11 patients with unsuccessful thrombolysis (group A) and 26 patients with successful thrombolysis (group B). An excellent linear relation was found for group A (sigma CK-MB = 6.4 X infarct volume + 47.7, r = 0.91), whereas a different linear relation was observed for group B (sigma CK-MB = 10.5 X infarct volume + 89.1, r = 0.80). Moreover, serum CK-MB activity reached a peak at 21.1 +/- 2.2 hours after the onset in group A and reached an earlier peak at 12.5 +/- 2.9 hours in group B (p less than 0.001). These data suggest that acute coronary recanalization alters the kinetics of CK-MB release, resulting in greater CK-MB release into the serum for equivalent infarct volume estimated by myocardial emission tomography with thallium-201. Thus, serum CK-MB time-activity curves after acute myocardial infarction may be influenced considerably by acute reperfusion, which is an important factor that should be incorporated in the interpretation of enzymatic estimates of infarct size in human patients.
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Creatina Quinasa/sangre , Infarto del Miocardio/diagnóstico por imagen , Radioisótopos , Talio , Adulto , Anciano , Circulación Colateral , Circulación Coronaria/efectos de los fármacos , Femenino , Corazón/diagnóstico por imagen , Humanos , Isoenzimas , Cinética , Masculino , Persona de Mediana Edad , Infarto del Miocardio/tratamiento farmacológico , Infarto del Miocardio/enzimología , Nitroglicerina/uso terapéutico , Tomografía Computarizada de Emisión , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéuticoRESUMEN
OBJECTIVES: We investigated the expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) and their genes in the hearts of patients with cardiac amyloidosis and those with isolated atrial amyloidosis. BACKGROUND: The expression of ANP and BNP is augmented in the ventricles of failing or hypertrophied hearts, or both. The expression of ANP and BNP in the ventricles of hearts with cardiac amyloidosis, which is hemodynamically similar to restrictive cardiomyopathy, is not yet known. ANP is the precursor protein of isolated atrial amyloid. METHODS: We analyzed the immunohistocytochemical localizations of ANP and BNP as well as the expression of their mRNAs by in situ hybridization in the myocardium and measured the plasma levels of ANP and BNP in patients with cardiac amyloidosis. RESULTS: Four of the five right and all six left ventricular endomyocardial biopsy specimens obtained from six patients with cardiac amyloidosis were immunohistochemically positive for both ANP and BNP; none of the biopsy specimens from eight normal subjects were positive for ANP or BNP. All four of the right atria obtained at operation showed positive immunoreactions for both peptides. Electron microscopy identified specific secretory granules in ventricular myocytes of the patients with cardiac amyloidosis, but not in ventricular myocytes from the normal control subjects. Double immunocytochemical analysis revealed the co-localization of ANP and BNP in the same granules and that isolated atrial amyloid fibrils were immunoreactive for ANP and BNP, whereas ventricular amyloid fibrils were negative for both peptides. Both ANP mRNA and BNP mRNA were expressed in the ventricles of the patients with cardiac amyloidosis but not in the normal ventricles. The autopsy study of four patients with cardiac amyloidosis revealed an almost transmural distribution of ANP and BNP, with predominance in the endocardial side. Plasma BNP levels in the patients were markedly elevated ([mean +/- SD] 1,165.1+/-561.2 pg/ml) compared with those in the control subjects (8.9+/-6.0 pg/ml, p < 0.05). CONCLUSIONS: Expression of ANP and BNP and their genes was augmented in the ventricular myocytes of the patients with cardiac amyloidosis. Both regional mechanical stress by amyloid deposits and hemodynamic stress by diastolic dysfunction may be responsible for the expression of the peptides in patients with cardiac amyloidosis.
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Amiloidosis/metabolismo , Factor Natriurético Atrial/metabolismo , Cardiomiopatías/metabolismo , Expresión Génica , Miocardio/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Anciano , Amiloidosis/genética , Amiloidosis/patología , Factor Natriurético Atrial/genética , Cardiomiopatías/genética , Cardiomiopatías/patología , Gránulos Citoplasmáticos/ultraestructura , Endocardio/metabolismo , Femenino , Ventrículos Cardíacos , Humanos , Inmunohistoquímica , Hibridación in Situ , Masculino , Persona de Mediana Edad , Miocardio/ultraestructura , Péptido Natriurético Encefálico , Proteínas del Tejido Nervioso/genética , ARN Mensajero/análisisRESUMEN
Diffuse coronary artery vasoconstriction was provoked in the rabbit by a stable thromboxane A2 analogue, STA2 (9,11-epithio-11,12-methano thromboxane A2). Injection of 25 micrograms.kg-1 STA2 into the left main trunk caused complete occlusion of the left anterior descending artery and narrowing of the left circumflex artery. Two minutes after injection, however, the diameter of the coronary artery returned to the control value (n = 10). The right coronary artery was also temporarily occluded by an injection of 25 micrograms.kg-1 STA2. Left ventricular end diastolic pressure increased significantly, and ST segment elevation of the electrocardiogram occurred during vasoconstriction. The angiographic findings showed that the vasoconstriction in the coronary artery induced by STA2 was similar to the diffuse vasoconstriction seen clinically. Induction of the vasoconstriction by STA2 was prevented by the preadministration of 25 micrograms.kg-1 of either a calcium antagonist, diltiazem, or a thromboxane A2 receptor antagonist, ONO 3708 (n = 10). The relation of the calcium movement to this vasoconstriction was studied in vitro using the isolated left circumflex artery in the rabbit. STA2 (50 micrograms.litre-1 to 0.5 mg.litre-1) produced a concentration dependent contraction of helical strips of left circumflex artery. Diltiazem (50-100 g.litre-1) suppressed this contraction dose dependently. ONO 3708 (10 micrograms.litre-1 to 1 mg.litre-1) caused a significant rightward and downward shift of the dose-response curve.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Vasoespasmo Coronario/inducido químicamente , Tromboxano A2/análogos & derivados , Animales , Calcio/farmacología , Angiografía Coronaria , Vasoespasmo Coronario/diagnóstico por imagen , Diltiazem/farmacología , Relación Dosis-Respuesta a Droga , Conejos , Tromboxano A2/antagonistas & inhibidores , Tromboxano A2/toxicidadRESUMEN
OBJECTIVE: The use of three-dimensional T1 weighted gradient echo sequences such as the Dixon technique and the frequency-selective fat suppression (FS) technique is currently widely accepted method in MRI examinations of the liver. To assess the image qualities of the Dixon technique and the frequency-selective FS technique, the contrast-to-noise ratios (CNRs) of hepatocellular carcinoma (HCC)-to-liver and fat-to-liver were compared between the two techniques in the hepatobiliary phase (HBP) following administration of gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid. METHODS: MR images of 59 patients with a total of 86 HCCs were retrospectively evaluated. Images were consecutively obtained with the Dixon and frequency-selective FS methods in the HBP and their CNRs of HCC-to-liver and fat-to-liver were compared. CNRs and contrast ratios were calculated by the mean value of the liver parenchyma, HCC, fat and standard deviation of the liver parenchyma. The Wilcoxon signed-ranks test was used for statistical analysis. RESULTS: The median CNRs for the frequency-selective FS and Dixon techniques of HCC-to-liver were 4.3 and 5.4 (p < 0.01), mesenteric fat-to-liver were 9.9 and 12.8 (p < 0.01) and subcutaneous fat-to-liver were 9.9 and 13.2 (p < 0.01), respectively. CONCLUSION: The Dixon technique yielded higher CNRs of HCC-to-liver than that of the frequency-selective FS technique. ADVANCES IN KNOWLEDGE: There are a limited number of reports on quantitative analysis of the image qualities of the Dixon technique and the frequency-selective FS technique, particularly within the same patient and examination.
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Carcinoma Hepatocelular/diagnóstico , Aumento de la Imagen/métodos , Imagenología Tridimensional , Neoplasias Hepáticas/diagnóstico , Imagen por Resonancia Magnética/métodos , Tejido Adiposo , Adulto , Anciano , Anciano de 80 o más Años , Medios de Contraste , Femenino , Gadolinio DTPA , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Galanin-like peptide (GALP) is a novel galanin-like peptide isolated from the porcine hypothalamus. To determine the distribution of GALP in the rat brain, we performed immunohistochemical studies using a monoclonal antibody toward the N-terminal sequence of GALP. GALP-immunoreactive neuronal cell bodies were observed only in the arcuate nucleus (Arc), which was further confirmed by in situ hybridization studies using digoxigenin-labeled antisense GALP riboprobe. Additional immunostained cells were found in the median eminence and infundibular stalk. The GALP neurons found in the Arc were further characterized by double label immunohistochemistry. More than 85% of the GALP neurons were immunostained with leptin receptor antibody. However, the GALP neurons and fibers found in the Arc were not labeled with alpha-MSH, somatostatin, neuropeptide Y, agouti-related protein, or galanin antibodies, indicating that GALP is found in neurons other than these known Arc neurons. Dense staining of GALP-containing fibers was found in the anterior parvicellular part of the paraventricular hypothalamic nucleus, in the ventral part of the lateral septal nucleus, and in the bed nucleus of the stria terminalis. Relatively dense staining was noted in the medial preoptic area (MPA), and weak staining was noted in the periventricular hypothalamic nucleus. Detailed double labeling studies in the paraventricular hypothalamic nucleus demonstrated that GALP-containing fibers converged in a more rostral direction than did agouti-related protein-containing fibers. Furthermore, GALP-immunoreactive fibers were in close apposition with GnRH-immunoreactive fibers in the MPA and bed nucleus of the stria terminalis, and about 6% of GnRH-positive neurons in the MPA showed close contact with the GALP-immunoreactive fibers. Our findings indicate that GALP neurons, as leptin-responsive neurons, may participate in the regulation of feeding behavior and/or reproductive functions.
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Química Encefálica/fisiología , Proteínas del Tejido Nervioso/metabolismo , Receptores de Superficie Celular , Animales , Anticuerpos Monoclonales , Núcleo Arqueado del Hipotálamo/metabolismo , Proteínas Portadoras/metabolismo , Péptido Similar a Galanina , Inmunohistoquímica , Hibridación in Situ , Masculino , Fibras Nerviosas/metabolismo , Neuropéptidos/metabolismo , Núcleo Hipotalámico Paraventricular/metabolismo , Ratas , Ratas Wistar , Receptores de LeptinaRESUMEN
Galanin-like peptide (GALP) is a recently isolated hypothalamic peptide which has sequence homology to galanin and binds to galanin receptors with high affinity. It has been shown that GALP neurons are localized in the arcuate nucleus and that GALP-immunoreactive fibers are in close apposition with LHRH neurons in the medial preoptic area (MPA). In the present study, we found that intracerebroventricular (icv) administration of GALP increased the plasma LH level but did not change the levels of other hormones. Concomitantly, accumulation of c-Fos protein was dramatically increased in the nuclei of LHRH-positive cells in the MPA by icv GALP administration. Furthermore, the GALP-induced plasma LH response was completely abolished by pretreatment with Cetrorelix, a LHRH receptor antagonist. On the other hand, GALP did not affect the release of LH, FSH, TSH, ACTH, GH or PRL directly from dispersed rat pituitary cells in vitro. These results strongly suggest a role for GALP in the control of gonadotropin secretion through a hypothalamic mechanism involving the release of LHRH.
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Hormona Liberadora de Gonadotropina/fisiología , Hormona Luteinizante/metabolismo , Proteínas del Tejido Nervioso/farmacología , Animales , Galanina/farmacología , Péptido Similar a Galanina , Hormona Liberadora de Gonadotropina/análogos & derivados , Hormona Liberadora de Gonadotropina/farmacología , Antagonistas de Hormonas/farmacología , Inmunohistoquímica , Inyecciones Intraventriculares , Hormona Luteinizante/sangre , Masculino , Hipófisis/citología , Hipófisis/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Ratas , Ratas Wistar , Receptores LHRH/antagonistas & inhibidoresRESUMEN
To examine the significance of technetium-99m pyrophosphate/thallium-201 scintigraphic overlap as an indicator of identifying early coronary reperfusion (less than or equal to 3 hours), 32 patients, in whom coronary recanalization was attempted for acute myocardial infarction (AMI), underwent myocardial imaging 3 days after the onset of AMI. The imaging was performed by simultaneous dual emission computed tomography, which allows simultaneous recording of technetium-99m pyrophosphate and thallium-201 images and comparison between both images in the same slice. The patients were separated into 3 groups: 9 patients in whom reperfusion was successful and showed scintigraphic overlap (group A), 12 with successful recanalization but no overlap (group B) and 11 with neither coronary reflow nor overlap (group C). No patient in whom reperfusion failed showed scintigraphic overlap (p less than 0.05). Groups A and B were comparable in age, infarct vessel, collateral circulation, residual coronary stenosis and cumulative release of creatine kinase-MB isoenzyme. However, compared with group B, group A had a shorter interval between onset of AMi and reflow (2.5 +/- 0.8 vs 4.8 +/- 1.3 hours, p less than 0.001). The presence of scintigraphic overlap identified early coronary reflow with a sensitivity of 80%, specificity of 91%, positive predictive accuracy of 89% and negative predictive accuracy of 83%. Thus, technetium-99m/thallium-201 overlap on dual emission computed tomography can be used as an index of documenting early recanalization and might reflect the presence of salvaged myocardium adjacent to the necrotic tissue.
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Difosfatos , Infarto del Miocardio/diagnóstico por imagen , Tecnecio , Radioisótopos de Talio , Tomografía Computarizada de Emisión , Pruebas Enzimáticas Clínicas , Angiografía Coronaria , Circulación Coronaria , Creatina Quinasa/sangre , Estudios de Evaluación como Asunto , Humanos , Infarto del Miocardio/tratamiento farmacológico , Pirofosfato de Tecnecio Tc 99m , Factores de TiempoRESUMEN
A new stable prostacyclin analog, OP-41483, was used in patients with severe congestive heart failure (CHF) due to coronary artery disease and compared with nitroprusside. During infusion of both drugs, mean brachial arterial pressure, total pulmonary resistance, pulmonary artery wedge pressure and systemic vascular resistance decreased significantly. Cardiac index and stroke index also increased significantly. Platelet aggregation did not change significantly during nitroprusside but decreased significantly with OP-41483 infusion. Thus, this analog may be useful for treatment of patients with CHF due to coronary artery disease.
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Enfermedad Coronaria/complicaciones , Epoprostenol/uso terapéutico , Ferricianuros/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Hemodinámica/efectos de los fármacos , Nitroprusiato/uso terapéutico , Agregación Plaquetaria/efectos de los fármacos , Prostaglandinas Sintéticas/uso terapéutico , Anciano , Femenino , Insuficiencia Cardíaca/etiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Early appearance of positive findings on a technetium-99m pyrophosphate scan has been shown to be associated with the presence of a reperfused acute myocardial infarction (AMI). Early technetium-99m pyrophosphate imaging was performed by emission computed tomography to evaluate reperfusion and to test the feasibility of estimating infarct size soon after coronary reperfusion based on acute positive tomographic findings. Twenty-seven patients with transmural AMI who were treated with intracoronary urokinase infusion followed by percutaneous transluminal coronary angioplasty underwent pyrophosphate imaging 8.7 +/- 2.1 hours after the onset of AMI. None of the 8 patients in whom reperfusion was unsuccessful had acute positive findings. Of 19 patients in whom reperfusion was successful, 17 had acute positive findings (p less than 0.001). In these 17, tomographic infarct volumes were determined from reconstructed transaxial images. The threshold for areas of increased pyrophosphate uptake within the infarct was set at 60% of peak activity by the computerized edge-detection algorithm. The total number of pixels in all transaxial sections showing increased tracer uptake were added and multiplied by a size factor and 1.05 g/cm3 muscle to determine infarct volume. The correlations of tomographic infarct volumes with peak serum creatine kinase (CK) levels (r = 0.82) and with cumulative release of CK-MB isoenzyme (r = 0.89) were good. Moreover, the time to positive imaging was significantly shorter than that to peak CK level (8.5 +/- 2.3 vs 10.4 +/- 2.2 hours, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Infarto del Miocardio/diagnóstico por imagen , Tomografía Computarizada de Emisión , Adulto , Anciano , Creatina Quinasa/sangre , Difosfatos , Femenino , Humanos , Isoenzimas/sangre , Masculino , Persona de Mediana Edad , Infarto del Miocardio/enzimología , Infarto del Miocardio/patología , Perfusión , Tecnecio , Pirofosfato de Tecnecio Tc 99m , Factores de TiempoRESUMEN
A 19-year-old man with untreated systemic lupus erythematosus had an acute myocardial infarction. A coronary arteriogram five hours after the onset of symptoms revealed total occlusion of the left anterior descending coronary artery. Reperfusion was achieved by coronary thrombolytic therapy with urokinase. Four weeks later, a coronary arteriogram showed only minimal luminal irregularities at the original site of occlusion, where significant reduction in diameter could be induced by ergonovine maleate. This case suggests that coronary arterial involvement in systemic lupus erythematosus may be related to coronary arterial spasm.
Asunto(s)
Angiografía Coronaria , Lupus Eritematoso Sistémico/complicaciones , Infarto del Miocardio/etiología , Adulto , Angiografía , Vasoespasmo Coronario/inducido químicamente , Ergonovina/efectos adversos , Ergonovina/análogos & derivados , Humanos , Masculino , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/tratamiento farmacológico , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéuticoRESUMEN
A 70-year-old man presented with diffuse triple-vessel coronary arterial spasm accompanied by ST segment elevation in the inferior and anterior leads when the severity of pain moderated. At the beginning, he noted throat and chest pain followed by syncope. Atropine, norepinephrine, and lidocaine were administered therapeutically. The initial electrocardiogram showed an idioventricular rhythm without ST segment deviations, which made the prompt diagnosis of coronary arterial spasm difficult.
Asunto(s)
Arritmias Cardíacas/etiología , Vasoespasmo Coronario/complicaciones , Síncope/etiología , Anciano , Angiografía , Arritmias Cardíacas/diagnóstico , Angiografía Coronaria , Vasoespasmo Coronario/diagnóstico , Vasoespasmo Coronario/diagnóstico por imagen , Electrocardiografía , Humanos , MasculinoRESUMEN
Intracardiac ectopic thyroid mass is an extremely rare occurrence. We describe a case of this rare disorder. The mass was clearly visualized by echocardiography, MRI, and cineangiography. The thyroid mass was excised successfully, and 50 months later the patient was well.