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1.
Pediatr Cardiol ; 44(3): 695-701, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36050410

RESUMEN

Palliative surgery is often performed in the treatment of congenital heart disease. Two representative palliative procedures are the systemic pulmonary shunt and pulmonary artery banding. Dramatic changes in cerebral hemodynamics may occur in these operations due to changes in the pulmonary-to-systemic blood flow ratio and systemic oxygenation. However, there seem to be almost no studies evaluating them. Accordingly, we evaluated cerebral perfusion by transcranial Doppler ultrasonography and cerebral oxygenation by near infrared spectroscopy during these procedures. In the post hoc analysis of a previous prospective observational study, cerebral blood flow velocities of the middle cerebral artery measured by transcranial Doppler were compared between the start and end of surgery as were the pulsatility index and resistance index. The cerebral oxygenation values were also compared between the start and end of surgery. Twenty-two infants with systemic pulmonary shunt and 20 infants with pulmonary artery banding were evaluated. There were no significant differences of the flow velocities between the start and end of surgery in either procedure. The pulsatility index significantly increased after pulmonary artery banding, which may compete with the increase in cerebral perfusion due to the increase in systemic blood flow. The cerebral oxygenation decreased in both procedures, possibly due to an increase in body temperature. Arterial oxygen saturation was almost the same before and after both procedures. Contrary to our expectation, the changes in cerebral hemodynamics in the palliative operations were small if the management of physiological indices such as arterial oxygen saturation was properly performed during the procedures.


Asunto(s)
Cardiopatías Congénitas , Arteria Pulmonar , Lactante , Humanos , Arteria Pulmonar/cirugía , Cardiopatías Congénitas/cirugía , Hemodinámica , Estudios Prospectivos , Procedimientos Quirúrgicos Vasculares
2.
J Anesth ; 37(6): 861-867, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37646882

RESUMEN

PURPOSE: It has been reported that cerebral oxygen saturation (rSO2) measured by near infrared spectroscopy is low in dialysis patients. We compared the rSO2 values of dialysis patients before living donor kidney transplantation and their donors as controls by using three spectroscopes that utilize different principals, the INVOS 5100C (spatially resolved spectroscopy), FORE-SIGHT ELITE (modified Beer-Lambert law) and tNIRS-1 (time-resolved spectroscopy). METHODS: Before induction of anesthesia, the sensors of one of the three spectroscopes were placed on the forehead and rSO2 values were recorded followed by the same measurement using the other two spectroscopes. The primary objective was to compare the rSO2 values of the dialysis patients and controls using the three spectroscopes by the unpaired t test. Then we compared the rSO2 values among the spectroscopes in both dialysis patients and controls by one-way ANOVA. Finally, we examined the relations between the rSO2 values and the physiological values by using the Pearson correlation coefficient. RESULTS: Fifteen pairs of dialysis patients and controls were studied. With the INVOS 5100 C, the values of the dialysis patients (59.7 ± 9.7% (mean ± standard deviation) were 13% lower than those of the controls (73.3 ± 6.9%) (P < 0.01). With the tNIRS-1, the values were 57.8 ± 4.8% in the dialysis patients and 63.3 ± 3.5% in the controls (P < 0.01). Almost no differences were observed with the FORE-SIGHT ELITE (71.6 ± 4.9% [dialysis patients] vs. 70.8 ± 4.3% [Controls]) (P = 0.62). Among the spectroscopes, the values were significantly different in both dialysis patients and controls. For the INVOS 5100C and tNIRS-1, correlation coefficients between rSO2 values and blood Hb and serum Alb were more than 0.5. CONCLUSIONS: The rSO2 values for comparisons between the dialysis patients and the controls were different according to differences of the principles of the near infrared spectroscopes. In the INVOS 5100C and tNIRS-1, rSO2 values may be related to blood Hb and serum Alb.


Asunto(s)
Oxígeno , Diálisis Renal , Humanos , Espectroscopía Infrarroja Corta/métodos , Saturación de Oxígeno , Encéfalo , Oximetría/métodos
3.
J Anesth ; 37(1): 92-96, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36355203

RESUMEN

PURPOSE: Remimazolam is a new ultra-short-acting benzodiazepine with unknown effects on cerebral circulation. We measured total cerebral hemoglobin concentrations, which reflect cerebral blood volume (CBV), and cerebral oxygen saturation, using time-domain near-infrared spectroscopy, which can measure the absolute values of cerebral hemoglobin concentrations. We also measured cerebral blood flow velocity (CBFV) in the middle cerebral artery using transcranial Doppler as an indicator of cerebral blood flow (CBF). We did so to examine the effect of remimazolam on cerebral circulation in humans, as assessed CBV, CBF, and cerebral oxygen saturation. METHODS: This was a prospective, observational study. Fifteen patients without serious complications scheduled for general anesthesia were recruited. We measured total cerebral hemoglobin concentrations, CBFV, and cerebral oxygen saturation throughout the anesthetic induction course with remimazolam. RESULTS: Total cerebral hemoglobin concentrations did not change during the process (p = 0.51). In contrast, the mean CBFV was reduced by 11% (significant, p = 0.04). The drop in mean blood pressure following the induction of anesthesia was 17%; however, it was within the range of cerebrovascular autoregulation. Moreover, cerebral oxygen saturation increased by 4% (statistically significant, p < 0.01). CONCLUSIONS: We found that anesthetic induction with remimazolam did not alter CBV and reduced CBF in uncomplicated patients.


Asunto(s)
Anestesia , Anestésicos , Humanos , Estudios Prospectivos , Benzodiazepinas/farmacología , Circulación Cerebrovascular , Hemoglobinas , Anestésicos/farmacología
4.
Heart Vessels ; 37(10): 1792-1800, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35469049

RESUMEN

The risk factors and the appropriate interventions for perioperative junctional ectopic tachycardia (JET) in congenital heart disease (CHD) surgery have not been sufficiently investigated despite the severity of this complication. This study aimed to examine the risk factors and interventions for perioperative JET. From 2013 to 2020, 1062 surgeries for CHD (median patient age: 4.3 years, range 0.0-53.0) with or without a cardiopulmonary bypass (CPB) were performed at Hokkaido University, Japan. We investigated the correlation between perioperative JET morbidity factors, such as age, genetic background, CPB/aortic cross-clamp (ACC) time, use of inotropes and dexmedetomidine, STAT score, and laboratory indices. The efficacy of JET therapies was also evaluated. Of the 1062 patients, 86 (8.1%) developed JET. The 30-day mortality was significantly high in JET groups (7% vs. 0.8%). The independent risk factors for JET included heterotaxy syndrome [odds ratio (OR) 4.83; 95% confidence interval (CI) 2.18-10.07], ACC time exceeding 90 min (OR 1.90; CI 1.27-2.39), and the use of 3 or more inotropes (OR 4.11; CI 3.02-5.60). The combination of anti-arrhythmic drugs and a temporary pacemaker was the most effective therapy for intractable JET. Perioperative JET after CHD surgery remains a common cause of mortality. Inotrope use was a risk factor for developing JET overall surgery risk. In short ACC surgeries, heterotaxy syndrome could increase the risk of JET, which could develop even without inotrope use in long ACC surgeries. It is crucial not to delay the treatment in cases with unstable hemodynamics caused by this arrhythmia. It is recommended to reduce numbers not dose of inotropes.


Asunto(s)
Cardiopatías Congénitas , Síndrome de Heterotaxia , Taquicardia Ectópica de Unión , Adolescente , Adulto , Puente Cardiopulmonar/efectos adversos , Niño , Preescolar , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/cirugía , Síndrome de Heterotaxia/complicaciones , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Factores de Riesgo , Taquicardia Ectópica de Unión/diagnóstico , Taquicardia Ectópica de Unión/etiología , Taquicardia Ectópica de Unión/terapia , Adulto Joven
5.
Pediatr Cardiol ; 43(7): 1606-1614, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35657421

RESUMEN

Recently, monitoring of cerebral oxygen saturation (ScO2) has become widespread in pediatric cardiac surgery. Our previous study reported that mean blood pressure (mBP) was the major contributor to ScO2 throughout cardiac surgery with cardiopulmonary bypass (CPB) in children weighing under 10 kg. We speculated that this result might be attributable to incomplete cerebral autoregulation in such young children. Accordingly, our hypothesis is that the relationship between ScO2 and the physiological parameters may change according to the growth of the children. ScO2 was measured with an INVOS 5100C (Somanetics, Troy, MI). Random-effects analysis was employed with ScO2 as a dependent variable, and seven physiological parameters (mBP, central venous pressure, nasopharyngeal temperature, SaO2, hematocrit, PaCO2, and pH) were entered as independent covariates. The analysis was performed during the pre-CPB, CPB, and post-CPB periods by dividing the patients into two groups: infants (Infant Group) and children who were more than 1 year old (Child Group). The Infant and Child Groups consisted of 28 and 21 patients. In the random-effects analysis, mBP was the major contributor to ScO2 during CPB in both groups. During the pre-CPB period, the effect of mBP was strongest in the Infant group. However, its effect was second to that of SaO2 in the Child Group. During the post-CPB period, SaO2 and mBP still affected ScO2 in the Infant group. However, the dominant contributors were unclear in the Child Group. Cerebral autoregulation may be immature in infants. In addition, it may be impaired during CPB even after 1 year of age.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Puente Cardiopulmonar , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Puente Cardiopulmonar/efectos adversos , Circulación Cerebrovascular/fisiología , Niño , Preescolar , Homeostasis , Humanos , Lactante , Oxígeno , Saturación de Oxígeno
6.
J Anesth ; 36(6): 707-714, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36125551

RESUMEN

PURPOSE: Studies in adults have reported that video laryngoscope is more useful than direct laryngoscope when training less experienced anesthesiologists. However, whether this is true for infants remains unclear. Therefore, this study aimed to evaluate whether the use of video laryngoscope would result in smaller differences in success rate according to anesthesiologists' expertise than those in direct laryngoscope. METHODS: Medical records and video recordings from the operating room of patients aged < 1 year who underwent non-cardiac surgery between March 2019 and September 2021 were reviewed. Tracheal intubations between April 8, 2020, and June 20, 2021, were excluded due to the shortage of video laryngoscope blades during the COVID-19 pandemic. Rates of first-time tracheal intubation success were compared by years of anesthesia experience and initial intubation device. RESULTS: In total, 125 of 175 tracheal intubations were analyzed (direct laryngoscope group, n = 72; video laryngoscope group, n = 53). The first-time tracheal intubation success rate increased with years of experience as an anesthesiologist in the direct laryngoscope group (odds ratio OR 1.70, 95% confidence interval CI 1.15, 2.49; P = 0.0070), but not the video laryngoscope group (OR 0.99, 95% CI 0.74, 1.35; P = 0.99). CONCLUSION: The differences in success rate according to the anesthesiologists' years of experience were non-significant when using video laryngoscope in infants, compared to those in direct laryngoscope.


Asunto(s)
Anestesia , COVID-19 , Laringoscopios , Adulto , Lactante , Humanos , Pandemias , Laringoscopía , Intubación Intratraqueal , Grabación en Video
7.
Paediatr Anaesth ; 27(5): 516-523, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28198572

RESUMEN

BACKGROUND: Ultrasound-guided rectus sheath block and local anesthetic infiltration are the standard options to improve postoperative pain for children undergoing surgery with a midline incision. However, there is no study comparing the effect of ultrasound-guided rectus sheath block with local anesthetic infiltration for children undergoing laparoscopic surgery. AIMS: The aim of this trial was to compare the onset of ultrasound-guided rectus sheath block with that of local anesthetic infiltration for laparoscopic percutaneous extraperitoneal closure in children. METHODS: We performed an observer-blinded, randomized, prospective trial. Enrolled patients were assigned to either an ultrasound-guided rectus sheath block group or a local anesthetic infiltration group. The ultrasound-guided rectus sheath block group (n = 17) received ultrasound-guided rectus sheath block with 0.2 ml·kg-1 of 0.375% ropivacaine per side in the posterior rectus sheath compartment. The local anesthetic infiltration group (n = 17) received local anesthetic infiltration with 0.2 ml·kg-1 of 0.75% ropivacaine. The Face, Legs, Activity, Cry, and Consolability (FLACC) pain scores were recorded at 0, 30, 60 min after arrival at the postanesthesia care unit. RESULTS: Of the 37 patients enrolled in this study, 34 completed the study protocol. A significant difference in the pain scale between the ultrasound-guided rectus sheath block group and local anesthetic infiltration group was found at 0 min (median: 0, interquartile range [IQR]: 0-1.5, vs median: 1, IQR 0-5, confidence interval of median [95% CI]: 0-3, P = 0.048), but no significant difference was found at 30 min (median: 1, IQR: 0-4 vs median: 6, IQR: 0-7, 95% CI: 0-5, P = 0.061), or 60 min (median: 0, IQR: 0-2 vs median: 1, IQR: 0-3, 95% CI: -1 to 1, P = 0.310). No significant difference was found in anesthesia time between the ultrasound-guided rectus sheath block and local anesthetic infiltration groups. No procedure-related complications were observed in either group. CONCLUSION: Ultrasound-guided rectus sheath block is a quicker way to control postoperative pain for pediatric patients undergoing laparoscopic extraperitoneal closure than local anesthetic infiltration, and thus may provide a clinical benefit.


Asunto(s)
Analgesia/métodos , Anestesia Local/métodos , Laparoscopía/métodos , Bloqueo Nervioso/métodos , Ultrasonografía Intervencional/métodos , Amidas , Analgesia/efectos adversos , Anestésicos Locales , Niño , Preescolar , Método Doble Ciego , Femenino , Humanos , Lactante , Masculino , Bloqueo Nervioso/efectos adversos , Dimensión del Dolor/efectos de los fármacos , Estudios Prospectivos , Ropivacaína
8.
Masui ; 64(9): 960-5, 2015 Sep.
Artículo en Japonés | MEDLINE | ID: mdl-26466496

RESUMEN

BACKGROUND: We evaluated the impact of age and cardiopulmonary bypass (CPB) on cerebral autoregulation in pediatric patients for the cardiac surgery with near-infrared spectroscopy. METHODS: This retrospective study was conducted with 67 children undergoing closure of atrial or ventricular septal defects with CPB. The regression coefficient ((see symbol)regional cerebral oxygenation index ((see symbol)SO2)/ mean arterial blood pressure (mABP)) for each patient was calculated by simple regression analysis, assuming that higher regression coefficients indicate less functional cerebral autoregulation. In addition, to determine the vital parameters affecting rSO2 values during CPB, we analyzed the data from on-line continuous blood gas monitor with random effects-mixed model. RESULTS: The regression coefficients were frequently high among younger children (0-4 years), suggesting that the cerebral autoregulation was immature. Although regression coefficient values in younger children remained high through the operation, those in older children (5-14 years) increased significantly only during CPB, suggesting that cerebral autoregulation was dysfunctional during CPB. With random effects-mixed model, we revealed that mABP had the most significant effect on rSO2 values during CPB. CONCLUSIONS: Cerebral autoregulation in younger children is immature. Moreover, it does not work during CPB even in older children, and clinicians must ensure perfusion pressure carefully during CPB in pediatric patients.


Asunto(s)
Puente Cardiopulmonar , Circulación Cerebrovascular , Factores de Edad , Procedimientos Quirúrgicos Cardíacos , Preescolar , Femenino , Homeostasis , Humanos , Masculino , Monitoreo Intraoperatorio , Estudios Retrospectivos , Espectroscopía Infrarroja Corta
9.
Masui ; 64(6): 622-7, 2015 Jun.
Artículo en Japonés | MEDLINE | ID: mdl-26437552

RESUMEN

A 58-year-old man with no history of cardiac disease was scheduled for a cerebral aneurysm clipping surgery. Anesthesia was administered with propofol, rocuronium, fentanyl, and remifentanil. At the end of the surgery, extubation was performed 3 min after the administration of 200 mg sugammadex, along with a simultaneous blood-pressure decrease with ST elevation on lead II. Cardiopulmonary resuscitation was per- formed owing to the occurrence of lethal arrhythmia, and the patient was successfully resuscitated. Subsequent emergent coronary angiography revealed normal coronary arteries. Twelve days after the first surgery, a tracheostomy was performed owing to persistent disturbance of consciousness. Anesthesia was administered with sevoflurane, fentanyl, and rocuronium. Sugammadex 200 mg was administered after the insertion of a tracheal cannula, and 5 min later, the blood pressure were gradually decreased with ST depression on lead V5. Finally, cardiopulmonary resuscitation was required, and the patient recovered again. An acetylcholine provocation test performed later showed positive results. We suspect sugammadex to be the cause of coronary vasospasm, because the time courses of the two cardiac arrest episodes after sugammadex administration were very similar. Therefore, clinicians should consider sugammadex as one of the causative agents of cardiac arrest in the operating room.


Asunto(s)
Vasoespasmo Coronario/inducido químicamente , Paro Cardíaco/etiología , gamma-Ciclodextrinas/efectos adversos , Vasoespasmo Coronario/fisiopatología , Electrocardiografía , Paro Cardíaco/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Resucitación , Sugammadex
11.
Crit Care ; 16(1): R33, 2012 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-22373120

RESUMEN

INTRODUCTION: Fever is frequently observed in critically ill patients. An independent association of fever with increased mortality has been observed in non-neurological critically ill patients with mixed febrile etiology. The association of fever and antipyretics with mortality, however, may be different between infective and non-infective illness. METHODS: We designed a prospective observational study to investigate the independent association of fever and the use of antipyretic treatments with mortality in critically ill patients with and without sepsis. We included 1,425 consecutive adult critically ill patients (without neurological injury) requiring >48 hours intensive care admitted in 25 ICUs. We recorded four-hourly body temperature and all antipyretic treatments until ICU discharge or 28 days after ICU admission, whichever occurred first. For septic and non-septic patients, we separately assessed the association of maximum body temperature during ICU stay (MAXICU) and the use of antipyretic treatments with 28-day mortality. RESULTS: We recorded body temperature 63,441 times. Antipyretic treatment was given 4,863 times to 737 patients (51.7%). We found that treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen independently increased 28-day mortality for septic patients (adjusted odds ratio: NSAIDs: 2.61, P=0.028, acetaminophen: 2.05, P=0.01), but not for non-septic patients (adjusted odds ratio: NSAIDs: 0.22, P=0.15, acetaminophen: 0.58, P=0.63). Application of physical cooling did not associate with mortality in either group. Relative to the reference range (MAXICU ≥ 39.5°C increased risk of 28-day mortality in non-septic patients (adjusted odds ratio 8.14, P=0.01), but not in septic patients (adjusted odds ratio 0.47, P=0.11) [corrected]. CONCLUSIONS: In non-septic patients, high fever (≥39.5°C) independently associated with mortality, without association of administration of NSAIDs or acetaminophen with mortality. In contrast, in septic patients, administration of NSAIDs or acetaminophen independently associated with 28-day mortality, without association of fever with mortality. These findings suggest that fever and antipyretics may have different biological or clinical or both implications for patients with and without sepsis. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00940654.


Asunto(s)
Antipiréticos/efectos adversos , Temperatura Corporal/efectos de los fármacos , Enfermedad Crítica/mortalidad , Enfermedad Crítica/terapia , Fiebre/mortalidad , Sepsis/mortalidad , Anciano , Temperatura Corporal/fisiología , Femenino , Fiebre/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sepsis/tratamiento farmacológico , Resultado del Tratamiento
12.
Prostate ; 71(9): 964-75, 2011 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-21541973

RESUMEN

BACKGROUND: Although the local renin-angiotensin system (RAS) of the prostate gland is related to cell proliferation and angiogenesis, the detailed mechanism remains unclear. We examined the effects of the angiotensin II type 1 receptor (AT1R) on androgen receptor (AR) expression in prostate cancer cells. METHODS: AR modulation by AT1R was examined by Western blot analysis, luciferase assay, and Immunocytochemical staining. The influence of AR expression by angiotensin II (Ang-II) and AT1R inhibition using siRNA was determined. Furthermore, using angiotensinogen or AT1R knockout (KO) mice, we performed quantitative real-time PCR to investigate the expression of AR. RESULTS: Ang-II induced cell proliferation with enhancement of AR, prostate specific antigen (PSA), NF-κB, and c-myc, and the activity of AR and PSA promoter. Cell proliferation of LNCaP transfected with AT1R siRNA was decreased by 75% at 7 days by inhibition of AR, PSA, NF-κB, and c-myc. Immunocytochemical staining confirmed the suppression of AR translocation into the nucleus in AT1R siRNA cells. AT1R KO mice showed a decrease in AR expression in the prostate gland. We also found that the expression level of AT1R could modulate the transcriptional level of AR by affecting NF-κB and c-myc expression. CONCLUSIONS: Knocking down of the AT1R protein resulted in significant inhibition of cell growth, associated with a marked decrease of AR protein. These results indicate that inhibition of AT1R has the potential to influence AR expression in prostate cells, and is anticipated to contribute to the development of novel therapeutic agents for prostate cancer.


Asunto(s)
Neoplasias de la Próstata/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Receptores Androgénicos/biosíntesis , Angiotensina II/metabolismo , Animales , Western Blotting , Línea Celular Tumoral , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Inmunohistoquímica , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos ICR , Ratones Noqueados , FN-kappa B/metabolismo , Antígeno Prostático Específico/metabolismo , Neoplasias de la Próstata/genética , Proteínas Proto-Oncogénicas c-myc/metabolismo , ARN/química , ARN/genética , ARN Interferente Pequeño/farmacología , Receptores Androgénicos/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
13.
Front Aging Neurosci ; 13: 637703, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33643027

RESUMEN

BACKGROUND: Aging and pre-existing cognitive impairment are considered to be independent risk factors for sepsis-associated encephalopathy. This study aimed to investigate the manner in which aging and pre-existing cognitive dysfunction modified neuroinflammation, synaptic plasticity, and basal synaptic transmission during the acute phase of sepsis using Senescence-Accelerated Mice Prone 8 (SAMP8) and Senescence-Accelerated Resistant Mice 1 (SAMR1). METHODS: We used 6-month-old SAMP8 and SAMR1. Sepsis was induced using cecal ligation and puncture (CLP). The animal's hippocampi and blood were collected for subsequent investigations 24 h after surgery. RESULTS: Long-term potentiation (LTP) was impaired in the Shaffer-collateral (SC)-CA1 pathway of the hippocampus in SAMP8 without surgery compared to the age-matched SAMR1, which was reflective of cognitive dysfunction in SAMP8. CLP impaired the SC-CA1 LTP in SAMR1 compared to the sham-operated controls, but not in SAMP8. Moreover, CLP decreased the input-output curve and increased the paired-pulse ratio in SAMP8, suggesting the reduced probability of basal synaptic transmission due to sepsis. Immunohistochemical analysis revealed that CLP elevated IL-1ß levels, especially in the hippocampi of SAMP8 with microglial activation. In vivo peripheral IL-1 receptor antagonist (IL-1ra) administration in the septic SAMP8 revealed that the neuroinflammation was not correlated with the peripheral elevation of IL-1ß. Ex vivo IL-1ra administration to the hippocampus ameliorated LTP impairment in SAMR1 and the reduction in basal transmission in SAMP8 after sepsis. CONCLUSIONS: The mechanism of the modulation of synaptic transmission and synaptic plasticity by the acute stage of sepsis differed between SAMR1 and SAMP8. These changes were related to centrally derived IL-1 receptor-mediated signaling and were accompanied by microglial activation, especially in SAMP8.

14.
Urol Int ; 84(2): 198-202, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20215826

RESUMEN

Nonsteroidal anti-inflammatory drugs (NSAIDs) induce expression of NSAID-activated gene 1 (NAG-1). NAG-1 expression in prostate cancer has previously been detected by microarray and immunohistochemical analyses. We examined the mRNA expression of NAG-1 by quantitative real-time polymerase chain reaction using 51 human prostate cancer tissue specimens. The level of NAG-1 expression was higher in prostate cancer than in normal prostate tissues (p = 0.025). The level of NAG-1 expression was also significantly higher in well-differentiated prostate cancer than in moderately (p = 0.04) and poorly differentiated adenocarcinomas (p = 0.03). These data suggest that NAG-1 may be a new biomarker for evaluating the grade of malignancy in prostate cancer.


Asunto(s)
Antiinflamatorios no Esteroideos/metabolismo , Biomarcadores de Tumor/metabolismo , Regulación Neoplásica de la Expresión Génica , Factor 15 de Diferenciación de Crecimiento/metabolismo , Próstata/metabolismo , Actinas/metabolismo , Adenocarcinoma/patología , Anciano , Diferenciación Celular , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Pronóstico , Neoplasias de la Próstata/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
15.
BJU Int ; 103(9): 1190-4, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19076142

RESUMEN

OBJECTIVE: To determine whether the 2005 International Society of Urologic Pathology (ISUP) Gleason Grading Consensus is clinically more useful than the conventional Gleason score (CGS), we compared the CGS and ISUP GS (IGS) of prostate needle biopsy (NB) and radical prostatectomy (RP) specimens, and evaluated the prognostic value of the ISUP GS. PATIENTS AND METHODS: Of 250 patients undergoing RP, 103 with clinical stage T1-2 N0M0 were enrolled. Pathological tumour grades of NB and RP specimens were classified according to CGS by experienced pathologists in the central pathology department of our hospital, and retrospectively according to IGS by one uropathologist at the central pathology department of another hospital. All patients had RP with no neoadjuvant or adjuvant therapy. We analysed associations of CGS and IGS with biochemical recurrence-free survival (BRFS) after RP. RESULTS: The concordance rates between NB and RP specimens by CGS and IGS were 64.1% and 69.9%. Under-grading and over-grading rates by CGS and IGS were 28.2% and 7.8% for NB, and 27.2% and 2.9% for RP, respectively. There was a significant difference in the over-grading rate between CGS and IGS (P = 0.026). When CGS and IGS of NB and RP specimens were compared, the concordance rates were similar, at 67% and 69.9%. The IGS was higher, by 15.6% in NB and by 20.4% in RP specimens, than CGS. Patients were divided into three groups based on IGS of NB specimens (< or =6, 7 and > or =8). These groups differed significantly in BRFS after RP (P = 0.022); CGS showed no such association. CONCLUSIONS: The IGS of NB specimens were significantly associated with BRFS after RP. The ISUP system is thus clinically useful for determining the most appropriate treatments for patients with early-stage prostate cancer.


Asunto(s)
Biopsia con Aguja/métodos , Próstata/patología , Prostatectomía/métodos , Neoplasias de la Próstata/patología , Anciano , Métodos Epidemiológicos , Humanos , Masculino , Próstata/cirugía , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/cirugía
16.
JA Clin Rep ; 5(1): 65, 2019 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-32025947

RESUMEN

BACKGROUND: The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. CASE PRESENTATION: A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. CONCLUSION: REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.

17.
J Am Chem Soc ; 130(5): 1759-65, 2008 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-18193872

RESUMEN

Noncovalent design of new liquid-crystalline (LC) columnar assemblies based on an ionic liquid has shown to be useful to achieve anisotropic high ionic conductivities. An equimolar mixture of an ionic liquid, 1-butyl-3-methylimidazolium bromide, and 3-[3,4,5-tri(octyloxy)benzoyloxy]propane-1,2-diol, which is partially miscible with the ionic liquid, exhibits an LC hexagonal columnar phase from -4 to 63 degrees C. This columnar supramolecular assembly forming the nanostructures shows the one-dimensional (1D) ionic conductivity of 3.9 x 10(-3) S cm(-1) at 50 degrees C along the column, which is more than 700 times higher than that of the corresponding covalent-type columnar ionic liquid, 1-methyl-3-[3,4,5-tri(octyloxy)benzyl]imidazolium bromide, which is 5.3 x 10(-6) S cm(-1) at 50 degrees C. This significant enhancement of the ionic conductivity is attributed to the increase of the mobility of the ionic part.


Asunto(s)
Conductividad Eléctrica , Cristales Líquidos/química , Nanoestructuras/química , Cristalografía por Rayos X , Iones/química , Espectroscopía de Resonancia Magnética , Estructura Molecular , Transición de Fase
18.
Prostate ; 68(15): 1666-73, 2008 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-18677709

RESUMEN

BACKGROUND: The aim of this study was to perform a comprehensive evaluation of angiotensin III (Ang-III) and related converting enzymes, aminopeptidase A (APA) and N (APN), in prostate cancer. METHODS: We investigated the effects of Ang-III on the in vitro growth of human prostate cancer cells and the expression of APA and APN in cells treated with Ang-III or hormonal agents. Furthermore, we performed real-time quantitative PCR to investigate the expression pattern of APA and APN in 86 prostate tissue samples including normal prostate, untreated and hormone refractory prostate cancer (HRPC). RESULTS: Ang-III stimulated cell proliferation, and the proliferative effect was inhibited by olmesartan, an AT(1) receptor blocker (ARB). Western blot analysis showed that phosphorylation of mitogen-activated protein kinase (MAPK) was enhanced by Ang-III and inhibited by olmesartan. APN mRNA level in HRPC was significantly lower than that in normal prostate and untreated prostate cancer tissue. In LNCaP cells, APN expression was augmented by Ang-III, whereas APA expression was not modulated. Hormonal agents, such as estradiol (E2) and dexamethasone (Dex), enhanced APA expression, but did not modulate APN expression in LNCaP cells. CONCLUSIONS: Our results suggest that Ang-III and related converting enzymes contribute to cell proliferation of prostate cancer, and may be implicated in cancer progression.


Asunto(s)
Angiotensina III/metabolismo , Antígenos CD13/metabolismo , Glutamil Aminopeptidasa/metabolismo , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/patología , Angiotensina III/farmacología , Antineoplásicos Hormonales/farmacología , Antígenos CD13/genética , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Dexametasona/farmacología , Estradiol/farmacología , Humanos , Masculino , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Fosforilación/efectos de los fármacos , ARN Mensajero/metabolismo
19.
Hinyokika Kiyo ; 53(1): 75-7, 2007 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-17310775

RESUMEN

We report a rare case of uterine corpus metastasis from superficial bladder cancer. A 78-year-old female presented with abnormal vaginal bleeding. She received transurethral resection of bladder tumor (TUR-Bt) two years previously, and the pathological findings were transitional cell carcinoma (TCC) grade 3 pT1. Eight courses of BCG instillation were performed postoperatively. There was no recurrence of bladder cancer when vaginal bleeding occurred. Cytology of vaginal discharge was class V, and transitional cell carcinoma suspected. Pathological finding of transvaginal uterine corpus biopsy was TCC. We diagnosed metastases to uterine corpus from bladder cancer.


Asunto(s)
Carcinoma de Células Transicionales/secundario , Neoplasias de la Vejiga Urinaria/patología , Neoplasias Uterinas/secundario , Administración Intravesical , Anciano , Vacuna BCG/uso terapéutico , Carcinoma de Células Transicionales/tratamiento farmacológico , Carcinoma de Células Transicionales/cirugía , Terapia Combinada , Cistectomía , Esquema de Medicación , Femenino , Humanos , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/cirugía
20.
Shock ; 48(2): 209-214, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28187038

RESUMEN

Sepsis-associated encephalopathy is a major complication during sepsis, and an effective treatment remains unknown. Although minocycline (MINO) has neuroprotective effects and is an attractive candidate for treating sepsis-associated encephalopathy, the effect of MINO on synaptic plasticity during sepsis is still unclear. In the present study, we investigated the effects of MINO on long-term potentiation (LTP) in the hippocampus in a cecal ligation and puncture (CLP) mouse model. We divided mice into four groups; sham + vehicle, sham + MINO (60 mg/kg, i.p. for 3 consecutive days before slice preparation), CLP + vehicle, and CLP + MINO. We tested LTP in the CA1 region of the hippocampus, using slices taken 24 h after surgery. Because MINO is also anti-inflammatory, LTP was analyzed following 30 min of IL-1 receptor antagonist (IL-1ra) perfusion. The endotoxin level in the blood was increased at 24 h after CLP operations regardless of MINO administrations, and LTP in the CLP + vehicle group mice was severely impaired (P < 0.05). High doses of MINO prevented the LTP impairment during sepsis in the CLP + MINO group. Interleukin (IL)-1ra administration ameliorated LTP impairment only in the CLP + vehicle group (P < 0.05); it had no additional effects on LTP in the CLP + MINO group. In conclusion, we have provided the first evidence that MINO prevents impaired LTP related to sepsis-induced encephalopathy in the mouse hippocampus, and that mechanisms associated with IL-1 receptor activity may be involved.


Asunto(s)
Encefalopatías , Potenciación a Largo Plazo/efectos de los fármacos , Minociclina/farmacología , Sepsis , Animales , Encefalopatías/tratamiento farmacológico , Encefalopatías/metabolismo , Encefalopatías/patología , Encefalopatías/fisiopatología , Hipocampo/metabolismo , Hipocampo/patología , Hipocampo/fisiopatología , Masculino , Ratones , Sepsis/tratamiento farmacológico , Sepsis/metabolismo , Sepsis/patología , Sepsis/fisiopatología
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