RESUMEN
The management of medication overuse headache (MOH) is sometimes challenging, particularly for patients with a long disease duration. We observed that patients who used goshuyuto, a traditional Japanese medicine, exhibited a favorable clinical course. Two women who had a history of MOH for over 20 years were treated using 5.0-7.5 g/day goshuyuto in an outpatient setting. The treatment reduced their use of habitual drugs, including triptan (33-55%) and non-steroidal anti-inflammatory drugs (75-82%), as well as the headache impact test score-6 (16-23%) over 24 weeks. As goshuyuto has a protective effect on chronic headache and is reported not to lead to MOH, it is a good candidate for the treatment of patients with MOH in an outpatient setting, even for those with an over 20-year history of MOH.
Asunto(s)
Analgésicos , Cefaleas Secundarias , Humanos , Femenino , Analgésicos/efectos adversos , Pacientes Ambulatorios , Cefaleas Secundarias/inducido químicamente , Dolor/inducido químicamenteRESUMEN
BACKGROUND: The aim of this study is (1) to observe the effect of the background music (BGM) in the incubator on heart rate variability (HRV) during the first few weeks of life in preterm infants in the neonatal intensive (NICU) and growing care units (GCU) and (2) to investigate the effect of environmental music on autonomic function in the infants. METHODS: Thirty infants, including premature (26 3/7 - 38 4/7 weeks) and low-birth weight (LBW) (946-2,440âg) infants, admitted to the NICU or GCU were involved. The heart rate, low- (LF, 0.05-0.15âHz) and high- (HF, 0.15-0.4âHz) frequency HRV components, and LF/HF ratio were measured. The BGM, lullabies for a baby, was delivered through a speaker in the incubator, and the HRV components were compared among before, during, and after intervention with BGM. RESULTS: The mean HR did not change among the experimental conditions. The LF and HF values decreased during the BGM condition, but not LF/HF, compared with the condition before BGM. CONCLUSIONS: The present results showed that an auditory environment affected the autonomic function of infants with a range of BGM in the NICU/GCU. The present study also suggested that BGM, a non-invasive and non-pharmacological intervention, could be an evaluation tool for autonomic function in infants in NICU/GCU.
Asunto(s)
Estimulación Acústica/métodos , Frecuencia Cardíaca/fisiología , Incubadoras para Lactantes , Recien Nacido Prematuro , Cuidado Intensivo Neonatal/métodos , Musicoterapia/métodos , Sistema Nervioso Autónomo/fisiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro/crecimiento & desarrollo , Recien Nacido Prematuro/fisiología , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Masculino , Evaluación de Procesos y Resultados en Atención de SaludRESUMEN
The hyperinsulinemic-euglycemic clamp (EGC) technique was used to investigate the effects of calcium salts of long-chain fatty acids (LCFA-Ca) and rumen-protected Met (RPM) on insulin sensitivity in the peripheral tissues of lactating cows. Six multiparous Holstein cows were used in a 3 × 3 Latin square experiment in each 14-d period. Dietary treatments were 0 (RPM0), 20 (RPM20), and 60 (RPM60) g/d of RPM, supplemented with a diet containing 1.5% of LCFA-Ca equal to 110% of the cows' ME requirement. And as a control for the 3 LCFA-Ca-containing diets, a dietary treatment without LCFA-Ca (Con) was also included. After a 10-d adaptation period, milk samples were collected for 4 d, and EGC experiments were performed on d 14 of each treatment period. Insulin solution was infused through a jugular vein catheter at a rate of 0.1, 0.2, 0.3, and 0.4 milliunits·kg BW-1·min-1 for 30 min and then at a rate of 0.5 milliunits·kg BW-1·min-1 for 60 min. Glucose solution was variably infused to maintain plasma glucose at steady state through the same catheter. Blood samples for measurements were taken using the contralateral catheter. Plasma total cholesterol, cholesterol ester, free cholesterol, and phospholipid concentrations in RPM0 and RPM20 were higher than those in Con, whereas the concentrations in RPM60 were low at the same degree of those in RPM0 (P < 0.05). Plasma Met concentration was greatest in RPM60 (P < 0.05). In the EGC experiment, the glucose infusion rate was greater in RPM60 than in RPM0 and RPM20 and an effective concentration of insulin resulting in 50% maximal glucose infusion rate was lower in RPM60 compared with RPM0 (P < 0.05), indicating that insulin sensitivity was intensified in RPM60. Although the insulin sensitivity evaluated from the EGC data in RPM0, RPM20, and RPM60 was not different from Con, a slight decline was observed in RPM0 and insulin sensitivity in RPM60 was higher than Con. Our results from the EGC experiment demonstrated that the feeding RPM lead to increased insulin sensitivity, which suggests that dietary Met affects lipid metabolism via insulin action in lactating dairy cows fed a LCFA-Ca-containing diet.
Asunto(s)
Dieta Alta en Grasa/veterinaria , Grasas de la Dieta/farmacología , Resistencia a la Insulina/fisiología , Metabolismo de los Lípidos/efectos de los fármacos , Metionina/farmacología , Animales , Bovinos , Colesterol/sangre , Suplementos Dietéticos , Relación Dosis-Respuesta a Droga , Ácidos Grasos/metabolismo , Femenino , Glucosa/administración & dosificación , Insulina/administración & dosificación , Insulina/sangre , Lactancia/fisiología , Metionina/sangre , Leche/metabolismo , Rumen/metabolismoRESUMEN
The purpose of this study was to elucidate the effects of medium-chain fatty acids (MCFAs) on plasma ghrelin concentration in lactating dairy cows. Five early-lactating Holstein cows were randomly assigned to 2 dietary treatments in a crossover design with 2-wk periods. Treatments consisted of diets supplemented or not (control) with calcium salts of MCFAs (MCFA-Ca; 1.5% dry matter). Plasma hormone and metabolite concentrations in blood samples taken from the jugular vein were measured on the morning of feeding on day 14 of each period. Dry matter intake, milk protein, and lactose content of cows fed the MCFA-Ca diet were decreased compared with controls, but with no change in milk yield. Plasma ghrelin concentrations were higher in cows fed the MCFA-Ca diet; however, no significant effect was found on glucagon-like peptide-1 concentrations in plasma. Plasma insulin concentrations decreased, but plasma glucagon concentrations remained unchanged in cows fed the MCFA-Ca diet. The concentrations of nonesterified FAs, total cholesterol, and ß-hydroxybutyrate in plasma increased in these cows. In conclusion, dietary MCFAs increase the plasma ghrelin concentrations in lactating dairy cows.
Asunto(s)
Bovinos/fisiología , Dieta/veterinaria , Ácidos Grasos/administración & dosificación , Ghrelina/sangre , Lactancia/fisiología , Ácido 3-Hidroxibutírico/sangre , Animales , Glucemia/análisis , Estudios Cruzados , Grasas de la Dieta/administración & dosificación , Suplementos Dietéticos , Ácidos Grasos/análisis , Ácidos Grasos no Esterificados/sangre , Femenino , Péptido 1 Similar al Glucagón/sangre , Insulina/sangre , Leche/químicaRESUMEN
Our objective was to determine the effects of calcium salts of long-chain fatty acids (CLFAs) and rumen-protected methionine (RPM) on plasma concentrations of ghrelin, glucagon-like peptide-1 (7 to 36) amide, and pancreatic hormones in lactating cows. Four Holstein cows in midlactation were used in a 4 by 4 Latin square experiment in each 2-wk period. Cows were fed corn silage-based diets with supplements of CLFAs (1.5% added on dry matter basis), RPM (20 g/d), CLFAs plus RPM, and without supplement. Jugular blood samples were taken from 1 h before to 2 h after morning feeding at 10-min intervals on day 12 of each period. CLFAs decreased dry matter intake, but RPM did not affect dry matter intake. Both supplements of CLFAs and RPM did not affect metabolizable energy intake and milk yield and composition. Plasma concentrations of NEFAs, triglyceride (TG), and total cholesterol (T-Cho) were increased with CLFAs alone, but increases of plasma concentrations of TG and T-Cho were moderated by CLFAs plus RPM. Calcium salts of long-chain fatty acids increased plasma ghrelin concentration, and the ghrelin concentration with CLFAs plus RPM was the highest among the treatments. Plasma concentrations of glucagon-like peptide-1, glucagon, and insulin were decreased with CLFAs, whereas adding RPM moderated the decrease of plasma glucagon concentration by CLFAs. These results indicate that the addition of methionine to cows given CLFAs increases plasma concentrations of ghrelin and glucagon associated with the decrease in plasma concentrations of TG and T-Cho.
Asunto(s)
Calcio/administración & dosificación , Bovinos/metabolismo , Ácidos Grasos/administración & dosificación , Ghrelina/sangre , Péptido 1 Similar al Glucagón/sangre , Metionina/administración & dosificación , Fragmentos de Péptidos/sangre , Animales , Colesterol/sangre , Suplementos Dietéticos , Ácidos Grasos no Esterificados/sangre , Femenino , Lactancia/efectos de los fármacos , Análisis de los Mínimos Cuadrados , Leche/química , Leche/metabolismo , Triglicéridos/sangreRESUMEN
No effective therapeutic approaches have been available for early recurrences following liver transplantation for hepatocellular carcinoma (HCC). The prognosis for such patients has been poor. We encountered two patients with recurrent HCC following liver transplantation, and in the prescribed sorafenib after the failure of various therapeutic approaches. In vitro experiments have shown sorafenib to be metabolized by the drug-metabolizing enzyme cytochrome P450 3A4 (CYP3A4) and glucuronosyltransferase (UGT1A9). The metabolic pathway is predicted to overlap that of calcineurin inhibitors (CNIs). In the two cases in which we used sorafenib, tacrolimus (FK506) was used in case 1 and cyclosporine, in case 2. We therefore have also reported the blood levels of the CNI at the time of sorafenib use. Patients with recurrent HCC following liver transplantation were less tolerant of sorafenib than advanced HCC patients who had not undergone transplantation. Poor tolerance was believed to be due to pharmacological interactions of sorafenib and CNIs. Likewise in our patients, determining blood levels of sorafenib, including the area under the blood concentration-time curve of at least the CNI, in each case allowed us to determine the optimal sorafenib dose for each patient. In the future, when administering sorafenib to treat recurrent liver cancers following liver transplantation, the dose of sorafenib should be started at 200 mg/d and gradually increased while measuring CNI blood levels.
Asunto(s)
Antineoplásicos/uso terapéutico , Bencenosulfonatos/uso terapéutico , Inhibidores de la Calcineurina , Carcinoma Hepatocelular/cirugía , Neoplasias Hepáticas/cirugía , Trasplante de Hígado , Piridinas/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Niacinamida/análogos & derivados , Compuestos de Fenilurea , Recurrencia , SorafenibRESUMEN
A gradual loss of anterior pituitary hormones is suspected in patients treated with irradiation due to brain tumors. Development of growth hormone deficiency (GHD) with age has been documented in patients with idiopathic GHD. A gradual loss of adrenocorticotropic hormone (ACTH) secretion has been also shown in a patient with severe GHD and an invisible pituitary stalk on magnetic resonance imaging (MRI). The purpose of this longitudinal and cross-sectional study was to evaluate the gradual loss of growth hormone (GH) and ACTH in a homogeneous group of patients with hypopituitarism. Twenty-eight patients (23 males, 5 females) from four hospitals were diagnosed as having prenatal or perinatal-onset hypothalamic hypopituitarism. They had an abnormal pituitary stalk on MRI (invisible in 18 patients, thin in 10 patients) without any other organic disease of the brain. Each patient had GHD upon initial evaluation. Height (n=20) was analyzed as standard deviation score (SDS). Longitudinal (n=8) and cross-sectional (n=28) GH secretion capacity was evaluated by GH peaks, in response to insulin tolerance test (ITT) and growth hormone releasing factor test (GRF test). Longitudinal (n=10) and cross-sectional (n=28) ACTH secretion capacity was evaluated by cortisol peaks in response to ITT. Height SDS decreased each year in all the untreated patients after birth. GH peaks decreased gradually with age. Longitudinal data showed decreased GH peaks with age in seven out of eight patients using ITT and in all four patients using GRF tests. Cortisol peaks also decreased gradually together with signs and symptoms for adrenal deficiency such as general fatigue. Cortisol peaks of less than 414 nmol/L (15 microg/dl) in response to ITT were seen in 24% of the tests before age 10 and 56% before age 25. In conclusion, GHD and ACTH deficiency developed gradually in patients with prenatal or perinatal-onset hypothalamic hypopituitarism who had invisible or thin pituitary stalks examined by MRI.
Asunto(s)
Hormona Adrenocorticotrópica/deficiencia , Hormona de Crecimiento Humana/deficiencia , Hipopituitarismo/etiología , Hipotálamo/fisiopatología , Hipófisis/anomalías , Adolescente , Adulto , Envejecimiento , Estatura , Niño , Preescolar , Estudios Transversales , Femenino , Trastornos del Crecimiento/etiología , Humanos , Hidrocortisona/sangre , Hipopituitarismo/fisiopatología , Recién Nacido , Insulina , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Glándula Tiroides/fisiopatología , Triyodotironina/sangreRESUMEN
The authors recently developed a primate thromboembolic stroke model. To characterize the primate model, the authors determined serial changes in cerebral blood flow (CBF) and the relation between CBF and cerebral metabolic rate of glucose (CMRglc) using high-resolution positron emission tomography. Thromboembolic stroke was produced in male cynomolgus monkeys (n = 4). Acute obstruction of the left middle cerebral artery was achieved by injecting an autologous blood clot into the left internal carotid artery. Cerebral blood flow was measured with [15O]H2O before and 1, 2, 4, 6, and 24 hours after embolization. CMRglc was measured with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) 24 hours after embolization. Lesion size and location 24 hours after embolization was determined by the 2,3,5-triphenyltetrazolium chloride (TTC) staining method. The results are summarized as follows: (1) 1 hour after embolization, CBF in the temporal cortex and the basal ganglia decreased to < 40% of the contralateral values. In these regions, regarded as an ischemic core, CBF decreased further with time and CMRglc at 24 hours also decreased. Infarcted lesions as indicated by being unstained with TTC were consistently observed in these regions. (2) In the parietal cortex and several regions surrounding the ischemic core, CBF was > 40% of the contralateral values 1 hour after embolization and recovered gradually with time (ischemic penumbra). In these regions, CMRglc at 24 hours increased compared with that in the contralateral regions, indicating an uncoupling of CBF and CMRglc. No obvious TTC-unstained lesions were detected in these regions. The authors demonstrated a gradual recovery of reduced CBF, an elevated CMRglc and a CBF-CMRglc uncoupling in the penumbra regions of the primate model. Positron emission tomography investigations using this model will provide better understanding of the pathophysiology of thromboembolic stroke in humans.
Asunto(s)
Encéfalo/metabolismo , Circulación Cerebrovascular/fisiología , Metabolismo Energético/fisiología , Embolia y Trombosis Intracraneal/fisiopatología , Accidente Cerebrovascular/fisiopatología , Enfermedad Aguda , Animales , Ganglios Basales/irrigación sanguínea , Ganglios Basales/metabolismo , Encéfalo/irrigación sanguínea , Modelos Animales de Enfermedad , Glucosa/metabolismo , Embolia y Trombosis Intracraneal/diagnóstico por imagen , Macaca fascicularis , Masculino , Lóbulo Parietal/irrigación sanguínea , Lóbulo Parietal/metabolismo , Accidente Cerebrovascular/diagnóstico por imagen , Lóbulo Temporal/irrigación sanguínea , Lóbulo Temporal/metabolismo , Tálamo/irrigación sanguínea , Tálamo/metabolismo , Tomografía Computarizada de EmisiónRESUMEN
The effects of music therapy on natural killer (NK) cell count and activity (NKCA) were studied in 19 persons. Alzheimer's disease, cerebrovessel disease and Parkinson's disease subjects were assigned to a music therapy. Blood samples were drawn at rest and after completion of music therapy. Music therapy did not change the number of circulating lymphocytes. The percentage of NK cells increased during music therapy, along with an increase in the NK cell activity. The proportion of T cells, CD4 and CD8 did not change significantly during music therapy. One hour after the music therapy session, plasma adrenaline increased but cortisol and noradrenalin did not change. The results indicate that music therapy can significantly increase NK cell count and activity. The change in NK cell and function were independent of neuro-degenerative diseases.
Asunto(s)
Enfermedad de Alzheimer/inmunología , Células Asesinas Naturales/citología , Células Asesinas Naturales/inmunología , Musicoterapia , Anciano , Anciano de 80 o más Años , Femenino , Hogares para Ancianos , Humanos , Recuento de Linfocitos , Masculino , Casas de SaludRESUMEN
A bacterial strain KU-7, identified as a Pseudomonas fluorescens by 16S rDNA sequencing, was one of the 12 new isolates that are able to grow on 2-nitrobenzoate as a sole source of carbon, nitrogen, and energy. Resting cells of KU-7 were found to accumulate ammonia in the medium indicating that degradation of 2-NBA proceeds through a reductive route. Metabolite analyses by thin layer chromatography and high pressure liquid chromatography indicated that 3-hydroxyanthranilate is an intermediate of 2-nitrobenzoate metabolism in KU-7 cells. This offers an alternative route to 2-nitrobenzoate metabolism since anthranilate (2-aminobenzoate) or catechol were detected as intermediates in other bacteria. Crude extracts of KU-7 cells converted 2-nitrobenzoate to 3-hydroxyanthranilate with oxidation of 2 mol of NADPH. Ring cleavage of 3-hydroxyanthranilate produced a transient yellow product, identified as 2-amino-3-carboxymuconic 6-semialdehyde, that has a maximum absorbance at 360 nm. The initial enzymes of the 2-nitrobenzoate degradation pathway were found to be inducible since succinate-grown cells produced very low enzyme activities. A pathway for 2-nitrobenzoate degradation in KU-7 was proposed.
Asunto(s)
Ácido 3-Hidroxiantranílico/metabolismo , Nitrobenzoatos/metabolismo , Pseudomonas fluorescens/metabolismo , Biodegradación Ambiental , Medios de Cultivo , Petróleo , Pseudomonas fluorescens/crecimiento & desarrollo , Pseudomonas fluorescens/aislamiento & purificación , Microbiología del Suelo , Microbiología del Agua , Contaminación del AguaRESUMEN
Metallothionein (MT), has selectively binding affinity for heavy metal ions and over expression of MT has a potential against resistance for CDDP anticancer agents and radiation treatment. The role of MT immunoreactivity of squamous cell carcinoma in oral and pharyngeal regions (n = 28) and in the maxillary sinus region (n = 3) was evaluated for distribution patterns of MT and clinicopathologic behaviors. All the sections were examined in 400x and counted for MT positive cells over 5 fields of tumor growing foci. MT immunoreactivity was expressed in both tumor cell cytoplasm and nuclei, and showed heterogeneous localization in tumor epithelial cells and in the stroma. Immunohistochemical localizations showed mosaic patterns as the highest MT staining tumor cells intermingled with negative or low staining cells in neoplastic foci, and in stromal cells. Histiocytic and fibrocytic cells in both peripheral and interstitial stromas were also not stained homogeneously. In oral and pharyngeal carcinomas (n = 28), MT positive cell index in treated cases (n = 11) was 17.85% and that in non treated tumors (n = 17) was 25.19%. In maxillary sinus carcinomas (n = 3), MT positive index was 4.56% and showed lowers levels as compacted to other SCC sites. Among histological grading in oral and pharyngeal SCCs, MT index of well differentiated SCC (n = 9) was 17.04%, of moderately differentiated SCC (n = 13) 21.92% and poorly differentiated SCC (n = 6) was 31.06%. There is no significant correlation of positive index of metallothionein between treated and untreated samples taken in oral and pharyngeal SCCs.
Asunto(s)
Carcinoma de Células Escamosas/química , Neoplasias de Cabeza y Cuello/química , Metalotioneína/análisis , Proteínas de Neoplasias/análisis , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/química , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Diferenciación Celular , Quimioterapia Adyuvante , Cisplatino/administración & dosificación , Terapia Combinada , Resistencia a Antineoplásicos , Femenino , Fluorouracilo/administración & dosificación , Neoplasias Gingivales/química , Neoplasias Gingivales/patología , Neoplasias Gingivales/terapia , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Neoplasias Hipofaríngeas/química , Neoplasias Hipofaríngeas/patología , Neoplasias Hipofaríngeas/terapia , Metástasis Linfática , Masculino , Neoplasias del Seno Maxilar/química , Neoplasias del Seno Maxilar/patología , Neoplasias del Seno Maxilar/terapia , Persona de Mediana Edad , Mucosa Bucal/química , Neoplasias de la Lengua/química , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/terapia , Resultado del TratamientoRESUMEN
Recombinant human erythropoietin (rHuEPO) is effective in allowing autologous blood donation in patients unable to donate because of anemia. As adverse effects of rHuEPO might include activation of coagulation and possibly fibrinolysis, we investigated these possibilities in the context of autologous blood donation preceding hip surgery. Thirty-seven patients who donated 800 ml of autologous blood for elective hip surgery were randomly assigned to either a group of 20 receiving preoperative treatment with rHuEPO (erythropoietin beta), 6000 U i.v. twice weekly for 3 weeks, or an untreated control group of 17. A significant increase in platelet count was associated with autologous blood donation and intraoperative blood loss with or without rHuEPO. Coagulation and fibrinolysis were increased significantly by intraoperative blood loss in both groups, but not by rHuEPO. Coagulation and fibrinolysis were not activated by rHuEPO for elective hip surgery.
Asunto(s)
Coagulación Sanguínea , Transfusión de Sangre Autóloga , Eritropoyetina/uso terapéutico , Fibrinólisis , Adulto , Pérdida de Sangre Quirúrgica , Femenino , Articulación de la Cadera/cirugía , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Proteínas RecombinantesRESUMEN
BACKGROUND: Pseudovitamin D-deficiency rickets is characterized by the early onset of rickets with hypocalcemia and is thought to be caused by a deficit in renal 25-hydroxyvitamin D3 1alpha-hydroxylase, the key enzyme for the synthesis of 1alpha,25-dihydroxyvitamin D3. METHODS: We cloned human 25-hydroxyvitamin D3 1alpha-hydroxylase complementary DNA (cDNA) using a mouse 1alpha-hydroxylase cDNA fragment as a probe. Its genomic structure was determined, and its chromosomal location was mapped by fluorescence in situ hybridization. We then identified mutations in the 1alpha-hydroxylase gene in four unrelated patients with pseudovitamin D-deficiency rickets by DNA-sequence analysis. Both the normal and the mutant 1alpha-hydroxylase proteins were expressed in COS-1 cells and were assayed for 1alpha-hydroxylase activity. RESULTS: The gene for 25-hydroxyvitamin D3 1alpha-hydroxylase was mapped to chromosome 12q13.3, which had previously been reported to be the locus for pseudovitamin D-deficiency rickets by linkage analysis. Four different homozygous missense mutations were detected in this gene in the four patients with pseudovitamin D-deficiency rickets. The unaffected parents and one sibling tested were heterozygous for the mutations. Functional analysis of the mutant 1alpha-hydroxylase protein revealed that all four mutations abolished 1alpha-hydroxylase activity. CONCLUSIONS: Inactivating mutations in the 25-hydroxyvitamin D3 1alpha-hydroxylase gene are a cause of pseudovitamin D-deficiency rickets.
Asunto(s)
25-Hidroxivitamina D3 1-alfa-Hidroxilasa/genética , Mutación , Raquitismo/genética , 25-Hidroxivitamina D3 1-alfa-Hidroxilasa/metabolismo , Secuencia de Bases , Mapeo Cromosómico , Cromosomas Humanos Par 12 , Clonación Molecular , Análisis Mutacional de ADN , ADN Complementario/genética , Femenino , Humanos , Masculino , Linaje , Raquitismo/enzimología , Análisis de Secuencia de ADN , Deficiencia de Vitamina DRESUMEN
We employed hypotensive anesthesia with prostaglandin E1 (PGE1) and transfused 400 ml of autologous whole blood on the first postoperative day to avoid homologous blood transfusion in 137 patients undergoing rotational acetabular osteotomy (RAO) and RAO combined with intertrochanteric valgus osteotomy. Four hundred ml of whole blood were donated 1 week before the surgery, and transfused on the first postoperative day after hematological examination. We employed induced hypotension with PGE1 under general anesthesia with enflurane or isoflurane. Intraoperative systolic blood pressure was maintained at approximately 70-80 mmHg. The mean operation time was 139 +/- 32 minutes. The mean intraoperative and the postoperative estimated blood loss was 286 +/- 152 g and 259 +/- 122 g, respectively. The mean hemoglobin content was 13.3 +/- 1.1 g/dl before the operation. It showed the lowest value of 9.4 +/- 1.0 g/dl on the first postoperative day but it returned to 10.4 +/- 1.0 g/dl in the second postoperative week. There was no use of homologous blood transfusion. We consider that the concomitant use of autologous blood donation and hypotensive anesthesia is an extremely useful method to avoid homologous blood transfusion.
Asunto(s)
Acetábulo/cirugía , Alprostadil/uso terapéutico , Transfusión de Sangre Autóloga , Hipotensión/inducido químicamente , Osteotomía/métodos , Adolescente , Adulto , Anestésicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , RotaciónRESUMEN
We examined the in vitro sensitivities of three bacteria: Propionibacterium acnes, and Staphylococcus epidermidis, commonly detected in acne lesions, and Staphylococcus aureus, a common cause of skin infections, to 10 Kampo formulations (Chinese herbal medicines; combinations of powdered extracts of crude drugs). Both Staphylococcus species showed similar sensitivities to all 10 formulations, with minimum inhibitory concentrations (MICs) ranging from 25 to 400 mg/ml. P. acnes, however, was particularly sensitive to one formulation, keigai-rengyo-to (MIC, 0.78-25 mg/ml), prompting speculation that it might contain components with strong antibacterial activity to P. acnes. P. acnes showed similar sensitivities to all the other formulations (MIC 6.25-200 mg/ml). The ranges of MICs and the MIC50S (concentrations that inhibit 50% of isolates) were very similar to those previously recorded in 1990 for the two Staphylococcus species.
Asunto(s)
Medicamentos Herbarios Chinos/farmacología , Medicina Tradicional China , Propionibacterium acnes/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Acné Vulgar/microbiología , Dermatitis Atópica/microbiología , Humanos , Pruebas de Sensibilidad Microbiana , Propionibacterium acnes/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Staphylococcus epidermidis/aislamiento & purificaciónRESUMEN
We reviewed the susceptibility of Propionibacterium acnes to eleven Kampo formulations and to eight Kampo crude drugs that had been studied by examining their minimum inhibitory concentrations (MIC) in 1990 and 1995. P. acnes strains were most sensitive to Oren-gedoku-to (OGT) among these Kampo formulations. Coptidis Rhizoma (CR) and Phellodendri Cortex (PC) inhibited the growth of P. acnes significantly among the eight Kampo crude drugs examined. The patterns of distribution of MIC of Kampo formulations and Kampo crude drugs to P. acnes in this study were almost the same as in our previous report in 1990. No significant increases in MIC of Kampo formulations and Kampo crude drugs to P. acnes were observed. We speculated that Kampo crude drugs such as CR and PC, were better than minocycline or erythromycin from the point of view of a progressive increase in MIC to P. acnes. CR and PC, which were each an ingredient of OGT, might contain some components with strong antibacterial activity to P. acnes.
Asunto(s)
Medicamentos Herbarios Chinos/farmacología , Propionibacterium/efectos de los fármacos , Acné Vulgar/microbiología , Farmacorresistencia Microbiana , Humanos , Pruebas de Sensibilidad Microbiana , Propionibacterium/aislamiento & purificación , Estudios RetrospectivosRESUMEN
We attempted to clarify the effects of an NMDA antagonist on postischemic hypoperfusion in gerbils with 10 min forebrain ischemia and to relate it to postischemic metabolic recovery. We administered 10 mg/kg of CGS-19755, a competitive NMDA antagonist, or the same volume of saline intraperitoneally 30 min before the vascular occlusion. In 26 gerbils, we measured local cerebral blood flow (LCBF) 60 min after the reperfusion using [14C]iodoantipyrine autoradiography. In 20 gerbils, the effects on metabolic recovery were determined by serial measurements of intracellular pH, adenosine triphosphate (ATP) and the ratio between phosphocreatine and inorganic phosphate (PCr/Pi) until 60 min after reperfusion using 31P-magnetic resonance spectroscopy. In another group of 24 gerbils, we determined histopathological damage 24 h after the ischemia. The LCBF autoradiograms in the control group consistently demonstrated a typical postischemic hypoperfusion, i.e. homogeneous 50-75% reduction of blood flow in all forebrain structures. In contrast, CGS-19755 pretreatment animals showed highly heterogeneous LCBF declines, and significantly higher LCBF values were observed in the frontoparietal cortex and thalamus both of which were the most vulnerable area in this model. No significant LCBF change was observed in sham operated animals with or without CGS-19755 pretreatment. The postischemic recovery of PCr/Pi in gerbils pretreated with CGS-19755 was significantly better than that in the control animals. No significant differences in the recovery of ATP and intracellular pH were observed. The histological damage in the CGS-19755-treated group was less extensive than those in the saline-treated group. CGS-19755 pretreatment improved postischemic hypoperfusion and PCr/Pi recovery in the 10-min forebrain ischemia model in gerbils. The improvement of postischemic hypoperfusion in selectively vulnerable regions suggests that the activation of NMDA receptors may be related to the mechanism of developing postischemic hypoperfusion.
Asunto(s)
Circulación Cerebrovascular/efectos de los fármacos , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Ataque Isquémico Transitorio/tratamiento farmacológico , Ácidos Pipecólicos/uso terapéutico , Prosencéfalo/irrigación sanguínea , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Animales , Unión Competitiva , Gerbillinae , Ataque Isquémico Transitorio/patología , Ataque Isquémico Transitorio/fisiopatología , Espectroscopía de Resonancia Magnética/métodos , Masculino , Neuronas/parasitología , Fósforo , Prosencéfalo/patologíaRESUMEN
Anti-lipase activity of Kampo formulations, Coptidis Rhizoma (CR), and its alkaloids against Propionibacterium acnes were examined in vitro. The amounts of propionic and butyric acids in the medium were measured as growth and lipase activity of P. acnes, respectively. In tributyrin-PYG medium with each concentration of Kampo formulation, CR, or the alkaloids added, the production of propionic acid was suppressed remarkably more than that of butyric acid. The suppression of production of these acids by CR was higher than that of the alkaloids. Furthermore, no lipase-negative colonies were found on the medium to which Kampo formulations were added. From these observations, we concluded that not only Kampo formulations and CR, but also their alkaloids, showed suppression of growth of P. acnes, which reduced anti-lipase activity. Furthermore, it was suggested that Kampo formulations and Kampo crude drugs with anti-lipase activity to P. acnes should be synergistic when their ingredients are combined.
Asunto(s)
Alcaloides/farmacología , Medicamentos Herbarios Chinos/farmacología , Lipasa/antagonistas & inhibidores , Propionibacterium acnes/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Propionibacterium acnes/enzimologíaRESUMEN
The effect of hyperbaric oxygenation (HBO) treatment on rachitic change was studied using 4-wk-old, 1-hydroxyethylidene-1, 1-bisphosphonic acid disodium (HEBP-EHDP)-induced rachitic rats. After treatment, the dry weight, ash weight, Ca and P content, and bone mineral density of the hind leg bones were measured in each rat. These parameters were significantly increased in the rats that were treated with HBO after HEBP administration compared with those parameters in the rats that received HEBP alone. However, there was no significant differences between the rats treated simultaneously with HEBP and HBO and those that were treated with HEBP alone. These results were consistent with radiologic and histologic findings. Marked calcification in the center of the growth plate was revealed in the rats treated with HBO after HEBP administration. We suggest that intermittent high-pressure pure oxygen has a beneficial effect on osteogenesis in rachitic bone but does not prevent rachitic change.