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1.
Transplant Proc ; 37(5): 2341-6, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15964412

RESUMEN

Compared to cadaveric liver transplantation, living-related liver transplantation (LRLT) has the physiological advantage of avoiding hemodynamic changes due to the nonsystemic clamping of the inferior vena cava (IVC). However, metabolic changes in the level of blood glucose and lactate usually occur during the anhepatic phase in LRLT. For pediatric patients, intraoperative infusions have the potential to maintain immature homeostasis during LRLT. In the present study, a complete anhepatic model of baby pigs with nonsystemic clamping of IVC, which mimics the procedure of pediatric LRLT, was established using a heparin-coated tube as an internal shunt lactate Ringer solution (LR, Lactec), acetate Ringer solution (AR, VeenF), and a solution comprising acetate Ringer with 1% glucose (AR-G, Phisio140) were tested using piglets. Hemodynamic and metabolic (blood gas analysis, electrolytes, blood lactate, and glucose) changes were observed during the anhepatic phase. Although no major difference was observed in hemodynamic parameters, arterial blood gas data, or concentration of electrolytes among the three solution groups, significant progressive hyperlactatemia was observed in the LR group. Also, though severe hypoglycemia was found in the LR and AR groups, the AR-G group maintained blood glucose levels throughout the anhepatic phase. To conclude, using the simplified pig anhepatic model, we evaluated various solutions for pediatric LRLT.


Asunto(s)
Infusiones Parenterales/métodos , Soluciones Isotónicas/administración & dosificación , Trasplante de Hígado/métodos , Animales , Niño , Femenino , Hemodinámica/fisiología , Humanos , Cuidados Intraoperatorios/métodos , Donadores Vivos , Masculino , Modelos Animales , Solución de Ringer , Porcinos
2.
Transplant Proc ; 37(10): 4567-70, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16387172

RESUMEN

In living donor liver transplantation, propofol, an intravenous anesthetic drug, has recently been used in both donors and recipients. Propofol is known to have intra- and extrahepatic metabolic pathways, but the effect of its continuous infusion during a long-term anhepatic state is yet to be determined. Recently, we successfully established a simplified pig model of the complete anhepatic state. In this state, we first evaluated hemodynamic parameters relating to the pharmacokinetics of continuously infused propofol (6 mg.kg(-1) x h(-1)). No significant changes in the concentration of hemoglobin or in hemodynamic parameters other than the heart rate were observed during the anhepatic phase when porpofol was continuously infused at the rate that maintains the state. Blood propofol concentrations in the mixed vein, artery, and portal vein were stable during the anhepatic phase. Finally, we confirmed the pharmacokinetics of continuously infused propofol using orthotropic liver transplantation in miniature pigs. The propofol concentration did not change markedly during the transplant procedure. In conclusion, the pharmacokinetics of continuously infused propofol was almost stable with and without the liver in pigs. Extrahepatic metabolism of propofol might help prevent changes in propofol concentrations.


Asunto(s)
Hepatectomía , Trasplante de Hígado/fisiología , Hígado/fisiología , Propofol/sangre , Propofol/farmacología , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/sangre , Anestésicos Intravenosos/farmacología , Animales , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Infusiones Intravenosas , Hígado/efectos de los fármacos , Modelos Animales , Consumo de Oxígeno/efectos de los fármacos , Propofol/administración & dosificación , Porcinos
3.
Br J Anaesth ; 92(6): 859-64, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15064251

RESUMEN

BACKGROUND: The effectiveness and toxicity of many drugs depends on the dosing-time schedule, relative to the circadian rhythms of biochemical, physiological, and behavioural processes. Previous studies have found chronopharmacology of ketamine, which is a N-methyl-d-aspartate (NMDA) receptor antagonist. The in vivo contribution of the NMDA receptor epsilon1 subunit (NR2A) in this effect is unclear. METHODS: In the present study, daily variations in the hypnotic effect of ketamine were determined in wild-type mice and NMDA epsilon1 knockout (KO) mice. RESULTS: The effect of ketamine had a definite daily variation in wild-type mice. No significant difference in blood concentration was observed at different dosing times (10:00 and 22:00). In NMDA receptor epsilon1 KO mice, the hypnotic effect of ketamine was weaker than in wild-type mice and there was no dependence on the time of administration. Significant pharmacokinetic differences were not observed between wild-type and KO mice. CONCLUSIONS: The enhanced hypnotic effect in the active phase of the circadian cycle is likely a result of changes with the time of day in the susceptibility of the central nervous system to ketamine. Knockout of the NMDA receptor epsilon1 subunit gene markedly reduced the effect of ketamine, and eliminated the time-dependent sensitivity to ketamine.


Asunto(s)
Anestésicos Disociativos/administración & dosificación , Ritmo Circadiano , Ketamina/administración & dosificación , Receptores de N-Metil-D-Aspartato/fisiología , Anestésicos Disociativos/sangre , Animales , Cronoterapia , Sistema Enzimático del Citocromo P-450/metabolismo , Ingestión de Líquidos/fisiología , Ketamina/sangre , Hígado/enzimología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Receptores de N-Metil-D-Aspartato/genética
4.
Neuroreport ; 12(15): 3169-72, 2001 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-11711849

RESUMEN

Heterozygous mice mutant for the NMDA-type glutamate receptor (GluR) epsilon2 subunit with a highly homogeneous genetic background showed exaggerated responses to various acute noxious stimuli in the footshock, tail-flick, hot-plate and tail-pinch tests. Because the noxious stimuli in these behavioral tests were electrical, thermal and mechanical, the reduction of GluRepsilon2 proteins exerted stimulatory effects on acute nociceptive responses across modalities. Previous studies showed that GluRepsilon1 and GluRepsilon4 subunit mutant mice exhibited no alteration in the responses to acute noxious stimuli. Thus, among NMDA receptor subunits, the GluRepsilon2 subunit specifically plays an important role in the regulation of the acute nociceptive responses.


Asunto(s)
Sistema Nervioso Central/metabolismo , Ácido Glutámico/metabolismo , Nociceptores/metabolismo , Dolor/metabolismo , Receptores de N-Metil-D-Aspartato/deficiencia , Reflejo/genética , Transmisión Sináptica/genética , Enfermedad Aguda , Animales , Estimulación Eléctrica , Femenino , Heterocigoto , Hiperalgesia/genética , Hiperalgesia/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Dolor/genética , Dimensión del Dolor , Umbral del Dolor/fisiología , Estimulación Física , Tiempo de Reacción/genética , Receptores de N-Metil-D-Aspartato/genética
5.
Cancer Res ; 51(7): 1940-5, 1991 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-2004380

RESUMEN

The role of acidic glycosphingolipids in cell growth and differentiation was investigated using the multipotent leukemia cell line K562. When GM3 was added to cell culture media, the growth of K562 cells was remarkably inhibited and the cells were shown to have megakaryocytoid morphology. Ultrastructural study demonstrated that K562 cells treated with GM3 had platelet peroxidase-positive structures, which were considered to be the specific marker of megakaryocyte. Furthermore, AP-3 directed against an epitope present on membrane glycoprotein IIIa reacted with the GM3-treated cells. Free N-acetylneuraminic acid, GM1, GM2, GD1a, and a mixture of bovine brain gangliosides containing GD1a and GT1b did not affect growth of K562 cells or show morphological changes. According to chemical analyses, GM3 content increased in megakaryocytoid differentiation induced by tetradecanoylphorbol-13-acetate, whereas GM3 decreased in erythroid differentiation induced by hemin. Enzymatic analysis showed that the GM3 increase during megakaryocytoid differentiation was a result of the sialyltransferase activation. These results indicated that exogenous GM3 induced differentiation of K562 cells into a "GM3-rich" lineage, i.e., mainly megakaryocytoid lineage, and that GM3 accumulation in the GM3-rich lineage was the result of the activation of GM3 synthase. These findings strongly suggested that GM3 ganglioside, a minor membrane component, has a crucial role in not only the differentiation induction but also the determination of the differentiation direction in pluripotent K562 cells.


Asunto(s)
Gangliósido G(M3)/farmacología , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Diferenciación Celular/efectos de los fármacos , División Celular/efectos de los fármacos , Humanos , Microscopía Electrónica , Acetato de Tetradecanoilforbol/farmacología , Células Tumorales Cultivadas/patología , Células Tumorales Cultivadas/ultraestructura
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