RESUMEN
Cytoskeletal transport in cells is driven by enzymes whose activity shows sensitive, typically Arrhenius, dependence on temperature. Often, the duration and outcome of cargo transport is determined by the relative success of kinesin vs. dynein motors, which can simultaneously bind to individual cargos and move in opposite direction on microtubules. The question of how kinesin and dynein activity remain coupled over the large temperature ranges experienced by some cells is one of clear biological relevance. We report a break in the Arrhenius behavior of both kinesin-1 and kinesin-3 enzymatic activity at 4.7 °C and 10.5 °C, respectively. Further, we report that this transition temperature significantly changes as a function of chemical background: addition of 200 mM TMAO increases transition temperatures by â¼6 °C in all cases. Our results show that Arrhenius trend breaks are common to all cytoskeletal motors and open a broad question of how such activity transitions are regulated in vivo. STATEMENT OF SIGNIFICANCE: Many cytoskeletal motors studied to date follow Arrhenius kinetics, at least from room temperature up to mammalian body temperature. However the thermal dynamic range is typically finite, and breaks in Arrhenius trends are commonly observed at biologically relevant temperatures. Here we report that the thermal dynamic range of kinesins is also limited and moreover that the location of the Arrhenius break for kinesins can shift significantly based on chemical backgrounds. This implies that the balance of multiple motor cargo transport along the cytoskeleton is far more tunable as a function of temperature than previously appreciated.
Asunto(s)
Cinesinas/metabolismo , Transporte Biológico Activo , Citoesqueleto/metabolismo , Humanos , Técnicas In Vitro , Cinesinas/química , Cinética , Metilaminas , Microtúbulos/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Temperatura , TermodinámicaRESUMEN
AIM: To present the technique and the diagnostic accuracy of the air test to diagnose Hirschsprung's disease (HD). MATERIALS AND METHODS: Children who attended hospital for chronic constipation (CC) between January 2012 and December 2016 for whom the air test was performed were enrolled. The test was conducted during contrast enema under fluoroscopic observation using 20-50 ml injections of air into the rectum through a 10 F Nelaton catheter. The demographics, results of the air test, and additional examinations, as well as the outcomes of subsequent treatments were analysed retrospectively. RESULTS: The air test was conducted in 179 patients (median: 3 years, range: 0-14 years), and was positive in 150 and negative in 29 cases. Of the 29 patients with negative results, four were diagnosed with HD by rectal suction biopsy (RSB). Of the remaining 25 patients, RSB was conducted in seven and HD was excluded in all cases. In all 150 patients with positive air test results, CC was adequately controlled with conservative treatment. The sensitivity and specificity of the air test were 100% (4/4) and 85.7% (150/175), respectively. CONCLUSIONS: The air test can be used as a new non-invasive screening method for HD, performed simultaneously with contrast enema.
Asunto(s)
Estreñimiento/diagnóstico , Enema/métodos , Enfermedad de Hirschsprung/diagnóstico , Recto/fisiopatología , Adolescente , Aire , Niño , Preescolar , Enfermedad Crónica , Estreñimiento/etiología , Estreñimiento/fisiopatología , Medios de Contraste , Femenino , Enfermedad de Hirschsprung/complicaciones , Enfermedad de Hirschsprung/fisiopatología , Humanos , Lactante , Recién Nacido , Masculino , Recto/diagnóstico por imagen , Reproducibilidad de los Resultados , Estudios Retrospectivos , SucciónAsunto(s)
COVID-19 , Trombosis , Genitales , Humanos , Necrosis , ARN Mensajero , SARS-CoV-2 , Trombosis/etiología , VacunaciónRESUMEN
Sixty-two patients with benign prostate hyperplasia (BPH) who were being treated with dutasteride participated in this study. Prostate volume, uroflowmetry, blood tests, the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) were determined before and 1, 3 and 12 months after the treatment with dutasteride. Patients were divided into two groups based on changes in serum testosterone after 1 month: Group A (>20% increase; n = 33) or Group B (<20% increase; n = 29). Serum free-testosterone levels were 20.4% higher after 1 month and remained constant thereafter. When Groups A and B were compared, baseline free-testosterone levels were significantly lower in Group A, IPSS QOL was significantly better in Group A at 3 and 12 months, and no significant differences were observed in uroflowmetry, prostate volume, IPSS or IIEF-5. A univariate analysis identified serum free-testosterone levels and the IPSS storage symptom subscore as significant factors influencing IPSS QOL at 12 months, and only the IPSS storage symptom subscore appeared to be independently related to IPSS QOL. These results indicate that dutasteride increases serum free-testosterone levels in BPH patients, particularly with low baseline free-testosterone levels, and the increase in free-testosterone may have further add-on impacts on their urinary tract symptoms.
Asunto(s)
Inhibidores de 5-alfa-Reductasa/farmacología , Dutasterida/farmacología , Hiperplasia Prostática/tratamiento farmacológico , Testosterona/sangre , Inhibidores de 5-alfa-Reductasa/uso terapéutico , Anciano , Dutasterida/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
The objectives of this study were to determine whether the inhibition of clusterin expression in rat Sertoli cells enhances heat stress-induced apoptosis. The scrotums of rats were immersed in a water bath of 43 °C for 15 min. Testicular weight and germ cell number markedly decreased after the heat treatment in a time-dependent manner. In contrast, clusterin mRNA and protein expression levels were significantly up-regulated and peaked on day 21. The apoptotic index was markedly increased 1 day after the heat treatment. We then purified Sertoli cells from the rat testes, and an expression vector containing siRNA targeting the clusterin gene was transiently transfected into Sertoli cells. Following exposure to heat stress at 41 °C for 12 h, clusterin mRNA was markedly up-regulated after transfection with the control vector; however, the transfection of siRNA targeting the clusterin resulted in >70% reduction in the expression of clusterin mRNA. Furthermore, the apoptotic index in these Sertoli cells was significantly higher after the treatment with siRNA targeting the clusterin than control, and the most prominent difference was observed within 24 h after the heat treatment. These results suggest that an increase in the secretion of clusterin by Sertoli cells protects the testes from heat stress-induced injury.
Asunto(s)
Apoptosis/genética , Clusterina/genética , Respuesta al Choque Térmico/genética , Calor , ARN Mensajero/metabolismo , Células de Sertoli/metabolismo , Testículo/patología , Animales , Recuento de Células , Clusterina/metabolismo , Masculino , Tamaño de los Órganos , ARN Interferente Pequeño , Ratas , EspermatozoidesRESUMEN
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multi-organ failure, and high mortality. In Japan, appropriate notification measures based on the Infectious Disease Control law are mandatory for cases of STSS caused by ß-haemolytic streptococcus. STSS is mainly caused by group A streptococcus (GAS). Although an average of 60-70 cases of GAS-induced STSS are reported annually, 143 cases were recorded in 2011. To determine the reason behind this marked increase, we characterized the emm genotype of 249 GAS isolates from STSS patients in Japan from 2010 to 2012 and performed antimicrobial susceptibility testing. The predominant genotype was found to be emm1, followed by emm89, emm12, emm28, emm3, and emm90. These six genotypes constituted more than 90% of the STSS isolates. The number of emm1, emm89, emm12, and emm28 isolates increased concomitantly with the increase in the total number of STSS cases. In particular, the number of mefA-positive emm1 isolates has escalated since 2011. Thus, the increase in the incidence of STSS can be attributed to an increase in the number of cases associated with specific genotypes.
Asunto(s)
Choque Séptico/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus pyogenes , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Clindamicina/farmacología , Farmacorresistencia Bacteriana/genética , Eritromicina/farmacología , Femenino , Genotipo , Humanos , Lactante , Japón/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Prevalencia , Choque Séptico/microbiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/efectos de los fármacos , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificación , Adulto JovenRESUMEN
We report pregnancy with the delivery of a healthy child by TESE-ICSI 7 years after bilateral adult orchidopexy. A 29-year-old patient presented with infertility and previous bilateral cryptorchidism, but no surgical treatment had ever been performed. His partner had been assessed by a gynaecologist, and no contributing female factors were detected. Orchidopexy and conventional testicular sperm extraction (TESE) were performed and microdissection TESE 10 months after orchidopexy. The second microdissection TESE with intracytoplasmic sperm injection (ICSI) was performed 7 years after orchidopexy. The couple achieved pregnancy with the delivery of a healthy child by TESE-ICSI. It is concluded that bilateral orchidopexy in adulthood progresses spermatogenesis gradually, and microdissection TESE may succeed after a certain period of time following treatment.
Asunto(s)
Orquidopexia , Recuperación de la Esperma , Adulto , Femenino , Humanos , Nacimiento Vivo , Masculino , Embarazo , Inyecciones de Esperma Intracitoplasmáticas , Factores de TiempoRESUMEN
SUMMARY: Subchondral trabecular bone structure was analyzed in knee osteoarthritis (OA) patients using 3-T MRI to investigate structural features of subchondral trabecular bone of knee OA. With OA progression, osteoporotic changes were observed in the lateral joint, showing a higher correlation than sclerotic changes in the medial joint. INTRODUCTION: To investigate structural features of subchondral trabecular bone of knee osteoarthritis (OA). METHODS: Sixty knees with KL grade 0-4 (all female) were examined. Fast imaging employing steady-state acquisition-cycled phases (FIESTA-c) and FatSat Spoiled gradient recalled acquisition in the steady state (SPGR) images were acquired by 3-T MRI. At four sites (the medial femur, medial tibia, lateral femur, and lateral tibia), subchondral trabecular bone structure was analyzed by FIESTA-c imaging, cartilage area was measured by SPGR imaging, and their correlation was analyzed. In addition, the subjects were classified into four groups from the cartilage area measured by SPGR imaging, and subchondral trabecular bone structure in each group was compared. RESULTS: As cartilage area decreased in the medial joint, bone volume fraction and trabecular thickness in the medial tibia increased, and bone volume fraction, trabecular thickness, number, and connectivity in the lateral femur and lateral tibia decreased (r ≥ 0.4 or ≤-0.4, p ≤ 0.001). Compared to medially, the changes laterally showed a higher correlation. When the medial-lateral ratio of trabecular thickness in the tibia was determined, it had the highest correlation coefficient (r=-0.7, p < 0.001). These changes were not significantly detected in the early stage. CONCLUSIONS: To more sensitively detect OA changes in subchondral trabecular bone structure, a focus on osteoporotic changes in the lateral joint and the medial-lateral ratio would be useful. Detectability of early OA remains unknown, but based on a strong correlation with the degree of OA progression, trabecular structural analysis of subchondral bone may be a useful parameter to evaluate OA severity and evaluate treatment.
Asunto(s)
Articulación de la Rodilla/patología , Osteoartritis de la Rodilla/complicaciones , Osteoporosis/etiología , Anciano , Anciano de 80 o más Años , Cartílago Articular/patología , Estudios Transversales , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico , Osteoporosis/diagnóstico , Tibia/patologíaRESUMEN
SUMMARY: A 36-month observational study compared the incidence of unaffected side hip fracture in Japanese female osteoporosis patients with a history of hip fracture between 173 patients receiving risedronate and 356 risedronate-untreated controls. New hip fractures were significantly less frequent in the risedronate group, suggesting a preventive effect in high-risk patients. INTRODUCTION: The purpose of this study was to investigate the preventive effect of risedronate on second hip fracture immediately following a first hip fracture in Japanese female osteoporosis patients with unilateral hip fracture. METHODS: We conducted a prospective matched cohort study in 184 patients treated with risedronate and 445 patients not receiving risedronate after discharge from hospital. Both groups were followed-up for 36 months, and the incidence of unaffected side hip fracture and the frequency of adverse events were assessed. RESULTS: Efficacy could be investigated in 173 patients from the risedronate group and 356 patients from the control group. Hip fracture was detected in 5 and 32 patients, respectively. Kaplan-Meier estimates of the 36-month fracture incidence were 4.3% in the risedronate group and 13.1% in the control group (P = 0.010, log-rank test). The hazard ratios (95% confidence intervals) obtained by univariate and multivariate analysis were 0.310 (0.121-0.796) and 0.218 (0.074-0.639), respectively, indicating a significantly lower incidence of unaffected side hip fracture in the risedronate group. Adverse events occurred in 38 patients (48 events) from the risedronate group and 94 patients (108 events) from the control group, with serious adverse events in 21 patients (26 events) and 78 patients (88 events), respectively. CONCLUSIONS: No significant differences were observed between the two groups. The incidence of unaffected side hip fracture was significantly lower in the risedronate group. Accordingly, risedronate may have a preventive effect on hip fracture in high-risk Japanese female osteoporosis patients for fracture with a history of unilateral hip fracture.
Asunto(s)
Conservadores de la Densidad Ósea/uso terapéutico , Ácido Etidrónico/análogos & derivados , Fracturas de Cadera/prevención & control , Fracturas Osteoporóticas/prevención & control , Anciano , Anciano de 80 o más Años , Densidad Ósea/efectos de los fármacos , Conservadores de la Densidad Ósea/efectos adversos , Métodos Epidemiológicos , Ácido Etidrónico/efectos adversos , Ácido Etidrónico/uso terapéutico , Femenino , Fracturas de Cadera/etiología , Fracturas de Cadera/fisiopatología , Humanos , Vértebras Lumbares/fisiopatología , Cumplimiento de la Medicación , Osteoporosis Posmenopáusica/complicaciones , Osteoporosis Posmenopáusica/tratamiento farmacológico , Osteoporosis Posmenopáusica/fisiopatología , Fracturas Osteoporóticas/etiología , Fracturas Osteoporóticas/fisiopatología , Ácido Risedrónico , Prevención Secundaria , Resultado del TratamientoRESUMEN
Despite the availability of newer classes of antibiotics, infection with multi-drug-resistant bacteria is a serious problem. To suppress the appearance of multi-drug-resistant bacteria and to avoid severe infection derived from febrile neutropenia (FN), we conducted cycling the administration of antibiotics for FN in patients with hematological malignancy. The treatment protocol consisted of the administration of four antibiotics each for 3 months in 1 year. The above regimen was repeated for 4 years. A total of 193 patients were registered in the protocol. The mean duration of the administration of cycling antibiotics was 5.9 days (range: 1-16 days). The frequency of FN before the study and during the study was unchanged until the third year, but decreased significantly in the fourth year. The frequency of detection of multi-drug-resistant bacteria in the first year was the same as that before the study was started, but dramatically decreased after the second year. Bacteriological treatment success rates were similar in each trimester and each year. The effective rate was not statistically different in each trimester and each year. We conclude that cycling the administration of antibiotics in patients with FN is useful for suppressing the appearance of multi-drug-resistant bacteria and for obtaining excellent clinical efficacy.
Asunto(s)
Antibacterianos/administración & dosificación , Infecciones Bacterianas/epidemiología , Fiebre/tratamiento farmacológico , Neoplasias Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Neutropenia/tratamiento farmacológico , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/microbiología , Esquema de Medicación , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Quimioterapia Combinada , Femenino , Fiebre/epidemiología , Humanos , Japón , Masculino , Persona de Mediana Edad , Neutropenia/epidemiología , Neutropenia/microbiología , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: With developments in clinical computed tomography (CT), in vivo analysis of patients' bone microstructure has become increasingly possible. We analyzed the subchondral trabecular bone of hip osteoarthritis (OA) patients using multi-detector row CT (MDCT) to closely examine the structural changes that occur as OA progresses. DESIGN: 47 female hip joints were studied: 20 with OA secondary to hip dysplasia (11 advanced OA, nine early-moderate OA), seven with hip dysplasia without OA, and 20 normal. The images' maximal spatial resolution was 280 × 280 × 500 µm. Regions of interest (ROIs) were the subchondral trabecular bones of the acetabulum and femoral head. Measurement parameters were bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), structure model index (SMI), trabecular bone pattern factor (TBPf), Euler's number, and degree of anisotropy (DA). Relationships between joint space volume and these parameters were analyzed. RESULTS: With decreasing joint space, Tb.Th and BV/TV increased, and Tb.Sp, Tb.N, SMI, TBPf, and DA decreased significantly. The microstructures were significantly different between the early to advanced OA groups and the normal and dysplasia groups; there was no significant difference between the normal and dysplasia groups. CONCLUSIONS: Changes of subchondral trabecular bone structure in OA could be evaluated using MDCT, despite imperfect spatial resolution and limited accuracy. Trabecular bone thickening and associated structural changes may be closely related to OA. Changes were observed in early to advanced OA, but not in dysplasia. This method may help to further elucidate OA pathogenesis, determine the therapeutic strategy, and evaluate therapy.
Asunto(s)
Articulación de la Cadera/diagnóstico por imagen , Osteoartritis de la Cadera/patología , Tomografía Computarizada por Rayos X/métodos , Anciano , Anciano de 80 o más Años , Femenino , Luxación de la Cadera/complicaciones , Humanos , Persona de Mediana Edad , Osteoartritis de la Cadera/etiología , Reproducibilidad de los ResultadosRESUMEN
We herein report clinical assessments of efficacy and side effects of T replacement therapy (TRT) in men with late-onset hypogonadism (LOH). The study included 56 patients who were diagnosed with LOH and treated with TRT for at least 6 months at our institution. Age, ageing male symptom (AMS) scale, and androgen decline in the ageing male (ADAM) questionnaires were examined. Fasting blood samples were analysed for sex hormones, total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GTP), red blood cell count (RBC), haemoglobin (Hb), haematocrit (Ht), and prostate-specific antigen (PSA). Total and psychological symptoms scores were measured by the AMS scale and the ADAM questionnaire score, demonstrating that the sum of positive responses to the questions were significantly improved after TRT (P < 0.05). TC, HDL, and LDL cholesterol, TG, AST, ALT, γ-GTP, RBC, Hb, Ht, and PSA were not significantly different between before and after TRT. Although TRT for men with LOH may cause favorable changes in psychological conditions, it may not have effects on lipid metabolism, liver function, RBC, and PSA level.
Asunto(s)
Terapia de Reemplazo de Hormonas/métodos , Hipogonadismo/tratamiento farmacológico , Hipogonadismo/metabolismo , Testosterona/uso terapéutico , Edad de Inicio , Anciano , Recuento de Eritrocitos , Encuestas Epidemiológicas , Humanos , Metabolismo de los Lípidos/efectos de los fármacos , Metabolismo de los Lípidos/fisiología , Hígado/efectos de los fármacos , Hígado/enzimología , Hígado/fisiología , Masculino , Persona de Mediana Edad , Antígeno Prostático Específico/sangre , Estudios Retrospectivos , Testosterona/farmacología , Resultado del TratamientoRESUMEN
OBJECTIVE: The role of postmenopause on the pathogenesis of cartilage degeneration has been an open question. We assessed cartilage degeneration in estrogen receptor (ER)alpha null mice and examined the role of glucocorticoid receptor-interacting protein 1 (GRIP1) in the ERalpha-dependent transcription of a type II collagen gene (col2a1) with special reference to a crosstalk with the transforming growth factor (TGF)-beta signaling pathway. METHODS: The vertebral cartilaginous endplate from female ERalpha null mice was subjected to histological analyses. Col2a1 expression of primary chondrocytes (PCs) obtained from ERalpha null mice after 17beta-estradiol (E(2)) and TGF-beta1 stimulation was examined by reverse transcription polymerase chain reaction (RT-PCR). Estrogen response element (ERE) or col2a1 promoter-enhancer luciferase reporter system was used to investigate the crosstalk among ERalpha, GRIP1, and MKK6. Col2a1 expression and glycosaminoglycan (GAG) content were measured in ATDC5 cells treated with GRIP1 small interfering RNA (siRNA). RESULTS: ERalpha deficiency clearly accelerated impairment of the vertebral cartilaginous endplate. E(2) and TGF-beta1 stimulation increased col2a1 expression in PC from wild-type mice, but not that from ERalpha null mice. The same stimulation increased the col2a1 promoter-enhancer reporter activity, and the elevated activity was decreased by dominant-negative ERalpha and p38 mitogen-activated protein kinase (MAPK) inhibitor. GRIP1 increased the E(2)-dependent ERE activation in the presence of ERalpha and constitutive-active MKK6. GRIP1 siRNA repressed col2a1 expression and GAG production in ATDC5 cells. CONCLUSIONS: Crosstalks between ERalpha/GRIP1 and TGF-beta/MKK6/p38 MAPK pathway have protective roles on cartilage metabolism via regulating the extracellular matrices expression. The finding may lead to the development of a novel therapeutic approach for cartilage degeneration.
Asunto(s)
Proteínas Portadoras/genética , Cartílago/metabolismo , Condrocitos/metabolismo , Receptor alfa de Estrógeno/genética , MAP Quinasa Quinasa 6/genética , Proteínas del Tejido Nervioso/genética , Factores de Edad , Animales , Receptor alfa de Estrógeno/metabolismo , Femenino , Regulación de la Expresión Génica , Disco Intervertebral/metabolismo , MAP Quinasa Quinasa 6/metabolismo , Ratones , Modelos Animales , Embarazo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
INTRODUCTION: A lumbar discal cyst is a relatively rare cystic lesion that communicates with lumbar intervertebral discs. Surgical resection of the cyst is the reported treatment of choice. In this study, the authors report the minimally invasive surgical resection of lumbar discal cysts using a microendoscopy. PATIENTS AND METHODS: Seven male patients with lumbar discal cysts underwent microendoscopic resections (mean age: 25.1+/-3.2 years and the mean follow-up period: 27.9 months). During the surgeries, the cysts were subtotally resected in a piecemeal fashion, and the fistulas forming the communications between the cysts and the corresponding intervertebral discs were coagulated using a bipolar coagulator. RESULTS: All the patients obtained relief from their pain after surgery, and no recurrences occurred during a mean follow-up period of 28 months. The mean operation time was 72.6+/-20.2 min, and the mean blood loss was 44.4+/-13.7 grams. No intra- or peri-operative complications were noted in any of the patients. CONCLUSIONS: Microendoscopic resection appears to be a minimally invasive and feasible surgical option for the treatment of lumbar discal cysts.
Asunto(s)
Quistes/cirugía , Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Enfermedades de la Columna Vertebral/cirugía , Adulto , Quistes/patología , Endoscopía , Humanos , Disco Intervertebral/patología , Vértebras Lumbares/patología , Masculino , Enfermedades de la Columna Vertebral/patología , Resultado del TratamientoRESUMEN
With bioactivity-guided phenotype screenings, a potent anti-inflammatory compound f152A1 has been isolated, characterized and identified as the known natural product LL-Z1640-2. Metabolic instability precluded its use for the study on animal disease models. Via total synthesis, a potent, metabolically stabilized analog ER-803064 has been created; addition of the (S)-Me group at C4 onto f152A1 has resulted in a dramatic improvement on its metabolic stability, while preserving the anti-inflammatory activities.
Asunto(s)
Antiinflamatorios/química , Lactonas/química , Animales , Antiinflamatorios/farmacocinética , Diseño de Fármacos , Humanos , Interleucina-6/metabolismo , Lactonas/síntesis química , Lactonas/farmacocinética , Ratones , Microsomas Hepáticos/metabolismoRESUMEN
Paraplegia associated with acute aortic dissection is one of the most serious complications. We experienced a case of Stanford type A acute aortic dissection with paraplegia and cardiac tamponade because the dissection was already thrombosed, conservative therapy was chosen. After drainage of pericardial effusion, a spinal drainage tube was inserted. Eleven days later, pulmonary embolism and re-dissection occurred, and an emergency operation was performed. Although the operation was successful, paraplegia did not improve. Even if type A acute aortic dissection is complicated with paraplegia, early surgical repair of aortic dissection should be considered, when paraplegia does not improve rapidly in spite of treatment.
Asunto(s)
Aneurisma de la Aorta/complicaciones , Disección Aórtica/complicaciones , Paraplejía/etiología , Embolia Pulmonar/complicaciones , Enfermedad Aguda , Disección Aórtica/cirugía , Aneurisma de la Aorta/cirugía , Humanos , Masculino , Persona de Mediana Edad , Embolia Pulmonar/cirugía , RecurrenciaRESUMEN
Lumbar disc herniation (LDH) is generally treated with a conservative therapy, and surgery is the only therapeutic option currently available for patients unresponsive to the conservative therapy. In the 1980s, chemonucleolysis with chymopapain, a protease, was widely used as the intermediate treatment between conservative therapy and surgical therapy in the Western countries. However, since chymopapain was withdrawn from the market in 2002 for non-scientific commercial reasons, chemonucleolysis has not been a therapeutic option for LDH. Condoliase (chondroitin sulfate ABC endolyase), a glycosaminoglycan-degrading enzyme, was approved by the drug regulatory authority in Japan as a newer intradiscal therapy for LDH after clinical studies conducted in Japan demonstrated efficacy and safety for patients with LDH. This review will focus on the preclinical pharmacology, pharmacokinetics, efficacy and safety of condoliase as a new option for treatment of LDH.
Asunto(s)
Glucuronidasa/uso terapéutico , Desplazamiento del Disco Intervertebral/terapia , Liasas/uso terapéutico , Quimopapaína , Glucuronidasa/farmacocinética , Humanos , Quimiólisis del Disco Intervertebral , Japón , Liasas/farmacocinéticaRESUMEN
The patient is a 59-year-old male who complained of acute palpitation, shivering and chest oppression. His laboratory data showed severe liver dysfunction (AST 3,445 IU/l, ALT 2,937 IU/l, and LDH 3,200 IU/l). By echocardiography, abnormal shunt flow was detected in the right atrium, and it was diagnosed as a ruptured aneurysm of the Valsalva sinus (Konno type IV). Suture closure of the fistula was performed from the right atrial side, and then, patch closure was performed from the aortic side with auto-pericardium to cover the whole non-coronary sinus, which was heavily calcified. The liver function rapidly restored to a normal range postoperatively. In a case of severe liver dysfunction, such cardiac disease should also be considered.
Asunto(s)
Rotura de la Aorta/cirugía , Hepatopatías/etiología , Seno Aórtico , Rotura de la Aorta/diagnóstico , Procedimientos Quirúrgicos Cardiovasculares , Diagnóstico por Imagen , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
The relationship between the charge-discharge properties and crystal structure of Na x Li0.67+y Ni0.33Mn0.67O2 (0.010 ≤ x ≤ 0.013, 0.16 ≤ y ≤ 0.20) has been investigated. Li/Na x Li0.67+y Ni0.33Mn0.67O2 cells exhibit gradually sloping initial charge and discharge voltage-capacity curves. The initial charge capacity increased from 171 mA h g-1 for thermally-treated Na0.15Li0.51Ni0.33Mn0.67O2 to 226 mA h g-1 for Na0.010Li0.83Ni0.33Mn0.67O2 with an increase in the Li content. The initial maximum discharge capacity was 252 mA h g-1 in the case of Na0.010Li0.83Ni0.33Mn0.67O2 between 4.8 and 2.0 V at a fixed current density of 15 mA g-1 (0.06C) at 25 °C. The predominance of the spinel phase leads to the high initial discharge capacity of Na0.010Li0.83Ni0.33Mn0.67O2. This study shows that chemical lithiation using LiI is effective to improve the electrochemical properties.
RESUMEN
beta gamma subunits of G proteins were purified from starfish oocytes, and their role in the induction of oocyte maturation by 1-methyladenine was investigated. When injected into starfish oocytes, the purified beta gamma subunit of the starfish G protein induced germinal vesicle breakdown (GVBD) faster than that of bovine brain G protein. Injection of the starfish beta gamma into cytoplasm near the germinal vesicle (GV) induced GVBD earlier than when injected into the GV or the cytoplasm near the plasma membrane. Fluorescent-labeled beta gamma was retained in the injected area even after GVBD. Injected beta gamma also induced the formation of maturation-promoting factor as well as an increase of histone H1 kinase activity. These results suggest that beta gamma dissociates from alpha-subunit by the stimulation of 1-methyladenine and interacts with a cytoplasmic effector, which results in formation of active cdc2 kinase.