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Loss of the inner blood-retinal barrier (BRB) integrity is a main feature of ocular diseases such as diabetic macular edema. However, there is a lack of clarity on how inner BRB function is modulated within the diabetic retina. The current study examined whether eucalyptol inhibited inner BRB destruction and aberrant retinal angiogenesis in 33 mM glucose-exposed human retinal microvascular endothelial (RVE) cells and db/db mice. This study further examined the molecular mechanisms underlying endothelial dysfunction including retinal endoplasmic reticulum (ER) stress and angiopoietin (Ang)/Tie axis in conjunction with vascular endothelial growth factor (VEGF). Eucalyptol is a naturally occurring monoterpenoid and an achiral aromatic component of many plants including eucalyptus leaves. Nontoxic eucalyptol reduced the production of amyloid-ß (Aß) protein in glucose-loaded RVE cells and in diabetic mice. This natural compound blocked apoptosis of Aß-exposed RVE cells in diabetic mouse eyes by targeting ER stress via the inhibition of PERK-eIF2α-ATF4-CHOP signaling. Eucalyptol promoted activation of the Ang-1/Tie-2 pathway and dual inhibition of Ang-2/VEGF in Aß-exposed RVE cells and in diabetic eyes. Supply of eucalyptol reversed the induction of junction proteins in glucose/Aß-exposed RVE cells within the retina and reduced permeability. In addition, oral administration of eucalyptol reduced vascular leaks in diabetic retinal vessels. Taken together, these findings clearly show that eucalyptol inhibits glucose-induced Aß-mediated ER stress and manipulates Ang signaling in diabetic retinal vessels, which ultimately blocks abnormal angiogenesis and loss of inner BRB integrity. Therefore, eucalyptol provides new treatment strategies for diabetes-associated RVE defects through modulating diverse therapeutic targets including ER stress, Ang-1/Tie-2 signaling, and Ang-2/VEGF.
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Diabetes Mellitus Experimental , Retinopatía Diabética , Estrés del Retículo Endoplásmico , Eucaliptol , Transducción de Señal , Animales , Estrés del Retículo Endoplásmico/efectos de los fármacos , Eucaliptol/farmacología , Ratones , Retinopatía Diabética/metabolismo , Retinopatía Diabética/tratamiento farmacológico , Retinopatía Diabética/patología , Transducción de Señal/efectos de los fármacos , Humanos , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular/metabolismo , Células Endoteliales/metabolismo , Células Endoteliales/efectos de los fármacos , Barrera Hematorretinal/metabolismo , Barrera Hematorretinal/efectos de los fármacos , Masculino , Apoptosis/efectos de los fármacos , Angiopoyetina 1/metabolismo , Ratones Endogámicos C57BL , Vasos Retinianos/metabolismo , Vasos Retinianos/efectos de los fármacos , Vasos Retinianos/patologíaRESUMEN
Electrocatalysts facilitating chlorine evolution reaction (ClER) play a vital role in chlor-alkali industries. Owing to a huge amount of chlorine consumed worldwide, inexpensive high-performing catalysts for Cl2 production are highly demanded. Here, a superb ClER catalyst fabricated through uniform dispersion of Pt single atoms (SAs) in C2 N2 moieties of N-doped graphene (denoted as Pt-1) is presented, which demonstrates near 100% exclusive ClER selectivity, long-term durability, extraordinary Cl2 production rate (3500 mmol h-1 gPt -1 ), and >140 000-fold increased mass activity over industrial electrodes in acidic medium. Excitingly, at the typical chlor-alkali industries' operating temperature (80 °C), Pt-1 supported on carbon paper electrode requires a near thermoneutral ultralow overpotential of 5 mV at 1 mA cm-2 current density to initiate the ClER, consistent with the predicted density functional theory (DFT) calculations. Altogether these results show the promising electrocatalyst of Pt-1 toward ClER.
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Malignant melanoma has an aggressive nature and a high metastatic propensity resulting in the highest mortality rate of any skin cancer. In this study, we synthesized 18F-labeled procainamide (PCA) for detection of melanoma using positron emission tomography (PET), and evaluated its biological characteristics. The non-decay-corrected radiochemical yield of 18F-PCA was 10-15% and its in vitro stability was over 98% for 2 h. At 1 h, cellular uptake of 18F-PCA was 3.8-fold higher in a group with the presence of l-tyrosine than in a non-l-tyrosine-treated group. Furthermore, 18F-PCA permitted visualization of B16F10 (mouse melanoma) xenografts on microPET after intravenous injection, and was retained in the tumor for 60 min, with a high tumor-to-liver uptake ratio. 18F-PCA showed specific melanoma uptake in primary lesions with a high melanin targeting ability in small animal models. 18F-PCA may have potential as a PET imaging agent for direct melanoma detection.
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Melanoma , Neoplasias Cutáneas , Animales , Ratones , Humanos , Procainamida , Melanoma/diagnóstico por imagen , Melanoma/patología , Tomografía de Emisión de Positrones/métodos , Radiofármacos , Línea Celular Tumoral , Radioisótopos de Flúor , Melanoma Cutáneo MalignoRESUMEN
Malignant melanoma has one of the highest mortality rates of any cancer because of its aggressive nature and high metastatic potential. Clinical staging of the disease at the time of diagnosis is very important for the prognosis and outcome of melanoma treatment. In this study, we designed and synthesized the 18F-labeled pyridine-based benzamide derivatives N-(2-(dimethylamino)ethyl)-5-[18F]fluoropicolinamide ([18F]DMPY2) and N-(2-(dimethylamino)ethyl)-6-[18F]fluoronicotinamide ([18F]DMPY3) to detect primary and metastatic melanoma at an early stage and evaluated their performance in this task. [18F]DMPY2 and [18F]DMPY3 were synthesized by direct radiofluorination of the bromo precursor, and radiochemical yields were â¼15-20%. Cell uptakes of [18F]DMPY2 and [18F]DMPY3 were >103-fold and 18-fold higher, respectively, in B16F10 (mouse melanoma) cells than in negative control cells. Biodistribution studies revealed strong tumor uptake and retention of [18F]DMPY2 (24.8% injected dose per gram of tissue [ID/g] at 60 min) and [18F]DMPY3 (11.7%ID/g at 60 min) in B16F10 xenografts. MicroPET imaging of both agents demonstrated strong tumoral uptake/retention and rapid washout, resulting in excellent tumor-to-background contrast in B16F10 xenografts. In particular, [18F]DMPY2 clearly visualized almost all metastatic lesions in lung and lymph nodes, with excellent image quality. [18F]DMPY2 demonstrated a significantly higher tumor-to-liver ratio than [18F]fluorodeoxyglucose ([18F]FDG) and the previously reported benzamide tracers N-[2-(diethylamino)-ethyl]-5-[18F]fluoropicolinamide ([18F]P3BZA) and N-[2-(diethylamino)-ethyl]-4-[18F]fluorobenzamide ([18F]FBZA) in B16F10-bearing or SK-MEL-3 (human melanoma)-bearing mice. In conclusion, [18F]DMPY2 might have strong potential for the diagnosis of early stage primary and metastatic melanoma using positron emission tomography (PET).
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Melanoma/diagnóstico por imagen , Imagen Molecular/métodos , Tomografía de Emisión de Positrones/métodos , Radiofármacos/administración & dosificación , Neoplasias Cutáneas/diagnóstico por imagen , Animales , Línea Celular Tumoral , Radioisótopos de Flúor/administración & dosificación , Humanos , Ratones , Ácidos Picolínicos/administración & dosificación , Radiofármacos/química , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Laser lipolysis may be considered for selective removal of excess orbital fat via minimally invasive lower blepharoplasty. To control the energy delivery to a precise anatomic location while avoiding complications, ultrasound guidance can be utilized. Under local anesthesia, a diode laser probe (Belody, Minslab, Korea) was introduced percutaneously to the lower eyelid. The tip of the laser device and changes in orbital fat volume were carefully controlled with ultrasound imaging. A 1470-nm wavelength was used for orbital fat reduction (maximal energy 300 J), and a 1064-nm wavelength was used to tighten the lower eyelid skin (maximal energy 200 J). From March 2015 to December 2019, a total of 261 patients underwent ultrasound-guided diode laser lower blepharoplasty. The procedure took 17 min on average. Total energy of 49 J-510 J (average = 228.31 J) was delivered in 1470-nm wavelengths or 45-297 J (average = 127.68 J) was delivered in 1064-nm wavelengths. Most patients were very satisfied with their results. Fourteen patients experienced complications, including nine cases of transient hypesthesia (3.45%), and three skin thermal burns (1.15%). However, these complications were not observed after strict control of the energy delivery below 500 J for each lower lid. Improvement in lower eyelid bags can be achieved using a minimally invasive approach in selected patients with ultrasound-guided laser lipolysis. It is a fast and safe procedure that can be performed in the outpatient setting.
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Blefaroplastia , Humanos , Lipólisis , Láseres de Semiconductores/uso terapéutico , Párpados , Ultrasonografía IntervencionalRESUMEN
Cooperative dual catalysis is a powerful strategy for achieving unique reactivity by combining catalysts with orthogonal modes of action. This approach allows for independent control of the absolute and relative stereochemistry of the product. Despite its potential utility, the combination of N-heterocyclic carbene (NHC) organocatalysis and transition metal catalysis has remained a formidable challenge as NHCs readily coordinate metal centers. This characteristic also makes it difficult to rationalize or predict the stereochemical outcomes of these reactions. Herein, we use quantum mechanical calculations to investigate formation of γ-butyrolactones from aldehydes and allyl cyclic carbonates by means of an NHC organocatalyst and an iridium catalyst. Stereoconvergent activation of the racemic allyl cyclic carbonate forms an Ir-π-allyl intermediate and activation of an unsaturated aldehyde forms an NHC enolate, the latter of which is rate-limiting. Union of the two fragments leads to stereodetermining C-C bond formation and ultimately ring closure to generate the product lactone. Notably, CO2 loss occurs after formation of the C-C bond and Et3NH+ plays a key role in stabilizing carboxylate intermediates and in facilitating proton transfer to form the NHC enolate. The computed pathways agree with the experimental findings in terms of the absolute configuration, the enantiomer excess, and the different diastereomers seen with the (R)- and (S)-spiro-phosphoramidite combined with the NHC catalyst. Calculations reveal the lowest energy pathway includes both an NHC ligand and a phosphoramidite ligand on the iridium center. However, the stereochemical features of this Ir-bound NHC were found to not contribute to the selectivity of the process.
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Compuestos Heterocíclicos , Iridio , 4-Butirolactona , Aldehídos/química , Catálisis , Compuestos Heterocíclicos/química , Iridio/química , Ligandos , Metano/análogos & derivadosRESUMEN
X-ray-induced acoustic computed tomography (XACT) has shown great potential as a hybrid imaging modality for real-time non-invasive x-ray dosimetry and low-dose three-dimensional (3D) imaging. While promising, one drawback of the XACT system is the underlying low signal-to-noise ratio (SNR), limiting its in vivo clinical use. In this Letter, we propose the first use of a conventional x-ray computed tomography contrast agent, Gastrografin, for improving the SNR of in situ XACT imaging. We obtained 3D volumetric XACT images of a mouse's stomach with orally injected Gastrografin establishing the proposal's feasibility. Thus, we believe, in the future, our proposed technique will allow in vivo imaging and expand or complement conventional x-ray modalities, such as radiotherapy and accelerators.
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Medios de Contraste , Tomografía Computarizada por Rayos X , Acústica , Animales , Imagenología Tridimensional , Ratones , Fantasmas de Imagen , Rayos XRESUMEN
The navigation of small unmanned aerial vehicles (UAVs), such as quadcopters, significantly relies on the global positioning system (GPS); however, UAVs are vulnerable to GPS spoofing attacks. GPS spoofing is an attempt to manipulate a GPS receiver by broadcasting manipulated signals. A commercial GPS simulator can cause a GPS-guided drone to deviate from its intended course by transmitting counterfeit GPS signals. Therefore, an anti-spoofing technique is essential to ensure the operational safety of UAVs. Various methods have been introduced to detect GPS spoofing; however, most methods require additional hardware. This may not be appropriate for small UAVs with limited capacity. This study proposes a deep learning-based anti-spoofing method equipped with 1D convolutional neural network. The proposed method is lightweight and power-efficient, enabling real-time detection on mobile platforms. Furthermore, the performance of our approach can be enhanced by increasing training data and adjusting the network architecture. We evaluated our algorithm on the embedded board of a drone in terms of power consumption and inference time. Compared to the support vector machine, the proposed method showed better performance in terms of precision, recall, and F-1 score. Flight test demonstrated our algorithm could successfully detect GPS spoofing attacks.
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Sistemas de Información Geográfica , Redes Neurales de la Computación , Algoritmos , Máquina de Vectores de SoporteRESUMEN
BACKGROUND: Arginine methylation is a posttranslational modification mediated by protein arginine methyltransferases (PRMTs). Although previous studies have shown that PRMT1 contributes to the severity of allergic airway inflammation or asthma, the underlying mechanism is poorly understood. OBJECTIVE: This study aimed to explore the role of PRMT1 and its relevant mechanism in the development of allergic rhinitis (AR). METHODS: The expression levels of PRMTs and cytokines were determined by RT-PCR, and the localization of PRMT1 was determined by immunohistochemistry and confocal microscopy. The levels of house dust mite (HDM)-specific immunoglobulins in serum and of cytokines in nasal lavage fluids were determined by ELISA. PRMT1 inhibition was achieved by siRNA and treatment with the pan PRMT inhibitor arginine N-methyltransferase inhibitor-1. RESULTS: PRMT1 expression was significantly increased in the nasal mucosa of patients and mice with AR. The degree of eosinophilic infiltration in the nasal mucosa was reduced in PRMT1+/- AR mice compared with wild-type mice. PRMT1 haploinsufficiency reduced the levels of HDM-specific immunoglobulins in serum and those of TH2 (IL-4, IL-5, and IL-13) and epithelial (thymic stromal lymphopoietin [TSLP], IL-25, and IL-33) cytokines in the nasal lavage fluids of AR mice. In nasal epithelial cells, HDM and IL-4 cooperate to enhance PRMT1 expression through a mitogen-activated protein kinase-dependent pathway. In addition, PRMT1 was essential for the production of TSLP, IL-25, and IL-33 in response to HDM and IL-4. Arginine N-methyltransferase inhibitor-1 treatment alleviated AR in the mouse model. CONCLUSIONS: PRMT1 plays an important role in AR development by regulating epithelial-derived cytokine production and might be a new therapeutic target for AR.
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Citocinas/inmunología , Células Epiteliales/inmunología , Proteína-Arginina N-Metiltransferasas/inmunología , Proteínas Represoras/inmunología , Rinitis Alérgica/inmunología , Alérgenos/inmunología , Animales , Humanos , Ratones Endogámicos C57BL , Ratones Transgénicos , Líquido del Lavado Nasal/inmunología , Mucosa Nasal/inmunología , Proteína-Arginina N-Metiltransferasas/genética , Pyroglyphidae/inmunologíaRESUMEN
Traumatic brain injury (TBI) broadly degrades the normal function of the brain after a bump, blow, or jolt to the head. TBI leads to the aggravation of pre-existing brain dysfunction and promotes neurotoxic cascades that involve processes such as oxidative stress, loss of dendritic arborization, and zinc accumulation. Acid sphingomyelinase (ASMase) is an enzyme that hydrolyzes sphingomyelin to ceramide in cells. Under normal conditions, ceramide plays an important role in various physiological functions, such as differentiation and apoptosis. However, under pathological conditions, excessive ceramide production is toxic and activates the neuronal-death pathway. Therefore, we hypothesized that the inhibition of ASMase activity by imipramine would reduce ceramide formation and thus prevent TBI-induced neuronal death. To test our hypothesis, an ASMase inhibitor, imipramine (10 mg/kg, i.p.), was administrated to rats immediately after TBI. Based on the results of this study, we confirmed that imipramine significantly reduced ceramide formation, dendritic loss, oxidative stress, and neuronal death in the TBI-imipramine group compared with the TBI-vehicle group. Additionally, we validated that imipramine prevented TBI-induced cognitive dysfunction and the modified neurological severity score. Consequently, we suggest that ASMase inhibition may be a promising therapeutic strategy to reduce hippocampal neuronal death after TBI.
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Lesiones Traumáticas del Encéfalo , Imipramina , Animales , Ratas , Imipramina/farmacología , Imipramina/uso terapéutico , Esfingomielina Fosfodiesterasa/metabolismo , Ceramidas/metabolismo , Hipocampo/metabolismo , Lesiones Traumáticas del Encéfalo/tratamiento farmacológico , Muerte Celular , ApoptosisRESUMEN
STATEMENT OF PROBLEM: Information on the fabrication of metal by selective laser melting (SLM) systems positioned at different angles is sparse. PURPOSE: The purpose of this in vitro study was to evaluate the extent of marginal and internal gaps in metal copings fabricated at different angles by using an SLM fabrication system. MATERIAL AND METHODS: A master metal model was produced and replicated (N=10) with silicone impressions and dental stone. Standard tessellation language (STL) files of the 10 coping designs were then obtained by using a model scanner and a 3D design software program on a scannable working die. Co-Cr alloy metal copings were fabricated by the SLM fabrication system at 45, 90, and 180 degrees. The marginal and internal gaps were measured by the silicone replica technique. The measured data were analyzed by using the nonparametric Kruskal-Wallis H test (α=.05). RESULTS: The specimens fabricated at 180 degrees showed the best fit in terms of the marginal gap, while the worst fit was observed in the specimens fabricated at 90 degrees. Statistically significant differences were seen among the marginal gaps produced in the 3 groups (P<.001). In terms of internal fit, the axial wall gap showed the best fit, and the occlusal gap the worst. The best fit overall was 66 µm at the axial wall of the 180-degree group, and the worst in the 90-degree group, at 663 µm. Statistically significant differences were observed between the chamfers, axial walls, and the occlusal gaps of the 3 groups (P<.001). CONCLUSIONS: Restorations fabricated by using an SLM system at 180 degrees were clinically acceptable. However, more research is required to investigate the performance of metal copings produced at 45 and 90 degrees to evaluate their clinical acceptability.
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Coronas , Adaptación Marginal Dental , Adaptación Psicológica , Aleaciones de Cromo , Diseño Asistido por Computadora , Diseño de Prótesis Dental/métodos , Rayos Láser , SiliconasRESUMEN
STATEMENT OF PROBLEM: A staircase effect is noted in the fabrication of metal frameworks for removable partial dentures (RPDs) when using stereolithography apparatus (SLA). It affects the adaptation of the definitive metal framework depending on the layer thickness setting. However, studies on the effect of the layer thickness setting on the adaptation of metal frameworks are lacking. PURPOSE: The purpose of this in vitro study was to determine the optimal layer thickness through comparative analysis of the adaptation of SLA-fabricated metal frameworks with different layer thickness settings. MATERIAL AND METHODS: A total of 15 metal RPD frameworks were SLA-fabricated by using 3 different layer thickness settings (16 µm, 50 µm, and 100 µm). The adaptation of the frameworks was measured by using the silicone replica technique, sectioned at the canine, first molar, and second molar regions by using a guide. The thickness of the light-body silicone was measured with a digital microscope at 3 points in each of the 3 areas. The measurements of the adaptation were statistically analyzed using the nonparametric Kruskal-Wallis test and post hoc Mann-Whitney U test with Bonferroni correction. RESULTS: The gaps measured in each area showed statistically significant differences in all 3 groups (P<.05). In the anterior, middle, and posterior areas, the 16-µm metal framework group showed the narrowest gaps (207 ±46 µm, 195 ±49 µm, and 188 ±40 µm, respectively). The 3 groups showed statistically significant differences in total gaps in the RPD frameworks relative to the layer thickness settings (P<.05); the total gap was lowest (197 ±42 µm) for the 16-µm group. CONCLUSIONS: For SLA, 50 µm is the recommended layer thickness considering the effect of layer thickness settings on the adaptation of the RPD framework and the fabrication time.
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Dentadura Parcial Removible , Estereolitografía , Diseño Asistido por ComputadoraRESUMEN
The selectivity of a drug toward various isoforms of the target protein family is important in terms of toxicology. Typically, drug or candidate selectivity is assessed by in vitro assays, but in vivo investigations are currently lacking. Positron emission tomography (PET) allows the non-invasive determination of the in vivo distribution of a radiolabeled drug, which can provide in vivo data regarding drug selectivity. Since the discovery of propranolol, a non-selective ß-blocker inhibiting both ß1- and ß2-adrenoreceptors (ß-ARs), various selective ß1-blockers, including bisoprolol, have been developed to overcome disadvantages associated with ß2-AR inhibition. As a proof of concept, we performed an in vivo PET study to understand the selectivity and efficacy of bisoprolol as a selective ß-blocker toward ß1-AR, as the heart and peripheral smooth muscles demonstrate distinct populations of ß1- and ß2-ARs. Biodistribution of 18F-labeled bisoprolol (1, [18F]bisoprolol) showed the retention of its uptake in the heart compared with other ß-AR-rich organs at late time points post-injection. The competitive blocking assay using unlabeled bisoprolol exhibited no inhibition of [18F]bisoprolol uptake in any organ but exhibited significantly rapid loss of radioactivity between two different time points in ß1-AR-rich organs such as the heart and brain. Furthermore, the organ-to-blood ratio revealed the slow excretion and better accumulation of [18F]bisoprolol inside the heart. Collectively, the ex vivo biodistribution and blocking study presented insightful evidence to better comprehend the in vivo distribution pattern of bisoprolol as a selective inhibitor targeting ß1-ARs in the heart and provided the possibility of PET as an in vivo technique for evaluating drug selectivity.
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Antagonistas Adrenérgicos beta/farmacología , Bisoprolol/farmacología , Corazón/efectos de los fármacos , Tomografía de Emisión de Positrones , Receptores Adrenérgicos beta 1/metabolismo , Antagonistas Adrenérgicos beta/síntesis química , Antagonistas Adrenérgicos beta/química , Animales , Bisoprolol/síntesis química , Bisoprolol/química , Relación Dosis-Respuesta a Droga , Radioisótopos de Flúor , Ratones , Ratones Endogámicos BALB C , Estructura Molecular , Relación Estructura-Actividad , Distribución TisularRESUMEN
BACKGROUND: During robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position, aeration loss leads to perioperative atelectasis. Recently developed ventilator mode pressure-controlled ventilation volume-guaranteed (PCV-VG) mode could provide adequate ventilation with lower inspiratory pressure compared to volume-controlled ventilation (VCV); we hypothesized that PCV-VG mode may be beneficial in reducing perioperative atelectasis via low tidal volume (VT) of 6 mL/kg ventilation during robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position. We applied lung ultrasound score (LUS) for detecting perioperative atelectasis. We aimed to compare perioperative atelectasis between VCV and PCV-VG with a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position using LUS. METHODS: Patients scheduled for robotic gynecologic surgery were randomly allocated to the VCV (n = 41) or PCV-VG group (n = 41). LUS, ventilatory, and hemodynamic parameters were evaluated at T1 (before induction), T2 (10 minutes after induction in the supine position), T3 (10 minutes after desufflation of CO2 in the supine position), and T4 (30 minutes after emergence from anesthesia in the recovery room). RESULTS: Eighty patients (40 with PCV-VG and 40 with VCV) were included. Demographic data showed no significant differences between the groups. The total LUS has changed from baseline to T4, 0.63 (95% confidence interval [CI], 0.32, 0.94) to 1.77 (95% CI, 1.42, 2.21) in the VCV group and 0.86 (95% CI, 0.56, 1.16) to 1.43 (95% CI, 1.08, 1.78) in the PCV-VG group (P = 0.170). In both groups, total LUS increased significantly compared to the baseline values. CONCLUSION: Using a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position, our study showed no evidence that PCV-VG ventilation was superior to VCV in terms of perioperative atelectasis. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0006404.
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Laparoscopía , Neumoperitoneo , Atelectasia Pulmonar , Femenino , Inclinación de Cabeza , Humanos , Laparoscopía/efectos adversos , Pulmón , Neumoperitoneo/diagnóstico por imagen , Atelectasia Pulmonar/diagnóstico por imagen , Atelectasia Pulmonar/etiología , Atelectasia Pulmonar/prevención & control , Respiración Artificial , UltrasonografíaRESUMEN
BACKGROUND: There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI). METHODS: Of 2,082 consecutive patients undergoing PCI using second-generation drug-eluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI. RESULTS: In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54-2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group. CONCLUSION: Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.
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Clopidogrel/efectos adversos , Enfermedad de la Arteria Coronaria/complicaciones , Intervención Coronaria Percutánea/efectos adversos , Inhibidores de Agregación Plaquetaria/efectos adversos , Anciano , Clopidogrel/uso terapéutico , Enfermedad de la Arteria Coronaria/epidemiología , Quimioterapia Combinada , Stents Liberadores de Fármacos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Infarto del Miocardio/etiología , Inhibidores de Agregación Plaquetaria/uso terapéutico , República de Corea/epidemiología , Accidente Cerebrovascular/etiología , Trombosis/etiología , Resultado del TratamientoRESUMEN
BACKGROUND: With severe vascular calcifications, vascular clamp application and utilizing the vessel for free flap recipient vessel becomes impossible. These obstacles can be overcome with the Fogarty catheter and vein graft. PATIENTS AND METHODS: When unclampable artery was encountered intraoperatively, a vein graft was used to make a clampable recipient site for six diabetic foot patients (ages from 42 to 80). The end of the Fogarty catheter was inserted into the proximal end of the vein graft and the transected calcified vessel in sequence, and the balloon of the catheter was used as an intraluminal tourniquet. The remaining end of the vein graft was connected to the distal vessel with a vascular clamp. RESULTS: Five short vein graft revascularization for segmental arterial occlusion, one long vein graft for recipient artery elongation was done (lengths from 2 to 13.8 cm). Three delayed, and two immediate anterolateral thigh flaps (sizes from 15 to 150 cm2 ) were performed, and one patient received vein graft revascularization surgery only. Postoperative vascular sonography of all six patients showed well-maintained patency. Minor flap marginal disruption occurred at two patients but healed with conservative care. Postoperative follow-up was done for 1-18 months (average 7.17). Limb salvage was achieved for five patients and all five free flaps survived. However, for one patient, arterial restenosis at popliteal artery a month later lead to major amputation. CONCLUSION: Using a Fogarty catheter and a vein graft may obtain perfect hemostasis during micro-anastomosis and achieve successful microvascular reconstruction in patients with severely calcified vessels.
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Colgajos Tisulares Libres , Recuperación del Miembro , Catéteres , Humanos , Extremidad Inferior/cirugía , Arteria Poplítea/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Grado de Desobstrucción VascularRESUMEN
Epidemiological evidence shows that smoking causes a thrombophilic milieu that may play a role in the pathophysiology of chronic obstructive pulmonary disease (COPD) as well as pulmonary thromboembolism. The increased nicotine level induces a prothrombotic status and abnormal blood coagulation in smokers. Since several anticoagulants increase bleeding risk, alternative therapies need to be identified to protect against thrombosis without affecting hemostasis. Astragalin is a flavonoid present in persimmon leaves and green tea seeds and exhibits diverse activities of antioxidant and anti-inflammation. The current study investigated that astragalin attenuated smoking-induced pulmonary thrombosis and alveolar inflammation. In addition, it was explored that molecular links between thrombosis and inflammation entailed protease-activated receptor (PAR) activation and oxidative stress-responsive mitogen-activated protein kinase (MAPK)-signaling. BALB/c mice were orally administrated with 10-20 mg/kg astragalin and exposed to cigarette smoke for 8 weeks. For the in vitro study, 10 U/mL thrombin was added to alveolar epithelial A549 cells in the presence of 1-20 µM astragalin. The cigarette smoking-induced the expression of PAR-1 and PAR-2 in lung tissues, which was attenuated by the administration of ≥10 mg/kg astragalin. The oral supplementation of ≥10 mg/kg astragalin to cigarette smoke-challenged mice attenuated the protein induction of urokinase plasminogen activator, plasminogen activator inhibitor-1and tissue factor, and instead enhanced the induction of tissue plasminogen activator in lung tissues. The astragalin treatment alleviated cigarette smoke-induced lung emphysema and pulmonary thrombosis. Astragalin caused lymphocytosis and neutrophilia in bronchoalveolar lavage fluid due to cigarette smoke but curtailed infiltration of neutrophils and macrophages in airways. Furthermore, this compound retarded thrombin-induced activation of PAR proteins and expression of inflammatory mediators in alveolar cells. Treating astragalin interrupted PAR proteins-activated reactive oxygen species production and MAPK signaling leading to alveolar inflammation. Accordingly, astragalin may interrupt the smoking-induced oxidative stress-MAPK signaling-inflammation axis via disconnection between alveolar PAR activation and pulmonary thromboembolism.
Asunto(s)
Quempferoles/uso terapéutico , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Embolia Pulmonar/prevención & control , Enfisema Pulmonar/prevención & control , Receptores Proteinasa-Activados/antagonistas & inhibidores , Animales , Fumar Cigarrillos/efectos adversos , Evaluación Preclínica de Medicamentos , Quempferoles/farmacología , Masculino , Ratones Endogámicos BALB C , Estrés Oxidativo , Embolia Pulmonar/etiologíaRESUMEN
Collagen hydrolysates have been suggested as a favorable antiaging modality in skin photoaged by persistent exposure to ultraviolet radiation (UV). The current study evaluated the beneficial effect of collagen hydrolysates (fsCH) extracted from Pangasius hypophthalmus fish skin on wrinkle formation and moisture preservation in dorsal skin of hairless mice challenged with UV-B. Inter-comparative experiments were conducted for anti-photoaging among fsCH, retinoic acid (RA), N-acetyl-D-glucosamine (NAG), and glycine-proline-hydroxyproline (GPH). Treating human HaCaT keratinocytes with 100-200 µg/mL fsCH reciprocally ameliorated the expression of aquaporin 3 (AQP3) and CD44 deranged by UV-B. The UV-B-induced deep furrows and skin thickening were improved in parched dorsal skin of mice supplemented with 206-412 mg/kg fsCH as well as RA and GPH. The UV-B irradiation enhanced collagen fiber loss in the dorsal dermis, which was attenuated by fsCH through enhancing procollagen conversion to collagen. The matrix metalloproteinase expression by UV-B in dorsal skin was diminished by fsCH, similar to RA and GPH, via blockade of collagen degradation. Supplementing fsCH to UV-B-irradiated mice decreased transepidermal water loss in dorsal skin with reduced AQP3 level and restored keratinocyte expression of filaggrin. The expression of hyaluronic acid synthase 2 and hyaluronidase 1 by UV-B was remarkably ameliorated with increased production of hyaluronic acid by treating fsCH to photoaged mice. Taken together, fsCH attenuated photoaging typical of deep wrinkles, epidermal thickening, and skin water loss, like NAG, RA, or GPH, through inhibiting collagen destruction and epidermal barrier impairment.
Asunto(s)
Colágeno/farmacología , Proteínas en la Dieta/farmacología , Envejecimiento de la Piel/efectos de los fármacos , Enfermedades de la Piel/tratamiento farmacológico , Piel/efectos de los fármacos , Rayos Ultravioleta/efectos adversos , Animales , Proteínas Filagrina , Masculino , Ratones , Ratones Pelados , Piel/patología , Piel/efectos de la radiación , Envejecimiento de la Piel/patología , Envejecimiento de la Piel/efectos de la radiación , Enfermedades de la Piel/etiología , Enfermedades de la Piel/patologíaRESUMEN
The imbalance between bone resorption and bone formation in favor of resorption results in bone loss and deterioration of bone architecture. Osteoblast differentiation is a sequential event accompanying biogenesis of matrix vesicles and mineralization of collagen matrix with hydroxyapatite crystals. Considerable efforts have been made in developing naturally-occurring plant compounds, preventing bone pathologies, or enhancing bone regeneration. Coumarin aesculetin inhibits osteoporosis through hampering the ruffled border formation of mature osteoclasts. However, little is known regarding the effects of aesculetin on the impairment of matrix vesicle biogenesis. MC3T3-E1 cells were cultured in differentiation media with 1-10 µM aesculetin for up to 21 days. Aesculetin boosted the bone morphogenetic protein-2 expression, and alkaline phosphatase activation of differentiating MC3T3-E1 cells. The presence of aesculetin strengthened the expression of collagen type 1 and osteoprotegerin and transcription of Runt-related transcription factor 2 in differentiating osteoblasts for 9 days. When ≥1-5 µM aesculetin was added to differentiating cells for 15-18 days, the induction of non-collagenous proteins of bone sialoprotein II, osteopontin, osteocalcin, and osteonectin was markedly enhanced, facilitating the formation of hydroxyapatite crystals and mineralized collagen matrix. The induction of annexin V and PHOSPHO 1 was further augmented in ≥5 µM aesculetin-treated differentiating osteoblasts for 21 days. In addition, the levels of tissue-nonspecific alkaline phosphatase and collagen type 1 were further enhanced within the extracellular space and on matrix vesicles of mature osteoblasts treated with aesculetin, indicating matrix vesicle-mediated bone mineralization. Finally, aesculetin markedly accelerated the production of thrombospondin-1 and tenascin C in mature osteoblasts, leading to their adhesion to preformed collagen matrix. Therefore, aesculetin enhanced osteoblast differentiation, and matrix vesicle biogenesis and mineralization. These findings suggest that aesculetin may be a potential osteo-inductive agent preventing bone pathologies or enhancing bone regeneration.
Asunto(s)
Matriz Ósea/metabolismo , Calcificación Fisiológica/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Vesículas Extracelulares/metabolismo , Osteoblastos/citología , Umbeliferonas/farmacología , Animales , Matriz Ósea/efectos de los fármacos , Línea Celular , Colágeno Tipo I/metabolismo , Subunidad alfa 1 del Factor de Unión al Sitio Principal/metabolismo , Vesículas Extracelulares/efectos de los fármacos , Sialoproteína de Unión a Integrina/metabolismo , Ratones , Osteoblastos/efectos de los fármacos , Osteocalcina/metabolismo , Osteogénesis/efectos de los fármacos , Osteonectina/metabolismo , Osteopontina/metabolismo , Osteoprotegerina/metabolismo , Transducción de Señal/efectos de los fármacosRESUMEN
The objective of this study was to estimate the peripherally inserted central catheter (PICC) insertion depth in newborns. We retrospectively reviewed the records of 790 neonates who underwent PICC insertion for intravenous injections administered for 6 days or more following neonatal intensive care unit admission at our institution between January 2011 and October 2015. We analyzed patients' electronic medical records and chest standard radiographs. PICC insertion depths were calculated using the following equation: Insertion depth = Section + (ß1 × Body weight). The predicted equation was checked for accuracy using Bland-Altman plots. Of 835 included neonates, 790 (94.6%) had properly positioned PICCs. Forty-three of 45 unsuitable patients (5.4%) had catheters inserted into the cephalic veins. Of the 790 patients with correctly inserted catheter tips, regression equations and standard errors were calculated for the average insertion depth and timing of PICC insertion. The catheter depth increased with every 100 g of weight gain and week of gestational age. More than 90% of the 4 vessels incorporating PICCs were included within the standard deviation of ±2.0, indicating high predictive validity. This study established a standard for accurately measuring PICC insertion depths.