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OBJECTIVE: Liver transient elastography (TE) using FibroScan® has gained popularity as a non-invasive technique to assess hepatic fibrosis by measuring liver stiffness. This study focused on biliary atresia patients post Kasai operation for more than 10 years to prospectively correlate the hepatic fibrosis score to the biochemical changes of liver fibrosis and clinical development of portal hypertensive complications. METHODS: TE was performed in 37 patients who had biliary atresia post Kasai operation done at median age of 60 days. Biochemical indices of liver fibrosis including aspartate aminotransferase/platelet ratio index (APRI) and Fibrosis-4 (FIB-4) score based on age, platelet count, alanine aminotransferase and aspartate aminotransferase level were calculated at the time of TE. Platelet count, spleen size, varices, ascites and hepatic encephalopathy were evaluated as clinical markers of portal hypertension. RESULTS: There were 22 female and 15 male with TE done at median age of 17.0 years. Median FibroScan® fibrosis score was 11.4. Fibrosis score of 6.8 kilopascal (kPa) was taken as the upper reference limit of normal. Nine patients (24%) had normal fibrosis score. Score above or equal to 6.8 kPa was significantly associated with lower platelet level (p = 0.001), higher INR (p = 0.043), higher APRI (p = 0.021), higher FIB-4 score (p = 0.013), and larger splenic diameter (p = 0.004). Higher FibroScan® fibrosis score was also significantly associated with portal hypertensive complications (p = 0.001). CONCLUSIONS: The FibroScan® fibrosis score correlated well with the biochemical changes of liver fibrosis and development of portal hypertensive complications clinically. Screening of portal hypertensive complications such as varices is recommended for patients with raised fibrosis score upon long-term follow-up. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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Atresia Biliar , Técnicas de Imagem por Elasticidade , Fígado , Varizes , Adolescente , Aspartato Aminotransferases/metabolismo , Atresia Biliar/complicações , Atresia Biliar/diagnóstico por imagem , Atresia Biliar/cirurgia , Biomarcadores/análise , Feminino , Seguimentos , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico por imagem , Masculino , Estudos Retrospectivos , Varizes/etiologia , Varizes/patologiaRESUMO
We report on the development of a high-resolution and highly efficient beamline for soft X-ray resonant inelastic X-ray scattering (RIXS) located at the Taiwan Photon Source. This beamline adopts an optical design that uses an active grating monochromator (AGM) and an active grating spectrometer (AGS) to implement the energy compensation principle of grating dispersion. Active gratings are utilized to diminish defocus, coma and higher-order aberrations, as well as to decrease the slope errors caused by thermal deformation and optical polishing. The AGS is mounted on a rotatable granite platform to enable momentum-resolved RIXS measurements with scattering angles over a wide range. Several high-precision instruments developed in-house for this beamline are described briefly. The best energy resolution obtained from this AGM-AGS beamline was 12.4â meV at 530â eV, achieving a resolving power of 4.2 × 104, while the bandwidth of the incident soft X-rays was kept at 0.5â eV. To demonstrate the scientific impact of high-resolution RIXS, we present an example of momentum-resolved RIXS measurements on a high-temperature superconducting cuprate, i.e. La2-xSrxCuO4. The measurements reveal the A1g buckling phonons in superconducting cuprates, opening a new opportunity to investigate the coupling between these phonons and charge-density waves.
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We carried out temperature-dependent (20-550 K) measurements of resonant inelastic x-ray scattering on LaCoO_{3} to investigate the evolution of its electronic structure across the spin-state crossover. In combination with charge-transfer multiplet calculations, we accurately quantified the renomalized crystal-field excitation energies and spin-state populations. We show that the screening of the effective on-site Coulomb interaction of 3d electrons is orbital selective and coupled to the spin-state crossover in LaCoO_{3}. The results establish that the gradual spin-state crossover is associated with a relative change of Coulomb energy versus bandwidth, leading to a Mott-type insulator-to-metal transition.
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Objective: To evaluate the effect of hydrogen-rich saline (HRS) on dry eye rats induced by subcutaneous injection of scopolamine hydrobromide. Methods: Experiment research. Thirty female Wistar rats at about six weeks old were randomly divided into the normal group, dry eye group, HRS eyedrops group, normal saline eyedrops group (NS), HRS intraperitoneal injection group and NS intraperitoneal injection group, with 5 rats in each group. The dry eye was induced by subcutaneous injection of scopolamine hydrobromide in the latter five groups. The clinical signs of dry eye such as tear volume (Sâ t), tear break-up time (BUT) and corneal epithelial fluorescein staining scores were evaluated on day 7, 14, 21 and 28. On the 28th day, ten eyes in each group were enucleated and processed for paraffin sections for HE, PAS and immunohistochemistry stainings. Analysis of variance was used to test the data, and independent samples t-test was used for comparison between the two groups. Two-way repeated measure ANOVA was used to compare the difference among groups at different time points, one-way ANOVA was used to test the comparisons of the clinical signs at one time, and LSD was used to for comparison between two groups. Results: Before and after the experiment of the day 7, 14, 21, 28, the values of SIt in HRS eyedrops group and HRS intraperitoneal injection group were respectively:(3.625±1.157),(3.313±0.704),(3.250±0.535),(3.313±0.372), (3.375±0.582)mm and (3.500±1.019), (2.893±0.656), (3.321±0.668), (3.179±0.575), (3.214±0.871)mm. The values of BUT were respectively: (2.750±0.707), (2.688±0.594), (2.813±0.753), (3.000±0.756), (2.750±0.707)s and (3.000±0.679), (2.321±0.464), (2.750±0.753), (3.214±0.699), (2.679±0.608)s. The values of fluorescein staining score were respectively: (6.250±0.707), (8.875±0.641), (8.750±0.707), (9.250±0.463), (8.250±1.282) and (6.000±0.679), (9.143±1.027), (8.857±0.770), (9.143±0.949), (8.500±0.760). The difference of SIt, BUT and fluorescein staining score between the groups was statistically significant on the 14th day(F=5.194, 3.894, 16.487, P<0.05), the values of Sâ t, BUT and fluorescein staining score of HRS eyedrops group showed significantly better than NS eyedrops group(P<0.05), HRS intraperitoneal injection group showed significantly better than NS intraperitoneal injection group(P<0.05), and there was no significant difference between HRS eyedrops group and HRS intraperitoneal injection group(P>0.05), which remained stable until the day 28. On the 28(th) day, HE, PAS and immunohistochemistry stainings showed the corneal and conjunctival epithelia became smooth and regular, the cell layer number decreased, the tissue hyperplasia and edema were lightened, and the size of goblet cells tended to be normal, and the squamous metaplasia and inflammation were relieved. In HRS eyedrops group and HRS intraperitoneal injection group. Conclusions: HRS eyedrops group and HRS intraperitoneal injection group can relieve the signs of dry eye, improve the pathological damage of cornea and conjunctiva, and protect the ocular surface of a rat dry eye model, which is better than NS groups from the 14(th) day. (Chin J Ophthalmol, 2017, 53: 363-372).
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Síndromes do Olho Seco/tratamento farmacológico , Hidrogênio/administração & dosagem , Soluções Oftálmicas/administração & dosagem , Cloreto de Sódio/administração & dosagem , Animais , Túnica Conjuntiva/efeitos dos fármacos , Córnea/efeitos dos fármacos , Modelos Animais de Doenças , Síndromes do Olho Seco/induzido quimicamente , Epitélio/efeitos dos fármacos , Feminino , Midriáticos , Distribuição Aleatória , Ratos , Ratos Wistar , Escopolamina , LágrimasRESUMO
Foreign bodies should not be allowed to remain in the esophagus beyond 24 hours after presentation. However, some patients with esophageal foreign body ingestion do not come to the hospital immediately and may delay medical intervention from the time of ingestion. The aim of this study was to investigate the outcomes of adults with suspected esophageal foreign body ingestion according to the time of ingestion and types of foreign bodies. A total of 326 adult patients (151 men and 175 women) were analyzed, and divided into two groups according to the time period: within or beyond 24 hours from ingestion to endoscopic intervention. A total of 172 patients (52.7%) were found to have ingested foreign bodies; 73.5% were removed smoothly, 10.3% were treated by push technique and 16.0% with failed retrieval received alternative treatments. A higher proportion of patients in the beyond-24 hours group suffered from odynophagia (25.9 vs. 12.9%, P < 0.05). Negative identification of esophageal foreign bodies was more frequent in the beyond-24 hours group (67 vs. 40.2%, P < 0.05), but these patients showed higher proportions of esophageal ulcers (21.1 vs. 7.2%, P < 0.05). The beyond-24 hours group also showed a significantly higher rate of foreign bodies in the lower esophagus (40.0 vs. 15.3%, P < 0.05). Patients with esophageal food bolus impaction had significant delayed endoscopic intervention, longer therapeutic endoscopic time, higher proportions of esophageal cancer, stricture and fewer complications. Endoscopic intervention within 24 hours from the time of ingestion should be considered early in adults, because delaying intervention may produce more symptomatic esophageal ulcerations with odynophagia.
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Esôfago , Corpos Estranhos/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Esofagoscopia , Feminino , Alimentos , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Carcinosarcoma of the esophagus is a rare neoplasm with both carcinomatous and sarcomatous components. This study aimed to investigate its clinicopathologic features and endoscopic characteristics. The data of patients diagnosed to have esophageal carcinosarcoma pathologically in the past 30 years (January 1976-December 2007) were reviewed. Of 3318 cases of esophageal malignancy, 12 were diagnosed as esophageal carcinosarcoma, with an incidence of 0.36%. All of the cases were male with a mean age of 62.3 years. Of the 12 tumors, 8 were polypoid type, and 4 were ulcerative type. In the endoscopic ultrasonography examination, the tumors show heterogeneous hypoechoic lesions with irregular outer margins and internal multicystic components. Four patients (33.3%) had previous head and neck squamous cell carcinoma that occurred metachronously. This is the first report about the characteristics of esophageal carcinosarcoma under endoscopic ultrasonography examination. The relationship between esophageal carcinosarcomas and head and neck cancer needs further investigation.
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Carcinossarcoma/epidemiologia , Neoplasias Esofágicas/epidemiologia , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Areca , Carcinoma de Células Escamosas/epidemiologia , Carcinossarcoma/secundário , Endoscopia do Sistema Digestório , Endossonografia , Seguimentos , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Incidência , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Segunda Neoplasia Primária/epidemiologia , Pólipos/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia , Taxa de Sobrevida , Taiwan/epidemiologia , Úlcera/epidemiologiaRESUMO
Objective:To investigate the overweight and obesity effects on pulmonary function in OSA patients.Method:Randomly selected 90 cases OSA patients who were treated January 2017 to December 2017. On the basis of BMI were divided into three groups, the normal OSA group(A,30 cases), overweight OSA group(B,30 cases) and obesity OSA group(C,30 cases). Comparative analysis between groups of age, AHI, lowest arterial saturation oxygen(LSaO2), the longest apnea time(LAD) and pulmonary function indicators include: a second volume(FEV1),forced vital capacity(FVC), FEV1/FVC,the chase volume(MVV), per minute resting ventilation(MV), peak expiratory flow velocity(PEF),tidal volume(VT), the residual gas volume(RV), functional residual capacity(FRC) and expiratory reserve volume volume(ERV), total lung volume(TLC) vital capacity(VC), deep inspiratory capacity(IC), RV/TLC. Result:Compared group C with B and A, B and A, AHI increased significantly(P<0.01); compared group C with B and A, LSaO2 significantly reduced(P<0.01); compared group C with A, LAD is prolonged(P<0.05).Compared group C with A, MVV, MV, TLC and IC increased significantly(P<0.05), FRC, ERV significantly reduced(P<0.05); compared C with B, MVV, MV and TLC increased significantly(P<0.05). Compared group B with A,MVV,MV,MEF75,ERV and IC increased significantly(P<0.05); AHI and VT,RV,TLC and FRC has significant positive correlation(P<0.05), and VT, MVV and FEV1/FVC has significant negative correlation(P<0.05);LAD with BMI,VC,FVC,FEV1,MEF50,PEF and MVV is a significant positive correlation(P<0.05).FEV1/FVC, IC is the independence of overweight and obesity OSA severe impact factor. Conclusion:With the increasing of BMI, not only increase the severity of OSA, and further damage to the pulmonary function; the OSA severity of overweight and obesity are closely associated with multiple pulmonary function index; FEV1% FVC, IC for overweight and obesity independent factor influencing the severity of OSA. Pulmonary function can be used as overweight and obesity auxiliary to assess the severity of OSA patients.
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Pulmão/fisiopatologia , Obesidade/complicações , Sobrepeso/complicações , Apneia Obstrutiva do Sono/fisiopatologia , Estudos de Casos e Controles , Humanos , Testes de Função Respiratória , Apneia Obstrutiva do Sono/complicações , Capacidade VitalRESUMO
We have used laser Doppler imaging to monitor the microcirculation of replanted digits during the post-operative period in 103 patients who underwent either replantation after traumatic amputation or toe-to-finger reconstruction. The blood flow (perfusion unit) in each revascularized digit was compared with that of an unaffected digit. The perfusion index was defined as the perfusion value of a revascularized digit divided by the perfusion value of the neighbouring normal digit. The ideal threshold value of the perfusion index (0.397) was calculated by determining the receiver operating characteristic curve with optimal sensitivity and specificity. The corresponding Youden's index was 0.828. We believe that by establishing a threshold, that laser Doppler imaging should provide a reliable and objective assessment for the development of perfusion compromise in revascularized digits. LEVEL OF EVIDENCE: III.
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Amputação Traumática/diagnóstico por imagem , Traumatismos dos Dedos/diagnóstico por imagem , Fluxometria por Laser-Doppler , Microcirculação/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Reimplante , Adolescente , Adulto , Amputação Traumática/fisiopatologia , Amputação Traumática/cirurgia , Traumatismos dos Dedos/fisiopatologia , Traumatismos dos Dedos/cirurgia , Humanos , Masculino , Microcirurgia , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Procedimentos Cirúrgicos Vasculares , Adulto JovemRESUMO
OBJECTIVE: Myocardial apoptosis is an important pathologic basis of ischemia-reperfusion injury (I/R). Transforming growth factor ß1 (TGFß1) participates in the regulation of oxidative damage and apoptosis. TGFß1 is upregulated in the repair process of I/R injury. It is speculated that TGFß1 over-expression is involved in the endogenous protective mechanism of I/R injury. This study explores the significance of TGFß1 in myocardial cell apoptosis after I/R. MATERIALS AND METHODS: Rat myocardial I/R injury model was established. Left ventricular ejection fraction (LVEF) and Left ventricular fractional shortening (LVFS) were detected by ultrasonic cardiogram. TGFß1 expression in the myocardium was tested. H9C2 cells were cultured under ischemic hypoxic condition for 6 h, and then were treated by reoxygenation for 6 h to simulate I/R model. H9C2 cells were divided into three groups, including I/R+pIRES2-Blank, I/R+pIRES2 TGFß1, and I/R+pIRES2-TGFß1+LY364947. TGFß1 mRNA and protein levels were evaluated. Cell apoptosis and reactive oxygen species (ROS) were determined by flow cytometry. RESULTS: LVEF and LVFS significantly decreased in I/R group compared with Sham group. TGFß1 mRNA and protein expressions in myocardium from I/R group up-regulated than the control. I/R treatment markedly elevated TGFß1 mRNA and protein levels, increased ROS content, and enhanced cell apoptosis in H9C2 cells. Over-expression of TGFß1 significantly weakened ROS production and apoptosis in H9C2 cells after I/R. TGFß receptor inhibitor LY364947 restrained ROS production and apoptosis attenuation in H9C2 cells treated by TGFß. CONCLUSIONS: TGFß1 alleviates myocardial cell apoptosis after I/R. Blocking TGFß1 attenuates the protective effect of TGFß1 on I/R injury.
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Apoptose/efeitos dos fármacos , Traumatismo por Reperfusão Miocárdica , Fator de Crescimento Transformador beta1/metabolismo , Animais , Miocárdio/metabolismo , Ratos , Espécies Reativas de Oxigênio/metabolismoRESUMO
To understand the molecular basis for the regulation of rat A2a adenosine receptor (A2a-R) expression, we have characterized the rat A2a-R gene and defined its promoter regions. Through a combination of restriction mapping and sequence analysis, we have demonstrated that the rat A2a-R gene is composed of two exons interrupted by a 7.2-kb intron. Primer extension and RNase protection on RNA isolated from PC12 cells suggested that the A2a-R gene encoded two clusters of alternative transcripts. The most upstream transcription start site was designated as +1. The sequence of the proximal 1.5 kb of 5'-flanking region demonstrated no potential TATA box, CCAAT box, or initiator element in the appropriate location. Varying lengths of 5'-flanking regions were inserted into a transient expression vector (pGL2-basic), which contained bacterial luciferase as the reporter gene, to determine its promoter region(s) in PC12 cells, CHOP cells, and C6 cells. Consistent with two clusters of transcription start sites, two independent functional promoter regions (designated P1, -67/-1; and P2, +272/+304) for the rat A2a-R gene were identified. Although both promoters are in use in PC12 cells, only P2 is active in CHOP cells, indicating possible cell line-specific usage of these two promoters.
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Regiões Promotoras Genéticas , Ratos/genética , Receptores Purinérgicos P1/biossíntese , Receptores Purinérgicos P1/genética , Processamento Alternativo , Animais , Sequência de Bases , Linhagem Celular , Primers do DNA , Cães , Regulação da Expressão Gênica , Humanos , Íntrons , Luciferases/biossíntese , Dados de Sequência Molecular , Células PC12 , Proteínas Recombinantes/biossíntese , Sequências Reguladoras de Ácido Nucleico , Homologia de Sequência do Ácido Nucleico , Transcrição Gênica , TransfecçãoRESUMO
Thin film metallic glasses (TFMGs) are demonstrated to exhibit excellent surface flatness, high corrosion resistance and satisfactory hydrophobic properties. Moreover, the antimicrobial and biocompatibility abilities of TFMGs are examined and the results are compared with the behavior of pure Ag and 316L stainless steel. Three TFMGs, Al48Ag37Ti15, Zr54Ti35Si11, and Zr59Ti22Ag19, are prepared by sputtering to assess the antimicrobial performance against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa, which are the most common nosocomial infection pathogens. Experimental results show that the antimicrobial effect of the Al- or Ag-containing AlAgTi and ZrTiAg TFMGs is similar to that of the pure Ag coating. The ZrTiSi TFMG with no Ag or Al shows poor antimicrobial capability. The physical properties of highly smooth surface and hydrophobic nature alone are not sufficient to result in promising antimicrobial ability. The chemical metal ion release still plays a major role, which should be born in mind in designing biomedical devices.
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Anti-Infecciosos/farmacologia , Vidro/química , Metais/farmacologia , Animais , Materiais Revestidos Biocompatíveis/farmacologia , Contagem de Colônia Microbiana , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Camundongos , Testes de Sensibilidade Microbiana , Microscopia de Força Atômica , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/crescimento & desenvolvimento , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento , Difração de Raios XRESUMO
The degradation of 4-nitrophenol was investigated using a novel electrochemical oxidation system, in which the anodic oxidation at Ti/SnO(2)-Sb(2)O(5)-IrO(2) electrode and the electro-Fenton oxidation with two cathodes were involved. In this system, gas diffusion electrode (GDE) was used to generate H(2)O(2) by O(2) reduction and graphite electrode was employed for the reduction of Fe(3+) regenerating Fe(2+). When the potential values of GDE and graphite cathode were controlled at -0.80 and -0.10 V/SCE respectively, the optimum Fe(2+) concentration for 4-nitrophenol degradation was about 0.10mM, much lower than the concentration of 0.25 mM obtained in the single-cathode system. Due to the combination of electro-Fenton oxidation and anodic oxidation, an effective degradation and a high mineralization current efficiency (MCE) were achieved. After 600 min treatment, 74.5% of the original TOC was removed by the dual-cathode oxidation system. Moreover, it was confirmed that 57.0% of the original nitrogen could be removed in gaseous form from the simulated wastewater. These results indicate that this electrochemical oxidation process might provide an alternative for the degradation of organic pollutants.
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Eletroquímica/métodos , Eletrodos , Peróxido de Hidrogênio/química , Ferro/química , Nitrofenóis/química , OxirreduçãoRESUMO
Id protein family consists of four members namely Id-1 to Id-4. Different from other basic helix-loop-helix transcription factors, they lack the DNA binding domain. Id proteins have been shown to be dysregulated in many different cancer types and their prognostic value has also been demonstrated. Recently, Id-1 has been shown to be upregulated in oesophageal squamous cell carcinoma (ESCC). However, the prognostic implications of Id proteins in ESCC have not been reported. We examined the expression of the Id proteins in ESCC cell lines and clinical ESCC specimens and found that Id protein expressions were dysregulated in both the ESCC cell lines and specimens. By correlating the expression levels of Id proteins and the clinicopathological data of our patient cohort, we found that M1 stage tumours had significantly higher nuclear Id-1 expression (P=0.012) while high nuclear Id-1 expression could predict development of distant metastasis within 1 year of oesophagectomy (P=0.005). In addition, high levels of Id-2 expression in both cytoplasmic and nuclear regions predicted longer patient survival (P=0.041). Multivariate analysis showed that high-level expression of Id-2 in both cytoplasmic and nuclear regions and lower level of nuclear Id-1 expression were independent favourable predictors of survival in our ESCC patients. Our results suggest that Id-1 may promote distant metastasis in ESCC, and both Id-1 and Id-2 may be used for prognostication for ESCC patients.
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Biomarcadores Tumorais/biossíntese , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/secundário , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/secundário , Proteína 1 Inibidora de Diferenciação/biossíntese , Proteína 2 Inibidora de Diferenciação/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular Tumoral , Estudos de Coortes , Células Epiteliais/patologia , Neoplasias Esofágicas/metabolismo , Esôfago/patologia , Feminino , Humanos , Imuno-Histoquímica , Proteínas Inibidoras de Diferenciação/biossíntese , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Prognóstico , Taxa de SobrevidaRESUMO
The aim of the study was to evaluate the usefulness of sequential organ failure assessment (SOFA) and acute physiology, age, chronic health evaluation III (APACHE III) scoring systems obtained on the first day of intensive care unit (ICU) admission in predicting hospital mortality in critically ill cirrhotic patients. The study enrolled 102 cirrhotic patients consecutively admitted to ICU during a 1-year period. Twenty-five demographic, clinical and laboratory variables were analysed as predicators of survival. Information considered necessary to calculate the Child-Pugh, SOFA and APACHE III scores on the first day of ICU admission was also gathered. Overall hospital mortality was 68.6%. Multiple logistic regression analysis revealed that mean arterial pressure, SOFA and APACHE III scores were significantly related to prognosis. Goodness-of-fit was good for the SOFA and APACHE III models. Both predictive models displayed a similar degree of the best Youden index (0.68) and overall correctness (84%) of prediction. The SOFA and APACHE III models displayed good areas under the receiver-operating characteristic curve (0.917 +/- 0.028 and 0.912 +/- 0.029, respectively). Finally, a strong and significant positive correlation exists between SOFA and APACHE III scores for individual patients (r(2) = 0.628, p < 0.001). This investigation confirms the grave prognosis for cirrhotic patients admitted to ICU. Both SOFA and APACHE III scores are excellent tools to predict the hospital mortality in critically ill cirrhotic patients. The overall predictive accuracy of SOFA and APACHE III is superior to that of Child-Pugh system. The role of these scoring systems in describing the dynamic aspects of clinical courses and allocating ICU resources needs to be clarified.
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APACHE , Cirrose Hepática/mortalidade , Insuficiência de Múltiplos Órgãos/mortalidade , Cuidados Críticos , Estado Terminal , Métodos Epidemiológicos , Feminino , Mortalidade Hospitalar , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Hepatitis B virus (HBV) infection is the most prevalent cause of fulminant hepatic failure (FHF) in the Far East. HBV-associated FHF is characterised by rapidly progressive end organ dysfunction/failure and a very poor prognosis. To investigate how molecular adsorbent recirculating system (MARS) treatment impacts multiple organ system function in HBV-associated FHF. Ten consecutive patients were treated with MARS in a period of 12 months. Clinical, biochemical and haemodynamic parameters were assessed before and after MARS. Various disease severity scoring systems including model for end-stage liver disease, APACHE II, APACHE III, sequential organ failure assessment and organ system failure scores were also assessed. There were significant improvements in hepatic encephalopathy grading (p < 0.001), mean arterial pressure (p < 0.001), plasma renin activity (p = 0.027), bilirubin (p < 0.001), ammonia (p = 0.001) and creatinine levels (p < 0.001). There were also significant improvements in all the scoring systems evaluated. Meanwhile, platelet count was significantly decreased (p < 0.001). One patient was successfully bridged to liver transplantation. Three patients were alive at 3 months of follow-up. MARS can improve multiple organ functions in HBV-associated FHF. On the basis of these findings, randomised controlled studies are indicated and justified.
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Hemodiafiltração/métodos , Hepatite B/complicações , Falência Hepática Aguda/terapia , Adulto , Idoso , Feminino , Hemodinâmica , Humanos , Falência Hepática Aguda/virologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Little is known about the effects of common antihypertensive drugs in obese, insulin-resistant females. Nine-month-old obese female SHHF/Mcc-fa(cp) rats that received either nifedipine, a calcium channel antagonist, or enalapril, an angiotensin-converting-enzyme inhibitor, for three months were compared with untreated SHHF/Mcc-fa(cp) rats (controls). After one month, nifedipine significantly decreased body weight in obese females compared to either enalapril or controls. After three months of treatment, total, abdominal, and subcutaneous fat masses were decreased in obese females given nifedipine compared to either enalapril or controls. Enalapril treatment was associated with a redistribution of fat mass from abdominal to subcutaneous depots. Nifedipine reduced plasma triglyceride and fasting glucose levels and improved insulin response to an oral glucose load in obese females, whereas enalapril did not appear to affect glycemic control. Systolic pressure was not significantly decreased until after two months of treatment with nifedipine or three months of treatment with enalapril in obese females and may have coincided with improvement in insulin-resistance. Similarly, plasma atrial natriuretic peptide concentrations were significantly lower in obese females given nifedipine. To determine how obese males responded to a calcium channel antagonist, six-month-old obese male SHHF/Mcc-fa(cp) rats were treated for three months with either nifedipine or placebo (controls). Nifedipine-treated obese males showed a mild but significant decrease in weight gain that was due to a decrease in fat deposition in both subcutaneous and abdominal depots and systolic blood pressure was significantly reduced after one month of treatment. Nifedipine did not affect other plasma biochemical parameters in obese males. In conclusion, nifedipine improved systolic pressure and glycemic control in obese female SHHF/Mcc-fa(cp) rats, effects that may be associated with a marked loss in body weight and fat mass and improved lipid metabolism. Nifedipine-treated obese males exhibited only a diminished weight gain that was not associated with changes in diabetic characteristics.
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Obesidade/tratamento farmacológico , Animais , Anti-Hipertensivos/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Composição Corporal , Constituição Corporal , Peso Corporal , Modelos Animais de Doenças , Enalapril/farmacologia , Feminino , Insulina/metabolismo , Resistência à Insulina , Metabolismo dos Lipídeos , Lipídeos , Masculino , Nifedipino/farmacologia , Placebos , Ratos , Fatores Sexuais , Sístole , Fatores de Tempo , Vasodilatadores/farmacologiaRESUMO
We have investigated the expression and regulation of rab3C in rat tissues and rat pheochromocytoma PC12 cells by using a polyclonal antibody that specifically recognizes this protein. Rab3C was expressed in the neuroendocrine systems, as is its highly homologous family member, rab3A. Strong immunoreactivity of rab3C was also observed in testis, heart and 3 different adipose tissues. In addition, induction of neuronal differentiation in PC12 cells, which causes an increase in catecholamine secretion, also led to an increase in rab3C expression. In summary, our data demonstrate a defined pattern of rab3C expression in the rat; such expression is not limited to the neuroendocrine systems. Regulated secretion of various hormones occurs from all of these rab3C-containing tissues. Our results provide important insight into understanding the potential role of rab3C in regulated exocytosis.
Assuntos
Proteínas de Ligação ao GTP/metabolismo , Medula Suprarrenal/metabolismo , Animais , Western Blotting , AMP Cíclico/farmacologia , Exocitose , Fatores de Crescimento Neural/farmacologia , Neuritos/metabolismo , Células PC12 , Ratos , Distribuição Tecidual , Proteínas rab3 de Ligação ao GTPRESUMO
We present results for antilambda and antiproton production in Au+Au collisions at 11.7 A GeV/c including spectra and extracted invariant yields for both species in central and peripheral collisions in the rapidity range 1.0
RESUMO
An excitation function of proton rapidity distributions for different centralities is reported from AGS Experiment E917 for Au+Au collisions at 6, 8, and 10.8 GeV/nucleon. The rapidity distributions from peripheral collisions have a valley at midrapidity which smoothly change to distributions that display a broad peak at midrapidity for central collisions. The mean rapidity loss increases with increasing beam energy, whereas the fraction of protons consistent with isotropic emission from a stationary source at midrapidity decreases with increasing beam energy. The data suggest that the stopping is substantially less than complete at these energies.