RESUMEN
OBJECTIVE: The authors evaluated the effectiveness and safety of "neo-metoro" or 'mini-metoro" metreurynters plus oxytocin for labor induction and assessed differences in parturition outcomes, according to the metreurynter used at induction initiation. MATERIALS AND METHODS: The authors retrospectively reviewed 146 consecutive women with live singleton pregnancies, and who underwent induction. Parturition outcomes were vaginal delivery achieved within the planned schedule (VDPS), vaginal delivery finally achieved (VDF), and induction-to-delivery interval (IDI). Women were divided into neo-metoro, mini-metoro, and without metreurynter groups based on metreurynter use at induction initiation. The authors examined the relationships of metreurynter groups with factors, parturition outcomes, and adverse events. In 113 women who underwent two-day induction, the authors calculated IDI and adjusted odds ratio (AOR) for achieving delivery per unit time. RESULTS: VDPS rates were 65% in nulliparous and 81% in multiparous women. VDF rates were 78% in nulliparous and 96% in multiparous women. AORs for VDPS were 0.30 in nulliparous women and 0.18 in Bishop score (BS) 1-3 class. AORs for VDF were 0.04 in BS1-3 class and 0.14 in BS4-5 class. In 113 women undergoing two-day induction, AORs for achieving delivery per unit time were 0.45 in nulliparous women, 0.46 in obese women, and 0.48 in BS1-3 class. Neo-metoro use at induction initiation tended to reduce IDI. CONCLUSIONS: Labor induction using these metreurynters plus oxytocin is safe and effective. The advantages of neo-metoro over mini-metoro use at induction initiation remain unclear; neo-metoro use at induction initiation may reduce IDI.
Asunto(s)
Catéteres , Trabajo de Parto Inducido/métodos , Oxitócicos/administración & dosificación , Oxitocina/administración & dosificación , Administración Intravaginal , Adulto , Terapia Combinada , Diseño de Equipo , Femenino , Rotura Prematura de Membranas Fetales/terapia , Humanos , Japón , Paridad , Embarazo , Resultado del Embarazo , Modelos de Riesgos Proporcionales , Estudios RetrospectivosRESUMEN
The Shozu Herpes Zoster (SHEZ) Study was designed to clarify the incidence of and predictive and immunological factors for herpes zoster in a defined community-based Japanese population. As part of this series, a total of 5683 residents aged ≥50 years received a varicella-zoster virus (VZV) skin test with VZV antigen, and 48 h later, the erythema and oedema were assessed by measuring the longest diameter. The diameters of both the erythema and oedema decreased with the increasing age of the subject. Sixty-three subjects contracted herpes zoster within a year after receiving the VZV skin test. Analysis of the herpes zoster incidence rate vs. the skin test reaction revealed that the shorter the diameter of erythema or oedema, the greater the likelihood of herpes zoster. These results demonstrated that the VZV skin test is an excellent surrogate marker for predicting the risk of herpes zoster.
Asunto(s)
Antígenos Virales/inmunología , Herpes Zóster/epidemiología , Herpesvirus Humano 3/inmunología , Anciano , Anciano de 80 o más Años , Femenino , Herpes Zóster/diagnóstico , Herpes Zóster/inmunología , Humanos , Inmunidad Celular , Incidencia , Japón/epidemiología , Funciones de Verosimilitud , Masculino , Persona de Mediana Edad , Pruebas CutáneasRESUMEN
When treatment planning before placing dental implants in the posterior region of the mandible, the locations of the inferior alveolar nerve and mental foramen need to be ascertained, as they determine the bone height available and the implant length selected. The purpose of this study was to introduce the clinical application of a newly developed compact computed tomography system (Ortho-CT) to assess three-dimensional (3-D) images for the preoperative treatment planning of implants in the posterior region of the mandible. To evaluate the 3-D images, we scanned using the Ortho-CT system the mandible with a radiopaque template placed in the posterior region. The Ortho-CT images provided excellent information for evaluating the morphology of the mandible, and for showing the location of the inferior alveolar nerve, mental foramen and the relationship of the template to the bone. We consider that Ortho-CT is a useful aid to preoperative treatment planning of implant therapy in the mandible.
Asunto(s)
Implantes Dentales , Imagenología Tridimensional/métodos , Mandíbula/cirugía , Planificación de Atención al Paciente , Tomografía Computarizada por Rayos X/métodos , Medios de Contraste , Humanos , Procesamiento de Imagen Asistido por Computador/instrumentación , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/instrumentación , Mandíbula/diagnóstico por imagen , Mandíbula/inervación , Nervio Mandibular/diagnóstico por imagen , Intensificación de Imagen Radiográfica/instrumentación , Intensificación de Imagen Radiográfica/métodos , Tomografía Computarizada por Rayos X/instrumentación , Pantallas Intensificadoras de Rayos XRESUMEN
Secretion of aldosterone from aldosterone-producing adenoma (APA) is to some degree under the control of ACTH and the suppressible effect of glucocorticoid on plasma aldosterone concentration (PAC) and blood pressure has been reported to be transient. We report a rare case of aldosteronism due to APA in which PAC and blood pressure were well controlled with small dose dexamethasone for over one year. No chimeric gene of glucocorticoid-remediable aldosteronism (GRA) was found in DNA of APA and leukocytes from peripheral blood and 17alpha-hydroxylase deficiency (17-OH-D) was ruled out by endocrinological examinations, this case indicates the possibility of an unknown mechanism of ACTH-dependent APA.
Asunto(s)
Adenoma/tratamiento farmacológico , Adenoma/metabolismo , Neoplasias de las Glándulas Suprarrenales/tratamiento farmacológico , Neoplasias de las Glándulas Suprarrenales/metabolismo , Aldosterona/biosíntesis , Glucocorticoides/uso terapéutico , Adenoma/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Glándulas Suprarrenales/irrigación sanguínea , Hormona Adrenocorticotrópica/farmacología , Adulto , Aldosterona/sangre , Presión Sanguínea , ADN/análisis , Dexametasona/uso terapéutico , Humanos , Hidrocortisona/sangre , Hiperaldosteronismo/tratamiento farmacológico , Hiperaldosteronismo/etiología , Masculino , Reacción en Cadena de la Polimerasa , Renina/sangre , Tomografía Computarizada por Rayos X , VenasRESUMEN
When nucleotide sequences of Oka vaccine and its parental viruses of varicella-zoster virus (VZV) were compared in 5 open reading frames (ORFs) including glycoprotein C (gC) and 4 immediate-early genes, mutations were detected only in gene 62 which is one of the immediate-early genes. Compared with its parental virus, the vaccine virus contained 15 nucleotide substitutions. With the differentiation method using the simplified restriction-enzyme fragment length polymorphism analysis by Nae I and Bss HII, which was established based on the sequence analysis data in this study, the Oka vaccine virus could be distinguished from its parental virus. Studies of the regulatory activities of the ORF62 gene product (IE62) in a transient assay indicate the IE62 of the parental virus had a stronger transactivational activity than that of the vaccine virus against immediate-early, early and late gene promoters. These data suggest that gene 62 might have an important role for attenuation of VZV. This is the first report in which many substitutions of nucleotides in gene 62 of Oka vaccine virus was found, compared with that of Oka parental virus.
Asunto(s)
Vacuna contra la Varicela/genética , Regulación Viral de la Expresión Génica , Proteínas Inmediatas-Precoces/genética , Sistemas de Lectura Abierta , Transactivadores/genética , Activación Transcripcional , Proteínas del Envoltorio Viral/genética , Línea Celular , Varicela/virología , ADN Viral , Genes Virales , Herpes Zóster/virología , Humanos , Proteínas Inmediatas-Precoces/metabolismo , Polimorfismo de Longitud del Fragmento de Restricción , Análisis de Secuencia de ADN , Transactivadores/metabolismo , Proteínas del Envoltorio Viral/metabolismo , Proteínas Virales/genéticaRESUMEN
We have reported that noradrenaline but not K+ induced a sustained and dose-dependent contraction without extracellular Ca2+ and Mn2+ in Ca2+-depleted Mn2+loaded vas deferens from the guinea pig. The Mn2+dependent noradrenaline-induced contractions developed without an increase in phosphorylation of 20-kDa myosin light chain. To clarify whether such an unusual Mn2+dependent contraction was induced only by noradrenaline or not, we examined effects of acetylcholine on Ca2+-depleted Mn2+-loaded guinea pig vas deferens. Acetylcholine (1 microM(-1) mM) induced a sustained dose-dependent contraction without extracellular Ca2+ or Mn2+. W-7 (10 microM or 100 microM) and wortmannin (1 microM) both reduced the Mn2+dependent acetylcholine-induced contractions similarly to Ca2+-dependent acetylcholine-induced contractions in isolated vas deferens without either Ca2+ depletion or Mn2+ loading. However, the Mn2+-dependent acetylcholine-induced contractions developed without a significant increase in the phosphorylation of the myosin light chain determined by urea-glycerol polyacrylamide gel electrophoresis and immunoblotting. These results indicate that acetylcholine as well as noradrenaline induces Mn2+-dependent contraction and are consistent with our previous assumption that Mn2+ may preferentially support receptor-mediated contractions in the guinea pig isolated vas deferens. The results also suggest that the activation of myosin light chain kinase is essential for the development of Mn2+-dependent acetylcholine-induced contractions, and that Mn2+ may accelerate formation of non-phosphorylated attached cross-bridges during receptor activation.
Asunto(s)
Acetilcolina/farmacología , Manganeso/farmacología , Contracción Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Cadenas Ligeras de Miosina/metabolismo , Vasodilatadores/farmacología , Animales , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Cobayas , Masculino , Músculo Liso/metabolismo , Fosforilación , Conducto Deferente/efectos de los fármacos , Conducto Deferente/metabolismoRESUMEN
When the nucleotide sequences of the Oka vaccine and its parental varicella-zoster virus (VZV) were compared in 6 open reading frames (ORFs), glycoprotein C (gC) and 5 transactivator genes, mutations were detected only in the immediate-early gene 62. The vaccine virus contained a mixture of different sequences that had variations at 15 nucleotide positions, but only one sequence was found for the Oka parental virus gene 62. The Oka vaccine virus gene 62 could be distinguished from the parental virus gene using a simplified restriction-enzyme fragment length polymorphism analysis, using NaeI and BssHII. This analysis was based on the sequence data obtained in this study. Studies of the regulatory activities of the ORF62 gene product (IE62) in a transient transfection assay indicated that IE62 of the parental virus had a stronger transactivational activity than that of the vaccine virus in activating immediate-early, early, and late gene promoters. These data suggest that IE62 might play an important role in the attenuation of VZV.
Asunto(s)
Vacuna contra la Varicela/genética , Herpesvirus Humano 3/genética , Células Cultivadas , Cartilla de ADN , Genes Inmediatos-Precoces , Glicoproteínas/genética , Humanos , Mutación , Sistemas de Lectura Abierta , Polimorfismo de Longitud del Fragmento de Restricción , Regiones Promotoras Genéticas , Activación Transcripcional , Transfección , Vacunas Atenuadas/genética , Proteínas del Envoltorio Viral/genéticaRESUMEN
We have characterized the human herpesvirus 6B (HHV-6B) rep gene, which is a homologue of the adeno-associated virus type 2 rep and is unique in the herpesvirus family. Three transcripts, 9.0, 5.0, and 2. 7 kb (the major transcript), were detected by Northern blotting using an HHV-6B rep probe under late conditions. We investigated the expression kinetics of the rep gene using cycloheximide (CHX) and phosphonoformic acid (PFA), which are inhibitors of protein synthesis and viral DNA synthesis, respectively. The 5.2-kb transcript was mainly detected in the absence of protein biosynthesis upon infection, and none of the 9.0-, 5.0-, and 2.7-kb transcripts detected under the late conditions were detected in the presence of CHX and PFA. Sequences obtained from a cDNA library showed that the 5.0- and 2.7-kb transcripts were spliced from two and three exons, respectively, and the 2.7-kb transcript was more abundant. Immunohistochemistry using an antibody raised against the HHV-6 rep gene product (REP) revealed that REP was mainly present in the nucleus of MT-4 cells within 24 h after infection with HHV-6B. Using pull-down assays, coimmunoprecipitation, and a mammalian two hybrid system, we showed that HHV-6 REP binds to a transcription factor, human TATA-binding protein, through its N-terminal region.
Asunto(s)
Proteínas de Unión al ADN/metabolismo , Herpesvirus Humano 6/metabolismo , Proteínas de Saccharomyces cerevisiae , Factores de Transcripción/metabolismo , Proteínas no Estructurales Virales/metabolismo , Animales , Línea Celular , Células Cultivadas , Proteínas Fúngicas/genética , Glutatión Transferasa/genética , Glutatión Transferasa/metabolismo , Herpesvirus Humano 6/genética , Humanos , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/metabolismo , Spodoptera/citología , Proteína de Unión a TATA-Box , Factores de Transcripción/genética , Transcripción Genética , Técnicas del Sistema de Dos Híbridos , Proteínas no Estructurales Virales/genéticaRESUMEN
In the determination of therapeutic 131I doses, it takes several days to measure effective half life (EHL) of radioiodine in thyroid glands (Ordinary method). We suggested the new method to estimate EHL by a single radioiodine uptake measurement (INDEX method). We evaluated the outcome of 131I treatment with these two methods in outpatients with Graves' disease. Eighty outpatients were treated with INDEX method (Group I) and 108 outpatients with Ordinary method (Group O). At the 5-yr follow up, the incidence of hypothyroidism in Group I was 22.5%, subclinical hypothyroidism 8.8%, euthyroidism 30.0%, subclinical hyperthyroidism 13.7% and hyperthyroidism 25.0%. In Group O, 17.6% of the patients were hypothyroid, 16.7% subclinical hypothyroid, 30.5% euthyroid, 9.3% subclinical hyperthyroid and 25.9% hyperthyroid. There were no significant differences between these two methods. We conclude that INDEX method surpasses Ordinary method in timesaver and is equal in effectiveness.
Asunto(s)
Enfermedad de Graves/radioterapia , Radioisótopos de Yodo/uso terapéutico , Radiofármacos/uso terapéutico , Glándula Tiroides/patología , Adulto , Femenino , Estudios de Seguimiento , Semivida , Humanos , Radioisótopos de Yodo/análisis , Radioisótopos de Yodo/farmacocinética , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Radiofármacos/análisis , Radiofármacos/farmacocinética , Dosificación Radioterapéutica , Equivalencia Terapéutica , Glándula Tiroides/metabolismo , Resultado del TratamientoRESUMEN
PURPOSE: We investigated changes in ciliary muscle caused by continual contraction in rabbits and evaluated the efficacy of topically applied amlexanox, which relaxes the ciliary muscle, on such changes. SUBJECTS AND METHODS: After topical application of carbachol ointment 5 times daily for 2 weeks, the contractile responses of isolated ciliary muscles to carbachol were measured isometrically, and the ciliary smooth muscle fibers were stained with phosphotungstic acid and hematoxylin and observed histologically. 1% amlexanox solution was instilled 5 minutes before every instillation of carbachol ointment. RESULTS: Repeated topical carbachol ointment caused decreases in both contractile responses of isolated ciliary muscles to carbachol and number of ciliary smooth muscle fibers stained by phosphotungstic acid and hematoxylin. Amlexanox inhibited these changes. CONCLUSION: We found that continual contraction of the ciliary muscle caused functional and histological changes in it. These changes are thought to occur in some diseases which cause excessive contraction of the ciliary muscle. Topical amlexanox might be useful for these diseases.
Asunto(s)
Aminopiridinas/farmacología , Carbacol/farmacología , Agonistas Colinérgicos/farmacología , Cuerpo Ciliar/efectos de los fármacos , Mióticos/farmacología , Administración Tópica , Aminopiridinas/administración & dosificación , Animales , Carbacol/administración & dosificación , Agonistas Colinérgicos/administración & dosificación , Técnicas In Vitro , Contracción Muscular/efectos de los fármacos , Pomadas , Soluciones Oftálmicas , ConejosRESUMEN
Fungal nitric-oxide reductase (NOR) is a heme enzyme that catalyzes the reduction of NO to N(2)O through its ferric-NO complex, the first intermediate of the catalysis. Crystal structures of the ferric-NO forms of wild type (WT) fungal NOR, and of the Ser(286) --> Val and Ser(286) --> Thr mutant enzymes were determined to 1.7-A resolution at cryogenic temperature (100 K). This shows a slightly tilted and bent NO binding to the heme iron, in sharp contrast to the highly bent NO coordination found in ferrous hemoproteins. In the WT structure, a specific hydrogen-bonding network that connects the active site to the solvent was identified, H(2)O(Wat(74))-Ser(286)-H(2)O(Wat(33))-Asp(393)-solvent. Wat(74) is located 3.10 A from the iron-bound NO. Replacement of Ser(286) with Val or Thr scarcely alters the NO coordination structure but expels the water molecules, Wat(74) from the active site. The Asp(393) mutation does not influence the position of Wat(74), but disrupts the hydrogen-bonding network at Wat(33), as evidenced by enzymatic, kinetic, and spectroscopic (resonance Raman and IR) results. The structural changes observed upon the Ser(286) or the Asp(393) mutation are consistent with the dramatic loss of the enzymatic activity for the NO reduction of fungal NOR. We have conclusively identified the water molecule, Wat(74), adjacent to the iron-bound NO as a proton donor to the Fe-NO moiety. In addition, we find the hydrogen-bonding network, H(2)O(Wat(74))-Ser(286)-H(2)O(Wat(33))-Asp(393), as a proton delivery pathway in the NO reduction reaction by fungal NOR.
Asunto(s)
Compuestos Férricos/química , Fusarium/enzimología , Óxido Nítrico/metabolismo , Oxidorreductasas/metabolismo , Ácido Aspártico/metabolismo , Secuencia de Bases , Catálisis , Cristalografía por Rayos X , Cartilla de ADN , Hemo/química , Enlace de Hidrógeno , Cinética , Modelos Moleculares , Estructura Molecular , Mutagénesis Sitio-Dirigida , Óxido Nítrico/química , Oxidación-Reducción , Oxidorreductasas/química , Oxidorreductasas/genética , Protones , Serina/metabolismoRESUMEN
Instillation of amlexanox, an anti-allergic drug, over a long period improves myopia in some allergy patients and in monkeys. The relaxing effect of amlexanox on persistent contraction of ciliary muscle may be involved in the improvement of myopia. In this study, the mechanism of the noncompetitive inhibition of carbachol-induced contractions by amlexanox (1-100 microM) was investigated in isolated smooth muscle preparations of the rabbit ciliary body and guinea-pig taenia caecum. In ciliary muscles, amlexanox (100 microM) inhibited both the phasic and tonic components of carbachol-induced contractions even in the presence of cyclopiazonic acid (10 microM) where the function of the sarcoplasmic reticulum was impaired, while diltiazem (3.2, 32 microM) did not. In taenia caecum, diltiazem (3.2 microM) slightly inhibited the phasic component and abolished the tonic component of carbachol-induced contractions. Amlexanox also abolished the tonic component, but it did not decrease the 45Ca2+ uptake into taenia caecum smooth muscle cells induced by carbachol. Amlexanox did not increase the cyclic adenosine monophosphate (cyclicAMP) content of ciliary muscles in the presence of 3-isobutyl-1-methylxanthine (10 microM), while forskolin (1 microM) did. Gel-shift assay showed that the inhibition of carbachol-induced contractions by amlexanox was accompanied by a decrease in phosphorylation of the 20-kDa myosin light chain in taenia caecum tissue preparations. Amlexanox had no effect on calmodulin activity, whereas it inhibited phosphorylation of the myosin light chain by purified myosin light-chain kinase from chicken gizzard. These results suggested that amlexanox may not affect either Ca2+ mobilization or calmodulin activity, although it inhibits myosin light-chain kinase, which may inhibit carbachol-induced contraction.
Asunto(s)
Aminopiridinas/farmacología , Antialérgicos/farmacología , Carbacol/farmacología , Ciego/efectos de los fármacos , Agonistas Colinérgicos/farmacología , Cuerpo Ciliar/efectos de los fármacos , Contracción Muscular/efectos de los fármacos , Animales , Calcio/metabolismo , Ciego/fisiología , Cuerpo Ciliar/fisiología , AMP Cíclico/metabolismo , Relación Dosis-Respuesta a Droga , Cobayas , Músculo Liso/fisiología , Miopía/tratamiento farmacológico , Quinasa de Cadena Ligera de Miosina , Fosforilación , ConejosRESUMEN
The cellular mechanisms of norepinephrine (NE)-induced Mn2+-dependent contractions were investigated in dispersed smooth muscle cells from guinea pig vas deferens by characterizing the effects of NE and K+ on cell length observed by videotape microscopy and on intracellular Mn2+ and Ca2+ concentration ([Mn2+]i and [Ca2+]i) observed by confocal microscopy. Both stimulants induced slow sustained contraction in Ca2+-depleted, Mn2+-accumulated cells (Mn2+-loaded cells), whereas they induced biphasic contractions in normal cells that were neither Ca2+-depleted nor Mn2+-loaded. In both conditions, the number of cells responding to NE as well as the magnitude of NE-induced contractions increased in a dose-dependent manner. Contractions induced by K+ in Mn2+-loaded strip preparations were markedly smaller than those induced by NE. Although individual K+-induced contractions in responsive Mn2+-loaded cells were as large as those induced by NE, a much smaller percentage of Mn2+-loaded cells was responsive to K+ than to NE. These results are consistent with the idea that the contractions of strip preparations may reflect the magnitude of the contractions of individual cells as well as the percentage of responsive cells in the preparations. Inconsistent with the contractions, the [Mn2+]i rise induced by K+ was larger than that induced by NE, and the percentage of cells responsive to K+ was larger than that responsive to NE. These results suggest that NE may increase the Mn2+ sensitivity of contractile elements.
Asunto(s)
Calcio/metabolismo , Manganeso/metabolismo , Contracción Muscular/efectos de los fármacos , Norepinefrina/farmacología , Potasio/farmacología , Conducto Deferente/efectos de los fármacos , Animales , Relación Dosis-Respuesta a Droga , Cobayas , Masculino , Músculo Liso/citología , Músculo Liso/efectos de los fármacos , Músculo Liso/fisiología , Factores de Tiempo , Conducto Deferente/fisiología , Vasoconstrictores/farmacologíaRESUMEN
We have reported that norepinephrine but not K+ induced a sustained and dose-dependent contraction without extracellular Ca2+ and Mn2+ in Ca2+-depleted Mn2+-loaded vas deferens from the guinea-pig. In the present study, we determined the phosphorylation of the 20-kDa myosin light chain and examined the effects of inhibitors of calmodulin and myosin light chain kinase on the Mn2+-dependent norepinephrine-induced contraction in order to evaluate the contribution of phosphorylation to this contraction. W-7 [N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide], ML-9 [1-(5-chloronaphthalene-1-sulfonyl)-homopiperazine] and wortmannin inhibited this contraction. However, the Mn2+-dependent norepinephrine-induced contraction developed without a significant increase in the phosphorylation of the 20-kDa myosin light chain. In beta-escin-permeabilized preparations, Mn2+ induced contractions that were inhibited by ML-9. These results suggest that the activation of myosin light chain kinase is essential for the development of Mn2+-dependent norepinephrine-induced contractions and that the phosphorylation of myosin light chain may act as a trigger for these contractions.
Asunto(s)
Manganeso/farmacología , Cadenas Ligeras de Miosina/fisiología , Quinasa de Cadena Ligera de Miosina/antagonistas & inhibidores , Conducto Deferente/fisiología , Animales , Azepinas/farmacología , Calcio/farmacología , Inhibidores Enzimáticos/farmacología , Cobayas , Técnicas In Vitro , Masculino , Contracción Muscular , Norepinefrina , Fosforilación , Conducto Deferente/efectos de los fármacosRESUMEN
A 48-year-old woman with Cushing's syndrome due to bilateral adrenocortical adenomas is reported. The patient presented with a typical Cushingoid appearance. The serum cortisol level was elevated with loss of the diurnal rhythm and the plasma adrenocorticotropic hormone (ACTH) level was undetectable. Dynamic testing showed no suppression of urinary 17-OHCS by high-dose dexamethasone and no stimulation by metyrapone. An abdominal computed tomography (CT) scan showed bilateral adrenal tumors. Bilateral adrenalectomy was performed. The right adrenal gland contained a tumor that was encapsulated and consisted mainly of compact cells. The surrounding cortex was atrophic. The left adrenal gland contained an encapsulated tumor composed predominantly of clear cells. There were numerous small adrenocortical nodules in the surrounding cortex. Immunohistochemical analysis of steroidogenic enzymes (P450scc, 3beta-HSD, P450c21, P450c17 and P450c11) was performed. Immunoreactivity of all the enzymes was intense in the compact cells of the right adrenocortical adenoma, while the adjacent non-neoplastic cortex was negative for the enzymes. In the left adrenal tumor, the immunoreactivity of 3beta-HSD was intense, while that of P450c17 was weak. In the adrenocortical nodules, 3beta-HSD activity was sporadically observed. G protein genes encoding Gs alpha and Gi2 were examined for activating mutations at codons 201 and 227 (Gs alpha) and codons 179 and 205 (Gi2 alpha) in the bilateral adrenal tumors, but no mutations were found. The bilateral adenomas of this patient showed marked differences in microscopic and immunohistochemical studies, suggesting that the capacity of steroidogenesis differs between the right and left tumors.
Asunto(s)
Neoplasias de la Corteza Suprarrenal/patología , Adenoma Corticosuprarrenal/patología , Síndrome de Cushing/etiología , Neoplasias de la Corteza Suprarrenal/complicaciones , Neoplasias de la Corteza Suprarrenal/enzimología , Adrenalectomía , Adenoma Corticosuprarrenal/complicaciones , Adenoma Corticosuprarrenal/enzimología , Hormona Adrenocorticotrópica/sangre , Codón/genética , Síndrome de Cushing/metabolismo , Síndrome de Cushing/terapia , Sistema Enzimático del Citocromo P-450/análisis , Sistema Enzimático del Citocromo P-450/genética , Dexametasona/uso terapéutico , Femenino , Proteínas de Unión al GTP/genética , Glucocorticoides/uso terapéutico , Humanos , Inmunohistoquímica , Metirapona/uso terapéutico , Persona de Mediana Edad , MutaciónRESUMEN
1. In Ca(2+)-depleted Mn(2+)-loaded vas deferens from the guinea pig (Mn-loaded preparations), norepinephrine (NE) induced a tonic contraction dose dependently without extracellular Ca2+ and Mn2+. 2. In the beta-escin skinned vas deferens, Mn2+ as well as Ca2+ induced contractions. Guanosine triphosphate and NE increased the sensitivity of contractile mechanisms to these divalent cations. 3. Phorbol-12,13-dibutyrate (PDBu) did not induce contractions in normal (Mn(2+)-unloaded Ca(2+)-contained) preparations, whereas it induced slow sustained contractions dose dependently in Mn-loaded preparations. Although cumulative applications of PDBu desensitized the preparations to this phorbol ester, the desensitization did not affect Mn(2+)-dependent NE-induced contractions. PDBu did not affect the dose-response relation of NE in Mn-loaded preparations. 4. Staurosporine (10-100 nM) preferentially inhibited NE-induced contractions in normal and in Mn-loaded preparations to that induced by K+ in normal preparations. However, bisindolylmaleimide I (1 microM) did not inhibit NE-induced contractions in normal and Mn-loaded preparations but abolished PDBu-induced contractions. 5. These results suggest that the NE-induced increase in the Mn2+ sensitivity of contractile mechanisms contributes to Mn(2+)-dependent NE-induced contractions, which may not involve the activation of protein kinase C.
Asunto(s)
Magnesio/farmacología , Contracción Muscular/efectos de los fármacos , Norepinefrina/farmacología , Forbol 12,13-Dibutirato/farmacología , Proteína Quinasa C/antagonistas & inhibidores , Conducto Deferente/efectos de los fármacos , Animales , Calcio/farmacología , Inhibidores Enzimáticos/farmacología , Escina/farmacología , Guanosina Trifosfato/farmacología , Cobayas , Técnicas In Vitro , Indoles/farmacología , Masculino , Maleimidas/farmacología , Músculo Liso/efectos de los fármacos , Estaurosporina/farmacologíaRESUMEN
We evaluated the outcome of 131I treatment of Graves' disease in two different protocols (old and new protocol) of adjusted accumulation dose from 1988 to 1995. Adjusted accumulation doses of patients with above 50 g thyroid weights were increased by 5-20 Gy/g tissue in new protocol compared to those in old one. In 166 patients treated with single and plural doses of 131I treatment in 1990 (Group In), the therapeutic doses were calculated according to new protocol and in 130 patients in 1988 (Group Io), according to old one, modification of Quimby's formula. The patients treated with plural doses were classified as hyperthyroidism because the efficacies of the first treatments with 131I were insufficient. At the 5-yr follow up, the incidence of hypothyroid in Group In was 9%, subclinical hypothyroid 17%, euthyroid 30%, subclinical hyperthyroid 7%, hyperthyroid 37%. In Group Io, 11% of the patients were hypothyroid, 6% subclinical hypothyroid, 29% euthyroid, 3% subclinical hyperthyroid, 51% hyperthyroid. The incidence of hyperthyroid in Group In was lower than that in Group Io (p < 0.05). There were no significant differences in hypothyroid and euthyroid. In conclusion, we suggest that an adjusted dose of 131I in relation to the patients' thyroid weight shows some room for improvement.
Asunto(s)
Enfermedad de Graves/radioterapia , Radioisótopos de Yodo/uso terapéutico , Radiofármacos/uso terapéutico , Glándula Tiroides/patología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Dosificación Radioterapéutica , Resultado del TratamientoRESUMEN
We investigated the effects of inhibitors of the sarcoplasmic reticulum (SR) functions on the tonic contractions induced by norepinephrine (NE) in the Ca(2+)-depleted Mn(2+)-loaded vas deferens of the guinea pig in the absence of both Ca2+ and Mn2+ (Mn(2+)-dependent NE-contraction). In control preparations without Ca(2+)-depletion and Mn(2+)-loading, either cyclopiazonic acid (CPA, 10 microM) or ryanodine (RYA, 3 microM) inhibited the initial phasic and tonic components but not the large phasic component of NE-induced contraction in normal medium containing 2.2 mM Ca2+. In contrast, CPA did not affect the Mn(2+)-dependent NE-contractions. The inhibitory effect of RYA slowly developed with each repetition of the Mn(2+)-dependent NE-contraction and the magnitude of the inhibition was slight. A23187 (10 microM) inhibited the NE-induced contractions of the control preparations in the same manner as CPA and RYA. Although A23187 did not induce contractions in the Mn(2+)-loaded preparations, A23187 augmented the Mn(2+)-dependent NE-contractions. The augmented tonic contractions returned to the resting level by washing NE and A23187. The augmentation remained for 3 successive contractions in the absence of A23187. However, the 2nd application of A23187 did not augment the contraction. These results suggest that neither Mn(2+)-release from SR nor Mn(2+)-influx from the extracellular space contributes to the Mn(2+)-dependent NE-contractions. We concluded that NE induces Mn(2+)-dependent contractions by increasing Mn2+ sensitivity of contractile processes but not by increasing intracellular Mn2+ concentration.
Asunto(s)
Manganeso/metabolismo , Contracción Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Norepinefrina/farmacología , Retículo Sarcoplasmático/fisiología , Animales , Calcimicina/farmacología , Calcio/metabolismo , Cobayas , Técnicas In Vitro , Indoles/farmacología , Masculino , Manganeso/fisiología , Rianodina/farmacología , Retículo Sarcoplasmático/metabolismo , Conducto Deferente/efectos de los fármacosRESUMEN
Intracellular accumulation of Mn2+ augmented the contractions induced by norepinephrine and acetylcholine in the guinea pig isolated vas deferens. Contractions repeatedly induced by norepinephrine, acetylcholine, or a high concentration of K+ decreased depending on the incubation time in Ca(2+)-free medium. The rate of decrease of all contractions was delayed by intracellularly accumulated manganese. In the Mn(2+)-loaded preparations, the tonic components of the contractions induced by norepinephrine and acetylcholine, but not K+, were highly resistant to extracellular Ca2+ elimination. Ryanodine abolished the initial phasic component but did not affect the tonic component of norepinephrine- and acetylcholine-contractions in Mn(2+)-loaded preparations in Ca(2+)-free medium. In Ca(2+)-depleted preparations, the tonic contraction induced by norepinephrine was restored after the Mn(2+)-loading procedure, and the magnitude of this tonic contraction was comparable to the tonic component of the norepinephrine contraction in the normal medium before Mn2+ loading. The tonic contraction was reproducible in medium without either Mn2+ or Ca2+. These results suggested that intracellular Mn2+ can support norepinephrine-induced tonic contractions. In the Ca(2+)-depleted Mn(2+)-loaded preparations, K+ also induced a tonic contraction in the presence of extracellular Mn2+. However, this contraction was much smaller than that induced by norepinephrine. These results suggested that intracellular Mn2+ augmented contractions not only via an increase in intracellular Ca2+ availability but also via the direct action of Mn2+ on contractile mechanisms, and that this action is highly specific for developing and/or maintaining tonic contractions mediated by receptor activation in the guinea pig isolated vas deferens.
Asunto(s)
Manganeso/farmacología , Contracción Muscular/efectos de los fármacos , Conducto Deferente/efectos de los fármacos , Acetilcolina/farmacología , Animales , Cafeína/farmacología , Calcio/metabolismo , Cobayas , Masculino , Norepinefrina/farmacología , Potasio/farmacologíaRESUMEN
Spontaneous tone of longitudinal muscle in guinea pig ileum was investigated in three types of preparations, intact segment preparation, segment preparation deprived of the mucosal layer and longitudinal strip preparation. Tone was defined as the sustained contraction that was lost by 10(-7) M atropine in the isotonically recorded manner. The magnitudes of tone were constant for at least 3 hr in the two types of segment preparations. Contractions in response to 10(-6) M acetylcholine, which were induced 9 times with an interval of 20 min between each induction, were almost identical throughout the period. In the longitudinal strip preparation, on the other hand, the tone gradually decayed and was eventually lost, while the amplitudes of acetylcholine-induced contractions were reciprocally increased. The tone in the intact segment preparation was reduced to 19% of the control by tetrodotoxin (3 x 10(-7) M), to 51% by indomethacin (3 x 10(-6) M) and to 26% by N6-cyclopentyladenosine (10(-7) M), but was not affected by AA-861 (3 x 10(-6) M) or CP-96,345 (3 x 10(-7) M). In the three types of preparations, the dose-response curves for acetylcholine were alike with similar EC50s. These results suggest that the tone of longitudinal muscle was mainly induced due to neural activity in the myenteric plexus of guinea pig ileum and that sensitivity to acetylcholine was not affected by the neural activity.