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1.
Sci Rep ; 13(1): 15197, 2023 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-37709803

RESUMEN

One feature of hypertension is a microbial imbalance with increased intestinal permeability. In this study, we examined whether an alteration in the microbiota affects blood pressure and intestinal permeability in spontaneously hypertensive rats (SHRs). We performed a 16S metagenome analysis of feces from 10- to 15-week-old SHRs using a synthetic long-read sequencing approach, and found a candidate for the microbiome treatment, Ligilactobacillus murinus (L. murinus), that was robustly decreased. Oral administration of L. murinus to SHRs for 2 weeks significantly inhibited blood pressure elevation and improved endothelium-dependent vasodilation but did not attenuate enhanced vascular contraction in SHR mesenteric arteries. The proximal colon of SHRs exhibited increased intestinal permeability with decreased levels of the tight junction protein claudin 4, morphological changes such as decreased intestinal crypts and elevated TNF-α levels, which was reversed by treatment with L. murinus. Consistent with these intestinal phenotypes, plasma lipopolysaccharides levels were elevated in SHR but decreased following L. murinus administration. We concluded that oral administration of L. murinus to SHRs exerts protective effects on intestinal permeability via restoration of claudin 4 expression and reversal of morphologic disorder, which may improve low-grade endotoxemia and thus reduce development of hypertension via recovery of endothelial vasodilating functions.


Asunto(s)
Hipertensión , Intestinos , Animales , Ratas , Presión Sanguínea , Ratas Endogámicas SHR , Claudina-4
2.
Arch Virol ; 168(3): 94, 2023 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-36806782

RESUMEN

Equine influenza virus strains of Florida sublineage clade 1 (Fc1) have been circulating in North America. In this study, virus neutralization assays were performed to evaluate antigenic differences between Fc1 vaccine strains and North American Fc1 strains isolated in 2021-2022, using equine antisera against A/equine/South Africa/4/2003 (a vaccine strain recommended by the World Organisation for Animal Health) and A/equine/Ibaraki/1/2007 (a Japanese vaccine strain). Antibody titers against four North American Fc1 strains isolated in 2021-2022 were comparable to those against the homologous vaccine strains. These results suggest that current Fc1 vaccine strains are effective against North American strains from 2021-2022.


Asunto(s)
Enfermedades de los Caballos , Subtipo H3N8 del Virus de la Influenza A , Vacunas contra la Influenza , Infecciones por Orthomyxoviridae , Vacunas , Animales , Caballos , Florida , América del Norte
3.
J Pharmacol Exp Ther ; 379(2): 117-124, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34389653

RESUMEN

Streptolysin O (SLO) is produced by common hemolytic streptococci that cause a wide range of diseases from pharyngitis to life-threatening necrotizing fasciitis and toxic shock syndrome. Although the importance of SLO in invasive hemolytic streptococcus infection has been well demonstrated, the role of circulating SLO in noninvasive infection remains unclear. The aim of this study was to characterize the pharmacological effect of SLO on vascular functions, focusing on cellular signaling pathways. In control Wistar rats, SLO treatment (1-1000 ng/ml) impaired acetylcholine-induced endothelial-dependent relaxation in the aorta and second-order mesenteric artery in a dose-dependent manner without any effects on sodium nitroprusside-induced endothelium-independent relaxation or agonist-induced contractions. SLO also increased phosphorylation of the endothelial NO synthase (eNOS) inhibitory site at Thr495 in the aorta. Pharmacological analysis indicated that either endothelial dysfunction or eNOS phosphorylation was mediated by protein kinase Cß (PKCß), but not by the p38 mitogen-activated protein kinase pathway. Consistent with this, SLO increased phosphorylation levels of protein kinase C substrates in the aorta. In vivo study of control Wistar rats indicated that intravenous administration of SLO did not change basal blood pressure but significantly counteracted the acetylcholine-induced decrease in blood pressure. Interestingly, plasma anti-SLO IgG levels were significantly higher in 10- to 15-week-old spontaneously hypertensive rats compared with age-matched control rats (P < 0.05). These findings demonstrated that SLO causes vascular endothelial dysfunction, which is mediated by PKCß-induced phosphorylation of the eNOS inhibitory site. SIGNIFICANCE STATEMENT: This study showed for the first time that in vitro exposure of vascular tissues to SLO impairs endothelial function, an effect that is mediated by protein kinase C ß-induced phosphorylation of the endothelial NO synthase inhibitory site. Intravenous administration of SLO in control and hypertensive rats blunted the acetylcholine-induced decrease in blood pressure, providing evidence for a possible role of SLO in dysregulation of blood pressure.


Asunto(s)
Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/enzimología , Proteína Quinasa C beta/metabolismo , Estreptolisinas/toxicidad , Vasoconstricción/efectos de los fármacos , Animales , Aorta Torácica/efectos de los fármacos , Aorta Torácica/enzimología , Proteínas Bacterianas/toxicidad , Relación Dosis-Respuesta a Droga , Masculino , Arterias Mesentéricas/efectos de los fármacos , Arterias Mesentéricas/enzimología , Técnicas de Cultivo de Órganos , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Ratas Wistar , Vasoconstricción/fisiología
4.
Appl Microbiol Biotechnol ; 101(1): 331-340, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27717963

RESUMEN

Rhodococcus erythropolis N9T-4, isolated from stored crude oil, shows extremely oligotrophic features and can grow on a basal medium without any additional carbon, nitrogen, sulfur, and energy sources, but requires CO2 for its oligotrophic growth. Transmission electron microscopic observation showed that a relatively large and spherical compartment was observed in a N9T-4 cell grown under oligotrophic conditions. In most cases, only one compartment was observed per cell, but in some cases, it was localized at each pole of the cell, suggesting that it divides at cell division. We termed this unique bacterial compartment an oligobody. The oligobody was not observed or very rarely observed in small sizes under nutrient rich conditions, whereas additional carbon sources did not affect oligobody formation. Energy dispersive X-ray spectroscopy analysis revealed remarkable peaks corresponding to phosphorus and potassium in the oligobody. The oligobodies in N9T-4 cells could be stained by Toluidine blue, suggesting that the oligobody is composed of inorganic polyphosphate and is a type of acidocalcisome. Two genes-encoding polyphosphate kinases, ppk1 and ppk2, were found in the N9T-4 genome: ppk1 disruption caused a negative effect on the formation of the oligobody. Although it was suggested that the oligobody plays an important role for the oligotrophic growth, both ppk-deleted mutants showed the same level of oligotrophic growth as the wild-type strain.


Asunto(s)
Medios de Cultivo/química , Citoplasma/ultraestructura , Rhodococcus/crecimiento & desarrollo , Rhodococcus/ultraestructura , Citoplasma/química , Eliminación de Gen , Microscopía Electrónica de Transmisión , Fósforo/análisis , Fosfotransferasas (Aceptor del Grupo Fosfato)/genética , Fosfotransferasas (Aceptor del Grupo Fosfato)/metabolismo , Potasio/análisis , Rhodococcus/química , Rhodococcus/metabolismo , Espectrometría por Rayos X , Coloración y Etiquetado
5.
Magn Reson Med Sci ; 16(1): 84-86, 2017 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-27725576

RESUMEN

We report a 34-year-old male who manifested T1 shortening of the cerebral cortices after more than 86 contrast-enhanced MRI studies. We observed high-signal intensity (SI) on T1-weighted images (T1WIs) not only in the globus pallidus, dentate nucleus, and pulvinar of thalamus, but also in the cortices of the pre- and post-central gyri and around the calcarine sulcus. High SI in the cerebral cortices was not clearly demonstrated on T1WI scans performed 11 years earlier. The high SI we observed in these areas of the brain corresponded to areas with a normal iron-deposition predilection. Gadolinium deposition in the brain may be associated with the iron metabolism.


Asunto(s)
Corteza Cerebral/efectos de los fármacos , Corteza Cerebral/patología , Medios de Contraste/efectos adversos , Gadolinio DTPA/efectos adversos , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Adulto , Gadolinio , Humanos , Masculino , Estudios Retrospectivos
6.
Biosci Biotechnol Biochem ; 80(3): 610-3, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26540516

RESUMEN

An extreme oligotroph, Rhodococcus erythropolis N9T-4, showed intracellular accumulation of trehalose and glycogen under oligotrophic conditions. No trehalose accumulation was observed in cells grown on the rich medium. Deletion of the polyphosphate kinase genes enhanced the trehalose accumulation and decreases the intracellular glycogen contents, suggesting an oligotrophic relationship between among the metabolic pathways of trehalose, glycogen, and inorganic polyphosphate biosyntheses.


Asunto(s)
Glucógeno/metabolismo , Rhodococcus/metabolismo , Trehalosa/metabolismo , Rhodococcus/genética
7.
Appl Microbiol Biotechnol ; 99(13): 5627-37, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25750047

RESUMEN

Rhodococcus erythropolis N9T-4 shows extremely oligotrophic growth requiring atmospheric CO2 and forms its colonies on an inorganic basal medium (BM) without any additional carbon source. Screening of a random mutation library constructed by a unique genome deletion method that we established indicated that the aceA, aceB, and pckG genes encoding isocitrate lyase, malate synthase, and phosphoenolpyruvate carboxykinase, respectively, were requisite for survival on BM plates. The aceA- and aceB deletion mutants and the pckG deletion mutant grew well on BM plates containing L-malate and D-glucose, respectively, suggesting that the glyoxylate (GO) shunt and gluconeogenesis are essential for the oligotrophic growth of N9T-4. Interestingly, most of the enzyme activities in the TCA cycle were observed in the cell-free extract of N9T-4, with perhaps the most important exception being α-ketoglutarate dehydrogenase (KGDH) activity. Instead of the KGDH activity, we detected a remarkable level of α-ketoglutarate decarboxylase (KGD) activity, which is the activity exhibited by the E1 component of the KGDH complex in Mycobacterium tuberculosis. The recombinant KGD of N9T-4 catalyzed the decarboxylation of α-ketoglutarate to form succinic semialdehyde (SSA) in a time-dependent manner. Since N9T-4 also showed a detectable SSA dehydrogenase activity, we concluded that N9T-4 possesses a variant TCA cycle, which uses SSA rather than succinyl-CoA. These results suggest that oligotrophic N9T-4 cells utilize the GO shunt to avoid the loss of carbons as CO2 and to conserve CoA units in the TCA cycle.


Asunto(s)
Dióxido de Carbono/metabolismo , Glioxilatos/metabolismo , Redes y Vías Metabólicas/genética , Rhodococcus/crecimiento & desarrollo , Rhodococcus/metabolismo , Medios de Cultivo/química , Viabilidad Microbiana , Mutagénesis
8.
Magn Reson Med Sci ; 14(2): 145-52, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25500780

RESUMEN

Readout-segmented echo planar imaging (rs-EPI) is a form of multi-shot EPI. rs-EPI is affected less by susceptibility artifacts than single-shot EPI (ss-EPI), which is widely used for diffusion-weighted imaging, so rs-EPI is expected to produce less image distortion. In this study, we compared rs-EPI and conventional ss-EPI of the temporal bone region, which contains abundant amounts of air and frequently exhibits changes in magnetic susceptibility. In addition, we used a phantom to determine the optimum rs-EPI acquisition conditions for clinical use and investigated the clinical utility of rs-EPI in 20 patients (8 men, 12 women, mean age, 54.3 ± 16.7-years-old) with cholesteatoma (mean apparent diffusion coefficient on ss-EPI, 0.88 × 10(-3) ± 0.18 mm(2)/s). The images of the temporal bone region produced using rs-EPI exhibited less distortion than those obtained with ss-EPI (P < 0.05).


Asunto(s)
Imagen Eco-Planar/métodos , Hueso Temporal/anatomía & histología , Adulto , Anciano , Artefactos , Enfermedades Óseas/diagnóstico , Colesteatoma/diagnóstico , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fantasmas de Imagen
9.
Genome Res ; 24(3): 522-34, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24407955

RESUMEN

Inosine is an abundant RNA modification in the human transcriptome and is essential for many biological processes in modulating gene expression at the post-transcriptional level. Adenosine deaminases acting on RNA (ADARs) catalyze the hydrolytic deamination of adenosines to inosines (A-to-I editing) in double-stranded regions. We previously established a biochemical method called "inosine chemical erasing" (ICE) to directly identify inosines on RNA strands with high reliability. Here, we have applied the ICE method combined with deep sequencing (ICE-seq) to conduct an unbiased genome-wide screening of A-to-I editing sites in the transcriptome of human adult brain. Taken together with the sites identified by the conventional ICE method, we mapped 19,791 novel sites and newly found 1258 edited mRNAs, including 66 novel sites in coding regions, 41 of which cause altered amino acid assignment. ICE-seq detected novel editing sites in various repeat elements as well as in short hairpins. Gene ontology analysis revealed that these edited mRNAs are associated with transcription, energy metabolism, and neurological disorders, providing new insights into various aspects of human brain functions.


Asunto(s)
Adenosina/genética , Encéfalo/metabolismo , Perfilación de la Expresión Génica/métodos , Inosina/genética , Edición de ARN , ARN Mensajero/genética , Transcriptoma/genética , Adulto , Cromosomas Humanos , Metabolismo Energético , Genoma Humano , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Modelos Genéticos , Enfermedades del Sistema Nervioso/genética , ARN Mensajero/fisiología , Transcripción Genética
10.
J Biosci Bioeng ; 114(1): 53-5, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22561879

RESUMEN

CO utilization by a CO(2)-requiring extremely oligotrophic bacterium, Rhodococcus erythropolis N9T-4 was found when CO(2) was removed from the culture environment before cultivation, suggesting that this bacterium can convert CO into CO(2). However, the gene encoding putative CO dehydrogenase large subunit in N9T-4 was not induced by CO.


Asunto(s)
Monóxido de Carbono/metabolismo , Rhodococcus/genética , Rhodococcus/metabolismo , Aldehído Oxidorreductasas/genética , Aldehído Oxidorreductasas/metabolismo , Perfilación de la Expresión Génica , Regulación Bacteriana de la Expresión Génica , Orden Génico , Datos de Secuencia Molecular , Complejos Multienzimáticos/genética , Complejos Multienzimáticos/metabolismo , Rhodococcus/enzimología
11.
Eur J Pharm Sci ; 42(4): 340-7, 2011 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-21216286

RESUMEN

We designed peanut agglutinin (PNA)-immobilized fluorescent nanospheres as a non-absorbable endoscopic imaging agent capable of being administered intracolonically. Following our previous researches with evidence that the imaging agent recognized small-sized colorectal tumors on the mucosal surface with high affinity and specificity in animal experiments, a potential of this nanoprobe as a drug candidate was evaluated from a safety perspective. The imaging agent detects colorectal tumors through recognition of the tumor-specific antigen by PNA immobilized on the nanosphere surface, and the detection is made via the fluorescent signal derived from coumarin 6 encapsulated into the nanosphere core. The stability studies revealed that the high activity of PNA was maintained and there was no significant leakage of coumarin 6 after intracolonic administration of the imaging agent. Cytotoxicity studies indicated that no local damage to the large intestinal membrane was induced by the imaging agent. Further, in vitro and in vivo permeation studies demonstrated that there was no significant permeation of the imaging agent through the monolayer of cultured cells and that the imaging agent administered locally to the luminal side of the large intestine was almost completely recovered from the administration site. Therefore, we concluded that the imaging agent is a safe and stable probe which remains in the large intestine without systemic exposure.


Asunto(s)
Colonoscopía/métodos , Cumarinas , Detección Precoz del Cáncer/métodos , Nanosferas , Aglutinina de Mani , Tiazoles , Animales , Células CACO-2 , Colon/patología , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/patología , Cumarinas/química , Femenino , Colorantes Fluorescentes/química , Humanos , Indicadores y Reactivos/química , Mucosa Intestinal/química , Ratones , Nanosferas/química , Aglutinina de Mani/química , Tiazoles/química
12.
Magn Reson Med Sci ; 9(3): 159-65, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20885090

RESUMEN

Hybrid of opposite-contrast (HOP) magnetic resonance angiography (MRA) is a new method that combines the advantages of 3-dimensional (3D) time-of-flight (TOF) MRA and black-blood (BB) MRA without prolonging acquisition time. In phantom and clinical studies, we focused on image differences when we applied gradient moment nulling (GMN) to 2 or 3 axes in the first echo. We made an original phantom with a semicircular tube of 3- and 5-mm internal diameter, with flow rate in the tube of 0, 20, 60, 80, or 120 cm/s. In original images of the phantom obtained with TOF MRA and flow-sensitive BB MRA and in filter frequency-weighted subtraction (FWS) processed images acquired with HOP MRA, we measured the contrast-to-noise ratio (CNR) of both the inside and outside of the tubes. In FWS processed images with GMN applied to 2 axes, the CNR was high at various flow rates in both straight and bending portions of the tubes in comparison with TOF images. In a clinical study in 15 patients, we evaluated vessel visualization in images obtained using conventional TOF MRA with magnetization transfer contrast (MTC) and HOP MRA. In clinical studies, visualization scores of HOP MRA were equivalent to those of conventional TOF MRA in the bilateral internal carotid arteries (ICA) and inferior in the basilar arteries. However, visualization of the peripheral portion of the middle cerebral artery (MCA) improved significantly in HOP MRA with GMN applied to 2 and 3 axes. Visualization of the main trunk of the ICA and MCA was superior in HOP MRA with GMN applied to 2 axes. HOP MRA with 2-axis GMN may be useful for excellent visualization of both major arteries and peripheral vessels in the head.


Asunto(s)
Velocidad del Flujo Sanguíneo , Circulación Cerebrovascular , Trastornos Cerebrovasculares/diagnóstico , Angiografía por Resonancia Magnética/métodos , Anciano , Arteria Basilar/patología , Arteria Carótida Interna/patología , Arterias Cerebrales/patología , Femenino , Humanos , Aumento de la Imagen , Masculino , Persona de Mediana Edad , Fantasmas de Imagen
13.
Nat Chem Biol ; 6(10): 733-40, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20835228

RESUMEN

Adenosine-to-inosine (A-to-I) RNA editing is a post-transcriptional processing event involved in diversifying the transcriptome responsible for various biological processes. Although bioinformatic approaches have predicted a number of A-to-I editing sites in cDNAs, the human transcriptome is thought to still harbor large numbers of as-yet-unknown editing sites. Exploring new editing sites requires a biochemical method to accurately identify inosines on RNA strands. We here describe a chemical method to identify inosines, called inosine chemical erasing (ICE), that is based on cyanoethylation combined with reverse transcription. We carried out a large-scale verification of the ICE method focusing on 642 regions in human cDNA and identified 5,072 editing sites, including 4,395 new sites. Functional study revealed that A-to-I intronic editing in the SARS gene mediated by ADAR1 is involved in preventing aberrant exonization of Alu sequence into mature mRNA.


Asunto(s)
Adenosina/metabolismo , Perfilación de la Expresión Génica , Inosina/análisis , Inosina/química , Edición de ARN/genética , Adenosina/química , Adenosina Desaminasa/genética , Alquilación , Elementos Alu/genética , Secuencia de Aminoácidos , Secuencia de Bases , ADN Complementario , Exones/genética , Humanos , Inosina/metabolismo , Datos de Secuencia Molecular , Proteínas de Unión al ARN , Serina-ARNt Ligasa/genética
14.
Eur J Pharm Biopharm ; 74(3): 451-60, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20060903

RESUMEN

Peanut agglutinin (PNA)-immobilized fluorescent nanospheres were designed as a novel imaging agent for colonoscopy. PNA is a targeting moiety that binds to beta-D-galactosyl-(1-3)-N-acetyl-D-galactosamine, which is the terminal sugar of the Thomsen-Friedenreich antigen that is specifically expressed on the mucosal side of colorectal cancer cells. The in vivo performance of the imaging agent was evaluated using a human colorectal cancer orthotopic animal model. Human colorectal adenocarcinoma cell lines, HT-29, HCT-116, and LS174T, were implanted on the cecal serosa of immune-deficient mice. A loop of the tumor-bearing cecum was made, and the luminal side was treated with the imaging agent. Strong fluorescence was observed at several sites of the cecal mucosa, irrespective of cancer cell type. Microscopic histological evaluation of the cecal mucosa revealed that bright areas with fluorescence derived from the imaging agent and dark areas without the fluorescence well denoted the presence and absence, respectively, of the invasion of implanted cancer cells on the mucosal side. This good correlation showed that PNA-immobilized fluorescent nanospheres recognized millimeter-sized tumors on the cecal mucosa with high affinity and specificity.


Asunto(s)
Acetamidas/química , Neoplasias Colorrectales/diagnóstico , Diagnóstico por Imagen/métodos , Colorantes Fluorescentes/química , Nanosferas/química , Aglutinina de Mani/química , Polivinilos/química , Animales , Ciego/patología , Línea Celular Tumoral , Colitis/diagnóstico , Colitis/patología , Colon/patología , Neoplasias Colorrectales/patología , Detección Precoz del Cáncer/métodos , Femenino , Colorantes Fluorescentes/síntesis química , Mucosa Intestinal/patología , Proteínas Luminiscentes/química , Proteínas Luminiscentes/genética , Ratones , Ratones Desnudos , Ratones SCID , Microscopía Fluorescente , Estructura Molecular , Trasplante de Neoplasias , Tamaño de la Partícula , Propiedades de Superficie , Proteína Fluorescente Roja
15.
J Control Release ; 134(1): 2-10, 2009 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-19014984

RESUMEN

Peanut agglutinin (PNA)-immobilized polystyrene nanospheres with surface poly(N-vinylacetamide) (PNVA) chains encapsulating coumarin 6 were designed as a novel colonoscopic imaging agent. PNA was a targeting moiety that binds to beta-D-galactosyl-(1-3)-N-acetyl-D-galactosamine, which is the terminal sugar of the Thomsen-Friedenreich antigen that is specifically expressed on the mucosal side of colorectal cancer cells. PNVA was immobilized with the aim of reducing nonspecific interactions between imaging agents and normal tissues. Coumarin 6 was encapsulated into nanosphere cores to provide endoscopically detectable fluorescence intensity. After incubation of imaging agents with human cells, the fluorescence intensity of imaging agent-bound cells was estimated quantitatively. The average fluorescence intensity of any type of colorectal cancer cell used in this study was higher than that of small intestinal epithelial cells that had not exposed the carbohydrate. The in vivo performance of imaging agents was subsequently evaluated using a human colorectal cancer orthotopic animal model. Imaging agent-derived strong fluorescence was observed at several sites of the large intestinal mucosa in the tumor-implanted nude mice after the luminal side of the colonic loop was contacted with imaging agents. In contrast, when mice that did not undergo tumor implantation were used, the fluorescence intensity on the mucosal surface was extremely low. Data indicated that imaging agents bound to colorectal cancer cells and the cancer cell-derived tumors with high affinity and specificity.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Diagnóstico por Imagen/métodos , Colorantes Fluorescentes/química , Nanosferas/química , Aglutinina de Mani/química , Acetamidas/química , Animales , Antígenos de Carbohidratos Asociados a Tumores/química , Línea Celular , Cumarinas/química , Humanos , Ratones , Ratones Desnudos , Modelos Animales , Polivinilos/química , Tiazoles/química
17.
Ann Nucl Med ; 20(4): 303-10, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16856574

RESUMEN

BACKGROUND: Chronic pain is defined as intractable pain caused by abnormal pain transmission or impairment of the pain control system per se. Alteration of regional cerebral blood flow (rCBF) is known to occur under the presence of pain stimulation. Epidural spinal cord stimulation (SCS) is occasionally effective in relieving the symptom. OBJECTIVE: The aim of the current study is to investigate the alteration of rCBF in baseline condition and to find the association between the rCBF change and the efficacy of SCS in chronic pain. METHODS: A total of 18 patients underwent Tc-99m-HMPAO SPECT before and after SCS. Analysis with three-dimensional stereo-tactic surface projections (3D-SSP) with stereo-tactic extraction estimation (SEE) software was adopted to evaluate the rCBF. We assessed the extent score of the abnormal region in each segment (rate of the coordinates with a Z-value that exceeds three kinds of threshold value 2.0, 2.5 and 3.0 in all coordinates within a segment). According to the therapeutic response defined by visual analogue scale, we categorized patients into two groups, the good responder (GR) group (n=12) and poor responder (PR) group (n=6). In the analysis, we compared the extent score in the following two conditions. (1) Comparison between the PR group and normal control group under both baseline condition and after SCS. (2) Comparison between the GR group and normal control group under both baseline condition and after SCS. RESULTS: (1) In the PR group, increased rCBF was observed in left thalamus, bilateral precuneus and bilateral cerebellum under the baseline condition. After SCS, the range of these increased rCBF areas localized but remained. Decrease of rCBF was noted in bilateral subcallosal gyrus, superior temporal gyrus (STG) and bilateral anterior cingulate gyrus (ACG). They localized after SCS, but remained. (2) In the GR group, increased rCBF areas were noted in bilateral precuneus and bilateral cerebellum under the baseline condition. After SCS, they localized in bilateral precuneus but those of bilateral cerebellum remained. Decreased rCBF area was noted in bilateral subcallosal gyrus, STG and bilateral ACG under the baseline. After SCS, they localized in bilateral subcallosal gyrus and bilateral STG. In contrast, they enlarged in bilateral ACG. CONCLUSION: Chronic pain patients demonstrated abnormal rCBF distribution on both baseline and post SCS conditions. Increased rCBF of thalamus and precuneus under both conditions in the PR group and decreased rCBF of ACG under post SCS conditions in the GR group were characteristic patterns. Tc-99m-HMPAO SPECT with 3D-SSP and SEE analysis is likely objective and effective in monitoring and evaluating therapeutic outcome by SCS in chronic pain. In addition, it provides information that is useful in the selection of SCS candidates.


Asunto(s)
Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Terapia por Estimulación Eléctrica/métodos , Manejo del Dolor , Dolor/diagnóstico por imagen , Médula Espinal/fisiopatología , Exametazima de Tecnecio Tc 99m , Circulación Cerebrovascular , Enfermedad Crónica , Espacio Epidural/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Resultado del Tratamiento
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