Your browser doesn't support javascript.
loading
Montrer: 20 | 50 | 100
Résultats 1 - 20 de 111
Filtrer
1.
Clin Transl Oncol ; 22(6): 919-927, 2020 Jun.
Article de Anglais | MEDLINE | ID: mdl-31576495

RÉSUMÉ

PURPOSE: Immune checkpoint inhibitors (ICIs) show promising clinical activity in advanced cancers. However, the safety and efficacy of PD-1/PD-L1 blockade in patients with preexisting antinuclear antibodies (ANA) are unclear. METHODS: 191 patients treated with nivolumab, pembrolizumab, atezolizumab, or durvalumab for unresectable advanced cancers between September 2014 and December 2018 were identified retrospectively. Patients were divided into positive (ANA titers ≥ 1:160) and negative ANA groups (ANA titers < 1:160). Development of immune-related adverse events (irAEs), the overall response rate (ORR), and disease control rate (DCR) were monitored. RESULTS: Positive ANA titers were seen in 9 out of 191 patients. Four patients in the positive ANA group and 69 patients in the negative group developed irAEs of any grade without a significant difference between the groups. The development of endocrine, pulmonary, and cutaneous irAEs was not significant, whereas positive ANA was significantly higher in patients who developed colitis (2/9) than in patients who did not (3/182, P = 0.0002). DCR in the positive and negative ANA group was 37.5% and 67.5%, respectively, and was not statistically significant, but had better efficacy in patients without ANA (P = 0.08). ANA-related autoimmune diseases such as SLE, Sjögren's syndrome, MCTD, scleroderma, dermatomyositis, and polymyositis was not induced in either group. However, one patient with preexisting dermatomyositis had a flare up after initiation of atezolizumab. CONCLUSION: Further studies to identify predictive factors for the development of irAEs are required to provide relevant patient care and maximize the therapeutic benefits of ICIs.


Sujet(s)
Anticorps antinucléaires/sang , Antinéoplasiques immunologiques/usage thérapeutique , Inhibiteurs de points de contrôle immunitaires/usage thérapeutique , Tumeurs/traitement médicamenteux , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Antigène CD274/antagonistes et inhibiteurs , Effets secondaires indésirables des médicaments/sang , Effets secondaires indésirables des médicaments/anatomopathologie , Femelle , Humains , Mâle , Adulte d'âge moyen , Tumeurs/sang , Récepteur-1 de mort cellulaire programmée/antagonistes et inhibiteurs , Études rétrospectives , Résultat thérapeutique
3.
Eur Surg Res ; 51(3-4): 118-28, 2013.
Article de Anglais | MEDLINE | ID: mdl-24247292

RÉSUMÉ

BACKGROUND: Preoperative portal vein embolization (PVE) is performed to enhance the future remnant liver function (FRLF) and volume (FRLV). However, the volume of the nonembolized liver does not increase enough in some patients, which results in an insufficient FRLF. The aim of this study was to evaluate the predictors of insufficient FRLF after PVE for extended hepatectomy. METHODS: This retrospective study included 172 patients (107 patients with cholangiocarcinoma, 40 patients with metastatic liver cancer and 25 patients with hepatocellular carcinoma) who underwent PVE before extended hepatectomy. The total liver function was evaluated by measuring the indocyanine green plasma clearance rate (KICG). Computed tomography volumetry was conducted to evaluate the total liver volume and FRLV. The KICG of the future remnant liver (remK) was calculated using the following formula: KICG × FRLV/total liver volume. The safety margin for hepatectomy was set at remK after PVE (post-PVE remK) ≥ 0.05. RESULTS: One hundred and twenty-three patients with a post-PVE remK level of >0.05 underwent hepatectomy without postoperative liver failure [sufficient liver regeneration (SLR) group], and 9 patients with a post-PVE remK level of <0.05 did not due to insufficient FRLF [insufficient liver regeneration (ILR) group]. In the SLR group, the KICG values did not change after PVE (median, 0.144-0.146, p = 0.523); however, the %FRLV and remK increased significantly (35.0-44.3%, p < 0.001 and 0.0488-0.0610, p < 0001, respectively). In contrast, in the ILR group, the KICG values decreased significantly (0.128-0.108, p = 0.021) and the %FRLV increased marginally (27.4-32.6%, p = 0.051). As a result, the remK did not increase significantly (0.0351-0.0365, p = 0.213). A receiver operating characteristic curve demonstrated an remK value of 0.04 obtained before PVE (pre-PVE remK) to be the optimal cutoff point for defective liver regeneration. The univariate and multivariate analyses revealed that a pre-PVE remK value of <0.04 was a factor for ILR. It was also correlated with postoperative liver failure in the analysis of the patients who underwent hepatectomy. CONCLUSIONS: The patients in the ILR group did not achieve SLR after PVE due to a significant decrease in the KICG and an insufficient increase in %FRLV. A pre-PVE remK value of <0.04 is a useful predictor of insufficient regeneration of the nonembolized liver, even after PVE.


Sujet(s)
Embolisation thérapeutique , Hépatectomie/méthodes , Régénération hépatique , Soins préopératoires , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Veine porte
4.
Br J Surg ; 99(11): 1584-90, 2012 Nov.
Article de Anglais | MEDLINE | ID: mdl-23027077

RÉSUMÉ

BACKGROUND: Abdominal drains have been placed prophylactically and removed in liver resection without robust evidence. The present study was designed to establish the optimal time for removal of such drains. METHODS: Data on abdominal prophylactic drains were analysed in a consecutive series of patients who underwent liver resection for malignancy between 2006 and 2009. Bilirubin levels in drain fluid were measured and bacteriological cultures were taken on days 1, 3, 5 and 7 after surgery. Drains were removed on day 3 if the drain-fluid bilirubin level was less than 5 mg/dl and bacteriological cultures were negative. Drains remained in situ until these conditions were met. RESULTS: A total of 514 abdominal drains were placed in 316 patients operated on in the study period. Fifty-eight patients (18·4 per cent) had positive drain-fluid cultures and 14 (4·4 per cent) had bile leakage (drain-fluid bilirubin level 5 mg/dl or more). Only one patient required ultrasound-guided abdominal drainage. On multivariable analysis, drain-fluid bilirubin level on day 3 after surgery was the strongest predictor of infection (odds ratio 15·11, 95 per cent confidence interval 3·04 to 92·11; P < 0·001). The area under the receiver operating characteristic curve on day 3 had the highest predictive value: 83·6 per cent accuracy and 3·9 per cent false-positive rate for a drain-fluid bilirubin level of 3·01 mg/dl (51·5 µmol/l). CONCLUSION: The '3 × 3 rule' (drain-fluid bilirubin level below 3 mg/dl on day 3 after operation) is an accurate criterion for removal of prophylactically placed abdominal drains in liver resection.


Sujet(s)
Drainage/méthodes , Tumeurs du foie/chirurgie , Infection de plaie opératoire/prévention et contrôle , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Bilirubine/sang , Ablation de dispositif , Hépatectomie/méthodes , Humains , Tumeurs du foie/sang , Adulte d'âge moyen , Infection de plaie opératoire/sang , Infection de plaie opératoire/étiologie , Facteurs temps , Résultat thérapeutique
5.
Bone Marrow Transplant ; 46(11): 1450-4, 2011 Nov.
Article de Anglais | MEDLINE | ID: mdl-21243022

RÉSUMÉ

Autologous hematopoietic SCT (ASCT) has been investigated as salvage therapy for refractory systemic lupus erythematosus (SLE). Although immune recovery after ASCT with in vitro purging of lymphocytes has been extensively studied, little information is available about immune recovery after ASCT without in vitro purging. Therefore, we analyzed the immune recovery of a patient who successfully underwent ASCT without in vitro purging for refractory SLE. In addition to the numbers of PBL subsets, T-cell receptor rearrangement excision circles (TRECs) and the T-cell receptor repertoire diversity of both CD4+ and CD8+ T cells were sequentially analyzed. All SLE-related symptoms disappeared within 3 months after ASCT and the serum anti-dsDNA Ab became undetectable. The number of CD4+CD45RO+ memory T cells remained lower than that in healthy adult controls, but the number of CD4+CD45RA+ naïve T cells showed a rapid increase after ASCT. TRECs of both CD4+ and CD8+ T cells were strongly suppressed before ASCT, but consistently increased after ASCT. The T-cell receptor repertoire of CD8+ T cells was skewed before ASCT, but the diversity recovered after ASCT. ASCT with the reinfusion of a large number of autologous T cells did not impair the recovery of naive T cells or resetting of the immune system.


Sujet(s)
Lupus érythémateux disséminé/immunologie , Lupus érythémateux disséminé/thérapie , Transplantation de cellules souches de sang périphérique/méthodes , Sous-populations de lymphocytes T/immunologie , Purge médullaire , Femelle , Transplantation de cellules souches hématopoïétiques , Humains , Jeune adulte
6.
J Hepatol ; 44(6): 1074-82, 2006 Jun.
Article de Anglais | MEDLINE | ID: mdl-16481065

RÉSUMÉ

BACKGROUND/AIMS: A major polyphenol of green tea, epigallocatechin-3-gallate (EGCG), has previously been shown to induce cell-cycle arrest and apoptosis in various cancers. However, little is known about its effects on hepatocellular carcinomas (HCCs). METHODS: Four HCC cell lines, HLE, HepG2, HuH-7 and PLC/PRF/5, were treated with EGCG or vehicle. Cell viability was assessed by trypan blue staining and WST-8 assay. Cell-cycle, apoptosis and apoptosis-related proteins in HLE cells were evaluated by flow cytometry and Western blotting. The effect of EGCG was also studied in vivo using a xenograft model. The effect of co-treatment with EGCG and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was also assessed. RESULTS: EGCG inhibited the growth of all HCC cell lines at concentrations of 50-100 microg/ml. In HLE cells, EGCG induced apoptosis but not cell-cycle arrest and appears to have down-regulated Bcl-2alpha and Bcl-xl by inactivation of NF-kappaB. Oral administration of EGCG showed similar effects in HLE xenograft tumors. Co-treatment with EGCG and TRAIL synergistically induced apoptosis in HLE cells. CONCLUSIONS: EGCG induced apoptosis in HLE cells, both in vitro and in vivo. Moreover, it enhanced TRAIL-induced apoptosis. Therefore, EGCG treatment may be useful for improving the prognosis of HCCs.


Sujet(s)
Anticarcinogènes/usage thérapeutique , Carcinome hépatocellulaire/traitement médicamenteux , Catéchine/analogues et dérivés , Tumeurs du foie/traitement médicamenteux , Protéine Bax/métabolisme , Protéine bcl-X/métabolisme , Administration par voie orale , Animaux , Anticarcinogènes/analyse , Apoptose , Protéines régulatrices de l'apoptose/usage thérapeutique , Camellia sinensis/composition chimique , Carcinome hépatocellulaire/métabolisme , Caspases/métabolisme , Catéchine/analyse , Catéchine/usage thérapeutique , Lignée cellulaire tumorale , Régulation négative , Activation enzymatique , Humains , Tumeurs du foie/métabolisme , Mâle , Glycoprotéines membranaires/usage thérapeutique , Souris , Lignées consanguines de souris , ARN messager/analyse , ARN messager/métabolisme , Ligand TRAIL , Thé/composition chimique , Facteur de nécrose tumorale alpha/usage thérapeutique , Tests d'activité antitumorale sur modèle de xénogreffe , Protéine Bax/génétique , Protéine bcl-X/génétique
7.
Ann Hum Genet ; 66(Pt 3): 183-93, 2002 May.
Article de Anglais | MEDLINE | ID: mdl-12174210

RÉSUMÉ

Haplotype analysis is important for mapping traits. Recently, methods for estimating haplotype frequencies from genotypes of unrelated individuals based on the expectation-maximization (EM) algorithm have been developed. Our program estimates haplotype frequencies in the population and determines the posterior probability distribution of diplotype configuration (diplotype distribution) for each subject based on the estimated haplotype frequencies. Samples from three ethnic groups for the smoothelin gene (SMTN) and those from three Japanese groups for serum amyloid A genes (SAA@) were analyzed. The estimated diplotype distribution for each individual was concentrated, in most cases, in a single diplotype configuration. The diplotype configuration thus determined was the same as that determined in in vitro experiments, with one exception. Thus, the diplotype configurations determined using the estimated haplotype frequencies from unrelated individuals are reliable. Using this method, the risk of a subject developing a phenotype may be estimated from the diplotype distribution when the phenotype is associated with diplotype configurations.


Sujet(s)
Algorithmes , Haplotypes/génétique , Apolipoprotéines/génétique , Séquence nucléotidique , Protéines du cytosquelette/génétique , Humains , Données de séquences moléculaires , Protéines du muscle/génétique , Polymorphisme de nucléotide simple , Analyse de séquence d'ADN , Protéine amyloïde A sérique/génétique
8.
Pacing Clin Electrophysiol ; 24(7): 1100-7, 2001 Jul.
Article de Anglais | MEDLINE | ID: mdl-11475826

RÉSUMÉ

The post-repolarization refractoriness (PRR) is an important factor to determine the conduction block in cardiac muscle. Recently, we proposed the block coupling interval (BCI) as an useful electrophysiological index for evaluating the PRR. In the present study, the effect of procainamide on PRR was evaluated using the BCI and the effective refractory period (ERP). In five beagle dogs, radiofrequency linear ablation was performed on the right atrial surface parallel to the AV groove, forming an artificial isthmus (8-10 mm width and 15-20 mm length). Bipolar recordings were performed in the isthmus at a resolution of 1.2 mm and single extrastimuli with eight basic drive trains were delivered to cause conduction blocks in the isthmus. When a conduction block occurred, the recorded coupling interval at the recording site just proximal to the site of block was defined as BCI. At the site of the block, the ERP and duration of the monophasic action potential (MAP) at each drive cycle length was measured. The PRR was calculated using two different formulas: (1) [ERP-MAP] and (2) [BCI-MAP]. Procainamide was administrated intravenously at a dose of 15 mg/kg after the control study and the whole study protocol was repeated. The site of the block in an individual dog was always the same. BCI, ERP, and MAP were all shortened in accordance with the shortening of the basic drive cycle length, and the BCI was always the longest, ERP the middle, and the MAP was the shortest. The administration of procainamide prolonged each parameter, but the order of BCI > ERP > MAP remained unchanged. The PRR calculated as [BCI-MAP] was prolonged from 15 +/- 10 ms to 29 +/- 8 ms by the administration of procainamide (P = 0.048), but [ERP-MAP] was unchanged (8 +/- 10 ms vs 8 +/- 4 ms). In the conduction block model in the canine right atrium, procainamide prolonged the [BCI-MAP], but did not change the [ERP-MAP]. The procainamide effect of prolonging the PRR might be expressed better by the change in the BCI than the ERP.


Sujet(s)
Antiarythmiques/pharmacologie , Bloc cardiaque/physiopathologie , Système de conduction du coeur/effets des médicaments et des substances chimiques , Système de conduction du coeur/physiopathologie , Procaïnamide/pharmacologie , Période réfractaire en électrophysiologie/effets des médicaments et des substances chimiques , Animaux , Modèles animaux de maladie humaine , Chiens , Électrophysiologie
10.
Arthritis Rheum ; 44(6): 1266-72, 2001 Jun.
Article de Anglais | MEDLINE | ID: mdl-11407685

RÉSUMÉ

OBJECTIVE: To address whether the gamma haplotype at exon 3 of the SAA1 gene is directly associated with type AA amyloidosis or is merely in linkage with an unknown polymorphism that is primarily associated with disease risk, we examined the SAA1 gene for new polymorphisms. METHODS: We analyzed DNA samples from 44 rheumatoid arthritis (RA) patients with AA amyloidosis (amyloid group), 55 RA patients without AA amyloidosis (RA group), and 58 non-RA healthy subjects (non-RA group). We also examined DNA samples from 50 Caucasians to compare linkage disequilibrium relationships involving SAA1 region polymorphisms between Japanese and Caucasoid populations. RESULTS: We observed 3 novel single-nucleotide polymorphisms (SNPs) in the 5'-flanking region of SAA1: -61C/G, -13T/C, and -2G/A. Comparison of allele frequencies and ratios of individuals with particular alleles between the study groups revealed statistically significant differences between the amyloid and RA groups and between the amyloid and non-RA groups. Statistical analysis revealed that the -13T/C SNP was strongly associated with AA amyloidosis. In addition, we found tight linkage between the -13T allele and the alpha haplotype, rather than the beta haplotype, at exon 3 in the Caucasoid population, while -13T was closely linked to the gamma and beta haplotypes, rather than the alpha haplotype, in the Japanese population. Since the linkage disequilibrium relationship was reversed between the Japanese and Caucasoid populations, different exon 3 haplotypes of SAA1 are found to be associated with the risk of AA amyloidosis in different ethnic groups. CONCLUSION: Our data suggest that the SAA1 -13T allele, rather than SAA1 exon 3 haplotypes, is primarily associated with AA amyloidosis risk.


Sujet(s)
Amyloïdose/étiologie , Amyloïdose/génétique , Polyarthrite rhumatoïde/complications , Polyarthrite rhumatoïde/génétique , Haplotypes/génétique , Polymorphisme de nucléotide simple , Protéine amyloïde A sérique/génétique , Séquences répétées terminales , Amyloïdose/épidémiologie , Polyarthrite rhumatoïde/épidémiologie , Asiatiques , Séquence nucléotidique , ADN/analyse , Humains , Données de séquences moléculaires , Odds ratio , Réaction de polymérisation en chaîne , Polymorphisme de restriction , Facteurs de risque , Analyse de séquence d'ADN ,
11.
Jpn Circ J ; 65(4): 335-40, 2001 Apr.
Article de Anglais | MEDLINE | ID: mdl-11316134

RÉSUMÉ

In the present study, the long-term process of progression of electrical remodeling at various atrial sites, which is not well understood, was compared while monitoring continuously the electrophysiologic parameters at multirecording sites in canine atria during continuous atrial burst pacing. A rapid pacing device was implanted in 5 dogs, and continuous atrial burst pacing (400 beats/min) was delivered at the right atrial appendage (RAA). Four pairs of epicardial wire electrodes were sutured on (1) the RAA, (2) Bachmann's bundle (BB), (3) the right atrium close to the inferior vena cava (IVC), and (4) the left atrium (LA). The distal ends of those wires were exteriorized posteriorly and used for pacing and recording. The atrial effective refractory period (AERP), AERP dispersion (AERPd), atrial conduction time (CT) and inducibility of atrial fibrillation (AF) were evaluated during burst pacing for 14 days and during the subsequent 7 days' recovery. The AERP at the LA pacing site was shorter than that at the other sites on day 0. The AERP shortening was greater in the RAA and LA sites than in the BB and IVC sites. The AERPd increased during pacing and reached the maximum level on day 3, and then decreased during the recovery phase. Prolongation of CT tended to be longer between the RAAand IVC sites than that between the other sites. The incidence of AF induction became higher in accordance with the time course of the rapid pacing phase. There was another peak of AF induction on days 7-10. In a canine chronic rapid atrial stimulation model, the progression of electrical remodeling (ie, the shortening of the AERP and the prolongation of the CT) was not homogeneous in both atria, the AERPd showed a temporal increase between days 3 and 7 and matched the increase in AF inducibility at the LA pacing site, the increase in the AERPd was mainly caused by more rapid AERP shortening at the RAA or LA sites, and the LA site always showed a shorter AERP than the other atrial sites in the control state and during the rapid pacing phase, whereas AF inducibility was higher at the LA site than the other sites.


Sujet(s)
Entraînement électrosystolique , Système de conduction du coeur/physiologie , Période réfractaire en électrophysiologie/physiologie , Animaux , Fibrillation auriculaire/étiologie , Entraînement électrosystolique/effets indésirables , Diastole , Chiens , Atrium du coeur , Rythme cardiaque , Contraction myocardique/physiologie
12.
Jpn Circ J ; 65(3): 219-25, 2001 Mar.
Article de Anglais | MEDLINE | ID: mdl-11266198

RÉSUMÉ

The leakage of electrical current to the body surface during defibrillation shock delivery by an implantable cardioverter-defibrillator (ICD) device (the Medtronic Jewel Plus PCD system) was evaluated in 5 dogs. The defibrillation shocks were delivered between the active-can implanted in the left subclavicular region and the endocardial lead placed in the right ventricle at the energy levels of 1, 2, 8, 12, 24 and 34 J. During each delivery, the electrical current leakage from the body surface was measured by electrodes connected to a circuit at 4 recording positions: (A) parallel-subcutaneous (the electrodes were fixed in the subcutaneous tissue of the left shoulder and the right lower chest, and the direction of the electrode vector was parallel to the direction of the defibrillation energy flow); (B) cross-subcutaneous (the electrodes were fixed in the subcutaneous tissue of the right shoulder and the left lower chest, and the vector of the electrodes was roughly perpendicular to the direction of the energy flow); (C) parallel-surface (the electrodes were fixed with ECG paste on the shaved skin surface at the left shoulder and the right lower chest); and (D) surface grounded (the electrodes were fixed on the shaved skin surface at the left shoulder and the left foot, which was grounded). The circuit resistance was set at a variable level (100-5,000 ohms) in accordance with the resistance measured through each canine body. Leakage energies were measured in 750 defibrillation shocks with each circuit resistance in 5 dogs. The leakage energy increased in accordance with the increase of the delivered energy and the decrease of the circuit resistance in all 4 recording positions. When the circuit resistance was set at 1,000 ohms, the leakage energy during shock delivery at 34 J was 32+/-17 mJ at position A, 5+/-9 mJ at B, 10+/-9 mJ at C, and 4+/-3 mJ at D (p=0.042). The peak current was highest at position A and was 87+/-22 mA with a circuit resistance of 1,000 ohms. The power of the leakage energy depended on the delivered energy and the impedance between the electrodes. The angle between the alignment of the recording electrodes and the direction of the energy flow was another important factor in determining the leakage energy. Although the peak current of the leakage energy reached the level of macro shock, the highest leakage energy from the body surface was considerably less because of the short duration of the shock delivery.


Sujet(s)
Défibrillateurs implantables/effets indésirables , Défibrillation/effets indésirables , Animaux , Chiens , Impédance électrique , Électrotraumatisme/étiologie , Électricité/effets indésirables , Peau
13.
Ann Rheum Dis ; 60(4): 327-31, 2001 Apr.
Article de Anglais | MEDLINE | ID: mdl-11247860

RÉSUMÉ

OBJECTIVES: This prospective study was designed to clarify the frequency, causes, and clinical course of renal disease in patients with early rheumatoid arthritis (RA). METHODS: 235 patients (185 women, mean age 49.4 years) with early RA of less than one year's duration were enrolled and assessed monthly. Proteinuria was defined as a positive dipstick result and microscopic haematuria was defined as the presence of > or =5 red blood cells per high power field. Urinary abnormalities lasting three months or longer were defined as persistent abnormalities. RESULTS: At entry, 40 patients exhibited haematuria, two had a raised serum creatinine concentration, and none had proteinuria. During the observation period (average 42 months), persistent haematuria was found in 43, persistent proteinuria in 17, and a raised serum creatinine concentration in 14 patients. Persistent proteinuria was caused by drugs in 14 of 17 patients and disappeared in most cases. Risk factors for drug induced proteinuria included a raised C reactive protein and erythrocyte sedimentation rate and age over 50 at entry. Drugs resulted in a raised serum creatinine concentration in eight of 14 patients. The incidence of haematuria at entry did not differ among patients who had been treated with non-steroidal anti-inflammatory drugs, disease modifying antirheumatic drugs, or no drugs. In some patients with isolated haematuria, the haematuria appeared when the activity of RA was high and resolved when it was low. CONCLUSIONS: This study suggests that a raised serum creatinine concentration or persistent proteinuria in patients with early RA is predominantly drug related whereas, in contrast, isolated haematuria is more directly associated with the activity of the disease process.


Sujet(s)
Polyarthrite rhumatoïde/complications , Maladies du rein/étiologie , Adulte , Facteurs âges , Sujet âgé , Anti-inflammatoires non stéroïdiens/usage thérapeutique , Antirhumatismaux/usage thérapeutique , Polyarthrite rhumatoïde/sang , Polyarthrite rhumatoïde/traitement médicamenteux , Sédimentation du sang , Protéine C-réactive/analyse , Créatinine/sang , Femelle , Hématurie/imagerie diagnostique , Hématurie/étiologie , Humains , Maladies du rein/sang , Maladies du rein/imagerie diagnostique , Mâle , Adulte d'âge moyen , Études prospectives , Protéinurie/étiologie , Facteurs de risque , Statistique non paramétrique , Échographie
14.
Jpn Circ J ; 65(1): 40-5, 2001 Jan.
Article de Anglais | MEDLINE | ID: mdl-11153820

RÉSUMÉ

Post-repolarization refractoriness (PRR) is an important factor in determining conduction block and is the difference between the effective refractory period (ERP) and the duration of the monophasic action potential (MAPD). In the present study, conduction block in an artificial isthmus in the canine atrium was evaluated and the coupling interval of a premature beat, which caused the block, was defined as the block coupling interval (BCI). The usefulness of this value was also evaluated. Radiofrequency linear ablation was performed on the right atrial surface parallel to the atrioventricular groove in 5 mongrel dogs, and an artificial isthmus (8-10mm wide and 25-30mm long) was created. Fourteen simultaneous unipolar recordings were performed in the isthmus with a resolution of 1.2 mm. Single extra-stimuli with basic drive train were delivered to induce conduction block in the isthmus and when it occurred, the coupling interval at the recording site just proximal to the site of the block was defined as the BCI. At the site of the block, the ERP and MAPD at each drive cycle length were measured. The PRR was calculated using 2 different formulae: (1) [ERP-MAPD], and (2) [BCI-MAPD]. It was found that each value was shortened in accordance with the shortening of the basic drive cycle length. In all basic drive trains, BCI>ERP>MAPD, and [ERP-MAPD] was always shorter than [BCI-MAPD]. In the shorter cycle length of basic drives, the difference between [ERP-MAPD] and [BCI-MAPD] was more prominent. In the artificial isthmus model in the canine atrium, BCI was always longer than the ERP measured at the same site as the block. Because the ERP may not directly reflect the block phenomenon, the electrophysiologic evaluation should use the BCI instead, as in the PRR evaluation.


Sujet(s)
Bloc cardiaque/physiopathologie , Potentiels d'action/physiologie , Animaux , Extrasystoles auriculaires/physiopathologie , Modèles animaux de maladie humaine , Chiens , Électrocardiographie , Techniques électrophysiologiques cardiaques , Atrium du coeur/physiopathologie , Bloc cardiaque/diagnostic , Bloc cardiaque/étiologie , Système de conduction du coeur/traumatismes
15.
Jpn Heart J ; 42(6): 713-23, 2001 Nov.
Article de Anglais | MEDLINE | ID: mdl-11933921

RÉSUMÉ

The second deflection of the atrial double potential (DP) recorded at the intercaval region is considered to reflect the far-field potential of the left atrium. The conduction via the upper interatrial connection was evaluated utilizing this DP and the relationship between atrial fibrillation (AF) and the conduction via the interatrial connection evaluated. In 30 consecutive patients with the DP at the intercaval region, prolongation in the left atrial activation time during the right atrial extra stimulation was measured at the intercaval region (deltaDP) and the coronary sinus (deltaCS). The difference between deltaDP and deltaCS (deltaDP-deltaCS) was used as an index of inhomogeneity in interatrial conduction. The patients were divided into AF (n=13) and non-AF (n=17) groups in accordance with the inducibility of AF in the electrophysiologic study. The max deltaDP and the max ACS were greater in the AF group than in the non-AF group, i.e., max deltaDP (43+/-19 vs 27+/-17 ms, P=0.021), max deltaCS (35+/-15 vs 21+/-14 ms, P=0.029). The max absolute value(deltaDP-deltaCS) was also greater in t


Sujet(s)
Fibrillation auriculaire/physiopathologie , Fonction auriculaire , Système de conduction du coeur/physiopathologie , Potentiels d'action/physiologie , Adolescent , Adulte , Sujet âgé , Électrophysiologie , Femelle , Humains , Mâle , Adulte d'âge moyen , Tachycardie par réentrée intranodale/physiopathologie
16.
J Biosci Bioeng ; 92(3): 298-300, 2001.
Article de Anglais | MEDLINE | ID: mdl-16233100

RÉSUMÉ

Thermophilic poly-L-lactide-degrading bacteria were isolated from a garbage fermentor. One of the isolates, strain PL21, was identified as Bacillus smithii based on its physiological properties, sugar assimilation pattern, and partial 16S rDNA sequence. The degradation activity of poly-L-lactide exibited by the culture fluid was parallel to the esterase activity, and the purified enzyme was active against various fatty acid esters and poly-L-lactide, at 60 degrees C and pH 5.

17.
Jpn Circ J ; 64(11): 876-82, 2000 Nov.
Article de Anglais | MEDLINE | ID: mdl-11110434

RÉSUMÉ

Quantitative information is needed on the directly depolarized area (DDA) induced by high-output energy during a precise mapping procedure to detect the origin of a tachycardia. In the present study, a DDA caused by high-output energy was quantitatively evaluated in the exposed canine heart. In 8 dogs, the right atrial and ventricular surfaces were exposed through a right thoracotomy and pacing with various outputs was delivered from the epicardial surface. A comb-shaped 16 polar electrode array and/or a 224 polar mat electrode array were used for recording the epicardial electrograms. The local activation time was measured at each electrode site, and the relationship of the distance between the electrode location from the pacing site and the local activation time was plotted and fitted to a primary regression line. The intercept of the regression line on the horizontal axis was defined as the radius of the 'DDA' and this was evaluated at each pacing output. The radius of the DDA was 0.6+/-0.1 mm with a 2 V and 3.8+/-0.2 mm with a 10 V output when it was evaluated in a direction perpendicular to the fiber orientation of the pectinate muscle, 0.8+/-0.1 mm with a 2 V and 4.1+/-0.3 mm with a 10 V output in a direction parallel to the pectinate muscle fiber orientation, and 0.9+/-0.3 mm with a 2 V and 3.6+/-0.5 mm with a 10 V output in the right ventricle. The DDA extended according to the increase in stimulation outputs at all sites, and there was no significant difference in the pacing site or the direction of the stimulation propagation. The DDA caused by high-output energy is a purely physical phenomenon that depends only on stimulation output and tissue resistance. The diameter of the DDA exceeded 4 mm (ie, the size of a standard tip electrode for catheter ablation) when pacing was delivered with an output greater than 6 V.


Sujet(s)
Entraînement électrosystolique/méthodes , Coeur/physiologie , Myocarde/ultrastructure , Animaux , Affichage de données , Chiens , Stimulation électrique , Électrodes , Conception d'appareillage , Potentiels de membrane
18.
Heart ; 83(5): E8, 2000 May.
Article de Anglais | MEDLINE | ID: mdl-10768920

RÉSUMÉ

A 55 year old man with intermittent Wolff-Parkinson-White (WPW) syndrome had an episode of atrial fibrillation (AF) that lasted for 117 days. After interruption of the AF a Delta wave appeared that lasted for two days and then disappeared. Exercise stress and isoprenaline infusion could not reproduce the Delta wave, but after another episode of AF which lasted for seven days a persistent Delta wave appeared that lasted for six hours. In an electrophysiological study performed on a day without a Delta wave, neither antegrade nor retrograde conduction via an accessory pathway was seen, but after atrial burst pacing (at 250 ms cycle length) for 10 minutes, a Delta wave appeared lasting for 16 seconds. Atrial electrical remodelling-that is, the shortening of the atrial effective refractory period caused by AF, is a possible mechanism of the appearance of the Delta wave.


Sujet(s)
Antiarythmiques/usage thérapeutique , Fibrillation auriculaire/physiopathologie , Système de conduction du coeur/malformations , Syndrome de Wolff-Parkinson-White/physiopathologie , Administration par voie orale , Fibrillation auriculaire/traitement médicamenteux , Disopyramide/usage thérapeutique , Électrocardiographie , Système de conduction du coeur/physiopathologie , Humains , Injections veineuses , Lidocaïne/analogues et dérivés , Lidocaïne/usage thérapeutique , Mâle , Adulte d'âge moyen , Procaïnamide/usage thérapeutique
19.
Biosci Biotechnol Biochem ; 64(1): 1-8, 2000 Jan.
Article de Anglais | MEDLINE | ID: mdl-10705441

RÉSUMÉ

D-Aminoacylase from Alcaligenes xylosoxydans subsp. xylosoxydans A-6 (Alcaligenes A-6) was strongly inactivated by diethylpyrocarbonate (DEPC). An H67N mutant was barely active, with a kcat/Km 6.3 x 10(4) times lower than that of the recombinant wild-type enzyme, while the H67I mutant lost detectable activity. The H67N mutant had almost constant Km, but greatly decreased kcat. These results suggested that His67 is essential to the catalytic event. Both H69N and H69I mutants were overproduced in the insoluble fraction. The kcat/Km of H250N mutant was reduced by a factor of 2.5 x 10(4)-fold as compared with the wild-type enzyme. No significant difference between H251N mutant and wild-type enzymes in the Km and kcat was found. The Zn content of H250N mutant was nearly half of that of wild-type enzyme. These results suggest that the His250 residue might be essential to catalysis via Zn binding.


Sujet(s)
Alcaligenes/enzymologie , Amidohydrolases/métabolisme , Histidine/métabolisme , Alcaligenes/effets des médicaments et des substances chimiques , Amidohydrolases/génétique , Catalyse , Dichroïsme circulaire , Cobalt/pharmacologie , Dicarbonate de diéthyle/pharmacologie , Histidine/génétique , Cinétique , Mutagenèse dirigée , Conformation des protéines , Relation structure-activité , Zinc/pharmacologie
20.
Biosci Biotechnol Biochem ; 64(12): 2727-30, 2000 Dec.
Article de Anglais | MEDLINE | ID: mdl-11210148

RÉSUMÉ

Nitrite-oxidizing enzyme I (NiOx I) was purified from a heterotrophic bacterium, Bacillus badius I-73. The enzyme was a homotetramer of a heme-containing peptide, and was similar to catalases from various sources in its N-terminal amino acid sequence. The purified enzyme also catalyzed H2O2 degradation. The nitrite oxidation reaction required ascorbic acid and oxygen. Successive H2O2 feeding could be substituted for ascorbic acid. These indicated that NiOx I is a catalase and nitrite was oxidized by a peroxidase-like reaction.


Sujet(s)
Bacillus/enzymologie , Catalase/métabolisme , Nitrites/métabolisme , Peroxidases/isolement et purification , Peroxidases/métabolisme , Séquence d'acides aminés , Acide ascorbique/composition chimique , Acide ascorbique/métabolisme , Peroxyde d'hydrogène/métabolisme , Concentration en ions d'hydrogène , Données de séquences moléculaires , Oxydoréduction , Oxygène/composition chimique , Oxygène/métabolisme
SÉLECTION CITATIONS
DÉTAIL DE RECHERCHE
...