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Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.
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Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning.Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.
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PURPOSE: This study investigates pediatric nurses' knowledge and attitudes regarding iatrogenic narcotic analgesic withdrawal symptoms management (INAWSM).METHOD: In this cross-sectional study, 253 pediatric nurses working at a tertiary hospital in Seoul participated. Instruments were the inventory consisting questionnaires on 35 items knowledge and 12 items attitude for INAWSM. Further, descriptive statistics, t-test, and analysis of variance were used to evaluate the nurses' knowledge and attitudes.RESULTS: The correct answers rate of knowledge toward INAWSM was 44.9%. With respect to the pediatric nurses' attitudes, the participants scored an average value of 2.83±0.25 out of 4 points. The factor related to the knowledge and attitude level was age, pediatric nursing experience, educational experience, and educational needs.CONCLUSION: Results revealed that pediatric nurses had inadequate knowledge and attitude on INAWSM despite a compulsory education. Therefore, it is necessary to develop an efficient INAWSM educational program.
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Criança , Humanos , Analgésicos , Estudos Transversais , Educação , Métodos , Entorpecentes , Enfermagem Pediátrica , Seul , Síndrome de Abstinência a Substâncias , Centros de Atenção TerciáriaRESUMO
BACKGROUND: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. METHODS: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. RESULTS: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. CONCLUSION: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
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Humanos , Consumo de Bebidas Alcoólicas , Anti-Hipertensivos , Pressão Sanguínea , Índice de Massa Corporal , Comorbidade , Educação , Medicina de Família e Comunidade , Seguimentos , Hipertensão , Coreia (Geográfico) , Estilo de Vida , Atividade Motora , Análise Multivariada , Atenção Primária à Saúde , Estudos Prospectivos , Estudos Retrospectivos , Fumaça , Fumar , Aumento de PesoRESUMO
We would like to replace Table 3 of the original paper with a revised version. We sincerely apologized to the readers.
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OBJECTIVE: To quantify changes in cardiopulmonary function using a lower body positive pressure supported (LBPPS) treadmill during the exercise tolerance test (ETT) in healthy subjects before applying the LBPPS treadmill in patients with gait problems. METHODS: We evaluated 30 healthy subjects who were able to walk independently. The ETT was performed using the Modified Bruce Protocol (stages 1–5) at four levels (0%, 40%, 60%, and 80%) of LBPPS. The time interval at each level of the LBPPS treadmill test was 20 minutes to recover to baseline status. We measured systolic blood pressure, diastolic blood pressure, peak heart rate (PHR), rating of perceived exertion (RPE), metabolic equivalents (METs), and oxygen consumption rate (VO₂) during each LBPPS condition. RESULTS: Systolic blood pressure increased as the LBPPS level was increased (40% to 80%). PHR, RPE, METs, and VO₂ were negatively associated with the LBPPS condition, although they were not always significant different among the LBPPS levels. The equation from a random effect linear regression model was as follows: VO₂ (mL/kg/min)=(2.75×stage)+(–0.14×LBPPS level)+11.9 (r²=0.69). CONCLUSION: Detection of the changes in physiological parameters during a submaximal ETT using the LBPPS system may be helpful for applying the LBPPS treadmill in patients who cannot perform the ETT due to gait problems, even at submaximal intensity.
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Humanos , Pressão Sanguínea , Teste de Esforço , Tolerância ao Exercício , Marcha , Voluntários Saudáveis , Frequência Cardíaca , Modelos Lineares , Equivalente Metabólico , Consumo de Oxigênio , ReabilitaçãoRESUMO
PURPOSE: To compare the accuracy and reliability of intraocular pressure (IOP) measurements in enucleated porcine eyes using the Icare PRO in the upright and horizontal positions. METHODS: We designed an enucleated porcine eye model whose anterior chamber was cannulated with a 30-gauge needle, connected in parallel to a pneumatic pressure device. The reference pressure was manipulated by changing the air pressure from 70 to 10 mm Hg at 10 mm Hg intervals, and the IOP of porcine eyes was measured with the Icare PRO at each pressure. Correlation analysis, comparison using the Bland-Altman plot and Wilcoxon signed rank test, was performed to assess the accuracy of IOP measurements. Intraclass correlation coefficients were calculated to assess the intra-observer variability in the upright and horizontal positions, respectively. RESULTS: The IOP value in both upright and horizontal positions was well correlated with the reference pressure (r = 0.992 and 0.985, respectively). The Bland-Altman plot showed good agreement between the two positions. However, all IOP values in both positions were lower than the reference pressures. The IOP values in the horizontal position were significantly lower than those in the upright position at the a reference pressure of 50 mm Hg or greater. Values of intraclass correlation coefficient ranged from 0.911 to 0.984 when measured in the upright position and from 0.707 to 0.914 in the horizontal position. CONCLUSIONS: IOP measurements of Icare PRO in porcine eyes were remarkably lower than reference pressures controlled by the pneumatic method even though they showed a good correlation with reference values. The higher was the reference pressure, the greater was the degree of underestimation of IOP measurement in both positions. This trend was more pronounced in the horizontal position, and the reliability of IOP measurements was also lower than that in the upright position.
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Pressão do Ar , Câmara Anterior , Pressão Intraocular , Complexo Ferro-Dextran , Agulhas , Variações Dependentes do Observador , Valores de ReferênciaRESUMO
A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere.
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Adulto , Humanos , Amputação Cirúrgica , Córtex Motor , Membro Fantasma , Estimulação Magnética Transcraniana , Escala Visual AnalógicaRESUMO
PURPOSE: Rebound tonometer has been used to measure the intraocular pressure (IOP) in the supine as well as normal upright positions. We investigated the reliability of IOP measurements using the rebound tonometer in the upright and supine positions. METHODS: IOP was measured in 30 patients (60 eyes) with open-angle glaucoma who had no history of ocular surgery and no anterior segment pathology, in both the upright and supine positions using rebound tonometer (IcarePRO; Icare Finland Oy, Finland). The average IOP value after 6 measurements was recorded. We measured IOP repeatedly until 3 reliable values within normal limits of the measurement's variation were obtained. We calculated the intraclass correlation coefficient (ICC), coefficient of variation, and number of repeated measurements necessary to obtain 3 reliable IOP values in each position as measured by one examiner. RESULTS: ICC values for IOP measurements were 0.852 (95% confidence interval [CI], 0.784-0.903; p < 0.001) in the upright position and 0.684 (95% CI, 0.563-0.784; p < 0.027) in the supine position. Coefficient of variation was 8.7 +/- 0.1% in the upright position and 24.0 +/- 0.1% in the supine position. An average of 3.3 times of repeated measurements in the upright position and 6.2 times in the supine position were necessary to obtain 3 reliable IOP values within the normal range of standard deviation. CONCLUSIONS: When measuring IOP using the IcarePRO rebound tonometer, the measurement reliability was different between the upright and supine positions. Reproducibility of IOP measurements was lower in the upright than the supine position.
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Humanos , Finlândia , Glaucoma de Ângulo Aberto , Pressão Intraocular , Complexo Ferro-Dextran , Patologia , Valores de Referência , Decúbito DorsalRESUMO
PURPOSE: To report a case of persistent shallow anterior chamber after silicone tube intubation, recovered by fibrin glue in glaucoma drainage device implantation (GDI). CASE SUMMARY: A 42-year-old female, diagnosed with neovascular glaucoma at a local clinic visited our clinic for uncontrolled intraocular pressure (IOP) in her right eye. We performed GDI on her right eye. Scleral flap and paracentesis of the anterior chamber were performed. Then, a silicone tube was inserted into the anterior chamber. Despite repetitive infusion of balanced salt solution (BSS), the anterior chamber became persistently shallow due to peritubular leakage. After dropping the fibrin glue in the peritubular space and beneath the scleral flap, attachment occurred. No additional leakage was observed near the scleral flap and after infusion of BSS, a deep anterior chamber was maintained. One day after surgery, IOP in the right eye was 3 mm Hg, deep anterior chamber was maintained, and no leakage of aqueous humor into the conjunctiva occurred. Two months after surgery, IOP was 16 mm Hg and a deep anterior chamber was maintained. CONCLUSIONS: In cases of persistent shallow anterior chamber after silicone tube intubation in intraoperative GDI, the best methods to maintain the anterior chamber is by suture ligation of the peritubular loosened site or infusion of viscoelastic agent to anterior chamber. In the present case, applying the fibrin glue beneath the scleral flap apparently obstructed the peritubular infiltration.
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Adulto , Feminino , Humanos , Assistência Ambulatorial , Câmara Anterior , Humor Aquoso , Túnica Conjuntiva , Drenagem , Adesivo Tecidual de Fibrina , Glaucoma , Glaucoma Neovascular , Pressão Intraocular , Intubação , Ligadura , Paracentese , Silicones , SuturasRESUMO
OBJECTIVES: The aim of this study was to investigate the effect of resilience on depression and life satisfaction in patients with end-stage renal disease (ESRD) on Hemodialysis. METHODS: Fifty ESRD patients, aged 18 or older, on hemodialysis visiting the hemodialysis room at Catholic University of Korea, Uijeongbu St. Mary's Hospital were included in this study. All patients were divided into two groups based on a Mini International Neuropsychiatric Interview : ESRD patients with major depressive disorder (MDD), and ESRD patients without MDD. The 17-item Hamilton Depression Rating Scale (HAM-D) and the Montgomery-Asberg Depression Rating Scale were used for assessment of the severity of depression symptoms. The Conner-Davidson Resilience Scale (CD-RISC) and Index of Well-being were used for measurement of resilience and life satisfaction, respectively. RESULTS: Sixteen (32%) patients were included in the MDD group, and 34 (68%) patients were included in the non-MDD group. The MDD group had significantly lower CD-RISC (p<0.005) and Index of well-being scores (p<0.005). The CD-RISC score showed a significant negative correlation with HAM-D-17 (r=-0.36, p<0.05) score and a positive correlation with Index of well-being score (r=0.37, p<0.01). Multiple regression analysis showed a significant relation of CD-RISC score with HAM-D-17 (beta=-0.36, p<0.05) and well-being score (beta=-0.56, p<0.005). CONCLUSION: Results of this study suggest that ESRD patients with higher resilience might be less depressed and have higher life satisfaction. Therefore, identification of clinical approaches that could increase resilience of ESRD patients might be important to prevention of depression and enhancement of life quality in ESRD patients on hemodialysis.
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Idoso , Humanos , Depressão , Transtorno Depressivo Maior , Falência Renal Crônica , Coreia (Geográfico) , Qualidade de Vida , Diálise RenalRESUMO
BACKGROUND: Depressive symptoms accompanied by chronic obstructive pulmonary disease (COPD) can be influenced by socioeconomic status, associated chronic diseases and the current smoking status. This study was conducted to assess factors that are associated with depressive symptoms accompanied by COPD, using the data obtained from the Korea National Health and Nutritional Survey (KNHANES) conducted in 2005 and 2008. METHODS: From the third (2005) and the fourth (2008) KNHANES, 407 (0.9%) with physician-diagnosed COPD were selected. Of the 407 subjects, only 180 (0.4%) who reported having depressive symptoms were included in this study. The associations of depressive symptoms with socioeconomic status, associated chronic diseases and smoking status were investigated. RESULTS: Of the total 180 subjects, 45 (25%) had depressive symptoms. There were 102 males (55%) and 78 females (45%) with a slight predilection for males. In multivariate analysis, significant predictors of depressive symptoms were dependent activities of daily living (odds ratio [OR], 2.42; 95% confidence interval [CI], 2.06 to 2.84) and association with number of chronic diseases (OR of one, two, and three, 1.40, 1.72, 2.60; 95% CI of one, two, and three, 1.20 to 1.63,1.41 to 2.10,1.99 to 3.39). CONCLUSION: This study provides the basis for managing COPD patients in a clinical setting by understanding the number and characteristics of COPD patients with depressive symptoms. The results of this study suggest that primary physicians should manage COPD patients with consideration of risk factors for depressive symptom.
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Feminino , Humanos , Masculino , Atividades Cotidianas , Doença Crônica , Depressão , Coreia (Geográfico) , Análise Multivariada , Inquéritos Nutricionais , Doença Pulmonar Obstrutiva Crônica , Fatores de Risco , Fumaça , Fumar , Classe SocialRESUMO
BACKGROUND: Premenstrual syndrome (PMS) is a common and disabling disorder among adolescents. But the research addressing premenstrual disorders in adolescents is sparse and such disorders may well be underrecognized. In this regard, the study aimed at identifying attributes to premenstrual symptoms by surveying one high school located in Busan, Korea. METHODS: A total of 381 adolescent females who accepted the participation in this study were recruited from one academic high school in Busan, Korea. For the evaluation of risk factors on the PMS, we investigated menstrual patterns, severity of premenstrual symptoms, environment and life events, stress, and physical activity. RESULTS: In bivariate analysis, earlier menarche (P = 0.007), higher BEPSI score (P < 0.001), higher physical activity score (P = 0.003), and drinking alcohol (P = 0.047) were related to PMS symptom severity. On multiple regression analysis, Brief Encounter Psychosocial Instrument Score (P < 0.001), age of menarche (P = 0.003) and physical activity (P = 0.004) were independent explanatory variables of PMS symptom severity. CONCLUSION: This study showed that the relationship between PMS symptom severity and age of menarche and stress was statistically significant in high school girls.
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Adolescente , Feminino , Humanos , Ingestão de Líquidos , Coreia (Geográfico) , Menarca , Atividade Motora , Síndrome Pré-Menstrual , Fatores de RiscoRESUMO
BACKGROUND: It is important to evaluate the functional ability of the elderly for optimal care. This study was conducted to identify factors associated with dependence for activities of daily living (ADL) and instrumental activities of daily living (IADL) in elderly adults in Korea. METHODS: A cross-sectional study of data from the third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 was undertaken. The sample consisted of 3,656 participants, 65 years of age or older. Multifactorial regression analysis was used to identify associations between ADL and IADL dependence and sociodemographics, lifestyle, and health history. RESULTS: Among the 629 (17.2%) ADL-dependent and significantly and independently associated factors were age, lower education level, health assistance or no-insurance, stroke, urinary incontinence, diabetes, arthritis, and lung cancer. Among the 1,674 (55.7%) IADL-dependent and significantly and independently associated factors were age, lower education level, single or widowed, male, stroke, arthritis, glaucoma and/or cataract. CONCLUSION: Functional dependence in older adults was directly related to aging and had multiple determinants. Awareness of these determinants should help design health programs that can identify individuals who are at high risk of losing their independence, and implement interventions for slowing or reversing the process.
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Adulto , Idoso , Humanos , Masculino , Atividades Cotidianas , Envelhecimento , Artrite , Catarata , Estudos Transversais , Glaucoma , Coreia (Geográfico) , Estilo de Vida , Neoplasias Pulmonares , Inquéritos Nutricionais , Acidente Vascular Cerebral , Incontinência Urinária , ViuvezRESUMO
BACKGROUND: It is not clear which demographic factors would be considered for human papillomavirus (HPV) infection in Korean women and how women understand the HPV infection. This study was conducted to find the factors related to HIV infection and the realities of follow-up tests and perception among women infected with HPV. METHODS: The subjects were 2,113 women (median 41 years old) who received a Papanicolaou smear and a HPV DNA test at a health promotion center from March 2006 to October 2007. The follow-up rate and perception for HPV infection among women infected by HPV were surveyed using telephone. RESULTS: Overall prevalence of HPV infection was 17.3% (N = 365). However, the prevalence of HPV infection among women younger than 30 years old reached 30.7% (17.6% for low-risk group of HPV, 13.1% for high-risk group of HPV). The odds for being infected with HPV was 3.2 (95% confidence interval, 2.0 to 5.2) among unmarried women younger than 30 years old compared to those at the ages of 30 years or older. Married women younger than 30 years were also 2.1-4.3 times more likely to be infected with low-risk group of HPV compared to those aged 30 years or older. Among those infected with HPV and answered to the survey (N = 282), 51.4% took irregular gynecologic follow-up and 66.2% did not have information for the need or importance of follow-up examination. CONCLUSION: The risk of being infected with HPV seems to be higher for unmarried women younger than 30 years old. Additionally, a standardized guideline should be provided to improve follow-up examination and knowledge about HPV infection.
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Idoso , Feminino , Humanos , Demografia , Seguimentos , Promoção da Saúde , Infecções por HIV , Testes de DNA para Papilomavírus Humano , Papiloma , Prevalência , Pessoa Solteira , Telefone , Esfregaço Vaginal , VírusRESUMO
BACKGROUND: After the referral system had been established, a tendency of patients who prefer to consult themselves to a specialist with 'self requested referral' is increasing in university hospital family medicine clinics. This study was conducted to know which factors of patients who for the first time visited university hospital family medicine clinic to require medical request for 'self requested referral' to a specialist influence 'self requested referral' tendency. METHODS: Among 905 patients, 647 agreed to the questionnaire were included in this study. We divided the patients in two, the 'self requested referral' group and the 'general patients' group that does not. Patients completed a four-item, self-administered questionnaire. RESULTS: 'Self requested referral' group tended to have no experience in family medicine and tended to be negative about the need for family medicine (P < 0.001) The factors that have effect on 'self requested referral' are age, occupation, education, experience of family medicine, and recognition degree of necessity of family medicine. Patients in 20-39 of age, who were white colored, higher education had higher tendency of 'self requested referral' and patients who had no experience in family medicine and lower degree of recognition about the necessity of family medicine had higher tendency of 'self-referral'. CONCLUSION: It is necessary to find ways to increase satisfaction of patients who have factors that have effect on their 'self requested referral' tendency such as age, occupation, education, experience of family medicine, and degree of recognition about the necessity of family medicine.
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Humanos , Ocupações , Encaminhamento e Consulta , Especialização , Inquéritos e QuestionáriosRESUMO
BACKGROUND: In chronic obstructive pulmonary disease (COPD) patients, the serum levels of C-reactive protein (CRP) are elevated and an increase of CRP is more exaggerated in the acute exacerbation form of COPD (AECOPD) than in stable COPD. Pulmonary arterial hypertension is a common complication of COPD. An increased level of CRP is known to be associated with the risk of systemic cardio-vascular disorders. However, few findings are available on the potential role of CRP in pulmonary arterial hypertension due to COPD. METHODS: This study was performed prospectively and the study population was composed of 72 patients that were hospitalized due to AECOPD. After receiving acute management for AECOPD, serum CRP levels were evaluated, arterial oxygen pressure (PaO2), was measured, and the existence of pulmonary arterial hypertension under room air inhalation was determined in the patients. RESULTS: The number of patients with pulmonary arterial hypertension was 47 (65.3%)., There was an increased prevalence of pulmonary arterial hypertension and an increase of serum CRP levels in patients with the higher stages of COPD (e.g., patients with stage 3 and stage 4 disease; P<0.05). The mean serum CRP levels of patients with pulmonary arterial hypertension and without pulmonary arterial hypertension were 37.6+/-7.4 mg/L and 19.9 +/-6.6 mg/L, respectively (P<0.05). However, there was no significant difference of the mean values of PaO2 between patients with pulmonary arterial hypertension and without pulmonary arterial hypertension statistically (77.8+/-3.6 mmHg versus 87.2+/-6.0 mmHg). CONCLUSION: We conclude that higher serum levels of CRP can be a sign for pulmonary arterial hypertension in AECOPD patients.
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Humanos , Proteína C-Reativa , Hipertensão , Hipertensão Pulmonar , Inalação , Oxigênio , Prevalência , Estudos Prospectivos , Doença Pulmonar Obstrutiva CrônicaRESUMO
Clear cell tumor of the lung is a rare and very unusual benign pulmonary tumor. As clear cell tumor of the lung contains abundant cytoplasmic glycogen, this tumor is called "sugar tumor". We report a case of sugar tumor in a 64-yr-old man presenting as a round pulmonary nodule. On dynamic computed tomography (CT) scans, the solitary pulmonary nodule showed early wash-in enhancement with an early washout pattern like a lung malignancy. The patient underwent wedge resection for the tumor. Pathologic examination, including immunohistochemical studies, revealed that the nodule was a benign clear cell tumor, so-called "sugar tumor". Because only a small number of cases have been reported previously, clinical aspects, radiological characteristics on dynamic contrast-enhanced CT, and differential diagnosis of the tumor are not well established. Herein we present a clear cell tumor of the lung and discuss the clinical, radiological, and pathological features of the tumor.
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Humanos , Masculino , Pessoa de Meia-Idade , Antígenos de Neoplasias/metabolismo , Diagnóstico Diferencial , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Proteínas de Neoplasias/metabolismo , Neoplasias de Células Epitelioides Perivasculares/diagnóstico , Nódulo Pulmonar Solitário/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Reactive oxygen species (ROS) play a crucial role in acute lung injury. Tissue inflammation, the increased vascular permeability, and plasma exudation are cardinal features of acute lung injury. Angiopoietin-1 (Ang1) has potential therapeutic applications in preventing vascular leakage and also has beneficial effects in several inflammatory disorders. Recently developed COMP-Ang1 is more potent than native Ang1 in phosphorylating tyrosine kinase with immunoglobulin and EGF homology domain 2 receptor in endothelial cells. However, there are no data on effects and related molecular mechanisms of COMP- Ang1 on ROS-induced acute lung injury. We used hydrogen peroxide (H2O2)-inhaled mice to evaluate the effect of COMP-Ang1 on pulmonary inflammation, bronchial hyper-responsiveness, and vascular leakage in acute lung injury. The results have revealed that VEGF expression, the levels of IL-4, TNF-alpha, IL-1 beta, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 in lungs, the levels of hypoxia-inducible factor-1alpha (HIF-1 alpha) and NF-kappa B in nuclear protein extracts, phosphorylation of Akt, and vascular permeability were increased after inhalation of H2O2 and that the administration of COMP-Ang1 markedly reduced airway hyper-responsiveness, pulmonary inflammation, plasma extravasation, and the increases of cytokines, adhesion molecules, and VEGF in lungs treated with H2O2. We have also found that the activation of HIF-1a and NF-kappa B and the increase of phosphoinositide 3-kinase activity in lung tissues after H2O2 inhalation were decreased by the administration of COMP-Ang1. These results suggest that COMP-Ang1 ameliorates ROS-induced acute lung injury through attenuating vascular leakage and modulating inflammatory mediators.
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Animais , Feminino , Camundongos , Lesão Pulmonar Aguda/induzido quimicamente , Administração por Inalação , Resistência das Vias Respiratórias/efeitos dos fármacos , Hiper-Reatividade Brônquica/tratamento farmacológico , Líquido da Lavagem Broncoalveolar , Permeabilidade Capilar/efeitos dos fármacos , Citocinas/antagonistas & inibidores , Peróxido de Hidrogênio/efeitos adversos , Subunidade alfa do Fator 1 Induzível por Hipóxia/antagonistas & inibidores , Molécula 1 de Adesão Intercelular/metabolismo , Camundongos Endogâmicos BALB C , NF-kappa B/antagonistas & inibidores , Pneumonia/tratamento farmacológico , Proteínas Recombinantes de Fusão/administração & dosagem , Molécula 1 de Adesão de Célula Vascular/metabolismoRESUMO
Gap junction channels formed with connexins directly link to the cytoplasm of adjacent cells and have been implicated in intercellular signaling. Connexin 37 (Cx37) is expressed in the gas-exchange region of the lung. Recently, Cx37 has been reported to be involved in the pathogenesis of inflammatory disease. However, no data are available on the role of Cx37 in allergic airway inflammatory disease. In the present study, we used a murine model of ovalbumin (OVA)-induced allergic airway disease and primary murine epithelial cells to examine the change of Cx37 in allergic airway disease. These mice develop the following typical pathophysiological features of asthma: airway hyperresponsiveness, airway inflammation, and increased IL-4, IL-5, IL-13, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, eotaxin, and RANTES levels in lungs. Cx37 protein and mRNA expression were decreased in OVA-induced allergic airway disease. Immunoreactive Cx37 localized in epithelial layers around the bronchioles in control mice, which dramatically disappeared in allergen-induced asthmatic lungs. Moreover, the levels of Cx37 protein in lung tissues showed significantly negative correlations with airway inflammation, airway responsiveness, and levels of Th2 cytokines in lungs. These findings indicate that change of Cx37 may be associated with the asthma phenotype.