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1.
Laryngoscope ; 134(1): 361-366, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37565739

RESUMO

OBJECTIVE(S): Voice rest is commonly recommended following phonomicrosurgery to minimize vocal fold scarring, but associated quality of life (QoL) is low resulting in poor compliance. This study aimed to explore patients' experiences with voice rest following phonomicrosurgery to identify facilitators and barriers. METHODS: This qualitative study used prospective, typical case technique for purposive sampling of consecutive patients who underwent voice rest following phonomicrosurgery for benign vocal fold lesions. Participants were enrolled at a single tertiary Laryngology center located at Unity Health Toronto - St. Michael's Hospital from 2020 to 2022. Semi-structured virtual interviews were conducted 4 weeks following patients' surgery. All interview transcripts were transcribed verbatim and underwent thematic analysis. Participant recruitment was stopped once thematic saturation was achieved. RESULTS: Twenty participants were recruited and 4 withdrew due to scheduling conflicts. Sixteen participants completed interviews, all of whom reported minimal impact of postoperative voice rest on QoL. The participants attributed their success to facilitators such as notifying close contacts of their situation beforehand and adopting nonverbal forms of communication. No participant endorsed a negative attitude toward voice rest. Understanding the rationale for voice rest and the consequences of noncompliance were reported to be effective in encouraging compliance. CONCLUSION: Overall, the participants tolerated voice rest well owing to facilitators such as early preparation, lifestyle modifications, and understanding the rationale for voice rest. Social disconnect and work demands were barriers of voice rest. Moving forward, facilitators and barriers should be addressed in efforts to optimize the voice rest experience for future patient populations. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:361-366, 2024.


Assuntos
Doenças da Laringe , Humanos , Doenças da Laringe/cirurgia , Qualidade de Vida , Qualidade da Voz , Estudos Prospectivos , Resultado do Tratamento , Microcirurgia/métodos , Prega Vocal/cirurgia , Avaliação de Resultados da Assistência ao Paciente
2.
Zhonghua Yi Xue Za Zhi ; 102(18): 1379-1382, 2022 May 17.
Artigo em Chinês | MEDLINE | ID: mdl-35545583

RESUMO

Objective: To investigate the effect of China Children's Asthma Action Plan (CCAAP) on the exercise status of school-age children with asthma. Methods: We included 400 school-age asthmatic children as research objects from CCAAP asthma management platform of the Affiliated Hospital of Qingdao University during March 1, 2018 to February 28, 2021 by simple random sampling method. The questionnaires of basic information and international physical activity were applied through WeChat or face to face investigation to collect the basic information and exercise status of the object. There were 346 valid questionnaires included in the study to compare the differences in exercise status and incidence of exercise-related asthma-like symptoms between the good and poor CCAAP application groups. Results: There were 232 (67.05%) and 114 (32.95%) cases in good and poor CCAAP application group, respectively. Age, female proportion and BMI of good CCAAP application group were (8±2) years, 47.0% (109/232) and (19.79±2.32) kg/m2, respectively, no statistic difference comparing to poor CCAAP application group [(8±2) years, 46.5% (53/114) and (19.87±2.43) kg/m2, respectively] (all P values>0.05). In good CCAAP application group, 30.18% (70/232) achieved the standard of moderate (high) intensity exercise per day, no statistic difference comparing to poor CCAAP application group [29.82% (34/112)] (P=0.947); 31.90% (74/232) participated in high-intensity exercise per week, higher than that of poor CCAAP application group [17.54% (20/112)] (P=0.005); incidence of exercise-related asthma-like symptoms was 19.83% (46/232), lower than that of poor CCAAP application group [29.82% (34/112)] (P=0.038). Conclusion: CCAAP promotes the exercise of school-age children with asthma.


Assuntos
Asma , Criança , China , Exercício Físico , Feminino , Humanos , Inquéritos e Questionários
3.
Zhonghua Yi Xue Za Zhi ; 100(46): 3702-3705, 2020 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-33342148

RESUMO

Objective: During the COVID-19 pandemic, the electronic "questionnaire star" was employed to investigate the general situation, medication situation and pandemic impact of children diagnosed with asthma in our hospital and enrolled in the electronic platform of the Chinese Children's Asthma Action Plan (CCAAP). The internet technology and big data were used to grasp the trend and asthma control of children who had been at home for a long time due to the pandemic, so as to facilitate the management. Methods: By random cluster sampling survey method, according to the needs and medication adherence score, the electronic "questionnaire star" was designed to conduct a survey among children (0 to 14 years old) who diagnosed with asthma and joined the CCAAP on the basis of bronchial asthma medication adherence scale. Finally, the results of electronic questionnaire survey were analyzed. Results: A total of 423 questionnaires were sent out, 422 of which were valid, with an effective response rate of 99.7%. The results of questionnaire survey showed that 296 cases were male, accounting for 70.1%, and 126 cases were female, accounting for 29.9%, with an average age of (5.4±2.6) years old. The average age of males and females was (5.3±2.6) and (5.4±2.6) years old, respectively. There were more children aged ≥5 years than children who were younger than 5 years. Additionally, 13.95% of the parents thought that the pandemic had more than moderate impact on children with asthma, and 76.12% of the children were in the green zone and had no asthma attack. The proportion of green zone inhaled drugs (79.8%) was higher than yellow zone and red zone (49.8%). After using the CCAAP platform, the dissatisfaction rate was only 1.42%. Moreover, 71.87% of the children's medical expenses decreased, and the proportion of frequent use and intermittent use of antibiotics reduced, however, the proportion of occasional use and never use of antibiotics increased significantly (all P<0.05). The average score of drug compliance was 4.56, and the more frequently the platform was used, the higher the score of medication compliance was (P<0.05). Conclusions: After using CCAAP management with the aid of internet technology, children with asthma who had been isolated at home for a long time were less affected by COVID-19, with high medication compliance, generally lower medical expenses, significantly reduced use of antibiotics, and high satisfaction. This management mode provides a new idea for internet medicine.


Assuntos
Asma , COVID-19 , Adolescente , Povo Asiático , Asma/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
5.
Zhonghua Er Ke Za Zhi ; 57(11): 870-875, 2019 Nov 02.
Artigo em Chinês | MEDLINE | ID: mdl-31665842

RESUMO

Objective: To investigate the influence of five-in-one management mode(standardized asthma treatment, asthma diary, peak expiratory flow (PEF) monitoring, reasonable diet and physical exercise) on disease prevention and control of school children with asthma. Methods: From April to October 2018, 70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design. These children were randomly divided into study group and control group, with 35 cases in each group. In the study group, 5 cases were lost to follow-up, and 30 cases were actually enrolled. In the control group, 6 cases were lost to follow-up, and 29 cases were actually enrolled. Children in the control group received routine medication and regular outpatient consultation, and children in the study group received the five-in-one asthma management model. In the first time of seeing a doctor, after 3 months and 6 months of follow-up, asthma control test score, medication compliance index score and lung function index (forced expiratory volume in 1 second (FEV1), PEF were evaluated respectively.Parental satisfaction, asthma acute episodes, weight, height and biochemical index were recorded during the 6 months of follow-up. Pulmonary function index, asthma control score and body mass index of overweight children with asthma were compared with t-test, medication compliance was compared with chi-square test, and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents' satisfaction. Results: A total of 59 children with asthma were included, among them 30 were in the study group (8.1±1.5) years old and 29 in the control group (9.2±1.1) years old. After 3 months of follow-up, FEV1, PEF, asthma control score in the study group were (86.3±1.5)%, (83.3±2.4)%, (24.7±2.6) points respectively; and in the control group, FEV1, PEF, asthma control score were (84.4±2.5)%, (82.2±1.9)%, (21.1±1.3) points respectively. The indicators in the study group were higher than those in the control group (t=3.62, 1.97, 6.64, P<0.05). After 6 months of follow-up, FEV1, PEF, asthma control score in the study group were (88.4±2.3)%, (85.4±2.2)%, (26.8±1.8) points respectively; and in the control group, FEV1, PEF, asthma control score were (85.5±1.9)%, (83.2±1.7)%, (22.5±1.4) points respectively. The indicators in the study group were significantly higher than those in the control group (t=5.34, 4.24, 10.41, P<0.05). During the 6-month follow up, the number of emergency visits of asthma attacks in the study group and in the control group were 0.42(0.36, 0.51) and 0.92(0.72, 1.27) respectively. The indicator in the study group was significantly lower than that in the control group (Z=3.21, P<0.05). After 3 months of follow-up, the proportions of children with good compliance in the study group and control group were 67% (20/30) and 62% (18/29), the proportions of poor compliance were 27% (8/30) and 34% (10/29), the proportions of non-compliance were 7% (2/30) and 7% (2/29). There were no statistically significant differences (χ(2)=0.14, 0.43, 0.00, P=0.71, 0.51, 0.97). After 6 months of follow-up, the proportions of children with good compliance in the study group and control group were 87% (26/30) and 69% (20/29), the proportion of poor compliance were 10% (3/30) and 28% (8/29), the proportion of non-compliance were 3% (1/30) and 7% (2/29), There were no statistically significant differences (χ(2)=2.70, 3.00, 0.39, P=0.10, 0.08, 0.53). After 6 months of follow-up, the number of great satisfaction, satisfaction and dissatisfaction in the study group were 20, 10 and 0 respectively, the satisfaction rate was 100%, meanwhile those indicators in the control group were 4, 15 and 10 respectively, the satisfaction rate was 66%, The indicator in the study group was significantly higher than that in the control group (Z=4.60, P<0.05). Conclusions: The application of "five-in-one" asthma management model (standardized asthma treatment, asthma diary, PEF monitoring, reasonable diet and physical exercise) for school-age children with asthma can significantly improve lung function, as well as reduce the number of acute asthma attacks. It has a high parent satisfaction, therefore it should be recommended for clinical implementation.


Assuntos
Asma/prevenção & controle , Gerenciamento Clínico , Criança , Feminino , Volume Expiratório Forçado , Humanos , Pulmão , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Testes de Função Respiratória
6.
J Eur Acad Dermatol Venereol ; 32(3): 474-481, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29117430

RESUMO

BACKGROUND: There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. OBJECTIVE: In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. METHODS: We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG. RESULTS: During the study period, a total of 1254 specimens underwent VDRL-CSF examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL-CSF. Of the 53 patients, 42 (79.2%) were true-positive cases and 11 (20.8%) were false-positive cases. In our setting, a positive non-treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true-positive VDRL-CSF based on our laboratory definition. HIV seropositivity was an independent predictor of a true-positive VDRL-CSF. CONCLUSION: Biological false-positive VDRL-CSF is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF evaluation for neurosyphilis.


Assuntos
Anticorpos Antibacterianos/líquido cefalorraquidiano , Imunoensaio/métodos , Neurossífilis/diagnóstico , Treponema pallidum/imunologia , Adulto , Idoso , Estudos de Casos e Controles , Reações Falso-Positivas , Feminino , Humanos , Imunoglobulina G/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade , Neurossífilis/líquido cefalorraquidiano , Estudos Retrospectivos , Sensibilidade e Especificidade
9.
J Clin Pharm Ther ; 36(2): 187-93, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21366648

RESUMO

UNLABELLED: WHAT IS NEW AND OBJECTIVE: Some evidence suggests that angiotensin-converting enzyme insertion/deletion (I/D) polymorphism may play a role in endothelium-dependent vasodilatation. However, the impact of I/D polymorphism on endogenous nitric oxide production, which may be of great therapeutic significance, has scarcely been studied. This study aimed to investigate this in hypertensives and hypercholesterolaemics. METHODS: Adult Han subjects were recruited by cluster sampling from two communities in Shunde, Guangdong province, China. Plasma nitrite and nitrate (NO(x)) levels were determined by colorimetry assay and angiotensin II and 6-keto-prostaglandin F1-alpha by radioimmunoassay. Angiotensin-converting enzyme gene I/D polymorphism were genotyped by polymer chain reaction-amplified fragment length polymorphism. RESULTS AND DISCUSSION: Of the 779 subjects who met our inclusion criteria, 502 were with normotensive and normocholesterolaemic, 76 had hypertension only, 146 hypercholesterolaemia only, and 55 had both hypertension and hypercholesterolaemia. Among subjects with hypertension only, the plasma levels of NO(x) for genotype DD were significantly lower than those for genotype II (P = 0·034). And the plasma levels of NO(x) for genotype DD was significantly higher than those for genotype II (P = 0·040) in subjects with hypercholesterolaemia only. WHAT IS NEW AND CONCLUSION: Our results suggest that I/D polymorphism has an impact on in vivo NO production in hypertensives and hypercholesterolaemics at the population level. Hypertensives with allele D may be benefit from L-arginine supplementation and hypercholesterolaemics with allele D may respond better to statins or antioxidants.


Assuntos
Hipercolesterolemia/genética , Hipertensão/genética , Mutação INDEL , Óxido Nítrico/biossíntese , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Adulto , Alelos , Angiotensina II/biossíntese , Angiotensina II/sangue , Angiotensina II/genética , Arginina , Sequência de Bases , Pressão Sanguínea/genética , China , Feminino , Deleção de Genes , Genótipo , Humanos , Hipercolesterolemia/metabolismo , Hipertensão/metabolismo , Masculino , Peptidil Dipeptidase A/biossíntese , Peptidil Dipeptidase A/sangue , Vasodilatação/genética , Vasodilatação/fisiologia
10.
Oncogene ; 26(49): 7017-27, 2007 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-17486064

RESUMO

The INK4A locus encodes two tumor suppressor genes, p16(INK4A) and p14(ARF), transcribed using alternative exons 1alpha or 1beta spliced onto the same exons 2 and 3. Both p16(INK4A) and p14(ARF) are capable of inhibiting the cell-cycle progression, albeit in different manner; p16(INK4A) is phosphorylation of retinoblastoma (pRB) dependent while p14(ARF) is p53-dependent. In this study, we report the discovery of a novel variant of p16(INK4A), termed p16gamma, in a primary T-cell acute lymphoblastic leukemia (T-ALL) patient sample and a neuroblastoma cell line, which was expressed at both the transcriptional and translational levels. Cloning and sequencing of the p16gamma cDNA revealed that p16gamma was identical to p16(INK4A), except that it contained an in-frame insertion of 197 bp between exons 2 and 3. p16gamma expression was detected in the majority of p16(INK4A)-expressing primary T-ALL and B-ALL patient samples and other p16(INK4A)-expressing tumor samples, but was only barely detectable in some normal mononuclear cells and other non-tumor samples. Structural analysis by nuclear magnetic resonance and circular dichroism confirmed that p16gamma, like p16(INK4A), is also an ankyrin-repeat protein. Functional analysis of p16gamma revealed that p16gamma protein interacted with cyclin D-dependent kinase4 and inhibited its kinase activity. Using a luciferase reporter assay, the transfection of p16gamma repressed the E2F response, the downstream target of pRB, with an efficacy equivalent to that of p16(INK4A). Moreover p16gamma, like p16(INK4A), induced cell-cycle arrest at G(0)/G(1), and inhibited cell growth in colony formation assay.


Assuntos
Linfoma de Burkitt/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/genética , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Fase G1 , Leucemia-Linfoma de Células T do Adulto/metabolismo , Neuroblastoma/metabolismo , Fase de Repouso do Ciclo Celular , Processamento Alternativo , Western Blotting , Linfoma de Burkitt/genética , Dicroísmo Circular , Ensaio de Unidades Formadoras de Colônias , Quinase 4 Dependente de Ciclina/metabolismo , Fatores de Transcrição E2F/metabolismo , Humanos , Imunoprecipitação , Leucemia-Linfoma de Células T do Adulto/genética , Luciferases/metabolismo , Neuroblastoma/genética , Técnicas do Sistema de Duplo-Híbrido
11.
Gene ; 278(1-2): 41-51, 2001 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-11707321

RESUMO

We have cloned the full-length cDNA and genomic region of a human prostate specific G-protein coupled receptor with properties characteristic of an olfactory receptor. A partial cDNA sequence of this gene, called PSGR, was recently cloned. The gene contains two exons and one intron of 14.9 kb in its 5'untranslated region, and was mapped to human chromosome 11p15.2. A cluster of transcription initiation sites for the 2.8 kb PSGR mRNA was identified. Cloning of the homologous gene from the mouse revealed 93% amino acid homology between the human and mouse or rat (previously cloned as RA1c) proteins, and 99% identity between the rat and mouse homologs. Although northern analysis indicated expression of the human PSGR homolog was prostate specific, its mRNA could also be detected in the olfactory zone and the medulla oblongata of the human brain. In the mouse, the PSGR gene is predominantly expressed in the brain and colon. In the rat, the PSGR homolog is expressed in the liver in addition to the brain. These data add to the growing body of evidence suggesting that olfactory receptors may have functional roles in tissues other than the olfactory organ, and further, suggest that these functions may vary across species.


Assuntos
Sequência Conservada/genética , Proteínas de Neoplasias , Receptores Odorantes/genética , Região 5'-Flanqueadora/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Northern Blotting , Mapeamento Cromossômico , Cromossomos Humanos Par 11/genética , Clonagem Molecular , DNA/química , DNA/genética , DNA Complementar/química , DNA Complementar/genética , DNA Complementar/isolamento & purificação , Evolução Molecular , Regulação da Expressão Gênica , Humanos , Masculino , Camundongos , Dados de Sequência Molecular , RNA/genética , RNA/metabolismo , Ratos , Alinhamento de Sequência , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , Especificidade da Espécie , Distribuição Tecidual , Sítio de Iniciação de Transcrição
12.
Oncogene ; 20(49): 7204-15, 2001 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-11704848

RESUMO

It has been 10 years since the seminal discovery that a mutant form of a retinoid acid receptor (RARalpha) is associated with acute promyelocytic leukemia (APL). This finding, coupled with the remarkable success of retinoic acid (RA), the natural ligand of RARalpha, in the treatment of APL, has made APL a unique model system in the study of oncogenic conversion of transcription factors in hematological malignancies. Indeed, subsequent basic and clinical studies showed that chromosomal translocation involving the RARalpha gene is the cytogenetic hallmark of APL and that these mutant forms of RARs are the oncogenes in APL that interfere with the proliferation and differentiation pathways controlled by both RAR and their fusion partners. However, it was not until recently that the role of aberrant transcriptional regulation in the pathogenesis of APL was revealed. In this review, we summarize the biochemical and biological mechanisms of transcriptional regulation by mutant RARs and their corresponding wild-type fusion partner PML and PLZF. These studies have been instrumental in our understanding of the process of leukemogenesis in general and have laid the scientific foundation for the novel concept of transcription therapy in the treatment of human cancer.


Assuntos
Regulação Leucêmica da Expressão Gênica , Leucemia Promielocítica Aguda/genética , Leucemia Promielocítica Aguda/metabolismo , Proteínas Nucleares , Diferenciação Celular/genética , Divisão Celular/genética , Estruturas do Núcleo Celular/metabolismo , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Inativação Gênica , Humanos , Fatores de Transcrição Kruppel-Like , Substâncias Macromoleculares , Mutação , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Proteínas de Fusão Oncogênica/genética , Proteínas de Fusão Oncogênica/metabolismo , Organelas/metabolismo , Proteína da Leucemia Promielocítica , Proteína com Dedos de Zinco da Leucemia Promielocítica , Receptores do Ácido Retinoico/genética , Receptores do Ácido Retinoico/metabolismo , Receptor alfa de Ácido Retinoico , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Translocação Genética , Proteínas Supressoras de Tumor
13.
Br J Pharmacol ; 134(2): 265-74, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11564644

RESUMO

1. KMUP-1 (1, 3, 5 mg kg(-1), i.v.), a xanthine derivative, produced dose-dependent sustained hypotensive and short-acting bradycardiac effects in anaesthetized rats. This hypotensive effect was inhibited by pretreatment with glibenclamide (5 mg kg(-1), i.v.). 2. In endothelium-intact or denuded aortic rings preconstricted with phenylephrine, KMUP-1 caused a concentration-dependent relaxation. This relaxation was reduced by endothelium removal, the presence of NOS inhibitor L-NAME (100 microM) and sGC inhibitors methylene blue (10 microM) and ODQ (1 microM). 3. The vasorelaxant effects of KMUP-1 was attenuated by pretreatment with various K(+) channel blockers TEA (10 mM), glibenclamide (1 microM), 4-AP (100 microM), apamin (1 microM) and charybdotoxin (ChTX, 0.1 microM). 4. Increased extracellular potassium levels (30 - 80 mM) caused a concentration-related reduction of KMUP-1-induced vasorelaxations. Preincubation with KMUP-1 (1, 10, 100 nM) increased the ACh-induced maximal vasorelaxations mediated by endogenous NO release, and enhanced the potency of exogenous NO-donor SNP. 5. The vasorelaxant responses of KMUP-1 (0.01, 0.05, 0.1 microM) together with a PDE inhibitor IBMX (0.5 microM) had an additive action. Additionally, KMUP-1 (100 microM) affected cyclic GMP metabolism since it inhibited the activity of PDE in human platelets. 6. KMUP-1 induced a dose-related increase in intracellular cyclic GMP levels in rat A10 vascular smooth muscle (VSM) cells, but not cyclic AMP. The increase in cyclic GMP content of KMUP-1 (0.1 - 100 microM) was almost completely abolished in the presence of methylene blue (10 microM), ODQ (10 microM), and L-NAME (100 microM). 7. In conclusion, these results indicate that KMUP-1 possesses the following merits: (1) stimulation of NO/sGC/cyclic GMP pathway and subsequent elevation of cyclic GMP, (2) K(+) channels opening, and (3) inhibition of PDE or cyclic GMP breakdown. Increased cyclic GMP display a prominent role in KMUP-1-induced VSM relaxations.


Assuntos
GMP Cíclico/metabolismo , Músculo Liso Vascular/efeitos dos fármacos , Piperidinas/farmacologia , Canais de Potássio/efeitos dos fármacos , Xantina/farmacologia , Xantinas/farmacologia , Acetilcolina/farmacologia , Adenilil Ciclases/efeitos dos fármacos , Adenilil Ciclases/metabolismo , Animais , Aorta/efeitos dos fármacos , Aorta/metabolismo , Aorta/fisiologia , Aorta Torácica/efeitos dos fármacos , Aorta Torácica/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Células Cultivadas , Cromakalim/farmacologia , AMP Cíclico/metabolismo , Relação Dose-Resposta a Droga , Endotélio Vascular/fisiologia , Inibidores Enzimáticos/farmacologia , Glibureto/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Técnicas In Vitro , Azul de Metileno/farmacologia , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/fisiologia , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico Sintase/efeitos dos fármacos , Óxido Nítrico Sintase/metabolismo , Nitroprussiato/farmacologia , Oxidiazóis/farmacologia , Diester Fosfórico Hidrolases/efeitos dos fármacos , Diester Fosfórico Hidrolases/metabolismo , Canais de Potássio/fisiologia , Quinoxalinas/farmacologia , Ratos , Ratos Wistar , Solubilidade , Vasodilatação/efeitos dos fármacos , Vasodilatadores/farmacologia , Xantina/química
14.
Respir Care ; 46(8): 772-82, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11463367

RESUMO

OBJECTIVE: Compare outcomes between physician-directed and protocol-directed weaning from mechanical ventilation in pediatric patients. DESIGN: Prospective-randomized. SETTING: Pediatric and cardiac intensive care units in a 307-bed tertiary referral hospital for children. INTERVENTIONS: The control group (physician-directed) was weaned according to individual physician order for reduction in minute ventilation, positive end-expiratory pressure, and ordered oxygen saturation parameters for reduction in fraction of inspired oxygen (F(IO)(2)). The study group (protocol-directed) was weaned according to a predetermined algorithm developed for the purpose of this investigation. METHODS: The study enrolled 223 patients (116 physician-directed, 107 protocol-directed). All patients were monitored for hemodynamics, ventilator parameters, arterial blood gas values when available, oxygen saturation, weaning time, pre-weaning time, extubation time, and time on F(IO)(2) > or = 0.40. We also monitored the incidence of reintubation, subglottic stenosis, tracheitis, and pneumonia. The protocol-directed group had additional measurements of actual versus predicted minute volume, comparisons of respiratory rate (actual versus predicted for age), and presence of spontaneous breathing effort for 10 consecutive minutes. Data analysis was done according to intent to treat. RESULTS: There was no significant difference in 12-hour and 24-hour pediatric risk of mortality (PRISM III) scores between groups. The protocol-directed group overall had shorter total ventilation time, weaning time, pre-weaning time, time to extubation, and time on F(IO)(2) >0.40, although after stratification for respiratory diagnosis, only the difference in weaning time remained significant. There was no difference in the incidence of reintubation, new-onset tracheitis, subglottic stenosis, or pneumonia. CONCLUSIONS: Protocol-directed weaning resulted in a shorter weaning time than physician-directed weaning in these pediatric patients.


Assuntos
Desmame do Respirador , Algoritmos , Criança , Pré-Escolar , Unidades de Cuidados Coronarianos , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica , Masculino , Estudos Prospectivos , Terapia Assistida por Computador/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento
15.
Nature ; 408(6814): 881-4, 2000 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-11130730

RESUMO

Introns are removed from nuclear messenger RNA precursors through two sequential phospho-transesterification reactions in a dynamic RNA-protein complex called the spliceosome. But whether splicing is catalysed by small nuclear RNAs in the spliceosome is unresolved. As the spliceosome is a metalloenzyme, it is important to determine whether snRNAs coordinate catalytic metals. Here we show that yeast U6 snRNA coordinates a metal ion that is required for the catalytic activity of the spliceosome. With Mg2+, U6 snRNA with a sulphur substitution for the pro-Rp or pro-Sp non-bridging phosphoryl oxygen of nucleotide U80 reconstitutes a fully assembled yet catalytically inactive spliceosome. Adding a thiophilic ion such as Mn2+ allows the first transesterification reaction to occur in the U6/sU80(Sp)- but not the U6/sU80(Rp)-reconstituted spliceosome. Mg2+ competitively inhibits the Mn2+-rescued reaction, indicating that the metal-binding site at U6/U80 exists in the wild-type spliceosome and that the site changes its metal requirement for activity in the Sp spliceosome. Thus, U6 snRNA contributes to pre-messenger RNA splicing through metal-ion coordination, which is consistent with RNA catalysis by the spliceosome.


Assuntos
Magnésio/metabolismo , Manganês/metabolismo , Splicing de RNA , RNA Nuclear Pequeno/metabolismo , Spliceossomos/metabolismo , Catálise , Ésteres/metabolismo , Precursores de RNA/metabolismo , RNA Fúngico/química , RNA Fúngico/metabolismo , RNA Mensageiro/metabolismo , RNA Nuclear Pequeno/química , Tionucleotídeos/metabolismo , Leveduras
16.
RNA ; 6(8): 1106-19, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10943890

RESUMO

The Prp2 protein of Saccharomyces cerevisiae is an RNA-dependent ATPase required before the first transesterification reaction in pre-mRNA splicing. Prp2 binds to the spliceosome in the absence of ATP and is released following ATP hydrolysis. We determined what regions in Prp2 are essential for release from the spliceosome by analyzing dominant negative mutants in vivo and in vitro. We made mutations in conserved motif II (DExH) and motif VI (QRxGR) of the helicase (H) domain. Mutations that inactivated PRP2 had a dominant negative phenotype when overexpressed in vivo. To test whether mutations outside of the H domain could confer a dominant negative phenotype, we mutagenized a GAL1-PRP2 construct and screened for mutants unable to grow on galactose-containing media. Five dominant negative mutants were characterized; three mapped within the H domain and two mapped downstream of motif VI, indicating that an extended helicase domain is required for release of Prp2 from the spliceosome. Most mutants stalled in the spliceosome in vitro. However, not all mutants that were dominant negative in vivo were dominant negative in vitro, indicating that multiple mechanisms may cause a dominant negative phenotype. Structural modeling of the H domain of Prp2 suggests that mutants map to a cleft region found in helicases of known structure.


Assuntos
Proteínas Fúngicas/química , Proteínas Fúngicas/genética , Proteínas de Saccharomyces cerevisiae , Adenosina Trifosfatases/metabolismo , Trifosfato de Adenosina/metabolismo , Motivos de Aminoácidos , Sequência de Aminoácidos , Western Blotting , Sequência Conservada , RNA Helicases DEAD-box , Eletroforese em Gel de Poliacrilamida , Galactose/metabolismo , Genes Dominantes , Histidina/metabolismo , Dados de Sequência Molecular , Mutagênese Sítio-Dirigida , Mutação , Mapeamento de Peptídeos , Fenótipo , Plasmídeos/metabolismo , Testes de Precipitina , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Splicing de RNA/genética , RNA Fúngico/genética , RNA Fúngico/metabolismo , Proteínas Recombinantes de Fusão , Saccharomyces cerevisiae/enzimologia , Saccharomyces cerevisiae/genética , Homologia de Sequência de Aminoácidos , Spliceossomos/metabolismo
17.
Mol Cell ; 5(5): 821-30, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10882118

RESUMO

The t(15;17) chromosomal translocation in acute promyelocytic leukemia (APL) generates the PML-RARalpha fusion protein. The recruitment of nuclear receptor corepressor SMRT/N-CoR and subsequent repression of retinoid target genes is critical for the oncogenic function of PML-RARalpha. Here we show that the ability of PML-RARalpha to form homodimers is both necessary and sufficient for its increased binding efficiency to corepressor and inhibitory effects on hormonal responses in myeloid differentiation. We further provide evidence that altered stoichiometric interaction of SMRT with PML-RARalpha homodimers may underlie these processes. Finally, we demonstrate that a RXR AF2 mutant recapitulates many biochemical and functional properties of PML-RARalpha. Taken together, our results provide an example that altered dimerization of a transcription factor can be directly linked to cellular transformation and implicate dimerization interfaces of oncogenes as potential drug targets.


Assuntos
Transformação Celular Neoplásica , Leucemia Promielocítica Aguda/etiologia , Proteínas de Neoplasias/metabolismo , Proteínas de Fusão Oncogênica/metabolismo , Diferenciação Celular , Colecalciferol/farmacologia , Proteínas de Ligação a DNA/metabolismo , Dimerização , Regulação Leucêmica da Expressão Gênica , Leucemia Promielocítica Aguda/genética , Modelos Genéticos , Monócitos/citologia , Correpressor 2 de Receptor Nuclear , Ligação Proteica , Receptores do Ácido Retinoico/genética , Proteínas Recombinantes de Fusão/metabolismo , Proteínas Repressoras/metabolismo , Receptores X de Retinoides , Transdução de Sinais , Fatores de Transcrição/genética , Transcrição Gênica , Translocação Genética , Tretinoína/farmacologia
18.
Mol Cell Biol ; 20(3): 816-24, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10629038

RESUMO

Arginine/serine-rich (RS) domain-containing proteins and their phosphorylation by specific protein kinases constitute control circuits to regulate pre-mRNA splicing and coordinate splicing with transcription in mammalian cells. We present here the finding that similar SR networks exist in Schizosaccharomyces pombe. We previously showed that Dsk1 protein, originally described as a mitotic regulator, displays high activity in phosphorylating S. pombe Prp2 protein (spU2AF59), a homologue of human U2AF65. We now demonstrate that Dsk1 also phosphorylates two recently identified fission yeast proteins with RS repeats, Srp1 and Srp2, in vitro. The phosphorylated proteins bear the same phosphoepitope found in mammalian SR proteins. Consistent with its substrate specificity, Dsk1 forms kinase-competent complexes with those proteins. Furthermore, dsk1(+) gene determines the phenotype of prp2(+) overexpression, providing in vivo evidence that Prp2 is a target for Dsk1. The dsk1-null mutant strain became severely sick with the additional deletion of a related kinase gene. Significantly, human SR protein-specific kinase 1 (SRPK1) complements the growth defect of the double-deletion mutant. In conjunction with the resemblance of dsk1(+) and SRPK1 in sequence homology, biochemical properties, and overexpression phenotypes, the complementation result indicates that SRPK1 is a functional homologue of Dsk1. Collectively, our studies illustrate the conserved SR networks in S. pombe consisting of RS domain-containing proteins and SR protein-specific kinases and thus establish the importance of the networks in eucaryotic organisms.


Assuntos
Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , Splicing de RNA , Schizosaccharomyces/genética , Sequência de Aminoácidos , Arginina , Clonagem Molecular , Escherichia coli , Glutationa Transferase/genética , Humanos , Fosforilação , Proteínas Serina-Treonina Quinases/química , Proteínas Recombinantes de Fusão/biossíntese , Proteínas Recombinantes de Fusão/metabolismo , Sequências Repetitivas de Aminoácidos , Schizosaccharomyces/citologia , Schizosaccharomyces/enzimologia , Serina
19.
Gen Pharmacol ; 34(5): 321-8, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-11368887

RESUMO

Various vanilloid-type beta-adrenoceptor blockers were studied on guinea pig right atrium and trachea and rat colon. In addition, we also investigated their beta(1)-, beta(2)-, and beta(3)-adrenoceptor binding affinities. All these beta-adrenergic antagonists inhibited (-)isoproterenol-induced positive chronotropic effects of the right atrium and tracheal relaxation responses in a concentration-dependent manner. Some of these agents prevented the inhibition of rat colon spontaneous motility by (-)isoproterenol. Of the agents tested, we found that ferulidilol, eugenodilol, eugenolol, isoeugenolol, and ferulinolol, as well as propranolol and metoprolol, possessed beta(3)-adrenoceptor blocking activities, others were nearly without effectiveness. Furthermore, the binding characteristics of vanilloid-type beta-adrenergic antagonists were evaluated in [3H]CGP-12177, a beta(1)/beta(2)-adrenoceptor blocker and a beta(3)-adrenoceptor agonist, binding to beta(1)-, beta(2)-, and beta(3)-adrenoceptor sites in rat ventricle, lung, and interscapular brown adipose tissue (IBAT) membranes, respectively. Eugenodilol, eugenolol, metoprolol, isoeugenolol, and ferulinolol were less potent than both propranolol and ferulidilol in competing for the beta(3)-adrenoceptor binding sites. From the results of in vitro functional and binding studies, we suggested that propranolol, ferulidilol, eugenodilol, eugenolol, metoprolol, isoeugenolol, and ferulinolol all possessed beta(3)-adrenoceptor blocking activities. On the other hand, we also found that eugenodilol, eugenolol, metoprolol, isoeugenolol, and ferulinolol had a low lipid solubility in comparison with propranolol and ferulidilol. In conclusion, we proposed that beta(3)-adrenoceptor antagonistic actions of these vanilloid-type beta-blockers were positively correlated with their lipid solubility.


Assuntos
Antagonistas Adrenérgicos beta/farmacologia , Metabolismo dos Lipídeos , Vasodilatadores/antagonistas & inibidores , Agonistas Adrenérgicos beta/farmacologia , Animais , Sítios de Ligação/efeitos dos fármacos , Ligação Competitiva/efeitos dos fármacos , Colo/efeitos dos fármacos , Feminino , Cobaias , Átrios do Coração/efeitos dos fármacos , Humanos , Isoproterenol/farmacologia , Masculino , Modelos Animais , Ratos , Ratos Wistar , Receptores Adrenérgicos/classificação , Receptores Adrenérgicos/metabolismo , Receptores Adrenérgicos/fisiologia , Solubilidade/efeitos dos fármacos , Traqueia/efeitos dos fármacos
20.
Gen Pharmacol ; 35(1): 47-57, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11679205

RESUMO

KMCP-98 is a newly synthesized adenosine receptor agonist by alkylation at the 7-position of the xanthines nucleus. We first investigated the pharmacological activities of KMCP-98 under in vivo and in vitro conditions. Acute intravenous injection of KMCP-98 (1.0, 2.0 and 3.0 mg/kg) produced a temporary fall in blood pressure and heart rate, followed by a sustained fall in heart rate in pentobarbital-anesthetized Wistar rats. The hypotensive and bradycardiac responses were inhibited by pretreatment with an A(1) adenosine receptor antagonist 8-phenyltheophylline (8-PT, 0.5 mg/kg). Both KMCP-98 and adenosine (0.3-100 microM) produced negative inotropic activity in isolated guinea pig left atria. The negative inotropic activity of KMCP-98 was significantly blocked by pretreatment with A(1) receptor antagonists 8-PT (10 microM) and xanthine amine congener (XAC, 10 microM), a nonselective adenosine antagonist theophylline (10 microM), a K(+) channel blocker tetraethylammonium (TEA, 10 mM) and a K(ATP) channel blocker glibenclamide (1 microM). KMCP-98 (0.03-30 microM) produced concentration-dependent relaxations in carbachol (1 microM) precontracted guinea pig tracheal smooth muscle. The trachea relaxant response of KMCP-98 was markedly inhibited by A(2), A(2a) and A(2b) adenosine receptor antagonists 3,7-dimethyl-1-propargylxanthine (DMPX, 10 microM), 8-(3-chlorostyryl)caffeine (CSC, 10 microM) and alloxazine (10 microM), respectively, the nitric oxide synthase (NOS) inhibitor L-NAME (100 microM) and also by TEA and glibenclamide. In addition, KMCP-98 (0.03-30 microM) elicited relaxant response in norepinephrine (3 microM) precontracted rat thoracic aorta in a concentration-dependent manner. The thoracic aorta relaxant response of KMCP-98 was also significantly inhibited by DMPX, CSC, alloxazine, L-NAME, TEA and glibenclamide. Furthermore, the binding characteristics of KMCP-98, adenosine and 5'-N-ethylcarboxaminoadenosine (NECA) were evaluated in [(3)H]DPCPX and [(3)H]CGS 21680 binding to rat cortex and striatum, respectively. The K(i) values of KMCP-98 for predominate A(1) and A(2) adenosine receptor sites were 3908+/-952 and 158+/-10 nM, respectively. In conclusion, KMCP-98 was found to be a xanthine-based adenosine receptor agonist associated cardiac depression, tracheal and aortic smooth muscle relaxations.


Assuntos
Agonistas do Receptor Purinérgico P1 , Receptores Purinérgicos P1/efeitos dos fármacos , Vasodilatadores/farmacologia , Xantinas/farmacologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Carbacol/farmacologia , Estimulação Elétrica , Feminino , Cobaias , Átrios do Coração/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Masculino , Modelos Animais , Modelos Cardiovasculares , Relaxamento Muscular/efeitos dos fármacos , Músculo Liso Vascular/efeitos dos fármacos , Ensaio Radioligante , Ratos , Ratos Wistar , Receptores Purinérgicos P1/análise , Traqueia/efeitos dos fármacos
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