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1.
Clin Radiol ; 79(4): 272-278, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38278741

RESUMO

AIM: To ascertain the association between body composition, including muscle mass and adiposity, and patient mortality in those requiring extracorporeal membrane oxygenation (ECMO) for acute respiratory failure. MATERIALS AND METHODS: A retrospective study was undertaken of all patients with acute respiratory failure requiring veno-venous (VV) ECMO between January 2015 and December 2019. Automated image segmentation software was used to quantify the cross-sectional area and average radiodensity (in Hounsfield units) of different muscle and fat compartments at the L3 level of whole-body computed tomography (CT) images taken within 48 h of initiation of ECMO support. The primary endpoint was 30-day post-ECMO initiation all-cause mortality. Logistic regression was used to analyse the correlation between CT measurements, co-morbidities, and 30-day survival. RESULTS: The study included 189 patients (age = 43.8 ± 14.6, sex = 42.3% female). There was no significant association between 30-day survival status and cross-sectional area of muscle or fat. Muscle attenuation (psoas, long spine, and abdominal muscles respectively) at the L3 level were significantly lower in those who died within 30 days of ECMO cannulation (p<0.05). On multivariable analysis including age, sex, and pre-existing respiratory comorbidities, psoas muscle attenuation was an independent predictor of survival at 30 days (OR 0.97; 95% CI 0.94 to 1.00; p=0.047). CONCLUSIONS: Reduced psoas muscle attenuation is associated with poorer survival outcomes at 30 days post-ECMO cannulation in patients who received VV ECMO support for respiratory failure. Cross-sectional areas of muscle and fat compartments did not correlate with survival outcomes at 30 days even when corrected for height and sex.


Assuntos
Oxigenação por Membrana Extracorpórea , Insuficiência Respiratória , Humanos , Feminino , Lactente , Adulto , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Oxigenação por Membrana Extracorpórea/métodos , Obesidade , Composição Corporal
2.
Biochim Biophys Acta ; 1403(2): 169-78, 1998 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-9630610

RESUMO

The cDNA encoding an intron 5-inserted form of the erythropoietin receptor (I5Epo-R) has been cloned from rat. DNA sequence analysis reveals that the insertion of intron 5, which consists of 79 bp, causes a shift in reading frame and results in termination in the region of exon 7. The deduced amino acid sequence is composed of 316 amino acid residues, which is a molecular weight of 34220. To study the function of rat I5Epo-R, we established a Chinese hamster ovary cell line expressing rat I5Epo-R. Western blot analysis and binding studies with 125I-recombinant human erythropoietin showed that the transfected cells expressed rat I5Epo-R with a molecular size of 36 kDa as a membrane-bound form, but not as a soluble form, and had a single class of binding sites with a Kd of 700 pM.


Assuntos
Processamento Alternativo , Íntrons , Proteínas de Membrana/genética , Receptores da Eritropoetina/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Encéfalo/irrigação sanguínea , Células CHO , Cricetinae , Reagentes de Ligações Cruzadas , Endotélio Vascular/metabolismo , Eritropoetina/metabolismo , Humanos , Proteínas de Membrana/biossíntese , Dados de Sequência Molecular , Ratos , Receptores da Eritropoetina/biossíntese , Proteínas Recombinantes/biossíntese , Homologia de Sequência de Aminoácidos , Solubilidade , Transfecção
3.
Biochim Biophys Acta ; 1426(1): 126-32, 1999 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-9878708

RESUMO

To clarify the relationship between diabetes mellitus and carbohydrate digestion, the activities of sucrase and isomaltase, which form a complex enzyme (SI complex) on the brush border membranes, were compared in the progression of diabetes mellitus in Otsuka Long-Evans Tokushima fatty (OLETF) rats, a model of human non-insulin-dependent diabetes mellitus with insulin resistance, and Long-Evans Tokushima Otsuka (LETO) rats as non-diabetic controls. Until 40 weeks of age, OLETF rats were obese and had a high plasma glucose level, compared to age-matched LETO rats, but the sucrase and isomaltase activities showed no significant differences between the two strains. Oral glucose tolerance test revealed that during 40-48 weeks of age, NIDDM became very severe with advancing insulin resistance in OLETF rats. In OLETF rats, in contrast to LETO rats, at 48 weeks of age, abnormal increases in the sucrase and isomaltase activities occurred, along with a remarkable decrease in body weight and a further great increase in the plasma glucose level in the non-fasting state. Hyperinsulinemia occurred in 20-week-old OLETF rats; however, at 40 and 48 weeks of age, the plasma insulin level in the non-fasting state in OLETF rats was not significantly different from that in LETO rats. The level of mRNA encoding the SI complex increased abnormally in 48-week-old OLETF rats. These results suggest that the advance of insulin resistance leads to an increase in the expression of the SI complex on the transcriptional level.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Resistência à Insulina , Intestino Delgado/enzimologia , Complexo Sacarase-Isomaltase/biossíntese , Fatores Etários , Animais , Glicemia/análise , Peso Corporal , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/enzimologia , Modelos Animais de Doenças , Teste de Tolerância a Glucose , Insulina/sangue , Masculino , Ratos , Ratos Endogâmicos OLETF , Ratos Long-Evans , Triglicerídeos/sangue
4.
Neuroreport ; 9(6): 1089-92, 1998 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-9601673

RESUMO

The effect of nitric oxide (NO) on GABA induced Cl- current of recombinant GABAA receptors was studied. Either alpha 1 beta 2 gamma 2s or alpha 1 beta 2 subunit mRNAs synthesized from cDNA of mouse brain were injected into Xenopus oocytes and functional GABAA receptors were expressed. GABA-induced Cl- current was measured with the two electrode voltage clamp technique. The NO donor NOC-18 reduced the GABA-induced Cl- current in the alpha 1 beta 2 gamma 2s subunit receptor in a dose-dependent manner. In alpha 1,beta 2 subunit receptor, NOC-18 had no effects on GABA-induced currents at low concentrations but showed potentiation at high concentration. These effects were antagonized by the NO extinguisher, carboxy-PTIO. The cGMP analogue 8-Br-cGMP failed to induce NO-like effects. NO directly acts at the GABAA receptor and the gamma 2s subunit is involved in its action.


Assuntos
Óxido Nítrico/fisiologia , Compostos Nitrosos/farmacologia , Fragmentos de Peptídeos/farmacologia , Receptores de GABA-A/química , Animais , Técnicas In Vitro , Camundongos , Oócitos/efeitos dos fármacos , Oócitos/metabolismo , Técnicas de Patch-Clamp , Proteínas Recombinantes/farmacologia , Xenopus
5.
Brain Res ; 402(2): 303-10, 1987 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-3030495

RESUMO

Action of halothane on synaptic transmission was studied on the isolated newborn rat spinal cord. Clinical doses of halothane (less than or equal to 3%) suppressed mono- and polysynaptic reflexes, dorsal root reflexes, excitatory and inhibitory postsynaptic potentials as well as the spontaneous synaptic potentials caused by impulse bombardment. However, the spontaneous miniature inhibitory postsynaptic potentials observed after blocking impulse activities by tetrodotoxin were not all suppressed by halothane. During halothane administration, the membrane potential of motoneurons was hyperpolarized by several millivolts, associated with an increase in input conductance. However, the threshold potential level for spike generation was virtually unaffected. Depression of synaptic transmission in spinal motoneurons by halothane is suggested to be due to two factors: a reduction in the amount of transmitter release secondary to interference with Ca2+ entry into nerve terminals, either by partial blockade of impulse invasion or voltage-dependent Ca2+ channels; and an increase in the depolarizing current necessary for excitation of motoneurons owing to hyperpolarization and decreased input resistance.


Assuntos
Animais Recém-Nascidos/fisiologia , Halotano/farmacologia , Neurônios Motores/efeitos dos fármacos , Sinapses/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacos , Potenciais de Ação , Animais , Fenômenos Biomecânicos , Neurônios Motores/fisiologia , Inibição Neural , Ratos , Reflexo , Sinapses/fisiologia
6.
Eur J Pharmacol ; 368(2-3): 269-76, 1999 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-10193664

RESUMO

The gamma-aminobutyric acid type A receptor (GABA(A) receptor) sites involved in the direct and modulatory actions of general anesthetics remain to be elucidated. The mutation of tyrosine at position 157 in the beta2 GABA(A) receptor subunit was reported to reduce sensitivity to activation by GABA, but not pentobarbital. We examined whether this mutation of the beta2 subunit (Tyr157-->Phe) affects the direct and modulatory actions of other general anesthetics such as propofol and etomidate. Using the two-electrode voltage clamp method, we recorded Cl- current in Xenopus oocytes expressing alpha1beta2gamma2s and alpha1-mutated beta2gamma2s subunits. The mutation of the beta2 subunit reduced the apparent affinity for propofol. However, the mutation had no effect on both the direct actions of pentobarbital and etomidate or on the modulatory actions of pentobarbital, propofol and etomidate. These results suggest that unique loci may exist for the direct action of propofol and that the GABA binding site may not mediate the modulatory actions of general anesthetics at GABA(A) receptors.


Assuntos
Anestésicos Gerais/farmacologia , Receptores de GABA-A/genética , Substituição de Aminoácidos , Animais , Canais de Cloreto/efeitos dos fármacos , Relação Dose-Resposta a Droga , Etomidato/farmacologia , Moduladores GABAérgicos/farmacologia , Hipnóticos e Sedativos/farmacologia , Potenciais da Membrana/efeitos dos fármacos , Camundongos , Oócitos , Pentobarbital/farmacologia , Fenilalanina/genética , Mutação Puntual , Propofol/farmacologia , Receptores de GABA-A/efeitos dos fármacos , Receptores de GABA-A/metabolismo , Tirosina/genética , Xenopus laevis , Ácido gama-Aminobutírico/farmacologia
7.
Eur J Pharmacol ; 401(3): 329-37, 2000 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-10936490

RESUMO

Although convulsions due to local anesthetic systemic toxicity are thought to be due to inhibition of GABA(A) receptor-linked currents in the central nervous system, the mechanism of action remains unclear. We therefore examined the effects of local anesthetics on gamma-aminobutyric acid (GABA)-induced currents using recombinant GABA(A) receptors with specific combinations of subunits. Murine GABA(A) receptors were expressed by injection of cRNAs encoding each subunit into Xenopus oocytes. The effects of local anesthetics (lidocaine, bupivacaine, procaine and tetracaine) on GABA-induced currents of receptors expressing different subunit combinations (alpha1beta2, alpha1beta2gamma2s, alpha4beta2gamma2s and beta2) were examined via the two electrode voltage clamp method. At alpha1beta2, alpha1beta2gamma2s and alpha4beta2gamma2s GABA(A) receptors, all local anesthetics inhibited GABA-induced currents in a dose-dependent manner. The presence of the gamma2s subunit resulted in a greater inhibition by all local anesthetics, but the presence of the alpha4 subunit resulted in less inhibition. At beta2 homomeric receptors, local anesthetics directly induced an outward current similar to that of picrotoxin. These data indicated that (1) the alpha and gamma subunits of GABA(A) receptors modulated the inhibitory effects of local anesthetics on GABA(A) function, and (2) local anesthetics can activate the beta2 subunit and may block the GABA(A) receptor channel pore.


Assuntos
Anestésicos Locais/farmacologia , Receptores de GABA-A/efeitos dos fármacos , Animais , Bupivacaína/farmacologia , DNA Recombinante/efeitos dos fármacos , DNA Recombinante/genética , DNA Recombinante/fisiologia , Relação Dose-Resposta a Droga , Concentração de Íons de Hidrogênio , Lidocaína/farmacologia , Potenciais da Membrana/efeitos dos fármacos , Camundongos , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , Picrotoxina/farmacologia , Procaína/farmacologia , RNA Complementar/administração & dosagem , RNA Complementar/genética , Receptores de GABA-A/genética , Receptores de GABA-A/fisiologia , Tetracaína/farmacologia , Xenopus laevis , Ácido gama-Aminobutírico/farmacologia
8.
J Nutr Sci Vitaminol (Tokyo) ; 46(3): 144-8, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10955282

RESUMO

When type 1 diabetes mellitus was induced in rats by injecting streptozotocin, histidine decarboxylase expression was abnormally up-regulated in a transcriptional level, and 7 d after the injection, the enzyme activity was increased about 3-fold over the control (p < 0.05). When the diabetic rats were administered with insulin for 3 d, the increased histidine decarboxylase activity returned to a normal level in addition to normalization of the plasma glucose level. The plasma gastrin level in the fasting state was also significantly elevated in the diabetic rats, and the insulin treatment normalized the level. In the diabetic rats, fasting gastric acid output increased significantly and gastric pH was lowered. These results suggest that the gastric histidine decarboxylase activity and plasma gastrin level are increased in connection with the depletion of insulin in streptozotocin-induced diabetic rats, and gastric acid secretion is stimulated at a basal level, presumably due to increases in the concentrations of histamine and gastrin in oxyntic mucosa.


Assuntos
Diabetes Mellitus Experimental/enzimologia , Ácido Gástrico/metabolismo , Mucosa Gástrica/enzimologia , Gastrinas/sangue , Histidina Descarboxilase/metabolismo , Animais , Glicemia/metabolismo , Northern Blotting , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/metabolismo , Histidina Descarboxilase/genética , Insulina/administração & dosagem , Intestino Delgado/enzimologia , Rim/enzimologia , Fígado/enzimologia , Masculino , Pâncreas/enzimologia , Ratos , Ratos Wistar , Estreptozocina , Regulação para Cima
9.
J Vet Med Sci ; 58(6): 511-4, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8811618

RESUMO

By using conscious chronically instrumented newborn goats, the circulatory effect of arginine vasopressin (AVP) (20 mIU/kg/ min) was studied, assuming a potential use for AVP to treat circulatory failure in the newborn, and the results were compared with those of dopamine (20 micrograms/kg/min). The AVP infusion decreased heart rate (HR) and cardiac output (CO) significantly, and increased systemic arterial pressure (SAP) and pulmonary arterial wedge pressure (PAWP) significantly, but did not change pulmonary arterial pressure (PAP) appreciably. The dopamine infusion did not change HR, SAP, and PAWP but increased CO and PAP significantly. Right atrial pressure (RAP) increased significantly in both groups. The pulmonary vascular resistance (PVR) increased significantly in both groups. The systemic vascular resistance (SVR) increased significantly in the AVP group, but did not change during experiments in the dopamine group. The calculated PVR/SVR ratios decreased significantly from the baseline value after initiation of the AVP infusion. In contrast, the dopamine infusion increased PVR/SVR ratios significantly throughout the experiments. Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome characterized by right-to-left shunting of blood at the level of the foramen ovale and ductus arteriosus. AVP may reduce the shunting of blood by elevating only SAP selectively.


Assuntos
Arginina Vasopressina/farmacologia , Dopamina/farmacologia , Hemodinâmica/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Pressão Sanguínea/efeitos dos fármacos , Dióxido de Carbono/sangue , Débito Cardíaco/efeitos dos fármacos , Cabras , Frequência Cardíaca/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Oxigênio/sangue , Pressão Parcial , Artéria Pulmonar/efeitos dos fármacos , Artéria Pulmonar/fisiologia , Pressão Propulsora Pulmonar/efeitos dos fármacos , Resistência Vascular/efeitos dos fármacos
10.
Masui ; 42(5): 756-60, 1993 May.
Artigo em Japonês | MEDLINE | ID: mdl-8515557

RESUMO

Carboplatin is one of most commonly used chemotherapeutic agents in clinical oncology practice. We presented a case of subacute cardiotoxicity supposedly due to carboplatin. A patient with ovarian cancer had been treated with carboplatin based chemotherapeutic agent for about a month before surgery. Although she had not shown symptoms of cardiac failure, severe pulmonary edema developed immediately after general anesthesia. It disappeared within a week. For three days following the administration of carboplatin alone for two weeks after surgery, arrhythmias (SVT, SVPB and VPB) and hypotension appeared. Symptoms of congestive heart failure, resembling dilated cardiomyopathy, lasted for one month. It required about two months to restore the normal cardiac functions. Carboplatin seems to have infrequent but possible cardiotoxicity as many other chemotherapeutic agents.


Assuntos
Carboplatina/efeitos adversos , Insuficiência Cardíaca/induzido quimicamente , Neoplasias Ovarianas/tratamento farmacológico , Terapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/cirurgia
11.
Masui ; 38(2): 182-9, 1989 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-2733136

RESUMO

The plasma concentrations of buprenorphine were measured and blood gas analysis was done after administration of buprenorphine suppositories (0.2 and 0.4 mg) or its intramuscular injection (0.2mg) in postoperative patients. The C max for 0.4mg suppositories was comparable to that for 0.2mg injection, whereas the T max for suppositories was as large as about 2 hrs in contrast to 1.5 hrs for 0.2mg injection. The size of AUC was in the following order: 0.4mg suppositories greater than 0.2mg injection greater than 0.2mg suppositories. Neither notable increase in PaCO2 nor decrease in respiration rate was observed after administration of the suppositories, indicating that the formulation will not cause clinically significant respiratory depression. No significant changes were observed in blood pressure or pulse rate. Buprenorphine suppositories are considered to be safe for use in postoperative patients. Percent pain relief in the suppository group was smaller than that in the injection group. This appears to be due to a slower rate of increase in the plasma levels of buprenorphine after administration of suppositories than that after intramuscular injection. Therefore, it seems practical to give this drug to postoperative patients before the start of pain.


Assuntos
Buprenorfina/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Dor Pós-Operatória/tratamento farmacológico , Respiração/efeitos dos fármacos , Administração Retal , Adolescente , Adulto , Buprenorfina/sangue , Avaliação de Medicamentos , Feminino , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/sangue , Supositórios
12.
Nihon Geka Gakkai Zasshi ; 93(1): 9-15, 1992 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-1549101

RESUMO

Recently coagulopathy caused by vitamin K (VK) deficiency following antibiotic therapy in malnourished patients has been reported. We studied on the same problem particularly in patients under chemotherapy during postoperative fasting period. For this purpose, prothrombin time (PT), vitamin K-dependent coagulation factors (Factor II (F-II), VII (F-VII) and protein C), PIVKA-II (PK-II) and plasma level of VK in two groups of patients with or without VK administration were measured in esophageal cancer patients. In the group with VK, VK2 were given intravenously everyday. In the group without VK, PT prolonged and F-II decreased from the seventh postoperative day, especially on the 14th day significantly. Although F-VII and protein C decreased on the first day and returned subsequently on the seventh day, no significance was observed between two groups. PK-II increased clearly in the group without VK from the seventh day, whereas no significant changes were observed in the group with VK. The plasma level of VK1 decreased in both groups, but VK2, especially MK-4, was high in the group with VK.


Assuntos
Biomarcadores , Neoplasias Esofágicas/sangue , Jejum , Vitamina K/administração & dosagem , Antineoplásicos/uso terapêutico , Esquema de Medicação , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/cirurgia , Fator VII/análise , Humanos , Período Pós-Operatório , Proteína C/análise , Precursores de Proteínas/análise , Protrombina/análise , Vitamina K/sangue
13.
Nihon Seirigaku Zasshi ; 54(4): 159-66, 1992.
Artigo em Japonês | MEDLINE | ID: mdl-1494988

RESUMO

A radio multichannel telemetry system has been developed for use with chronically instrumented, unrestrained, small animals. The system can simultaneously record autonomic neural signals, blood flow velocity, blood pressure, and ECG. The system is time-multiplexed and pulse width modulation (PWM)/FM device, which employs two sampling frequencies. The system is designed with 10 standard low power integrated circuits, a 3 terminal voltage regulator, and a transistor. The size is 53 x 42 x 20 mm, and the weight, including two batteries is 40 grams. The system is powered by two lithium cells, which provide 60 hours of continuous operation.


Assuntos
Sistema Nervoso Autônomo/fisiologia , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Eletrocardiografia , Telemetria/instrumentação , Potenciais de Ação , Animais , Telemetria/métodos
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