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Koraki E, Mantzoros I, Chatzakis C, Gkiouliava A, Cheva A, Lavrentieva A, Sifaki F, Argiriadou H, Kesisoglou I, Galanos-Demiris K, Bitsianis S, Tsalis K. Metalloproteinase expression after desflurane preconditioning in hepatectomies: A randomized clinical trial. World J Hepatol 2020; 12:1098-1114. [PMID: 33312433 PMCID: PMC7701968 DOI: 10.4254/wjh.v12.i11.1098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/26/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatectomy with inflow occlusion results in ischemia-reperfusion injury; however, pharmacological preconditioning can prevent such injury and optimize the postoperative recovery of hepatectomized patients. The normal inflammatory response after a hepatectomy involves increased expression of metalloproteinases, which may signal pathologic hepatic tissue reformation.
AIM To investigate the effect of desflurane preconditioning on these inflammatory indices in patients with inflow occlusion undergoing hepatectomy.
METHODS This is a single-center, prospective, randomized controlled trial conducted at the 4th Department of Surgery of the Medical School of Aristotle University of Thessaloniki, between August 2016 and December 2017. Forty-six patients were randomized to either the desflurane treatment group for pharmacological preconditioning (by replacement of propofol with desflurane, administered 30 min before induction of ischemia) or the control group for standard intravenous propofol. The primary endpoint of expression levels of matrix metalloproteinases and their inhibitors was determined preoperatively and at 30 min posthepatic reperfusion. The secondary endpoints of neutrophil infiltration, coagulation profile, activity of antithrombin III (AT III), protein C (PC), protein S and biochemical markers of liver function were determined for 5 d postoperatively and compared between the groups.
RESULTS The desflurane treatment group showed significantly increased levels of tissue inhibitor of metalloproteinases 1 and 2, significantly decreased levels of matrix metalloproteinases 2 and 9, decreased neutrophil infiltration, and less profound changes in the coagulation profile. During the 5-d postoperative period, all patients showed significantly decreased activity of AT III, PC and protein S (vs baseline values, P < 0.05). The activity of AT III and PC differed significantly between the two groups from postoperative day 1 to postoperative day 5 (P < 0.05), showing a moderate drop in activity of AT III and PC in the desflurane treatment group and a dramatic drop in the control group. Compared to the control group, the desflurane treatment group also had significantly lower international normalized ratio values on all postoperative days (P < 0.005) and lower serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase values on postoperative days 2 and 3 (P < 0.05). Total length of stay was significantly less in the desflurane group (P = 0.009).
CONCLUSION Desflurane preconditioning can lessen the inflammatory response related to ischemia-reperfusion injury and may shorten length of hospitalization.
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Affiliation(s)
- Eleni Koraki
- Department of Anaesthesiology, “G Papanikolaou” General Hospital, Thessaloniki 57010, Greece
| | - Ioannis Mantzoros
- Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Christos Chatzakis
- Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Anna Gkiouliava
- Department of Anaesthesiology, “G Papanikolaou” General Hospital, Thessaloniki 57010, Greece
| | - Angeliki Cheva
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Athina Lavrentieva
- First Department of Intensive Care Unit, "G Papanikolaou" General Hospital, Thessaloniki 57010, Greece
| | - Freideriki Sifaki
- Department of Anaesthesiology, “G Papanikolaou” General Hospital, Thessaloniki 57010, Greece
| | - Helena Argiriadou
- Department of Anaesthesiology and Intensive Care Unit, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
| | - Isaak Kesisoglou
- Third Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
| | | | - Stefanos Bitsianis
- Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Konstantinos Tsalis
- Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
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Yu L, Liu H. Perillaldehyde prevents the formations of atherosclerotic plaques through recoupling endothelial nitric oxide synthase. J Cell Biochem 2018; 119:10204-10215. [DOI: 10.1002/jcb.27362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 06/26/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Li Yu
- Department of Physiology, School of Basic Medical Sciences Jinzhou Medical University Jinzhou China
- Institue of Eyes Jinzhou Medical University Jinzhou China
| | - Hua Liu
- Institue of Eyes Jinzhou Medical University Jinzhou China
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Zhao H, Bu M, Li B, Zhang Y. Lipoic acid inhibited desflurane-induced hippocampal neuronal apoptosis through Caspase3 and NF-KappaB dependent pathway. Tissue Cell 2017; 50:37-42. [PMID: 29429516 DOI: 10.1016/j.tice.2017.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/19/2017] [Accepted: 12/01/2017] [Indexed: 02/07/2023]
Abstract
Desfluraneis a widely-used general anesthetics. However, recent reports showed its significant side effect in the nervous system. Desflurane could lead to the neuronal death and affect the working memory. Unfortunately, the mechanism underlying the action of desflurane is still not clear and there is still no potent medicine to prevent the lesion in the central nervous system caused by general anesthetics. In this study, we found α-lipoic acid, an antioxidant exerting protective effect on multiple cells tissues, could resist the neurotoxicity caused by desflurane exposure. Lipoic acid possessed strong anti-apoptotic effect on the desflurane-treated hippocampal neurons, which was mediated by the Caspase-3 dependent pathway and NF-kappaB signaling. Collectively, we found a promising candidate to be clinically applied in intervention against the damage in nervous system by the desflurane.
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Affiliation(s)
- Hui Zhao
- Galactophore Department, The Maternal and Child Health Hospital of Jinan City, Jinan, Shandong, China
| | - Meimei Bu
- Anesthesia Department, The Maternal and Child Health Hospital of Jinan City, Jinan, Shandong, China
| | - Binglu Li
- Pharmacy Department, The Infectious Diseases Hospital of Jinan City, Jinan, Shandong, China
| | - Yong Zhang
- Galactophore Department, The Maternal and Child Health Hospital of Jinan City, Jinan, Shandong, China.
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Yin YL, Zhu ML, Wan J, Zhang C, Pan GP, Lu JX, Ping S, Chen Y, Zhao FR, Yu HY, Guo T, Jian X, Liu LY, Zhang JN, Wan GR, Wang SX, Li P. Traditional Chinese medicine xin-mai-jia recouples endothelial nitric oxide synthase to prevent atherosclerosis in vivo. Sci Rep 2017; 7:43508. [PMID: 28252100 PMCID: PMC5333158 DOI: 10.1038/srep43508] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 01/27/2017] [Indexed: 11/09/2022] Open
Abstract
Endothelial dysfunction, which is caused by endothelial nitric oxide synthase (eNOS) uncoupling, is an initial step in atherosclerosis. This study was designed to explore whether Chinese medicine xin-mai-jia (XMJ) recouples eNOS to exert anti-atherosclerotic effects. Pretreatment of XMJ (25, 50, 100 μg/ml) for 30 minutes concentration-dependently activated eNOS, improved cell viabilities, increased NO generations, and reduced ROS productions in human umbilical vein endothelial cells incubated with H2O2 for 2 hours, accompanied with restoration of BH4. Importantly, these protective effects produced by XMJ were abolished by eNOS inhibitor L-NAME or specific eNOS siRNA in H2O2-treated cells. In ex vivo experiments, exposure of isolated aortic rings from rats to H2O2 for 6 hours dramatically impaired acetylcholine-induced vasorelaxation, reduced NO levels and increased ROS productions, which were ablated by XMJ in concentration-dependent manner. In vivo analysis indicated that administration of XMJ (0.6, 2.0, 6.0 g/kg/d) for 12 weeks remarkably recoupled eNOS and reduced the size of carotid atherosclerotic plaque in rats feeding with high fat diet plus balloon injury. In conclusion, XMJ recouples eNOS to prevent the growth of atherosclerosis in rats. Clinically, XMJ is potentially considered as a medicine to treat patients with atherosclerosis.
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Affiliation(s)
- Ya-Ling Yin
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Mo-Li Zhu
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Jia Wan
- Department of Drug and Cosmetics Supervision, Henan Food and Drug Administration, Zhengzhou, 450018, China
| | - Chong Zhang
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Guo-Pin Pan
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Jun-Xiu Lu
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Song Ping
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Yuan Chen
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Fan-Rong Zhao
- Sanquan College of Xinxiang Medical University, Xinxiang, 453003, China
| | - Hai-Ya Yu
- Department of Neurology, The People's Hospital of Xishui County, Huangang, Hubei, China
| | - Tao Guo
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Xu Jian
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Li-Ying Liu
- Sanquan College of Xinxiang Medical University, Xinxiang, 453003, China.,Department of Pharmacology, Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China
| | - Jia-Ning Zhang
- Biology and Chemistry, Denison University, Granville, OH, USA
| | - Guang-Rui Wan
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
| | - Shuang-Xi Wang
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China.,The Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital, Shandong University, Jinan, 250012, China
| | - Peng Li
- College of Pharmacy and School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, China
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Li H, He C, Wang J, Li X, Yang Z, Sun X, Fang L, Liu N. Berberine activates peroxisome proliferator-activated receptor gamma to increase atherosclerotic plaque stability in Apoe -/- mice with hyperhomocysteinemia. J Diabetes Investig 2016; 7:824-832. [PMID: 27181586 PMCID: PMC5089944 DOI: 10.1111/jdi.12516] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/19/2016] [Accepted: 03/04/2016] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION An elevated level of plasma homocysteine has long been suspected as a metabolic risk factor for the development of atherosclerotic vascular diseases in diabetes. Berberine (BBR) has several preventive effects on cardiovascular diseases. The effects of BBR on atherosclerotic plaque stability increased by homocysteine thiolactone (HTL) remain unknown. MATERIALS AND METHODS The model of atherosclerotic vulnerable plaque was induced by placing a collar around the carotid artery in Apoe-/- mice. Endothelium-dependent relaxation was assayed by organ chamber. RESULTS Homocysteine thiolactone (50 mg/kg/day, 8 weeks) reduced the atherosclerotic plaque stability in the carotid artery of Apoe-/- mice, which was reversed by BBR administration (1.0 g/kg/day). In vivo and ex vivo experiments showed that HTL dramatically reduced acetylcholine-induced endothelium-dependent relaxation and superoxide dismutase activity, and increased malondialdehyde content, which were inhibited by BBR. Importantly, all effects induced by BBR were abolished by GW9662, an antagonist of peroxisome proliferator-activated receptor-γ. Incubation of cultured endothelial cells with HTL significantly reduced cell viabilities and enhanced production of reactive oxygen species. Pretreatment of cells with BBR dose-dependently reversed HTL-induced detrimental effects, which were GW9662-reversible. CONCLUSIONS Berberine increases atherosclerotic plaque stability in hyperhomocysteinemia mice, which is related to the activation of peroxisome proliferator-activated receptor-γ and subsequent suppression of oxidative stress in endothelial cells.
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Affiliation(s)
- Hongjun Li
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Chengyan He
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Jingying Wang
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Xiaoou Li
- Tumor Hospital of Jilin Province, The Second Hospital of Jilin University, Changchun, China
| | - Zhaowei Yang
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Xiaoying Sun
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Ling Fang
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Ning Liu
- Central Laboratory, The Second Hospital of Jilin University, Changchun, China.
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Tongxinluo Prevents Endothelial Dysfunction Induced by Homocysteine Thiolactone In Vivo via Suppression of Oxidative Stress. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:929012. [PMID: 26539238 PMCID: PMC4619956 DOI: 10.1155/2015/929012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 03/07/2015] [Accepted: 05/26/2015] [Indexed: 12/16/2022]
Abstract
Aim. To explore whether Chinese traditional medicine, tongxinluo (TXL), exerts beneficial effects on endothelial dysfunction induced by homocysteine thiolactone (HTL) and to investigate the potential mechanisms. Methods and Results. Incubation of cultured human umbilical vein endothelial cells with HTL (1 mM) for 24 hours significantly reduced cell viabilities assayed by MTT, and enhanced productions of reactive oxygen species. Pretreatment of cells with TXL (100, 200, and 400 μg/mL) for 1 hour reversed these effects induced by HTL. Further, coincubation with GW9662 (0.01, 0.1 mM) abolished the protective effects of TXL on HTL-treated cells. In ex vivo experiments, exposure of isolated aortic rings from rats to HTL (1 mM) for 1 hour dramatically impaired acetylcholine-induced endothelium-dependent relaxation, reduced SOD activity, and increased malondialdehyde content in aortic tissues. Preincubation of aortic rings with TXL (100, 200, and 400 μg/mL) normalized the disorders induced by HTL. Importantly, all effects induced by TXL were reversed by GW9662. In vivo analysis indicated that the administration of TXL (1.0 g/kg/d) remarkably suppressed oxidative stress and prevented endothelial dysfunction in rats fed with HTL (50 mg/kg/d) for 8 weeks. Conclusions. TXL improves endothelial functions in rats fed with HTL, which is related to PPARγ-dependent suppression of oxidative stress.
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Sun Z, Lv J, Zhu Y, Song D, Zhu B, Miao C. Desflurane preconditioning protects human umbilical vein endothelial cells against anoxia/reoxygenation by upregulating NLRP12 and inhibiting non-canonical nuclear factor-κB signaling. Int J Mol Med 2015; 36:1327-34. [PMID: 26329693 DOI: 10.3892/ijmm.2015.2335] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 07/29/2015] [Indexed: 11/06/2022] Open
Abstract
Volatile anesthetics modulate endothelial cell apoptosis and inhibit nuclear factor-κB (NF-κB) signaling. In this study, we aimed to assess whether desflurane preconditioning protects human umbilical vein endothelial cells (HUVECs) agaist anoxia/reoxygenation (A/R) injury. HUVECs were pre-conditioned with desflurane (1.0 MAC) for 30 min, followed by a 15-min washout, then exposed to 60 min anoxia and 60 min reoxygenation (A/R), and incubated with 10 ng/ml tumor necrosis factor (TNF)-α for 60 min. HUVEC viability and apoptosis were measured by MTT assay and annexin V staining, and immunoblot analysis was used to measure the levels of Smac and cellular inhibitor of apoptosis 1 (cIAP1). NF-κB activation was assessed using the NF-κB signaling pathway real‑time PCR array, and the levels of NF-κB inducing kinase (NIK), p52, IκB kinase (IKK)α, p100, RelB and NLR family, pyrin domain containing 12 (NLRP12) were assessed by immunoblot analysis. Desflurane preconditioning attenuated the effects of A/R and/or A/R plus TNF-α on cell viability, decreasing the levels of Smac and enhancing the levels of of cIAP1 (P<0.05). Preconditioning with desflurane also enhanced the mRNA levels of interleukin (IL)-10 and NLRP12 in the cells exposed to A/R by 2.40- and 2.16‑fold, respectively. The HUVECs exposed to A/R had greater levels of NIK and p100 and reduced levels of p52 and IKKα. Desflurance preconditioning further increased p100 levels, decreased the level of NIK, further decreased p52 levels and further reduced IKKα levels. A/R in combination with TNF-α increased the NIK, IKKα, p100 and RelB levels, and this increase was significantly attenuated by desflurance preconditioning (all P<0.05). Desflurane preconditioning enhanced HUVEC survival and protected the cells against A/R injury, and our results suggested that this process involved the upregulation of NLRP12 and the inhibition of non-canonical NF-κB signaling.
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Affiliation(s)
- Zhirong Sun
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Jianing Lv
- Department of Neurology, Fudan University Shanghai Zhongshan Hospital, Shanghai, P.R. China
| | - Yun Zhu
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Dongli Song
- Biomedical Research Center, Fudan University Zhongshan Hospital, Shanghai, P.R. China
| | - Biao Zhu
- Department of Anesthesiology and Critical Care Unit, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Changhong Miao
- Department of Anesthesiology and Critical Care Unit, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
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Álvarez P, Tapia L, Mardones LA, Pedemonte JC, Farías JG, Castillo RL. Cellular mechanisms against ischemia reperfusion injury induced by the use of anesthetic pharmacological agents. Chem Biol Interact 2014; 218:89-98. [PMID: 24835546 DOI: 10.1016/j.cbi.2014.04.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/20/2014] [Accepted: 04/28/2014] [Indexed: 12/15/2022]
Abstract
Ischemia-reperfusion (IR) cycle in the myocardium is associated with activation of an injurious cascade, thus leading to new myocardial challenges, which account for up to 50% of infarct size. Some evidence implicates reactive oxygen species (ROS) as a probable cause of myocardial injury in prooxidant clinical settings. Damage occurs during both ischemia and post-ischemic reperfusion in animal and human models. The mechanisms that contribute to this damage include the increase in cellular calcium (Ca(2+)) concentration and induction of ROS sources during reperfusion. Pharmacological preconditioning, which includes pharmacological strategies that counteract the ROS burst and Ca(2+) overload followed to IR cycle in the myocardium, could be effective in limiting injury. Currently widespread evidence supports the use of anesthetics agents as an important cardioprotective strategy that act at various levels such as metabotropic receptors, ion channels or mitochondrial level. Their administration before a prolonged ischemic episode is known as anesthetic preconditioning, whereas when given at the very onset of reperfusion, is termed anesthetic postconditioning. Both types of anesthetic conditioning reduce, albeit not to the same degree, the extent of myocardial injury. This review focuses on cellular and pathophysiological concepts on the myocardial damage induced by IR and how anesthetic pharmacological agents commonly used could attenuate the functional and structural effects induced by oxidative stress in cardiac tissue.
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Affiliation(s)
- P Álvarez
- Critical Care Unit, Hospital Clínico Metropolitano La Florida, Santiago, Chile; Faculty of Medicine, University Finis Terrae, Chile; Pathophysiology Program, Faculty of Medicine, University of Chile, Chile
| | - L Tapia
- Pathophysiology Program, Faculty of Medicine, University of Chile, Chile; Emergency Unit, Clínica Dávila, Santiago, Chile
| | - L A Mardones
- Pathophysiology Program, Faculty of Medicine, University of Chile, Chile
| | - J C Pedemonte
- Anesthesia Unit, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J G Farías
- Departamento de Ingeniería Química, Facultad de Ingeniería y Ciencias, Universidad de la Frontera, Casilla 54-D, Temuco, Chile
| | - R L Castillo
- Pathophysiology Program, Faculty of Medicine, University of Chile, Chile.
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