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Right parasternal approach is useful in an adult patient after arterial switch operation. J Echocardiogr 2024; 22:104-105. [PMID: 37505368 DOI: 10.1007/s12574-023-00613-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/02/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
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2
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Overview of the 87 th Annual Scientific Meeting of the Japanese Circulation Society (JCS2023) - New Challenge With Next Generation. Circ J 2024; 88:615-619. [PMID: 38448007 DOI: 10.1253/circj.cj-24-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
The 87thAnnual Meeting of the Japanese Circulation Society (JCS2023) was held in March 2023 in Fukuoka, Japan, marking the first in-person gathering after the COVID-19 pandemic. With the theme of "New Challenge With Next Generation" the conference emphasized the development of future cardiovascular leaders and technologies such as artificial intelligence (AI). Notable sessions included the Mikamo Lecture on heart failure and the Mashimo Lecture on AI in medicine. Various hands-on sessions and participatory events were well received, promoting learning and networking. Post-event surveys showed high satisfaction among participants, with positive feedback on face-to-face interactions and the overall experience. JCS2023, attended by 17,852 participants, concluded successfully, marking a significant milestone in post-pandemic meetings, and advancing cardiovascular medicine.
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Perforation of the chest wall from bioprosthetic pulmonary valve endocarditis. J Echocardiogr 2024:10.1007/s12574-024-00647-x. [PMID: 38504087 DOI: 10.1007/s12574-024-00647-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 03/21/2024]
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Oxygen inhalation decreases the central venous pressure in adult patients late after Fontan operations. J Cardiol 2024:S0914-5087(24)00036-4. [PMID: 38401702 DOI: 10.1016/j.jjcc.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Elevated central venous pressure (CVP) and decreased arterial oxygen saturation (SaO2) are the characteristics of patients after Fontan operations and determine morbidity and mortality in the long-term. Oxygen inhalation therapy theoretically increases SaO2 and may decrease the elevated CVP in these patients. However, there is no previous study to support this hypothesis. This study aimed to determine the acute effects of oxygen inhalation on the hemodynamics of adult patients late after Fontan operations using cardiac catheterization. METHODS This study enrolled 58 consecutive adult patients (median age, 30 years; female, n = 24) who had undergone Fontan operations. We assessed the hemodynamic changes during oxygen inhalation (2 L/min) with a nasal cannula in cardiac catheterization. We divided the studied patients into two groups according to the reduction in CVP during oxygen inhalation using the median value: responders (>2 mmHg) and non-responders (≤2 mmHg). Clinical characteristics of the responders to oxygen inhalation were investigated with uni- and multivariate analyses. RESULTS SaO2 increased from 93.3 % (91.3-94.5 %) to 97.5 % (95.2-98.4 %) (p < 0.001) and CVP decreased from 12 mmHg (11-14 mmHg) to 10 mmHg (9-12 mmHg) (p < 0.001) after oxygen inhalation. There was a weak but significant correlation between the increase in SaO2 and the decrease in CVP (R = 0.29, p = 0.025). Pulmonary blood flow increased from 4.1 L/min (3.5-5.0 L/min) to 4.4 L/min (3.7-5.3 L/min) (p = 0.007), while systemic blood flow showed no significant changes. A multivariate analysis revealed that high baseline CVP was associated with a larger decrease in CVP (>2 mmHg) after oxygen inhalation. CONCLUSIONS Oxygen inhalation increased SaO2 and decreased CVP, especially in patients with high baseline CVP. Further studies with home oxygen therapy are needed to investigate the long-term effects of oxygen inhalation in adult patients who underwent Fontan operations.
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Long-Term Renal Involvement in Association with Fontan Circulation. Pediatr Cardiol 2024; 45:340-350. [PMID: 37966520 DOI: 10.1007/s00246-023-03334-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023]
Abstract
Multiorgan dysfunction is a concern of Fontan patients. To clarify the pathophysiology of Fontan nephropathy, we characterize renal disease in the long-term observational study. Medical records of 128 consecutive Fontan patients [median age: 22 (range 15-37) years old] treated between 2009 and 2018 were reviewed to investigate the incidence of nephropathy and its association with other clinical variables. Thirty-seven patients (29%) showed proteinuria (n = 34) or < 90 mL/min/1.73 m2 of estimated glomerular filtration rate (eGFR) (n = 7), including 4 overlapping cases. Ninety-six patients (75%) had liver dysfunction (Forns index > 4.21). Patients with proteinuria received the Fontan procedure at an older age [78 (26-194) vs. 56 (8-292) months old, p = 0.02] and had a higher cardiac index [3.11 (1.49-6.35) vs. 2.71 (1.40-4.95) L/min/m2, p = 0.02], central venous pressure [12 (7-19) vs. 9 (5-19) mmHg, p < 0.001], and proportion with > 4.21 of Forns index (88% vs. 70%, p = 0.04) than those without proteinuria. The mean renal perfusion pressure was lower in patients with a reduced eGFR than those without it [55 (44-65) vs. 65 (45-102) mmHg, p = 0.03], but no other variables differed significantly. A multivariable analysis revealed that proteinuria was associated with an increased cardiac index (unit odds ratio 2.02, 95% confidence interval 1.12-3.65, p = 0.02). Seven patients with severe proteinuria had a lower oxygen saturation than those with no or mild proteinuria (p = 0.01, 0.03). Proteinuria or a decreased eGFR differentially occurred in approximately 30% of Fontan patients. Suboptimal Fontan circulation may contribute to the development of proteinuria and reduced eGFR.
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Right-Sided Endocarditis With Mitral Valve Aneurysm. Circ J 2023; 87:379. [PMID: 36450538 DOI: 10.1253/circj.cj-22-0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Successful Total Management of Multi-Causative Sleep-Disordered Breathing Complicated with Patient with Adult Congenital Heart Disease. Int Heart J 2022; 63:978-983. [PMID: 36104229 DOI: 10.1536/ihj.22-073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sleep-disordered breathing is one of the complications commonly seen in patients with adult congenital heart disease (ACHD) due to multiple causes including complex underlying cardiac defects, cardiomegaly, previous thoracotomies, obesity, scoliosis, and paralysis of the diaphragm. It is often hard to determine its main cause and predict the efficacy of each treatment in its management. We herein report a 30-year-old woman after biventricular repair of pulmonary atresia with intact ventricular septum diagnosed as sleep-related hypoventilation disorder. Simultaneous treatment targeting obesity, paralysis of the diaphragm, and cardiomegaly followed by respiratory muscle reinforcement through non-invasive ventilation resolved her sleep-related hypoventilation disorder. Such management for each factor responsible for the hypoventilation is expected to provide synergetic therapeutic efficacy and increase daily activity in a patient with ACHD.
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A Rare Manifestation of Right Ventricular Dysfunction in an Adult Patient With Mucolipidosis Type III α/β. Can J Cardiol 2020; 36:1978.e1-1978.e3. [PMID: 32818557 DOI: 10.1016/j.cjca.2020.07.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/11/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022] Open
Abstract
Mucolipidosis type III α/β is an autosomal recessive lysosomal storage disease, caused by the deficient activity of UDP-N-acetyl glucosamine-1-phosphotransferase. The resultant intralysosomal accumulation of partly degraded mucopolysaccharides and sphingolipids causes multiple-organ damage, including the heart. The most documented cardiac manifestation is the thickening and insufficiency of mitral and aortic valves, but there are very few reports about the myocardial involvement. We report a case with mucolipidosis type III α/β complicated by marked dilatation and dysfunction of the right ventricle, which is quite rare and further broadens the clinical spectrum of the disease.
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Crystallization granuloma by nifekalant hydrochloride infusion. Geriatr Gerontol Int 2018; 18:1133-1134. [PMID: 30133966 DOI: 10.1111/ggi.13329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/23/2018] [Accepted: 03/06/2018] [Indexed: 11/27/2022]
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10
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11
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Novel Parametric Method to Identify the System Characteristics of Respiratory Central Chemoreflex in Human. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12
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Chronic Heart Failure Markedly Attenuates the Low Pressure Baroreflex in Regulating Sympathetic Function in Rats. J Card Fail 2015. [DOI: 10.1016/j.cardfail.2015.08.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Risk factors for coronary artery calcification in Japanese patients. J Cardiol 2015; 66:36-40. [PMID: 25448727 DOI: 10.1016/j.jjcc.2014.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 08/11/2014] [Accepted: 09/08/2014] [Indexed: 11/17/2022]
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14
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Chronic Heart Failure Blunts the Low Pressure Baroreflex Induced Biphasic Change of Sympathetic Nerve Activity. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.649.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Vagal nerve stimulation suppressed the inflammatory response in chronic heart failure before improving hemodynamics. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.651.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Carotid Body Denervation Attenuates Sympathetic Nerve Activity, Shifts the Pressure‐Diuresis Curve to the Left and Improves Survival in rats with Hypertensive Heart Failure. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.858.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Carotid Body Denervation Markedly Improves the Survival of Monocrotaline Induced Pulmonary Hypertension Rats. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.858.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Concomitant Vagal Nerve Stimulation (VNS) with Totally Left Ventricular Unloading Markedly Reduces the Infarct Size in Ischemia Reperfusion (IR) Model. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.07.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Combination therapy of vagal nerve stimulation and left ventricular assist device maximally reduces the infarct size in ischemia reperfusion model (1080.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1080.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Development of a rat model of exercise under anesthesia capable of reproducing abnormal respiratory responses in chronic heart failure (882.5). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.882.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Vagally mediated low pressure baroreflex evokes biphasic changes in sympathetic nerve activity and resets the arterial baroreflex (1169.12). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1169.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Carotid body denervation prevents pulmonary edema, attenuates left ventricular remodeling and restores normal autonomic balance in chronic heart failure after myocardial infarction (709.5). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.709.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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23
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Transvenous vagal nerve stimulation (VNS) in acute myocardial infarction (AMI) markedly reduces the infarction size and improves chronic cardiac function (LB670). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.lb670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Low Pressure Baroreflex Evokes Biphasic Change in Sympathetic Nerve Activity through Vagal Nerve. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.08.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Anesthetized Exercise Model Mimics the Characteristics of Respiratory Pattern in CHF Rat. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.08.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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26
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Baroreflex Failure Deteriorates Salt-induced Transient Increase of Left Atrial Pressure in Spontaneously Hypertensive Rat. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.08.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Afferent vagal nerve stimulation induced sympathoinhibition may in part attribute to the beneficial impact of vagal nerve stimulation on heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Prediction of hemodynamic impact of the venoarterial Extracorporeal Membrane Oxygenation (ECMO). Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Quantitative Prediction of Impact of Left Ventricular Assist Device (LVAD) on Hemodynamics. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1184.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Afferent Vagal Nerve Stimulation Resets the Baroreflex Neural Arc and Inhibits Sympathetic Nerve Activity. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1118.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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31
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Redox mechanism as alternative to ligand binding for receptor activation delivering disregulated cellular signals. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1994; 152:1064-71. [PMID: 7507957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cross-linking with specific ligand is a general requirement for ordered activation of cell surface receptors. In this study we demonstrated a novel pathway for disregulated receptor activation through a redox mechanism. Treatment of murine thymocytes or spleen cells with thiol-reactive HgCl2, a known inducer of autoimmune proliferative lymphocyte disorders in rodents, was found to induce tyrosine phosphorylation of several cellular proteins, which was up to 100 times as extensive as that triggered by stimulation with antireceptor antibody or mitogen. Through the cross-linkage by thiol-reactive bivalent mercury, transmembrane CD4, CD3, and CD45 and glycosylphosphatidylinositol-anchored Thy-1 were aggregated together on thymocytes or T lymphocytes. Along with the aggregation of Thy-1 and CD4, nonreceptor protein tyrosine kinase p56lck was aggregated and activated. These events were linked to extensive protein tyrosine phosphorylation, which was visualized as a well localized spot beneath the membrane. Under appropriate conditions, this novel pathway of multiple receptor aggregation delivered a disregulated signal into T lymphocytes, which cross-talked to the antireceptor antibody-induced signal, for prolonged cell proliferation and IL-2 production. These results suggest a novel mechanism of disregulation of the ligand-dependent receptor function.
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Redox mechanism as alternative to ligand binding for receptor activation delivering disregulated cellular signals. THE JOURNAL OF IMMUNOLOGY 1994. [DOI: 10.4049/jimmunol.152.3.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Cross-linking with specific ligand is a general requirement for ordered activation of cell surface receptors. In this study we demonstrated a novel pathway for disregulated receptor activation through a redox mechanism. Treatment of murine thymocytes or spleen cells with thiol-reactive HgCl2, a known inducer of autoimmune proliferative lymphocyte disorders in rodents, was found to induce tyrosine phosphorylation of several cellular proteins, which was up to 100 times as extensive as that triggered by stimulation with antireceptor antibody or mitogen. Through the cross-linkage by thiol-reactive bivalent mercury, transmembrane CD4, CD3, and CD45 and glycosylphosphatidylinositol-anchored Thy-1 were aggregated together on thymocytes or T lymphocytes. Along with the aggregation of Thy-1 and CD4, nonreceptor protein tyrosine kinase p56lck was aggregated and activated. These events were linked to extensive protein tyrosine phosphorylation, which was visualized as a well localized spot beneath the membrane. Under appropriate conditions, this novel pathway of multiple receptor aggregation delivered a disregulated signal into T lymphocytes, which cross-talked to the antireceptor antibody-induced signal, for prolonged cell proliferation and IL-2 production. These results suggest a novel mechanism of disregulation of the ligand-dependent receptor function.
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Successful total removal of intramedullary hemangioblastoma from the medulla oblongata. SURGICAL NEUROLOGY 1993; 39:25-30. [PMID: 8451715 DOI: 10.1016/0090-3019(93)90105-a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The case of a large solid hemangioblastoma embedded wholly in the medulla oblongata is reported. Preoperative magnetic resonance imaging provided precise indications of the anatomical location and radiologic features of the tumor, which facilitated its total removal by microsurgery. Short-latency somatosensory evoked potentials were monitored throughout the operation.
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[Transfer of ofloxacin into suction blister fluid after its oral administration]. THE JAPANESE JOURNAL OF ANTIBIOTICS 1987; 40:1937-40. [PMID: 3481837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
After oral administration of 300 mg of ofloxacin (OFLX), the concentration of OFLX in serum peaked at 2 hours and reached 2.88 +/- 0.62 micrograms/ml (mean +/- S.D.). In the fluid of dermal blisters produced by suction, the peak value was 1.74 +/- 0.88 micrograms/ml at 4 hours. Pharmacokinetically, Cmax (maximum concentration), Tmax (time of maximum concentration), Ka (absorption rate constant) and AUC0-8hrs. (area under the concentration-time curve) were calculated as 2.65 micrograms/ml, 2.07 hours, 0.79 hr-1 and 14.5 micrograms.hr/ml in serum, and 1.59 micrograms/ml, 4.49 hours, 0.27 hr-1 and 10.1 micrograms.hr/ml, respectively. Therapeutic AUC (area under the curve above minimum effective concentration) were also calculated as 13.3 micrograms.hr/ml (0.14-12.4 hours) in serum, and 11.5 micrograms.hr/ml (0.42-17.3 hours).
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Abstract
The concentrations of tobramycin (TOB) or cefmenoxime (CMX) in serum and burn blister fluid of 51 burn patients (21 for TOB, 30 for CMX) after an i.v. or i.m. injection were determined to find the optimal administration of TOB (2 mg/kg) or CMX (50 mg/kg). Among the various protocols tested, we found from the values of tAUC for TOB that a bolus i.v. injection, or 1-h drip infusion, or i.m. injection are recommended for systemic sepsis, however, the 1-h drip infusion is strongly suggested for treating wound surface infection. It has also been found that with CMX a bolus i.v. injection with a long period of efficacy is recommended for treating systemic sepsis, while a 1-h drip infusion or bolus i.v. injection was the best method for treating wound-surface infection.
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Studies on systemic absorption of tobramycin in polyethylene glycol ointment applied to wounds of burn patients. Burns 1986; 12:153-60. [PMID: 3708410 DOI: 10.1016/0305-4179(86)90152-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The penetration of tobramycin ointment (0.2 per cent) through human burn wounds was studied in two patients with superficial dermal burn (SDB) and deep dermal burn (DDB), two patients with DDB, one patient with full thickness burn (FB) and one patient with burn ulcer (BU). After application of the ointment, the absorption of tobramycin occurred promptly with a peak level at 2-6 h in the sera of patients with SDB + DDB and DDB only. In the BU patient it was found at 2 h; while in the FB, at 10-12 h. The excretion of tobramycin into the urine was also studied. The absorption rate constants (ka) of the two SDB + DDB patients were 0.31 and 0.74, of the two DDB patients, 0.079 and 0.18, and those of the DB and the BU patients, 0.053 and 0.95, respectively. The absorption ratios of tobramycin (amount excreted into the urine during 24 h/applied dose) were different, depending on the condition of the burn wound, and ranged from a low of 10.3 per cent (FB) to a high of 44.0 per cent (BU). These results show that the treatment of burn patients with tobramycin ointment to control burn wound infection should be carefully supervised, especially in the case of BU.
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[Transfer of latamoxef into human burn blister fluid and its pharmacokinetic analysis]. THE JAPANESE JOURNAL OF ANTIBIOTICS 1985; 38:2821-6. [PMID: 4078995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Latamoxef (LMOX) (50 mg/kg) was administrated intravenously to burned patients over 1 hour period. Burn blister fluid and serum were taken during 8 hours after injection, and concentrations of LMOX in burn blister fluid and serum were determined by bioassay using E. coli as a test organism. The serum concentrations of LMOX were 170.8 +/- 30.6 micrograms/ml at 30 minutes, 227.0 +/- 19.8 micrograms/ml at 1 hour, 90.3 +/- 21.4 micrograms/ml at 2 hours, 52.9 +/- 14.6 micrograms/ml at 3 hours, 38.7 +/- 13.3 micrograms/ml at 4 hours, 25.1 +/- 8.1 micrograms/ml at 5 hours, 20.5 +/- 8.1 micrograms/ml at 6 hours, 13.0 +/- 5.5 micrograms/ml (mean +/- S.D., n = 5) at 8 hours after the injection. The LMOX concentrations in burn blister fluid were 36.9 +/- 32.8 micrograms/ml at 30 minutes, 77.5 +/- 42.2 micrograms/ml at 1 hour, 85.4 +/- 19.6 micrograms/ml at 2 hours, 76.4 +/- 18.5 micrograms/ml at 3 hours, 63.5 +/- 17.8 micrograms/ml at 4 hours, 54.9 +/- 17.1 micrograms/ml at 5 hours, 34.8 +/- 10.3 micrograms/ml at 6 hours, 25.2 +/- 4.8 micrograms/ml (mean +/- S.D., n = 7) at 8 hours after the injection. The data obtained were analysed pharmacokinetically. The serum levels were analysed by two-compartment model, and the LMOX levels in burn blister fluid were analysed by the model, in which blister was considered as a small part of the peripheral compartment. In results, Tmax and Cmax of LMOX levels in burn blister fluid were calculated as 1.81 hours and 90.6 micrograms/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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The effect of some ointment bases on the systemic absorption of tobramycin from various wound surfaces of burned patients. Burns 1984; 10:290-9. [PMID: 6713243 DOI: 10.1016/0305-4179(84)90008-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Three kinds of 0.2 per cent tobramycin ointment were prepared with tobramycin and 3 ointment bases (cream, polyethylene glycol and hydrophilic petrolatum), and applied to the various wound surfaces of 5 burned patients. The systemic absorptions of tobramycin were compared with the values of the tentative AUC (area under the curve of tobramycin blood level, micrograms.h/ml.g) until 12 hours after the applications, by determining tobramycin level in blood. Similar values of AUC from the cream and polyethylene glycol ointments were obtained, while that of hydrophilic petrolatum ointment was very low. The systemic absorption of tobramycin from the polyethylene glycol ointment was studied when the ointment was applied to the wound surfaces of 7 patients with partial-thickness burn, 9 patients with full-thickness burn and 6 patients with burn ulcer. The mean values of the tentative AUC of patients with partial-thickness burn, full-thickness burn and burn ulcer were found to be 0.06, 0.03 and 0.15, respectively. These results showed that cream and polyethylene glycol bases should be used carefully as a vehicle of tobramycin ointments because of the rapid systemic absorption of tobramycin from human burn wounds, especially burn ulcer.
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[Transfer of cefmenoxime to burn blister fluids]. THE JAPANESE JOURNAL OF ANTIBIOTICS 1984; 37:295-302. [PMID: 6330396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Transfer of cefmenoxime (CMX) into the burn blister fluids was studied in 10 burned patients with 2 administrated doses (25, 50 mg/kg). CMX concentrations in serum and burn blister fluid after 1 hour intravenous drip infusion were measured using Proteus mirabilis ATCC 21100 as the test organism grown in the DST agar medium. In the case of CMX 25 mg/kg dose, the peak serum concentration was observed 61.5 micrograms/ml at 1 hour, while the peak burn blister fluid concentration was observed 15.2 micrograms/ml at 2 hours. Pharmacokinetic parameters of serum concentration calculated were 1.02 hours as half-life (beta) and 0.42 L/kg as distribution volume, respectively. In the case of CMX 50 mg/kg dose, the peak serum concentration was observed 122.0 micrograms/ml at 1 hour and the peak burn blister fluid concentration was observed 40.8 micrograms/ml at 2 hours. Pharmacokinetic parameters of serum concentration calculated were 1.27 hours as half-life (beta) and 0.55 L/kg as distribution volume. From this study, the dose dependency between 25 mg/kg dose and 50 mg/kg dose in serum and in burn blister fluid is recognized.
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