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STUDY DESIGN: A pilot cross-sectional study of patients with acute cervical spinal cord injury (SCI). OBJECTIVES: The precise evaluation of the severity of SCI is important for developing novel therapies. Although several biomarkers in cerebrospinal fluid have been tested, few analyses of blood samples have been reported. A novel biomarker for axonal injury, phosphorylated form of the high-molecular-weight neurofilament subunit NF-H (pNF-H), has been reported to be elevated in blood from rodent SCI model. The aim of this study is to investigate whether pNF-H values in blood can serve as a biomarker to evaluate the severity of patients with SCI. SETTING: Tokyo Metropolitan Bokutoh Hospital and National Rehabilitation Center, Japan. METHODS: This study enrolled 14 patients with acute cervical SCI. Sequential plasma samples were obtained from 6 h to 21 days after injury. Patients were classified according to American Spinal Injury Association impairment scale (AIS) at the end of the follow-up (average, 229.1 days). Plasma pNF-H values were compared between different AIS grades. RESULTS: In patients with complete SCI, pNF-H became detectable at 12 h after injury and remained elevated at 21 days after injury. There was a statistically significant difference between AIS A (complete paralysis) patients and AIS C (incomplete paralysis) patients. CONCLUSIONS: Plasma pNF-H was elevated in accordance with the severity of SCI and reflected a greater magnitude of axonal damage. Therefore, pNF-H is a potential biomarker to independently distinguish AIS A patients (complete SCI) from AIS C-E patients (incomplete SCI). However, further studies are required to evaluate its utility in predicting prognosis of patients in the incomplete category.
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Vértebras Cervicales/lesiones , Proteínas de Neurofilamentos/sangre , Traumatismos de la Médula Espinal/diagnóstico , Índices de Gravedad del Trauma , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fosforilación , Proyectos Piloto , Subunidades de Proteína/sangre , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Expansion of the progenitor pool of oligodendrocytes (OLs) is a critical process for obtaining appropriate amounts of mature myelin-forming OLs in the developing and regenerating central nervous system. In vitro, fibroblast growth factor-2 (FGF2), together with platelet-derived growth factor (PDGF), is required to expand oligodendrocyte progenitor cells (OLPs) in an unlimited manner, maintaining them in the early progenitor stage. However, the intracellular mechanisms that prevent OLP maturation remain elusive. In order to investigate these mechanisms, we established a mouse OLP primary culture, which enabled us to undertake biochemical analyses. We found that the suppressive effects on maturation of early OLP to the late O4(+) progenitor by PDGF+FGF2 treatment was abrogated by Mek inhibitor, while transfecting cells with a constitutively active Mek1 construct prevented OLP maturation, suggesting that the Mek-Erk pathway is implicated in the effects of the growth factor treatment. The activation of Mek-Erk pathway promoted proliferation of OLP suggesting that cell cycle progression has suppressive effects to the maturation of OLP. Furthermore, molecular screening using DNA microarrays revealed that Hes1, a negative regulator of bHLH transcription factors, is one of the downstream molecules induced by PDGF+FGF2 treatment. We confirmed that forced activation of Mek-Erk pathway is sufficient to induce Hes1 expression and that Hes1, in turn, exerts suppressive effects on the maturation of OL lineage by itself. Our observations thus indicate that Mek-Erk pathway plays pivotal role in preventing early OLP maturation to late OLPs and the effect is mediated by cell cycle progression as well as Hes1 induction.
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Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/metabolismo , Linaje de la Célula , Proteínas de Homeodominio/metabolismo , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Oligodendroglía/citología , Transducción de Señal/fisiología , Células Madre/citología , Animales , Western Blotting , Ciclo Celular/fisiología , Células Cultivadas , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Inmunohistoquímica , Quinasas Quinasa Quinasa PAM/metabolismo , Ratones , Oligodendroglía/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células Madre/metabolismo , Factor de Transcripción HES-1RESUMEN
In order to clarify the effect of oxidation itself on the gel formation of salted-surimi through setting, the gel-forming properties were examined with or without transglutaminase (TGase) inhibitor. The gels were prepared from walleye pollack salted-surimi mixed with KBrO3 through setting at 30 degrees C (suwari gel) for 2 h prior to heating at 80 degrees C for 20 min (kamaboko gel) in the presence or absence of TGase inhibitor. The gel strength of kamaboko gel increased through setting but KBrO3 almost did not promote the gel formation of kamaboko gels through setting comparing with control. KBrO3 increased the breaking strength and decreased elongation so that the gel became harder. Even in the presence of TGase inhibitor, where the increase in gel strength during setting was suppressed, KBrO3 showed the promotion of gel formation, although the gel strength is lower than the gel without TGase inhibitor. Almost, similar behaviors of protein polymerization by disulfide bonds and the oxidation of sulfhydryl groups to those in the absence of TGase inhibitor were observed. These results suggest that KBrO3 enhances the gel forming ability of walleye pollack surimi through the disulfide bonding of myosin heavy chain by oxidation during the setting. In conclusion, the oxidation of salted surimi sol during setting at 30 degrees C can contribute to the gel formation, but its contribution seems not to be cooperative with that of TGase.
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Bromatos/química , Productos Pesqueros , Gadiformes , Geles/química , Transglutaminasas/antagonistas & inhibidores , Animales , Oxidación-ReducciónRESUMEN
Perioperative increase in oxidative activity in surgical patients reportedly prevents postoperative surgical site infection (SSI). Several clinical studies have shown that oxidative activity under sevoflurane anaesthesia was higher than that under propofol anaesthesia. Therefore, we hypothesised that sevoflurane anaesthesia would discourage SSI compared with propofol anaesthesia. To examine the effect of anaesthesia maintained with sevoflurane and propofol on SSI, a total of 265 consecutive adult patients, with American Society of Anesthesiologists physical status 1-3, who underwent elective open gastrointestinal surgery under general anaesthesia, were surveyed for SSI between January 2007 and December 2008. Sevoflurane or propofol was selected to maintain anaesthesia in 95 and 170 patients, respectively. A propensity score was used for pairwise matching of these patients to avoid selection biases between the two methods of anaesthesia. Propensity matching yielded 84 pairs of patients. We compared standardised infection ratios (SIRs), i.e. the quotient of the number of SSI cases observed and the number of SSI cases expected, calculated using data from the National Nosocomial Infection Surveillance, between sevoflurane and propofol anaesthesia. After propensity matching, SIR after sevoflurane anaesthesia was 1.89 [95% confidence interval (CI): 1.46-2.32], which was significantly lower than after propofol anaesthesia (4.78; 95% CI: 4.30-5.27) (P=0.02). This study suggests that sevoflurane tends to suppress SSI after elective open gastrointestinal surgery compared with propofol.
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Anestesia/métodos , Procedimientos Quirúrgicos del Sistema Digestivo , Éteres Metílicos/administración & dosificación , Propofol/administración & dosificación , Infección de la Herida Quirúrgica/epidemiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sevoflurano , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
OBJECTIVE: Shikonin, a component of the herbal medicine "Shikon", is known to suppress inflammatory reactions, but its molecular targets are not identified. This study examines the effect of shikonin on human basophil degranulation response and aims to identify its targets. MATERIALS: Human basophils in isolated leukocytes from healthy volunteers' peripheral blood; recombinant human Syk and Lyn tyrosine kinases. METHODS: Histamine release from basophils stimulated with anti-IgE antibody was analyzed fluorimetrically. Syk and Lyn kinase activities were tested in Vitro with recombinant proteins and analyzed by off-chip mobility shift assay. RESULTS: Shikonin dose-dependently inhibited the histamine release from basophils induced by anti-IgE antibody (IC50 = 2.6 +/- 1.0 microM; mean +/- SEM). A search for the target(s) of shikonin in the signal cascade of IgE-mediated activation showed that it strongly inhibits Syk (IC50 = 7.8 microM, in the recombinant kinase assay), which plays a pivotal role in the degranulation response. A less significant inhibition was found for Lyn, which phosphorylates FcepsilonRI-betagamma subunits and also Syk. CONCLUSIONS: These results indicate that the inhibition of Syk-dependent phosphorylation events might underlie the blocked histamine release from human basophils, thus contributing to the anti-inflammatory effects of shikonin.
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Antiinflamatorios no Esteroideos/farmacología , Basófilos/efectos de los fármacos , Basófilos/inmunología , Liberación de Histamina/inmunología , Inmunoglobulina E/inmunología , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Naftoquinonas/farmacología , Proteínas Tirosina Quinasas/metabolismo , Basófilos/citología , Humanos , Quinasa SykRESUMEN
BACKGROUND: There are an increasing number of elderly patients with critical aortic stenosis. This study was performed to evaluate the surgical outcome of aortic valve surgery for elderly patients with aortic stenosis. METHODS: Eleven patients aged over 75 years old (mean 79.7 +/- 4.4) underwent aortic valve replacement with stented bioprosthesis from May 2001 to August 2004. All of the patients had a history of congestive heart failure, syncope, or angina pectoris with multiple medical problems including renal dysfunction, diabetes mellitus, cerebral infarction, or coronary artery disease. The New York Heart Association (NYHA) classification ranged II to IV (mean 2.8 +/- 0.7). Their logistic Euro score ranged from 2.56 to 41.61 (mean 8.6 +/- 10.9). The concomitant procedures were annular enlargement in 2 and coronary artery bypass grafting (CABG) in 3 patients. RESULTS: All patients tolerated these procedures well and were discharged except 1 patient who died from arrhythmia on the postoperative day 14. Postoperative echocardiogram after 3 months showed satisfactory decrease in peak left ventricular-aortic pressure gradient as well as left ventricular mass regression. All surviving patients are in NYHA class I. CONCLUSIONS: Aortic valve replacement provided satisfactory results for elderly patients. Surgical treatment should be considered even for the elderly patients with critical aortic stenosis under meticulous perioperative management.
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Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica/cirugía , Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas , Anciano , Anciano de 80 o más Años , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Ecocardiografía , Femenino , Insuficiencia Cardíaca/complicaciones , Humanos , MasculinoRESUMEN
A 31-year-old female was clinically diagnosed as having a anterior mediastinal yolk sac tumor because of the elevation of the AFP (17,500 ng/ml), a large mass lesion (9 x 5 cm) in the anterior mediastinum and bilateral lung metastases. After 4 courses of chemotherapy with cisplatin (CDDP), etoposide (VP-16) and bleomycin hydrochloride (BLM), the mediastinal mass reduced in size significantly and the serum AFP level reached within normal range. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed a weak uptake in the mediastinum, accordingly the operation was performed. The tumor was completely removed and there were no viable foci of the tumor in part of the tumor. After the operation, 4 courses of chemotherapy with carboplatin (CBDCA), VP-16 and ifosfamide (IFM) were performed. She is alive without evidence of recurrence in 5 months after operation. It was noticed that the serum AFP is a useful indicator for determing the chance of operation after chemotherapy.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Tumor del Seno Endodérmico/secundario , Neoplasias Pulmonares/secundario , Neoplasias del Mediastino/patología , Síndrome de la Vena Cava Superior/complicaciones , Adulto , Carboplatino/administración & dosificación , Terapia Combinada , Esquema de Medicación , Tumor del Seno Endodérmico/diagnóstico por imagen , Tumor del Seno Endodérmico/tratamiento farmacológico , Tumor del Seno Endodérmico/cirugía , Etopósido/administración & dosificación , Femenino , Fluorodesoxiglucosa F18 , Humanos , Ifosfamida/administración & dosificación , Neoplasias del Mediastino/diagnóstico por imagen , Neoplasias del Mediastino/tratamiento farmacológico , Neoplasias del Mediastino/cirugía , Tomografía de Emisión de Positrones , alfa-Fetoproteínas/análisisRESUMEN
Reciprocal interspecific crosses were carried out between six lines of Dianthus caryophyllus L. and one line of Dianthus japonicus Thunb. Although no seed was set when D. japonicus was used as the seed parent, six seedlings were successfully obtained from 2,380 immature ovules by applying the embryo-rescue technique. However, they showed seed parent-like morphology and no evidence for the hybridity by flow cytometry and RAPD analyses. When six lines of D. caryophyllus were used as seed parents, a total of 192 seedlings were successfully obtained without using the embryo-rescue technique. Among these seedlings, 12 out of 25 progenies obtained from the carnation line '98sp1651' were confirmed to be the hybrids. The remaining 13 progenies of this line, and the total 167 progenies obtained from the other carnation lines, had carnation-like morphology without any evidence of hybridity by flow cytometry and RAPD analyses. The progenies confirmed as hybrids had intermediate characters of the parents with respect to leaf width and flower size, but they had a uniform flower color, reddish purple, which was different from that of either parent. Since the hybrids obtained in the present study have some profitable characters such as vigorous growth in summer time, upright robust stem, broad leaves and early flowering, they are expected to be used for the breeding of carnation which is suitable for growing under the Japanese climate.
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Dianthus/genética , Hibridación Genética , ADN de Plantas/genética , Citometría de Flujo , Regulación de la Expresión Génica de las Plantas , Genotipo , Técnica del ADN Polimorfo Amplificado AleatorioRESUMEN
A 42-year-old female was referred to our vascular service because of her right arm fatigue and cold sensitivity. On elevation of right arm, her radial pulse was absent with pallor of the hand. Angiography demonstrated a significant stenosis of the right subclavian artery, which was considered to be complication of thoracic outlet syndrome. We performed resection of the first rib using the standard subclavicular approach and the subclavian-subclavian artery bypass using a new transsternal extension approach to the subclavian artery. After follow-up 18 months, she was working and asymptomatic. This transsternal extension is effective to treat the arterial complication after decompression of the thoracic outlet.
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Arteria Subclavia/patología , Síndrome del Desfiladero Torácico/cirugía , Procedimientos Quirúrgicos Torácicos/métodos , Adulto , Constricción Patológica/complicaciones , Femenino , Humanos , Esternón , Síndrome del Desfiladero Torácico/complicacionesRESUMEN
Hyperamylasemia after cardiac surgery is common but typically causes no clinical concern because it consists mainly of the salivary isoenzyme. In this study we evaluated the incidence, source, and time course of postoperative hyperamylasemia with special attention to the possibility of subclinical pancreatitis. In 88 patients prospectively tested for serum amylase and lipase concentrations, elastase 1 activity, and amylase isoenzyme characteristics, 57 (64%) showed hyperamylasemia during the early postoperative period. In most cases early hyperamylasemia was not of pancreatic origin, but two patients were diagnosed with subclinical pancreatitis. Among the last 23 patients, 5 of 10 patients with early hyperamylasemia exceeding 1000 IU/L showed late hyperamylasemia on the seventh postoperative day, when it represented mainly the pancreatic isoenzyme. Lipase concentrations and elastase 1 activities were elevated in these cases. Late hyperamylasemia following cardiac surgery may be of pancreatic origin and indicative of subclinical pancreatitis, even if early hyperamylasemia was of salivary origin.
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Amilasas/sangre , Puente Cardiopulmonar/efectos adversos , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/cirugía , Enfermedades de las Válvulas Cardíacas/sangre , Enfermedades de las Válvulas Cardíacas/cirugía , Pancreatitis/etiología , Complicaciones Posoperatorias , Adulto , Anciano , Válvula Aórtica/cirugía , Femenino , Humanos , Isoenzimas/sangre , Lipasa/sangre , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Elastasa Pancreática/sangre , Pancreatitis/sangre , Periodo Posoperatorio , Estudios Prospectivos , Factores de TiempoRESUMEN
The surgical outcome of infectious abdominal aortic aneurysms was evaluated based on the preoperative presence or absence of systemic inflammatory response syndrome (SIRS). Nine patients were divided into two groups according to the criteria for SIRS such as body temperature, heart rate, respiratory rate, and white blood cell count. In the group with SIRS, rupture and impending rupture of aneurysms occurred in three of the four patients (75%). All aneurysms were resected with a small part as a remnant; two in situ and two extraanatomic reconstructions were performed. Three patients died after surgery: one after in situ (cerebral infarction) and two after extraanatomic reconstruction (sepsis and multiple organ failure). In the group without SIRS, closed en bloc resection in two patients and resection of the aneurysm with a small part as a remnant in three patients were performed. In situ reconstruction in all patients and omentum wrapping in two patients were performed. One of the five patients died of massive hematemesis 70 days after surgery. The overall mortality rate was 75% in the group with SIRS versus 20% in the group without SIRS. The surgical outcome of infectious abdominal aortic aneurysm depends upon the severity of underlying infection. A possibility exists that SIRS is a useful indicator for predicting the surgical outcome of patients.
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Aneurisma Infectado/cirugía , Aorta Abdominal/patología , Aorta Abdominal/cirugía , Aneurisma de la Aorta Abdominal/cirugía , Síndrome de Respuesta Inflamatoria Sistémica/cirugía , Anciano , Anciano de 80 o más Años , Aneurisma Infectado/mortalidad , Aneurisma de la Aorta Abdominal/mortalidad , Temperatura Corporal , Proteína C-Reactiva/metabolismo , Femenino , Frecuencia Cardíaca , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Análisis de Supervivencia , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Resultado del TratamientoRESUMEN
The deltopectoral skin flap is an axial flap; therefore, it can be fashioned as a free skin flap. Although color and texture of the skin are well suited for facial resurfacing, the structural features of inconsistent thickness of the skin, a short vascular pedicle, a minute caliber of the nutrient vessel, and donor site morbidity often preclude the use of this flap for this purpose. The deltopectoral skin flap fabricated as a free skin flap transferred by means of a microsurgical technique was used in 27 patients between 1985 and 1998 at our hospital. The anterior perforating branches of the internal mammary vessels were the primary nutrient vessels of the flap in seven instances. The external caliber of this artery varied between 0.6 mm and 1.2 mm, with an average size of 0.9 mm. The size of the accompanying vein varied between 1.5 mm and 3.2 mm, with an average of 2.3 mm. Coaptation of these vessels with those in the recipient site was technically difficult. Thrombosis occurred at the anastomotic site in three patients, requiring reoperation. Two flaps were saved. The flap failure was drastically reduced in the remaining 20 patients by including a segment of the internal mammary vessel when fabricating the vascular pedicle. The size of the internal mammary arterial segment averaged 2.1 mm, and the average size of the accompanying vein was 2.9 mm. The problem of a bulky flap was managed by surgical defatting/thinning of the flap at the time of flap fabrication and transfer. A V-to-Y skin flap advancement technique of wound closure was used in eight individuals. The flap donor-site morbidities were minimized with this method of wound closure.
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Colgajos Quirúrgicos , Adulto , Anciano , Quemaduras/cirugía , Niño , Traumatismos Faciales/cirugía , Neoplasias Faciales/cirugía , Femenino , Estudios de Seguimiento , Granuloma de Cuerpo Extraño/cirugía , Humanos , Masculino , Persona de Mediana Edad , Elastómeros de Silicona/efectos adversos , Colgajos Quirúrgicos/irrigación sanguínea , Factores de TiempoRESUMEN
Aortic dissection rarely occurs in 2 or more family members without Marfan's syndrome. This report describes two aged siblings who underwent emergency operations for aortic dissection. Case 1: A 71-year-old female (sister), who had Stanford type B aortic dissection, underwent replacement of the descending aorta with a Hemashield graft. Case 2: A 72-year-old male (brother of case 1), who had Stanford type A aortic dissection, underwent replacement of the ascending aorta with a UBE graft following the closure of the entry located in the proximal arch. Neither of 2 siblings nor other family members had any features of the Marfan's syndrome. It is proposed that two aortic dissections occurred coincidentally in one family without Marfan's syndrome.
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Aneurisma de la Aorta Abdominal/genética , Aneurisma de la Aorta Abdominal/cirugía , Aneurisma de la Aorta Torácica/genética , Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/genética , Disección Aórtica/cirugía , Anciano , Salud de la Familia , Femenino , Humanos , Masculino , Síndrome de MarfanRESUMEN
Subclavian artery aneurysms are relatively rare, and the surgical approach depends on the location (intrathoracic or extrathoracic) and size of the aneurysm. Right subclavian artery aneurysms are usually operated upon using a supraclavicular approach or median sternotomy incision with right supraclavicular extension. We treated a right intrathoracic subclavian artery aneurysm by subclavicular trans-sternal approach. This surgical approach is recommended for treatment of right intrathoracic subclavian artery aneurysms for its easy access and excellent cosmetic results.
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Aneurisma/cirugía , Arteria Subclavia/cirugía , Aneurisma/diagnóstico por imagen , Angiografía de Substracción Digital , Femenino , Humanos , Persona de Mediana Edad , Arteria Subclavia/diagnóstico por imagen , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
OBJECTIVE: Transmyocardial laser revascularization (TMLR) has been widely evaluated as a treatment for ischemic myocardium. However, its mechanism remains unclear. One mechanism is angiogenesis. This study examines the relationship between TMLR and angiogenesis from the viewpoint of matrix metalloproteinases and platelet-derived endothelial cell growth factor. METHODS: The left anterior descending coronary artery (LAD) was ligated permanently in 12 beagle dogs. TMLR was accomplished in six of the 12 dogs using a carbon dioxide laser. No laser treatment was done in the six control dogs. Two weeks after the initial operation, dogs were euthanized and transmural samples (each of approximately 0.5 g) were cut from the center of the infarcted LAD territory, right ventricular wall, left circumflex artery perfuse area and interventricular septum except the LAD perfuse area. They were snap-frozen in liquid nitrogen for matrix metalloproteinases and platelet-derived endothelial cell growth factor activity analysis. Hematoxylin and eosin staining, double immunohistologic staining with anti-proliferating cell nuclear antigen and von Willebrand factor antibody, and immunohistologic staining with antibody against platelet-derived endothelial cell growth factor were performed for histologic studies. The activities of matrix metalloproteinases were examined by gelatin zymography. The activity of platelet-derived endothelial cell growth factor was examined by a spectrophotometric method. RESULTS: The channels were found to be infiltrated with granulation tissue and fibrosis. In the laser group, the active matrix metalloproteinase-2 and platelet-derived endothelial cell growth factor activity in the area of the left anterior descending coronary artery was significantly higher than in the control group (P<0.0001 and P=0.037, respectively). Within the channel remnants or close to these areas, the number of von Willebrand factor positive microvessels and proliferating cell nuclear antigen with correlating von Willebrand factor positive microvessels were significantly higher than in the control group (P=0.001 and P=0.0006, respectively). These increases in microvessels significantly correlated with the expression of matrix metalloproteinases and platelet-derived endothelial cell growth factor. CONCLUSION: Based on these findings it was concluded that transmyocardial laser revascularization induced angiogenesis correlated with the expression of active matrix metalloproteinases-2 and platelet-derived endothelial cell growth factor.
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Terapia por Láser , Metaloproteinasas de la Matriz/metabolismo , Revascularización Miocárdica/métodos , Neovascularización Fisiológica , Timidina/metabolismo , Animales , Perros , Endocardio/patología , Femenino , Humanos , Inmunohistoquímica , MasculinoRESUMEN
Yolk sac-derived embryonic erythroid cells differentiate synchronously in the peripheral blood of Syrian hamster. The stage of differentiation on day 10 of gestation is equivalent to polychromatophilic erythroblast stage and that on day 13 is equivalent to the reticulocyte stage in adult animals. The cytoplasm of embryonic erythroid cells became scant and devoid of most organelles on day 12 of gestation. In addition, there were very few non-erythroid cells in circulation before day 13. Thus the embryonic erythroid cells serve a pure and synchronous system to study the mechanisms of terminal differentiation. The number of mitochondria in the embryonic erythroid cells decreased to about 10% of the initial number during the period between day 10 and day 12 of gestation. In contrast, the frequency of autophagy of mitochondria increased 4.6-fold in the same period. The cytochrome c content of the cell decreased as the mitochondria became extinct. However, release of cytochrome c into the cytoplasm was not detectable through day 10-13 of gestation, suggesting that the mitochondria were digested within a closed compartment. Decomposed mitochondria and ferritin particles were detected in lysosomes by electron microscopy on and after day 12 of gestation, which also suggested digestion in a closed compartment. Mitochondrial ATP synthase subunit c, which is known to be a protease-refractory protein, was retained in the cells even after the disappearance of mitochondria, indicating that most of the mitochondria were not extruded from the cells. The digestion of mitochondria in autolysosomes may allow the cells to escape from rapid apoptotic cell death through concomitant removal of mitochondrial death-promoting factors such as cytochrome c.
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Eritrocitos/metabolismo , Eritrocitos/fisiología , Complejos de ATP Sintetasa , Animales , Apoptosis , Diferenciación Celular , Cricetinae , Grupo Citocromo c/biosíntesis , Electroforesis en Gel de Poliacrilamida , Eritrocitos/citología , Ferritinas/metabolismo , Immunoblotting , Mesocricetus/embriología , Microscopía Electrónica , Mitocondrias/enzimología , Mitocondrias/metabolismo , Complejos Multienzimáticos/metabolismo , Fosfotransferasas (Aceptor del Grupo Fosfato)/metabolismo , Factores de TiempoAsunto(s)
Aneurisma de la Aorta Torácica/congénito , Disección Aórtica/congénito , Adulto , Disección Aórtica/diagnóstico , Disección Aórtica/cirugía , Angiografía , Aneurisma de la Aorta Torácica/diagnóstico , Aneurisma de la Aorta Torácica/cirugía , Implantación de Prótesis Vascular , Diagnóstico Diferencial , Ecocardiografía , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Madres , Hijo Único , Tomografía Computarizada por Rayos XRESUMEN
Primary aortoenteric fistula is a rare disease with a fatal outcome unless it is diagnosed accurately and treated surgically. We present an elderly patient with primary aortosigmoid fistula confirmed by endoscopy. Descending thoracic aortofemoral bypass was performed and the aortoiliac aneurysm and sigmoid colon were then resected in continuity. The patient maintains a good quality of life 6 years after the operation with good graft patency and no sign of graft infection.