RESUMEN
We report a case of well leg compartment syndrome (WLCS) in both legs after robot-assisted laparoscopic prostatectomy (RALP). A 65-year-old man underwent surgery for prostate cancer. He was placed in the lithotomy position and both his legs were protected with elastic stockings and intermittent pneumatic com- pression to prevent deep vein thrombosis during sur- gery. After surgery, he complained of pain in both calves. Movement and sensory disorder along with swelling were found in both legs. Computed tomogra- phy of the legs showed damage to the soleus and gas- trocnemius muscles of both legs. The creatinine phos- phokinase level had increased to 10,560 IU · l⻹. The patient was diagnosed with WLCS in both legs and underwent conservative treatment. Symptoms in both legs started to improve from the next day. The right leg swelling receded within 10 days, while the left leg swelling receded 67 days after surgery. WLCS in the legs after RALP is a rare but severe complication requiring early diagnosis and intervention. To prevent WLCS, it is important that we recognize this disease as a potential complication after RALP.
Asunto(s)
Celulitis (Flemón)/etiología , Síndromes Compartimentales/etiología , Eosinofilia/etiología , Laparoscopía/efectos adversos , Pierna , Complicaciones Posoperatorias , Prostatectomía/efectos adversos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Anciano , Humanos , Masculino , Complicaciones Posoperatorias/diagnóstico , Neoplasias de la Próstata/cirugía , Posición SupinaRESUMEN
The initial attachment of influenza virus to cells is the binding of hemagglutinin (HA) to the sialyloligosaccharide receptor; therefore, the small molecules that inhibit the sugar-protein interaction are promising as HA inhibitors to prevent the infection. We herein demonstrate that sialic acid-mimic heptapeptides are identified through a selection from a primary library against influenza virus HA. In order to obtain lead peptides, an affinity selection from a phage-displayed random heptapeptide library was performed with the HAs of the H1 and H3 strains, and two kinds of the HA-binding peptides were identified. The binding of the peptides to HAs was inhibited in the presence of sialic acid, and plaque assays indicated that the corresponding N-stearoyl peptide strongly inhibited infections by the A/Aichi/2/68 (H3N2) strain of the virus. Alanine scanning of the peptides indicated that arginine and proline were responsible for binding. The affinities of several mutant peptides with single-amino-acid substitutions against H3 HA were determined, and corresponding docking studies were performed. A Spearman analysis revealed a correlation between the affinity of the peptides and the docking study. These results provide a practicable method to design of peptide-based HA inhibitors that are promising as anti-influenza drugs.
Asunto(s)
Antivirales/química , Antivirales/farmacología , Glicoproteínas Hemaglutininas del Virus de la Influenza/metabolismo , Virus de la Influenza A/efectos de los fármacos , Gripe Humana/prevención & control , Oligopéptidos/química , Oligopéptidos/farmacología , Animales , Antivirales/metabolismo , Línea Celular , Perros , Humanos , Virus de la Influenza A/fisiología , Gripe Humana/metabolismo , Simulación del Acoplamiento Molecular , Mutagénesis Sitio-Dirigida , Ácido N-Acetilneuramínico/análogos & derivados , Ácido N-Acetilneuramínico/farmacología , Oligopéptidos/genética , Infecciones por Orthomyxoviridae/metabolismo , Infecciones por Orthomyxoviridae/prevención & control , Biblioteca de PéptidosRESUMEN
BACKGROUND: There are some reports stating that interscalene block is effective in relieving perioperative pain during arthroscopic rotator cuff repair (ARCR), and we used this procedure for ARCR in our department since May 2011. METHODS: We examined the effect of interscalene block on the blood pressure variability during ARCR. For this purpose, we used standard deviation (SD) of each blood pressure data, recorded every 5 minutes during operation as the blood pressure variability. We compared the SD between non-block group, who had only general anesthesia and block group, who received interscalene brachial plexus block before induction of general anesthesia with 0.2-0.375% ropivacaine 10-20 ml. In addition, we compared the doses of fentanyl administered during operation, between the block group and non-block group. RESULTS: The average systolic blood pressure was lower during operation than that before anesthesia in both groups, but a significant reduction was not shown in percentage, in both systolic and diastolic blood pressures. As for the blood pressure variability during operation, SDs of systolic and diastolic blood pressure were 11.1 mmHg and 6.9 mmHg in average in block group, and they were both lower than those in non-block group, 17.5 mmHg and 9.8 mmHg. Total fentanyl consumption in block group was 40 microg on average, significantly reduced than that in non-block group, 150 microg. CONCLUSIONS: Single-shot interscalene block before ARCR reduced both blood pressure variability and the dose of fentanyl given during operation.
Asunto(s)
Artroscopía , Presión Sanguínea , Monitoreo Intraoperatorio , Bloqueo Nervioso/métodos , Dolor Postoperatorio/prevención & control , Manguito de los Rotadores/cirugía , Anciano , Anciano de 80 o más Años , Amidas/administración & dosificación , Anestesia General , Anestésicos Locales/administración & dosificación , Plexo Braquial , Femenino , Fentanilo/administración & dosificación , Fentanilo/efectos adversos , Humanos , Cuidados Intraoperatorios , Masculino , Persona de Mediana Edad , Náusea y Vómito Posoperatorios/inducido químicamente , Náusea y Vómito Posoperatorios/prevención & control , RopivacaínaRESUMEN
Sialyloligosaccharides of glycoproteins and glycosphingolipids play important roles in biological events on cell membranes. GT1b is a ganglioside having a trisialyloligosaccharide and is a receptor for tetanus toxin. In the present study, pentadecapeptide ligands for GT1b were obtained by phage display selection from a random peptide library with the use of a GT1b monolayer. The artificial pentadecapeptides had high affinity for GT1b which tended to increase depending on the number of sialic acids in sialyloligosaccharides. Arg, Ser, and hydrophobic amino acids were found in a consensus motif and may contribute to carbohydrate recognition. The consensus motif of the GT1b-binding peptides was different from that of GM1-, GM2-, GM3-, or GD1a-binding peptides. Peptide ligands for GT1b should be investigated for trisialyloligosaccharide functions and the development of therapeutic agents against trisialyloligosaccharide-related diseases.
Asunto(s)
Carbohidratos/química , Oligosacáridos/química , Ensayo de Inmunoadsorción Enzimática , Cinética , Ligandos , Modelos Moleculares , Oligopéptidos , Biblioteca de Péptidos , Resonancia por Plasmón de SuperficieRESUMEN
Influenza is an infectious disease caused by the influenza virus, and each year many people suffer from this disease. Hemagglutinin (HA) in the membrane of type A influenza viruses recognizes sialylglycoconjugate receptors on the host cell surface at an initial step in the infection process; consequently, HA inhibitors are considered potential candidates for antiviral drugs. We identified peptides that bind to receptor-binding sites through a multiple serial selection from phage-displayed random peptide libraries. Using the HA of the H1 and H3 strains as target proteins, we obtained peptides that bind to both HAs. The binding affinities of peptides for these HAs were improved by secondary and tertiary selections from the corresponding sublibraries. A docking simulation suggested that, similar to sialic acid, the peptides are recognized by the receptor-binding site in HA, which indicates that these peptides mimic the sialic acid structure. N-stearoyl peptides inhibited infections by the A/Puerto Rico/8/34 (H1N1) and A/Aichi/2/68 (H3N2) strains of influenza virus. Such HA-inhibitors are promising candidates for novel antiviral drugs.