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BACKGROUND: The superficial radial artery (SRA) is a rare congenital anomaly in the forearm. However, it can be detected incidentally via trauma, intraoperative findings, angiography, or ultrasonography. In addition, intra-arterial infusion of intravenous medications and difficulties in radial artery catheterization may occur in cases of the SRA. METHODS: Between December 2016 and July 2020, anomalous branches of radial arteries were found incidentally in nine patients at the preoperative visit and identified during ultrasound-guided radial artery puncture in 21 patients when radial artery catheterization using the palpation method proved difficult. Ultrasound examinations were performed for diagnosis and evaluation of these 30 patients. RESULTS: All anomalous branches of the radial artery were SRAs; 11 (37%), 13 (43%), 6 (20%) were present on the right side, on the left side, and bilaterally, respectively. All SRAs ran close to the cephalic vein. The vascular diameters of the radial arteries were the smallest in the radial artery distal to the SRA bifurcation (followed by in the SRA) and the largest in the radial artery proximal to the bifurcation (p < .001). In two cases, color Doppler study revealed that both the blood flow and color Doppler signal of the SRA disappeared with compression of the radial artery proximal to the SRA bifurcation. CONCLUSIONS: Because the SRA runs very close to the cephalic vein, a tourniquet applied to the arm may easily lead to intravenous catheter misplacement into the SRA. In addition, the small radial artery distal to the SRA bifurcation causes difficulty in radial artery catheterization. Furthermore, SRA cases may have falsely normal Allen's test results. Therefore, the authors recommend that the SRA must be identified before vascular puncture for safe vascular catheterization in the forearm.
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Landiolol, a highly cardioselective ultra-short-acting ß1-blocker, prevents perioperative atrial fibrillation associated with systemic inflammation and oxidative stress. We evaluated the direct scavenging activity of landiolol against multiple free radical species. Nine free radical species (hydroxyl, superoxide anion, ascorbyl, tert-butyl peroxyl, tert-butoxyl, singlet oxygen, 2,2-diphenyl-1-picrylhydrazyl, nitric oxide, and tyrosyl radicals) were directly quantified using an X-band ESR spectrometer with the spin-trapping method. IC50 and reaction rate constants were estimated from the dose-response curve for each free radical. Landiolol scavenged six of the free radical species examined: hydroxyl radical (IC50â =â 0.76â mM, k landiololâ =â 1.4â ×â 10|10â M|-1â s|-1, p<0.001), superoxide anion (58â mM, 2.1â M|-1â s|-1, pâ =â 0.044), tert-butoxyl radical (4.3â mM, k landiolol/k CYPMPOâ =â 0.77, p<0.001), ascorbyl free radical (0.31â mM, p<0.001), singlet oxygen (0.69â mM, k landiolol/k 4-OH |TEMPâ =â 2.9, p<0.001), and nitric oxide (15â mM, 1.7â ×â 10â M|-1â s|-1, p<0.001). This study is the first to report that landiolol dose-dependently scavenges multiple free radical species with different reaction rate constants. These results indicate the potential clinical application of landiolol as an antioxidative and anti-inflammatory agent in addition to its present clinical use as an anti-arrhythmic agent.
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PURPOSE: The obturator nerve branches into the obturator canal; therefore, local anesthetic spread into the obturator canal predicts the success of the obturator nerve block (ONB). We compared three ONB techniques for the spread of local anesthetic mixed with contrast medium into the obturator canal. METHODS: We performed the ONB using the classical pubic approach (PA), inguinal approach (IA), or ultrasound-guided methodologic approach (UMA) in 143 patients undergoing transurethral resection of bladder tumors. The obturator nerve course and branching patterns of the UMA group were examined using ultrasound imaging. After injecting a local anesthetic mixed with a contrast medium, we evaluated its spread into the obturator canal using fluoroscopic imaging. P < 0.05 indicated statistical significance. RESULTS: Success rate of obturator canal enhancement was the greatest in the UMA group (84%; P < 0.001); the PA (42.6%; 20/47 patients) and IA (47.8%; 22/46 patients) groups did not differ significantly (P = 1.000). Both branches of the obturator nerve passed above the superior margin of the external obturator muscle (EOM), and the obturator canal was enhanced in 13 of 50 (26%) patients in the UMA group. The posterior branch of the obturator nerve passed between the superior and main fasciculi of the EOM in 37 of 50 patients (74%) in the UMA group; the obturator canal was enhanced in 29 of these 37 patients (78%). CONCLUSION: Local anesthetic spread into the obturator canal using the UMA was superior to that using the PA and IA. Both branches of the obturator nerve could be blocked using the UMA.
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Anestesia de Conducción , Bloqueo Nervioso , Anestésicos Locales , Humanos , Inyecciones , Bloqueo Nervioso/métodos , Nervio Obturador/cirugíaAsunto(s)
Hallazgos Incidentales , Cuidados Preoperatorios/métodos , Arteria Radial/anomalías , Arteria Radial/diagnóstico por imagen , Ultrasonografía Intervencional/métodos , Cateterismo/métodos , Cateterismo/normas , Femenino , Humanos , Persona de Mediana Edad , Cuidados Preoperatorios/normas , Ultrasonografía Intervencional/normasRESUMEN
INTRODUCTION:: Ultrasound-guided central venous catheter tip confirmation has a potential to precisely locate the central venous catheter, preventing its misplacement, using real-time guidance. This observational study sought to determine the accuracy of central venous catheter tip positioning via the external jugular vein via a supraclavicular fossa view under ultrasound guidance. METHODS:: In total, 77 patients scheduled for central venous catheter insertion via the right external jugular vein were enrolled. The depth of central venous catheter insertion was determined by advancing the tip of the guidewire to the junction of the superior vena cava and right pulmonary artery, using a right supraclavicular fossa view ultrasound method. We determined the reference insertion depth to the carina using a postoperative chest x-ray photograph method. We then compared insertion depths obtained by the ultrasound and x-ray photograph methods and body-height formula. RESULTS:: In total, 62 patients were able to advance the guidewire and underwent ultrasound-guided central venous catheter insertion. In four patients, we corrected for misplaced guidewires. According to Bland-Altman plots, the insertion depth was 0.88 cm shorter for the ultrasound method (95% limits of agreement, -1.66 to 3.41 cm) and 0.90 cm shorter for the formulaic method (95% limits of agreement, -2.77 to 4.56 cm), compared with the x-ray photograph method. The x-ray photograph method had significantly positive correlations with the ultrasound (r = 0.73) and formulaic methods (r = 0.27). CONCLUSION:: A right supraclavicular fossa view improves the accuracy of central venous catheter tip positioning and prevents central venous catheter misplacement via the right external jugular vein.
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Cateterismo Venoso Central/instrumentación , Cateterismo Venoso Central/métodos , Catéteres de Permanencia , Catéteres Venosos Centrales , Venas Yugulares/diagnóstico por imagen , Ultrasonografía Intervencional , Anciano , Anciano de 80 o más Años , Puntos Anatómicos de Referencia , Cateterismo Venoso Central/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Flebografía , Valor Predictivo de las Pruebas , PuncionesAsunto(s)
Anestesia Epidural/efectos adversos , Catéteres/efectos adversos , Rotura/cirugía , Espacio Subaracnoideo/diagnóstico por imagen , Procedimientos Quirúrgicos Urológicos/efectos adversos , Anciano , Anestesia General , Medios de Contraste/administración & dosificación , Espacio Epidural/diagnóstico por imagen , Humanos , Masculino , Tomografía Computarizada por Rayos X/métodos , Vejiga Urinaria/lesiones , Vejiga Urinaria/cirugíaRESUMEN
BACKGROUND: During epidural anesthesia, the catheter tip occasionally deviates from the epidural space into the intervertebral foramen, resulting in inadequate anesthesia. METHODS: During postoperative plain radiography, iohexol was injected via the epidural catheter to determine its position and to observe the spread of the material. After exclusion of seven patients with catheters that migrated into the subcutaneous area and 25 patients with no evidence of the contrast medium, 415 patients were evaluated. We retrospectively compared patients to determine whether the incidence of deviation into the intervertebral foramen differed between four types of epidural catheters. We also investigated the load applied to the catheter tip using a Shimadzu Autograph AG-X-500 N-111 universal testing machine. RESULTS: Deviation of the epidural catheter into the intervertebral foramen was observed in eight and 33 patients in the Hakko and Perifix Soft tip catheter groups, respectively. The incidence of deviation was higher in the Perifix Soft tip catheter group, and lower in the FlexTip Plus and Perifix FX catheter groups. A rapid increase was observed in the force exerted on the tips of the Hakko and Perifix Soft tip catheters, while the force transmitted to the tips of the FlexTip Plus and Perifix FX catheters gradually increased and then reached a plateau at a low level. CONCLUSIONS: The incidence of deviation was significantly lower with spiral-type catheters than with other types of catheters. This might be attributable to the gradual transmission of a lower level of force to the tip in spiral-type catheters.
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Anestesia Epidural/métodos , Cateterismo/métodos , Catéteres , Adulto , Anciano , Medios de Contraste , Espacio Epidural , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Radiografía , Estudios RetrospectivosRESUMEN
Reversed feeding uncouples peripheral and master clock gene rhythms and leads to an increased risk of disease development. The aim of this study was to determine the effects of clock gene uncoupling on sepsis-induced inflammation using a mouse cecal ligation and puncture (CLP) model. C57BL/6N mice were entrained to a 12-h light-dark cycle (lights on at 7 AM). Mice were permitted ad libitum feeding either during the night (7 PM-7 AM) or the nonphysiological light phase (7 AM-7 PM) for a week before CLP. In daytime-fed mice, phase inversion of clock gene expression was observed in the liver, but not in the suprachiasmatic nucleus. Daytime-fed mice also had decreased body weight and food intake. Survival rate was significantly lower in daytime-fed mice (29%) compared with nighttime-fed mice (54%) 72 h after CLP (P = 0.03). Serum levels of interleukin 6 (IL-6), tumor necrosis factor α, high mobility group box 1, IL-1α, IL-9, eotaxin, and granulocyte colony-stimulating factor increased in daytime-fed mice compared with nighttime-fed mice after CLP. Baseline expression levels of sirtuin peroxisome 1 and proliferator-activated receptor γ coactivator 1α in the liver decreased in daytime-fed mice compared with nighttime-fed mice. Thus, daytime feeding induces clock gene uncoupling, which leads to decreased expression of longevity-related and energy metabolism proteins. Daytime feeding may also increase the levels of inflammatory cytokines, thereby increasing mortality in a mouse sepsis model. Our findings suggest that uncoupling of peripheral and master clock gene rhythms by reversed feeding exacerbates inflammatory responses.
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Relojes Circadianos , Ritmo Circadiano , Ingestión de Alimentos , Conducta Alimentaria , Regulación de la Expresión Génica , Hígado/metabolismo , Sepsis , Sirtuina 1/biosíntesis , Factores de Transcripción/biosíntesis , Animales , Citocinas/sangre , Modelos Animales de Enfermedad , Hígado/patología , Masculino , Ratones , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma , Sepsis/sangre , Sepsis/patología , Sepsis/fisiopatologíaRESUMEN
BACKGROUND: Ischemia-reperfusion (I/R) occurs frequently in a variety of clinical settings, such as renal transplantation. In addition, I/R is a major cause of acute kidney injury (AKI). A recent study has reported that reactive oxygen species (ROS) are important mediators of AKI, suggesting that reducing ROS generation may prevent renal injury. The present study evaluated the ability of DHL-HisZn, a new α-lipoic acid derivative, to inhibit ROS generation and prevent renal I/R injury in rats. MATERIALS AND METHODS: Rats received an intravenous infusion of DHL-HisZn or saline, and then underwent experimentally induced renal I/R injury or sham treatment. Rats were sacrificed after 60 min of ischemia and 24 h of reperfusion. To evaluate the renal protective effects of DHL-HisZn, serum blood urea nitrogen (BUN) and creatinine (Cre) concentrations were determined, kidneys were histologically assessed, and malondialdehyde (MDA), a biomarker of oxidative stress, was evaluated. In addition, antimycin A (AMA)-stimulated RAW264.7 cells were treated with DHL-HisZn to assess its antioxidant effects in vitro. RESULTS: DHL-HisZn treatment attenuated I/R-induced histologic alterations, reduced serum levels of serum BUN and Cre, and decreased MDA levels in the kidneys of rats with renal I/R injury. Furthermore, DHL-HisZn decreased ROS levels in AMA-stimulated RAW264.7 cells. CONCLUSIONS: Our in vitro and in vivo findings suggest that DHL-HisZn may have therapeutic potential against various human I/R conditions.
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Lesión Renal Aguda/prevención & control , Histidina/análogos & derivados , Especies Reactivas de Oxígeno/metabolismo , Daño por Reperfusión/prevención & control , Ácido Tióctico/análogos & derivados , Lesión Renal Aguda/patología , Animales , Línea Celular , Histidina/farmacología , Histidina/uso terapéutico , Riñón/metabolismo , Riñón/ultraestructura , Pruebas de Función Renal , Masculino , Malondialdehído/metabolismo , Ratones , Ratas , Ratas Wistar , Daño por Reperfusión/patología , Ácido Tióctico/farmacología , Ácido Tióctico/uso terapéuticoRESUMEN
BACKGROUND: Acute kidney injury (AKI) occurs frequently in the intensive care unit. A primary cause is renal ischemia/reperfusion (I/R) injury, during which excess reactive oxygen species (ROS) are produced. ROS subsequently damage renal cells, leading to the development of AKI. Here, we investigated whether renal I/R injury could be attenuated by the antioxidant EPC-K1. METHODS: We divided male Wistar rats into the following three groups: (1) a renal I/R group, (2) an EPC-K1 + renal I/R group and (3) a control group. Rats were sacrificed 24 h after treatment (I/R or sham). To measure oxidative stress in renal tissue, histological examinations were performed and serum levels of blood urea nitrogen (BUN) and creatinine were measured. The antioxidant action of EPC-K1 was also evaluated in RAW264.7 cells stimulated with antimycin A. RESULTS: Serum BUN and creatinine levels were elevated in the I/R group; however, this increase was significantly attenuated by EPC-K1 in the EPC-K1 + I/R group. Renal tissue injury was also significantly lower in the EPC-K1 + I/R group compared with the I/R group. In vitro experiments showed that EPC-K1 significantly attenuated the generation of ROS induced by antimycin A. CONCLUSION: In our study, EPC-K1 was able to attenuate AKI due to renal I/R by reducing oxidative stress. These results suggest that EPC-K1 may be effective against various types of I/R injury.
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Antioxidantes/uso terapéutico , Ácido Ascórbico/análogos & derivados , Enfermedades Renales/prevención & control , Riñón/irrigación sanguínea , Daño por Reperfusión/prevención & control , Vitamina E/análogos & derivados , Animales , Ácido Ascórbico/uso terapéutico , Biomarcadores/sangre , Línea Celular , Modelos Animales de Enfermedad , Riñón/ultraestructura , Enfermedades Renales/sangre , Enfermedades Renales/patología , Pruebas de Función Renal , Masculino , Malondialdehído/metabolismo , Ratones , Estrés Oxidativo , Ratas , Ratas Wistar , Especies Reactivas de Oxígeno/metabolismo , Daño por Reperfusión/sangre , Daño por Reperfusión/patología , Vitamina E/uso terapéuticoRESUMEN
Isolated adrenocorticotropic hormone (ACTH) deficiency is an extremely rare disease in which ACTH-producing cells of the pituitary gland are selectively damaged. The resulting decline in ACTH production and secretion results in chronic secondary adrenocortical insufficiency. The patient in this case did not present with adrenal insufficiency symptoms prior to surgery. However, after cardiotomy under extracorporeal circulation, the patient lapsed into a catecholamine-resistant shock and hypoglycemic coma. Acute adrenal insufficiency was strongly suspected, and the patient was diagnosed with isolated ACTH deficiency after careful examination. Because the demand for cortisol increases after highly invasive surgeries, cortisol supplementation therapy is essential for patients with complications from isolated ACTH deficiency. There is a high risk of a lethal outcome when surgery is carried out without a diagnosis, as in this case. Therefore, cortisol must be supplemented without delay when acute adrenal insufficiency is suspected during the perioperative period.
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Insuficiencia Suprarrenal/complicaciones , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Catecolaminas/uso terapéutico , Coma Diabético/etiología , Complicaciones Posoperatorias/tratamiento farmacológico , Choque/etiología , Lesión Renal Aguda/complicaciones , Lesión Renal Aguda/tratamiento farmacológico , Anestesia , Análisis de los Gases de la Sangre , Puente Cardiopulmonar , Enfermedad Crónica , Coma Diabético/tratamiento farmacológico , Resistencia a Medicamentos , Hemodinámica/fisiología , Humanos , Hidrocortisona/sangre , Masculino , Persona de Mediana Edad , Insuficiencia de la Válvula Mitral/complicaciones , Insuficiencia de la Válvula Mitral/cirugía , Pruebas de Función Hipofisaria , Potasio/sangre , Medicación Preanestésica , Choque/tratamiento farmacológico , Sodio/sangreRESUMEN
BACKGROUND: Heat stroke is a condition characterized by high body temperature that can lead to hemorrhage and necrosis in multiple organs. Anticoagulants, such as danaparoid sodium (DA), inhibit various types of inflammation; however, the anti-inflammatory mechanism of action is not well understood. Given that heat stroke is a severe inflammatory response disease, we hypothesized that DA could inhibit inflammation from heat stress and prevent acute heat stroke. MATERIALS AND METHODS: Male Wistar rats were given a bolus injection of saline or DA (50 U/kg body weight) into the tail vein just prior to heat stress (42 °C for 30 min). Markers of inflammation were then determined in serum and tissue samples. RESULTS: In rats pretreated with DA, induction of cytokines (interleukin [IL]-1ß, IL-6, and tumor necrosis factor [TNF]-α), nitric oxide (NO), and high mobility group box 1 (HMGB1) protein were reduced compared with saline-treated rats. Histologic changes observed in lung, liver, and small intestine tissue samples of saline-treated rats were attenuated in DA-treated rats. Moreover, DA pretreatment improved survival in our rat model of heat stress-induced acute inflammation. CONCLUSION: Collectively, our findings demonstrate that DA pretreatment may have value as a new therapeutic tool for heat stroke.
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Anticoagulantes/farmacología , Sulfatos de Condroitina/farmacología , Dermatán Sulfato/farmacología , Agotamiento por Calor/tratamiento farmacológico , Golpe de Calor/prevención & control , Heparitina Sulfato/farmacología , Enfermedad Aguda , Animales , Antitrombina III , Citocinas/sangre , Modelos Animales de Enfermedad , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Proteína HMGB1/sangre , Agotamiento por Calor/inmunología , Agotamiento por Calor/patología , Inflamación/tratamiento farmacológico , Inflamación/inmunología , Inflamación/patología , Intestino Delgado/efectos de los fármacos , Intestino Delgado/patología , Hígado/efectos de los fármacos , Hígado/patología , Pulmón/efectos de los fármacos , Pulmón/patología , Masculino , Nitratos/sangre , Óxido Nítrico/sangre , Nitritos/sangre , Péptido Hidrolasas/sangre , Ratas , Ratas Wistar , Tasa de SupervivenciaRESUMEN
BACKGROUND: Phosphate ester of vitamin C and vitamin E (EPCK1), a strong antioxidant, is a water- and lipid-soluble phosphate ester of vitamin C and vitamin E. In the current study, we tested whether EPCK1 inhibits oxidative stress and prevents systemic inflammation. MATERIALS AND METHODS: Mice were randomly divided into a negative control group, a lipopolysaccharide (LPS)-induced sepsis group, and a group treated with an intraperitoneal infusion of EPCK1 (10 mg/kg) prior to or following LPS administration. In addition, RAW 264.7 cells were treated with LPS in the presence or absence of EPCK1. We examined levels of high mobility group box 1 (HMGB1) protein and inducible nitric oxide synthase (iNOS) in both in vivo and in vitro experiments, and liver histopathology in the in vivo experiment. RESULTS: Liver histopathology significantly improved in the EPCK1 group compared with the LPS group. Although LPS administration increased HMGB1 and nitric oxide (NO) secretion, EPCK1 decreased the secretion of these mediators in vitro and in vivo. CONCLUSIONS: Our findings suggest that EPCK1 may inhibit inflammation and potentially function as a novel anti-inflammatory therapeutic agent.
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Ácido Ascórbico/análogos & derivados , Ácido Ascórbico/farmacología , Inflamación/tratamiento farmacológico , Vitamina E/análogos & derivados , Vitamina E/farmacología , Animales , Antiinflamatorios/farmacología , Antioxidantes/farmacología , Línea Celular , Modelos Animales de Enfermedad , Ésteres/farmacología , Proteína HMGB1/metabolismo , Inflamación/inducido químicamente , Inflamación/metabolismo , Lipopolisacáridos/toxicidad , Hígado/metabolismo , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Masculino , Ratones , Ratones Endogámicos BALB C , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa de Tipo II/metabolismo , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/inmunología , Fosfatos/farmacología , Sepsis/inducido químicamente , Sepsis/tratamiento farmacológico , Sepsis/metabolismo , Tasa de SupervivenciaRESUMEN
The incidence and prevalence of diabetes have recently increased. Hyperglycemia, which is commonly seen in intensive care medicine, is associated with increased morbidity and mortality. For instance, diabetes is associated with altered immune and hemostatic responses. High mobility group box 1 (HMGB1) protein plays a key role in various inflammatory diseases. This study investigated the increase in lung damage due to diabetes and the rise in HMGB1 levels in a lipopolysaccharide (LPS)-induced systemic inflammation rat model. Diabetes was induced by streptozotocin infusion 4 wk prior to LPS administration, followed by measurements of blood glucose and serum cytokine levels. Separate cohorts were sacrificed 12h post-LPS administration and analyzed for lung damage. Diabetic animals had significantly higher blood glucose and enhanced lung damage. In addition, levels of serum HMGB1, tumor necrosis factor-α, and interleukin-6 were increased in diabetic rats. Diabetes may exacerbate systemic inflammation as evidenced by higher serum HMGB1 and cytokine levels and enhanced lung damage in the rat systemic inflammation model.
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Lesión Pulmonar Aguda/sangre , Lesión Pulmonar Aguda/epidemiología , Diabetes Mellitus Experimental/sangre , Diabetes Mellitus Experimental/epidemiología , Proteína HMGB1/sangre , Lesión Pulmonar Aguda/inducido químicamente , Animales , Comorbilidad , Diabetes Mellitus Experimental/inducido químicamente , Modelos Animales de Enfermedad , Endotoxinas/efectos adversos , Insulina/sangre , Interleucina-6/sangre , Masculino , Ratas , Ratas Wistar , Estreptozocina/efectos adversos , Factor de Necrosis Tumoral alfa/sangreRESUMEN
We describe a rare case of a 79-year-old woman who developed herpes simplex virus pneumonia after mitral valve replacement. The patient showed persistent hypoxemia with bilateral glass-like shadows on chest radiography. Cytopathology examination of intratracheal secretions revealed herpes simplex virus infection. The patient, who improved gradually after acyclovir administration, was taken off the ventilator completely. Physicians should consider viral pulmonary infection to be a potential cause of unexplained hypoxemia that does not respond to conventional antibiotic treatment in critically ill, immunocompromised patients.
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Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Herpes Simple/virología , Insuficiencia de la Válvula Mitral/cirugía , Válvula Mitral/cirugía , Neumonía Viral/virología , Aciclovir/uso terapéutico , Anciano , Antivirales/uso terapéutico , Femenino , Herpes Simple/diagnóstico por imagen , Herpes Simple/terapia , Humanos , Hipoxia/virología , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/terapia , Respiración Artificial , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Desconexión del VentiladorRESUMEN
PURPOSE: Renal ischemia-reperfusion (I/R), an important cause of acute kidney injury, is unavoidable during various types of operations, including renal transplantation, surgical revascularization of the renal artery, partial nephrectomy, and treatment of suprarenal aortic aneurysms. Exacerbation of I/R injury is mediated by reactive oxygen species (ROS). A recent study has shown that hydrogen has antioxidant properties. In this study, we tested the hypothesis that a hydrogen-rich saline solution (HRSS) attenuates renal I/R injury in a rodent model. METHODS: Rats were treated with an intravenous injection of HRSS or control saline solution followed by renal I/R. After 24 h of treatment, we performed a histological examination and transmission electron microscopy, and measured serum levels of 8-OHdG. RESULTS: Histological analysis revealed a marked reduction of interstitial congestion, edema, inflammation, and hemorrhage in renal tissue harvested 24 h after HRSS treatment compared to saline administration. Renal I/R injury, which led to altered mitochondrial morphology, was also inhibited by HRSS. Furthermore, serum 8-OHdG levels were significantly lower in rats treated with HRSS and subjected to renal I/R. CONCLUSIONS: These protective effects were likely due to the antioxidant properties of HRSS. These results suggest that HRSS is a potential therapeutic candidate for treating various I/R diseases.
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Hidrógeno/farmacología , Riñón/irrigación sanguínea , Daño por Reperfusión/prevención & control , Cloruro de Sodio/farmacología , 8-Hidroxi-2'-Desoxicoguanosina , Animales , Desoxiguanosina/análogos & derivados , Desoxiguanosina/sangre , Riñón/fisiopatología , Masculino , Ratas , Ratas Wistar , Cloruro de Sodio/análisisRESUMEN
Acute lung injury, a common component of systemic inflammatory disease, is a life-threatening condition without many effective treatments. However, recent studies have demonstrated that the multifunctional human atrial natriuretic peptide (hANP) exerts anti-inflammatory effects. Therefore, we tested the hypothesis that hANP could prevent lipopolysaccharide (LPS)-induced acute lung injury in a rodent model. Rats received an LPS injection and continuous intravenous infusion (CIV) of hANP or saline solution. We evaluated the anti-inflammatory effects of hANP by histological examination and determination of serum cytokine levels and lung myeloperoxidase (MPO) activity. Histological examination revealed marked reductions in interstitial congestion, edema, inflammation, and hemorrhage in lung tissue harvested 12 h after hANP treatment compared with tissue from rats that received saline treatment after LPS. LPS injection induced elevated cytokine (IL-1beta and IL-6) secretion and lung MPO activity, which was also attenuated by hANP treatment. Taken together, these data demonstrate that hANP exerts an anti-inflammatory effect and may have potential as a therapeutic agent to treat systemic inflammatory diseases.
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Lesión Pulmonar Aguda/tratamiento farmacológico , Factor Natriurético Atrial/uso terapéutico , Lesión Pulmonar Aguda/patología , Animales , Factor Natriurético Atrial/administración & dosificación , Humanos , Infusiones Intravenosas , Interleucina-1beta/sangre , Interleucina-6/sangre , Lipopolisacáridos , Masculino , Peroxidasa/análisis , Ratas , Ratas WistarRESUMEN
Electron spin resonance (ESR)-silent ascorbate solutions generate a detectable, likely concentration-dependent signal of ascorbyl free radicals (AFR) immediately upon addition of a molar excess of dimethyl sulfoxide (DMSO). We aimed to perform quantitative ESR analysis of AFR in real time after addition of DMSO (AFR/DMSO) to evaluate ascorbate concentrations in fresh hippocampus or plasma following systemic administration of kainate in mice. Use of a special tissue-type quartz cell allowed immediate detection of AFR/DMSO ESR spectra in fresh tissues from mice. AFR/DMSO content was increased significantly in fresh hippocampus or plasma obtained during kainate-induced seizures of mice, reaching maximum levels at 90 min after intraperitoneal administration of 50 mg/kg kainic acid. This suggests that oxidative injury of the hippocampus resulted from the accumulation of large amounts of ascorbic acid in the brain after kainic acid administration. AFR/DMSO content measured on an ESR spectrometer can be used for real-time evaluation of ascorbate content in fresh tissue. Due to the simplicity, good performance, low cost and real-time monitoring of ascorbate, this method may be applied to clinical research and treatment in the future.
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Ácido Ascórbico/metabolismo , Dimetilsulfóxido/farmacología , Hipocampo/metabolismo , Ácido Kaínico , Convulsiones/metabolismo , Animales , Ácido Ascórbico/sangre , Espectroscopía de Resonancia por Spin del Electrón , Radicales Libres/sangre , Radicales Libres/metabolismo , Masculino , Ratones , Convulsiones/sangre , Convulsiones/inducido químicamente , Manejo de EspecímenesRESUMEN
PURPOSE: To examine the effect of landiolol on cerebral blood flow in patients with normal or deteriorated cardiac function. METHODS: Thirty adult patients who were diagnosed with angina pectoris and who underwent elective off-pump coronary artery bypass surgery were studied. Patients were divided into two groups, one with a preoperative left ventricular ejection fraction (EF) of 50% or higher (normal EF group; n = 15) and the other with an EF of less than 50% (low EF group; n = 15). The mean cerebral blood flow velocity (Vmca) and pulsatility index (PI) in the middle cerebral artery were recorded using transcranial Doppler ultrasonography (TCD). Individual hemodynamic data were obtained using a pulmonary arterial catheter. RESULTS: In both groups, landiolol produced a significant decrease in heart rate (HR), which then returned to baseline 15 min after administration was completed. A significant decrease in mean arterial pressure occurred in the low EF group, but the decrease was within 30% of the baseline. In the normal EF group, there was no decrease in cardiac index (CI), whereas in the low EF group, CI significantly decreased along with the decrease in HR. There were no significant differences in Vmca and PI between the two groups. CONCLUSION: Continuous administration of landiolol at a dose of 0.04 mg/kg/min after 1 min rapid i.v. administration at a dose of 0.125 mg/kg/min decreases HR without causing aggravation of CBF during treatment of intraoperative tachycardia in patients with normal and deteriorated cardiac function.
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Antagonistas Adrenérgicos beta/uso terapéutico , Circulación Cerebrovascular/efectos de los fármacos , Puente de Arteria Coronaria Off-Pump , Complicaciones Intraoperatorias/tratamiento farmacológico , Morfolinas/uso terapéutico , Taquicardia/tratamiento farmacológico , Urea/análogos & derivados , Antagonistas Adrenérgicos beta/administración & dosificación , Anciano , Angina de Pecho/cirugía , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Arteria Cerebral Media/diagnóstico por imagen , Morfolinas/administración & dosificación , Índice de Severidad de la Enfermedad , Volumen Sistólico/efectos de los fármacos , Ultrasonografía Doppler Transcraneal , Urea/administración & dosificación , Urea/uso terapéuticoRESUMEN
OBJECTIVE: Systemic inflammatory mediators, including the high mobility group box 1 (HMGB1) protein, play important roles in the development of various inflammatory conditions. Although anticoagulants, such as antithrombin III (AT III), inhibit inflammation resulting from various causes, their anti-inflammatory mechanism of action is not well understood. Nevertheless, as heat stroke is a severe inflammatory response disease, we hypothesized that AT III would inhibit inflammation and prevent heat stress-induced acute heat stroke. METHODS: Male Wistar rats received a bolus injection of saline or 250 U of AT III per kg of body weight into the tail vein, followed by heat stress (exposure to 42 degrees C for 30 min). Levels of cytokines (interleukin-1 beta, interleukin-6, and TNF-alpha), NOx, and HMGB1 were measured in serum and tissue at regular intervals for 6 h after the heat stress induction. RESULTS: Levels of cytokines, NOx, and HMGB1 in serum decreased over time in AT III-treated rats. AT III pretreatment also reduced NOx levels during heat stress-induced inflammation. As a result, AT III pretreatment improved survival in a rat model of heat stress-induced acute inflammation. CONCLUSIONS: Our data suggest that AT III pretreatment inhibited the secretion of cytokines, NOx, and HMGB1, and prevented heat stress-induced acute inflammation.