OBJECTIVEThe effect of vascular endothelial growth factor(165) (VEGF(165)) on intracellular free magnesium ([Mg(2+)](i)) and the relationship between Mg(2+) and angiogenesis in human umbilical vein endothelial cells (HUVECs) were investigated in this study.

METHODS[Mg(2+)](i) in HUVECs loaded with fluorescent magnesium indicator mag-fura-2 were quantitatively detected with the use of intracellular cation measurement system. HUVECs were obtained from normal fetus and cultured in M199 with 0.2 fetal bovine serum. The angiogenesis effects of VEGF(165) were observed in presence of 0 mmol/L, 1 mmol/L or 2 mmol/L of extracellular Mg(2+).

RESULTSVEGF(165) significantly increased [Mg(2+)](i) in a dose-dependent manner independent of extracellular Mg(2+), Na(+) and Ca(2+) and this effect could be blocked by pretreatment with VEGF(165) receptor-2 (KDR) inhibitor (SU1498). The angiogenesis induced by VEGF(165) was significantly inhibited cells with 0 mmol/L extracellular Mg(2+), the angiogenesis effects of VEGF(165) were similar in cells with 1 mmol/L and 2 mmol/L extracellular Mg(2+) and these effects could be blocked by SU1498.

CONCLUSIONSThese results suggest that the [Mg(2+)](i) increase induced by VEGF(165) originates from intracellular Mg(2+) pools and promotes angiogenesis via KDR-dependent signaling pathways.

Cations, Divalent ; Cells, Cultured ; Endothelial Cells ; metabolism ; Humans ; Magnesium ; metabolism ; Neovascularization, Physiologic ; Signal Transduction ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

BACKGROUND: Analgesic tolerance to opioids has been described in both experimental and clinical conditions, which may limit their clinical utility. This study investigated the effects of intrathecal adenosine A1 receptor agonist (R-PIA) on spinal morphine tolerance. METHODS: SD rats were given intrathecal injections of saline 10microliter, R-PIA 10microgram, morphine 10microgram, or R-PIA plus morphine combinations for 7 days (R-PIA given for days 1-7; days 1-3; or days 5-7). Antiallodynic testing using von Frey filaments was carried out before and 30 minutes after the drug injection. On day 8, an antiallodynic dose-response curve was constructed and the 50% effective dose (ED(50)) for morphine (given alone) was calculated for each study group. RESULTS: The coinjection group of R-PIA with morphine blocked the development of tolerance, as shown by the preservation of morphine antiallodynia over 7 days the concomitant decrease in the ED(50) values on day 8, compared with the morphine-alone group. Although additive analgesia over days 1-7 cannot be ruled out, the reductions of the ED(50) in the R-PIA and morphine combination group suggest some suppression of tolerance. CONCLUSIONS: These results suggest that intrathecal R-PIA prevents the development of spinal opioid tolerance. Future studies will be needed to examine the respective roles of supraspinal and peripheral sites of R-PIA and morphine interaction, and to investigate the mechanisms underlying the action of R-PIA on opioid tolerance.
Adenosine A1 Receptor Agonists* ; Adenosine* ; Analgesia ; Analgesics, Opioid ; Animals ; Hyperalgesia ; Injections, Spinal ; Models, Animal* ; Morphine* ; Pain, Postoperative* ; Rats* ; Receptor, Adenosine A1*

BACKGROUND: Marked changes in systemic hemodynamics during liver transplantation may lead to changes in cerebral hemodynamics and metabolism. Therefore, continuous monitoring of the jugular venous oxygen saturation (SjvO2) may help the anesthetic management of liver transplantation. METHODS: We observed changes in SjvO2 using a double lumen oximetry catheter for continuous monitoring and analyzed the correlation between SjvO2 and hemodynamic measurements in thirty patients undergoing liver transplantation. RESULTS: There were no significant changes in SjvO2 compared to initial SjvO2 during liver transplantation. SjvO2, however, increased from 72.5 to 79.6 % (P < 0.05), before and after reperfusion. There was a weak correlation between changes in SjvO2 and cardiac output (r = 0.38, P < 0.05), whereas no correlation was found among changes in SjvO2 and arterial carbon dioxide tension, mean arterial pressure, central venous pressure, or mixed venous oxygen saturation before and after reperfusion. CONCLUSIONS: SjvO2 that reflects changes in cerebral oxygen demand-supply balance was well maintained during liver transplantation except the reperfusion period. Continuous monitoring of changes in SjvO2 at this period may provide further insight to understand physiology of cerebral oxygenation during liver transplantation and merits further studies.
Arterial Pressure ; Carbon Dioxide ; Cardiac Output ; Catheters ; Central Venous Pressure ; Hemodynamics ; Humans ; Liver Transplantation* ; Liver* ; Metabolism ; Oximetry ; Oxygen* ; Physiology ; Reperfusion

Cerebral complication after cardiac surgery with cardiopulmonary bypass varies widely focal neurologic deficit, stupor, coma, dementia, memory deficit, or seizures. The incidence of visual loss from ischemic optic neuropathy is from 0.06% to 0.113%. Visual loss is a rare but devastating complication of cardiac surgery. This report describes a patient who had reversible visual loss in postoperative period. She had undergone the decrease of bispectral index, cerebral oxygen saturation and the increase of suppression ratio during mitral valvuloplasty.
Cardiopulmonary Bypass ; Coma ; Delirium ; Dementia ; Humans ; Hypertensive Encephalopathy ; Incidence ; Memory Disorders ; Neurologic Manifestations ; Optic Neuropathy, Ischemic ; Oxygen* ; Postoperative Period* ; Seizures ; Stupor ; Thoracic Surgery

BACKGROUND/AIMS: Evidence suggests that Shen-Kang (SK), a traditional Chinese herbal medicine, protects against various types of renal injury. In this study, we evaluated whether SK treatment confers renoprotection in a rat model of chronic tacrolimus (TAC) nephropathy. METHODS: Rats were treated daily with TAC (1.5mg/kg, subcutaneously) and SK (450 mg/kg, intravenously) for 4 weeks. The effects of SK on TAC-induced renal injury were assessed by measuring renal function, urine albumin excretion, histopathology, inflammatory cell infiltration, expression of profibrotic (transforming growth factor β1 [TGF-β1] and TGF-β inducible gene-h3 [βig-h3]) and proinflammatory cytokines, oxidative stress, and apoptotic cell death. RESULTS: Administration of SK preserved glomerular integrity (fractional mesangial area and Wilms tumor 1-positive glomeruli), attenuated tubulointerstitial fibrosis, and reduced the number of ectodermal dysplasia 1-positive cells, and this was paralleled by improved urine albumin excretion and renal dysfunction. At the molecular level, SK treatment suppressed expression of TGF-β1/Smad2/3, βig-h3, and proinflammatory cytokines. Oxidative stress and apoptotic cell death were significantly decreased with SK treatment, and apoptosis-related genes were regulated toward cell survival (active caspase-3 and the B-cell lymphoma-2/Bcl2-associated X [Bcl-2/Bax] ratio). CONCLUSIONS SK protects against TAC-induced renal injury.

Background/Aims: Accumulating evidence indicates that L-carnitine (LC) protects against multiorgan damage through its antioxidant properties and preservation of the mitochondria. Little information is available about the effects of LC on renal fibrosis. This study examined whether LC treatment would provide renoprotection in a rat model of unilateral ureteral obstruction (UUO) and in vitro. Methods: Sprague-Dawley rats that underwent UUO were treated daily with LC for 7 or 14 days. The influence of LC on renal injury caused by UUO was evaluated by histopathology, and analysis of gene expression, oxidative stress, mitochondrial function, programmed cell death, and phosphatidylinositol 3-kinase (PI3K)/ AKT/forkhead box protein O 1a (FoxO1a) signaling. In addition, H2O2-exposed human kidney cells (HK-2) were treated with LC. Results: LC treatment inhibited expression of proinflammatory and profibrotic cytokines, and was followed by a significant attenuation of tubulointerstitial inflammation and fibrosis. The increased oxidative stress caused by UUO was associated with mitochondrial dysfunction and excessive apoptosis and autophagy via PI3K/AKT/FoxO1a-dependent signaling, and this was abrogated by administration of LC. In H2O2-exposed HK-2 cells, LC decreased intracellular production of reactive oxygen species, and suppressed expression of profibrotic cytokines and reduced the number of apoptotic cells. Conclusions LC protects against the progression of tubulointerstitial fibrosis in an obstructed kidney.