1.Effects of sevoflurane on tight junction protein expression and PKC-alpha translocation after pulmonary ischemia-reperfusion injury.
Jun CHAI ; Bo LONG ; Xiaomei LIU ; Yan LI ; Ning HAN ; Ping ZHAO ; Weimin CHEN
Experimental & Molecular Medicine 2015;47(6):e167-
Pulmonary dysfunction caused by ischemia-reperfusion injury is the leading cause of mortality in lung transplantation. We aimed to investigate the effects of sevoflurane pretreatment on lung permeability, tight junction protein occludin and zona occludens 1 (ZO-1) expression, and translocation of protein kinase C (PKC)-alpha after ischemia-reperfusion. A lung ischemia-reperfusion injury model was established in 96 male Wistar rats following the modified Eppinger method. The rats were divided into four groups with 24 rats in each group: a control (group C), an ischemia-reperfusion group (IR group), a sevoflurane control group (sev-C group), and a sevoflurane ischemia-reperfusion group (sev-IR group). There were three time points in each group: ischemic occlusion for 45 min, reperfusion for 60 min and reperfusion for 120 min; and there were six rats per time point. For the 120-min reperfusion group, six extra rats underwent bronchoalveolar lavage. Mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) were recorded at each time point. The wet/dry weight ratio and lung permeability index (LPI) were measured. Quantitative RT-PCR and Western blot were used to measure pulmonary occludin and ZO-1, and Western blot was used to measure cytosolic and membranous PKC-alpha in the lung. Lung permeability was significantly increased after ischemia-reperfusion. Sevoflurane pretreatment promoted pulmonary expression of occludin and ZO-1 after reperfusion and inhibited the translocation of PKC-alpha. In conclusion, sevoflurane pretreatment alleviated lung permeability by upregulating occludin and ZO-1 after ischemia-reperfusion. Sevoflurane pretreatment inhibited the translocation and activation of PKC-alpha, which also contributed to the lung-protective effect of sevoflurane.
Anesthetics, Inhalation/*therapeutic use
;
Animals
;
Capillary Permeability/drug effects
;
Gene Expression Regulation/drug effects
;
Lung/*drug effects/metabolism/pathology
;
Lung Diseases/*drug therapy/genetics/metabolism/pathology
;
Male
;
Methyl Ethers/*therapeutic use
;
Protein Kinase C-alpha/*metabolism
;
Protein Transport/drug effects
;
RNA, Messenger/genetics
;
Rats, Wistar
;
Reperfusion Injury/*drug therapy/genetics/metabolism/pathology
;
Zonula Occludens-1 Protein/analysis/*genetics
2.Impact of Direct Cardiovascular Laboratory Activation by Emergency Physicians on False-Positive Activation Rates.
Julian Ck TAY ; Liou Wei LUN ; Zhong LIANG ; Terrance Sj CHUA ; Swee Han LIM ; Aaron Sl WONG ; Marcus Eh ONG ; Kay Woon HO
Annals of the Academy of Medicine, Singapore 2016;45(8):351-356
INTRODUCTIONDoor-to-balloon (DTB) time is critical to ST elevation myocardial infarction (STEMI) patients' survival. Although DTB time is reduced with direct cardiovascular laboratory (CVL) activation by emergency physicians, concerns regarding false-positive activation remain. We evaluate false-positive rates before and after direct CVL activation and factors associated with false-positive activations.
MATERIALS AND METHODSThis is a retrospective single centre study of all emergency CVL activation 3 years before and after introduction of direct activation in July 2007. False-positive activation is defined as either: 1) absence of culprit vessel with coronary artery thrombus or ulceration, or 2) presence of chronic total occlusion of culprit vessel, with no cardiac biomarker elevations and no regional wall abnormalities. All false-positive cases were verified by reviewing their coronary angiograms and patient records.
RESULTSA total of 1809 subjects were recruited; 84 (4.64%) identified as false-positives. Incidence of false-positive before and after direct activation was 4.1% and 5.1% respectively, which was not significant (P = 0.315). In multivariate logistic regression analysis, factors associated with false-positive were: female (odds ratio (OR): 2.104 [1.247-3.548], P = 0.005), absence of chest pain (OR: 5.369 [3.024-9.531], P <0.0001) and presence of only left bundle branch block (LBBB) as indication for activation (OR: 65.691 [19.870-217.179], P <0.0001).
CONCLUSIONImprovement in DTB time with direct CVL activation by emergency physicians is not associated with increased false-positive activations. Factors associated with false-positive, especially lack of chest pain or LBBB, can be taken into account to optimise STEMI management.
Bundle-Branch Block ; epidemiology ; Cardiac Catheterization ; Chest Pain ; epidemiology ; Coronary Angiography ; Disease Management ; Emergency Medicine ; Humans ; Logistic Models ; Multivariate Analysis ; Percutaneous Coronary Intervention ; Physicians ; Retrospective Studies ; ST Elevation Myocardial Infarction ; diagnosis ; epidemiology ; therapy ; Sex Factors ; Singapore ; epidemiology ; Time-to-Treatment
3.Branchial Anomalies in Korea: A Survey by the Korean Association of Pediatric Surgeons
WH PARK ; SI KWON ; SY KIM ; SC KIM ; SK KIM ; WK KIM ; IK KIM ; JE KIM ; HH KIM ; KW PARK ; YS PARK ; JS PARK ; YT SONG ; WS AHN ; NK OH ; SM OH ; SY YOO ; NH LEE ; OS LEE ; MD LEE ; SC LEE ; SK LEE ; SI CHANG ; YS CHUN ; ES CHUNG ; SY CHUNG ; SE CHUNG ; PM CHUNG ; MH CHO ; KJ CHOI ; SO CHOI ; SH CHOI ; SJ HAN ; YS HUH ; C HONG ; EH WHANG
Journal of the Korean Association of Pediatric Surgeons 1996;2(2):119-128
The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients(43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(l9) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50 (78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.
Abscess
;
Branchioma
;
Child
;
Classification
;
Dermoid Cyst
;
Diagnosis
;
Epithelium
;
Facial Nerve
;
Fistula
;
Humans
;
Korea
;
Lymphangioma, Cystic
;
Lymphatic Diseases
;
Lymphoid Tissue
;
Manubrium
;
Neck
;
Paralysis
;
Postoperative Complications
;
Recurrence
;
Respiratory Mucosa
;
Retrospective Studies
;
Skin
;
Surgeons
;
Thyroglossal Cyst
;
Wounds and Injuries