bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuronal network properties underlying the generation of gasping
Authors: Peña Fernando 
Published: September 2009

Summary1. The pre‐Bötzinger complex (PreBötC) generates different inspiratory rhythms. Under control normoxic conditions, a mixture of intrinsic and synaptic properties underlies the generation of eupnoea by the PreBötC. Under hypoxia, those network properties change and modify the respiratory rhythm pattern. Hypoxia can be caused by a reduction in oxygen availability in the environment, inadequate oxygen transport, an inability of tissues to use oxygen or several pathological conditions.2. During severe hypoxia, the network properties within the PreBötC are reconfigured whereby the network no longer generates eupnoea, but instead generates a new rhythm, named gasping. Such reconfiguration includes changes in synaptic and intrinsic properties triggered by hypoxia itself, as well as the influence of different neuromodulators released during hypoxia. Gasping has been considered an important arousal mechanism that triggers autoresuscitation. Dysregulation of gasping has been proposed to result in failure to autoresuscitate and has been hypothesised to contribute to Sudden Infant Death Syndrome.3. Precisely which synaptic and/or neuronal intrinsic membrane properties are critical to central respiratory rhythmogenesis, in either normoxia or hypoxia, is still the subject of considerable debate. In the present article I review how hypoxia alters the respiratory network and discuss my hypotheses regarding the cellular and network mechanisms involved in gasping rhythm generation. Finally, I review changes in the hypoxic response during postnatal development and the contribution of several neuromodulators to such a response.
Upregulation of angiotensin‐converting enzyme (ACE) 2 in hepatic fibrosis by ACE inhibitors
Authors: Huang Mao‐liang , Li Xu , Meng Ying , Xiao Bing , Ma Qiang , Ying Song‐song , Wu Ping‐sheng , Zhang Zhen‐shu 
Published: September 2009

Summary1. The role of angiotensin‐converting enzyme (ACE) 2 is likely to balance the status of the renin–angiotensin system (RAS) by degrading angiotensin (Ang) II and generating Ang‐(1–7). Earlier demonstrations that ACE2 is insensitive to ACE inhibitors prompted us to evaluate the effect of ACE inhibitors on ACE2 expression.2. Liver fibrosis was induced in rats with 40% CCl4 (2.5 mL/kg, s.c., twice per week). Half the rats were further treated with perindopril (2 mg/kg, p.o., daily). After 2 and 4 weeks treatment, ACE2 immunoreactivity was assessed by immunohistochemical staining, ACE2 protein expression was determined by western blot and mRNA expression of ACE2 and the Ang‐(1–7) receptor Mas was determined by reverse transcription–polymerase chain reaction (RT‐PCR).3. As an in vitro study, hepatic stellate cells (HSC) were treated with AngII (0.1–10 μmol/L) alone or in combination with the synthesized peptide ACEI (Sigma‐Aldrich). Western blot and RT‐PCR were used to evaluate ACE2 expression and Mas mRNA levels. Furthermore, after treatment of HSC with the Mas antagonist A779 (1 μmol/L), the protein expression of connective tissue growth factor (CTGF) was detected to evaluate the interaction between AngII, ACEI and the ACE2–Mas axis.4. Expression of both ACE2 mRNA and protein and Mas mRNA was markedly upregulated in both CCl4‐injured rat liver and AngII‐treated HSC. Further significant upregulation was observed following additional administration of ACEI. In addition, ACEI treatment of HSC inhibited AngII–induced overexpression of connective tissue growth factor and this effect was ameliorated by blockade of the Mas receptor with A779.5. The findings of the present study suggest that ACE inhibitors are able to upregulate ACE2 under conditions of liver injury both in vivo and in vitro, which may indicate potential benefits of ACE inhibitors in the therapeutic treatment of liver fibrosis.
The hypotensive effect of intravenous amiodarone is sustained throughout the maintenance infusion period
Authors: Cushing Daniel J , Cooper Warren D , Gralinski Michael R , Lipicky Raymond J 
Published: September 2009

Summary1. Hypotension frequently occurs with use of intravenous amiodarone and is managed by slowing the rate of administration. This response has been attributed to the cosolvents in the formulation and is believed to be solely related to the initial loading dose. The present study was performed to determine whether intravenous amiodarone‐induced hypotension persists beyond the loading dose and into the maintenance infusion period and also whether hypotension occurs with maintenance level dosing alone.2. Anaesthetized beagle dogs (n = 7/group) were instrumented to assess haemodynamics. Animals were treated with the human‐equivalent dosing regimen (loading dose followed by maintenance infusion) of intravenous amiodarone or control (5% dextrose in water).3. No haemodynamic changes were observed in the control group during the 6 h study. In contrast, administration of the standard intravenous amiodarone regimen produced rapid and significant decreases in mean aortic pressure, cardiac output and maximum rate of change of left ventricular pressure that persisted throughout the 6 h maintenance infusion period. Administration of amiodarone as the maintenance infusion dose alone produced haemodynamic changes that were similar in magnitude to those observed with administration of the full dosing regimen, but were delayed in onset by approximately 60 min.4. Dosing with a cosolvent‐free formulation of amiodarone (PM101) caused no haemodynamic effects during the 6 h dosing period, indicating that the cardiodepressant effects of intravenous amiodarone were due to its cosolvents.5. These data suggest that consideration should be given to intravenous amiodarone as a potential cause for sustained hypotension during prolonged infusion.
Inhibition of cGMP phosphodiesterase 5 suppresses matrix metalloproteinase‐2 production in pulmonary artery smooth muscles cells
Authors: Sun Xiu‐Zhen , Li Zong‐Fang , Liu Yun , Fang Ping , Li Man‐Xiang 
Published: September 2009

Summary1. It has been shown that the beneficial effects of phosphodiesterase (PDE) 5 inhibition on pulmonary hypertension (PH) are associated with the induction of vascular relaxation and suppression of the proliferation of pulmonary artery smooth muscle cells (PASMC). In the present study, we investigated whether PDE5 inhibition affects the production and/or secretion of matrix metalloproteinases (MMPs) in PASMC, resulting in extracellular matrix remodelling in the pulmonary vasculature and, thus, the development of PH.2. Primary cultured PASMC were stimulated with endothelin (ET)‐1 and MMP‐2 production and RhoA activation were then determinded using gelatin zymography and a GTP‐bound RhoA assay, respectively. The effects of the selective PDE5 inhibitor sildenafil and subsequent protein kinase G‐specific inhibitor Rp‐8Br‐cGMPs on MMP‐2 production and RhoA activation were further exmamined.3. Endothelin‐1 (1–1000 nmol/L) concentration‐dependently stimulated MMP‐2 production and/or secretion in primary cultured PASMC, with 100 nmol/L ET‐1 causing a 2.41‐fold increase in MMP‐2 production compared with control (P < 0.01). This increase in MMP‐2 production was accompanied by RhoA activation, which was abolished by preincubation of cells with 10 μmol/L Y27632, an inhibitor of Rho‐associated kinase (ROCK). Furthermore, 10 μmol/L Y27632 abolished the ET‐1‐induced production of MMP‐2.4. The selective PDE5 inhibitor sildenafil (0.1–1 μmol/L) concentration‐dependently reduced the increased MMP‐2 production induced by 100 nmol/L ET‐1. Specifically, in the presence of 1 μmol/L sildenafil, the 100 nmol/L ET‐1‐induced increase in MMP‐2 production was only increased 1.3‐fold over that of the control (P < 0.01 vs 100 nmol/L ET‐1‐stimulated cells).5. Suppression of RhoA activation was found to mediate the inhibitory effect of sildenafil on ET‐1‐induced increases in MMP‐2 production. Furthermore, the protein kinase G‐specific inhibitor Rp‐8Br‐cGMPs reversed the inhibitory effects of sildenafil on RhoA activation and MMP‐2 production.6. The results of the present study indicate that PDE5 inhibition suppresses RhoA/ROCK‐mediated MMP‐2 production by PASMC, which may contribute to the regulation of pulmonary vascular remodelling. Thus, PDE5 inhibition may benefit patients with PH through multiple mechanisms of action.
Impairment of α1‐adrenoceptor‐mediated contractile activity in caudal arterial smooth muscle from Type 2 diabetic Goto‐Kakizaki rats
Authors: Mita Mitsuo , Kuramoto Takuto , Ito Kazushi , Toguchi‐Senrui Natsuko , Hishinuma Shigeru , Walsh Michael P , Shoji Masaru 
Published: September 2009

Summary1. In the present study, we compared the responsiveness of de‐endothelialized caudal artery smooth muscle strips, isolated from Type 2 diabetic Goto‐Kakizaki (GK) and normal Wistar rats, to α1‐adrenoceptor stimulation (cirazoline) and membrane depolarization (K+).2. The contractile and myosin 20 kDa light chain (LC20) phosphorylation responses to 0.3 μmol/L cirazoline of caudal artery strips isolated from 12‐week‐old GK rats were significantly reduced compared with those of age‐matched Wistar rats, whereas the contractile and LC20phosphorylation responses to 60 mmol/L K+were unaltered.3. Stimulation of fura 2‐AM‐loaded strips from GK rats with 0.3 μmol/L cirazoline induced a significantly smaller rise in [Ca2+]i(by ∼20%) compared with that in strips from Wistar rats, whereas comparable Ca2+transients were evoked by K+in both.4. Using quantitative polymerase chain reaction, no significant differences were detected in the mRNA expression of α1A‐, α1B‐ and α1D‐adrenoceptor subtypes between GK and Wistar rats.5. Cirazoline (1 μmol/L)‐ and caffeine (20 mmol/L)‐induced contractions in the absence of extracellular Ca2+were unaltered in GK rats, suggesting that the release of Ca2+from the sarcoplasmic reticulum in response to cirazoline does not differ between GK and Wistar rats.6. The results of the present study suggest that Ca2+entry from the extracellular space via α1‐adrenoceptor‐activated, Ca2+‐permeable channels, but not via membrane depolarization and voltage‐gated L‐type Ca2+channels, is impaired in caudal artery smooth muscle of GK rats.
Usefulness of polyethylene glycol solution with dimethylpolysiloxanes for bowel preparation before capsule endoscopy
Authors: Nouda Sadaharu , Morita Eijiro , Murano Mitsuyuki , Imoto Akira , Kuramoto Takanori , Inoue Takuya , Murano Naoko , Toshina Ken , Umegaki Eiji , Higuchi Kazuhide 
Published: September 2009

AbstractBackground and Aim:  Capsule endoscopy (CE) is widely used for diagnosing small intestinal diseases. In some cases, however, observation of target sites is very poor during CE because of residues etc. Herein we report the usefulness of a preparation comprised of polyethylene glycol solution (PEG) for CE.Methods:  This was a prospective, randomized, and single‐blind study. Forty subjects, fasted for 12 h before CE, were randomized into two groups: 20 subjects in Group A were fasted only, whereas 20 in Group B received 1 liter (L) PEG with 200 mg dimethylpolysiloxane 3 h before CE. For evaluation, the observation period of the small intestine was divided into first and second halves. Subsequently, four investigators, blinded as to which group received the preparation, assessed the condition of the intestine using four rating scales in terms of ‘residue’ and ‘intraluminal gas bubbles’. The effects of the preparation were statistically compared.Results:  CE images were better in Group B than in Group A with respect to ‘intraluminal gas bubbles’ (P = 0.0038) in the first half of the observation period, as well as residue (P = 0.0087) and intraluminal gas bubbles (P = 0.0011) in the second half.Conclusion:  Bowel preparation using 1 L PEG with dimethylpolysiloxane 3 h before CE significantly reduced residue and intraluminal gas bubbles, and was considered to be a useful method for CE.
Outcomes of endoscopic resection of large colorectal neoplasms: An Australian experience
Authors: Salama Muna , Ormonde Donald , Quach Thai , Ee Hooi , Yusoff Ian 
Published: September 2009

AbstractBackground and Aims:  Endoscopic resection of large colorectal neoplasms is increasingly being used as an alternative to surgery. However data on failure rates, safety and long‐term outcomes remain limited. The aim of the study was to report short‐ and long‐term outcomes from endoscopic resection of large colorectal neoplasms from a single centre and use a model to predict mortality had surgery been performed.Methods:  Consecutive patients referred for endoscopic resection of large (≥ 20 mm) colorectal neoplasms from January 2001 to February 2008 were included. Resection details were recorded in a prospectively maintained database. Data was collected on 30‐day complication rates, and follow‐up colonoscopy findings. The Colorectal‐POSSUM score was used to estimate mortality from open surgery.Results:  There were 154 large neoplasms in 140 patients. Mean age was 68 years (range 22–94). Mean neoplasm size was 26 mm (range 20–80 mm, 24 ≥ 40 mm). Complete endoscopic removal was achieved in 95% of cases. Twenty patients were referred for surgery (14%). In the endoscopy group, there were no deaths within 30 days. Twelve patients had a complication including two perforations. Endoscopic follow‐up data was available in 90% of cases and five patients (4%) were found to have residual adenoma that was treated endoscopically with subsequent clearance. If surgery had been performed, the mean predicted mortality was 2.2% (range 0.5–10%). There were two deaths (10%) in patients who underwent elective surgery within 30 days.Conclusion:  Endoscopic resection of large colorectal neoplasms is safe and effective even for very large benign neoplasms. When the lesion is endoscopically resectable this should be the preferred treatment.
Diagnostic role of serum glypican‐3 in differentiating hepatocellular carcinoma from non‐malignant chronic liver disease and other liver cancers
Authors: Tangkijvanich Pisit , Chanmee Theerawut , Komtong Sanpoj , Mahachai Varocha , Wisedopas Naruemon , Pothacharoen Peraphan , Kongtawelert Prachya 
Published: September 2009

AbstractBackground and Aims:  The role of glypican‐3 (GPC3), a novel serum marker, in differentiating hepatocellular carcinoma (HCC) from non‐malignant chronic liver disease and other malignant space‐occupying lesions in the liver is largely unknown. The aims of this study were to evaluate its diagnostic role and clinical correlations in patients with HCC.Methods:  Six groups were studied which included 40 healthy subjects, 50 patients with chronic hepatitis (CH), 50 patients with liver cirrhosis (LC), 100 patients with HCC, 50 patients with intrahepatic cholangiocarcinoma (ICC) and 50 patients with metastatic carcinoma (MCA). Serum GPC3 levels were measured by using a sandwich enzyme‐linked immunosorbent assay method.Results:  Fifty‐three percent of HCC patients had elevated serum GPC3 levels with values ranging 35.5–7826.6 ng/mL. The serum marker was undetectable in other groups except one patient (2%) with LC and another patient (2%) with MCA. In most cases of HCC, elevated GPC3 values did not correlate with α‐fetoprotein (AFP) levels. Detectable GPC3 was significantly correlated with the presence of viral hepatitis markers but was not correlated with tumor size and stage of HCC. Serum GPC3 was superior to AFP in detecting small HCC (56.3% and 31.3%, respectively). A combination of serum GPC3 and AFP yielded an improved sensitivity for detecting small HCC to 75%.Conclusion:  Serum GPC3 is highly specific for detecting HCC. The combined use of serum GPC3 and AFP provides a potentially promising tool to better differentiate HCC from benign liver disorders, as well as from other liver cancers.
Statins for prevention of contrast‐induced nephropathy in patients undergoing non‐emergent percutaneous coronary intervention
Authors: KANDULA PRAVEEN , SHAH RAVISH , SINGH NISHITH , MARKWELL STEPHEN J , BHENSDADIA NISHANT , NAVANEETHAN SANKAR D 
Published: September 2009

ABSTRACT:Aim:  Oxidative stress and ischaemia are suggested as possible mechanisms of contrast‐induced nephropathy (CIN). Statins may offer renoprotection in both acute and chronic kidney diseases because of their antioxidant and anti‐inflammatory properties. We investigated whether use of statins before non‐emergent percutaneous coronary intervention (PCI) reduces the incidence of CIN.Methods:  We retrospectively evaluated 540 consecutive adult patients who underwent non‐emergent PCI over a 3 year period at a tertiary care centre. CIN was defined as 25% or 44 mmol/L increase from baseline creatinine at 48–72 h. In addition, we classified patients based on Mehran score for risk of development of CIN and analysed the effect of statins.Results:  Three‐hundred and fifty‐three patients met inclusion criteria. Two‐hundred and thirty‐nine patients were taking statins before PCI and 114 were not. Baseline characteristics were similar for both groups. CIN occurred in 75 patients (21.2%). There was a higher incidence of CIN in patients on statins as compared with patients not on statins (24.7% vs 14%; 95% CI: 1.09–3.67; P = 0.02). However, propensity‐based adjustment for receipt of statins revealed no significant differences in CIN between both groups (OR: 1.6; 95% CI: 0.87–3.22; P = 0.12). Multivariate logistic regression revealed Mehran score to be independently predictive of CIN. None of the patients who developed CIN required dialysis.Conclusions:  Statin use before non‐emergent PCI is not associated with reduction in CIN. Further randomized controlled trials based on proper risk adjustment for development of CIN are needed.
Pediatric eosinophilic esophagitis: Single‐center experience in northwestern USA
Authors: Eroglu Yasemen , Lu Huiying , Terry Annie , Tendler Janice , Knopes Barbara , Corless Christopher , Byrne William J , Zhang Zili 
Published: September 2009

AbstractBackground:  Eosinophilic esophagitis (EE) is an emerging disease. Its incidence and prevalence have been exponentially increasing in the last decade. The clinical manifestations of EE vary especially in children. Allergic reaction is strongly implicated in the disease. The aim of the present study was to retrospectively examine the demographic, clinical, laboratory, and endoscopic features of pediatric patients with EE, in order to better understand the diversity of the disease, thereby improving clinical diagnosis and treatment.Methods:  The data were retrospectively collected from 20 pediatric patients with biopsy‐proven EE. Demographic information, clinical symptoms and duration, as well as endoscopic findings were correlated and statistically analyzed.Results:  Median age at diagnosis was 11 years. Male patients had higher prevalence of EE. Thirty‐five percent of the children had food allergy on either skin prick test or IgE radioallergosorbent test, and atopic diseases were common in the group. Gastroesophageal reflux appeared to be the major symptom in younger children, whereas dysphagia and food impaction were more common in older patients. The referral and final diagnosis were often delayed. Esophageal white exudates were the most prominent feature in the younger age group, whereas esophageal ring‐like lesion occurred more often in older children.Conclusion:  EE is more common in male subjects. The clinical and endoscopic features depend upon the age. Allergic processes are strongly involved in pathogenesis. The present results will improve understanding of the characteristics of the disease in the pediatric population and enhance clinicians' vigilance for the diagnosis of EE.
Effects of ghrelin on growth and cardiac function in infants with congenital heart disease
Authors: Kitamura Tomohiro , Shimizu Toshiaki , Ohkawa Natsuki , Oda Hisayuki , Ohtsuki Masahiro , Kishiro Masahiko 
Published: September 2009

AbstractBackground:  Ghrelin has effects on appetite and growth. Recent reports suggest effects on cardiac function, but no study has evaluated the ghrelin levels of congenital heart disease (CHD) infants with heart failure. The purpose of the present study was therefore to investigate the relationship between ghrelin level and growth and cardiac function in CHD infants.Methods:  Twenty‐eight infants with CHD were eligible for the study. Blood samples were obtained at the time of insertion of intracardiac catheter and correlation was examined between ghrelin plasma level and anthropometric parameters, including z score of height and weight, body mass index (BMI), and %bodyweight gain rate, severity of heart failure, and the levels of leptin and insulin‐like growth factor‐1.Results:  In the CHD group, active ghrelin (A‐Ghr) had a significant negative correlation with z score of bodyweight, and a significant positive correlation with cardiac function. There were no correlations, however, with height and BMI. A‐Ghr levels were significantly higher in the high heart failure index score group. Significant correlation between A‐Ghr and desacyl‐ghrelin in the CHD group was observed.Conclusions:  A‐Ghr is involved in cardiac function and has little effect on their physique in infants with CHD.
Patients' preferences for positioning during phaco‐emulsification under topical‐intracameral anaesthesia
Authors: Tsatsos Michael , Chong Loy , Eke Tom 
Published: September 2009

AbstractIn many eye departments it is routine to ask patients to lie completely flat for cataract surgery. However, many patients prefer not to lie completely flat, if given the choice. It is our practice to ensure patients are in a comfortable position before commencing surgery. We conducted a prospective observational study of our routine practice comprising 125 consecutive cataract operations conducted by a single surgeon with local anaesthesia (occasional phaco under general anaesthetic was not included). All patients were initially positioned lying flat on the reclining chair and were given the option of staying in that position throughout the operation or having the chair‐back raised until they were comfortable. Only 27% (34 patients of 125 total) were happy to lie flat (angle between 0° and 5°). The majority of our patients (62% – 78 patients) preferred to sit up slightly, with the chair‐back 10° to 25° above the horizontal; 8% (10 patients) of the patients were sited at an angle of 30° to 35° and 2% (three patients) needed to be sited at 35° or more. Patients who sat up above 30° generally had a medical reason such as orthopnoea (3% – four patients), back pain (5% – six patients), anxiety (2% – two patients), Meniere's disease (1% – one patient). Patients who sat up below 25° chose this position for comfort or preference. Our results show that patient preferences for positioning during cataract phaco‐emulsification under topical‐intracameral anaesthesia should increase overall patient satisfaction without the need to compromise safety.