bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latent IgA deposition from donor kidney is the major risk factor for recurrent IgA nephropathy in renal transplantation
Authors: Moriyama Takahito , Nitta Kosaku , Suzuki Koichi , Honda Kazuho , Horita Shigeru , Uchida Keiko , Yumura Wako , Tanabe Kazunari , Toma Hiroshi , Nihei Hiroshi , Yamaguchi Yutaka 
Published: June 2005

Abstract: Background: Previous studies have recognized risk factors for recurrent IgA nephropathy (r‐IgAN) in renal transplantation. However the clinical significance of latent IgA deposition from the donor kidney remains to be determined.Patients and methods: Between 1992 and 1999, 0‐hour allograft biopsies were performed in 510 renal transplantation recipients at the Kidney Center of Tokyo Women's Medical University. Among these 510 patients, there were 49 whose primary disease was identified as IgAN. Among these 49 patients, 13 patients (26.5%) were diagnosed as having r‐IgAN based on renal biopsy. We compared risk factors of r‐IgAN, including IgA deposition, between the r‐IgAN and non‐r‐IgAN groups.Results: We assessed factors previously reported to be risk factors for r‐IgAN, such as follow‐up period after transplantation, sex, ages of donors and recipients, donor type, ABO compatible or incompatible transplantation, number of HLA‐A, B, and DR mismatches, number of donors with HLA‐A2, B35, B46, and/or DR4, duration to end stage renal disease, duration of dialysis, and latent IgA deposition from donor kidneys. Latent IgA deposition was the only risk factor that differed significantly in frequency between patients with and without recurrence (38.5% in r‐IgAN group vs. 9.1% in non‐r‐IgAN group, p = 0.037). Other factors did not differ significantly between the two groups. Clinical factors, such as urinary protein excretion, urinary red blood cell sediment and serum creatinine, were significantly worse and the number of patients who required hemodialysis 5 yr after transplantation was significantly higher in the r‐IgAN group than in the non‐r‐IgAN group (38.5 vs. 5.6%, p = 0.001). Four of the five patients who required hemodialysis in the r‐IgAN group had latent IgA deposition from the donor kidney.Conclusion: Our data suggest that 26.5% out of patients with primary IgAN will develop recurrence within 5 yr after transplantation. Latent IgA deposition from the donor kidney was one of the risk factors of r‐IgAN and it would lead to the development of r‐IgAN. Moreover, r‐IgAN will compromise graft survival, especially in cases with latent IgA deposition from the donor kidney.
Mixed venous oxygen desaturation during early mobilization after coronary artery bypass surgery
Authors: Kirkeby‐Garstad I. , Sellevold O. F. M. , Stenseth R. , Skogvoll E. 
Published: June 2005

Background:  Early postoperative mobilization induces a marked reduction in mixed venous oxygen saturation (SvO2) after aortic valve replacement. We investigated whether a similar desaturation occurs among coronary artery bypass grafting (CABG) patients, and if the desaturation was related to the preoperative ejection fraction (EF).Methods:  Thirty‐one CABG patients with a wide range in EF were included in an open observational study. We recorded hemodynamic and oxygenation variables during mobilization on postoperative day 1 and day 2 using a pulmonary artery catheter.Results:  Patients with an EF ranging from 24 to 87% were mobilized without clinical problems. SvO2 at rest was 65.4 ± 4.9% (mean ± SD) on day 1 and 64.3 ± 5.8% on day 2 (NS). During mobilization, cardiac index and oxygen delivery were reduced while oxygen consumption was increased (P‐values: 0.000, 0.007 and 0.000, respectively). Consequently, oxygen extraction increased, resulting in a marked reduction in SvO2−42.9 ± 8.3% on day 1 and 47.4 ± 8.5% on day 2 (P = 0.025 between days). Several pre‐, intra‐ and postoperative factors were tested as possible predictors for SvO2 during mobilization. No factor contributed substantially.Conclusion:  Patients with CABG exhibit a marked desaturation during early postoperative mobilization. Preoperative ejection fraction did not affect SvO2 during exercise. The clinical consequences and underlying mechanism require further investigation.
Xenon anaesthesia may preserve cardiovascular function in patients with heart failure
Authors: Baumert J.‐H. , Falter F. , Eletr D. , Hecker K. E. , Reyle‐Hahn M. , Rossaint R. 
Published: June 2005

Background:  The hypothesis that xenon anaesthesia provided haemodynamic stability was tested in patients with heart failure in a prospective, randomized, single‐blind design.Methods:  Twenty‐six patients scheduled for implantation of a cardioverter‐defibrillator (ICD) received xenon 60–65% in oxygen (xenon group, n = 12) or propofol 3 mg/kg/h (propofol group, n = 14), both combined with remifentanil 0.2 µg/kg/min. After induction of anaesthesia with etomidate and remifentanil, heart rate (HR), mean arterial pressure (MAP) and left ventricular ejection fraction (LVEF) were recorded. After 60 min of propofol or xenon anaesthesia, the same parameters were recorded.Results:  While HR decreased in both groups, MAP was unchanged with xenon (73 vs. 76 mmHg) and decreased with propofol (from 78 to 64 mmHg, P < 0.02). LVEF was stable in both groups [32% vs. 37%, xenon (NS), and 30% vs. 34%, propofol (NS)]. Preload, as measured by end‐diastolic volume (EDV), did not change (66 vs. 63 ml with xenon; 79 vs. 81 ml with propofol, both NS). Afterload, as determined by end‐systolic pressure‐volume product (ESPV), decreased with propofol (6760 vs. 4920 ml mmHg) but not with xenon (4060 vs. 3780 ml mmHg, P < 0.01 between groups).Conclusion:  With propofol, MAP is reduced and LVEF is not increased in spite of reduced afterload. In contrast, MAP and LVEF are maintained with xenon.
Effects of phosphodiesterase‐III inhibitors on sevoflurane‐induced impairment of rat diaphragmatic function
Authors: Uesugi T. , Mikawa K. , Nishina K. , Kodama S‐I. , Obara H. 
Published: June 2005

Background:  Volatile anesthetics are known to cause diaphragmatic dysfunction using a whole body model. The first aim of the current study was to compare the impairing effect of halothane and sevoflurane on diaphragmatic contractile functions under unfatigued and fatigued conditions. The second purpose was to determine whether phosphodiesterase‐III inhibitors can attenuate sevoflurane‐potentiated reduction of contractility after fatigue.Methods:  Using rat‐isolated muscle strips, diaphragmatic twitch characteristics and tetanic contractions were measured before and after muscle fatigue, which was induced by repetitive tetanic contraction with or without exposure to halothane (1–3 MAC) or sevoflurane (1–3 MAC). Diaphragmatic functions were further assessed with exposure to 3 MAC sevoflurane in the presence and absence of milrinone, or olprinone. Cyclic adenosine monophosphate (cAMP) concentrations in the fatigued diaphragm were also measured.Results:  Halothane (1–3 MAC) or sevoflurane (1–2 MAC) did not induce a direct inotropic effect under unfatigued and fatigued conditions. Sevoflurane at 3 MAC enhanced fatigue‐induced impairment of twitch and tetanic tensions. Clinically relevant concentrations of olprinone improved the sevoflurane‐induced potentiation of diaphragmatic dysfunction following fatigue, accompanied by restoration of diaphragmatic cAMP levels, although milrinone failed to do so.Conclusion:  Our findings suggest that sevoflurane has a greater decreasing effect on diaphragmatic contractility after fatigue than halothane, and that the clinical dose of olprinone surmounts the disadvantage of sevoflurane in various conditions where diaphragmatic fatigue is predisposed.
Palmar skin conductance compared to a developed stress score and to noxious and awakening stimuli on patients in anaesthesia
Authors: Storm H. , Shafiei M. , Myre K. , Ræder J. 
Published: June 2005

Background:  The number of fluctuations in the skin conductance per s (NFSC) as a measure of the sympathetic nervous system may be a tool for monitoring physiological stress during surgery and general anaesthesia. The purpose of this study was to find the sensitivity and specificity of the NFSC when compared to a peroperative clinical stress score. Moreover, different patterns of skin conductance responses were compared with the BIS score to find out if the mean level of skin conductance (SC) and NFSC monitoring could differentiate between awakening and noxious stimuli.Methods:  Fourteen patients were studied during stressful or non‐stressful registration periods. During each registration period, the NFSC was compared to a five‐point clinical stress score (CSS) (systolic blood pressure >130 mmHg, cough, tears, EMG in the forehead >50 or movements) and BIS score.Results:  The NFSC and the CSS both indicated physiological stress at 12 registrations and no stress at 186 registrations. The NFSC indicated physiological stress without signs of clinical stress (CSS = 0) in 28 registrations, whereas signs of clinical stress (CSS > 0) were indicated on two occasions without signs of stress in the NFSC. The sensitivity of the NFSC when compared to the CSS was 86% and the specificity was 86%. Moreover, in all situations (n = 16) where NFSC indicated stress and the BIS score >50, the SC increased. This was different from situations (n = 13) where NFSC indicated stress and the BIS score <50, then the SC did not increase (P < 0.001).Conclusion:  The NFSC is sensitive to clinical stress during surgical stimulation. Moreover, the combined use of SC and NFSC may have a potential to differentiate between situations of stress due to inadequate hypnotic effect vs. inadequate analgesic effect.
Plasma propofol concentrations during orthotopic liver transplantation
Authors: Wu J. , Zhu S. M. , He H. L. , Weng X. C. , Huang S. Q. , Chen Y. Z. 
Published: June 2005

Objective:  The aim of this study was to investigate the changes in plasma concentrations of propofol in three phases (the paleohepatic, anhepatic, and neohepatic phases) during orthotopic liver transplantation (OLT) using target‐controlled infusion (TCI).Methods:  Ten patients undergoing OLT without venovenous bypass were studied (age 29–53 years, weight 56–79 kg). After intubation, a non‐hypnotic target concentration of propofol 0.5 µg ml−1 using a Diprifusor® pump (Zeneca Pharmaceuticals, Macclesfield, UK) was administered as a supplement anesthesia throughout the procedure. Plasma samples were obtained in each phase for propofol assay, respectively. Performance parameters for the Diprifusor® system in each phase, the percentage median performance error (MDPE), the percentage median absolute performance error (MDAPE), and the percentage median absolute constancy error (MDACE) were evaluated.Results:  In all patients, measured plasma propofol concentrations were several times higher than Diprifusor® values in each phase during the procedure. In nine patients, propofol concentrations in the anhepatic phase were higher than those in the paleohepatic or neohepatic phase (P < 0.05). There were no significant differences between the paleohepatic and neohepatic phases. Interindividual variation of the plasma propofol concentrations was significant (P < 0.05). Percentage median performance error of Diprifusor® in each phase, as well as MDAPE, was large (>300%) and was significantly higher in the anhepatic phase (P < 0.01), whereas MDACE was relatively small and there was no significant difference between phases.Conclusions:  Models used by Diprifusor® are not suitable for liver transplantation patients. A further study should be performed in order to determine all pharmacokinetic parameters of propofol in these patients.
Effects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery
Authors: Koksal G. M. , Sayilgan C. , Gungor G. , Oz H. , Sen O. , Uzun H. , Aydin S. 
Published: June 2005

Background:  This study was devised to compare the effects of sevoflurane and desflurane anaesthesia on the cytokine response.Methods:  Sixty ASA I–II patients, scheduled for tympanoplasty, were randomly allocated to be anaesthetized with either sevoflurane or desflurane at maintenance inspiratory concentrations of 1–1.5 MAC of either agent. Blood samples were taken for plasma tumour necrosis factor α (TNFα), interleukin 1β and interleukin‐6 assay before induction of anaesthesia, before surgery, and at the end of surgery. Alveolar cells were obtained after induction of anaesthesia and at the end of surgery.Results:  Plasma TNFα was greater with desflurane than sevoflurane both before surgery (45.1 ± 3.5 pg ml−1 for desflurane vs. 23.2 ± 2.5 pg ml−1 for sevoflurane, P < 0.01) and (62.0 ± 5.3 pg ml−1 vs. 35.5 ± 4.6 pg ml−1, P < 0.001). Interleukin 1β was similarly greater with desflurane than sevoflurane before (39.3 ± 4.0 pg ml−1 vs. 17.4 ± 3.0 pg ml−1; P < 0.01) and after surgery (46.0 ± 3.4 pg ml−1 vs. 23.3 ± 3.2 pg ml−1, P < 0.001). There were similar results for interleukin 6 before (42.3 ± 3.5 pg mls−1. 29.0 ± 2.6 pg ml−1, P < 0.001) and after surgery (86.0 ± 4.5 pg ml−1 vs. 45.9 ± 6.3 pg ml−1, P < 0.001). Alveolar cell TNFα concentrations after surgery were also greater with desflurane than sevoflurane (96.3 ± 12.4 pg ml−1 vs. 64.8 ± 10.1 pg ml−1, P < 0.001), as were interleukin 1β (75.4 ± 6.2 pg ml−1 vs. 32.0 ± 8.3 pg ml−1, P < 0.001) and interleukin 6 concentrations (540.1 ± 65.3 pg ml−1 vs. 363.6 ± 29.2 pg ml−1, P < 0.001).Conclusion:  Desflurane appears to cause a greater systemic and intrapulmonary pro‐inflammatory response than sevoflurane during anaesthesia for ear surgery.
Effects of ephedrine on intubating conditions following priming with rocuronium
Authors: Leykin Y. , Pellis T. , Lucca M. , Gullo A. 
Published: June 2005

Background:  Onset of action of muscle relaxants is influenced by cardiac output and muscle blood flow. Ephedrine reduces the onset time of rocuronium. Onset is also shortened by priming. Accordingly, we hypothesized that priming combined with ephedrine is superior to either technique used separately.Methods:  Four groups of randomly allocated patients (n = 31), ASA I – II, were induced with propofol 2.5 mg kg−1. In groups I and II, 0.04 mg kg−1 of rocuronium was followed by a 3‐min priming interval. Induction was followed by an intubation dose of 0.04 mg kg−1. Then a 30‐s intubation was attempted. In groups III and IV the same sequence was repeated except for sham priming and an intubation dose of 0.44 mg kg−1. In groups I and II, ephedrine (210 µg kg−1) was injected before propofol. In groups II and V, an equivalent volume of normal saline was injected. Jaw relaxation, vocal cord position, and diaphragmatic response were used to assess intubating conditions.Results:  All patients of group I were intubated 30 s after the intubating dose and within a 20‐s interval compared with 74% of patients in groups II and III, and 84% of patients in group IV. Intubating conditions were graded good to excellent in all patients in group I compared with 42% of those in group II, 35% in group III and 52% in group IV (P < 0.01 vs. group I). During the priming interval, no adverse effects were observed or reported.Conclusions:  Ephedrine in combination with propofol significantly improved clinical intubating conditions at 30 s following priming with rocuronium compared with priming with ephedrine without priming.
Comparison of the effects of isoflurane and sevoflurane on protein tyrosine phosphorylation‐mediated vascular contraction
Authors: Yu J. , Mizumoto K. , Kakutani T. , Hasegawa A. , Ogawa K. , Hatano Y. 
Published: June 2005

Background:  Isoflurane induces greater effects on vasodilation and decreasing blood pressure than sevoflurane. Tyrosine kinase‐catalyzed protein tyrosine phosphorylation plays an important role in regulating vascular smooth muscle contraction. The aim of the present study was to compare the effects of isoflurane and sevoflurane on tyrosine phosphorylation‐mediated vascular constriction, by assessing the degree of sodium orthovanadate (Na3VO4, tyrosine phosphatase inhibitor)‐induced contraction and protein tyrosine phosphorylation of rat aortic smooth muscle.Methods:  Na3VO4‐induced contraction and protein tyrosine phosphorylation of rat aortic smooth muscle were measured in the presence of genistein, a tyrosine kinase inhibitor, and different concentrations of isoflurane and sevoflurane, using isometric force measurement and Western blot, respectively.Results:  Na3VO4 (10−4 M) induced sustained contraction and tyrosine phosphorylation of substrates that were both markedly attenuated in the presence of genistein (5 × 10−5 M). Isoflurane and sevoflurane dose‐dependently (1, 2, 3 MAC) attenuated the Na3VO4‐induced contraction (P < 0.05–0.005, n = 8), with a greater degree of inhibition by isoflurane than sevoflurane at 2 MAC (P < 0.01) and 3 MAC (P < 0.05). Both anesthetics also attenuated the total band density of the Na3VO4‐induced, tyrosine‐phosphorylated substrates in a concentration‐dependent manner (P < 0.05–0.005, n = 4), with much greater attenuation by isoflurane than sevoflurane at 1 and 2 MAC (P < 0.05), respectively.Conclusion:  The results of the present study demonstrate that isoflurane exhibits a greater degree of inhibition on the Na3VO4‐stimulated contraction and protein tyrosine phosphorylation of rat aortic smooth muscle compared with sevoflurane. These findings suggest that isoflurane depresses the protein tyrosine phosphorylation‐mediated contraction of vascular smooth muscle to a greater degree than sevoflurane.
Characterization of inhibition of platelet function by paracetamol and its interaction with diclofenac in vitro
Authors: Munsterhjelm E. , Niemi T. T. , Ylikorkala O. , Silvanto M. , Rosenberg P. H. 
Published: June 2005

Background:  Paracetamol (acetaminophen) is an effective analgesic and a weak inhibitor of cyclo‐oxygenase (COX). Clinically paracetamol is often used together with traditional NSAIDs, which are strong inhibitors of COX. We studied binding of paracetamol to COX and its action on platelet function together with diclofenac.Methods:  Blood was collected from healthy donors and platelet function was assessed by photometric aggregometry, a platelet function analyser (PFA‐100™, Dade Behring, Deerfield, IL) and by measuring the release of thromboxane B2 (TxB2), the stable metabolite of thromboxane A2, after addition of paracetamol (10–80 µg ml−1). A concentration‐inhibition relationship was established and the inhibition coefficient (Ki) demonstrating 50% binding to COX was determined using a Schild‐plot. Interaction of paracetamol (5–20 µg ml−1) and diclofenac (0.1–0.8 µg ml−1) was determined and an isobolographic analysis was performed.Results:  Paracetamol added to platelet‐rich plasma (PRP) caused a concentration‐dependent inhibition of platelet function. Photometric aggregometry and TxB2 release was significantly inhibited by paracetamol from 10 µg ml−1 onwards. The PFA‐100™ closure time was significantly prolonged by paracetamol at a high concentration only. Ki was 15.2 µg ml−1 with a 95% confidence interval of 11.8–18.6 µg ml−1. Inhibition of aggregation by diclofenac was augmented by paracetamol. Isobolographic analysis showed synergism.Conclusions:  The 95% confidence interval of Ki equals the antipyretic plasma concentration of paracetamol, i.e. 10–20 µg ml−1. High doses of paracetamol and a combination of diclofenac and paracetamol cause platelet inhibition and thus may increase risk of surgical bleeding.
Effect of low‐dose N‐acetyl‐cysteine infusion on tourniquet‐induced ischaemia‐reperfusion injury in arthroscopic knee surgery
Authors: Saricaoglu F. , Dal D. , Salman A. E. , Atay Ö. A. , Doral M. N. , Salman M. A. , Kilinç K. , Aypar Ü. 
Published: June 2005

Background:  Temporary occlusion of blood flow is used during arthroscopic knee surgery in order to provide a bloodless surgical field. The resulting ischaemia‐reperfusion causes lipid peroxidation, which contributes to tissue injury. The aim of the study was to investigate the effect of low‐dose n‐acetyl cysteine (NAC) infusion on oxidative stress by determining malondialdehyde (MDA) levels during arthroscopic knee surgery.Methods:  Thirty patients, ASA I – II, undergoing arthroscopic knee debridement under a tourniquet were divided into NAC and control groups. Anaesthesia was induced with propofol, fentanyl and vecuronium bromide and maintained with desflurane in an equal parts O2‐N2O mixture. In the NAC group, an infusion of NAC, 5 mg kg−1.h−1, was started after intubation, and continued until extubation. An equal volume of saline was infused to the control group. Duration of ischaemia, anaesthesia time, total dose of NAC infused were also recorded. Venous blood and synovial membrane tissue samples were obtained 10 min after the onset of NAC infusion but before tourniquet inflation (t1), after 30 min of ischaemia (t2), and after 5 min of reperfusion following tourniquet release (t3).Results:  Plasma MDA levels were significantly lower in the NAC group on reperfusion. There were no differences between the groups in tissue MDA levels at ischaemia and reperfusion times.Conclusion:  Low‐dose n‐acetyl cysteine infusion attenuates lipid peroxidation and ischaemia‐reperfusion injury in arthroscopic knee surgery requiring tourniquet application.
Remifentanil patient‐controlled analgesia following cardiac surgery
Authors: Krishnan K. , Elliot S. C. , Berridge J. C. , Mallick A. 
Published: June 2005

Background:  Remifentanil is increasingly used as a component of cardiac anaesthesia. Following cardiac surgery remifentanil is often substituted for alternative opioids on the intensive care unit. We were interested to evaluate postoperative continuation of remifentanil in the form of remifentanil patient control analgesia (RPCA) for those patients who received intraoperative remifentanil. The objectives of this study were to assess the safety, efficacy and feasibility of the RPCA.Methods:  Ten patients who received an intravenous infusion of remifentanil perioperatively for coronary artery bypass graft surgery (CABG) had their remifentanil infusion converted to RPCA following extubation on the intensive care unit. Remifentanil patient control analgesia delivered an initial background infusion consistent with the infusion rate at extubation and with a bolus facility of 50 µg administered over 5 min followed by a 5‐min lockout. Data collection included sedation and pain scores, respiratory rate, arterial blood gases, number of successful/unsuccessful attempts and the background infusion rate for each subject over a period of 12 h following extubation.Results:  The data from nine male and one female patient were analyzed by using SPSS11 for Windows. During the study period the patients achieved adequate pain control and made more RPCA attempts at lower background infusion rates. No episodes of apnoea, SpO2 less than 95% or a rise in PaCO2 greater than 6.5 kPa were observed.Conclusion:  Remifentanil patient control analgesia with a background infusion was effective and safe for postoperative pain relief in this group of spontaneously breathing ICU patients following cardiac surgery.