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1.
Up-regulation of endothelial nitric oxide synthase inhibits pulmonary leukocyte migration following lung ischemia-reperfusion in mice 总被引:7,自引:0,他引:7 下载免费PDF全文
Kaminski A Pohl CB Sponholz C Ma N Stamm C Vollmar B Steinhoff G 《The American journal of pathology》2004,164(6):2241-2249
Endogenous nitric oxide (NO) is known to modulate post-ischemic inflammatory response in various organs. However, the role of nitric oxide synthase isoforms (NOS) in mediating pulmonary post-ischemic inflammatory response is poorly understood. We therefore studied post-ischemic endothelial adhesion molecule expression and leukocyte migration in endothelial NOS knockout (eNOS-KO) mice subjected to pulmonary ischemia and reperfusion in vivo. Under anesthesia and mechanical ventilation, the left pulmonary hilum in wild-type (WT) and eNOS-KO mice was clamped for 1 hour, followed by reperfusion for up to 24 hours. In WT mice, we observed a selective up-regulation of both eNOS mRNA and protein in lung tissue, while inducible NOS (iNOS) and neuronal NOS (nNOS) remained unchanged. Survival in eNOS-KO mice was reduced due to severe pulmonary edema, underlining an increased susceptibility to ischemia-reperfusion (I/R) injury. Interstitial tissue infiltration by CD18- and CD11a-positive white blood cells as well as lung tissue water content peaked at 5 hours of reperfusion and were found significantly higher than in WT mice. Enhanced leukocyte-endothelial interaction was associated with pronounced up-regulation of vascular cell adhesion molecule (VCAM) in eNOS-KO mice during post-ischemic reperfusion. We conclude that eNOS attenuates post-ischemic inflammatory injury to the lung most probably via inhibition of endothelial adhesion molecule expression. 相似文献
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Background Procalcitonin (PCT) has been increasingly used as an inflammatory marker to identify patients with systemic infection. Moreover,
PCT guidance allowed significant reduction of antibiotic therapy in patients with respiratory disease. The aim of this qualitative
review was, therefore, to evaluate the role of PCT measurements in febrile neutropenic patients in differentiating between
various causes of fever and to investigate the value of PCT levels in terms of diagnosing infection or predicting outcome
in these patients.
Patients and Methods A MEDLINE search was performed using the keyword ‘procalcitonin’ crossed with ‘febrile neutropenia’, ‘neutropenia’, ‘fever’,
‘bone marrow transplantation’, and ‘stem cell transplantation’, and limited to human studies published between January 1990
and October 2006. Bibliographies of identified articles were also searched. Predefined variables were collected from the articles,
including year of publication, study design, number of patients included, age group, disease group, markers other than PCT,
and study results.
Results From the 30 articles included, PCT seems to be able to discriminate fever due to systemic forms of infection from non-infectious
etiologies. Patients with fungal infection may have a delayed increase in PCT levels. PCT has a minimal role, if any, in discriminating
Gram-negative from Gram-positive infections. PCT may be useful in outcome prediction in patients with febrile neutropenia
but is not superior to interleukin-6 or C-reactive protein concentrations for this purpose.
Conclusions Despite lack of standard definitions, heterogeneity of study populations, and small numbers of patients included in some studies,
our review provides important insight into the value of PCT as a diagnostic and prognostic tool in patients with febrile neutropenia. 相似文献
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Mariana Sponholz Araujo Frederico Leon Arrabal Fernandes Fernando Uliana Kay Carlos Roberto Ribeiro Carvalho 《Jornal brasileiro de pneumologia》2013,39(5):613-619
Spontaneous pneumomediastinum is an uncommon event, the clinical picture of which
includes retrosternal chest pain, subcutaneous emphysema, dyspnea, and dysphonia. The
pathophysiological mechanism involved is the emergence of a pressure gradient between
the alveoli and surrounding structures, causing alveolar rupture with subsequent
dissection of the peribronchovascular sheath and infiltration of the mediastinum and
subcutaneous tissue with air. Known triggers include acute exacerbations of asthma
and situations that require the Valsalva maneuver. We described and documented with
HRCT scans the occurrence of pneumomediastinum after a patient with bleomycin-induced
interstitial lung disease underwent pulmonary function testing. Although uncommon,
the association between pulmonary function testing and air leak syndromes has been
increasingly reported in the literature, and lung diseases, such as interstitial lung
diseases, include structural changes that facilitate the occurrence of this
complication. 相似文献
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M. Schirren S. Sponholz S. Oguzhan A. Fisseler-Eckhoff A. Fischer J. Schirren 《Der Chirurg》2016,87(5):455-466
Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor disease, which rapidly leads to death if untreated. In Germany the incidence of newly occurring disease is expected to reach a peak in the coming 5 years. An R0 resection for MPM is technically impossible; therefore, the aim of surgical procedures is to achieve the maximum amount of cytoreduction. There are two established surgical techniques for treatment of MPM, extrapleural pneumonectomy and tumor pleurectomy with decortication. The type and extent of surgery are currently controversially discussed. Within multimodal therapy concepts including cytoreductive surgery, long-term remission is possible in selected patients. When choosing the appropriate surgical therapy the high incidence of recurrence has to be borne in mind. 相似文献
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