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21.
Plasma levels and vascular effects of vasopressin in patients undergoing coronary artery bypass grafting. 总被引:1,自引:0,他引:1
Susana Novella Ana Cristina Martínez Rosa María Pagán Medardo Hernández Albino García-Sacristán Angel González-Pinto José María González-Santos Sara Benedito 《European journal of cardio-thoracic surgery》2007,32(1):69-76
OBJECTIVE: Recent studies have suggested that endogenous vasopressin (AVP) acts as a spasmogen during coronary artery bypass grafting (CABG). Given that AVP could induce vasospasm in the grafted vessel, we assessed the release of this peptide during and after CABG, and explored ways of counteracting its contractile effect on the internal mammary artery (IMA). METHODS: Plasma levels of AVP were determined by radioimmunoassay in 16 patients before, during and after CABG. Using isometric force recording techniques, we also investigated the mechanisms involved in the contractile effect of AVP in ring preparations of IMA specimens taken from 95 patients. RESULTS: Plasma AVP levels peaked after the start of cardiopulmonary bypass (CPB) and correlated well with serum osmolality (Pearson's r=0.9490; P<0.0001; n=16). An inverse correlation was observed between plasma AVP levels recorded at this stage and the maximal contraction induced in vitro by AVP in vascular rings from the same patients (Pearson's r=-0.6968; P<0.01; n=16). No change in the AVP response was produced by endothelium removal, exposure to the NO precursor (3 x 10(-4)M L-arginine), inhibition of nitric oxide (NO) synthase (3 x 10(-5) M L-NAME) or soluble guanylate cyclase (3 x 10(-6) M 1H-[1,2,4]oxadiazol [4,3,-alpha]quinoxalin-1-one (ODQ)), removal of the superoxide anion (100 U/ml superoxide dismutase (SOD) plus 1200 U/ml catalase) or hydroxyl radical (10(-4) M deferoxamine), or specific alpha1 - (10(-6) M prazosin) or endothelin (10(-5) M bosentan) receptor antagonism. In contrast, adenylate cyclase activation (3 x 10(-8) M forskolin) reduced the contractile response to AVP, while prostanoid synthesis (3 x 10(-6) M indomethacin) inhibition and blockade of Ca2+ -activated potassium channels (KCa) (10(-3) M tetraethylammonium (TEA)) enhanced AVP contraction. Age, gender and smoking also modified the AVP response. CONCLUSION: Our findings suggest a role for AVP as a modulator of vascular tone in human IMA. The effect of AVP is dependent on prostanoids and Ca2+ -activated K+ channels, so its dysfunction in pathophysiological cardiovascular processes could mean that AVP, among other factors, produces vasospasm in IMA grafts. 相似文献
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Carmen Guillén Ponce María Pilar Garrido López María José Molina Garrido Gema Muñoz Molina Alfredo Carrato 《Clinical & translational oncology》2007,9(1):53-55
Pituitary metastases of solid tumours are infrequent, specially as a first manifestation. When they happen, they are usually
due to breast or lung cancer and are asymptomatic or produce diabetes insipidus. It is very strange that they produce hormonal
deficiency.
We present a case report of a bronchogenic adenocarcinoma in a 65-year-old man which began with panhypopituitarism, diabetes
insipidus and visual alterations. Magnetic resonance imaging revealed a large sellar mass, with clivus infiltration and invading
the right cavernous sinus. The biopsy result was adenocarcinoma metastases from lung cancer. 相似文献
26.
José Ignacio Bilbao Mercedes Arias Jesús María Longo Pedro Luis Alejandre María Teresa Betés Arlette María Elizalde 《Cardiovascular and interventional radiology》1997,20(2):149-153
Percutaneous embolization of large portosystemic collaterals was performed in three patients following placement of a transjugular
intrahepatic portosystemic shunt in order to improve hepatopetal portal flow. Improved hepatic portal perfusion was achieved
in these cases, thereby theoretically reducing the risk of chronic hepatic encephalopathy. 相似文献
27.
Paclitaxel is an antineoplastic agent derived from the bark of the Pacific yew tree that has activity against many tumors including breast and ovarian carcinomas. In the past, its extravasation quality has been considered to be a local irritant; however, recent reports suggest that the agent may be a vesicant. A patient experienced a delayed vesicant reaction to a paclitaxel extravasation that resulted in severe necrosis. No acute symptoms were reported at the time of extravasation from the 24-hour peripheral paclitaxel infusion. However, on day 11 the patient complained of severe and progressive pain at the site of extravasation. The site was erythematous and had areas of central necrosis requiring debridement and closure by a plastic surgeon. Because paclitaxel possesses vesicant characteristics, health care professionals should be aware of its potential extravasation hazard. Prolonged peripheral infusions should be avoided or administered with extreme caution. 相似文献
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José Ramón Cansino Alcaide Luis Martínez-Piñeiro 《Clinical & translational oncology》2006,8(3):148-152
Summary Genes involved in cancer generation are usually tumor suppressors and oncogenes. Progressive genetic alterations in these
genes are involved in the mechanisms of tumorigenesis. In prostate cancer, additionally several chromosomal loci that should
harbor mutated genes have been proposed. Some genes have been found altered in prostate cancer, such as PTEN, TP53, AR, RNASEL
(HPC1), ELAC2 (HPC2), CDKN2A and MSR1 and those can be natural targets for new strategies of treatment. Besides, gene therapy
has been suggested to be suitable for prostate cancer treatment. This approach includesex vivo corrective therapy, suicide, and antisense therapy. 相似文献
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