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11.
Molecular system bioenergetics: regulation of substrate supply in response to heart energy demands 总被引:1,自引:0,他引:1
Valdur Saks Roland Favier Rita Guzun Uwe Schlattner Theo Wallimann 《The Journal of physiology》2006,577(3):769-777
This review re-evaluates regulatory aspects of substrate supply in heart. In aerobic heart, the preferred substrates are always free fatty acids, and workload-induced increase in their oxidation is observed at unchanged global levels of ATP, phosphocreatine and AMP. Here, we evaluate the mechanisms of regulation of substrate supply for mitochondrial respiration in muscle cells, and show that a system approach is useful also for revealing mechanisms of feedback signalling within the network of substrate oxidation and particularly for explaining the role of malonyl-CoA in regulation of fatty acid oxidation in cardiac muscle. This approach shows that a key regulator of fatty acid oxidation is the energy demand. Alterations in malonyl-CoA would not be the reason for, but rather the consequence of, the increased fatty acid oxidation at elevated workloads, when the level of acetyl-CoA decreases due to shifts in the kinetics of the Krebs cycle. This would make malonyl-CoA a feedback regulator that allows acyl-CoA entry into mitochondrial matrix space only when it is needed. Regulation of malonyl-CoA levels by AMPK does not seem to work as a master on–off switch, but rather as a modulator of fatty acid import. 相似文献
12.
Radiofrequency-ablation of unresectable primary and secondary liver tumors: results in 88 patients 总被引:5,自引:0,他引:5
Philipp Hildebrand Markus Kleemann Uwe J. Roblick Lutz Mirow Matthias Birth Thorsten Leibecke Hans-Peter Bruch 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2006,391(2):118-123
Background and aims Radiofrequency-ablation (RFA) is increasingly used for destruction of unresectable primary and secondary liver tumors. We
report our experience in the use of RFA for the management of unresectable hepatic malignancies.
Patients and methods Between February 2000 and December 2004 we have undertaken 120 RFA procedures to ablate 426 unresectable primary or metastatic
liver tumors in 88 patients. RFA was performed via laparotomy (n=68), laparoscopy (n=9) or a percutaneous approach (n=43). Primary liver cancer was treated in seven patients (8%) and metastatic liver tumors were treated in 81 patients (92%).
All patients were followed to assess complications, treatment response and recurrence of malignant disease.
Results Procedure-related complication rate was low (3.4%). During a mean follow-up of 21.2 months, 15 patients had local tumor progression
(17%), 21 patients (23,9%) had new malignant disease and 27 patients (30.7%) died from intervention-unrelated complications
of their malignant disease. Additional liver lesions were identified in 27 (35%) of 77 cases by intraoperative ultrasound.
Thirty-six patients received simultaneous resection and RFA.
Conclusion RFA is a safe, well-tolerated and effective treatment for patients with unresectable primary and secondary liver malignancies. 相似文献
13.
Using the whole-cell configuration of the patch clamp technique, calcium-activated potassium currents (IK,Ca) were investigated in ramified murine brain macrophages. In order to induce IK,Ca the intracellular concentration of nominal free Ca2+ was adjusted to 1μM. The Ca2+-activated K+ current of brain macrophages did not show any voltage dependence at test potentials between –120 and +30mV. A tenfold change
in extracellular K+ concentration shifted the reversal potential of IK,Ca by 51mV. The bee venom toxin apamin applied at concentrations of up to 1μM did not affect IK,Ca. Ca2+-activated K+ currents of ramified brain macrophages were highly sensitive to extracellularly applied charybdotoxin (CTX). The half-maximal
effective concentration of CTX was calculated to be 4.3nM. In contrast to CTX, the scorpion toxin kaliotoxin did not inhibit
IK,Ca at concentrations between 1 and 50nM. Tetraethylammonium (TEA) blocked 8.0% of IK,Ca at a concentration of 1mM, whereas 31.4% of current was blocked by 10mM TEA. Several inorganic polyvalent cations were tested
at a concentration of 2mM for their ability to block IK,Ca. La3+ reduced IK,Ca by 72.8%, whereas Cd2+ decreased IK,Ca by 17.4%; in contrast, Ni2+ did not have any effect on IK,Ca. Ba2+ applied at a concentration of 1mM reduced IK,Ca voltage-dependently at hyperpolarizing potentials.
Received: 17 January / Accepted: 5 May 1997 相似文献
14.
Andrea Bernatowicz Uwe Kdel Karl Frei Adriano Fontana Hans-walter Pfister 《Journal of neuroimmunology》1995,60(1-2):53-61
Recent studies using a rat model of pneumococcal meningitis have shown that nitric oxide synthase (NOS) inhibitors greatly attenuated microvascular changes and brain edema formation. The site of NO production during bacterial meningitis is unknown. In this study we tested whether primary astrocyte cultures from neonatal rat cortex can be induced to release NO upon stimulation with pneumococci. NO production was assessed by measuring nitrite in the cell culture supernatant using the Griess reaction. Stimulation with heat-killed unencapsulated pneumococci (HKP) increased nitrite concentrations in astrocyte culture supernatants in a dose-dependent fashion. Administration of AT-nitro-L-arginine (L-NA), aminoguanidine, L-canavanine, cycloheximide, and dexamethasone prevented the increase in nitrite concentrations. Addition of L-arginine, but not of o-arginine, partially reversed the inhibitory effect of L-NA. Administration of SOD increased nitrite accumulation. Moreover, at 72 h after stimulation with heat-killed pneumococci (107 cfu/ml) astrocytes showed an inducible NOS-like immunoreactivity. Accumulation of nitrite was also observed when rat cerebellar neurons and microglia were stimulated with HKP, whereas there was only a slight increase of nitrite in media of rat C6 glioma cells, but no increase of nitrite when the human glioblastoma cell line LN-229 was stimulated with HKP. There was a stronger increase in nitrite levels when astrocytes from Lewis rats were used compared to that from Wistar rats. In conclusion, our study indicates that astrocytes, neurons and microglia are inducible for NO production upon stimulation with pneumococci. 相似文献
15.
Uwe Lenhardt 《Zeitschrift fur Gesundheitswissenschaften》2003,11(1):18-37
Until now there is no comprehensive und standardized reporting system for worksite health promotion activities by the health insurance funds. Thus, it is still difficult to make a clear statement on the health-related effectiveness of such activities. In this article a study is presented, which tries to come closer to a sound judgement pragmatically. Documents from health promotion projects provided by four health insurance funds served as an empirical basis for the study. The information and data included in these documents were assessed by means of a point system. Ten of thirteen documents scored the minimum number of points, which had been defined as necessary to justify the assumption that the health promotion measures taken were effective with regard to back disorders. The study therefore indicates that worksite health promotion can contribute to the reduction of disorders and work disability if it complies with certain preconditions such as: systematic and cooperative planning and controlling, participation of employees, stepwise integration into the regular organizational structures and processes of the company, and combination of structural and behavioural prevention measures. 相似文献
16.
17.
Angelika Heese Ulrike Lacher Hans Uwe Koch Janna Kubosch Yasmin Ghane Klaus-Peter Peters 《Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete》1996,47(11):817-824
Zusammenfassung
Die Typ I-Allergien gegen Latex sind in den vergangenen Jahren zu einem zunehmenden berufsdermatologischen Problem geworden,
zumal mindestens 10% der Angestellten im Gesundheitswesen betroffen sind. In der Dermatologischen Klinik der Universit?t Erlangen-Nürnberg
stieg die Anzahl der j?hrlich diagnostizierten Patienten mit Latexallergien von 1989 bis 1995 auf das 12fache, wobei der Anteil
der schweren, generalisierten Formen der Erkrankung von 10,7% (1989/1990) auf 44% (1994/1995) zunahm.
Unter den m?glichen Ausl?sern der Latexallergie (wasserl?sliche Proteine mit Molekulargewichten von 2 bis 200 kD) sind mindestens
5 Hauptproteine mit bereits bekannter Prim?rstruktur zu berücksichtigen. Zus?tzlich gibt es Hinweise für Markerproteine, die
in bestimmten Risikogruppen geh?uft zur Ausl?sung spezifischer IgE-Antik?rper führen (z.B. 46 kD-Protein in medizinischen
Berufen, 14,6 kD- und 27 kD-Proteine bei Kindern mit Spina bifida). Das Vorkommen von Kreuzreaktionen zwischen Latex und unterschiedlichen
Früchten (besonders Avocado, Kiwi, Banane, E?kastanie) bei 60 bis 70% der Latexallergiker ist bei der allergologischen Abkl?rung
und Beratung dieser Patienten zu beachten. Wesentliche Aspekte der Prophylaxe umfassen die konsequente Umstellung medizinischer
Einrichtungen auf ungepuderte Latexhandschuhe mit niedrigem Proteingehalt. Eine Zusammenstellung von OP- und Untersuchungshandschuhen,
welche Angaben über die von uns ermittelten Proteinkonzentrationen (modifizierte Lowry-Methode und Hochdruck-Flüssigkeits-Chromatographie,
HPLC) enth?lt, soll ein Leitfaden bei der Auswahl allergologisch geeigneter Handschuhe sein.
Eingegangen am 10. August 1996 Angenommen am 21. August 1996 相似文献
18.
Kazuaki Fukahara Kazutomo Minami Bert Hansky Sebastian A Schulte-Eistrup Gero Tenderich Uwe Schulz Reiner Koerfer 《The Journal of heart and lung transplantation》2003,22(4):468-473
The association is well established between congenital heart disease and spinal deformities such as scoliosis or kyphosis, but data are not available for risks and the outcome of heart surgery in patients with spinal deformities. We report a case of successful orthotopic heart lung transplantation in a patient with complex congenital heart disease and severe chest deformity who had undergone previous spinal fusion surgery for progressive right convex thoracic kyphoscoliosis. 相似文献
19.
Dr. K. Hekmat Dr. A. Kröner Dr. H. Stützer Prof. Dr. R. H. G. Schwinger PD Dr. S. Kampe Prof. Dr. G. B. W. E. Bennink Prof. Dr. U. Mehlhorn 《Zeitschrift für Herz-, Thorax- und Gef??chirurgie》2004,18(6):257-267
Zusammenfassung
Einleitung:
Das Ziel dieser Studie war die Entwicklung eines spezifischen Schweregradklassifizierungssystems für die Beurteilung und Vorhersage von Organfunktionsstörungen und Überleben bei herzchirurgischen Intensivpatienten.
Methoden:
Hierzu wurden konsekutiv alle erwachsenen Patienten nach einem herzchirurgischen Eingriff unter Einsatz der Herzlungenmaschine über einen Zeitraum von 3 Jahren in die Studie aufgenommen. Im Konstruktionsset erfolgte die Auswahl der Variablen mit Hilfe der Patienten, die mindestens 24 Stunden auf der Intensivstation verbrachten. Die Ergebnisse wurden dann in zwei Validierungssets mit allen Intensivpatienten überprüft. Die Qualität des Scores wurde mit dem Hosmer-Lemeshow-Test (HL) sowie der ROC-Analyse beurteilt, und mit dem APACHE-II- und dem MODS-Score verglichen.
Ergebnisse:
Insgesamt wurden 3230 Patienten über einen Zeitraum von 3 Jahren auf unserer Intensivstation aufgenommen. Die HL-Werte für den neuen Score waren 5,8 (APACHE-II: 11,3; MODS: 9,7) für das Konstruktionsset, 7,2 (APACHE-II: 8,0; MODS: 4,5) für das Validierungsset I und 5,9 für das Validierungsset II. Die Fläche unter der ROC-Kurve war 0,91 (APACHE-II: 0,86; MODS: 0,84) für den neuen Score im Konstruktionsset, 0,88 (APACHE-II: 0,84; MODS: 0,84) in dem Validierungsset I, und 0,92 in dem Validierungsset II.
Schlussfolgerung:
Der neue CASUS (Cardiac Surgery Score) zeigt für herzchirurgische Intensivpatienten eine exzellente Kalibrierung und Diskriminierung bezüglich der 30-Tage-Letalität. Die Variablen des CASUS sind einfach, reproduzierbar und werden routinemäßig in herzchirurgischen Intensivstationen erfasst. Der CASUS könnte als Expertensystem für das Diagnostizieren von Organfunktionsstörungen, der Entscheidungsfindung, der Ressourcenauswertung und Vorhersage der Letalität für herzchirurgische Intensivpatienten dienen. 相似文献
20.
Role of angiotensin II in dynamic renal blood flow autoregulation of the conscious dog 总被引:2,自引:1,他引:1
Armin Just Heimo Ehmke† Uwe Wittmann† Hartmut R. Kirchheim¶ 《The Journal of physiology》2002,538(1):167-177
The influence of angiotensin II (ANGII) on the dynamic characteristics of renal blood flow (RBF) was studied in conscious dogs by testing the response to a step increase in renal artery pressure (RAP) after a 60 s period of pressure reduction (to 50 mmHg) and by calculating the transfer function between physiological fluctuations in RAP and RBF. During the RAP reduction, renal vascular resistance (RVR) decreased and upon rapid restoration of RAP, RVR returned to baseline with a characteristic time course: within the first 10 s, RVR rose rapidly by 40 % of the initial change (first response, myogenic response). A second rise began after 20–30 s and reached baseline after an overshoot at 40 s (second response, tubuloglomerular feedback (TGF)). Between both responses, RVR rose very slowly (plateau). The transfer function had a low gain below 0.01 Hz (high autoregulatory efficiency) and two corner frequencies at 0.026 Hz (TGF) and at 0.12 Hz (myogenic response). Inhibition of angiotensin converting enzyme (ACE) lowered baseline RVR, but not the minimum RVR at the end of the RAP reduction (autoregulation-independent RVR). Both the first and second response were reduced, but the normalised level of the plateau (balance between myogenic response, TGF and possible slower mechanisms) and the transfer gain below 0.01 Hz were not affected. Infusion of ANGII after ramipril raised baseline RVR above the control condition. The first and second response and the transfer gain at both corner frequencies were slightly augmented, but the normalised level of the plateau was not affected. It is concluded that alterations of plasma ANGII within a physiological range do not modulate the relative contribution of the myogenic response to the overall short-term autoregulation of RBF. Consequently, it appears that ANGII augments not only TGF, but also the myogenic response. 相似文献