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排序方式: 共有4922条查询结果,搜索用时 15 毫秒
1.
Yosuke Homma Takashi Shiga Hiraku Funakoshi Dai Miyazaki Atsushi Sakurai Yoshio Tahara Ken Nagao Naohiro Yonemoto Arino Yaguchi Naoto Morimura 《The American journal of emergency medicine》2019,37(2):241-248
Objective
This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.Methods
This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine. The primary result included 1-month favorable neurological outcomes defined as cerebral performance category (CPC) 1 or 2. Secondary results included 1-month survival and return of spontaneous circulation (ROSC) after arrival at the hospital. Multivariable logistic regression analysis determined the association between delay per minute of the time from call to first EA in both pre- or in-hospital settings and outcomes.Results
Of the 16,452 patients, 9344 were eligible for our analyses. In univariable analysis, the delay in EA was associated with decreased favorable neurological outcomes only when the initial rhythm was a non-shockable rhythm. In multivariable analyses, delay in EA was associated with decreased ROSC (adjusted odds ratio [OR] for one minute delay, 0.97; 95% confidence interval [CI], 0.96–0.98) and 1-month survival (adjusted OR, 0.95; 95% CI, 0.92–0.97) when the initial rhythm was a non-shockable rhythm, whereas during a shockable rhythm, delay in EA was not associated with decreased ROSC and 1-month survival.Conclusions
While assessing the effectiveness of epinephrine for OHCA, we should consider the time-limited effects of epinephrine. Additionally, consideration of early EA based on the pathophysiology is needed. 相似文献2.
Eitaro Ito Akihiro Takai Yoshinori Imai Hiromi Otani Yoshihiro Onishi Yosuke Yamamoto Kohei Ogawa Taiji Tohyama Shunichi Fukuhara Yasutsugu Takada 《Surgery》2019,165(2):353-359
Background
Controversy continues as to whether single-incision laparoscopic cholecystectomy, with the somewhat larger incision at the umbilicus, may lead to a worse postoperative quality of life and more pain compared with the more classic 4-port laparoscopic cholecystectomy. The aim of this study was to compare single-incision and 4-port laparoscopic cholecystectomy from the perspective of quality of life.Methods
This study was a multicenter, parallel-group, open-label, randomized clinical trial. A total of 120 patients who were scheduled to undergo elective cholecystectomy were randomly assigned 1:1 into the single-incision laparoscopic cholecystectomy or the 4-port laparoscopic cholecystectomy group and then assessed continuously for 2 weeks during the postoperative period. The primary outcome was quality of life, defined as the time to resume normal daily activities. Postoperative pain was also assessed. To explore the heterogeneity of treatment effects, we assessed the interactions of sex, age, and working status on recovery time.Results
A total of 58 patients in the single-incision group and 53 in the 4-port group (n?=?111, 47 male, mean age 57 years) were analyzed. The mean time to resume daily activities was 10.2 days and 8.8 days, respectively, for single-incision and 4-port laparoscopic cholecystectomy (95% confidence interval –0.4 to 3.2, P?=?.12). Similarly, the time to relief from postoperative pain did not differ significantly between the groups. Statistically insignificant but qualitative interactions were noted; in the subgroups of women, full-time workers, and patients younger than 60 years, recovery tended to be slower after single-incision laparoscopic cholecystectomy.Conclusion
Postoperative quality of life did not differ substantially between single-incision laparoscopic cholecystectomy and 4-port laparoscopic cholecystectomy. Patients younger than 60 years, women, and full-time workers tended to have a somewhat slower recovery after single-incision laparoscopic cholecystectomy. 相似文献3.
4.
Masahiro Miyashita Junko Otsuki Yosuke Hanai Yoshiaki Nakagawa Hisashi Miyagawa 《Toxicon》2007,50(3):428-437
Scorpion venoms are composed of a number of neurotoxic peptides. A variety of toxins have been isolated from the venoms of scorpions of the family Buthidae, however, little interest has been paid to non-Buthidae scorpions. In this study, we examined the toxicity of the venom of Liocheles australasiae (Hemiscorpiidae) to mice and crickets, and characterized the peptide components by HPLC and mass spectrometry. Over 200 components were detected in the L. australasiae venom by LC/MS analysis, with components of molecular masses ranging from 500 to 5000 Da being particularly abundant. A number of peptides contained two to four disulfide bridges, which was estimated based on the mass difference after derivatization of Cys residues. A peptide having a monoisotopic molecular mass of 7781.6 Da and four disulfide bridges was isolated from the venom. The peptide has a primary structure similar in terms of the position of eight Cys residues to those observed in several peptides found from scorpions, ticks and insects, although biological roles of these peptides are unknown. 相似文献
5.
6.
T. Nishikawa H. Kuwahara A. Tsuda M. Tanaka I. Koga Y. Uchida 《Human psychopharmacology》1990,5(4):363-368
Ceruletide, a potent analogue of cholecystokinin, was administered by injection to eight schizophrenics treated with neuroleptics. We examined the dose–response effect on microvibration (MV) recorded from the chin of these patients. After 15 min of bed rest, MV was recorded for 5 min as a control recording. Subsequently, saline or ceruletide, at a dose of either 0.4 m?g/kg or at 0.8 m?g/kg, was injected according to a Latin square design with an interval of 4 weeks for washing out the drug effect and MV was recorded for 30 min. MV data obtained were subjected to the fast Fourier transform and an average power spectrum was computed. A three-way analysis of variance for these data was performed upon dose-effect, time-effect after treatment, and band-effect of the average power spectrum. The present results were similar to previous findings which had revealed effects of ceruletide on tardive dyskinesia symptoms, namely, the effects of ceruletide on MV were different according to the subjects (three cases: facilitation followed by inhibition, three cases: inhibition, two cases: no effects). The dose-response curve of ceruletide appears to be linear in some cases and an inverted U-shape in other cases. Present findings showed small doses of systemically administered ceruletide would modify muscle tonus of schizophrenics under chronic treatment of neuroleptics, and provided further reason for the therapeutic drug of tardive dyskinesia. 相似文献
7.
Neutrophil Oxygen Radical Production by Dialysis Membranes 总被引:1,自引:0,他引:1
The ability of different dialysis membranes to activate polymorphonuclearneutrophil oxygen radical production was investigated with chemiluminescence.All the six membranes, namely cuprophan, cellulose acetate,polycarbonate, polysulphone, polyacrilonitrile and polymethylmethacrylatewere able to interact with neutrophils and stimulate their oxygenradical production, the highest responses being seen with polyacrilonitrile,polymethylmethacrylate and polycarbonate. To analyse the roleof complement in this interaction, fresh plasma, heat inactivatedand zymosan-activated plasma were added: with fresh plasma oxygenradical production was stimulated on cuprophan, cellulose acetateand polysulphone, not modified on polycarbonate, and decreasedon polyacrilonitrile and polymethylmethacrylate. With heat-inactivatedplasma, the responses were decreased or abrogated on all themembranes except polycarbonate and polymethylmethacrylate, whereaswith zymosanactivated plasma similar responses to fresh plasmawere observed. In addition, when plasma was used to precoatthe membrane, cuprophan, cellulose acetate and polysulphonedisclosed an enhanced neutrophil oxidative burst, while precoatedpolyacrilonitrile and polymethylmethacrylate were less stimulatorythan uncoated membranes. In contrast the precoating of polycarbonatedid not modify oxygen radical production. These data suggestthat neutrophil activation occurs by direct membrane neutrophilinteraction. Plasmatic factors modulate this interaction butcomplement seems involved on cellulosic and polysulphone membranesonly. Therefore, it appears that oxygen radicals produced fromcontact of neutrophils with the dialysis membrane might playan initial and/or additional role in the events occurring atthe initiation of haemodialysis. 相似文献
8.
Hisashi Kai Takahiro Mori Keisuke Tokuda Narimasa Takayama Nobuhiro Tahara Kiyoko Takemiya Hiroshi Kudo Yusuke Sugi Daisuke Fukui Hideo Yasukawa Fumitaka Kuwahara Tsutomu Imaizumi 《Hypertension research》2006,29(9):711-718
Oxidative stress is implicated in the pathogenesis of various cardiovascular diseases. We have shown that in Wistar rats with a suprarenal aortic constriction (AC), pressure overload-induced transient perivascular inflammation (monocyte chemoattractant protein-1 [MCP-1] induction and macrophage accumulation) in the early phase is the determinant of reactive myocardial fibrosis and resultant diastolic dysfunction in the late phase. Thus, we investigated the role of reactive oxygen species production in cardiac remodeling in AC rats. Superoxide production and the footprint of lipid peroxidation were assessed using dihydroethidium staining and immunohistostaining against 4-hydroxy-2-nonenal (4-HNE), respectively. In sham rats, dihydroethidium and 4-HNE signals were scarcely found in the heart. At day 3, AC rats showed dihydroethidium signals mainly in the intramyocardial arterial wall, whereas modest 4-HNE staining was observed diffusely in the myocardium. These signals declined to lower levels by day 14 despite sustained hypertension. Chronic administration of a subdepressor dose of an angiotensin II type 1 receptor blocker candesartan reduced the pressure overload-induced dihydroethidium and 4-HNE signals at day 3. Moreover, candesartan decreased MCP-1 induction and macrophage infiltration at day 3 and prevented myocardial fibrosis at day 14, without affecting left ventricle and myocyte hypertrophy. In conclusion, acute pressure overload induced self-limited superoxide production mainly in the vascular wall. The reactive oxygen species production would contribute to the perivascular inflammation and subsequent myocardial fibrosis. Angiotensin II was suggested to have a pressure-independent effect on the reactive oxygen species production. 相似文献
9.
The study of the autopsies of six patients with progressive esophageal cancer to investigate complications caused by esophageal stents] 总被引:2,自引:0,他引:2
Yuya Nakamura Masaho Ota Yosuke Izumi Nobuaki Funada 《Nihon Shokakibyo Gakkai zasshi》2006,103(7):812-818
Endoscopic placement of metal stents are used widely for patients with esophageal obstruction and fistula due to progressive esophageal cancer, but cause high rate of severe complications associated with the immediate causes of death. To determine severe complications caused by stents, we studied clinical data and autopsy of six patients who had been treated with stents for inoperable progressive esophageal cancer. Occording to the clinical records only two patients had severe complications due to stents. But at autopsy, three patients had massive hemorrhage in the stent placement, one patient had mediastinitis, and one patient were in imminent danger of perforation whose stent had been incorporated into the adventitia of the wall. More severe complications were revealed than those expected clinically. Endoscopic placement of metal stents have a great deal for the improvement of quality of life. But we should carefully decide the indication because endoscopic placement of metal stents could cause severe complications associated with the immediate causes of death. 相似文献
10.
Kunihiro Ichinose Mitsuru Nakamura Kenji Takezawa Ichiro Masutomi Yoichi Shima Yoko Hirayama Kahoko Sorimachi Teruhiko Shimizu Hiroyo Ishikawa Namiko Kaji Sayaka Nakajima Michiko Wataru Shiho Nishigaki Hiroshi Suwa Yosuke Toyama Masaki Okumura Yoshikazu Ishitsuka Ken Shimizu Kazuya Kokubo Kenji Sasaki Shodai Saito 《Seishin shinkeigaku zasshi》2006,108(9):945-954