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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3.
Yosiaki Yajima Nobutaka Takahashi Atsusi Miyazaki Ryosuke Kikuchi Keisuke Kakisaka Keisuke Oikawa Kazuhiko Sugawara Yoshiki Eda Hiroshi Naganuma Masamitsu Unagami 《Nihon Shokakibyo Gakkai zasshi》2006,103(5):515-522
From April 1989 to December 2004, we performed liver biopsy on 475 patients and obtained biopsy proven 35 cases of non-alcoholic fatty liver. Among them, 18 cases were diagnosed as non-alcoholic steatohepatitis (NASH). During the last three years, we have tried to detect NASH using ultrasonography and elevated value of serum ferritin (> 300 ng/ml). All of the eligible 7 cases biopsied during the course were diagnosed as NASH. In these 7 cases, ALT levels improved after the body weight loss accompanied by the parallel decrease of serum ferritin levels. Measurement of serum ferritin is useful in the detection of NASH but the normal value of ferritin cannot rule out the possibility of NASH. 相似文献
4.
5.
Effects of halothane on spinal dorsal horn WDR(wide dynamic range) neuronal activity in cats 总被引:1,自引:0,他引:1
H Nagasaka S Nakamura T Genda T Miyazaki K Aikawa N Matsumoto I Matsumoto T Hori I Sato 《Masui. The Japanese journal of anesthesiology》1991,40(7):1096-1101
The effects of halothane (0.2%, 0.5%, and 1.0%) on the spinal dorsal horn wide dynamic range (WDR) neuronal activity was studied in either spinal cord intact or spinal transected cats. Extracellular activity was recorded in the dorsal horn from single WDR neurons responding to noxious and non-noxious stimuli applied to the cutaneous receptive fields on the left hind foot pads of intact or decerebrate, spinal cord transected (L 1-2) cats. When 10 micrograms of bradykinin was injected into the femoral artery ipsilateral to the recording site as the noxious test stimulus in the spinal cat, all of 7 WDR neurons gave excitatory responses which were not depressed by 0.2% and 0.5% halothane but were depressed significantly by 1.0%. On the other hand, when the injection of 10 micrograms of bradykinin into the femoral artery ipsilateral to the recording site was used in the intact cat, 7 of 14 WDR neurons (50%) gave excitatory responses, which were not depressed by 0.2% halothane but were significantly depressed by 0.5% and 1.0% halothane, and 7 of 14 WDR neurons (50%) gave inhibitory responses, which were significantly depressed by 0.2%, 0.5%, and 1.0% halothane. We have found that halothane reduces the excitation as well as the inhibition of dorsal horn WDR neuronal activity induced by bradykinin injection. 相似文献
6.
Y Imamura K Yanagihara Y Fukuda Y Kaneko M Seki K Izumikawa Y Miyazaki Y Hirakata T Sawa J P Wiener-Kronish S Kohno 《The European respiratory journal》2007,29(5):965-968
Pseudomonas aeruginosa is one of the most important pathogens in patients with chronic airway conditions, such as cystic fibrosis and diffuse panbronchiolitis. Type III secretion system-mediated virulence factors contribute to the lung damage in chronic P. aeruginosa infection. The effects of the anti-PcrV immunoglobulin (Ig)G, which blocks the type III secretion system, were evaluated in a mouse model of chronic P. aeruginosa infection. On bacteriological examination, anti-PcrV IgG showed no bactericidal effects. On bronchoalveolar lavage fluid (BALF) analysis, total cell number and neutrophil ratios in the anti-PcrV IgG-treated groups were lower than those in the control group. In addition, macrophage inflammatory protein-2, tumour necrosis factor-alpha, and interleukin-beta concentrations in BALF were lower in the anti-PcrV IgG-treated groups when compared with controls. Plasma anti-PcrV IgG titre was elevated after administration of anti-PcrV IgG. Although plasma titre decreased gradually, a significant concentration was maintained during the experimental period. These data suggest that anti-PcrV immunoglobulin G reduces the inflammatory reaction caused by chronic Pseudomonas aeruginosa respiratory infection and may be useful in treating respiratory diseases. 相似文献
7.
Tadamasa Miyauchi Hiroshi Takiya Toshihiko Sawamura Eiji Murakami 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(4):206-209
Pericardial abscess is rare in healthy individuals, especially the amebic type. We report a case of pericardial abscess and
cardiac tamponade due to intrapericardial rupture of an amebic liver abscess. A 31-year old Japanese male complained of fever
to a local hospital. A liver mass was discovered in his left hepatic lobe by an abdominal echogram. He was referred to the
internal department of our hospital and was treated with quinolone antibiotics. Two weeks after medication, he suddenly complained
of epigastralgia and severe orthopnea and was admitted. Abdominal computed tomographic scan showed an enlarged liver mass,
and massive pericardial effusion suggested cardiac tamponade. He underwent an emergency subxiphoid partial pericardiectomy
under local anesthesia. 1,000 ml of light brownish fluid was removed and his condition improved. Although no ameba was cultivated
from the pus, the amebic serological test was positive. Metronidazole was administered and the patients was discharged 31
days after surgery. 相似文献
8.
We report a rare case of advanced renal cell carcinoma in apatient who showed complete resolution of metastases to thelung and bones after nephrectomy, partial jejunectomy and subsequentalpha-interferon therapy. The patient was a 54-year-old manwhose right lung and left femur metastases were detected beforenephrectomy. In the seventh week after nephrectomy, a partialjejunectomy was carried out because of the obstructive ileuscaused by intraluminal multiple metastases of the jejunum. Apathological fracture of the metastasized right humerus occurredsubsequently. After four months of intramuscular alpha-interferonadministration (3x106 units/day), however, x-rays revealed thecomplete disappearance of the metastatic lung shadow and a solidunion of the humerus, and there were no tumor cells in the femurspecimen resected at the subsequent reconstruction surgery ofthe left leg. Seven years have passed from onset, and the patientis still alive and disease free. 相似文献
9.
Immunohistochemical detection of imidazolone, a novel advanced glycation end product, in kidneys and aortas of diabetic patients. 总被引:11,自引:0,他引:11 下载免费PDF全文
T Niwa T Katsuzaki S Miyazaki T Miyazaki Y Ishizaki F Hayase N Tatemichi Y Takei 《The Journal of clinical investigation》1997,99(6):1272-1280
To investigate the role of the Maillard reaction in the pathogenesis of diabetic complications, we produced several clones of monoclonal antibodies against advanced glycation end products (AGEs) by immunizing mice with AGE-modified keyhole limpet hemocyanin, and found that one clone (AG-1) of the anti-AGE antibodies reacted specifically with imidazolones A and B, novel AGEs. Thus, the imidazolones, which are the reaction products of the guanidino group of arginine with 3-deoxyglucosone (3-DG), a reactive intermediate of the Maillard reaction, were found to be common epitopes of AGE-modified proteins produced in vitro. We determined the erythrocyte levels of imidazolone in diabetic patients using ELISA with the monoclonal anti-imidazolone antibody. The imidazolone levels in the erythrocytes of diabetic patients were found to be significantly increased as compared with those of healthy subjects. Then we studied the localization of imidazolone in the kidneys and aortas obtained from diabetic patients by immunohistochemistry using the antibody. Specific imidazolone immunoreactivity was detected in nodular lesions and expanded mesangial matrix of glomeruli, and renal arteries in an advanced stage of diabetic nephropathy, as well as in atherosclerotic lesions of aortas. This study first demonstrates the localization of imidazolone in the characteristic lesions of diabetic nephropathy and atherosclerosis. These results, taken together with a recent demonstration of increased serum 3-DG levels in diabetes, strongly suggest that imidazolone produced by 3-DG may contribute to the progression of long-term diabetic complications such as nephropathy and atherosclerosis. 相似文献
10.
Eiji Takeuchi Yuji Nimura Shin-ichi Mizuno Hideaki Suzuki Shinsuke Iyomasa Masaki Terasaki Hiroshi Kuriki Keiko Tamiya-Koizumi Shonen Yoshida 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):254-262
Hepatocyte regeneration has been widely investigated, with the mitotic index and the incorporation of [3H]thymidine being used as regeneration markers. We focused on the induction of DNA replication enzymes, particularly DNA polymerases
(pol) α, δ, and ε. Using rat models, we have shown that the activity of pol α in crude liver extract well represents the regenerating
capacity of hepatocytes. Using pol α as an indicator, we analyzed liver regeneration in rat models under various conditions:
obstructive jaundice, external or internal biliary drainage, and the obstruction of portal vein branches. It has been revealed
that the ligation of the common bile duct alone induces a certain amount of hepatocyte proliferation. It was striking that
external biliary drainage suppressed regeneration capacity in cholestatic rat liver after partial hepatectomy. The strong
regeneration in nonligated lobes induced by portal branch ligation was similar to the liver regeneration seen after partial
hepatectomy with respect to the induction of DNA polymerases. Taken together, the aspects of DNA replication, particularly
the induction of DNA polymerases, may contribute to shedding new light on the regeneration of human liver.
This work was supported in part by a Grant-in-Aid for General Scientific Research and for Cancer Research from the Ministry
of Education, Science and Culture, Japan, and by grants from the Uehara Memorial Foundation 相似文献