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Atabak Najafi Mojtaba Mojtahedzadeh Keyvan Haji Ahmadi Mohammad Abdollahi Maryam Mousavi Legese Chelkeba Farhad Najmeddin Arezoo Ahmadi 《Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences》2014,22(1):57
Background
Sepsis complication is a major cause of death in multiple trauma critically ill patients. Defensin (cysteine rich anti-microbial peptides), as an important component of immune system, might play an important role in this process. There is also rising data on immunological effects of N-acetyl-cysteine (NAC), a commonly used anti-oxidant in oxidative stress conditions and glutathione (GSH) deficiencies. The aim of the present study was to evaluate the potential beneficial effects of NAC administration on multiple trauma patients with sepsis.Methods
In a prospective, randomized controlled study, 44 multiple trauma critically ill patients who were mechanically ventilated and met the criteria of sepsis and admitted to the intensive care unit (ICU) were randomized into two groups . Control group received all standard ICU therapies and NAC group received intravenous NAC 3 gr every 6 hours for 72 hours in addition to standard therapies. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, length of ICU stay, ICU mortality were recorded. Levels of serum Immunoglobulin M (IgM), Human β-Defensin 2 (HβD2) and GSH were assessed at baseline and 24, 72, 120 hours after intervention.Results
During a period of 13-month screening, 44 patients underwent randomization but 5 patients had to be excluded. 21 patients in NAC group and 18 patients in control group completed the study. For both groups the length of ICU stay, SOFA score and systemic oxygenation were similar. Mortality rate (40% vs. 22% respectively, p = 0.209) and ventilator days (Mean ± SD 19.82 ± 19.55 days vs. 13.82 ± 11.89 days respectively, p = 0.266) were slightly higher for NAC group. IgM and GSH levels were similar between two groups (p = 0.325, 0.125 respectively), HβD2 levels were higher for NAC group (at day 3).Conclusion
High dose of NAC administration not only did not improve patients’ outcome, but also raised the risk of inflammation and was associated with increased serum creatinine. 相似文献2.
Grachev ID Ramachandran TS Thomas PS Szeverenyi NM Fredrickson BE 《Journal of neural transmission (Vienna, Austria : 1996)》2003,110(3):287-312
Most studies of pain, including chronic pain, agree that depression and pain are interrelated, although the neurobiology of this relationship remains unknown. Neuroimaging studies suggest a specific role of the prefrontal brain regions in the mechanisms of mood disorders and chronic pain. The present study examines the interrelationships between regional brain N-Acetyl aspartate (NAA) levels (as identified by in vivo proton magnetic resonance spectroscopy in the right and left dorsolateral prefrontal cortex [DLPFC], orbitofrontal cortex, cingulate and thalamus), depression (as measured by the Beck Depression Inventory), and pain (as measured by short form of the McGill Pain Questionnaire) in 10 chronic back pain (CBP) patients with depression, and compared to the relationship between regional brain NAA levels and depression in 10 normal subjects (sex and age-matched). Reduction of NAA levels was demonstrated in the right DLPFC of CBP patients with depression, as compared to the normal controls (p < 0.02, two-tailed t-test). The depression levels in CBP patients were highly correlated with NAA levels in the right DLPFC (r = -0.99, p < 0.0001), and were unrelated to the other studied regional NAA in both groups, including the right DLPFC in normal subjects (p < 10(-6); comparing the difference between r values in the right DLPFC between the two groups). The pain levels in CBP patients were also associated with the right DLPFC (r = -0.62, p < 0.05), although these relationships were much weaker as compared to depression-NAA correlations (p < 0.0001; comparing the difference between r values). The interrelationships between NAA across brain regions were examined using correlation analysis, which detected different connectivity patterns between CBP patients with depression and normal subjects. These findings provide evidence for a stronger association of prefrontal NAA to depression than to pain in CBP, which may reflect the common neurobiological substrate underlying these conditions in CBP patients. Spectroscopic brain mapping of NAA, the marker of neuronal density and function, to the depression and pain measures might be used for segregation of their circuitries in the chronic pain brain. 相似文献
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Kelly A. McLaughlin Barbara A. Osborne Richard A. Goldsby 《European journal of immunology》1996,26(5):1170-1174
Signals generated by T cell receptor (TCR) cross-linking (or phorbol 12-myristate-13-acetate + Ca2+ ionophore), glucocorticoids or ionizing radiation all stimulate apoptotic cell death in thymocytes by signals that are initially distinct from each other. However, when these stimuli were administered to thymocyte cultures that were maintained under an atmosphere containing less than 20 ppm oxygen as opposed to one that contained 18.5 % molecular oxygen, cell death was inhibited or abrogated, suggesting that the induction of death by all three different stimuli depend on the presence of molecular oxygen. Studies of the effects of the cysteine analog N-acetyl cysteine (NAC) with normal thymocytes demonstrated that this antioxidant inhibited the induction of death by each of the different stimuli in a manner that paralleled anaerobiosis. Furthermore, studies with thymocytes demonstrated that the induction of nur77, a gene shown to be involved in thymocyte apoptosis signaled through the TCR or its surrogates, is not inhibited by NAC or dependent upon molecular oxygen. The possible implications for negative selection of NAC-mediated inhibition of TCR-signaled thymocyte cell death was examined in thymic organ culture. Treatment of these cultures with NAC provided significant protection against staphylococcal enterotoxin B-mediated deletion of Vβ8-expressing thymocytes. 相似文献
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羧甲基壳聚糖、盐酸氨基葡萄糖及N-乙酰氨基葡萄糖对大鼠胰岛细胞生长及胰岛素分泌量的影响 总被引:1,自引:0,他引:1
通过胶原酶消化法获得大鼠胰岛单层细胞 ,并用转板以及碘乙酸处理的方法除去其中的成纤维细胞 ,得到比较纯的胰岛内分泌细胞 ,以此为材料研究了羧甲基壳聚糖、盐酸氨基葡萄糖、N 乙酰氨基葡萄糖对大鼠胰岛细胞生长和胰岛素释放的影响。实验结果表明 ,羧甲基壳聚糖、盐酸氨基葡萄糖、N 乙酰氨基葡萄糖均能够促进大鼠胰岛细胞的生长。采用放射免疫法测定培养的胰岛细胞分泌胰岛素含量 ,结果表明 ,羧甲基壳聚糖具有刺激大鼠胰岛细胞胰岛素释放的作用。 相似文献
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Hiroaki Kakinuma Akira Ohtake Namiko Ogura Masaki Takayanagi Hironori Nakajima Tadashi Nishioka Yoko Matsuura Yutaka Takeuchi Katsumi Asanuma 《Pediatrics international》1984,26(1):16-19
A female infant, who showed hyperammonemia in the neonatal period, died on 43rd postnatal day. Her female sibling also died on 42nd day after birth with an identical clinical picture and hyperammonemia. Urinary organic acids were negative in both cases. Their blood amino acids showed no specific pattern, and urinary orotic acid excretion was normal. The first two urea cycle enzymes and N-acetyl L-glutamate synthetase of the liver tissues of these two infants obtained at autopsy were assayed. They revealed a selective deficiency of carbamyl phosphate synthetase I. 相似文献
8.
Magnetic resonance spectroscopy of brain in epilepsy 总被引:12,自引:0,他引:12
The current applications of magnetic resonance spectroscopy (MRS) in the clinical management of epileptic patients are reviewed.
A major contribution of MRS to epilepsy is its ability to determine lateralisation before surgical resection of the diseased
brain region. Phosphorus-31 and proton single-voxel MRS identify abnormalities in high-energy metabolism, neuronal function
and neurotransmitter levels, but information can only be obtained from restricted regions of the brain. Spectroscopic imaging
techniques (also known as chemical shift imaging) provide a metabolic mapping of the whole brain. They expand the range of
applications of MRS to other types of epilepsy (neocortical, frontal) than temporal lobe epilepsy, which is the most often
studied. Also, spectral editing techniques in proton MRS make it possible to detect and monitor drug-induced variations of
GABA in the human brain, opening new insights into patient response to drug therapy of epilepsy. MRS is playing an increasing
role in the noninvasive characterisation and management of epileptic patients.
Received: 1 December 1999 相似文献
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Roberto Ferreira Meirelles Junior M��rcia Saldanha Kubrusly Marta Bellodi-Privato Nilza Aparecida Trindade Molan Marcel Cerqueira Cesar Machado Luis Augusto Carneiro D��Albuquerque 《Clinics (S?o Paulo, Brazil)》2010,65(3):311-316