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Earlier biomarkers in fish evidencing stress responses to metal and organic pollution along the Doce River Basin. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 329:121720. [PMID: 37105459 DOI: 10.1016/j.envpol.2023.121720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023]
Abstract
The Doce River Basin (DRB) represents a well-described watershed in terms of contamination by metals, especially after a major environmental disaster of a mining tailing dam failure. Despite the massive mortality of the ichthyofauna, very few studies addressed the risks to the health of wild fish exposed to complex mixtures of pollutants from multiple sources. The present study proposed to investigate earlier responses of fish for assessing the impacts of multiple sources of pollution, considering: different niches of fish and target organs; and the influence of seasonality, associated with their probable sources of pollution. To achieve that, fish were collected along the DRB, and biomarkers responses were assessed in target organs and correlated with the levels of inorganic and organic contaminants. As one of the most prominent responses, fishes from the Upper DRB showed the highest expression of the metallothionein and oxidative stress parameters which were related to the higher levels of metals in this region due to the proximity of mining activities. On the other hand, higher levels of DNA damage and increased AChE activity from fish sampled in the Mid and Lower DRB were more associated with organic contaminants, from other sources of pollution than mining residues. The integrated biomarker responses also revealed seasonal variations, with higher values in fishes from the dry season, and pelagic fish showing greater variation within the seasons. The multivariate analysis integrating suitable biomarkers with chemical data represented an adequate strategy for assessing the ecological risks in the DRB, allowing the identification of distinct spatio-temporal impacts from multiple sources of contaminants. The continued exposure of the ichthyofauna representing future risks reinforces the need for ecological restoration and the protection of the fauna from the Doce River.
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Lambert-Eaton Myasthenic Syndrome Recurrence Induced by Pembrolizumab in a Patient with Non-small-cell Lung Cancer. Intern Med 2023; 62:1055-1058. [PMID: 36047125 PMCID: PMC10125817 DOI: 10.2169/internalmedicine.0072-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 73-year-old woman in complete remission from localized small-cell lung cancer associated with Lambert-Eaton myasthenic syndrome (LEMS) 22 years earlier was referred to our hospital and diagnosed with non-small-cell lung cancer. After three courses of pembrolizumab, an immune checkpoint inhibitor, the patient complained of muscle weakness, fatigue, ptosis, and dysarthria. The anti-voltage-gated calcium channel antibody level was elevated, and waxing was observed on a high-frequency repetitive stimulation test using an electromyogram. We diagnosed her with recurrence of LEMS as an immune-related adverse event (irAE) induced by pembrolizumab. After intravenous immunoglobulin therapy, the patient's symptoms improved, and she was discharged.
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Acute eosinophilic pneumonia caused by nicotine‐free vaping in an adolescent patient: A case report. Respirol Case Rep 2022; 10:e0961. [PMID: 35592268 PMCID: PMC9105137 DOI: 10.1002/rcr2.961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
An 18‐year‐old man was admitted to our hospital with pneumonia 4 days after he initiated vaping. The patient did not show improvement after ceftriaxone and azithromycin treatment. The cell count of the bronchoalveolar lavage fluid (BALF) revealed 64% eosinophils and 18% lymphocytes. Based on the BALF findings, the patient met the current diagnostic criteria and was diagnosed with vaping‐induced acute eosinophilic pneumonia (AEP). AEP caused by nicotine‐free vaping is rare in Japan. Thus, in cases of AEP, the patient's history of cigarette smoking as well as vaping should be considered.
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Thrombotic Microangiopathy Associated with Gemcitabine in Non-Small Cell Lung Cancer: A Case Report. Case Rep Oncol 2021; 14:1712-1718. [PMID: 35082630 PMCID: PMC8740084 DOI: 10.1159/000520484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
A 69-year-old man with refractory lung adenocarcinoma was treated with gemcitabine and vinorelbine. Dyspnea and hypertension developed after the 17th cycle of chemotherapy. Laboratory findings revealed intravascular hemolysis and renal dysfunction. Thrombotic microangiopathy (TMA) was confirmed by renal biopsy. Antihypertensive and steroid therapies were ineffective. After plasmapheresis, intravascular hemolysis and renal dysfunction gradually improved. However, the disease progressed, and he died 6 months after TMA diagnosis. Autopsy revealed similar pathological findings to those of the renal biopsy. It is important to discontinue gemcitabine at the onset of TMA and consider TMA when using gemcitabine for long periods.
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End-tidal capnographic monitoring during flexible bronchoscopy under fentanyl and midazolam sedation. ANNALS OF PALLIATIVE MEDICINE 2021; 10:8665-8671. [PMID: 34379981 DOI: 10.21037/apm-21-1009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/14/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Bronchoscopic examination including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is well established for lung cancer diagnosis and staging. Sedation using fentanyl and midazolam is recommended during bronchoscopic examinations. Meanwhile, inadvertent oversedation is a clinical problem. The objective of this research was to estimate the frequency of apnea episodes by endtidal capnography under fentanyl and midazolam sedation during bronchoscopy. METHODS Eighty-five patients were enrolled retrospectively between August 2017 and March 2018 at Okayama Medical Center. Apnea was defined as the cessation of airflow for more than 10 seconds. We reviewed medical records, including capnographic data, by cap-ONE YG-227T (NIHON KOHDEN, Tokyo, Japan) during flexible bronchoscopy under fentanyl and midazolam sedation. RESULTS Patients received 49.4±20.6 µg of fentanyl [mean ± standard deviation (SD)] and 4.35±2.0 mg of midazolam (mean ± SD). The patients included 52 males and 33 females; the median age was 71 (range, 31-88) years were enrolled. Apnea episodes were recorded (median duration 18 seconds) in 85 patients (100%). Prolonged apnea episodes with more than 30 seconds occurred in 56 patients (65.8%). Furthermore, the median time was 32 (range, 5-102) seconds whose delay between the onset of an apnea episode and decline in the SpO2 level of ≥4% from baseline. CONCLUSIONS End-tidal capnography, cap-ONE YG-227T was effective for detecting the occurrence of apnea in patients undergoing a bronchoscopic examination under fentanyl and midazolam sedation. Monitoring might be useful for preventing inadvertent oversedation.
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Reply to "Benralizumab as a First-line Treatment for ABPA: Is It Really Indicated?". Intern Med 2021; 60:2521. [PMID: 33583909 PMCID: PMC8381187 DOI: 10.2169/internalmedicine.6952-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Optic Perineuritis Associated with Nivolumab Treatment for Non-Small Cell Lung Cancer. Case Rep Oncol 2021; 14:792-796. [PMID: 34248541 PMCID: PMC8255753 DOI: 10.1159/000516275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022] Open
Abstract
We report the case of a 54-year-old man who was treated with nivolumab for recurrent squamous cell lung cancer. After 7 cycles of nivolumab treatment, the patient presented to our hospital with right eye vision loss. Gadolinium-enhanced magnetic resonance imaging of the brain showed enhancement around the optic nerve sheath. This finding and his symptoms led to the diagnosis of optic perineuritis (OPN). Steroid pulse therapy was administered twice although there was no remarkable improvement in his visual field defect. The relationship between OPN and nivolumab is unclear. However, immune-related adverse events caused by immune checkpoint inhibitors should be considered.
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Successful Treatment with Benralizumab for Allergic Bronchopulmonary Aspergillosis That Developed after Disastrous Heavy Rainfall in Western Japan. Intern Med 2021; 60:1443-1450. [PMID: 33191330 PMCID: PMC8170259 DOI: 10.2169/internalmedicine.6217-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We herein report a 56-year-old woman who developed allergic bronchopulmonary aspergillosis (ABPA) possibly due to fungal exposure after disastrous heavy rainfall in Western Japan in 2018. She was diagnosed with ABPA complicated with asthma, increased peripheral blood eosinophil count, elevation of specific immunoglobulin E for Aspergillus fumigatus, positive Aspergillus fumigatus precipitation antibody reaction test results, and notable chest computed tomography findings. After treatment with benralizumab, her symptoms, peripheral blood eosinophil count, radiological findings, and respiratory function dramatically improved. The administration of benralizumab appears to be an effective treatment strategy for ABPA.
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Comparison of effects of air pollution on children between urban and rural area in west Bengal, India. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Air pollution is a serious problem in India. According to World Bank's data in 2015, about 660 million people were categorized as poor (US$3.20 per day per capita) in India and the proportion to total the population was 50.4 %. Even though the number and proportion are large, the effects on the poor people have not been studied very well. We measured the effects of air pollution on children of the poor and compared between urban and rural area in West Bengal, India.
Methods
24 male students (12.5 ± 0.8 years) in urban area (Kolkata) and 20 male students (12.5 ± 0.5 years) in rural area (Jata) were recruited. We measured fractional exhaled nitric oxide (FeNO), which was index of airway inflammation and checked allergic symptoms. The survey was conducted in January (dry season) and August (rainy season) 2019 to confirm a seasonal difference. Air quality index (AQI) in each area was used for index of air pollution.
Results
Average AQI was 335 (Kolkata) and 155 (Haldia: near Jata) for 2 months from December 2018 to January 2019, while average AQI was 51 (Kolkata) and 38 (Haldia) for 2 months from July to August 2019. As for FeNO in dry season, the value in Kolkata was 24.9 ± 16.1 and the value in Jata was 11.7 ± 3.5. As for FeNO in rainy season, the value in Kolkata was 22.3 ± 17.5 and the value in Jata was 16.8 ± 6.7. The value of FeNO in Kolkata was higher than Jata in either season. Although a seasonal difference was not detected in Kolkata, the value in dry season was lower than in rainy season in Jata. The prevalence of allergic symptoms in dry season was higher than in rainy season in Kolkata. On the other hand, there was no difference in the prevalence between dry and rainy season in Jata.
Conclusions
Even though AQI and the prevalence of allergic symptoms decreased, the value of FeNO did not decrease in Kolkata. Because AQI decreased, indoor air pollution might have influenced on airway. It is supposed that prevention of indoor air pollution is important.
Key messages
Airway of children in urban area may be influenced on by air pollution more than in rural area. Indoor air pollution may influence on children of the poor more than outdoor air pollution.
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P6159The efficacy of heart rate reduction with bisoprolol transdermal patch prior to coronary computed tomography angiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Oral or intravenous beta-blockers have commonly been used to control the heart rate (HR) prior to coronary computed tomography angiography (CCTA). However, the administration after arrival at the hospital was time-consuming, and could not achieve the target heart rate in several cases. Moreover, the efficacy of transdermal beta blockers in HR control for patients who underwent CCTA have not been fully reported.
Purpose
The purpose of this study was to clarify the usefulness of the bisoprolol patch prior to the arrival at the hospital in HR control for patients who underwent CCTA.
Methods
A total of 282 consecutive patients (160 male, age 64±12 years) who underwent CCTA were included in this study. The bisoprolol transdermal patch (8mg) was administered before arrival at the hospital in 191 patients (beta group), and no additional medication was administered in 91 patients (control group). Intravenous landiolol hydrochloride was administered when HR remained over 65 bpm on arrival at the hospital. The HR on arrival, during and after CCTA was evaluated.
Results
The baseline HR was significantly higher in the beta group (80±15 vs. 72±15, P<0.0001). However, the achievement rate of HR ≤65 bpm on arrival was significantly higher in the beta group (56.5% vs. 44.0%, P=0.047). Thus, additional treatment with intravenous landiolol hydrochloride was administered to 43.5% of the patients in the beta group and 56.0% of those in the control group. There were no significant differences in the HR during and after CCTA between the 2 groups. Multivariate analysis revealed that the use of bisoprolol transdermal patch (OR, 3.54; 95% CI 1.67–7.51, P=0.001) and the baseline HR (OR, 0.91; 95% CI 0.89–0.94, P<0.0001) were significant predictors of the achievement rate of HR ≤65 bpm on arrival. There were no serious adverse effects throughout CCTA in all patients.
Conclusions
The administration of bisoprolol transdermal patch before arrival at the hospital was useful for HR control and reduced the rate of additional intravenous treatment in patients who underwent CCTA.
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EP-1444 Clinical results of proton beam therapy for unresectable intrahepatic cholangiocarcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abnormal Histograms of Platelets and Spuriously Normalizing Platelet Counts by Sysmex Cell Counters in Hemolytic Uremic Syndrome due to Escherichia coli 0157:H7 Infection. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1656144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Nafamostat mesilate (FUT-175) is a strong protease inhibitor and is used as an anticoagulant in extracorporeal circulation. In the present study, we administered FUT and dipyridamole as anticoagulants during donor plasmapheresis, and the additional effect of dipyridamole was examined. In dogs weighing about 15 Kg, donor plasmapheresis was performed using a cellulose triacetate membrane plasmaseparator (PEX-15, Nipro), and 300 ml of filtrated plasma was obtained within 30 minutes. These dogs were divided into two groups, 50 mg/h of FUT alone was infused (group A, n=10), and the same dose of FUT and 25 mg/h of dipyridamole were infused (group B, n=5) during plasmapheresis. Changes of the coagulation system, blood cell counts and complement system were investigated. In clinical cases, an artificial liver support therapy using FUT as an anticoagulant was performed on 8 patients with acute liver failure, and blood compatibility was examined. In dogs, RBC counts and hematocrits were almost stable, but WBC counts were decreased to about 70% of the previous value. Platelets counts were about 60% and 80% of the previous value, in group A and group B, respectively, at the end of the plasmapheresis (P<0.01). Clotting factor VIII was diminished to about 20% and 35% of the previous value in group A and B, respectively. In clinical cases, all patients received the plasma exchange combined with hemodialysis using FUT as an anticoagulant, and no distinct side effect was observed during plasma exchange.
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PO-0770: Concurrent chemoradiotherapy using photon and proton for locally advanced pancreatic cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Electrochemical microdevices for rapid and on-site determination of the minimum inhibitory concentration of antibiotics. Analyst 2018; 143:396-399. [DOI: 10.1039/c7an01873h] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A tool for rapid selection of appropriate antibiotics may be useful to maximize the benefits of their effectiveness against severe infectious diseases.
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Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear. Bone Joint J 2017; 99-B:806-811. [DOI: 10.1302/0301-620x.99b6.bjj-2016-0885.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 01/30/2017] [Indexed: 12/19/2022]
Abstract
Aims The aim of this study was to assess hypertrophy of the extra-articular tendon of the long head of biceps (LHB) in patients with a rotator cuff tear. Patients and Methods The study involved 638 shoulders in 334 patients (175 men, 159 women, mean age 62.6 years; 25 to 81) with unilateral symptomatic rotator cuff tears. The cross-sectional area (CSA) of the LHB tendon in the bicipital groove was measured pre-operatively in both shoulders using ultrasound. There were 154 asymptomatic rotator cuff tears in the contralateral shoulder. Comparisons were made between those with a symptomatic tear, an asymptomatic tear and those with no rotator cuff tear. In the affected shoulders, the CSAs were compared in relation to the location and size of the rotator cuff tear. Results The mean CSA was 21.0 mm2 (4 to 71) in those with a symptomatic rotator cuff tear, 19.9 mm2 (4 to 75) in those with an asymptomatic rotator cuff tear and 14.1 mm2 (5 to 43) in those with no rotator cuff tear. The mean CSA in patients with both symptomatic and asymptomatic rotator cuff tears was significantly larger than in those with no rotator cuff tear (p < 0.001). In the affected shoulders, there were significant differences between patients with more than a medium sized posterosuperior cuff tear and those with an antero-superior cuff tear. Conclusion Regardless of the symptoms, there was significant hypertrophy of the extra-articular LHB tendon in patients with a rotator cuff tear. The values were significantly related to the size of the tear. Cite this article: Bone Joint J 2017;99-B:806–11.
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Blood viscosity in fatty liver patients with obesity. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1986-6614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Assessing Health Risks of Exposure to Asian Dust (Soil Dust) among Healthy Individuals and Allergic Rhinitis Patients in Japan. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Risk Prediction of the Effects of Severe Winter Disasters (dzud) on Nomadic Health and Society in Mongolia with regard to Loss of Livestock. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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SAT0120 Ninja, A Japanese Rheumatoid Arthritis Database, Demonstrated that the Size and Number of Swollen Joints Correlated with Increased Systemic Inflammation Markers. Digital Joint Swelling Showed Only Trace Increases of Serum C-Reactive Protein and Erythrocyte Sedimentation Rate. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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The clinical and pathological significance of nitric oxide synthase in human pituitary adenomas: a comparison with MIB-1. Endocrine 2014; 46:154-9. [PMID: 24008756 DOI: 10.1007/s12020-013-0046-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 08/22/2013] [Indexed: 11/27/2022]
Abstract
The purpose of the present study was to define the clinical and pathological significance of nitric oxide synthase (NOS) in human pituitary adenomas, and to compare these values with those of the MIB-1 labeling index (LI) using an immunohistochemical method. Tissue specimens from 82 cases of surgically-treated pituitary adenomas were immunostained for hormone production for the MIB-1 LI and for the three NOS isoenzymes and five normal pituitary glands were immunostained for the three NOS isoenzymes as a control. The correlation between the clinical variables (age, functional status, tumor size, Hardy's grading, cavernous and/or sphenoid invasiveness, and progression) and mean MIB-1 LI, or between the same clinical variables and NOS immunoreactivity (IR) were analyzed. There was a statistically significant difference in the MIB-1 LI between macroadenomas and microadenomas, and between invasive adenomas and noninvasive adenomas. On the other hand, there was a statistically significant difference in the inducible NOS (iNOS) IR between invasive adenomas and noninvasive adenomas. Furthermore, the iNOS IR had a significant correlation with the MIB-1 LI. Invasive adenomas have a higher iNOS IR, and this correlated with the MIB-1 LI. These findings may be due to the function of iNOS, which plays an important role in tissue injury and repair.
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Progressive Nonfluent Aphasia: Language, Cognitive, and PET Measures Contrasted with Probable Alzheimer's Disease. J Cogn Neurosci 2013; 8:135-54. [PMID: 23971420 DOI: 10.1162/jocn.1996.8.2.135] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The purpose of this study was to compare the language and cognitive profiles of four progressive nonfluent aphasia (PNFA) patients with 25 probable Alzheimer's disease (pAD) patients, and to identify the distinct cortical defects associated with cognitive deficits in PNFA using positron emission tomography (PET). Longitudinal observations of PNFA patients revealed progressively telegraphic speech and writing and a gradual deterioration of sentence comprehension, but memory and visual functioning were relatively preserved. Direct contrast with PAD patients revealed that PNFA patients are significantly impaired on grammatical phrase structure aspects of sentence comprehension and expression, phonemic judgments, repetition, and digit span, but not on other cognitive measures. PET studies of PNFA revealed reduced cortical activity throughout the left hemisphere. In addition, there was a prominent defect in left superior and middle temporal and inferior frontal regions of PNFA patients that differed significantly from the distribution of regional cerebral dysfunction in pAD. We conclude that PNFA is associated with a distinct profile of language and cognitive difficulty, and that this pattern of impairment is related to cortical dysfunction in a specific distribution of the left hemisphere.
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Prognostic value of serum parathyroid hormone in patients with acute heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stress myocardial perfusion computed tomography at 320 detector-row to detect hemodynamically significant coronary stenoses in the presence of a high coronary calcium score. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Myocardial perfusion reserve is impaired in patients with chronic obstructive pulmonary disease: a comparison to current smokers. Eur Heart J Cardiovasc Imaging 2013; 15:180-8. [DOI: 10.1093/ehjci/jet131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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THU0055 Interstitial pneumonitis associated with rheumatoid arthritis is more prevalent in aged male with a higher RF level, and frequently combined with emphysema. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Real-time estimation of tongue movement based on suprahyoid muscle activity. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:4605-4608. [PMID: 24110760 DOI: 10.1109/embc.2013.6610573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this study, we introduce a real-time method for tongue movement estimation based on the analysis of the surface electromyography (EMG) signals from the suprahyoid muscles, which usual function is to open the mouth and to control the position of the hyoid, the base of the tongue. Nine surface electrodes were affixed to the underside of the jaw and their signals were processed via multi-channel EMG system. The features of the EMG signals were extracted by using a root mean square (RMS) method. The dimension of the variables was reduced additionally from 108 to 10 by applying the Principal Component Analysis (PCA). The feature quantities of the reduced dimension set were associated with the tongue movements by using an artificial neural network. Results showed that the proposed method allows precise estimation of the tongue movements. For the test data set, the identification rate was greater than 97 % and the response time was less than 0.7 s. The proposed method could be implemented to facilitate novel approaches for alternative communication and control of assistive technology for supporting the independent living of people with severe quadriplegia.
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Type III procollagen-N-peptide as a predictor of persistent atrial fibrillation recurrence after cardioversion. Europace 2012; 14:1719-25. [DOI: 10.1093/europace/eus162] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Atomic-resolution imaging in liquid by frequency modulation atomic force microscopy using small cantilevers with megahertz-order resonance frequencies. NANOTECHNOLOGY 2012; 23:135706. [PMID: 22421199 DOI: 10.1088/0957-4484/23/13/135706] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this study, we have investigated the performance of liquid-environment FM-AFM with various cantilevers having different dimensions from theoretical and experimental aspects. The results show that reduction of the cantilever dimensions provides improvement in the minimum detectable force as long as the tip height is sufficiently long compared with the width of the cantilever. However, we also found two important issues to be overcome to achieve this theoretically expected performance. The stable photothermal excitation of a small cantilever requires much higher pointing stability of the exciting laser beam than that for a long cantilever. We present a way to satisfy this stringent requirement using a temperature controlled laser diode module and a polarization-maintaining optical fiber. Another issue is associated with the tip. While a small carbon tip formed by electron beam deposition (EBD) is desirable for small cantilevers, we found that an EBD tip is not suitable for atomic-scale applications due to the weak tip-sample interaction. Here we show that the tip-sample interaction can be greatly enhanced by coating the tip with Si. With these improvements, we demonstrate atomic-resolution imaging of mica in liquid using a small cantilever with a megahertz-order resonance frequency. In addition, we experimentally demonstrate the improvement in the minimum detectable force obtained by the small cantilever in measurements of oscillatory hydration forces.
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Intraperitoneal and intrapleural administrations of triamcinolone acetonide for control of malignant ascites and pleural effusion. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Glary appearance of men's faces and an evaluation method. Int J Cosmet Sci 2010. [DOI: 10.1111/j.1468-2494.2010.00618_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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An Improved Glycerin-Jelly Mounting Procedure for Permanent Preparations of Helminth Eggs. J Parasitol 2010; 96:440-1. [DOI: 10.1645/ge-2263.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Reliability and validity of Japanese version of the McGill Quality of Life Questionnaire assessed by application in palliative care wards. Palliat Med 2009; 23:659-64. [PMID: 19643951 DOI: 10.1177/0269216309106875] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The McGill Quality of Life Questionnaire (MQOL), which consists of 16 items constructing physical, psychological, existential and support subscales and one item of overall quality of life (QOL), has been developed to assess QOL of terminal cancer patients. To examine if MQOL Japanese version (MQOL-J) is applicable, it was administered to 83 terminal cancer patients in palliative care wards several days after admission and then 7 to 10 days after the first interview. Cronbach's alpha coefficient for four subscales was 0.584-0.860. Sixteen items were classified into four factors by factor analysis, similar to the original English version. The results indicated that psychological and existential domains of the MQOL-J significantly related to overall QOL. Existential and support domains as well as overall QOL were significantly improved between the first and second interviews, although performance status assessed by Eastern Cooperative Oncology Group worsened. It is suggested that MQOL-J can reflect perceived health status of terminal cancer patients.
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An atomic resolution scanning tunneling microscope that applies external tensile stress and strain in an ultrahigh vacuum. NANOTECHNOLOGY 2008; 19:025705. [PMID: 21817554 DOI: 10.1088/0957-4484/19/02/025705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We have developed an ultrahigh vacuum scanning tunneling microscope with an in situ external stress application capability in order to determine the effects of stress and strain on surface atomistic structures. It is necessary to understand these effects because controlling them will be a key technology that will very likely be used in future nanometer-scale fabrication processes. We used our microscope to demonstrate atomic resolution imaging under external tensile stress and strain on the surfaces of wafers of Si(111) and Si(001). We also successfully observed domain redistribution induced by applying uniaxial stress at an elevated temperature on the surface of a wafer of vicinal Si(100). We confirmed that domains for which an applied tensile stress is directed along the dimer bond become less stable and shrink. This suggests that it may be feasible to fabricate single domain surfaces in a process that controls surface stress and strain.
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HLA-haploidentical nonmyeloablative stem cell transplantation: induction to tolerance without passing through mixed chimaerism. ACTA ACUST UNITED AC 2005; 27:139-41. [PMID: 15784130 DOI: 10.1111/j.1365-2257.2005.00675.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are few reports of unmanipulated HLA-haploidentical nonmyeloablative stem cell transplantation (NST) using only pharmacological acute graft-vs.-host disease (GVHD) prophylaxis. We present here a successful case of unmanipulated HLA-haploidentical NST for mediastinal large B cell lymphoma that was resistant to autologous peripheral blood stem cell transplantation (PBSCT). The conditioning regimen consisted of fludarabine, busulfan and rabbit anti-T-lymphocyte globulin (ATG) in addition to rituximab. GVHD prophylaxis was performed using tacrolimus and methylprednisolone 1 mg/kg. The patient had rapid engraftment, with 100% donor chimaerism in the lineages of both T cells and granulocytes on day +12, but developed no GVHD clinically. The patient is still in complete remission past day +1020, with no sign of chronic GVHD without receiving immunosuppressive agents. HLA-haploidentical NST may be performed without utilizing mixed chimaerism.
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Proton magnetic resonance spectroscopy and white matter hyperintensities on magnetic resonance imaging in patients with Alzheimer's disease. Ann N Y Acad Sci 2002; 977:423-9. [PMID: 12480782 DOI: 10.1111/j.1749-6632.2002.tb04847.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Circadian rhythm of blood pressure is transformed from a dipper to a non-dipper pattern in shift workers with hypertension. J Hum Hypertens 2002; 16:193-7. [PMID: 11896509 DOI: 10.1038/sj.jhh.1001328] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2001] [Revised: 10/17/2001] [Accepted: 10/17/2001] [Indexed: 11/08/2022]
Abstract
Shift workers make great use of health care services because they are associated with increased cardiovascular morbidity and mortality. Whether the circadian rhythm of blood pressure rapidly adapts to shift work is controversial. It is unknown if shift work has adverse effects on blood pressure in patients with hypertension. To evaluate the effects of shift work, we examined 12 male shift workers with untreated hypertension aged 53.6 +/- 2.5 years. Twenty-four hour ambulatory blood pressure monitoring was performed three times as follows: the last day of a 4-day period of day shifts (09.00 to 21.00), the first day of a 4-day period of night shifts (21.00 to 09.00), and the fourth day of night shifts (21.00 to 09.00). Blood pressure at night-time dropped significantly in the day-shift workers, showing a dipper pattern. Average differences in blood pressure in the sleep-wake cycle were decreased by 8.5% at the beginning of night shift work showing a non-dipper pattern. After 4 days the pattern was completely reversed to a dipper pattern. The results indicate that the circadian blood pressure pattern is changed from a dipper to a non-dipper pattern on the first day of the night shift and reverses to a dipper pattern within a few days. We suggest that night shift work may have unfavourable effects on blood pressure in patients with hypertension.
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The development for polymer actuator active catheter system. Interv Neuroradiol 2001; 7:115-23. [PMID: 20663388 DOI: 10.1177/15910199010070s117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 09/15/2001] [Indexed: 11/16/2022] Open
Abstract
SUMMARY Electric stimuli polymer-metal composite actuator material has been developed for active catheter system and other widely new applications. Thepolymer actuator is made of ion exchange polymer and gold as electrode, and a pulse voltage of 3 volts on the actuator gave a quick bend 90 degree angle. This composite material is possible to make small size, light and soft actuator. So now we can actually develop an active catheter for the interventional radiology surgery. The prototype polymer actuator active catheter has been developed by using polymer actuator technology and Micro Electronics Mechanical System (MEMS) technologies. The active catheter is controllable from the outside of the body by electric signal. The tip part of the catheter is made of the polymer actuator tube and bends 90 degree angles. The animal tests (dog) showed good actuator performance to control right direction and bending angle at bifurcation of blood vessel and aneurysms.
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Abstract
The aim of pilonidal sinus surgery includes complete resection of the lesion and filling of the resultant soft-tissue defect by some means; this has a major influence on whether a lesion will occur after surgical treatment. The creation of a sacral adipofascial turn-over flap for the excisional defect has been performed in seven cases of pilonidal sinus since November of 1992. During the postoperative follow-up period, which ranged from 10 months to 7 years 11 months (mean duration, 5 years 2 months), partial dehiscence of the wound as a result of fatlysis was observed and treated conservatively in one case; however, primary healing was obtained in the other cases. No recurrence was seen in any of the seven cases. This procedure is not indicated in patients in whom wide skin resection is required because of the excessive tension associated with skin closure in such cases. However, the method is convenient, less invasive, and reliable, and therefore considered to be useful in the treatment of pilonidal sinus.
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Effects of therapeutic doses of human atrial natriuretic peptide on load and myocardial performance in patients with congestive heart failure. Am J Cardiol 2001; 88:863-6. [PMID: 11676948 DOI: 10.1016/s0002-9149(01)01893-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The benefits of atrial natriuretic peptide (ANP) in patients with congestive heart failure (CHF) have been demonstrated. However, the myocardial actions of ANP remain unclear. Using relatively load-insensitive left ventricular pressure-volume analysis, the myocardial and load-altering actions of ANP in patients with moderate CHF were studied. After obtaining steady-state data using micromanometers and conductance catheters, ANP was infused in 9 patients with CHF at 0.01 and 0.1 microg/kg/min for 30 minutes, respectively. Hemodynamic variables, plasma ANP, and cyclic guanosine monophosphate (cGMP) levels were determined before and 30 minutes after each ANP infusion. ANP at 0.01 microg/kg/min increased plasma ANP and cGMP levels from 73 +/- 34 to 139 +/- 34 pg/ml and from 4 +/- 1 to 8 +/- 2 pmol/ml, respectively. ANP infusion caused a significant decrease in end-systolic pressure without any changes in heart rate. End-diastolic pressure was significantly decreased but there was no significant change in left ventricular end-diastolic volume. The time constant for isovolumetric relaxation was decreased. ANP infusion at 0.1microg/kg/min caused further decreases in end-systolic pressure, end-diastolic pressure and volume, and the time constant for isovolumetric relaxation (p <0.05) without any changes in heart rate. The slope of the end-systolic pressure-volume relation was increased from 1.3 +/- 0.2 to 1.6 +/- 0.3 mm Hg/ml (p <0.05), indicating increased contractility. Plasma ANP and cGMP levels were increased to 422 +/- 44 pg/ml and 16 +/- 3 pmol/ml, respectively. Thus, ANP infusion increased cGMP generation, decreased afterload and preload, and improved left ventricular systolic and diastolic function.
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Multiple pulmonary emboli with pulmonary hypertension caused by effort thrombosis and effective balloon venoplasty of the subclavian vein. JAPANESE CIRCULATION JOURNAL 2001; 65:920-2. [PMID: 11665800 DOI: 10.1253/jcj.65.920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 36-year-old woman with effort thrombosis of the subclavian vein associated with multiple pulmonary emboli was successfully treated with local thrombolysis of the subclavian vein using a pulse-spray catheter and systemic anticoagulation. Balloon venoplasty of the residual stenosis of subclavian vein was carried out and in follow-up venography 6 months later, there was no restenosis, and the patient has been asymptomatic for 12 months. Pulmonary embolism is not a rare complication of upper extremity deep vein thrombosis and should be managed as aggressively as lower extremity deep vein thrombosis.
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Abstract
Altered expression and functional responses to cardiac beta(3)-adrenergic receptors (ARs) may contribute to progressive cardiac dysfunction in heart failure (CHF). We compared myocyte beta(3)-AR mRNA and protein levels and myocyte contractile, [Ca(2+)](i) transient, and Ca(2+) current (I(Ca,L)) responses to BRL-37344 (BRL, 10(-8) mol/L), a selective beta(3)-AR agonist, in 9 instrumented dogs before and after pacing-induced CHF. Myocytes were isolated from left ventricular myocardium biopsy tissues. Using reverse transcription-polymerase chain reaction, we detected beta(3)-AR mRNA from myocyte total RNA in each animal. Using a cloned canine beta(3)-AR cDNA probe and myocyte poly A(+) RNA, we detected a single band about 3.4 kb in normal and CHF myocytes. beta(3)-AR protein was detected by Western blot. beta(3)-AR mRNA and protein levels were significantly greater in CHF myocytes than in normal myocytes. Importantly, these changes were associated with enhanced beta(3)-AR-mediated negative modulation on myocyte contractile response and [Ca(2+)](i) regulation. Compared with normal myocytes, CHF myocytes had much greater decreases in the velocity of shortening and relengthening with BRL accompanied by larger reductions in the peak systolic [Ca(2+)](i) transient and I(Ca,L). These responses were not modified by pretreating myocytes with metoprolol (a beta(1)-AR antagonist) or nadolol (a beta(1)- and beta(2)-AR antagonist), but were nearly prevented by bupranolol or L-748,337 (beta(3)-AR antagonists). We conclude that in dogs with pacing-induced CHF, beta(3)-AR gene expression and protein levels are upregulated, and the functional response to beta(3)-AR stimulation is increased. This may contribute to progression of cardiac dysfunction in CHF.
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MESH Headings
- Adrenergic beta-1 Receptor Antagonists
- Adrenergic beta-2 Receptor Antagonists
- Adrenergic beta-Agonists/pharmacology
- Adrenergic beta-Antagonists/pharmacology
- Animals
- Blotting, Western
- Calcium/metabolism
- Cardiac Pacing, Artificial/adverse effects
- Cell Separation
- Disease Models, Animal
- Disease Progression
- Dogs
- Dose-Response Relationship, Drug
- Enzyme Inhibitors/pharmacology
- Ethanolamines/pharmacology
- Heart Failure/etiology
- Heart Failure/pathology
- Heart Failure/physiopathology
- Myocardial Contraction/drug effects
- Myocardium/metabolism
- Myocardium/pathology
- RNA, Messenger/metabolism
- Receptors, Adrenergic, beta-3/drug effects
- Receptors, Adrenergic, beta-3/genetics
- Receptors, Adrenergic, beta-3/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Up-Regulation
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Functional role of endogenous endothelin-1 in congestive heart failure treated with angiotensin II receptor antagonist. THE JAPANESE JOURNAL OF PHYSIOLOGY 2001; 51:445-53. [PMID: 11564281 DOI: 10.2170/jjphysiol.51.445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Interactions between angiotensin (ANG) II and endothelin (ET)-1 receptor transduction pathways have been unclear in congestive heart failure (CHF). Therefore the objects of this study are, in CHF, whether production of ET-1 is modulated by ANG II and/or whether hemodynamic effects of endogenous ET-1 are modulated by ANG II. Twelve dogs were randomly assigned to two groups: untreated (n = 6) and treated with ANG II type 1 (AT1) receptor antagonist (TCV116, 1.5 mg/kg/d) (n = 6). After rapid ventricular pacing (240 bpm) for 4 weeks, plasma and cardiac ET-1 levels were compared between the two groups. Acute hemodynamic effects of a nonspecific ET(A&B) receptor antagonist, TAK044 (3 mg/kg plus 3 mg/kg/h i.v.) were examined in both groups by a conductance catheter and a micromanometer. After 4 weeks of pacing, plasma and cardiac tissue ET-1 levels were elevated in both groups to a similar degree. In the group treated with TCV116, TAK044 produced an increase in stroke volume and a decrease in total systemic resistance; heart rate was unchanged. The time constant of left ventricular (LV) relaxation was significantly decreased. The slope of LV end-systolic pressure-volume relation (E(ES)) was increased (p < 0.05), indicating an increased LV contractility. Thus endogenous ET-1 produces an arterial vasoconstriction and impairs LV contractility and relaxation in CHF with AT1 receptor antagonism. These hemodynamic responses to TAK044 in CHF treated with TCV116 were similar in untreated CHF. These results suggest that the production of ET-1 and the cardiac effects of endogenous ET-1 in CHF may be unaffected by ANG II acting through AT1 receptors.
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Abstract
Bisphenol A was oxidized to monoquinone and bisquinone derivatives by Fremy's salt, a radical oxidant, though salcomine and alkali did not catalyze the oxidation by molecular oxygen. Bisphenol A, bisphenol B, and 3,4'-(1-methylethylidene)bisphenol were converted to their monoquinone derivatives in the presence of tyrosinase at 25 degrees C at pH 6.5, but not to the bisquinone derivatives under these conditions.
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SMRT as a T3SF-binding protein. Int J Oncol 2001; 18:985-9. [PMID: 11295045 DOI: 10.3892/ijo.18.5.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
p53-binding consensus-like sequence (T3SF) is located in the murine promoter region of tissue inhibitor of metalloproteinase 3 gene. To identify the genes that encode proteins that bind to T3SF DNA sequence, we screened a cDNA library using the Southwestern technique. The SMRT gene was cloned as one of the candidates. Addition of antibody against SMRT reduced the intensity of a band that is supposed to contain SMRT in electrophoresis mobility shift assay, although antibody against p53 had no effect. Ultraviolet (UV)-irradiation reduced the intensity of the SMRT complex whereas p53 complex was stabilized by UV-irradiation. These results suggest that SMRT may bind to T3SF sequence in p53-independent manner and dissociate from the sequence by UV irradiation.
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Abstract
The diastolic dysfunction present at rest in congestive heart failure (CHF) is exacerbated during exercise (Ex). Increases in circulating ANG II and endothelin-1 (ET-1) during Ex may contribute to this response. We assessed the effect of Ex on circulating plasma levels of ANG II and ET-1 and left ventricular (LV) dynamics before and after pacing-induced CHF at rest and during Ex in nine conscious, instrumented dogs. Before CHF, there were modest increases in circulating levels of ANG II (but not ET-1) during Ex. LV diastolic performance was enhanced during Ex with decreases in the time constant of LV relaxation (tau), LV end-systolic volume (V(ES)), and LV minimum pressure with a downward shift of the LV early diastolic portion of the pressure-volume (P-V) loop. This produced an increase in peak LV filling rate without an increase in mean left atrial (LA) pressure. After CHF, the resting values of ANG II and ET-1 were elevated and increased to very high levels during Ex. After CHF, mean LA pressure, tau, and LV minimum pressure were elevated at rest and increased further during Ex. Treatment with L-754,142, a potent ET-1 antagonist, or losartan, an ANG II AT(1)-receptor blocker, decreased these abnormal Ex responses in CHF more effectively than an equally vasodilatory dose of sodium nitroprusside. Combined treatment with both ANG II- and ET-1-receptor blockers was more effective than either agent alone. We conclude that in CHF, circulating ANG II and ET-1 increase to very high levels during Ex and exacerbate the diastolic dysfunction present at rest.
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