Evolución cardiológica postnatal y factores asociados a la agenesia de ductus venoso de diagnóstico prenatal / Postnatal cardiac outcomes associated with the prenatal diagnosis of absence of ductus venosus

Resumen Introducción: la agenesia del ductus venoso es una anomalía infrecuente con pronóstico variable. Puede ir de hallazgo aislado a producir muerte fetal. Así mismo, puede asociarse a otras anomalías y síndromes genéticos. Material y métodos: estudio descriptivo de 12 niños con diagnóstico prenatal de agenesia del ductus venoso. Se evaluó lugar de drenaje de vena umbilical, variables perinatales, obstétricas, otras anomalías asociadas y evolución. Resultados: el 75% (9/12) presentaba drenaje extrahepático de vena umbilical; de ellos, el 44,4% (4/9) presentó insuficiencia cardiaca fetal. Al nacimiento, un 50% (6/12) asociaba anomalías cardiacas estructurales y un 41,6% (5/12) precisaron tratamiento médico. El 25% (3/12) asociaba síndromes genéticos. 25% (3/12) de niños fallecieron (100% con cardiopatía), y un tercio de los supervivientes (3/9) presentó anomalías estructurales cardiacas. El 50% (6/12) de madres tenían antecedente de aborto o muerte fetal intraútero previa, 25% (3/12) de embarazos fueron producto de reproducción asistida y 25% (3/12) de gestaciones múltiples. Conclusiones: se halló una incidencia elevada de defectos estructurales cardiacos en niños con agenesia del ductus venoso. Son más usuales si el drenaje es extrahepático y en ellos hay mayor frecuencia de anomalías genéticas y mortalidad. Un porcentaje importante de pacientes precisan tratamiento perinatal; la evolución es satisfactoria en los supervivientes.

Abstract Introduction: The absence of ductus venosus is an uncommon condition with a variable prognosis, which can vary from an isolated finding to causing foetal death. Furthermore, it can also be associated with other genetic anomalies and syndromes. Material and method: A descriptive study was conducted on 12 children with a prenatal diagnosis of absence of ductus venosus. An evaluation was made of the umbilical vein drainage site, perinatal and obstetric variables, other associated anomalies, and the outcomes. Results: Extra-hepatic drainage of the umbilical vein was observed in 75% (9/12) of cases, of which 44.4% (4/9) had foetal heart failure. At birth, 50% (6/12) were associated with cardiac structure anomalies, and 41.6% (5/12) required medical treatment. Genetic syndromes were detected in 25% (3/12) of cases. There were 25% (3/12) deaths (100% with heart disease), and one-third (3/9) of the survivors had cardiac structure anomalies. A history of abortion or previous intrauterine death was recorded in 50% (6/12) of the mothers, and in 25% (3/12) the pregnancies were the result of assisted reproduction, and 25% (3/12) multiple gestations. Conclusions: An elevated incidence of cardiac structure defects is found in children with absence of ductus venosus. They are more common if the drainage is extrahepatic, and within those, there is a higher frequency of genetic anomalies and death. A significant percentage of patients require perinatal treatment: The outcome is satisfactory in the survivors.

Influences of influenza virus on cystic fibrosis transmembrane conductance regulator ( CFTR) / 中华微生物学和免疫学杂志

Objective To evaluate the differentiation of mouse tracheal epithelial cells ( MTEC) at an air-liquid interface and to investigate the influences of influenza virus on the cystic fibrosis transmem-brane conductance regulator ( CFTR) in primary cultured MTEC for further elucidating the possible mecha-nism of imbalanced fluid and salt transportation in respiratory system caused by influenza virus infection . Methods The morphology of primarily cultured MTEC was observed under inverted microscope .Trans epi-thelial electrical resistance ( TEER) was measured by a resistance meter to evaluate the integrity of cultured MTEC.An Ussing chamber apparatus was used to record the short-circuit current of primary cultured MTEC . Results The primarily cultured MTEC clustered together and had a tight pavement-like appearance under light microscope .The TEER was greater than 1000 Ωafter 6 days of culture .Influenza virus could reduce the short-circuit current of CFTR to (52.77±10.30)％in intact cell membrane and to (41.50±1.09)％in monolayer MTEC after increasing the permeability of basement membrane .It had been proved that CFTR was essential to maintaining the balance of fluid and salt transportation in respiratory system.Conclusion Mouse MTEC are efficiently cultured at a air-liquid interface and the primarily cultured cells are highly simi-lar to those in a normal physiologic state .Influenza virus may block the secretion of anions through inhibiting the function of CFTR , which may induce the development of chronic obstructive pulmonary disease and the incidence of asthma .

Study on the relationship between CFTR physiological secretion pathway and intracellular calcium signaling in rabbit cornea epithelium / 中华实验眼科杂志

Background Researches showed that cystic fibrosis transmembrane conductance regulator protein(CFTR) is a channel secreting anion and water,and it plays an important role in tear secreting.Traditional conception thought that CFTR pathway is cAMP-PKA-dependent without the participation of intracellular calcium.However,studies disclosed that elevating intracellular cAMP could not open the CFTR channel.So whether calcium signal is associated with CFTR-related corneal epithelial secretion is controversial.Objective This study was to investigate the association between CFTR secretion and intracellular calcium signaling in rabbit corneal epithelium.Methods Sixteen New Zealand white rabbits were randomized into odd number group and even number group by computer randomized number method.The corneas were obtained under the general anesthesia and placed in Ussing Chamber for the record of short cricuit current (Isc).The right eyes of rabbits in the odd number group were stimulated with ATP and served as ATP stimulating group.The left eyes were pretreated with CFTRinh-172 prior to ATP stimulation and served as CFTRinh-172 pretreated group.In the even number group,the left eyes of rabbits were pretreated with BMPTA/AM before ATP stimulation and served as BMPTA/AM pretreated group,and the right eyes of the rabbits were used to isolate and culture corneal epithelial cells by explant adherent method,the level of intracellular calcium were evaluated using Leica SP5 laser scan confocal microscope.Results The ATP-induced ΔIsc of corneal epithelium was (5.73 ± 1.36),(1.30 ± 0.95) and (2.47 ± 0.55) μA/cm2 in the ATP stimulating group,CFTRinh.172 pretreated group and BMPTA/AM pretreated group,respectively,and the AIsc was significantly reduced in the CFTRinh.172 pretreated group and BMPTA/AM pretreated group compared with ATP stimulating group (t=11.201,5.508,both at P ＜ 0.001).The fluorescence intensity of intracellular calcium release after ATP stimulation was 3.25 folds more than that before ATP stimulation.Conclusions ATP promotes rapid short circuit current of corneal epithelium.CFTRinh-172 depresses the ATP-induced corneal epithelium AIsc,and BMPTA/AM suppresses intracellular calcium release.It is suggested that intracellular calcium signaling secretion probably participates in the functional CFTR activity in rabbit corneal epithelium.

Effects of bupivacaine on short-circuit currents in human alveolar epithelial cells / 中国药理学通报

Aim Bupivacaine is a kind of long-acting amide local anesthetics.This paper aims to explore the effects of bupivacaine on the short-circuit currents in human alveolar epithelial monolayers and study the possible mechanisms.Methods Short-circuit currents were recorded by ussing-chamber setup.Amiloride-sensitive currents were defined as the difference be-tween the total current and the amiloride-resistant cur-rent.ERK1 /2 phosphorylation protein levels were ana-lyzed by Western blot at 0,1 5,30 and 60 min after administration of 1 00 μmol·L -1 bupivacaine.Results Bupivacaine could inhibit the short-circuit currents in H441 monolayers dose-dependently,which could be inhibited by amiloride.Western blot analysis showed that bupivacaine increased the level of ERK1 /2 phos-phorylation.Conclusion These data demonstrate that bupivacaine can reduce the alveolar ion transport by in-hibiting the amiloride-sensitive currents,possibly by the enhancement of ERK1 /2 phosphorylation. The effects of alveolar fluid clearance following application of bupivacaine should be considered clinically when the patient is complicated with lung injury.

La vivencia como unidad de análisis de la conciencia: sentidos y significados en trayectorias de profesionalización de psicólogos y profesores en comunidades de práctica / The emotional experience as unit of analysis of consciousness: senses and meanings through psychologists and teachers trajectories of becoming professionals in communities of practice

El trabajo explora la potencialidad de los escritos de Vygotsky sobre el concepto de pereshivanie ­ vivencia -, entrelazando emoción-cognición y sujeto-situación-historia-contexto, como lo hace el autor en Pensamiento y Lenguaje (1934). Profundiza la significatividad de las unidades de análisis sistémicas, genéticas y dialécticas para abordar el desarrollo, la conciencia y la educación. Retomamos la propuesta de Valsiner de pensar la síntesis dialéctica mediante estas preguntas: ¿Es la emoción, en su tensión entre contrarios, obstáculo para la cognición, como en el "cortocircuito"? ¿O la emoción, en su aporte a la articulación de significado y sentido, experiencia y concepto, puede representar lo nuevo, lo emergente? Entre ambas posibilidades, ¿de qué depende la posición que puede ocupar el afecto en la conciencia? Abrimos un diálogo entre conceptos y problematizaciones, reflexiones y análisis, primeras conjeturas sobre trayectorias formativas de profesionalización en comunidades de práctica, con psicólogos y profesores de psicología en escenarios educativos.

The work explores the potential of Vygotsky writings about the concept of pereshivanie ­ traduced emotional experience -, weaving emotion and cognition and subject-situation-history-context, like the author makes it in Thinking and Speech (1934). It deepens the meaning of the systemic, genetic and dialectic units of analysis to board development, conscience and education. We retake Valsiner proposal of thinking in the dialectic synthesis through these questions: Is emotion, in its tension between contraries, an obstacle for cognition, like in the idea of short circuit? Or emotion, in its role of linking meaning and sense, experience and concept, can represent the new, the emergent? Between both of them, on what depends the position that emotion reach into the conscience? We open a dialogue between concepts and questions, reflections and analysis, early guesses about formative trajectories of psychologists and psychology teachers becoming professionals through communities of practice into educational stages.

Evaluation of endoscopically obtained duodenal biopsy samples from cats and dogs in an adapter-modified Ussing chamber

This study was conducted to evaluate an adapter-modified Ussing chamber for assessment of transport physiology in endoscopically obtained duodenal biopsies from healthy cats and dogs, as well as dogs with chronic enteropathies. 17 duodenal biopsies from five cats and 51 duodenal biopsies from 13 dogs were obtained. Samples were transferred into an adapter-modified Ussing chamber and sequentially exposed to various absorbagogues and secretagogues. Overall, 78.6% of duodenal samples obtained from cats responded to at least one compound. In duodenal biopsies obtained from dogs, the rate of overall response ranged from 87.5% (healthy individuals; n = 8), to 63.6% (animals exhibiting clinical signs of gastrointestinal disease and histopathological unremarkable duodenum; n = 15), and 32.1% (animals exhibiting clinical signs of gastrointestinal diseases and moderate to severe histopathological lesions; n = 28). Detailed information regarding the magnitude and duration of the response are provided. The adapter-modified Ussing chamber enables investigation of the absorptive and secretory capacity of endoscopically obtained duodenal biopsies from cats and dogs and has the potential to become a valuable research tool. The response of samples was correlated with histopathological findings.

Drug overdose due to malfunction of a patient-controlled analgesia machine: A case report / 대한마취과학회지

Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future.

Evaluación inicial de las cardiopatías congénitas con cortocircuito en el embarazo / Initial evaluation of congenital heart with short-circuit in pregnancy

Existe en la actualidad un gran número de mujeres con cardiopatía congénita, las cuales alcanzan la edad reproductiva gracias a las correcciones quirúrgicas que se realizan en edades pediátricas. Las mujeres que llegan al embarazo luego de haber recibido tratamiento quirúrgico correctivo o paliativo generalmente tienen un buen resultado perinatal y con pocos riesgos maternos. En otras pacientes, el diagnóstico primario de cardiopatías congénitas se realiza en una consulta de rutina durante el embarazo y la gran mayoría de éstas requieren un manejo especializado; de igual forma existe un tercer grupo con diagnóstico previo, pero que nunca ha recibido tratamiento quirúrgico. La gran mayoría de estas pacientes requieren de un manejo especializado durante el embarazo, el trabajo de parto y el puerperio por un equipo médico interdisciplinario que debe incluir cardiólogos, internistas e intensivistas que comprendan los cambios fisiológicos asociados al embarazo, obstetras con conocimiento de la fisiopatología de la malformación cardiaca y anestesiólogos con un enfoque de la paciente obstétrica en el marco de su enfermedad cardiovascular. El objetivo de esta revisión es mostrar las características clínicas y hemodinámicas de pacientes embarazadas con las cardiopatías congénitas con cortocircuito intracardiaco; se mencionan los mecanismos de diagnóstico y los parámetros a evaluar para determinar el pronóstico durante el embarazo.

There is now a large number of women with congenital heart disease, which reach reproductive age due to surgical corrections done during childhood. Women who become pregnant after receiving corrective or palliative surgery generally have a good perinatal outcome and few maternal risks. In other patients the primary diagnosis of congenital heart disease is performed, in a routinely query during pregnancy, there is a third group with previous diagnosis but who have never undergone surgery, and the vast majority of these require specialized handling during pregnancy, labor and the postpartum period by a multidisciplinary medical team, which should include cardiologists, internists, and intensivists who understand the physiological changes associated with pregnancy, and obstetricians with knowledge of the pathophysiology of cardiac malformations. Finally a group anesthesiologists with training on the obstetric patients in the context of cardiovascular disease.The aim of this review is to show the clinical and hemodynamic characteristics of pregnant patients with congenital heart disease with intracardiac short-circuit,the diagnostic mechanisms and parameters to be evaluated to determine the prognosis for pregnancy.

Helicobacter pylori Vacuolating Toxin Exhibits Polar Activity of Cl Secretion and Secretory Response to Carbachol in T84 Cells

To investigate whether VacA (vacuolating toxin) produced by Helicobacter pylori Korean stain 99 induces intestinal secretion, purified VacA was added to T84 cell monolayers mounted in Ussing chambers, and electrical parameters were monitored. Mucosal addition of low pH-pretreated VacA increased short circuit current (Isc). The effect was time- and dose-dependent and saturable. The time-to-peak Isc was concentration-dependent. Chloride channel inhibitors, niflumic acid or 5- nitro-2- (3-phenylpropylamino) -benzoate (NPPB), inhibited VacA-stimulated Isc. Carbachol (CCh) -induced increase of Isc was prolonged by the addition of VacA to the mucosal side only. The effect was unaltered by the addition of niflumic acid. VacA did not show cytopathic effects. These studies indicate that VacA is a nonlethal toxin that acts in a polar manner on T84 monolayers to potentiate Cl secretion and the response to CCh secretion without decrease in monolayer resistance. VacA may contribute to diarrhea diseases in human intestinal epithelial cells.

Asymmetrical distribution of P2Y nucleotide receptors in rabbit inner medullary collecting duct cells

We cultured the rabbit inner medullary collecting duct (IMCD) cells as monolayers on collagen-coated membrane filters, and investigated distribution of the P2Y receptors by analyzing nucleotide-induced short circuit current (Isc) responses. Exposure to different nucleotides of either the apical or basolateral surface of cell monolayers stimulated Isc. Dose-response relationship and cross-desensitization studies suggested that at least 3 distinct P2Y receptors are expressed asymmetrically on the apical and basolateral membranes. A P2Y2-like receptor, which responds to UTP and ATP, is expressed on both the apical and basolateral membranes. In addition, a uracil nucleotide receptor, which responds to UDP and UTP, but not ATP, is expressed predominantly on the apical membrane. In contrast, a P2Y1-like receptor, which responds to ADP and 2-methylthio-ATP, is expressed predominantly on the basolateral membrane. These nucleotides stimulated intracellular cAMP production with an asymmetrical profile, which was comparable to that in the stimulation of Isc. Our results suggest that the adenine and uracil nucleotides can interact with different P2Y nucleotide receptors that are expressed asymmetrically on the apical and basolateral membranes of the rabbit IMCD cells, and that both cAMP- and Ca2+-dependent signaling mechanisms underlie the stimulation of Isc.

Effects of Hydrogen Peroxide on Rabbit Corneal Bioelectric Properties

The rabbit cornea was studied in vitro in modified Ussing chambers to determine the effects of ion transport inhibitors and hydrogen peroxide(H2O2) on ion transport through the cornea by measuring the bioelectric properties. Apical(tear side, T side) addition of furosemide, bumetanide and SITS were ineffective on resting Isc(short circuit current). Apical addition of 1.0mM amiloride(Na+/H+ antiport inhibitor) and NPAA(Cl- channel blocker) markedly reduced the resting Isc, but basolateral(stromal side, S side) addition of amiloride was ineffective. The site of action of these agents was the apical membrane. H2O2, an oxygen free radical, markedly increased the lsc when was added to the T side, but S side addition of the H2O2 was ineffective. To determine the degree of cellular catalase participation in protection against H2O2 induced injury the cornea was pretreated with ATAZ for 30 min prior to H2O2 action. The increase of lsc by H2O2 was markedly potentiated after pretreatment with ATAZ on T side compared to that of S side addition. This result indicates that the corneal endothelial H2O2 may be largely degraded by catalase. When H2O2 was added to the T side, Isc was raised by increased ion transport. All ion transport inhibitors that were used inhibited the H2O2 effect on Isc. Moreover, amiloride and NPAA markedly inhibited induced lsc by H2O2. These results suggest that H2O2 stimulates the corneal epithelial ion transport and that its site of action is apical membrane Na+/H+ antiport system and CI- channel system.