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The irreversible thermodynamics of a multicomponent fluid is reviewed. This includes a discussion of the role of individual component fluxes. It is argued that their differences vanish on the same time scale as that which establishes local thermodynamic equilibrium and thus do not play an independent role in fluid dynamics, but only arise in response to gradients in conserved thermodynamic variables. The contributions to the energy flux are examined and it is argued that there should be explicit contributions associated with the various component fluxes, which are not mentioned in standard kinetic theory presentations. Three different thermodynamic perspectives are discussed as to their form, with the respective equations for the entropy flux and production described and contrasted. The Onsager reciprocal relations are considered to be a consequence of the single-valuedness of the entropy production with the chemical potential gradients as the driving forces for diffusion. These are specialized to ideal gas mixtures using the component density gradients associated with Fick's laws and to using the mole fraction gradients that are standardly used in gas kinetic theory. The ideal gas Onsager relations are identical to those deduced from the Boltzmann equation. Irving and Kirkwood's statistical mechanics treatment of the evolution equations of a one-component fluid [J. Chem. Phys. 18, 817 (1950)JCPSA60021-960610.1063/1.1747782] is generalized to multicomponent fluids and agrees with the thermodynamic perspective that treats the energy transfers as reversible.
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BACKGROUND AND PURPOSE: knowledge on the natural history and clinical impact of perihematomal edema (PHE) associated with intracerebral hemorrhage is limited. We aimed to define the time course, predictors, and clinical significance of PHE measured by serial magnetic resonance imaging. METHODS: patients with primary supratentorial intracerebral hemorrhage ≥ 5 cm(3) underwent serial MRIs at prespecified intervals during the first month. Hematoma (H(v)) and PHE (E(v)) volumes were measured on fluid-attenuated inversion recovery images. Relative PHE was defined as E(v)/H(v). Neurologic assessments were performed at admission and with each MRI. Barthel Index, modified Rankin scale, and extended Glasgow Outcome scale scores were assigned at 3 months. RESULTS: twenty-seven patients with 88 MRIs were prospectively included. Median H(v) and E(v) on the first MRI were 39 and 46 cm(3), respectively. Median peak absolute E(v) was 88 cm(3). Larger hematomas produced a larger absolute E(v) (r(2)=0.6) and a smaller relative PHE (r(2)=0.7). Edema volume growth was fastest in the first 2 days but continued until 12 ± 3 days. In multivariate analysis, a higher admission hematocrit was associated with a greater delay in peak PHE (P=0.06). Higher admission partial thromboplastin time was associated with higher peak rPHE (P=0.02). Edema volume growth was correlated with a decline in neurologic status at 48 hours (81 vs 43 cm(3), P=0.03) but not with 3-month functional outcome. CONCLUSIONS: PHE volume measured by MRI increases most rapidly in the first 2 days after symptom onset and peaks toward the end of the second week. The timing and magnitude of PHE volume are associated with hematologic factors. Its clinical significance deserves further study.
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Edema Encefálico , Hemorragia Cerebral , Imagen por Resonancia Magnética , Anciano , Edema Encefálico/diagnóstico por imagen , Edema Encefálico/etiología , Edema Encefálico/fisiopatología , Hemorragia Cerebral/complicaciones , Hemorragia Cerebral/diagnóstico por imagen , Hemorragia Cerebral/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
The phase rule states that a fluid element is determined locally by c+1 independent intensive variables when there are c components. In solving the Boltzmann equation for gas transport coefficients, the standard procedures involve only c independent gradients of intensive variables for the local properties (exclusive of the convective motion). This paper addresses this disparity and proposes an alternative set of gradients when solving the Boltzmann equation. The consequence is added terms in the expressions for the thermal diffusion coefficients. As well, the standard expression for the binary diffusion constant is identified as being valid only at constant total density. Irreversible thermodynamics is used as a reference base for comparing the alternate formulations.
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BACKGROUND: Patients with acute intracerebral hemorrhage (ICH) presenting within 3 hours of symptom onset are known to be at increased risk of expansion. However, only a minority arrive within this time frame. Therefore, alternative markers for expansion risk are needed. OBJECTIVE: To examine whether contrast extravasation on CT angiography (CTA) at presentation predicts subsequent hematoma expansion. METHODS: Consecutive patients with primary ICH presenting to an urban tertiary care hospital were prospectively captured in a database. We retrospectively reviewed images for all patients receiving a CTA and at least one further CT scan within 48 hours. RESULTS: Complete data were available for 104 patients. Contrast extravasation at the time of CTA was present in 56% of patients, and associated with an increased risk of hematoma expansion (22% vs 2%, p = 0.003). Patients who received a baseline CTA within 3 hours were more likely to have subsequent expansion (27%, vs 13% for those presenting later, p = 0.1). However, after multivariable analysis, contrast extravasation was the only significant predictor of hematoma expansion (OR 18, 95% CI 2.1 to 162). This effect was independent of time to presentation. CONCLUSIONS: Contrast extravasation is independently associated with hematoma expansion. Patients presenting within the first few hours after symptom onset have traditionally been considered those at highest risk of expansion. However, for those presenting later, the presence of contrast may be a useful marker to guide therapies aimed at decreasing this risk.
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Angiografía Cerebral/métodos , Arterias Cerebrales/fisiopatología , Hemorragia Cerebral/diagnóstico por imagen , Extravasación de Materiales Terapéuticos y Diagnósticos/diagnóstico por imagen , Hematoma/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Anciano , Anciano de 80 o más Años , Arterias Cerebrales/patología , Corteza Cerebral/irrigación sanguínea , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/fisiopatología , Hemorragia Cerebral/patología , Hemorragia Cerebral/fisiopatología , Estudios de Cohortes , Medios de Contraste/farmacocinética , Progresión de la Enfermedad , Diagnóstico Precoz , Extravasación de Materiales Terapéuticos y Diagnósticos/fisiopatología , Femenino , Hematoma/patología , Hematoma/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios ProspectivosRESUMEN
Leukotriene A4 (LTA4) hydrolase catalyzes a rate-limiting final biosynthetic step of leukotriene B4 (LTB4), a potent lipid chemotactic agent and proinflammatory mediator. LTB4 has been implicated in the pathogenesis of various acute and chronic inflammatory diseases, and thus LTA4 hydrolase is regarded as an attractive therapeutic target for anti-inflammation. To facilitate identification and optimization of LTA4 hydrolase inhibitors, a specific and efficient assay to quantify LTB4 is essential. This article describes the development of a novel 384-well homogeneous time-resolved fluorescence assay for LTB4 (LTB4 HTRF assay) and its application to establish an HTRF-based LTA4 hydrolase assay for lead optimization. This LTB4 HTRF assay is based on competitive inhibition and was established by optimizing the reagent concentration, buffer composition, incubation time, and assay miniaturization. The optimized assay is sensitive, selective, and robust, with a Z' factor of 0.89 and a subnanomolar detection limit for LTB4. By coupling this LTB4 HTRF assay to the LTA4 hydrolase reaction, an HTRF-based LTA4 hydrolase assay was established and validated. Using a test set of 16 LTA4 hydrolase inhibitors, a good correlation was found between the IC50 values obtained using LTB4 HTRF with those determined using the LTB enzyme-linked immunoassay (R = 0.84). The HTRF-based LTA4 hydrolase assay was shown to be an efficient and suitable assay for determining compound potency and library screening to guide the development of potent inhibitors of LTA4 hydrolase.
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Epóxido Hidrolasas/metabolismo , Leucotrieno B4/metabolismo , Animales , Anticuerpos Monoclonales/metabolismo , Unión Competitiva , Activación Enzimática , Epóxido Hidrolasas/química , Fluoroinmunoensayo , Humanos , Leucotrieno B4/química , Leucotrieno B4/inmunología , Ratones , Unión ProteicaRESUMEN
BACKGROUND: Survivors of intracerebral hemorrhage are at risk for recurrent intracerebral hemorrhage and ischemic cardiovascular and cerebrovascular disease. OBJECTIVE: To determine whether antiplatelet therapy increases the risk of recurrent intracerebral hemorrhage. METHODS: The authors reviewed data from consecutive survivors of primary intracerebral hemorrhage enrolled in a single-center prospective cohort study. Survivors were followed by telephone interview; recurrent intracerebral hemorrhage and post-index antiplatelet agent use and duration were recorded. Cox proportional hazards models was used with antiplatelet agent exposure as a time-dependent variable to assess the effect of antiplatelet agent use on recurrent intracerebral hemorrhage, stratified by lobar and deep hemispheric location. RESULTS: Recurrent intracerebral hemorrhage was more common in survivors of lobar hemorrhage compared with survivors of deep hemorrhage (cumulative 2-year rate 22% vs 4%; p = 0.007). Antiplatelet agents were prescribed in 22% of intracerebral hemorrhage survivors (27/127 lobar, 19/80 deep hemispheric), most commonly for prevention of ischemic heart disease. Antiplatelet agent use was not associated with intracerebral hemorrhage recurrence in survivors of either lobar hemorrhage (hazard ratio [HR] 0.8, 95% CI 0.3 to 2.3, p = 0.73) or of deep hemorrhage (HR 1.2, 95% CI 0.1 to 14.3, p = 0.88). CONCLUSION: Antiplatelet agent use is relatively common following intracerebral hemorrhage but did not appear to be associated with a large increased risk of intracerebral hemorrhage recurrence in this observational study.
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Hemorragia Cerebral/inducido químicamente , Inhibidores de Agregación Plaquetaria/efectos adversos , Inhibidores de Agregación Plaquetaria/uso terapéutico , Anciano , Anciano de 80 o más Años , Hemorragia Cerebral/clasificación , Estudios de Cohortes , Femenino , Humanos , Masculino , Registros Médicos , Persona de Mediana Edad , Isquemia Miocárdica/prevención & control , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Recurrencia , Medición de Riesgo , SobrevivientesRESUMEN
Secreted extracellular acid sphingomyelinase (sASM) activity has been suggested to promote atherosclerosis by enhancing subendothelial aggregation and retention of low-density lipoprotein (LDL) with resultant foam cell formation. Compounds that inhibit sASM activity, at neutral pH, may prevent lipid retention and thus would be expected to be anti-atherosclerotic. With the goal of identifying novel compounds that inhibit sASM at pH 7.4, a high-throughput screen was performed. Initial screening was run using a modification of a proven system that measures the hydrolysis of radiolabeled sphingomyelin presented in detergent micelles in a 96-well format. Separation of the radiolabeled aqueous phosphorylcholine reaction product from uncleaved sphingomyelin lipid substrate was achieved by chloroform/methanol extraction. During the screening campaign, a novel extraction procedure was developed to eliminate the use of the hazardous organic reagents. This new procedure exploited the ability of uncleaved, radiolabeled lipid substrate to interact with hydrophobic phenyl-sepharose beads. A comparison of the organic-based and the bead-based extraction sASM screening assays revealed Z' factor values ranging from 0.7 to 0.95 for both formats. In addition, both assay formats led to the identification of sub- to low micromolar inhibitors of sASM at pH 7.4 with similar IC(50) values. Subsequent studies demonstrated that both methods were also adaptable to run in a 384-well format. In contrast to the results observed at neutral pH, however, only the organic extraction assay was capable of accurately measuring sASM activity at its pH optimum of 5.0. The advantages and disadvantages of both sASM assay formats are discussed.
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Evaluación Preclínica de Medicamentos/métodos , Inhibidores Enzimáticos/farmacología , Esfingomielina Fosfodiesterasa/antagonistas & inhibidores , Humanos , Concentración de Iones de Hidrógeno , Micelas , Microquímica/métodosRESUMEN
Plasminogen activator inhibitor-1 (PAI-1) is a key negative regulator of the fibrinolytic system. In animal studies, inhibition of PAI-1 activity prevents arterial and venous thrombosis, indicating that PAI-1 inhibitors may be used as a new class of antithrombotics. In this study, we characterize a small molecule PAI-1 inhibitor, ZK4044, which was identified by high throughput screening and chemically optimized. In a chromogenic substrate-based urokinse (uPA)/PAI-1 assay and a tissue-type plasminogen activator (tPA)-mediated clot lysis assay, ZK4044 inhibited human PAI-1 activity with IC50 values of 644+/-255 and 100+/-90 nM, respectively. ZK4044 had no detectable inhibitory activity toward other serpins such as antithrombin III, alpha1-antitrypsin and alpha2-antiplasmin, indicating that ZK4044 is a specific PAI-1 inhibitor. ZK4044 was shown to bind directly to PAI-1 and prevent the binding of PAI-1 to tPA in a dose-dependent manner in surface plasmon resonance Biacore-based experiments. ZK4044 also prevented PAI-1/tPA complex formation, as analyzed by SDS/PAGE. ZK4044 had little effect on elastase-mediated cleavage of active PAI-1, indicating that the primary mode of action of ZK4044 is most likely to directly block the PAI-1/tPA interaction rather than to convert active PAI-1 to latent PAI-1. In the chromogenic substrate-based uPA/PAI-1 assay, ZK4044 was approximately 2-fold less potent against a mutant PAI-1 (14B-1), which contains four mutations at N150H, K154T, Q319L and M354I, compared with wild-type PAI-1, suggesting that the ZK4044 binding site on the surface of PAI-1 is close to these mutant residues. Together, our data show that ZK4044 represents a new class of small molecule PAI-1 inhibitors with anti-thrombotic potential.
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Compuestos de Anilina/farmacología , Benzoatos/farmacología , Factores de Coagulación Sanguínea/antagonistas & inhibidores , Fibrinolíticos/farmacología , Inhibidor 1 de Activador Plasminogénico/metabolismo , Compuestos de Anilina/química , Animales , Benzoatos/química , Evaluación Preclínica de Medicamentos , Fibrinolíticos/química , Humanos , Técnicas In Vitro , Cinética , Mutación , Inhibidor 1 de Activador Plasminogénico/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Serpinas/efectos de los fármacos , Serpinas/metabolismo , Resonancia por Plasmón de Superficie , Activador de Tejido Plasminógeno/metabolismoRESUMEN
DESIGN: The hormonal serum marker for the presence and course of patients with medullary thyroid cancer (MTC) is the mature calcitonin (CT) peptide. Other CALC-1 gene products such as the 116-amino acid polypeptide prohormone, procalcitonin, as well as its component calcitonin precursors (CTpr) may also be increased in their sera. We performed a study to evaluate the clinical utility of serum levels CTpr in these patients. METHODS: Twenty-one patients with MTC (9 males, 12 females; 23-76 years of age) were evaluated. The diagnosis was confirmed by histologic examination, except for 2 (a proven RET mutation plus an abnormal pentagastrin-stimulated CT level). Nine patients had postoperative hypercalcitoninemia and 3 of these died. The specific assay for mature CT was a commercial immunoradiometric assay (hCT-IRMA); the immunoluminometric assay for CTpr (B.R.A.H.M.S Diagnostica, Berlin, Germany) detects intact procalcitonin and the free CT:CT carboxypeptide-1. RESULTS: All patients had detectable serum CTpr. These levels considerably exceeded those of mature CT, averaging 7.6-fold greater. CTpr levels correlated positively with mature CT (r = 0.61; p < 0.001). After pentagastrin administration, there was a parallelism of response between the two assays. Whenever there were known metastases, CTpr increased markedly. CONCLUSION: This study demonstrates the universal presence of CTpr in the blood of patients with MTC. The measurement of these peptides may offer a new dimension to the clinical evaluation of this malignancy.
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Calcitonina/sangre , Precursores de Proteínas/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Biomarcadores de Tumor/sangre , Péptido Relacionado con Gen de Calcitonina , Humanos , Proteínas Oncogénicas/genética , Pronóstico , Proteínas Proto-Oncogénicas c-ret , Proteínas Tirosina Quinasas Receptoras/genética , Valores de Referencia , Estudios Retrospectivos , Neoplasias de la Tiroides/genéticaRESUMEN
BACKGROUND: Severe acute pancreatitis is associated with an early increase in intestinal permeability and endotoxemia. Endotoxin is a potent stimulator for the production and release of procalcitonin and its components (calcitonin precursors; [CTpr]). The aim of this study is to evaluate the role of plasma CTpr as an early marker for gut barrier dysfunction in patients with acute pancreatitis. METHODS: Intestinal permeability to macromolecules (polyethylene glycol 3350), serum endotoxin and antiendotoxin core antibodies, plasma CTpr, and serum C-reactive protein (CRP) were measured on admission in 60 patients with acute pancreatitis. Attacks were classified as mild (n = 48) or severe (n = 12) according to the Atlanta criteria. RESULTS: Compared with mild attacks of acute pancreatitis, severe attacks were significantly associated with an increase in intestinal permeability index (median: 0.02 vs. 0.006, P < 0.001), the frequency of endotoxemia (73% vs. 41%, P = 0.04), and the extent of depletion of serum IgM antiendotoxin antibodies (median: 43 MMU vs. 100 MMU, P = 0.004). Plasma CTpr levels were significantly elevated in patients with severe attacks compared with mild attacks on both the day of admission and on day 3 (median: 64 vs. 22 fmol/mL, P = 0.03; and 90 vs. 29 fmol/mL, P = 0.003 respectively). A positive and significant correlation was observed between the admission serum endotoxin and plasma CTpr levels on admission (r = 0.7, P < 0.0001) and on day 3 (r = 0.96, P < 0.0001), and between plasma CTpr on day 7 and the intestinal permeability index (r = 0.85, P = 0.0001). In contrast, only a weak positive correlation was observed between peak serum levels of CRP and plasma CTpr on admission (r = 0.3, P = 0.017) and on day 7 (r = 0.471, P = 0.049), as well as between CRP and each of the admission serum endotoxin (r = 0.3, P = 0.03) and the intestinal permeability index (r = 0.375, P = 0.007). CONCLUSIONS: In patients with acute pancreatitis, plasma concentrations of CTpr appear to reflect more closely the derangement in gut barrier function rather than the extent of systemic inflammation.
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Calcitonina/sangre , Intestinos/fisiopatología , Pancreatitis/sangre , Pancreatitis/fisiopatología , Precursores de Proteínas/sangre , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos/inmunología , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Péptido Relacionado con Gen de Calcitonina , Endotoxemia/sangre , Endotoxemia/complicaciones , Endotoxemia/fisiopatología , Endotoxinas/sangre , Endotoxinas/inmunología , Femenino , Humanos , Inflamación/sangre , Inflamación/complicaciones , Masculino , Persona de Mediana Edad , Pancreatitis/complicaciones , Permeabilidad , Polietilenglicoles , PronósticoRESUMEN
An exact expression for the cross polarization between two spin-1/2 particles is derived from the quantum Liouville equation. This is given in the form of two integrodifferential equations. These can be solved exactly in the static case (no sample spinning) and a powder average easily performed numerically. With magic-angle spinning, the neglect of certain interference terms simplifies the numerical calculation. A further assumption decoupling the calculation of the sidebands gives a very simple formula that is capable of giving a qualitative interpretation of all experimental observations. Examples are given illustrating typical buildup curves and CPMAS matching profiles.
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BACKGROUND: Calcitonin precursors are sensitive markers of inflammation and infection. The aim of this study was to evaluate the role of plasma calcitonin precursor levels on the day of admission in the prediction of severity of acute pancreatitis, and to compare this with the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system. METHODS: Plasma concentrations of calcitonin precursors were determined on admission in 69 patients with acute pancreatitis. APACHE II scores were calculated on admission. Attacks were classified as mild (n = 55) or severe (n = 14) according to the Atlanta criteria. Plasma calcitonin precursor levels were determined with a sensitive radioimmunoassay. RESULTS: On the day of hospital admission, plasma levels of calcitonin precursors were significantly greater in patients with a severe attack compared with levels in those with a mild attack of pancreatitis (median 64 versus 25 fmol/ml; P = 0.014), but the APACHE II scores were no different (median 9 versus 8; P = 0.2). The sensitivity, specificity, positive predictive and negative predictive values, and accuracy for the prediction of severe acute pancreatitis were 67, 89, 57, 93 and 85 per cent respectively for plasma calcitonin precursor levels higher than 48 fmol/ml, and 69, 45, 23, 86 and 50 per cent respectively for an APACHE II score greater than 7. Differences in the specificity and accuracy of the two prognostic indicators were significant (P < 0.001 and P = 0.001 respectively). A plasma calcitonin precursor concentration of more than 160 fmol/ml on admission was highly accurate (94 per cent) in predicting the development of septic complications and death. CONCLUSION: The assay of plasma calcitonin precursors on the day of admission to hospital has the potential to provide a more accurate prediction of the severity of acute pancreatitis than the APACHE II scoring system.
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Calcitonina/sangre , Pancreatitis/diagnóstico , APACHE , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Pancreatitis/sangre , Pronóstico , Sensibilidad y Especificidad , Sepsis/complicacionesRESUMEN
A selected suite of cytochemical parameters in Mytilus edulis are altered in response to field and laboratory exposure to chemical contaminants. These biomarkers include lysosomal stability, nicotinamide adenine dinucleotide phosphate (NADPH)-ferrihemoprotein reductase activity, liposfuscin deposition, and accumulation of lysosomal and cytoplasmic unsaturated neutral lipid. Normal variations in physiological processes (influenced by exogenous seasonal changes in temperature, salinity, food availability, etc.) may alter the sensitivity of these biomarkers to contaminant exposure. To address this issue, M. edulis (complex) were sampled monthly from a reference nonurban site (Coupeville, Penn Cove) and a polluted urban site (Seacrest, Elliott Bay) in Puget Sound, WA, for a period of 15 months. Physiological measurements including total length, total weight, somatic and mantle weights (an indication of gonadal development and reproductive status), condition index, and the presence or absence of hemic neoplasia (HN, or leukemia) were recorded. Significant differences in lysosomal stability, lysosomal and cytoplasmic unsaturated neutral lipids, lipofuscin deposition, and NADPH-ferrihemoprotein reductase activity in cells of the digestive gland or digestive tubules were generally found in mussels taken throughout the year from Seacrest compared to mussels sampled from Coupeville, consistent with exposure to chemical contaminants. No seasonally influenced suppression of the entire suite of parameters as measures of contaminant exposure was evident. Therefore these biomarkers can be used to evaluate contaminant exposure in mussels throughout the entire year.
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Adaptación Fisiológica , Biomarcadores/análisis , Bivalvos/fisiología , Contaminantes del Agua/efectos adversos , Animales , Peso Corporal , Monitoreo del Ambiente , Ferredoxina-NADP Reductasa/análisis , Ferredoxina-NADP Reductasa/farmacología , Metabolismo de los Lípidos , Lipofuscina/metabolismo , Lisosomas/metabolismo , Reproducción , Estaciones del AñoRESUMEN
Prior studies have demonstrated that the prohormone, procalcitonin (ProCT), and its component calcitonin precursors (CTpr) are increased in the serum of septic patients, correlate with the severity of the illness, and persist for relatively long periods of time. Animal studies in septic hamsters have revealed that the administration of ProCT is toxic and that immunoneutralization with IgG that is reactive to this molecule significantly improves survival. A large animal model of a very rapidly lethal polymicrobial sepsis has been developed in the pig in order to measure continuous physiological and metabolic parameters and also to compare the effects in this animal of an immunoneutralization, which is performed late in the course of the disease, to an identical, but early, therapy. Based upon the physiological and metabolic parameters, the late therapy, which was initiated during the fourth hour at a time when pigs were nearly moribund, was found to be as beneficial as early therapy. In both late and early therapy, the only animals to survive at the predetermined time of euthanasia were those which had received immunoneutralization therapy.
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Calcitonina/inmunología , Inmunoglobulina G/administración & dosificación , Inmunoglobulina G/inmunología , Precursores de Proteínas/inmunología , Sepsis/terapia , Animales , Calcitonina/sangre , Calcitonina/genética , Calcitonina/metabolismo , Calcitonina/toxicidad , Cricetinae , Mesocricetus , Precursores de Proteínas/sangre , Precursores de Proteínas/genética , Precursores de Proteínas/metabolismo , Precursores de Proteínas/toxicidad , Sepsis/sangre , Sepsis/inmunología , Sepsis/mortalidad , Sepsis/fisiopatología , Porcinos , Factores de TiempoRESUMEN
BACKGROUND: Recently, we reported an unexpected ubiquitous expression of calcitonin (CT)-mRNA in a hamster peritonitis model of sepsis. Using this animal model,we undertook a study to further investigate the pattern of expression of the calcitonin I (CALC-I) gene and CT gene-related peptide (CGRP)-mRNA in sepsis. METHODS: Live Escherichia coli impregnated in agar pellets were implanted in the peritoneal cavities of hamsters. Twelve hours after sepsis induction, the septic and healthy control animals were sacrificed and tissues and peritoneal macrophages were collected. CGRP-mRNA content was evaluated by reverse transcription polymerase chain reaction (RT-PCR), quantitated by the Taq-Man technique, and compared with the mRNA expression of CT, tumor necrosis factor alpha (TNF-alpha), and interleukin-6 (IL-6). The 5' untranslated regions of the mRNA and potential alternative splicing sites were identified by 5' rapid amplification of cDNA ends. RESULTS: We found a tissue-wide, ubiquitous and uniform expression of CGRP-mRNA in all septic tissues examined. CGRP-mRNA was detectable by RT-PCR in various extraneuronal and extrathyroidal septic tissues, but not in healthy control tissues. As found for CT-mRNA in our earlier studies, CGRP-mRNA seemed to be more specifically up-regulated as compared with other classical cytokines (ie, II-6 and TNF-alpha). Importantly, the 5' untranslated sequence in control and septic thyroid was similar to the sequence obtained from septic spleen. CONCLUSIONS: We postulate the presence of microbial infection-specific response elements in the CALC-I gene promotor, which, upon a specific stimulus, override the tissue-selective expression pattern. This new form of endocrine plasticity may be of importance in the response to systemic inflammation.
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Péptido Relacionado con Gen de Calcitonina/genética , Calcitonina/genética , Regiones Promotoras Genéticas , ARN Mensajero/análisis , Elementos de Respuesta , Sepsis/genética , Regiones no Traducidas 5'/química , Animales , Secuencia de Bases , Cricetinae , Masculino , Mesocricetus , Datos de Secuencia Molecular , Sepsis/metabolismoRESUMEN
Calcitonin precursor (CTpr) levels are both markers and mediators of inflammation. The duration of their elevation after intravenous endotoxin challenge and the effects of anti-inflammatory therapies were studied in 52 subjects. CTpr levels maximized at 24 h in all subjects. At 7 days (n=4), after levels of acute-phase cytokines and C-reactive protein had normalized, CTpr levels remained 2-4-fold above baseline levels. The elimination half-life of CTpr levels ranged from 26.9 to 45.7 h. At 24 h, endotoxin and ibuprofen (compared with endotoxin alone) increased CTpr levels approximately 2-fold (P=.03), whereas soluble tumor necrosis factor receptor blunted the increase in CTpr levels by 2-3-fold (P=.0015). However, soluble interleukin-1 receptor failed to alter the increase in CTpr levels. Thus, the fact that anti-inflammatory agents may alter CTpr levels resulting from a single stimulus must be considered when CTpr is used as a clinical marker. Of importance, this study reveals that anti-inflammatory agents may modulate the CTpr level, which is a potential toxic mediator of inflammation.
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Antiinflamatorios no Esteroideos/farmacología , Proteína C-Reactiva/metabolismo , Calcitonina/sangre , Endotoxemia/sangre , Ibuprofeno/farmacología , Precursores de Proteínas/sangre , Adolescente , Adulto , Biomarcadores/sangre , Endotoxemia/fisiopatología , Endotoxinas/administración & dosificación , Endotoxinas/toxicidad , Escherichia coli , Etanercept , Femenino , Semivida , Humanos , Inmunoglobulina G/farmacología , Inflamación , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Placebos , Radioinmunoensayo , Receptores del Factor de Necrosis TumoralRESUMEN
The measurement of plasma CT has an important role as a screening test for medullary thyroid carcinoma (MTC) in patients with thyroid nodules. However, elevated plasma CT levels should be interpreted within the context of the overall clinical picture in each individual case and carefully validated before therapeutic decisions are made. We present the case of a 17-yr-old girl who was referred to us with a thyroid nodule and elevated plasma CT levels, as measured by a one-site RIA not involving prior plasma extraction. Plasma CT was re-measured using two different methods, a RIA with prior plasma extraction and a two-site immunochemiluminometric assay (ICMA), and was either very low or undetectable. Subsequently, samples were re-assayed using the initially applied CT RIA; plasma CT levels were again found to be elevated. These elevations were of a spurious nature, probably caused by the presence of an unidentified substance in the patient's plasma interfering with the measurement of CT in the initially used RIA. Our patient was eventually diagnosed with Hashimoto's thyroiditis, and had no evidence of MTC. As several conditions can cause either true or spurious hypercalcitoninemia, we suggest that elevated plasma CT levels should be confirmed at least once before other extensive diagnostic investigations are initiated or thyroidectomy is recommended. Finally, the assay selected should detect only the mature CT molecule.
Asunto(s)
Calcitonina/sangre , Carcinoma Medular/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Nódulo Tiroideo/sangre , Adolescente , Anticuerpos Antiidiotipos/sangre , Biopsia con Aguja , Reacciones Falso Positivas , Femenino , Humanos , Inmunoensayo , Mediciones Luminiscentes , Imagen por Resonancia Magnética , Neoplasia Endocrina Múltiple Tipo 2a/genética , Radioinmunoensayo , Tiroiditis Autoinmune/diagnóstico , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
In order to study how the auditory cortex extracts communication sounds in a realistic acoustic environment, a wireless system is being developed that will transmit acoustic as well as neural signals. The miniature transmitter will be capable of transmitting two acoustic signals with 37.5 KHz bandwidths (75 KHz sample rate) and 56 neural signals with bandwidths of 9.375 KHz (18.75 KHz sample rate). These signals will be time-division multiplexed into one high bandwidth signal with a 1.2 MHz sample rate. This high bandwidth signal will then be frequency modulated onto a 2.4 GHz carrier, which resides in the industrial, scientic, and medical (ISM) band that is designed for low-power short-range wireless applications. On the receiver side, the signal will be demodulated from the 2.4 GHz carrier and then digitized by an analog-to-digital (A/D) converter. The acoustic and neural signals will be digitally demultiplexed from the multiplexed signal into their respective channels. Oversampling (20 MHz) will allow the reconstruction of the multiplexing clock by a digital signal processor (DSP) that will perform frame and bit synchronization. A frame is a subset of the signal that contains all the channels and several channels tied high and low will signal the start of a frame. This technological development will bring two benefits to auditory neuroscience. It will allow simultaneous recording of many neurons that will permit studies of population codes. It will also allow neural functions to be determined in higher auditory areas by correlating neural and acoustic signals without apriori knowledge of the necessary stimuli.