RESUMO
Possible pathways by which brassinosteroids affect the monooxygenase enzymatic system of mammalian liver microsomes, which is involved in the transformation of a broad spectrum of xenobiotics, were studied. The role of the structure of the side chain of brassinosteroids in the regulation of monooxygenase activity was studied using two natural compounds (24-epibrassinolide and 28-homobrassinolide) and two synthetic analogues, (22S, 23S-dihydroxy) stereoisomers. The results of this study show that brassinosteroids can directly influence the functioning of the microsomal enzymatic system. It was found that the degree of this influence depends on the side chain structure. This suggests the possibility of targeted modification of natural compounds to ensure the desired physiological effects.
Assuntos
Hidrocarboneto de Aril Hidroxilases/metabolismo , Colestanóis/química , Colestanonas/química , Microssomos Hepáticos/efeitos dos fármacos , Esteroides Heterocíclicos/química , Animais , Brassinosteroides , Colestanóis/farmacologia , Colestanonas/farmacologia , Masculino , Microssomos Hepáticos/enzimologia , Ratos , Estereoisomerismo , Esteroides Heterocíclicos/farmacologiaRESUMO
A 5-year-old child with hypoplastic left heart syndrome (HLHS) was noted to have left pulmonary artery stenosis after Glenn shunt placement. Therefore, a stent was implanted into the left pulmonary artery to relieve stenosis. After redilatation of the pulmonary artery stent, wheezing, fatigue, asymmetric bronchial sound, and desaturation was noted. Computed tomography, bronchoscopy, and bronchography confirmed critical left main bronchus compression as a consequence of the mass effect of the dilated stent. Balloon plasty of the left bronchus successfully relieved bronchial stenosis. Tracheobronchial obstruction is a possible adverse effect of vascular stenting in children with congenital heart defects. Balloon plasty seems to be a safe and efficient therapeutic option in those cases.
Assuntos
Broncopatias/diagnóstico , Derivação Cardíaca Direita , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Complicações Pós-Operatórias/terapia , Artéria Pulmonar/anormalidades , Stents/efeitos adversos , Broncopatias/terapia , Broncografia , Broncoscopia , Cateterismo , Pré-Escolar , Constrição Patológica/diagnóstico , Constrição Patológica/cirurgia , Constrição Patológica/terapia , Feminino , Humanos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Interventional procedures often are used as part of multistage treatment for hypoplastic left heart syndrome (HLHS). This study aimed to evaluate the efficacy of interventions in multistage treatment of HLHS. METHODS AND RESULTS: Between 1999 and 2007, 78 interventions were performed for 58 children with HLHS at different stages of surgical treatment. Group 1, involving 30 interventions for 22 patients with postoperative pulmonary arterial stenosis, showed reduced pulmonary artery pressure and increased vessel diameter. Group 2, involving 15 interventions after the Norwood operation for 12 patients with aortic arch obstruction, showed success for 11 patients. Group 3, involving eight balloon angioplasties of narrowed Glenn anastomosis for seven patients, showed abolition of the pressure gradient between the superior vena cava and the right pulmonary artery. Group 4, involving eight interventional closures of a fenestration for eight patients after a Fontan operation, showed increased oxygen saturation for all eight patients. Group 5, involving seven interventions for six patients in whom venovenous collaterals were closed percutaneously, showed improved oxygen saturation. For Group 6, uncommon miscellaneous interventions were used to stabilize the patients' condition before the next surgical treatment. CONCLUSIONS: Interventional procedures play an important role during multistage treatment of HLHS. They allow for a reduction in the number of operations or stabilization of the patients' condition before the next surgical treatment.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Angioplastia com Balão , Angioplastia Coronária com Balão , Criança , Pré-Escolar , Feminino , Técnica de Fontan , Humanos , Síndrome do Coração Esquerdo Hipoplásico/terapia , Lactente , Masculino , Estudos Retrospectivos , Stents , Resultado do TratamentoRESUMO
OBJECTIVE: To develop criteria for disease activity in systemic sclerosis (SSc) that are valid, reliable, and easy to use. METHODS: Investigators from 19 European centres completed a standardised clinical chart for a consecutive number of patients with SSc. Three protocol management members blindly evaluated each chart and assigned a disease activity score on a semiquantitative scale of 0-10. Two of them, in addition, gave a blinded, qualitative evaluation of disease activity ("inactive to moderately active" or "active to very active" disease). Both these evaluations were found to be reliable. A final disease activity score and qualitative evaluation of disease activity were arrived at by consensus for each patient; the former represented the gold standard for subsequent analyses. The correlations between individual items in the chart and this gold standard were then analysed. RESULTS: A total of 290 patients with SSc (117 with diffuse SSc (dSSc) and 173 with limited SSc (lSSc)) were enrolled in the study. The items (including Delta-factors-that is, worsening according to the patient report) that were found to correlate with the gold standard on multiple regression were used to construct three separate 10-point indices of disease activity: (a) Delta-cardiopulmonary (4.0), Delta-skin (3.0), Delta-vascular (2.0), and Delta-articular/muscular (1.0) for patients with dSSc; (b) Delta-skin (2.5), erythrocyte sedimentation rate (ESR) >30 mm/1st h (2.5), Delta-cardiopulmonary (1.5), Delta-vascular (1.0), arthritis (1.0), hypocomplementaemia (1.0), and scleredema (0.5) for lSSc; (c) Delta-cardiopulmonary (2.0), Delta-skin (2.0), ESR >30 mm/1st h (1.5), total skin score >20 (1.0), hypocomplementaemia (1.0), scleredema (0.5), digital necrosis (0.5), Delta-vascular (0.5), arthritis (0.5), TLCO <80% (0.5) for all patients with SSc. The three indexes were validated by the jackknife technique. Finally, receiver operating characteristic curves were constructed in order to define the value of the index with the best discriminant capacity for "active to very active" patients. CONCLUSIONS: Three feasible, reliable, and valid preliminary indices to define disease activity in SSc were constructed.
Assuntos
Escleroderma Sistêmico/diagnóstico , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Criança , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes , Escleroderma Sistêmico/complicações , Método Simples-CegoRESUMO
Effect of UV-irradiation in vitro on metabolism of adenine nucleotides: ADP, ATP and AXP, osmotic properties and submicroscopic structure of nucleated pigeon red blood cell was investigated. Irradiation carried out for 60, 120, 180, 240 and 300 minutes. Hanau S-500 lamp with efficiency 4.34-10(8) erh/sec was used. A decrease of ATP content with a stimultaneous increase of ADP and AXP contents and a rather constant level of the sum of adenine compounds was observed. UV-irradiation caused a decrease of reversal of hemolysis and osmotic resistance to hypotonic NaCl solutions. An equivalent exchange of Na+ and K+ ion and an increase of hematocrit value, following UV-irradiation was observed. Electron microscope studies demonstrated changes of ultrastructure concerning both cell nucleus and thickness and granulation of cell membrane.