A fluid extract of Zizyphi Semen was employed in this experiment. The cardiac effects of Zizyphi Semen were examined on isolated rabbits atria and heart in situ of anesthetized cats and rabbits. The adrenergic blocking activity and refractory period of cardiac muscle were measured after administration of this drug. In rabbits and cats the antiarrhythmic action of Zizyphi Semen on atrial and ventricular arrhythmias produced by epinephrine or ouabain was examined. The results were following: 1. Zizyphi Semen produced a decrease in rate and contractile amplitude of the isolated rabbit atria and had a week blocking effect on epinephrine acceleration of atrial movement. 2. Zizyphi Semen effectively abolished the spontaneous arrhythmia occurring in the isolated rabbit atria ana the atrial arrhythmia induced by ouabain. 3. Zizyphi Semen produced a marked prolongation of the refractory period in isolated atrial muscle of rabbit. 4. Zizyphi Semen prevented the induction of ventricular arrhythmia arising from excessive dose of epinephrine in anesthetized rabbits and cats. 5. With regard to the ventricular arrhythmia induced by a continuous infusion of ouabain, Zizyphi Semen exerted suppressive effect and produced a marked prolongation of cardiac arrest time in anesthetized rabbits and cats. From the above results, it may be concluded that Zizyphi Semen is effective against atrial and ventricular arrhythmias. The antiarrhythmic effect of this drug may be the result of direct myocardial depressive and partially adrenergic beta receptor blocking activities including prolongation of the refractory period of cardiac muscle.
Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.
The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.
Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by the deficiency of ${\alpha}$-galactosidase A. Patients with classical FD present acroparesthesia, hypohidrosis, cornea verticillata, disseminated angiokeratoma, and microalbuminuria in childhood, and develop life-threatening renal, cardiac, and cerebrovascular complications typically after the fourth decade of life. To date, more than 700 mutations responsible for FD have been identified in the human GLA gene. Herein, we report a novel GLA mutation, c.1117_1141del25 (p.Gly373Profs*10), identified in an 11-year-old Korean boy with FD presenting early cardiac and neurologic manifestation and in other affected family members. The boy had acroparesthesia, hypohidrosis, cornea verticillata, and left ventricular hypertrophy. His mother and sister also had acroparesthesia. Two males on the mother's side had similar pain and died of unknown causes. The plasma ${\alpha}$-galactosidase A activity (4.1 nmol/hr/mg protein) of the patient was markedly lower than the mean value of the controls. The plasma level of globotriaosylsphingosine was elevated in the patient and all the carriers. We concluded the novel GLA mutation c.1117_1141del25 is a pathogenic mutation for FD, probably related to the early cardiac manifestation of FD.
Proceedings of the Korean Biophysical Society Conference
/
2003.06a
/
pp.30-30
/
2003
Without a definitive resolution of stoichiometry of cardiac Na$^{+}$-Ca$^{2+}$exchange (NCX), we cannot proceed to any quantitative analysis of exchange function as well as cardiac excitation-contraction coupling. The stoichiometry of cardiac NCX, however, is presently in doubt because reversal potentials determined by various groups range between those expected for a 3-to-1 and a 4-to-1 flux coupling. For a new perspective on this problem, we have used ion-selective microelectrodes to quantify directly exchanger-mediated fluxes of $Ca^{2+}$and Na$^{+}$in giant membrane patches. $Ca^{2+}$- and Na$^{+}$-selective microelectrodes, fabricated from quartz capillaries, are placed inside of the patch pipettes to detect extracellular ion transients associated with exchange activity. Ion changes are monitored at various distances from the membrane, and the absolute ion fluxes through NCX are determined via simulations of ion diffusion and compared with standard ion fluxes (Ca$^{2+}$ fluxes mediated by $Ca^{2+}$ ionophore, and Na$^{+}$ fluxes through gramicidin channels and Na$^{+}$/K$^{+}$pumps). Both guinea pig myocytes and NCX1-expressing BHK cells were employed, and for both systems the calculated stoichiometries for inward and outward exchange currents range between 3.2- and 3.4-to-1. The coupling ratios do not change significantly when currents are varied by changing cytoplasmic [Ca$^{2+}$] or by adding cytoplasmic Na$^{+}$. The exchanger reversal potentials, measured in both systems under several ionic conditions, range from 3.1- to 3.3-to-1. Taken together, a clear discrepancy from a NCX stoichiometry of 3-to-1 was obtained. Further definitive experiments are required to acquire a fixed number, and the present working hypothesis is that NCX current has an extra current via ‘conduction mode’.ent via ‘conduction mode’.
Zhang, Chao;Wang, Deng-Feng;Zhang, Zhuang;Han, Dong;Yang, Kan
Journal of Microbiology and Biotechnology
/
v.27
no.3
/
pp.584-590
/
2017
Ginkgo biloba extract (EGb 761) has been widely used clinically to reduce myocardial ischemia reperfusion injury (MIRI). Microvascular endothelial cells (MVECs) may be a proper cellular model in vitro for the effect and mechanism study against MIRI. However, the protective effect of EGb 761 on MVECs resisting hypoxia/reoxygenation (H/R) injury is little reported. In this study, H/R-injured MVECs were treated with EGb 761, and then the cell viability, apoptosis, ROS production, SOD activity, caspase-3 activity, and protein level of ATM, ${\gamma}$-H2AX, p53, and Bax were measured. ATM siRNA was transfected to study the changes of protein in the ATM pathway. EGb 761 presented protective effect on H/R-injured MVECs, with decreasing cell death, apoptosis, and ROS, and elevated SOD activity. Next, EGb 761 could inhibit H/R-induced ATM, ${\gamma}$-H2AX, p53, and Bax in a dose-dependent manner. Moreover, ATM siRNA also could inhibit H/R-induced ATM, ${\gamma}$-H2AX, p53, and Bax. Overall, these findings verify that EGb 761 protects cardiac MVECs from H/R injury, and for the first time, illustrate the influence on the ATM pathway and apoptosis by EGb 761 via dampening ROS.
The effects of ginseng saponins on the sarcolemmal $Na^{+}$, $K^{+}$-ATPase were compared to gypsophila saponin, sodium dodecylsulfate (SDS), and Triton X-100 to elucidate whether the effects are due to the membrane distruption, using a highly enriched preparation of cardiac sarcolemma prepared from dog ventricular myocardium. About 26% and 29% of vesicles in the preparation, enriched in ouabain-sensitive $Na^{+}$, $K^{+}$-ATP ase, $\beta$-adrenergic and muscarinic receptors are rightside-out and inside-out orientation, respectively. Ginseng saponins (triol>total> diol) inhibited $Na^{+}$, $K^{+}$-ATP ase activity, $Na^{+}$, $K^{+}$-ATPase activity and [$^{3}$H]ouabain binding of sarcolemmal vesicles. However, gypsophila saponin, SDS (0.4$\mu$g/$\mu$g protein) and Triton X-100 (0.6 $\mu$g/$\mu$g protein) caused about 1.35 and 1.40-fold increase in $Na^{+}$, $K^{+}$-ATPase activity and [$^{3}$H] oubain binding, respectively. Especially, the activating effect of gypsophila saponin on membrane Na+, K+ ATPase was detected at gypsophila saponin to sarcolemmal protein ratios as high as 100. Low dose of ginseng saponin (3$\mu$g/$\mu$g protein) decreased the phosphorylation sites and the concentration of ouabain binding sites (Bmax) without affecting the turnover number and affinity for ouabain binding, while gypsophila saponin, SDS(0.4 ug/ug protein), ahd Triton X-100 (0.6$\mu$g/$\mu$g protein) increased the Bmax. The results suggest that ginseng saponins cause a decrease in the number of active sites by interacting directly with $Na^{+}$, $K^{+}$-ATPase before disruption of membrane barriers of sarcolemmal vesicles.
Austin J. Peters;Saad A. Khan;Seiji Koike;Susan Rowell;Martin Schreiber
Journal of Trauma and Injury
/
v.36
no.4
/
pp.354-361
/
2023
Purpose: Ketamine has historically been contraindicated in traumatic brain injury (TBI) due to concern for raising intracranial pressure. However, it is increasingly being used in TBI due to the favorable respiratory and hemodynamic properties. To date, no studies have evaluated whether ketamine administered in subjects with TBI is associated with patient survival or disability. Methods: We performed a retrospective analysis of data from the multicenter Prehospital Tranexamic Acid Use for Traumatic Brain Injury trial, comparing ketamine-exposed and ketamine-unexposed TBI subjects to determine whether an association exists between ketamine administration and mortality, as well as secondary outcome measures. Results: We analyzed 841 eligible subjects from the original study, of which 131 (15.5%) received ketamine. Ketamine-exposed subjects were younger (37.3±16.9 years vs. 42.0±18.6 years, P=0.037), had a worse initial Glasgow Coma Scale score (7±3 vs. 8±4, P=0.003), and were more likely to be intubated than ketamine-unexposed subjects (88.5% vs. 44.2%, P<0.001). Overall, there was no difference in mortality (12.2% vs. 15.5%, P=0.391) or disability measures between groups. Ketamine-exposed subjects had significantly fewer instances of elevated intracranial pressure (ICP) compared to ketamine-unexposed subjects (56.3% vs. 82.3%, P=0.048). In the very rare outcomes of cardiac events and seizure activity, seizure activity was statistically more likely in ketamine-exposed subjects (3.1% vs. 1.0%, P=0.010). In the intracranial hemorrhage subgroup, cardiac events were more likely in ketamine-exposed subjects (2.3% vs. 0.2%, P=0.025). Ketamine exposure was associated with a smaller increase in TBI protein biomarker concentrations. Conclusions: Ketamine administration was not associated with worse survival or disability despite being administered to more severely injured subjects. Ketamine exposure was associated with reduced elevations of ICP, more instances of seizure activity, and lower concentrations of TBI protein biomarkers.
Leucine-rich repeat containing protein 10 (LRRC10) is characterized as a cardiac-specific gene, suggesting a role in heart development and disease. A severe cardiac morphogenic defect in zebrafish morphants was recently reported but a contradictory result was found in mice, suggesting a more complicated molecular mechanism exists during mouse embryonic development. To elucidate how LRRC10 is regulated, we analyzed the 5'enhancer region approximately 3 kilo bases (kb) upstream of the Lrrc10 start site using luciferase reporter gene assays. Our characterization of the Lrrc10 promoter indicates it possesses complicated cis-and trans-acting elements. We show that GATA4 and MEF2C could both increase transcriptional activity of Lrrc10 promoter individually but that they do not act synergistically, suggesting that there exists a more complex regulation pattern. Surprisingly, knockout of Gata4 and Mef2c binding sites in the 5’enhancer region (-2,894/-2,889) didn't change the transcriptional activity of the Lrrc10 promoter and the likely GATA4 binding site identified was located in a region only 100 base pair (bp) upstream of the promoter. Our data provides insight into the molecular regulation of Lrrc10 expression, which probably also contributes to its tissue-specific expression.
Proceedings of the Korean Society for Emotion and Sensibility Conference
/
2000.11a
/
pp.81-87
/
2000
Beat-to-beat changes in heart period (heart period variability, HPV) are mediated by fluctuations in autonomic activity. Spectral analysis is used to quantify such fluctuations in the range of 0.15-0.40 Hz (high frequency, HF), which are influenced primarily by parasympathetic factors. These fluctuations are often referred to as RSA (respiratory sinus arrhythmia), the physiological phenomenon extracted by spectral analysis and other methods including histograms of heart rate ( HR), deviations of HR etc. Respiratory sinus arrhythmia indexing with peak-to-valley method suggested by Grossman et at., (1981) yields a simple range statistic and is quantified on breath-by-breath basis, thus being quite sensitive and less dependent on recording time as compared to spectral analysis. It is strongly recommended to use at least 1 min epoch to asses HF component of HPV and at least 2 min fer low frequency (LF) of HPV and even 5 min far valid clinical assessment. Peak-to-valley statistic is limited to RSA index only, but has its pragmatic advantages. Most important is possibility of its application far relatively small epoch analysis. We used short periods (20,30, 40 sec only) and off-line analysis of RSA using ECG and respiration curve this method of assessment and proved that this method is more practically effective. The RSA index was not so far dependent on respiration pattern differences and reflected actual vagal control of HR and were accompanied by low HR under some high stress conditions and in an aversive affective visual stimulation experiments. Another factor that might modulate cardiac chronotropic response is the interaction of sympathetic and parasympathetic inputs on sino-atrial (SA) node level, because responses to vagal influences are known to be proportional to ongoing sympathetic activity, that is so called accentuated antagonism. Since sympathetic outflow (increment of influences on SA) under negative emotions or stress was high in almost all physiological responses, vagal effects on HR could be therefore potentiated, leading to masking of output cardiac response seen in HPV, In the case of moderate sympathetic activation, on the other hand, autonomic interactions in cardiac control appear to be minimal. Thus RSA index appears to be an effective alternative method to assess and measure spectral HPV.
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