Derangement Research Articles

Expiratory Time an Indicator of Pulmonary Efficiency in Obese-A Case Control Study

Obesity is a global health hazard and has been linked to numerous disorders such as dyslipidemia, type II diabetes, cardio vascular diseases and derangement of pulmonary functions. The mechanism for negative association of obesity with pulmonary functions is still debated. We assessed the association of Forced vital capacity and maximal voluntary ventilation parameters and body mass index by using a case control study. These parameters measured between obese and non obese groups were statistically analysed using student 't' test. Changes in expiratory time was statistically extremely significant ('p' 0.05).

The role of inflammatory response in myocardial ischemia reperfusion injury

Background Myocardial/ischemia reperfusion injury (I/RI) is defined as myocardial injury caused by the restoration of coronary blood flow after an ischemic episode, which leads to severe myocyte metabolic derangements and ultrastructural impairment. The I/RI also triggers the activation of an inflammatory cascade evidenced by neutrophils accumulating and inflammatory mediators releasing. Thus the inflammatory response has been recognized as one of the most important mechanisms of I/ RI. It has been identified that reperfusion -induced inflammation and excessive production of cytokines can promote myocardial damage during ischemia and reperfusion. Thus modulating the inflammatory response at the onset of reperfusion may represent a potent therapeutic strategy to attenuate the myocardial I/RI. Objective Objects of this review are to evaluate the possible roles of the inflammatory response in mechanisms of myocardial I/RI. Content The effects of inflammatory mediators including inflammatory cells and cytokines in I/RI process are in detailed introduced. Trend The inflammatory response is exactly an important mechanism in IRI, but its effects in the I/RI process are not simple. Except damages caused by the inflammatory response, it can produce benefits. For improving cardioprotection, all treatments by regulating I/RI -induced inflammation should keep the balance of its two sides. Key words: Ischemia/reperfusion injury; Inflammatory response; Reactive oxygen species; Cytokines

Diabetes Mellitus and bone metabolism

Deranged bone metabolism including osteoporosis is now clinically recognized as one of the diabetic complications. Diabetes could affect bone through multiple mechanisms, insulin deficiency, insulin resistance, hyperglycemia, atherosclerosis, etc. However, the exact mechanisms by which bone derangement is brought about in diabetes are yet unknown. In type 2 diabetes, fracture risk is increased despite high bone mineral density (BMD) through deteriorated "bone quality" , of which assessment is clinically difficult. Thus, it would be important for physicians to recognize diabetes as a fracture risk, and to assess each patient's fracture risk using available tools i.e. BMD, metabolic bone markers, etc. Intense treatment for osteoporosis is warranted in diabetics who have other established fracture risks such as those with prevalent fractures or postmenopausal state.

An experimental study on the safety of intratracheal drug administration

To explore whether injury and repair occur in the trachea and the lung after intra-tracheal administration of different drugs. Wistar rats were randomly divided into 5 groups, a normal group, a blank control (BC) group, a normal saline (NS) group, a lidocaine (LD) group and an amikacin (AK) group. For the latter 3 groups, normal saline, lidocaine and amikacin were injected into trachea by needle puncture. Scanning electron microscope was used to observe the ultra-structural changes of the epithelium, and the percentage of the area of damage (PAD) in tracheal mucosa was calculated. Moreover, pathological changes of the mucous membrane of bronchioles and alveolar epithelial cells were also examined, and the degree of lung pathology was semi-quantified. Two hours after the injection of the 3 drugs, derangement and edema of the cilia were evident by scanning electron microscopy. The PAD of the NS group, the LD group and the AK group were (94.2 ± 3.2)%, (93.1 ± 3.0)% and (95.5 ± 1.8)%, respectively; all being significantly higher than that of the BC group (1.3 ± 0.3)%. For the NS group and the LD group, the PAD decreased significantly after 24 h, which were (73.7 ± 7.8)% and (81.0 ± 4.6)% respectively, and returned to normal at 48 h and 96 h. While for the AK group, the damage began to improve at 72 h [PAD (62.1 ± 5.2)%], and recovered at 96 h. Airway epithelial derangement and cell edema in the alveoli and the bronchioles also occurred 2 h after drug injection, and inflammatory cell infiltration became evident at 24 h. At this time, the score of pathology was 1.80 ± 0.84, 2.60 ± 0.55 and 2.80 ± 0.45 for the NS group, the LD group and the AK group, respectively; all being higher than that of the BC group (0). These pathological changes recovered totally after 72 h for the NS and the LD groups, and 96 h for the AK group. Intra-tracheal administration of normal saline, lidocaine and amikacin in rats led to reversible airway mucosal and lung tissue damages.

Wireless Monitoring of Pulmonary Artery Pressure in Patients with Heart Failure

Intense interest surrounds the development of implantable hemodynamic monitoring systems, designed to improve outcomes and reduce hospitalization rates in patients with heart failure (HF) by enabling management of derangements in physiologic parameters before they become clinically apparent. In a manufacturer-sponsored trial, researchers tested the effects of the Champion heart sensor on HF-related hospitalizations. Eligible patients had New …

Gamma knife irradiation - induced histopathological changes in the trigeminal nerves of Rhesus monkeys

Objective The authors sought to observe histopathological changes in the trigeminal nerve(TN)after Gamma knife treatment in rhesus monkeys and to investigate the radiobiological mechanism of Gamma knife treatment for primary trigeminal neuralgia. The nerve length dose effect of irradiation was discussed. Method One of five rhesus monkeys randomly served as control and the other four monkeys were randomly administered a target dose of 60,70,80, and 100 Gy respectively. The size of the collimator was 4 mm and the target point was the TN root. In each experimental monkey, one side was exposed to single - target point irradiation and the contralateral side to two - target point irradiation. After 6 months, the TN root was examined by light microscopy, transmission electron microscopy, and immunohistochemistry.Results At the same dose of radiation, the damage to the nervous tissue by single - target point irradiation was identical to that caused by two - target point irradiation. In the trigeminal nerve tissues of the monkeys irradiated with 60 and 70 Gy,there was scant nerve demyelination and degeneration, fragmentation, or loss of axons. In the trigeminal nerve tissue of the monkey irradiated with 80 Gy, the nervous tissue showed a disordered structure. In the trigeminal nerve tissue of the monkey irradiated with 100 Gy, there were severe derangement in the structure of the nervous tissue and extensive demyelination, fragmentation, and loss of axons. Conclusions The target doses of 60 and 70 Gy have very little impact on the structure of the TN. Irradiation at 80 Gy can cause partial degeneration and loss of axons and demyelination. A 100 Gy dose can cause some necrosis of neurons. Comparing the single - target irradiation with the two - target point irradiation,the extent of damage to the nervous tissue is identical and no difference in the nerve length dose effect was found. Key words: Gamma knife; Macaque; Trigeminal neuralgia; Pathology; Stereotactic radiosurgery

Post-tuberculous chronic obstructive pulmonary disease.

To determine the frequency of chronic obstructive pulmonary disease (COPD) as a sequel of treated pulmonary tuberculosis. A case series. Department of Pulmonology, Military Hospital, Rawalpindi, from April to November 2007. Forty seven adults, previously treated for pulmonary tuberculosis and presenting subsequently with chronic exertional dyspnoea for which no other alternate cause was found were included. Those having a probability of re-activated TB, having history of current or previous smoking or occupational exposure, asthmatics and cases of interstitial lung disease and ischemic heart disease were excluded. Pre- and post-dilator FVC, FEV1 and FEV1/FVC were recorded in each case through simple spirometry on Spirolab-II-MIR S/N 507213. Stage and pattern of COPD was recorded. There were 76.5% (n=36) males. Mean age was 56.4 and 44.2 years in males and females respectively. Twenty six (55.3%) were found to have an obstructive ventilatory defect of different degrees: severe/stage III in 69.2% (n=18), moderate/stage II in 23.0 % (n=6) and mild/stage I in 5.9% (n=2). Fourteen (29.7%) were found to have a restrictive pattern and 7 (14.8%) revealed a mixed obstructive and restrictive pattern. Chronic obstructive pulmonary disease can occur as one of the chronic complications of pulmonary tuberculosis and the obstructive ventilatory defect appears more common among various pulmonary function derangements.

Possíveis fatores etiológicos para desordens temporomandibulares de origem articular com implicações para diagnóstico e tratamento

Os fatores envolvidos na etiologia, diagnóstico e tratamento das desordens temporomandibulares (DTM) de origem articular foram revisados. Critérios específicos de inclusão e exclusão para o diagnóstico de DTM são essenciais, mas apresentam utilidade limitada. Atualmente, os Critérios Diagnósticos de Pesquisa para Desordem Temporomandibular (RDC/TMD) oferecem a melhor classificação baseada em evidências para os subgrupos mais comuns de DTM. O RDC/TMD inclui não apenas métodos para a classificação diagnóstica física, presentes em seu Eixo I, mas ao mesmo tempo métodos para avaliar a intensidade e a severidade da dor crônica e os níveis de sintomas depressivos e físicos não-específicos, presentes em seu Eixo II. Embora historicamente as más oclusões tenham sido consideradas como fatores de risco para o desenvolvimento das DTM, incluindo as predominantemente articulares, em muitos casos a associação estabelecida entre essas variáveis parece ter tomado direção oposta. No que diz respeito aos desarranjos internos da ATM, os resultados de estudos prévios sobre a redução induzida do ramo mandibular, secundária ao deslocamento anterior do disco articular, indicam que o reposicionamento do disco deslocado em crianças ou adolescentes jovens pode fazer mais sentido do que previamente imaginado. O uso terapêutico de suplementos alimentares, como o sulfato de glicosamina, parece uma alternativa segura ao uso dos medicamentos anti-inflamatórios normalmente utilizados para controlar a dor relacionada à osteoartrite da articulação temporomandibular (ATM), embora a evidência em torno de sua eficácia para a maioria dos pacientes de DTM não tenha sido completamente estabelecida.

Secondary osteoporosis UPDATE. The etiology, prevalence, and characteristics of secondary osteoporosis

Secondary osteoporosis is caused by various disorders, metabolic derangements, and drug administration, whose elimination as a cause for osteoporosis is necessary before establishing the diagnosis of primary osteoporosis. The underlying diseases or conditions are diversified, including those related to endocrine, nutrition, rheumatism, immobility, medicine, hematology, and congenital one. Among them, osteoporosis induced by steroid administration and that accompanied by diabetes mellitus are most frequently observed. They exhibit high fracture risks based on deteriorated bone quality rather than reduced bone mass.

Ultrastructure observation of refractory epilepsy with cortical dysplasia

Objective To study the relationship between the ultrasturcture changes and pathogenesis of refractory epilepsy with cortical dysplasia.Method To analyze the clinical data of 7 cases of refractory epilepsy retrospectively.The electron microscope was used to observe specimens of brain tissue got from surgical excision.ResultsMacrogyria,gray matter heterotopia,cortex underdevelopment and cortex derangement were observed in the brain tissue of refractory epileptic patients with cortical dysplasia.The electron microscopic examination showed nerve tissue degeneration,decreased or increased number of neurons,swelling astrocytes,synaptic number changes,increased presynaptic terminal round clear excitatory transmitters.Conclisions Ultrastructural pathological changes including less neurons,pyknosis and degeneration,cortex architecture disorders,changes of synaptic numbers and structures could be found in dysplasia cortex of refractory epilepsy patients. Key words: Cortical dysplasia; Refractory epilepsy; Ultramicropathology

Glucocorticoid induced osteoporosis in childhood: prophylaxis and treatment

Bone turnover rate during growth is extremely rapid. Bone growth is under the control of various hormonal environments. Long term administration of glucocorticoid in childhood induced not only osteoporosis but also growth failure via direct action on bone and cartilage and indirectly via hormonal derangements. Sex steroid is one of the important hormones for the bone mineral accrual and for cartilage maturation. Thus glucocorticoid usage during puberty resulted in irreversible effect on bone health including bone growth and peak bone mass accrual. Recently bisphosphonates have been widely used in prophylaxis and treatment of the steroid induced osteoporosis in adult with large amount of evidences, which is largely unknown for the pediatric patients.

Clinical and immunological features of childhood vitiligo

Objective To discuss the relationship between immunity and childhood vitiligo. Methods A questionnaire was designed to investigate the clinical characteristic of patients younger than 14 years with vi-tiligo and their relatives. The serum levels of immunoglobulin, complement and T-lymphocyte subsets were de-tected in 270 cases of pediatric vitiligo. Results A total of 620 patients were investigated. Of them, 302(48.71%) were boys and 318 (51.29% ) were girls, with a mean age of 8.81 years and mean onset age at 7.57years. The mean disease duration was 8.14 months. The involvement of head and neck was observed in 453(73.06%) children. Segmental vitiligo was diagnosed in 160 (25.81%) children. Spring and summer are predilected seasons of pediatric vitiligo. Halo nevi were found in 73 (11.77%) children,and most in those with scattered vitiligo. Family history was observed in 84 (13.55%) children. A significant decrease of serum C3 and C4 was observed in patients with segmental vitiligo in active phase compared with those in stable phase (P < 0.05). Similarly, the count of CD4+ and CD3+ lymphocytes in peripheral blood as well as the CD4+/CD8+ ratio were decreased in patients with vitiligo vulgaris in active phase compared with those in stable phase (P<0.01).Conclusion There is an abnormality in some immune parameters in children with vitiligo, which may be relat-ed to the immunologic derangement. Key words: Vitiligo; Monitoring,immunologic; Child

Neurobehavioral Profile of F1 and F2 Generation Mice Following One Stage Zidovudine Exposure through Pregnancy and Lactation

Background: Several animal studies have reported behavioural alteration in zidovudine exposed neonates, possibly resulting from an action of this drug on CNS targets. Purpose: The aim of the present study was to assess the neurobehavioral effects of one-stage zidovudine exposure during pregnancy and lactation in F 1 and F 2 generation of mice. Methods: Zidovudine (50 mg/ kg/ day) was administered to female Swiss mice given orally from day 8 of gestation through pregnancy and up to day 10 of postnatal life. Control mice were given equal volume of distilled water. F 1 generation mice on attainment of 60–90 days of age, underwent neurobehavioural testing for propensity towards anxiety and disturbances of learning and memory in the open field test, elevated plus-maze and Morris water-maze test. F 1 generation mice were crossed to produce F 2 mice. On attainment of 60–90 days, F 2 mice were also subjected to same neurobehavioral testings. Results: Perinatal Zidovudine exposure caused significant decreased mobility suggesting certain degree of anxiety in F 1 mice whereas the opposite is true in F2 mice. No derangement of motor activity was detected at maturity in the zidovudine exposed generation of mice in F 2 mice. Fl mice, in the elevated plus maze test showed reduced entry in open arm whereas the entries were increased in F 2 mice. Morris water maze test showed decreased learning capabilities in F 1 mice and regained learning ability in F 2 . Conclusion: This study suggests that neurobehavioral functions are affected in F 1 generation and recovery in F 2 generation. Recovery in F 2 generation beyond normal profiles could be due to activation of oncogenes as a result of chromosomal alterations. doi: 10.5214/ans.0972.7531.2008.150303 Competing interests: None. Source of Funding: None Received Date: 12 March 2008 Revised Date: 03 May 2008 Accepted Date: 08 June 2008

Off-pump coronary artery bypass grafting: pathophysiology and anesthetic monitoring

Off-pump coronary artery bypass grafting (OPCABG) might reduce perioperative morbidity and improve outcome because of avoidance of cardiopulmonary bypass (CPB). Therefore, OPCABG is performed widely now. However, displacement of the heart and positioning the stabilizer device can result in particular pathophysiologic changes during beating -heart surgery, which make the anesthetic management more difficult. Moreover, these pathophysiologic changes may lead to myocardial ischemia and cardiac dysfunction. Especially, ventricular diastolic function and right ventricular function get more attentions recently. Anesthetist must know well the intraoperative monitoring in which the new type Swan -Ganz catheter and transesophageal echocardiography(TEE) have more important effects on hemodynamic and cardiac performance monitoring. In addition, ventricular pressure - volume loop is an attractive index to assess cardiac function. Key words: hcmodynamic derangement; cardiac function; monitoring; off- pump coronary artery bypass grafting

Progress in immunologic derangement of idiopathic thrombocytopenic purpura

特发性血小板减少性紫癜(ITP)是一种自身免疫性疾病,其病因和发病机制尚未完全明确.目前研究认为与免疫紊乱密切相关:急性期呈辅助T细胞(Th)1优势分化、缓解期呈Th2优势分化;CD4+T细胞是机体的重要调节细胞,在转录因子T-bet/GATA3的作用下,其激活后选择性地优势分化为Th1/Th2,通过分泌特征性细胞因子而发挥免疫作用;也有研究认为,ITP患儿自身反应性T细胞凋亡受到抑制,引起自身反应性T细胞克隆积聚,不断刺激B细胞产生自身抗体并激活细胞毒性T细胞,导致血小板持续破坏。

Journey to the End of the Night: Disillusion and Derangement among the Senses

Journey to the End of the Night: Disillusion and Derangement among the Senses

Tônus e diâmetro arterial coronário não se correlacionam com o grau de denervação autonômica em pacientes com cardiopatia chagásica crônica

INTRODUÇÃO: Portadores de cardiopatia chagásica crônica (CCC) apresentam precoce e intensa disautonomia, postulando-se potenciais anormalidades vasomotoras coronárias e conseqüente isquemia e fibrose miocárdica. Esta investigação correlacionou o grau de denervação parassimpática cardíaca com o diâmetro e o tônus arterial coronário. MÉTODO: Em 18 pacientes com CCC (55 ± 9 anos, 8 do gênero masculino) e 23 voluntários normais (37 ± 11 anos, 16 do gênero masculino), avaliou-se a sensibilidade barorreflexa (SBR) com monitoração contínua da pressão arterial (PA) e indução de aumentos transitórios da PA por administração endovenosa de fenilefrina (50 µg a 150 µg). Cateterismo cardíaco com cinecoronariografia basal e 5 minutos após 5 mg de dinitrato de isossorbida (DNIS) foi realizado em pacientes chagásicos. Análise quantitativa do diâmetro arterial coronário foi realizada off-line nas duas condições. O tônus basal arterial coronário foi estimado pelo aumento porcentual do diâmetro após DNIS. A fração de ejeção do ventrículo esquerdo (FEVE) foi calculada pelo método de Dodge biplanar na ventriculografia de contraste, usando-se ecocardiografia bidimensional para o diâmetro diastólico (DDVE) e estimativa da massa do ventrículo esquerdo. RESULTADOS: Verificou-se acentuada redução da SBR (4,1 ± 1,7 ms/mmHg) na CCC comparativamente aos controles (15,0 ± 1,5 ms/mmHg) (p < 0,001). O diâmetro coronário médio foi de 2,2 ± 0,3 mm, correlacionando-se significativamente com variáveis expressando remodelamento cardíaco: FEVE (p = 0,017, R = 0,554), DDVE (p = 0,0036, R = 0,648) e massa VE (p = 0,022, R = 0,534). Não foi observada correlação significante entre diâmetro coronário e SBR (p = 0,457, R = 0,187). O tônus arterial coronário basal foi de 13 ± 17%, sem correlação com qualquer variável, incluindo o diâmetro coronário (p = 0,386, R = 0,218) e a SBR (p = 0,822, R = 0,057). CONCLUSÕES: A denervação parassimpática não parece influenciar o diâmetro e o tônus arterial coronário basal na CCC.

Foucault’s concept of literature

This paper aims to analyse the concept of literature in Foucault’s thoughts in the sixties. Departing from Foucault’s thoughts about the ontology of literature, we demonstrated that the emergence of literature was possible as a consequence of the modern experience. Foucault shows that literature is the manifestation of the being of the language in its relation with death. We discuss the relation of literary writing with the modern experience, pointing its limits in sexuality, language and madness. Literature is seen here as the derangement of language, where we can observe the creation of its deciphering principals. Through this article, we observe that the literary writing is characterized by a basic transgressivity that refuses all tradition: past or future. Keywords: literature, literary writing, modern experience.

Alteration of prostaglandin metabolism in alcoholic liver disease: its association with platelet dysfunction after chronic alcohol ingestion

Recently, hepatic microcirculation has been focused on as an important pathogenic factor in progression of alcoholic liver disease (ALD). Therefore, blood levels of several prostaglandins, which are associated with organ microcirculation, were determined in various liver diseases, including ALD. Blood thromboxane B2 (TXB2) level was significantly increased in ALD, when compared to other types of liver diseases, whereas both 6-keto prostaglandin F1 alpha (6-keto PGF1 alpha) and prostaglandin E were not changed. These consequences resulted in the imbalance of 6-keto PGF1 alpha to TXB2, which might promote platelet aggregation and blood vessel contraction. Indeed, the increase of beta-thromboglobulin and platelet factor 4 in blood was observed in ALD. Furthermore, in ALD, the rate of arachidonate-induced platelet aggregation was prominently enhanced, and malondialdehyde production in platelet, which was well correlated with blood TXB2 levels, significantly increased. Thus, the present study may indicate that, in ALD, hyper-aggregability of platelet is produced, because of the derangement of prostaglandin metabolism and platelet dysfunction.

Acute gastric mucosal lesions induced by vasomotor derangement--participation of xanthine oxidase and neutrophil-mediated oxidative stress

Acute gastric mucosal lesions induced by vasomotor derangement--participation of xanthine oxidase and neutrophil-mediated oxidative stress