Action of Pyrroloquinolinequinol As an Antioxidant Against Lipid Peroxidation in Solution

This is the publisher's version, also available electronically from: http://online.liebertpub.com/doi/pdfplus/10.1089/ars.1999.1.4-547.The activities of pyrroloquinoline quinone (PQQ), a coenzyme of methanol dehydrogenase and amine oxidase, and its reduced form pyrroloquinoline quinol (PQQH2 ) as an antioxidant have been measured in solution. PQQH2 was stable in the absence of oxygen but rapidly auto-oxidized to PQQ in the presence of oxygen in water. PQQH2 was stable in an aprotic solvent such as acetonitrile, even in air. PQQ did not exert appreciable antioxidant activity, whereas PQQH2 exerted higher reactivity than a-tocopherol toward galvinoxyl radical and peroxyl radical. PQQH2 acted as a potent antioxidant against the oxidation of methyl linoleate in acetonitrile induced by azo compound and produced a clear induction period, from which the apparent stoichiometric number was obtained as 1.1. PQQH2 reduced the a-tocopheroxyl radical and spared a-tocopherol in the oxidation of methyl linoleate. These results suggest that PQQH2 may act as a potent antioxidant, particularly in combination with a-tocopherol. Antiox. Redox Signal. 1, 547-554

レミフェンタニル麻酔中の１％糖負荷が高齢者の代謝に与える影響 : 無作為対照比較試験

Background: Previous studies showed that remifentanil-induced anesthesia can inhibit surgical stress response in non-diabetic adult patients and that low-dose glucose loading during anesthesia may attenuate fat catabolism. However, little is known about the influence of glucose loading on metabolism in elderly patients, whose condition may be influenced by decreased basal metabolism and increased insulin resistance. We hypothesized that, in elderly patients, intraoperative low glucose infusion may attenuate the catabolism of fat without causing harmful hyperglycemia during remifentanil-induced anesthesia. Methods: Elderly, non-diabetic patients scheduled to undergo elective surgery were enrolled and randomized to receive no glucose (0G group) or low-dose glucose infusion (0.1 g/kg/hr. for 1 h followed by 0.05 g/kg/hr. for 1 h; LG group) during surgery. Glucose, adrenocorticotropic hormone (ACTH), 3-methylhistidine (3-MH), insulin, cortisol, free fatty acid (FFA), creatinine (Cr), and ketone body levels were measured pre-anesthesia, 1 h post-glucose infusion, at the end of surgery, and on the following morning. Results: A total of 31 patients (aged 75–85) were included (0G, n = 16; LG, n = 15). ACTH levels during anesthesia decreased significantly in both groups. In the LG group, glucose levels increased significantly after glucose loading but hyperglycemia was not observed. During surgery, ketone bodies and FFA were significantly lower in the LG group than the 0G group. There were no significant differences in insulin, Cr, 3-MH, and 3-MH/Cr between the two groups. Conclusion: Remifentanil-induced anesthesia inhibited surgical stress response in elderly patients. Intraoperative low-dose glucose infusion attenuated catabolism of fat without inducing hyperglycemia

Anaphylactic shock due to latex allergy

Natural rubber latex (NRL) allergy is one of the most important causes of severe anaphylaxis during medical intervention. We report a pediatric case of latex allergy with multiple surgical histories. A 12-year-old girl developed anaphylactic shock during the pyeloplasty for ureteropelvic junction restenosis. Latex gloves or medications used during the surgery were suspected to be the cause of anaphylactic shock. We diagnosed her latex allergy on the basis of the results that serum latex-specific IgE, skin prick tests of extract from NRL gloves and recombinant Hev b 6.02 solution were positive. Basophil activation test of NRL gloves was also positive, supporting the diagnosis of immediate allergic reactions caused by NRL. It was speculated that a history of multiple surgeries in infancy became a trigger of sensitization to latex in this patient. Reoperation after the diagnosis of NRL allergy was carried out in a latex-free environment and completed without any allergic symptoms. It would be necessary to perform the pre-screening of latex allergy to prevent the onset of latex allergy especially in the patients with multiple surgical histories

ジュウショウ シンフゼン カンジャ ニオケル サンソ リョウホウ ト Adaptive-servo ventilator ノ コウカ ノ ケントウ ハイドウミャクセイ ハイコウケツアツ ニ トモナウ ウシンフゼン ニ タイシテ ノ Adaptive-servo ventilator ノ コウカ

Pulmonary arterial hypertension（PAH）, including idiopathic or connective tissue diseaserelated PAH is very poor prognosis. Recently it has been reported that Adaptive-servo ventilator（ASV）is useful device for improving congestive heart failure compared with oxygen therapy however, it has not been clear whether ASV is useful not only in congestive heart failure but also in PAH patients. We experienced a drug therapy-resistant PAH patient, whose subjective symptom and pulmonary arterial pressure were ameliorated by ASV. We also found that ASV was also effective on improving subjective symptoms and on decreasing pulmonary arterial pressure in ６patients with PAH. These findings suggest that ASV is a useful and new device in patients with drug therapy-resistant PAH

プロテインC カッセイ テイカ オ ハイケイ トシ オートマチックシャ エノ ヘンコウ オ ケイキ ニ ハイケッセン ソクセンショウ オ ハッショウ シタ タクシー ウンテンシュ ノ イチレイ

A ６２-year-old man, who was a taxi-driver, presented to our hospital for further examination and treatment of deep venous thrombosis（DVT）suspected in another clinic. Before ３ months of consultation, he had changed his taxi from manual transmission car to automatic transmission car. Around the same time, he had complained progressively worsening left pedal edema and pain. When he consulted our hospital, blood examination showed elevated D-dimer and deficiency of protein C. A venous ultrasound showed an occlusive DVT in left lower extremity through an external iliac vein. A contrast-enhanced computed tomography showed bilateral pulmonary embolism（PE） and extensive thrombus in the left lower extremity. Following hospitalization, an inferior vena cava （IVC）filter was placed in an infrarenal IVC position, and anticoagulant therapy was initiated with heparin and warfarin. His DVT and PE were managed successfully with anticoagulant therapy, and pedal edema was improved. Besides some risk factors of thrombogenicity such as age and deficiency of protein C, sitting position for long hours and decreased motion of left leg might have triggered off the thrombus formation in the left lower extremity. This report demonstrates the importance of careful follow-ups to long-distance drivers with risk factors of thrombus formation, especially about clutch operation

クリカエス シンフゼン ト イジ トウセキ ドウニュウ カラ リダツシエタ ジンドウミャク キョウサクショウ ノ イチレイ

A ７２-year-old woman with chronic renal failure and hypertension was admitted to Tokushima University Hospital due to progressive dyspnea. The patient had a history of right nephrectomy for renal tubular carcinoma two years before admission. The patient was diagnosed as acute left ventricular decompensation with pulmonary edema, and dyspnea was improved by means of mechanical ventilation. Although diuretics and antihypertensive agent were given intensively, acute pulmonary edema easily recurred with deterioration of renal function, and continuous hemodiafiltration（ CHDF）was required. Abdominal ultrasound showed marked increase of blood flow velocity of left renal artery, suggesting renal artery stenosis. Renal angiography with ultrasound guidance revealed narrowing of left renal artery ostia, and percutaneous transluminal renal angioplasty（ PTRA）with stenting placement was performed. Renal dysfunction and blood pressure control were improved immediately after PTRA, and the patient became asymptomatic

シン サルコイドーシス シンダン ノ テビキ ニオケル カクシュ シンダン モダリティー ノ ケントウ

Background : Sarcoidosis is a multiple organ granulomatous disease of undefined cause. Although cardiac involvement often leads to adverse outcomes in patients with sarcoidosis, diagnosis of cardiac sarcoidosis（CS）remains difficult due to the lack of sensitive diagnostic tests. Purpose : To determine an appropriate combination of diagnostic tests for detecting CS. Method and Results : Thirteen patients were diagnosed with CS from December ２００６ to November２０１０by the use of２００６revised guidelines for diagnosing CS of the Japanese Society of Sarcoidosis and Other Granulomatous Disorders. Positive rate of each major or minor criterion in the guidelines was examined. We also evaluated positive rate of each diagnostic test. In the major criteria, basal thinning of the ventricular septum showed a high positive rate of７１．４％, although the others were less than５０％. In the minor criteria, positive rates of abnormal electrocardiogram findings and abnormal echocardiogram were７６．９％ and８４．６％, respectively. Late gadolinium enhancement （LGE）of the myocardium on cardiac MRI scanning（CMR）showed a positive rate of１００％ ; however, CMR was not performed in four patients due to life-threatening arrhythmia. All１３patients showed abnormal findings at least in either echocardiogram or LGE on CMR. Conclusion : Echocardiography is a convenient diagnostic test for detecting CS. The combination of cardiac MRI and echocardiography may improve diagnostic sensitivity

ニンシン オ ケイキ ニ ジョウミャク ケッセンショウ オ ハッショウシ センテンセイ アンチトロンビンIII ケッソンショウ ト シンダン サレタ イチレイ

Congenital antithrombin III (AT III) deficiency is an inherited autosomal dominant disorder. Patients often suffer from recurrent venous thromboses that are triggered by several occasions (operation, gestation, trauma, oral contraceptive drug etc.). Moreover, 60% of them are said to be associated with pulmonary embolism. The patient of this report is 27-year-old pregnant woman in the first trimester. She felt pain in the back of her head and left auricle and presented with dyslexia and aphasia in late of March, 20XX. Getting CT brain scan, MRI brain scan, and blood sampling at the nearby hospital, she was suspected of having thrombosis of left sigmoid and transverse sinus due to AT III deficiency. Because she wanted to give birth to her first child without termination, she was referred to our hospital. We used heparin as the anticoagulant therapy because warfarin had the risk of teratogenesis. But in condition of low serum level of AT III activity, it didn’t work effectively. So we also did frequent complement of AT III. Strict anticoagulant therapy resulted in better outcome for both the patient and her baby without fatal venous thromboses or fetal complications