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1. Management of the patient with a failed kidney transplantmanagement of the patient with a failed kidney transplant [show details]
…of residual antigen . Although this hypothesis has not been tested in humans, antigen-specific hyporeactivity induced by pretransplantation blood transfusions suggests that this mechanism is plausible .…
2. 全身化学療法に対する輸注反応infusion reactions to systemic chemotherapy [show details]
…deferred for two to four weeks, since false negative results are possible during this period due to hyporeactivity of cutaneous mast cells. However, testing may be performed sooner if necessary, since positive…

English Journal

Vasoplegia in septic shock: Do we really fight the right enemy?

Sharawy N.Author information Department of Anaesthesia, Dalhousie University, Halifax, Nova Scotia, Canada B3H 2Y9. Electronic address: n_sharawy@yahoo.com.AbstractVasoplegia is a key factor for the death of patients with septic shock in intensive care unit owing to persistent and irreversible hypotension. Impairment of vascular reactivity has been attributed to a combination of endothelial injury, arginine-vasopressin system dysfunction, release of other vasodilatory inflammatory mediators, and muscle hyperpolarizaton. Nitric oxide induced by a Ca(+2) independent isoform of nitric oxide synthase has been suggested to play an important role in sepsis-induced vasoplegia. However, inhibition of nitric oxide synthase only partially restores the endotoxin-induced vascular hyporeactivity. The aim of this review is to discuss in detail the recent suggested alternative mechanisms of vasoplegia and to briefly outline the current therapeutic strategies and the novel therapeutic options based on those mechanisms.
Journal of critical care.J Crit Care.2014 Feb;29(1):83-7. doi: 10.1016/j.jcrc.2013.08.021. Epub 2013 Oct 4.
Vasoplegia is a key factor for the death of patients with septic shock in intensive care unit owing to persistent and irreversible hypotension. Impairment of vascular reactivity has been attributed to a combination of endothelial injury, arginine-vasopressin system dysfunction, release of other vaso
PMID 24095623

Postshock mesenteric lymph drainage ameliorates vascular reactivity and calcium sensitivity through RhoA.

Zhao Z, Si Y, Zhang Y, Du S, Zhang L, Niu C.Author information Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei, People's Republic of China.AbstractBACKGROUND: Vascular hyporeactivity plays an important role in the pathogenesis of severe shock. Previous studies have shown that postshock mesenteric lymph (PSML) blockage ameliorates the vascular reactivity and calcium sensitivity, and RhoA is involved in the regulation of vascular reactivity after hemorrhagic shock. Therefore, the present study tested whether small GTPase RhoA mediates the improvement of the vascular reactivity and calcium sensitivity in superior mesenteric artery (SMA) of rats with PSML drainage.
The Journal of surgical research.J Surg Res.2014 Jan;186(1):304-9. doi: 10.1016/j.jss.2013.08.017. Epub 2013 Sep 10.
BACKGROUND: Vascular hyporeactivity plays an important role in the pathogenesis of severe shock. Previous studies have shown that postshock mesenteric lymph (PSML) blockage ameliorates the vascular reactivity and calcium sensitivity, and RhoA is involved in the regulation of vascular reactivity afte
PMID 24075254

The 5-HTTLPR genotype modulates heart rate variability and its adjustment by pharmacological panic challenge in healthy men.

Agorastos A1, Kellner M2, Stiedl O3, Muhtz C4, Becktepe JS2, Wiedemann K2, Demiralay C2.Author information 1Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Str. 52, D-20246 Hamburg, Germany. Electronic address: aagorast@uke.uni-hamburg.de.2Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Str. 52, D-20246 Hamburg, Germany.3Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Amsterdam, Netherlands; Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Amsterdam, Netherlands.4Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Str. 52, D-20246 Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.AbstractAbnormal serotonin transporter (5-HTT) function and autonomic nervous system (ANS) dysregulation has been proposed in panic disorder. However, in contrast to hypothalamo-pituitary-adrenocortical (HPA) functioning, ANS reactivity during panic response has yet not been investigated in humans with respect to the 5-HTT genotype. The present study assessed the influence of challenging by cholecystokinin tetrapeptide (CCK-4) on heart rate variability (HRV) measures, to monitor autonomic reactivity and its relationship to 5-HTT-linked polymorphic region (5-HTTLPR) genotypes. We hypothesized substantial effects of the 5-HTTLPR genotype on autonomic reactivity. We studied 30 healthy young men, 15 of each with the long/long (l/l) or short/short (s/s) genotype for the 5-HTTLPR. All participants received an intravenous application of 50 μg CCK-4. HRV measures were assessed in both groups at baseline and immediately after CCK-4 application. Our results indicated lower parasympathetic activity in s/s carriers during baseline, time and frequency domain measures. CCK-4 application significantly enhanced the sympathetic tone in both groups, leading to diminished group differences. A significant treatment by genotype effect indicated reduced autonomic reactivity to CCK-4 challenge in the s/s compared to l/l carriers. Our findings show enhanced sympathetic and/or diminished cardiac vagal activity under basal conditions and blunted autonomic reactivity in s/s vs. l/l carriers. Our study provides novel data supporting claims that the s/s genotype represents a genetic vulnerability factor associated with inadequate hyporeactivity to stress and extends current knowledge on the impact of the central serotonergic activity on the sympathoadrenal pathway.
Journal of psychiatric research.J Psychiatr Res.2013 Dec 7. pii: S0022-3956(13)00365-8. doi: 10.1016/j.jpsychires.2013.11.013. [Epub ahead of print]
Abnormal serotonin transporter (5-HTT) function and autonomic nervous system (ANS) dysregulation has been proposed in panic disorder. However, in contrast to hypothalamo-pituitary-adrenocortical (HPA) functioning, ANS reactivity during panic response has yet not been investigated in humans with resp
PMID 24342768

Japanese Journal

人工内耳手術を施行した前庭水管拡大症における平衡機能の検討

橘澄,岩﨑真一,山岨達也,樫尾明憲,尾形エリカ,赤松裕介,五十嵐一紀,星雄二郎,坂田阿希,藤本千里,江上直也
日本耳鼻咽喉科学会会報 121(6), 791-798, 2018
<p>　前庭水管拡大症は反復するめまい発作と進行性難聴を伴う疾患である. 難聴とともに平衡機能障害が潜在的に存在することが予想され, 難聴が進行し人工内耳手術の適応となった場合, 残存する平衡機能が術側決定において一つの重要な因子となるが, これまで平衡機能について検討した報告は少ない. 今回われわれは1999年～2016年までに当科で人工内耳埋込み術を行った前庭水管拡大症患者13例2 …
NAID 130007402899

Glycyrrhetinic Acid Reverses the Lipopolysaccharide-Induced Hypocontractility to Noradrenaline in Rat Aorta: Implications to Septic Shock

Muller Bernard,Aparin Petr G.,Stoclet Jean-Claude [他],Kleschyov Andrei L.
Journal of Pharmacological Sciences 125(4), 422-425, 2014
… Septic shock and associated vascular hyporeactivity to vasoconstrictor agonists remain a major problem of critical care medicine. …
NAID 130004677793

迷路性耳鳴に対する"中西医結合診療"の臨床研究 : 鍼治療の有用性について

呉孟達,LAWRENCE C-L Huang
全日本鍼灸学会雑誌 58(4), 626-641, 2008-08-01
今回われわれは西洋医学的に"迷路性耳鳴"と診断された65例の耳鳴症例に対して、中医学的虚実弁証の理論を導入することによって、新たに耳鳴を三つの、西洋医学と中医学両方法論を加味した類型、すなわち実証型迷路性耳鳴、虚証型迷路性耳鳴および中間証型迷路性耳鳴に分類した。次いで、これらのそれぞれの病態証候に応じて、中医学的"治病求本"の原則に基づき、鍼治療を行った。 <BR>　 …
NAID 10031188624