Hyperbaric oxygen (HBO) treatment reduces ischemia reperfusion injuries via nitric oxide synthase (NOS) and vascular endothelial growth factor (VEGF). The purpose of this study was to determine the effects of ischemia and HBO on VEGF plasma concentrations. As well as, the activity of NOS in the ischemic muscle and the abdominal aorta since HBO works systemically. The anterior gracilis muscle was raised (isolated) in 40 male Wistar rats and randomly assigned to four groups: 1) nonischemic control (Sham), 2) ischemia reperfusion (IR), 3) IR treated with HBO (IR-HBO), and 4) nonischemic control treated with HBO (Sham-HBO). Ischemia was induced by clamping the femoral artery for four hours; the clamp was removed for reperfusion. HBO treatment consisted of 100% oxygen at 2.5 atmospheres for the last 90 minutes of ischemia. Plasma and tissue were harvested after 30 minutes of reperfusion. Those tissues harvested were the anterior gracilis muscle and the abdominal aorta. The plasma VEGF concentrations were determined via ELISA, and the activity of both endothelial NOS (eNOS) and inducible NOS (iNOS) were determined by using [H3] arginine. Group comparisons were made by ANOVA with mean differences compared by Duncan#'s post-hoc analysis. A p > 0.05 was accepted as significant. Data is presented as mean ± SEM. The results for the plasma VEGF levels indicated that ischemia and HBO caused a significant decrease in plasma concentrations of VEGF, and the NOS activity levels implied there were significant increases in eNOS activity due to HBO treatment in this model. Given this information it is probable that a decreased amount of VEGF is seen in the plasma following ischemia and HBO because VEGF is binding to the endothelium and becoming more active. VEGF when activated leads to the downstream activation of eNOS, which can be seen in the increased activity of eNOS following HBO treatment.
A strong link exists between gastroesophageal reflux disease (GERD) and airway disease. We sought to determine the long-term results of laparoscopic antireflux surgery (LARS) for multiple airway symptoms of GERD. Methods: Between 12/15/1993 and 12/21/2002, 750 patients underwent LARS at the University of Washington. Of these patients, 230 (31%) experienced cough, hoarseness, or wheezing more than once per week and had failed medical management. We attempted to contact each patient and succeeded in 136 patients (59%). At a median follow-up of 53 months (range 19-110 mo) we determined frequency and severity of airway symptoms (cough, hoarseness, wheezing, sore throat, dyspnea), esophageal symptoms (heartburn, regurgitation, dysphagia), anti-acid medication usage, happiness with surgery, and rating of operative treatment. Results: Airway symptoms improved in the majority of patients (Table ). Typical GERD symptoms (heartburn, regurgitation) improved in 87-93% of patients. Preoperatively, almost all patients (98%) used prescription medical therapy. Forty-five patients (33%) continue to use daily prescription medication. The majority of patients (88%) were happy with the operative treatment, which was rated excellent by 78 patients (57%) and good by 33 patients (24%). Symptom Number of Patients % Pts Improved Pre-Op Freq Score* Post-Op Freq Score* p-value (Mean [138} SD) (Mean Ϯ SD) Cough 108 74 3.51 Ϯ 0.65 1.58 Ϯ 1.62 0.001 Hoarseness 82 66 2.93 Ϯ 1.09 1.45 Ϯ 1.54 0.001 Wheezing 37 69 2.86 Ϯ 1.13 1.46 Ϯ1.52 0.001 Sore Throat 41 70 2.56 Ϯ 1.10 1.10Ϯ 1.36 0.001 Dyspnea 31 65 2.84 Ϯ 1.00 1.97 Ϯ 1.66 0.01 *Frequency score: 0= never, 1= once/month, 2= once/week, 3= once/day, 4= several/day Conclusions: LARS provides long-term relief of airway symptoms in over two-thirds of patients with associated abnormal GERD, and in 90% of patients with typical symptoms of GERD. LARS should be considered for patients with proven GERD and cough, hoarseness, or wheezing, especially when medical management has failed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.