Oxygen dynamics were measured in both sides of the paraspinal muscles of patients with degenerative lumbar scoliosis. The objective was to investigate the extent of stress by measuring the changes in oxygenation and blood flow volume using near-infrared spectroscopy. There were 44 patients with degenerative lumbar scoliosis (7 men, 37 women) and 11 controls with no scoliosis (2 men, 9 women). The measured recovery time for deoxyhemoglobin indicated the recovery from energy deficit after exercise. The average recovery time of the 11 control subjects was 2.4 +/- 0.7 s on the right and 2.4 +/- 0.8 s on the left. Among the 44 patients the average recovery time was 3.8 +/- 1.8 s on the convex side and 2.1 +/- 1.1 s on the concave side. There was a significant difference between the two groups. The recovery time on the concave side in patients was faster than that on the convex side. The results of the current study support the theory that stretching the muscles at the convex side results in chronic increases in the intramuscular compartment and reduced muscular blood flow.
Case: A 71-year-old woman was admitted to the Emergency Department with severe dyspnea followed by unconsciousness. She had a history of hyperthyroidism and her anterior neck was markedly swollen. After ventilation was started, she soon became conscious with the improvement of oxygenation. Computed tomography findings indicated giant goiter surrounding the trachea. Later, we carried out a thyroidectomy for the giant goiter (800 g), and tracheostomy. Bronchoscopy carried out at the end of surgery showed a deformed tracheal wall on breathing. During inspiration, the collapsed wall of the trachea occluded the airway, although the tracheal wall recovered to normal during expiration. We diagnosed this case as acquired tracheomalacia and a tracheal stent graft made of silicon was inserted immediately after bronchoscopy.Outcome: After stent graft insertion, the patient was transferred to another hospital. Conclusion: Emergency physicians should be aware of the causes of tracheomalacia in order to safely carry out treatment, particularly in the case of patients with giant goiter.
Aims/Introduction: Nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasomes produce IL-18 upon being activated by various stimuli via the P2 receptors. Previously, we showed that serum and urine IL-18 levels are positively associated with albuminuria in patients with type 2 diabetes, indicating the involvement of inflammasome activation in the pathogenesis of diabetic kidney disease (DKD). In the present study, we investigated whether the administration of suramin, a nonselective antagonist of the P2 receptors, protects diabetic KK.Cg-A y /TaJcl (KK-Ay) mice against DKD progression. Materials and Methods: Suramin or saline was administered i.p. to KK-Ay and C57BL/ 6J mice once every 2 weeks for a period of 8 weeks. Mouse mesangial cells (MMCs) were stimulated with ATP in the presence or absence of suramin. Results: Suramin treatment significantly suppressed the increase in the urinary albuminto-creatinine ratio, glomerular hypertrophy, mesangial matrix expansion, and glomerular fibrosis in KK-Ay mice. Suramin also suppressed the upregulation of NLRP3 inflammasome-related genes and proteins in the renal cortex of KK-Ay mice. P2X4 and P2X7 receptors were significantly upregulated in the isolated glomeruli of KK-Ay mice and mainly distributed in the glomerular mesangial cells of KK-Ay mice. Although neither ATP nor suramin affected NLRP3 expression in MMCs, suramin inhibited ATP-induced NLRP3 complex formation and the downstream expression of caspase-1 and IL-18 in MMCs. Conclusions: These results suggest that the NLRP3 inflammasome is activated in a diabetic kidney and that inhibition of the NLRP3 inflammasome with suramin protects against the progression of early stage DKD.
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