Introduction: In humans, it has not been established that the use of elastic tourniquet (ET) during myomectomies, whose delivery times do not exceed 90 minutes, which is responsible for ischemia reperfusion (I/R) syst...Introduction: In humans, it has not been established that the use of elastic tourniquet (ET) during myomectomies, whose delivery times do not exceed 90 minutes, which is responsible for ischemia reperfusion (I/R) systemic. Objectives: To study the plasma variations of markers of I/R during myomectomies performed with ET, whose exposure time does not exceed 90 minutes. Population and methods: Plasma créatinin phosphokinase kinase (CPK) and gluthatione peroxydase (GPX) levels of patients with ET myoma (M + G +, n = 19), taken before, during and after exposure, were compared to those of women operated on myoma without tourniquet (M + G -, n = 15), carriers of unoperated myomas (M + G0, n = 20) and controls (M0G0, n = 18). The duration of exposure of the ET was determined, and perioperative variations of GPX, Ca2+, K+ and CPK between M + G + and others groups were analyzed (p Results: The average duration of exposure of the ET was 51.56 ± 14.12 [30 - 88] min. In M + G +, prior to insertion, CPK was 71.64, GPX 3.537, Ca2+ 3.000, K+ 3.934, and did not vary from those of M + G - (CPK = 59.354, GPX = 3.205, Ca2+ = 2.525, K+ = 3.788), M + G0 (CPK = 71.640, GPX = 2.759, Ca2+ = 3.004, K+ = 3.934) and M0G0 (CPK = 57.2, GPX = 2.306, Ca2+ = 2.879, K+ = 3.705). Conversely, during the posture (CPK = 95.665, GPX = 3.645, Ca2+ = 3.642, K+ = 4.757) and after the release of the ET (CPK = 135.443, GPX = 3.694, Ca2+ = 3.892, K+ = 5.322), these rates were higher among the M + G + compared to the M + G0 and M0G0, but did not differ from those of the M + G - during (CPK = 91.270, GPX = 3.413, Ca2+ = 3.068, K+ = 4.257) and after release (CPK = 137.776, GPX = 3.632, Ca2+ = 3.148, K+ = 5.075). Conclusion: The plasmatic concentration of ischemia (CPK, K+) and reperfusion (GPX, Ca2+) biomarkers does not differ between M + G + and M + G -, but is elevated relatively to controls (M0G0), but also to M + G0’s group. These results show that, for exposure times not exceeding 90 minutes, the elastic tourniquet is probably not the cause of the increase in plasma I/R markers observed in M + G + women. Moreover, these data suggest that the variations of the markers observed during the different surgical stages within each of the two groups of women M + G + and M + G - compared to those of the controls (M0G0) and unoperated myomas (M + G0) are due essentially to the surgical act.展开更多
Introduction: Neuroglobin (Ngb) owes its name to its preferred location in the nervous system. Its plasma concentration increases during cerebral ischemia. However, the interest of its dosage in the diagnosis and the ...Introduction: Neuroglobin (Ngb) owes its name to its preferred location in the nervous system. Its plasma concentration increases during cerebral ischemia. However, the interest of its dosage in the diagnosis and the prognosis of the strokes in the adult is not defined. Objectives: To determine if plasmatic Ngb can be used as a diagnostic biomarker and prognostic for stroke in adults at the acute phase. Population and Methods: This was a prospective study in 69 people, including 39 suspected stroke (Cerebral ischemia or CI, Intracerebral hemorrhage or ICH) and 30 healthy volunteers (controls). The plasma concentration of Ngb (CmNgb in ng/ml) of the patients was determined at admission day (d1), at the third day (d3) and seventh day (d7). CmNgbtaken at d1 was compared between patients and controls. Its evolution over time, as well as its relation with the clinical parameters, including the Glasgow coma scale and the short-term mortality in stroke subjects was analyzed by the Mann and Whitney tests and the Wilcoxon test (p Results: At d1, the CmNgb of all types of stroke was 3.140 ± 2.700 ng/ml, and did not differ significantly from controls (0.303 ± 0.114 ng/ml, p = 0.070). On the other hand, it was higher in CI victims (5.800 ± 0.720 ng/ml) than in ICH (1.750 ± 0,090 ng/ml) (p = 0.030). It then decreased on d3 in CI victims (2.600 ± 0.112 ng/ml) and ICH (0.420 ± 0.211 ng/ml), returning to normal on d7 (0.420 ± 0.200 ng/ml for CI’s, p = 0.001, and 0.360 ± 0.300 ng/ml for ICH, p = 0.002). There was a relationship between CmNgb, delay of occurrence of the first symptoms of the stroke (3.140 ± 2.700 ng/ml before the 6th hour, and 0.643 ± 0.244 ng/ml after the 6th hour (p = 0.003) and the volume of the hematoma (p = 0.0027). None relationship existed between CmNgb, Glasgow coma scale (p = 0.427) and short-term mortality (CmNgb = 3.95 ng/ml in survivors versus 2.65 ng/ml in deceased p = 0.060). Conclusion: This study shows that the plasma concentration of Neuroglobin is high during stroke in humans in the acute phase. This elevation follows triphasic?kinetics and appears to be more important during infarction than hemorrhage. These results suggest that CmNgb can be used as a diagnostic marker for stroke in adult at the acute phase, by differentiating ischemia from hemorrhage. However, this work needs to be confirmed on a larger sample of patients.展开更多
<strong>Introduction:</strong> The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. <strong>Objective: </stro...<strong>Introduction:</strong> The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. <strong>Objective: </strong>To determine if there is a relationship between ED and AHPT observed during the 1st 15 minutes after SA. <strong>Population and Methods:</strong> The study concerned 40 people who were to benefit from a programmed herniorrhaphy under SA and 40 controls (SA<sup>-</sup>). The correlations between mean plasma concentrations of endothelin-1 (CmET-1, pg/ml) and Vascular Cell Adhesion Molecule-1 (CmVCAM-1, pg/ml) taken from SA<sup>+</sup> one hour before (H0), then 15 minutes after the SA (H15) and the mean arterial pression (AMP, mmHg) with heart rate (bpm) were analyzed (p < 5%). <strong>Results:</strong> CmET-1 and CmVCAM-1 of SA<sup>-</sup> were 1.07 and 3.34, respectively, compared to 1.12 (p = 0.735) and 3.57 (p = 0.862) in SA<sup>+</sup> at H0 and H15. In SA+, at H15, CmET-1 was 1.13 (p = 0.823) and CmVCAM-1 was 3.57 (p = 0.257). In SA<sup>-</sup>, a negative correlation existed between CmET-1 and CmVCAM-1 (r = -0.438;p = 0.005). Conversely, in SA<sup>+</sup>, whether at H0 (r = -0.31;p = 0.051) or at H15 (r = 0.024;p = 0.883), no correlation existed between CmET-1 and CmVCAM-1, nor between MAP and ED markers (r = 0.111;p = 0.325). <strong>Conclusion: </strong>These results show that there is no relationship between the AHPT which occurs during the first fifteen minutes post SA, CmVCAM-1 and CmET-1. Moreover, these data suggest that ED is not involved in AHPT post SA.展开更多
文摘Introduction: In humans, it has not been established that the use of elastic tourniquet (ET) during myomectomies, whose delivery times do not exceed 90 minutes, which is responsible for ischemia reperfusion (I/R) systemic. Objectives: To study the plasma variations of markers of I/R during myomectomies performed with ET, whose exposure time does not exceed 90 minutes. Population and methods: Plasma créatinin phosphokinase kinase (CPK) and gluthatione peroxydase (GPX) levels of patients with ET myoma (M + G +, n = 19), taken before, during and after exposure, were compared to those of women operated on myoma without tourniquet (M + G -, n = 15), carriers of unoperated myomas (M + G0, n = 20) and controls (M0G0, n = 18). The duration of exposure of the ET was determined, and perioperative variations of GPX, Ca2+, K+ and CPK between M + G + and others groups were analyzed (p Results: The average duration of exposure of the ET was 51.56 ± 14.12 [30 - 88] min. In M + G +, prior to insertion, CPK was 71.64, GPX 3.537, Ca2+ 3.000, K+ 3.934, and did not vary from those of M + G - (CPK = 59.354, GPX = 3.205, Ca2+ = 2.525, K+ = 3.788), M + G0 (CPK = 71.640, GPX = 2.759, Ca2+ = 3.004, K+ = 3.934) and M0G0 (CPK = 57.2, GPX = 2.306, Ca2+ = 2.879, K+ = 3.705). Conversely, during the posture (CPK = 95.665, GPX = 3.645, Ca2+ = 3.642, K+ = 4.757) and after the release of the ET (CPK = 135.443, GPX = 3.694, Ca2+ = 3.892, K+ = 5.322), these rates were higher among the M + G + compared to the M + G0 and M0G0, but did not differ from those of the M + G - during (CPK = 91.270, GPX = 3.413, Ca2+ = 3.068, K+ = 4.257) and after release (CPK = 137.776, GPX = 3.632, Ca2+ = 3.148, K+ = 5.075). Conclusion: The plasmatic concentration of ischemia (CPK, K+) and reperfusion (GPX, Ca2+) biomarkers does not differ between M + G + and M + G -, but is elevated relatively to controls (M0G0), but also to M + G0’s group. These results show that, for exposure times not exceeding 90 minutes, the elastic tourniquet is probably not the cause of the increase in plasma I/R markers observed in M + G + women. Moreover, these data suggest that the variations of the markers observed during the different surgical stages within each of the two groups of women M + G + and M + G - compared to those of the controls (M0G0) and unoperated myomas (M + G0) are due essentially to the surgical act.
文摘Introduction: Neuroglobin (Ngb) owes its name to its preferred location in the nervous system. Its plasma concentration increases during cerebral ischemia. However, the interest of its dosage in the diagnosis and the prognosis of the strokes in the adult is not defined. Objectives: To determine if plasmatic Ngb can be used as a diagnostic biomarker and prognostic for stroke in adults at the acute phase. Population and Methods: This was a prospective study in 69 people, including 39 suspected stroke (Cerebral ischemia or CI, Intracerebral hemorrhage or ICH) and 30 healthy volunteers (controls). The plasma concentration of Ngb (CmNgb in ng/ml) of the patients was determined at admission day (d1), at the third day (d3) and seventh day (d7). CmNgbtaken at d1 was compared between patients and controls. Its evolution over time, as well as its relation with the clinical parameters, including the Glasgow coma scale and the short-term mortality in stroke subjects was analyzed by the Mann and Whitney tests and the Wilcoxon test (p Results: At d1, the CmNgb of all types of stroke was 3.140 ± 2.700 ng/ml, and did not differ significantly from controls (0.303 ± 0.114 ng/ml, p = 0.070). On the other hand, it was higher in CI victims (5.800 ± 0.720 ng/ml) than in ICH (1.750 ± 0,090 ng/ml) (p = 0.030). It then decreased on d3 in CI victims (2.600 ± 0.112 ng/ml) and ICH (0.420 ± 0.211 ng/ml), returning to normal on d7 (0.420 ± 0.200 ng/ml for CI’s, p = 0.001, and 0.360 ± 0.300 ng/ml for ICH, p = 0.002). There was a relationship between CmNgb, delay of occurrence of the first symptoms of the stroke (3.140 ± 2.700 ng/ml before the 6th hour, and 0.643 ± 0.244 ng/ml after the 6th hour (p = 0.003) and the volume of the hematoma (p = 0.0027). None relationship existed between CmNgb, Glasgow coma scale (p = 0.427) and short-term mortality (CmNgb = 3.95 ng/ml in survivors versus 2.65 ng/ml in deceased p = 0.060). Conclusion: This study shows that the plasma concentration of Neuroglobin is high during stroke in humans in the acute phase. This elevation follows triphasic?kinetics and appears to be more important during infarction than hemorrhage. These results suggest that CmNgb can be used as a diagnostic marker for stroke in adult at the acute phase, by differentiating ischemia from hemorrhage. However, this work needs to be confirmed on a larger sample of patients.
文摘<strong>Introduction:</strong> The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. <strong>Objective: </strong>To determine if there is a relationship between ED and AHPT observed during the 1st 15 minutes after SA. <strong>Population and Methods:</strong> The study concerned 40 people who were to benefit from a programmed herniorrhaphy under SA and 40 controls (SA<sup>-</sup>). The correlations between mean plasma concentrations of endothelin-1 (CmET-1, pg/ml) and Vascular Cell Adhesion Molecule-1 (CmVCAM-1, pg/ml) taken from SA<sup>+</sup> one hour before (H0), then 15 minutes after the SA (H15) and the mean arterial pression (AMP, mmHg) with heart rate (bpm) were analyzed (p < 5%). <strong>Results:</strong> CmET-1 and CmVCAM-1 of SA<sup>-</sup> were 1.07 and 3.34, respectively, compared to 1.12 (p = 0.735) and 3.57 (p = 0.862) in SA<sup>+</sup> at H0 and H15. In SA+, at H15, CmET-1 was 1.13 (p = 0.823) and CmVCAM-1 was 3.57 (p = 0.257). In SA<sup>-</sup>, a negative correlation existed between CmET-1 and CmVCAM-1 (r = -0.438;p = 0.005). Conversely, in SA<sup>+</sup>, whether at H0 (r = -0.31;p = 0.051) or at H15 (r = 0.024;p = 0.883), no correlation existed between CmET-1 and CmVCAM-1, nor between MAP and ED markers (r = 0.111;p = 0.325). <strong>Conclusion: </strong>These results show that there is no relationship between the AHPT which occurs during the first fifteen minutes post SA, CmVCAM-1 and CmET-1. Moreover, these data suggest that ED is not involved in AHPT post SA.
