BACKGROUND Managing left ventricular outflow tract obstruction(LVOTO)and systolic anterior motion(SAM)of the mitral valve can be challenging,especially in the context of circulatory shock and pulmonary edema post card...BACKGROUND Managing left ventricular outflow tract obstruction(LVOTO)and systolic anterior motion(SAM)of the mitral valve can be challenging,especially in the context of circulatory shock and pulmonary edema post cardiac surgery.CASE SUMMARY We describe a case of an 80-year-old female patient with a history of severe aortic stenosis and hypertrophic obstructive cardiomyopathy that underwent aortic valve replacement and myectomy.The patient presented with acute pulmonary edema and low blood pressure due to LVOTO and SAM post cardiac surgery in the intensive care unit.She was paced with an epicardial dual-chamber pacing system due to complete atrioventricular block and treated initially with norepinephrine,furosemide,and esmolol infusion and continuous positive pressure ventilation.The patient remained hypoxemic and kept deteriorating hemodynamically despite titrating up norepinephrine.The addition of vasopressin infusion and tapering of norepinephrine finally stabilized the patient with significant reduction of LVOTO,confirmed by transthoracic echocardiography assessment,improved oxygenation and increased urine output.CONCLUSION Vasopressin seems to be the preferred vasopressor for managing LVOTO and SAM post-cardiac surgery,because of its absence of inotropic effects.Echocardiography is crucial for early diagnosis and therapeutic management.展开更多
Diabetes mellitus significantly affects the male reproduction and sexual function. In the present study, we investigated the diabetes-induced dysfunction of seminal vesicles （SVs） in the diabetes-rat model and the r...Diabetes mellitus significantly affects the male reproduction and sexual function. In the present study, we investigated the diabetes-induced dysfunction of seminal vesicles （SVs） in the diabetes-rat model and the role of antioxidants. Streptozotocin-induced diabetes after 4 weeks caused smaller size of the organs, hypercontractility, histological abnormalities, increased concentrations of malondialdehyde in the serum and tissue, overexpression of oxidative stress markers, and cleaved caspase-3 as identified by immunohistochemistry in the SVs. In addition, diabetes resulted in deceased levels of serum testosterone and no newborns after the mating studies. Antioxidants significantly normalized all the above parameters, except for the severely decreased serum testosterone levels and the negative outcome of the mating studies. The present study gives evidence for the important role of diabetes-induced oxidative stress in the function and structure of these androgen-dependent organs. Antioxidants may be a promising supplementary therapy for diabetic male patients to alleviate ejaculatory disorders but alone is not efficient treatment for the mitigation of infertility.展开更多
The article by Wu et al.1 is an interesting and meticulous work investigating the role of human umbilical cord Wharton’s jelly-derived mesenchymal stem cells(hWJ-MSCs)in the treatment of erectile dysfunction(ED)in th...The article by Wu et al.1 is an interesting and meticulous work investigating the role of human umbilical cord Wharton’s jelly-derived mesenchymal stem cells(hWJ-MSCs)in the treatment of erectile dysfunction(ED)in the diabetic rat model.展开更多
文摘BACKGROUND Managing left ventricular outflow tract obstruction(LVOTO)and systolic anterior motion(SAM)of the mitral valve can be challenging,especially in the context of circulatory shock and pulmonary edema post cardiac surgery.CASE SUMMARY We describe a case of an 80-year-old female patient with a history of severe aortic stenosis and hypertrophic obstructive cardiomyopathy that underwent aortic valve replacement and myectomy.The patient presented with acute pulmonary edema and low blood pressure due to LVOTO and SAM post cardiac surgery in the intensive care unit.She was paced with an epicardial dual-chamber pacing system due to complete atrioventricular block and treated initially with norepinephrine,furosemide,and esmolol infusion and continuous positive pressure ventilation.The patient remained hypoxemic and kept deteriorating hemodynamically despite titrating up norepinephrine.The addition of vasopressin infusion and tapering of norepinephrine finally stabilized the patient with significant reduction of LVOTO,confirmed by transthoracic echocardiography assessment,improved oxygenation and increased urine output.CONCLUSION Vasopressin seems to be the preferred vasopressor for managing LVOTO and SAM post-cardiac surgery,because of its absence of inotropic effects.Echocardiography is crucial for early diagnosis and therapeutic management.
文摘Diabetes mellitus significantly affects the male reproduction and sexual function. In the present study, we investigated the diabetes-induced dysfunction of seminal vesicles （SVs） in the diabetes-rat model and the role of antioxidants. Streptozotocin-induced diabetes after 4 weeks caused smaller size of the organs, hypercontractility, histological abnormalities, increased concentrations of malondialdehyde in the serum and tissue, overexpression of oxidative stress markers, and cleaved caspase-3 as identified by immunohistochemistry in the SVs. In addition, diabetes resulted in deceased levels of serum testosterone and no newborns after the mating studies. Antioxidants significantly normalized all the above parameters, except for the severely decreased serum testosterone levels and the negative outcome of the mating studies. The present study gives evidence for the important role of diabetes-induced oxidative stress in the function and structure of these androgen-dependent organs. Antioxidants may be a promising supplementary therapy for diabetic male patients to alleviate ejaculatory disorders but alone is not efficient treatment for the mitigation of infertility.
文摘The article by Wu et al.1 is an interesting and meticulous work investigating the role of human umbilical cord Wharton’s jelly-derived mesenchymal stem cells(hWJ-MSCs)in the treatment of erectile dysfunction(ED)in the diabetic rat model.
