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Severe aconite poisoning successfully treated with.veno-arterial extracorporeal membrane oxygenation:A case report

World Journal of Clinical Cases 2024年第2期12卷 399-404页

作者： Saeko Koh.ra Yosh.to Kamijo Ryoko Kyan Ich.ro Okada Eiju h.segawa Soich.ro Yamada Koich. Imai Asuka Kaizaki-Mitsumoto Satosh. Numazawa Department of Critical Care Medicine and Trauma National Hospital Organization Disaster Medical CenterTokyo 1900014Japan Department of Clinical Toxicology Saitama Medical UniversitySaitama 3500495Japan Saitama Prefectural Institute of Public h.alth Saitama Prefectural Institute of Public HealthSaitama 3550133Japan Division of Toxicology Department of PharmacologyToxicology and TherapeuticsShowa University School of PharmacyTokyo 1428555Japan

BACKGROUND Most species of aconite contain h.gh.y toxic aconitines,th. oral ingestion of wh.ch.can be fatal,primarily because th.y cause ventricular *** describe a case of severe aconite poisoning th.t was successfully treated th.ough.venoarterial extracorporeal membrane oxygenation(va-ECMO)and in wh.ch.detailed toxicological analyses of th. aconite roots and biological samples were performed using liquid ch.omatograph.-tandem mass spectrometry(LC-MS/MS).CASE SUMMARY A 23-year-old male presented to th. emergency room with.circulatory collapse and ventricular arrh.th.ia after ingesting approximately h.lf of a root labeled,“Aconitum japonicum Th.nb”.Two h.urs after arrival,va-ECMO was initiated as circulatory collapse became refractory to antiarrh.th.ics and *** h.urs after arrival,an electrocardiogram revealed a return to sinus *** patient was weaned off va-ECMO and th. ventilator on h.spital days 3 and 5,*** h.spital day 15,h. was transferred to a psych.atric *** oth.r h.lf of th. root and h.s biological samples were toxicologically analyzed using LC-MS/MS,revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in th. *** on admission contained 1.50 ng/mL of *** h.spital day 2,neith.r were *** on admission sh.wed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine,but th.se rapidly decreased after h.spital day *** Th. key to saving th. life of a patient with.severe aconite poisoning is to introduce va-ECMO as soon as possible.

关键词： Aconite poisoning Fatal arrh.th.ia Veno-arterial extracorporeal membrane oxygenation Aconitine Mesaconitine Case report

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Multisensory mech.nisms of gait and balance in Parkinson’s disease:an integrative review

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Neural Regeneration Research 2025年第1期20卷 82-92页

作者： Stiven Roytman Rebecca Paalanen Giulia Carli Uros Marusic Prabesh.Kanel Teus van Laar Nico I.Boh.en Department of Radiology University of MichiganAnn ArborMIUSA Department of Neurology University of MichiganAnn ArborMIUSA Morris K.Udall center of Excellence for Parkinson’s Disease Research University of MichiganAnn ArborMIUSA Institute for Kinesiology Research Science and Research Centre KoperKoperSlovenia Department of h.alth.Sciences Alma Mater Europaea–ECMMariborSlovenia Parkinson’s Foundation Research.center of Excellence University of MichiganAnn ArborMIUSA Department of Neurology University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands Neurology Service and GRECC VA Ann Arbor Healthcare SystemAnn ArborMIUSA

Understanding th. neural underpinning of h.man gait and balance is one of th. most pertinent ch.llenges for 21st-century translational neuroscience due to th. profound impact th.t falls and mobility disturbances h.ve on our aging *** and gait control does not h.ppen automatically,as previously believed,but rath.r requires continuous involvement of central nervous *** effectively exert control over th. body,th. brain must integrate multiple streams of sensory information,including visual,vestibular,and somatosensory *** mech.nisms wh.ch.underpin th. integration of th.se multisensory signals are th. principal topic of th. present *** multisensory integration th.ories focus on h.w failure of cognitive processes th.ugh. to be involved in multisensory integration leads to falls in older *** emph.sis,h.wever,h.s been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions th.t occur between th. sensory modalities in relation to gait and *** th. present work,we review th. contributions of somatosensory,visual,and vestibular modalities,along with.th.ir multisensory intersections to gait and balance in older adults and patients with.Parkinson’s *** also review evidence of vestibular contributions to multisensory temporal binding windows,previously sh.wn to be h.gh.y pertinent to fall risk in older ***,we relate multisensory vestibular mech.nisms to potential neural substrates,both.at th. level of neurobiology(concerning positron emission tomograph. imaging)and at th. level of electroph.siology(concerning electroenceph.lograph.).We h.pe th.t th.s integrative review,drawing influence across multiple subdisciplines of neuroscience,paves th. way for novel research.directions and th.rapeutic neuromodulatory approach.s,to improve th. lives of older adults and patients with.neurodegenerative diseases.

关键词： aging balance enceph.lograph. functional magnetic resonance imaging gait multisensory integration Parkinson’s disease positron emission tomograph. somatosensory vestibular visual

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Th. Impact of Psych.social Influences on Ch.onic Wound h.aling

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Open Journal of medical Psych.logy 2024年第3期13卷 39-57页

作者： Kelly Frasier Vivian Li Sara Ch.istoforides Kath.een Daly Alexandra Loperfito Karina Stech.Milena Dragovic Nuvance h.alth.vassar Broth.rs medical center Poughkeepsie NY USA Lake Erie College of Osteopath.c Medicine New York NY USA medical College of Georgia Augusta University Augusta GA USA Edward Via College of Osteopath.c Medicine Blacksburg VA USA Lewis Katz Sch.ol of Medicine Temple University Philadelphia PA USA College of Osteopath.c Medicine California Health Sciences University Clovis CA USA

Th.s compreh.nsive review explores th. intricate dynamics between psych.social factors and ch.onic wound h.aling processes, specifically focusing on prevalent conditions such.as pressure ulcers, diabetic foot ulcers, and venous leg ulcers. By examining th. roles of psych.atric conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), th.s paper illuminates h.w th.se factors intricately influence wound h.aling dynamics, including mech.nisms of pain perception and inflammatory responses. Furth.rmore, we evaluate th. effectiveness of integrated biopsych.social interventions, wh.ch.encompass a h.listic approach.to wound care, th.reby enh.ncing h.aling outcomes for dermatology patients. Future studies sh.uld focus on investigating th. specific psych.social determinants th.t significantly influence wound h.aling, exploring novel th.rapeutic strategies, and implementing personalized interventions to meet th. unique needs of each.patient. Such.endeavors h.ld promise in advancing th. fields of psych.dermatology and wound management, fostering a deeper understanding and application of psych.social considerations in dermatological care.

关键词： Psych.social Factors Ch.onic Wound h.aling Biopsych.social Interventions Psych.atric Conditions Dermatology Patients

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Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis:A propensity-match.d analysis

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World Journal of Experimental Medicine 2024年第2期14卷 75-88页

作者： h.ssam Ali Faisal Inayat Waqas Rash.ed Arslan Afzal Ah.sh.mullah.Ch.udh.y Pratik Patel Attiq Ur Reh.an Muh.mmad Sajeel Anwar Gul Nawaz Muh.mmad Soh.ib Afzal Amir h.Soh.il Subanandh.ni Subramanium Dush.ant Singh.Dah.ya Deepa Budh.Babu P Moh.n Douglas G Adler Department of Gastroenterology and h.patology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Texas Tech University Health Sciences CenterLubbockTX 79430United States Department of Internal Medicine St.Dominic’s HospitalJacksonMS 39216United States Department of Gastroenterology Mather Hospital and Hofstra University Zucker School of MedicinePort JeffersonNY 11777United States Department of h.patology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine UHS Wilson Medical CenterJohnson CityNY 13790United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Division of Gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 64108United States Department of Internal Medicine St.Barnabas Hospital and Albert Einstein College of MedicineBronxNY 10457United States Department of Gastroenterology and h.patology University of Utah School of MedicineSalt Lake CityUT 84132United States center for Advanced Th.rapeutic Endoscopy Porter Adventist HospitalCentura HealthDenverCO 80210United States

BACKGROUND Patients with.acute pancreatitis(AP)frequently experience h.spital readmissions,posing a significant burden to h.alth.are *** peripancreatic fluid collection(APFC)may negatively impact th. clinical course of *** could worsen symptoms and potentially lead to additional ***,clinical evidence regarding th. specific association between APFC and early readmission in AP remains *** th. link between APFC and readmission may h.lp improve clinical care for AP patients and reduce h.alth.are *** To evaluate th. association between APFC and 30-day readmission in patients with.*** Th.s retrospective coh.rt study is based on th. Nationwide Readmission Database for *** with.a primary diagnosis of AP were *** were categorized into th.se with.and with.ut APFC.A 1:1 propensity score match.ng for age,gender,and Elixh.user comorbidities was *** primary outcome was early readmission *** outcomes included th. incidence of inpatient complications and h.alth.are *** analyses used Mann-Wh.tney U andχ2 tests,wh.le Cox regression models assessed 30-day readmission risks and reported th.m as adjusted h.zard ratios(ah.).Kaplan-Meier curves and log-rank tests verified readmission *** A total of 673059 patients with.th. principal diagnosis of AP were *** th.se,5.1%h.d APFC on initial *** propensity score match.ng,each.coh.rt consisted of 33914 *** with.APFC sh.wed a h.gh.r incidence of inpatient complications,including septic sh.ck(3.1%vs 1.3%,Ph.ombosis(4.4%vs 0.8%,Ph.nical ventilation(1.8%vs 0.9%,Ph. length.of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,Ph.spital ch.rges($29451 vs$24418,Ph.d a h.gh.r rate(15.7%vs 6.5%,Ph. APF

关键词： Acute pancreatitis Acute peripancreatic fluid collections Readmission predictors Inpatient complications h.alth.are utilization and costs

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Calcium/calcimimetic via calcium-sensing receptor ameliorates ch.lera toxin-induced secretory diarrh.a in mice

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World Journal of Gastroenterology 2024年第3期30卷 268-279页

作者： Lie-Qi Tang Joh.ath.n Fraebel Sh. Jin Steven P Winesett Jane h.rrell Wen-h.n Ch.ng Sam Xianjun Ch.ng Department of Pediatrics University of FloridaGainesvilleFL 32610United States College of Medicine University of FloridaGainesvilleFL 32610United States Applied Ph.siology and Kinesiology University of FloridaGainesvilleFL 32610United States Brain Reh.bilitation Research.center Malcom Randall VA Medical CenterGainesvilleFL 32610United States Department of Medicine Endocrine Research UnitVeterans Affairs Medical CenterUniversity of CaliforniaSan FranciscoSan FranciscoCA 94121United States Department of Pediatric Gastroenterology Hepatologyand NutritionUniversity of Florida Shands Children’s HospitalGainesvilleFL 32608United States

BACKGROUND Enterotoxins produce diarrh.a th.ough.direct epith.lial action and indirectly by activating th. enteric nervous ***-sensing receptor(CaSR)inh.bits both.*** latter h.s been well documented in vitro but not in *** h.poth.sis to be tested was th.t activating CaSR inh.bits diarrh.a in *** To determine wh.th.r CaSR agonists ameliorate secretory diarrh.a evoked by ch.lera toxin(CTX)in *** CTX was given orally to C57BL/6 mice to induce *** and calci-mimetic R568 were used to activate *** maximize th.ir local intestinal actions,calcium was administered luminally via oral reh.dration solution(ORS),wh.reas R568 was applied serosally using an intraperitoneal *** verify th.t th.ir actions resulted from th. intestine,effects were also examined on Cre-lox intestine-specific CaSR *** outcome was measured bioch.mically by monitoring ch.nges in fecal Cl-or clinically by assessing stool consistency and weigh. *** CTX induced secretory diarrh.a,as evidenced by increases in fecal Cl-,stool consistency,and weigh. loss following CTX exposure,but did not alter CaSR,neith.r in content nor in ***,calcium and R568 were each.able to ameliorate diarrh.a wh.n applied to diseased *** CaSR involvement is suggested by gene knockout experiments wh.re th. anti-diarrh.al actions of R568 were lost in intestinal epith.lial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrh.as remains a global *** advances in diarrh.a research.few h.ve been made in th. realm of diarrh.a *** th.rapy h.s remained th. standard of care,alth.ugh.it does not h.lt th. losses of intestinal fluid and ions caused by *** is no cost-effective th.rapeutic for *** and oth.r studies suggest th.t adding calcium to ORS or using calcimimetics to activate intestinal CaSR migh.

关键词： Ch.lera Enteric nervous system Secretory diarrh.a Oral reh.dration solution Calcium-sensing receptor Gene knockout

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Epigenetic basis of cancer drug resistance

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Cancer Drug Resistance 2020年第1期3卷 113-116页

作者： Moammir h.Aziz Aamir Ah.ad James h.Quillen va medical center Johnson CityTN 37604USA Sch.ol of Medicine University of Alabama at BirminghamBirminghamAL 35205USA

Cancer is a deadly disease and resistance to th.rapies is a major reason th.t renders it particularly leth.l.A majority of research.th.s far h.s focused on genetic factors th.t form th. basis of cancer drug ***,it is increasingly being realized th.t epigenetic regulation plays a very important role in determining th. resistance of individual tumors to certain *** novel drugs th.t target epigenetic events are under investigation,th.s serving as a testimony to th. enormous potential of exploiting epigenetics in tackling th. problem of cancer drug *** forward,a focus on epigenetics will be critical for a better understanding of th. ph.nomenon of cancer drug resistance and for th. design of novel th.rapies.

关键词： drug cancer drugs

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Involvement of eicosanoids in th. path.genesis of pancreatic cancer: th. roles of cyclooxygenase-2 and 5-lipoxygenase

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World Journal of Gastroenterology 2014年第31期20卷 10729-10739页

作者： Lawrence M Knab Paul J Grippo David J Bentrem Department of Surgery Northwestern University Feinberg School of Medicine Robert h.Lurie Compreh.nsive Cancer center Northwestern University Jesse Brown va medical center

Th. interplay between inflammation and cancer progression is a growing area of research. A combination of clinical, epidemiological, and basic science investigations indicate th.t th.re is a relationsh.p between inflammatory ch.nges in th. pancreas and neoplastic progression. Diets h.gh.in ω-6 polyunsaturated fatty acids provide increased substrate for arach.donic acid metabolism by cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) to form eicosanoids. Th.se eicosanoids directly contribute to pancreatic cancer cell proliferation. Both.COX-2 and 5-LOX are upregulated in multiple cancer types, including pancreatic cancer. In vitro studies using pancreatic cancer cell lines h.ve demonstrated upregulation of COX-2 and 5-LOX at both.th. mRNA and protein levels. Wh.n COX-2 and 5-LOX are blocked via a variety of mech.nisms, cancer cell proliferation is abrogated both.in vitro and in vivo. Th. mech.nism of COX-2 h.s been sh.wn to include effects on apoptosis as well as angiogenesis. 5-LOX h.s been implicated in apoptosis. Th. use of COX-2 and 5-LOX inh.bitors in clinical studies in patients with.pancreatic cancer h.s been limited. Patient enrollment h.s been restricted to th.se with.advanced disease wh.ch.makes evaluation of th.se drugs as ch.mopreventive agents difficult. COX-2 and 5-LOX expression h.ve been sh.wn to be present during th. early neoplastic ch.nges of pancreatic cancer, well before progression to invasive disease. Th.s indicates th.t th. ideal role for th.se interventions is early in th. disease process as preventive agents, perh.ps in patients with.ch.onic pancreatitis or h.reditary pancreatitis.

关键词： Arach.donic acid Eicosanoid Cyclooxygenase-2 5-lipoxygenase Pancreatic cancer Inflammation

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Absence of h.gh.amplitude propagating contractions in subjects with.ch.onic spinal cord injury

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World Journal of Gastroenterology 2010年第43期16卷 5435-5439页

作者： h.numanth. R Anch. Noel R Fajardo William A Bauman Alan S Rosman Marinella Galea Grah.m Creasey Mark A Korsten Reh.bilitation Research.and Development center of Excellence for medical Consequences of Spinal Cord Injury James J. Peters VA Medical Center medical Service James J. Peters VA Medical Center Department of Medicine Mount Sinai School of Medicine Department of Reh.bilitation Medicine Mount Sinai School of Medicine Spinal Cord Injury Service James J. Peters VA Medical Center Spinal Cord Injury Service VA Medical Center

AIM: To investigate th. presence or absence of h.gh.amplitude propagating contractions (h.PC), as well as th. oth.r measures of colonic motility, in persons with.spinal cord injury (SCI). METh.DS: Prolonged colonic ambulatory manometric studies were performed on 14 male volunteers: 8 with.SCI (mean age, 59 ± 13 years; mean duration of injury, 13 ± 4 years) and 6 h.alth. able-bodied controls (mean age, 57 ± 10 years). A solid-state manometry cath.ter was endoscopically clipped to th. splenic flexure. Recording was performed for > 24 h.after manometric cath.ter placement. RESULTS: h.PC were absent in individuals with.SCI during pre-sleep, sleep, and post-sleep ph.ses. h.PC were significantly increased after awakening in non-SCI controls (0.8 ± 0.2 h.PC/h.vs 10.5 ± 2.0 h.PC/h. P h. motility index was lower in th.se with.SCI th.n in controls preand post-sleep (SCI vs non-SCI: Pre-sleep, 2.4 ± 0.4 vs 8.8 ± 1.9, P h.wever, a sleepinduced depression of colonic motility was observed in both.th. SCI and non-SCI groups (Pre-sleep vs Sleep, non-SCI: 8.8 ± 1.9 vs 2.1 ± 0.9, P h.th. motility index of th.se with.SCI during sleep not significantly different th.n th.t of th. controls. CONCLUSION: h.PC were not observed in individuals with.SCI preor post-sleep. A sleep-induced depression in general colonic motility was evident in SCI and control subjects.

关键词： Spinal cord injury Neurogenic bowel Bowel motility h.gh amplitude propagating contractions Motility index

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Skeletal muscle stiffness as measured by magnetic resonance elastograph. after ch.onic spinal cord injury:a cross-sectional pilot study

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Neural Regeneration Research 2021年第12期16卷 2486-2493页

作者： Mina P.Gh.tas M.Reh.n Kh.n Ash.af S.Gorgey Department of Spinal Cord Injury and Disorders Hunter Holmes McGuire VA Medical CenterRichmondVAUSA Department of Radiology Hunter Holmes McGuire VA Medical CenterRichmondVAUSA Department of Ph.sical Medicine and Reh.bilitation Virginia Commonwealth UniversityRichmondVAUSA

Skeletal muscle stiffness is altered after spinal cord injury(SCI).Assessing muscle stiffness is essential for reh.bilitation and ph.rmaceutical interventions design after *** study used magnetic resonance elastograph. to assess th. ch.nges in stiffness after ch.onic SCI compared to match.d able-bodied controls and determine its association with.muscle size,spasticity,and peak torque in persons with.*** studies examined th. association between muscle stiffness and spasticity,h.wever,we are unaware of oth.r studies th.t examined th. effects of muscle composition on stiffness after *** participants(one female)with.ch.onic SCI and eigh.(one female)match.d able-bodied controls participated in th.s cross-sectional *** resonance elastograph. was utilized to monitor stiffness derived from sh.ar waves *** Ash.orth.scale was used to evaluate spasticity scores in a blinded *** isometric and isokinetic torques were measured using a biodex *** values were non-significantly lower(12.5%;P=0.3)in th. SCI group compared to able-bodied ***,stiffness was positively related to vastus lateralis wh.le muscle cross-sectional area(CSA)(r2=0.64,Pvastus lateralis absolute muscle CSA after accounting for intramuscular fat(r2=0.78,Ph.isometric(r2=0.55-0.57,Ph.t larger clinical trial is warranted to confirm th. preliminary findings th.t muscle stiffness is altered after SCI compared to h.alth. *** appeared to be influenced by infiltration of intramuscular fat and modestly by th. spasticity of th. paralyzed *** preliminary data indicated th.t th. relationsh.p between muscle stiffness and peak torque is not altered with.ch.nging th. frequency of pulses or angular *** study procedures were approved by th. Institutional Review Board at th.

关键词： ch.onic spinal cord injury isometric and isokinetic torques magnetic resonance elastograph. muscle size reh.bilitation sh.ar modulus spasticity stiffness

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Genotypic ch.racteristics of resistant tumors to pre-operative ionizing radiation in rectal cancer

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World Journal of Gastrointestinal Oncology 2014年第7期6卷 194-210页

作者： Zeesh.n Ramzan Ammar B Nassri Sergio h.erta va North.Texas h.alth.are System-Dallas va medical center University of Texas Southwestern Medical Center Dallas TX 75216 United States

Due to a wide range of clinical response in patients un-dergoing neo-adjuvant ch.moradiation for rectal cancer it is essential to understand molecular factors th.t lead to th. broad response observed in patients receiving th. same form of *** extensive research.in th.s field,th. exact mech.nisms still remain *** raging from DNA-repair to specific molecules lead-ing to cell survival as well as resistance to apoptosis h.ve been ***,or in combination,th.re is no single path.ay th.t h.s become clinically applicable to *** th. following review,we describe th. current status of various path.ays th.t migh. lead to resistance to th. th.rapeutic applications of ionizing radiation in rectal cancer.

关键词： Ionizing radiation DNA double-strand break Non-h.mologous end-joining path.ay DNA-PKcs Ku proteins Complete path.logical response Radiation th.rapy Apoptosis Angiogenesis

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