The erector spinae plane block (ESPB), which was introduced to manage the thoracic pain, is a technical easy and less invasive ultrasound-guided technique. Although the ESPB is used widely in various ...clinical situations, no studies have evaluated the association between the clinical outcomes of the ESPB and the numerical changes of the perfusion index (PI).
The purpose of this study is to investigate the association between the clinical response following ESPB and other possible factors including the changes of PI.
Prospective, nonrandomized, and an open-label study.
The pain clinic of a tertiary university hospital.
This study included 91 patients of low back pain with degenerative spinal disease who received L4 ESPB using 20 mL of 0.2% ropivacaine. For the predication of clinical outcome, the PI was measured for 30 min at the blocked side subsequent to the ESPB. Various demographic data were also analyzed to predict the clinical outcomes.
The PI of the responder group was higher value than that of the nonresponder group until 30 min but did not show any statistically significant differences. Multivariate logistic regression analysis revealed that the duration of pain (odds ratio OR, 0.95; 95% CI, 0.90-1.00; P = 0.043), the right side injection (OR, 3.87; 95% CI, 1.42-10.55; P = 0.008), and the PI ratio of 1.5-3 at 10 min (OR, 3.79; 95% CI, 1.36-10.57; P = 0.011), were independent factors associated with successful outcomes.
The responder and the nonresponders were categorized using only changes of the numeric rating scale. The categorization based on the changes of functional disability or quality of life was not used.
The right side injection, duration of pain less than 3 months, PI ratio of 1.5-3 at 10 min following the ESPB were associated with successful clinical outcomes.
Reprogrammed metabolism is one of the hallmarks of cancer. The dysregulation of glycolysis in cancer has been heavily studied. However, it remains largely unclear how other metabolic processes are ...regulated in cancer cells. Here we show that microRNA-182 (miR-182) suppresses pyruvate dehydrogenase (PDH) kinase 4 (PDK4) and promotes lung tumorigenesis. miR-182 is dysregulated and inversely correlated with PDK4 in human lung adenocarcinomas. The miR-182-PDK4 axis regulates lung cancer cell growth by modulating the activity of PDH, the gatekeeping enzyme of pyruvate flux into acetyl-CoA, and subsequently de novo lipogenesis of cancer cells. Suppression of lipogenesis by silencing ATP citrate lyase (ACLY) and fatty acid synthase (FASN) or by chemical inhibitors diminishes the effects of miR-182-PDK4 in tumor growth. Alteration of de novo lipogenesis also affects reactive oxygen species (ROS) production and the downstream JNK signaling pathway. Hence, our work suggests that the miR-182-PDK4 axis is a crucial regulator of cancer cell metabolism and a potential target for antitumor therapy.
The erector spinae plane block (ESPB) is an interfascial plane block for managing neuropathic thoracic pain. Although the ESPB is applied widely in various clinical situations, no studies have ...evaluated the association between the analgesic outcomes of the ESPB and the numerical changes in the perfusion index (PI) and PI ratio.
The purpose of this study is to investigate the association between the clinical response following ESPB and other possible factors, including changes in the PI and PI ratio.
A prospective, nonrandomized, and open-label study.
The pain clinic of a tertiary university hospital.
This study included 92 patients with neck or arm pain who received T2 ESPB using 20 mL of 0.2% ropivacaine. To aid in the prediction of clinical outcomes, the PI was measured at the blocked side for 30 minutes as soon as the ESPB was finished. Various demographic data were also analyzed to predict the clinical outcomes.
Among 92 patients, 59 patients (64%) showed successful treatment outcomes (> 50% reduction in the numerical rating scale score or > 30% reduction in the neck disability index). The baseline PI of the responders was statistically higher than the nonresponders' (P < 0.05). Also, the responders' PI demonstrated statistically higher values than the nonresponders' at the time points of 4, 6, and 8 minutes after the ESPB. Multivariate logistic regression analysis revealed that a higher baseline PI (OR, 1.91; 95% CI, 1.27-2.86; P = 0.002) was an independent factor associated with a successful outcome.
Only a small number of patients with nonspinal diseases were included, except for those who had cervical radiculopathy. Therefore, it is hard to conclude that thoracic ESPB has any therapeutic benefits to patients with nonspinal diseases such as complex regional pain syndrome, adhesive capsulitis, or post-thoracotomy pain syndrome.
A successful outcome at 4 weeks after T2 ESPB was achieved in 64% of patients with cervical radiculopathy. A higher baseline PI value was an independent factor associated with a successful response to T2 ESPB.
Taylor-Couette flow for astrophysical purposes Ji, H; Goodman, J
Philosophical transactions of the Royal Society of London. Series A: Mathematical, physical, and engineering sciences,
05/2023, Letnik:
381, Številka:
2246
Journal Article
Recenzirano
Odprti dostop
A concise review is given of astrophysically motivated experimental and theoretical research on Taylor-Couette flow. The flows of interest rotate differentially with the inner cylinder faster than ...the outer, but are linearly stable against Rayleigh's inviscid centrifugal instability. At shear Reynolds numbers as large as Formula: see text, hydrodynamic flows of this type (quasi-Keplerian) appear to be nonlinearly stable: no turbulence is seen that cannot be attributed to interaction with the axial boundaries, rather than the radial shear itself. Direct numerical simulations agree, although they cannot yet reach such high Reynolds numbers. This result indicates that accretion-disc turbulence is not purely hydrodynamic in origin, at least insofar as it is driven by radial shear. Theory, however, predicts linear magnetohydrodynamic (MHD) instabilities in astrophysical discs: in particular, the standard magnetorotational instability (SMRI). MHD Taylor-Couette experiments aimed at SMRI are challenged by the low magnetic Prandtl numbers of liquid metals. High fluid Reynolds numbers and careful control of the axial boundaries are required. The quest for laboratory SMRI has been rewarded with the discovery of some interesting inductionless cousins of SMRI, and with the recently reported success in demonstrating SMRI itself using conducting axial boundaries. Some outstanding questions and near-future prospects are discussed, especially in connection with astrophysics. This article is part of the theme issue 'Taylor-Couette and related flows on the centennial of Taylor's seminal
paper (Part 2)'.
The unique immunomodulatory properties of mesenchymal stem cells (MSCs) make them an invaluable cell type for the repair of tissue/ organ damage caused by chronic inflammation or autoimmune ...disorders. Although they hold great promise in the treatment of immune disorders such as graft versus host disease (GvHD) and allergic disorders, there remain many challenges to overcome before their widespread clinical application. An understanding of the biological properties of MSCs will clarify the mechanisms of MSC-based transplantation for immunomodulation. In this review, we summarize the preclinical and clinical studies of MSCs from different adult tissues, discuss the current hurdles to their use and propose the future development of pluripotent stem cell-derived MSCs as an approach to immunomodulation therapy.
The erector spinae plane block (ESPB), which was introduced for the management of thoracic pain, is a technically easy and relatively noninvasive ultrasound (ULSD)-guided technique. Although the ESPB ...is used widely in variable clinical situations, its sympatholytic effect has never been studied.
The purpose of this study is to demonstrate the sympatholytic effect of the high thoracic ESPB by comparing the blocked and unblocked sides of patients' upper extremities, using the changes in the perfusion index (PI).
Prospective, single-group, and open-label study.
The study was carried out in the pain clinic of a tertiary university hospital.
This study included 47 patients with upper extremity pain and various diseases who received T2 or T3 ESPBs using 20 mL of 0.2% ropivacaine. For the evaluation of the sympatholytic effect, measurements were taken on the numeric rating scale (NRS), the neck disability index (NDI), and the PI.
The PIs of the blocked sides demonstrated significant increases at 10, 20, and 30 minutes compared to the PIs of the baseline and unblocked sides (P < 0.001). The PI ratio at 10 minutes was 2.74 ± 1.65, which was the highest value during the measurement period. Until 30 minutes after the ESPB, the PI ratio was significantly higher in the blocked side than in the unblocked side. During the study period, significant reductions in NRS and NDI scores were found irrespective of disease entity.
The period of PI measurement was only 30 minutes, so we could not determine the time point when the PI returned to the baseline value.
The high thoracic ESPB was effective in relieving upper extremity pain in diverse disease entities, and the PIs of patients' blocked sides demonstrated significant increases over the baseline value and contralateral unblocked sides.
Abstract Nicotinamide adenine dinucleotide (NAD+ ) is an essential cofactor for multiple cellular metabolic reactions and has a central role in energy production. Brain ischemia depletes NAD+ pools ...leading to bioenergetics failure and cell death. Nicotinamide mononucleotide (NMN) is utilized by the NAD+ salvage pathway enzyme, nicotinamide adenylyltransferase (Nmnat) to generate NAD+ . Therefore, we examined whether NMN could protect against ischemic brain damage. Mice were subjected to transient forebrain ischemia and treated with NMN or vehicle at the start of reperfusion or 30 min after the ischemic insult. At 2, 4, and 24 h of recovery, the proteins poly-ADP-ribosylation (PAR), hippocampal NAD+ levels, and expression levels of NAD+ salvage pathway enzymes were determined. Furthermore, animal's neurologic outcome and hippocampal CA1 neuronal death was assessed after six days of reperfusion. NMN (62.5 mg/kg) dramatically ameliorated the hippocampal CA1 injury and significantly improved the neurological outcome. Additionally, the post-ischemic NMN treatment prevented the increase in PAR formation and NAD+ catabolism. Since the NMN administration did not affect animal's temperature, blood gases or regional cerebral blood flow during recovery, the protective effect was not a result of altered reperfusion conditions. These data suggest that administration of NMN at a proper dosage has a strong protective effect against ischemic brain injury.
By examining the entropy production in fully kinetic simulations of collisional plasmas, it is shown that the transition from collisional Sweet-Parker reconnection to collisionless Hall reconnection ...may be viewed as a thermodynamic phase transition. The phase transition occurs when the reconnection electric field satisfies E = ED √me / mi, where me / mi is the electron-to-ion mass ratio and ED is the Dreicer electric field. This condition applies for all mi / me, including mi / me = 1, where the Hall regime vanishes and a direct phase transition from the collisional to the kinetic regime occurs. In the limit me / mi → 0, this condition is equivalent to there being a critical electron temperature Te ≈ mi Ωi2 δ2, where Ωi is the ion cyclotron frequency and δ is the current sheet half-thickness. The heat capacity of the current sheet changes discontinuously across the phase transition, and a critical power law is identified in an effective heat capacity. A model for the time-dependent evolution of an isolated current sheet in the collisional regime is derived.
A high-performance H
gas sensor system based on capacitive electrodes and a volumetric analysis technique were developed. Coaxial capacitive electrodes were fabricated by placing a thin copper rod in ...the center and by adhering a transparent conductive film on the exterior surface of a graduated cylinder. Thus, H
from a polymer specimen lowered the water level in the cylinder between the two electrodes, producing measurable changes in capacitance that allowed for the measurement of the H
concentration emitted from the specimen enriched by H
under high-pressure conditions. The sensing system detected diffused/permeated hydrogen gas from a specimen and hydrogen gas leaks caused by imperfect sealing. The hydrogen gas sensor responded almost instantly at 1 s and measured hydrogen concentrations ranging from 0.15 to 1500 ppm with controllable sensitivity and a measurable range. In addition, performance tests with polymer specimens used in hydrogen infrastructure verified that the sensor system was reliable; additionally, it had a broad measurement range to four decimal places. The sensor system developed in this study could be applied to detect and characterize pure gases (He, N
, O
and Ar) by real time measurement.
Effective targeted therapy for non-small-cell lung cancer (NSCLC) patients with human epidermal growth factor receptor 2 (HER2) mutations remains an unmet need. This study investigated the antitumor ...effect of an irreversible pan-HER receptor tyrosine kinase inhibitor, pyrotinib.
Using patient-derived organoids and xenografts established from an HER2-A775_G776YVMA-inserted advanced lung adenocarcinoma patient sample, we investigated the antitumor activity of pyrotinib. Preliminary safety and efficacy of pyrotinib in 15 HER2-mutant NSCLC patients in a phase II clinical trial are also presented.
Pyrotinib showed significant growth inhibition of organoids relative to afatinib in vitro (P = 0.0038). In the PDX model, pyrotinib showed a superior antitumor effect than afatinib (P = 0.0471) and T-DM1 (P = 0.0138). Mice treated with pyrotinib displayed significant tumor burden reduction (mean tumor volume, −52.2%). In contrast, afatinib (25.4%) and T-DM1 (10.9%) showed no obvious reduction. Moreover, pyrotinib showed a robust ability to inhibit pHER2, pERK and pAkt. In the phase II cohort of 15 patients with HER2-mutant NSCLC, pyrotinib 400 mg resulted in a objective response rate of 53.3% and a median progression-free survival of 6.4 months.
Pyrotinib showed activity against NSCLC with HER2 exon 20 mutations in both patient-derived organoids and a PDX model. In the clinical trial, pyrotinib showed promising efficacy.
NCT02535507.
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