Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years. They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate. Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis. These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours. They were straight, sometimes slightly bent, rarely (one case out of 12) arciform. In 11 of 12 cases, the affected patient was female. In most cases, the urine was infected by Proteus mirabilis. In spite of their size, the calculi caused total obstruction in 3 of 12 cases only. They were or were not associated to ipsilateral coral calculi of the same chemical type. Destruction was easily achieved with physical agents. The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi.
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PMID:[Long ureteral ammonium-magnesium phosphate (struvite) and calcium phospho-carbonate calculi]. 180 76

We determined total plasma calcium levels in 44 critically ill patients without evidence of renal or hepatic failure, 25 of them with active systemic infection. Plasma Ca was 7.49 +/- 0.1 mg/dl in the septic group compared to 8.46 +/- 0.2 in non septic patients (p < 0.01). Corresponding levels of serum albumin were 2.26 +/- 0.1 and 3.05 +/- 0.2 milligrams, respectively (p < 0.01). Corresponding corrected plasma Ca levels were 9.19 +/- 0.1 and 9.39 +/- 0.1 mg/dl (NS). No correlation of lactate and plasma Ca levels was found. Mortality was 56% for septic and 16% for non septic patients. Patients with hypocalcemia had 53% mortality rate compared to only 16% in normocalcemic patients. PTH levels were normal in all but one patients, thus ruling out a rapid installation secondary hyperparathyroidism. Hypoperfusion does not appear related to ionic Ca levels given the lack of correlation of Ca and lactate levels. Mortality is related to sepsis and hypoalbuminemia but not to corrected Ca plasma levels.
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PMID:[Plasma calcium levels in critical patients with and without sepsis]. 184 18

Cytokines have been implicated in the modulation of fat metabolism after sepsis. Carnitine palmitoyltransferase (CPT), the regulatory enzyme of hepatic mitochondrial long-chain fatty-acid oxidation, is involved in the control of hepatic fat oxidation in sepsis. Using either H4IIe rat hepatoma cells or rat hepatocytes in primary culture, we tested the hypothesis that interleukin-1-alpha (IL-1 alpha) would modulate CPT transcription (CPT mRNA), CPT translation (35S-methionine CPT protein incorporation), and hepatic mitochondrial oxidation of 1-Carbon 14-labeled (14C) palmitate to ketone bodies (acid soluble products). We showed that IL-1 alpha significantly increased CPT mRNA, 35S-methionine incorporation CPT protein, and hepatic mitochondrial oxidation of 1-14C-palmitate to acid soluble products. We further hypothesized that the Ca2+ second messenger system may play a role in the IL-1 alpha induction of hepatic CPT gene transcription. We showed that either calcium ionophore (A23187) or phorbol myristate acetate increased CPT gene transcription and that either calcium chelation, protein kinase C inhibition (acridine orange), or chronic exposure to phorbol myristate acetate significantly inhibited IL-1 alpha induction of CPT mRNA. We conclude that the IL-1 alpha increases in hepatic mitochondrial fatty-acid oxidation may be, in part, secondary to increased CPT gene transcription and translation and that the Ca2+ second messenger system may play an important role in IL-1 alpha induction of CPT gene transcription.
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PMID:The Ca2+ second messenger system and interleukin-1-alpha modulation of hepatic gene transcription and mitochondrial fat oxidation. 185 38

Calciphylaxis is a rare, severe complication of secondary hyperparathyroidism. Patients present with painful, violaceous, mottled skin lesions of the upper and lower extremities, which become necrotic and produce nonhealing ulcers. Gangrene of fingers and toes frequently requires amputation, produces nonhealing wounds, and can lead to sepsis and death. We reviewed the clinical course of five patients with calciphylaxis treated in our institution. The three men and two women (aged 47 to 72 years) had secondary hyperparathyroidism from chronic renal failure. All patients had severe pruritus, painful ulcers, and severe hyperphosphatemia with elevated serum calcium-phosphate product (greater than 12 mmol2/L2), but the serum parathyroid hormone levels were only moderately elevated. Most patients had medical calcification of medium and small blood vessels, and some had soft-tissue calcification visible on roentgenography. Treatment consisted of local wound care, antibiotics, phosphate-binding agents, and parathyroidectomy. Two patients died of uncontrollable sepsis. The three survivors had dramatic improvement of pain and ulcers after parathyroidectomy. Calciphylaxis is a limb- and life-threatening complication of secondary hyperparathyroidism. Diagnosis can be made by recognizing the characteristic painful skin lesions, ulcers, and gangrene of the digits, and patients should be treated with subtotal parathyroidectomy.
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PMID:Calciphylaxis in secondary hyperparathyroidism. Diagnosis and parathyroidectomy. 192 21

The potential deleterious effects of aerosolized fibrin on contaminated procedures were investigated in a rat model of peritonitis. One hundred forty rats were divided into two groups. In the control group, gelatin capsules containing feces (10(7) bacteria per milliliter) and barium sulfate at various dilutions were placed into the abdomen; in the second experimental group, a solution of cryoprecipitate, thrombin, and calcium was sprayed diffusely into the peritoneal cavity after similar fecal contamination. Fecal inocula with low bacterial concentrations (0.01, 0.1, and 0.15 mL) caused few deaths from peritonitis or abscess formation in either group. Heavy peritoneal contamination (0.25, 0.3, and 0.5 mL) caused early deaths from peritonitis in both groups, with 80% of the deaths due to sepsis in the first 48 hours. However, in the moderately contaminated rats (0.2 mL of fecal inoculate), fibrin aerosol reduced the 10-day mortality from 80% to 10%. In all survivors in the fibrin-treated group, intraperitoneal abscesses developed. With intraperitoneal bacterial concentrations of 2 x 10(6) organisms, early acute mortality from fibrinopurulent peritonitis is decreased at the expense of late, localized, nonlethal abscess formation. Aerosolized fibrin solution must be used with caution in contaminated surgery.
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PMID:Effect of aerosolized fibrin solution on intraperitoneal contamination. 198 38

Vibrio anguillarum is a pathogenic marine bacterium which causes the disease vibriosis in salmonid fish, which is characterized by a fatal hemorrhagic septicemia accompanied by massive tissue destruction. In this paper, the purification of the major caseinolytic extracellular protease from V. anguillarum is presented. The purification steps include ammonium sulfate precipitation, DEAE-Sepharose chromatography, Sephacryl S-200 chromatography, and DEAE high-pressure liquid chromatography. The purified protease migrates with Mr = 38,000 upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A slightly larger protease of Mr 40,000 is also separated by this procedure, but accounts for only a minor fraction of the caseinolytic activity. The Mr 38,000 protease displays a broad pH activity profile in the neutral to basic range. It is not inhibited by serine, cysteine, or acid protease inhibitors, but is inhibited by EDTA and 1,10-phenanthroline, suggesting that it is a metalloprotease. The activity of the EDTA-inactivated protease could be partially restored by the addition of Ca2+ and Zn2+ together. The molecular weight and inhibition data show some similarities with proteases isolated from other Vibrio species such as Vibrio cholerae and Vibrio vulnificus.
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PMID:Purification and characterization of a secreted protease from the pathogenic marine bacterium Vibrio anguillarum. 201 4

One hundred and twenty-five previously untreated patients bearing metastatic or advanced recurrent (inoperable) colorectal carcinoma and measurable disease were prospectively randomized. Those in arm A received 5-fluorouracil (5-FU), 1,200 mg/m2 i.v. infusion over 2 h, while those in arm B received methotrexate (MTX), 200 mg/m2 i.v. (push injection), followed 20 h later by 5-FU, 1,200 mg/m2 i.v. infusion over 2 h, plus calcium leucovorin (LV), 25 mg i.m. every 6 h for eight doses beginning 24 h after MTX administration. Cycles were repeated every 15 days. All patients receiving treatment were evaluable for toxicity and survival, and 118 patients were evaluable for response. The objective regression rate (complete plus partial response) was 12% (7 of 58) in arm A and 28% (17 of 60) in arm B (p = 0.049). No change was observed in 24% (14 of 58) in arm A and in 35% (21 of 60) in arm B (p = 0.28), while progressive disease was registered in 64% (37 of 58) and 37% (22 of 60) in arms A and B, respectively (p = 0.006). Median duration of response was 3 months in arm A and 5 months in arm B (p = 0.39). The median survival was 8.3 months in arm A and 11.2 months in arm B (p = 0.25). No statistically significant differences were found when objective regression and survival were related to site of primary tumor, performance status, and number of involved organs. There were two drug-related deaths in arm B due to severe myelosuppression followed by mucositis and sepsis. Of nonhematologic toxicities, diarrhea was more frequently observed in arm B, as were mucositis and infectious complications. Our results indicate that the sequential schedule MTX-5-FU-LV with 20-h intervals between MTX and 5-FU is superior in terms of objective regression to 5-FU alone given at the dose and schedule used in the present study. However, MTX-5-FU-LV did not have a significant impact on survival.
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PMID:Advanced colorectal carcinoma. A prospective randomized trial of sequential methotrexate, 5-fluorouracil, and leucovorin versus 5-fluorouracil alone. 203 8

The object of this is to evaluate the influence of several micronutrients on the survival rate of septic patients following abdominal surgery. A retrospective assessment was done of sixty-one patients suffering from neoplastic or non-neoplastic pathology associated to septicemia. On admission the following parameters were determined: number of total lymphocytes, serum albumin, transferrin, zinc, copper, magnesium, iron, calcium, phosphorus, and copper/zinc levels. The differences obtained between surviving and non-surviving patients were analyzed. The most relevant findings revealed statistically significant lower serum albumin, zinc and transferrin values in the latter group. We conclude by stating that such parameters may be of prognostic value in this type of patients, and that supplemental micronutrients must be administered in order to improve prognosis.
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PMID:[Micronutrients in severe septic aggression. Their usefulness as prognostic markers]. 207 2

Traumatic injury often results in profound immunopathology that can lead to immunosuppression, thereby increasing the morbidity and mortality due to sepsis. The isolation and partial characterization of an immunosuppressive glycopeptide (SAP) from serum of severely burned patients has previously been reported by our laboratory. Recently, this trauma peptide has also been identified in the serum of patients with multiple blunt trauma. This glycopeptide is capable of suppressing neutrophil chemotaxis, T-cell blastogenesis and the lysis of human erythrocytes. We demonstrate in this report that SAP inhibits interleukin 2 (IL-2) biosynthesis by mitogen-stimulated peripheral blood mononuclear cells. Peptide concentrations of 50 nmol and above significantly inhibited IL-2 production. Inhibition was not reduced by the addition of indomethacin or anti-PGE2 to cultures containing greater than 100 nmol of peptide, suggesting that inhibition is not entirely prostaglandin-mediated. Preliminary studies have shown that IL-2 suppression by SAP can be partially reversed by the addition of calcium ionophore. These results suggest a potential immunosuppressive mechanism of the trauma peptide in which T cell blastogenesis is inhibited by interference in IL-2 biosynthesis.
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PMID:In vitro inhibition of IL-2 biosynthesis in activated human peripheral blood mononuclear cells by a trauma-induced glycopeptide. 210 88

It is likely that dynamic interactions between hepatocytes and Kupffer cells contribute to the responses of these cell types both under normal conditions and during sepsis. In this study, we examined the influences of hepatocytes on the concentration of the inflammatory mediator PGE2 in Kupffer cell cultures. Evidence to suggest that cultured rat hepatocytes both metabolize PGE2 and produce a substance that promotes LPS-stimulated Kupffer cell PGE2 biosynthesis include the following: 1) PGE2 levels in Kupffer cell: hepatocyte coculture were lower than the levels in Kupffer cell cultures early after LPS stimulation; 2) 36 h after LPS, coculture PGE2 levels exceeded the levels in Kupffer cell cultures despite the demonstrated capacity for hepatocytes to metabolize PGE2; 3) a transferable, non-dialyzable, and heat-unstable factor in hepatocyte supernatant promoted PGE2 production when added to Kupffer cells with LPS or after LPS; 4) there was no increased PGE2 synthesis when the hepatocyte supernatant was added without LPS or if hepatocyte supernatant was preincubated with the Kupffer cells for 6 or 18 h before LPS administration; 5) there was an inability of the hepatocyte factor to promote PGE2 production in response to other macrophage-activating agents, including calcium ionophore A23187 or phorphol myristate acetate; and 6) there was no increased cell replication or protein synthesis in the Kupffer cell cultures following hepatocyte supernatant incubation. The increased Kupffer cell PGE2 production by the hepatocyte supernatant was not due to contamination of the hepatocyte supernatant by endotoxin or PGE2. These in vitro results raise the possibility that hepatocytes have the capacity to modulate local PGE2 levels by two distinct mechanisms. Hepatocytes can metabolize PGE2 as well as release factor(s) which promote LPS-induced PGE2 production by Kupffer cells.
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PMID:Hepatocyte modulation of Kupffer cell prostaglandin E2 production in vitro. 210 27


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