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미국
Organ culture: a new model for vascular endothelium dysfunction
Background Endothelium dysfunction is believed to play a role in the development of cardiovascular disease. The aim of the present study was to evaluate the suitability of organ culture as a model for endothelium dysfunction. Methods The isometric tension was recorded in isolated segments of the rat mesenteric artery branch, before and after organ culture for 20 h. Vasodilatation was expressed as % of preconstriction with U46619. The acetylcholine (ACh) induced nitric oxide (NO) mediated dilatation was studied in the presence of 10 μM indomethacin, 50 nM charybdotoxin and 1 μM apamin. Endothelium-derived hyperpolarising factor (EDHF) was studied in the presence of 0.1 mM L-NOARG and indomethacin. Prostaglandins were studied in the presence of L-NOARG, charybdotoxin and apamin. Results The ACh-induced NO and prostaglandin-mediated dilatations decreased significantly during organ culture (NO: 84% in control and 36% in cultured; prostaglandins: 48% in control and 16% in cultured). Notably, the total ACh-dilatation was not changed. This might be explained by the finding that EDHF alone stimulated a full dilatation even after organ culture (83% in control and 80% in cultured). EDHF may thereby compensate for the loss in NO and prostaglandin-mediated dilatation. Dilatations induced by forskolin or sodium nitroprusside did not change after organ culture, indicating intact smooth muscle cell function. Conclusions Organ culture induces a loss in NO and prostaglandin-mediated dilatation, which is compensated for by EDHF. This shift in mediator profile resembles that in endothelium dysfunction. Organ culture provides an easily accessible model where the molecular changes that take place, when endothelium dysfunction is developed, can be examined over time.
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Debate: The slippery slope of surrogate outcomes
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Surrogate outcomes are frequently used in cardiovascular disease research. A concern is that changes in surrogate markers may not reflect changes in disease outcomes. Two recent clinical trials (Heart and Estrogen/Progestin Replacement Study [HERS], and the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial [ALLHAT]) underscore this problem since their results contradicted what was expected based on the surrogate outcomes. The current regulatory policy to allow new therapies to be introduced onto the market based solely on surrogate outcomes may need to be reviewed.
Abdominal compartment syndrome
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Intra-abdominal hypertension (IAH) associated with organ dysfunction defines the abdominal compartment syndrome (ACS). Elevated intra-abdominal pressure (IAP) adversely impacts pulmonary, cardiovascular, renal, splanchnic, musculoskeletal/integumentary, and central nervous system physiology. The combination of IAH and disordered physiology results in a clinical syndrome with significant morbidity and mortality. The onset of the ACS requires prompt recognition and appropriately timed and staged intervention in order to optimize outcome. The history, pathophysiology, clinical presentation, and management of this disorder is outlined.
Dataset for Impact of living conditions on cardiovascular function in atherosclerosis-prone mice and smoke exposure
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Raw data for all figures and tables in manuscript for study analyzing the impact of living conditions on cardiovascular function in ApoE -/- mice. This dataset is associated with the following publication: Fiamingo, M., S. Toler, K. Lee, W. Oshiro, Q. Krantz, P. Evansky, D. Davies, M. Gilmour, A. Farraj, and M. Hazari. Depleted housing elicits cardiopulmonary dysfunction after a single flaming eucalyptus wildfire smoke exposure in a sex-specific manner in ApoE knockout mice.. Cardiovascular Toxicology. Humana Press Incorporated, Totowa, NJ, USA, 24: 852-869, (2024).
가톨릭대학교 은평성모병원 - (은평)고지혈증 환자의 스타틴 최초 처방 데이터 2020
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고지혈증 환자들의 최초 진단과와 최초 진단명과 진단코드 데이터. 진단과로는 소화기내과, 순환기내과, 내분비내과 등이 포함되어 환자 유입 경로를 분석할 수 있음. 스타틴 약물 데이터는 RxNorm 코드로 매핑됨.
Noninferiority trials
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In one of the biggest dilemmas facing cardiovascular clinical research, clinical trials are increasingly being required to show benefits on clinical end-points rather than surrogate end-points, while at the same time the incremental benefits of newer treatments are getting smaller. These two factors have a huge impact on sample size, which has led some investigators to design trials to show that the new treatment has an effect similar to that of the standard, rather than outright superiority. Recent examples of fibrinolytic trials that have demonstrated similar effects of two drugs are ASSENT (Assessment of the Safety and Efficacy of a New Thrombolytic)-2, GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries)-III, and COBALT (Continuous Infusion Versus Double-Bolus Administration of Alteplase) [1,2,3,4]. However, as discussed by several authors [5,6,7,8], there are issues with trials of this type that make them considerably less credible than superiority trials.