PubMed Health⌕ Search

Biomedical subjects

T Mitsuo

Publications and source records attributed to T Mitsuo.

3 recordsLinked to original sources

Glucocorticoid receptor antagonism by mifepristone alters phosphocreatine breakdown during sepsis.

OBJECTIVE: To determine the role of glucocorticoids in the regulation of myocellular energetics induced by sepsis by means of the glucocorticoid receptor antagonist mifepristone (RU 38486). DESIGN: Randomized controlled study. SETTING: University laboratories. PARTICIPANTS: Thirty-two adult male Wistar rats. METHODS: Animals were randomly assigned to 1 of 4 groups. In 2 groups, mifepristone (10 mg/kg) was administered by gavage feeding 2 hours before cecal ligation and single 18-gauge needle puncture or sham operation. The other 2 groups of animals received placebo gavage feedings 2 hours before their surgical procedures. Twenty-four hours after operation, high-energy phosphate ratios, intracellular pH, the forward rate constant for the creatine kinase reaction, and phosphocreatine breakdown rates were measured in the gastrocnemius muscle by in vivo phosphorus 31 magnetic resonance spectroscopy. Tissue and blood samples were collected to measure creatine and adenosine 5'-triphosphate concentrations, Na(+)-K+ adenosine triphosphatase activity, and circulating corticosterone levels. RESULTS: Circulating corticosterone levels were twice as high in septic animals as in sham-operation control rats (P < .01). Phosphocreatine breakdown rates and Na(+)-K+ adenosine triphosphatase activity were significantly higher (40% and 75%, respectively; P < .01) in placebo-treated septic rats than in sham-operation control rats. However, phosphocreatine breakdown rates and Na(+)-K+ adenosine triphosphatase activity in mifepristone-treated septic animals were not significantly elevated above control levels. CONCLUSION: Pretreatment with mifepristone reduces the demand for adenosine triphosphate production from phosphocreatine breakdown and downregulates Na(+)-K+ adenosine triphosphatase activity during sepsis.

Adenosine Triphosphate↗

Right ventricular dysfunction in septic patients.

OBJECTIVE: To compare right ventricular ejection fraction in trauma and septic patients during the hyperdynamic circulatory phase of these states. DESIGN: Prospective, consecutive study. SETTING: University hospital ICU. PATIENTS: Eleven trauma patients (group 1) and ten septic patients (group 2) were studied. Patients with circulatory shock were excluded from the study. INTERVENTIONS: Right ventricular ejection fraction was measured with a modified pulmonary artery catheter using the thermodilution method. Patients requiring catecholamines to maintain a systolic BP greater than 90 mm Hg were excluded from the study. MEASUREMENTS AND MAIN RESULTS: Both groups 1 and 2 had high mean cardiac output values (cardiac indices 4.7 +/- 0.9 [SD] and 4.6 +/- 1.4 L/min/m2, respectively). Right ventricular ejection fraction was significantly (p less than .005) reduced in septic patients (47 +/- 7.0% vs. 36 +/- 9.7%; group 1 vs. group 2) and end-diastolic volume index was significantly (p less than .01) increased (101 +/- 34 vs. 122 +/- 40 mL/m2; group 1 vs. group 2) in comparison with the trauma patients. However, there were no significant differences in afterload between the two groups. CONCLUSIONS: Hemodynamic measurements comparing septic and trauma patients showed increased cardiac output in both groups and no differences in the pulmonary resistance. Right ventricular ejection fraction in the septic patients was significantly reduced compared with the trauma patients. Therefore, we concluded that right ventricular contractility may be decreased in septic patients.

Adult↗