http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Role of NHE1 in the Cellular Dysfunction of Acute Metabolic Acidosis
Wu, Dongmei,Kraut, Jeffrey A. S. Karger AG 2014 American journal of nephrology Vol.40 No.1
<P>Abstract</P><P><B><I>Background:</I></B> Metabolic acidosis is associated with impaired cellular function. This has been attributed to the accompanying reduction in intracellular and interstitial pH of the myocardium. Recent studies suggest that activation of the cellular Na<SUP>+</SUP>-H<SUP>+</SUP> exchanger NHE1 might contribute to myocardial dysfunction. This review examines the experimental evidence which supports the role of NHE1 in the genesis of acidosis-induced cellular dysfunction, the benefits of its inhibition, and the type of acidosis that might benefit from therapy. <B><I>Summary:</I></B> Information was obtained by searching MEDLINE for articles published between 1969 and 2013 using the terms: NHE1, metabolic acidosis, lactic acidosis, ischemia-reperfusion, shock, resuscitation, high anion gap acidosis, and non-gap acidosis. Each article was also reviewed for additional suitable references. Nineteen manuscripts published between 2002 and 2013 assessed the impact of inhibition of NHE1 on cellular function. They revealed that NHE1 is activated with metabolic acidosis associated with hypoxia, hypoperfusion, hemorrhagic shock, and sepsis. This was associated with a rise in cellular sodium and calcium and cardiac dysfunction including reduced contractility and a predisposition to cardiac arrhythmias. Inhibition of NHE1 with specific inhibitors improved cardiac function, reduced blood and tissue levels of proinflammatory cytokines, and decreased mortality. <B><I>Key Message:</I></B> These results suggest that use of inhibitors of NHE1 might be worthwhile in the treatment of some types of acute metabolic acidosis, specifically the lactic acidosis associated with hypoxia, hemorrhagic shock, and cardiac arrest. Its potential role in the treatment of other forms of acute metabolic acidosis remains to be determined.</P><P>© 2014 S. Karger AG, Basel</P>
Lin, Xinchun,Kraut, Jeffrey A,Wu, Dongmei Williams & Wilkins Co.[etc.] 2014 Pediatric research Vol.76 No.2
<P>The present study tested the hypothesis that addition of an inhibitor of Na(+)/H(+) exchanger (NHE1) to sodium bicarbonate might improve the response to base therapy from prolonged asphyxial cardiac arrest in piglets.</P>
Jason Lai,Benjamin Holden Schnapp,David Simon Tillman,Mary Westergaard,Jamie Hess,Aaron Kraut 한국보건의료인국가시험원 2020 보건의료교육평가 Vol.17 No.-
Purpose: The Accreditation Council for Graduate Medical Education (ACGME) requires all residency programs to provide increasing autonomy as residents progress through training, known as graded responsibility. However, there is little guidance on how to implement graded responsibility in practice and a paucity of literature on how it is currently implemented in emergency medicine (EM). Wesought to determine how EM residency programs apply graded responsibility across a variety of activities and to identify which considerations are important in affording additional responsibilities to trainees. Methods: We conducted a cross-sectional study of EM residency programs using a 23-question survey that was distributed by email to162 ACGME-accredited EM program directors. Seven different domains of practice were queried. Results: We received 91 responses (56.2% response rate) to the survey. Among all domains of practice except for managing critically illmedical patients, the use of graded responsibility exceeded 50% of surveyed programs. When graded responsibility was applied,post-graduate year (PGY) level was ranked an “extremely important” or “very important” consideration between 80.9% and 100.0% ofthe time. Conclusion: The majority of EM residency programs are implementing graded responsibility within most domains of practice. Whendecisions are made surrounding graded responsibility, programs still rely heavily on the time-based model of PGY level to determineadvancement.