Polydeoxyribonucleotide Ameliorates Inflammation and Apoptosis in Achilles Tendon-Injury Rats / 대한배뇨장애요실금학회지

Purpose@#Adenosine A2A receptor agonist polydeoxyribonucleotide (PDRN) possesses an anti-inflammatory effect and suppress apoptotic cell death in several disorders. In this current study, the effect of PDRN on inflammation and apoptosis in rats with Achilles tendon injury was investigated. @*Methods@#von Frey filament test and plantar test were conducted for the determination of pain threshold. Analysis of histological alterations was conducted by hematoxylin and eosin staining. Immunohistochemistry for cleaved caspase-3-positive cells and cleaved caspase-9-positive cells was done. Enzyme-linked immunoassay was used to detect the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and cyclic adenosine-3’,5’-monophosphate (cAMP). Western blot was conducted to detect the protein levels of cAMP response element-binding protein (CREB), protein kinase A (PKA), Bcl-2-associated X (Bax), and B-cell lymphoma 2 (Bcl-2). @*Results@#PDRN treatment relieved mechanical allodynia and alleviated thermal hyperalgesia after Achilles tendon injury. TNF-α and IL-6 concentrations were decreased by PDRN application. PDRN injection significantly enhanced cAMP concentration and phosphorylated CREB versus CREB ratio, showing cAMP-PKA-CREB pathway was activated by PDRN application. PDRN treatment inhibited percentages of cleaved caspase-3-positive cells and caspase-9-posiive cells and the suppressed Bax versus Bcl-2 ratio in Achilles tendon injury rats. @*Conclusions@#PDRN is probably believed to have a good effect on pain and inflammation in the urogenital organs. PDRN may be used as a new treatment for Achilles tendon injury.

Anesthetic management of a parturient for combined cesarean section and surgical removal of pituitary tumor: A case report / 대한마취과학회지

A 40-year-old woman was referred to our hospital because of bitemporal hemianopsia at 23 weeks of gestation. A brain magnetic resonance imaging showed a pituitary tumor having suprasellar extension. At 30 weeks of gestation, she complained of rapidly deteriorating vision and bitemporal hemianopsia in both eyes and the ensuing radiological examination revealed increased tumor size, displaced tumor location and compressed optic chiasm. The cesarean section was performed at 31 weeks and 3 days of gestation and simultaneous surgical removal of pituitary tumor was carried out due to the risk of irreversible blindness. Anesthetic management for combined cesarean section and brain surgery can be more complex and challenging for anesthesiologists, and the aim was to achieve both the control of intracranial pressure and fetal well being at the same time. In this case, maternal outcome was somewhat improved after the procedure, and neonatal complications were not detected.

The effect of the humidifier on sore throat and cough after thyroidectomy / 대한마취과학회지

BACKGROUND: This study was performed to determine the effects of a humidifier with heated wire circuits on the incidence and severity of postoperative sore throat (POST) and cough after thyroidectomy. METHODS: A total of 61 patients scheduled for elective thyroid surgery under general anesthesia were included in this prospective study. We randomized the patients in to two groups, "without active warming and humidification" (Group C) and "using a heated humidifier" (Group H). The patients were interviewed to obtain the POST and cough scores at 1, 6, 24 and 48 hours after thyroidectomy. RESULTS: The incidence of POST was significantly lower in Group H compared to Group C at 6 hours (57% vs 84%, P = 0.041), 24 hours (37% vs 65%, P = 0.045), and 48 hours (10% vs 52%, P = 0.001). Also the incidence of cough was significantly lower in Group H at 6 hours (27% vs 71%, P = 0.001), 24 hours (13% vs 45%, P = 0.015), and 48 hours (7% vs 32%, P = 0.028). The severity of POST was significantly lower in Group H at all times. In addition, the severity of cough was lower in Group H at other times except at 1 hour. CONCLUSIONS: This result suggests that an active humidification of inspired gases may have the appreciable effect on reducing the incidence and severity of sore throat and cough after thyroid surgery using the endotracheal tube.

Spontaneous Rupture of Spleen in a Patient with Malarial Infection

Malaria is a protozoan disease transmitted by the bite of infected mosquitoes. During acute and chronic malarial infection, altered splenic structure and function produce asymptomatic enlargement or com plications such as hematoma formation, rupture, hypersplenism, or cyst formation. Spontaneous splenic rupture occurs during acute infection, usually during the primary attack. However, rupture occurring in chronic malarial splenomegaly is seldom spontaneous; obvious trauma is almost always the precipitating event. Recently, conservative therapy has been applied in all cases of malarial splenic rupture. Surgical therapy should be reserved for patients with severe rupture or for those with continued or recurrent bleeding. We report the case of a recently treated 25-year-old male who had acute malaria complicated by fever and by severe abdominal pain, tenderness, and distension, a condition that may result in splenic rupture. At operation, the spleen was slightly enlarged and multiple tearing was found in the lateral surface of the capsule. A splenectomy was preformed.

Spontaneous Rupture of Spleen in a Patient with Malarial Infection

Malaria is a protozoan disease transmitted by the bite of infected mosquitoes. During acute and chronic malarial infection, altered splenic structure and function produce asymptomatic enlargement or com plications such as hematoma formation, rupture, hypersplenism, or cyst formation. Spontaneous splenic rupture occurs during acute infection, usually during the primary attack. However, rupture occurring in chronic malarial splenomegaly is seldom spontaneous; obvious trauma is almost always the precipitating event. Recently, conservative therapy has been applied in all cases of malarial splenic rupture. Surgical therapy should be reserved for patients with severe rupture or for those with continued or recurrent bleeding. We report the case of a recently treated 25-year-old male who had acute malaria complicated by fever and by severe abdominal pain, tenderness, and distension, a condition that may result in splenic rupture. At operation, the spleen was slightly enlarged and multiple tearing was found in the lateral surface of the capsule. A splenectomy was preformed.