Role of T-type Calcium Channels in Generating Hyperexcitatory Behaviors during Emergence from Sevoflurane Anesthesia in Neonatal Rats / 神经科学通报·英文版

In the current study, we sought to investigate whether T-type Ca channels (TCCs) in the brain are involved in generating post-anesthetic hyperexcitatory behaviors (PAHBs). We found that younger rat pups (postnatal days 9-11) had a higher incidence of PAHBs and higher PAHB scores than older pups (postnatal days 16-18) during emergence from sevoflurane anesthesia. The power spectrum of the theta oscillations (4 Hz-8 Hz) in the prefrontal cortex was significantly enhanced in younger pups when PAHBs occurred, while there were no significant changes in older pups. Both the power of theta oscillations and the level of PAHBs were significantly reduced by the administration of TCC inhibitors. Moreover, the sensitivity of TCCs in the medial dorsal thalamic nucleus to sevoflurane was found to increase with age by investigating the kinetic properties of TCCs in vitro. TCCs were activated by potentiated GABAergic depolarization with a sub-anesthetic dose of sevoflurane (1%). These data suggest that (1) TCCs in the brain contribute to the generation of PAHBs and the concomitant electroencephalographic changes; (2) the stronger inhibitory effect of sevoflurane contributes to the lack of PAHBs in older rats; and (3) the contribution of TCCs to PAHBs is not mediated by a direct effect of sevoflurane on TCCs.

Oxytocin produces thermal analgesia via vasopressin-1a receptor by modulating TRPV1 and potassium conductance in the dorsal root ganglion neurons

Recent studies have provided several lines of evidence that peripheral administration of oxytocin induces analgesia in human and rodents. However, the exact underlying mechanism of analgesia still remains elusive. In the present study, we aimed to identify which receptor could mediate the analgesic effect of intraperitoneal injection of oxytocin and its cellular mechanisms in thermal pain behavior. We found that oxytocin-induced analgesia could be reversed by d(CH₂)₅[Tyr(Me)²,Dab⁵] AVP, a vasopressin-1a (V1a) receptor antagonist, but not by desGly-NH₂-d(CH₂)₅[DTyr², Thr⁴]OVT, an oxytocin receptor antagonist. Single cell RT-PCR analysis revealed that V1a receptor, compared to oxytocin, vasopressin-1b and vasopressin-2 receptors, was more profoundly expressed in dorsal root ganglion (DRG) neurons and the expression of V1a receptor was predominant in transient receptor potential vanilloid 1 (TRPV1)-expressing DRG neurons. Fura-2 based calcium imaging experiments showed that capsaicin-induced calcium transient was significantly inhibited by oxytocin and that such inhibition was reversed by V1a receptor antagonist. Additionally, whole cell patch clamp recording demonstrated that oxytocin significantly increased potassium conductance via V1a receptor in DRG neurons. Taken together, our findings suggest that analgesic effects produced by peripheral administration of oxytocin were attributable to the activation of V1a receptor, resulting in reduction of TRPV1 activity and enhancement of potassium conductance in DRG neurons.

Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment. MATERIALS AND METHODS: Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. RESULTS: The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ -1.05 LODDs. In multivariate analysis, ≥ -1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ -1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). CONCLUSION: LODDs ≥ -1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ -1.05, intensified chemotherapy might be required, considering the high rate of DF.

HRCT Findings of Adult Mycoplasma Pneumonia

PURPOSE: To analyze the HRCT findings of adult mycoplasma pneumonia and correlate these with clinical information. MATERIALS AND METHODS: HRCT was performed in 17 cases of 15 adult patients (M:F=5:10) in whom mycoplasma pneumonia had been serologically confirmed. The pattern, extent and distribution of abnormalities were reviewed retrospectively and a changing pattern of abnormalities during the course of the disease was correlated with clinical symptoms. RESULTS: Unilateral(n=11) and lower lobe(n=12) involvement and multiplicity in involved lobes(n=10) were the most common abnormalities. Abnormalities on HRCT were as follows : nodules(n=15), areas of consolidation(n=14), nodules and areas of consolidation(n=13). Most abnormalities(n=11) were segmental or subsegmental in distribution. The most common nodular pattern was centrilobular micronodules(2/3)) at 2 weeks,and Group 3 (prominent areas of nodules(>2/3)) over 3 weeks. CONCLUSION: The main findings of adult mycoplasma pneumonia were nodules or areas of consolidation with segmental or subsegmental distribution. The early stage of the disease may show a pattern of a similar propartion of areas of consolidation and of nodules, followed by an increase in the propertion of areas of consolidation(>2/3) as the disease progresses. At the resolvtion stage, the extent of lesions will decrease and nodules will be the main finding.

HRCT Findings of Adult Mycoplasma Pneumonia

PURPOSE: To analyze the HRCT findings of adult mycoplasma pneumonia and correlate these with clinical information. MATERIALS AND METHODS: HRCT was performed in 17 cases of 15 adult patients (M:F=5:10) in whom mycoplasma pneumonia had been serologically confirmed. The pattern, extent and distribution of abnormalities were reviewed retrospectively and a changing pattern of abnormalities during the course of the disease was correlated with clinical symptoms. RESULTS: Unilateral(n=11) and lower lobe(n=12) involvement and multiplicity in involved lobes(n=10) were the most common abnormalities. Abnormalities on HRCT were as follows : nodules(n=15), areas of consolidation(n=14), nodules and areas of consolidation(n=13). Most abnormalities(n=11) were segmental or subsegmental in distribution. The most common nodular pattern was centrilobular micronodules(2/3)) at 2 weeks,and Group 3 (prominent areas of nodules(>2/3)) over 3 weeks. CONCLUSION: The main findings of adult mycoplasma pneumonia were nodules or areas of consolidation with segmental or subsegmental distribution. The early stage of the disease may show a pattern of a similar propartion of areas of consolidation and of nodules, followed by an increase in the propertion of areas of consolidation(>2/3) as the disease progresses. At the resolvtion stage, the extent of lesions will decrease and nodules will be the main finding.

Air Trapping on HRCT in Asthmatics: Correlation with Pulmonary Function Test

PURPOSE: To evaluate on the basis of the pulmonary function test the correlation between the extent of air trapping on HRCT with the severity of airway obstruction and also to identify the prognostic effect of the extent of air trapping after treatment of asthma. MATERIALS AND METHODS: Thirty five patients with clinically diagnosed bronchial asthma and air trapping, as seen on HRCT, were included in this study. We quantitatively analysed on HRCT the extent of air trapping and then statistically compared this with the clinical parameters of the pulmonary function test. We classified the patients into two groups on the basis of the pulmonary function test and clinical status : Group 1(N=35), the total number of asthmatic patients ; Group 2(N=18), relatively stable asthmatics without acute asthmatic attack who showed FEV1 of more than 80% of the predicted value. Using the functional parameters of PEFR, one of the objective indications of improvement in airway obstruction, we also classified the patients into three groups on the basis of interval between treatment and clinical improvement. The result of this was as follows ; group 1, asymptomatic group(initial PEFR within normal limit, N=7) ; group 2, early responder(improvement of PEFR within three hospital days, N=18) ; group 3, late responder(improvement of PEFRwithin fourteen hospital days should there be a number here). Using HRCT, we then statistically analysed the differences between the three groups in the extent of air trapping. RESULTS: Among the total of 35 asthmatics, the extent of air trapping on HRCT showed significant correlation with the FEV1(r=-0.6161, p<0.001) and MEFR(r=-0.6012, p<0.001). Among the relatively stable asthmatics who showed FEV1 of more than 80% of the predicted value, MEFR(r=-0.7553, p<0.001) and FEF75(r=-0.7529, p=0.012) showed statistically significant correlation with the extent of air trapping on HRCT, but there was no significant corrlation between air trapping on HRCT and FEV1. In the three groups of asthmatics classified on the basis of interval between treatment and clinical improvement, the extents of air trapping on HRCT in the asymptomatic, early responder and late responder groups was as follows: (mean valuse) 9.31%, 21.50% and 27.89%, respectively ; these differences were statistically significant. CONCLUSION: The extent of air trapping on HRCT in asthmatics showed positive correlation with FEV1 and MEFR. Quantitative analysis of air trapping on HRCT also provides prognostic information about a patient's response to treatment.

Ultrasonographic and Mammographic Findings of Gynecomastia

PURPOSE: The purpose of this study is to evaluate the radiologic features and clinical utility of ultrasonography and mammography in cases of gynecomastia. MATERIALS AND METHODS: This study involved 40 men inwhom gynecomastia had been pathologically diagnosed by surgical incision. In 21 cases, a retrospective analysis of ultrasonographic and mammographic findings was performed. RESULTS: Causative factors of gynecomastia among the 40 pathologically-proven cases were idiopathic or pubertal in 33 cases, related to male hormone deficiency in three cases and to chronic liver disease in four. Bilateral involvement was seen in 14 cases, and unilateral involvementin 26 ; among unilateral cases, right side was involved in 10 cases, and the left side in 16. Mammographically, asubareolar discoid lesion was present in 12 cases, diffuse increased breast density was seen in five cases and dendritic marginated subareolar lesion without microcalcification in one. Ultrasonographically, a round smooth marginated low echogenic lesion in the subareolar region was seen in five cases, a diffuse hyperechogenic pattern without definite mass in two cases and an ill defined low echogenic lesion in one. CONCLUSION: The male breast is small, so in cases of gynecomastia, ultrasonography is an effective diagnostic modality. Mamography will, however, be helpful in the detection of microcalcification in cases of gynecomastia seen on sonography.