In vitro antibacterial and anti-inflammatory properties of seaweed extracts against acne inducing bacteria, Propionibacterium acnes.

This study was conducted to evaluate the antimicrobial activities of common seaweeds from the coast of South Korea against the etiologic agents of acne vulgaris. Fifty-seven species of seaweed were screened for potential antimicrobial activity. Methanol extracts of 13 species (22.8%) showed inhibitory effects against Propionibacterium acnes. The aqueous extracts of only two species (3.5%) showed antimicrobial activity. When tested with the agar disk diffusion method, Ecklonia cava, E. kurome, Ishige sinicola, and Symphyocladia latiuscula had the strongest inhibitory effects. However, these four seaweed extracts showed no antibacterial activity against Staphylococcus epidermidis at 5 mg disk-1. The minimum inhibitory concentration (MIC) values of E. cava and E. kurome were both 0.31 mg ml-1 and the MIC values of I. sinicola and S. latiuscula were 0.26 and 0.21 mg ml-1, respectively. Among whole plants of E. cava and E. kurome, extracts of the pinnate blade had the highest inhibitory activity on bacterial growth. In cytotoxicity assays, methanol extracts of E. cava, E. kurome, and I. sinicola showed no effect on cell viability at concentrations of 200 μg ml-1. However, the methanol extracts of S. latiuscula reduced cell viability rates to 50% at the same concentration. Additionally, methanol extracts of E. cava, E. kurome, and I. sinicola potently inhibited the in vitro production of nitric oxide. These results suggest that the methanol extracts from these three species may be useful in the development of therapeutic agents for acne vulgaris. Further investigations to determine the bioactive compound are in progress.

Three Cases of Lung Volume Reduction Surgery in Patients with Severe Emphysema / 대한마취과학회지

We have recently experienced with 3 cases of bilateral lung volume reduction surgery (LVRS) in patients with severe emphysematous disease in an effort to improve pulmonary mechanics. We compared intraoperative total dynamic lung compliance (CT) and % of breath exhaled in one second (V1.0%) obtained immediately pre-lung reduction and immediate post-lung reduction. In addition we also compared preoperative pulmonary function test (PFT) [FEV1, TLC, TG (trapped gas) and FRC] with 3 month postoperative values. Two of the three patients demonstrated post-reduction improvement in dynamic CT while only one patient demonstrated post-reduction improvement in V1.0%. All three patients demonstrated an increase in FEV1 and a decrease in TLC, TG and FRC with the greatest change in one patient who also had a significant reduction in CT and an improvement in V1.0% intraoperatively, and post-lung reduction. Although our results of the 3 cases are preliminary, it appears that side stream spirometry with immediate intraoperative measurement of dynamic CT and V1.0% could play a role in predicting expected follow-up objective pulmonary function tests; improvement in both CT and V1.0% may predict significant improvements in PFT.

The Spectral Analysis of EEG according to Change in the Concentration of Isoflurane / 대한마취과학회지

BACKGROUND: Adequate depth of anesthesia requires a sufficient amount of the agent to secure unconsciousness and other components of anesthesia as needed for that particular surgical procedure, without jeopardizing vital organ functions. To evaluate the relationship of depth of anesthesia to EEG, we studied the effects of increasing minimum alveolar concentration (MAC) of isoflurane (arousal, 1, 1.3, 1.5 MAC) on power spectral analysis of the EEG. METHODS: To determine 1 MAC, we studied sixty patients undergoing general anesthesia who were randomly allocated to receive isoflurane at several predetermined end-tidal concentration. A minimum of 15 min was allowed between induction and skin incision to allow steady state condition. Patients were observed for gross purposeful movement for 60 seconds after incision. The MAC was calculated using maximum likelihood solution to a logistic regression model. Another forty patients were randomly allocated to have their EEGs recorded. General anesthesia was induced with oxygen and isoflurane only. After loss of consciousness, succinylcholine 1.5 mg/kg was given and intubation followed. The EEG was recorded awake and after 15 min at steady state conditions of 1, 1.3 and 1.5 MAC isoflurane had been achieved. Spectral edge frequency 95% (SEF95), median spectral frequency (MSF), total power (TP) and relative power in the delta, theta, alpha and beta band were calculated. RESULTS: The MAC of isoflurane was 1.21 vol% (20 - 40 years) and 1.09 vol% (40 - 60 years). The distribution of spectral EEG indices of the EEGs were established and compared. The threshold value of SEF95 14 Hz to differentiate between arousal and 1.3 and 1.5 MAC had a sensitivity of 60.5% (1.3 MAC), 71% (1.5 MAC) and specificity of 74.4% (1.3 and 1.5 MAC) and that of MSF 5 Hz had a sensitivity of 71% (1.3 MAC), 81.5% (1.5 MAC) and specificity of 48% (1.3 MAC), 48.8% (1.5 MAC). CONCLUSIONS: With regard to the dose-related decrease in SEF95 and MSF under increasing end- expiratory concentrations of isoflurane as described in the present study, future studies may have todetermine whether EEG feedback control of volatile anesthetic administration may be used successfully. It seems that if neglected parts by MSF and SEF95, which are really true values are considered in the future studies, those would increase the sensitivity and specificity of EEG could be used as tool for determining depth of anesthesia.

A Comparison of the Size and Shape of Radiofrequency Lesions Produced by Different Temperatures Using Straight and Curved Electrodes / 대한마취과학회지

BACKGROUND: Understanding the electrophysiology of radiofrequency (RF) lesions and determining the size and shape of RF lesions is important for reducing side effects when applied to patients in a clinical setting. We compared the shape and size of RF thermocoagulation produced by straight and curved 20-gauge electrodes and considered its application in clinical settings. METHODS: The white from a fresh hen's egg was warmed to 37oC and placed in a rectangular glass container. Straight and curved 20-gauge electrodes were immersed. The transparency of the egg white and the glass container made it possible to photograph the changes in size of the RF lesions over time. We applied thermocoagulation for 60 seconds at 70, 80, and 90oC. Photographs were taken at 60 seconds. We measured the maximal size of the lesions. A two-way statistical analysis of variance was performed. RESULTS: The thermocoagulations were started at the junction of the insulated and uninsulated portion of the electrode and did not extended beyond the tip. The thermocoagulation size was 4.2 +/- 0.8 at 70oC, 6.1 +/- 2.9 at 80oC and 6.1 +/- 1.9 at 90oC using the 20-gauge, 10 mm active tip, straight electrode and 4.5 +/- 1.1 at 70oC, 7.2 +/- 1.9 at 80oC and 7.9 +/- 2.7 at 90oC using the 20-gauge, 10 mm active tip, curved electrode. There was no observable difference in the size of the lesions produced by the straight and curved electrodes. CONCLUSIONS: We found that temperature was the more important factor in determining lesion size. When the temperature setting is the same, lesions produced by straight and curved electrode of the same gauge are also same size. Therefore the choice of straight or curved electrode should be made to optimize ease of handling and ensure proper location of the electrode tip.

Anesthetic Management for Repair of Delayed Presentation of Congenital Diaphragmatic Hernia: A case report / 대한마취과학회지

Congenital diaphragmatic hernia (CDH) associated with pulmonary hypoplasia usually presents in early neonatal life. Despite recent advances in perioperative intensive care and neonatal pharmacology, there is still a 53-62% mortality rate. CDH presenting outside of the neonatal period is called CDH delayed presentation, and it is uncommon and the diagnosis is difficult due to misleading clinical signs and symptoms. The prognosis in delayed presentation is determined by complications as strangulation or incarceration of the herniated bowel or stomach, mediastinal shift. A 3 month-old male infant was visited to pediatric department because of irritability. Breath sound were decreased over the left hemithorax and blood gas examination showed hypoxemia. Plain chest X-rays demonstrated intestinal bowel gas shadow in the left hemithorax and had done revealed CDH. An immediate operation was performed. The post-operative course was uneventful and the postoperative chest X-ray returned to normal. She was discharged on the 8th post-opertive day.

Acute Hepatitis after General Anesthesia in a Child / 대한마취과학회지

A 4year old female admitted for the management of degloving injury of popliteal area. The patient was injuried by traffic accident, and underwent emergency sugery for irrigation and debriment of wound area under halothane anesthesia. She has the 2nd administration of halothane in a period of 18days Two days after the 2nd anesthesia, the patient began to suffer from acute hepatitis with increasing SGOT/SGPT. The patient was cared for at the department of pediatrics and had 3rd operation after 38days and was discharged after 71 days hospitalization.

Effects of Endotracheal Intubation on the Temporomandibular Joint / 대한마취과학회지

Tracheal intubation for general anesthesia is usually performed using a rigid laryngoscope and reguires the mandible to be opened with forward and upward traction of the patient's jaw which may at times result in the inadvertant injury to temporomandibular joint(TMJ). The injury may include internal derangement, dislocation and hematoma of TMJ; subsequent intraarticular adhesion formation ; dislocation of the meniscus, and rarely auriculotemporal nerve damage from traumatic TMJ dislocation. We studied in 200 patients the size of mouth opening during intubation, the change of mouth opening by tracheal intubation evaluated after operation, and any TMJ disorder arising after tracheal intubation. The results were as follows; 1) The mean size of mouth opening before operation was 42.7+/-7.0 and 40.6+/-6.2mm in male and female patients, respectively. 2) The mean size of mouth opening during intubation was 24.7+/-2.6 and 23.4+/-2.7mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean was 24.3+/-3.1 and 25.2+/-2.0mm in male and female patients, respectively. 3) One week following operation The mean size of mouth opening one week postoperation was 48.3+/-8.9 and 42.2+/-6.3mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean size of mouth opening was 55.5+/-5.3 and 43.2+/-6.2mm in male and female patients, respectively. 4) Five patients complained of discomfort around TMJ after tracheal intubation. It seems that upward 45 mandibule lifting by laryngoscope caused trauma to TMJs.