A comparative study on the analgesic effect of continuous intraarticular infusion with ropivacaine, ropivacaine/fentanyl and ropivacaine/fentanyl/ketorolac after arthroscopic shoulder surgery / 대한마취과학회지

BACKGROUND: Arthroscopic shoulder surgery can result in severe postoperative pain. A variety of methods have been used to control pain in postoperative period and the results are variable. The purpose of this study was to compare the relative analgesic efficacies of the postoperative intraarticular infusion of ropivacaine, ropivacaine/fentanyl, and ropivacaine/fentanyl/ketorolac after arthroscopic shoulder surgery. METHODS: Thirty patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to three groups. At the end of surgery, 0.5% ropivacaine 20 ml was infused into the articular space and a continuous infusion catheter was inserted into intraarticular operated site. After surgery, continuous infusion of 0.5% ropivacaine 100 ml (Group 1, n = 10), 0.5% ropivacaine 100 ml including fentanyl 10 microg/kg (Group 2, n = 10), or 0.5% ropivacaine 100 ml including fentanyl 10 microgram/kg and ketorolac 150 mg (Group 3, n = 10) was started through catheter at rate of 2 ml/hr with bolus dose of 0.5 ml with a lock out time of 15 minutes for 2 days. The level of pain was assessed using a visual analogue scale (VAS) postoperative 2, 6, 12, 24 and 48 hours and the amounts of supplemental analgesics were recorded. RESULTS: The VAS was significantly lower after 2, 6, 12 hours in Group 2 than in Group 1. In Group 3, the VAS was significantly lower all hours than in the other two groups. CONCLUSIONS: The combination of fentanyl and ketorolac with ropivacaine did provide better postoperative analgesia than the other groups after arthroscopic shoulder surgery.

The CDH2 Gene Polymorphism in Schizophrenia

OBJECTIVE: There has been increasing evidence that neurodevelopmental dysfunction is involved in the pathophysiology of schizophrenia. Cadherin is known to be one of the important molecules in neurodevelopment. This study was performed to examine the relationship between T816C polymorphism of CDH2 gene and schizophrenia. METHODS: Genoytypes of T816C polymorphism of CDH2 gene were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) in 156 Korea patents with schizophrenia and 170 controls. RESULTS: No difference was found between the patients with schizophrenia and the controls in genotype and allele frequencies of T816C polymorphism of CDH2 gene. CONCLUSION: The results of this study do not support an association between T816C polymorphism of CDH2 gene and schizophrenia. However, it is necessary to investigate other polymorphic regions of CDH2 in schizophrenia.

The Association between Korean Schizophrenics and GDNF Gene Polymorphism / 대한정신약물학회지

OBJECTIVE: The association of neurotrophic factors with the etiology of schizophrenia has been widely studied. Among them, glial cell line-derived neurotrophic factor (GDNF) is known to promote the survival and differentiation of dopaminergic neurons. Considering dopamine hypothesis and neurodevelopmental theory, GDNF gene may be related with schizophrenia. In this study, we tried to clarify the association between schizophrenia and GDNF gene polymorphism. METHODS: Genotype and allele frequencies in the promoter and intron regions of GDNF gene were studied by using restriction fragment length polymorphism to compare 180 Korean schizophrenics with 105 Korean controls. RESULTS: We found significant differences between the schizophrenics and the controls in genotype and allele frequencies of BsaI polymorphism in the promoter region of GDNF gene (x2=18.208, df=2, p=0.0001/x2=11.264, df=1, p=0.0008). But no significant differences were found in intron region (p=0.06, p=0.984). CONCLUSION: These results suggest that polymorphism of GDNF gene might be related to the pathogenesis of schizophrenia.