Effects of thiopental sodium, ketamine, and propofol on the onset time of rocuronium in children

BACKGROUND: In emergency condition, failure in securing airway is a common and serious reason of pediatric death. Rapid intubation is required to minimize physiologic complication in children due to airway failure. Rapid loss of consciousness and rapid onset of neuromuscular blocking agent are necessary for the rapid sequence intubation. In this study, we compared the effects of thiopental sodium, ketamine, and propofol (drugs commonly used to induce anesthesia in children) on the onset time of rocuronium. We also compared the effects of these anesthesia induction drugs on intubation condition and their duration of action. METHODS: A total of 89 patients undergoing various elective surgeries were enrolled and allocated to the following three groups according to the anesthesia induction drug: 1) Group T, thiopental sodium; 2) Group P, propofol; and 3) Group K, ketamine. After loss of consciousness, neuromuscular monitoring was performed and rocurunium 0.6 mg/kg was administered. Onset time and duration of action of rocuronium were measured. Intubation condition was recorded with a tracheal intubation scoring system. Hemodynamic changes were observed before induction until 5 min after endotracheal intubation. RESULTS: The onset time of rocuronium in group K (39.9 s) was significantly faster than that in group T (61.7 s) or group P (50.7 s). There was no significant difference in duration of action of rocuronium or intubation condition among the three groups. CONCLUSIONS: Ketamine can decrease the onset time of rocuronium significantly compared to thiopental sodium or propofol.

Thrombin-induced Migration and Matrix Metalloproteinase-9 Expression Are Regulated by MAPK and PI3K Pathways in C6 Glioma Cells

Glioblastoma multiforme is one of the most common and aggressive tumors in central nervous system. It often possesses characteristic necrotic lesions with hemorrhages, which increase the chances of exposure to thrombin. Thrombin has been known as a regulator of MMP-9 expression and cancer cell migration. However, the effects of thrombin on glioma cells have not been clearly understood. In the present study, influences of thrombin on glioma cell migration were examined using Boyden chamber migration assay and thrombin-induced changes in MMP-9 expression were measured using zymography, semi-quantitative RT-PCR, and Western blotting. Furthermore, underlying signaling pathways by which thrombin induces MMP-9 expression were examined. Thrombin-induced migration and MMP-9 expression were significantly potentiated in the presence of wortmannin, a PI3K inhibitor, whereas MAPK inhibitors suppressed thrombin-induced migration and MMP-9 expression in C6 glioma cells. The present data strongly demonstrate that MAPK and PI3K pathways evidently regulate thrombin-induced migration and MMP-9 expression of C6 glioma cells. Therefore, the control of these pathways might be a beneficial therapeutic strategy for treatment of invasive glioblastoma multiforme.

Generation accumulation of murine ovarian genes in offspring exposed to microwave in uterus / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate generational accumulation of murine fetal ovarian genes following prenatal exposure to 1.765-GHz microwave radiation. METHODS: A 1.765-GHz microwave generator was used. Twenty pregnant ICR mice were divided into two groups: the microwave-exposed experimental (irradiated) group, and the sham-exposed (sham) group. On the fifth day post-mating, dam mice were exposed to microwave irradiation in the insulated cage for 8 hours each day. The remaining mice were treated in the same way. Second generation mice were raised for 8 weeks then classified into four groups for examination. We removed the neonatal ovaries on the seventh day after the third delivery. We investigated the expression of six genes in the ovaries: Tnfaip 8, TNFsf 12, Cfd, CCL 11, Zfp 74, and Brd 3. Real time reverse transcription-polymerase chain reaction was performed using total RNA extracted from the removed ovaries. RESULTS: In the third-generation offspring, we detected some differences in ovarian gene expression between the first group and the fourth. Expression of CCL 11, and TNFsf 12 was decreased in the first group compared to the fourth group. Expression of Tnfaip 8, brd 3, Cfd, and Zfp 74 was higher in the first group than in the fourth group. We found differing results when we compared ovarian gene expression in mice of the second generation with those of the third. CONCLUSION: The results suggest that there is no generational accumulation of murine ovarian genes in offspring exposed to 1.765-GHz microwaves in the uterus.

A Case of Improved Refractory Uveitis in Behcet's Disease after Infliximab Therapy / 대한류마티스학회지

Behcet's disease is a multisystemic, chronic relapsing inflammatory disease characterized by vasculitides, mucocutaneous lesions, thrombophlebitis, arthritis. Among them, the ocular involvement is usual (50~70%) and the most serious morbidity is blindness (20~25% of those of affected). Immunosuppressive treatment is currently the main therapy in chronic relapsing uveitis, but many patients experience recurrent sight-threatening uveitis. T lymphocytes play an important role in the pathogenesis of uveitis by releasing cytokines such as tumor necrosis factor (TNF) alpha. There are some reports that the anti-TNFalpha treatment is effective in refractory Behcet's uveitis, but it has not been reported in Korea. We report a case of refractory uveitis in Behcet's disease which is improved after anti-TNFalpha therapy.

Electromyographic Evaluation of Extraocular Muscle Contractibility after Artificial Muscle Incarceration in the Rabbit

The orbital blowout fracture has been increasingly noticed due to trauma and traffic accidents. The diagnostic confirmation is early established by CT scan, but indication for surgical treatment, the technique for repair, and timing of repair are still controversial. The main symptoms of orbital fracture include diplopia, enophthalmos and hypesthesia in distributions of the infraorbital nerve. These are usually accompained by other symptoms such as emphysema of the eyelids, ptosis, epistaxis and ocular injury. Among these diplopia and enophthalmos are considered as main surgical indications. Especially operation is performed when the contractibility of extraocular muscle(EOM) is changed due to incarceration of EOM and persistent diplopia at straight forward gaze or downward gaze. Many theories for sugical repiar timing are insisted but at present the accepted timing for operation is posttraumatic 1-2 weeks. To prevent the fibrosis and atrophy of extraocular muscle from the incarceration of EoM due to orbital fracture is the indication of surgery. To estimate the optimal time to perform the operation, we checked the EOM contractivilty by electromyography before and after artificial muscle incareceration in the rabbit. The results were as follows. The differences in RMS(root mean square) and MRV(mean rectified voltage) were not shown before or after the artivicial incarceration of extraocular muscle until the 5th day of the surgery. But the RMS and MRV measurements performed on the 7th day decreased significantly and these decreases were sustained. According to the results of this experiment. if the incarceration of the extraocular muscle due to the orbital fracture is diagnosed, relieving the incarceration by surgery before the 7th day can prevent the change of EOM contractibility. It will provide significant benefit, in maintaining the normal functioin of the extraocualr muscle.

A Case of Ocular Deviation after Excinier Laser Photorefractive Keratectomy

Patients undergoing monocular excimer laser photorefractive keratectomy (PRK) for myopic correction can develop strabismus secondary to decompensated heterophorias. We experienced a case of ocular esodeviation and diplopia that developed 8 nionths after monocular excimer laser phtorefractive keratectomy. So, we report this case with 8 review of the literature.