ABSTRACT
Malignant peripheral nerve sheath tumors (MPNSTs) are very rare tumors. We experienced a case of MPNST in the cervical paraspinal space which was not associated with neurofibromatosis. The tumor located in left C6-7 foramen and compressed C7 root. The tumor was removed through the occipital triangle. We report a case of the primary cerivcal MPNST in a patient who did not have neurofibromatosis-1.
Subject(s)
Humans , Nerve Sheath Neoplasms , Neurofibromatoses , Peripheral NervesABSTRACT
BACKGROUND: Beat-to-beat heart rate variability (HRV) is caused by the fluctuating balance of sympathetic and parasympathetic tone. Analysis of heart rate variations may provide important clinical information and the influence of anesthesia on the autonomic nervous system. METHODS: We studied 18 ASA I female patients undergoing propofol-O2-N2O anesthesia for transabdominal hysterectomy and analyzed the HRV using power spectral analysis (PSA) at preinduction period, 2~5 minutes after induction, and 30~33 minutes after skin incision. RESULTS: The powers in all frequency bands decreased, but the decrease in low+middle frequency power was less than that in high frequency power during 2~5 minutes after induction. At 30~33 minutes after skin incision, all frequency bands and ratio of low middle/high frequency power spectra recovered and were not significantly different from those of before induction. CONCLUSIONS: Propofol-N2O-O2 anesthesia depress autonomic nervous system with relative preservation of sympathetic components. However autonomic nervous system and sympathetic/parasympathetic balance during operation recovered to the pre-anesthetic pattern, probably due to surgical stimuli and stress.
Subject(s)
Female , Humans , Anesthesia , Anesthetics , Autonomic Nervous System , Heart Rate , Heart , Hysterectomy , SkinABSTRACT
BACKGROUND AND OBJECTIVES: Estrogen has been reported to inhibit migration and proliferation of vascular smooth muscle cells in vitro and in vivo. Sustained local delivery represents a potential alternative to systemic administrationbecauseitcan achieve higher tissue drug levels at site of balloon injury avoiding systemic side effects. We investigated the effect and mechanism of nanoparticulate sustained-release carrier system using liposome incorporating 17beta-estradiol (E2) on neointimal formation in rat carotid artery balloon injury model. MATERIALS AND METHODS: 17-estradiol benzoate, egg phosphatidylcholine, cholesterol, polyethyleneglycol-phosphatidylethanolamine were mixed to produce E2 -liposome formula where the final concentrations of lipids and E2 were 10 mg/ml and 66 M, respectively. The size of the particle was less than 200 nm. Rat carotid artery balloon injury model was used with Sprague-Dawley rats weighing 350+/-30g. Rats were divided into 3 groups of saline (n=22), liposome (n=46) and E2-liposome (n=46) and received 0.2 ml of each agent at injured site. 1) Rats from all groups were sacrificed at 7 (n=4), 14 (n=6), and 21 (n=12) days after injury, respectively. Morphometric analysis was performed for calculating medial area, neointimal area and I/M (intimal area/medialarea)ratio2)Rats from liposome and E2-liposome group sreceived 100mg/kg of 5-bromo-2'-deoxyuridine (BrdU) at 25, 9 and 1hr before sacrifice at 1 (n=4), 3 (n=4), 7 (n=4), and 14 (n=4) days after injury. BrdU and proliferating cell nuclear antigen (PCNA) stains were performed to elucidate a mechanism of inhibitory effect of E2. RESULTS: 1) There was no increase in the neointimal area in liposome group compared with saline group at 7, 14, and 21 days after injury, respectively. 2) There was 17%, 30%, and 34% reduction of I/M ratio in E2 -liposome group compared with liposome group at 7, 14 and 21 days after injury, respectively. 3) BrdU and PCNA stain revealed that at day 3, labelling index (LI) of media was lower in E2-liposome than in liposome group (p<0.05), and at day 7, LI of neointima was not significantly different between the two groups despite smaller neointimal area in the E2-liposomegroup. CONCLUSION: Nanoparticulateliposomeformula appears to be biocompatible. Local intraluminal infusion of E2 liposome formula after balloon injury of rat carotid artery significantly decreased neointimal formation. The mechanism seems to be the inhibitory effect on the proliferative response of smooth muscle cells in media at an early stage of injury. This formula appears to show potential for clinical applications in the prevention of neointimal formation following balloon angioplsty.