Characterization of the Repeat Sequences of Varicella-Zoster Virus

Varicella-zoster virus (VZV) is a causative agent for shingles and herpes zoster. The genomes of VZV contain five reiteration (R) sequences and an origin of replication (ORI) sequences composed of tandem repeats whose numbers vary among different strains. Variation of the genome lengths among VZV strains could be attributed by the lengths of R sequences. There was a strong correlation between the lengths of VZV genome and R sequences, while variation of ORI did not contribute the variation of VZV genome length. The high G+C contents of The R sequences in ORF11, 14 and 22 influenced the codon usage of VZV in these ORFs. None of the most frequent 5 codons in R sequences was included in the top 5 most frequent codon in ORF11-14-22 or VZV genome, and vice versa.

Codon Usage Bias of Human Cytomegalovirus Genes with Different Evolutionary Conservancy

Human cytomegalovirus (HCMV) is a member of beta-herpesvirus and contains a double-stranded genome with longer than 230 Kbp. HCMV infection of human is mostly asymptomatic, but often causes fatal diseases in immunocompromised people. In this study, codon usages of HCMV genes were analyzed and attempted to correlate with evolutionary conservancy. Core genes are the most conserved genes common among herpesvirus family, beta-herpes genes are common to beta-herpesviruses, and CMV genes are the least conserved found only in CMVs. Core genes had higher codon adaptation index (CAI) and GC content of silent 3rd codon position (GC3s) values and lower effective number of codons (Nc) and Nc/GC3s values than CMV genes. The average length of core genes was statistically longer than CMV genes, and core genes were found to be less varied than CMV genes. beta-herpes genes could be placed between core and CMV genes. Higher CAI and GC3s values along with lower Nc and Nc/GC3s values are suggestive of higher codon usage bias and more adaptation to host cells. Thus it is concluded that core genes of HCMV are more biased in codon usage and adapted to host cells compared to CMV genes.

AIRWAY MANAGEMENT FOR SYNGNATHIA

Syngnathia(maxillomandidular fusion) is a rare congenital anomaly involving soft tissue bony adhesions between the maxilla and mandible. Bony fusion, as in this case, is extremely rare and to the time, no specific anesthetic management has been reported. In our case, physical examinition of the 130-day infant patient(weight 5.5kg) with syngnathia revealed apparent left side fusion between maxilla and mandible. The opening between upper and lower gingiva was limited to 10mm on the right side. Left choanal atresia, microstomia, low set ears and blue sclera were also detected. When patient arrived at the OR.5l/min oxygen was administered using nasal prong with end-tidal CO2 monnitoring cannula though mough. Glycopyrrolate 0.1mg and ketamine 5mg were administered intravenously. A solution of 2% lidocaine 2ml and 0.1% phenylephrine 1ml was used to topicalize the right nostril. Subanesthetic doses(2~3mg) of ketamine were used to provide sedation while maintaining spontaneous ventilation. Warm, softed I.D. 3.5mm preformed nasotracheal tube was inserted via the rigrht nostril with a 3.2mm O.D. fiberoptic bronchoscope. After that vecuronium and dexamethasone were given intravenously. The Infant had been anesthetized uneventfully with isoflurane. Fiberoptic nasotracheal intubation under spontaneous ventilation using low doses of ketamine offers a safe and non-invasive technique compared with tracheostomy or blind nasotracheal intubtion. To increase safey, oxygen should be given via nasal or oral routes and adequate monitoring, especially capnography and pulse oxymeter, should be performed.

Sedation and Hemodynamic Stability during Fiberoptic Awake Nasotracheal Intubation: Comparison between Propofol Infusion and Intravenous Boluses of Fentanyl and Midazolam / 대한마취과학회지

BACKGROUND: Crucial to the success of fiberoptic awake tracheal intubation is proper preparation of the patient; this technique will work well in most patients when they are quiet and cooperative and have a larynx nonreactive to physical stimuli. We have attempted to ascertain how well these conditions are achieved with a low-dose infusion of propofol, because of its pharmacological profile. METHODS: Thirty patients, physical status by American Society of Anesthesiologists (A. S. A.) I-II, scheduled for oral and maxillofacial surgery, were randomly assigned to receive either propofol infusion 1 mg kg-1 h-1 preceded by a 1 mg kg-1 bolus (Group P) or intravenous fentanyl 1ug kg-1 and midazolam 0.05 mg kg-1 (Group F). These two groups were compared in terms of hemodynamic profile, sedation score, condition for intubation, coughing and swallowing. RESULTS: There were no statistically significant differences in mean arterial blood pressures according to time between two groups. But in Group F, heart rates were significantly increased in immediately after transtracheal injection of lidocaine, immediately before the fiberoscopy was started, 1, 2 minutes after start of fiberoscopy, compared to Group P (p<0.05). The patients in Group P were more sedated than those in Group F (p<0.05) but there were no significant differences in condition for intubation, reflex of coughing and swallowing, duration of fiberoptic intubation. CONCLUSIONS: We conclude that propofol is useful sedative agent in fiberoptic awake intubation with similar efficacy to midazolam and fentanyl but with more profound sedation and stable hemodynamic profile. These represent significant advantages for severe anxious or hypertensive patients and prolonged procedure of intubation.