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Resumen: Se realizó un ensayo clínico controlado, prospectivo, comparativo, aleatorizado, ciego simple. Objetivo: Determinar la correlación y valor predictivo de las escalas de evaluación de vía aérea e intubación difícil, obesidad, hoja McCoy y videolaringoscopio tipo Airtraq®. Material y métodos: 152 pacientes programados para cirugía, con antecedentes de obesidad y factores de riesgo de ventilación e intubación difícil sometidos a anestesia general. Se formaron dos grupos: grupo 1 intubación con hoja McCoy y grupo 2 videolaringoscopio Airtraq®. Resultados: En la estadística de contraste de ventilación difícil se obtuvo significancia estadística con p < de 0.05 para todos los factores, excepto el ronquido. En predictores de intubación difícil, la clasificación de Mallampati y Cormack-Lehane obtuvo p < 0.05, con sensibilidad de 63 y 68% respectivamente, con valor predictivo negativo alto para todos los factores. El promedio de intentos fue uno y duración de 55-59 segundos en ambos grupos. No hubo diferencias con el uso de hoja McCoy y Airtraq®. Conclusiones: La intubación orotraqueal fue exitosa en 97% de los casos gracias al uso de predictores de intubación difícil y de dispositivos para manejo de la misma.
Abstract: A controlled, prospective, comparative, randomized, simple blind clinical trial was conducted. Objective: Determine the correlation and predictive value of the airway assessment and difficult intubation scales, obesity, McCoy sheet and Airtraq® type videolaryngoscope. Material and methods: 152 patients scheduled for surgery, with a history of obesity and risk factors for difficult ventilation and intubation under general anesthesia. Two groups were formed: group, intubation with McCoy sheet and group 2, Airtraq® videolaryngoscope. Results: In the contrast statistics of difficult ventilation, statistical significance was obtained with p < 0.05 for all factors except snoring. In predictors of difficult intubation, the Mallampati and Cormack-Lehane classification obtained p < 0.05, with sensitivity of 63 and 68% respectively, with a high negative predictive value for all factors. The average of attempts was 1 and duration 55-59 seconds, in both groups. There were not differences with the use of McCoy sheet and Airtraq®. Conclusions: Orotracheal intubation was successful in 97% of cases, thanks to the use of difficult intubation predictors and devices for managing it.
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Cervical spine motion restriction is an integral component of protocol for management of trauma victims. The use of rigid cervical collar for the same, presents a hurdle in airway management in patients where intubation is mandated for successful resuscitation. Hence, techniques alternative to conventional laryngoscopy need to be explored through simulation studies, to ease the process of intubation and benefit the actual trauma victims. We wanted to assess the performance of McCoy laryngoscope and LMA CTrach assembly and compare the intubation characteristics in patients with cervical collar.METHODS80 patients of ASA status I or II, scheduled for elective surgery requiring general anaesthesia and endotracheal intubation were randomly allocated to two groups- A and B. Patients in Group A were intubated using McCoy laryngoscope and Group B using LMA CTrach, with cervical collar in situ. Airway assessment included measuring thyromental distance, observing MPC grade and measuring inter-incisor distance, before and after application of semirigid cervical collar. Glottic view was noted using modified Cormack-Lehane grading. Device insertion time, total intubation time, number of attempts, haemodynamic factors and airway complications during the procedure were noted.RESULTSThere was decrease in inter-incisor distance and worsening of MPC grade in both groups post application of cervical collar. The time taken for device insertion in Group A was 16.95 + 3 sec, and in Group B was 33 + 4 sec (P= 0.0001). The total intubation time in Group A was 40.4 + 6 sec and in Group B was 57.4 + 4.37 sec (P= 0.0001). CL grade I was more common in Group B (31) than Group A (17) (P= 0.003). The number of attempts required, mean haemodynamic parameters and airway complication were comparable between the two groups.CONCLUSIONSThe McCoy laryngoscope requires less time to obtain glottic view and subsequent intubation, but LMA CTrach provides better glottic exposure. Thus, LMA CTrach has better performance characteristics in patients with cervical collar in situ.
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Introduction: Laryngoscopy induces haemodynamic responsewhich has implications for patients with cardiovascularillnesses. We devised this study to compare the laryngoscopicview of the glottis obtained with the Macintosh, McCoy andMiller blades, and corresponding haemodynamic changes.Material and Methods: 105 ASA grade I and II patientsrandomly divided into three groups were intubated usingMacintosh, McCoy and Miller blade respectively. Cormackand Lehane grade of glottic view obtained, heart rate, systolicand diastolic blood pressure at baseline, immediately beforeinduction, following induction, and at 1, 3 and 10 minutesafter intubation were noted. Epi Info 7.2 was used forstatistical analysis. Chi square and ANOVA tests were appliedto compare haemodynamic parameters.Results: 18 patients (51.4%) were CL grade I and 17 (48.6%)were CL grade II in Macintosh, 24 (68.6%) were CL gradeI and 11 (31.4%) were CL II in McCoy and, 32 (91.4%)were CL I and 3 (8.6%) were CL II in Miller group. Risein heart rate following intubation was greatest with Millerblade, followed by Macintosh and least with McCoy, andwas statistically significant (P< 0.01). Rise in both, systolicand diastolic blood pressure following intubation was highestwith the Miller blade, followed by Macintosh and least withMcCoy, and the difference compared with baseline values wasstatistically significant (P<0.01).Conclusions: Miller blade provides best visualization of larynxbut McCoy blade produced least haemodynamic response,hence the latter is preferable when less haemodynamicresponse is desired.
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Background: McCoy laryngoscope and video laryngoscopes are being increasingly used and have a definitive advantage over conventional laryngoscopes in management of potentially difficult airways. The aim of our study was to compare relative effectiveness of McCoy laryngoscope and True view PCDTM video laryngoscope in patients undergoing oral tracheal intubation. Methods: Fifty patients of American Society of Anaesthesiologists (ASA) grade I and II, aged 20 – 50 years, posted for elective surgery under general anaesthesia were randomly allocated into Group T (Truview group, n=25) and Group M (McCoy group, n=25). The two groups were compared for demographic data, intubation difficulty score (IDS), Cormack-Lehane (CL) grade, POGO score, time to intubation, number of intubation attempts and haemodynamic parameters. Results: The demographic data and ASA status was comparable in both the groups. Group T had a significantly less IDS score as compared to Group M (p < 0.001). Seventeen patients in Group T and 8 patients in Group M had IDS = 0. The CL grade and POGO scores were better in Group T than in Group M. Intubation was successful in the first attempt in 94% patients in Group T and 88% patients in Group M. There was a transient increase in HR and NIBP after intubation in both the groups which returned back to the baseline within 5 minutes. No incidence of hypoxia and airway trauma was noted in the two groups.Conclusion: Truview PCDTM video laryngoscope resulted in better glottic visualization with lower IDS than McCoy laryngoscope in patients undergoing oral tracheal intubation.
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Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method:McGrath-5 video-laryngoscope group (group A, n = 30) and McCoy laryngoscope group (group B, n = 30). All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 < 90% within intubation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction (T0), glottic exposure upon laryngoscope insertion (T1), immediately after intubation (T2), 3 min (T3) after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B (P < 0.05), whereas the intubation time in group A was significantly higher than that in group B (P < 0.05). The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at T0 in both groups (P < 0.05). The systolic pressure and heart rate at T1 and T2 in group A were considerably lower in group A than those in group B (P < 0.05). Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient's oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.
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Objective To investigate differences in Rab protein expressions in McCoy cells with acute versus persistent Chlamydia trachomatis (Ct) infection.Methods Cultured McCoy cells were infected with different amounts (400,500,550 μl/well) of Ct strain D suspensions,then cultured with the medium containing 100 U/ml penicillin G (persistent Ct infection groups) or that without penicillin G (acute Ct infection groups).Ct-uninfected McCoy cells receiving no penicillin G treatment served as the blank control group,and those receiving penicillin G treatment as the penicillin group.Mter 48-hour culture,McCoy cells were lysed,proteins were collected,and total RNA was extracted from the cells.Enzyme-linked immunosorbent assay (ELISA) was conducted to measure protein levels of Rab4A,Rab6A,Rab10,Rab11A and Rab14,and fluorescence-based quantitative PCR to quantify mRNA expressions of Rab4A and Rab14 (expressed as 2-ΔΔα).Results Protein levels of Rab4A,Rab6A,Rab10,Rab11A and Rab14 were all significantly lower in the acute than in the persistent Ct infection groups (all Z =3.621,P ＜ 0.001),and lower in the persistent and acute Ct infection groups than in the blank control group (all P ＜ 0.008 3),but insignificantly different between the blank control group and penicillin group (all P ＞ 0.05).In addition,the expressions of Rab4A and Rab14 mRNAs were consistent with those of their proteins in these groups.Conclusion The transcriptional and expression levels of Rab proteins are higher in McCoy cells persistently infected with Ct than in those acutely infected with Ct.
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BACKGROUND: This study was designed to compare the hemodynamic changes in response to direct laryngoscopy with using the McCoy or Macintosh blade. METHODS: Seventy seven patients were randomly allocated into two groups. The induction of anesthesia was done with target controlled infusion of propofol (5 microgram/ml) and remifentanil (3 ng/ml) and vecuronium 0.1 mg/kg was also given. The vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, and then tracheal intubation was performed. The heart rate and blood pressure were measured just before induction, at intubation and at 1, 3 and 5 minutes after intubation. RESULTS: There were no significant differences in the blood pressure and heart rate responses to tracheal intubation with using the McCoy or Macintosh blade. But, in the Macintosh groups, the blood pressure at 1 and 3 minutes and the heart rate at 1 minute after intubation were increased significantly compared with the preintubation values. Also, in the McCoy groups, the blood pressure and heart rate at 1 minute after intubation were significantly higher than the preintubation values. CONCLUSIONS: The McCoy and the Macintosh blade show similar changes in heart rate and blood pressure after tracheal intuba tion.
Subject(s)
Humans , Anesthesia , Blood Pressure , Heart , Heart Rate , Hemodynamics , Intubation , Laryngoscopes , Laryngoscopy , Piperidines , Propofol , Vecuronium Bromide , Vocal CordsABSTRACT
Inhibition of the cell growth or induction of cell death is the most promising area in cancer therapy. The induction of apoptosis by dichloromethane extract of Prangos uloptera was evaluated on the McCoy cell line. This plant's roots, aerial parts and fruit have medicinal value. Cell growth inhibitory and cell cytotoxicity effects of the extract were assayed by MTT and Trypan-blue tests, respectively. Morphological changes and DNA fragmentation were also evaluated. The viability tests showed 0.49 and 0.3 mg/ml as 50 percent inhibition concentration and 50 percent cytotoxicity concentration after 24 hours of treatment, respectively. Fluorescent microscopy analysis revealed chromatin fragmentation and scanning electron microscopy showed cell shrinkage and cytoplasmic blebbing. These findings were confirmed by DNA fragmentation analysis. The results demonstrated efficient induction of apoptosis by the plant extract in moderate concentrations, but administration of higher concentrations showed that the primary manner of cell death was necrosis.
Subject(s)
Humans , Apiaceae/chemistry , Apoptosis/drug effects , Plant Extracts/pharmacology , Cell Line , Microscopy, Electron, Scanning , Microscopy, FluorescenceABSTRACT
The Western blot technique was used to demonstrate the presence of antibodies in the blood of dogs that presented canine visceral leishmaniasis. This technique was used against some specific molecules present in the lysate of the promastigote form of Leshmania chagasi.Through the association of the results of the Western blot technique with the morphological alterations seen as a result of the serum neutralization technique performed in McCoy cells (which mimetizes the macrophage) it was possible to observe the role of some molecules of great relevance in determining the disease in symptomatic dogs as well as that of some other molecules associated with asymptomatic infected dogs that may become transmitters as well as differentiating them as asymptomatic resistant dogs. In the sera analyses carried out during the immunobloting a variation of 9 to 27 immunoreacting bands was observed, which were then compared using Dice's similarity coefficient. In the dendrogram constructed on the basis of the coefficient, 50 percent similarity was observed among the total number of reagent bands with the promastigote lysate, thus creating five groups. The main difference observed related to the clinical condition of the dogs: symptomatic and asymptomatic dogs were found in separate groups. The asymptomatic group of dogs was distributed in two different places in the dendrogram because they presented two different behavior patterns regarding the cellular morphology in the serum neutralization reaction: the presence or absence of cellular lysis. According to this analysis it is possible to evaluate the immune status and associate it with specific markers observed in the reaction found in the Western blot strips.
A técnica de Western blot foi utilizada para demonstrar a presença de anticorpos do soro de cães, que apresentavam leishmaniose visceral canina, contra algumas moléculas específicas no lisado da forma promastigota de Leshmania chagasi.Através da associação da técnica de Western blot com as alterações morfológicas observadas como resultado da técnica de soro-neutralização em células McCoy (que mimetizam o macrófago) foi possível observar o papel de algumas moléculas de maior relevância para a determinação da doença em cães sintomáticos bem como o papel de outras moléculas na predição de cães infectados assintomáticos com o potencial de serem transmissores e ainda diferenciá-los como cães assintomáticos resistentes. Na análise dos soros durante a reação de immunoblotting observou-se uma variação de 9 a 27 bandas imunorreagentes, que foram comparadas utilizando-se o coeficiente de similaridade de Dice. No dendrograma construído com base no coeficiente, observou-se 50 por cento de similaridade entre as bandas totais reagentes com o lisado de promastigota formando cinco agrupamentos. A principal diferença foi observada com respeito à condição clínica, ou seja, cães sintomáticos e assintomáticos ficaram em grupos separados. Os soros dos cães assintomáticos distribuídos em dois grupos diferentes do dendrograma apresentaram padrões de comportamento diferentes, quanto à morfologia celular na reação de soro-neutralização, ou seja, a presença ou ausência de lise celular. De acordo com esta análise foi possível avaliar o status imunitário e associá-lo com determinados marcadores específicos observados na reação encontrada nas fitas de Western blot.