Application of Tetrode Technology for Analysis of Changes in Neural Excitability of Medial Vestibular Nucleus by Acute Arterial Hypotension / 대한평형의학회지

OBJECTIVES: Excitability o medial vestibular nucleus (MVN) in the brainstem can be affected by changes in the arterial blood pressure. Several animal studies have demonstrated that acute hypotension results in the alteration of multiunit activities and expression of cFos protein in the MVN. In the field of extracellular electrophysiological recording, tetrode technology and spike sorting algorithms can easily identify single unit activity from multiunit activities in the brain. However, detailed properties of electrophysiological changes in single unit of the MVN during acute hypotension have been unknown. METHODS: Therefore, we applied tetrode techniques and electrophysiological characterization methods to know the effect of acute hypotension on single unit activities of the MVN of rats. RESULTS: Two or 3 types of unit could be classified according to the morphology of spikes and firing properties of neurons. Acute hypotension elicited 4 types of changes in spontaneous firing of single unit in the MVN. Most of these neurons showed excitatory responses for about within 1 minute after the induction of acute hypotension and then returned to the baseline activity 10 minutes after the injection of sodium nitroprusside. There was also gradual increase in spontaneous firing in some units. In contrast small proportion of units showed rapid reduction of firing rate just after acute hypotension. CONCLUSIONS: Therefore, application of tetrode technology and spike sorting algorithms is another method for the monitoring of electrical activity of vestibular nuclear during acute hypotension.

Comparison of the Anyplex II STI-7 and Seeplex STD6 ACE Detection Kits for the Detection of Sexually Transmitted Infections / 임상검사와정도관리

BACKGROUND: Sexually transmitted infections (STI) encompass a variety of clinical syndromes caused by many pathogens that are transmitted through sexual activity. Multiplex PCR is frequently used to detect STI. In this study, two multiplex real-time PCR-based assays were used to detect STI in clinical specimens, and the concordance of the results obtained by each method was evaluated. METHODS: A total of 626 specimens were tested using the Anyplex II STI-7 (Seegene, Korea) and Seeplex STD6 ACE Detection kits (Seegene). RESULTS: Among the 626 individuals tested, 227 (44.2%) tested positive for STI by using Anyplex II STI-7. The prevalence rates of the various infectious microorganisms detected were as follows: Chlamydia trachomatis (C. trachomatis), 19.2% (120/626); Neisseria gonorrhoeae (N. gonorrhoeae), 5.6% (35/626); Trichomonas vaginalis (T. vaginalis), 0.2% (1/626); Mycoplasma genitalium (M. genitalium), 8.1% (51/626); Mycoplasma hominis (M. hominis), 2.9% (18/626); Ureaplasma urealyticum (U. urealyticum), 17.6% (110/626); and Ureaplasma parvum, 3.7% (23/626). The concordance rates for the STI-7 and STD6 assays in detecting the various types of microorganism were as follows: C. trachomatis, (99.5%); N. gonorrhoeae, (99.7%); T. vaginalis, (100%); M. genitalium, (100%); M. hominis, (100%); and U. urealyticum (99.2%). CONCLUSIONS: A high degree of concordance was observed between the results obtained using the Anyplex II STI-7 kits and those obtained using the Seeplex STD6 ACE Detection kits.

Influence of the Pre-Analytical Specimen Storage Conditions on the Fecal Occult Blood Test Results / 대한진단검사의학회지

BACKGROUND: Korean national cancer screening program selected fecal occult blood test (FOBT) as a primary screening method of colorectal carcinoma in adult > or =50 yr old irrespective of symptom. Notice to pre-analytical errors is especially important for the FOBT because examinees collect and submit their specimens to laboratories by themselves. We examined the influences of the fecal storage temperatures, durations and with or without buffer on the FOBT results. METHODS: Thirty FOBT-positive specimens above 100 ng/mL were used for the study from July to August 2008. Quantitative FOBT was performed with OC-sensors II (Eiken Chemical Co., Japan). Each specimen was divided into 4 groups. Two groups in plastic buffer-free containers were kept either at 4degrees C or room temperature (25-28degrees C), respectively. Another two groups in buffer-tubes were also kept either at 4degrees C or room temperature. Each group was repeatedly examined with same method every 24 hr up to 120 hr. RESULTS: Eleven specimens (36.7%) in buffer-free containers converted to negative results (below the 100 ng/mL) after 24 hr and 17 specimens (56.7%) did after 48 hr at room temperature. Ten specimens (33.3%) in buffer-free containers converted to negative after 48 hr at 4degrees C. Specimens contained in buffer-tubes showed little change; 3 specimens (10.0%) at room temperature and no specimen at 4degrees C showed negative conversions after 48 hr. CONCLUSIONS: Buffer-tube minimizes false negative FOBT results during pre-analytical delay of specimen. The examinees using buffer-free containers need to be educated to hand in their specimens to laboratories as soon as possible.

The Effect of Morphine administered with Bupivacaine in Brachial Plexus Block / 대한마취과학회지

Morphine administered via the intrathecal or epidural route can produce long-lasting analgesic effect for acute and chronic pain. Unfortunately, little was known about the action of opioid drugs on the peripheral nerve system. The author administered morphine and local anesthetic when performing brachial plexus block in 64 selected cases and observed the effects of morphine on postoperative pain relief and the duration time of the local anesthetic. The following results were obtained. 1) Morphine 10mg administered in the brachial plexus block produced no significant increase in the duration of the block and no significant effect on postoperative pain relief. 2) Morphine 10mg administered in the brachial plexus block produced systemic side effects.

One Case of Anesthesia in a Thyrotoxic Patient / 대한마취과학회지

It is rare to meet an uncontrolled hyperthyroid patient in elective surgery. But, in emergency surgery, recognition of hyperthyroidism may be difficult, as trauma or pain may mask hyperthyroidism. The patient may be unaware of its existence or incapable of transmitting the information. During or after surgery, untreated hyperthyroidism can cause thyrotoxic crisis (thyroid storm), which may be a highly fatal complication. Thyrotoxic crisis is an extreme accentuation of signs and symptoms of throtoxicosis. Clinical manifestations are sinus tachycardia or atrial fibrillation, marked increase in systolic pressure and pulse pressure, high temperature, profuse sweating, tremor, dehydration, tachypnea, extreme restlessness and agitation, delirium, and frank psychosis. In this case, atrial fibrillation and hypertension developed after induction, and severe thyrotoxic symptoms appeared after emergence, which were caused by undetected hyperthyroidism.

AnaIysis of Anesthesia for Total Correction of TOF / 대한마취과학회지

TOF is a congenital cyanotic heart disease which has severe physiodynamic changes in the cardiovascular system. The anesthesiologist should be able to manage the anesthesia for open heart surgery, be aware of the operation procedure, and have knowledge and experience to cope with the unpredictable changes of the patient's condition during operation. One hundred open heart anesthesias have been performed in BNUH from July 1981 to August 1983, of which 17 cases of anesthesia for total correction of TOF were analyzed and the following results were obtained. 1) It was difficult to predict the prognosis for the patient after open heart anesthesia by the chest X-ray, echocardiogram or electrocardiogram. 2) Anesthesia were performed by the combination of halothane-N2O0morphine as the main anesthetic agents. 3) Postoperative complication were wound infection(4 cases, 14.3%), arrhythmia(3 cases, 10.7%), low cardiac output syndrome(3 cases, 10.7%) and cardiac arrest (3 cases, 10.7%). 4) In 7 cases of death, the causes of death were low cardiac output syndrome(3 cases, 43.9%), heart failure (2 cases, 28.5%), renal failure (1 case, 14.3%) and aneurysmal rupture (1case, 14.3%).