Effect of manassantin B, a lignan isolated from Saururus chinensis, on lipopolysaccharide-induced interleukin-1beta in RAW 264.7 cells / 대한마취과학회지

BACKGROUND: Elevated systemic levels of pro-inflammatory cytokines cause hypotension during septic shock and induce capillary leakage in acute lung injury. Manassantin B has anti-inflammatory and anti-plasmoidal properties. This study examined the effects of manassantin B on lipopolysaccharide (LPS)-induced inflammatory response in murine macrophages. METHODS: RAW 264.7 macrophage cells were incubated without or with (1, 3 and 10 microM) manassantin B and without or with (100 ng/ml) LPS. Manassantin B dissolved in phosphate buffered saline was added to the medium 1 h prior to the addition of LPS. The degree of activation of mitogen-activated protein kinase (MAPK) including extracellular signal-regulated kinases 1 and 2 (ERK1/2), c-Jun amino terminal kinases (JNK) and p38 MAPK, and the level of interleukin (IL)-1beta were determined 30 min and 24 h after the addition of LPS respectively. RESULTS: Manassantin B inhibited the production of IL-1beta and attenuated the phosphorylations of ERK1/2 and p38 MAPK, but not that of JNK, in RAW 264.7 cells treated with LPS. CONCLUSIONS: Manassantin B reduces LPS-induced IL-1beta expression through effects on ERK1/2- and p38 MAPK-mediated pathways. Manassantin B has potential as a potent anti-inflammatory drug for use in pathological processes such as sepsis or acute lung injury.

Urinary trypsin inhibitor attenuates liver enzyme elevation after liver resection / 대한마취과학회지

BACKGROUND: Urinary trypsin inhibitors (UTI) have been widely used for the treatment of diseases including disseminated intravascular coagulation, shock, and pancreatitis. Since UTI synthesis is likely to be reduced in patients who have undergone liver resection, the incidence of inflammatory reactions may be increasing accordingly. For such patients, the liver enzyme increases after the operation can reflect liver damage. The purpose of this study was to examine if ulinastatin can inhibit liver enzyme increases after liver resection. METHODS: After receiving Institutional Review Board approval, a retrospective chart review was performed on 201 patients who underwent hepatic resection from 2006 to 2010. We divided the records into the control (n = 69) and ulinastatin (n = 132) groups according to the use of intraoperative ulinastatin and compared the preoperative and postoperative laboratory test results. The number of patients who had > 400 U/L elevation of aspartate transaminase (AST) level after surgery was compared between the 2 groups. RESULTS: The mean AST, alanine transaminase (ALT), and total bilirubin levels after liver resection were significantly lower in the ulinastatin group than in the control group. The number of patients who showed an AST > 400 U/L after liver resection was significantly higher in the control group (odds ratio = 3.02). CONCLUSIONS: Ulinastatin attenuates the elevation of hepatic enzymes and bilirubin after liver resection.

Reexpansion Pulmonary Edema Following the Early Decompression of Pneumothorax Occurred after Anesthetic Induction in a Patient with Lung Bulla: A Case Report / 대한구급학회지

When a rapidly re-expanding lung has been in a state of collapse for more than several days, pulmonary edema sometimes occurs. This is called reexpansion pulmonary edema. In general, it most commonly occurs in patients with a large pneumothorax of long duration. In this case, a 15 year old female patient with a 2.3 cm sized bulla in the right lung developed right pneumothorax after anesthetic induction. Although early drainage by closed thoracostomy was performed, right pulmonary edema eventually occurred. It is unusual that vigorous reexpansion pulmonary edema developed even though early decompression was performed within one hour after development of pneumothorax.

Effect of mixed administration of propofol and rocuronium on intubating conditions / 대한마취과학회지

BACKGROUND: We investigated whether the intubating condition change acoording to the methods of administration of propofol and rocuronium. METHODS: Ninety adult patients (ASA physical status I or II) undergoing elective surgery were randomly assigned to one of three groups; Group I (n = 30) received rocuronium (0.6 mg/kg) after administration of propofol (2 mg/kg), Group II (n = 30) received propofol and rocuronium simultaneously via different intravenous routes, and Group III (n = 30) received a mixture of propofol and rocuronium via same intravenous route. Intubation was attempted at 60 seconds after administration of rocuronium. Hemodynamic parameters (mean blood pressure, heart rate) were measured before and after propofol administration with 20 seconds interval. Intubating conditions (jaw relaxation, vocal cord movement, and response to tracheal intubation) were evaluated as excellent, good, fair and poor. Train of four counts were recorded at 60 seconds after administration of rocuronium. RESULTS: Excellent intubating conditions were obtained in 13% in group I, 60% in group II, 77% in group III. Mean train of four counts were 3.7 in group I, 3.4 in group II, and 3.5 in group III. Mean blood pressures were decreased gradually after propofol administration in all groups. However, heart rates were not changed in all groups. CONCLUSIONS: At induction of anesthesia, simultaneous or mixed administration of propofol and rocuronium provides excellent or good intubating conditions 60 seconds after rocuronium administration. It could be an effective alternative to succinylcholine for rapid sequence induction of anesthesia.