beta PAK-interacting exchange factor may regulate actin cytoskeleton through interaction with actin

p21-activated kinase (PAK)-interacting exchange factor (PIX) is known to be involved in regulation of Cdc42/Rac GTPases and PAK activity. PIX binds to the proline-rich region of PAK, and regulates biological events through activation of Cdc42/Rac GTPase. To further investigate the role of PIX we produced monoclonal antibodies (Mab) against beta PAK. Three clones; N-C6 against N-terminal half and C-A3 and C-B7 against C- terminal half of beta PAK were generated and characterized. N-C6 Mab detected beta PAK as a major band in most cell lines. C-A3 Mab recognizes GIT-binding domain (GBD), but it does not interfere with GIT binding to beta PAK. Using C-A3 Mab possible beta PAK interaction with actin in PC12 cells was examined. beta PAK Mab (C-A3) specifically precipitated actin of the PC12 cell lysates whereas actin Mab failed to immunoprecpitate beta PAK. Co-sedimentation of PC12 cell lysates with the polymerized F-actin resulted in the recovery of most of beta PAK in the cell lysates. These results suggest that beta PAK may not interact with soluble actin but with polymerized F-actin and revealed that beta PAK constitutes a functional complex with actin. These data indicate real usefulness of the beta PAK Mab in the study of beta PAK role(s) in regulation of actin cyoskeleton.

Is Muscle Relaxants Necessary during the Anesthesia for Cataract Surgery with LMA? / 대한마취과학회지

BACKGROUND: The recovery of spontaneous ventilation is delayed in elderly patients in whom muscle relaxants has been administered for general anesthesia. We evaluated the appropriateness of microscopic cataract surgery without using muscle relaxants in elderly patients. METHODS: Forty two ASA physical status I and II patients for cataract surgery were randomly assigned to two groups. Glycopyrrolate 0.2 mg, fentanyl 2 mcg/kg and propofol 2 mg/kg were administered intravenously followed by vecuronium 1 mg/kg iv in group I and 10% lidocaine 1.5 mg/kg spray into oropharynx in group II. Laryngeal mask (LMA) was inserted for airway management and anesthesia was maintained by only propofol infusion in both groups. Whether the patient moved during the surgery, whether ephedrine was administered and the propofol infusion rate were recorded. RESULTS: Six patients of group I and 1 patient of group II were moved during surgery. Only in group II, 7 patients received intravenously ephedrine administration. Mean infusion rate of propofol was 0.114 mg/kg/min in group I and 0.159 mg/kg/min in group II. CONCLUSION: In general anesthesia for microscopic cataract surgery, the combination of fentanyl 2 mcg/kg, propofol 2 mg/kg and infusion, 10% lidocaine spray and laryngeal mask without muscle relaxants is a good alternate method of keeping airway.

Is Muscle Relaxants Necessary during the Anesthesia for Cataract Surgery with LMA? / 대한마취과학회지

BACKGROUND: The recovery of spontaneous ventilation is delayed in elderly patients in whom muscle relaxants has been administered for general anesthesia. We evaluated the appropriateness of microscopic cataract surgery without using muscle relaxants in elderly patients. METHODS: Forty two ASA physical status I and II patients for cataract surgery were randomly assigned to two groups. Glycopyrrolate 0.2 mg, fentanyl 2 mcg/kg and propofol 2 mg/kg were administered intravenously followed by vecuronium 1 mg/kg iv in group I and 10% lidocaine 1.5 mg/kg spray into oropharynx in group II. Laryngeal mask (LMA) was inserted for airway management and anesthesia was maintained by only propofol infusion in both groups. Whether the patient moved during the surgery, whether ephedrine was administered and the propofol infusion rate were recorded. RESULTS: Six patients of group I and 1 patient of group II were moved during surgery. Only in group II, 7 patients received intravenously ephedrine administration. Mean infusion rate of propofol was 0.114 mg/kg/min in group I and 0.159 mg/kg/min in group II. CONCLUSION: In general anesthesia for microscopic cataract surgery, the combination of fentanyl 2 mcg/kg, propofol 2 mg/kg and infusion, 10% lidocaine spray and laryngeal mask without muscle relaxants is a good alternate method of keeping airway.

Anesthesia for Cesarean Section with HELLP Syndrome: A case report / 대한마취과학회지

Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a variant presentation of severe preeclampsia/eclampsia. A 24-year old woman presented herself at 34 wk of pregnancy. Based on the clinical and laboratory assessment, HELLP syndrome was diagnosed. Cesarean section was performed under general anesthesia without invasive monitoring due to stable blood pressure. The course of anesthesia and surgery was uneventful and she delivered female neonate weighing 1770 gram. After the operation, the patient was transferred to the intensive care unit immediately. During the intensive care bleeding started and signs of disseminated intravascular coagulopathy showed up. Any improvement was not made after transfusion and every other supportive therapy. By the request of guardian, she was transferred to tertiary hospital, where she died.