Activation of Nuclear Factor-kappaB in the Atherosclerotic Human Coronary Artery / 대한해부학회지

Paraffin sections of atherosclerotic vessels were classified into initial lesion, preatheroma and complicated severe lesion by classification method from American Heart Association. Activation of NF-kappaB was hardly detectable in the initial atherosclerotic lesion. In the preatheroma, activated NF-kappaB was enhanced in the neointimal smooth muscle cells and macrophages in the lipid core. In contrast, activated NF-kappaB increased markedly in the neointimal and medial smooth muscle cells in the severe atherosclerotic vessel wall. However, in the severe lesion, NF-kappaB activation was diminished in the macrophages of lipid core. Our findings show that NF-kappaB was activated in the smooth muscle cells with the progression of atherosclerosis in the human coronary artery.

Relationship of Angiopoietin-2 Expression to Atherosclerosis in Middle Cerebral and Coronary Arteries / 대한해부학회지

Atherosclerosis is a systemic and multifactorial disease, its incidence is raised recently. Cerebral and coronary atherosclerosis have some similar pathogenesis, but their relationship and mechanisms are still remain unclear. Intimal neovascularization in the atherosclerotic plaque was focused with respect to its pathological roles, intimal thickening and atherosclerotic progression. Ang-2, which is an angiogenesis regulating factor, provides a destabilizing signal for endothelial cells, leading to vessel regression or sprouting. However the role and distribution of Ang-2 in atherosclerotic coronary and cerebral arteries are still not well known. Thus, we analyzed 1) atherosclerotic lesion progression 2) relationship of atherosclerosis to Ang-2 expression in human middle cerebral and coronary artery. Paraffin sections from 25 human coronary (COA) and 36 middle cerebral arteries (MCA) were characterized according to AHA classification. In the same person, the score of atherosclerosis progression in COA was higher than that of MCA. In the two kinds of arteries having same atherosclerotic progression, the degree of intimal proliferation and luminal stenosis in COA was higher than that of MCA. Expression of Ang-2 was not shown in normal artery but localized in lumen-lining endothelium, macrophage in preatheroma, atheroma and complicated lesion. Ang-2 expression and infiltration of macrophages were rich in COA than MCA. Our result indicated that cerebral atherosclerosis has some different pathogenic mechanisms with coronary atherosclerosis according to difference of progression and angiogenic factor Ang-2 expression. Thus this is a fundamental study for understanding the progression of atherosclerosis in different vascular beds.

Comparison of Pharmacokinetic Affinity of Various Non-depolarizing Neuromuscular Blocking Agents in the Isolated Foream / 대한마취과학회지

It is well known that the plasma concentration is important in determining the rate of recovery from neuromuscular block. However, nondepolarizing neuromuscular blockade are retained at the neuromuscular junction and are not readily displaced in response of changes in plasma drug concentration, for instance, the neuromuscular block induced by mivacurium appears to considerably outlast the theoretical plasma half-life of the drug and is continued long after the plasma level has fallen to subparalytic levels due to rapid metabolism by pseudocholinesterase. It has been suggested that although plasma concentration may be the key determinant of recovery from neuromuscular block, recovery will depend upon the dissociation from the affinity of drug in the effect compartrnent and not upon its plasma concentration. In an attempt to confirm these evidences, we have investigated the response of changes in neuromuscular block after releasing tourniquet at 50% twitch depression using the isolated forearm experiment with various neuromuscular blocking agents. The results of this study demonstrated the further increase of block after early toumiquet release in the isolated forarm in all agents; 66+/-14% in vecuronium, 90+/-9% in atracurium, 92+/-7% in pancuronium, and 73+/-18% in mivacurium Conclusively, the further block continued to increase in spite of the negligible plasma drug concentration after early tourniquet release may be caused by more in affinity of drugs in binding sites than plasma drug concentration. Therfore, it is evident that both the affinity of drug to the receptor and the plasma drug concentration have influenced on the recovery from the neuromuscular block.

A Case Report of Neurologic Sequelae Following Spinal Anesthesia / 대한마취과학회지

Neurologic deficits following spinal anesthesia are extremely rare since the use of sterile spinal anesthesia kit and the relative small doses of the local anesthetics employed. We have experienced 29 years old healthy female patient developed left S root radiculopathy with dysesthesia and motor weakness of left foot after spinal anesthesia for appendectomy. And the patient recovered spontaneously after 6 months without specific treatment except physical and symptomatic therapy.