Diesel Exhaust Particles Impair Therapeutic Effect of Human Wharton’s Jelly-Derived Mesenchymal Stem Cells against Experimental Colitis through ROS/ERK/cFos Signaling Pathway

Background and Objectives@#Epidemiological investigations have shown positive correlations between increased diesel exhaust particles (DEP) in ambient air and adverse health outcomes. DEP are the major constituent of particulate atmospheric pollution and have been shown to induce proinflammatory responses both in the lung and systemically. Here, we report the effects of DEP exposure on the properties of human Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs), including stemness, regeneration, and immunomodulation. @*Methods@#and Results: Non-apoptotic concentrations of DEP (10 μg/ml) inhibited the migration and osteogenic differentiation capacity of WJ-MSCs. Gene expression profiling showed that DEP increased intracellular reactive oxygen species (ROS) and expression of pro-inflammatory and metabolic-process-related genes including cFos. Furthermore, WJ-MSCs cultured with DEP showed impaired suppression of T cell proliferation that was reversed by inhibition of ROS or knockdown of cFos. ERK inhibition assay revealed that DEP-induced ROS regulated cFos through activation of ERK but not NF-κB signaling. Overall, low concentrations of DEP (10 μg/ml) significantly suppressed the stemness and immunomodulatory properties of WJ-MSCs through ROS/ERK/cFos signaling pathways. Furthermore, WJ-MSCs cultured with DEP impaired the therapeutic effect of WJ-MSCs in experimental colitis mice, but was partly reversed by inhibition of ROS. @*Conclusions@#Taken together, these results indicate that exposure to DEP enhances the expression of pro-inflammatory cytokines and immune responses through a mechanism involving the ROS/ERK/cFos pathway in WJ-MSCs, and that DEP-induced ROS damage impairs the therapeutic effect of WJ-MSCs in colitis. Our results suggest that modulation of ROS/ERK/cFos signaling pathways in WJ-MSCs might be a novel therapeutic strategy for DEP-induced diseases.

Development of bilateral tension pneumothorax under anesthesia in a Boerhaave's syndrome patient: a case report / 대한마취과학회지

A 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.

A loading dose of 1 µg/kg and maintenance dose of 0.5 µg/kg/h of dexmedetomidine for sedation under spinal anesthesia may induce excessive sedation and airway obstruction

BACKGROUND: For many drugs, dosing scalars such as ideal body weight (IBW) and lean body mass are recommended over the use of total body weight (TBW) during weight-based dose calculations. Doses based on TBW are frequently used, and this may cause under- or over-dosing. Because dexmedetomidine (DEX) overdosing could increase the incidence of side effects, and spinal anesthesia may increase sensitivity to a sedative agent, determining an appropriate dose is critical. METHODS: Eighty patients were randomly divided into 2 groups, the IBW and TBW groups. Patients received a loading dose of DEX 1 µg/kg IBW or TBW for 10 min, followed by a continuous infusion at 0.5 µg/kg/h IBW or TBW after the induction of spinal anesthesia. The patients' vital signs, bispectral index (BIS), peripheral capillary oxygen saturation, time to reach a BIS of 80, airway obstruction score, and coughing were monitored and recorded at 0, 10, 30, and 50 min after the start of the loading dose injection. RESULTS: The changes in BIS, airway obstruction score, the incidence of side effects, and time to reach a BIS of 80 did not show statistically significant differences between the two groups. However, airway obstruction and/or coughing occurred in both groups, and the average BIS in both groups was lower than the target BIS of 60-80 at 30 and 50 min. CONCLUSIONS: A loading dose of DEX 1 µg/kg for 10 min, and a maintenance dose of DEX 0.5 µg/kg/h of either IBW or TBW, may induce excessive sedation, airway obstruction, and/or coughing under spinal anesthesia.

Polymorphism of Haptoglobin in Patients with Premature Rupture of Membrane

PURPOSE: To investigate whether allelic polymorphism of haptoglobin (Hp) is associated with premature rupture of membrane (PROM), the Hp phenotypes of pregnant women with PROM were analyzed. PATIENTS AND METHODS: The Hp phenotypes of 221 pregnant Korean women (187 control and 34 PROM patients) were determined by benzidine/hydrogen peroxide staining, following native polyacrylamide gel electrophoresis of hemoglobin-mixed sera. The Hp allele frequencies were calculated from the data of Hp phenotypes, and overall association with PROM was evaluated using Pearson Chi-Square test. RESULTS: The polymorphic distribution of the patients cohort who underwent a normal delivery (control group) was similar to that of healthy Koreans. In contrast, however, patients with PROM showed significantly higher occurrence of the Hp 1-1 phenotype than control group (23.5% vs 8.0%). Hp 2-2 phenotype was lower in PROM cohort (38.2%) than in the control group (48.7%). The Hp1 allele frequency in PROM group was significantly higher than that in the control group (0.426 vs 0.297, p = 0.034) with odds ratio of 1.762 (95% CI: 1.038 - 2.991). CONCLUSION: These findings suggest that pregnant Korean women who possess Hp1 allele (expressed as Hp 1-1 phenotype) have higher incidence of PROM than women with Hp2 allele (expressed as Hp 2-2 phenotype). This is the first study that evaluated the significance of Hp polymorphism with respect to the development of PROM.

Effects of Amrinone on the Vascular Tension of the Isolated Rabbit Pulmonary Artery / 대한마취과학회지

BACKGROUND: Amrinone is a noncatecholamine, nonglycoside compound, which is known to possess both cardiac inotropic and vasodilatory actions. This drugs has been increasingly used in clinical practice for the management of low cardiac output syndrome during anesthesia, particularly for patients associated with right heart failure and pulmonary hypertension. The aim of this study was to explore the direct vasoactive effect of amrinone and its action mechanisms in the isolated rabbit pulmonary artery. METHODS: The rabbits' pulmonary arteries were dissected free and cut into rings (3 4 mm) and mounted for isometric tension in a tissue chamber. The effects of amrinone (5 10 6 5 10 4 M) on the vascular tension were assessed in the by KCl (40 mM)- or norepinephrine (NE, 10 6 M)- precontracted pulmonary arterial rings with or without endothelium. Also effects of K channel blockers (tetraethyl ammonium 20 mM, glybenclamide 2.5 10 5 M, 4-aminopyridine (4-AP) 5 10 4 M), protein kinase A & G inhibitor (H8), L-NAME, methylene blue and indomethacin on the amrinone- induced vascular responses were investigated. Also studied was effects of amrinone on the Ca2 influx through voltage operated channel (VOC) and receptor operated channel (ROC) of the vascular cells. RESULTS: Amrinone produced vasorelaxation of KCl- or NE-precontracted pulmonary artery in a dose-dependent fashion. The amrinone-induced vasorelaxation was not affected by the denudation of the endothelium. Pretreatment with L-NAME and methylene blue did not affect the vasodilatory effect of amrinone, suggesting that nitric oxide is not involved. Following pretreatment with indomethacin (a cyclooxygenase inhibitor) or K channel blockers, the amrinone-induced vasorelaxation was not altered. After exposure to Ca2 free solution, amrinone attenuated the KCl- or NE-induced contraction even in the presence of Ca2 , implying that VOC and ROC are blocked by amrinone. On the other hand, protein kinase A blocker (H8) completely abolished the amrinone-induced relaxation in the KCl-precontracted pulmonary artery. CONCLUSIONS: These findings suggest that the amrinone-induced vasorelaxations result from inhibition of VOC and ROC as well as from the activation of protein kinase A in the isolated rabbit pulmonary artery.

The Postoperative Antiemetic Effect of Midazolam in Patients Undergoing Appendectomy / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting are common postoperative complaints. The purpose of this study was to assess the effect of preoperative midazolam on vomiting after appendectomy. METHODS: Sixty patients, aged 10 64 yr, undergoing emergency appendectomy were randomly allocated to receive midazolam 30, 50, 75 microgram/kg or placebo after induction of anesthesia. Anesthesia consisted of 67% nitrous oxide, 33% oxygen and propofol infusion 6 10 mg/kg/h. Postoperative vomiting was checked by the recovery room nurse at 1 h after operation and we examined the incidence of postoperative vomiting at 24 h after operation. RESULTS: Midazolam reduced the overall incidence of vomiting, especially in the midazolam 50 and 75 microgram/kg groups, completely abolishing vomiting (P< 0.05). However, in the midazolam 75 microgram/kg group, there was a delay in eye opening time (P< 0.05). CONCLUSIONS: Preoperative injections of midazolam 30 or 50 microgram/kg were useful to prevent postoperative vomiting in patients undergoing appendectomy without delayed recovery.

Two Cases of Epidural Anesthesia for Patients with Moyamoya Disease Presenting for Elective Cesarean Section: 2 cases report / 대한마취과학회지

Moyamoya disease is a rare progressive occlusive disease of the internal carotid arteries, along with the presence of an abnormal capillary network of vessels at the base of the brain. There are few reports regarding moyamoya disease during pregnancy. Since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, elective cesarean section has been recommended to avoid neurologic complications for pregnant women with moyamoya disease. The optimal anesthetic management for cesarean section in these patients has not been discussed. We describe two cases of epidural anesthesia for elective cesarean section for patients with known moyamoya disease, which were delivered successfully.

The Factor that Determines Mechanical Ventilation during Cesarean Section under General Anesthesia: Weight before pregnancy vs. weight during delivery / 대한마취과학회지

BACKGROUND: During general anesthesia the adult patient's tidal volume is determined by patient's weight. Therefore patients with severe ascites, huge abdominal mass or pregnancy have considerable ventilatory change during the operation because the great change in their body weight, that might cause unwanted respiratory alkalosis or acidosis. The purpose of this study is to identify the effects of such changes in ventilation between pre-delivery and post-delivery periods during the cesarean section. METHODS: Eighteen 36weeks or older pregnant patients (ASA 1), scheduled for elective cesarean section under general anesthesia, are selected for the study. PhysioFlex was used for ventilation. Pre-induction maternal gas analysis were performed in all cases. They were randomly divided into two groups according to the ventilator setting for minute ventilation, one set by pre-pregnant weight (Group 1) and the other by pregnant (term) weight (Group 2). Blood gas analysis were performed 5 minutes after induction and 20 minutes after delivery. End-tidal CO2 and inspiratory airway pressure were also measured. RESULTS: All patients show mild hyperventilation with normal acid-base status at pre-induction period. There were no significant differences in arterial PCO2 value between two groups. Group 1 shows mild metabolic acidosis compared with group 2 (by pH at 20 minutes after delivery). CONCLUSION: Term(just prior to operation) body weight rather than pre-pregnant weight is preferable for ventilator setting in the case of cesarean section under general anesthesia.

Screening criteria of alcoholism by alcohol use disorders identification test(AUDIT) in Korea

BACKGROUND: Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol-related psyhosocial problems. But some men can be exduded in a study using these tools whereas they might be at risk for alcohol related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol- related potential harms, are being developed. With focus on these aspects, 10 itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT. METHOD: The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangmung hospital af Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuser' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians diagnostic procedures, they were again made to complete a questionnaire induding all the items of AUDIT, MAST, NAST and CAGE. RESULTS: As regards physicians' diagnostic results, 31 were normal, 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUD1T scores of all the sub were 17.5(+/-9.5) and the mean AUDIT scores of each group were 7.1(+/-4.3), 16.6(+/-3.4), 19.9(+/-5.0), 29.3(+/-5.1), respectively and revealed significant difference among them AUDlT scores were significantly correlated with those marked from physicians' diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of mean AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT scores for detection of a broader sense of 'problem drinker' including physical as well as psychosocial problems were most possibly 12, 13, 14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3% and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning alcohol use disorders hased on DSM IV criteria were most possibly 14, 15, 16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25, 26, 27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3 in 26 points, and 71.4% and 94.7% in 27 points. CONCLUSIONS: The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of problem drinking including physical as well as psychasocial problems, 15 for 'alcohol use disorders' based on DSM IV criteria, and 26 for 'alcohol dependence' in Korea.

Depression of highschool senior students in Seoul

No abstract available.

Training satisfaction according to the type of family practice residency program

No abstract available.

Comparison of patient's desire, physician's recommendiation andhealth examination cneter's performance on periodic healthexamination

No abstract available.

A clinical review on ectopic pregnancy

No abstract available.

Epidemiologic study of mumps in a part of large city

No abstract available.

The relationship between gylcemic control and family dunction in adult-onset diabetes mellitus patients using FACES III

No abstract available.

Maternal and fetal outcomes of pyelonephritis during pregnancy

No abstract available.

A study of the relatioship between parent-adolescent communication and family function

No abstract available.

Clinical features of chest pain in a university hospital emergency room

No abstract available.

A comparative study on family function between the psychiatric families and the normal families

No abstract available.

Comparison of characteristics between fatty and normal liver diagnosed by abdominal ultrasonography

No abstract available.