Biomechanical calculation of human TM joint loading with jaw opening

A three-dimensional, static mathematical calculation of the stomatognathic system was done to predict total temporomandibular joint (TMJ) loading at different levels of jaw opening. The model assumed that muscle forces acting on the mandible could be simulated by a combination of contractile components (CCs) and elastic components (ECs) and that static equilibrium existed within the body of the mandible. The model also imposed the constraint that any generated joint reaction force would act on the centre of the condyle. The results of the model demonstrated that under all conditions of opening and for all values of the elastic modulus selected, the forces between the TMJ condyle and the articular eminence were compressive in nature. The compressive force magnitude increased from 2.7 to 27.6 N incrementally as the jaw opened from 10 to 40 mm. Overall data in this study indicated that the TMJ tissues undergo low levels of compression at open positions up to 40 mm. Finally, the condition of trismus (increased jaw closing activation with opening) was simulated, the joint reaction force at 20 mm opening increased from 7.7 to 64.9 N with only a 20% activation of the closers.

Characterization of Solt, a novel SoxLZ/Sox6 binding protein expressed in adult mouse testis

SoxLZ/Sox6, a member of the Sox protein family, contains a leucine zipper motif in addition to an HMG box, which is its DNA binding domain. Here we have identified a novel SoxLZ/Sox6 binding protein, termed Solt, which we obtained independently using both a far-Western blot and a yeast two-hybrid screen. Like SoxLZ/Sox6 mRNA, Solt mRNA was exclusively expressed in the testis in mouse. Solt contains an unusual leucine zipper, which bound to the leucine zipper region of SoxLZ/Sox6 in vitro. In transient transfection assays in CHO cells with SoxLZ/Sox6 containing the transactivational region of herpes simplex virus VP16, expression of a reporter gene that carries a cis binding region for Sox proteins was significantly enhanced by the co-expression of Solt and Ca(2+)/calmodulin-dependent protein kinase IV.

[Diagnosis of breast cancer extent using dynamic multidetector-row CT: correlation between MPR imaging and pathological cross-sections]

PURPOSE

To evaluate the clinical usefulness of dynamic multidetector-row CT (dynamic MD-CT) for the detection of intraductal extension of breast cancer.

MATERIALS AND METHODS

Dynamic MD-CT was performed in 31 patients with breast masses (26 invasive ductal carcinomas, 4 non-invasive ductal carcinomas and one benign lesion). We grouped the cases into four categories according to the degree of intraductal extension of the main tumor: IDS1: intraductal component less than 1 cm, IDS2: intraductal component 1 cm to 2 cm, IDS3: intraductal component 2 cm to 3 cm, IDS4: intraductal component more than 3 cm. To achieve complete CT-pathologic correlation, we retrospectively reconstructed MPR in the same plane as the histological cross-section.

RESULTS

Thirty breast carcinomas (100%) showed strong enhancement in both the first and second phases of contrast enhanced dynamic MD-CT. The sensitivity and specificity of dynamic MD-CT for the detection of the intraductal component were 80.0% (12/15) and 100% (15/15). The accuracy of detection for the four tumor categories was 100% (15/15) for IDS1, 25% (1/4) for IDS2, 42.9% (3/7) for IDS3, and 100% (4/4) for IDS4.

CONCLUSION

Dynamic MD-CT of the breast was found to be effective for the detection of intraductal extension of breast carcinoma and thought to be useful in the preoperative assessment of indications of breast-conserving surgery.

[Perioperative management of endovascular stent graft placement for abdominal aortic aneurysm]

We retrospectively examined the changes in hemodynamics, oxygen index and renal function along with the complications in 25 patients who had undergone endovascular stent graft placement (ESG) surgery for abdominal aortic aneurysm. During stent graft placement, mean arterial pressure decreased to 58 +/- 8 mmHg by increasing the dose of anesthetics and/or using vasodilators. Except for this intended hypotensive period, mean arterial pressure and heart rate were relatively stable and adequately maintained during surgical manipulation. Oxygenation index was well maintained. A patient with a high preoperative creatinine level underwent prophylactic hemodialysis postoperatively. In other patients except one who died in early postoperative period, both BUN and creatinine levels were kept within normal ranges. Four patients died postoperatively and the causes of the death in two patients are related to the surgical procedure; one with multiple emboli possibly due to released atheloma from the aortic wall during procedure, the other with sepsis due to infected stent graft. Although ESG is a well tolerated procedure, embolism is the most serious complication. Careful preoperative evaluation of the ascending arch and descending aortic wall and monitoring with transcranial doppler are necessary.

Expression of GAP-43 and SCG10 mRNAs in lateral geniculate nucleus of normal and monocularly deprived macaque monkeys

We performed nonradioactive in situ hybridization histochemistry (ISH) in the lateral geniculate nucleus (LGN) of the macaque monkey to investigate the distribution of mRNA for two growth-associated proteins, GAP-43 and SCG10. GAP-43 and SCG10 mRNAs were coexpressed in most neurons of both magnocellular layers (layers I and II) and parvocellular layers (layers III-VI). Double-labeling using nonradioactive ISH and immunofluorescence revealed that both GAP-43 and SCG10 mRNAs were coexpressed with the alpha-subunit of type II calcium/calmodulin-dependent protein kinase, indicating that both mRNAs are expressed also in koniocellular neurons in the LGN. We also showed that GABA-immunoreactive neurons in the LGN did not contain GAP-43 and SCG10 mRNAs, indicating that neither GAP-43 nor SCG10 mRNAs were expressed in inhibitory interneurons in the LGN. GABA-immunoreactive neurons in the perigeniculate nucleus, however, contained both GAP-43 and SCG10 mRNAs, indicating that both mRNAs were expressed in inhibitory neurons in the perigeniculate nucleus, which project to relay neurons in the LGN. Furthermore, to determine whether the expression of GAP-43 and SCG10 mRNAs is regulated by visual input, we performed nonradioactive ISH in the LGN and the primary visual area of monkeys deprived of monocular visual input by intraocular injections of tetrodotoxin. Both mRNAs were downregulated in the LGN after monocular deprivation for 5 d or longer. From these results, we conclude that both GAP-43 and SCG10 mRNAs are expressed in the excitatory relay neurons of the monkey LGN in an activity-dependent manner.

MAPK upstream kinase (MUK)-binding inhibitory protein, a negative regulator of MUK/dual leucine zipper-bearing kinase/leucine zipper protein kinase

Mitogen-activated protein kinase upstream kinase/dual leucine zipper-bearing kinase/leucine-zipper protein kinase (MUK/DLK/ZPK) is a MAPKKK class protein kinase that induces JNK/SAPK activation. We report here a protein named MBIP that binds to MUK/DLK/ZPK. MUK-binding inhibitory protein (MBIP) contains two tandemly orientated leucine-zipper-like motifs with a cluster of basic amino acids located between the two motifs. MBIP interacts with one of the two leucine-zipper-like motifs of MUK/DLK/ZPK and inhibits the activity of MUK/DLK/ZPK to induce JNK/SAPK activation. Notably, no similar effect was observed with another JNK/SAPK-inducing MAPKKK, COT/Tpl-2, showing the specificity of MBIP action. Furthermore, the overexpression of MBIP partially inhibits the activation of JNK by 0.3 m sorbitol in 293T cells. Taken together, these observations indicate that MBIP can function as a regulator of MUK/DLK/ZPK, a finding that may provide a clue to understanding the molecular mechanism of JNK/SAPK activation by hyperosmotic stress.

Ultrastructural and functional studies of cryopreserved rat lungs for transplantation using a new hyperosmolal solution

One of the most promising approaches for extending the period of tissue or organ preservation is to induce a state of cryopreservation. In this report, to achieve successful lung cryopreservation, we created a new hyperosmolal solution (HOS) containing 10% glycerol and 5% dimethyl sulfoxide (Me2SO). We compared the efficacy of HOS with that of Euro-Collins solution (ECS) in rat lung cryopreservation from an ultrastructural and functional point of view. Using ECS, widespread damage to the air-blood barrier was observed even in the lungs cryopreserved at -10 degrees C. At -196 degrees C, the capillary lumen was obstructed with a mesh-like formation derived from deteriorated endothelial cells. In contrast, using HOS, the cryopreserved lungs at -10 degrees C were characterized by well preserved endothelial cells and basal laminae, despite the existence of focal cytoplasmic swelling of epithelial cells. The endothelial cells and basal laminae were successfully preserved up to -196 degrees C. Considering the survival rates at day 7 after cryopreserved lung transplantation, the grafted left lungs functioned normally only when perfused by and preserved in HOS at -10 degrees C. These findings demonstrate that HOS was effective not only for endothelial cells and basal laminae up to -196 degrees C, but also lung cryopreservation at least up to -10 degrees C.

The influence of blood contamination on bond strengths between dentin and an adhesive resin cement

The objective of this study was to determine in which step of adherent surface treatments blood contamination affects the bond strength between an adhesive resin and dentin. The coronal part of bovine incisors was polished flat to expose the dentin. The specimens were randomly divided into three groups and specific surface treatments were applied to each group: (1) a self-etching primer application (SP group); (2) 38% phosphoric acid etching followed by primer (non-HC group); (3) acid etching followed by 10% sodium hypochlorite solution application and primer (HC group). The dentin surface was contaminated by human blood before or after either step of the surface treatments. The contaminated surfaces were washed with water after 30-second exposure and air-dried. A stainless-steel rod was adhered on the dentin surface with Panavia 21 after completing the surface treatment(s), and the tensile bond strength was measured. Fifteen subgroups including control groups were tested. If blood contamination occurred before collagen fibers were exposed by either phosphoric acid etching or self-etching primer application, the contamination presented almost no influence on bond strength. Blood contamination of the dentin surface where collagen fibers had been exposed decreased the bond strength. However, when the contaminated collagen fibers were dissolved or when the contamination occurred after the exposed collagen fibers were dissolved, the bond strength was maintained. The bond strength was markedly decreased when the contamination occurred after the primer application (Scheffé's Comparison, SP group: p = 0.0003, non-HC group: p < 0.0001), but was restored by reapplication of the self-etching primer. This study revealed that the effects of blood contamination on the bond strength of adhesive resin to dentin vary greatly depending on the adherent surface conditions.

Atypical aortic coarctation with resistant hypertension treated with axilloiliac artery bypass

A 68-year-old woman was found to have atypical coarctation of the aorta, accompanied by systolic hypertension of the upper extremities despite administration of five types of antihypertensive drugs. Since the systolic hypertension was resistant to the conventional antihypertensive therapy, axilloiliac artery bypass grafting with a subcutaneous tunnel was performed to alleviate the pressure gradient. Systolic blood pressure was successfully reduced and hypertension was controlled after surgery.

Pilot study of conditioner/primer effects on resin-dentin bonding after provisional cement contamination using SEM, energy dispersive x-ray spectroscopy, and bond strength evaluation measures

STATEMENT OF PROBLEM

Previous studies have shown that provisional cement cannot be completely removed from the dentin surface and the remnants inhibit adhesion of resin cement to dentin.

PURPOSE

This study investigated the effects of dentin conditioners on resin-dentin bonding after provisional cement contamination.

MATERIAL AND METHODS

A total of 216 bovine dentin specimens were divided into 2 groups with and without provisional cement coating on the dentin surface. Each group was further divided into 3 subgroups with 2 conditioning methods and without dentin conditioning (36 specimens per subgroup). The 2 methods applied were (1) phosphoric acid etching and (2) phosphoric acid etching, followed by sodium hypochlorite gel. Provisional cement was completely removed with a curette before dentin conditioning. Stainless steel rods were luted to dentin surfaces with Panavia 21 resin cement. Tensile bond strengths were measured before and after thermocycling. The dentin surface was analyzed by SEM and energy dispersive x-ray spectroscopy. Three-way ANOVA and Scheffe's comparison test were performed (P =. 05).

RESULTS

Bond strength was significantly influenced by provisional cement application, type of dentin conditioning, and thermocycling. Bond strength decreased when treated with provisional cement, but the decreased strengths were restored to their original values or higher by both dentin conditioners used. Specimens treated with sodium hypochlorite gel applied after phosphoric acid etching demonstrated the highest bond strengths with good stability after thermocycling.

CONCLUSION

Application of sodium hypochlorite gel after phosphoric acid etching was more effective than etching with phosphoric acid alone to eliminate the inhibitory effect of provisional cement remnants on adhesion between resin cement and dentin.

Peroxisomal membrane protein Pmp47 is essential in the metabolism of middle-chain fatty acid in yeast peroxisomes and Is associated with peroxisome proliferation

Pmp47 of the methylotrophic yeast Candida boidinii belongs to a mitochondrial family of solute transporters and is localized in peroxisomal membranes. Its human homolog, Pmp34, is also known. In this study, we characterized the role of Pmp47 in fatty acid metabolism and peroxisome proliferation using the PMP47-deleted strain of C. boidinii (strain pmp47Delta). The wild-type strain grew well on a middle-chain fatty acid, laureate, as the single carbon source, and mild peroxisome proliferation was observed during its growth. The pmp47Delta strain could not grow on laureate but could grow on long-chain fatty acids including palmitate, myristate, and oleate. The levels of laureate oxidation activity in intact cells and in semi-permeabilized cells of strain pmp47Delta were lower than the respective level in the wild-type strain, although the level of laureate oxidation activity in the cell lysate and the level of lauroyl-CoA oxidation in semi-permeabilized cells of strain pmp47Delta were indistinguishable from the respective level in the wild-type strain. When lauroyl-CoA was provided in the cytosol of strain pmp47Delta through expression of Saccharomyces cerevisiae Faa2p (lauroyl-CoA synthetase) in which its peroxisome targeting signal was deleted, the growth of strain pmp47Delta on laureate was recovered to the level of growth of the wild-type strain. Laureate is converted to its CoA form in peroxisomes by the action of lauroyl-CoA synthetase. These results suggested that Pmp47 is involved in the transport of a small molecule (possibly ATP) required in the conversion of laureate to its CoA form in peroxisomes and that the absence of Pmp47 causes impairment of laureate metabolism, which results in the inability of pmp47Delta cells to grow on laureate. In addition, Pmp47 may be involved in peroxisome proliferation, because the pmp47Delta strain contained a reduced number of peroxisomes, as judged from the fluorescence analysis of cells expressing green fluorescent protein tagged with the peroxisome targeting signal 1 (GFP-AKL).

[A case of acute diffuse atrophy of retinal pigment epithelium]

PURPOSE

To report a case of acute bilateral visual disturbance where the ocular fundus changed like retinitis pigmentosa in a short time.

PATIENT

26-year-old man.

FINDINGS

In initial examination, the patient's visual acuity was 0.01 OD and 0.02 OS with myopic correction, but his fundus did not look abnormal. Fluorescein angiogram showed marked background hyperfluorescence and dye leaking to the vitreous. After 2-3 weeks, the fundus appearance changed like retinitis pigmentosa. Best corrected visual acuity became 1.0 OD and 0.9 OS after steroid pulse therapy. We were unable to find the cause of this disease in spite of blood tests and other examinations.

CONCLUSION

This case with acute diffuse atrophy of retinal pigment epithelium and damage of the function of blood-retinal barrier was considered remarkably rare.

Development of full-length Trk B-immunoreactive structures in the prefrontal and visual cortices of the macaque monkey

Distribution and morphological changes of cells containing the signal transducing neurotrophin receptor, full-length Trk B (fl-Trk B), were investigated in the prefrontal cortex (area FD) and the primary visual cortex (area OC) of the macaque monkey between embryonic day 140 and the adult stage. In area FD at the adult stage, fl-Trk B immunoreactivity was mainly observed in the pyramidal cells in layers II/III, V and VI. Small numbers of granule cells in layer IV were immunopositive. Bipolar and multipolar cells in layer II were rarely immunoreactive. At embryonic day 140, the number of fl-Trk B immunoreactive pyramidal cell was high, and gradually decreased until the adult stage. In layer IV, the number of fl-Trk B-ir cells was also high at embryonic day 140, and decreased remarkably from postnatal day 7 to the adult stage. On the other hand, in area OC at the adult stage, cells in layers II/III, IV, V and VI were fl-Trk B immunopositive. From embryonic day 140 until adulthood, the cells in layer IVc were fl-Trk B immunoreactive. The strongest fl-Trk B immunoreactivity in areas FD and OC occurred at postnatal month 6, coinciding with the time of the synapse overproduction. These findings suggest that ligands of fl-Trk B, such as BDNF and NT4/5 may be involved in the development and maintenance of the monkey cerebral cortices.

Isolation of transformation suppressor genes by cDNA subtraction: lumican suppresses transformation induced by v-src and v-K-ras

We have reported that suppressive factors for transformation by viral oncogenes are expressed in primary rat embryo fibroblasts (REFs). To identify such transformation suppressor genes, we prepared a subtracted cDNA library by using REFs and a rat normal fibroblast cell line, F2408, and isolated 30 different cDNA clones whose mRNA expression was markedly reduced in F2408 cells relative to that in REFs. We referred to these as TRIF (transcript reduced in F2408) clones. Among these genes, we initially tested the suppressor activity for transformation on three TRIF genes, TRIF1 (neuronatin), TRIF2 (heparin-binding growth-associated molecule), and TRIF3 (lumican) by focus formation assay and found that lumican inhibited focus formation induced by activated H-ras in F2408 cells. Colony formation in soft agar induced by v-K-ras or v-src was also suppressed in F2408 clones stably expressing exogenous lumican without disturbing cell proliferation. Tumorigenicity in nude mice induced by these oncogenes was also suppressed in these lumican-expressing clones. These results indicate that lumican has the ability to suppress transformation by v-src and v-K-ras.

Rapid turnover of tryptophan hydroxylase is driven by proteasomes in RBL2H3 cells, a serotonin producing mast cell line

Previously we demonstrated that tryptophan hydroxylase (TPH) undergoes very fast turnover driven by ATP-dependent proteolysis in serotonin producing mast cells [Hasegawa et al. (1995) FEBS Lett. 368, 151-154]. We searched for the major proteases involved in the rapid degradation of TPH in RBL2H3 cells. Among various protease inhibitors tested, proteasome inhibitors MG115, MG101, MG132, and lactacystin effectively inhibited the intracellular degradation of TPH. Administration of the proteasome inhibitors to cultured cells caused more than a 5-fold accumulation of TPH. Administration of the inhibitors together with cycloheximide stabilized the amount of TPH with no appreciable increase or decrease. Although MG-series proteasome inhibitors could inhibit calpain, the involvement of calpain was excluded since the cysteine protease inhibitor E-64-d, which acts on calpain, had no effect. Extracts of RBL2H3 cells were shown to contain a protease that digests TPH in an ATP-dependent manner and is sensitive to proteasome inhibitors. The ubiquitination of TPH could be visualized by Western blot analysis using both anti-TPH and anti-ubiquitin antibodies. Based on these results, we conclude that 26S proteasomes are mainly involved in the degradation of TPH. In the reported amino acid sequences of TPH from various sources including human, rabbit, rat, and mouse, a PEST sequence that is widely shared among short-lived proteins has been recognized. It was noted that the PEST sequence lies within the most conserved portion of the enzyme, the pteridine binding site.

[A case of traumatic aneurysm of innominate artery with occlusion of right subclavian artery]

A 42-year-old woman with history of chest blunt trauma from an automobile accident 250 days earlier had suffered easy fatigability of the right upper extremity. She had difference of blood pressure between upper extremities, 94/60 mmHg in the right and 126/70 mmHg in the left. Chest CT showed dilation of the innominate artery which compressed the trachea. Aortography showed an aneurysm of the innominate artery and occlusion of the right subclavian artery at its origin. The aneurysm of the innominate artery was resected and replaced with a 6 mm Dacron graft with aid of the external shunt. The right subclavian artery was also reconstructed with same graft. The aneurysm of the innominate artery should be suspected as a rare complication in blunt trauma of the chest.

[Postoperative sore throat and intracuff pressure: comparison among endotracheal intubation, laryngeal mask airway and cuffed oropharyngeal airway]

We studied which device is most useful to reduce postoperative sore-throat. We investigated the relationship between intracuff pressure and postoperative sore-throat in using endotracheal intubation (ET), the laryngeal mask airway (LMA) and the cuffed oropharyngeal airway (COPA) in adult patients. We classified sore-throat into categories; pain at rest, hoarseness and dysphasia. We evaluated pain at rest by the score (0: no pain, 1: mild discomfort, 2: mild pain, 3: severe pain). Pain at rest (scores 1, 2, 3) was complained by 10 patients in ET group, 3 in LMA group, 5 in COPA group on the day of operation, showing significantly lower incidence of pain at rest in LMA group than in ET group. Hoarseness was complained by 15 patients in ET group, 2 in LMA group and 4 in COPA group, showing significantly lower incidence of hoarseness in LMA and COPA groups than in ET group. Dysphasia was complained by 3 in ET group, 1 in LMA group and 2 in COPA group, showing no significant difference. These results suggest that LMA is most appropriate to reduce postoperative sore-throat.

Nicergoline enhances glutamate re-uptake and protects against brain damage in rat global brain ischemia

Whereas a 2-3 degrees C decrease in intraischemic brain temperature can be neuroprotective, mild brain hyperthermia significantly worsens outcome. Our previous study suggested that an ischemic injury mechanism which is sensitive to temperature may not actually increase the extracellular glutamate concentration ([Glu](e)) during the intraischemic period, but rather impairs the Glu re-uptake system, which has been suggested to be involved in the reversed uptake of Glu. We speculated that enhancing Glu re-uptake, pharmacologically or hypothermically, may shorten exposure to high [Glu](e) in the postischemic period and thereby decrease its deleterious excitotoxic effect on neuronal cells. In the present study, rats treated with nicergoline (32 mg/kg, i.p.), an ergot alkaloid derivative, showed minimal inhibition of the [Glu](e) elevation which characteristically occurs during the 10-min intraischemic period, while Glu re-uptake was dramatically improved in the postischemic period, when severe transient global ischemia was caused by mild hyperthermia. Moreover, the nicergoline (32 mg/kg, i.p.) treated rats showed reduced cell death morphologically and clearly had a far lower mortality. The present study suggests that the development of therapeutic strategies aimed at inhibition or prevention of the reversed uptake of glutamate release during ischemia, i.e., activation of the glutamate uptake mechanism, is a promising approach to reduce neural damage occurring in response to brain ischemia.

Effect of cold pressor stimulation (4 degrees C) on human masseter muscle haemodynamics during and after sustained isometric contraction

The effect of cold pressor (CP) stimulation and sustained isometric contraction on the blood volume of the right masseter muscle was examined in seven healthy males, who performed 1 min of isometric jaw clenching at 50% of their maximum voluntary contraction without, with and again without a 4 degrees C CP stimulation. Total haemoglobin was measured in the masseter before, during and after the contraction task using near-infrared spectroscopy. CP stimulation during the isometric contraction diminished the magnitude of the contraction-induced decrease of blood volume when compared to the trials without CP stimulation. However, in the immediate post-contraction period (while the CP stimulation was still in place), no increase in blood volume above the usual post-contraction hyperaemia was evident. Once the CP stimulation had been removed, there was a clear decrease (faster return to baseline) in the vasodilation occurring in the post-contraction period. This diminished period of vasodilation occurred in spite of the fact that the vascular resistance (blood pressure) and heart rate were still substantially elevated by the CP effect during this same period. These data suggest that the strong CP stimulation produced a biphasic response. First, there was an early-onset strong vasodilation (during CP), which was followed by a period of diminished vasodilation, suggesting that an active, but delayed, vasoconstrictive drive may be induced by the CP stimulus.

Inhibitory effects of propofol on acetylcholine-induced, endothelium-dependent relaxation and prostacyclin synthesis in rabbit mesenteric resistance arteries

BACKGROUND

Propofol (2,6-diisopropylphenol) modulates endothelium-dependent relaxation in some arterial preparations. The effect of propofol on endothelium-dependent, prostacyclin-mediated responses in mesenteric resistance arteries has not yet been clarified.

METHODS

The effect of propofol was examined on acetylcholine-induced membrane potential changes in the presence of N(G)-nitro-L-arginine (L-NOARG) in endothelium-intact rabbit mesenteric resistance arteries in vitro. The effects of propofol were also examined on the endothelium-dependent relaxation and prostacyclin synthesis that was induced by acetylcholine in the presence of L-NOARG and nicardipine. The effect of propofol on the relaxation induced by a prostacyclin analogue was examined in strips treated with L-NOARG and diclofenac.

RESULTS

Acetylcholine produced an initial and a slow membrane hyperpolarization. Propofol, 10 microM, and diclofenac each inhibited the acetylcholine-induced slow hyperpolarization, but not the initial hyperpolarization. Acetylcholine produced an endothelium-dependent relaxation that was significantly inhibited by propofol, 10 microM, and diclofenac. Propofol, 10 microM, greatly inhibited the acetylcholine-induced synthesis of prostacyclin, as did diclofenac. Propofol, 10 microM, had no effect on the relaxation induced by a prostacyclin analog.

CONCLUSIONS

In rabbit mesenteric resistance arteries, propofol inhibits the synthesis of prostacyclin and thus attenuates acetylcholine-induced, endothelium-dependent responses. Our results may help to explain why some actions seen with propofol in some preparations (e.g., vasoconstriction) are not seen after the endothelium is removed.

Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation

The aim was to compare haemodynamic responses in trapezius muscles to cold pressor stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold pressor and mock) trials were performed in a randomly assigned sequence. In the cold pressor trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold pressor stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold pressor stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold pressor stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia.

[Anesthetic management of a patient with tracheal bronchus with one lung ventilation]

A 56-year-old-male with malignant pleural mesothelioma of the left lung underwent pneumonectomy and pleurectomy. Fiberoptic bronchoscopy was not done preoperatively. Anesthesia was induced rapidly and a double-lumen endobronchial tube was inserted. When we checked the position of the tube with a fiberoptic bronchoscope, we found that the normal right upper lobe bronchus was absent and that the inflated tracheal cuff had obstructed the right upper lobe bronchus originating above the carina. Then we changed the double-lumen endobronchial tube to a endotracheal tube with the blocker. Thereafter, the surgery was completed safely and his postoperative course was uneventful. Routine bronchoscopy is essential just after intubation and before extubation of the endobronchial tube in safe airway management. How to use a fiberoptic bronchoscope to check the position of a double-lumen endobronchial tube is also discussed.