1
|
Lee JM, Lim CM, Jung JH, Lee SJ, Yang HS, Jeong CY, Park DH. Airway leakage due to malpositioning of esophageal temperature probe during robot-assisted radical prostatectomy: a case report. J Int Med Res 2024; 52:3000605231224231. [PMID: 38217419 PMCID: PMC10788078 DOI: 10.1177/03000605231224231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024] Open
Abstract
Measuring patients' core body temperature during surgery is essential and commonly performed with an esophageal temperature probe. The probe must be placed in the lower third of the esophagus for accurate measurement. In this case report, we describe our experience of discovering an inadvertently malpositioned esophageal temperature probe in the right inferior lobar bronchus, which led to ventilation-related problems in a patient undergoing prostate surgery.
Collapse
Affiliation(s)
- Jong Min Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Chang Mook Lim
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Jae Hoon Jung
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Seok Jin Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Chang Yeong Jeong
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Dong Ho Park
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| |
Collapse
|
2
|
Yang HS, Joung KW. Electroconvulsive therapy and muscle relaxants. Anesth Pain Med (Seoul) 2023; 18:447-448. [PMID: 37468202 PMCID: PMC10635848 DOI: 10.17085/apm.23018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/21/2023] Open
Affiliation(s)
- Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulgi University Hospital, School of Medicine, University of Eulji, Daejeon, Korea
| | - Kyoung-Woon Joung
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Korea
| |
Collapse
|
3
|
Yang HS, Choi JM, In J, Sung TY, Kim YB, Sultana S. Current clinical application of dantrolene sodium. Anesth Pain Med (Seoul) 2023; 18:220-232. [PMID: 37691593 PMCID: PMC10410554 DOI: 10.17085/apm.22260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 09/12/2023] Open
Abstract
Dantrolene sodium (DS) was first introduced as an oral antispasmodic drug. However, in 1975, DS was demonstrated to be effective for managing malignant hyperthermia (MH) and was adopted as the primary therapeutic drug after intravenous administration. However, it is difficult to administer DS intravenously to manage MH. MH is life-threatening, pharmacogenomically related, and induced by depolarizing neuromuscular blocking agents or inhalational anesthetics. All anesthesiologists should know the pharmacology of DS. DS suppresses Ca2+ release from ryanodine receptors (RyRs). RyRs are expressed in various tissues, although their distribution differs among subtypes. The anatomical and physiological functions of RyRs have also been demonstrated as effective therapeutic drugs for cardiac arrhythmias, Alzheimer's disease, and other RyR-related diseases. Recently, a new formulation was introduced that enhanced the hydrophilicity of the lipophilic DS. The authors summarize the pharmacological properties of DS and comment on its indications, contraindications, adverse effects, and interactions with other drugs by reviewing reference articles.
Collapse
Affiliation(s)
- Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Junyong In
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Dongguk University, Goyang, Korea
| | - Tae-yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hopsital, Konyang University College of Medicine, Daejeon, Korea
| | - Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Shofina Sultana
- Department of Anesthesia, Analgesia and lntensive Care lVedicine, Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh
| |
Collapse
|
4
|
Park HY, Choi HR, Kim YB, Oh SK, Kim T, Yang HS, In J. Chronic exposure to dexamethasone may not affect sugammadex reversal of rocuronium-induced neuromuscular blockade: an in vivo study on rats. Anesth Pain Med (Seoul) 2023; 18:275-283. [PMID: 37468197 PMCID: PMC10410550 DOI: 10.17085/apm.23021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/14/2023] [Accepted: 05/22/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Chronic glucocorticoid exposure is associated with resistance to nondepolarizing neuromuscular blocking agents. Therefore, we hypothesized that sugammadex-induced recovery would occur more rapidly in subjects exposed to chronic dexamethasone compared to those who were not exposed. This study evaluated the sugammadex-induced recovery profile after neuromuscular blockade (NMB) in rats exposed to chronic dexamethasone. METHODS Sprague-Dawley rats were allocated to three groups (dexamethasone, control, and pair-fed group) for the in vivo study. The mice received daily intraperitoneal dexamethasone injections (500 μg/kg) or 0.9% saline for 15 days. To achieve complete NMB, 3.5 mg/kg rocuronium was administered on the sixteenth day. The recovery time to a train-of-four ratio ≥ 0.9 was measured to evaluate the complete recovery following the sugammadex injection. RESULTS Among the groups, no significant differences were observed in the recovery time to a train-of-four ratio ≥ 0.9 following sugammadex administration (P = 0.531). The time to the second twitch of the train-of-four recovery following rocuronium administration indicated that the duration of NMB was significantly shorter in Group D than that in Groups C and P (P = 0.001). CONCLUSIONS Chronic exposure to dexamethasone did not shorten the recovery time of sugammadex-induced NMB reversal. However, the findings of this study indicated that no adjustments to sugammadex dosage or route of administration is required, even in patients undergoing long-term steroid treatment.
Collapse
Affiliation(s)
| | - Hey Ran Choi
- Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Yong Beom Kim
- Department of Anesthesia and Pain Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Seok Kyeong Oh
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Taehoon Kim
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Junyong In
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| |
Collapse
|
5
|
Lim CM, Lee SJ, Kim HJ, Park DH, Jeong CY, Yang HS. Spontaneous pneumothorax after shoulder arthroscopy under general anesthesia: a case report. J Int Med Res 2023; 51:3000605231189367. [PMID: 37523598 PMCID: PMC10392293 DOI: 10.1177/03000605231189367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
A woman in her early 70s presented with a right fifth rib fracture along with left scapular body and glenoid fractures resulting from a traffic accident. She had no history of lung disease. The patient underwent multi-incisional video-guided arthroscopic fracture reduction and screw fixation in the right lateral decubitus position under general anesthesia, and surgery was followed by chest tube insertion. Left-sided pneumothorax was found during routine postoperative radiography despite the absence of relevant symptoms or signs such as hypoxia, chest pain, or respiratory difficulty. We herein report this unusual case with a brief literature review.
Collapse
Affiliation(s)
- Chang Mook Lim
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Seok Jin Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hyo June Kim
- Department of Orthopedic Surgery, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Dong Ho Park
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Chang Young Jeong
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea
| |
Collapse
|
6
|
Yang HS, Zhang T, Ye HJ. [Role of imaging classification in the diagnosis and management of orbital inflammatory pseudotumor]. Zhonghua Yan Ke Za Zhi 2023; 59:8-12. [PMID: 36631051 DOI: 10.3760/cma.j.cn112142-20220511-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Orbital inflammatory pseudotumor (OIP) is a kind of orbital idiopathic benign space-occupying lesion with no clear etiology and mainly characterized by inflammatory response. The clinical diagnosis of OIP should be based on exclusion of other diseases or surgical biopsy. Medication and surgical excision are both diagnostic and therapeutic methods. The choice of which is a problem that baffles clinicians. This article discusses a new strategy basing on the imaging features and classifications of OIP. It is expected to be further discussed and promoted in clinical practice to improve the diagnosis and treatment of OIP.
Collapse
Affiliation(s)
- H S Yang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - T Zhang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - H J Ye
- Zhongshan Ophthalmic Center, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| |
Collapse
|
7
|
Choi JM, Yang HS. Sugammadex in pediatric patients. Anesth Pain Med (Seoul) 2022; 17:340. [PMID: 35918869 PMCID: PMC9346208 DOI: 10.17085/apm.22159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
- Corresponding author: Hong Seuk Yang, M.D., Ph.D. Department of Anesthesiology and Pain Medicine,Daejeon Eulji Medical Center, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea Tel: 82-42-220-8921, Fax: 82-42-611-3882 E-mail:
| |
Collapse
|
8
|
Kim KM, Bang JY, Lee JM, Yang HS, Choi BM, Noh GJ. Effect-site concentration of remimazolam at loss and recovery of responsiveness during general anesthesia: a simulation study. Anesth Pain Med (Seoul) 2022; 17:262-270. [PMID: 35918858 PMCID: PMC9346207 DOI: 10.17085/apm.21121] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background The objective of this study was to investigate the effect-site concentration (Ce) of remimazolam at loss of response (LOR) and recovery of response (ROR) in patients underwent general anesthesia using simulation. In addition, the relationships between patient’s factors and simulated Ce at LOR and ROR were examined. Methods The medical records of 81 patients who underwent elective surgery under general anesthesia using remimazolam with simulation of Ce between August 4, 2021 and October 12, 2021, were retrospectively reviewed. Remimazolam was administered as an induction dose of 6 or 12 mg/kg/h until the patient became unresponsive, followed by 0.3–2 mg/kg/h to maintain BIS values below 60. Simultaneously, simulations of manual infusion mode were performed using Asan Pump software and the Ce of remimazolam was simulated using the Schüttler model. Whenever infusion rate of remimazolam was manually changed, the simulated Ce was confirmed almost simultaneously. LOR and ROR, defined as unresponsive and eye-opening to verbal commands, respectively, were recorded in the Asan Pump program. Results The median (1Q, 3Q) simulated Ce at LOR and ROR were 0.7 (0.5, 0.9) and 0.3 (0.2, 0.4) μg/ml, respectively. LOR was achieved in 1.9 min after remimazolam infusion with cumulative doses of 0.3 mg/kg. There was a significant relationship between age and simulated Ce at ROR (Ce at ROR = –0.0043 × age + 0.57, r = 0.30, P = 0.014). Conclusions For optimal dosage adjustment, simulating Ce while administering remimazolam with a weight-based dose during anesthesia is helpful. Elderly patients may recover from anesthesia at lower Ce of remimazolam.
Collapse
Affiliation(s)
- Kyung Mi Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Yeon Bang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Byung-Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding author: Byung-Moon Choi, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: 82-2-3010-1704, Fax: 82-2-3010-6790, E-mail:
| | - Gyu-Jeong Noh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Han W, Kim GS, Lee JM, Lim CM, Yang HS, Jeong CY, Park DH. Unexpected pulmonary edema and cardiac arrest following wedge resection of spontaneous pneumothorax
-A case report-. Anesth Pain Med (Seoul) 2022; 17:298-303. [PMID: 35918863 PMCID: PMC9346198 DOI: 10.17085/apm.21116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background Reexpansion pulmonary edema is a rare but potentially lethal complication. We report a case of suspected reexpansion pulmonary edema that led to cardiac arrest. Case A 16-year-old male patient underwent wedge resection due to right pneumothorax. The patient showed pink frothy sputum three hours following surgery, and a chest x-ray showed right unilateral pulmonary edema. Thirteen hours following surgery, the patient continuously showed pink frothy sputum and presented with severe hypoxemia, tachypnea, and tachycardia. After transferring to the intensive care unit (ICU), he developed ventricular tachycardia. Cardiopulmonary resuscitation was performed for 32 min. Chest X-ray showed diffuse bilateral pulmonary edema. Extracorporeal membrane oxygenation was performed. During the 65 days of ICU care, the patient became mentally alert. However, follow-up echocardiography revealed severe heart failure. Conclusions Rexpansion pulmonary edema can rapidly progress to diffuse bilateral pulmonary edema. Therefore, careful observation is required for the patients who show signs of pulmonary edema after reexpansion.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Dong Ho Park
- Corresponding author: Dong Ho Park, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Daejeon Eulji University Medical Center, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea Tel: 82-42-611-3883, Fax: 82-42-611-3882, E-mail:
| |
Collapse
|
10
|
Kim KM, Jung J, Lee JM, Yang HS, Bang J, Lee E, Choi B, Noh G. The expected advantage of administering prophylactic antibiotics using target‐ concentration controlled infusion: Development of a new pharmacokinetic model of cefazolin. Clin Exp Pharmacol Physiol 2022; 49:731-739. [DOI: 10.1111/1440-1681.13648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/29/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kyung Mi Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Jong Min Lee
- Department of Anesthesiology and Pain Medicine Daejeon Eulji University Hospital Eulji University School of Medicine Daejeon Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine Daejeon Eulji University Hospital Eulji University School of Medicine Daejeon Korea
| | - Ji‐Yeon Bang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul Korea
| | - Eun‐Kyung Lee
- Department of Statistics Ewha Womans University Seoul South Korea
| | - Byung‐Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Gyu‐Jeong Noh
- Departments of Anesthesiology and Pain Medicine, Clinical Pharmacology and Therapeutics, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| |
Collapse
|
11
|
Joung KW, Park DH, Jeong CY, Yang HS. Anesthetic care for electroconvulsive therapy. Anesth Pain Med (Seoul) 2022; 17:145-156. [PMID: 35538655 PMCID: PMC9091667 DOI: 10.17085/apm.22145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Counselling and medication are often thought of as the only interventions for psychiatric disorders, but electroconvulsive therapy (ECT) has also been applied in clinical practice for over 80 years. ECT refers to the application of an electric stimulus through the patient’s scalp to treat psychiatric disorders such as treatment-resistant depression, catatonia, and schizophrenia. It is a safe, effective, and evidence-based therapy performed under general anesthesia with muscle relaxation. An appropriate level of anesthesia is essential for safe and successful ECT; however, little is known about this because of the limited interest from anesthesiologists. As the incidence of ECT increases, more anesthesiologists will be required to better understand the physiological changes, complications, and pharmacological actions of anesthetics and adjuvant drugs. Therefore, this review focuses on the fundamental physiological changes, management, and pharmacological actions associated with various drugs, such as anesthetics and neuromuscular blocking agents, as well as the comorbidities, indications, contraindications, and complications of using these agents as part of an ECT procedure through a literature review and our own experiences.
Collapse
Affiliation(s)
- Kyoung-Woon Joung
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Ho Park
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Chang Young Jeong
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
- Corresponding author Hong Seuk Yang, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea Tel: 82-42-611-3881, Fax: 82-42-259-1111 E-mail:
| |
Collapse
|
12
|
Han W, Lee JM, Park DH, Lee CA, Jeong CY, Yang HS. Adverse events of sugammadex that occurred in a Korean population. Anesth Pain Med (Seoul) 2022; 17:191-198. [PMID: 35378568 PMCID: PMC9091674 DOI: 10.17085/apm.21096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background With increasing use, the incidence of adverse events associated with sugammadex, a neuromuscular blockade reverser, is increasing. This study aimed to identify and analyze cases of adverse events caused by sugammadex reported in Korean population. Methods Out of a total of 12 cases detected using various keywords in the Korean Journal of Anesthesia, Anesthesia and Pain Medicine (Seoul), KoreaMed, PubMed, EMBASE, Web of Science, and The Cochrane Library-CENTRAL from 2013 to December 2020, 10 cases directly associated with sugammadex were selected. Results Adverse events included five cases of anaphylaxis, one case of cardiac arrest, one case of profound bradycardia, one case of negative pressure pulmonary edema, and two cases of incomplete recovery. Three patients had American Society of Anesthesiologists physical status ≥ 3, two had emergency surgery, and two had a history of allergic reaction. Neuromuscular monitoring was applied in nine cases. The average dose of sugammadex was 2.87 mg/kg, and there were six cases in which one full vial was used, regardless of the state of neuromuscular recovery. Sugammadex was administered immediately after surgery in two cases, at train of four (TOF) 0 in four cases, at TOF 3 in one case, and after evaluation of the clinical signs only with no neuromuscular monitoring in one case. Conclusions Even with neuromuscular monitoring, an excessive dose of sugammadex was observed. Given that adverse events tend to occur within 10 min of administration, continuous monitoring is important even after administration.
Collapse
Affiliation(s)
| | | | | | | | | | - Hong Seuk Yang
- Corresponding author: Hong Seuk Yang, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Korea Tel: +82-42-220-8921, Fax: +82-42-611-3882 E-mail:
| |
Collapse
|
13
|
Ledowski T, Szabó-Maák Z, Loh PS, Turlach BA, Yang HS, de Boer HD, Asztalos L, Shariffuddin II, Chan L, Fülesdi B. Reversal of residual neuromuscular block with neostigmine or sugammadex and postoperative pulmonary complications: a prospective, randomised, double-blind trial in high-risk older patients. Br J Anaesth 2021; 127:316-323. [PMID: 34127252 DOI: 10.1016/j.bja.2021.04.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 03/29/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Residual neuromuscular block is associated with an increased risk of postoperative pulmonary complications in retrospective studies. The aim of our study was to investigate prospectively the incidence of postoperative pulmonary complications after reversal with either sugammadex (SUG) or neostigmine (NEO) in high-risk older patients. METHODS We randomly allocated 180 older patients with significant morbidity (ASA physical status 3) ≥75 yr old to reversal of rocuronium with either SUG or NEO. Adverse events in the recovery room and pulmonary complications (defined by a 5-point [0-4; 0=best to 4=worst] outcome score) on postoperative Days 1, 3, and 7 were compared between groups. RESULTS Data from 168 patients aged 80 (4) yr were analysed; SUG vs NEO resulted in a reduced probability (0.052 vs 0.122) of increased pulmonary outcome score (impaired outcome) on postoperative Day 7, but not on Days 1 and 3. More patients in the NEO group were diagnosed with radiographically confirmed pneumonia (9.6% vs 2.4%; P=0.046). The NEO group showed a non-significant trend towards longer hospital length of stay across all individual centres (combined 9 vs 7.5 days), with a significant difference in Malaysia (6 vs 4 days; P=0.011). CONCLUSIONS Reversal of rocuronium neuromuscular block with SUG resulted in a small, but possibly clinically relevant improvement in pulmonary outcome in a select cohort of high-risk older patients. CLINICAL TRIAL REGISTRATION ACTRN12614000108617.
Collapse
Affiliation(s)
- Thomas Ledowski
- Medical School, University of Western Australia, Perth, Australia; Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Australia.
| | - Zoltan Szabó-Maák
- Department of Anaesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary
| | - Pui San Loh
- Department of Anaesthesiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Berwin A Turlach
- Centre of Applied Statistics, University of Western Australia, Perth, Australia
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Eulji University, School of Medicine, DaejeonEulji University Hospital, Daejeon, Republic of Korea; College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Hans D de Boer
- Department of Anaesthesiology, Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital, Groningen, the Netherlands
| | - László Asztalos
- Department of Anaesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary
| | | | - Lucy Chan
- Department of Anaesthesiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Béla Fülesdi
- Department of Anaesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary
| |
Collapse
|
14
|
Yang HS, Park DH, Jeong CY. Change of inspired oxygen concentration and temperature in low flow anesthesia. Anesth Pain Med (Seoul) 2021; 16:116-117. [PMID: 33530680 PMCID: PMC7861906 DOI: 10.17085/apm.20095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Medical College, Eulji University, Daejeon, Korea
| | - Dong Ho Park
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Medical College, Eulji University, Daejeon, Korea
| | - Chang Young Jeong
- Department of Anesthesiology and Pain Medicine, Daejeon Eulji Medical Center, Medical College, Eulji University, Daejeon, Korea
| |
Collapse
|
15
|
Kim JS, Kim YM, Kim HJ, Choi JM, Kim YB, Song JS, Yang HS. Effects of hyperthermia on the effective concentration of rocuronium and sugammadex-mediated reversal in isolated phrenic nerve hemidiaphragm preparations of rats. BMC Anesthesiol 2020; 20:194. [PMID: 32767970 PMCID: PMC7412831 DOI: 10.1186/s12871-020-01114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 07/29/2020] [Indexed: 11/29/2022] Open
Abstract
Background Hyperthermia is relatively rare during general anesthesia; however, a few studies have been conducted on hyperthermia and the neuromuscular blockade (NMB) induced by rocuronium, and the reversal of NMB by sugammadex. We investigated the effect of hyperthermia status on the NMB induced by rocuronium, and its reversal by sugammadex, in isolated phrenic nerve hemidiaphragm (PNHD) preparations of the rat. Methods Thirty-three male Sprague-Dawley rat PNHD preparations were randomly assigned to three groups at different temperatures (36 °C, 38 °C, and 40 °C; each group, n = 11, in Krebs solution). The train-of-four (TOF) and twitch height responses were checked mechanomyographically. The PNHD were treated with progressively increasing doses of rocuronium and three effective concentrations (ECs), EC50, EC90, and EC95, of rocuronium were analyzed in each group via nonlinear regression analysis. Then, sugammadex was administered in doses equimolar to rocuronium. Thereafter, the T1 height (%), TOFR (%) and the duration index were measured. Results The EC of rocuronium (EC50, EC90, and EC95) decreased significantly in accordance with increasing temperature. The groups at 36 °C and 40 °C showed clear differences in all areas (all P < 0.001). Moreover, the T1 height (%) and the duration index upon sugammadex administration showed faster recovery results in the36 °C than the 38 °C and 40 °C groups. Conclusion A rise of temperature from 38 °C to 40 °C in rat PNHD preparations proportionally enhanced the NMB induced by rocuronium. In addition, equimolar doses of sugammadex to the administered rocuronium showed a slower recovery time as the temperature rises.
Collapse
|
16
|
Yin C, Li DY, Guo X, Cao HY, Chen YB, Zhou F, Ge NJ, Liu Y, Guo SS, Zhao Z, Yang HS, Xing JL. NGS-based profiling reveals a critical contributing role of somatic D-loop mtDNA mutations in HBV-related hepatocarcinogenesis. Ann Oncol 2020; 30:953-962. [PMID: 30887045 DOI: 10.1093/annonc/mdz105] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Somatic mutations of mitochondrial DNA (mtDNA) have been extensively identified mainly by traditional Sanger sequencing technology in various cancer types. However, low detection sensitivity of traditional methods greatly limits the comprehensive profiling of mtDNA somatic mutations in cancers, especially in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Moreover, the functional roles of mtDNA mutation in HBV-related hepatocarcinogenesis have not been systematically revealed. PATIENTS AND METHODS Next-generation sequencing (NGS) platform was applied to profile the somatic mtDNA mutations of HCC and paired paratumor (non-HCC) tissues from a large cohort of 156 HBV-HCC patients. RESULTS Our data revealed the common existence of mtDNA mutation in both inflammatory and cancer tissues with significantly different mutation pattern. The mutation density (mutation number/region length) of D-loop region was much higher than that of other regions in both HCC and non-HCC tissues. Unexpectedly, the average mutation number in D-loop region of HCC tissues was significantly less than that of non-HCC tissues. In contrast, the heteroplasmy level of D-loop region mutations was significantly increased in HCC tissues, implying that the D-loop mutations might be positively selected in HCC tissues. Furthermore, our results indicated that the patients with D-loop mutations had a significantly lower mtDNA copy number and were more likely to relapse. In vitro experiments demonstrated that proliferation, invasion and metastasis ability of HCC cells with D-loop region mutations were significantly higher than those without D-loop region mutations. CONCLUSION These results emphasize the critical contributing role of somatic mtDNA D-loop mutations in HBV-related hepatocarcinogenesis.
Collapse
Affiliation(s)
- C Yin
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - D Y Li
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - X Guo
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - H Y Cao
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - Y B Chen
- Department of Gynecology and Obstetrics, Genetic and Prenatal Diagnosis Center, First Affiliated Hospital, Zhengzhou University, Zhengzhou
| | - F Zhou
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - N J Ge
- Department of Radioactive Intervention, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai
| | - Y Liu
- Department of Pathology, Basic Medical College, Inner Mongolia Medical University, Huhhot
| | - S S Guo
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an
| | - Z Zhao
- Third Department of Medical Oncology, Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - H S Yang
- Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, USA
| | - J L Xing
- State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an.
| |
Collapse
|
17
|
|
18
|
Kim HJ, Lee HK, Lee CW, Kim EG, Yang HS. Sugammadex-induced anaphylactic shock. Anesth Pain Med (Seoul) 2020; 15:131. [PMID: 33329804 PMCID: PMC7713857 DOI: 10.17085/apm.2020.15.1.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ha-Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hae Kyung Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Chan Woo Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Eung Gyun Kim
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| |
Collapse
|
19
|
Choi JM, Lee HK, Lee CW, Kim EG, Yang HS. Sugammadex associated profound bradycardia and sustained hypotension. Anesth Pain Med (Seoul) 2020; 15:129. [PMID: 33329802 PMCID: PMC7713861 DOI: 10.17085/apm.2020.15.1.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hae Kyung Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Chan Woo Lee
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Eung Gyun Kim
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Sun Medical Center, Daejeon, Korea
| |
Collapse
|
20
|
Yang HS, Ye HJ. [Whether lowering intraocular pressure is needed for thyroid associated ophthalmopathy with intraocular hypertension]. Zhonghua Yan Ke Za Zhi 2019; 55:811-813. [PMID: 31715677 DOI: 10.3760/cma.j.issn.0412-4081.2019.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patients with thyroid associated ophthalmopathy often have elevated intraocular pressure. Patients and doctors are often confused about whether intraocular hypertension in thyroid associated ophthalmopathy needs to be lowered. There are several theories on the possible causes of this kind of increased intraocular pressure: restriction and compression of the globe by fibrotic and enlarged rectus muscles, increased episcleral venous pressure resulting from orbital congestion and venous outflow obstruction, and increased resistance to trabecular outflow. In addition, the patient's eye position and the device for measuring intraocular pressure also have great impacts on the accuracy of intraocular pressure measurement. At the same time, there are very few patients with thyroid associated ophthalmopathy combined with primary glaucoma. Therefore, whether patients with elevated intraocular pressure need to be treated depends on the specific clinical manifestations of the thyroid associated ophthalmopathy. Intraocular pressure of most patients can be lowered by active treatment for thyroid associated ophthalmopathy; antiglaucoma medical therapy may be necessary for patients whose intraocular pressure cannot be lowered; only very few cases of glaucoma require antiglaucoma drugs or surgery. (Chin J Ophthalmol, 2019, 55:811-813).
Collapse
Affiliation(s)
- H S Yang
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangzhou 510060, China
| | | |
Collapse
|
21
|
Abstract
The gut is composed of a single layer of intestinal epithelial cells and plays important roles in the digestion and absorption of nutrients, immune and barrier functions and amino acid metabolism. Weaning stress impairs piglet intestinal epithelium structural and functional integrities, which results in reduced feed intake, growth rates and increased morbidity and mortality. Several measures are needed to maintain swine gut development and growth performance after weaning stress. A large body of evidence indicates that, in weaning piglets, glutamine, a functional amino acid, may improve growth performance and intestinal morphology, reduce oxidative damage, stimulate enterocyte proliferation, modulate cell survival and death and enhance intestinal paracellular permeability. This review focuses on the effects of glutamine on intestinal health in piglets. The aim is to provide evidentiary support for using glutamine as a feed additive to alleviate weaning stress.
Collapse
Affiliation(s)
- F J Ji
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, Laboratory of Animal Nutrition and Human Health, College of Life Sciences, Hunan Normal University, 36 Lushan Road, Changsha 410081, People's Republic of China
- Tropical Crops Genetic Resources Institute, Chinese Academy of Tropical Agricultural Sciences, 4 West Xueyuan Road, Haikou 571101, People's Republic of China
- Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process; National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Institute of Subtropical Agriculture, Chinese Academy of Sciences, 644 Yuanda 2nd Road, Changsha 410125, People's Republic of China
| | - L X Wang
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, Laboratory of Animal Nutrition and Human Health, College of Life Sciences, Hunan Normal University, 36 Lushan Road, Changsha 410081, People's Republic of China
- Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process; National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Institute of Subtropical Agriculture, Chinese Academy of Sciences, 644 Yuanda 2nd Road, Changsha 410125, People's Republic of China
| | - H S Yang
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, Laboratory of Animal Nutrition and Human Health, College of Life Sciences, Hunan Normal University, 36 Lushan Road, Changsha 410081, People's Republic of China
- Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process; National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Institute of Subtropical Agriculture, Chinese Academy of Sciences, 644 Yuanda 2nd Road, Changsha 410125, People's Republic of China
| | - A Hu
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, Laboratory of Animal Nutrition and Human Health, College of Life Sciences, Hunan Normal University, 36 Lushan Road, Changsha 410081, People's Republic of China
| | - Y L Yin
- Hunan International Joint Laboratory of Animal Intestinal Ecology and Health, Laboratory of Animal Nutrition and Human Health, College of Life Sciences, Hunan Normal University, 36 Lushan Road, Changsha 410081, People's Republic of China
- Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process; National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Institute of Subtropical Agriculture, Chinese Academy of Sciences, 644 Yuanda 2nd Road, Changsha 410125, People's Republic of China
- Academician Workstation of Changsha Medical University, 1501 Leifeng Road, Changsha 410219, People's Republic of China
| |
Collapse
|
22
|
Kim JS, Han JW, Lee JH, Choi JM, Kim HJ, Sung TY, Kim YB, Shin YS, Yang HS. Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey. Anesth Pain Med (Seoul) 2019; 14:441-448. [PMID: 33329775 PMCID: PMC7713803 DOI: 10.17085/apm.2019.14.4.441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/28/2019] [Accepted: 05/14/2019] [Indexed: 12/18/2022] Open
Abstract
Background Neuromuscular blocking agents (NMBAs) and neuromuscular monitoring in anesthetic management are integral for endotracheal intubation, better visualization of the surgical field, and prevention of residual neuromuscular blockade and pulmonary complications. Sugammadex is a drug that reduces risk of residual neuromuscular blockade, with more rapid recovery compared to anticholinesterase. The purpose of this study was to investigate current usage status of NMBAs and antagonist with neuromuscular monitoring, among anesthesiologists in Korea. Methods Anesthesiologists working in Korea were invited to participate in an online survey via email January 2–February 28, 2018. The questionnaire consisted of 45 items, including preferred NMBAs, antagonists, neuromuscular monitoring, and complications related to the use sugammadex. A total of 174 responses were analyzed. Results Rocuronium was a commonly used NMBA for endotracheal intubation (98%) of hospitals, and maintenance of anesthesia (83.3%) in of hospitals. Sugammadex, pyridostigmine, and neostigmine were used in 89.1%, 87.9%, and 45.4% of hospitals. Neuromuscular monitoring was employed in 79.3% of hospitals; however only 39.7% of hospitals used neuromuscular monitoring before antagonist administration. Usual dosage range of sugammadex was 2.1–4 mg/kg in 35.1% of hospitals, within 2 mg/kg in 34.5% of hospitals, and 1 vial regardless of body weight in 22.4% of hospitals. Sugammadexrelated complications were encountered by 14.9% of respondents. Conclusions This survey indicates several minor problems associated with the use of antagonists and neuromuscular monitoring. However, most anesthesiologists appear to have appropriate information regarding the usage of NMBAs and sugammadex.
Collapse
Affiliation(s)
- Jin Sun Kim
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea
| | - Jung Woo Han
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea
| | - Jae Ho Lee
- Department of Anesthesiology and Pain Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea
| | - Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ha Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hopsital, Konyang University College of Medicine, Daejeon, Korea
| | - Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yong Seop Shin
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Daejeon Sun General Hospital, Daejeon, Korea
| |
Collapse
|
23
|
Li XT, Li PY, Liu Y, Yang HS, He LY, Fang YG, Liu J, Liu BY, Chaplin JE. Health-related quality-of-life among patients with premature ovarian insufficiency: a systematic review and meta-analysis. Qual Life Res 2019; 29:19-36. [PMID: 31620985 PMCID: PMC6962283 DOI: 10.1007/s11136-019-02326-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To systematically review studies investigating health-related quality-of-life (HrQoL) in patients with premature ovarian insufficiency (POI), to examine questionnaires used and to conduct a meta-analysis of control studies with normal ovarian function. METHODS Data sources: PubMed, Embase, Web of science, CNKI, and CQVIP, searched from inception until June 2018. The search strategy was a combination of medical (e.g. POI), subjective (e.g. well-being) and methodological (e.g. questionnaires) keywords. PRISMA guidelines were used to assess outcome data quality/validity by one reviewer, verified by a second reviewer. Risk of bias within studies was evaluated. A meta-analysis compared HrQoL in patients and non-patients. Due to measurement differences in the studies, the effect size was calculated as standard mean difference. RESULTS We identified 6869 HrQoL studies. Nineteen geographically diverse studies met inclusion criteria, dated from 2006, using 23 questionnaires. The meta-analysis included six studies with 645 POI participants (age 33.3 ± 5.47) and 492 normal-ovarian control subjects (age 32.87 ± 5.61). Medium effect sizes were found for lower overall HrQoL (pooled SMD = - 0.73, 95% CI - 0.94, - 0.51; I2 = 54%) and physical function (pooled SMD = - 0.54, 95% CI - 0.69, - 0.39; I2 = 55%). Heterogeneity was investigated. Effect sizes varied for sexual function depending on the measure (SMD = - 0.27 to - 0.74), overall HrQoL (SF-36) had the largest effect size (- 0.93) in one study. The effect sizes for psychological and social HrQoL were small. CONCLUSION POI is associated with low-to-medium effect size on HrQoL compared to normal ovarian controls. The greatest effects are found in general HrQoL and most sexual function areas. Condition-specific questionnaires and RCTs are recommended for further investigation.
Collapse
Affiliation(s)
- X T Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - P Y Li
- Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 416 85, Gothenburg, Sweden
| | - Y Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - H S Yang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - L Y He
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Y G Fang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - J Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - B Y Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
| | - J E Chaplin
- Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 416 85, Gothenburg, Sweden
| |
Collapse
|
24
|
Choi JM, Kim HJ, Choi HR, Kim YB, Bae HJ, Yang HS. Remifentanil does not inhibit sugammadex reversal after rocuronium-induced neuromuscular block in the isolated hemidiaphragm of the rat: an ex vivo study. J Anesth 2019; 33:642-646. [PMID: 31535219 DOI: 10.1007/s00540-019-02681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/07/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Sugammadex is used to reverse neuromuscular block induced by rocuronium or vecuronium by forming a stable complex. If the binding capacity of any substance to sugammadex is large enough, this molecule will displace rocuronium or vecuronium from the complex. For drugs used in anesthesia, the binding affinity of remifentanil for sugammadex was highest. The aim of the current study was to investigate the decrease in the reversal of neuromuscular blockade with sugammadex by complex formation between remifentanil and sugammadex in the model using isolated hemidiaphragm of the rat. METHODS Phrenic nerve-hemidiaphragms from 34 male Sprague-Dawley rats were allocated randomly to four groups: 0 or 100 ng/ml remifentanil with equimolar amounts of sugammadex and 0 or 100 ng/ml remifentanil with three-quarter dose of sugammadex. Muscle contraction responses were recorded during the stimulation of the phrenic nerve by train-of-four (TOF) stimulation. Rocuronium was added to the organ bath with or without 100 ng/ml remifentanil until the first height response (T1) of TOF disappeared completely. Then, equimolar amounts or three-quarter dose of sugammadex was added. RESULTS Remifentanil has no significant effects on the concentration-response curves of rocuronium. No significant differences were observed in the recoveries of T1 and TOF ratio with time after administration of equimolar amounts or three-quarter dose of sugammadex regardless of the presence of 100 ng/ml remifentanil. CONCLUSION Clinical concentration of remifentanil does not inhibit sugammadex reversal after rocuronium-induced neuromuscular block. Sugammadex can be used safely without worrying about the interaction with remifentanil.
Collapse
Affiliation(s)
- Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ha-Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hey Ran Choi
- Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea
| | - Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gil Medical Center, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Hyeun Joon Bae
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Sun Medical Center, Daejeon, 34811, Republic of Korea.
| |
Collapse
|
25
|
Oh SK, Lim BG, Park S, Yang HS, In J, Kim YB, Choi HR, Lee IO. Effect of protracted dexamethasone exposure and its withdrawal on rocuronium-induced neuromuscular blockade and sugammadex reversal: an ex vivo rat study. Sci Rep 2019; 9:11268. [PMID: 31375743 PMCID: PMC6677897 DOI: 10.1038/s41598-019-47784-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/23/2019] [Indexed: 02/07/2023] Open
Abstract
Studies have reported that protracted dexamethasone treatment induces resistance to nondepolarizing neuromuscular blocking agents (NMBAs) and the association with nicotinic acetylcholine receptors in the diaphragm of rats. Here, we investigated the effect of protracted dexamethasone administration on the sensitivity to rocuronium and the recovery profile when reversed by sugammadex; additionally, we observed the recovery period of pharmacodynamic change after withdrawal. Sprague-Dawley rats received daily intraperitoneal injections of dexamethasone or saline for 14 days. On days 1, 3, and 7 after the last dexamethasone treatment (Dexa1, Dexa3, and Dexa7, respectively) or 1 day after saline (control group), the phrenic nerve-hemidiaphragm preparation was dissected for assay. The dose-response curve of rocuronium in Dexa1 was shifted to the right compared to controls, but curves in Dexa3 and Dexa7 were not significantly different. Groups were not significantly different in attaining the train-of-four ratio ≥ 0.9, but the recovery index in Dexa7 was shorter than that in control and Dexa1. Recovery profiles (period of sugammadex reversal) were not correlated with resistance properties but rather with total administered drugs (binding capacity of NMBAs and sugammadex). Protracted dexamethasone exposure induced resistance to rocuronium but seemed to have no effect on sugammadex reversal in the rat diaphragm.
Collapse
Affiliation(s)
- Seok Kyeong Oh
- Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Byung Gun Lim
- Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sungsoo Park
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hong Seuk Yang
- Department of Anaesthesiology and Pain Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Junyong In
- Department of Anaesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Yong Beom Kim
- Department of Anaesthesiology and Pain Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Hey-Ran Choi
- Department of Anaesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea
| | - Il Ok Lee
- Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
26
|
Yang HS, Ye HJ. [Orbital decompression for thyroid associated ophthalmopathy: transnasal endoscopic approach or external orbital approach?]. Zhonghua Yan Ke Za Zhi 2019; 54:484-487. [PMID: 29996608 DOI: 10.3760/cma.j.issn.0412-4081.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
External orbital decompression, including medial wall, inferior wall, lateral wall and orbital fat decompression alone or in combination, has long been considered to be the standard treatment for thyroid related eye diseases. Deep lateral wall orbital decompression has better effect in the balance of eye position, correction of serious exophthalmos and severe oppression optic neuropathy. Recently, however, endoscopic orbital decompression is becoming increasingly popular with the development of endoscopic surgery technique in naso-orbit related diseases. Endoscopic orbital decompression has the advantages of avoiding an external incision scar. Nevertheless, the new method also has some disadvantages, for example, application limited to medial and inferior orbital wall orbital decompression, high incidence of esotropia, need for external lateral wall decompression and expensive cost for equipment. Both surgical approaches have advantages and disadvantages respectively for medial wall and inferior wall decompression. The operative result depends on the individualized surgical design and the experience of the surgeon rather than the choice of the surgical approach. As a result, the choice of the surgical approaches should be specifically based on the patient's conditions, patient's acceptance of the operation, experience of the surgeon and available resources. (Chin J Ophthalmol, 2018, 54: 484-487).
Collapse
Affiliation(s)
- H S Yang
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangzhou 510060, China
| | | |
Collapse
|
27
|
Choi H, Park SY, Kim YB, In J, Yang HS, Lee JS, Kim S, Park S. Effects of dexamethasone and hydrocortisone on rocuroniuminduced neuromuscular blockade and reversal by sugammadex in phrenic nerve-hemidiaphragm rat model. Korean J Anesthesiol 2019; 72:366-374. [PMID: 30886132 PMCID: PMC6676030 DOI: 10.4097/kja.d.18.00238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background The facilitator effects of steroids on neuromuscular transmission may cause resistance to neuromuscular blocking agents. Additionally, steroids may hinder sugammadex reversal of neuromuscular blockade, but these findings remain controversial. Therefore, we explored the effect of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and their inhibitory effect on sugammadex. Methods We explored the effects of steroids, dexamethasone and hydrocortisone, in vitro using a phrenic nerve-hemidiaphragm rat model. In the first phase, an effective dose of rocuronium was calculated, and in the second phase, following sugammadex administration, the recovery of the train-of-four (TOF) ratio and T1 was evaluated for 30 minutes, and the recovery index was calculated in dexamethasone 0, 0.5, 5, and 50 μg/ml, or hydrocortisone 0, 1, 10, or 100 μg/ml. Results No significant effect of steroids on the effective dose of rocuronium was observed. The TOF ratios at 30 minutes after sugammadex administration were decreased significantly only at high experimental concentrations of steroids: dexamethasone 50 μg/ml and hydrocortisone 100 μg/ml (P < 0.001 and P = 0.042, respectively). There were no statistical significances in other concentrations. No differences were observed in T1. Recovery index was significantly different only in 100 μg/ml of hydrocortisone (P = 0.03). Conclusions Acute exposure to steroids did not resist the neuromuscular blockade caused by rocuronium. And inhibition of sugammadex reversal on rocuronium-induced neuromuscular blockade is unlikely at typical clinical doses of dexamethasone and also hydrocortisone. Conclusively, we can expect proper effects of rocuronium and sugammadex when dexamethasone or hydrocortisone is used during general anesthesia.
Collapse
Affiliation(s)
- Heyran Choi
- Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.,Neuromuscular Physiology Research Team at the Laboratory of Animal Research, Asan Institute of Life Science, Seoul, Korea
| | - Sun Young Park
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.,Neuromuscular Physiology Research Team at the Laboratory of Animal Research, Asan Institute of Life Science, Seoul, Korea
| | - Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, Korea.,Neuromuscular Physiology Research Team at the Laboratory of Animal Research, Asan Institute of Life Science, Seoul, Korea
| | - Junyong In
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.,Neuromuscular Physiology Research Team at the Laboratory of Animal Research, Asan Institute of Life Science, Seoul, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Neuromuscular Physiology Research Team at the Laboratory of Animal Research, Asan Institute of Life Science, Seoul, Korea
| | - Jeong-Seok Lee
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sanghyun Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchunhyang University College of Medicine, Asan, Korea
| |
Collapse
|
28
|
Kim HJ, Choi JM, Koh WU, Kim JS, Yang HS. Regarding "Successful Laparoscopic Surgery without Neuromuscular Blockade in a Patient with Malignant Hyperthermia Susceptibility". J Minim Invasive Gynecol 2019; 26:987-988. [PMID: 30790707 DOI: 10.1016/j.jmig.2018.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/28/2018] [Indexed: 11/29/2022]
|
29
|
Lee SJ, Kim JS, Chee HK, Yun IJ, Park KS, Yang HS, Park JH. Seven Years of Experiences of Preclinical Experiments of Xeno-Heart Transplantation of Pig to Non-Human Primate (Cynomolgus Monkey). Transplant Proc 2018; 50:1167-1171. [PMID: 29731087 DOI: 10.1016/j.transproceed.2018.01.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/22/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The absolute shortage of donors compared with patients requiring transplantation is currently an unsolved problem, and the only possible solution may be xenotransplantation. To establish a successful clinical trial, a preclinical study using nonhuman primates is essential. Starting in November 2011, our team initiated heterotopic abdominal heart xenotransplantation, the first in the Republic of Korea. We present here the initial 7-year results. METHODS A total of 22 xenotransplantation procedures have been performed since 2011. Single transgenic pig (alpha-galactosidase transferase knockout [GalT KO], n = 16), double transgenic pig (GalT KO + CD46, n = 3, and GalT KO + CD39, n = 2), and triple transgenic pig (GalT KO + CD46 + CD70, n = 1) models were used. Our baseline regimen of immunosuppressants comprised CD154 ab, rituximab, anti-thymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. RESULTS The mean graft survival was 16 ± 16.27 days, and the mean graft survival was significantly longer in cases performed since 2014 (7.5 ± 8.03 days vs 24.67 ± 17.50; P = .01). Although the donor heart ischemic time was decreased per annum, no correlations could be found between ischemic time and survival days of the graft. Double or triple genetic manipulated hearts exhibited significantly better survival (11.63 ± 11.29 days vs 30.83 ± 20.34 days; P = .03). When the ratio of heart weight (grams) to nonhuman primate weight (kilograms) was lower, the results tended to be better (P < .05). The rate of immediate postoperative bleeding (9%, n = 2) causing death was relatively high in the earlier period, but there have been no serious surgical complications affecting graft survival since 2013. CONCLUSIONS Investigation of effective and optimal target genes for each organ to further progression toward better results is important. In addition, the immunosuppressive regimen needs to be further studied and constantly refined.
Collapse
Affiliation(s)
- S J Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - J S Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - H K Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
| | - I J Yun
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - K S Park
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - H S Yang
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - J H Park
- Department of Nephrology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
30
|
Kim HJ, Koh WU, Choi JM, Ro YJ, Yang HS. Malignant hyperthermia and dantrolene sodium. Korean J Anesthesiol 2018; 72:78-79. [PMID: 29921086 PMCID: PMC6369340 DOI: 10.4097/kja.d.18.00139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 06/01/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ha Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Uk Koh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Jin Ro
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
31
|
Kim YB, Sung TY, Yang HS. Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents. Korean J Anesthesiol 2017; 70:500-510. [PMID: 29046769 PMCID: PMC5645582 DOI: 10.4097/kjae.2017.70.5.500] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/02/2017] [Indexed: 12/14/2022] Open
Abstract
Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.
Collapse
Affiliation(s)
- Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Tae-Yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
32
|
Meng YK, Zhang J, Yang Y, Zhou LL, Yan TF, Wang Y, Yang HS, Shi GD, Chen DY, Shi JG, Guo YF, Jia LS. [Clinical diagnosis and management of cervical spondylotic amyotrophy]. Zhonghua Yi Xue Za Zhi 2017; 97:1320-1323. [PMID: 28482434 DOI: 10.3760/cma.j.issn.0376-2491.2017.17.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical characteristics and surgical treatment of cervical spondylotic amyotrophy. Methods: Thirteen patients(13 man) with proximal (10) and distal(3) cervical spondylotic amyotrophy between November 2014 and September 2016 were included in this study. The average age of the patients was 55 (range, 47-66) years. The sex, age, clinical course, type of amyotrophy, lesion segment and postdecompression improvement in muscle power were reviewed. Results: Of 13 cervical spondylotic amyotrophy patients, 9 were performed on with cervical disectomy, 2 were performed on with cervical posterior operation, 2 remainding patients received nonoperative treatment. Cervical spondylotic amyotrophy patients were followed up 6-22 (average 10.6) months, muscle power of 4 patients (all proximal-type)were improved completely (the average recovery time were 4.4 months), muscle power of 6 patients were improved uncompletely, 1 patients failed to improve, the 2 remainding patients received nonoperative treatment had no change. Conclusion: Cervical spondylotic amyotrophy as a rare type of cervical spondylotic disorder, It should distinguish cervical spondylotic amyotrophy from amyotrophic lateral sclerosis, especially in the early stage of amyotrophic lateral sclerosis. A surgical treatment is recommended as the first line of proximal-type CSA, especially those with serious compression. It is important that clinicians should be aware that distal-type CSA had a poor results, resulting in a lower lower satisfaction, especially those with no, or insignificant, sensory disturbance.
Collapse
Affiliation(s)
- Y K Meng
- Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Wang F, Lu Y, Yuan C, Bai JR, Yang HS, Wu L. [Evaluation of a low dose imaging protocol on radiation exposure reduction in pediatric supraventricular tachycardia ablation procedure]. Zhonghua Er Ke Za Zhi 2017; 55:272-276. [PMID: 28441823 DOI: 10.3760/cma.j.issn.0578-1310.2017.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure. Method: Data were collected from 103 patients who underwent catheter ablation for SVT in Children's Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group, n=47) from January 2014 to September 2015, 36 nGy/frame and 10 frames/s with removal of the grid (Grid-out group, n=24) from October 2015 to April 2016, as well as 23 nGy/frame and 4.0-7.5 frames/s without the grid (Grid-out plus low dose group, n=32) from May 2016 to October 2016, respectively.Comparisons among groups were performed by independent-sample t-test or one-way analysis of variance for normally distributed continuous variables, and χ(2) test for categorical variables. Result: The average body weight, BSA, fluoroscopy time and AIR KERMA of the three groups was (34±14) kg, (1.14±0.33) m(2,) (11±8) minutes and (12.97±12.43) mGy, respectively.No significant differences in body weight (F=2.551), BSA (F=2.359), SVT types (χ(2)=6.15), and accessory pathway location (χ(2)=3.438) were observed among these three groups (P>0.05). Images acquired by low dose protocol could provide enough information for procedures, and no complication occurred.The acute success rates were 100% in all of these three groups, and there was no significant difference in mean fluoroscopy time (F=0.004, P>0.05) among them.However, the radiation dose (AIR KERMA) in the Grid-out plus low dose group was much lower than that in the Standard group ((7.54±7.31) mGy vs. (16.25±12.08) mGy, F=6.112, P<0.01)). Conclusion: The new strategy of combination of low dose fluoroscopy protocol with removal of grid markedly reduced radiation exposure to children undergoing supraventricular tachycardia ablation while maintaining procedural efficacy and safety.
Collapse
Affiliation(s)
- F Wang
- Catheterization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China
| | | | | | | | | | | |
Collapse
|
34
|
Kim YB, Sung TY, Yang HS. Erratum: Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents. Korean J Anesthesiol 2017; 70:656. [PMID: 29226915 PMCID: PMC5716827 DOI: 10.4097/kjae.2017.70.6.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yong Beom Kim
- Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Tae-Yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Kim HJ, Oh JE, Koh WU, Ro YJ, Yang HS. Comparison of warming methods for core temperature preservation during total knee arthroplasty using a pneumatic tourniquet. Anesth Pain Med (Seoul) 2016. [DOI: 10.17085/apm.2016.11.1.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ha Jung Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Eun Oh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Uk Koh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Jin Ro
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Choi YJ, Hahm KD, Kwon K, Lee EH, Ro YJ, Yang HS. [Bedside prediction of right subclavian venous catheter insertion length]. Rev Bras Anestesiol 2014; 64:419-24. [PMID: 25437699 DOI: 10.1016/j.bjan.2013.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/08/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The present study aimed to evaluate whether right subclavian vein (SCV) catheter insertion depth can be predicted reliably by the distances from the SCV insertion site to the ipsilateral clavicular notch directly (denoted as I-IC), via the top of the SCV arch, or via the clavicle (denoted as I-T-IC and I-C-IC, respectively). METHOD In total, 70 SCV catheterizations were studied. The I-IC, I-T-IC, and I-C-IC distances in each case were measured after ultrasound-guided SCV catheter insertion. The actual length of the catheter between the insertion site and the ipsilateral clavicular notch, denoted as L, was calculated by using chest X-ray. RESULTS L differed from the I-T-IC, I-C-IC, and I-IC distances by 0.14±0.53, 2.19±1.17, and -0.45±0.68cm, respectively. The mean I-T-IC distance was the most similar to the mean L (intraclass correlation coefficient=0.89). The mean I-IC was significantly shorter than L, while the mean I-C-IC was significantly longer. Linear regression analysis provided the following formula: Predicted SCV catheter insertion length (cm)=-0.037+0.036×Height (cm)+0.903×I-T-IC (cm) (adjusted r(2)=0.64). CONCLUSION The I-T-IC distance may be a reliable bedside predictor of the optimal insertion length for a right SCV cannulation.
Collapse
Affiliation(s)
- Yoon Ji Choi
- Departamento de Anestesiologia e Medicina da Dor, Seoul Paik Hospital, College of Medicine, Inje University, Seul, República da Coreia
| | - Kyung-Don Hahm
- Departamento de Anestesiologia e Medicina da Dor, Asan Medical Center, University of Ulsan College of Medicine, Seul, República da Coreia.
| | - Koo Kwon
- Departamento de Anestesiologia e Medicina da Dor, Asan Medical Center, University of Ulsan College of Medicine, Seul, República da Coreia
| | - Eun-Ho Lee
- Departamento de Anestesiologia e Medicina da Dor, Asan Medical Center, University of Ulsan College of Medicine, Seul, República da Coreia
| | - Young Jin Ro
- Departamento de Anestesiologia e Medicina da Dor, Asan Medical Center, University of Ulsan College of Medicine, Seul, República da Coreia
| | - Hong Seuk Yang
- Departamento de Anestesiologia e Medicina da Dor, Asan Medical Center, University of Ulsan College of Medicine, Seul, República da Coreia
| |
Collapse
|
37
|
Yang HS, Chen IC, Lee YT, Lee KC, Chuang YC, Chang CY, Wei J. Cardiac transplantation and concomitant coronary artery bypass grafting: our experiences in 11 cases. Transplant Proc 2014; 46:900-2. [PMID: 24767376 DOI: 10.1016/j.transproceed.2013.11.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/07/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The shortage of donor hearts for transplantation could be alleviated by including the hearts of older donors. Previous literature revealed similar early and medium-term survival outcomes compared with those of younger donors. This study presents our experience with patients who underwent orthotopic heart transplantation and concomitant coronary artery bypass grafting at our institution. METHODS We present our experience with 11 patients with end-stage cardiomyopathy (8 men and 3 women) undergoing orthotopic heart transplantation and concomitant coronary artery bypass grafting from September 2002 to November 2011 at our institute. RESULTS All 11 donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. Two patients received concurrent 2-coronary-artery bypass, and the other 9 patients received concurrent single-coronary-artery bypass during orthotopic heart transplantation. All patients had an uneventful postoperative course, with follow-up completed 3 to 128 months after cardiac transplantation and concomitant coronary artery bypass grafting surgery. CONCLUSIONS Our experiences suggest that donor hearts requiring coronary artery bypass grafting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.
Collapse
Affiliation(s)
- H S Yang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - I C Chen
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y T Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - K C Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y C Chuang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - C Y Chang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - J Wei
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C.
| |
Collapse
|
38
|
Woo T, Kim KS, Shim YH, Kim MK, Yoon SM, Lim YJ, Yang HS, Phiri P, Chon JY. Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients. Korean J Anesthesiol 2013; 65:501-7. [PMID: 24427455 PMCID: PMC3888842 DOI: 10.4097/kjae.2013.65.6.501] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 06/17/2013] [Accepted: 07/16/2013] [Indexed: 11/29/2022] Open
Abstract
Background Rapid and complete reversal of neuromuscular blockade (NMB) is desirable at the end of surgery. Sugammadex reverses rocuronium-induced NMB by encapsulation. It is well tolerated in Caucasian patients, providing rapid reversal of moderate (reappearance of T2) rocuronium-induced NMB. We investigated the efficacy and safety of sugammadex versus neostigmine in Korean patients. Methods This randomized, safety assessor-blinded trial (NCT01050543) included Korean patients undergoing general anesthesia. Rocuronium 0.6 mg/kg was given prior to intubation with maintenance doses of 0.1-0.2 mg/kg as required. Patients received sugammadex 2.0 mg/kg or neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg to reverse the NMB at the reappearance of T2, after the last rocuronium dose. The primary efficacy endpoint was the time from sugammadex or neostigmine administration to recovery of the train-of-four (TOF) ratio to 0.9. The safety of these medications was also assessed. Results Of 128 randomized patients, 118 had evaluable data (n = 59 in each group). The geometric mean (95% confidence interval) time to recovery of the TOF ratio to 0.9 was 1.8 (1.6, 2.0) minutes in the sugammadex group and 14.8 (12.4, 17.6) minutes in the neostigmine group (P < 0.0001). Sugammadex was generally well tolerated, with no evidence of residual or recurrence of NMB; four patients in the neostigmine group reported adverse events possibly indicative of inadequate NMB reversal. Conclusions Sugammadex was well tolerated and provided rapid reversal of moderate rocuronium-induced NMB in Korean patients, with a recovery time 8.1 times faster than neostigmine. These results are consistent with those reported for Caucasian patients.
Collapse
Affiliation(s)
- Tiffany Woo
- Clinical Development, Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
| | - Kyo Sang Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Yon Hee Shim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Kyeong Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Suk Min Yoon
- Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Young Jin Lim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hong Seuk Yang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Phillip Phiri
- Clinical Development, Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA
| | - Jin Young Chon
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, School of Medicine, St. Mary's Hospital, Seoul, Korea
| |
Collapse
|
39
|
Sun LN, Yang HS, Chen MY, Xu DX. Cloning and expression analysis of Wnt6 and Hox6 during intestinal regeneration in the sea cucumber Apostichopus japonicus. Genet Mol Res 2013; 12:5321-34. [PMID: 24301793 DOI: 10.4238/2013.november.7.7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Many developmental genes play important roles in regeneration. Here, we cloned the two developmental genes, Wnt6 and Hox6, from Apostichopus japonicus by rapid amplification of cDNA ends (RACE) polymerase chain reaction (PCR). The Wnt6 full-length cDNA is 1140 bp long with a 1029-bp open reading frame encoding 342 amino acids. The deduced Wnt6 protein contained a 22-amino acid signal peptide and a 274-amino acid mature peptide. The Hox6 (AjHBOX6) full-length cDNA contained 1312 bp with a 966-bp open reading frame encoding 321 amino acids. Its deduced amino acid sequence included one homeodomain (60 amino acids) and three domains with low compositional complexity. Comparison and phylogenetic analysis revealed that Wnt6 and Hox6 in A. japonicus had the nearest relationship to those in sea urchins. Further expression analysis by real-time PCR showed that Wnt6 and Hox6 were apparently upregulated during intestine regeneration, which suggested that they were involved in the intestinal regeneration of sea cucumbers.
Collapse
Affiliation(s)
- L N Sun
- Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China
| | | | | | | |
Collapse
|
40
|
Yang HS, Fu DZ, Kong XF, Wang WC, Yang XJ, Nyachoti CM, Yin YL. Dietary supplementation with N-carbamylglutamate increases the expression of intestinal amino acid transporters in weaned Huanjiang mini-pig piglets. J Anim Sci 2013; 91:2740-8. [PMID: 23478823 DOI: 10.2527/jas.2012-5795] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Weaning is associated with reduced intestinal absorptive capacity in piglets. Our previous study indicated that dietary supplementation with N-carbamylglutamate (NCG) enhanced growth performance and improved intestinal function in weaned piglets. The present study was conducted to test the hypothesis that dietary supplementation with NCG may increase the growth performance of weaned piglets by regulating the expression of intestinal nutrient transporters, thus enhancing nutrient absorption. Twenty-four Huanjiang mini-pig piglets weaned at 21 d of age (3.17 ± 0.21 kg average BW) were randomly assigned to 2 dietary treatments consisting of a basal diet and the basal diet with 0.1% NCG supplementation for a 14-d period with 6 pens per treatment and 1 male and 1 female per pen. On d 14, 1 piglet was randomly selected from each pen for blood and tissue sampling. Dietary NCG supplementation enhanced (P < 0.05) growth rate and the efficiency of feed use in weaned Huanjiang mini-pig piglets. The NCG-supplemented diet increased (P < 0.05) mRNA expression levels of Slc6a19, Slc7a9, and Slc1a1 and the protein abundance of ASCT2, B(0)AT1, b(0,+)AT, y(+)LAT1, and EAAC1 in the jejunum. Furthermore, the contents of low density lipoprotein, ammonia, urea nitrogen, and AA as well as the activity of alkaline phosphatase in plasma were all altered (P < 0.05) by supplementation with NCG. These findings indicate that dietary supplementation with NCG may improve intestinal absorptive function in weaned piglets by increasing the expression of AA transporters in the intestine.
Collapse
Affiliation(s)
- H S Yang
- Chinese Acad. Sci., Inst. Subtrop. Agric., Res. Ctr. Healthy Breeding Livestock & Poultry, Hunan Eng. & Res. Ctr. Anim. & Poultry Sci., Key Lab Agroecol. Proc. Subtrop. Reg., Scientific Observation and Experimental Station of Animal Nutrition and Feed Science in South-Central, Ministry of Agriculture, Changsha City, Hunan, 410125, PR China
| | | | | | | | | | | | | |
Collapse
|
41
|
Nishiyama T, Kohno Y, Kim HJ, Shin WJ, Yang HS. The effects of prewarming the I-gel on fitting to laryngeal structure. Am J Emerg Med 2012; 30:1756-9. [DOI: 10.1016/j.ajem.2012.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 02/12/2012] [Accepted: 02/17/2012] [Indexed: 11/26/2022] Open
|
42
|
Noh YH, Chob HS, Kim DH, Kim OH, Park J, Lee SA, Yang HS, Sohn DS, Kim W, Kim D, Chung YH, Kim KY, Kim SS, Lee WB. N-acetylcysteine enhances neuronal differentiation of P19 embryonic stem cells via Akt and N-cadherin activation. Mol Biol (Mosk) 2012; 46:741-746. [PMID: 23156673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We examined whether N-acetylcysteine (NAC) enhanced embryonic body (EB) formation and neuronal differentiation in terms of EB formation, neuronal marker (microtubule-associated protein 2; MAP-2) expression, and neuron maturation using P19 embryonic stem cells. The size and numbers of EBs were greatly increased, together with the up-regulated N-cadherin expression. Also, MAP-2 expression and neurite outgrowth were much increased with activation of serine/threonine protein kinase (Akt) and blocked by addition of an Akt inhibitor (LY294002). Our results suggested that NAC increased EB formation by up-regulating the N-cadherin expression. Furthermore, NAC-enhanced neuronal differentiation was mediated by activation of Akt.
Collapse
Affiliation(s)
- Y H Noh
- Department of Cell Biology and Anatomy, College of Medicine, Chung-Ang University, Seoul 156-756, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Yang HS, Zhang L, Dong XH, Zhu WM, Zhu J, Nelson BJ, Zhang XB. Precise control of the number of walls formed during carbon nanotube growth using chemical vapor deposition. Nanotechnology 2012; 23:065604. [PMID: 22248487 DOI: 10.1088/0957-4484/23/6/065604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We demonstrate a one-step approach for selecting the number of walls formed during carbon nanotube (CNT) growth by catalytic decomposition of CH(4) over Fe-Mo/MgO catalysts. Scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HRTEM), thermal gravimetric analysis (TGA) and Raman spectroscopy analyses indicate that high purity single-walled, double-walled and triple-walled carbon nanotubes can be synthesized by tuning the Fe:Mo atomic ratio of catalysts. The results reveal that the concentration of Mo in the catalyst plays an important role in the size of catalyst particles and in the deposition rate of carbon atoms during CNT growth. Thus, the wall numbers of CNTs can be controlled precisely.
Collapse
Affiliation(s)
- H S Yang
- State Key Laboratory of Silicon Materials, Department of Materials Science and Engineering, Zhejiang University, Hangzhou, People's Republic of China.
| | | | | | | | | | | | | |
Collapse
|
44
|
Yang HS, Shimomura K, Vitaterna MH, Turek FW. High-resolution mapping of a novel genetic locus regulating voluntary physical activity in mice. Genes Brain Behav 2011; 11:113-24. [PMID: 21978078 DOI: 10.1111/j.1601-183x.2011.00737.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Both human beings and animals exhibit substantial inter-individual variation in voluntary physical activity, and evidence indicates that a significant component of this variation is because of genetic factors. However, little is known of the genetic basis underlying central regulation of voluntary physical activity in mammals. In this study, using an F(2) intercross population and interval-specific congenic strains (ISCS) derived from the C57BL/6J strain and a chromosome 13 substitution strain, C57BL/6J-Chr13A/J/NA/J, we identified a 3.76-Mb interval on chromosome 13 containing 25 genes with a significant impact on daily voluntary wheel running activity in mice. Brain expression and polymorphisms between the C57BL/6J and A/J strains were examined to prioritize candidate genes. As the dopaminergic pathway regulates motor movement and motivational behaviors, we tested its function by examining cocaine-induced locomotor responses in ISCS with different levels of activity. The low-activity ISCS exhibited a significantly higher response to acute cocaine administration than the high-activity ISCS. Expression analysis of key dopamine-related genes (dopamine transporter and D1, D2, D3, D4 and D5 receptors) revealed that expression of D1 receptor was higher in the low-activity ISCS than in the high-activity ISCS in both the dorsal striatum and nucleus accumbens. Pathway analysis implicated Tcfap2a, a gene found within the 3.76-Mb interval, involved in the D1 receptor pathway. Using a luciferase reporter assay, we confirmed that the transcriptional factor, Tcfap2a, regulates the promoter activity of the D1 receptor gene. Thus, Tcfap2a is proposed as a candidate genetic regulator of the level of voluntary physical activity through its influence on a dopaminergic pathway.
Collapse
Affiliation(s)
- H S Yang
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL 60208-3520, USA
| | | | | | | |
Collapse
|
45
|
Yang HS, Tamayo R, Almonte M, Horten B, DaSilva M, Gangi M, Vazquez E, Joseph D, Okamoto P, Scholl T. Clinical significance of MUC1, MUC2 and CK17 expression patterns for diagnosis of pancreatobiliary arcinoma. Biotech Histochem 2011; 87:126-32. [PMID: 21438791 DOI: 10.3109/10520295.2011.570276] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Pancreatic cancer is characterized by aggressive growth and resistance to treatment. Identification of unique biomarkers for diagnosis and prognosis is important for treatment of this disease. We investigated the expression patterns of mucin 1 (MUC1), mucin 2 (MUC2) and cytokeratin 17 (CK17) in both normal tissues and metastatic adenocarcinomas using immunohistochemistry (IHC). We have shown that MUC1 (pan-epithelial membrane mucin), MUC2 (intestinal-type secretory mucin) and CK17 can be used as a panel of markers to distinguish collectively pancreatobiliary carcinoma from other primary site carcinomas. Tumors originating in the pancreatobiliary system showed an expression pattern of MUC1 (+), MUC2 (-) and CK17 (+). By contrast, tumors arising from the colorectal region were MUC1 (-), MUC2 (+) and CK17 (-), while tumors originating from non-pancreatobiliary system tissue expressed a MUC1 (+), MUC2 (-) and CK17 (-) profile. More importantly, the MUC1 (+), MUC2 (-) and CK17 (+) result showed greater sensitivity than CA19-9 by IHC, which is the currently accepted and widely used pancreatic tumor marker for diagnosing pancreatic cancer. Thirteen of 51 cases (25%) of pancreatobiliary adenocarcinomas with the pattern MUC1 (+), MUC2 (-) and CK17 (+) showed no immunoreactivity for CA19-9, while 34/51 (67%) cases having MUC1 (+), MUC2 (-) and CK17 (+) were correlated with positive CA19-9 staining. Our data support using an antibody panel of MUC1, MUC2 and CK17 to enhance current methods for pancreatic cancer diagnosis by identifying specifically the primary tissue of origin.
Collapse
Affiliation(s)
- H S Yang
- Genzyme Genetics, Westborough, Massachusetts 01581, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kim JH, Okour Y, Yang HS, Kim JB, Shon HK. Preparation and characterisation of TiO2 nanoparticle and titanate nanotube obtained from Ti-salt flocculated sludge with drinking water and seawater. J Nanosci Nanotechnol 2011; 11:1640-1643. [PMID: 21456256 DOI: 10.1166/jnn.2011.3297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study aimed to prepare and characterise titanium dioxide (TiO2) nanoparticles and titanate nanotubes produced from Ti-sat flocculated sludge with drinking water (DW) and seawater (SW). The Ti-salt flocculated sludge from DW and SW was incinerated at 600 degrees C to produce TiO2 nanoparticles. XRD results showed that the anatase TiO2 structure was predominant for TiO2 from DW (TiO2-DW) and TiO2 from SW (TiO2-SW), which were mainly doped with carbon atoms. Titanate nanotubes (tiNT) were obtained when TiO2-DW and TiO2-SW were hydrothermally treated with NaOH solution. Structure phase, shape, crystallisation and photocatalytic activity of tiNT were affected by the incineration temperature and the amount of sodium present in different tiNT. The tiNT doped with thiourea incinerated at 600 degrees C presented anatase phase, showing a high increase of the degree of crystallisation with nanotube-like structures. The photocatalytic activity of these photocatalysts was evaluated using photooxidation of gaseous acetaldehyde. Thiourea doped tiNT-DW and tiNT-SW showed similar photocatalytic activity compared to commercially available TiO2-P25 under UV light and indicated a photocatalytic activity under visible light.
Collapse
Affiliation(s)
- J H Kim
- School of Applied Chemical Engineering, Research Institute for Catalysis, Chonnam National University, Gwangju 500-757, Korea
| | | | | | | | | |
Collapse
|
47
|
Abstract
We report a case of osteoid osteoma involving the ethmoid sinus, which presented as a unilateral fixed headache with some features suggestive of hemicrania continua.
Collapse
Affiliation(s)
- K S Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, Heukseok-dong, Dongjak-gu, Seoul, Korea
| | | |
Collapse
|
48
|
Yang HS, Park SY, Park HK, Park YH. Palliative atrial switch operation in a 22-year-old patient with transposition of the great arteries. Thorac Cardiovasc Surg 2010; 58:45-7. [PMID: 20072977 DOI: 10.1055/s-2008-1039232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A 2-year-old boy was diagnosed as having transposition of the great arteries (TGA) and ventricular septal defect (VSD) and underwent pulmonary artery banding. The patient showed slow progression of cyanosis and dyspnea on exertion. Oxygen saturation was 70-75 % and cardiac catheterization showed severe pulmonary hypertension. At the age of 22, the patient underwent a palliative atrial switch operation; oxygen saturation increased to around 95 % and the patient experienced relief of symptoms. Atrial fibrillation and right side pleural effusion occurred but resolved and the patient was discharged.
Collapse
Affiliation(s)
- H S Yang
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | | |
Collapse
|
49
|
Affiliation(s)
- H S Yang
- Division of Applied Life Science, Graduate School, Gyeongsang National University, Jinju, Gyeongnam 660-701, Korea
| | | | | | | | | | | | | |
Collapse
|
50
|
Jeong ED, Kim HJ, Ahn CW, Ha MG, Hong TE, Kim HG, Jin JS, Bae JS, Hong KS, Kim YS, Kim HJ, Doh CH, Yang HS. Synthesis and electrochemical studies of nano-scale carbon-coated LiFePO4 electrodes for Li-ion batteries. J Nanosci Nanotechnol 2009; 9:4467-4471. [PMID: 19916475 DOI: 10.1166/jnn.2009.m78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Regardless of high capacity and stability during lithium extraction, LiFePO4 materials have difficulty in the applications for high electrical density because of low electrical conductivities. In order to optimize this problem, we synthesized carbon coated LiFePO4 by adding humic acid using solid state reaction method. We characterized the synthesized compounds via the crystallinity, the valence states of Fe ions, and their shapes. We found the carbon coating using X-ray photoelectron spectroscopy (XPS) and transmission electron microscope (TEM). We also found that the iron ion is substituted from 3+ to 2+ through XPS measurement. We showed that the carbon coating increased the electrochemical behavior by measuring the charge-discharge characteristics.
Collapse
Affiliation(s)
- Euh Duck Jeong
- High-Technology Components and Materials Research Center, Korea Basic Science Institute, Pusan 618-230, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|