Nucleic scids transfer the genetic information for serving a central biological purpose. The nucleic acids are polymers of nucleotides and they are mainly ribonucleic acid(RNA) and deoxyribonucleic acid(DNA). The nucleotides are stoichiometrically composed of five-carbon sugars, nitrogeneous bases, and phosphoric acids. The chemistry of nucleic acids and characteristics of different genomes are decribed for further study. Most of DNA genomes tend to be circular including bacterial genomes and eukaryotic mitochondrial DNA. Eukaryotic chromosomes in cells, in contrast, are generally linear. The ends of linear chromosomes are called telomeres. The genomes of different species, such as mammals, plants, invertebrates can be compared with the chromosome ends. The telomeric complex allows cells to distinguish the random DNA breaks and natural chromosomal ends. The very ends of chromosomes cannot be replicated by any ordinary mechanisms. The shortening of telomeric DNA templates in semiconservative replication is occurred with each cell division. The short telomere length is critically related to aging, tumors and dieases.
Aging ; Carbohydrates ; Cell Division ; DNA ; DNA Breaks ; DNA, Mitochondrial ; Genome ; Genome, Bacterial ; Genome, Mitochondrial ; Invertebrates ; Mammals ; Nitrogen ; Nucleic Acids ; Nucleotides ; Phosphoric Acids ; Polymers ; Telomere

Aim To avoid the limitation of the use of cationic polyethlenimine (PEI)-complexed plasmid DNA use for in vitro or in vivo gene delivery due to its cytotoxicity and lower efficiency in the presence of serum. Methods A polyplex with decreased positive charge on the complex surface was designed. The PEI/DNA (PD) complexes coated with an anionic biodegradable polymer, alginate were prepared and their gene delivery behavior with PD was compared. Results The alginate-coated PD polyplex, where alginate: PEI: DNA [alginate: DNA, 0. 15 (w/w); PEI: DNA, N: P = 10] showed about 10 -30 fold-increased transfection efficiency compared to corresponding non-coated complexes to C3 cells in the presence of 50% serum. The surface charge of the alginate-coated complex was approximately half of that of the alginate-lacking complex. The size of alginate-coated complex was slightly smaller than that of the corresponding complex without alginate. The former complex also showed a reduced erythrocyte aggregation activity and decreased cytotoxicities to C3 cells in comparison with PD complex. Conclusion The alginate-coated PD polyplexes as a new gene delivery system can improve transfection efficiency in high serum concentration with low cytotoxicity to C3 cells.

The characteristics of hand trauma are changing due to automation of industrial facilities, improved access to health care, and the aging population. Since the inception of hand surgery as a subspecialty, hand defects have been reconstructed with the restoration of the original functionality as the primary goal. With advancement and maturation of surgical techniques, however, restoration of aesthetics also began to take hold as an important aspect of hand surgery practice. After the first successful replantation of an amputated digit, the rapid development of microsurgical techniques had a significant impact on the field of reconstructive hand surgery. In the first two decades, the success of replantation was evaluated by the survival rate for a single operator or a specialized institution. These days, however, microsurgical techniques have been widely adopted, with digital replantation possible even for infants. In addition to various local flaps, the evolution of free flaps has vastly expanded the repertoire of reconstructive options for hand surgeons. With the wide variety of free flaps available, it is possible for a severely injured hand to be salvaged and restored to its original functional and aesthetic status. In South Korea, hand surgery is becoming an established profession with a separate subspecialty certification. Hand surgery has a bright outlook, with future research directed at new biocompatible materials and novel reconstructive methods.
Aging ; Automation ; Biocompatible Materials ; Certification ; Esthetics ; Free Tissue Flaps ; Hand* ; Health Services Accessibility ; Humans ; Infant ; Korea ; Microsurgery ; Replantation ; Survival Rate

BACKGROUND: The purpose of this study was to determine the clinical effective dose of alfentanil required for successful tracheal intubation during inhalation induction using 5% sevoflurane without neuromuscular blockade in children sedated with ketamine. METHODS: Twenty-one children, aged 3-10 years, undergoing surgeries under general anesthesia were enrolled into the study. All patients were premedicated with 0.004 mg/kg glycopyrrolate intramuscularly 30 min before anesthesia.To facilitate separation of the child from the parents, intravenous 1 mg/kg ketamine was given prior to transfer into the operating room.After inhalation induction with 5% sevoflurane and 100% oxygen, pre-determined dose of alfentanil was injected over 20 sec. The dose of alfentanil was determined by modified Dixon's up-and-down method (2microgramkg as a step size starting from 12microgramkg).The study ended when six independent pairs of patients, who manifested cross over from 'failure' to 'success' for tracheal intubation, were recruited. RESULTS: In 50% of children, the effective bolus dose (ED50) (95% confidence intervals) of alfentanil for successful tracheal intubation was 7.2microgram/kg (6.3-8.1microgram/kg) during sevoflurane inhalation induction.From isotonic regression, 95% effective dose (ED95) (95% confidence intervals) of alfentanil was 9.9microgram/kg (2.2-16.0microgram/kg). CONCLUSIONS: During inhalation induction using 5% sevoflurane without neuromuscular blockade after ketamine sedation, the ED50 and ED95 of alfentanil for successful tracheal intubation were 7.2 microgram/kg and 9.9microgram/kg in children, respectively.
Aged ; Alfentanil ; Anesthesia, General ; Child ; Glycopyrrolate ; Humans ; Inhalation ; Intubation ; Ketamine ; Methyl Ethers ; Neuromuscular Blockade ; Oxygen ; Parents

Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a 40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presented with swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computed tomography. The patient was carefully monitored under conservative care and discharged without complications. Although subcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management, in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incision along the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase in intrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed with meticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complications and, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.
Adult ; Emphysema ; Health Personnel ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Subcutaneous Emphysema* ; Tongue ; Tonsillectomy

BACKGROUND: Elevated blood pressures during emergence from general anesthesia in patients with hypertension often result in undesirable complications such as myocardial ischemia, intracranial hemorrhages. The aim of this study was to assess the effect of intracuff 4% lidocaine on the dosage of nitroglycerine required to maintain the stable blood pressure during peri-extubation period in patients with hypertension. METHODS: Forty-nine patients scheduled for elective surgery were randomly allocated to group 1 and 2. We filled endotracheal tube's cuff with normal saline for group 1 and with 4% lidocaine for group 2. Blood pressures and heart rates were recorded before operation, during emergence, and after extubation. Nitroglycerine infusion was adjusted to maintain systolic blood pressure below 150 mmHg. Total infused dosages of nitroglycerine were recorded during operation and after stop of inhalational anesthetics for comparison of both groups' hemodynamic stability. RESULTS: Mean infused volume (microg/kg/min) of nitroglycerine during peri-extubation period was less in the group 2 than group 1. CONCLUSIONS: Intra-cuff 4% lidocaine in patients with hypertension during emergence from general anesthesia reduces the nitroglycerine dosage required to maintain hemodynamic stability.
Anesthesia, General ; Anesthetics ; Blood Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension* ; Intracranial Hemorrhages ; Lidocaine* ; Myocardial Ischemia ; Nitroglycerin*

BACKGROUND: General anesthesia for cesarean section is usually maintained at a low dose after induction with using other agents. Many anesthesiologists have experience difficulty in maintaining stable blood pressure at intubation, as compared with nonobstetric anesthesia. We wanted to determine the efficacy of nicardipine for treating rising blood pressure that is related to intubation. METHODS: Twenty one parturient women, who were scheduled for elective cesarean section, were randomly allocated to two groups. Group 1 (n = 10) received no nicardipine and group 2 (n = 11) received nicardipine (7microg/kg) 60 seconds before intubation. The systolic blood pressures, diastolic blood pressures and heart rates were measured at preoperation, after induction of anesthesia, before intubation, immediately after intubation and at 1, 5, 10, 15 and 30 minutes after intubation. RESULTS: The systolic and diastolic blood pressures were lower in group 2 than group 1 at immediate after intubation. Yet the heart rate was higher in group 2 than in group 1 at the same time. CONCLUSIONS: Intravenous nicardipine given 60 seconds before intubation has some benefit from the viewpoint of blood pressure stability at intubation during cesarean section.
Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Cesarean Section* ; Female ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal* ; Nicardipine* ; Pregnancy

BACKGROUND: The aim of this study was to determine the clinical effective dose of rocuronium for tracheal intubation using a lightwand after induction with propofol, alfentanil, and a low concentration of sevoflurane. METHODS: Twenty-eight adults scheduled to undergo elective surgery lasting less than one hour were enrolled in this study. All patients received alfentanil (10 microgram/kg) and propofol (1.5 mg/kg) for the induction of anesthesia. Tracheal intubation using a lightwand was attempted 3 minutes after administering rocuronium and mask ventilation with 2 vol% of sevoflurane. The initial rocuronium dose was 0.5 mg/kg. The rocuronium dose for consecutive patients, determined by Dixon's up-and-down method, was increased or decreased by 0.05 mg/kg according to the result of the previous patient. The mean arterial pressure and heart rate were recorded before induction, 1 min before intubation, 1 and 2 min after intubation. RESULTS: The 50% clinical effective dose (cED(50)) of rocuronium for tracheal intubation using a lightwand was 0.20 +/- 0.05 mg/kg according to Dixon's up and down method. Isotonic regression revealed the cED(50) and cED(95) (95% confidence intervals) to be 0.20 mg/kg (0.10-0.3 mg/kg) and 0.35 mg/kg (0.16-0.49 mg/kg), respectively. CONCLUSIONS: The cED(50) and cED(95) of rocuronium for tracheal intubation using the lightwand were 0.20 mg/kg and 0.35 mg/kg, respectively, after induction with alfentanil, propofol, and a low concentration of sevoflurane.
Adult ; Alfentanil ; Androstanols ; Anesthesia ; Arterial Pressure ; Heart Rate ; Humans ; Intubation ; Masks ; Methyl Ethers ; Propofol ; Ventilation

Tuberous sclerosis is an autosomal dominantly transmitted genetic disorder that has characteristic symptoms triad of mental retardation, convulsion, and facial angiofibroma. Because it is a relatively uncommon disorder, there are few informations about anesthetic management for this disorder. We report a case of tuberous sclerosis that had involved bilateral kidneys. A 14-year old female patient was induced with thiopental sodium, rocuronium bromide and then intubated with an internal diameter 6.5 mm of reinforced tube. Anesthesia was maintained with O2-N2O-isoflurane. Surgery took 3 hours and there were no remarkable changes in vital signs and arterial blood gas analysis.
Adolescent ; Anesthesia ; Angiofibroma ; Blood Gas Analysis ; Female ; Humans ; Intellectual Disability ; Kidney ; Nephrectomy* ; Seizures ; Thiopental ; Tuberous Sclerosis* ; Vital Signs

BACKGROUND: The patients with traumatic brain injury showed ischemia due to increased intracranial pressure. This study evaluated the relationship of pre-anesthetic serum lactate level with in-hospital mortality. METHODS: The archived medical records of 121 patients were retrospectively reviewed. Demographics and preoperative serum lactate level were analyzed. RESULTS: Of the 121 patients, 32 patients expired in the hospital after decompressive craniectomy. Preoperative serum lactate levels were 3.2 +/- 2.2 mmol/L in the survivors and 5.4 +/- 3.0 mmol/L in the dead (P = 0.001), and the receiver operating characteristic curve revealed that a cut off value of 3.60 mmol/L was reasonable for predicting mortality. CONCLUSIONS: Preoperative serum lactate level is highly correlated with in-hospital mortality after decompressive craniectomy in traumatic brain injury.
Brain Injuries* ; Decompressive Craniectomy* ; Demography ; Hospital Mortality* ; Humans ; Intracranial Pressure ; Ischemia ; Lactic Acid* ; Medical Records ; Mortality ; Retrospective Studies ; ROC Curve ; Survivors