Background and objectives: Carvedilol is a cardiovascular drug, beta- and alpha1-adrenoceptor antagonist, currently approved for the treatment of hypertension, angina, congestive heart failure by FDA. Carvedilol has been shown to attenuate oxygen free radical-initiated lipid peroxidation and to inhibit neointimal formation of aorta following vascular injury by balloon angioplasty. We have investigated the effect of carvedilol on DNA synthesis of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor (PDGF)-BB. MATERIALS AND METHOD: Rat aortic smooth muscle cells were obtained by the combined collagenase and elastase methods. Cells between the 4th and 8th passages were used for the experiments. Incorporated radioactivity of [3H]-thymidine was measured by liquid scintillation spectrometry. RESULTS: PDGF-BB (1 nM) increased [3H]-thymidine incorporation about 70-100% over basal value in cultured VSMC. PDGF-stimulated increase in DNA synthesis was significantly suppressed by simultaneous administration of carvedilol. In contrast, propranolol did not significantly affect 3[H]-thymidine uptake in rat aortic VSMC. CONCLUSION: The present study demonstrate that carvedilol significantly inhibits the proliferation of vascular smooth muscle cell in our condition. These results indicate that carvedilol may be effective in the treatment of cardiovascular diseases principally associated with abnormal vascular smooth muscle growth.
Angioplasty, Balloon ; Animals ; Aorta ; Cardiovascular Diseases ; Cell Proliferation ; Collagenases ; DNA ; Heart Failure ; Hypertension ; Lipid Peroxidation ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Oxygen ; Pancreatic Elastase ; Platelet-Derived Growth Factor ; Propranolol ; Radioactivity ; Rats ; Spectrum Analysis ; Vascular System Injuries

OBJECTIVES: This study was performed in order to investigate the molecular mechanism regulating nitric oxide synthase(NOS) induced by alpha-quartz in Rat2 fibroblast. METHODS: alpha-quartz-induced nitric oxide(NO) and H2O2 formation and alpha- quartz-induced iNOS protein expression in Rat2 fibroblast were monitored. With iNOS inhibitor(L-N6- (1-iminoethyl)lysine hydrochloride, L-NIL) or antioxidant(catalase), we observed NO and H2O2 formation and iNOS protein expression in Rat2 fibroblast stimulated with alpha-quartz. RESULTS: alpha-quartz stimulated iNOS-induced NO and H2O2 formation in Rat2 fibroblast. L-NIL inhibited H2O2 formation and iNOS protein expression by alpha-quartz in Rat2 fibroblast. Pretreatment with catalase blocked the autoinhibitory pathway of iNOS by iNOSinduced H2O2, therefore H2O2 and NO production and iNOS protein expression were increased in Rat2 fibrobalst stimulated with alpha-quartz CONCLUSIONS: alpha-quartz-induced iNOS stimulated H2O2 formation in Rat2 fibroblast. INOS-induced H2O2 by alpha-quartz plays an important role in the autoinhibition pathway for regulating the iNOS function in Rat2 fibroblast
Catalase ; Fibroblasts* ; Homeostasis* ; Hydrogen Peroxide* ; Hydrogen* ; Nitric Oxide ; Quartz

Since 1920, when Harvey Cushing first used radiofrequency in electrosurgery, the procedural technique has developed rapidly. Even though this procedure is minimally invasive and safer than other neurodestructive procedures, it is still not free of complications. A 72-year-old female patient had constant facial pain, despite several operations and radiotherapies for her maxillary cancer. The region innervated ophthalmic branch and maxillary branch of the trigeminal nerve was involved, with radiofrequency procedure of the gasserian ganglion for pain control also performed at the area. After the procedure, her blood pressure became elevated and she complained of a headache, and six hours later, she became irritable and distracted. Bacterial meningitis was diagnosed by a spinal tap, with third-generation cephalosporin administered as the treatment. The following day, her symptoms had improved and the pain was also reduced. She was discharged from hospital after 14 days, without any sequelae.
Aged ; Blood Pressure ; Electrosurgery ; Facial Pain ; Female ; Headache ; Humans ; Meningitis ; Meningitis, Bacterial* ; Radiotherapy ; Spinal Puncture ; Trigeminal Ganglion ; Trigeminal Nerve

BACKGROUND: Remifentanil combined with propofol is usually used to induce anesthesia. However, remifentanil and propofol depress the cardiovascular system. This study investigated the effects of a continuous infusion of remifentanil on the propofol dose and hemodynamics using the bispectral index (BIS) during anesthetic induction. METHODS: Sixty female ASA physical status class I or II patients, who were scheduled to undergo gynecologic surgery were randomly assigned to one of three groups (n = 20). Normal saline 20 ml/hr (Group S), remifentanil 0.25microgram/kg/min (Group 0.25), or remifentanil 0.5microgram/kg/min (Group 0.5) was infused intravenously. Propofol was administered slowly two minutes after administering remifentanil or normal saline. The heart rate, mean arterial pressure (MAP) and BIS were measured at baseline, preintubation and postintubation. RESULT: There were no significant differences in the changes in the BIS among the groups. The MAP and heart rate decreased at preintubation compared with baseline (P < 0.05). The MAP of Group 0.5 at postintubation was lower than that in the other groups (P < 0.05). The heart rate in all groups increased at postintubation compared with baseline (P < 0.05). The heart rate of Group 0.5 at postintubation was lower than that of Group S (P < 0.05). The propofol requirement for unconsciousness was lower in Groups 0.25 and 0.5 than in Group S. The propofol requirement in Groups S, 0.25 and 0.5 was 1.56+/-0.2 mg/kg, 1.07+/-0.2 mg/kg and 0.9+/-0.1 mg/kg, respectively. CONCLUSIONS: A combined injection of 0.5microgram/kg/min remifantanil with 0.9 mg/kg of propofol decreases the heart rate and MAP at preintubation without adverse effects and appropriately prevents the cardiovascular responses to tracheal intubation, and reduces the propofol dose needed for a loss of consciousness.
Anesthesia ; Arterial Pressure ; Cardiovascular System ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Propofol* ; Unconsciousness

BACKGROUND: Remifentanil combined with propofol is usually used to induce anesthesia. However, remifentanil and propofol depress the cardiovascular system. This study investigated the effects of a continuous infusion of remifentanil on the propofol dose and hemodynamics using the bispectral index (BIS) during anesthetic induction. METHODS: Sixty female ASA physical status class I or II patients, who were scheduled to undergo gynecologic surgery were randomly assigned to one of three groups (n = 20). Normal saline 20 ml/hr (Group S), remifentanil 0.25microgram/kg/min (Group 0.25), or remifentanil 0.5microgram/kg/min (Group 0.5) was infused intravenously. Propofol was administered slowly two minutes after administering remifentanil or normal saline. The heart rate, mean arterial pressure (MAP) and BIS were measured at baseline, preintubation and postintubation. RESULT: There were no significant differences in the changes in the BIS among the groups. The MAP and heart rate decreased at preintubation compared with baseline (P < 0.05). The MAP of Group 0.5 at postintubation was lower than that in the other groups (P < 0.05). The heart rate in all groups increased at postintubation compared with baseline (P < 0.05). The heart rate of Group 0.5 at postintubation was lower than that of Group S (P < 0.05). The propofol requirement for unconsciousness was lower in Groups 0.25 and 0.5 than in Group S. The propofol requirement in Groups S, 0.25 and 0.5 was 1.56+/-0.2 mg/kg, 1.07+/-0.2 mg/kg and 0.9+/-0.1 mg/kg, respectively. CONCLUSIONS: A combined injection of 0.5microgram/kg/min remifantanil with 0.9 mg/kg of propofol decreases the heart rate and MAP at preintubation without adverse effects and appropriately prevents the cardiovascular responses to tracheal intubation, and reduces the propofol dose needed for a loss of consciousness.
Anesthesia ; Arterial Pressure ; Cardiovascular System ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Propofol* ; Unconsciousness

BACKGROUND: Intravenous injection of rocuronium is associated with withdrawal responses which are attributable to the pain from the injection of rocuronium. Several methods have been proposed to abolish and attenuate rocuronium-induced pain. We hypothesized priming dose of rocuronium could reduce withdrawal responses associated with administering a second large dose of rocuronium for tracheal intubation. We compared the efficacy of the priming dose technique of rocuronium with intravenous lidocaine as a pre-treatment for the prevention of withdrawal responses associated with rocuronium injection. METHODS: We recruited 150 patients aged between 18 and 60 years, ASA physical status 1 or 2, who were going to undergo elective surgery requiring general anesthesia. Patients were allocated into three groups. Group C received normal saline, Group L received lidocaine 1 mg/kg, and Group P received rocuronium 0.06 mg/kg 2 minutes before administering a second large dose of rocuronium for tracheal intubation. After the loss of consciousness, rocuronium 0.6 mg/kg was administered intravenously over 10 seconds for tracheal intubation. The withdrawal responses to the injection of rocuronium were evaluated. RESULTS: The incidence of withdrawal responses associated with rocuronium injection for tracheal intubation was 56, 50, 24% in group C, group L, and group P, respectively. The incidence of withdrawal responses was lower in group P than group C and group L, but there was no difference between group L and group C. CONCLUSIONS: Priming dose technique is a useful clinical method to alleviate withdrawal responses associated with rocuronium injection.
Administration, Intravenous ; Aged ; Androstanols ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Lidocaine ; Unconsciousness

Alveolitis is believed to be a primary response after dust inhalation. Activated inflammatory cells by dust and their mediators are major participants in the evolution of pneumoconiosis. Therefore evaluation of degree of alveolitis is useful for assessing disease activity and estimating of prognosis in pneumoconiosis. This study focused on the workers with pneumoconiosis who are working and worked in manufacturing industries because the occupying fraction by them among total pneumoconioses patients in our country is increasing recently. In order to identify and validate biomarkers to early diagnosis and better predict for the suceptible workers, the release of tumor necrosis factor (TNF alpha ), interleukine-8 (IL-8), platelet-derived growth factor-AA(PDGF-AA) and transforming growth factor-beta TGF beta ) from alveolar macrophages and blood monocytes, their concentration in BAL (bronchoalveolar lavage) fluid, pulmonary function test and Gallium index of lung were performed on 25 patients with pneumoconiosis who worked in manufactory industries. The results of this study were as follows ; 1. No significant differences were demonstrated between large opacity group and small opacity group, however pulmonary diffusing capacity in large opacity group was significantly lower than that in small opacity group. 2. (67)Gallium index was significantly correlated with increase of category in pnemoconiosis(r=0.83, p<0.05). 3. Numbers of total cells (r=0.583, p<0.05) and alveolar macrophages (r=0.499, p<0.05) in BAL were significantly correlated with the category of pneumoconiosis. 4. Spontaneous (r=0.474, p<0.05) and LPS (r=0.463, p<0.05) stimulated release of TNF alpha from macrophage, IL-8 (r=0.464, p<0.05) and TGF beta r=0.460, p<0.05) in BAL fluid were significantly correlated with category of pneumoconiosis. 5. Significantly positive correlation was demonstrated between spontaneous (r=0.443, p<0.05) and LPS (r=0.573, p<0.05) stimulated release of TNF alpha with the category of pneumoconiosis. 6. Release of TNF alpha from alveolar macrophages(r=0.61, p<0.05) and blood monocytes (r=0.48, p<0.05), IL-8 concentration in BAL fluid (r=0.52, p<0.05) and (67)Gallium index (r=0.53, p<0.05) were consider to sensitive biomarkers for alveolitis by dust.
Biological Markers* ; Dust* ; Early Diagnosis ; Gallium ; Humans ; Inhalation ; Interleukin-8 ; Lung ; Macrophages ; Macrophages, Alveolar ; Monocytes ; Pneumoconiosis* ; Prognosis ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Tumor Necrosis Factor-alpha

Tremor is a rhythmic, involuntary and oscillatory movement of body parts, and it is the most common movement disorder. Spasticity is also one of the movement disorders that is commonly accompanied with Complex Regional Pain Syndrome; however, the basic nature of spasticity has not yet been proved. A 25-year-old male patient had two operations and he was being treated because of a back injury that occurred 4 years ago. He suffered from pain, tremor and spasticity on both his lower legs, and his symptoms were diagnosed as failed back surgery syndrome. The tremor and spasticity were aggravated despite of continuous treatments. We then treated him with spinal cord stimulation. His pain, tremor and spasticity disappeared after spinal cord stimulation.
Adult ; Back Injuries ; Failed Back Surgery Syndrome* ; Human Body ; Humans ; Leg ; Male ; Movement Disorders ; Muscle Spasticity* ; Spinal Cord Stimulation* ; Spinal Cord* ; Tremor*

Foreign body ingestion induces various complications during the induction of and emergence from anesthesia. These complications include inconsequential mucosal scratches, abrasion, laceration, esophageal stricture, necrosis, retropharyngeal abscess formation, hemorrhage, obstruction and perforation. We experienced a case of esophageal perforation after ingestion of a dental prosthesis during emergence. A 71-year-old female patient received general anesthesia for a lumbar laminectomy. At postanesthesia care unit, she complained of a sore throat and found that her dental prosthesis was missing. The impacted dental prosthesis was found at the T7 level, which was followed due to its perforation through the esophageal wall, causing mediastinitis. She underwent an operation for the esophageal repair and was discharged with slight chest discomfort due to operation, after 10 days.
Aged ; Anesthesia ; Anesthesia, General* ; Dental Prosthesis* ; Eating ; Esophageal Perforation* ; Esophageal Stenosis ; Female ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Laminectomy ; Mediastinitis ; Necrosis ; Pharyngitis ; Retropharyngeal Abscess ; Thorax

Foreign body ingestion induces various complications during the induction of and emergence from anesthesia. These complications include inconsequential mucosal scratches, abrasion, laceration, esophageal stricture, necrosis, retropharyngeal abscess formation, hemorrhage, obstruction and perforation. We experienced a case of esophageal perforation after ingestion of a dental prosthesis during emergence. A 71-year-old female patient received general anesthesia for a lumbar laminectomy. At postanesthesia care unit, she complained of a sore throat and found that her dental prosthesis was missing. The impacted dental prosthesis was found at the T7 level, which was followed due to its perforation through the esophageal wall, causing mediastinitis. She underwent an operation for the esophageal repair and was discharged with slight chest discomfort due to operation, after 10 days.
Aged ; Anesthesia ; Anesthesia, General* ; Dental Prosthesis* ; Eating ; Esophageal Perforation* ; Esophageal Stenosis ; Female ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Laminectomy ; Mediastinitis ; Necrosis ; Pharyngitis ; Retropharyngeal Abscess ; Thorax