BACKGROUND: Postoperative nausea and vomiting (PONV) are common problems in patients undergoing general anesthesia. Ondansetron is widely used for this problems. But, some patients treated with ondansetron do not respond to therapy. We hypothesized that patients with genetic variation in 5-HT3b receptor and CYP2D6 gene might respond differently to ondansetron treatment. METHODS: 135 patients undergoing gynecologic surgery were given 4 mg ondansetron 15 min before extubation. The assessment of PONV was performed during < 2 hours and 2-24 hours. DNA was extracted from blood and was analyzed by using restriction fragment-length polymorphism (RFLP) and site-specific PCR. RESULTS: In 5-HT3b AAG deletion mutation, the incidence of nausea and vomiting < 2 hr were 25% and 12.5% for wild, 23.4% and 12.2% for heteromutant. The incidence of nausea and vomiting 2-24 hr were 3.2% and 1.1% for wild, 4.9% and 2.4% for heteromutant. This showed no significant differences between two groups. In CYP2D6*10 mutation, the incidence of nausea and vomiting < 2 hr were 28.6% and 19.6% for wild, 22.8% and 8.8% for heteromutant and 23.5% and 5.9% for homomutant. The incidence of nausea and vomiting 2-24 hr were 5.4% and 1.8% for wild, 3.2% and 1.6% for heteromutant, 0% and 0% for homomutant. This showed no significant differences among three groups. CONCLUSIONS: The incidence of PONV were not different among the genotype of CYP2D6*10 and 5HT3b AAG mutation.
Anesthesia, General ; Cytochrome P-450 CYP2D6 ; DNA ; Female ; Genetic Variation ; Genotype ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Nausea ; Ondansetron* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Postoperative Nausea and Vomiting ; Sequence Deletion* ; Vomiting

PURPOSE: To evaluate the effect of anti-interleukin-33 (anti-IL-33) on a mouse model of ovalbumin (OVA)-induced acute kidney injury (AKI). METHODS: Twenty-four female BALB/c mice were assigned to 4 groups: group A (control, n=6) was administered sterile saline intraperitoneally (i.p.) and intranasally (i.n.); group B (allergic, n=6) was administered i.p./i.n. OVA challenge; group C (null treatment, n=6) was administered control IgG i.p. before OVA challenge; and group D (anti-IL-33, n=6) was pretreated with 3.6 µg of anti-IL-33 i.p. before every OVA challenge. The following were evaluated after sacrifice: serum blood urea nitrogen and creatinine levels, Kidney injury molecule-1 gene (Kim-1) and protein (KIM-1) expression in renal parenchyma, and expression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), phosphorylated endothelial NOS (p-eNOS), and phosphorylated AMP kinase (p-AMPK) proteins in renal parenchyma. RESULTS: After OVA injection and intranasal challenge, mice in groups B and C showed significant increases in the expression of Kim-1 at both the mRNA and protein levels. After anti-IL-33 treatment, mice in group D showed significant Kim-1 down-regulation at the mRNA and protein levels. Group D also showed significantly lower COX-2 protein expression, marginally lesser iNOS expression than groups B and C, and p-eNOS and p-AMPK expression at baseline levels. CONCLUSIONS: Kim-1 could be a useful marker for detecting early-stage renal injury in mouse models of OVA-induced AKI. Further, anti-IL-33 might have beneficial effects on these mouse models.
Acute Kidney Injury ; Adenylate Kinase ; Animals ; Blood Urea Nitrogen ; Creatinine ; Cyclooxygenase 2 ; Down-Regulation ; Female ; Humans ; Immunoglobulin G ; Interleukin-33 ; Kidney* ; Mice ; Nitric Oxide Synthase Type II ; Ovalbumin ; Ovum ; RNA, Messenger

BACKGROUND: Mitral stenosis (MS) and mitral regurgitation (MR) have different pathophysiologies and left ventricular function after miral valve replacement (MVR) in both diseases has been well known. However, there has been no report comparing the change of right ventricular (RV) function immediately after MVR. We evaluated the change of RV function following MVR in MS and MR using a RV ejection fraction (RVEF) thermodilution catheter. METHODS: With IRB approval, 27 patients with MS and 22 patients with MR undergoing MVR were included. Patients with tricuspid regurgitation were excluded. A RVEF catheter was inserted before the induction of anesthesia. Hemodynamic parameters were measured after anesthesia (T1, control), immediately after the termination of cardiopulmonay bypass (T2) and after the sternum was closed (T3). RESULTS: Pulmonary capillary wedge pressure (PCWP) and end systolic and end diastolic RV volume index (RVESVI and RVEDVI) were higher in MS than in MR and there was no difference in RVEF at T1. Heart rate increased and mean pulmonary artery pressure (mPAP), PCWP, and pulmonary vascular resistance significantly decreased at T2 in both groups. RVEF increased and RVESV and RVEDV decreased significantly only in MS after MVR versus that at T2. There was no difference in hemodynamic parameters between both groups at T2 and T3. CONCLUSIONS: RV function was significantly improved in MS but not in MR after MVR. However, there was no significant hemodynamic difference between MS and MR after MVR, though they are known to have different preoperative pathophysilogies and postoperative left heart functions.
Anesthesia ; Catheters ; Ethics Committees, Research ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sternum ; Thermodilution ; Tricuspid Valve Insufficiency ; Vascular Resistance ; Ventricular Function, Left ; Ventricular Function, Right*

BACKGROUND: Aspirin has been shown to effectively increase survival and reduce morbidity in patients with ischemic heart disease. Continued aspirin use during the preoperative period could increase the postoperative blood loss in patients who have on-pump coronary artery bypass grafting. This study aimed to determine the effect of continued aspirin use before off-pump CABG on intraoperative and postoperative bleeding and coagulation profile in thromboelastography. METHODS: In 43 patients undergoing OPCAB, they were assigned aspirin user (n = 22), who received aspirin until the day of operation or nonaspirin user (n = 21), who discontinued aspirin before 7 days before the surgery. Intraoperative and postoperative bleeding and transfusion requirement were measured. TEG was performed and R, K, alpha angle, maximum amplitude and TEG index was measured at preinduction and at 24 hours after surgery. RESULTS: There were no differences in patient characteristics between aspirin users and nonaspirin users. We found no significant difference between postoperative bleeding and blood product requirements for the two groups. Similarly, we found no significant difference in the coagulation profiles. CONCLUSIONS: The use of aspirin continued preoperatively does not increase intraoperative and postoperative blood loss, and blood product requirement and influence on coagulation profile.
Aspirin* ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Hemorrhage* ; Humans ; Myocardial Ischemia ; Postoperative Hemorrhage ; Preoperative Period ; Thrombelastography*