BACKGROUND: We investigated the hypothesis that pretreatment with nefopam 20 mg would influence the onset and recovery profiles of rocuronium-induced neuromuscular block. METHODS: After Institutional Review Board approval, 134 patients, aged between 20–65 years, belonging to the American Society of Anesthesiologists physical status classification I or II, were randomly allocated to receive either 0.9% normal saline (control group) or nefopam 20 mg (nefopam group), infused over one hour before induction of anesthesia. Anesthesia was induced with remifentanil and propofol, followed by endotracheal intubation with rocuronium 0.6 mg/kg. We recorded the lag time, onset time, clinical duration, recovery index, recovery time, and total recovery time. RESULTS: We included 111 patients in the final analysis. The lag time, onset time, clinical duration, recovery index, recovery time, and total recovery time of the nefopam group (n = 57) were not significantly different compared with that of the control group (n = 54). CONCLUSIONS: Pretreatment with nefopam 20 mg one hour before induction of anesthesia does not have a significant influence on the onset and recovery profiles of rocuronium-induced neuromuscular block.
Anesthesia ; Classification ; Drug Interactions ; Ethics Committees, Research ; Humans ; Intubation, Intratracheal ; Nefopam* ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Neuromuscular Nondepolarizing Agents ; Propofol ; Prospective Studies*

The purpose of this study is to investigate the effect of loss of incisal function on the thickness, growth activities, ultrastructure of the condylar cartilage and on the muscle fibers of masseter superficialis, anterior belly of digastric muscle in the growing rats. 37 day-old-rats of which incisors had been trimmed every day received soft diet from weaning and were studied by the autoradiography, electron microscopy and muscle histochemistry. The results obtained were as follows: The thickness of the fibrous, proliferative layer in superior, posterosuperior portion of the condylar cartilage was significantly(p<0.01) reduced in experimental groups and the decrease rate of fibrous layer thickness was greater in posterosuperior portion than in superior portion of cartilage and was greater than in proliferative layer. In normal group, more cells of posterosuperior portion moved more rapidly towards the medullary cavity. In experimental group, the labelling index of posterosuperior portion was decreased in proliferative layer at 2 hours, in transitional layer at 1, 2 days, in hypertrophic layer at 4 days after injection relative to posterosuperior portion of control group. But labelling index of superior portion was not different from that of control group at all time course after injection. From the muscle histochemistry, the diameter of type IIB fibers in masseter superficialis muscle, type IIA, type IIB fibers in anterior belly of digastric muscle decreased significantly(p<0.01) relative to controls in experimental group. From electron microscopic study, in the fibrous layer of the posterosuperior portion of condylar cartilage in normal group, many fibroblast like cells near the joint cavity showed extensive remodelling activities in ultrastructure. There was no morphological changes between experimental and control group in all cartilage cell layers of superior portion but cells near the joint cavity in fibrous layer of posterosuperior portion of experimental group showed morphologically inactive state relative to control group.
Animals ; Autoradiography ; Cartilage* ; Diet ; Fibroblasts ; Incisor ; Joints ; Mandibular Condyle ; Microscopy, Electron ; Rats* ; Weaning

Tapia's syndrome is the palsy of the 10th and 12th cranial nerves, resulting in ipsilateral paralysis of the vocal cord and tongue. It is a rare complication which is related to the anesthetic airway management and positioning of the patient's head during the surgery. We describe a patient with a postoperative unilateral Tapia's syndrome, after general anesthesia, with uncomplicated endotracheal intubation. The patient's symptoms improved gradually for three months.
Airway Management ; Anesthesia, General ; Cranial Nerves ; Head ; Humans ; Intubation, Intratracheal ; Paralysis ; Tongue ; Vocal Cords

The heterodimeric c-Jun/c-Fos, an activator protein-1 (AP-1) has been implicated in mesoderm induction (Dong et al., 1996; Kim et al., 1998) whereas the homodimer of c-Jun was reported to be involved in neural inhibition during the early development of Xenopus embryos. During the early vertebrate development AP-1 involvement in the neural induction is still not clearly understood. We report here that AP-1 has a role in Zic3 expression, a critical proneural gene and a primary regulator of neural and neural crest development (Nakata et al., 1997; Nakata et al., 1998). AP-1 was able to induce the Zic3 gene in a dose dependent manner but other homo- or hetero-dimeric proteins, such as c-Jun/c-Jun, JunD/FosB or JunD/Fra-1 were not. The inhibition of AP-1 activity using morpholino antisenses of c-jun mRNAs blocked the Zic3 expression induced by activin. In addition, co-injection of c-jun mRNA rescued the down-regulated Zic3 expression. The promoter region of isolated Zic3 genomic DNA was found to possess several consensus-binding site of AP-1. Thus, in the functional assays, AP-1 could increase promoter activity of Zic3 gene. These findings suggest that proneural gene, Zic3 may be regulated by heterodimeric AP-1(c-Jun/c-Fos) and it may have a role in activin signaling for the regulation of neural specific gene, Zic3.
Activins/pharmacology/physiology ; Animals ; Base Sequence ; Binding Sites/genetics ; Consensus Sequence/genetics ; Dimerization ; Embryo, Nonmammalian/metabolism ; *Gene Expression Regulation, Developmental ; Homeodomain Proteins/*genetics ; Molecular Sequence Data ; Promoter Regions (Genetics)/genetics ; Proto-Oncogene Proteins c-fos/genetics/physiology ; Proto-Oncogene Proteins c-jun/genetics/physiology ; RNA, Antisense/genetics ; Research Support, Non-U.S. Gov't ; Transcription Factor AP-1/genetics/*physiology ; Transcription Factors/*genetics ; *Transcription, Genetic ; Up-Regulation ; Xenopus Proteins/*genetics ; Xenopus laevis/*embryology/*genetics