A 46 year-old female patient underwent cholecystectomy under general anesthesia. During the preoperative preparation, pulmonary edema developed from fluid overloading in the early septic condition. Pulmonary edema contributed significantly to the acute respiratory failure, which played a major role in the pathogenesis of multiple organ failure. For this condition, early surgical intervention is most important. After preoperative evaluaion, the authors anesthetized the patient with Morphine, used Enfluane intermitently, along with pancronium and oxygen and used endotracheal semiclosed circle absorption techniques with CMV incorporated PEEP. PEEP level was 5cm H2O. Inspired oxygen fraction was 1.0. Arterial oxygen tension increased from 62 torr to 183 torr despite the overt pulmonary edema. A-aDO2 was greater than 480 mmHg during the anesthesia of 2 hrs 40 minutes. For further treatment of pulmonary edema and postoperative respiratory care, synchronized IMV with PEEP, along with conventional methods for pulmonary edema and sepsis, were used in the ICU. After 6 days of intensive care, the patient was transferred to the general ward in good cardiovascular and respiratory function.
Absorption ; Anesthesia* ; Anesthesia, General ; Cholecystectomy ; Cholecystitis* ; Female ; Humans ; Critical Care ; Middle Aged ; Morphine ; Multiple Organ Failure ; Oxygen ; Patients' Rooms ; Pulmonary Edema* ; Respiratory Insufficiency ; Sepsis

OBJECTIVE: This study was undertaken to evaluate the cell cycle signaling pathway by cyclins-cyclin dependent kinases (CDKs) and cyclin dependent kinase inhibitors (CDKIs) in endometriosis. METHODS: 38 women with endometriosis were recruited. Endometrioma and the normal ovarian tissues were obtained during laparoscopic surgery on the follicular phase of menstrual cycle. And then, the normal endometrial tissues were taken by currettage. Nuclear proteins (cyclin D1, cyclin E etc), CDK molecules and CDK inhibitors (p27(kip1), p21 etc) were quantitated on transcriptional and translational levels by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. RESULTS: In RT-PCR analysis, the expression of cyclin D1-CDK6, cyclin E-CDK2 of endometrioma and eutopic endometrium was increased, and the expression of p27(kip1) was decreased compared with normal ovary. The mRNA expression of cyclins-CDKs and p27(kip1) was not significantly different between endometrioma and eutopic endometrium. In Western blot analysis, the expression of cyclin D1-CDK6, cyclin E-CDK2 was significantly increased and the expression of p27(kip1) was significantly decreased in endometrioma and eutopic endometrium compared with normal ovary. And, the expression of p27(kip1) in endometrioma was further decreased than that of eutopic endometrium. CONCLUSION: These results suggest that p27(kip1) on the translational level, in the cell cycle signaling pathway, was closely related to endometriosis. In future, further experimental studies will be needed for the understanding of the cell cycle signaling pathway in endometriosis.
Blotting, Western ; Cell Cycle* ; Cyclin E ; Cyclins ; Endometriosis* ; Endometrium ; Female ; Follicular Phase ; Humans ; Laparoscopy ; Menstrual Cycle ; Nuclear Proteins ; Ovary ; Phosphotransferases ; RNA, Messenger

OBJECTIVE: This study was undertaken to evaluate the cell cycle signaling pathway by cyclins-cyclin dependent kinases (CDKs) and cyclin dependent kinase inhibitors (CDKIs) in endometriosis. METHODS: 38 women with endometriosis were recruited. Endometrioma and the normal ovarian tissues were obtained during laparoscopic surgery on the follicular phase of menstrual cycle. And then, the normal endometrial tissues were taken by currettage. Nuclear proteins (cyclin D1, cyclin E etc), CDK molecules and CDK inhibitors (p27(kip1), p21 etc) were quantitated on transcriptional and translational levels by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. RESULTS: In RT-PCR analysis, the expression of cyclin D1-CDK6, cyclin E-CDK2 of endometrioma and eutopic endometrium was increased, and the expression of p27(kip1) was decreased compared with normal ovary. The mRNA expression of cyclins-CDKs and p27(kip1) was not significantly different between endometrioma and eutopic endometrium. In Western blot analysis, the expression of cyclin D1-CDK6, cyclin E-CDK2 was significantly increased and the expression of p27(kip1) was significantly decreased in endometrioma and eutopic endometrium compared with normal ovary. And, the expression of p27(kip1) in endometrioma was further decreased than that of eutopic endometrium. CONCLUSION: These results suggest that p27(kip1) on the translational level, in the cell cycle signaling pathway, was closely related to endometriosis. In future, further experimental studies will be needed for the understanding of the cell cycle signaling pathway in endometriosis.
Blotting, Western ; Cell Cycle* ; Cyclin E ; Cyclins ; Endometriosis* ; Endometrium ; Female ; Follicular Phase ; Humans ; Laparoscopy ; Menstrual Cycle ; Nuclear Proteins ; Ovary ; Phosphotransferases ; RNA, Messenger