BACKGROUND: The 5-hydroxytryptamine type 3 (5-HT3) receptor is a member of the Cys-loop superfamily of ligand-gated ion channels (LGICs) and modulated by pharmacologic relevant concentrations of volatile anesthetics or n-alcohols like most receptors of LGICs. The goal of this study was to reveal whether the site-directed single mutations of E-106, F-107 and R-222 in 5-HT3 receptor may affect the anesthetic modulation of halothane known as positive modulator. METHODS: The wild-type and mutant receptors, E106D, F107Y, R222F, R222V, were expressed in Xenopus Laevis oocytes and receptor function was assessed using two electrode voltage clamp techniques. RESULTS: E106D, F107Y, R222F, R222V mutant 5-HT3A receptors were functionally expressed. F107Y mutant 5-HT3A receptors displayed decreased sensitivity to 5-HT compared to the wild type 5-HT3A receptor (P < 0.05). Halothane showed positive modulation in both wild and F107Y mutant 5-HT3A receptors but F107Y mutant 5-HT3 receptor showed greater enhancing modulation comparing to wild-type receptor. Meanwhile, R222F and R222V mutant 5-HT3 receptor lost positive modulation with 1 and 2 MAC of halothane. Most interestingly, positive modulation by halothane was converted into negative modulation in E106D mutant 5-HT3A receptor. CONCLUSIONS: The present study implicate the amino acid residues known for agonist binding and linking agonist binding to channel gating might also have important role for anesthetic modulation in 5-HT3A receptor.
Anesthetics ; Electrodes ; Electrophysiology ; Halothane ; Ligand-Gated Ion Channels ; Oocytes ; Patch-Clamp Techniques ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Xenopus laevis

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to improving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28%(males) and 31%(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p<0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.
Adipose Tissue ; Aged* ; Anemia ; Blood Pressure ; Depression ; Education ; Female ; Friends ; Gyeonggi-do ; Humans ; Hypertension ; Korea ; Male ; Nutritional Status ; Overweight ; Prevalence ; Public Health ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires

Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), B1, B2, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.
Aged* ; Community Health Centers* ; Counseling* ; Diet ; Education* ; Female ; Humans ; Korea ; Male ; Niacin ; Nutritional Status ; Nutritive Value ; Vegetables ; Vitamins

No abstract available.
Brain Injuries*

BACKGROUND: Postoperative nausea and vomiting (PONV) is the most frequent and discomforting side effect following general anesthesia. Most volatile anesthetics have a potent effect on serotonin (5-hydroxydtryptamine, 5-HT) type 3 receptor mediating PONV, and their antagonists have been currently used effectively to prevent and/or reduce the incidence and severity of PONV. The authors reported previously that ginsenosides have inhibitory effect on 5-HT3A receptor. In this study we intended to elucidate the inhibitory effect of ginsenosides on the potentiated 5-HT3A receptor by desflurane. METHODS: After in vitro transcription of the recombinant mouse 5-HT3A receptor in the Xenopus laevis oocyte, we examined the effects of ginsenosides (g-Rb1, g-Rg1, g-Rd, g-Rg2) as well as ginsenoside metabolite, compound K on the modulation of desflurane by measuring currents flowing through 5-HT3A receptor using two-electrode voltage clamp technique. RESULTS: Although normalized inhibitory responses of ginsenosides were same regardless of desflurane, some ginsenosides such as g-Rd, g-Rg2, and g-Rg1 showed potential inhibition to the enhanced 5-HT induced current of 5-HT3A receptor by desflurane. CONCLUSIONS: Although ginsenosides have substantial inhibitory effect on 5-HT3A receptor, the effects of ginsenoside on potentiation by desflurane of 5-HT induced current via recombinant 5HT3A receptor may depend on the types of ginsenoside, which suggesting that ginsenoside might have an antagonistic action to nausea and vomiting associated with volatile anesthetics.
Anesthesia, General ; Anesthetics ; Animals ; Ginsenosides ; Incidence ; Isoflurane ; Mice ; Nausea ; Negotiating ; Oocytes ; Postoperative Nausea and Vomiting ; Serotonin ; Vomiting ; Xenopus ; Xenopus laevis

The neuromuscular blocking effect of pipecuronium was evaluated in 35 patients under N2O-O2-isoflurane anesthesia with visual and/or tactile counts for the twitch of the adductor pollicis muscle in response to train-of-tour(TOF) stimulation of the ulnar nerve at the wrist. Group I, II and III were classified according to the initial dose of pipecuronium of 50, 80 and 100ug/kg, respectively. The additional dose, 30 ug/kg, was given in all three groups when the first twitch of TOF(T) reappeared. The onset time in Group I, II and III was 361.4+/-98.6, 218.7+/- 80.8 and 239.0+/-73.7 seconds, respectively. The onset time in Group I was significantly slower(p<0.005) than those in the other groups. All three doses of pipecuronium provided good to exceUent intubating condition in about 4 to 6 minutes after the administration of the initial dose. The time interval from the disappearance of T1 to the reappearance of T1 was 39.0+/-20.8 min in Group I, which was significantly longer(p<0.05) in Group II(67.7+/-26.4 min) or III(63.8+/-20.8 min). The cumulative effect of pipecuronium was evaluated by comparing the mean time intervals of an additional dose to the succeeding ones. The intervals between additional doses were independent of the size or duration of the initial dose. There were no significant differences in the intervals between additional doses. Heart rates, rhythms and mean arterial blood pressures were not significantly changed in any groups following the administration of pipecuronium In conclusion, pipecuronium bromide can be recommended as a long-acting neuromuscular blocking agent with an absence or minimum of cumulative and cardiovascular effects for patients in whom a long operation is scheduled and the cardiovascular stability is required.
Anesthesia ; Arterial Pressure ; Heart Rate ; Humans ; Neuromuscular Blockade ; Pipecuronium* ; Ulnar Nerve ; Wrist

During the laparoscopic cholecystectomy, the ventilatory and hemodynamic changes could occur due to the peritoneal insufflation of CO2 as well as the position change. Various sults of the relationship between arterial and end-tidal PCO2 in different conditions have been reported. The authars studied to determine how closely end-tidal PCO2 reflects arterial PCO2 before, during, and after laparoscopic cholecystectomy. Peak inspiratory airway pressures, arterial blood pressures and heart rates were also measured simultaneously. Peritoneal insufflation of CO2 resulted in significant increase in peak inspiratory airway pressure and arterial blood pressure, but there were no significant changes in heart rates. Arterial and end-tidal PCO2 increased during laproscopy and, although there was no statistical significance in P(a-ET)CO2, P(a-ET)CO2 increased during laparoscopy and retumed to perinsufflation level after deflation of CO2. There was positive correlation between arterial and end-tidal PCO2 before CO2 insufflation, 10 minutes after CO2 insufflation and 10 minutes after deflation of CO2. However there was no correlation at 30 and 50 minutes after CO2 insufflation. These results suggested that the arterial PCO2 could not reflect end-tidal PCO2 exactly, and intermittent arterial blood gas studies should be warranted during laparoscopic cholecystectomy.
Arterial Pressure ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Hemodynamics ; Insufflation ; Laparoscopy

We observed one patient who developed sudden unilateral blindness following general anesthesia. After genera1 anesthesia with the prone position of the patient, the affected eye had no perception of light. Three days after, funduscopic features revealed narrowing of retinal artery, whitening or opacification of the retinal and a cherry-red spot. Central retinal artery occlusion can occur after surgery, possible etiologic factors being hypotension, extrinsic pressure on the eyeball. Proper positioning of the head on an adequate headrest and avoidance of an ocular compression will prevent the extrinsic pressure on the eyeball.
Anesthesia* ; Anesthesia, General ; Blindness ; Head ; Humans ; Hypotension ; Prone Position ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde

Leventhal, et al. described a preoperative scoring system for myasthenic patients undergoing transsternal thymectomy, which includes four key risk factors. There were : 1) duration of myasthenia gravis greater than 6 years (12 points); 2) a history of chronic respiratory disease not due to myasthenia gravis(10 points); 3) a dose of pyridostigmine greater than 750mg per day 48 hours before operation (8 points); 4) a preoperative vital capacity less than 2.9L(4 points). Thirty-seven patients with myasthenia gravis undergoing transsternal thymectomy under general inhalation anesthesia with or without muscle relaxants were applied to scoring system by leventhal, et al. retrospectively. The predicitive score was assessed for each patient and the duration of postoperative mechanical ventilation was also noted for each patient. in this study, there was correct in 23/37(62.2%) of the cases, with 9 out of 27 being incorrectly predicted to be ready for tracheal extubation(false positive) and 5 out of 10 being incorrectly predicted to need ventilation(false positve). In conclusion, the scoring system proposed by leventhal, et al. may be some value in predicting whether or not a particular myasthenic patient was likely to need mechanical ventilation following transsternal thymectomy.
Anesthesia, Inhalation ; Humans ; Myasthenia Gravis* ; Pyridostigmine Bromide ; Respiration, Artificial* ; Retrospective Studies ; Risk Factors ; Thymectomy* ; Ventilation ; Vital Capacity

No abstract available.
Anesthetics, General* ; Brain Injuries* ; Brain*