Background: Neuroinflammation plays an important role in cognitive decline and memory impairment in neurodegenerative disorders. Previously, we demonstrated that Humulus japonicus (HJ) has anti-inflammatory effects in rodent models of Alzheimer’s disease and Parkinson’s disease. The present study aimed to examine the protective potential of HJ extracts against lipopolysaccharide (LPS)-induced cognitive impairment and scopolamine-induced amnesia in mouse models. Cognitive improvement of mice was investigated by novel object recognition test. For analyzing effects on neuroinflammation, immunohistochemistry and quantitative real-time polymerase chain reaction (qRTPCR) assays were performed. Results: We found that the oral administration of HJ significantly improved cognitive dysfunction induced by LPS in a novel object recognition test. The LPS-induced activation of microglia was notably decreased by HJ treatment in the cortex and hippocampus. HJ administration with LPS also significantly increased the mRNA expression of interleukin (IL)-10 and decreased the mRNA expression of IL-12 in the parietal cortex of mice. The increased expression of LPS-induced complement C1q B chain (C1bq) and triggering receptor expressed on myeloid cells 2 (Trem2) genes was significantly suppressed by HJ treatment. In addition, HJ administration significantly improved novel object recognition in a scopolamine-induced amnesia mouse model. Conclusions These findings revealed that HJ has a beneficial effect on cognitive impairment and neuroinflammation induced by systemic inflammation and on amnesia induced by scopolamine in mice.

BACKGROUND: Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion. METHODS: Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient's pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated. RESULTS: No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients. CONCLUSIONS: Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.
Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Appendectomy* ; Bradycardia ; Conversion to Open Surgery ; Dexmedetomidine* ; Feasibility Studies ; Fentanyl ; Humans ; Ketamine

BACKGROUND: Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion. METHODS: Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient's pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated. RESULTS: No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients. CONCLUSIONS: Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.
Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Spinal* ; Appendectomy* ; Bradycardia ; Conversion to Open Surgery ; Dexmedetomidine* ; Feasibility Studies ; Fentanyl ; Humans ; Ketamine

BACKGROUND: Electroconvulsive therapy (ECT) is effective for major psychosis and affective disorder. The ideal anesthetics for ECT provide rapid induction and recovery, and they attenuate the adverse effects of ECT. We compared the effects of etomidate, propofol and thiopental sodium during ECT. METHODS: Nine patients were enrolled in this double blinded cross over design study. The ECT was done 3 times per week for two weeks. We monitored the patients with electrocardiography, pulse oximetry, the bispectral index score and the blood pressure. We recorded the data at the time of arrival to the therapy room, just before ECT and at 1, 2, 3, 4, 5, 7 and 10 minutes after ECT. Hypnosis was induced with 3 mg/kg of thiopental sodium (group T), 1.5 mg/kg of propofol (group P) or 0.15 mg/kg of etomidate (group E). The ECT was done after administering 1 mg/kg of succinylcholine. The duration of seizure were measured after ECT. RESULTS: There were significantly different durations of motor seizure among the three groups. The duration of EEG seizure in group E was longer than that of group P and group T. The blood pressure and the heart rate of group P were significantly lower than that of the other groups (P < 0.05). CONCLUSIONS: Compared to thiopental sodium and etomidate, propofol was not associated with clinically significant changes in the duration of seizure and hemodynamic stability. It has a good hypnotic effect and it did not affect the therapeutic efficacy of ECT. Etomidate is effective for patients for achieving a short duration of seizure after ECT is applied.
Anesthetics ; Blood Pressure ; Cross-Over Studies ; Electrocardiography ; Electroconvulsive Therapy ; Electroencephalography ; Etomidate ; Heart Rate ; Hemodynamics ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Mood Disorders ; Oximetry ; Propofol ; Psychotic Disorders ; Seizures ; Succinylcholine ; Thiopental

Abscess ; Breast ; Jaw ; Kidney ; Lung ; Mandible ; Mouth ; Mouth Neoplasms ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Temporomandibular Joint ; Thyroid Neoplasms

Animals ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diphosphonates ; Humans ; Ilium ; Imidazoles ; Macrophages ; Maxillary Sinus ; Membranes ; Osteonecrosis ; Periosteum ; Rabbits ; Sodium Chloride ; Transplants

BACKGROUND: The proper use of sedation and analgesia in the intensive care unit (ICU) minimizes its physical and psychological impact. Otherwise, patients can suffer from recall, nightmares, and depression after discharge. We investigated the sedatives, analgesics, and muscle relaxants used in the ICU. METHODS: We visited 79 ICUs in 52 training hospitals and noted the use of sedatives, analgesics, and muscle relaxants from July, 2007, to December, 2007, using a 5-item questionnaire with 57 sub-questions. The survey evaluated the ICU system administration of analgesics and muscle relaxants. RESULTS: Most ICU management is done by the anesthesiology department (55%). Most have resident doctors (63.3%) and an ICU committee (60.8%) in charge of the ICU, as well as a special ICU chart (88.6%) and scoring system (65.8%). Most hospitals have a consulting system (94.9%). The standard ICU analgesics are fentanyl (65.8%), NSAIDs (53.2%), and morphine (48.1%). CONCLUSIONS: Adequate sedation is difficult to achieve in the ICU, but is important for patient comfort and to reduce ICU stay duration. Awareness of patient status and appropriate drug/protocol use are therefore important.
Analgesia ; Analgesics ; Anesthesiology ; Anti-Inflammatory Agents, Non-Steroidal ; Depression ; Dreams ; Fees and Charges ; Fentanyl ; Humans ; Hypnotics and Sedatives ; Critical Care ; Intensive Care Units ; Morphine ; Muscles

BACKGROUND/AIMS: Chronic obstructive pulmonary disease (COPD) is characterized by an incompletely reversible airflow limitation. Pulmonary function test (PFT) has been considered the gold standard test for diagnosis and severity evaluation in COPD. However, PFT by spirometry does not provide information about exercise performance in COPD patients. Therefore, the present study was performed to compare pulmonary function determined by spirometry with exercise function determined by cardiopulmonary exercise test (CPET) for grading of COPD. METHODS: A total of 105 patients with airway obstruction were examined. The patients' mean age was 65 years, and the mean smoking history was 27 pack-years. The patients underwent spirometry and CPET. The results were analyzed by categorical statistical comparison, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society guidelines. RESULTS: The two methods agreed on the classification of only 44 patients (42%). Of the remaining patients, 21 (20%) were found to be less severe according to CPET than according to PFT, whereas 40 (38%) were more severe. Those who were more severe according to CPET had significantly low maximal minute ventilation, low anaerobic threshold, low oxygen pulse, and high breathing reserve. CONCLUSIONS: The present study revealed the large disagreement between the results of resting and exercise pulmonary function tests, and therefore suggests the need for a novel approach or guideline. Additional cardiological evaluation may be needed in patients classified as more severe according to CPET, who are assumed to have a greater degree of impairment of cardiovascular function.
Airway Obstruction ; Anaerobic Threshold ; Bacterial Toxins ; Exercise Test ; Humans ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Respiration ; Respiratory Function Tests ; Smoke ; Smoking ; Spirometry ; Ventilation

BACKGROUND: Phenytoin and carbamazepine may augment a neuromuscular block from nondepolarizing muscle relaxants. The potency of rocuronium is increased after the administration of an acute high dose of phenytoin. We investigated the effects of phenytoin and carbamazepine on rocuronium-induced neuromuscular blockade. METHODS: Male Sprague Dawley rats (n = 80) were randomly allocated into a control group, phenytoin group, carbamazepine group, and phenytoin with carbamazepine group. The phrenic nerve was stimulated with supramaximal intensity and twitch responses were measured. After a stabilization period, 300microg rocuronium was added. After 10 minutes, in the pheytoin group of rats, phenytoin in Krebs solution was administered at a concentration of 1microg/ml (P1), 10microg/ml (P10) and 100microg/ml (P100). In the carbamazepine group of rats, carbamazepine in Krebs solution was administered at a concentration of 0.5microg/ml (C0.5), 5microg/ml (C5) and 50microg/ml (C50). In the phenytoin with carbamazepine group of rats, phenytoin simultaneously with carbamazepine was administered in Krebs solution at a phenytoin concentration of 10microg/ml (P10) and a carbamazepine concentration of 5microg/ml (C5). We measured twitch responses at 10 minutes after rocuronium administration and 10 minutes after the administration of the anticonvulsants. RESULTS: There were significant depressions in the twitch response of rocuronium in the 100microg/ml phenytoin group of rats, 5microg/ml and 50microg/ml carbamazepine group of rats, and the 10microg/ml phenytoin with 5microg/ml carbamazepine group of rats. CONCLUSIONS: The potency of rocuronium increased with phenytoin and carbamazepine administration. Phenytoin and carbamazepine can cause recurarization perioperatively.
Animals ; Anticonvulsants ; Carbamazepine* ; Depression ; Humans ; Male ; Neuromuscular Blockade* ; Phenytoin* ; Phrenic Nerve ; Rats ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Helicobacter pylori is found in more than 90% of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Regression of lymphoma after H. pylori eradication was reported. Therefore, early detection of gastric MALT lymphoma is important. On reported several endoscopic findings, nonspecific gastritis with erosion and ulceration were common and there is no typical endoscopic findings. METHODS: Therefore we analyzed the endoscopic findings of 16 low-grade B-cell gastric MALT lymphoma confirmed by biopsy, PCR and immunostain and compared histologic change after eradicating H. pylori infection in patients who refused operation retrospectively from March 1995 to October 1996. RESULTS: The male: female ratio was 7:9 and mean age was 43,7 years ald (23-71 yr), On endoscopic findings of gastric MALT lymphoma, irregular shaped geographic superficial ulcer was 7 cases (43.7%), diffuse mucosal nodularity was 4 cases (25.0%) and erosion was 3 cases (18.7%). The most common site of MALT lymphoma was antrum and angle. H. pylori was positive in 87.5% (14/16 cases) and eradication of H. pylori was done in patients who refused operation and histologic improvement after H. pylori eradication was found in 62.5% (5/8 cases). CONCLUSIONS: The most common endoscopic findings of gastric MALT lymphoma was irregular geographic superficial ulcer but diffuse mucosal nodularity and erosions were also common. Therefore, biopsy must be taken, especially on the antrum and angle although nonspecific lesion may be suspected.
B-Lymphocytes ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Gastric Mucosa* ; Gastritis ; Helicobacter pylori ; Humans ; Intestines* ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Male ; Polymerase Chain Reaction ; Retrospective Studies ; Stomach* ; Ulcer