BACKGROUND: It is well established that vascular contraction is caused by not only an increase in cytosolic Ca2+ level but also activations of Ca2+-sensitizing mechanisms including protein kinase C (PKC) and low molecular GTP binding protein. However, the roles of PKC and RhoA, a low molecular GTP-binding protein, on the receptor agonist-mediated contraction in swine pulmonary artery has not been clarified. In the present study, we examined the contribution of PKC isoform and RhoA to the arterial stimulants-induced contraction in swine pulmonary artery. METHOD: The large (> 5 mm), medium (1-3 mm) and small (< 1 mm in outer diameter) sized pulmonary arteries were excised and the contractions were recorded isometrically. The contents and subcellular distribution of PKC isoforms and RhoA were detected using immunoblotting. RESULTS: In medium pulmonary artery, norepinephrine (NE, 10 nM-30micrometer) led contraction in a dose-dependent manner. In large and small pulmonary arteries, however, NE failed to induce a contraction. Adding of 12-deoxyphorbol 13-isobutyrate (DPB, 1micrometer), a PKC activator, developed muscle force in 1 mM EGTA-contained Ca2+-free physiological salt solution. The expressions of PKC alpha, elsilon were significantly increased in medium pulmonary artery. NE (10micrometer) evoked the translocation of RhoA from cytosol to the membrane but not those of PKC isoforms. In Ca2+-free physiological salt solution, DPB (1micrometer) caused a translocation of PKC isoforms. CONCLUSIONS: These results support that NE induces contraction via RhoA pathway but not PKC pathway in swine pulmonary artery.
Cytosol ; GTP Phosphohydrolases* ; GTP-Binding Proteins ; Immunoblotting ; Membranes ; Norepinephrine ; Protein Isoforms ; Protein Kinase C* ; Protein Kinases* ; Pulmonary Artery* ; Swine*

BACKGROUND: We studied the interaction between Succinylcholine (SCh) and mivacurium when mivacurium was administered during early and late recovery from SCh block was investigated. METHODS: Eighty patients undergoing elective surgery under general anesthesia were studied. General anesthesia was induced and maintained with propofol under TCI control. Neuromuscular function was measured in response to TOF stimulation of the ulnar nerve using an electromyographic method. The patients were allocated randomly to the following four groups; group 1 (n = 20): a bolus intravenous injection of 0.08 mg/kg mivacurium; group 2 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 2 minutes of 1 mg/kg SCh injection; group 3 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 25% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh; group 4 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 75% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh. The onset and duration of neuromuscular blockade, recovery rate and TOF ratio at T75% were measured. RESULTS: The onset of block in groups 3 and 4 were slower than in group 1 (5.2 +/- 0.7 and 2.3 +/- 0.6 vs 2.5 +/- 0.4 min P < 0.05). The clinical duration in groups 2 and 3 were longer than in groups 1 and 4 (12.5 +/- 2.1 min and 11.3 +/- 1.7 min vs 17.0 +/- 3.0 min and 18.5 +/- 2.6 min, p < 0.05). There was no difference in recovery index all groups. The TOF ratio of groups 2, 3 and 4 were smaller than for group 1 (38.2 +/- 5.3, 32.3 +/- 5.6 and 31.5 +/- 4.2 vs 56.0 +/- 7.3, P < 0.05). CONCLUSIONS: The Previous 1 mg/kg SCh injection was affected the time course of action of mivacurium 0.08 mg/kg-induced neuromuscular block.
Anesthesia, General ; Depression ; Humans ; Injections, Intravenous ; Neuromuscular Blockade* ; Propofol ; Succinylcholine* ; Ulnar Nerve

Serum Ta and T were measured in 34 patients scheduled elective surgery with general anesthesia, who were divided into two groups (enflurane group' 12, propofol group' 22). No clinical signs of thyroid disturbances could be observed preoperatively in the patients. Anesthesia was induced with thiopental 5 mg/kg in enflurane group; propofol 2 mg/kg in propofol group, and maintained with Oz 2 L/min, NH 2 L/min, enflurane (1.0-2.596) in enflurane group,' 2 L/ min, N 4 L/min and continuous controlled infusion of pmpofol (50-150 mcg/kg/min) in propofol group. Blood samples were collected 5 minutes after arrival in operating room, 1 minute after induction, 5 minutes after intubation, 1 minute after skin incision, during operation and 10 minutes after extubation. Blood samples were centrifused and serum was taken from each sample. Determinations of Ta and T4 were performed using enhanced chemiluminescence immunoassay (ELIA). Comparisons of our results were made using repeated measuves analysis of variance, paired students t-test and statistically significant when p value was less than 0.05. The results are summarized as follows' 1) In enflurane group, serum Ta levels showed a decreasing tendency after extubation compared to baseline. Decreasing serum T4 after administration of thiopental could be considered statistically significant and serum T levels showed a decreasing tendency after extubation compared to baseline. 2) In propofol gnup, serum Tz levels showed a decreasing tendency after extubation compared to baseline. Rises in serum Te after incision and extubation could be considered statistically significant. Based on these results, no direct negative influence of propofol need be expected on Tg metabolism in euthyroid patients. However, the changes in these hormones, although with in the physiological range here, indicate that propofol may adversely influence their levels in the presence of manifested thyroid disease.
Anesthesia ; Anesthesia, General* ; Enflurane* ; Humans ; Immunoassay ; Intubation ; Luminescence ; Metabolism ; Operating Rooms ; Propofol* ; Skin ; Thiopental ; Thyroid Diseases ; Thyroid Gland ; Thyroxine ; Triiodothyronine

The usefulness of nondepolarizing muscle relaxants for intubation is limited by a relatively slow onset of neuromuscular block compared to that achived with succinylcholine. But, authors have reported that larger doses of nondepolarizing muscle relaxants produce a more rapid onset of maximal neuromuscular block and conditions conductive to endotracheal intubation and recent reports support the use of the "priming principle in the clinical practice of anesthesiology. This phenomenon may apply to all nondepolarizing relaxants: it is reported to facilitated neuromuscular blockade and tracheal intubation when used with atracurium, vecurouium, alcuronium or pancuronium. In this study, administering a small subclinical dose of atracurium (75ug/kg) Smin. prior to the remainder of an intubating doae of atracurium (250ug/kg) had no different on grade of block for intubation compared to single IV bolus of atracurium (500ug/kg).
Alcuronium ; Anesthesiology ; Atracurium* ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Pancuronium ; Succinylcholine

The usefulness of nondepolarizing muscle relaxants for intubation is limited by a relatively slow onset of neuromuscular block compared to that achived with succinylcholine. But, authors have reported that larger doses of nondepolarizing muscle relaxants produce a more rapid onset of maximal neuromuscular block and conditions conductive to endotracheal intubation and recent reports support the use of the "priming principle in the clinical practice of anesthesiology. This phenomenon may apply to all nondepolarizing relaxants: it is reported to facilitated neuromuscular blockade and tracheal intubation when used with atracurium, vecurouium, alcuronium or pancuronium. In this study, administering a small subclinical dose of atracurium (75ug/kg) Smin. prior to the remainder of an intubating doae of atracurium (250ug/kg) had no different on grade of block for intubation compared to single IV bolus of atracurium (500ug/kg).
Alcuronium ; Anesthesiology ; Atracurium* ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Pancuronium ; Succinylcholine

This article reports the case of a woman who developed a pure motor paraplegia following epidural analgesia. 80mg of Depomedrol and 2ml of 1% lidocaine were injected epidurally for relief of back pain. Within one day the patient complained of severe pain in both lower extremities and the left lower extremity rapidly became paraplegic. Myelography showed no obstruction and compression. The paraplegia was permanent in the left lower extermity. We note a number of potential etiologies and analyze their possible mechanism of action.
Analgesia, Epidural* ; Back Pain ; Female ; Humans ; Lidocaine ; Lower Extremity ; Myelography ; Paraplegia*

Pain relief becomes a major concern when treating patients with rib fractures so adequate ventilation must be maintained. Many techniques have been described for the management of frectured ribs, including systemic analgesics, intercostal nerve blockade, intrathecal morphine, epidural bupivacaine and epidural morphine. This case report illustrates the successful use of epidural narcotics in a patient with multiple fractured ribs.
Analgesics ; Bupivacaine ; Humans ; Intercostal Nerves ; Morphine ; Narcotics* ; Rib Fractures ; Ribs* ; Ventilation

The popular term malignant hyperthermia syndrome (MHS) refers to a clinical syndrome classically observed during general anesthesia. It is characterized by a rapidly increasing .temperature and a high mortality rate. A case of MHS was experienced which developed 60 minutes after induction of general anesthesia with thiopental sodium, succinylcholine, halothane, N2O and 02. High fever, muscle rigidity and cyanosis developed and were followed by arrythmia and unstable blood pressure. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient died about 6 hours after induction of anesthesia.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Cyanosis ; Emergency Treatment ; Fever ; Halothane ; Humans ; Malignant Hyperthermia* ; Mortality ; Muscle Rigidity ; Succinylcholine ; Thiopental

Patients with advanced pulmonary tuberculosis suffer from chronic obstrutive pulmonary disease, making them poor risks for anesthesia. Also, general anesthesia for patients with active hepatitis or arteriosclerotic cardiovascular disease complicates the intraoperative and postoperative course. Inhalation anesthetics, along with the assissted ventilation used in general anesthesia, further complicate the intraoperative and postoperative course. Although regional anesthetic techiques have been used extensively for pelvic and limbic surgery to avoid the complications of general anesthesia, thoracic epidural anesthesia has not been common for upper abdominal surgery because of the fear of damage to the spinal cord. But compared with the lumbar.approach, the danger of accidental damage to the spinal cord has been exaggerated. Thoracic epidural anesthesia has been employed in a number of cases of upper abdominal surgery at Y.U.W.M.C wish remarkable success. We have in describe the use of thoracic epidural anesthesia for upper abdominal surgery.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Anesthetics, Inhalation ; Cardiovascular Diseases ; Hepatitis ; Humans ; Lung Diseases ; Spinal Cord ; Tuberculosis, Pulmonary ; Ventilation

Patients with advanced pulmonary tuberculosis suffer from chronic obstrutive pulmonary disease, making them poor risks for anesthesia. Also, general anesthesia for patients with active hepatitis or arteriosclerotic cardiovascular disease complicates the intraoperative and postoperative course. Inhalation anesthetics, along with the assissted ventilation used in general anesthesia, further complicate the intraoperative and postoperative course. Although regional anesthetic techiques have been used extensively for pelvic and limbic surgery to avoid the complications of general anesthesia, thoracic epidural anesthesia has not been common for upper abdominal surgery because of the fear of damage to the spinal cord. But compared with the lumbar.approach, the danger of accidental damage to the spinal cord has been exaggerated. Thoracic epidural anesthesia has been employed in a number of cases of upper abdominal surgery at Y.U.W.M.C wish remarkable success. We have in describe the use of thoracic epidural anesthesia for upper abdominal surgery.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Anesthetics, Inhalation ; Cardiovascular Diseases ; Hepatitis ; Humans ; Lung Diseases ; Spinal Cord ; Tuberculosis, Pulmonary ; Ventilation