Purpose: The effects of dexmedetomidine on locomotor function and thermal hyperalgesia in sciatic nerve crush injury (SNCI) were investigated using rats. Methods: After exposing the right sciatic nerve, the sciatic nerve was crushed for 1 minute by a surgical clip. One day after nerve injury, dexmedetomidine (5, 25, and 50 µg/kg) was directly applied to the injured sciatic nerve once a day for 14 days. Walking track analysis was used to assess locomotor function and plantar test was conducted to assess thermal pain sensitivity. Immunohistochemistry was performed to determine the expression of c-Fos in the ventrolateral periaqueductal gray (vlPAG) and paraventricular nucleus (PVN). Western blot was used to evaluate the expression level of nerve growth factor (NGF) and myelin basic protein (MBP) in the sciatic nerve. Results: SNCI resulted in deterioration of locomotor function and increased thermal pain sensitivity. The level of c-Fos expression in the PVN and vlPAG was increased and the level of NGF and MBP expression in the sciatic nerve was enhanced by SNCI. Dexmedetomidine treatment improved locomotor function and upregulated expression of NGF and MBP in the sciatic nerve of SNCI. Dexmedetomidine treatment alleviated thermal hyperalgesia and downregulated expression of c-Fos in the vlPAG and PVN after SNCI. Conclusions Dexmedetomidine may be used as a potential new treatment drug for recovery of locomotion and control of pain in peripheral nerve injury.

OBJECTIVES: This study investigated the effects of chronic medical diseases on depressive symptoms in individuals at high risk for depression living in rural areas, over a 1-year period.METHODS: A community-based longitudinal study was conducted; 67 participants aged 18–79 years residing in rural areas were included. In the first survey, all participants completed a self-report questionnaire battery. An interview was also conducted to obtain data on demographic variables and current or past chronic medical diseases. In the first survey, participants with the Center for Epidemiologic Studies Depression scale(CES-D) scores of 16 or higher were categorized as being at high risk for depression; the same assessments were carried out 1 year later in a follow-up survey. Multiple regression analysis was performed to determine the association of chronic medical diseases with 1-year follow-up depressive symptoms in the high-risk group.RESULTS: In model 1, which controlled for sociodemographic variables, the number of chronic medical diseases (p =0.026), baseline severity of depressive symptoms(p =0.002), and presence of diabetes(p =0.039) were significantly associated with the follow-up CES-D scores. In model 2, which further adjusted for Alcohol Use Disorder Identification Test and Beck Anxiety Inventory scores, the number of chronic medical diseases(p =0.036), baseline severity of depressive symptoms(p =0.017), and prevalence of diabetes(p =0.037) were also significantly associated with the follow-up CES-D scores.CONCLUSION: This study suggests that the number of chronic medical diseases, prevalence of diabetes, and severity of depressive symptoms are significantly associated with 1-year follow-up depressive symptoms in individuals at high risk for depression.
Anxiety ; Depression ; Diabetes Mellitus ; Epidemiologic Studies ; Follow-Up Studies ; Longitudinal Studies ; Prevalence ; Rural Population

Penetrating neck injuries can be a fatal event and they are difficult to manage for both surgeons and anesthesiologists. So, adequate preoperative evaluation is important to improve the patients' outcomes, but this can not be done for hemodynamically unstable or uncooperative patient. Here we present our clinical experience with a patient with a penetrating neck injury and who was hemodynamically stable, but she was uncooperative and the knife was still embedded in her neck. The surgical exploration and bronchoscopic examination were successfully done under monitored anesthesia care.
Anesthesia ; Humans ; Neck ; Neck Injuries

Rett syndrome is a neurological disease that occurs only in females and it manifests with mental retardation, seizures, movement disorders, autistic behavior and abnormal breathing. A 19-year-old female with Rett syndrome underwent ophthalmologic surgery under general anesthesia at our institution. Airway control was difficult due to her limited mouth opening. We recommend that anesthesiologists should have proper knowledge about this disease and the patients to avoid the complications and problems that can be encountered during the perioperative period.
Adult ; Airway Management ; Anesthesia, General ; Female ; Humans ; Intellectual Disability ; Mouth ; Movement Disorders ; Perioperative Period ; Respiration ; Rett Syndrome ; Seizures ; Young Adult

This study examined the prevalence of oral microbes in the saliva of oncological patients and healthy subjects. PCR was used to assess the frequency of oral microbes including 3 cariogenic bacteria, 5 periodontopathic bacteria and 4 Candida species in the saliva of 104 oncological patients and 52 healthy subjects. Among these microorganims, Streptococcus mutans, Fusobacterium nucleatum and Candida albicans were most frequently detected in both groups. There were no significant differences in the prevalence of cariogenic bacteria between the patient and healthy groups, whereas significant differences in the frequency of Porphyromonas gingivalis and Tannerella forsythia were observed between the two groups (p < 0.05). The prevalence of all five periodontopathogens was higher in the healthy group than in the patient group. The prevalence of C. albicans in patients was significantly higher than that of healthy group (p < 0.05). In conclusion, there were significant differences in the prevalence of P. gingivalis, T. forsythia and C. albicans between the oncological patient group and healthy group.
Bacteria ; Candida ; Candida albicans ; Forsythia ; Fusobacterium nucleatum ; Humans ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Prevalence ; Saliva ; Streptococcus mutans

There has been an increase in the use of central venous catheters for temporary hemodialysis. Infected thrombus of right atrium is a rare but life-threatening complication of the central venous catheterization. A 35-year-old female hemodialysis patient was admitted with fever and dyspnea. She had been inserted tunneled hemodialysis catheter 2 months before. Blood cultures revealed methicillin- resistant Staphylococcus aureus. Chest CT showed multi-focal pneumonia and 4 cm sized huge thrombus in the right atrium. Echocardiography demonstrated same thrombus attached to the catheter tip in the right atrium. The catheter could not be removed because of high risk of pulmonary thromboembolism. Despite intravenous vancomycin treatment, the patient died from esophageal varix bleeding.
Adult ; Catheter-Related Infections ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Dyspnea ; Echocardiography ; Esophageal and Gastric Varices ; Female ; Fever ; Heart Atria ; Hemorrhage ; Humans ; Pneumonia ; Pulmonary Embolism ; Renal Dialysis ; Staphylococcus aureus ; Thorax ; Thrombosis ; Vancomycin

PURPOSE: Although acute renal failure (ARF) commonly develops in patients with severe acute pancreatitis (SAP), the impact of ARF on disease severity is rarely reported in Korea. This study was performed to compare the clinical findings, morbidity and mortality between SAP patients with and without ARF. METHODS: We retrospectively evaluated the medical records of 102 patients with SAP between january 2001 and June 2008 in 3 hospitals. We investigated the incidence and clinical course of ARF in SAP patients. Then, we compared morbidity and mortality between the patients with ARF and normal renal function (NRF). RESULTS: Of the total 102 SAP patients, ARF was observed in 39 patients (38.2%). The peak serum creatinine level in ARF patients was 4.5+/-2.3 mg/dL. Eight of the 39 ARF patients (20.5%) received hemodialysis and ten patients (25.6%) died. When compared to NRF patiens, ARF patients (n=39) had higher incidence of dyspnea (17.9% vs 3.2%, p=0.011), loss of consciousness (17.9% vs 1.6%, p=0.003), and APACHE II scores more than 8 (92.3% vs 0%, p<0.001). The ARF group had also higher incidences of sepsis (35.9% vs 7.9%, p<0.001), multiorgan failure (15.4% vs 0%, p=0.001), respiratory failure (28.2% vs 4.7%, p=0.001) and mortality (25.6% vs 3.2%, p=0.001). Multivariate analysis demonstrated thrombocytopenia, hemoconcentration, and high LDH as independent risk factors of ARF in SAP patients. CONCLUSION: The incidence of ARF was high (38.2%) and ARF patients showed higher morbidity and mortality, compared to NRF patients. We suggest that early management of ARF should be performed for reducing the mortality in SAP patients.
Acute Kidney Injury ; APACHE ; Creatinine ; Dyspnea ; Humans ; Incidence ; Korea ; Medical Records ; Multivariate Analysis ; Pancreatitis ; Renal Dialysis ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors ; Sepsis ; Thrombocytopenia ; Unconsciousness

The Montgomery T-tube is a device that supports the trachea and facilitates ventilation after laryngotracheal surgery. Because its use is sporadic, many anesthesiologists may not be familiar with this device, and its anesthetic management requires careful planning and discussion with surgeons. We describe the techniques of anesthetic management of exchanging endotracheal tube to Montgomery T-tube in case where upper tracheal stenosis exists.
Constriction, Pathologic ; Trachea ; Tracheal Stenosis ; Ventilation

Pseudomeningocele is rare complication after lumbar discectomy. Most pseudomeningoceles are asymptomatic, but sometimes can cause headaches, infection, back pain, and radicular pain. Treatment modalities include conservative management, epidural blood patch, lumbar subarachnoid drainage, and surgery. We report a successful treatment of pseudomeningocele with epidural blood and fibrin glue patch, which did not treated with conservative management and epidural blood patch alone.
Back Pain ; Blood Patch, Epidural ; Diskectomy ; Drainage ; Fibrin ; Fibrin Tissue Adhesive ; Headache

Chios gum mastic (CGM) is obtained from the stem and leaves of Pistacia lentiscus trees and has been extensively used for centuries in Mediterranean and Middle Eastern countries, both as a dietary supplement and herbal remedy. This study was undertaken to examine in vitro effects of cytotoxicity and growth inhibition, and the molecular mechanism underlying modulation of cell cycle and induction of apoptosis in YD9 human oral squamous carcinoma cell line treated with CGM. The viability of YD9 cells and human normal keratinocyes (HaCaT cells), and the growth inhibition of YD9 cells were assessed by the MTT assay and clonogenic assay respectively. The hoechst staining and DNA electrophoresis were conducted to observe the YD9 cells undergoing apoptosis. YD9 cells were treated with CGM, and Western blotting, immunocytochemistry, confocal microscopy and FACScan flow cytometry were conducted. Mitochondrial membrane potential change and proteasome activity were measured. CGM treatment on YD9 cells resulted in a does-dependent inhibition of cell growth and induced apoptotic cell death. And tested YD9 cells showed several lines of apoptotic manifestation. Flow cytometric analysis revealed that CGM resulted in G1 arrest in cell cycle progression which was associated with decrease in the protein expression of cyclin D1, cyclin D3, Cdk2 and Cdk4, and increase in the protein expression of p21(WAF1/CIP1) and p53. These results demonstrate that CGM induces G1 the cell cycle arrest via the modulation of cell cycle-related proteins, and apoptosis via mitochondria and caspase pathway in YD9 cells, suggesting that CGM can be considered as a novel therapeutic strategy for human oral squamous cell carcinoma from its strong cell cycle arrest and apoptosis-inducing activity.
Apoptosis ; Blotting, Western ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Death ; Cell Line ; Cyclin D1 ; Cyclin D3 ; Dietary Supplements ; DNA ; Electrophoresis ; Flow Cytometry ; Gingiva ; Humans ; Immunohistochemistry ; Membrane Potential, Mitochondrial ; Microscopy, Confocal ; Mitochondria ; Pistacia ; Proteasome Endopeptidase Complex ; Proteins ; Resins, Plant ; Trees