RESUMEN

We present a mode locking (ML) phenomenon of vortex matter observed around the peak effect regime of 2H-NbSe2 pure single crystals. The ML features allow us not only to trace how the shear rigidity of driven vortices persists on approaching the second critical field, but also to demonstrate a dynamic melting transition of driven vortices at a given velocity. We observe the velocity dependent melting signatures in the peak effect regime, which reveal a crossover between the disorder-induced transition at small velocity and the thermally induced transition at large velocity. This uncovers the relationship between the peak effect and the thermal melting.

RESUMEN

BACKGROUND: Nociceptin/orphanin FQ (N/OFQ) is the endogenous agonist of the orphan opioid receptor-like receptor (NOP receptor, previously termed ORL1), a novel member of the opioid receptor family. The aim of the present study, using in vitro newborn rat preparations, was to elucidate the roles N/OFQ and the NOP receptor play in medullary generation of respiratory rhythm. METHODS: The brainstem-spinal cord from 3-day-old Wistar rats was isolated and perfused with artificial cerebrospinal fluid (27.5 degrees C) equilibrated with oxygen 95% and carbon dioxide 5% at pH 7.4. Respiratory activity was recorded from the C4/C5 ventral roots. The effects of N/OFQ (10 nM, 30 nM, 100 nM) on respiratory frequency (fR) (bursts min(-1)) was measured. Drugs were administered through the recording chamber by means of a perfusion system. In addition, the effects of pretreatment with the classical non-selective opioid receptor antagonist naloxone 1 microM, and the selective NOP antagonist CompB 10 microM, were evaluated. Statistical significance was evaluated using ANOVA followed by Dunnett's test (P<0.05). RESULTS: N/OFQ reduced fR in a concentration-dependent manner. Pretreatment with CompB 10 microM prevented the N/OFQ 10 nM-induced fR reduction, whereas CompB itself was inactive. Pretreatment with naloxone did not prevent the N/OFQ-induced fR reduction. CONCLUSION: N/OFQ acts as a neuromodulator to reduce fR in the respiratory rhythm- generating centre of the medulla oblongata, and this action of N/OFQ is mediated by NOP receptors.

Asunto(s)

Bulbo Raquídeo/efectos de los fármacos , Péptidos Opioides/farmacología , Receptores Opioides/fisiología , Mecánica Respiratoria/efectos de los fármacos , Animales , Animales Recién Nacidos , Técnicas de Cultivo , Relación Dosis-Respuesta a Droga , Bulbo Raquídeo/fisiología , Péptidos Opioides/fisiología , Ratas , Ratas Wistar , Mecánica Respiratoria/fisiología , Receptor de Nociceptina , Nociceptina

RESUMEN

Transforming growth factor-beta(TGF-beta) is known to play an important role in controlling embryonal development, cell proliferation and homeostasis. The purpose of this study is to elucidate the involvement of the TGF-beta pathway in colorectal carcinogenesis. DNA was extracted from 100 patients with colorectal cancer. Then, all coding regions of the TGF-beta type II receptor (TRII) and the genes for Smad2, Smad3, Smad4, Smad6, and Smad7 were analyzed by PCR-SSCP and direct sequencing. Also, a LOH analysis of 18q21, where the Smad2 and Smad4 genes are located, was performed. We detected 11 cases of frameshift mutation in the TRII gene (11%) and 5 cases of point mutations in the Smad4 gene (5.0%); LOH at 18q21 was detected with 33% frequency. No abnormalities were found in the genes for Smad2, Smad3, Smad6, and Smad7. These results suggest that the abnormalities of TRII and Smad4 play an important role inhibiting TGF-beta signaling in colorectal carcinogenesis.

Asunto(s)

Neoplasias Colorrectales/genética , Análisis Mutacional de ADN , Proteínas de Unión al ADN/genética , Receptores de Factores de Crecimiento Transformadores beta/genética , Transactivadores/genética , Secuencia de Bases , Cromosomas Humanos Par 18 , Mutación del Sistema de Lectura , Humanos , Pérdida de Heterocigocidad , Datos de Secuencia Molecular , Mutación , Mutación Puntual , Polimorfismo Genético , Polimorfismo Conformacional Retorcido-Simple , Proteínas Serina-Treonina Quinasas , Receptor Tipo II de Factor de Crecimiento Transformador beta , Análisis de Secuencia de ADN , Transducción de Señal , Proteína Smad2 , Proteína smad3 , Proteína Smad4 , Proteína smad6 , Proteína smad7

RESUMEN

PURPOSE: In order to examine the efficacy of tracheal lidocaine (TL) for attenuation of the cardiovascular responses to endotracheal intubation (EI), we compared the cardiovascular responses to TL alone and EI with TL, with those to EI without TL. METHODS: Seventy-five patients (ASA I-II) were studied. Anesthesia was induced with fentanyl 2 microg x kg(-1) iv, thiamylal 5 mg x kg(-1) iv and sevoflurane 1.0% in oxygen. Vecuronium 0.12 mg x kg(-1) was used to facilitate EI. In Group A (n=25), three minutes after induction, EI was performed. In Group B (n=25), three minutes after induction, the patients received TL (4% lidocaine, 4 mL). This was followed by immediate EI. In Group C (n=25), EI was performed two minutes after TL. Heart rate, arterial blood pressure and rate- pressure product (RPP) were measured from one minute before induction until five minutes after EI. RESULTS: The changes of RPP caused by TL alone in Group C (TL; +34.6 +/- 29.0%, mean +/- SD) were significantly (P <0.01) less than those caused by EI without TL in Group A (+77.3 +/- 42.6%). EI after TL in Group C did not cause significant changes in RPP (+5.4 +/- 15.2%). There were no significant differences between Groups A and B (+58.3 +/- 36.6%). CONCLUSION: We conclude that the cardiovascular responses to TL alone are half as great as those to EI without TL, and that TL is effective for attenuation of the cardiovascular responses to EI. EI should be performed more than two minutes after TL.

Asunto(s)

Anestésicos Locales/farmacología , Hemodinámica/efectos de los fármacos , Intubación Intratraqueal , Lidocaína/farmacología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

STUDY OBJECTIVES: To determine whether the duration of action of vecuronium is influenced by chronic renal failure. DESIGN: Prospective clinical comparison. SETTING: Operating room, Hokkaido University Hospital. PATIENTS: 7 adult ASA physical status II and III patients with impaired renal function undergoing living-related renal transplantation (Group A), 5 adult ASA physical status II and III patients with impaired renal function undergoing elective surgery other than renal transplantation (Group B), and 13 adult ASA physical status I and II patients with normal hepatorenal function undergoing elective surgery (Group C). INTERVENTIONS: Anesthesia was induced with thiamylal 5 mg x kg(-1) and fentanyl 100 microg IV and maintained with 60% nitrous oxide and 1% isoflurane. An initial dose of vecuronium was administered and patients' tracheas were intubated. MEASUREMENTS: Neuromuscular function was monitored by acceleration of thumb adduction with train-of-four stimulation. Vecuronium 60 microg x kg(-1) was administered as the initial dose via a central catheter, and if the first twitch was more than 3% of the control, another dose of vecuronium 20 microg x kg(-1) was given as necessary. Both onset time and duration of action until 25% recovery were measured. Plasma vecuronium and its metabolite, 3-desacetyl-vecuronium, levels were measured at onset and at 25% recovery in Groups A and C. MAIN RESULTS: The total dose of vecuronium and initial concentration of vecuronium showed no significant difference between Group A and Group C. Duration of action was significantly prolonged in Group A and Group B compared with Group C. CONCLUSIONS: Duration of action of vecuronium is prolonged in patients with end-stage renal failure mainly due to higher sensitivity to vecuronium.

Asunto(s)

Anestesia , Fallo Renal Crónico/complicaciones , Fármacos Neuromusculares no Despolarizantes , Bromuro de Vecuronio , Adulto , Biotransformación , Femenino , Humanos , Pruebas de Función Renal , Trasplante de Riñón , Masculino , Monitoreo Intraoperatorio , Fármacos Neuromusculares no Despolarizantes/farmacocinética , Estimulación Física , Estudios Prospectivos , Nervio Cubital/fisiología , Bromuro de Vecuronio/farmacocinética

RESUMEN

On 7 patients with Pierre-Robin syndrome (PR), 8 patients with first and second brachial arch syndrome (BA) and 7 patients with Treacher Collins syndrome (TC), we examined retrospectively the number of patients whom anesthesiologists found difficult to perform laryngoscopy and intubation, the number of attempt necessary for proper insertion of the tracheal tube, the number of patients in whom the endotracheal intubation with laryngoscopy was given up and the time necessary for endotracheal intubation. We compared these with those from 22 control patients. Our results suggest that the difficult laryngoscopy and intubation are more frequent in TC. On the other hand, most of PR and BA may not present difficulty in intubation.

Asunto(s)

Intubación Intratraqueal , Mandíbula/anomalías , Disostosis Mandibulofacial/complicaciones , Síndrome de Pierre Robin/complicaciones , Niño , Femenino , Humanos , Intubación Intratraqueal/métodos , Laringoscopía , Masculino , Estudios Retrospectivos

RESUMEN

PURPOSE: Age-based formulae have been widely used to predict the appropriate size of the endotracheal tube (ETT) in children. These formulae are based on old data from Western countries. The current study was undertaken to assess the effectiveness of these formulae in Japanese children. METHODS: We reviewed data for the past 5 years from children (0-8 years of age) intubated orally with the regular uncuffed ETT or RAE type. The data included the child's age in years and months and the internal diameter (ID) of the ETT. RESULTS: Data from 1301 children were reviewed. The IDs of the most frequently used ETT were 3.0 mm for patients less than 1 month old, 3.5 mm for those 1 to 4 months old, 4.0 mm for those 5 to 17 months old, and 4.5 mm for those 18 to 23 months old. In children 2 to 8 years old, the ID of the most frequently used ETT was in accordance with the ID predicted by the formula ID (mm) = [age in years + 16]/4. However, the ID predicted by this formula applied to only 53.5% of our patients. CONCLUSION: The age-based formula, ID (mm) = [age in years + 16]/4, is applicable to Japanese children. However, we recommend that three sizes be available before endotracheal intubation.

RESUMEN

Effects of different neuroactive substances on morphine-induced respiratory depression were studied in medullary respiration-related structures using in vitro brainstem-spinal cord preparation from 1 to 4-day-old rats. Application of morphine (10 microM) reduced respiratory rhythm (fR) as measured by C4 ventral root activity. The depressant effects of morphine were reversed by acetylcholine (10 microM), substance P (50 nM), thyrotropin releasing hormone (TRH) (100 nM) and forskolin (10 microM). The adenosine receptor antagonist, theophylline (100 microM), the dopamine receptors antagonist, haloperidol (10 microM), the cyclooxygenase inhibitor, indomethacin (10 microM) and the phospholipase A(2) inhibitor, quinacrine (10 microM) had no effect on morphine-induced respiratory depression.

Asunto(s)

Interacciones Farmacológicas/fisiología , Vías Eferentes/efectos de los fármacos , Morfina/efectos adversos , Neuronas/efectos de los fármacos , Neurotransmisores/farmacología , Centro Respiratorio/efectos de los fármacos , Insuficiencia Respiratoria/inducido químicamente , Médula Espinal/efectos de los fármacos , Acetilcolina/farmacología , Animales , Animales Recién Nacidos , Colforsina/farmacología , Vías Eferentes/citología , Vías Eferentes/metabolismo , Haloperidol/farmacología , Indometacina/farmacología , Neuronas/metabolismo , Quinacrina/farmacología , Ratas , Ratas Sprague-Dawley , Centro Respiratorio/citología , Centro Respiratorio/metabolismo , Insuficiencia Respiratoria/patología , Insuficiencia Respiratoria/fisiopatología , Médula Espinal/citología , Médula Espinal/metabolismo , Sustancia P/farmacología , Hormona Liberadora de Tirotropina/farmacología

RESUMEN

Influences of post-natal age (P0-P4) and temperature (22.5 degrees-31.5 degrees C) on the action(s) of opioids on respiratory activities from neonatal rat brainstem-spinal cord preparations were examined in this study. A temperature-dependent mu-opioid receptor effect on respiration was found. In addition, the effect of morphine increased with postnatal age (P0-P4). Hence, age and temperature must be taken into account when performing studies on medullary respiration-related structures using the neonatal rat brainstem-spinal cord preparation.

Asunto(s)

Analgésicos Opioides/farmacología , Bulbo Raquídeo/efectos de los fármacos , Bulbo Raquídeo/fisiología , Morfina/farmacología , Respiración/fisiología , 3,4-Dicloro-N-metil-N-(2-(1-pirrolidinil)-ciclohexil)-bencenacetamida, (trans)-Isómero/farmacología , Factores de Edad , Analgésicos/farmacología , Analgésicos no Narcóticos/farmacología , Animales , Animales Recién Nacidos , Relación Dosis-Respuesta a Droga , Encefalina Ala(2)-MeFe(4)-Gli(5) , Encefalina D-Penicilamina (2,5) , Encefalinas/farmacología , Técnicas In Vitro , Ratas , Ratas Sprague-Dawley , Médula Espinal/fisiología , Temperatura

RESUMEN

We investigated the possible correlation between the microsatellite alterations (replication error: RER, and loss of heterozygosity: LOH) and clinicopathologic factors and survival in colorectal cancer. A total of 78 colorectal cancers was examined for microsatellite alteration at three microsatellite loci containing D2S123, D18S58 and C117-703. RER is considered positive when at least one microsatellite locus is detected. RER was positive in 28.2%, and the respective positivity was 12.8%, 15.3% and 11.5%. The positivity of LOH was 6.4%, 10.3% and 19.2%, in that order. RER-positive cancers were more significantly found in the proximal colon than the distal colorectum. Node-negative colorectal cancers were more noted in RER (+)-positive cancers. Multivariate analysis showed that LOH in D18S58 locus and RER in CI17-703 locus were independent prognostic factors.

Asunto(s)

Neoplasias Colorrectales/genética , Repeticiones de Microsatélite , Anciano , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Femenino , Humanos , Pérdida de Heterocigocidad , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Invasividad Neoplásica , Reacción en Cadena de la Polimerasa , Pronóstico , Tasa de Supervivencia

RESUMEN

A 4-year-old boy was admitted with disturbed consciousness following a convulsion. He developed bilateral pyramidal tract signs and showed a decerebrate posture. Laboratory findings revealed severe liver dysfunction and disseminated intravascular coagulation. On the eighth day eight in hospital he developed parkinsonism. However, 5 months from onset he had recovered almost completely. Brain CT on admission showed low density areas in the basal ganglia, thalamus, midbrain and pons. A T2-weighted scan in magnetic resonance imaging (MRI) showed almost symmetrical high signal intensities in both basal ganglia (including putamen, caudate nucleus, globus pallidus), external capsule, internal capsule thalamus, midbrain, pons and white matter of the peribasal ganglia; but a T1-weighted scan showed low signal intensities in the same regions during all phases. Therefore hemorrhagic lesions or the presence of thalamic methemoglobin were excluded. It was considered that the pathogenesis may be cytotoxic cellular edema due to cytotoxic agents or acute metabolic factors. Clinical presentation, laboratory findings and radiological findings were most suggestive of acute necrotizing encephalopathy. As differential diagnoses, acute disseminated encephalomyelitis and brainstem encephalitis were considered.

Asunto(s)

Encefalopatías/diagnóstico , Imagen por Resonancia Magnética , Enfermedad Aguda , Preescolar , Diagnóstico Diferencial , Coagulación Intravascular Diseminada , Encefalomielitis Aguda Diseminada , Humanos , Masculino

RESUMEN

Opioid-induced respiratory depression is well documented. However, exact sites of action and mechanisms for opioid-induced effects on respiration have not yet been elucidated. The present study was carried out on isolated brainstem-spinal cord preparations from newborn rats in order to explore the opioid activity on brainstem mu-, delta- and kappa-receptors. The brainstem-spinal cord was isolated from 0- to 4-day-old Sprague-Dawley rats. The preparation was perfused with artificial cerebrospinal fluid (28.5 degrees C) equilibrated with 95% O2 and 5% CO2 at a pH of 7.4. Neuronal respiratory activity was recorded from the ventrolateral part of the medulla oblongata and efferent impulses from C4 or C5 ventral roots. Effects of the mu-receptor agonist DAGO, the delta-receptor agonist DPDPE and the kappa-receptor agonist U50,488 on respiratory frequency (fR), inspiratory time (Ti) and peak integrated C4 amplitude (Int[C4]) were measured. In addition, the effect of pre-treatment with the mu1 receptor antagonist naloxanazine (35 mg/kg, subcutaneous injection) was evaluated. DAGO reduced fR and Ti in a concentration-dependent manner and caused a reduction of Int(C4) at high concentrations (10 microM). The mu1 receptor antagonist naloxanazine shifted the fR concentration-response curve for DAGO to the right (P < 0.05). DPDPE had no effect on respiratory activities whereas U50,488, like DAGO, reduced fR and Int(C4) in a concentration-dependent manner. It was concluded that mu-opioid receptors, including the mu1 were involved in fR reduction whereas kappa-opioid receptors were involved in reduction of both fR and respiratory amplitude. Delta-opioid receptors do not seem to participate in respiratory modulation at this age.

Asunto(s)

Tronco Encefálico/efectos de los fármacos , Bulbo Raquídeo/efectos de los fármacos , Narcóticos/farmacología , Receptores Opioides delta/agonistas , Receptores Opioides kappa/agonistas , Receptores Opioides mu/agonistas , Sistema Respiratorio/efectos de los fármacos , 3,4-Dicloro-N-metil-N-(2-(1-pirrolidinil)-ciclohexil)-bencenacetamida, (trans)-Isómero/farmacología , Animales , Animales Recién Nacidos , Encefalina Ala(2)-MeFe(4)-Gli(5) , Encefalina D-Penicilamina (2,5) , Encefalinas/farmacología , Naloxona/farmacología , Antagonistas de Narcóticos/farmacología , Ratas , Ratas Sprague-Dawley

RESUMEN

Little is known about mechanisms for the perception of gibberellin (GA), a phytohormone, by plants. A GA-binding protein (GBP) with receptor-like characteristics was partially purified from azuki bean (Azukia angularis) seedlings. Gibberellins that caused much elongation of azuki epicotyl sections showed strong binding affinity for the GBP, and their biosynthetic precursors and inactive metabolites had weak affinity for it. The apparent Kd value for GA4 was calculated to be 7 x 10(-10) M from Scatchard plots. The molecular weight of the GBP in the native state was estimated to be 25,000 by high-performance liquid chromatography with a gel-permeation column. The GBP may be one of the receptor candidates for GAs.

Asunto(s)

Proteínas Portadoras/química , Proteínas Portadoras/aislamiento & purificación , Giberelinas/metabolismo , Fosfoproteínas/química , Fosfoproteínas/aislamiento & purificación , Proteínas de Plantas/química , Proteínas de Plantas/aislamiento & purificación , Cromatografía en Gel , Fabaceae , Giberelinas/farmacología , Concentración de Iones de Hidrógeno , Cinética , Peso Molecular , Plantas Medicinales , Unión Proteica , Semillas/química

RESUMEN

A 18-year-old woman underwent total colectomy for familial adenomatous polyposis. In order to clarify the significance of K-ras mutations in early colorectal carcinogenesis, K-ras mutations were analyzed in multiple adenomas by PCR-SSCP method. A total of 256 adenomas were found throughout the entire colon and rectum, and the distribution was a sparse type. The correlation between K-ras gene and clinicopathological factors was examined in 90 adenomas. There was no correlation among K-ras mutations and anatomical distribution, or morphological classification, but K-ras mutation was more frequent in severe compared with slight atypia. We investigated the correlation between the size of adenoma in the horizontal and vertical directions and K-ras mutation. K-ras mutation was more frequent in the horizontal size greater than 6 mm in diameter, and also more frequent in vertical size greater than 20 mm in height. It was concluded that the adenomas detecting K-ras mutations might have proliferating potential, and would be applied to determine polypectomy.

Asunto(s)

Adenoma/genética , Poliposis Adenomatosa del Colon/genética , Genes ras/genética , Mutación , Adenoma/patología , Poliposis Adenomatosa del Colon/patología , Pólipos del Colon/genética , Femenino , Genes APC , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Polimorfismo Conformacional Retorcido-Simple

RESUMEN

We compared the duration of vecuronium action in five patients after the kidney transplantation with that during kidney transplantation. After the transplantation, three patients required no hemodialysis therapy but two patients underwent hemodialysis therapy again. In all these five patients, including patients who were back to hemodialysis therapy, the durations of vecuronium action after receiving transplanted kidney were shorter than those during kidney transplantation. These shortened durations are speculated to be mainly due to excretion of vecuronium by the transplanted kidney and the effect of long term steroid therapy. However in this study the durations of vecuronium action in patients who required further hemodialysis therapy were also shorter than those during kidney transplantation. To determine whether this is a common or exceptional phenomenon, further evaluation should be needed.

Asunto(s)

Trasplante de Riñón , Bromuro de Vecuronio/farmacocinética , Adulto , Humanos , Periodo Intraoperatorio , Riñón/metabolismo , Masculino , Periodo Posoperatorio , Diálisis Renal , Factores de Tiempo , Bromuro de Vecuronio/farmacología

RESUMEN

The authors studied the duration of action of vecuronium in 15 patients with normal renal function and 40 patients with chronic renal failure to evaluate the effect of secondary hyperparathyroidism on the action of vecuronium. The patients were divided into four groups: 15 patients with normal renal function (Group A); nine patients with chronic renal failure who did not need haemodialysis (Group B); 15 anephric patients who did not require parathyroidectomy (Group C); and 16 anephric patients who underwent parathyroidectomy because of severe secondary hyperparathyroidism (Group D). The ratio of the height of the first twitch (T1) to the baseline value before vecuronium administration was measured by an electromyogram. Baseline T1 was obtained after anaesthesia induction with thiamylal iv. The time to 10% recovery of the first twitch (REC 10) after administration of vecuronium 0.12 mg.kg-1 iv was measured in each group. Anaesthesia was maintained with isoflurane and nitrous oxide in oxygen, and supplemented with fentanyl iv. Patients in Group D showed shorter REC 10 (51 +/- 4 min) than those in Groups B (71 +/- 6 min) and C (80 +/- 10 min) (P < 0.05), but similar REC 10 to patients in Group A (37 +/- 4 min). These results suggest that the duration of action of vecuronium in anephric patients with secondary hyperparathyroidism is shorter than in those without secondary hyperparathyroidism.

Asunto(s)

Hiperparatiroidismo Secundario/fisiopatología , Fallo Renal Crónico/fisiopatología , Unión Neuromuscular/efectos de los fármacos , Bromuro de Vecuronio/farmacología , Anestesia por Inhalación , Anestesia Intravenosa , Estudios de Casos y Controles , Electromiografía/efectos de los fármacos , Femenino , Fentanilo/administración & dosificación , Humanos , Hiperparatiroidismo Secundario/cirugía , Isoflurano/administración & dosificación , Riñón/fisiología , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Óxido Nitroso/administración & dosificación , Paratiroidectomía , Diálisis Renal , Tiamilal/administración & dosificación , Factores de Tiempo , Nervio Cubital/efectos de los fármacos

RESUMEN

BACKGROUND: The authors' previous study of arterial tonometry in children demonstrated poor agreement of tonometric blood pressure (TBP) measurements with intraarterial blood pressure (IBP) measurements. The aim of the current study is to evaluate the feasibility of TBP measurements in children aged 1-6 yr using a newly designed pediatric sensor housing, by comparing TBP values with values obtained by IBP measurements. METHODS: Thirty-four children (aged 1-6 yr, ASA physical status 1-2) were studied undergoing elective abdominal or urologic surgery under general anesthesia. A 22- or 24-G cannula was inserted into the right radial artery. A TBP sensor housing was positioned over the left radial artery. TBP and IBP were continuously monitored and data were periodically sampled during and after intubation, during surgery, and during the recovery period. RESULTS: TBP waveforms were similar to those of IBP. Limits of agreement (bias +/- 2 SD) were 12 and -13.3 mmHg for systolic, 11.6 and -10.4 mmHg for mean, and 13.2 and -10.8 mmHg for diastolic pressures for 3,400 paired points. Measurements could not be made in ten children because of insufficient pulse contour. CONCLUSIONS: When pulse contour is sufficient for analysis, TBP monitoring provides an apparently safe and accurate method for the continuous measurement of arterial blood pressure during anesthesia in children aged 1-6 yr.

Asunto(s)

Determinación de la Presión Sanguínea/instrumentación , Monitoreo Fisiológico/instrumentación , Anestesia , Niño , Preescolar , Humanos , Lactante , Manometría

RESUMEN

STUDY OBJECTIVES: To determine whether serum and urine inorganic fluoride levels with prolonged (more than 7 hours) low-dose (0.8 to 2.0 vol %) sevoflurane anesthesia plus epidural anesthesia were increased as compared with isoflurane anesthesia plus epidural anesthesia. To measure the urine tubular enzymes N-acetyl-beta-glucosaminidase (NAG), alpha 1-microglobulin (alpha 1-M), and beta 2-microglobulin (beta 2-M) for renal tubular injury in both groups. DESIGN: Randomized, prospective study. SETTING: University hospital. PATIENTS: 15 ASA physical status I and II adults (7 males, 8 females) who were scheduled for prolonged laparotomy (lasting 9.5 to 10.2 hours) with general anesthesia. MEASUREMENTS AND MAIN RESULTS: Epidural anesthesia was administered before induction of general anesthesia. General anesthesia was induced with thiamylal administered intravenously (IV), and the trachea was intubated following administration of vecuronium IV. It was maintained with either sevoflurane or isoflurane in nitrous oxide and oxygen. Standard monitoring was used in all patients. Serum and urine inorganic fluoride and urine tubular enzymes were measured periodically. Serum inorganic fluoride was 54 mumol/L at 4.3 minimum alveolar concentration (MAC) hours of sevoflurane; the peak level for isoflurane was 8 mumol/L at the same MAC hours. Sevoflurane also increased urine inorganic fluoride excretion to 96 mumol/hr 8 hours. NAG excretion started to increase after inhalation of either sevoflurane or isoflurane. alpha 1-M and beta 2-M excretion increased markedly postoperatively. Even though fluoride levels and tubular enzymes were high, there was no evidence of postoperative renal dysfunction. CONCLUSIONS: There was no increase in urinary enzymes, which are indicators of tubular injury, specific to sevoflurane. There was no postoperative renal dysfunction, as indicated by unchanged serum creatinine and blood urea nitrogen levels.

Asunto(s)

Anestesia Epidural , Anestesia por Inhalación , Anestésicos por Inhalación/administración & dosificación , Éteres/administración & dosificación , Fluoruros/sangre , Fluoruros/orina , Éteres Metílicos , Bloqueo Nervioso , Acetilglucosaminidasa/orina , Adulto , alfa-Globulinas/orina , Anestésicos por Inhalación/metabolismo , Nitrógeno de la Urea Sanguínea , Creatinina/sangre , Éteres/metabolismo , Femenino , Humanos , Isoflurano/administración & dosificación , Túbulos Renales/efectos de los fármacos , Túbulos Renales/enzimología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Inhibidores de Proteasas/orina , Sevoflurano , Factores de Tiempo , Microglobulina beta-2/orina

RESUMEN

Five cosmid clones, isolated by procedures to screen genomic libraries for homologous variants of the human prohibitin gene (PHB), were analyzed to determine their genomic structures. Four of these (PHBP1-4) were found to be processed pseudogenes, each located on a different chromosome from their counterparts on chromosome 17q21. The DNA sequence of one clone (PHBP1, on chromosome 6q25) shared a 91.3% identity at the nucleotide level with the cDNA of functional prohibitin. A large number of human tumors of the breast, ovary, liver, and lung were examined for somatic mutations in the PHB gene. Although mutations were observed in a few sporadic breast cancers, none were identified in any of the other cancers.

Asunto(s)

Genes Supresores de Tumor , Familia de Multigenes , Neoplasias/genética , Proteínas/genética , Proteínas Represoras , Secuencia de Bases , Neoplasias de la Mama/genética , Cromosomas Humanos Par 17 , Cromosomas Humanos Par 6 , Clonación Molecular , Cósmidos , ADN Complementario/genética , Femenino , Humanos , Hibridación Fluorescente in Situ , Neoplasias Hepáticas/genética , Neoplasias Pulmonares/genética , Datos de Secuencia Molecular , Mutación , Neoplasias Ováricas/genética , Prohibitinas , Seudogenes

RESUMEN

Pharmacodynamics of vecuronium were evaluated in seven kidney transplant recipients and compared with seven patients with normal renal function. Vecuronium 0.12 mg.kg-1 was used for the initial dose and 0.03 mg.kg-1 for the second dose for each patient under general anesthesia with either isoflurane, sevoflurane or halothane plus nitrous oxide after induction by thiamylal. The effect of vecuronium was evaluated by a muscle relaxation monitor. The time to the maximum blockade (onset time) and the time of 25% recovery of the first twitch height (duration time) were measured after each administration of vecuronium in patients of both groups. The onset times after the initial and second doses were similar in both groups (180.0 +/- 15.5 sec for recipients versus 185.7 +/- 14.9 sec for patients of normal renal function). However, duration was significantly longer in recipients than in patients of normal renal function. Durations after the initial and second doses were 130 +/- 19 min for the initial dose and 86 +/- 12 min for the second dose in recipients, whereas they were 51 +/- 5 min and 37 +/- 5 min in patients of normal renal function. The prolonged durations of vecuronium in the kidney transplant recipient were speculated to be mainly due to delayed elimination of the drug and effect of cyclosporin, an immunosuppressive agent in the recipients. These results suggest that the titrated administration of vecuronium by keen monitoring of muscle relaxation is needed in the kidney transplant recipient to avoid unnecessary prolongation in duration of action.

Asunto(s)

Anestesia por Inhalación , Trasplante de Riñón , Riñón/efectos de los fármacos , Unión Neuromuscular/efectos de los fármacos , Bromuro de Vecuronio/farmacología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores de Tiempo