Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2011
Comparative Study2-Deoxy-D-glucose attenuates isoflurane-induced cytotoxicity in an in vitro cell culture model of H4 human neuroglioma cells.
β-Amyloid protein (Aβ) accumulation and caspase activation have been shown to contribute to Alzheimer disease neuropathogenesis. Aβ is produced from amyloid precursor protein through proteolytic processing by aspartyl protease β-site amyloid precursor protein-cleaving enzyme (BACE). The inhaled anesthetic isoflurane has been shown to induce caspase activation and increase levels of BACE and Aβ. However, the underlying mechanisms and interventions of the isoflurane-induced neurotoxicity remain largely to be determined. The glucose analog 2-deoxy-d-glucose (2-DG) has neuroprotective effects. Therefore, we sought to determine whether 2-DG can reduce caspase-3 activation and the increase in the levels of BACE and reactive oxygen species (ROS) induced by isoflurane. ⋯ These results suggest that 2-DG may decrease oxidative stress and increase cytosolic calcium levels, thus attenuating isoflurane-induced neurotoxicity.
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Anesthesia and analgesia · Dec 2011
Comparative StudyApplication of the Rasch model to develop a simplified version of a multiattribute utility measurement on attitude toward labor epidural analgesia.
Valid and reliable measures based on health behavior theory, such as multiattribute utility decision theory, are essential to elucidate complex relationships between psychological factors and labor pain. In this study we aimed to use Rasch analysis to simplify a previously developed 20-item multidimensional questionnaire on attitude toward labor epidural analgesia using multiattribute utility theory. ⋯ We demonstrated application of the Rasch analysis to simplifying a multiattribute utility questionnaire without compromising reliability. Further study is necessary to determine whether the simplified questionnaire is valid for use in clinical practice.
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Anesthesia and analgesia · Dec 2011
Comparative StudyMutated p.4894 RyR1 function related to malignant hyperthermia and congenital neuromuscular disease with uniform type 1 fiber (CNMDU1).
Ryanodine receptor 1 (RyR1) is a Ca(2+) release channel located in the sarcoplasmic reticulum membrane of skeletal muscle. More than 200 variants in RyR1 have been identified in DNA from patients with malignant hyperthermia (MH) and congenital myopathies; only 30 have been sufficiently studied so as to be identified as MH-causative mutations. The Ala4894Thr RyR1 variant was found in a Japanese patient with susceptibility to MH, and the Ala4894Pro variant in a rare case of myopathy: congenital neuromuscular disease with uniform type 1 fiber (CNMDU1). We hypothesized that different Ala4894 variants of RyR1 cause different pathophysiological changes that are identifiable by having differing pharmacological sensitivities to RYR1 agonists. ⋯ We concluded that different Ala4894 variants of RyR1 lead to different agonist/antagonist sensitivities, which may predict differing RYR1 functionality during excitation-contraction coupling and sensitivity to MH. The hypersensitive Ala4894Thr-RyR1 is associated with MH and the poorly functional Ala4894Pro-RyR1 with CNMDU1.
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Anesthesia and analgesia · Dec 2011
Comparative StudyKnockdown of synaptic scaffolding protein Homer 1b/c attenuates secondary hyperalgesia induced by complete Freund's adjuvant in rats.
Previous studies have demonstrated that Homer 1b/c, a postsynaptic molecular scaffolding protein that binds and clusters metabotropic glutamate receptors at neuronal synapses, has an important role in the metabotropic glutamate receptor signaling process. In the current study, we investigated the possible involvement of Homer 1b/c in secondary hyperalgesia induced by complete Freund's adjuvant (CFA). ⋯ These novel results demonstrate that Homer 1b/c in the spinal cord contributes to the maintenance of secondary hyperalgesia induced by CFA and suggest that Homer 1b/c may be a novel target for pain therapy.
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Anesthesia and analgesia · Dec 2011
Comparative StudyAn uncalibrated pulse contour method to measure cardiac output during aortic counterpulsation.
Less-invasive monitoring systems, such as pulse contour methods, are increasingly being used to estimate cardiac output (CO). However, alterations in the arterial waveform caused by intraaortic balloon pump counterpulsation may affect the ability of pulse contour algorithms to determine CO. We investigated the reliability of an uncalibrated pulse contour method, the MostCare system, in patients with cardiac failure receiving intraaortic balloon pump counterpulsation by comparing its measurements of CO with those determined by an intermittent thermodilution method. ⋯ The MostCare system provided measurements of CO that were comparable to ThD-CO in patients assisted with an intraaortic balloon pump. The reliability of the MostCare system is not significantly affected by changes in arterial waveform morphology caused by inflation and deflation of the intraaortic balloon pump.