[Intra-occular pressure during robotic-assisted laparoscopic radical prostectomy].

BACKGROUND: Aeroperitoneum increases intra-occular pressure (IOP). We measured IOP during robotic-assisted laparoscopic radical prostectomy (RALP) that requires steeper Trenderenburg position. METHODS: Fourteen patients with no ocular diseases were candidates. We measured their IOP during robotic operation from beginning to end. RESULTS: Our date shows that IOP continues to increase over the time of steep Trenderenburg position. CONCLUSIONS: Long time RALP might be risky for IOP.

[Effectiveness of gum elastic bougie for tracheal intubation with Airtraq optical laryngoscope].

BACKGROUND: Although Airtraq (ATQ) is well accepted as a useful device for tracheal intubation especially in cases of difficult airway management, we sometimes encounter difficulty in insertion of a tracheal tube along the blade of ATQ across the vocal cord in spite of ATQ assistance. Gum Elastic Bougie (GEB) is well known as a practical device for intubation assistance with Macintosh laryngoscope. We studied the efficacy of GEB for intubation with ATQ. METHODS: One-hundred-forty one patients scheduled for general anesthesia, ASA physical status 1 or 2, were allocated into two groups randomly; patients intubated with ATQ without GEB (n = 70), and those with ATQ with GEB (n = 71). Twenty anesthegiologists were assinged to them evenly according to their experience. We measured the time they needed for intubation. RESULTS: The combinational advantage of ATQ and GEB was not significantly proved among board certified anesthesiologist. However, among non-board-certified anesthesiologist group, the time needed for successful intubation was significantly shorter with combined use of ATQ and GEB. CONCLUSIONS: For the people with less experience of intubation, GEB is useful assistance for intubation with ATQ. It was concluded that the combined use of ATQ and GEB is a simple and effective process for ordinary doctors or paramedics.

Des-gamma-carboxyprothrombin (PIVKA-II) levels in maternal serum throughout gestation.

The status of vitamin K in pregnant women was investigated using the highly sensitive method for des-gamma-carboxyprothrombin (protein induced by vitamin K absence [PIVKA-II]), electrochemiluminescence immunoassay. A gradual elevation of PIVKA-II related to gestational weeks was observed in healthy pregnant women, suggesting that a modest vitamin K deficiency takes place in gestation. Furthermore, throughout gestation the majority of pregnant women exceeded the healthy adult levels in PIVKA-II. Among complicated gestations of preeclampsia, a remarkable elevation of PIVKA-II was observed in severe preeclampsia, in which a high correlation between PIVKA-II level and coagulation parameters, including thrombin-antithrombin (TAT) complexes, was revealed. These data were suggestive that the vitamin K status readily decreased into a deficient status in hypercoagulative conditions. Among other complicated gestations, a moderate elevation of PIVKA-II was demonstrated in hyperemetic conditions, and, if at all, only a slight elevation of PIVKA-II was observed in other maternal diseases. The present study is the first report regarding the changes of PIVKA-II in pregnant women.

Changes in oligosaccharide expression on plasma membrane of the mouse oocyte during fertilisation and early cleavage.

It has been reported that various structural and functional changes occur on the surface of the plasma membrane of the ovum and embryo during fertilisation and cleavage in preparation for implantation. Glycoproteins are thought to be one of the factors in cell attachment. Thus, we investigated the changes in glycoprotein expression on the cell surface membrane of the mouse embryo by using lectins. Among seven types of lectin (ConA, WGA, UEA-I, MPA, LCA, DBA and PNA), the fluorescent intensities of ConA and WGA markedly increased from unfertilised ova to blastocysts. By quantitative analysis using immuno-scanning electron microscopy, the numbers of ConA-gold particles were small until 4-cell cleavage, but increased significantly at the blastocyst stage. In contrast, an increased number of WGA-gold particles was detected even at the 4-cell stage, and this increase continued to the blastocyst stage. From the above observations, we conclude that the numbers of sugar chains bound to both ConA andWGA increases with blastocyst formation and earlier expression is observed with WGA. The present study dearly shows that glycoproteins on the cell membrane surface of the mouse embryo quantitatively increase at the time of implantation, and the possibility has been indicated that glycoproteins are involved in intercellular recognition and adhesion between the embryo and endometrial epithelium.

Improvement of vitamin K status of breastfeeding infants with maternal supplement of vitamin K2 (MK40).

The present study is aimed at evaluating the efficacy of maternal vitamin K2 supplementation on the vitamin K status of newborn infants using the measurement of des-gamma-carboxyprothrombin (PIVKA-II [protein induced by vitamin K absence]) and the hepaplastin test (HPT). PIVKA-II and HPT were measured at the 1st month of age in two groups: 31 infants with maternal vitamin K supplementation (15 mg/d Menatetrenone since the 14th day after parturition) (group 1) and 46 without maternal supplementation (group 2). All infants received vitamin K2 syrup twice within the 1st week of life. The PIVKA-II levels of 31 infants (group 1) were 23.6 mAU/mL (standard deviation [SD] 5.8), showing extremely low levels, and close to healthy adult levels, with a smaller deviation than what was seen in group 2. The levels of the 46 infants in group 2 were 27.8 (SD 16.0). This does not differ significantly from group 1, but a small number of infants showed a modestly high level in PIVKA-II. There also was no significant difference between the two groups in the HPT. These data would indicate that maternal vitamin K supplementation can maintain the vitamin K status throughout the late neonatal period and prevent an onset of vitamin K-deficient hemorrhage.