Recovery of driving skills after endoscopy under propofol sedation: a prospective pilot study to assess the driving skills after endoscopic sedation using driving simulation.

BACKGROUND: Patients are recommended not to drive for at least the first 24 h after endoscopy with propofol sedation. However, the evidence underlying these recommendations is scarce. We hypothesized that after endoscopic procedures performed under propofol sedation, the subject's driving ability was restored in less than 24 h. METHODS: We prospectively enrolled thirty patients between 20 and 70 years possessing a legitimate driver's license scheduled for endoscopy at our hospital. The sample chosen was a convenience sample. Gastroscopy or colonoscopy was performed with propofol sedation. Before and after endoscopy, the investigator drove the subjects to the laboratory to assess their driving skills using a driving simulation system, which employs 3 driving scenarios designed by professional transportation researchers. The blood propofol concentration was estimated before endoscopy, and 2 and 4 h after endoscopy. The primary outcome was the time required for subjects to recover their driving ability after propofol sedation. The secondary outcome was the blood propofol concentration before and after endoscopic procedures under propofol anesthesia. RESULTS: Thirty volunteers participated in the study and 18 of them completed all the interventions. In the low-risk S-curve scene, the mean acceleration, lane deviation, and number of deviations from the path at baseline (0.016 cm/s2, 42.50 cm, and 0.83, respectively) were significantly less than that at post-2 h (0.029 cm/s2, P = 0.001; 53.80 cm, P = 0.014; 2.06, P = 0.022). In the moderate-(overtaking) and high-risk (emergency collision avoidance) scenes, the tested parameters at baseline and post-2 h were statistically comparable. In the low-, moderate-, and high-risk scenes the tested parameters at baseline and post-4 h were statistically comparable. The total range of propofol was 120-280 mg.The mean blood concentration of propofol at post-2 h was 0.81 ± 0.40 µg/mL, and at post-4 h was below the limit of detection. CONCLUSION: After endoscopy performed under propofol sedation, subjects' driving abilities were completely restored at 4 h when tested on a simulator.

Characteristics of traffic flow at nonsignalized T-shaped intersection with U-turn movements.

Most nonsignalized T-shaped intersections permit U-turn movements, which make the traffic conditions of intersection complex. In this paper, a new cellular automaton (CA) model is proposed to characterize the traffic flow at the intersection of this type. In present CA model, new rules are designed to avoid the conflicts among different directional vehicles and eliminate the gridlock. Two kinds of performance measures (i.e., flux and average control delay) for intersection are compared. The impacts of U-turn movements are analyzed under different initial conditions. Simulation results demonstrate that (i) the average control delay is more practical than flux in measuring the performance of intersection, (ii) U-turn movements increase the range and degree of high congestion, and (iii) U-turn movements on the different direction of main road have asymmetrical influences on the traffic conditions of intersection.

Biological comparison of ovarian cancer resistant cell lines to cisplatin and Taxol by two different administrations.

Drug resistance is one of the major obstacles to chemotherapy of ovarian cancer. Studies with cell lines can serve as an initial screen for agents that might modulate drug resistance. To establish more appropriate models of drug resistance and explore whether the differences exist in the different drug resistant sublines selected by different treatments, we induced SKOV3 cell line using cisplatin (CDDP) and Taxol over a period of 16 months by the pulse (SKOV3/CDDP-P and SKOV3/Taxol-P) and intermittent incremental (SKOV3/CDDP-80 and SKOV3/Taxol-25) method, respectively. The resistant phenotype of the four resistant sublines, SKOV3/CDDP-P, SKOV3/CDDP-80, SKOV3/Taxol-P and SKOV3/Taxol-25, was very stable and the resistance index was 4.12, 11.50, 261.98 and 622.76, respectively. In cell morphology, the cells from pulse treatment had remarkable changes compared with the cells from intermittent incremental treatment. SKOV3/CDDP-80 and SKOV3/Taxol-P grew more slowly than SKOV3/CDDP-P and SKOV3/Taxol-25. Multidrug resistance gene 1, multidrug resistance protein 1, lung resistance protein and glutathione S-transferase pi mRNA expression of SKOV3/CDDP-P and SKOV3/Taxol-25 had greater changes than that of SKOV3/CDDP-80 and SKOV3/Taxol-P. The results suggest there are great differences between the resistant cell lines resulting from pulse and intermittent incremental method. The resistant cells selected by the intermittent method were more resistant than the cells selected by the pulse method. The two resistant sublines selected by the pulse method may serve as appropriate models for the study of mechanisms of drug resistance in ovarian cancer.

[Proteomic analysis of human ovarian cancer cell lines and their platinum-resistant clones].

OBJECTIVE: To perform comparative proteomic analysis of human ovarian cancer cell lines for detecting platinum-resistance associated proteins. METHODS: The total proteins of two sensitive (SKOV3 and A2780) and four resistant (SKOV3/CDDP, SKOV3/CBP, A2780/CDDP and A2780/CBP) human ovarian cancer cell lines were separated by two-dimensional gel electrophoresis (2-DE). The differentially expressed proteins were analyzed using image analysis software, stained with Coomassie Brilliant Blue, then identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and database searching. The mRNA and protein levels of the differentially expressed protein which was most significant in all of the four resistant cell lines were validated by RT-PCR and western blotting, respectively. RESULTS: Five proteins were found to be significant in four cell lines. Annexin A3 and destrin were up-regulated and nicotinamide-adenine dinucleotide phosphate (NADP)-dependent isocitrate dehydrogenase 1 was down-regulated in all the four resistant samples. Glutathione transferase omega 1 had an increased expression in the other three resistant cell lines except for SKOV3/CBP in which its expression was not changed. However, cofilin 1 represented a different trend. In the two resistant sublines of SKOV3, cofilin 1 had a down-regulation, but it had an up-regulation in the cell lines induced from SKOV3. The expression of annexin A3 was up-regulated by 3 - 20 fold and the results of RT-PCR and western blotting showed complete consistency with that by 2-DE. CONCLUSIONS: Proteomic techniques are useful to the identification of the resistance-associated proteins in ovarian cancer platinum-resistant cell lines and five candidates have been found. The five differential proteins might become hopeful candidate biomarkers for resistance.

Identification of platinum-resistance associated proteins through proteomic analysis of human ovarian cancer cells and their platinum-resistant sublines.

Chemoresistance is a major therapeutic obstacle in cancer patients, and the mechanisms of drug resistance are not fully understood. In the present study, we established platinum-resistant human ovarian cancer cell lines and identified differentially expressed proteins related to platinum resistance. The total proteins of two sensitive (SKOV3 and A2780) and four resistant (SKOV3/CDDP, SKOV3/CBP, A2780/CDDP, and A2780/CBP) human ovarian cancer cell lines were isolated by two-dimensional gel electrophoresis (2-DE). The differentially expressed proteins were identified using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). In total, 57 differential protein spots were identified, and five proteins, including annexin A3, destrin, cofilin 1, Glutathione-S-transferase omega 1 (GSTO1-1), and cytosolic NADP+-dependent isocitrate dehydrogenase (IDHc), were found to be co-instantaneous significance compared with their parental cells. The expression of the five proteins was validated by quantitative PCR and western blot, and the western blot results showed complete consistency with proteomic techniques. The five proteins are hopeful to become candidates for platinum resistance. These may be useful for further study of resistance mechanisms and screening of resistant biomarkers.