Unilateral Abducens Nerve Palsy Associated with Ruptured Anterior Communicating Artery Aneurysm / 대한신경손상학회지

Isolated unilateral abducens nerve palsies associated with spontaneous subarachnoid hemorrhage have rarely been reported, and their association with anterior communicating artery is even rarer. We report two cases of unilateral abducens nerve palsies following rupture of anterior communicating artery aneurysms. The aneurysms were successfully clipped, and abducens nerve palsies were gradually recovered.

Isolated, Contralateral Trochlear Nerve Palsy Associated with a Ruptured Right Posterior Communicating Artery Aneurysm

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.

CD98 Activation Increases the Invasion of Human Breast Carcinoma MCF-7 Cells / 체질인류학회지

CD98, a disulfide-linked 125-kDa heterodimeric type II transmembrane glycoprotein, regulates the func-tions of beta1 integrin, suggesting that it may play a role in tumor cell invasion. In this study, the effects of CD98 signaling on the adhesion and invasion of tumor cells were investigated. The expression of CD98 on MCF-7 human breast carcinoma cells was confirmed by immunohistochemistry. The effects of CD98 activation on the adhesion to extracellular matrix (ECM) and invasion of MCF-7 cells were determined by adhesion assay and cell invasion assay. Dominant negative forms of focal adhesion kinase (FAK) were transiently transfected into MCF-7 cells using liposome reagents. CD98 stimulation increased the adhesion of MCF-7 cells to fibronectin, laminin and collagen IV. Activation of CD98 augmented the invasion rate of MCF-7 cells through ECM. EDTA or a function-blocking anti-beta1 integrin mAb suppressed the effect of CD98 on invasiveness. Inhibition of phosphorylation of FAK by PP2, an inhibitor of Src family kinase, reduced CD98-induced invasion of MCF-7 cells. This result was confirmed by over-expression of dominant negative forms of FAK. In addition, cytochalasin D or phalloidin inhibited CD98-mediated induction of tumor cell invasion. Inhibitory effects of PP2, cytochalasin D or phalloidin on CD98-stimulated invasion of MCF-7 cells were diminished by pretreatment of cells with Mn++, which is shown to induce conformational change of beta1 intgerin. These results provide the first evidence that CD98 activation increases tumor cell invasion by activating beta1 integrin affinity, and that FAK phosphorylation and subsequent cytoskeletal reorganization may be essential for CD98-mediated regulation of cell motility.

Anesthetic Management of Cesarean Section in Human Immunodeficiency Virus (HIV)Positive Pregnant Woman : A case report

Anesthesiologists are encountering an increasing number of human immunodeficiency virus (HIV) infections in pregnant women. In HIV infected patients, the history should include an evaluation of opportunistic infections, malignancies and treatments with antiretroviral drugs. The anesthesiologist should be aware of the possible toxic side effects or interactions between the antiretroviral drugs and anesthetics. In addition, a HIV infection passing from patient to physician can occur. Therefore, safety measures must be taken when handling body fluid or blood. We report the anesthetic management of an elective cesarean section in a HIV positive pregnant woman who was treated with antiretroviral drugs to decrease the possibility of vertical transmission.

The Aortic Reactivity to Nitric Oxide after Cardiopulmonary Bypass in Rats / 대한마취과학회지

BACKGROUND: We evaluated whether vessel reactivity to nitric oxide changed after cardiopulmonary bypass, which would play an inportant role in temporary vital organ perfusion. METHODS: We used the distal aortas of five rats weighing 400-500 g after cardiopulmonary bypass in experimental group. We also used the distal aortas of five rats before cardiopulmonary bypass under sham operation in control group. All cumulative concentration-effect curves were performed in the aortic rings and EC50 and maximal response (Emax) were calculated by using nonlineal logistic regression analysis with the software PRISM (Graphpad, Mountain View, CA). RESULTS: CPB inhibited acetylcholine induced relaxation in aortic rings and also inhibited sodium nitroprusside (SNP) induced relaxation in ones. It was similar to depression of acetylcholine induced relaxation. CONCLUSIONS: The depression of aortic rings relaxation after CPB may be associated with attenuated sensitivity of them to NO in rats.

The Pulmonary Arterial Reactivity to Nitric Oxide after Cardiopulmonary Bypass and Reperfusion in Pigs / 대한마취과학회지

BACKGROUND: We hypothesized that the decreased nitric oxide after cardiopulmonary bypass and reperfusion would play an important role in temporary pulmonary hypertension. METHODS: We used the pulmonary arteries of three pigs weighing 40-50 kg after cardiopulmonary bypass and reperfusion in experimental group. We also used the pulmonary arteries of five pigs before cardiopulmonary bypass under sham operation in control group. All cumulative concentration-effect curves were performed on vessel rings beginning at their optimum resting zone. EC50 and maximal response (Emax) were calculated by using nonlineal logistic regression analysis with the software PRISM (Graphpad, Mountain View, CA). RESULTS: CPB inhibited endothelium-dependent relaxation to acetylcholine in pulmonary arterial rings, but did not affect SNP induced relaxation in ones. CONCLUSIONS: The Ability of pulmonary arterial relaxation after CPB and reperfusion in pigs was decreased without attenuated pulmonary arterial sensitivity to NO.

Management of the Exophthalmos

We presented several cases of the exophthalmos due to the orbital tumors, with the review of the literatures. We performed modified Kronlein operation and anterior orbitotomy, appropriately for each cases to improve the visual acuity and at least to correct cosmetically the proptosed eye. It will be better to do one's best in order to search a possible way to save the eye ball by which the ophthalmologist can remove the orbital tumor even if the patient lost his vision.