Expression of neurotransmitter receptors in oral keratinocytes and their response to agonists

This study aimed to investigate whether neurotransmitter receptors in the nervous system were also expressed in oral keratinocytes. Expressions of various neurotransmitter receptor genes in immortalized mouse oral keratinocyte (IMOK) cells were examined by reverse transcriptase polymerase chain reaction. IMOK cells expressed calcitonin gene-related peptide (CGRP) receptor subunit genes Ramp1 and Ramp3 and glutamate receptor subunit genes Grina , Gria3 , Grin1 , Grin2a , and Grin2d . Moreover, IMOK cells expressed Adrb2 and Chrna5 that encode beta 2 adrenergic receptor and cholinergic receptor nicotinic alpha 5 for sympathetic and parasympathetic neurotransmitters, respectively. The expression of Bdkrb1 and Ptger4 , which encode receptors for bradykinin and prostaglandin E2 involved in inflammatory responses, was also observed at low levels. Expressions of Ramp1 and Grina in the mouse gingival epithelium were also confirmed by immunohistochemistry. When the function of neurotransmitter receptors expressed on IMOK cells was tested by intracellular calcium response, CGRP, glutamate, and cholinergic receptors did not respond to their agonists, but the bradykinin receptor responded to bradykinin. Collectively, oral keratinocytes express several neurotransmitter receptors, suggesting the potential regulation of oral epithelial homeostasis by the nervous system.

Expression of neurotransmitter receptors in oral keratinocytes and their response to agonists

This study aimed to investigate whether neurotransmitter receptors in the nervous system were also expressed in oral keratinocytes. Expressions of various neurotransmitter receptor genes in immortalized mouse oral keratinocyte (IMOK) cells were examined by reverse transcriptase polymerase chain reaction. IMOK cells expressed calcitonin gene-related peptide (CGRP) receptor subunit genes Ramp1 and Ramp3 and glutamate receptor subunit genes Grina , Gria3 , Grin1 , Grin2a , and Grin2d . Moreover, IMOK cells expressed Adrb2 and Chrna5 that encode beta 2 adrenergic receptor and cholinergic receptor nicotinic alpha 5 for sympathetic and parasympathetic neurotransmitters, respectively. The expression of Bdkrb1 and Ptger4 , which encode receptors for bradykinin and prostaglandin E2 involved in inflammatory responses, was also observed at low levels. Expressions of Ramp1 and Grina in the mouse gingival epithelium were also confirmed by immunohistochemistry. When the function of neurotransmitter receptors expressed on IMOK cells was tested by intracellular calcium response, CGRP, glutamate, and cholinergic receptors did not respond to their agonists, but the bradykinin receptor responded to bradykinin. Collectively, oral keratinocytes express several neurotransmitter receptors, suggesting the potential regulation of oral epithelial homeostasis by the nervous system.

Alpha-Melanocyte Stimulating Hormone Protects Pancreatic Islet Dysfunction by Peripheral Blood Mononuclear Cells in vitro / 대한이식학회지

PURPOSE: The alpha-melanocyte-stimulating hormone (alpha-MSH) has been shown to interact with various cells of the immune and inflammatory system and down-regulate either the production or the action of the pro-inflammatory cytokines. In this study, we investigated the potential of alpha-MSH on preventing pancreatic islet cell from death and dysfunction by inflammatory cytokines released from peripheral blood mononuclear cells (PBMCs) in rat. METHODS: Rat pancreatic islets were co-cultured with PBMCs, stimulated by phorbol myrstic acid and ionomycin. alpha-MSH was treated to PBMCs for 2 hours before co-culture. Viability and apoptosis of islets were observed by MTT and FACS. Inflammatory cytokines and nitric oxide (NO) were measured. Insulin release from islet co-cultured with mononuclear cells was checked for the islet function. RESULTS: In comparison to control group, viability of islets with alpha-MSH treated mononuclear cells was increased and apoptosis was reduced significantly. Inflammatory cytokines such as TNF-alpha and IL-1beta were reduced in alpha-MSH-treated group. NO production in alpha-MSH-treated group was decreased. Insulin secretory function of islet was recovered in condition of alpha-MSH treatment. CONCLUSION: This study demonstrates that alpha-MSH protects cell death and preserves the secretory function of pancreatic islet cells from the pro-inflammatory reaction of mononuclear cells, and may have the potential to improve the graft survival in clinical islet transplantation.

Unilateral Pulmonary Edema in the Lateral Decubitus Position: A Case Report / 대한마취과학회지

Characteristically pulmonary edema is bilateral, unless there is an underlying defect or abnormality in the cardiopulmonary system. Unilateral pulmonary edema following general anesthesia is a rare complication in a healthy patient. The etiology of unilateral pulmonary edema include, the re-expansion of a collapsed lung, unilateral pulmonary veno-occulusive disease, pulmonary contusion, compression of pulmonary vasculatures, cerebral autonomic dysfunction, bronchial obstruction and severe ischemic left ventricular dysfunction. We describe a 52-yr-old patient who developed acute unilateral pulmonary edema after a total hip replacement athroplasty in the lateral decubitus position. The patient recovered following 16 hours of intensive treatment involving fluid restriction, diuretics, sedation, and continuous positive airway pressure ventilation.

The effect of Korean mistletoe extract M11C (non-lectin components) on IL-1beta release and expression from macrophages

BACKGROUND: Korean mistletoe (Viscum album) extract has been found to posses immunostimulatory activity. In this study, Korean mistletoe extract, M11C (non-lectin components), was used to know whether this extract might activate mouse peritoneal macrophages to produce interleukin 1 beta (IL-1 beta). METHODS: Hemagglutination assay was carried out to examine whether M11C contained a lectin or not . To know the effect of M11C on the production of IL-1 beta, the macrophages were treated by the M11C, and then collected the supernatant (M11C stimulated macrophages-conditioned media; MMCM). MMCM was analyzed for the IL-1 beta quantification and mRNA expression by means of ELISA and RT-PCR, respectively. RESULTS: Maximum effective dose and time of M11C on IL-1 beta production from macrophages were 20 micro gram/ml and 8 hours, respectively . This ELISA data was reconfirmed by immunoblotting assay . indicating that M11C is a good candidate for an immunomodulator. The dose and time dependent effect s of M11C on the expression of IL-1 beta mRNA from macrophages was also shown in expression of mRNA detected by RT-PCR. Treatment dose and time for the maximum expression of IL-1 beta mRNA were 20 micro gram/ml and 4 hours, respectively . Maximum gene expression of IL-1 beta was much earlier than maximum production of it. CONCLUSION: As results, Korean mistletoe extract, M11C, may be used for an immunomodulator. This will be able to make up for and solve the problems caused by existent immunoagent with many adverse effects through many other studies in future including one molecule extraction.

The Effect of Korean Mistletoe Extract M11C ( Non - Lectin Components ) on TNF-alpha Release and Expression from Macrophages / 대한면역학회지

No abstract available.

Mental Depression after General Anesthesia Caused by Unknown Intracranial Tumor: A case report / 대한마취과학회지

Slowly growing brain tumors may not present specific symtoms or signs related to increased intracranial pressure due to volume-spacial compensation. So we may not find brain tumors in patients in preoperative evaluations. But patients with unknown brain tumors may have severe complications after anesthesia. We experienced a patient whose emergence was delayed from general anesthesia for laparascopic urinary incontinence surgery (Burch's operation). The patient had such neurologic signs as deeply confused mentality, loss of pupil reflex and anisocoria. A large brain tumor in the left parietal lobe was revealed by brain MRI and it was resected. After further evaluation we found that it had originated from pulmonary adenocarcinoma, so the patient was designated for radiation therapy.

The Effects of Morphine on the Sensory Receptors in the Acutely Inflamed Feline Urinary Bladder / 대한마취과학회지

BACKGROUNDS: Pain can occur following acute noxious stimuli and tissue damage. The duration of such pain may outlast the stimulus and its amplitude may be exaggerated (hyperalgesia). This response comes from a sensitization of the peripheral nociceptor. Traditional thought has associated the antinociceptive effects of opiates with the activation of opioid receptors located in the central nervous system. Recently, however, opiate receptors in the peripheral nervous system have led to the hypothesis that analgesic action might, in part, result from a reduction in the response of peripheral nerve fibers thought to be concerned with signaling pain. METHODS: Twenty units were recorded from the strands of the hypogastric nerve innervating the urinary bladder of the cat. Nerve activity and intravesical pressure were monitored before and after the onset of an acute inflammation induced by the intravesical instillation of 2% mustard oil. The responses of afferent units to chemical stimuli by intra-arterially injected bradykinin (10 microgram/0.2 ml., i.a.) and potassium chloride (0.3 M/0.2 ml, i.a.) were compared each time at control, after inflammation, and after administration of morphine (2.5 mg/kg) and naloxone (5 microgram/kg) respectively. RESULTS: Polymodal receptors in the urinary bladder showed excitatory response to algesic substances such as bradykinin, potassium chloride and the urinary bladder contracted simultaneously, both the responses of the nerve impulse and bladder contraction to bradykinin and potassium chloride increased significantly after bladder inflammation induced by 2% mustard oil and the sensitization of the sensory receptors attenuated by morphine and naloxone reversed the effect of morphine. CONCLUSIONS: These observations suggest that morphine might have a peripheral effect.

The Effects of Thoracic Epidural Anesthesia on Pulmonary Shunt during One Lung Anesthesia / 대한마취과학회지

BACKGROUND: Hypoxemia during one lung ventilation (OLV) for thoracotomy in patients in the lateral position remains a clinical problem. And thoracic epidural anesthesia (TEA) during one lung ventilation recently has been combined with general anesthesia in our clinical practice for thoracic surgery. Then the effects of TEA combined with general anesthesia on PaO2 remains controversial. The aim of this study to investigate whether thoracic epidural anesthesia (TEA) affect PaO2 and pulmonary shunt during one lung anesthesia. METHODS: Fifteen patients undergoing lobectomy with one lung ventilation were examined. Each group was injected normal saline (control group, n = 7) or 1% lidocaine (TEA group, n = 8) 8 ml through thoracic epidural catheter after induction. We compared pulmonary shunt fraction (Qs/Qt) after OLV 30, 60 minutes and after two lung ventilation (TLV). RESULTS: We found the significant increases of intrapulmonary shunt fraction (%) in the TEA group compared to control group at each event, OLV30, 60 and TLV. And significant increase of intrapulmonary shunt was found after one lung ventilation in the both groups. CONCLUSIONS: These results suggest that TEA may influence hypoxic pulmonary vasoconstriction (HPV) by blockade of sympathetic activity during OLV.

Effects of Concentration of Preoperatively Administered Epidural Bupivacaine on Postoperative Pain Control / 대한마취과학회지

BACKGROUNDS: Epidural anesthesia before surgical stimulus may reduce or prevent subsequent pain by preemptive analgesia. We studied the effect of varied concentration of a local anesthetic agent administered through epidural catheter before operation on preemptive analgesia after an abdominal hysterectomy. METHODS: Fourty-five patients scheduled for abdominal hysterectomy were blindly randomized to receive 10 ml of 0.5% bupivacaine (group I), 0.25% bupivacaine (group II) or saline (group III) respectively before induction of anesthesia. For postoperative pain control all patients received the same analgesic regimen which was 10 ml of 0.125% bupivacaine and buprenorphine 0.15 mg after resection of the uterus. Then the epidural catheter was connected with infusion pump containing 100 ml of 0.125% bupivacaine and buprenorphine 0.45 mg. Its infusion rate was 2 ml/hour. Pain was assessed using the Visual Analogue Scale (0 = no pain to 10 = intolerable pain) on rest, motion, cough and verbal rating scale at 1, 3, 6, 24 and 48 hour after operation. Side effects were recorded at the same time intervals. RESULTS: Using the ANOVA on ranksum test, pain scores 1 hour after operation differed between groups I and III (P<0.05). In VAS in motion, the pain scores 24 hours after operation differed between groups I and III (P<0.05). In VRS, the pain scores 3 hours after operation differed between groups II and III (P<0.05), and those 24 hours after operation differed between groups I and III (P< 0.05). The incidence of motor weakness using Chi-square test in group I differed from groups II, III (P< 0.05). CONCLUSIONS: Among the 45 patients who had a postoperative pain control after abdominal hysterectomy with initial bolus injection and then continuous infusion of epidural bupivacaine and buprenorphine, postoperative pain scores of patients who had preoperative epidural injection of 10 ml of 0.5% bupivacaine (n = 15) were lower than those of saline injected patients (n = 15), but those of patients with a preoperative epidural injection of 10 ml of 0.25% bupivacaine (n = 15) were not lower than those of saline injected patients.

Effects of Pretreated-Fentanyl on the Myocardial Function in Isolated Stunned Rat Heart / 대한마취과학회지

BACKGROUND: Fentanyl is commonly used as a anesthetics for patients who have poor cardiac reserve, because it provides cardiovascular stability. But little data exist on the effects of fentanyl on myocardial ischemia and reperfusion injury. The purpose of this study was to examine the effects of the fentanyl on the recovery of myocardial contracility, coronary flow, and myocardial oxygen balance in isolated rat hearts subjected to ischemia and reperfusion. METHODS: Isolated Sprague-Dawley rat hearts were perfused at constant pressure with oxygenated modified-Krebs solution (pH 7.4, 37oC). After stabilization period, all hearts were given fentanyl 0, 1, 10 ng/ml, respectively. Then, myocardial ischemia was induced by global ischemia for 15 minutes. Isovolumetric left ventricular pressure (LVP) and dP/dt were measured via a latex balloon and transducer. Also, coronary flow and oxygen tensions at the coronary inflow and outflow were measured. RESULTS: The application of fentanyl did not significantly affect myocardial contractility, coronary flow, and myocardial oxygen balance. After global ischemia, myocardial contractility, coronary flow, and myocardial O2 consumption were decreased, but percentage of O2 extraction was increased. However, these changes were not significantly different between fentanyl pretreated and control groups. CONCLUSIONS: These in vitro findings demonstrate that the pretreatment of fentanyl is devoid of major effects on recovery of the myocardial contracility, coronary flow, and myocardial oxygen balance in isolated stunned rat hearts.

The Effect of Deep Breathing Exercise and Incentive Spirometry to Prevent Postoperative Pulmonary Complications after Abdominal Surgery in Geriatric Patients / 대한마취과학회지

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.

A Clinical Study on Fatal Cases within 30 Days Following Surgery / 대한마취과학회지

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.

Clinical Studies of Purulent Meningitis in Infant and Children

No abstract available.

Clinical Study of Shigellosis

Clinical and Bacteriological studies were carried out on 57 cases of infants and children with shigellosis who were cared from January, 1976 to December, 1980 in our hospital. The results were as follows: 1. The age distribution revealed the range between 6 months and 5 years(85% of all) with sex ratio of 30(53%) of male and 27(47%) of female, 1.1:1. 2. The peak incidence was noted in summer, althought there were occurrence throughout the year, even in winter. 3. On bacteriological studies, Shigellan flexneri was isolated most frequenty(90%) and Shigella sonnei was the next(8.8%). 4. Only 8.3% of Shigella strains were resistant to ampicillin between 1976 and 1977 but resistance increased to 76.7% in 1980. Gentamicin and Kanamycin which are aminoglycosiides were quite effectived but their use was limited becauseof their nephrotoxicity. 5. The average duration from the onset to the clinical improvement including stool character in the 32 ampicillin treated patients was 3.6 days and in the 25 rifampin treated patients was 2.2 days. Rifampin was effective in eradicating the shigella stralins and stool cultures taken at 7th therapeutic day remained negative in all 25 rifampin treated patients but yielded growth of shigella strains in 13 ampicillin treated patients. There was no doubt that rfaimpin was superior to ampicillin for bacillary dysentry. 6. One of these 57 cases was expired and motality rate was 1.8%.

Clinical study of low birth weight infants

No abstract available.

Anesthetic Management for the Resection of Pheochromocytoma / 대한마취과학회지

Inhalation anesthetics, particularly the hydrocarbons and cyclopropane. lower the threshold to the arrhythmogenic activity of catecholamines. This interaction is of concern during the resection of a pheochromocytoma when the surgically-induced release of large amounts of norepinephrine and epinephrine from tumors sets the stage for ventricular arrhythmia by a direct effect on the myocardium together with an increase in blood pressure. In this communication, anesthesia was performed with N2,O-O2,-halothane. In addition patient was managed successfully, using d-tubocurarine, phentolamine (Regitine) and propranolol (Inderal). For the next same case, enflurane is recommended because of absence of flammability, arrhythmogenic activity and nephrotoxity. etc.

An Experimental Study on the Effects of Operation Sites on Respiratory Functions in the Postoperative Period / 대한마취과학회지

The site of operation is one of the most significant factors affecting the degree of decreased respiratory function and arterial hypoxemia in the postoperative period. To elucidate the relationship between the site of operation and the postoperative hypoxemia, the authors have performed pre-and post-operative arterial blood gas analysises on the 1st POD through the 4th POD on 30 subjects. The experiment was performed on 3 groups, each of which consisted of 10 subjects; an upper abdominal surgery group, lower abdominal surgery group and extremity surgery group. We have selected only those who have had no preoperative cardiopulmonary problems and excluded those who have developed such complications. The results were as follows; 1) In the upper abdominal surgery group, all postoperative PaO2, values were found to be decreased significantly. 2) In the lower abdominal surgery group, only the 2nd POD PaO2 value was found to be significantly decreased. 3) No demonstrable postoperative change of PaO2, was noted in the extremity surgery group.