1. Epidural abscess after multiple lumbar punctures for labour epidural
catheter placement. J Biomed Res, 2010; 24(4):332-335
Sundeep S. Tumber, Hong Liu
Department of Anaesthesiology and Pain Medicine, University of California,
Davis, CA 95817, USA.
Abstract: Epidural catheterization is routinely used by anaesthesiologists to provide
labour and post-operative analgesia. In most cases, catheter placement is without
serious side effects and uneventful. However, epidural abscess is a rare complication
that may result in severe morbidity. We present a case of epidural abscess after labour
epidural catheter placement in a healthy 36-year-old female who presented on
post-partum d 10 with complaints of fever and back pain. She was treated with
intravenous antibiotics and fully recovered.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=JBR100411&flag=1
2. Effects of propofol on early and late cytokines in lipopolysaccharide-induced
septic shock in rats. J Biomed Res, 2010; 24(5):389-394
Sha Li, Hongguang Bao, Liu Han, Lele Liu
Department of Anesthesiology, Nanjing First Hospital Affiliated to Nanjing
Medical University, Nanjing, Jiangsu 210006, China.
Abstract: Objective: It has been reported that the intravenous anesthetic propofol (PPF)
has anti-inflammatory effects in vitro and in patients. The purpose of this study was to
investigate whether PPF has anti-inflammatory effects in lipopolysaccharide
(LPS)-induced septic shock by inhibiting the induction of pro-inflammatory cytokines
[inter-leukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] and high mobility group
box 1 (HMGB1) in rats. Methods: Thirty six male Wistar rats were randomly assigned
to one of three groups (control group, PPF + LPS group and LPS group; n = 12 per
group). Control group rats received a 0.9% NaCl solution (NS) by the tail vein. The
PPF + LPS group rats received PPF (10 mg/kg bolus, followed by infusion at 10
mg/(kg·h) through a femoral vein catheter) 1 h before LPS (7.5 mg/kg) administration
via the tail vein. The LPS group rats received injection of LPS (7.5 mg/kg) via the tail
vein. Hemodynamic effects were recorded as well as mortality rates, and plasma
cytokine concentrations (TNF-α, IL-6, HMGB1) were measured for the 24-h
observation period. Results: The mean arterial pressure and heart rate of the PPF +
LPS group were more stable than those of the LPS group. The mortality at 24 h after
the administration of the LPS injection was much higher in the LPS group (58.3%)
compared to the PPF + LPS group (25.0%). Plasma concentrations of cytokines (IL-6
and TNF-α) and HMGB1 were significantly reduced in the PPF + LPS group
compared to the LPS group (P < 0.05). Conclusion: Pretreatment with PPF reduced
the mortality rate of rats and attenuated the pro-inflammatory cytokine responses in an
endotoxin shock model through an anti-inflammatory action inhibiting induction of
HMGB1.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=JBR100506&flag=1
3. Protocol for electrophysiological monitoring of carotid endarterectomies. J
Biomed Res, 2010; 24(6):460-466
Hong Liua, Anthony M Di Giorgiob, Eric S Williamsc, William Evansc, Michael J
Russellb,d
a
Department of Anesthesiology University of California, Davis Medical Center,
Sacramento, CA 95817, USA;
b
Active Diagnostics, Inc., Davis, CA 95616, USA;
c
Kaiser Permanente Sacramento Medical Center, Sacramento, CA 95825, USA
d
Aaken Laboratories, Inc., Davis, CA 95616, USA.
Abstract: Near zero stroke rates can be achieved in carotid endarterectomy (CEA)
surgery with selective shunting and electrophysiological neuromonitoring. though
false negative rates as high as 40% have been reported. We sought to determine if
improved training for interpretation of the monitoring signals can advance the
efficacy of selective shunting with electrophysiological monitoring across multiple
centers, and determine if other factors could con-tribute to the differences in reports.
Processed and raw beta band (12.5-30 Hz) electroencephalogram (EEG) and median
and tibial nerve somatosensory evoked potentials (SSEP) were monitored in 668 CEA
cases at six surgical centers. A decrease in amplitude of 50% or more in any EEG or
SSEP channel was the criteria for shunting or initiating a neuroprotective protocol. A
reduction of 50% or greater in the beta band of the EEG or amplitude of the SSEP
was observed in 150 cases. No patient showed signs of a cerebral infarct after surgery.
Selective shunting based on EEG and SSEP monitoring can reduce CEA
intraoperative stroke rate to a near zero level if trained personnel adopted standardized
protocols. We also found that the rapid administration of a protective stroke protocol
by attending anesthesiologists was an important aspect of this success rate.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=jbr100607&flag=1
4. Crystalloid and colloid preload for maintaining cardiac output in elderly
patients undergoing total hip replacement under spinal anesthesia. J Biomed
Res, 2011; 25(3):185-190
Rufeng Xiea, Lizhong Wangb, Hongguang Baoa
a
Department of Anesthesiology, Nanjing First Hospital Nanjing, Jiangsu 210006,
China;
b
Department of Anesthesiology, Jiaxing Maternity and Child Care Hospital,
Jiaxing, Zhejiang 314000, China.
Abstract: The aim of the present study was to compare the effects of colloid and
crystalloid preload on cardiac output (CO) and incidence of hypotension in elderly
patients under spinal anesthesia (SA). A randomized, double-blinded study was
conducted including 47 elderly patients undergoing scheduled total hip replacement
(THR), who were randomized to three groups: the control group (C group, n = 15),
crystalloid (RS group, n =16) and colloid group (HES group, n = 16). An intravenous
preload of 8 mL/kg of either lactated Ringer’s solution in the RS group or 6%
hydroxyethyl starch in the HES group was infused within 20 min before SA induction,
while no intravenous preload was given in the C group. There was a trend of decrease
in CO and systolic blood pressure after SA with time in the C group. In the RS and
HES groups, CO increased significantly after fluid preloading as compared with
baseline (P < 0.01). Thereafter, CO remained higher than baseline until 30 min after
SA in the HES group. The change of systolic blood pressure was similar to CO, but
no significant difference from baseline was observed in each group. Hypotension
occurred in 3 patients in the C group and one each in the RS and HES group,
respectively (P = 0.362). Intravascular volume preload with colloid is more effective
than crystalloid solution in maintaining CO, which may be improved the
hemodynamic stability in elderly patients during SA.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=jbr110305&flag=1
5. Effects of infusion of different fluids during controlled hypotension on gastric
intramucosal pH and postoperative gastroenterological function. J Biomed
Res, 2011; 25(3):191-196
Guanglei Wang, Su Liu, Gongjian Liu
Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical College,
Xuzhou, Jiangsu 221002, China.
Abstract: The present study was aimed to investigate the effects of infusion of
different fluids combined with control-led hypotension on gastric intramucosal pH
(pHi) and postoperative gastrointestinal function in patients undergo-ing
hepatocarcinoma surgery. Forty-five patients (ASAⅡ) scheduled for surgical
resection of hepatocarcinoma undergoing controlled hypotension were randomly
assigned to three groups and received infusion of 20 mL/kg Ringer’s solution (R
group), 6% HAES(H group) or 6% Voluven group (W group). Intragastric PgCO2,
pHi, hematocrit and hemoglobin were measured. The significant decrease of pHi and
increase of PgCO2 were produced at 1 and 2 h after controlled hypotension in the R
group (P < 0.05 or P < 0.01). The time of bowel movement after operation was shorter
in the W group than the R group. Meanwhile, we also did not find obvious difference
in blood gas indexes among the three groups. The infusion of HAES and Voluven
during controlled hypotension could improve gastrointestinal perfusion and accelerate
the recovery of postoperative gastrointestinal function.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=jbr110306&flag=1
6. Anisocoria in a 10-month old girl in the immediate preoperative setting: can
you proceed with surgery. J Biomed Res, 2011; 25(3):224-226
Zoel A Quinonez, Niroop R Ravula
Department of Anesthesiology and Pain Medicine, University of California Davis
Health System, CA 95817, USA.
Abstract: We report the case of a 10-month old girl with a significant past medical
history who presented for elective surgery with a new-onset fixed, dilated pupil. We
briefly review the diagnostic approach to such patients and provide guidelines for
managing these patients in the immediate preoperative setting.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=jbr110311&flag=1
7. Preoperative administration of intramuscular dezocine reduces postoperative
pain for laparoscopic cholecystectomy. J Biomed Res, 2011; 25(5):356-361
Yaomin Zhu, Guixia Jing, Wei Yuan
Department of Anesthesiology, the First Affiliated Hospital of Medical College,
Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China.
Abstract: Postoperative pain is the most common complaint after laparoscopic
cholecystectomy. This study was carried out to evaluate whether preoperative
administration of intramuscular dezocine can provide postoperative analgesia and
reduce postoperative opioid consumption in patients undergoing laparoscopic
cholecystectomy. Patients (ASA Ⅰ or Ⅱ) scheduled for laparoscopic
cholecystectomy were randomly assigned into intramuscular dezocine group (group 1)
or intramuscular normal saline group (group 2). Dezocine and equal volume normal
saline were administered intramuscularly 10 min before the induction of anesthesia.
After operation, the severity of postoperative pain, postoperative fentanyl requirement,
incidence and severity of side-effects were assessed. Postoperative pain and
postoperative patient-controlled fentanyl consumption were reduced significantly in
group 1 compared with group 2. The incidence and severity of side effects were
similar between the two groups. Preoperative single-dose administration of
intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and
postoperative patient-controlled fentanyl requirement in patients undergoing
laparoscopic cholecystectomy.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=jbr110507&flag=1
8. Parthenolide attenuates LPS-induced activation of NF-κB in a
time-dependent manner in rat myocardium. J Biomed Res, 2012; 26(1):37-43
Hong Xiea, Chen Wanga,b, Xuemei Wua, Xia Liua, Shigang Qiaoa, Chunfeng Liub,
Hong Liuc
a
Department of Anesthesiology, the Second Affiliated Hospital of Soochow
University, Suzhou 215004, China;
b
Institute of Neuroscience, Soochow University, Suzhou 215004, China;
c
Department of Anesthesiology and Pain Medicine, University of California Davis,
Davis, CA 95616, USA.
Abstract: Parthenolide (PTN), a selective nuclear factor kappa B (NF-κB) inhibitor,
has been used extensively to inhibit NF-κB activation. The duration of the inhibitory
effect of PTN on NF-κB in vivo remains unclear. This study was to determine
whether a lipopolysaccharide (LPS) challenge 6, 12 and 24 h after the administration
of PTN could activate NF-κB. Rats were devided into five groups. The rats in the
PTN, PTN+LPS and DMSO groups were injected intraperitoneally with PTN or
DMSO. After 6, 12 or 24 h, LPS was administered in LPS and PTN+LPS groups. The
expressions of NF-κB p50, IκBα and p-IκBα were inhibited in both PTN and
PTN+LPS group at end of 6 and 12 h and no effects at 24 h. In summary, myocardial
NF-κB expression occurs 1 h after the administration of LPS. PTN blocks this effect
given at 6 h and no inhibitory effect 24 h after administration in vivo.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=JBR120105&flag=1
9. Cellular exposure to muscle relaxants and propofol could lead to genomic
instability in vitro. J Biomed Res, 2012; 26(2):117-124
Allen Edward Colemana, Nicole McNeilb, Alexander Leonidovich Kovalchuckc, Dara
Wangsab, Thomas Riedb, Hong Wanga
a
Department of Anesthesiology, Wayne State University, Detroit Medical Center,
Detroit, Michigan 48201, USA;
b
Laboratory of Cancer Genomics, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland 20892, USA;
c
Laboratory of Immunogenetics, National Institute of Allergy and Infectious
Disease, National Institutes of Health, Rockville, Maryland 20852, USA.
Abstract: Anesthesia is widely used in several medical settings and accepted as safe.
However, there is some evidence that anesthetic agents can induce genomic changes
leading to neural degeneration or apoptosis. Although chromosomal changes have not
been observed in vivo, this is most likely due to DNA repair mechanisms, apoptosis,
or cellular senescence. Potential chromosomal alterations after exposure to common
anesthetic agents may be relevant in patients with genomic instability syndromes or
with aggressive treatment of malignancies. In this study, the P388 murine B cells
were cultured in vitro, and spectral karyotyping (SKY) was utilized to uncover
genome-wide changes. Clinically relevant doses of cisatracurium and propofol
increased structural and numerical chromosomal instability. These results may be
relevant in patients with underlying chromosomal instability syndromes or
concurrently being exposed to chemotherapeutic agents. Future studies may include
utilization of stimulated peripheral blood lymphocytes to further confirm the
significance of these results.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=JBR120208&flag=1
10. Reduced turnover times make flexible optical reusable scope with
EndoSheath® Technology significantly cost-effective. J Biomed Res, 2012;
26(4):241-247
Deepak Gupta, Arvind Srirajakalidindi, Hong Wang
Department of Anesthesiology, Detroit Medical Center, Wayne State University,
Detroit, MI 48201, USA
Abstract: ndoSheath bronchoscopy (Vision Sciences, Inc.) uses a sterile, disposable
microbial barrier that may meet the growing needs for safe, efficient, and cost
effective flexible bronchoscopy. The purpose of this open-label comparative study
was to compare and calculate the costs-per-airway-procedure of the reusable
fiberscope when used with and without EndoSheath? Technology; and to record the
turnover time from the completion of the use of each scope until its readiness again
for the next use. Seventy-five new patients' airways requiring airway maneuvers and
manipulations with Vision Sciences, Inc., reusable fiberscope with EndoSheath?
Technology were evaluated for the costs comparisons with reassessed historical costs
data for Olympus scope assisted tracheal intubations. As compared to costs of an
intubation ($158.50) with Olympus scope at our institute, the intubation costs with
Vision Sciences, Inc., reusable fiberscope with EndoSheath technology was $81.50 (P
< 0.001). The mean turnover time was 5.44 min with EndoSheath technology as
compared to previously reported 30 min with Olympus fiberscope (P < 0.001). Based
on our institutional experience, Vision Sciences, Inc., reusable fiberscope with
EndoSheath technology is significantly cost effective as compared to the Olympus
scope with significantly improved turnover times.
http://www.jbr-pub.org/ch/reader/view_abstract.aspx?file_no=JBR120402&flag=1