Group Rs Research Articles

Effect and mechanism of ketogenic diet on neurobehavioral demages induced by recurrent neonatal seizures

Objective To investigate the intervention effect of ketogenic diet (KD) on neurobehavioral demages after flurothyl-induced recurrent neonatal seizures in rats and on the expression of ApoE. Methods Postnatal day 8 (P8) SD rats (quantity: 48) were randomly divided into two groups: the non-seizure group (NS group, n=24) and the recurrent-seizure group (RS group, n=24). From P9, rats in RS group were subjected to recurrent seizures induced by volatile flurothyl 30 min each day for consecutive 8 days. While rats in NS group were placed into the container for an equal amount of time to their counterpart without exposuring to flurothyl. At P28, each group was divided into two groups again: non-seizure and normal diet group(NS+ ND group, n=12), non-seizure and ketogenic diet group(NS+ KD group, n=12), recurrent-seizure and normal diet group(RS+ ND group, n=12), recurrent-seizure and ketogenic diet group(RS+ KD group, n=12). At P42, neurodevelopmental indicators were monitored. ApoE protein levels in cerebral cortex were determined by western blot at P58. Results Neurodevelopmental indicators were analyzed at P42: in the plane righting experiment, the rats of group NS+ ND (1.0±0.14) about the time of plane righting was significant different comparing with group RS+ ND ((0.75±0.32)s)(P 0.05). In the negative geotaxis reaction experiment, the rats of groups NS+ KD and RS+ ND((3.17±0.58)s, (6.75±0.75)s) about the time of negative geotaxis reaction were significant different comparing with group NS+ ND ((1.58±0.52)s)(P<0.05). Compared with group RS+ ND, the group RS+ KD in the time of negative geotaxis reaction was obviously shortened(P<0.05). In the cliff avoidance test, there were significant differences between group NS+ ND、RS+ KD ((5.75±2.90)s, (9.50±4.36)s)and group RS+ ND((14.00±4.79)s) about the time of cliff avoidance(P<0.05). In western blot, the expression of ApoE in cerebral cortex in the RS+ ND group (1.26±0.30) was obviously increased compared with group NS+ ND (0.78±0.12) (P<0.05), and there had also significant difference between group RS+ KD (0.89±0.10) and group RS+ ND(P<0.05). Conclusion The neuroprotective effects of ketogenic diet on recurrent neonatal seizure-induced neurobehavioral demages may be associated with the reduction of ApoE in cerebral cortex. Key words: Neonatal seizure; Ketogenic diet; Neurobehavior; ApoE

Effect of stellate ganglion block on cardiomyocyte apoptosis and expression of Bcl-2/Bax protein in spontaneously hypertensive rats

To investigate the relationship between apoptosis of myocardial cells in spontaneously hypertensive rats (SHRs) and the expressions of Bcl-2 and Bax protein, and the protective effect of stellate ganglion block on apoptosis of myocardial cells. A total of 32 ten-week-old male SHRs were assigned randomly into 4 groups: a left stellate ganglion block group (group LS), a right stellate ganglion block group (group RS), a captopril group (group D) and a control group (group C). The arterial systolic blood pressure was measured by ALC-NIBP system. After 10 weeks, all rats were anaesthetized by 3% pentobarbital sodium, cardiomyocyte apoptosis index of left ventricle was assessed by TUNEL, and the localization of myocardium Bcl-2, Bax was investigated by immunohistochemistry. Compared with group LS and C, the apoptotic index decreased (P<0.05). SHR myocardial expression of Bcl-2 significantly increased (P<0.05), Bax expression significantly decreased (P<0.05) and Bcl-2/Bax was significantly higher (P<0. 05) in group RS. Bcl-2 and Bax play an important role in the apoptosis of myocardial cells in SHRs. Right stellate ganglion block can reduce the apoptosis of myocardial cells and reverse the reconstruction of the left ventricle in SHRs via regulation of apoptosis-related gene proteins.

Effect of stellate ganglion block on reconstruction of the left ventricle in spontaneously hypertensive rats

To determine the effect of stellate ganglion block on reconstruction of the left ventricle in spontaneously hypertensive rats (SHRs). Thirty-two 10-week-old male SHRs were randomly assigned into 4 groups: a left stellate ganglion block group (group LS), a right stellate ganglion block group (group RS), a captopril group (group D) and a control group (group C). The arterial systolic blood pressure (SBP) was measured by ALC-NIBP measuring system. After 10 weeks, we observed the left ventricular mass index (LVMI), myocardial pathologic changes, and detected the endothelin (ET-1) and endothelial nitric oxide synthase (eNOS) level in the left ventricle by radioimmunoassay and the collagen protein level in the left ventricle by immunohistochemical method. Compared with group LS and group C, the LVMI in group RS was lowered most notably (P<0.05) and pathological changes were improved obviously. The expression of eNOS in group RS was significantly increased and ET-1 significantly decreased (P<0.05) compared with that in group C and group LS. The expression of type I collagen fibers in group RS was significantly lower and type III collagen fibers significantly higher (P<0.05) when compared with that in group C and LS. Right stellate ganglion block can not only decrease the arterial pressure but also reverse the reconstruction of the left ventricle.

Patterns of femoropopliteal recurrence after routine and selective stenting endoluminal therapy

This study determined the incidence and characteristics of recurrent disease after femoropopliteal angioplasty, following either selective or routine stenting of diseased site(s). Retrospective analysis of a prospectively maintained database for femoropopliteal interventions from June 2003 to July 2010 was performed. Interventions during this period were from a single institution, followed up at 1, 3, and 6 months after initial intervention and on a semiannual basis thereafter with clinical examinations and duplex ultrasound imaging. Two groups were identified: those with routine stenting (RS; routine stenting for all diseased areas) and those with selective stenting (SS; selective stenting for only segments which exhibited compromised flow from residual stenosis or significant dissection). Patients who developed recurrent symptoms (claudication, rest pain), a decrease in ankle-brachial index (ABI) (>0.2), or duplex documentation of a significant (>80%) recurrent stenosis underwent reintervention. Patient demographics, comorbidities, Trans-Atlantic Inter-Society Consensus (TASC) II classification, runoff, and degree of calcification (none, mild, moderate, severe) at initial intervention were recorded. The time to reintervention and recurrence pattern were recorded for both groups. During the study period, 746 endovascular interventions in 477 patients were performed. Total reintervention rate, including bypass, amputation, and asymptomatic occlusion after initial intervention, was 36.48% (group SS, 42.9%; group RS, 33.1%; P=.04). Of all initial interventions, 182 endovascular reinterventions in 165 patients for recurrent femoropopliteal disease were identified (group SS, 70; group RS, 95). No differences were noted among the groups in gender, comorbidities, initial TASC II classification, run off, calcification scores, or statin or clopidogrel use, or both. Time to recurrence was similar in the RS and SS groups. TASC II classification, runoff score, and degree of calcification were similar between the two groups. Although not statistically significant, analysis of recurrence pattern demonstrated de novo stenosis was more common in the SS group (50.0% vs 34.7%; P=.06). This single-center retrospective study found a significant difference in the incidence of recurrence requiring reintervention between patients treated with selective and routine stenting for femoropopliteal disease. Analysis of endovascular reinterventions, however, reveals no significant difference in recurrence time or recurrence pattern between the two groups. No significant differences were identified in time to recurrence, TASC II classification, runoff, and calcification of endovascular reinterventions between the two groups' end points. Additional prospective studies to evaluate the roles of routine and selective stenting in symptomatic femoropopliteal peripheral arterial disease and to investigate recurrence lesion characteristics and the patency of multiple endovascular interventions between these two groups are needed.

Geometric Analysis of Root Canals Prepared by Four Rotary NiTi Shaping Systems

IntroductionA great number of nickel-titanium (NiTi) rotary systems with noncutting tips, different cross-sections, superior resistance to torsional fracture, varying tapers, and manufacturing method have been introduced to the market. The purpose of this study was to evaluate and compare the effect of 4 rotary NiTi preparation systems, Revo-S (RS; Micro-Mega, Besancon Cedex, France), Twisted file (TF; SybronEndo, Amersfoort, The Netherlands), ProFile GT Series X (GTX; Dentsply, Tulsa Dental Specialties, Tulsa, OK), and ProTaper (PT; Dentsply Maillefer, Ballaigues, Switzerland), on volumetric changes and transportation of curved root canals. MethodsForty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 25° to 40° were divided according to the instrument used in canal preparation into 4 groups of 10 samples each: group RS, group TF, group GTX, and group PT. Canals were scanned using an i-CAT CBCT scanner (Imaging Science International, Hatfield, PA) before and after preparation to evaluate the volumetric changes. Root canal transportation and centering ratio were evaluated at 1.3, 2.6, 5.2, and 7.8 mm from the apex. The significance level was set at P ≤ .05. ResultsThe PT system removed a significantly higher amount of dentin than the other systems (P = .025). At the 1.3-mm level, there was no significant difference in canal transportation and centering ratio among the groups. However, at the other levels, TF maintained the original canal curvature recording significantly the least degree of canal transportation as well as the highest mean centering ratio. ConclusionsThe TF system showed superior shaping ability in curved canals. Revo-S and GTX were better than ProTaper regarding both canal transportation and centering ability.

Morphological characterization of the liver in a murine non‐alcoholic fatty liver disease model

Non‐alcoholic fatty liver disease (NAFLD) is increasing and may progress to hepatocellular carcinomas. We sought to clarify the morphological and functional characteristics of the hepatic changes in a murine NAFLD model. Nine‐week(wk)‐old male C57BL/6 mice were fed an MCD (methionine‐chorine deficient) diet up to 30 wk (group M). Recovery model mice (group R) were prepared by feeding normal control diet for two weeks after the termination of MCD diet feeding for 8, 16, 30 wk. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured and liver cryosections were made. A multiple‐immunostaining technique for various markers was employed for the 3‐dimentional imaging by the confocal laser‐scanning microscopy. Serum AST was elevated from 2 wk (Wk 2) to Wk 16, but decreased at Wk 30 in group M. Oil red O staining also indicated that the group M caused fat accumulation in hepatocytes from Wk 2 to Wk 16. Fibrosis started from Wk 10 and progressed thereafter in group M. In group Rs, serum AST decreased and the fat deposition and fibrosis improved. The immunohistochemical data revealed swollen CD68 positive cells appeared and increased after Wk 16. In semi‐thin sections, these cells contained various‐shaped contents including dead cell fragments, and they remained in group R. The significance of these CD68 positive cells in the pathogenesis of the hepatic changes caused by the MCD diet is discussed.

Effects of stellate ganglion block on blood pressure in spontaneously hypertensive rats

To investigate the effects of stellate ganglion block (SGB) on blood pressure in spontaneously hypertensive rats(SHRs). Thirty-two 10-week-old male spontaneously hypertensive rats(SHRs) were assigned randomly into four groups: left stellate ganglion block group(Group LS), right stellate ganglion block group(Group RS), captopril group(Group D) and control group(Group C). Arterial systolic blood pressure(SBP) was measured, and endothelin (ET-1) and endothelial nitric oxide synthase(eNOS) in blood vessels were detected by radioimmunoassay. Compared with baseline value, the blood pressure of Group LS gradually increased significantly (P<0.05 or P <0.01); however, the blood pressure of Group RS was stable(P >0.05) and increased only at week 2(P <0.05).The blood pressure of Group D decreased significantly at week 2 and week 4, and it remained stable compared with baseline value (P<0.05). The blood pressure of Group C gradually increased at weeks 2-10, compared with baseline values (P <0.01). Compared with Group LS and Group C, the expression of eNOS in blood vessels of Group RS significantly increased (P <0.05), and ET-1 decreased (P <0.05). The right stellate ganglion block can significantly lower blood pressure, down-regulate ET-1 and up-regulate eNOS protein expression.

Effect of volume therapy with 6 ％ hydroxyethyl starch 130/0.4 on mesenteric microcirculation in a rabbit model of hypovolemia

Objective To investigate the effect of volume therapy with 6％ hydroxyethyl starch (HES) 130/0.4 on mesenteric microcirculation in a rabbit model of hypovolemia.Methods Sixty-four adult male rabbits,weighing 2.0-2.3 kg,were randomly divided into 4 groups( n =16 each):control group (group C),hypovolemia group (group HM),Ringer's solution group (group RS) and 6％ HES 130/0.4 group (group HES).The animals were anesthetized with sodiun pentobarbital 3.0-3.5 mg/kg.Femoral artery,femoral vein and right internal jugular vein were cannulated for MAP monitoring,blood withdrawing and fluid adminstration.Hypovolemia was induced by withdrawing blood from femoral vein of 30％ blood volume in 30 min in groups HM,RS and HES.In group C,no blood was withdrawed.In group RS,Ringer's solution 3 times of the volume of blood withdrawn was infused,while 6％ HES 130/0.4 equal volume of blood withdrawn was infused via right internal jugular vein immediately at the end of blood withdrawing.MAP and HR were recorded and femoral artery and femoral vein blood samples were taken before blood withdrawing (T0),immediately at the end of blood withdrawing(T1 ),immediately at the end of volume therapy(T2 ) and 30 min after volume therapy(T3 ).DO2,VO2 and ERO2 were calculated.Diameter and blood flow speed of microvessel were determined.Results Compared with group C,HR was significantly increased,MAP decreased,diameter and blood flow speed of microvessel were decreased at T1～3,DO2 was increased at T1 in group HM.Compared with group HM,MAP was significantly increased at T2,HR decreased at T2,3,DO2and VO2 were increased at T1～3,diameter of arteriole was increased at T2 whlie decreased at T3,diameter of veinule and blood flow speed of microvessel were increased at T2,3 in group RS,MAP was significantly increased at T2,HR was decreased whlie DO2 and VO2 were decreased,VO2,ERO2,diameter and blood flow speed of microvessel were increased at T2,3 in group HES.Compared with group RS,DO2,VO2 and ERO2 were significantly decreased at T3 in group HES.Conclusion Volume therapy with 6％ HES 130/0.4 can improve mesenteric microcirculation,organ perfusion and oxygen metabolic in a rabbit model of hypovolemia. Key words: Hetastarch ; Fluid therapy ; Hypovolemia; Microcirculation

Diagnostic value of early secretory antigenic target⁃6 and interferon⁃γ in cerebrospinal fluid for the diagnosis of tuberculous meningitis

Objective To explore the value of early secretory antigenic target-6 (ESAT-6) and interferon-γ (IFN-γ) in cerebrospinal fluid (CSF) for the diagnosis of tuberculous meningitis (TBM). Methods Eighty-one patients were examined in our hospital or outpatient clinic. Referenced to the diagnostic criteria of TBM, patients were divided into 3 groups: 21 cases were patients with TBM; 28 were patients with intracranial infection of non-TBM; and 32 controls without nervous system disease. CSF sample was collected by standard lumbar puncture and was used for detection of ESAT-6 and IFN-γ with enzyme-linked immunosorbent assay (ELISA). Results The concentration of ESAT-6 in the CSF of TBM group was 4.46 pg/ml [(2.20-10.55) pg/ml] and the IFN-γ was 34.86 ng/L [(25.62-241.71) ng/L]. The average concentrations of ESAT-6 and IFN-γ in the intracranial infection of non-TBM group and the control group were (1.18 ± 0.49) pg/ml, (12.00 ± 3.37) ng/L and (1.05 ± 0.47) pg/ml, (14.58 ± 3.46) ng/L, respectively. The levels of ESAT-6 and IFN-γ were significantly higher in the TBM group than in the intracranial infection of non-TBM group (H = 35.695, P = 0.000) and the control group (H = 31.560, P = 0.000), but were not significantly different between the intracranial infection of non-TBM group and the control group (t ＝ 1.226, P = 0.226; t = 0.060, P = 0.952, respectively). The Spearman rank correlation analysis showed positive correlation between ESAT-6 and IFN-γ detected in the TBM group (rs = 1.000, P = 0.000). Conclusion The levels of ESAT-6 and IFN-γ in the TBM group were significantly different from the intracranial infection of non-TBM group and the control group. The 2 indicators present certain correlation and can be helpful in the clinical diagnosis of TBM. DOI：10.3969/j.issn.1672-6731.2011.05.014

Bending moments of zirconia and titanium abutments with internal and external implant–abutment connections after aging and chewing simulation

To test the fracture load of zirconia abutments with different types of implant-abutment connections after chewing simulation and to compare their bending moments to internally connected identical titanium abutments. Forty-eight identical customized zirconia abutments with different implant-abutment connections were fabricated for four different test groups: one-piece internal implant-abutment connection (BL; Straumann Bonelevel), two-piece internal implant-abutment connection (RS; Nobel Biocare Replace Select), external implant-abutment connection (B; Brånemark MK III), two-piece internal implant-abutment connection (SP; Straumann Standard Plus). Twelve titanium abutments with one-piece internal implant-abutment connection (T; Straumann Bonelevel) served as control group. After aging by means of thermocycling (5-50°C, 120 s) and chewing simulation (1,200,000 cycles, 49 N load, 1.67 Hz), static load was applied at a 30° angle to the palatal surface until failure. Bending moments were calculated for comparison of the groups. Data were analyzed descriptively and by performing the Kruskal-Wallis test with Bonferroni correction. The mean bending moments of the abutments were 714.1 ± 184.9 N cm (T), 331.7 ± 57.8 N cm (BL), 429.7 ± 62.8 N cm (RS), 285.8 ± 64.4 N cm (B) and 379.9 ± 59.1 N cm (SP). The bending moments of control group T were significantly higher than those of all other groups. The values of group RS were significantly higher than those of group B but within the value range of groups SP and BL. The bending moments of the different tested types of zirconia abutments vary with different implant-abutment connections after chewing simulation. The use of a secondary metallic component might have a beneficial influence on the stability of zirconia abutments.

Two-dimensional strain combined with adenosine stress echocardiography assessment of viable myocardium

The objective of this study was to explore a new method for the identification of viable myocardium by means of two-dimensional (2D) strain imaging combined with adenosine stress echocardiography. A total of 15 anesthetized open-chest healthy mongrel dogs underwent left anterior descending coronary artery occlusion for 90 min followed by 120-min reperfusion. Adenosine was infused at 140 μg kg(-1) min(-1) over a period of 6 min. Images were acquired at baseline (when pericardial cradle was made), after reperfusion (when reperfusion finished) and after adenosine administration (while administration stopped). Measurements of the regional peak-systolic strain in radial, circumferential, and longitudinal motion on anterior wall and anterior septum were, respectively, performed under different conditions. The dogs were killed after the echocardiographic studies finished and then the area of infracted myocardium was defined by triphenyltetrazolium chloride histology. A segment with equal or less than 50% area of infracted myocardium was considered to be viable. As a result, 37 regions were viable whereas 53 were non-viable among 90 regions in 15 dogs. At baseline, there was no significant difference in peak-systolic radial strain (Rs), circumferential strain (Cs), and longitudinal strain (Ls) between the viable and non-viable groups. After reperfusion, Rs, Cs, and Ls in absolute value decreased compared to those at baseline in both groups, although there was no significant difference between these groups. Rs and Ls increased after adenosine administration compared to reperfusion (p < 0.01; p < 0.05) in viable group while there were no changes in non-viable group. Compared with non-viable group Rs, Cs and Ls in viable group increased significantly (p < 0.01; 0.05) after adenosine administration. There was a negative correlation between Rs and infarct size (r = -0.72). Cs and Ls correlated well with infarct size, respectively (r = 0.40; 0.67). A change of Rs more than 13.5% has a sensitivity of 83.8% and a specificity of 83.0% for viable whereas a change of Ls more than 11% allowed a sensitivity of 78.4% and a specificity of 88.7%. Combined with these two variables, the sensitivity and specificity could reach 91.9 and 79.2%. Two-dimensional strain imaging combined with adenosine stress echocardiography can provide a new way to distinguish viable myocardium from the non-viable.

Effects of volume therapy with different doses of 6% hydroxyethyl starch 130/0.4 on lung injury in a rat model of hemorrhagic shock

Objective To evaluate the effects of volume therapy with different doses of 6% hydroxyethyl starch 130/0.4 (6% HES 130/0.4) on lung injury in a rat model of hemonhagic shock.Methods Twenty-four male SD rats weighing 220-300 g were randomly divided into 4 groups ( n = 6 each) : group I sham operation (group S); group II Ringer's solution (group RS); group HI and IV 2 HES groups (group H1, H2 ). The animals were anesthetized with intraperitoneal 1% sodium pentobarbital 45 ing/kg. Right common carotid artery (CCA) and left femoral vein were cannulated for blood letting, MAP monitoring, fluid administration and blood sampling. Hemonhagic shock was induced by withdrawing blood from right CCA in group II , III and IV . MAP was reduced to 35-45 mmHg which was maintained for 90 min. In group RS, hemorrhagic shock was resuscitated with Ringer's solution 3 times of the volume of blood withdrawn, while group H1 and H2 received HES 33 and 50 ml/kg respectively and Ringer' s solution (the total volume was equal to 3 times of the volume of blood removed) . Arterial blood samples were taken before blood letting (T0 , baseline), and at 2, 3 h after volume therapy (T1,2) for blood gas analysis and PaO2/FiO2 was calculated. The animals were then sacrificed by exsanguination and the lungs were immediately removed for microscopic examination and determination of protein concentration in broncho-alveolar lavage fuid (BALF), W/D lung weight ratio and TNF-α, IL-1 β and IL-10 contents in the lung.Results TNF-α, IL-1β and IL-10 content in the lung, protein concentration in BALF and W/D ratio were significantly higher in group RS, H1 and H2, while PaO2/FiO2 was significantly lower at T,2 in group RS and at T2 in group H2 than in group S (P < 0.05). TNF-α and IL-1β contents in the lung, protein concentration in BALF and W/D ratio were significantly lower in group H1 and H2 , while PaO2/FiO2 was significantly higher at T,i2 in group H1 and at T1 in group H2 than in group RS (P <0.05) . PaO2/FiO2 at T2 and IL-10 content in the lung were significantly lower in group H2 than in group H, ( P < 0.05) . The lung damage was significantly ameliorated in group H1 and H2 especially in group H, as compared with group RS. Conclusion Volume therapy with 6% HES 130/0.4 33 or 50 ml/kg can attenuate lung injury in a rat model of hemorrhagic shock and the efficacy of 33 ml/kg is better. Key words: Hetastarch; Shock,hemorrhagic; Respiratory distress syndrome,adult

Comparison of remifentanil-propofol and remifentanil-sevoflurane anaesthesia for laparoscopic cholecystectomy

Objective To examine recovery profile and haemodynamic differences using remifentanil infusion with either propofol target controlled infusion system or sevoflurane inhalation for laparoscopic choleeystectomy. Methods Forty-eight adult patients, ASAⅠ～Ⅱgrade, undergoing elective laparoseopie cholecystectomy were randomly divided into two groups(n=24). Group R P received propofol target controlled infusion system and remifentanil; Group RS received sevoflurane and remifentanil for maintenance of anaesthesia. The amount of narcotie medication during the oporation, mean arterial pressure (MAP) and heart rate (HR) at each time point during anesthesia and awake time for patients after surgery of the two grous were recorded. Results No statistically significant differences between the two groups with tegards to the haemodynamic changes(P>O.05). Recovery times were considerably shorter after remifentanil-sevoflurane (7.0±3.4)min in comparison with remifentanil-prpofol (13.1±7.8) min target controlled infusion system group (P<0.01). Conclusion Remifentanil-propofol and sevoflurane-remifentanil combinations provide a similar adequate haemodynamic stability. However, sevoflurane-remifentanil gives a faster recovery compared with propofol target controlled infusion system with remifentanil for laparoscopic cholecystectomy. Key words: Propofol; Sevoflurane; Remifentanil; Target control infusion; Anaesthesia; Laparoscopic cholecystectomy

Attenuation of Propofol Tolerance Conferred by Remifentanil Co-Administration Does Not Reduce Propofol Toxicity in Rabbits Under Prolonged Mechanical Ventilation

Prolonged sedation with propofol at high doses may lead to fatal multi-organ dysfunction, know as propofol infusion syndrome. We tested the hypothesis that propofol plus remifentanil co-administration attenuates propofol tolerance to its sedative effect and assessed if such an effect has an impact on propofol toxicity in rabbits under prolonged mechanical ventilation. Eighteen healthy male rabbits were mechanically ventilated and received propofol (group P, n = 6), propofol plus remifentanil (group PR, n = 6), or remifentanil plus sevoflurane (group RS, n = 6) in order to be kept under sedation (group P) or sedation/analgesia (groups PR and RS) for up to 48 h. Initial propofol and remifentanil infusion rates (IRs) were adjusted, if needed, to maintain the desired level of sedation and analgesia, respectively (groups P and PR). In group RS, remifentanil was infused at IRs equivalent to those of group PR. Propofol IRs were recorded, propofol concentrations were measured in the arterial plasma, and blood biochemical parameters and organ histopathology were assessed. Animals survived for 29-36 h in group P and 22-38 h in group PR (100% mortality rate). Tolerance was developed to propofol's sedative effect. The onset of tolerance was delayed and its magnitude was decreased in group PR compared with group P. Propofol was accumulated in the systemic circulation. Propofol clearance rate was gradually decreased. Arterial lactate, and serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH), bilirubin, cholesterol, triglycerides, and creatine kinase (CK) levels were increased. The heart, lungs, liver, gallbladder, kidneys, urinary bladder, and skeletal muscles were seriously injured in groups P and PR. In group RS, mortality was 0%, while there was only mild injury of the lungs, liver, gallbladder, kidneys, and urinary bladder. Although propofol tolerance is attenuated in propofol plus remifentanil receiving rabbits under prolonged mechanical ventilation, fatal multi-organ injury occurs resembling human propofol infusion syndrome.

The expression and meaning of TGF-β and TGIF in endometrosis

Objective To explore the role of TGF-βand TGIF in the pathogenesis of endometriosis. Methods The expression of TGF-β and TGIF was detected by immunohistochemistry method in the ectopic and eutopic endometrium of 30 cases with endometriosis (ec-topic endometrium group and eutopic endometrium group) and in the normal endometrium of 40 cases without endometriosis (control group). Result The expression of TGF -β in ectopic endometrium group was significantly higher than that in eutopic endometrium group and control group (P 0.05). The expression of TGIF in ectopic endometrium group was significantly lower than that in eutopic endometrium group and control group( P 0.05). There were negative correlation between the expressions of TGF - β and TGIF in ectopic endometrium group and eutopic endome-trium group(rs= - 0.769, - 0.549, P < 0.05). Conclusion The abnormal expression of TGF-β and TGIF in ectopic endometrium of pa-tients with endometriosis may be associated with the genesis and progression of endometriosis. Key words: Transforming growth factor beta/ME; Endometriosis/ME

Effects of a low dose infusion of racemic and S-ketamine on the nociceptive withdrawal reflex in standing ponies

ObjectiveTo investigate the effect of plasma concentrations obtained by a low dose constant rate infusion (CRI) of racemic ketamine or S-ketamine on the nociceptive withdrawal reflex (NWR) in standing ponies. Study designProspective, blinded, cross-over study. AnimalsSix healthy 5-year-old Shetland ponies. MethodsPonies received either 0.6 mg kg−1 racemic ketamine (group RS) or 0.3 mg kg−1 S-ketamine (group S) intravenously (IV), followed by a CRI of 20 μg kg−1minute−1 racemic ketamine (group RS) or 10 μg kg−1minute−1 S-ketamine (group S) for 59 minutes. The NWR was evoked by transcutaneous electrical stimulation of a peripheral nerve before drug administration, 15 and 45 minutes after the start of the bolus injection and 15 minutes after the end of the CRI. Electromyographic responses were recorded and analysed. Arterial blood was collected before stimulation and plasma concentrations of ketamine and norketamine were measured enantioselectively using capillary electrophoresis. Ponies were video recorded and monitored to assess drug effects on behaviour, heart rate (HR), mean arterial blood pressure (MAP) and respiratory rate. ResultsThe NWR was significantly depressed in group RS at plasma concentrations between 20 and 25 ng mL−1 of each enantiomer. In group S, no significant NWR depression could be observed; plasma concentrations of S-ketamine (9–15 ng mL−1) were lower, compared to S-ketamine concentrations in group RS, although this difference was not statistically significant. Minor changes in behaviour, HR and MAP only occurred within the first 5–10 minutes after bolus drug administration in both groups. ConclusionAntinociceptive activity in standing ponies, demonstrated as a depression of the NWR, could only be detected after treatment with racemic ketamine. S-ketamine may have lacked this effect as a result of lower plasma concentrations, a more rapid metabolism or a lower potency of S-ketamine in Equidae so further investigation is necessary.

Can Exercise, Calcium Supplementation, And Changes In Body Composition Explain Bone Responders And Nonresponders?

PURPOSE: To determine whether 4-year bone mineral density (BMD) changes were different between responders (R) and nonresponders (NR) after adjusting for age, 4-year exercise frequency (EX Freq), 4-year calcium supplementation (CA) and 4-year changes in body composition (BC). METHODS: Sedentary postmenopausal women (40-65 years) with HT (1-3.9 years) or without HT (>1 year) were recruited to participate in a study designed to determine the effects of strength and weight-bearing exercise training on BMD in calcium- supplemented postmenopausal women. After year 1, women randomized to control were invited to self-select exercise or control. One hundred and sixty-seven women completed 4 years of the study. Regional BMD and BC were measured using dual-energy x-ray absorptiometry at baseline and yearly thereafter. EX Freq, CA and HT use were monitored throughout the study. Hierarchical multiple regression analyses were used to predict 4-year BMD changes from EX Freq, CA, age, and 4-year changes in BC. Analyses were conducted separately for HT users (n = 115, 55.3 ±4.3 yrs) and non-users (n = 52, 57.5 ± 4.7 yrs). Factor analyses were used to identify groups of women who had similar patterns of 4-year BMD changes from: those who did not train (Ctrl, n = 23) and those who did train (EX, n = 52) for 4years of the study. Those with increasing BMD patterns were denned as Rs and those with decreasing BMD patterns were denned as NRs. Adjusted 4-year BMD changes were calculated from the above regressions. Independent t-tests were used to determine whether R and NR differed in their 4-year BMD changes at the spine, trochanter and femoral neck. RESULTS: For the Ctrls, the mean differences between R and NR for the spine, trochanter and neck BMD changes were 0.09, 0.03, and 0.08 g/cm2 (p = 0.00) prior to adjustment and were 0.02, 0.01, and 0.02 g/cm2 (p > 0.05) after adjustment. For the EXs, the mean differences between R and NR for the spine, trochanter and neck BMD changes were 0.13, 0.08, and 0.08 g/cm2 (p = 0.00) prior to adjustment and were 0.02 (p = 0.05), 0.02 (p = 0.003), and 0.01 g/cm2 (p = 0.16) after adjustment. CONCLUSIONS: EX NRs and Ctrl group Rs existed. Age, EX Freq, CA and changes in BC accounted for the differences between R and NR in all cases except for the trochanter and spine BMD changes in EXs where mean differences were reduced but not eliminated.

Is there an ideal approach for rapid-sequence induction in hypertensive patients?

Study Objective To compare 4 different anesthesia induction protocols, in a simulated model of rapid-sequence induction, in controlled hypertensive patients. Design Prospective, randomized, double-blind, clinical investigation. Setting Large metropolitan university hospital. Patients 120 ASA II-III adult hypertensive patients. Interventions Patients were allocated to 4 groups at random. After preoxygenation for 3 minutes, induction and tracheal intubation was performed in a 30° head-up position. Thiopental (5-7 mg/kg) was the induction agent. Study groups were as follows: group LS (n = 30), lidocaine (1.5 mg/kg) and succinylcholine (1 mg/kg); group LR (n = 30), lidocaine (1.5 mg/kg) and rocuronium (1 mg/kg); group RS (n = 30), remifentanil (1 μg/kg) and succinylcholine (1 mg/kg); group RR (n = 30), remifentanil (1 μg/kg) and rocuronium (1 mg/kg). Patients were intubated 60 seconds after administration of muscle relaxant. Measurements Hemodynamic data were obtained before induction (baseline), after induction, at intubation, and at 1, 3, 5, and 10 minutes after intubation. More than 20% change in blood pressure and heart rate was considered significant. Main Results Systolic and mean arterial blood pressures at intubation and 1 and 3 minutes after intubation were higher in group LS compared with groups RS and RR ( P < 0.01). Mean arterial blood pressure decreased after induction in groups LS, LR, and RR, but increased at intubation and 1 minute after intubation in groups LS and LR ( P < 0.01). Mean arterial blood pressure was similar at all measurement intervals in group RS. The median area under the systolic, mean, and diastolic blood pressure time curves was higher in groups LS and LR compared with groups RS and RR ( P < 0.05 and P < 0.01). Conclusions Remifentanil is a better adjunct for attenuation of the response to laryngoscopy and intubation compared with lidocaine, whereas remifentanil-succinylcholine combination appears to be more beneficial in terms of hemodynamic stability in hypertensive patients.

Periapical resurgery versus periapical surgery: a 5‐year longitudinal comparison

To monitor and compare the outcome of periradicular surgery in teeth that had previously undergone surgical treatment versus teeth that were undergoing a surgical procedure for the first time. A total of 164 patients with 231 roots with previously unresolved periapical lesions were followed for up to 5 years following surgery. In all, 162 roots had received unsuccessful conventional root canal treatment (group AS) and 69 had been treated previously using apical surgery (group RS). The surgical procedure was completed using ultrasonic retrotips to prepare the apical root-end cavity, and a zinc-oxide EBA reinforced material was used to fill the apical root-end cavities. Lesions were radiologically examined from 1 to 5 years following the surgical procedure. Radiographs were independently analysed, according to a previously published classification. In all the roots examined after 5 years, the overall healing rate was 78%; in group AS, 140 (86%) healed with complete bone filling of the surgical cavity, 12 (7%) were considered to have incompletely healed and 10 (6%) were associated with post-treatment disease. In group RS, 41 (59%) healed completely, 12 (17%) were considered to have incompletely healed and 16 (23%) were associated with post-treatment disease. The difference between a second surgical procedure and a first surgical procedure was statistically significant (Mann-Whitney U-test, P=0.001). Surgical retreatment of teeth previously treated with surgery is a valid alternative to extraction. However, association with post-treatment disease was greater than after a primary surgical approach.

Effects of different water treatment methods and antibiotic addition on larval survival and gut microflora development in Atlantic halibut ( Hippoglossus hippoglossus L.) yolk-sac larvae

The survival of Atlantic halibut ( Hippoglossus hippoglossus) yolk-sac larvae and the development of their gut bacterial flora were compared in pilot-commercial scale rearing trials under different conditions. Four different treatments were tested; water recirculation using non-disinfected embryos (RN); water recirculation using disinfected embryos (RS); flow-to-waste water with disinfected embryos (F); flow-to-waste water with disinfected embryos and addition of antibiotics, oxytetracycline, oxolinic acid and amoxycillin at 20 mg l −1 (FA). Mean survival was greatest in the FA group (53%), which was significantly higher ( p<0.01) than group F (28.8%). Both of the recycled water groups performed relatively well (42.3% survival for group RN and 47.8% for group RS), and physical environmental conditions were most stable in the two recycled water groups. The average incidence of abnormal developmental morphologies was low with an average of >71% morphologically normal larvae in all treatments. Addition of antibiotics appeared to prevent the colonisation of yolk-sac larvae by Marine Agar (MA)-culturable bacteria (<10 CFU/larva for group FA compared to 9.6×10 2 CFU/larva for group F). Higher levels of bacteria were recovered from both groups of larvae reared in recycled water (5.8×10 3 CFU/larva for group RN and 7.79×10 3 for group RS), indicating that bacterial abundance is not, in itself, a determinant of survival. Differences in the types of bacteria that colonised the halibut yolk-sac larvae under the different rearing regimes were described by characterization of the isolates. There appeared to be a relationship between larval survival rate and the presence, or absence, of certain phenotypes. In particular, the gut microflora in the poorest performing group (group F) was dominated by isolates biochemically and morphologically distinct from the predominant Pseudoalteromonas species isolated from the better performing recycled water groups. This lends weight to the hypothesis that certain types of bacteria may act as opportunistic pathogens in yolk-sac incubators while others are benign.