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The Effects of Intrathecal Ketamine and NBQX on Neurologic Injury and Spinal Cord Glutamate Receptor mRNA Expression in Transient Spinal Ischemia in the Rat
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Seung Hoon Baek, Jung Min Hong, Kyoo Sub Chung
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Korean J Crit Care Med. 2005;20(1):24-31.
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- BACKGROUND
Spinal cord injury occurring as the result of surgical repair of thoracic and thoracoabdominal aortic disease remains a devastating complication. Excitatory amino acids have been known to cause neurologic injury after neuronal ischemia. The purpose of this study was to elucidate the effects of intrathecal ketamine or NBQX on neurologic outcome and NMDA receptor gene expression in transient spinal ischemia. METHODS: Sprague-Dawley rats were anesthetized with enflurane, divided by 4 groups: Control (C group), Intrathecal ketamine 0.1 mg (K-1 group), Intrathecal ketamine 0.2 mg (K-2 group), and intrathecal NBQX 1 nM (N group). Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. After spinal ischemia, neurologic scores were assessed after 1, 2, 3 hours. After 3 hours rats were euthenized and spinal cords were removed for the assay of NMDAR and mGlu1 mRNA. RESULTS: The neurol ogic scores of K-2 and N groups were significantly lower than C group and K-1 group. There were no significant difference between K-1 group and C group. The NMDAR and mGlu1 gene expression was increase in C and K-1 group compared to sham operation. In K-2 and N groups, the gene expressions were significantly lesser than C group.
CONCLUSIONS
The NMDAR and mGlu1 gene expressions were increased in transient spinal ischemia. Intrathecal ketamine and NBQX were effective in preventing neurologic injury after transient spinal ischemia. The NMDA antagonistic action of ketamine might involve to prevent neurologic injury.
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The Effects of Moderate Hypothermia on the Formation of Apoptosis in Transient F degrees Cal Cerebral Ischemia Model in Rats
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Tae Jung Woo, Seong Wan Baik, Kyoo Sub Chung, Inn Se Kim, Hae Kyu Kim, Jae Young Kwon
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Korean J Crit Care Med. 2002;17(1):12-18.
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Abstract
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- BACKGROUND
Delayed neuronal injury after cerebral ischemia came major neurologic complication after stroke or cardiac arrest. Apoptosis formation after ischemia may be one of a mechanism of delayed neuronal injury. This study was conducted to evaluate the effect of moderate hypothermia on apoptosis formation after one hour of middle cerebral artery degrees Cclusion in rats.
METHODS
Ten Sprague-Dawley rats (300 g) were freely fed till just before operation. Anesthesia was induced with 4 vol% isoflurane in oxygen and then maintained with 2 vol% isoflurane in oxygen. Middle cerebral artery degrees Cclusion (MCAO) was induced by intraluminal monofilament nylon with blunted tip. All rats were divided randomly into two groups. In group 1 (n=5), rectal temperature was maintained at 38 degrees C. In group 2 (n=5), rectal temperature was maintained at 32 degrees C. Rectal temperature was monitored during experiment. After 60 minutes of MCAO, intraluminal monofilament was removed and all rats were returned to cages. Brain were quickly removed and cerebral hemispheres were separated after 23 hours reperfusion. Apoptosis formation were counted with TUNEL stain.
RESULTS
In group 1, after 60 minutes of MCAO and 23 hours reperfusion, 51 3.6% of hipp degrees Campal neurons were TUNEL-positive stained apoptotic cells. In group 2, TUNEL-positve neurons were 26.1 6.5% and significantly less than those of group 1 (p<0.05).
CONCLUSIONS
Sixty minutes of MCAO and 23 hours reperfusion induce hipp degrees Campal neuronal apoptosis. Moderate hypothermia of 32 degrees C reduces apoptosis of hipp degrees Campal neurons after 60 minutes of MCAO and 23 hours reperfusion.
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Molecular Biologic Study on the Changes of Glutamate Receptor (mGluR5) in Rat Hippocampus after Brain Ischemia
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Hae Kyu Kim, Pyong Ju Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 2000;15(2):75-81.
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Abstract
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- BACKGROUND
Metabotropic glutamate receptors (mGluRs) participate in the induction of synaptic plasticity phenomena, such as long-term potentiation and long-term depression that are thought to be at the origin of learning and memory. They are also likely to play a role in modulating glutamate-induced neurotoxicity. It will become apparent that mGluRs are excellent targets for the development of drugs that modulate excitatory synaptic transmission. But there were several controversies about the exact role of group 1 mGluRs subtype 5 (mGluR5). This study was designed for evaluation of the neuroprotective role of mGluR5.
METHODS
Fifty male Sprague-Dawley rats were divided into three groups, control, MK-801 and lamotrigine. The hippocampus and basal ganglia were removed at 6 hours and 3 days after the one hour transient middle cerebral artery occlusion. The gene expression of mRNA of the brain samples were evaluated by using reverse transcriptase polymerase chain reaction technique.
RESULTS
The gene expression of mGluR5 mRNA in hippocampus was increased by 101.96 +/- 18.45% at 6 hours after ischemia and decreased by 50.70 +/- 15.73% at 3 days after ischemia (p<0.01). MK-801 and lamotrigine attenuated the ischemia-induced increases of gene expression of mGluR5 mRNA. In MK-801 group, the expression in basal ganglia was increased by only 0.23 +/- 5.41% at 6 hours after ischemia and decreased by 9.82 +/- 4.35% at 3 days after ischemia. In MK-801 group, the expression in hippocampus was decreased by 3.45 +/- 8.24% and 9.35 5.69% at 6 hours and 3 days after ischemia. In lamotrigine group, the expressions in hippocampus and basal ganglia were decreased by 26.66 +/- 9.85% and 9.45 +/- 5.22% at 6 hours after ischemia.
CONCLUSIONS
From these results, the role of mGluR5 was defined as a mediator for neuronal damage after transient focal cerebral ischemia in hippocampus and basal ganglia.
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Quality Assessment of Blood Transfusion in Operating Room
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Myoung Gil Chae, Byeung Ho Byeun, Dong Hee Kang, Hae Kyu Kim, Seong Wan Baik, Kyoo Sub Chung
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Korean J Crit Care Med. 1998;13(2):234-238.
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Abstract
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- BACKGOUND: Transfusion of red blood cells is a life saving measure in the management of a variety of surgical conditions. A guideline for blood transfusion during elective surgical procedure is necessary to reduce the risks of transfusion-associated complications, excessive blood bank workload, excessive blood request and overtransfusion, and the cost. From this, a program of quality assessment was adopted to improve blood transfusion practice and to establish the guideline for blood transfusion in elective surgery at Pusan National University Hospital.
METHODS
Fifty-six patients undergoing elective surgery was divided 2 groups. Transfusion (T) group was 18 persons.
Non-transfusion (NT) group was 38 persons. The preoperative, pre-transfusion, postoperative, and post-transfusion hemoglobin (Hb), hematocrit, mean arterial blood pressure (MAP), heart rate (HR), average amount of transfused red blood cell units, allowable blood loss, and the amount of infused crystalloids and colloids was estimated for 9 months in Pusan National University Hospital.
RESULTS
There were no significant differences in Hb between T & NT group. Hb decreased significantly until postoperative 3rd day in NT group. Platelet count decreased in NT group on postop. 3rd day. There were no significant differences in MAP & HR. One-ninth of T group was overestimated blood loss & 18.4% of NT group was underestimated blood loss. One-third of transfusion patient were overtransfused & 36.2% of transfused RBC was unnecessary. Nearly 90% of patient was transfused packed RBC with FFP concurrently.
CONCLUSIONS
To minimize overtransfusion, transfusion based on intraoperative hematocrit is necessary. If possible, single use of packed RBC is recommended when the blood loss is below allowable blood loss. In massive bleeding above allowable blood loss, combined administration of FFP and packed RBC or transfusion of whole blood will be better.
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Suturing of a Pulmonary Artery Catheter during Open Heart Surgery
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Kyoo Sub Chung, Seong Wan Baik, Jae Young Kwon, Jae Woo Kim, Jin Ho Song
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Korean J Crit Care Med. 1998;13(1):109-112.
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- Insertion of a pulmonary artery catheter for the measurement of pulmonary artery pressures and cardiac output has been widely used for the management of patients undergoing open heart surgery. Complications of pulmonary artery catheter insertion include cardiac arrhythmia, thromboembolism, tricuspid valve injury, intracardiac knotting, pulmonary artery rupture. We experienced a case of catheter-related complication which was caused by suturing pulmonary artery catheter during right atrial bleeding control during open heart surgery. The catheter was attached to the right atrial wall by nylon suture and successfully removed by operation without significant complication.
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Profound Hypothermia and Circulatory Arrest for Adult PDA Surgery: Case report
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Seung Hun Baek, Sang Wook Shin, Hae Kyu Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1997;12(2):187-191.
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- Correction of a calcified patent ductus arteriosus (PDA) is a difficult surgical procedure. Simple ligation or division of PDA is not possible if diffuse circumferential calcification is present. Several techniques using cardiopulmonary bypass and closure of PDA from within the aorta or pulmonary artery have been introduced. And the surgical procedure is performed under profound hypothermia and circulatory arrest. Total ischemia time should be less than 30 minutes, which is free from the organ damage by the circulatory arrest. Barbiturates, calcium channel blockers and steroids are used for brain protection. We experienced successful use of these techniques for adult female patch closure of PDA and reviewed the anesthetic considerations of the profound hypothermia and circulatory arrest for cardiac surgery.
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Acute Lung Edema from Unknown Cause: A case report
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Changgi Rho, Sang Wook Shin, Hae Kyu Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1997;12(1):75-80.
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- Acute lung edema during anesthesia and operation is not common. We experienced a case of 7 year-old boy who developed acute lung edema during open reduction for his fractured lateral condyle of right humerus under general anesthesia with enflurane. In his previous history, we couldn't detect any abnormal finding that could induce lung edema intraoperatively. Preoperative routine laboratory findings and chest x-ray findings were within normal ranges.
In the end of operation, increased airway resistance and sudden facial cyanosis were detected and he received immediate, careful supportive respiratory management. He improved from severe lung edema, but hypoxic brain damage and motor dysfunction resulted. We couldn't find any evidence that he had heart failure, hypoalbuminemia, sepsis, severe trauma, fluid overloading. Authors couldn't get exact causes of acute lung edema in this case.
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The change of brain temperature during forebrain ischemia in rat
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Yoon Seob Na, Jae Young Kwon, Hae Kyu Kim, Soung Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1992;7(1):35-40.
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Hemothorax after subclavian vein catheterization
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Won Bae Moon, Hae Kyu Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1991;6(1):53-56.
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- No abstract available.
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