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ABSTRACT: PURPOSE: The use of opioids following surgery is associated with a high incidence of postoperative nausea and vomiting (PONV). We conducted a prospective, randomized, double-blind, placebo-controlled study to investigate the effect of orally administered aprepitant, a neurokinin-1 receptor antagonist, for reducing PONV in patients with fentanyl-based, patient-controlled analgesia (PCA) given intravenously after gynecological laparoscopy. METHODS: One hundred and twenty female patients (ages 21-60) undergoing laparoscopic hysterectomy were randomly allocated to receive 80 mg (A80 group, n = 40) or 125 mg aprepitant (A125 group, n = 40) or placebo (control group, n = 40) orally 2 h before anesthesia induction. Anesthesia was maintained with isoflurane and remifentanil, and PCA IV using fentanyl and ketorolac were provided for 48 h after surgery. Incidences of nausea, vomiting/retching, and use of rescue antiemetics were recorded at 2, 24, and 48 h after surgery. Complete response was defined as no PONV and no need for rescue treatment. RESULTS: The incidence of complete response was significantly lower in the A80 and A125 groups than in controls, 56 % and 63 %, vs. 28 %, respectively, P = 0.007 and P = 0.003, respectively, during the first 48 h, and 65 % and 65 % vs. 38 %, respectively, both P = 0.025, during the first 2 h. However, there were no statistically significant differences between A80 and A125 groups in the incidences of complete response and PONV during the study period. CONCLUSIONS: Aprepitant 80 mg orally was effective in lowering the incidence of PONV in the first 48 h after anesthesia in patients receiving fentanyl-based PCA after gynecological laparoscopy.
Journal of Anesthesia 12/2012; · 0.83 Impact Factor
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ABSTRACT: We hypothesized that the 2 ventilation modes might have a different influence on the stroke volume variation (SVV). This study investigated the effect of the ventilation modes on SVV as a predictor of fluid responsiveness during major abdominal surgery.
Sixty patients were randomly allocated to volume-controlled ventilation (VCV, n = 30) or pressure-controlled ventilation (PCV, n = 30) modes. After the induction of anesthesia, hemodynamic variables and SVV were measured before and after volume expansion (VE) with colloid solution of 10 mL/kg. The ability of SVV to predict the fluid responsiveness was tested by calculation of the area under a receiver operating characteristic curve for an increase in stroke volume index of at least 15% after VE.
There were 10 and 16 responders in the VCV and PCV groups, respectively. The area under a receiver operating characteristic curve (95% confidence interval) for SVV before VE was 0.723 (0.538-0.907) and 0.799 (0.625-0.973) in the VCV and PCV groups, respectively. The optimal threshold value of SVV was 11% and 14% in the VCV and PCV groups, respectively.
Stroke volume variation can predict fluid responsiveness during both VCV and PCV modes. However, the optimal threshold values of SVV may differ according to the ventilation modes.
Journal of critical care 01/2012; 27(5):531.e9-531.e14. · 2.13 Impact Factor
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ABSTRACT: Plants have developed various regulatory pathways to adapt to environmental stresses. In this study, we identified Arabidopsis MKKK20 as a regulator in the response to osmotic stress. mkkk20 mutants were found to be sensitive to high concentration of salt and showed higher water loss rates than wild-type (WT) plants under dehydration conditions. In addition, mkkk20 mutants showed higher accumulation of superoxide, a reactive oxygen species (ROS), compared to WT plants under high salt condition. In contrast, transgenic plants overexpressing MKKK20 displayed tolerance to salt stress. MKKK20 transcripts were increased by the treatments with NaCl, mannitol, MV, sorbitol, and cold, suggesting that MKKK20 is involved in the response to osmotic, ROS, and cold stresses. In-gel kinase assay showed that MKKK20 regulates the activity of MPK6 under NaCl, cold, and H(2)O(2) treatments. Taken together, our results suggest that MKKK20 might be involved in the response to various abiotic stresses, especially osmotic stress, through its regulation of MPK6 activity.
Plant Cell Reports 01/2012; 31(1):217-24. · 2.27 Impact Factor
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ABSTRACT: The administration of short-acting opioids before emergence is useful for preventing emergence cough induced by an endotracheal tube. This study examined the clinically effective dose of alfentanil for suppressing cough during emergence from desflurane anesthesia.
Twenty-nine adult patients undergoing elective oral surgery were enrolled in this study. During emergence from anesthesia, the patients received alfentanil diluted in 10 ml normal saline when the end-tidal vol% of desflurane decreased to 3%. The initial alfentanil dose was 16 µg/kg. The alfentanil dose for consecutive patients, determined by Dixon's up-and-down method, increased or decreased by 2 µg/kg according to a previous patient's result.
The 50% effective dose (ED(50)) of alfentanil for suppressing cough during emergence from desflurane anaesthesia was 9.3 ± 1.5 µg/kg according to Dixon's up-and-down method. Isotonic regression revealed an ED(50) and ED(95) (95% confidence interval) of alfentanil 10.0 µg/kg (6.8-13.2 µg/kg) and 14.0 µg/kg (7.7-19.4 µg/kg), respectively.
The ED(95) of alfentanil for suppressing emergence cough was 14.0 µg/kg. A single bolus administration of alfentanil during emergence from anesthesia was useful for suppressing emergence cough.
Korean journal of anesthesiology 10/2011; 61(4):292-6.
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ABSTRACT: Various transcription factors are involved in the response to environmental stresses in plants. In this study, we characterized AtERF71/HRE2, a member of the Arabidopsis AP2/ERF family, as an important regulator of the osmotic and hypoxic stress responses in plants. Transcript level of AtERF71/HRE2 was highly increased by anoxia, NaCl, mannitol, ABA, and MV treatments. aterf71/hre2 loss-of-function mutants displayed higher sensitivity to osmotic stress such as high salt and mannitol, accumulating higher levels of ROS under high salt treatment. In contrast, AtERF71/HRE2-overexpressing transgenic plants showed tolerance to salt and mannitol as well as flooding and MV stresses, exhibiting lower levels of ROS under high salt treatment. AtERF71/HRE2 protein was localized in the nucleus, and the C-terminal region of AtERF71/HRE2 was required for transcription activation activity. Taken together, our results suggest that AtERF71/HRE2 might function as a transcription factor involved in the response to osmotic stress as well as hypoxia.
Biochemical and Biophysical Research Communications 09/2011; 414(1):135-41. · 2.48 Impact Factor
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ABSTRACT: The EMBRYONIC FLOWER (EMF) 1 gene has been shown to be necessary for maintenance of vegetative development. To investigate the molecular mechanism of EMF1-mediated plant development, we screened EMF1-interacting proteins and identified 11 candidate proteins using the yeast two-hybrid system. Among the candidate genes, three EMF1-Interacting Protein (EIP) genes, EIP1, EIP6 and EIP9, are predicted to encode a WNK (with-no-lysine) kinase, a B-box zinc-finger protein and a DnaJ-domain protein, respectively. The expression patterns of EIP1, EIP6 and EIP9 were similar to that of EMF1, and EMF1-EIP1, EMF1-EIP6 and EMF1-EIP9 heterodimers were localized in the nucleus. In addition, eip1, eip6 and eip9 mutants flowered early and showed increased expression of flowering-time and floral organ identity genes, while EIP1-, EIP6- and EIP9-overexpressing transgenic plants showed late flowering phenotypes. Our results suggest that EMF1 interacts with EIP1, EIP6 and EIP9 during vegetative development to regulate flowering time in Arabidopsis.
Plant and Cell Physiology 06/2011; 52(8):1376-88. · 4.70 Impact Factor
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ABSTRACT: The plant hormone, abscisic acid (ABA), is a main signal transducer that confers abiotic stress tolerance to plants. Although the pathway of ABA production and the genes catalyzing its biosynthesis are largely defined, the regulatory mechanism of ABA biosynthesis in response to abiotic stress remains much unknown. In this study, to identify upstream genes regulating ABA biosynthesis involved in abiotic stress signal transduction, Arabidopsis thaliana mutants with altered promoter activity of 9-cis-epoxycarotenoid dioxygenase 3 (NCED3), a key gene in ABA biosynthesis, were identified and characterized. Among selected mutants, lenc1 (for low expression of NCED3 1) after dehydration treatment had lower AtNCED3 promoter activity compared with wild type. lenc1 mutation is recessive and is located on chromosome 4. Expression analysis of AtNCED3 and quantification of ABA levels showed that both the AtNCED3 transcripts and the endogenous ABA in lenc1 were less abundant than in wild type under dehydration treatments. The lenc1 was hypersensitive to methyl viologen (MV), LiCl, NaCl and high light. The aerial part of lenc1 lost water faster than wild type possibly due to a larger stomata opening. Our results suggest LENC1 might act as a positive regulator in AtNCED3 gene expression under osmotic stress.
Journal of plant physiology 01/2011; 168(2):140-7. · 2.50 Impact Factor
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ABSTRACT: This study aimed to compare respiratory variation in transthoracic echo-derived aortic blood flow velocity (∆Vpeak) and inferior vena cava diameter (∆IVCD) with central venous pressure (CVP) as predictors of fluid responsiveness in children after repair of ventricular septal defect (VSD). A prospective study conducted in pediatric intensive care unit investigated 21 mechanically ventilated children who had undergone repair of VSD. Standardized volume replacement (VR) was the intervention used. Hemodynamic measurements including CVP, heart rate, mean arterial pressure, transthoracic echo-derived stroke volume (SV), cardiac output, ∆Vpeak, and ∆IVCD were performed 1 h after patient arrival in the intensive care unit. Hemodynamic measurements were repeated 10 min after VR by an infusion of 6% hydroxyethyl starch 130/0.4 (10 ml/kg) over 20 min. The volume-induced increase in the SV was 15% or more in 11 patients (responders) and less than 15% in 10 patients (nonresponders). Before volume replacement, the ∆Vpeak (23.1 ± 5.7% vs. 14.0 ± 7.7%; p = 0.006) and ∆IVCD (26.5 ± 16.2% vs. 9.2 ± 9.1%; p = 0.008) was higher in the responders than in the nonresponders, whereas CVP did not significantly differ between the two groups. The prediction of fluid responsiveness was higher with the ΔVpeak, as shown by a receiver operating characteristic curve area of 0.83 (95% confidence interval [CI], 0.61-1.00; p = 0.01), a ΔIVCD of 0.85 (95% CI, 0.69-1.00; p = 0.01), and a CVP of 0.48 (95% CI, 0.22-0.73; nonsignificant difference). The ∆Vpeak and ∆IVCD measured by transthoracic echocardiography can predict the response of SV after volume expansion in mechanically ventilated children at completion of VSD repair.
Pediatric Cardiology 11/2010; 31(8):1166-70. · 1.30 Impact Factor
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ABSTRACT: To investigate ternary MADS protein complexes involved in the regulation of floral organ development in rice, we identified MADS proteins interacting with the class B MADS heterodimers, OsMADS16-OsMADS4 and OsMADS16-OsMADS2, using yeast three-hybrid assay. The class B heterodimers interacted with OsMADS6, 7, 8, 14 and 17, which belong to AP1-like, SEP-like or AGL6-like MADS proteins, generating ternary complexes. The entire region of the K and C domains of OsMADS4 was required for the formation of the OsMADS16-OsMADS4-OsMADS6 and OsMADS16-OsMADS4-OsMADS7 ternary complexes. Analysis results of transgenic plants concomitantly suppressing OsMADS4 and OsMADS6, together with the results of previous studies, suggest that the OsMADS16-OsMADS4-OsMADS6 ternary complex plays an important role in floral development, especially lodicule development.
Biochemical and Biophysical Research Communications 09/2010; 401(4):598-604. · 2.48 Impact Factor
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ABSTRACT: The aim of this study was to determine the clinical effective dose of rocuronium for tracheal intubation using a lightwand after induction with propofol, alfentanil, and a low concentration of sevoflurane.
Twenty-eight adults scheduled to undergo elective surgery lasting less than one hour were enrolled in this study. All patients received alfentanil (10 microg/kg) and propofol (1.5 mg/kg) for the induction of anesthesia. Tracheal intubation using a lightwand was attempted 3 minutes after administering rocuronium and mask ventilation with 2 vol% of sevoflurane. The initial rocuronium dose was 0.5 mg/kg. The rocuronium dose for consecutive patients, determined by Dixon's up-and-down method, was increased or decreased by 0.05 mg/kg according to the result of the previous patient. The mean arterial pressure and heart rate were recorded before induction, 1 min before intubation, 1 and 2 min after intubation.
The 50% clinical effective dose (cED(50)) of rocuronium for tracheal intubation using a lightwand was 0.20 +/- 0.05 mg/kg according to Dixon's up and down method. Isotonic regression revealed the cED(50) and cED(95) (95% confidence intervals) to be 0.20 mg/kg (0.10-0.3 mg/kg) and 0.35 mg/kg (0.16-0.49 mg/kg), respectively.
The cED(50) and cED(95) of rocuronium for tracheal intubation using the lightwand were 0.20 mg/kg and 0.35 mg/kg, respectively, after induction with alfentanil, propofol, and a low concentration of sevoflurane.
Korean journal of anesthesiology 08/2010; 59(2):82-6.
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ABSTRACT: Excessive light can be harmful to photosynthetic apparatus since it causes photoinhibition and photooxidation, and plants often encounter hypoxic or anoxic environments when they become submerged by heavy rain or an ensuing flood. In this study, Oryza sativa Differentially Expressed Genes (OsDEGs) from rice under photooxidation and anoxia conditions were isolated using DD-PCR. Among them, OsDEG10 is predicted to encode a small RNA-binding protein (RBP) and the transcript levels of OsDEG10 strongly increased under most of abiotic stress treatments such as high light, anoxia, NaCl, ABA, MV and cold. However, the transcript levels of two rice OsDEG10 homologs were not changed under those treatments. OsDEG10 RNAi transgenic plants were more sensitive to high light and cold stresses compared to wild-type plants. Our results suggest that OsDEG10 is a small RBP involved in the response to various abiotic stresses.
Biochemical and Biophysical Research Communications 04/2009; 380(3):597-602. · 2.48 Impact Factor
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ABSTRACT: Zeaxanthin epoxidase (ZEP) is an enzyme important in ABA biosynthesis and in the xanthophyll cycle. ABA, a plant hormone, is a key molecule that regulates plant responses to abiotic stress, such as drought and salinity, and is required for stress tolerance. To investigate the biological roles of the Arabidopsis thaliana ZEP gene (AtZEP) in stress response, we generated transgenic plants overexpressing the AtZEP gene and analyzed their responses to salt and drought stresses. AtZEP-overexpressing plants exhibited more vigorous growth under high salt and drought treatments than wild-type plants. In addition to enhanced de novo ABA biosynthesis, AtZEP-overexpressing plants also exhibited much higher expression of the endogenous stress-responsive genes RD29A and Rab18 than wild-type plants under salt stress. Moreover, the stomatal aperture of the AtZEP-overexpressing plants was smaller than wild-type plants after exposure to light. Our results therefore indicated that AtZEP plays important roles in response to osmotic stress.
Biochemical and Biophysical Research Communications 11/2008; 375(1):80-5. · 2.48 Impact Factor
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ABSTRACT: Glutamate is the major excitatory neurotransmitter in the central nervous system and is critical for essentially all physiological processes, such as learning, memory, central pain transduction, and control of motor function. Excitatory amino acid transporters (EAATs) play a key role in regulating glutamate neurotransmission by uptake of glutamate into cells. EAAT4 is the major EAAT in the cerebellar Purkinje cells. The authors investigated the effects of ethanol on EAAT4 and the mediatory effects of protein kinase C (PKC) and phosphatidylinositol 3-kinase (PI3K) in this context.
Excitatory amino acid transporter 4 was expressed in Xenopus oocytes by injecting EAAT4 mRNA. l-aspartate-induced membrane currents were measured using a two-electrode voltage clamp. Responses were quantified by integrating current traces and are represented in microCoulombs (microC).
Ethanol increased EAAT4 activity in a dose-dependent manner. At ethanol concentrations of 25, 50, 100, and 200 mM, the responses were significantly higher than untreated control values. Ethanol (25 mM) significantly increased the V(max) (1.5 +/- 0.1 microC for control vs. 2.0 +/- 0.1 microC for ethanol, p < 0.05), but did not affect K(m) (2.3 +/- 0.6 microM for control vs. 1.7 +/- 0.7 microM for ethanol, p > 0.05) of EAAT4 for l-aspartate. Preincubation of oocytes with phorbol-12-myristate-13-acetate (PMA, a PKC activator) significantly increased EAAT4 activity. However, combinations of PMA and ethanol versus PMA or ethanol alone did not increase responses further. Two PKC inhibitors, chelerythrine and staurosporine did not reduce basal EAAT4 activity but abolished ethanol-enhanced EAAT4 activity. Pretreatment with wortmannin (a PI3K inhibitor) also abolished ethanol-enhanced EAAT4 activity.
These results demonstrate that acute ethanol exposure increases EAAT4 activity at clinically relevant concentrations and that PKC and PI3K may mediate this. The effects of ethanol on EAAT4 may play a role in the cerebellar dysfunction caused by ethanol intoxication.
Alcoholism Clinical and Experimental Research 03/2008; 32(2):348-54. · 3.34 Impact Factor
