Temporal Genetic Modifications after Controlled Cortical Impact--Understanding Traumatic Brain Injury through a Systematic Network Approach.

Traumatic brain injury (TBI) is a primary injury caused by external physical force and also a secondary injury caused by biological processes such as metabolic, cellular, and other molecular events that eventually lead to brain cell death, tissue and nerve damage, and atrophy. It is a common disease process (as opposed to an event) that causes disabilities and high death rates. In order to treat all the repercussions of this injury, treatment becomes increasingly complex and difficult throughout the evolution of a TBI.

Identification of network-based biomarkers of cardioembolic stroke using a systems biology approach with time series data.

Background: Molecular signaling of angiogenesis begins within hours after initiation of a stroke and the following regulation of endothelial integrity mediated by growth factor receptors and vascular growth factors. Recent studies further provided insights into the coordinated patterns of post-stroke gene expressions and the relationships between neurodegenerative diseases and neural function recovery processes after a stroke.

Results: Differential protein-protein interaction networks (PPINs) were constructed at 3 post-stroke time points, and proteins with a significant stroke relevance value (SRV) were discovered.

Comparison of 3 video laryngoscopes with the Macintosh in a manikin with easy and difficult simulated airways.

Objectives: Tracheal intubation is used to maintain a patent airway and can occasionally be difficult in a potentially difficult airway, especially for novice managers. In this study, we evaluated the time required, extent of the difficulty, and number of dental clicks in the tracheal intubation for novice medical students between the Macintosh (Truphatek International Ltd, Netanya, Israel) and 3 video laryngoscopes in normal and difficult simulated intubation positions on manikins on both the table and floor.

Methods: We recruited 20 medical students as novice airway managers.

Comparison of dexamethasone with ondansetron or haloperidol for prevention of patient-controlled analgesia-related postoperative nausea and vomiting: a randomized clinical trial.

Background: Patient-controlled analgesia (PCA) with parenteral opioids is associated with a high incidence of postoperative nausea and vomiting (PONV). The aim of the present study was to compare the efficacy of dexamethasone plus haloperidol with dexamethasone plus ondansetron for the prevention of PCA-related PONV. Patients who received dexamethasone alone were used as controls.

Trachway intubating stylet for tracheal intubation in an ankylosing spondylitis patient undergoing total hip replacement under general anesthesia.

The Trachway is a new device which provides better glottic view than conventional direct laryngoscopy during tracheal intubation. This intubating stylet consists of a camera on the distal tip of the style, with a monitor attached to the rechargeable handle, so that it can overcome the difficulty of limited neck motion and mouth opening in tracheal intubation. We present here a 54-year-old man with ankylosing spondylitis, scheduled to undergo total hip replacement.

The use of the GlideScope® for tracheal intubation in patients with halo vest.

Objective: GlideScope® provides better laryngoscopic view and is advantageous in tracheal intubation in ankylosing spondylitis patients with difficult airway.

Methods: This study was performed to investigate the use of the GlideScope® for tracheal intubation in 15 patients wearing halo vests scheduled for elective surgery under general anesthesia. Preoperative airway assessments were evaluated to predict the difficulty of tracheal intubation.

Accidental pulmonary emboli noted by TEE during aortic valve replacement: a case report.

Pulmonary embolism (PE) is difficult to diagnose clinically. In a patient who was scheduled for elective aortic valve replacement, several fresh emboli were recognized in the right atrium on transesophageal echocardiography (TEE). The PEs then disappeared on the echocardiographic image, with significant immediate hemodynamic changes noted by real-time monitors, such as tachycardia and increased pulmonary artery (PA) pressure.

Pentax-airway scope for tracheal intubation breaks through the limitation of neck motion in an ankylosing spondylitis patient wearing halo vest--a case report.

The Airway Scope (AWS) provides better glottic view than the conventional direct laryngoscopy in tracheal intubation. With it, the endotracheal tube can be more easily inserted into the tracheal lumen easily. We hereby presented a 24-year-old ankylosing spondylitis (AS) patient wearing a halo vest who was successfully intubated for undergoing cervical spine surgery involving C1 and C2 under general anesthesia.

Dynamic effects of respiration on aortic blood flow and its autonomic control in rats.

1. Respiratory related arterial pressure variability may reflect body fluid status and/or cardiac sympathetic function. The underlying mechanism is not clear.

Emergency tracheal intubation in an ankylosing spondylitis patient in the lateral position using the GlideScope.

Anesthesia for ankylosing spondylitis (AS) patients with difficult airway is of great stress to anesthesiologists. If tracheal intubation is not mandatory for general anesthesia, laryngeal mask airway (LMA) may suffice for adequate ventilation. Yet, in certain circumstances, no one can guarantee that LMA will reliably serve the purpose in surgical AS patients, especially in operations performed in the lateral decubitus position.

Sympathetic and parasympathetic activities evaluated by heart-rate variability in head injury of various severities.

Objective: To investigate the autonomic function in patients with brain damage of various extents. The purposes were to correlate the parameters derived from spectral analysis of the heart-rate variability (HRV) with the classic Glasgow coma scale (GCS), and to evaluate the possible clinical application of HRV in the autonomic functions in patients with various severities of brain-stem injury.

Methods: A total of 90 patients was divided into 5 groups based on the GCS: I: 15, II: 9-14, III: 4-8, no pupil dilatation, IV: 4-8, pupil dilatation, and V: 3, brain death.

Effect of esmolol on positive-pressure ventilation-induced variations of arterial pressure in anaesthetized humans.

Positive-pressure ventilation-induced variations in arterial pressure have been related to cardiac sympathetic activity in animals. However, the effect of beta-adrenoceptor blockade on these variations in anaesthetized humans under positive-pressure ventilation has not yet been investigated. In the present study, RAPV (respiratory-related arterial pressure variability) and %SPV (percentile systolic pressure variation) were determined before and after esmolol treatment in ten mechanically ventilated patients.

Respiratory-related arterial pressure variability as an indicator of graded blood loss: involvement of the autonomic nervous system.

During positive pressure mechanical ventilation, percentile systolic pressure variation (%SPV) or respiratory-related arterial pressure variability (RAPV) have both been used in assessment of graded haemorrhage. We aimed to investigate whether changes in %SPV and RAPV are correlated during graded haemorrhage (by 5, 10 or 20% of the estimated blood volume) in anaesthetized positive pressure ventilated rats and to investigate the involvement of autonomic regulation. Saline vehicle or atropine produced no discernible effect on baseline %SPV or RAPV but, thereafter, %SPV and RAPV increased progressively with graded haemorrhage.

Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness.

Purpose: To evaluate the antiemetic effect of iv dexamethasone for preventing postoperative nausea and vomiting (PONV) in women with and without a history of motion sickness.

Methods: This randomized, double-blinded, placebo-controlled study was carried out in 168 female patients with (n = 84) and without (n = 84) a history of motion sickness undergoing gynecological laparoscopy. Patients received 8 mg dexamethasone or saline immediately before induction of anesthesia.

Relationship between electroencephalogram slow-wave magnitude and heart rate variability during sleep in humans.

To explore whether depth of sleep is related to changes in autonomic control, continuous power-spectral analysis of the electroencephalogram (EEG) and heart rate variability (HRV) was performed in ten normal subjects during nocturnal sleep. Quiet sleep (QS) was associated with an increase in high-frequency power (HF) of HRV (0.15-0.