Biomedical subjects

Ching-Yue Yang

Publications and source records attributed to Ching-Yue Yang.

8 recordsLinked to original sources

PubMed2005

Serotonin modulates glutamate action in the medulla to regulate cardiovascular functions in cats.

We examined the effects of serotonin (5-HT) on cardiovascular responses and blood flows in the right common carotid artery (RCCA), superior mesenteric artery (SMA) and right femoral artery (RFA), stimulated by glutamate (Glu) in the dorsomedial medulla (DM), rostral ventrolateral medulla (RVLM) and caudal ventrolateral medulla (CVLM). Microinjection of Glu into the DM produced increases in systemic arterial pressure (SAP) and flows in the RCCA and RFA, and decrease in flow in the SMA. Microinjection of Glu into the RVLM produced increases in SAP and decreases in flows in the RCCA, SMA and RFA. Prior microinjections of 5-HT into the same sites attenuated all the Glu-induced responses. Microinjection of Glu into the CVLM produced decreases in SAP and flows in the RCCA, SMA and RFA. These decreases were potentiated by prior injection of 5-HT. These findings suggest that 5-HT modulates the cardiovascular and blood flow responses induced by Glu in the medulla.

Animals↗

PubMed2005

Airway obstruction by a metastatic mediastinal tumor during anesthesia.

A case of low back pain syndrome was diagnosed due to spinal metastasis with unknown primary origin. During anesthesia for surgical stabilization, unexpected airway obstruction occurred after endotracheal intubation. Fiber-optic bronchoscopic examination showed narrowing of the trachea and main bronchi caused by extrinsic compression. After administration of neostigmine to reverse neuromuscular blockade, the patient resumed spontaneous breath. Airway obstruction was relieved thereafter. The extrinsic lesion was diagnosed as mediastinal lung cancer. The mechanism and management of this airway compromise caused by mediastinal tumor is discussed.

Adult↗

PubMed2004

High satisfaction with problem-based learning for anesthesia.

BACKGROUND: The aim of this study was to compare students' satisfaction between problem-based learning (PBL) and lecture-based traditional teaching of anesthesia. METHODS: One hundred and thirty-seven fifth-year medical students were enrolled in a course which used a hybrid curriculum for teaching about anesthesia. The hybrid curriculum included 9 essential lectures and 3 related PBL case discussions. A Linkert 5-point scale was used for to assess students' satisfaction levels between PBL and lecture-based traditional teaching. Data were collected through a year-end questionnaire over 2 academic years from 2002 to 2003. Scores regarding the satisfaction levels between these 2 teaching methods were analyzed using a 2-sided paired t-test. RESULTS: Most students preferred PBL over the lecture-based traditional teaching in the following 6 aspects: learning about anesthesia, understanding other medical knowledge, being interested in and motivated to learn, training for future work, training of personal abilities, and being confident and satisfied with the teaching method (p < 0.05). However, traditional teaching was superior to PBL in enhancing the speed of learning with greater understanding of a basic knowledge of anesthesia, as well as in providing more solid content with understanding of a greater number of anesthetic techniques (p < 0.05). Satisfaction levels with this curriculum did not generally differ between students enrolled in different classes in 2002 and 2003. CONCLUSIONS: Although the assessment tools and content of PBL need to be modified, implementation of PBL for teaching anesthesia showed satisfactory results.

Anesthesiology↗

PubMed2003

The nNos/cGMP mediation of the depressor response to NMDA receptor stimulation in the caudal ventrolateral medulla.

Using in vivo voltammetry to directly measure extracellular nitric oxide (NO) levels, our previous studies suggested that the neuronal NO synthase (nNOS) and cyclic guanosine monophosphate (cGMP) signal transducing systems are involved in the cardiovascular responses elicited by activation of N-methyl-D-aspartate (NMDA) receptors in the rostral ventrolateral medulla. In this study, we examined if the depressor responses elicited by activation of NMDA receptors in the caudal ventrolateral medulla (CVLM) also depend on the actions of nNOS and soluble guanylyl cyclase. In anesthetized cats, microinjection of NMDA into the CVLM produced hypotension and bradycardia associated with NO formation. These NMDA-induced responses were attenuated by prior injections of 2-amino-5-phosphonopentanoate (a NMDA receptor competitive antagonist), 7-nitroindazole (a nNOS inhibitor) and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (an inhibitor of soluble guanylyl cyclase). These findings suggest that NO is also involved in the NMDA-induced depressor responses of the CVLM.

Anesthesia↗

PubMed2003

Chemical burn caused by povidone-iodine alcohol solution--a case report.

Burns associated with chemical disinfectants for skin preparation are rare. Skin irritation and maceration associated with pressure factors may contribute to its occurrence. We report a 24-year-old female with thyroid tumor who was admitted for subtotal thyroidectomy. After anesthetic induction, the patient was placed in the supine position with the trunk elevated to 20 degree. The skin over the anterior neck was sterilized with 10% Povidone-iodine (PI) alcohol solution. After a 3-hour surgery, the patient complained of burning pain over the back at the recovery room. Physical examination revealed a 9 x 11 cm area of skin lesion partially thickened amid on the middle of the back suggestive of chemical burn. After conservative treatment, she was discharged uneventfully 4 days later. Upon follow-up, the wound was seen to heal with minimal scarring within 3 weeks.

Adult↗

PubMed2003

Propofol inhibits neuronal firing activities in the caudal ventrolateral medulla.

BACKGROUND: Propofol is a potent intravenous anesthetic. The action of propofol on the medullary depressor area, the caudal ventrolateral medulla (CVLM), has not been well established. We therefore performed extracellular recordings to study the neuronal activity of the CVLM in cats before and after intravenous propofol administration, to investigate its influence on neuronal firings. METHODS: Experiments were performed on 31 cats anaesthetized with a mixture of alpha-chloralose and urethane administered intraperitoneally. Mean systemic arterial pressure, heart rate, and the neuronal firing (NF) rate were continuously recorded before and after intravenous injection of a single dose of 2 mg x kg(-1) propofol or separate supplemental doses of 1, 2, and 4 mg x kg(-1) propofol until those parameters had returned to the premedication level. RESULTS: Propofol dose-dependently and reversibly inhibited the NF rate after the supplemental doses of 1, 2, and 4 mg x kg(-1) propofol. The control NF rate of 17.9 +/- 8.6 Hz was depressed to 15.8 +/- 8.5 Hz after the first dose of propofol (p < 0.05 vs. the control), and was further depressed to 12.8 +/- 8.3 Hz (p < 0.05 vs. the control) and 10.0 +/- 7.9 Hz (p < 0.05 vs. the control) after the second and the third doses of propofol, respectively. CONCLUSION: The dose-dependent inhibition of the spontaneous neuronal firing rate is the main pharmacological action of propofol in the caudal ventrolateral medulla of cats.

Anesthetics, Intravenous↗

PubMed2002

Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration.

Rapid-sequence induction with cricoid pressure is a standard procedure for inducing anesthesia in patients with a potentially full stomach. During the induction period, if the patient develops generalized movements of the body, the pressure level of the cricoid may change unexpectedly. As a result, the increase in intragastric pressure may cause gastric regurgitation and consequent pulmonary aspiration. Rocuronium has been widely used as an alternative to succinylcholine during the induction of anesthesia. However, most patients who received rocuronium complained of severe burning pain in their arm during intravenous injection. Even after the administration of the induction agents, rocuronium injection can also cause withdrawal of the hand or other generalized movements of the body. We describe a case of gastric regurgitation with pulmonary aspiration following generalized spontaneous movements associated with rocuronium injection in a girl who received pediatric emergent surgery.

Androstanols↗

PubMedDate not supplied

Propofol ensures a more stable A-line ARX index than thiopental during intubation.

BACKGROUND: The A-line autoregressive modelling with exogenous input index (AAI) is a new method of assessing depth of anesthesia. We examined the effects of tracheal intubation on the AAI and hemodynamics during induction of anesthesia with propofol compared with thiopental in patients aged over 50 yr. METHODS: 40 patients scheduled for a laminectomy, posterior spinal fusion, vertebroplasty, or total hip replacement, ASA physical status I or II and aged over 50 yr, were randomly divided into two groups. Thiopental 5 mg.kg(-1) iv, fentanyl 2.5 microg.kg(-1) iv, and rocuronium 0.7 mg.kg(-1) iv were used in the thiopental group (n = 20) for anesthetic induction; the same protocol was used in the propofol group (n = 20) except that 2 mg.kg(-1) propofol iv was given instead of thiopental. The AAI, non-invasive blood pressure, and heart rate were measured every minute before induction for three minutes, at 1.5 min post-induction, and then each minute post-intubation for eight minutes. RESULTS: The AAI increased significantly at one and two minutes after intubation in the thiopental group (to 56.5 +/- 18.6 at 1 min and 44.7 +/- 18.7 at 2 min after intubation vs 19.9 +/- 7.5 at 1.5 min after induction; P < 0.05). Thereafter, AAI values gradually decreased three minutes after intubation. The AAI was inhibited continuously after intubation in the propofol group, and no significant elevation was seen. CONCLUSION: Our results, using the AAI to monitor anesthetic depth during induction and tracheal intubation, suggest that at equipotent doses propofol provided a more stable level of anesthesia than did thiopental.

Anesthetics, Intravenous↗