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Rett syndrome is a neurodevelopmental disease that almost always affects female patients. It is caused by mutations in MeCP2 in the majority of cases. Patients diagnosed with Rett syndrome may experience serious adverse events even with smaller amounts of medication for sedation and anesthesia. The major anesthetic concerns associated with Rett syndrome are lack of cooperation, abnormal continuous limb movements, abnormal respiratory control, difficult positioning secondary to scoliosis, and altered sensitivity to painful stimuli. Because of the risks caused by these problems, anesthesiologists should be aware of the specific anesthetic concerns of patients with Rett syndrome in order to safely administer anesthesia. Here, we describe the management of a pediatric patient diagnosed with Rett syndrome. [ABSTRACT FROM AUTHOR]

Castleman's disease (CD) is a rare lymphoproliferative disorder of undetermined etiology. Unicentric Castleman's disease is confined to a single lymph node; it is usually asymptomatic though sometimes has local manifestations related to mass effects. In contrast, multicentric Castleman's disease (MCD) typically presents with lymphoid hyperplasia at multiple sites; it is associated with systemic symptoms and abnormal laboratory findings, with a less favorable prognosis. In case of anesthesia in CD, an exhaustive preanesthetic evaluation is essential to identify associated clinical manifestations which may influence the management of the anesthesia. Perioperative careful monitoring and proper anesthetic management are both important. We report a case of general anesthesia with anesthetic management in a patient with MCD that has not been documented in the literature. [ABSTRACT FROM AUTHOR]

The Korean government is considering the implementation of a project to develop a deep-sea human-operated vehicle (HOV) to improve the level of deep-sea research. Information on the scientific benefits from the project is urgently needed in order to come to a decision about whether to implement the project. This paper measures the conservation value of developing nine attributes associated with HOV by using the choice experiment (CE). A survey of about 356 experts was undertaken and 132 experts completely responded to the survey. To deal with the CE data from the survey, we employed a multinomial logit model. All the coefficient estimates are statistically significant and consistent with prior expectations. Therefore, we can judge that the respondents' works required in the CE survey were within their cognitive abilities and they reported responsible and significant values. Each marginal willingness to pay for each attribute associated with the HOV is statistically significant and provides good information on the scientific values with regard to developing the HOV. The results can be utilized in evaluating and planning several alternatives related to developing the HOV. [ABSTRACT FROM AUTHOR]

Background: Cerebral hypotension and desaturation can occur during shoulder surgery in the seated position. We evaluated the correlation of cerebral oxygen saturation (rSO2) using near infra-red spectroscopy (NIRS) and mean arterial pressures (MAP) (at the levels of the brain and heart). Methods: Fifty patients, scheduled for the arthroscopic shoulder surgery in the seated position, were enrolled to monitor the rSO2, bispectral Index (BIS), and MAPs at the levels of the brain and heart. The values of each parameter were collected at 5 min after intubation, immediately after placing the patient in the sitting position, 5 min after the patient was seated, immediately after the surgical incision, and every 30 min after incision. Results: A correlation between the cerebral rSO2 and the MAP at the level of brain were statistically significant. Cerebral rSO2 and MAP after a change of posture from supine to sitting position were significantly decreased, compared to the baseline value. Conclusions: Monitoring cerebral rSO2 and MAP at the level of brain can be helpful to detect the possibility of cerebral deoxygenation earlier. [ABSTRACT FROM AUTHOR]

Liver ischemia/reperfusion has been shown to result in injury of remote organs such as the heart and lungs. Whether or not acute liver injury also results in kidney injury has so far not been adequately addressed. In anesthetized Wistar rats, partial (70%) normothermic hepatic ischemia was applied for 75 min. After 24 h of reperfusion, renal injury was assessed by histology, creatinine and blood urea nitrogen (BUN) serum concentrations, renal expression of proinflammatory genes [quantitative real-time polymerase chain reaction (qRT-PCR)], caspase-3 activation (Western blot), and neutrophil accumulation (myeloperoxidase assay). Twenty-four hours after hepatic ischemia, creatinine (0.57+/-0.06 vs. 0.32+/-0.04 mg/dL) and BUN (40.7+/-15.3 vs. 14.3+/-2.0 mg/dL) were increased when compared to sham. qRT-PCR revealed higher renal intercellular adhesion molecule-1 gene expression following hepatic ischemia (166+/-45% when compared to sham) but no differences in renal monocyte chemoattractant protein-1, macrophage inflammatory protein-2, and inducible NO synthase expression. In both groups, kidneys showed no morphological damage and no increase in caspase-3 and myeloperoxidase activity. Severe hepatic ischemia results in a moderate impairment of renal function in rats but does not trigger an inflammatory response in the kidney and does not result in morphological damage of the kidney. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effect of a single dose of methylphenidate on the cognitive performance of patients with traumatic brain injury (TBI), and particularly on working memory and visuospatial attention. Design: A double-blind placebo-controlled study. The subjects were randomly divided into an experimental group taking methylphenidate and a control group taking a placebo. Setting: The Department of Rehabilitation Medicine of a university hospital. Subjects: Eighteen subjects with TBI (16 male and two female) were enrolled. Interventions: The patients were given 20 mg methylphenidate or a placebo. Cognitive assessments were performed at three times: before the medication as a baseline, 2 h after medication and at follow-up (48 h later). Main measures: Cognitive assessments consisted of working memory tasks and endogenous visuospatial attention tasks designed using SuperLabPro 2.0 software. Response accuracy and reaction time were measured. Results: There were significant improvements in response accuracy in the methylphenidate group compared with the placebo group for both the working memory and visuospatial attention tasks. A significant decrease in the reaction time was also observed in the methylphenidate group only for the working memory task. Conclusions: The administration of single-dose methylphenidate has an effect in improving cognitive functioning following a TBI. The effects were most prominent regarding the reaction time of the working memory. [ABSTRACT FROM AUTHOR]

Compression garments are frequently used in daily life activities as well as in specialized fields, such as medical and sports sciences, to enhance bodily functions. However, conventional compression garments provide a fixed compression force to the body and can thus cause several side effects including discomfort, skin irritation, and loss of circulation when worn incorrectly. Development of a new type of compression garment that can control the compression force is required. This paper proposes a new sleeve-type compression garment that alters its compression force by employing a wire-fabric based mechanism. The proposed sleeve has several benefits compared with conventional methods. It not only is lightweight compared with those with pneumatic actuation but also can generate variable compression force by bidirectional driving of the tendons, which is not possible with other wire driving mechanism, such as shape memory alloy actuation. The proposed garment was manufactured by integrating two-layered fabrics with a soft pressure sensor, a wire actuation system, and a feedback controller. The performance was evaluated using three different experiments that tested the ability of varying and maintaining the compression force. This design can be employed in the field of compression garments and assistive devices to provide a means of applying an accurate and customized compression force to the body. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Cerebral oxygenation monitoring of patients during arthroscopic shoulder surgery in the sitting position" by S.H. Ko and colleagues in a 2012 issue of the journal and a response from the authors to the letter is also provided.