Irinotecan-induced dysarthria in a man being treated for colon cancer resolved with the discontinuation of irinotecan. With increases in the duration of infusion, the man received additional irinotecan treatments with no recurrence of dysarthria.

Golgi staining has been modified and developed since Camillo Golgi introduced the black reaction in 1873. This study focuses on the commonly used Golgi staining methods and presents comprehensive data regarding three Golgi staining methods along with their strong and weak points. The Golgi-Cox method uses mercuric chloride for brain tissue impregnation and is a reliable technique for analyzing the complete dendritic tree of cortical neurons. However, specimens tend to shrink during the staining steps. Recent combination of the Golgi-Cox method and immunofluorescence provides additional options for neuroscientists. Rapid Golgi staining requires osmium tetroxide for the postfixation process. It homogenously stains whole structures of neurons and provides their detailed anatomical morphology. This staining is influenced by the age of the specimen, temperature of the laboratory, and duration of each procedure. The Golgi-Kopsch method uses formaldehyde and glutaraldehyde instead of osmium tetroxide and can be used regardless of the age of the specimen and the duration after fixation. This method is suitable for research using human brain fixed for a long time or for specimens obtained from old-aged animals. Selecting a Golgi staining protocol that is appropriate for the specimen type and research purpose is important to achieve best results.

Objective Cranial electrotherapy stimulation (CES) is a non-invasive treatment that improves symptoms such as anxiety and pain. The purpose of this study was to analyze the effect of CES pretreatment on levels of preoperative anxiety, pain, and hemodynamic responses—especially changes in blood pressure—during anesthetic induction in patients with essential hypertension. Methods Eighty patients undergoing general anesthesia were randomly assigned to receive either no pretreatment (control group, n = 40) or CES pretreatment (CES group, n = 40). Anxiety scores, systolic and diastolic blood pressures, mean arterial pressure, and heart rate were measured in the general ward the evening before surgery, as well as in the preoperative holding area, operating room, and after intubation. Withdrawal responses to rocuronium injection were also measured. Results Anxiety scores in the operating room were significantly lower in the CES group. Withdrawal responses to rocuronium injection were also significantly lower in the CES group. There were no significant differences in hemodynamic values between the two groups. Conclusions CES pretreatment reduces both preoperative anxiety levels and withdrawal responses to rocuronium injection. However, it does not have a significant effect on hemodynamic responses.

PurposeTo differentiate adenoviral pharyngoconjunctival fever (PCF) from acute Kawasaki disease (KD) using laboratory tests before results of virus-real time polymerase chain reaction and ophthalmologic examination are obtained.MethodsBaseline patient characteristics and laboratory measurements were compared between 40 patients with adenovirus infection and 123 patients with KD.ResultsThe patients with adenovirus infection were generally older than those with KD (median: 3.9 years vs. 2 years, P=0.000). White blood cell and, platelet count, and aspartate aminotransferase, alanine aminotransferase, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels showed significant differences between the 2 groups, but the C-reactive protein (CRP) levels did not (6.8±3.0 mg/dL vs. 8.3±5.8 mg/dL, P=0.126). In the adenovirus infection group, the CRP levels were <1, <3, <10, and ≥10 mg/dL in 2 (5%), 3 (7.5%), 30 (75%), and 5 patients (12.5%), respectively. The cutoff NT-proBNP level was 265 pg/mL. Discrepancy was defined as CRP and NT-proBNP levels of ≥3 or <3 mg/dL, and <265 or ≥265 pg/mL, respectively. Among the 35 patients with adenovirus infection whose CRP levels were ≥3 mg/dL, 29 (82.9%) showed a discrepancy. Conversely, of the 103 patients with KD whose CRP levels were ≥3 mg/dL, 83 (80.6%) showed no discrepancy. Between the groups, a significant difference in discrepancy rate was observed (P=0.000). None of the patients with adenovirus infection had CRP and NT-proBNP levels of <3 mg/dL and ≥265 pg/mL, respectively.ConclusionWith a sensitivity of 82.9% and a specificity of 80.6%, CRP and NT-proBNP levels may differentiate between adenoviral PCF and acute KD.

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Objective The dose of neuromuscular blocking drugs is commonly based on body weight, but using muscle mass might be more effective. This study investigated the relationship between the effect of neuromuscular blocking drugs and muscle mass measured using bioelectrical impedance analysis. Methods Patients who were scheduled for elective surgery using a muscle relaxant were screened for inclusion in this study. Under intravenous anaesthesia, 12 mg or 9 mg of rocuronium was administered to males and females, respectively; and the maximal relaxation effect of T1 was measured using a TOF-Watch-SX® acceleromyograph. Results This study enrolled 40 patients; 20 males and 20 females. For both sexes, the maximal relaxation effect of T1 did not correlate with the body weight-based dose of neuromuscular blocking drugs (males, r2 = 0.12; females, r2 = 0.26). Instead, it correlated with the dose based on bioelectrical impedance analysis-measured muscle mass when injected with the same dose of rocuronium (males, r2 = 0.78, female, r2 = 0.82). Conclusions This study showed that the muscle relaxation effect of rocuronium was correlated with muscle mass and did not correlate with body weight when using the same dose. Therefore, a muscle mass-based dose of neuromuscular blocking drugs is recommended.

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