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Biological evaluation of the effect of sugammadex on hemostasis and bleeding
Julien Raft,Philippe Guerci,Valentin Harter,Thomas Fuchs-Buder,Claude Meistelman 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.1
Background: Notification of sugammadex has been supplemented with a section on hemostasis, including a longer clottingtime in the first minutes following injection, without any documented clinical consequences. The objective of thisobservational study was to analyze the effects of sugammadex administration on routine coagulation tests and bleedingin the clinical setting. Methods: After Institutional Review Board approval, a prospective observational study was conducted between Januaryand December 2011. Adult patients scheduled for laparotomies were analyzed in groups according to the type of reversal(without sugammadex versus 2 or 4 mg/kg sugammadex). There were no changes in our current clinical practice. Blood samples drawn from these patients were standardized at the same time and tested using the same daily calibratedmachine. The endpoint was a comparison of the activated partial thromboplastin time (aPTT), prothrombin time (PT),hemoglobin (Hb) level and hematocrit (Ht), immediately before sugammadex administration (H0) and 1 h after neuromuscularblock reversal (H1). Results: One hundred and forty-two patients in three groups were included as follows: 11 in the “without sugammadex”group, 64 in the “2 mg/kg sugammadex” group and 67 in the “4 mg/kg sugammadex” group. Results did not differ significantlyamong the groups. Conclusions: In this prospective observational study, the use of 2 and 4 mg/kg sugammadex was not associated with alonger clotting time or decreased hemoglobin concentrations. Future prospective investigations should study patients receiving16 mg/kg sugammadex and/or with abnormal coagulation tests.
Transient retinoic acid signaling confers anterior-posterior polarity to the inner ear.
Bok, Jinwoong,Raft, Steven,Kong, Kyoung-Ah,Koo, Soo Kyung,Drä,ger, Ursula C,Wu, Doris K National Academy of Sciences 2011 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.108 No.1
<P>Vertebrate hearing and balance are based in complex asymmetries of inner ear structure. Here, we identify retinoic acid (RA) as an extrinsic signal that acts directly on the ear rudiment to affect its compartmentalization along the anterior-posterior axis. A rostrocaudal wave of RA activity, generated by tissues surrounding the nascent ear, induces distinct responses from anterior and posterior halves of the inner ear rudiment. Prolonged response to RA by posterior otic tissue correlates with Tbx1 transcription and formation of mostly nonsensory inner ear structures. By contrast, anterior otic tissue displays only a brief response to RA and forms neuronal elements and most sensory structures of the inner ear.</P>
Sugammadex: clinical development and practical use
Thomas Fuchs-Buder,Claude Meistelman,Julien Raft 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.6
Sugammadex is belonging to a new class of drugs: the selective relaxant binding agents. Sugammadex can reverse residual paralysis by encapsulating free circulating non depolarizing muscle relaxants. The mains advantages of sugammadex when compared with conventional anticholinesterase agents are a much faster recovery time and the unique ability, for the first time, to reverse rapidly and efficiently deep levels of neuromuscular blockade. However it only works for reversal of rocuronium or vecuronium-induced neuromuscular blockade. When administered 3 min after rocuronium the use of a large dose (16 mg/kg) can even reverse rocuronium significantly faster than the spontaneous recovery after succinylcholine.