BackgroundChildren with sensorineural hearing loss are at risk of cardiac electrophysiologic abnormalities. Inhalational Sevoflurane induction in these children can cause QT prolongation.ObjectivesIn order to evaluate the safety of inhalational induction of anesthesia with sevoflurane in children with sensorineural hearing loss, who are candidates for cochlear implant, its electrophysiologic effects was compared with intravenous induction of anesthesia with propofol.MethodsIn this double-blind randomized clinical trial, 61 children aged between one and eighteen years old, who were candidates for cochlear implantation, were randomly allocated to groups receiving anesthesia with sevoflurane (n = 32) or propofol (n = 29) for induction of anesthesia. Two 12-leads ECG were taken from all of patients before and after induction and QTc, Tp-e interval, and JTc were measured and compared.ResultsTwo cases, who had pre-induction QTc longer than 500 ms were excluded from the study. Patients had similar age (102.58 ± 87 versus 101.46 ± 67 months, P = 0.95) and gender (males: 48.3% versus 56.3%, P = 0.53) distribution. The researchers observed significant post induction difference in QTc values between these groups (propofol 422.5 ± 40, sevoflurane 445.0 ± 29, P = 0.016). There was no significant difference in the percent QTc and Tp-e changes in propofol and sevoflurane groups. Greater percentage of patients with increased Tp-e interval (> 100 ms) in the sevoflurane group than the propofol group was also seen. There was no significant long QTc difference (QTc > 500 ms or more than 60 ms increase from baseline) after induction of anesthesia in the sevoflurane group compared to the propofol group (15.6% versus 13.8%, P = 0.84).ConclusionsAfter electrophysiological evaluations in children with sensorineural hearing loss, in patients whose pre-induction QTc is not longer than 500 ms, propofol seems safer than inhalational sevoflurane for induction of anesthesia.

Background Malignant melanoma is a common form of skin cancer that contains different cell types recognized by various cell surface markers. Dacarbazine-based combination chemotherapy is frequently used for the treatment of melanoma. Despite its potent anticancer properties, resistance to dacarbazine develops in malignant melanoma. Here, we aim to improve response to dacarbazine therapy by pretreatment with all-trans retinoic acid (ATRA) in CD117+ melanoma cells. Methods The CD117+ melanoma cells were sorted from A375 malignant melanoma cell line using magnetic-activated cell sorting (MACS). The cell viability was examined by cell proliferation assay (MTT). Apoptosis was determined by acridine orange/ ethidium bromide staining. Indeed, we performed flow cytometry to evaluate the cell cycle arrest. Results Here, the CD117+ melanoma cells were incubated with various concentrations of ATRA, dacarbazine, and their combination to determine IC50 values. We found that 20 µM ATRA treatment followed by dacarbazine was found to be more effective than dacarbazine alone. There was an indication that the combination of ATRA with dacarbazine (ATRA/dacarbazine) caused more apoptosis and necrosis in the melanoma cells (P<0.05). Furthermore, ATRA/dacarbazine treatment inhibited the cell at the G0/G1 phase, while dacarbazine alone inhibited the cells at S phase. Conclusion Collectively, combined treatment with ATRA and dacarbazine induced more apoptosis and enhanced the cell cycle arrest of CD117+ melanoma cells. These results suggested that ATRA increased the sensitivity of melanoma cells to the effect of dacarbazine.