A 53-year-old Japanese woman with a point mutation in mitochondrial DNA (tRNALeu(UUR), nt3243) consistent with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) and Alzheimer-type brain pathology is reported. This woman had suffered myopathy and psychosis without any clinical evidence of, stroke-like episodes during the last 10 years of her life, and had died after an accident. At autopsy 30 h post mortem, a part of the brain was snap frozen for biochemical and histochemical studies, and the remaining part was processed for a routine examination and electron microscopy. In the brain there were no ischemic lesions. Instead, primitive/diffuse senile plaques were found throughout the brain, predominantly in the frontal and temporal lobes, while Alzheimer neurofibrillary tangles were found only in the parahippocampal gyrus. These plaques were positive for beta-protein and mostly negative for tau protein, ubiquitin, neurofilaments, alpha-choline acetyltransferase, and acetylcholinesterase. Mutations in codon 331 of the ND2 gene as well as codons 693, 713 and 717 of the beta-amyloid precursor protein gene, known to be responsible for some cases of familial Alzheimer disease, were not found. Furthermore, coincidental Down syndrome was ruled out by chromosome analysis. The results suggest a possible correlation between this mitochondrial DNA abnormality and Alzheimer-type pathology.

We compared the characteristics of postoperative pharyngeal morbidity in intubation between the AirWay Scope (AWS) and Macintosh laryngoscope in 68 ASA I-II female patients aged 35-77 years in a randomized, double-blinded, controlled fashion. After induction of general anesthesia, the patient's trachea was intubated using the AWS or Macintosh laryngoscope by five anesthesiologists. Before leaving the operating room, postoperative sore throat, hoarseness, and dysphagia were assessed, and oral bleeding was evaluated by observation of the extubated tracheal tube. On the day after surgery, pharyngeal complications were evaluated again, and patients were questioned on delay of oral intake. Incidence of sore throat with the AWS (27.2%) was significantly lower than that with the Macintosh laryngoscope (52.9%) on the day of surgery. Severity of sore throat with the AWS was also significantly less compared with the Macintosh laryngoscope. Incidence of oral bleeding with the AWS (6.1%) was significantly lower than that with the Macintosh laryngoscope (23.5%). Pharyngeal morbidity on the day after surgery did not differ between groups, and no patient complained of delayed oral intake. In female patients, the AWS successfully reduced the incidence and severity of sore throat on the day of surgery in comparison with the Macintosh laryngoscope.

Our findings provide valuable information for personalized pain treatment after LAC, in which the C allele of the rs2076222 SNP is associated with lower opioid sensitivity and requires more opioid analgesic after LAC.

No abstract