Bedeutung klinischer Tests zur Überprüfung einer postoperativen Restcurarisierung im Aufwachraum

Muskelrelaxanzien sind ein wichtiger Bestandteil moderner Anästhesieverfahren. Ihre Verwendung birgt jedoch das Risiko einer postoperativen Restcurarisierung. In der vorliegenden Studie wurden vier klinische Tests zur Vermeidung eines Relaxansüberhanges untersucht und ihre Beeinflussung durch vorherige Relaxabsgabe, intraoperatives Monitoring und Patientenalter. Des Weiteren wurde untersucht, ob es in den drei teilnehmenden Kliniken Unterschiede in der Häufigkeit des Einsatzes von apparativem neuromuskulärem Monitoring gab

A proinflammatory role for Fas in joints of mice with collagen-induced arthritis

Collagen-induced arthritis (CIA) is a chronic inflammatory disease bearing all the hallmarks of rheumatoid arthritis, e.g. polyarthritis, synovitis, and subsequent cartilage/bone erosions. One feature of the disease contributing to joint damage is synovial hyperplasia. The factors responsible for the hyperplasia are unknown; however, an imbalance between rates of cell proliferation and cell death (apoptosis) has been suggested. To evaluate the role of a major pathway of cell death – Fas (CD95)/FasL – in the pathogenesis of CIA, DBA/1J mice with a mutation of the Fas gene (lpr) were generated. The susceptibility of the mutant DBA-lpr/lpr mice to arthritis induced by collagen type II was evaluated. Contrary to expectations, the DBA-lpr/lpr mice developed significantly milder disease than the control littermates. The incidence of disease was also significantly lower in the lpr/lpr mice than in the controls (40% versus 81%; P < 0.05). However DBA-lpr/lpr mice mounted a robust immune response to collagen, and the expression of local proinflammatory cytokines such as, e.g., tumor necrosis factor α (TNF-α) and IL-6 were increased at the onset of disease. Since the contribution of synovial fibroblasts to inflammation and joint destruction is crucial, the potential activating effect of Fas on mouse fibroblast cell line NIH3T3 was investigated. On treatment with anti-Fas in vitro, the cell death of NIH3T3 fibroblasts was reduced and the expression of proinflammatory cytokines TNF-α and IL-6 was increased. These findings suggest that impairment of immune tolerance by increased T-cell reactivity does not lead to enhanced susceptibility to CIA and point to a role of Fas in joint destruction