Journal-related Activities and Other Special Activities at the 2011 American Society of Anesthesiologists Annual Meeting

20th Annual Journal Symposium: Anesthesia and Cancer Tuesday, October 18, 2011, 8:00 AM to 11:00 AM, Room S405A, McCormick Convention Center, Chicago, Illinois. This year ANESTHESIOLOGY will sponsor three sessions at the Annual Meeting of the American Society of Anesthesiologists (ASA). The Journal Symposium will highlight, in lectures and presentations of original research, the role of anesthetic and analgesic drugs and techniques on cancer outcome. Several retrospective studies suggest that anesthetic technique influences cancer recurrence, metastases, and mortality, and large prospective studies are currently under way. This symposium provides the scientist and clinician with state of the art information to help guide clinical practice.Cancer recurrence is among the long-term postoperative outcomes that may be influenced by perioperative patient management. The 2011 Journal Symposium will explore factors that may affect the recurrence of cancer after surgery and how perioperative patient management could influence this outcome.Three invited speakers will lead the session: Marcel E. Durieux, M.D., Ph.D., Professor of Anesthesiology and Neurologic Surgery at the University of Virginia, will provide a scientific overview of possible mechanisms of cancer recurrence; Jonathan Moss, M.D., Ph.D., Professor and Vice Chairman in the Department of Anesthesia and Critical Care at the University of Chicago, will discuss the effect of opioids on tumor growth and metastasis; and Daniel I. Sessler, M.D., Professor and Chair Department of Outcomes Research at the Cleveland Clinic, will discuss clinical studies of the relationship between anesthetic choices and cancer recurrence.These lectures will be followed by the oral presentations of 10 abstracts that were selected for their relevance to the Symposium topic. The text for each abstract can be found at the ASA abstract Web site.“Caveolin-1 Expression Can Determine the Outcome of Volatile Anesthetics and TRAIL Induced Apoptosis on Cancer Cells” by Y. Horikawa, Y Kawaraguchi, P.M. Patel, D.M. Roth, and H.H. Patel, Department of Anesthesiology, University of California, San Diego, California. The effects of isoflurane on cancer cell survival and death after exposure to it was determined by measuring tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis and its regulation by caveolin-1 expression. TRAIL-induced apoptosis was increased by isoflurane exposure in human cancer cell lines with low caveolin-1 levels and those with high Cav-1 levels after the levels has been knocked down using caveolin-1 small interferingRNA. Isoflurane protected cells with high caveollin-1 levels from TRAIL-induced apoptosis by a G-protein-dependent mechanism. [3062]“Volatile Anesthetics Reduce Release of Matrix-Metalloproteinase-9 from Human Neutrophils” by B. Mueller-Edenborn, B. Roth Zgraggen, L. Bircher, A. Borgeat, and B. Beck-Schimmer, University Hospital Zurich, Switzerland. Sevoflurane and desflurane preconditioned human neutrophils released less matrix metalloproteinase-9, which degrades components of the extracellular matrix leading to the spread of malignant solid tumors to distant sites, in response to stimulation by the main cytokine of ischemia–reperfusion injury, CXCL8. This suggests volatile anesthetics may reduce cancer recurrence in surgeries, such as liver or lung resection, involving ischemia reperfusion injury. [5133]“Antiproliferative Effects of Local Anesthetics on Mesenchymal Cells: Implications for Perioperative Tumor Spreading and Metastasis Formation” by M. Zaugg, E. Lucchinetti, A. Awad, J. Feng, P. Lou, H. Lemieux, and L. Zhang, University of Alberta, Edmonton, Alberta, Canada; University of Zurich, Zurich, Switzerland. Mesenchymal stem cells facilitate vasculogenesis after engrafting at the sites of tissue damage, and they elicit pronounced immunomodulatory effects. Lidocaine, bupivacaine, and ropivacaine dose-dependently reduced mesenchymal stem cell proliferation and colony formation as well as the expression of ICAM -1, the critical surface receptor involved in mesenchymal stem cell migration, in tumor necrosis factor-α treated cells by fundamentally changing their transcriptome. [2791]“Ropivacaine Inhibits Transendothelial Migration of Leukocytes Possibly by Attenuation of Src and ICAM-1 Phosphorylation” by T. Piegeler, G. Votta-Velis, D. E. Schwartz, A. Borgeat, R. D. Minshall, and B. Beck-Schimmer, Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois; Division of Anesthesiology, Balgrist University Hospital Zurich, Zurich, Switzerland, Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Ropivacaine dose-dependently decreased migration of polymorphonuclear leukocytes across human lung microvascular endothelial cells that had been cultured to confluence and treated with lipopolysaccharide, an inflammatory stimulant. Ropivacaine also inhibited activation of Src, a tyrosine kinase, and its resultant phosphorylation of ICAM-1, a cell surface receptor that is necessary for neutrophil adhesion and subsequent transmigration in acute lung injury and acute respiratory distress syndrome, suggesting a mechanism by which ropivacaine decreases polymorphonuclear leukocyte transendothelial migration. [4823]“Ropivacaine Attenuates Src Activation, ICAM-1 Phosphorylation, and MCP-1 Production in H838 Lung Cancer Cells” by T. Piegeler, G. Liu, G. Votta-Velis, D. E. Schwartz, B. Beck-Schimmer, R. D. Minshall, and A. Borgeat, Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois, Department of Pharmacology, University of Illinois at Chicago, Chicago, Illinois; Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland, Division of Anesthesiology, Balgrist University Hospital Zurich, Zurich, Switzerland. Ropivacaine dose-dependently decreased activation of the tyrosine kinase Src and its resultant phosphorylation of the cell surface receptor ICAM-1, which is necessary for neutrophil adhesion, in nonsmall cell lung cancer cells in both the absence and the presence of inflammatory stimulation by lipopolysaccharide. Ropivacaine also decreased tumor necrosis factor -α induced production of monocyte chemoattractant protein-1 in nonsmall cell lung cancer cells. [4822]“μ-Opioid Receptor Gene Polymorphism A118G Is Associated with Breast Cancer Survival” by A. Bortsov, R. Millikan, L. Diatchenko, I. Belfer, R. Boortz-Marx, H. Arora, and S. McLean, Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, Epidemiology, University of North Carolina, Chapel Hill, North Carolina, Center for Neurosensory Disorders, University of North Carolina, Chapel Hill, North Carolina; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Two thousand thirty-nine women between 23 and 74 years of age who were diagnosed with breast cancer between 1993 and 2001 were identified from the Carolina Breast Cancer Study and their survival status determined through 2006. The 323 women who had one copy of the μopioid receptor gene minor allele 118G had one-half the breast cancer specific mortality of the 1,682 women without the minor allele, whereas the 22 women with two copies of the minor allele had a breast cancer specific mortality that was one-quarter that of those without it. [4631]“Overexpression of the μ Opioid Receptor in Human Nonsmall Cell Lung Cancer Promotes Tumor Growth and Metastasis” by P. A. Singleton, F. E. Lennon, T. Mirzapoiazova, and J. Moss, Department of Medicine, University of Chicago, Chicago, Illinois, Anesthesia and Critical Care, University of Chicago, Chicago, Illinois. To determine the potential role of μ opioid receptor overexpression in human cancer recurrence, stable control and μ opioid receptor overexpressing bronchiooalveolar carcinoma cells were inserted into the hind flank of nude mice and primary tumor growth rates and lung metastasis were analyzed. Primary tumor growth rate more than doubled and lung metastasis increased by more than an order of magnitude when cells overexpressed the μ opioid receptor. [4939]“A Comparison of Epidural Analgesia and Traditional Pain Management Effects on Cancer Recurrence after Colectomy: A Population-Based Study” by K. C. Cummings III, L. C. Cummings, F. Xu, and G. S. Cooper, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, Gastroenterology, Case Western Reserve University, Cleveland, Ohio. The Medicare-Surveillance Epidemiology and End Results database was used to identify 31,950 patients who were older than 65 yr and underwent a colectomy for incident nonmetastatic colorectal cancer diagnosed between 1996 and 2005. Cancer recurrence rates and all-cause survival were compared between the 7,701 patients who had received epidural anesthesia or analgesia and the 24,249 who had not. A significantly reduced risk of recurrence was found in the epidural group only after adjusting for demographic and clinical covariates. [3980]“Epidural Anesthesia and Recurrence Free Longer Survival in Post Esophagectomy Patients” by M. Egi, S. Takenouchi, Y. Toda, and K. Morita, Okayama University Hospital, Okayama City, Japan. In this retrospective study with a 1,500-day postoperative follow- up, recurrence-free survival of patients undergoing esophagectomy under general anesthesia without epidural analgesia was compared with that of patients undergoing the same procedure under general anesthesia with epidural analgesia. The mean survival time of the 247 patients receiving epidural analgesia was 1,206 days, whereas that of the remaining 71 patients was 1,041 days (P = 0.041). [3981]“Preoperative, Fever-Range Whole-Body Hyperthermia in Patients Undergoing Colorectal Cancer Surgery” by O. Kimberger, E. Fleischmann, and I. Sulyok, Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Vienna, Austria. Eighteen patients undergoing curative colorectal surgery were randomly assigned to a preoperative placebo treatment group or a preoperative whole-body hyperthermia group in whom a target core body temperature of 30 ± 0.5°C was maintained for 2 h. Postoperative immunologic serum parameter profiles, such as that of lipopolysaccharide -induced tumor necrosis factor-α, suggested whole-body hyperthermia may improve the ability of the immune system to react to surgical stress. [5325]ANESTHESIOLOGY will sponsor two Best Abstract sessions this year, one in basic science and the other in clinical science. These abstracts were chosen by a panel of editors who examined the highest scoring abstracts from the ASA subcommittees, choosing those with important scientific and clinical application and novelty. Subsequently, a combination of these editors and appointees from the ASA will choose one abstract in each category to receive the inaugural Best Abstract award for basic science and for clinical science at the meeting in Chicago.Following is a description of these sessions and the superlative abstracts that will be presented.Monday, October 17, 8:00 AM to 10:00 AM, McCormick Convention Center, S405A, Chicago, Illinois. “Role of the DRG-NR2B Subunit in Mechanical Allodynia Induced by Spared Nerve Injury” by M. Norcini, L. Martin Hernandez, J. Zhang, T. J. Blanck, and E. Recio-Pinto, Anesthesiology, New York Langone Medical Center, New York, New York. Neuropathic pain is often accompanied by hypersensitivity to touch or temperature changes and is frequently difficult to treat with traditional analgesics. Hypersensitivity to touch stimuli in rodents after peripheral nerve injury can be alleviated by N -methyl-D-aspartate (NMDA) antagonists, and there is evidence for increased NMDA receptor signaling on neurons in the spinal cord. This study shows that NMDA receptors are also present on the peripheral nerves as well and, paradoxically, they are more up-regulated in surgical models leading to slow resolution of hypersensitivity than in those without such resolution. As such, NMDA receptor changes may trigger resolution of pain as well as its persistence. [5170]“In Utero Nitrous Oxide Exposure Increases Agouti Signal Protein Expression in Avy/a Mice” by K. Hogan, University of Wisconsin School of Medicine and Public Health, Anesthesiology, Madison, Wisconsin. Environmental factors in utero can change genetic structure and subsequent development of the fetus in part by altering methylation of DNA, which affects gene expression. In this study N2O exposure during day 4 of gestation in mice altered coat color of the offspring, associated with reduction in methylation of DNA. Not only does this show that environmentally triggered epigenetic modifications in utero during a critical interval after fertilization may provide a mechanism for varying individual susceptibilities to nitrous oxide, but suggests that this effect could result in transgenerational inheritance. [2802]“Peri-operative Fentanyl Administration Induces Spinal Cord Sensitization in Rat” by P. G. Richebe, M. Xu, E. H. Chudler, M. R. Byers, A. Cahana, and C. Rivat, Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, Washington. Opioids, especially fentanyl, are commonly used as part of a balanced anesthetic for surgery, yet some studies suggest that acute, large-dose opioid exposure may later paradoxically increase pain and hypersensitivity. In this study, rats that received fentanyl exhibited more hypersensitivity to light touch stimuli after paw incision surgery than those without such exposure. This behavioral effect was mirrored in enhanced responsivity of spinal dorsal horn neurons to stimulation, and this effect was blocked by ketamine and by inhibitors of p38 MAP kinase. These data are consistent with a complex interaction between spinal cord neurons and microglia, leading to enhanced pain after surgery when large doses of opioids are used. [5776]“Isoflurane anesthesia increases mortality rate in aged Fischer 344 rats” by M. C. Lewis, L. Jones Mawhinney, and H. Bramlett, University of Miami School of Medicine, Miami, Florida, Miami Project to Cure Paralysis, University of Miami School of Medicine, Miami, Florida. It is of great interest whether the elderly have increased cognitive dysfunction and mortality after general anesthesia. Baseline cognitive function was determined by the Morris water maze tests in aged (18 months) male Fischer 344 rats. Rats were randomly assigned to receive anesthesia for 4 or anesthesia. cognitive dysfunction and general anesthesia increased mortality rate in aged rats. Results suggest that cognitive present anesthetic exposure may increase the of anesthesia death in surgical Attenuates in Human Induced by S. A. F. M. C. and Anesthesiology Medical of Wisconsin. can which the of from an this effect of anesthetics is by The human by of induced stem cells from patients without and those with of decreased anesthetic in both of of by S. H. R. P. and M. Anesthesiology, University of at California. Several have been to or the development of Journal of and has been to The that rats with and at day after the is of were for days to the rats. and the of the rats that the decreased the of and survival of the treated rats. and the response during by A. D. R. R. P. C. A. and H. B. Department of Anesthesiology, University, North The treatment of and patients has mortality for the of the system have been to improve outcomes Care there is a to the changes that during that lead to The in the of mice and mice with the same who were is a of respiratory gene expression and These that the components of the as well as of and were reduced in the as were is Associated with at by M. T. H. K. C. and L. and the University of California, California. The of the effect of was in human using to identify changes in of reduced with changes in This effect was associated with reduction in a important to long-term of by P. G. K. and M. M. Research Institute, Seattle, Case Western Reserve University, Cleveland, Anesthesiology, Research Institute, Seattle, Washington. in the was using of in or of a in neurons the effect of whereas activation of a enhanced the of neurons affect These the that function by of Isoflurane on The by A. M. M. S. G. A. C. E. and J. and University, Department of Anesthesiology, Washington University School of Medicine, Primary Research Center, and University, Department of Washington University School of Medicine, Exposure of to ketamine for in the In this study to the effects of anesthetic treatment of with isoflurane or ketamine for to in the This effect was than that for ketamine treatment of but less than that for isoflurane exposure of These studies changes in the and of that between specific October 18, to McCormick Convention Center, S405A, Chicago, Illinois. that to a for by C. K. B. and T. and Anesthesiology, University of City, The response surface for that lead to respiratory during to was by both and for both effects in this study to associated with respiratory effects and that was associated with whereas was associated with These models will during using target in the Pain at a Care Pain by C. M. R. J. K. and A. L. University of pain and commonly and is frequently treated with opioids or yet is from It is that some of these patients have an of pain that may be to such In this study of patients with a primary of or pain in a pain one-half for with the those with had pain and levels of and opioids and as less These data suggest that may with spinal pain and that patients with both may to treatment than those without of is Associated of by M. A. Y. Zhang, R. E. M. T. T. and M. Anesthesiology, University of Miami, Miami, Anesthesiology, Anesthesiology, Center, Anesthesiology, School of Pharmacology, Chapel Hill, North Nerve that from surgery, in pain in some but and whether this a genetic in some patients is In of the gene are associated with to hypersensitivity after nerve In this study, patients from and were for of the and one of the was associated with an increased of pain after and in those with pain from These data as a for to and in the Anesthesiology by G. S. T. J. C. and R. Anesthesiology, University, Chicago, Illinois. The for and has been the of the In this study, data from to for the were from the American Medical adjusting for older on and were of a to into an These data are consistent with the presence of in the for anesthesia older and A Study of and by M. S. K. S. and A. M. Department of Anesthesiology, University of and of are of great for management. A of with were patients a risk factors for a were increased body male and surgical In patients more frequently difficult of Postoperative in with by A. J. T. and S. Anesthesiology, Hospital Medical Center, University of for Medical Perioperative behavioral factors in anesthesia significantly to postoperative of of and using the behavioral Perioperative perioperative behavioral between and in the in Patients to yr A Study and by C. E. D. Postoperative cognitive dysfunction in the elderly has a on A study to identify postoperative cognitive dysfunction at yr in elderly patients and a to of and on the postoperative cognitive dysfunction were studies increase of postoperative cognitive dysfunction in surgical patients than control studies reduction of postoperative cognitive dysfunction by the of in to A of Perioperative by R. R. R. and B. Department of and Intensive Care Medicine, University Hospital of Department of Epidemiology, The University of M. D. Cancer Center, Department of The University of M. D. Cancer Department of and Pain Medicine, Cancer postoperative and mortality is the risk has been used to perioperative but only well between patients at low high risk for after surgery there is a for other tests that can help the perioperative patients The used the of endothelial cells after to determine whether patients have or other surgical after The of endothelial cells to be an important of the that tissue injury. Patients who had a in cells with surface more (P = postoperative that patients who had an increase in these cells after on by an to a by T. H. A. L. K. G. and C. J. Division of Anesthesiology, Intensive Care and Medicine, University Medical Center The Center for and Primary Care, University Medical Center The are data that suggest that an to has a on than only a risk The studies both in the same a was in the at a University The group was a without a and the control group was In the same underwent a and after were a on how to their increased compared with but when with a the same significantly more patient than when only with information Perioperative and in A by M. S. P. H. A. J. E. K. C. H. A. E. and D. A. University Medical Center and Intensive Care Medicine, University Medical Center Medical University Center The a on of and for during and after Patients were to two the or a control group using an on and mean or with were data from patients could be analyzed. was in but of in the and time to for were significantly less in the patients receiving the that used and of using Anesthesia Management by R. H. and F. Anesthesiology, Medical University of City, The the of of in or for a preoperative and the of that the absence of a preoperative was associated with data that and and are without data which are associated with and can by the of tests that are to Outcomes in Patients” by C. C. I. T. P. and L. Anesthesia and Perioperative Care, University of California, San San Anesthesiology and Critical Care, Hospital, University and University of California, San San California. In a prospective study, the used of clinical and to and a to mortality after for A and high levels of and was (P to other in and also well in the in (P October 17, 2011, to McCormick Convention Center, Chicago, Illinois. will be This of Research will on during the Annual C. M.D., of will as speakers will be the 2011 of the ASA in Research D. M.D., Ph.D., Department of Anesthesiology, Washington University, and the of the 2011 A. M.D., Ph.D., Division of University of Medical The of the 2011 Research will also be during the information and will be in the of Research at the 2011 Annual

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