Relationship between Gb3 Expression and Cytotoxicity of Shiga-like Toxin I

PURPOSE: Infection with Shiga-like toxin (SLT)-producing Escherichia coli, an emerging human pathogen found particularly in young children under 5 years of age, causes a spectrum of illnesses with high morbidity and mortality, ranging from diarrhea to hemorrhagic colitis and hemolytic uremic syndrome. Host mediators play an important role in the pathogenesis of SLT-I toxicity. The experiments described here were designed to investigate the effect of SLT-I on TNF- alpha production and to understand the effect of TNF-alpha on GB3 expression. We also further examine the relationship between the Gb3 level and the differential susceptibility of cells to the cytotoxic action of SLT-I. METHODS: The effect of purified SLT-1 from E. coli O157 : H7 (ATCC 43890) on tumor necrosis factor-alpha (TNF- alpha) production in Raw264.7 cells was investigated. Many mediators regulate endothelial cell membrane expression of the glycolipid globotriaosyleramide (Gb3), which serves as the toxin receptor, suggesting that the host response to the toxin or other bacterial products may contribute to pathogenesis by regulating target cell sensitivity to the toxins. Therefore, the relationships between Gb3 expression and cytotoxicity against SLT-I on three types of cells were evaluated. RESULTS: Detectable levels of TNF-alpha were produced as early as six hours after induction and continued to increase during 48 hours by SLT-I. It was also found that Vero cells and dendritic cells (DC2.4 cells) expressed high levels of Gb3, 83% and 68%, respectively, and that Raw264.7 cells had a low level of Gb3 (29%) and appeared refractory to cytotoxicity against SLT-I. Vero cells and DC2.4 cells expressing high levels of Gb3 were highly susceptible to SLT-I. Furthermore, macrophages showed a resistance to SLT-I cytotoxicity, despite the fact that Gb3 expression was enhanced. CONCLUSION: These results strongly suggest that the expression of Gb3 is necessary but not sufficient to confer sensitivity of macrophages to SLT-I and further underpin the important role of SLT-I and its Gb3 receptors in the pathogenesis of E. coli O157 infection.

Prevalence and Risk Factors of Candida Sepsis in Neonatal Intensive Care Unit

PURPOSE: With the development of neonatal intensive care and the increased use of systemic antibiotics, candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The purpose of this study was to investigate the prevalence rate and its associated risk factors. METHODS: We retrospectively reviewed medical records of 28 cases with candida sepsis who were admitted in the neonatal intensive care unit(NICU) of Chonnam University Hospital from July 1995 to June 2001. Twenty-nine patients without candida sepsis were enrolled for the control group to verify the risk factors. RESULTS: The overall incidence of candida sepsis was 0.61% for all NICU admissions and 3.68% for all very low birth weight infants with the gradual increase of the annual prevalance rate over time. The endotracheal intubation, percutaneous central vein catheter(PCVC), umbilical vein catheter, total parenteral nutrition, intralipid and dopamine were more applied than the control group (P<0.01 for all). The durations of mechanical ventilator care, central catheter appliance, nothing per os, and admission were also significantly longer than the control group(P<0.01 for all). Ampicillin/sulbactam, ceftazidime, amikacin, netilmicin, teicoplanin and imipenem/cilastatin were significantly more used than the control group(P<0.05). The durations of ampicillin/sulbactam, ceftazidime, netilmicin and imipenem/cilastatin administration were also proved to be significant as the risk factors(P<0.01). CONCLUSION: The average annual prevalence rate of candida sepsis in NICU for six years was 0.61% with gradual increasing tendency over time. The elimination of the above risk factors is important in decreasing neonatal morbidity and mortality associated with candida sepsis.

Frequency of Platelet Transfusions and Outcome in Neonates with Thrombocytopenia

PURPOSE: We compared the underlying or associated diseases according to the frequency of platelet transfusions in neonates with thrombocytopenia to know the factors predicting which patients will require multiple platelet transfusions. We also compared mortality. METHODS: A retrospective study was performed in 72 neonates who received the platelet transfusions in neonatal intensive care unit(NICU) between August 1996 and July 2001. Group I received one platelet transfusion and group II received two or more. We compared the frequency of underlying or assodiated diseases such as sepsis/disseminated intravascular coagulopathy(DIC), respiratory distress syndrome(RDS), intraventricular hemorrhage(IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis(NEC), liver or renal disease, and mortality between two groups. RESULTS: Of the 72 patients, 29(40.2%) received one and 43(59.7%) received two or more transfusions; 16(22.2%) received four or more. There were no statistically significant differences in gestational age, birth weight, sex, and maternal history between two groups. C-section rate was higher in group II(20.7% vs. 55.8%, P<0.05) and the incidence of PDA was higher in group I (55.2% vs. 30.2%, P<0.05). Otherwise, there were no statistically significant differences in the incidence of sepsis/DIC, RDS, IVH, RDS, CLD, NEC, liver or renal disease, pulmonary hemorrhage and hypoxic ischemic encephalopathy, and mortality between group I and group II. CONCLUSION: There was no significant difference in clinical morbidity and mortality according to the frequency of platelet transfusion in neonates with thrombocytopenia. Further study is needed to know the predicting factor for multiple platelet transfusions in neonates with thrombocytopenia.

Salvia miltiorrhiza Inhibits Tumor Cell Growth in Association with Rb Dephosphorylation through Up-regulation of p21 Via a p53-dependent Pathway

BACKGROUND: Salvia miltiorrhiza (SM), a traditional oriental medicine, has been reported to have anti-tumor properties, but its exact mechanism remains to be elucidated. In this study, we investigated several of the molecular events that occur in human breast carcinoma MCF-7 cells and human pulmonary adenocarcinoma A549 cells. METHODS: For this purpose, we evaluated the growth-inhibitory effect of SM in association with the expressions of p53, p21, cyclin D1, and pRb, which are known to be involved in cell cycle arrest. The extent of thymidine incorporation was also examined to assess G1/S phase cell cycle arrest in both cells by 3H-thymidine incorporation. RESULTS: Our results show that SM inhibits the growth and the proliferation of MCF-7 and A549 cells. Furthermore, we also observed increased expression of p21 via a p53-dependent pathway in both cell lines after treating with SM. In addition, treatment with SM for 24 hours caused the suppression of hyperphosphorylated retinoblastoma protein (pRb) expression and the dephosphorylation of pRb. CONCLUSION: These findings suggest that the growth inhibitory and the anti-proliferation effects of SM on MCF-7 cells and A549 cells are mediated via the decreased expression and dephosphorylation of pRB by p21 up-regulation in a p53-dependent manner. To the best of our knowledge, this study is the first to report upon the molecular mechanisms involved in SM-induced tumor cell growth inhibition.

Expression of Multidrug Resistance Genes, mdr1, mrp, Topo IIalpha and Topo IIbeta in Childhood Acute Lymphoblastic Leukemia / 대한소아혈액종양학회지

PURPOSE: Multidrug resistance in the treatment of cancer mediated by several drug resistant genes impedes the successful management of cancer. The authors investigated the expression of drug resistant genes, including multidrug resistance (mdr1), multidrug resistance-associated protein (mrp), topoisomerase IIalpha (Topo IIalpha), and topoisomerase IIbeta (Topo IIbeta) in patients with childhood acute lymphoblastic leukemia (ALL; n=24) and in normal controls (n=6). METHODS: The levels of their transcripts in the bone marrow mononuclear cells were compared by semiquantitative RT-PCR, comparing the optical density ratio of PCR products of target genes to that of beta2-microglobulin. RESULTS: The expression of all 4 genes were detected in ALL patients as well as in normal controls except for Topo IIalpha, which were not detected in controls. The expression levels of mdr1, mrp and Topo IIbeta in ALL patients were significantly higher than those of normal controls [(2.1+/-2.2 vs 0.9+/-0.3, P> 0.024), (0.5+/-0.2 vs 0.2+/-0.1, P=0.016), and (0.7+/-0.2 vs 0.3+/-0.1, P=0.016)], respectively. The expression level of mdr1 gene transcript was relatively higher than those of mrp and Topo IIbeta. However, there was no correlation between the expression of multidrug resistant genes and survival and/or relapse of ALL. CONCLUSION: Though multidrug resistance genes did not serve as an independent prognostic factor, they might be used for markers for disease progression or relapse in childhood ALL. A longitudinal study of those genes is necessary to elucidate the prognostic significance in childhood ALL.

Effect of pseudomonas aeruginosa infection on production of IL-2 and IL-6, and other parameters of immunocompetency in mice

No abstract available.

Changes in End - tidal Carbon Dioxide Tension during Laparoscopy Using Carbon Dioxide under General Endotracheal Anesthesia / 대한마취과학회지

Laparoscopy is a useful technique for a diagnostic purpose of pelvic diseases in gynecologic patients, but it may be associated with many complications related to a steep Trendelenburg position and a usage of Trocar. It may also be developed that a large amount of CO2 insufflation into the peritoneal cavity causes respiratory acidemia and its related hemodynamic changes. To investigate the influence of the CO2, insufflation and the positional changes on the end-tidal CO2, tension (P>CO2), blood pressure and heart rate during laparoscopy in gynecologic patients, the authors observed the changes in PetCO2,heart rate, and blood pressure before the CO2, insufflation, at 1,3,5,7 and 10 minutes after the CO2, insufflation and at 2,5 and 10 minutes after the CO2, exsufflation respectvely under general endotracheal anesthesia with controlled ventilation (tidal volume 10 ml/kg, ventilatory rate 10 breaths/min). The results were as follows. 1) Pet>CO2 was increased until 10 minutes after CO2 insufflation. 2) PetCO2 was decreased at 2,5 and 10 minute after CO2 exsufflation but increased from the control value. 3) Heart rate was decreased at 1,3,5,7 and 10 minutes after CO2 insufflation and at 2,5 and 10 minutes after CO2 exsufflation from the control value respectively. 4) Systolic and diastolic blood pressures were increased after CO insuffiation and unti15 minutes after CO2 exsufflation. On the basis of the above results, because an increase of the PetCO2, and the hemodynamic changes occur during the laparoscopy using CO2 under general endotracheal anesthesia with controlled ventilation, it is recommended to monitor carefully PetCO2, heart rate and blood pressure to control adequately ventilation, blood pressure and heart rate.

Transient Cauda Equinal Irritation due to the Subarachnoid Spread of Epidural Morphine Through a Previous Dural Puncture Site / 대한마취과학회지

Signs and Symptoms consistent with the irritation of the cauda equina developed during epidural morphine therapy for the relief of pain from osteosarcoma in a 10-year-old female patient. This was considered to be due to a subarachnoid diffusion of the epidurally administrated morphine through the dural opening formed by a previous inadvertent dural puncture. The subarachnoid diffusion of the drug was confirmed by fluoroscopy following injection of the contrast media through the indwelling epidural catheter. The chemical inflammation of the cauda equina might be due to substances formed by chemical reactions with a certain preservative vehicle rather than the morphine itself. Spinal steroid therapy may be effective for the suppression of a chemical inflammatory reaction.

Effects of Diazepam-Ketamine-N2O-O2 Anesthesia on the Cardiovascular System and Psychotomimetic Reaction / 대한마취과학회지

The authors observed the anesthetic effects of an intravenous drip of ketamine hydrochloride supplemented with diazepam and nitrous oxide on the cardiovascular system and the psychotomimetic reaction in 38 relarively healthy patients who underwent abdominal surgery at Chonbuk National Hospital from May to Sept., 1985. The results were compared with those obtained from patients anesthetized with halothanenitrous oxide-oxygen. 1) The rate of intravenous drip of ketamine was 1mg/kg/hr, which adequately maintained the level of surgical anesthesia. The total amount of pancuronium required for satisfactory skeletal muscle relaxation was 40% more in the ketamine group than in the halothane group. 2) Following ketamine anesthesia, systolic pressure revealed a transient increase immediately after induction, and about 4minutes after the commencement of surgery it thereafter returned to the preinduction level and remained stable during the operation this is in contrast with halothane anesthesia in which the systolic pressure decreased and remained below the level of preinduction after a transient increase immediately after induction. 3) The difference in diastolic pressure between ketamine and halothane anesthesia was significant(p0.05). 5) Contrary to halothane anesthesia, anticholinergic premedication could not completely prevent endotracheal secretion following ketamine anesthesia. 6) Premedication with diazepam could not completely relieve psychotomimetic reactions including convulsion and hallucination after ketamine anesthesia.

A Clinical Study on the Temperature Correction of Blood Gas Values during Hypothermia in Patients Undergoing Open Heart Surgery / 대한마취과학회지

Blood gas values corrected for temperature were compared to uncorrected values in 35 cases of open heart surgery and the following results were obtained. 1) The corrected pH values were higher than the uncorrected values, and a 1 degrees C decrease in the rectal temperatures resulted in an increase pH values by 0.013(Y=-0.013x + 0.504, p<0.01). 2) The corrected values for PCO2 were lower han the uncorrected values, and a 1 degrees C decrease in the rectal temperature resulted in a decrease in corrected PCO2 values by 1.256mmHg(Y=-1.256x + 49.267, p<0.01). 3) The corrected values for PO2 were slightly lower than the uncorrected values, and the differences between temperature corrected and uncorrected PO2 values had statistically significant, but clinically no significant correlation (Y=-3.236x + 133.075, p<0.01). 4) The differences between temperature corrected and uncorrected base excess values had no satistical correlation. 5) If the uncorrected pH values were maintained around 7.4 at any temperature then the corrected pH values at each temperature were very close to the theoretically ideal values (Y=-0.014x).