Epigenetic Regulation of the Expression of T Cell Stimulatory and Inhibitory Factors by Histone H3 Lysine Modification Enzymes and Its Prognostic Roles in Glioblastoma

Background@#This study aimed to identify the specific T cell co-stimulatory and co-inhibitory factors that play prognostic roles in patients with glioblastoma. Additionally, the unique histone H3 modification enzymes that regulate the expression levels of these specific costimulatory and co-inhibitory factors were investigated. @*Methods@#The medical records of 84 patients newly diagnosed with glioblastoma at our institution from January 2006 to December 2020 were retrospectively reviewed.Immunohistochemical (IHC) staining for T cell co-stimulatory factors (CD27, CD28, CD137, OX40, and ICOS), T cell co-inhibitory factors (CTLA4, PD1, PD-L1, TIM3, and CD200R), and histone H3 lysine modification enzymes (MLL4, RIZ, EZH1, NSD2, KDM5c, JMJD1a, UTX, and JMJD5) was performed on archived paraffin-embedded tissues obtained by biopsy or resection. Quantitative real time-polymerase chain reaction (qRT-PCR) was performed for specific factors, which demonstrated causal relationships, in order to validate the findings of the IHC examinations. @*Results@#The mean follow-up duration was 27.5 months (range, 4.1–43.5 months). During this period, 76 patients (90.5%) died, and the mean OS was 19.4 months (95% confidence interval, 16.3–20.9 months). Linear positive correlations were observed between the expression levels of CD28 and JMJD1a (R2 linear = 0.982) and those of CD137 and UTX (R2 linear = 1.528). Alternatively, significant negative correlations were observed between the expression levels of CTLA4 and RIZ (R2 linear = −1.746) and those of PD-L1 and EZH1 (R2 linear = −2.118); relationships were confirmed by qRT-PCR. In the multivariate analysis, increased expression levels of CD28 (P = 0.042), and CD137 (P = 0.009), and decreased expression levels of CTLA4 (P = 0.003), PD-L1 (P = 0.020), and EZH1 (P = 0.040) were significantly associated with longer survival. @*Conclusion@#These findings suggest that the expression of certain T cell co-stimulatory factors, such as CD28 and CD 137, and co-inhibitory factors, such as CTLA4 and PD-L1 are associated with prognosis of glioblastoma patients.

Preliminary Study of the Antioxidant Effects of Oenanthe javanica Extract on the Skin of Aged Mice / 대한피부과학회지

No abstract available.

Green discoloration of urine after propofol infusion / 대한마취과학회지

No abstract available.

Quantitative Determination of Plasmodium Parasitemia by Flow Cytometry and Microscopy

The traditional light microscopy has limitations for precise growth assays of malaria parasites in culture or for assessment of new compounds for antimalarial activity; the speed and high reproducibility of flow cytometry can overcome these limitations. A flow cytometric method using PicoGreen, a DNA-binding fluorochrome, was developed with optimal precision suitable for performing growth assays of low-parasitemia field isolates. In addition, intra- and inter-person reproducibility of the flow cytometric and the microscopic method were compared in order to quantitatively demonstrate the improved precision. RNase treatment contributed to the precision of the flow cytometric measurements by enhancing the signal-to-noise ratios. Coefficients of variation of the method were smaller than 10% for 0.1% or higher parasitemia samples. The intra- and inter-person coefficients of variation of the flow cytometric method were three to six times smaller than those of the microscopic method. The flow cytometric method developed in this study yielded substantially more precise results than the microscopic method, allowing determination of parasitemia levels of 0.1% or higher, with coefficients of variation smaller than 10%. Thus, the PicoGreen method could be a reliable high sensitivity assay for analysis of low parasitemia samples and might be applied to a high throughput system testing antimalarial drug activity.

The Effects of Tetracycline-loaded Silk Fibroin Membrane on Guided Bone Regeneration in a Rabbit Calvarial Defect Model

0.05). Regenerated bone volume (mm3) of 1% TC-loaded SFM, SFM, and control were 36.56+/-8.50, 25.86+/-8.17, and 19.09+/-5.07 at 8 weeks postoperatively, respectively (P<0.05).CONCLUSION: The 1% TC-loaded SFM showed more bone regeneration than the SFM and the uncovered control, in guided bone regeneration.

Malignant hyperthermia during cesarean section: A case report

Malignant hyperthermia is manifestated in susceptible individuals exposed to triggering drugs, such as depolarizing muscle relaxants and inhalational anesthetics. Various musculoskeletal abnormalities, such as scoliosis, hernias and strabismus, have been associated with malignant hyperthermia susceptibility. During cesarean section of the patient who had undergone scoliosis correction surgery, we experienced malingnant hyperthermia due to succinylcholine and inhalation anesthetics. In our case, as soon as we suspected the episode, all anesthetics were stopped and anesthetic machines were changed to unexposed anesthetic machine for inhalational anesthetics. Dantrolene was given intravenously and the patient was cooled by tepid sponging, cooled fluids. The patient recovered normal temperature and consciousness without any complications.

Prevalence of Sleep Disorder and Associated Factors in Family Practice / 가정의학회지

BACKGROUND: Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice. METHODS: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression. RESULTS: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression. CONCLUSION: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.

Uterine bleeding in a postmenopausal women following epidural triamcinolone acetonide injection: A case report / 대한마취과학회지

Epidural steroid therapy for herpes zoster associated pain is known to be effective with rare complications. However, certain amount of epidurally-injected steroid may be absorbed and affect endocrinological system. Specially, triamcinolone acetonide has high affinity for progesterone receptors and may influence mensturation. We report a case of a postmenopausal women treated with 40 mg of epidural triamcinolone acetonide twice with a two week interval and followed a large amount of uterine bleeding.

Incidental diagnosis of multiple myeloma during the treatment of low back pain: A case report / 대한마취과학회지

A 49-year-old male patient presented at our clinic with back pain due to an insignificant injury that had occurred approximately 7 months earlier. Although the patient had been treated at primary clinics, the pain had gradually become aggravated and characterized by resting and night pain. We initially diagnosed the patient with myofascial pain syndrome and began treatment comprised of trigger point injection (TPI) on the back muscles to control the pain. His symptoms improved after the first treatment (TPI), but he complained of back pain again several days later. At that time he also reported that he had lost 10 kg over the 4 months preceding his initial visit. Plain radiographs of the thoracolumbar spine revealed L1-L5 compression fractures and generalized osteopenia. The patient was then diagnosed with multiple myeloma based on the results of a bone marrow biopsy. This case demonstrates the importance of using comprehensive diagnostic approaches when the patient manifests symptoms that are unresponsive to conventional treatment.

Trend of the Subjects and Participants of the Korean Academy of Family Medicine Conference / 가정의학회지

BACKGROUND: Throughout the past 20 years in the Korean academy of family medicine seasonal conference, on-going study is done to promote overall development and satisfaction of the conference participants and to overlook the trend of the conference subject, the number of classes, the number of participants, etc. METHODS: About 2,132 topics during the conference from the year 1992 to 2007 collected from the Korean academy of family medicine website were categorized by subject based on the standard of the contents of the latest textbook. There were a total of 7 main classifications including 5 categories like 'principles of family medicine', 'disease prevention and health promotion', 'symptoms', 'clinical procedures', 'diseases' and adding 2 categories such as each committee's classes and other subjects. The scope of the changes of the main and sub-titles were categorized as in the 1990s and 21 century. RESULTS: The number of attendees has increased during the past 20 years, especially the residents were the main portion of the participants. On the proportion of the clinical topics, there was a remarkable increase of geriatric medicine, palliative medicine, obesity, exercise, nutrition, gastroscopy, and colonoscopy procedure in the later half rather than the former half period. In the field of the main category, the core principle subjects of family medicine seemed to be decreased in contrast to disease category. CONCLUSION: During the last 20 years, the titles of family medicine conference are changing with the trend of practice. The core knowledge of family medicine should be maintained and balanced for the future of family medicine conference.

Cauda equina syndrome after spinal anesthesia: A case report / 대한마취과학회지

A 72-year-old man undergoing emergency arthroscopic irrigation and debridement of the left knee joint due to pyogenic arthritis developed cauda equina syndrome after spinal anesthesia with 0.5% hyperbaric tetracaine mixed with epinephrine. Epinephrine was added to local anesthetic to prolong the duration and to increase the quality of spinal anesthesia. There was no paresthesia on needle placement. We injected anesthetics twice because the first subarachnoid injection failed. The patient experienced impaired sensation in the perineal region and alterations in bowel and urinary habits. Magnetic resonance imaging revealed spondylolisthesis and disc protrusion (L4-5), with spinal stenosis (L5-S1), but did not show suspicious lesions such as hematoma and abscess. We suggest the causative factors are temporary neural compression due to his spinal diseases and spinal cord ischemia due to decreased spinal blood flow because of epinephrine. We also cannot rule out the tetracaine neurotoxicity.

A case of cardiac arrest following bupivacaine injection for shoulder arthroscopy : A case report

Intra-articular administration of local anesthetics such as bupivacaine can produce short-term postoperative analgesia in patients who are undergoing shoulder arthroscopy. Yet bupivacaine can result in cardiovascular toxicity that can lead to cardiac arrest. We experienced a case of 63-year-old male patient with severe cardiac toxicity that led to ventricular fibrillation 15 minutes after injecting 0.5% bupivacaine into the patient's shoulder joint for shoulder arthroscopy.

The Preventive Effects of Dexamethasone and Ondansetron for Postoperative Nausea and Vomiting after Tympanomastoidectomy / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting (PONV) is the major cause of patient's discomfort after surgery. Dexamethasone and ondansetron have been known to have some preventive effects on PONV. The purpose of this study was to compare the effects combination therapy of these drugs in the prevention of PONV after tympanomastoidectomy which has been known to be a high risk factor of PONV. METHODS: Ninty patients scheduled tympanomastoidectomy under general anesthesia were included. Patients were randomly divided into three groups and received dexamethasone 5 mg (group D), ondansetron 4 mg (group O), or dexamethasone 5 mg plus ondansetron 4 mg (group DO) at 30 min before the end of operation. The degree of PONV was assessed at 6 h, 12 h, 24 h, and 48 h after operation. RESULTS: The degrees of nausea in group DO during 0-6 h and 6-12 h were lesser than those of other groups. The overall incidences of nausea were 73% (group D), 62% (group O), and 23% (group DO, P < 0.05). The degrees of vomiting in group O and DO during 0-6 h were lesser than those of group D. The overall incidences of vomiting were 37% (group D), 17% (group O), and 7% (group DO, P < 0.05). CONCLUSIONS: The combination of dexamethasone and ondansetron is more effective than single use of each drug for the prevention on PONV after tympanomastoidectomy.

Effect of Rapamycin on the Cell Cycle Arrest of T Lymphocytes

PURPOSE: Rapamycin (RPM) and its analogues are known for their potent immunosuppressant and anti-proliferative properties, which stem from their ability to modulate the signal transduction pathways involved in cell cycle progression from the G1 to S phase. Thus, RPM has been shown to inhibit the proliferation of a number of non-immune cell types, including hepatocytes, vascular smooth cells and fibroblasts. In addition to its effects on proliferation, RPM may also play a role in the regulation of apoptosis under certain circumstances. METHODS: The effects of RPM on the activation, proliferation and expression of cytotoxic effector molecules were examined on Molt-4 human T-lymphocyte by determining its effects on apoptosis, cell viability, reactive oxygen species (ROS) production and mitochondrial dysfunction. Cells were cultured in the presence or absence of RPM, and then analyzed by Flow cytometry after staining with PI (propidium iodide). RESULTS: The viability of Molt-4 T cells dose- and time-dependently decreased on the addition of RPM. CONCLUSION: RPM induced cytotoxicity was characterized by G2/M phase cell cycle arrest. In addition, a pharmacological scavenging study of ROS, including H2O2, revealed the cytotoxicity was mainly induced by the generation of ROS, which might modulate the expression of Bak protein and mitochondrial dysfunction.

Multiple Metastatic Brain Tumor: Complicated with Post-dural Puncture Headache : A case report

Epidural blood patch is an effective management for treatment of severe post-dural puncture headache. Here we describe a case of a patient with hip fracture, who was complained regarded as having suspicious post-dural puncture headache after epidural anesthesia, but it failed to be treated with 4 times of epidural blood patch, and later was diagnosed with multiple metastatic brain tumor.

A Case of Isolated Abducens Nerve Palsy Caused by Vascular Compression

No abstract available.

A Case of Isolated Abducens Nerve Palsy Caused by Vascular Compression

No abstract available.

A Case of Encephalitis, Meningoradiculitis and Intestinal Pseudo-Obstruction Caused by Varicella-Zoster Virus

A 19-year-old woman developed painful abdominal distension, headache and mental deterioration. Several days later, she complained of paraparesis, urinary incontinence and diuresis. Intestinal pseudo-obstruction was detected by a laparoscopic examination. Brain MRI showed encephalitis with a high signal intensity of the corpus callosum on diffusion-weighted images. In serum and CSF, the varicella-zoster virus (VZV) IgM antibody was positive. After treatment with steroids and acyclovir, her symptoms improved. We report a patient with intestinal pseudo-obstruction, encephalitis and meningoradiculitis caused by VZV without skin lesions.

Histochemical Characteristics and Ultrastructure of Mast Cells in Pheasant (Phasianus colchicus) / 대한해부학회지

This study describes the histochemical characteristics and ultrastructure of mast cells from tongue, proventriculus, ileum and fabricius bursa, in pheasant (Phasianus colchicus) by light and electron microscopy. We compared the stainability of 4 different methods, toluidine blue, alcian blue, congo red and alkaline Giemsa, to stain mast cell granules from fixed pheasant organs in three different fixatives, 10% neutral buffered formalin, Carnoy's solution or half-strength Karnovsky's solution. Mast cells in all experimental organs were not stained with 4 different staining methods after fixation in 10% neutral buffered formalin but well stained in fixed organs with half-strength Karnovsky's solution. The mast cells had many metachromatic granules stained with toluidine blue or alkaline Giemsa and orthochromatic granules stained with alcian blue or congo red in tissues fixed in half-strength Karnovsky's solution. In electron microscopy, pheasant mast cells were oval, triangular, spindle-like or irregular and had a few finger-like cytoplasmic processes. There were the membrane-bounded secretory granules and the well-developed organelles in mast cells. Internal large granules were oval or irregular, and had variable shape; some higher or lower electron density with homogeneous appearance; some had a particular appearance, and a few showed reticular or spongy-like structure. This indicates that 10% neutral buffered formalin or Carnoy's fixation may be inadequate for detection of mast cells in pheasant, whereas the half-strength Karnovsky's fixation provides metachromatic or orthochromatic staining of mast cell granules.

Roles of TNF-alpha and IgE in the late phase of contact hypersensitivity induced by trimellitic anhydride

Trimellitic anhydride (TMA) is widely used industrially to make epoxy and alkyd resins, plasticizers and surfactants. The purpose of this study was to investigate whether contact hypersensitivity (CHS) is induced by repeated TMA challenge and the role of TNF-a and IgE in the TMA-induced CHS. The repetition of the challenge enlarged the extent of an early and a late phase of CHS in TNF-alpha+/+ (B6129SF2/J) and Balb/c mice. In the late phase of TMA-induced CHS, the peak of ear swelling responses by single challenge showed at 24 h after challenge, but the peak was observed at 8 h after repeated challenge. In the TNF-a knockout TNF-alpha-/- (B6;129S-Tnf(tm1Gk1) mice, the repetition of the TMA challenges enlarged the extent of the late phase of CHS, but less than those in TNF-alpha+/+ mice. Injection of anti-TNF-alpha antibody into the peritoneal cavity of Balb/c mice significantly decreased the extent of the late phase of CHS. Subcutaneous injection of anti-IgE antibody into Balb/c mice also decreased the extent of the late phase of CHS in dose-dependent manner. Histologically, infiltration of polymorphonuclear leukocytes and eosinophils was more pronounced in repeatedly TMA-challenged TNF-alpha+/+ and Balb/c mice than in the TNF-alpha-/- mice and anti-TNF-alpha or anti-IgE antibodies treated Balb/c mice. These results indicate that mice sensitized by TMA could possibly offer a useful model to study the mechanism of CHS, and TNF-a and IgE may act as potential modulators in the late phase of TMA-induced CHS. Neutralization of TNF-alpha and IgE by anti-TNF-a or anti-IgE antibodies may provide therapeutic tools for the treatment of TMA-induced CHS.