The presence of high level soluble herpes virus entry mediator in sera of gastric cancer patients

The development of gastric cancer (GC) is closely related to chronic inflammation caused by Helicobacter pylori infection, and herpes virus entry mediator (HVEM) is a receptor expressed on the surface of leukocytes that mediates potent inflammatory responses in animal models. However, the role of HVEM in human GC has not been studied. Previously, we showed that the interaction of HVEM on human leukocytes with its ligand LIGHT induces intracellular calcium mobilization, which results in inflammatory responses including induction of proinflammatory cytokine production and anti-bacterial activities. In this study, we report that leukocytes from GC patients express lower levels of membrane HVEM (mHVEM) and have lower LIGHT-induced bactericidal activities than those from healthy controls (HC). In contrast, levels of soluble HVEM (sHVEM) in the sera of GC patients were significantly higher than in those of HC. We found that monocyte membrane-bound HVEM is released into the medium when cells are activated by proinflammatory cytokines such as TNF-alpha and IL-8, which are elevated in the sera of GC patients. mHVEM level dropped in parallel with the release of sHVEM, and release was completely blocked by the metalloprotease inhibitor, GM6001. We also found that the low level of mHVEM on GC patient leukocytes was correlated with low LIGHT-induced bactericidal activities against H. pylori and S. aureus and production of reactive oxygen species. Our results indicate that mHVEM on leukocytes and sHVEM in sera may contribute to the development and/or progression of GC.

The effects of callander modification of laryngoscopic blade on hemodynamic changes according to the degree of difficult airway / 대한마취과학회지

BACKGROUND: Laryngoscopy and tracheal intubation are known to have profound cardiovascular effects. The Callander modification of Macintosh blade is associated with greater field of laryngoscopic view and decreased risk of dental contact. The purpose of this study was to compare the hemodynamic responses to laryngoscopy and tracheal intubation according to the degree of difficult airway, and to evaluate the usefulness of Callander modification of Macintosh blade for attenuating the hemodynamic responses. METHODS: One hundred, forty-eight patients scheduled for elective surgery were divided into Easy group and Difficult group by Wilson's risk sum score. Laryngoscopy was performed using either an ordinary Macintosh No. 3 blade or the modified Macintosh blade. The modification consisted of reducing the height of the flange by partial removal, as described by Callander et al. Hemodynamic variables (systolic, diastolic, mean blood pressure, heart rate and rate pressure product) were noted before induction (baseline) and immediately after intubation. RESULTS: The hemodynamic changes after tracheal intubation in Difficult group were significantly greater than those in Easy group (P < 0.05). When using the modified blade, systolic, diastolic and mean blood pressure after tracheal intubation were lower than those using the conventional blade regardless of Wilson's risk sum score, but no statistical significances could be found. CONCLUSIONS: The hemodynamic changes after tracheal intubation increased as the degree of airway difficulty increased. Laryngoscopy with the Callander's modified blade did not reduce the degree of hemodynamic stimulation compared with the conventional Macintosh blade.

Comparison of various tests designed to assess the recovery of cognitive and psychomotor function after ambulatory anesthesia / 대한마취과학회지

BACKGROUND: Few studies have been conducted to evaluate the reliability of the various tools used to assess cognitive and psychomotor recovery after ambulatory anesthesia. Therefore, this study was conducted to compare the sensitivity and reliability of simple, standard tests used to measure postoperative cognitive and psychomotor functions. METHODS: Twenty-seven patients admitted for same day surgery were included in this prospective, randomized study. While in the preanesthetic unit, each patient was asked to perform three different standard psychometric tests, the digit symbol substitution test (DSST), digit span test (DST), and perceptual speed test (PST), to evaluate cognitive and psychomotor functions. The results were then used as baseline values that were subsequently compared to results obtained when patients repeated the tests at 15, 30 and 60 min after extubation. In addition, the observer's assessment of alertness and sedation was evaluated. RESULTS: The DSST scores were significantly lower than the baseline scores at 15 and 30 min after extubation, with a performance ratio of 64.9 and 89.2, respectively (P < 0.05). The DST scores had returned to preanesthetic levels at 30 min post-anesthesia and the PST scores were found to be significantly higher than the baseline scores at 30 and 60 min post-anesthesia. CONCLUSIONS: DSST is a more sensitive indicator of residual drug effect following anesthesia than the other tests evaluated in this study. In addition, a learning effect was obvious when the PST was administered.

Intubating Conditions and Hemodynamic Changes according to Induction Agent and Tracheal Intubation Time after Rocuronium / 대한마취과학회지

BACKGROUND: Intubating conditions would be excellent and hemodynamic variables would be relatively stable during rapid- sequence anesthesia induction if tracheal intubation was performed at a proper time. The purpose of this study was to identify the ideal intubation time after rocuronium with either thiopental or propofol. METHODS: 113 patients, ASA physical status I or II, were randomly divided into four groups. Patients in group TR60 (thiopental-rocuronium) and in group PR60 (propofol-rocuronium) were intubated within 60 s, while groups TR90 and PR90 were intubated within 90 s after the administration of rocuronium. Intubating conditions were graded by an experienced anesthesiologist, and hemodynamic variables were noted just before induction (baseline), immediate after induction, immediate after intubation, and 5 min after intubation. RESULTS: Clinically acceptable intubating conditions (good or excellent) were not statistically different among the four groups. However, 55 and 64% of patients in groups TR90 and PR90, respectively, had excellent intubating conditions compared to only 39 and 38% in groups TR60 and PR60 (P < 0.05). Mean arterial pressure and rate pressure product (RPP) immediately after intubation were relatively stable in groups TR90 and PR90 compared to those in groups TR60 and PR60 (P < 0.05). CONCLUSIONS: The intubation time after rocuronium, rather than the choice of induction agent, is the deciding factor affecting intubating conditions and hemodynamic variables during rapid-sequence anesthesia induction. Ninety seconds after the administration of rocuronium with either thiopental or propofol might be an ideal intubation time.

The Effects of Superior Cervical Ganglionectomy on C-fos Expression in Rat Brain / 대한마취과학회지

BACKGROUND: C-fos is a marker of neuronal activity and its expression may be related to various types of stimulation of primary sensory neurons. We evaluated the effect of superior cervical ganglionectomy on c-fos expression in rat brain, which was expected to have the same effect as stellate ganglion block in human. METHODS: Male Sprague-Dawley rats (140-150 g) were divided into 4 groups; a no treatment (control group, n = 10), a 2 hour enflurane inhalation (anesthesia group, n = 10), a cervical skin incision only group (sham group, n = 10) and a superior cervical ganglionectomy group (sympathectomy group, n = 10). Two hours after each procedure, rats were killed and perfused with formaldehyde solution. c-fos protein expressions in the thalamus, hypothalamus, cortex, amygdala and cingulate gyrus were examined by immunohistochemistry using a specific antibody. RESULTS: In the thalamus, c-fos expression increased in the sympathectomy group vs. the control and the anesthesia groups, and in the sham group vs. the control group. In amygdala, the sham group showed significantly higher c-fos expression than the control group. In the hypothalamus and cortex no significant differences among the 4 groups were apparent. In the cingulate gyrus higher c-fos expression was observed than the control and anesthesia group but no differences with sham group. CONCLUSIONS: Superior cervical ganglionectomy itself may not affect c-fos expression in rat brain. For best results special effort should be made to avoid surgical or emotional stress.

High levels of soluble herpes virus entry mediator in sera of patients with allergic and autoimmune diseases

Herpes virus entry mediator (HVEM) is a newly discovered member of the tumor necrosis factor receptor (TNFR) superfamily that has a role in herpes simplex virus entry, in T cell activation and in tumor immunity. We generated mAb against HVEM and detected soluble HVEM (SHVEM) in the sera of patients with various autoimmune diseases. HVEM was constitutively expressed on CD4(+)and CD8(+)T cells, CD19(+)B cells, CD14(+)monocytes, neutrophils and dendritic cells. In three-way MLR, mAb 122 and 139 were agonists and mAb 108 had blocking activity. An ELISA was developed to detect sHVEM in patient sera. sHVEM levels were elevated in sera of patients with allergic asthma, atopic dermatitis and rheumatoid arthritis. The mAbs discussed here may be useful for studies of the role of HVEM in immune responses. Detection of soluble HVEM might have diagnostic and prognostic value in certain immunological disorders.

Involvement of tumor necrosis factor receptor superfamily (TNFRSF) members in the pathogenesis of inflammatory diseases

Current therapies for autoimmune diseases are not cures but merely palliatives, aimed at reducing symptoms. For the most part, these treatments provide nonspecific suppression of the immune system and thus do not distinguish between a pathogenic autoimmune response and a protective immune response. Recently emerging evidence not only has indicated the involvement of members of the TNF receptor/ligand superfamilies but also has revealed exciting innovative strategies for the treatment of autoimmune diseases and other chronic inflammatory diseases without depressing the immune response in general. In this review, we will discuss the regulatory mechanisms of TNF receptor/ligand family members, such as HVEM/ LIGHT, 4-1BB/4-1BBL, and GITR/GITRL that regulate T and B cell functions and participate in the process of inflammatory diseases. We will also discuss how intervening in the costimulatory pathways mediated by these molecules might have some potential as a therapeutic approach to immune disorders.

Newly dentified members of the TNF recept or superfamily (mTNFRH1 and mTNFRH2) inhibit T-cell proliferation

By searching an EST database, we identified two TNF receptor superfamily members (named mTNFRH1 and mTNFRH2). Amino acid sequences are highly conserved between the two receptors (78% identity). The chromosomal loci of mTnfrh1 and mTnfrh2 genes are found in distal chromosome 7 in the mouse. mTNFRH1 and mTNFRH2 do not contain the cytoplasmic domain, indicating that they might function as decoy receptors. Furthermore, an alternatively spliced form of mTNFRH1 was found which contains neither the transmembrane domain nor the cytoplasmic domain, thus presumably existing as a soluble form. Northern blot analysis showed that mTnfrh1 mRNA was negligibly expressed in tissues, while mTnfrh2 mRNA was strongly expressed in spleen, lung, liver, kidney, and testis. When the extracellular domains of mTNFRH1 and mTNFRH2 were expressed in bacteria, their molecular weight of extracellular region was approximately 15 kDa. Both of the soluble forms were effective in inhibiting T-cell proliferation stimulated by anti-CD3 monoclonal antibody. Our data suggest that mTNFRH1 and mTNFRH2 may be implicated in exerting a modulatory role in the immune response.

Study of Capsaicin-induced Apoptosis in Human Colon Cancer Cell Lines

PURPOSE: Numerous investigations have been conducted in order to determine the potential carcinogenic or chemopreventive activity of capsaicin. The aim of this study is to characterize the effects of capsaicin on colon cancer cells, and provide valuable information concerning the application of capsaicin in chemoprevention as well as for therapeutic purposes. METHODS: CoLo320DM and LoVo cells (human colon cancer cell line) were treated with capsaicin. In order to access cell viability and altered morphology, an MTT assay was performed and the cells were microscopically examined. Decreasing DNA staining was accessed by FACS. The cells were stained with FITC labeled annexin V and analyzed by FACS to detect cellular membrane alteration during apoptosis. The cells were stained with DiOC6(3) and Hydroethidine and analyzed by FACS in order to access ROS and dleta psi m. RESULTS: Capsaicin decreased cell viability in a dose-dependent manner. Capsaicin produced a cell morphology corresponding to the apoptotic features including cell shrinkage and chromatic condensation. Capsaicin treated cells induced a loss of nuclear DNA leading to hypoploidy in a dose-dependent manner. Cells were excluded by double staining with PI and FITC labeled annexin v and detected by FACS. We show that treatment of CoLo320DM, L0Vo cells with increasing concentrations of capsaicin parallel an increase in the percentage of red fluorescent cells (HE-->Eth) that reflect ROS hypergeneration and a decrease in the percentage of green fluorescent cells that reflect delta psi m disruption. CONCLUSION: These results clearly demonstrate that capsaicin-induced colon cancer cell death is apoptotic.

Unanticipated Difficult Intubation in a Patient with Asymptomatic Congenital Subglottic Stenosis Caused by a Laryngeal Web and Thyroid Cartilage Anomaly: A case report / 대한마취과학회지

Both a laryngeal web and thyroid cartilage anomaly are rare airway abnormalities and can cause the obliteration of the tracheal diameter, which may be asymptomatic or symptomatic. In asymptomatic patients, the presence of unsuspected obliteration of the tracheal diameter may be problematic if endotracheal intubation is indicated. We report a case of unsuspected difficult intubation caused by a combined laryngeal web and congenital anomaly of the thyroid cartilage. A 14-year-old female was scheduled for corrective surgery for idiopathic scoliosis of the spine. After injection of IV induction agent and muscle relaxant, most of the vocal cords were exposed clearly by laryngoscopy, but a 6.0 mm internal diameter (ID) endotracheal tube could not be advanced below the level of the vocal cords because of resistance. Intubation was re-attempted with smaller tube (5.0 mm ID) only to fail. We awakened the patient and consulted an otolaryngologist. An Otolaryngologic examination and radiologic study revealed the narrowing of the trachea was caused by a laryngeal web and congenital anomaly of the thyroid cartilage. Later, a tracheotomy was performed under local anesthesia and then the laryngeal web and anomalous portion of the thyroid cartilage were removed under general anesthesia.

The Cold Preservation of Mice Hepatocytes Induces Apoptosis but Not over Expression of MHC Class I Antigen / 대한이식학회지

Hepatocyte transplantation is a potential treatment modality for liver diseased patients. Purified hepatocytes stimulates allospecific cytotoxicity by expressing the MHC class I antigen. Also, during cold preservation, hepatocytes are damaged by lipid peroxidation with oxygen free radicals, which may induce apoptosis on cold preserved hepatocyte. For measuring the degree of antigenicity on cold- preserved mice hepatocytes with UW solution, we studied the expression of MHC class I antigen in various time period by FACS and RT-PCR. For analysis of apoptotic hepatocyte death, we studied morphological changes and DNA fragmentation. We used flow cytometry techniques with rhodamine 123,3,3'-dihexiloxadicarbocyanine (DiOC6 (3)) and propidium iodide (PI). DiOC6 (3) is mitochondrial probe to measure the mitochondrial transmembrane potential that drops early in apoptosis. The percentage of cells undergoing chromatinolysis (subdiploid cells) was determined by ethanol fixation followed by RNA digestion and PI staining. The cold preserved hepatocytes expressed MHC class I constitutively, but revealed no significant differences among various preservation period. However, apoptosis of hepatocytes occured progressively during cold preservation. These results provides that the cold preservation of mice hepatocyte induces apoptosis with involvement of an oxidative process, but does not stimulate over expression of MHC class I antigen.

Stimulation of Bactericidal and Fungicidal Activity of Neonatal Monocytes by Immunoactivating Peptide

PURPOSE: To evaluate the function of Trp-Lys-Tyr-Met-Val-D-Met (WKYMVm) in human neonatal monocytes. METHODS: The peptide, Trp-Lys-Tyr-Met-Val-D-Met (WKYMVm), was synthesized, purified, and prepared in the Peptide Library Support Facility at Pohang University of Science and Technology. Female Sprague-Dawley rats (200+/-10 g) were preinfected with S. aureus and treated with WKYMVm through femoral vein. At various time points, blood samples were obtained by puncture of femoral artery and the serum was plated on the nutrient agar plate. The number of viable bacteria was determined by counting the number of bacterial colonies. In addition, using S. aureus and C. albicans, we evaluated the bactericidal and fungicidal activities of neonatal monocytes, which were separated from umbilical cord blood by Ficoll gradient. RESULTS: The numbers of bacteria in the blood of WKYMVm-treated rats were rapidly decreased with time, as compared with those of the untreated rats. The peptide treatment enhanced the bactericidal activity in vivo within 10 minutes. In neonatal monocytes, WKYMVm stimulated the intracellular killing of S. aureus in a dose dependent manner, showing the maximum effect at 100 nM. WKYMVm stimulated the phagocytic and fungicidal activities against C. albicans in a dose dependent manner, with the maximum effect at the 100 nM. CONCLUSION: These results suggest that WKYMVm may be an effective agent against the neonatal infections.

The Effect of Preadministration of Ketamine on Induction and Recovery Using Propofol Target Controlled Infusion (TCI) / 대한마취과학회지

BACKGROUND: Propofol is increasingly being used as an anesthetic since the introduction of the TCI (target controlled infusion) technique, but previous reports have demonstrated that hypotension and injection pain occur especially during fast infusion of propofol. We therefore studied the effect of ketamine preadministration on induction and recovery when using propofol TCI. METHODS: Thirty-four patients undergoing elective surgery within 2 hours were randomly assigned to one of two groups according to induction methods; Group P (propofol TCI, 6 microgram/ml, flash mode), Group KP (ketamine 0.25 mg/kg followed by propofol TCI, 4.5 microgram/ml, flash mode). Anesthesia was maintained with fentanyl, N2O, and propofol TCI. Outcome measures were induction time, injection pain, hemodynamic responses during induction period, propofol doses, emergence time and postoperative side effects. RESULTS: Incidence of injection pain and induction dose of propofol were significantly reduced in Group KP but there was no significant difference in induction time, emergence time or postoperative side effects between two groups. Heart rates showed no differences between the two groups, but the changes of mean arterial pressures from base line at 30 sec after intubation were significantly greater in Group P compared to Group KP. CONCLUSIONS: During fast induction with the flash mode of propofol TCI, small amounts of ketamine preadministration could significantly reduce the target concentration for hypnosis, injection pain and hemodynamic changes without a delay of emergence and an increase of postoperative side effects.

Evaluation of Clinical Factors Associated with Early Tracheal Extubation after Liver Transplantation / 대한마취과학회지

BACKGROUND: The timing of tracheal extubation in patients undergoing major intraoperative procedures is controversial. Immediate postoperative tracheal extubation after liver transplantation was not popularized. But in these days, early tracheal extubation has been safely performed in certain cases and routine use of mechanical ventilation is being questioned. We performed preliminary study of our 25 liver transplantation cases to evaluate factors affecting duration and indications of postoperative mechanical ventilation. METHODS: Our 25 cases were divided into two groups by periodic difference - early 13 cases (group 1) and late 12 cases (group 2). We evaluated preoperative UNOS (united network for organ sharing) scale, intraoperative transfusion and vasopressor requirement, postoperative multiple organ complications which would have influence upon tracheal extubation. RESULTS: We found great difference between two groups in duration of mechanical ventilation (Group 1: 94.4+/-7.12 hrs, Group 2: 36.1+/-28.3 hrs) and ICU stay (Group 1: 22.8+/-8.3 days, Group 2: 11.8+/-5.5 days). CONCLUSIONS: We concluded that early tracheal extubation in selected liver transplantation cases was safe and effective because it could shorten duration of ICU stay and reduce postoperative mortality. But more experience and knowledge may be needed to get more ideal guidelines for postoperative mechanical ventilation.

Clinical Experience of Coagulation Management in Multiple Myeloma Patient with Thrombocytopenia Using Thromboelastography: A case report / 대한마취과학회지

Multiple myeloma is malignant proliferation of plasma cells whose pathologic condition is produced by bone marrow invasion as well as excessive production of immunoglobulin. Its invasion into bone marrow causes severe pancytopenia. Therefore these patients are susceptible to thrombocytopenia and have bleeding tendency, especially during surgery. We experienced an anesthetic management of meningioma operation in a patient with multiple myeloma who showed severe thrombocytopenia and excessive abonormal immunoglobulin.

Clinical Experience of Coagulation Management in Multiple Myeloma Patient with Thrombocytopenia Using Thromboelastography: A case report / 대한마취과학회지

Multiple myeloma is malignant proliferation of plasma cells whose pathologic condition is produced by bone marrow invasion as well as excessive production of immunoglobulin. Its invasion into bone marrow causes severe pancytopenia. Therefore these patients are susceptible to thrombocytopenia and have bleeding tendency, especially during surgery. We experienced an anesthetic management of meningioma operation in a patient with multiple myeloma who showed severe thrombocytopenia and excessive abonormal immunoglobulin.

A clinical experience of basal cell carcinoma developed on eyelids

No abstract available.

Effect of nicardipine nitroprusside and enalapril on the survival of random pattern skin flaps in rats

No abstract available.