Overexpression of USF Increases TGF-beta1 Protein Levels, But G1 Phase Arrest was not Induced in FRTL-5 Cells

Transforming growth factor-beta1 (TGF-beta1) is a potent inhibitor of cellular growth and proliferation by G1 phase arrest or apoptosis. We investigated the association of TGF-beta1 with the anti-proliferative effect of upstream stimulatory factor (USF) in Fischer rat thyroid cell line (FRTL-5) cells. [Methyl-(3)H] thymidine uptake was measured after treatment of FRTL-5 cells with TGF-beta1 to identify its anti-proliferative effect. USF-1 and USF-2 proteins were in vitro translated, and an electrophoretic mobility shift assay was performed to identify the interaction between USF and the TGF-beta1 promoter. FRTL-5 cells were transfected with USF cDNA, and then the expression of TGF-beta1 was examined with Northern and Western blotting. The cell cycle-regulating proteins associated with TGF-beta1 were also measured. TGF-beta1 significantly inhibited [methyl-(3)H] thymidine uptake in FRTL-5 cells. Two specific binding sites for USF were found in the TGF-beta1 promoter: -1,846~-1,841 (CACATG) and -621~-616 (CATGTG). Overexpression of USF increased both the mRNA levels and protein levels of TGF-beta1. However, the expression of cyclin D1, CDK4, cyclin E, and CDK2, and the phosphorylation of retinoblastoma protein remained unchanged. Overexpression of USF in FRTL-5 cells increased the expression of TGF-beta10 through specific binding to TGF-beta1 promoter. However, the USF-induced expression of TGF-beta1 did not cause G1 arrest.

The Efficacy of BIS Monitoring for the Preventing of Withdrawal Movement on the Intravenous Injection of Rocuronium / 대한마취과학회지

BACKGROUND: Arm withdrawal movements are often observed on the administration of rocuronium. This study used the BIS to predict the depth of sedation and the prevention of withdrawal movements. METHODS: With the approval of the institutional review board and the informed consent of the subjects, sixty patients, with ASA physical stati of 1 to 2, were randomized into four groups. After the induction of anesthesia using 0.5 mg/kg of thiopental sodium, each group received 0.6 mg/kg of rocuronium when their BIS values were 85 (Group I), 75 (Group II), 65 (Group III), or 55 (Group IV). The blood pressure, heart rate, BIS value at the time of loss of eyelash reflex, incidence of withdrawal movement and grade, and the correlation between the BIS value and loss of eyelash reflex were observed. RESULTS: No difference were observed in the incidence of withdrawal movement and grade between the four groups. The correlation coefficients of the BIS value and time of loss of eyelash reflex were both 0.33 (P<0.05). CONCLUSIONS: It may be impossible to rely solely on the BIS value to insure patients reach a deep anesthetic state after induction of anesthesia with thiopental. The withdrawal movement on injection of rocuronium can not be prevented with BIS monitoring.

Stereotactic Neurotomy of the Ganglion Impar through the Sacrococcygeal Junction in Cancer-Related Perianal Pain: A case report / 대한통증학회지

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

Comparison of Emergence Agitation from Sevoflurane Anesthesia in Propofol or Thiopental Sodium Induction / 대한마취과학회지

BACKGROUND: Sevoflurane, with its low pungency, rapid emergence and recovery, is an attractive anesthetic in paediatric anesthesia, but the high incidence of postoperative agitation represents a problem. Propofol-anesthesia is recognised for its rapid and clear-headed emergence. We tested the hypothesis that the maintenance of anesthesia with sevoflurane after propofol induction reduces the incidence of excitatory behavior compared with thiopental sodium induction. METHODS: Children aged 4-10 years, undergoing elective tonsillectomy, were randomly assigned to receive propofol 2.5 mg/kg (Group P) or thiopental sodium 5 mg/kg (Group T) for induction. After loss of consciousness, tracheal intubation was performed with rocuronium 0.6 mg/kg and all patients received sevoflurane (2-3 vol.%)-N2O (2 L/min)-O2 (2 L/min) for anesthesia maintenance. Ventilation was controlled to maintain normocarpnia. At the end of surgery, sevoflurane and N2O were discontinued and muscle relaxant was reversed. Extubation time, agitation grade in recovery room, postoperative side effects and time in the recovery room were checked and compared between the two groups. RESULTS: Time to extubation (6.84+/-1.57 vs 8.48+/-1.05 min), discharge from the recovery room(33.7+/-3.9 vs 55.0+/-7.9 min) and emergence agitation incidence (8% vs 92%) were significantly different in Group P and Group T, respectively (P < 0.05). The incidence of nausea and vomiting was not significantly different (4% vs 16%). CONCLUSIONS: Emergence agitation after sevoflurane anesthesia was significantly reduced by propofol induction compared with thiopental sodium.

Two Cases of Infective Endocarditis in Burn Patients Requiring Surgical Intervention / 감염과화학요법

No abstract available.

Two Cases of Infective Endocarditis in Burn Patients Requiring Surgical Intervention / 감염과화학요법

No abstract available.

The Early Prognosis of Burn Patients with Elevated Initial Arterial Carboxyhemoglobin Level / 결핵

BACKGROUND: Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. METHODS: Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. RESULTS: COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were 16.6+/-17.8% and 60.7+/-28.8% (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. CONCLUSION: Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.

Clinical Significance of Atrioventricular Plane Displacement for Evaluating Left Ventricular Diastolic Dysfunction

BACKGROUND AND OBJECTIVES: Atrioventricular plane displacement (AVPD) has been used for evaluating systolic function. However, its relations with other echocardiographic variables reflecting diastolic function are not well documented. This study was designed to assess the relations between AVPD and those echocardiographic variables known to reflect diastolic function, especially using mitral annulus velocity. SUBJECTS AND METHODS: Eighty-seven patients with normal left ventricular (LV) systolic function (normal echocardiography group (Group I, n=44), concentric left ventricular hypertrophy (LVH) group (Group II, n=43)) and 51 patients with LV dysfunction (Group III) were studied. To evaluate the correlation with echocardiographic variables reflecting LV systolic and diastolic function, we measured mitral inflow velocity and mitral annulus Doppler tissue velocity. RESULTS: AVPD was correlated negatively with age, the ratio of early diastolic mitral inflow velocity and early diastolic mitral annulus velocity (E/E'), isovolumic relaxation time, and E/A ratio. AVPD was correlated positively with deceleration time, ejection fraction, and systolic mitral annulus velocity (S'). By multivariate analysis, AVPD was independently correlated with S' (beta=0.4, p<0.001) and E' (beta=0.5, p<0.001) in the normal LV function group, and with S' (beta=0.6, p<0.001) and E/E'(beta=-0.3, p=0.005) in the LV dysfunction group. CONCLUSION: AVPD may be used as a diagnostic tool for evaluating LV diastolic function.

A Case of Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava Diagnosed During Internal Jugular Venous Catheterization for Acute Hemodialysis / 대한신장학회잡지

Persistent left superior vena cava(PLSVC) derives from abnormally persistent patency of an embryological vessel normally present during the early developmental period. The incidence of PLSVC is 0.3% in healty persons, 4.8% in patients with congenital heart anomaly. Most of the patients with PLSVC have normal right superior vena cava (RSVC), but PLSVC plus absent RSVC is very rare, especially in those without congenital heart anomalies. We experienced a case of PLSVC and absent RSVC during an insertion of internal jugular venous catheter for acute hemodialysis. A 53-year-old female was admitted due to uremia for initiation of dialytic therapy. She had long history of diabetic nephropathy but without congenital heart anomalies. We inserted a dual lumen catheter for acute hemodialysis via right internal jugular vein. On the chest x-ray film taken after the insertion of the catheter, we detected unusual course of the catheter curved to the left. PLSVC and absent RSVC was confirmed by normal saline contrast echocardiography and CT angiograpy.

Experimental Radiofrequency Lesion Size Utilizing Different Parameters and Neuropathologic Correlation on the Peripheral Nerve / 대한마취과학회지

BACKGROUND: Radiofrequency (RF) lesioning is one of the most frequently used neurolytic techniques for the relief of pain. Technical advances enables one to make a more reliable and reproducible lesion production. If the size at different parameters is known, the maximal effects and reduction of the side effects could be achieved. However, its size can not be measured systematically using thermocouple (TC) electrodes. 'Differential selection of pain fibers' was proposed but there was not any neuropathologic evidence. We studied pathologic changes produced with various sizes and shapes of electrodes using different parameters. METHODS: Using fresh egg white, RF lesions were produced by four different electrodes at 65, 70, 75, 80 and 90degreesC. At each temperature, Photographs were taken at 10, 20, 30, 40, 50, 60, 90 and 120 seconds. Using the sciatic nerve of the rats, we performed RF lesioning utilizing two different electrodes at 70, 80 and 90degreesC and dissected them 1, 7, and 30 days after treatment. The pathologic changes of lesions were studied and analyzed by applying a quantitative experimental scoring system on the light and electron microscopy (LM and EM). RESULTS: The lesion size increased with a higher temperature and larger electrode. Among the electrodes with the same thickness, the lesion size with the longer electrode was larger than the shorter one. In a histopathologic study, there were significant changes with time, but no significant changes with different electrode and temperature. On electron microscope (EM), large myelinated fibers were relatively intact on RF lesion of 80degreesC after 1 day. 7 days after treatment, there were significant inflammatory cell infiltration and axonal regeneration. At 30 days after the same treatment, there were relatively large amount of small myelinated fibers and unmyelinated fibers. CONCLUSIONS: We measured the lesions systematically with different parameters expecting the result can be used as the reference for the RF lesion. There were no histopathologic differences on LM at different electrodes and temperatures. But we found the evidence of 'differential selection of pain fibers' with 22 gauge electrode at 80degreesC. And also we found the axonal regeneration as early as 1 week later. We learned the neuropathic pain can be induced by pathologic changes, such as bleb formation, inflammatory cell infiltration and predominance of small myelinated and unmyelinated fibers.