ABSTRACT
NDRG1 (N-myc downstream regulated gene-1) was reported to be necessary for p53-mediated apoptosis and to be regulated by PTEN (phosphatase and tensin homolog). In several cancers, it was suggested to be a tumor suppressor gene. Its significance in esophageal squamous cell carcinoma (ESCC) has not been studied. The objective of this study was to clarify the relation between clinicopathological and biologic factors in esophageal carcinoma and to determine the prognostic significance of the expression of NDRG1. Expression of NDRG1 mRNA was quantified by real-time reverse transcription polymerase chain reaction using a Lightcycler in 47 esophageal ESCC specimens. The data were analyzed with reference to clinicopathological factors. Among the esophageal cancer tissues, NDRG1 mRNA expression was significantly lower in tumors of more advanced pathological stage (0-I vs. II-IV; P = 0.0027) and local tumor invasion (T1-2 vs. T3-4; P = 0.0136). Patients who had low NDRG1 mRNA expression had a significantly shorter survival after surgery compared with patients who had high NDRG1 mRNA expression (log-rank test, P = 0.0478). Impaired NDRG1 expression may lead to more aggressive invasion of ESCC.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Cell Cycle Proteins/metabolism , Esophageal Neoplasms/metabolism , Intracellular Signaling Peptides and Proteins/metabolism , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Cell Cycle Proteins/genetics , Disease Progression , Esophageal Neoplasms/genetics , Esophageal Neoplasms/pathology , Female , Gene Expression Regulation, Neoplastic , Humans , Intracellular Signaling Peptides and Proteins/genetics , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Prognosis , RNA, Messenger/genetics , Reverse Transcriptase Polymerase Chain Reaction , Survival Analysis , Up-Regulation/physiologyABSTRACT
A newly developed non-invasive monitor, NICO (Novametrix Medical Systems Inc.), measures cardiac output based on changes in respiratory CO2 concentration caused by a brief period of rebreathing. By applying modified form of the CO2 Fick principle, cardiac output is calculated. We determined the accuracy and precision of this technique (RBCO) by comparing it with continuous thermodilution technique (TDCCO) and pulse dye densitometry technique (PDD). The overall difference between RBCO and TDCCO(n = 46) was -0.21 +/- 1.43 (bias +/- 2 SD)l.min-1. On the other hand, the overall difference between RBCO and PDD (n = 53) was -0.1 +/- 2.04 (bias +/- 2 SD)l.min-1. The degree of accuracy of RBCO was thought to be the same as those of TDCCO and PDD. We expect that NICO will be a useful cardiac output monitor in any method of general anesthesia in which PA catheterization is difficult or not indicated.
Subject(s)
Breath Tests/methods , Carbon Dioxide/analysis , Cardiac Output , Monitoring, Intraoperative/instrumentation , Anesthesia, General , Humans , Monitoring, Intraoperative/methodsABSTRACT
We encountered a rare case of complications at the time of central venous catheterization due to extrapleural hematoma. A 71-year-old woman was scheduled to undergo subtotal gastrectomy. After introduction of general anesthesia, a CVP catheter was inserted from the right jugular vein, but it was removed intraoperatively, because of poor dropping of the infusion fluid. A few minutes later, the blood pressure started to decrease. We considered that this symptom was derived from the surgical procedure, and rapid blood transfusion associated with administration of a vasopressor was performed. Postoperative chest X ray revealed poorly delineated right lung field, and hemothorax was suspected. However thoracic drainage resulted in an extremely small amount of blood-like fluid. The abnormal defect in the right pulmonary field was found to be an extrapleural hematoma by thoracic CT on the first postoperative day. The hematoma was reduced by subsequent management in 7 days, and the patient was discharged from the ICU without any further complications.
Subject(s)
Catheterization, Central Venous/adverse effects , Hematoma/etiology , Iatrogenic Disease , Jugular Veins , Lung Diseases/etiology , Aged , Anesthesia, General , Female , HumansABSTRACT
We gave general anesthesia using sevoflurane to a patient undergoing cadaveric renal transplantation. Although the maximum inorganic fluoride concentration in the serum was unexpectedly high (74 uM) in the perioperative period, urine output from the transplanted kidney started simultaneously with reperfusion of the kidney and renal functions also recovered swiftly. Enzyme induction caused by anticonvulsants, which had been administered prior to operation, was assumed to be the cause of the elevation in serum inorganic fluoride concentrations in the patient. We recognized that inorganic fluoride ion is not a primary factor to aggravate functions of the transplanted kidney and concluded that sevoflurane could be selected as a volatile anesthetic used in renal transplant surgery.
