BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

No abstract available.
Drug Therapy*

There are many complications after traumatic shoulder dislocation including redislocation, dislocation capsulitis especially in the older age and dislocation arthropathy. Redislocation rates have been primarily related to age at the time of initial dislocation, to lesser degree, athletic participation, length of immobilization, rehabilitative exercises, and time hefore return to sports or full activity. So we wanted to confirm the difference of the lesion between the young and the old at the initial dislocation. Arthroscopic evaluation of the twelve patients with an acute traumatic anterior dislocation of the shoulder was done to identify the intraarticular pathology within 10 days of the initial injury. All patients were taken MRI and evaluated under anesthesia. We classified these shoulders into two groups based on the age of patient. Young agegroup under 30 were seven patients and old age-group over 40 were five patients. And the following results were ohtained; 1. The detachment of the anterior labrum with the inferior glenohumeral ligament from the glenoid rim was primary finding and might cause the shoulder unstable under anesthesia in the young age-group under 30. 2. In the age-group over 40, there were the capsular tears with no labral lesion and these shoulders were stable under anesthesia 3. In acute traumatic anterior dislocation, examination under anesthesia was more closely related to the prediction of the extent of labro-ligamental detachment than MRI examination. 4. We believe that arthroscopic surgical intervention after the initial shoulder dislocation should be considered as a treatment option
Anesthesia ; Arthroscopy ; Dislocations* ; Exercise ; Humans ; Immobilization ; Ligaments ; Magnetic Resonance Imaging ; Pathology ; Shoulder Dislocation ; Shoulder* ; Sports

BACKGROUND: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. MATERIAL AND METHOD: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. RESULT: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7+/-7.2%, 9.3+/-3.2%, 16.8+/-8.6%, and 23.1+/-9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1+/-4.6% and 17.7+/-9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34+/-2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5+/-2.7%, systolic left ventricular pressure by 15.8+/-2.5% and the elevation of left ventricular end-diastole pressure by 54.3+/-15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5+/-1.8% and 3.1+/-1.1%, 5.7+/-3.6%, and 6.9+/-4.4%, respectively, whereas LVEDP decreased by 11.7+/-4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. CONCLUSION: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.
Animals ; Atrial Pressure ; Capillaries ; Cardiac Output ; Cardiomyoplasty* ; Dogs ; Doxorubicin ; Heart Failure* ; Heart* ; Hemodynamics* ; Imipramine ; Inflammation ; Muscle Contraction ; Stroke ; Ventricular Pressure

Sertoli-Leydig cell tumor is an uncommon tumor that may manifest itself by a characteri-stic virilization symptom. It is a rare gonadal tumor of sex-cord type, representing only 0.1~0.5% of all primary ovarian neoplasm. These tumors are the most common virilizing tumors in women of reproductive age. However, only one-third of patients develop masculinization. We have seen two cases of Sertoli-Leydig cell tumors without the virilizing symptom. These two cases have been confirmed by permanent tissue biopsies and have been presented in a 32-year old female who has had only amenorrhea and in a 56-year old postmenopausal female who has not manifested virilizing symptom. These cases are presented with brief review of the literature.
Adult ; alpha-Fetoproteins ; Amenorrhea ; Biopsy ; Female ; Gonads ; Humans ; Middle Aged ; Ovarian Neoplasms ; Sertoli-Leydig Cell Tumor* ; Testosterone ; Virilism

BACKGROUND: Accumulating evidence shows that interleukin(IL)-1 plays a critical role in inflammation and connective tissue destruction observed in both osteoarthritis and rheumatoid arthritis. IL-1 induces gene expression related to cytokines, chemokines and matrix metalloproteinases by activation of many different transcription factors. MATERIALS AND METHODS: The chondrosarcoma cell line, SW1353, is known to be a valuable in vitro system for investigating catabolic gene regulation by IL-1beta in chondrocytic cells. To explore and analyze the changes in gene expression by IL-1 responsible for arthritis, SW1353 was treated with IL-1 for 1, 6 and 24 h and then total RNAs were purified for each time. The changes in gene expression were analyzed with 17k human cDNA microarrays and validated by semi-quantitative RT-PCR. RESULTS: Greater than a two-fold change was observed in 1,200 genes including metallothioneins, matrix metalloproteinases, extracellular matrix proteins, antioxidant proteins, cytoskeleton proteins, cell cycle regulatory proteins, proteins for cell growth and apoptosis, signaling proteins and transcription factors. These changes appeared to be correlate with the pathophysiological changes observed in early osteoarthritis. CONCLUSION: cDNA microarray analysis revealed a marked variability in gene expression, and provided insight into the overall molecular changes. The result of this study provide initial information for further studies to identify therapeutic targets in osteoarthritis pathogenesis.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Cell Cycle Proteins ; Cell Line ; Chemokines ; Chondrosarcoma* ; Connective Tissue ; Cytokines ; Cytoskeleton ; DNA, Complementary* ; Extracellular Matrix Proteins ; Gene Expression ; Humans* ; Inflammation ; Interleukin-1 ; Interleukin-1beta ; Interleukins* ; Matrix Metalloproteinases ; Metallothionein ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis* ; Osteoarthritis ; RNA ; Transcription Factors

Microarray analysis was used to investigate the lack of identified mammalian target of rapamycin (mTOR) pathway downstream genes to overcome cross-talk at non-muscle invasive high-grade (HG)-urothelial carcinoma (UC) of the bladder, gene expression patterns, gene ontology, and gene clustering by triple (p70S6K, S6K, and eIF4E) small interfering RNAs (siRNAs) or rapamycin in 5637 and T24 cell lines. We selected mTOR pathway downstream genes that were suppressed by siRNAs more than 2-fold, or were up-regulated or down-regulated by rapamycin more than 2-fold. We validated mTOR downstream genes with immunohistochemistry using a tissue microarray (TMA) of 125 non-muscle invasive HG-UC patients and knockout study to evaluate the synergistic effect with rapamycin. The microarray analysis selected mTOR pathway downstream genes consisting of 4 rapamycin up-regulated genes (FABP4, H19, ANXA10, and UPK3A) and 4 rapamycin down-regulated genes (FOXD3, ATP7A, plexin D1, and ADAMTS5). In the TMA, FABP4, and ATP7A were more expressed at T1 and FOXD3 was at Ta. ANXA10 and ADAMTS5 were more expressed in tumors ≤ 3 cm in diameter. In a multivariate Cox regression model, ANXA10 was a significant predictor of recurrence and ATP7A was a significant predictor of progression in non-muscle invasive HG-UC of the bladder. In an ATP7A knock-out model, rapamycin treatment synergistically inhibited cell viability, wound healing, and invasion ability compared to rapamycin only. Activity of the ANXA10 and ATP7A mTOR pathway downstream genes might predict recurrence and progression in non-muscle invasive HG-UC of the bladder. ATP7A knockout overcomes rapamycin cross-talk.
Cell Line ; Cell Survival ; Gene Expression ; Gene Ontology ; Humans ; Immunohistochemistry ; Microarray Analysis ; Recurrence* ; RNA, Small Interfering ; Sirolimus ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Wound Healing

OBJECTIVE: To examine the pattern of gestational weight gain using maternal characteristics and pregnancy outcomes. METHODS: We used maternal weight data from 1,825 women who had noncomplicated pregnancy between Jan. 2002 and Aug. 2009. The rate of maternal weight gain in each trimester, the associations between gestational weight gain per trimester and maternal characteristics and pregnancy outcomes, and the relationship between maternal characteristics and trimester weight gain were analyzed. RESULTS: The average rate of weight gain (kg/week) was lowest during the first trimester (0.06+/-0.30), peaked during the second trimester (0.52+/-0.23), and slowed slightly in the third trimester (0.47+/-0.23). With the exception of infant sex, all six maternal characteristics and pregnancy outcomes included in the multivariate analyses (parity, maternal age, height, BMI, preeclampsia, gestational DM) were associated significantly with maternal weight gain in at least one trimester. The important maternal predictors of weight gain per trimester were prepregnancy BMI, height and age in the first trimester; prepregnacy BMI, parity and height in the second; and height, age and parity in the third. CONCLUSION: The pattern of gestational weight gain is associated with a number of maternal characteristics and pregnancy outcomes, and these relationships vary according to which trimester is being examined.
Female ; Humans ; Infant ; Maternal Age ; Multivariate Analysis ; Parity ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Weight Gain

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*

BACKGROUND/AIMS: The effect of entecavir (ETV) in treatment-naive chronic hepatitis B (CHB) is well established. This study aimed to assess the efficacy of ETV treatment at 0.5 mg/day in ETV-switch and ETV-retreatment groups of CHB patients without lamivudine (LMV)-resistance from LMV monotherapy. METHODS: Study subjects included 350 CHB patients who had been treated with 0.5 mg/day of ETV for at least 6 months. Patients were divided into two groups: an LMV-naive group (n = 263) and an LMV-experienced group (n = 87). The LMV-experienced group was further subdivided into an ETV-switch group (n = 43) and an ETV-retreatment group (n = 44) defined by the period between stopping LMV and restarting ETV. RESULTS: There were no significant differences in mean age, sex ratio, prevalence of liver cirrhosis and hepatitis B e antigen (HBeAg) positivity between the LMV-naive and -experienced groups. However, the LMV-naive group had higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and a shorter ETV treatment duration than the LMV-experienced group. There were also distributional differences in the hepatitis B virus (HBV) DNA levels of LMV-naive and -experienced patients prior to ETV treatment. After ETV treatment, there were no significant differences between the two groups in the rates of undetectable HBV DNA at 6, 12 and 18 months; HBeAg loss and seroconversion; normalization of ALT; virologic breakthrough; and ETV-genotypic resistance. Lastly, the effect of ETV did not differ between the ETV-switch and -retreatment groups. CONCLUSIONS: The effect of ETV in the LMV-experienced group without LMV-resistance did not differ from that in the LMV-naive group. Furthermore, there was no difference in the effect of ETV between the ETV-switch and -retreatment groups.
Alanine Transaminase ; Aspartate Aminotransferases ; DNA ; Guanine ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Lamivudine ; Liver Cirrhosis ; Prevalence ; Sex Ratio