BACKGROUND: Genomic instability has been reported as a novel mechanism of tumorigenesis. Microsatellites are short tandemly repeated nucleotide sequences throughout the human genome. Widespread somatic mutations in these sequences due to the loss or gain of one or more repeated units are termed as microsatellite instabilites (MI). MI have been found to be the result of numerous replication errors due to mutations in mismatched repair genes. Recently, MI have been recognized as the causes of the increased mutation rates of cancer cells. An elevated mutation rate manifested by MI may also affect various genes that are essential for normal cell function and growth, thus contributing to tumor initiation, promotion, and progression. We investigated the frequency of MI in a series of 44 gastric carcinomas in an attempt to clarify the role of these genetic alterations in gastric carcinogenesis and to see whether the cases with MI displayed any clinical significance and morphologic features and/or whether they showed distinctive relations with any clinicopathologic characteristics. METHODS: We analyzed 44 gastric carcinomas and paired samples from non-neoplastic mucosa of Korean patients who had undergone a gastrectomy. The samples were immediately frozen in liquid nitrogen and stored at 70oC until use. High molecular weight DNAs were isolated by standard methods only from cases whose were composed of more than 50% tumor cells. Ten loci of microsatellites were used in this study: D3S1766, D3S1339, D3S1029, D9S162, D9S171, INF-a, D11S925, D11S1818, D11S35, and D11S1284. The MI analysis was performed by Polymerace Chein Reaction (PCR) with 33P-labelled primers. PCR products were separated on 6% polyacrylamide gel containing 7M urea, and autoradiographed. H-E stained sections were used to review the pathologic features. The relationships between MI incidence and clinicopathologic findings were statistically tested. RESULT: Analysis of the 44 cases at the 10 loci of microsatellites allowed us to identify 19 instabilities (43%): 15 cases at 1 locus, 2 cases at 2 loci, and 2 cases at multiple loci. The incidence of MI was remarkably increased in cases with poor differentiation and node metastasis (p=0.067 and p=0.007, respectively). Comparing the histologic type (diffuse vs. intestinal type), the diffuse type of carcinoma had a higher incidence; however, there was no statistical significance (55% vs. 33%, p=0.108). There was no significant correlation between MI and other prognostic variables including location, tumor size, and distant metastasis. CONCLUSIONS: These results confirm that the mutator phenotype plays in a certain role gastric carcinogenesis. The gastric cancers with MI were correlated with the worse prognostic variables of poor differentiation and node metastasis, suggesting that MI appear to be useful as possible indicators of the worst prognosis and represent important genetic alterations associated with tumor progression in gastric carcinogenesis.
Base Sequence ; Carcinogenesis ; DNA ; Gastrectomy ; Genome, Human ; Genomic Instability ; Humans ; Incidence ; Microsatellite Instability* ; Microsatellite Repeats* ; Molecular Weight ; Mucous Membrane ; Mutation Rate ; Neoplasm Metastasis ; Nitrogen ; Phenotype ; Polymerase Chain Reaction ; Prognosis ; Stomach Neoplasms* ; Urea

BACKGROUN: Many studies have shown that diabetes mellitus does not modify the clinical features and treatment outcomes. However, to our knowledge, those surveys for clinical features and treatment outcomes in pulmonary tuberculosis with diabetics were performed 15 years ago and have not been confirmed by more recent reports. Therefore, the purpose of this study is to investigate the effect of diabetes mellitus on microbiologic findings in far advanced stage of pulmonary tuberculosis and so to make some suggestions for the management of pulmonary tuberculosis with diabetes mellitus. METHODS: This study population was composed of 47 patients with far advanced stage of culture-proven pulmonary tuberculosis hospitalized in our department from 2000 through 2002. None of patients was intractable. Patients were divided into 4 groups; group1;nondiabetics with initial treatment, group2;diabetics with initial treatment, group3;nondiabetics with retreatment, group4; diabetics with retreatment. Treatment regimens were individualized on the basis of susceptibility results. A retrospective review of the records of all 47 patients with pulmonary tuberculosis and diabetes mellitus was carried out. The clinical features, bacteriologic, radiographic findings and treatment outcomes were compared among 4 groups. RESULTS: Time to negative conversion of AFB in sputum smear was significantly increased in diabetics group than nondiabetics, but time to negative conversion of AFB in sputum culture was not significant. Also time to negative conversion of AFB in sputum smear or culture was not affected by treatment pattern. The effect of antituberculosis medication significantly delayed response in diabetics with retreatment and resistance rate was higher in diabetics or retreatment. Time to negative conversion of AFB in sputum smear was related to cavitary size in radiographic findings, but time to negative conversion of AFB in sputum culture was related to drug sensitivity. Natural course of cavity on radiographic findings after antituberculosis therapy was not significant. CONCLUSION: It seems that diabetes mellitus does not affect bacteriological negative conversion rates except negative conversion rate of AFB in sputum smear, which chiefly related to cavitary size, in far advanced stage of pulmonary tuberculosis. Therefore, because the presence of AFB in sputum smear after 5th months of therapy is not necessarily a treatment failure in far advanced stage of pulmonary tuberculosis with diabetics, any decision regarding prologation or change in therapy maybe required based on the results of culture and drug susceptibility tests.
Bacteriology ; Diabetes Mellitus* ; Humans ; Retreatment ; Retrospective Studies ; Sputum ; Treatment Failure ; Treatment Outcome ; Tuberculosis, Pulmonary*

No abstract available.
Albendazole/therapeutic use ; Anthelmintics/therapeutic use ; Biopsy ; Combined Modality Therapy ; *Cysts/diagnostic imaging/parasitology/therapy ; *Echinococcosis, Hepatic/diagnostic imaging/parasitology/therapy ; Hepatectomy ; Humans ; *Liver/diagnostic imaging/drug effects/parasitology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

Recent in vitro studies have revealed that a certain Mycobacterium can survive and multiply within freeliving amoebae. It is believed that protozoans function as host cells for the intracellular replication and evasion of Mycobacterium spp. under harmful conditions. In this study, we describe the isolation and characterization of a bacterium naturally observed within an amoeba isolate acquired from a contact lens storage case. The bacterium multiplied within Acanthamoeba, but exerted no cytopathic effects on the amoeba during a 6-year amoebic culture. Trasnmission electron microscopy showed that the bacteria were randomly distributed within the cytoplasm of trophozoites and cysts of Acanthamoeba. On the basis of the results of 18S rRNA gene analysis, the amoeba was identified as A. lugdunensis. A 16S rRNA gene analysis placed this bacterium within the genus Mycobacterium. The bacterium evidenced positive reactivity for acid-fast and fluorescent acid-fast stains. The bacterium was capable of growth on the Middlebrook 7H11-Mycobacterium-specific agar. The identification and characterization of bacterial endosymbionts of free-living protozoa bears significant implications for our understanding of the ecology and the identification of other atypical mycobacterial pathogens.
Acanthamoeba/genetics/isolation & purification/*microbiology ; Animals ; Base Sequence ; Contact Lens Solutions ; *Contact Lenses ; DNA, Mitochondrial/genetics ; Microscopy, Electron, Transmission/methods ; Mycobacterium/genetics/*isolation & purification ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S/genetics ; RNA, Ribosomal, 18S/genetics ; Symbiosis

Major pelvic ganglia (MPG) neurons are classified into sympathetic and parasympathetic neurons according to the electrophysiological properties; membrane capacitance (Cm), expression of T-type Ca2+ channels, and the firing patterns during depolarization. In the present study, function and molecular expression of ATP-sensitive K+ (K(ATP)) channels was investigated in MPG neurons of male rats. Only in parasympathetic MPG neurons showing phasic firing patterns, hyperpolarizing changes were elicited by the application of diazoxide, an activator of K(ATP) channels. Glibenclamide (10microM), a K(ATP) channel blocker, completely abolished the diazoxide-induced hyperpolarization. Diazoxide increased inward currents at high K+ (90 mM) external solution, which was also blocked by glibenclamide. The metabolic inhibition by the treatment with mitochondrial respiratory chain inhibitors (rotenone and antimycin) hyperpolarized the resting membrane potential of parasympathetic neurons, which was not observed in sympathetic neurons. The hyperpolarizing response to metabolic inhibition was partially blocked by glibenclamide. RT-PCR analysis revealed that MPG neurons mainly expressed the K(ATP) channel subunits of Kir6.2 and SUR1. Our results suggest that MPG neurons have K(ATP) channels, mainly formed by Kir6.2 and SUR1, with phenotype-specificity, and that the conductance through this channel in parasympathetic neurons may contribute to the changes in excitability during hypoxia and/or metabolic inhibition.
Animals ; Anoxia ; Diazoxide ; Electron Transport ; Fires ; Ganglia ; Ganglion Cysts* ; Glyburide ; Humans ; Male* ; Membrane Potentials ; Membranes ; Neurons* ; Rats*

OBJECTIVE: The purpose of this study was to investigate the effects of fluoxetine (Prozac) on membrane potential and ionic currents in RINm5F insulinoma cells. METHODS: Membrane potential and ionic currents in RINm5F cell were recorded by using whole-cell and perforated-patch clamp techniques. RESULTS: Under current clamp conditions, diazoxide (200 microM), an activator of K ATP channels, induced a hyperpolarization of the resting membrane potential (-16.1+/-1.4 mV, n=), which was accompanied by a abolition of action potential firing. This diazoxide-induced hyperpolarization was blocked by glibenclamide (10 microM). Fluoxetine produced significant depolarization of membrane potential (15.9+/-3.1 mV, n=) and blocked diazoxide-induced hyperpolarization. Diazoxide activated inward currents in the presence of high external K + (90 mM) at a holding potential of -60 mV. Fluoxetine suppressed diazoxide-activated currents in a concentration-dependent (IC 50 =.84 microM) manner. However, the inhibitory action of fluoxetine was not specific to K ATP currents because it also inhibited both voltage-activated K + and Ca 2+ currents in a concentration-dependent manner. K ATP currents were more sensitive to fluoxetine block than both voltage-activated K + and Ca 2+ currents. CONCLUSION: Our results indicate that fluoxetine increased excitability of RINm5F cells mainly by the preferential block of K ATP currents. Fluoxetine-induced depolarization may influence insulin secretion in insulinoma cells.
Action Potentials ; Adenosine Triphosphate ; Diazoxide ; Fires ; Fluoxetine* ; Glyburide ; Insulin ; Insulinoma* ; Membrane Potentials* ; Membranes*

BACKGROUND: Although visual analogue scale (VAS) is a good self-assessment method for postoperative pain, faces pain scale (FPS) may be also used as objective assessment method in patients with unavailable of VAS. We investigated the usefulness of facial rating scale (FRS), the variants of VAS and FPS, compared with VAS in postoperative adult patients. METHODS: One hundred and six, ASA 1 or 2, patients undergoing elective surgery under general anesthesia were educated VAS (10 cm) and FRS. One hour after operation, patients' self-reported VAS and FRS were measured in the recovery room. The scores were analyzed by Spearman's correlation and Intraclass correlation. RESULTS: Correlations indicated a highly significant relationship between VAS and FRS (Spearman's correlation coefficient = 0.84, Intraclass correlation coefficient = 0.92, both of P < 0.01). CONCLSIONS: FRS may be useful for self-reported pain assessment instead of VAS in postoperative adult patients.
Adult ; Anesthesia, General ; Humans ; Pain Measurement ; Pain, Postoperative* ; Recovery Room ; Self-Assessment

BACKGROUND: Urinary retention after anorectal surgery is thought to be a mild complication but has a high incidence. Since anal pain and distention can contribute to the urethral spasm reflex which may cause urinary retention, we investigated the effect of absorbable gelatin sponge (Gelfoam(R)) used for anal packing postoperatively on urinary retention after hemorrhoidectomy under spinal anesthesia. METHODS: One hundred and nineteen ASA Physical Status I patients scheduled for hemorrhoidectomy were selected. Patients were randomly divided into Group A, postoperative anal packing free group and Group B, postoperative anal packing group and studied prospectively. Spinal anesthesia was performed with the bevel of 25 gauge Quincke needle parallel to dura fibers at lumber 3 4 intervertebral space and the injection of hyperbaric 0.5% tetracaine 6 mg (1.2 ml) to patients in sitting position. After hemorrhoidectomy, all patients were permitted to ambulate as soon as possible and urinate spontaneously. If urinary retention occurred, urinary catheterization was done temporarily. The number of patients who received urinary catheterization were recorded. Surgical technique and the total amount of intravenous fluid during the operation were controlled. RESULTS: The incidence of urinary retention in Group A (11/57, 19.3%) was similar to that in Group B (10/62, 16.1%) (P = 0.651, chi 2 = 0.205, degree of freedom = 1). CONCLUSIONS: Our study did not indicate the clue that the absence of anal packing helped to reduce the incidence of urinary retention after hemorrhoidectomy under spinal anesthesia.
Anesthesia, Spinal* ; Freedom ; Gelatin Sponge, Absorbable ; Hemorrhoidectomy* ; Humans ; Incidence ; Needles ; Prospective Studies ; Reflex ; Spasm ; Tetracaine ; Urinary Catheterization ; Urinary Catheters ; Urinary Retention*

BACKGROUND: It has been known that bed rest after spinal anesthesia for benign anorectal surgery helps to reduce the incidence of postdural puncture headache, but the bed rest position is thought to have a negative effect on urinary retention, as a result of anxiety, anal distention, bladder distention and pain-induced reflex inhibition of the urinary bladder detrusor muscle. We investigate the effect of early ambulation after spinal anesthesia on postdural puncture headache and on urinary retention compared with bed rest for 24 hours. METHODS: One hundred and fifty-three ASA Physical Status I patients received spinal anesthesia for scheduled benign anorectal surgery. We applied hyperbaric 0.5% tetracaine 6 mg (1.2 ml) using 25 gauge Quincke needles with the cutting bevel parallel to the dural fibers at the patients' sitting position. All patients were randomly divided into an early ambulation group or bed rest group. We investigated the incidence of urinary retention and headache. The duration of operation, the perioperative intravenous fluid volume, surgical technique and postoperative pain regimen were standardized. RESULTS: The incidence of urinary retention in the early ambulation group (16/75, 21.3%) was lower than that in bed rest group (32/78, 41.0%). There was no difference in any parameters between the two groups. CONCLUSIONS: To reduce the incidence of urinary retention, early ambulation after spinal anesthesia for benign anorectal surgery is recommended over bed rest with no increase in the incidence of postdural puncture headache.
Anesthesia, Spinal* ; Anxiety ; Bed Rest ; Early Ambulation* ; Headache ; Humans ; Incidence* ; Needles ; Pain, Postoperative ; Post-Dural Puncture Headache ; Reflex ; Tetracaine ; Urinary Bladder ; Urinary Retention*

BACKGROUND: It is known that pain after a laparoscopic cholecystectomy is less compared with an open cholecystectomy. There are various methods of pain relief used but a controversy exists over the effectiveness and value of intraperitoneal local anesthetics. The aim of this study was to investigate which components of pain were more predominant for pain after a laparoscopic cholecystectomy, somatic pain or visceral pain. METHODS: Twenty-four patients who received an elective laparoscopic cholecystectomy were selected. General anesthesia was induced with thiopental sodium and succinylcholine, and maintained with vecuronium and isoflurane. After surgery, the degree of postoperative somatic pain (superficial, sharp and definite in the abdominal wall) and visceral pain (dull, vague and/or colicky in the peritoneal cavity) was assessed at postoperative 1, 3, 6, 9, 24 and 36-hour by a 10 cm-visual analogue scale (VAS) scores and other complaints were recorded. RESULTS: VAS scores of somatic pain were significantly higher than those of visceral pain at all the recorded times. CONCLUSIONS: Somatic pain was predominant after a laparoscopic cholecystectomy compared with visceral pain and it should be helpful to treat pain after a laparoscopic cholecystectomy.
Anesthesia, General ; Anesthetics, Local ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Humans ; Isoflurane ; Nociceptive Pain* ; Succinylcholine ; Thiopental ; Vecuronium Bromide ; Visceral Pain*