In skeletal muscles, oxygen free radicals generated during ischemia -reperfusion are known as inducers that cause cellular injury and apoptosis and contribute to the pathogenensis of reperfusion injury. Ischemia -reperfusion for 2 hours may cause reversible changes, while prolonged ischemia -reperfusion causes irreversible changes. Following ischemia -reperfusion, diverse signals are transduced to induce a variety of gene expression. Ischemic preconditioning, defined as brief episodes of ischemia and reperfusion, is known to provide protection from the consequences of prolonged ischemia followed by reperfusion. NF -kappa B is a transcription factor that activated during ischemic preconditioning and ischemia -reperfusion. It initiates inflammation through inducing transcription of proinflammatory, procoagulant and vasoactive gene, while mediates the expression of cytoprotective proteins that block apoptosis or inhibit inflammation. The present study was performed to study the change of NF -kappa B immunoreacitvity in rat anterior tibialis and soleus muscles in response to ischemia -reperfusion and preconditioning. Experimental animals, Sprague -Dawley rats (250 ~300 g), were divided into 6 groups; 1) control, 2) ischemic preconditioning, 3) 2 hours of ischemia, 4) 4 hours of ischemia, 5) 2 hours of ischemia after ischemic preconditioning, 6) 4 hours ischemia after ischemic preconditioning. For ischemic preconditioning, left common iliac artery was occluded three times for 5 minutes followed by 5 minutes of reperfusion using vascular clamp. Ischemia was done by occlusion of the same artery for 2 or 4 hours. The specimens of tibialis anterior and soleus muscles were obtained 0, 1, 3, 6, and 24 hours after onset of reperfusion. The specimens were paraffin sectioned at 6 micrometer and NF -kappa B expression was examined using immunohistochemical methods. The results obtained were as follows : 1. In normal control group, immunoreactivity of NF -kappa B was moderate to strong in tibialis anterior muscles and weak in soleus muscles. 2. In tibialis anterior, immunoreactivity of NF -kappa B was decreased in 2 and 4 hours of ischemia comparede with normal control group. In soleus muscle, immunoreactivity of NF -kappa B was decreased in 2 hours of ischemia but it was comparable to that of normal control group in 4 hours of ischemia. 3. Ischemia for 4 hours induced more remarkable change in NF -kappa B immunoreactivity than that for 2 hours. 4. After ischemic preconditioning, changes in NF -kappa B immunoreactivity after 2 and 4 hours of ischemia were decreased compared with normal control group. 5. In ischemia for 2 and 4 hours, changes in NF -kappa B immunoreactivity of tibialis anterior muscles were more severe than that of soleus muscles. These results suggest that in the skeletal muscle, changes in NF -kappa B immunoreactivity of 4 hours of ischemia were more remarkable than that of 2 hours ischemia, and changes in NF -kappa B of tibialis anterior muscles were more remarkable than that of soleus muscles. Ischemic preconditiong attenuated the alteration of the NF -kappa B immunoreactivity induced by ischemia -reperfusion in the muscles.
Animals ; Apoptosis ; Arteries ; Free Radicals ; Gene Expression ; Iliac Artery ; Inflammation ; Ischemia ; Ischemic Preconditioning ; Muscle, Skeletal ; Muscles* ; Oxygen ; Paraffin ; Rats* ; Reperfusion ; Reperfusion Injury ; Transcription Factors

BACKGROUND: It is known that cathepsin D expression in host stromal cells is associated with a more aggressive tumor behavior in breast cancers. METHODS: Cathepsin D expression was examined in 222 cases of invasive ductal carcinoma (CA) and 25 cases of ductal carcinoma in situ (DCIS) by the immunohistochemical staining. Cathepsin D expression was evaluated according to the expression site, either in the tumor cells (CD-T) or in the stromal cells (CD-S), and graded according to the immunopositivity. The differences of CD-T and CD-S in each case were evaluated according to the pathologic parameters and estrogen receptor (ER)/progesterone receptor (PR) status. RESULTS: The rate of CD-S was significantly higher in the CA than in the DCIS (p<0.0001). In the CA, the rate of CD-S was higher than that of CD-T, while in the DCIS, the rate of CD-T was higher than that of CD-S. In the CA, the rate of CD-S and the tumor grade showed a positive relationship (p=0.0281). There were positive correlations between the ER positivity and CD-S (p=0.0236), and between the PR positivity and CD-T (p=0.0246). For the DCIS, no significant relationships were noted between the pathologic parameters including ER/PR status and CD-T/CD-S. CONCLUSION: Cathepsin D expression in the stromal cells seems to be related to the invasiveness and aggressive biological behavior in breast cancers. In addition, there might be some relationship betweeen the ER positivity and CD-S, and between the PR positivity and CD-T.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Cathepsin D* ; Cathepsins* ; Estrogens ; Stromal Cells

Akt, a key protein of cell survival, can promote cell growth and survival by activations of various cellular protective factors. Ischemic preconditioning (IP) has been known to reduce ischemic injury through upregulation of phosphorylation of Akt (p-Akt). CuZn-superoxide dismutase (SOD-1), an antioxidant enzyme, scavenges reactive oxygen species and protects cell from oxidative stress by increasing the activaiton of Akt. The present study was performed to examine the effects of IP on the expression of p-Akt and SOD-1 in the ischemicreperfused rat skeletal muscles. Thirty weeks old male SD rats were divided into 4 groups, such as controls, IP, 4 hour ischemia and 4 hour ischemia with IP. For IP, commom iliac artery was occluded three times for 5 min ischemia followed by 5 min reperfusion using rodent vascular clamps. Ischemia was induced by occlusion on the same artery for 4 hours. The Tibialis anterior and Soleus were removed at 0, 1, 3, and 24 hours of reperfusion. The expressions of p-Akt (Ser 473) and SOD-1 were examined with immunohistochemistry and Western blot analysis.In the IP group, the p-Akt and SOD-1 were increased, compared to the control group. In the ischemia group, the p- Akt and SOD-1 were decreased, compared to the control group, and were more abundant when reperfusion time were increased. IP increased the p-Akt and SOD-1 after 4 hour ischemia, and the p-Akt and SOD-1 were higher in Soleus compared to Tibialis anterior. These findings suggest that IP increases p-Akt and expression of SOD-1 in the ischemic-reperfused rat skeletal muscles, and that upregulations of p-Akt and SOD-1 induced by IP were higher in the red muscle fiber, Soleus, than the white muscle fiber, Tibialis anterior.
Animals ; Arteries ; Blotting, Western ; Cell Survival ; Humans ; Iliac Artery ; Immunohistochemistry ; Ischemia ; Ischemic Preconditioning ; Male ; Muscle Fibers, Fast-Twitch ; Muscle Fibers, Slow-Twitch ; Muscle, Skeletal ; Oxidative Stress ; Phosphorylation ; Rats ; Reactive Oxygen Species ; Reperfusion ; Rodentia ; Up-Regulation

A balance between production and degradation of reactive oxygen species has an important role in the cardiovascular homeostasis, and is known to contribute to hypertension. Under oxidative stress, an upregulation of inducible NOS (iNOS) induces ischemic-reperfusion injury, and is involved in the pathophysiology of the hypertension. Ischemic-reperfusion injury of the skeletal muscle results from reactive oxygen species, and overexpression of iNOS in the skeletal muscle increases the ischemic injury. Superoxide dismutase (SOD), antioxidant, is a major enzyme for degradation of reactive oxygen species (ROS). The purpose of this study was to observe the effect ischemic preconditioning (IP) of the lower limb on the expression of iNOS, CuZnSOD and MnSOD in the white and red muscle of the spontaneously hypertensive rat (SHR). Nine weeks old male normotensive rat (Wistar-Kyoto rat, WKY) and SHR were divided into control and IP groups. The IP group was further divided into 3 (3IP) and 10 (10IP) times of IP. Left common iliac artery was occluded 3 and 10 times for 5 min of ischemia-5 min of reperfusion using rodent vascular clamp. The animals were sacrificed at 0, 0.5, 1, and 3 hours after reperfusion and the Tibialis anterior and Soleus were removed. The expressions of iNOS, CuZnSOD and MnSOD in the skeletal muscle were examined with immunohistochemical methods and Western blot analysis. iNOS was expressed in Tibialis anterior, but in Soleus after IP. The expression of iNOS was increased in both WKY and SHR, it was higher in SHR than WKY. CuZnSOD and MnSOD were expressed in Tibialis anterior and Soleus, higher in Soleus, after IP. The expression of CuZnSOD and MnSOD were increased in both WKY and SHR, higher in WKY than SHR. It is consequently suggested that hypertensive individual and white muscle are more sensitive to ischemic injury of the skeletal muscle as considering their high expression of iNOS and low expression of SODs.
Animals ; Blotting, Western ; European Continental Ancestry Group ; Homeostasis ; Humans ; Hypertension ; Iliac Artery ; Ischemic Preconditioning ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Oxidative Stress ; Rats ; Rats, Inbred SHR ; Reactive Oxygen Species ; Reperfusion ; Rodentia ; Superoxide Dismutase ; Superoxides ; Up-Regulation

Ischemic preconditioning (IP), short pre-treatment sublethal ischemia, induces a state of protection against subsequent prolonged ischemia-reperfusion. The purpose of this study was to investigate the expression of HO-1, HSP70, and iNOS proteins in the liver subjected to the courses of reperfusion after repetitive cycles of remote IP in the rat. Using thirty five week-old rats, the remote preconditioning was undertaken by vascular clamp occlusion of blood flow to one hindlimb, with 3 and 10 cycles of 5 minutes occlusion followed by 5 minutes reperfusion. The liver was removed 0, 3, 6, 24, and 72 hours of reperfusion after remote IP and assayed by immunohistochemical staining and Western blotting analyses for anti-HO-1, anti-HSP70, and anti-iNOS antibodies. The expression of HO-1 in rat liver increased at 72 hours of reperfusion groups after 3 and 10 cycles of remote IP, compared with normal control groups. The expression of HSP70 in rat liver increased at 6 hours of reperfusion groups after 3 cycles of remote IP, compared with normal control groups. The expression of HSP70 in rat liver increased at 0 hour of reperfusion groups after 10 cycles of remote IP, compared with normal control groups and decreased at 24 and 72 hours of reperfusion groups. The expression of iNOS in rat liver increased at 24 hours of reperfusion groups, but decreased at 72 hours of reperfusion groups after 3 and 10 cycles of remote IP, compared with normal control groups. In summary, these results showed that at early phase of reperfusion after remote IP, HSP70 expression was increased in rat liver. However, at 72 hrs of reperfusion after remote IP, HO-1 expression was increased and iNOS expression was decreased in rat liver.
Animals ; Blotting, Western ; Hindlimb ; Ischemia ; Ischemic Preconditioning ; Liver ; Proteins ; Rats ; Reperfusion

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff ; Suture Anchors ; Tears

Adenomyoepithelioma is an uncommon benign tumor of the breast. We present the fine needle aspiration cytologic features of adenomyoepithelioma in a 23 year-old Korean women, initially diagnosed as fibroadenoma. Aspiration cytologic findings of the left breast mass revealed high cellularity, small to medium sized, less cohesive epithelial clusters, rich naked cells and amorphous materials on background. The epithelial cells were round and uniform with no cytologic atypia or mitosis. Myoepithelial cells were conspicuous with peripheral rimming along the epithelial clusters. Small amount of fibrotic stromal tissues were observed. Distinguishing features from typical fibroadenoma are less tight epithelial clusters, dyscohesive epithelial cell aggregates, more abundant naked cells and scant stromal tissue fragments.
Adenomyoepithelioma* ; Biopsy, Fine-Needle* ; Breast* ; Epithelial Cells ; Female ; Fibroadenoma* ; Humans ; Mitosis ; Young Adult

BACKGROUND: The association of Kaposi's sarcoma-associated human herpesvirus, or human herpesvirus 8 (HHV8) with various skin diseases has been described in many reports. However, only 3 human diseases: Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman disease were proved to be associated with HHV8. In addition to Karposi's sarcoma, sarcoidosis and Kikuchi's disease were also described to be associated with HHV8. OBJECTIVE: The purpose of this study was aimed at the association of HHV8 with various skin diseases, such as Kaposi's sarcoma, sarcoidosis, and Kikuchi's disease. METHODS: We performed PCR to examine whether the 233-bp segment of the viral DNA of HHV8 was detected in Korean patients with Kaposi's sarcoma, sarcoidosis, Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia. The medical records and histopathological specimens of patients diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. RESULTS: HHV8 DNA sequences were identified in 9 (69%) of sarcoid tissues from 12 patients with sarcoidosis and in all (100%) of from 8 patients with Kaposi's sarcoma but not in 2 tissues from 2 patients with Kikuchi's disease, in 3 tissues from 2 patients with angiosarcoma and 2 tissues from 2 patients with angiolymphoid hyperplasia with eosinophilia. CONCLUSION: HHV8 may be strongly associated with the pathogenesis of Kaposi's sarcoma and sarcoidosis. However, the association with Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia was denied in this study. Further extensive study will be needed.
Angiolymphoid Hyperplasia with Eosinophilia ; Base Sequence ; Chungcheongnam-do ; DNA, Viral ; Giant Lymph Node Hyperplasia ; Hemangiosarcoma ; Herpesvirus 8, Human* ; Histiocytic Necrotizing Lymphadenitis ; Humans* ; Lymphoma, Primary Effusion ; Medical Records ; Polymerase Chain Reaction* ; Sarcoidosis ; Sarcoma ; Sarcoma, Kaposi ; Skin Diseases

Akt, heat shock protein (HSP72)72, and HSP90 induced by ischemic preconditioning protect cells from the ischemic injury. The purpose of this study was to examine the alterations of the level of phospho-Akt, HSP72, and HSP90 in the rat tibialis anterior and soleus muscles after cyclic episodes of ischemic preconditioning. Sprague-Dawley rats aged 35 weeks were divided into control and ischemic preconditioning (IP) groups. The IP group was divided into 3 subgroups based on cycles of IP. Left common iliac artery was occluded 3, 6, and 10 times for 5 minutes, followed by 5 minutes reperfusion. The experimental animals were sacrificed at 0, 3, 6, 24, and 72 hours after reperfusion, and left tibialis anterior and soleus muscles were removed. The expression of phospho-Akt, HSP72, and HSP90 were examined with immunohistochemical methods and Western blot analysis. The results were as follows; 1. In the 3 and 6 times of IP groups, the expression of phospho-Akt (p-Akt) was increased at 0 and 3 hours after reperfusion, compared with control group. The expression of p-Akt in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of p-Akt showed no difference among the IP groups. The expression of p-Akt was higher in Soleus than that in Tibialis anterior. 2. The expression of HSP72 in 3 times of IP group increased at 0 and 3 hours after reperfusion, compared with 6 and 10 times of IP groups. The expression of HSP72 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of HSP72 showed no difference among the IP groups. The expression of HSP72 was higher in Soleus than that in Tibialis anterior. 3. In the 3 and 6 times of IP groups, the expression of HSP90 increased at 0 and 3 hours after reperfusion, compared with control group. The expression of HSP90 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 24 hours after reperfusion, the expression of HSP90 showed no difference with increasing episode of IP. The expression level of HSP90 was higher in Soleus than that in Tibialis anterior. These findings suggest that ischemic preconditioning increases the expression of p-Akt, HSP72 and HSP90 at early phase after reperfusion in the rat tibialis anterior and soleus muscles. However, increased cycles of ischemic preconditioning may not induce the expression of them.
Animals ; Blotting, Western ; Heat-Shock Proteins ; Iliac Artery ; Ischemic Preconditioning* ; Muscles* ; Phosphorylation* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Remote ischemic preconditioning (IP), brief tolerating cycles of ischemia and reperfusion in remote non-vital organs, can reduce ischemic injury of the heart. IP induces cardiac protection by down-regulating iNOS or up-regulating eNOS. In addition, Akt has been known to protect myocardium against ischemia-reperfusion injury. This study was undertaken to observe the expression of iNOS, eNOS, Akt and phospho-Akt (p-Akt) in the rat myocardium after IP. Thirty-five weeks-old male Sprague-Dawley rats were divided into control and IP groups. The IP group was further subdivided into 3 groups based on the number of cycles of IP. For IP, left commom iliac artery was occluded 3, 6 and 10 cycles for 5 min of ischemia alternating with 5 min of reperfusion. The rat were sacrificed at 0, 3, 6, 24 and 72 hours of IP and the heart was removed. The expression of iNOS, eNOS, Akt and p-Akt in the rat myocardium was examined by immunohistochemical staining and Western blot analysis. The expression of iNOS was increased by IP and was higher in 10IP groups than 3IP and 6IP group. The expression of eNOS was increased or decreased by IP and was showed no difference with increasing episode of IP. The expression of Akt was decreased by IP at 24 and 72 hours after reperfusion, and showed no differences with increasing episode of IP. The expression of p-Akt was increased by IP and showed no difference with increasing episode of IP. These results suggest that hind limb ischemic preconditioning provides cardiac protection through up-regulation of eNOS and phosphorylation of Akt, however excessive episodes of remote preconditioning may induce the myocardial ischemic injury through overexpression of iNOS.
Animals ; Blotting, Western ; Extremities ; Heart ; Humans ; Iliac Artery ; Ischemia ; Ischemic Preconditioning ; Male ; Myocardium ; Phosphorylation ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Up-Regulation