PURPOSE: Transforming growth factor-beta(TGF-beta) is a potent modulator of cell proliferation, differentiation, angiogenesis and immune system. We evaluate the significance of the expression of TGF-beta1 and TGF-beta2 and correlation with Ki-67 as prognostic factors in prostate cancer. MATERIALS AND METHODS: In order to investigate the expression of TGF-beta1, TGF-beta2 and Ki-67, we analyzed immunohistochemical staining from paraffin blocks of 22 cases of the prostate carcinoma and adjacent normal prostate. RESULTS: The TGF-beta1 staining scores of the tumor cells were higher than those of the adjacent normal epithelial cells(p=0.001). The TGF-beta2 staining scores of the tumor cells were also higher than those of the adjacent normal epithelial cells(p=0.003). However no correlation was observed between tumor surrounding stroma and normal stroma in TGF-beta1 and TGF-beta2 staining scores. The serum PSA level, the clinical stage, the Gleason score and the lymph node metastasis of the tumor was not correlated with the staining score of TGF-beta1 and TGF-beta2. Ki-67 labelling index(LI) was significantly associated with the histologic grade, while no relationship was observed between Ki-67 LI and clinical stage. TGF-beta1 and TGF-beta2 staining score was not statistically correlated with the Ki-67 LI. CONCLUSIONS: These results indicate that the prostatic cancer was associated with alteration of TGF-beta1 and TGF-beta2 expression by prostatic epithelial cells which may be biologically important in the development of prostate cancer and TGF-beta1 and TGF-beta2 expression may be new target of treatment of prostate cancer. Prognostic value of TGF-beta1 and TGF-beta2 expression was not statistically significant but Ki-67 LI was significantly associated with Gleason score.
Cell Proliferation ; Epithelial Cells ; Immune System ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Paraffin ; Prostate* ; Prostatic Neoplasms* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta2*

BACKGROUND: Sevoflurane and desflurane are widely used anesthetics and can be simulated in pharmacokinetic models. These models are related to steady state pharmacokinetics, As anesthetic elimination is a non-steady state process, we evaluated the elimination data of volatile anesthetics using a two-compartment model (bi-exponential function). 50, 80, and 90% context-sensitive decrement times were evaluated with this function. These times are related to awakening and cognitive function recovery. METHODS: Forty-eight healthy patients were enrolled for minimal surgery under general anesthesia. They were randomly anesthetized with either sevoflurane or desflurane. At the end of surgery, when the administration of the volatile anesthetics was discontinued, end-tidal concentrations (PE) were recorded for 15 minutes. We calculated and analyzed the fraction of anesthetic concentrations (PE/PE0) using a bi-exponential function (PE0: the last end-tidal concentration of anesthetics during anesthesia). RESULTS: A bi-exponential function was fit to the elimination data using non-linear mixed-effect modeling. It showed that the anesthetic duration had effects on the coefficients of early and late components and not on the log rate constants. The coefficient of late components increased and the coefficient of early components decreased with prolonged anesthetic duration. Irrespective to the type of anesthetics, prolonged anesthesia did not affect the context-sensitive half-life; however, a prolonged period of time was required to reach 80 and 90% decrement after prolonged anesthesia. CONCLUSIONS: Prolonged anesthetic duration slowed down the elimination of volatile anesthetics. It delayed awakeness and a return to normal cognitive function after anesthesia.
Anesthesia ; Anesthesia, General ; Anesthetics ; Humans ; Isoflurane ; Methyl Ethers

BACKGROUND: The regional cerebral oxygen saturation (rSO2) decreases significantly during ordinary anesthetic recovery in pediatric patients anesthetized with sevoflurane or desflurane. The present study examined the relationship between rSO2 and the clinical parameters associated with the degree of anesthetic recovery. METHODS: Twelve pediatric patients with American Society of Anesthesiologists physical status 1 were assigned randomly to receive anesthesia with sevoflurane or desflurane. All children underwent general anesthesia for minor surgery. After surgery, the rSO2, the age-adjusted MAC fraction of anesthetic concentration (F(E)), and the bispectral index (BIS) were recorded over a 10-minute period. The correlations between rSO2 and candidate predictors, such as F(E), BIS, anesthetic, and duration of anesthesia, were analyzed. RESULTS: All children recovered uneventfully. The lowest observed rSO2 reached 63% and the maximum decrease in rSO2 was 24%. The mean blood pressure and heart rate were maintained within clinical ranges. The decrease in rSO2 correlated positively with the F(E) (r = 0.25, P = 0.00) and the duration of anesthesia (r = 0.24, P = 0.01), and inversely with the use of sevoflurane (r = -0.30, P = 0.00). CONCLUSIONS: Despite normal parameters, cerebral desaturation occurred during the emergence of ordinary general anesthesia even without hemodynamic compromise or arterial desaturation. Cerebral desaturation might be associated with the degree of anesthetic recovery and the use of sevoflurane.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Child ; Heart Rate ; Hemodynamics ; Humans ; Isoflurane ; Methyl Ethers ; Oxygen ; Pediatrics ; Surgical Procedures, Minor

Tonicity-responsive enhancer binding protein (TonEBP) is a signal transcription factor of transporters such as sodium-myo-inositol cotransporter (SMIT), aldose reductase. TonEBP has a variety of functions such as control of intracellular osmolytes and immunomodulating. It is known that TonEBP is abundant in the placenta, but location and function aren't known. The aim of this study is to describe the localization of TonEBP in the placenta. We assayed the immunohistochemistry of TonEBP and performed in situ hybridization of SMIT in normal human full term placenta. In normal human full term placenta, TonEBP was in villous trophoblasts, extravillous trophoblasts and some endothelial cells. The result of the in situ hybridization of SMIT was similar to that of immunohistochemistry of TonEBP. Neither TonEBP nor SMIT was present in TonEBP knockout mouse placenta. This shows TonEBP is a key factor in SMIT transcription. TonEBP may play an important role in transporting of inositol to fetus in placenta.
Aldehyde Reductase ; Animals ; Carrier Proteins ; Endothelial Cells ; Fetus ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Inositol ; Mice ; Mice, Knockout ; Placenta ; Transcription Factors ; Trophoblasts

PURPOSE: The incidence of renal stones is three times higher in men than women due to sex hormones, and most are calcium oxalate stones. Therefore, the effects of testosterone and estrogen in the formation of urinary stones were investigated. MATERIALS AND METHODS: One hundred female Sprague-Dawley rats were divided into seven groups. The first was the control group; the second was injected with testosterone cypionate into the muscle, every week; the third was fed tamoxifen only, everyday; the fourth was oophorectomized; the fifth was fed tamoxifen after an oophorectomy; the sixth was treated with testosterone after an oophorectomy; and the seventh was injected with testosterone, weekly, and fed tamoxifen everyday after an oophorectomy. The bladder stone formation and degree of renal crystal deposition of the control group was compared with those of the other groups. The composition of the bladder stones was analyzed by SEM (scanning electron microscopy)-EDX (energy dispersive X-ray microanalysis). RESULTS: Bladder stones were found in 9 rats from group 6 only, which also showed the most predominant renal crystal deposition rate (65.5%). There was a statistical significance in the renal crystal deposition rate only between groups 6 and 1. According to SEM-EDX analysis of the bladder stones, they were composed of struvite and apatite. CONCLUSIONS: It is suggested that testosterone and estrogen influenced the formation of struvite and apatite stones.
Animals ; Calcium Oxalate ; Estrogens ; Female ; Gonadal Steroid Hormones* ; Humans ; Incidence ; Male ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley ; Tamoxifen ; Testosterone ; Urinary Bladder Calculi ; Urinary Calculi*

BACKGROUND: The elimination of anesthetic agents is a decisive factor in the emergence from general anesthesia. In this pilot study, we hypothesized that hypercapnia would decrease the emergence time from propofol anesthesia by increasing cardiac output and cerebral blood flow. METHODS: A total of 32 patients were randomly divided into two groups based on the end-tidal carbon dioxide values: 30 mmHg (the hypocapnia group) and 50 mmHg (the hypercapnia group). Propofol and remifentanil were infused to maintain a bispectral index of 40–50. Remifentanil infusion was stopped 10 min before the discontinuation of propofol. After cessation of propofol infusion, ventilation settings in the hypocapnia group were maintained constant; a rebreathing tube was connected to the respiratory circuit in the hypercapnia group. The time to spontaneous respiration, eye opening (primary endpoint), mouth opening, and tracheal extubation was recorded and analyzed. RESULTS: Time to eye opening was 9.7 (1.3) min in the hypocapnia group and 9.0 (1.0) min in the hypercapnia group. The difference in the mean times to eye opening between groups was −0.7 min (95% CI, −4.0 to 2.7, P = 0.688). On multiple regression analysis, there was a significant difference in the mean time to eye opening between males and females. Females recovered about 3.6 min faster than males (95% CI, −6.1 to −1.1, P = 0.009). CONCLUSIONS: We could not detect a beneficial effect of hypercapnia on propofol emergence time. Irrespective of hypercapnia, females seemed to recover faster than males.
Airway Extubation ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Carbon Dioxide ; Cardiac Output ; Cerebrovascular Circulation ; Clinical Study* ; Female ; Humans ; Hypercapnia* ; Hypocapnia ; Male ; Mouth ; Pilot Projects ; Propofol* ; Respiration ; Ventilation

The activation of nuclear factor of activated T cells 5 (NFAT5), a well-known osmoprotective factor, can be induced by isotonic stimuli, such as activated Toll-like receptors (TLRs). It is unclear, however, how NFAT5 discriminates between isotonic and hypertonic stimuli. In this study we identified a novel context-dependent suppression of NFAT5 target gene expression in RAW 264.7 macrophages stimulated with lipopolysaccharide (LPS) or a high salt (NaCl) concentration. Although LPS and NaCl both used NFAT5 as a core transcription factor, these stimuli mutually inhibited distinct sets of NFAT5 targets within the cells. Although reactive oxygen species (ROS) are essential for this inhibition, the source of ROS differed depending on the context: mitochondria for high salt and xanthine oxidase for TLRs. Specifically, the high salt-induced suppression of interleukin-6 (IL-6) production was mediated through the ROS-induced inhibition of NFAT5 binding to the IL-6 promoter. The context-dependent inhibition of NFAT5 target gene expression was also confirmed in mouse spleen and kidney tissues that were cotreated with LPS and high salt. Taken together, our data suggest that ROS function as molecular sensors to discriminate between TLR ligation and osmotic stimuli in RAW 264.7 macrophages, directing NFAT5 activity toward proinflammatory or hypertonic responses in a context-dependent manner.
Animals ; *Gene Expression Regulation/drug effects ; Interleukin-6/biosynthesis/genetics ; Lipopolysaccharides/pharmacology ; Macrophages/drug effects/metabolism ; Male ; Mannitol/pharmacology ; Mice ; Mice, Inbred BALB C ; NF-kappa B/metabolism ; Promoter Regions, Genetic/genetics ; Protein Binding/drug effects/genetics ; Reactive Oxygen Species/*metabolism ; Rotenone/pharmacology ; Sodium Chloride/pharmacology ; Toll-Like Receptors ; Transcription Factors/genetics/*metabolism

PURPOSE: To report the advantages and the results of arthroscopic removal of loose bodies by posteri-or-posterior triangulation, using the posteromedial and posteroleteral portal. MATERIALS AND METHODS: Sixteen cases in this study had loose bodies in the posterior compartment of the knee joint; nine cases in the posteromediaI, three cases in the posterolateral and four cases in the both compartments. Under the supine position, the knee is flexed to a 90 angle, and an obturator was inserted in the posterolateral compartment through the fat areolar tissue eliminating the loose bodies in the posterior compartment. RESULT: In sixteen cases we eliminated all loose bodies under arthroscopy which were in the posterior compartment of the knee joint and there was no complication such as saphenous nerve palsy, common peroneal nerve palsy, or the rupture of popliteal artery. CONCLUSION: Arthroscopic removal of loose body in the posterior compartment of the knee joint using posterior-posterior triangulation was considered as one of the useful methods in terms of safety and good visualization.
Arthroscopy ; Knee Joint ; Knee* ; Paralysis ; Peroneal Nerve ; Popliteal Artery ; Rupture ; Supine Position

OBJECTIVE: The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). METHODS: Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. RESULTS: The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09 +/-0.10), peaked during the second trimester (0.52+/-0.14), and slowed after 34 gestational weeks (0.46+/-0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18+/-0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. CONCLUSION: This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.
Diabetes, Gestational* ; Female ; Fetal Development ; Gestational Age ; Glucose* ; Humans ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Ultrasonography ; Weight Gain*