The time-course and RNA interference of TNF-alpha, IL-6, and IL-1beta expression on neuropathic pain induced by L5 spinal nerve transection in rats / 대한마취과학회지

BACKGROUND: The objective of this study was to investigate the time-course of the expression of TNF-alpha, IL-6, and IL-1beta after L5 spinal nerve transection (SNT), and to determine the effect of small interfering RNA (siRNA) targeting these cytokines on neuropathic pain. METHODS: Rats received control siRNA (CON group, n = 80) or a cocktail of siRNAs targeting these cytokines (COCK group, n = 70). The siRNAs were given via intrathecal catheter 1 d prior to SNT, on the operation day, and 1, 2 and 3 d postoperatively. Behavioral tests and levels of the cytokine mRNAs and proteins as well as glial cell activity were following the L5 SNT. RESULTS: In the CON group, TNF-alpha and IL-1beta mRNA levels increased immediately after SNT and remained high for 6 d, while IL-6 transcripts only began to increase after 12 h. TNF-alpha and IL-1beta mRNA levels in the COCK group were lower than in the CON group at all time points (P < 0.05). In the behavioral tests, allodynia and hyperalgesia were significantly lower in the COCK group from 2 d after SNT (P < 0.05). CONCLUSIONS: The time courses of TNF-alpha, IL-6 and IL-1beta mRNA expression after L5 SNT differ. RNA interference may be a method of reducing the development of mechanical allodynia and hyperalgesia in response to nerve injury.

Corrigendum: The time-course and RNA interference of TNF-alpha, IL-6, and IL-1beta expression on neuropathic pain induced by L5 spinal nerve transection in rats (Korean J Anesthesiol 2015 April 68(2): 159-169) / 대한마취과학회지

This article was inadvertently omitted Acknowledgments section for grant support.

Epidemiology of brucellosis among cattle in Korea from 2001 to 2011

In the present study, the outbreak patterns of bovine brucellosis in Korea from 2000 to 2011 were analyzed to understand the epidemiological evolution of this disease in the country. A total of 85,521 brucella reactor animals were identified during 14,215 outbreaks over the 12-year study period. The number of bovine brucellosis cases increased after 2003 and peaked in 2006 before decreasing thereafter. The majority of the bovine brucellosis cases were Korean native cattle, Han Woo. The numbers of human brucellosis cases and cattle outbreaks increased and decreased in the same pattern. The correlation coefficient for human and bovine cases per year was 0.96 (95% confidence interval = 0.86~0.99; p < 10(-3)). The epidemiological characteristics of bovine brucellosis appeared to be affected by the intensity of eradication programs that mainly involved a test-and-slaughter policy. Findings from the present study were based on freely available statistics from web pages maintained by government agencies. This unlimited access to information demonstrates the usefulness of government statistics for continually monitoring the health of animal populations.

The Relationship between Higher-order Aberrations and Amblyopia Treatment in Hyperopic Anisometropic Amblyopia

PURPOSE: To investigate the relationship between higher-order aberrations (HOAs) and amblyopia treatment in children with hyperopic anisometropic amblyopia. METHODS: The medical records of hyperopic amblyopia patients with both spherical anisometropia of 1.00 diopter (D) or more and astigmatic anisometropia of less than 1.00 D were reviewed retrospectively. Based on the results of the amblyopia treatment, patients were divided into two groups: treatment successes and failures. Using the degree of spherical anisometropia, subjects were categorized into mild, moderate, or severe groups. Ocular, corneal, and internal HOAs were measured using a KR-1W aberrometer at the initial visit, and at 3-month, 6-month, and 12-month follow-ups. RESULTS: The results of the 45 (21 males and 24 females) hyperopic anisometropic amblyopia patients who completed the 12-month follow-up examinations were analyzed. The mean patient age at the initial visit was 70.3 months. In total, 28 patients (62.2%) had successful amblyopia treatments and 17 patients (37.8%) failed treatment after 12 months. Among the patient population, 24 (53.3%) had mild hyperopic anisometropia and 21 (46.7%) had moderate hyperopic anisometropia. When comparing the two groups (i.e., the success and failure groups), ocular spherical aberrations and internal spherical aberrations in the amblyopic eyes were significantly higher in the failure group at every follow-up point. There were no significant differences in any of the HOAs between mild and moderate cases of hyperopic anisometropia at any follow-up. When the amblyopic and fellow eyes were compared between the groups there were no significant differences in any of the HOAs. CONCLUSIONS: HOAs, particularly ocular spherical aberrations and internal spherical aberrations, should be considered as reasons for failed amblyopia treatment.

The Relationship between Higher-order Aberrations and Amblyopia Treatment in Hyperopic Anisometropic Amblyopia

PURPOSE: To investigate the relationship between higher-order aberrations (HOAs) and amblyopia treatment in children with hyperopic anisometropic amblyopia. METHODS: The medical records of hyperopic amblyopia patients with both spherical anisometropia of 1.00 diopter (D) or more and astigmatic anisometropia of less than 1.00 D were reviewed retrospectively. Based on the results of the amblyopia treatment, patients were divided into two groups: treatment successes and failures. Using the degree of spherical anisometropia, subjects were categorized into mild, moderate, or severe groups. Ocular, corneal, and internal HOAs were measured using a KR-1W aberrometer at the initial visit, and at 3-month, 6-month, and 12-month follow-ups. RESULTS: The results of the 45 (21 males and 24 females) hyperopic anisometropic amblyopia patients who completed the 12-month follow-up examinations were analyzed. The mean patient age at the initial visit was 70.3 months. In total, 28 patients (62.2%) had successful amblyopia treatments and 17 patients (37.8%) failed treatment after 12 months. Among the patient population, 24 (53.3%) had mild hyperopic anisometropia and 21 (46.7%) had moderate hyperopic anisometropia. When comparing the two groups (i.e., the success and failure groups), ocular spherical aberrations and internal spherical aberrations in the amblyopic eyes were significantly higher in the failure group at every follow-up point. There were no significant differences in any of the HOAs between mild and moderate cases of hyperopic anisometropia at any follow-up. When the amblyopic and fellow eyes were compared between the groups there were no significant differences in any of the HOAs. CONCLUSIONS: HOAs, particularly ocular spherical aberrations and internal spherical aberrations, should be considered as reasons for failed amblyopia treatment.

Thrombocytopenia after Intravitreal Bevacizumab Injection for Macular Edema in Branch Retinal Vein Occlusion

PURPOSE: To report a rare case of thrombocytopenia after intravitreal bevacizumab injection (IVBI) in a patient with macular edema secondary to branch retinal vein occlusion (BRVO). CASE SUMMARY: A 52-year-old female presented to our clinic with complaints of visual disturbance in her right eye for 2 months. She was receiving hemodialysis therapy 3 times a week for 4 years due to chronic renal failure. Unilateral macular edema secondary to BRVO was observed on fundus examination and was confirmed with optical coherence tomography (OCT). The first IVBI was performed, and an additional injection was given 4 weeks later. Four weeks after the second injection, thrombocytopenia was present. The patient was followed up in our clinic without IVBI for 8 weeks and the platelet count recovered. Thrombocytopenia was reconfirmed after 2 additional monthly injections. After she revisited our clinic without IVBI for 8 weeks, the platelet count recovered without any treatment. CONCLUSIONS: When a patient presents with thrombocytopenia after IVBI with macular edema in BRVO, thrombocytopenia due to IVBI should be considered as a possible diagnosis.

Epidemiology of Hemorrhagic Fever with Renal Syndrome in Korea, 2001-2010

This study describes the epidemiology of hemorrhagic fever with renal syndrome (HFRS) in the past 10 yr (2001-2010) in Korea. During this period, a total of 3,953 HFRS patients and an average prevalence rate of 0.81 per 100,000 population were recorded, with a total of 40 fatal cases, corresponding to a case fatality rate of 1.01%. More HFRS cases were found in men than in women (57% vs 43%), and a higher prevalence rate of HFRS was observed in patients older than 40 yr (82.1%). The highest numbers of HFRS cases were found amongst farmers (35.6%). The majority of HFRS cases (71.3%) occurred in the last quarter of the calendar year (October to December). More HFRS cases occurred in the western part than in the eastern part of Korea (68.9% vs 31.1%). The incidence of HFRS was significantly higher (P < 0.001) in rural areas than in urban areas (80.3% vs 19.7%). HFRS still occurs commonly among men, in autumn, and in western rural area of Korea.

Effect of 5-FU and MTX on the Expression of Drug-resistance Related Cancer Stem Cell Markers in Non-small Cell Lung Cancer Cells

Cancer stem cells (CSCs) are often characterized by the elevated expression of drug-resistance related stem-cell surface markers, such as CD133 and ABCG2. Recently, we reported that CSCs have a high level of expression of the IL-6 receptor (IL-6R). The purpose of this study was to investigate the effect of anticancer drugs on the expression of the drug resistance-related cancer stem cell markers, ABCG2, IL-6R, and CD133 in non-small cell lung cancer (NSCLC) cell lines. A549, H460, and H23 NSCLC cell lines were treated with the anticancer drugs 5-fluorouracil (5-FU; 25 microg/ml) and methotrexate (MTX; 50 microg/ml), and the expression of putative CSC markers was analyzed by fluorescent activated cell sorter (FACS) and the gene expression level of abcg2, il-6r and cd133 by reverse transcriptasepolymerase chain reaction (RT-PCR). We found that the fraction of ABCG2-positive(+) cells was significantly increased by treatment with both 5-FU and MTX in NSCLC cells, and the elevation of abcg2, il-6r and cd133 expressions in response to these drugs was also confirmed using RT-PCR. Also, the number of IL-6R(+) cells was increased by MTX in the 3 cell lines mentioned and increased by 5-FU in the H460 cell line. The number of CD133(+) cells was also significantly increased by both 5-FU and MTX treatment in all of the cell lines tested. These results indicate that 5-FU and MTX considerably enhance the expression of drug-resistance related CSC markers in NSCLC cell lines. Thus, we suggest that antimetabolite cancer drugs, such as 5-FU and MTX, can lead to the propagation of CSCs through altering the expression of CSC markers.

The Reason to Select Complementary and Alternative Therapy for Terminally Ill Cancer Patients / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study was to analyze the reason to select complementary and alternative therapy for terminally ill cancer patients. METHODS: The data were collected from 21 terminal cancer patients and families through the in-depth interview. Data analysis were performed by the Colaizzi's phenomenological method (1976). RESULTS: The reason to select complementary and alternative therapy for terminal cancer patients and families was then categorized with 4 elements; Awareness of limitations in contemporary medical treatments, Belief in effectiveness of the CAM, Satisfaction with emotional needs of family members, and Disbelief due to negative attitudes of physicians. The result indicated the following 9 themes expectation for a complete cure, uncertainty in hospital treatments, complementary method for management of side effect of chemotherapy, alleviation of symptoms and life-sustaining, fear for side effects of cancer treatments, belief in earned information, referrals by other, responsibility of family, and dissatisfaction with negatine attitudes of physicians. CONCLUSION: Physicians should provide a sufficient explanation and try to effectively communicate with clients about hospice and palliative service and the CAM. We strongly realized that concerns about patients' best care and satisfactions with family's needs should be understood.

Inhibitory Effects of Quercetin on Muscle-type of Nicotinic Acetylcholine Receptor-Mediated Ion Currents Expressed in Xenopus Oocytes

The flavonoid quercetin is a low molecular weight compound generally found in apple, gingko, tomato, onion and other red-colored fruits and vegetables. Like other flavonoids, quercetin has diverse pharmacological actions. However, relatively little is known about the influence of quercetin effects in the regulation of ligand-gated ion channels. Previously, we reported that quercetin regulates subsets of nicotinic acetylcholine receptors such as alpha3beta4, alpha7 and alpha9alpha10. Presently, we investigated the effects of quercetin on muscle-type of nicotinic acetylcholine receptor channel activity expressed in Xenopus oocytes after injection of cRNA encoding human fetal or adult muscle-type of nicotinic acetylcholine receptor subunits. Acetylcholine treatment elicited an inward peak current (IACh) in oocytes expressing both muscle-type of nicotinic acetylcholine receptors and co-treatment of quercetin with acetylcholine inhibited IACh. Pre-treatment of quercetin further inhibited IACh in oocytes expressing adult and fetal muscle-type nicotinic acetylcholine receptors. The inhibition of IACh by quercetin was reversible and concentration-dependent. The IC50 of quercetin was 18.9+/-1.2 microM in oocytes expressing adult muscle-type nicotinic acetylcholine receptor. The inhibition of IACh by quercetin was voltage-independent and non-competitive. These results indicate that quercetin might regulate human muscle-type nicotinic acetylcholine receptor channel activity and that quercetin-mediated regulation of muscle-type nicotinic acetylcholine receptor might be coupled to regulation of neuromuscular junction activity.

The optimal concentration of siRNA for gene silencing in primary cultured astrocytes and microglial cells of rats / 대한마취과학회지

BACKGROUND: Small interfering RNAs (siRNAs) have been used to knockdown specific gene expression in various cells. Astrocytes and microglial cells play a key role in fundamental central nervous system functions and in chronic neuroinflammation. The aims of this study were to determine the optimal concentration of siRNA demonstrating efficient transfection and inhibition of gene expression via RNA interference (RNAi) and lower cytotoxicity, in primary cultured astrocytes and microglial cells of rats. METHODS: Astrocytes and microglial cells were isolated from the cerebral cortices of 2-day-old rats. Both the cells were transfected using transfection reagent (Lipofectaminetrade mark 2000), and fluorescein-labeled double-stranded RNA (dsRNA) or siRNA targeting green fluorescent protein. Transfection efficiency and cytotoxicity of dsRNA, and the degrees of RNAi induced by siRNA in these cells, were evaluated at various concentrations of RNA. RESULTS: Transfection efficiencies of dsRNA in both astrocytes and microglial cells were significantly higher (P < 0.05) at the concentrations of 20, 40, and 80 nM than at the concentrations of 0, 5, and 10 nM. There were no significant cytotoxicities within the applied concentrations of dsRNA (0-80 nM). The degrees of RNAi induced by siRNA were significantly higher (P < 0.05) at the concentrations of 5, 10, 20, 40, 80 nM, and 20, 40, 80 nM in astrocytes and microglial cells, respectively, compared with the control (0 nM). CONCLUSIONS: The siRNA concentration of 20 nM may be appropriate to induce RNAi in both astrocytes and microglial cells, while demonstrating low cytotoxicity, high transfection efficiency, and effective RNAi.

Development of an Adequate Propofol Sedation Model in Elderly Patients for Elective Surgery under Regional Anesthesia

BACKGROUND: Propofol, an ultrashort-acting anesthetic agent, is being increasingly used for sedation during regional anesthesia. The goal of this study was to characterize the pharmacodynamic relation between the effect site concentration of propofol and the occurrence of loss of consciousness (LOC) and apnea in elderly patients undergoing regional anesthesia. METHODS: Twenty patients aged 65 years or older presenting for elective surgery requiring regional anesthesia were enrolled. After performing spinal anesthesia, the target effect site concentration of propofol was set at 1.0 microg/mL. Effect site concentration was increased by 0.2 or 0.3 microg/mL until LOC and apnea were observed. LOC was determined by the loss of response to verbal command ("open your eyes") and apnea as the loss of spontaneous breathing for 20 seconds. The pharmacodynamic relation between effect site concentrations of propofol and LOC or apnea was characterized by population analysis using nonlinear mixed effects model. Approximate entropy (ApEn) as a surrogate measure of central nervous effect of propofol was calculated from raw electroencephalogram, retrospectively. The correlation between effect site concentration of propofol and ApEn was tested. RESULTS: The estimates (standard error) of Ce50 for LOC and apnea (the effect site concentration of propofol associated with 50% probability of LOC and apnea) were 1.74 (0.09) and 2.35 (0.11) microg/mL, respectively. The Spearman correlation coefficient between effect site concentration of propofol and ApEn was -0.8164 (p<0.0001). CONCLUSION: These results provide an adequate guidance for sedation in elderly patients for elective surgery under regional anesthesia.

Assessment of Apoptosis by M30 Immunoreactivity and the Relationship with the MSI status and the Clinicopathological Characteristics of Colorectal Carcinomas

BACKGROUND: The monoclonal antibody M30 recognizes a neoepitope of cytokeratin 18 that's produced during the process of apoptosis, and it is reactive in formalin-fixed, paraffin-embedded tissue. The detailed nature of apoptosis in colorectal cancer is unclear, especially in regard to the MSI status and the clinicopathologic factors. The purpose of this study was to elucidate the apoptosis assessed by M30 immunoreactivity in colorectal cancer and its relationship with the MSI status and the various clinicopathologic factors of colorectal cancers. METHODS: 101 colorectal cancers were classified according to levels of MSI as 12 MSI-H, 4 MSI-L and 85 MSS. Apoptosis was quantified by immunohistochemistry with using M30 CytoDEATH anti-body. RESULTS: The apoptotic index assessed by M30 was significantly increased in the MSI-H and MSI-L colorectal cancer compared to that in the MSS colorectal cancer. Right sided colon cancer showed a significant higher apoptotic index than did the left sided colon cancer. There was also a tendency for decreased apoptosis in metastatic colorectal cancers (Duke's stage D). There was somewhat of an increase of apoptosis in colorectal cancers with mucinous carcinoma and medullary carcinoma, and also in the colorectal cancers with an increased TIL count, but this was not statistically significant. CONCLUSION: M30 immunoreactivity is a valuable method to detect apoptosis in formalin-fixed, paraffin-embedded tissue and it might explain that MSI-H colorectal cancer shows better clinical behavior than MSS colorectal cancer in regard to the increased apoptosis.

CT and MR Findings of Ovarian Fibroma

PURPOSE: To evaluate the charateristic CT and MR findings of primary ovarian fibromas. MATERIALS AND METHODS: We retrospectively reviewed 11 cases which had undergone precontrast and postcontrast scanning, and two in which cases T1-weighted (WI) and postcontrast T1WI and T2WI images had been done. All cases were pathologically confirmed after surgical resection. These masses were analysed on the basis of clinical symptom, age, size (longest diameter), laterality, margin, attenuation (unenhanced and enhanced), signal intensity (SI), calcification, and amount of the ascites. RESULTS: The patients' mean age was 46.6 (range, 22-81) years, and the longest diameter was 14.8 (range, 8-28)cm. All tumors were unilateral, and eight were located in the left ovary and five in the right ovary. In all cases, the tumor margin was well-defined; seven were lobulated, four were oval, one was round, and one was nodularly marginated. On CT scan, the masses showed mildl to moderate heterogenous enhancement with irregular lower density portions. The amount of the ascites was marked in three cases (23%) mild in two (15%), and minimal in three cases. Calcifications were seen in 3 of 11 CT cases (27%), and in one, this was extensive. On MR scans, signal intensity (SI) of the masses on T1WI was isoSI, relativetive to the uterine myometrium, and heterogeneously enhanced after infusion of contrast media. On T2WI, SI was slightly lower that of the uterine myometrium with internal high SI portions. CONCLUSION: The characteristic finding of ovarian fibroma is a unilateral, well-defined, oval or lobulated, solid mass with or without ascites and calcification. On CT scan, tumor has mild to moderate heterogeneous enhancement. On MR scan, SI of mass is isoSI on T1WI with heterogeneous enhancement, and low SI on T2WI due to fibrous component.

A case of renomedullary interstitial cell tumor(so-called renal medullary fibroma) / 대한비뇨기과학회지

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.

HCG therapy for extracanalicularly located testis / 대한비뇨기과학회지

Reported results of HCG treatment for cryptorchism are quite variable because many factors may influence the success of the therapy. It is possible that the anatomic stratification introduces an element of selection bias into the data. 12 cases of extracanalicularly located testis were treated with HCG from December 1988 year to June 1990 year. Five of the 12 cases were cosmetically satisfactory. 3 became retractile testis which is disturbing in all that could be treated successfully but could not be satisfactory from the cosmetic point of view. Apparent hernial sac developed in 4 cases who were clinically inapparent before initiation of the hormonal therapy.

A Case of Cushing's Syndrome / 대한비뇨기과학회지

Cushing's syndrome refers to a clinical pictures that develops in a patient who are exposed to excess quantities of cortisol like substances. A case of Cushing's syndrome in 62-year-old man who was followed by a Nelson's syndrome after bilateral adrenalectomy is presented with brief review of literatures.