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    Image: J. P. Rathmell.
  • Anesthesiology >
    Fig. 1. Electroencephalographic and network property differences between infants and adults. Spectrograms ( A ) and coherograms ( B ) of infants (less than 1 yr old) and adults (21 to 28 yr old) during the maintenance phase of general anesthesia with sevoflurane (reproduced from the work of Akeju et al . 9 , with permission from Elsevier).
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    Table 1. Comparison of Demographic and Tumor Staging Data between the Propofol and Sevoflurane Group
  • Anesthesiology >
    Table 2. Comparison of Intraoperative Drug and Volume Use between the Propofol and Sevoflurane Group
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    Fig. 1. Illustration of the patient selection and matching process. In both groups, extracellular vesicles were isolated from pre- and postoperative sera. Vesicular microRNA profiles were subsequently assessed by next generation sequencing (NGS). After stringent quality filtering, eight (propofol) and nine (sevoflurane) patients were included for in silico analyses and validation by real-time quantitative polymerase chain reaction (RT-qPCR).
  • Anesthesiology >
    Fig. 2. Characterization of extracellular vesicles. ( A ) Pre- and postoperative vesicles in the sevoflurane ( left ) and propofol ( right ) group were positive for the protein markers alix, syntenin, CD63, and CD81. Calnexin (CNX) was not detected, indicating the absence of contamination with cellular debris. ( B ) Nanoparticle tracking analysis revealed homogenous size distributions of vesicles from pre- and postoperative sera in both groups. ( C ) Postoperative particle concentrations were reduced in both groups, whereas preoperative baseline concentrations were not significantly different. Whiskers indicate 10th and 90th percentiles; line indicates modal diameter; and + indicates mean diameter.
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    Fig. 3. Characterization of sequencing libraries. ( A ) Individual library sizes for extracellular vesicles isolated from pre- and postoperative sera. No significant differences were detected between all time points and groups. ( B ) Mean relative mapping distributions for various classes of small RNA revealed a strong enrichment of microRNAs in circulating vesicles from all groups. Less than 0.2% of reads carried no adaptor or mapped to snRNA or snoRNA. rRNA, ribosomal RNA; Short, read less than or equal to 15 nt; snRNA, small nuclear RNA; snoRNA, small nucleolar RNA; tRNA, transfer RNA.
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    Fig. 4. Graphical demonstration of the shift in pre- and postoperative microRNA expression in circulating vesicles from patients in the propofol ( A ) or sevoflurane ( B ) group by Principal Component Analysis. When interpreting this finding, the small study sample in this proof-of-concept investigation, which limits the applicability of Principal Component Analysis to illustrative purposes, should be kept in mind.
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    Table 3. MicroRNAs Exclusively Regulated by Propofol or Sevoflurane
  • Anesthesiology >
    Fig. 5. Differential regulation of microRNAs by propofol and sevoflurane. ( A ) The majority of microRNAs significantly upregulated after tumor resection was shared in both anesthetic groups. Twenty and four microRNAs were exclusively upregulated by propofol and sevoflurane, respectively. ( B ) Postoperatively downregulated microRNAs displayed no overlap between groups. Sixteen (propofol) and one (sevoflurane) microRNAs had significantly lower expression levels after tumor resection.
  • Anesthesiology >
    Table 4. Validation of MicroRNAs Significantly Regulated in Patients Anesthetized Using Propofol or Sevoflurane by Real Time Quantitative Polymerase Chain Reaction
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    Table 5. Extracellular Vesicle-associated MicroRNAs Regulated by Propofol Anesthesia during Colorectal Cancer Resection and Their Possible Gene Targets
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    Table 6. Extracellular Vesicle-associated MicroRNAs Regulated by Sevoflurane Anesthesia during Colorectal Cancer Resection and Their Potential mRNA Targets