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J Int Med Res 2010;38 (3) ContentsNon-thermal Cellular Effects of Low-power Microwave Radiation on the Lens and Lens Epithelial Cells Early Diagnosis of Oral Cancer Scientific Publications in Pharmacology and Pharmacy Journals from Chinese Authors in Various Parts of North Asia: a 10-year Survey of the Literature Impaired Mitochondrial Oxidative Phosphorylation in Multiple Insulin-sensitive Tissues of Humans with Type 2 Diabetes Mellitus Resistance Exercise Did Not Alter Intramuscular Adipose Tissue but Reduced Retinol-binding Protein-4 Concentration in Individuals with Type 2 Diabetes Mellitus Adiponectin Levels in Non-obese First-degree Relatives of Type 2 Diabetes Patients and Non-diabetic Subjects: a 5-Year Follow-up Study
Assessment of Transvaginal Sonography Combined with Endometrial Cytology as a Mass Screening Method for Endometrial Cancer in Beijing Mutations in the beta-Myosin Heavy Chain Gene in Southern Chinese Families with Hypertrophic Cardiomyopathy Intraperitoneal Ropivacaine for Effective Pain Relief after Laparoscopic Appendectomy: a Prospective, Randomized, Double-blind, Placebo-controlled Study Validity of Proxy Data Obtained by Different Psychological Autopsy Information Reconstruction Techniques Evaluation of the Antiobesity Effects of an Amino Acid Mixture and Conjugated Linoleic Acid on Exercising Healthy Overweight Humans: a Randomized, Double-blind, Placebo-controlled Trial Common Carotid Artery Intima-media Thickness is not Increased but Distensibility is Reduced in Normotensive Patients with Type 2 Diabetes compared with Control Subjects Variants in the Dihydropyrimidine Dehydrogenase, Methylenetetrahydrofolate Reductase and Thymidylate Synthase Genes Predict Early Toxicity of 5-Fluorouracil in Colorectal Cancer Patients Assessment of Serum Antioxidant Status in Patients with Silicosis Mini-subvastus versus a Standard Approach in Total Knee Arthroplasty: a Prospective, Randomized, Controlled Study Non-invasive Indices for the Estimation of the Anaerobic Threshold of Oarsmen Hand-assisted Laparoscopic Surgery versus the Open Approach in Curative Resection of Rectal Cancer Seminal Plasma Zinc Level May be Associated with the Effect of Cigarette Smoking on Sperm Parameters Experimental Study on Angiogenesis in a Rabbit VX2 Early Liver Tumour by Perfusion Computed Tomography The Beneficial Effect of n-3 Polyunsaturated Fatty Acids on Doxorubicin-induced Chronic Heart Failure in Rats Expression of the Genes Encoding Human Leucocyte Antigens-A, -B, -DP, -DQ and -G in Gastric Cancer Patients A Comparative Study of Transfection Efficiency between Liposomes, Immunoliposomes and Brain-specific Immunoliposomes Effects of Ulinastatin and Cyclophosphamide on the Growth of Xenograft Breast Cancer and Expression of CXC Chemokine Receptor 4 and Matrix Metalloproteinase-9 in Cancers Genetic Polymorphisms of Cytochrome P450 and Glutathione S-transferase Associated with Antituberculosis Drug-induced Hepatotoxicity in Chinese Tuberculosis Patients Differences in Mitochondrial Proteins in the Eutopic Endometrium of Patients with Adenomyosis and Endometriosis Identified Using Surface-enhanced Laser Desorption/Ionization Time-of-flight Mass Spectrometry Growth Suppression of Human Laryngeal Squamous Cell Carcinoma by Adenoviral-mediated Interleukin-12 Experimental Research on Wild-type p53 Plasmid Transfected into Retinoblastoma Cells and Tissues using an Ultrasound Microbubble Intensifier Decreased Chaperone Activity of alpha-Crystallins in Naphthalene-induced Cataract Possibly Results from C-terminal Truncation Effect of Gentamicin-absorbed Collagen in Wound Healing in Pilonidal Sinus Surgery: a Prospective Randomized Study Documentation of Post-operative Nausea and Vomiting in Routine Clinical Practice Expression of the Actin-binding Proteins Indicates that Cofilin and Fascin are Related to Breast Tumour Size CD8/MHC-I Complex is Specific but Not Sensitive for the Diagnosis of Polymyositis Changes in Femoral Head Blood Supply and Vascular Endothelial Growth Factor in Rabbits with Steroid-induced Osteonecrosis The Diagnostic Utility of Maspin in the Distinction between Malignant Mesothelioma and Pulmonary Adenocarcinoma Evaluation of the Correlation between Colour Power Doppler Flow Imaging and Vascular Endothelial Growth Factor in Breast Cancer
Neuroprotective Effect of Gypenosides against Oxidative Injury in the Substantia Nigra of a Mouse Model of Parkinson’s Disease Association of Vitamin D Binding Protein Variants with Susceptibility to Chronic Obstructive Pulmonary Disease Clonal Status and Clinicopathological Features of Langerhans Cell Histiocytosis The Influence of Complete Coronary Revascularization on Long-term Outcomes in Patients with Multivessel Coronary Heart Disease Undergoing Successful Percutaneous Coronary Intervention Lentivirus-mediated Gene Transfer of Small Interfering RNA Against the Chemokine Receptor CXCR3 Suppresses Cytokine Indicators of Acute Graft Rejection in a Rat Model Transjugular Intrahepatic Portosystemic Shunt versus Endoscopic Sclerotherapy in the Elective Treatment of Recurrent Variceal Bleeding Clinical Analysis of Elderly Patients with Elderly-onset Type 2 Diabetes Mellitus in China: Assessment of Appropriate Therapy Metabolic Syndrome: Prevalence and Risk Factors in Southern China Urodynamic Study of Bladder Function for Patients with Lumbar Spinal Stenosis Treated by Surgical Decompression Factors Associated with Multidrug-resistant Tuberculosis: Comparison of Patients Born Inside and Outside of the Czech Republic Malignant Atrophic Papulosis with Severe Gastrointestinal Perforation and Omental Necrosis: a Case Report CD20-positive T-cell Lymphoma with Indolent Clinical Behaviour Tumour Necrosis Factor-alpha Polymorphisms and Hepatocellular Carcinoma: a Meta-analysis Review ArticleJ Int Med Res 2010;38 (3):729-736Non-thermal Cellular Effects of Low-power Microwave Radiation on the Lens and Lens Epithelial Cells Because of the increased use of modern radiofrequency devices, public concern about the possible health effects of exposure to microwave radiation has arisen in many countries. It is well established that high-power microwave radiation can induce cataracts via its thermal effects. It remains unclear whether low-power microwave radiation, especially at levels below the current exposure limits, is cataractogenic. This review summarizes studies on the biological effects of low-power microwave radiation on lens and lens epithelial cells (LECs). It has been reported that exposure affects lens transparency, alters cell proliferation and apoptosis, inhibits gap junctional intercellular communication, and induces genetic instability and stress responses in LECs. These results raise the question of whether the ambient microwave environment can induce non-thermal effects in the lens and whether such effects have potential health consequences. Further in vivo studies on the effects on the lens of exposure to low-power microwave radiation are needed.
Early Diagnosis of Oral Cancer Survival rates for oral cancer are very poor, at approximately 50% overall, and have not improved markedly in recent decades despite advances in therapeutic interventions. Detecting oral cancer at an early stage is believed to be the most effective means of reducing rates of death, morbidity and disfigurement from this disease. Tobacco and alcohol consumption and pre-malign lesions are the most common aetiological factors. The proportion of patients presenting with oral cancer at an advanced stage is troubling. Early diagnosis is the most effective way of reducing the individual burden of the disease, decreasing morbidity and mortality and improving quality of life. For early diagnosis, healthcare providers should perform oral cancer examinations as part of their patient care regime, and need to be knowledgeable about early signs of oral carcinoma. Oral cancer awareness among the public should also be improved.
Scientific Publications in Pharmacology and Pharmacy Journals from Chinese Authors in Various Parts of North Asia: a 10-year Survey of the Literature The amount and quality of pharmacology and pharmacy research by authors from China was investigated by comparing published articles from 136 international journals (1998 – 2007) by authors from mainland China, Hong Kong and Taiwan. The number of articles, clinical trials, randomized controlled trials, case reports, impact factors, number of citations and number of articles published in top general medicine journals were compared. The total number of articles increased significantly between 1998 and 2007 (from 324 to 2536 per year). In total, there were 12 021 articles: 7576 from mainland China, 3267 from Taiwan and 1178 from Hong Kong. The accumulated impact factor of the articles from mainland China (16 688.94) was much higher than for those from Taiwan (8726.92) and Hong Kong (3161.22) but, among the three regions, Hong Kong had the highest mean impact factor and the most articles published in top general medicine journals.
Research ReportJ Int Med Res 2010;38 (3):769-781Impaired Mitochondrial Oxidative Phosphorylation in Multiple Insulin-sensitive Tissues of Humans with Type 2 Diabetes Mellitus Alteration of mitochondrial oxidative phosphorylation (OXPHOS) may contribute to insulin resistance. It is unclear, however, which characteristics are common to insulin-sensitive tissues. Using an oligonucleotide microarray and quantitative real-time polymerase chain reaction, the gene expression profiles of skeletal muscle, visceral adipose tissue and liver from autopsy donors with and without type 2 diabetes mellitus were determined. Common dysregulated genes were enriched in mitochondrial OXPHOS, and most of these genes were down-regulated in both the skeletal muscle and visceral adipose tissue of diabetic subjects, but up-regulated in diabetic liver. Messenger RNA (mRNA) for peroxisome proliferator-activated receptor-gamma co-activator 1alpha was significantly increased in diabetic liver but significantly reduced in diabetic skeletal muscle. Tumour necrosis factor-alpha mRNA was significantly down-regulated in diabetic visceral adipose tissue. The mitochondrial DNA content was slightly, though not significantly, reduced in diabetic liver and diabetic skeletal muscle. It is concluded that defects in OXPHOS genes and individual transcription co-factors in insulin-sensitive tissues may play an important role in the development of type 2 diabetes and the insulin-resistant state.
Resistance Exercise Did Not Alter Intramuscular Adipose Tissue but Reduced Retinol-binding Protein-4 Concentration in Individuals with Type 2 Diabetes Mellitus Lipid accumulation in muscle is associated with diminished insulin sensitivity. It was hypothesized that resistance exercise decreases muscular adipose tissue and reduces the level of retinol-binding protein-4 (RBP4), which is linked to adipose tissue and insulin sensitivity in diabetics. Forty-four women with type 2 diabetes were randomly assigned to three groups for a period of 12 weeks: control (asked to maintain a sedentary lifestyle); resistance exercise (elastic band exercise at moderate intensity five times per week); and aerobic exercise (walking for 60 min at moderate intensity five times per week). Subcutaneous (SCAT), subfascial (SFAT) and intramuscular (IMAT) adipose tissues at mid-thigh level were assessed using computed tomography, and RBP4 level and insulin sensitivity (fractional disappearance rate of insulin, kITT) were assessed before and after intervention. Changes in SCAT, SFAT, IMAT, RBP4 and kITT were similar among the three groups. Within-group analysis revealed that body mass index and waist circumference decreased significantly in both exercise groups, but RBP4 decreased significantly only with resistance exercise. Resistance exercise did not alter muscular adipose tissue or improve insulin sensitivity.
Adiponectin Levels in Non-obese First-degree Relatives of Type 2 Diabetes Patients and Non-diabetic Subjects: a 5-Year Follow-up Study
This study was designed to investigate adiponectin levels and their relationship to various parameters at baseline and after 5 years in non-obese first-degree relatives of type 2 diabetes patients (FDR group) versus subjects without a family history of diabetes (normal group). Adiponectin levels at baseline were lower in the FDR group versus the normal group. After 5 years, adiponectin levels had fallen significantly in both the FDR (24.3% reduction) and the normal (35.7% reduction) groups. Adiponectin levels were negatively correlated with waist/hip ratio, fasting plasma glucose, carotid intima-media thickness (IMT) and insulin resistance in the FDR group. When adjusted for relevant risk factors, adiponectin was associated with age, high-density lipoprotein-cholesterol and IMT; these factors explained 45% of the variation in adiponectin in the FDR group. In the normal group, multiple regression analyses revealed that low-density lipoprotein-cholesterol and IMT explained 25% of the variability in the adiponectin concentration. In both groups, however, the correlation between adiponectin and IMT just failed to reach statistical significance in this population group. We conclude that adiponectin levels were reduced in non-obese first-degree relatives of patients with type 2 diabetes and normal individuals over a 5-year period. This study supports previous findings that hypoadiponectinaemia is a risk factor for atherosclerosis.
Assessment of Transvaginal Sonography Combined with Endometrial Cytology as a Mass Screening Method for Endometrial Cancer in Beijing This was a two-phase, large sample-group study assessing the effectiveness of combined transvaginal sonography (TVS) and endometrial cytology in endometrial cancer screening. In phase one, 3308 women without known cancer were enrolled and TVS was performed on those with symptoms or endometrial cancer risk factors. Endometrial cytology was carried out on post-menopausal women with endometrial thickness of 5 mm or more and on pre-menopausal women with endometrial thickness of 10 mm or more. Dilation and curettage (D & C) was performed if cytological findings were inconclusive, or indicated cancer or pre-cancer. The mass screening safety interval is at least 2 years and phase two was carried out 2 years after phase one, using the same procedures, on the 3305 women who were originally found to be cancer free. Combined TVS and endometrial cytology resulted in 100% sensitivity and 99.0% specificity, reducing unnecessary D & C by 91.7% and screening costs by 20.1%. Combined TVS examination and endometrial cytology decreased potentially harmful examinations, patient suffering and medical costs, and is worth considering for broad implementation.
Mutations in the beta-Myosin Heavy Chain Gene in Southern Chinese Families with Hypertrophic Cardiomyopathy
Intraperitoneal Ropivacaine for Effective Pain Relief after Laparoscopic Appendectomy: a Prospective, Randomized, Double-blind, Placebo-controlled Study This prospective, randomized, double-blind, placebo-controlled study evaluated the effectiveness of intraperitoneal instillation of ropivacaine in the relief of pain in patients undergoing laparoscopic appendectomy. Patients in group C (placebo control group; n = 33) received normal saline and those in group I (instillation group; n = 30) received an instillation of 2 mg/kg ropivacaine at the initiation of the pneumoperitoneum. Visual analogue scale pain scores, fentanyl consumption and the frequency at which patients pushed the button (FPB) of a patient-controlled analgesia system during the post-operative period were significantly lower in group I compared with group C, and decreased gradually with time in both groups. The total amount of fentanyl consumed and the total FPB were significantly lower in group I compared with group C. Thus, intraperitoneal ropivacaine instillation reduced pain during the post-operative period after laparoscopic appendectomy. In addition, this drug was easy to administer and had no adverse effects at the dose used.
Validity of Proxy Data Obtained by Different Psychological Autopsy Information Reconstruction Techniques Two informants were interviewed for each of 416 living controls (individuals sampled from the normal population) interviewed in a Chinese case–control psychological autopsy study. The validity of proxy data, obtained using seven psychological autopsy information reconstruction techniques (types 1, 2 and A – E), was evaluated, with living controls’ self reports used as the gold-standard. Proxy data for reconstruction technique types 1, 2 and D on the Impulsivity Inventory Scale (total impulsivity score) were no different from the living controls’ self report gold standard, whereas data for types A and E were smaller than data from living controls. On the ‘acceptance or resignation’ sub-scale of the avoidance coping dimension of the Moos Coping Response Inventory, information obtained by reconstruction technique types 1 and D was not significantly different from the living controls’ self reports, whereas proxy data from types 2, A and E were smaller than those from the living controls. No statistically significant differences were identified for other proxy data obtained by reconstruction technique types 1, 2, A, D and E. These results indicate that using a second informant does not significantly enhance information reconstruction for the target.
Evaluation of the Antiobesity Effects of an Amino Acid Mixture and Conjugated Linoleic Acid on Exercising Healthy Overweight Humans: a Randomized, Double-blind, Placebo-controlled Trial This single-centre, randomized, double-blind, placebo-controlled trial investigated the effects of administering a mixture of four amino acids (lysine, proline, alanine and arginine) with or without conjugated linoleic acid to healthy overweight humans before and after exercising. Forty-one healthy subjects (body mass index at least 23 kg/m2 to less than 30 kg/m2) completed the study following randomization to receive either placebo or one of three test supplements: amino acid mixture 0.76 g/day; amino acid mixture 1.52 g/day; or amino acid mixture 1.52 g/day coadministered with conjugated linoleic acid 1.6 g/day. Each of the study treatments was administered 30 min before and immediately after a period of daily exercise, which was delivered by an exercise expert, for a period of 12 weeks. When compared with the placebo group, several indicators, such as waist and hip circumferences, were found to have significantly decreased in the test supplement groups compared with the placebo. These results suggest that ingestion of these supplements might enhance the fat-burning effects of exercise.
Common Carotid Artery Intima-media Thickness is not Increased but Distensibility is Reduced in Normotensive Patients with Type 2 Diabetes compared with Control Subjects This study evaluated carotid artery parameters in normotensive patients with type 2 diabetes compared with non-diabetic control subjects. Using a high-resolution B-mode ultrasound scanner, common carotid artery intima-media thickness (IMT) and carotid tree atheroma thickness were measured in 82 patients with type 2 diabetes and 41 controls. The distensibility of the common carotid artery was calculated using the Reneman equation. Distensibility was significantly decreased and atheroma thickness was significantly increased in the diabetes group. There was no significant difference in IMT between the two groups. Stepwise linear regression analysis revealed an association between common carotid artery distensibility and post-ischaemic dilatation of the brachial artery (a measure of endothelial function), body mass index and diabetes duration in patients with type 2 diabetes. In conclusion, common carotid artery IMT in normotensive patients with type 2 diabetes is comparable to that of control subjects, whereas atheroma thickness is higher and arterial stiffness more pronounced in those with type 2 diabetes, indicating the existence of atherosclerotic changes in normotensive type 2 diabetes patients.
Variants in the Dihydropyrimidine Dehydrogenase, Methylenetetrahydrofolate Reductase and Thymidylate Synthase Genes Predict Early Toxicity of 5-Fluorouracil in Colorectal Cancer Patients Adverse drug reactions to 5-fluorouracil (5-FU)-based chemotherapy have been reported to be due, in part, to genetic variants of the genes for the drug-related enzymes thymidylate synthase (TS; TYMS gene), methylenetetrahydrofolate reductase (MTHFR gene) and dihydropyrimidine dehydrogenase (DPD; DPYD gene). This study investigated whether selected genetic variants of the TYMS, MTHFR and DPYD genes predict 5-FU-related early toxicity. The prevalence of the genetic variants was determined in 122 colorectal cancer patients and in a reference population of 320 blood donors. Subgroup analysis of 68 of the colorectal cancer patients was carried out to determine the relationship between selected gene variants detected in peripheral mononuclear cells and tolerability during the first or second cycle of 5-FU based treatment. Toxicity was linked to the TYMS 2R/2R variant (relative risk [RR] 1.66; sensitivity 0.37; specificity 0.77) and to the MTHFR c1298 C/C genetic variant (RR 1.77; sensitivity 0.17; specificity 0.91). Patients with the genetic variant IVS14+1 G/A or c1896 C/T in the DPYD gene had a statistically significant increased risk of experiencing toxicity (RR 2 and 6, respectively), both having a high specificity (0.97 and 0.98, respectively) and low sensitivity (0.04 and 0.13, respectively). It is concluded that pre-treatment detection of genetic variants can help to predict early toxicity experienced by patients receiving 5-FU-based chemotherapy.
Assessment of Serum Antioxidant Status in Patients with Silicosis
Mini-subvastus versus a Standard Approach in Total Knee Arthroplasty: a Prospective, Randomized, Controlled Study This prospective randomized study compared the clinical and radiological results of primary total knee arthropasty (TKA) using a mini-subvastus approach (group I; n = 35) or a standard approach (group II; n = 33). A posterior-stabilized prosthesis was used in both groups by the same surgeon. Mean follow-up was 18 months (range 14 – 26 months). Patients in group I lost less blood and experienced less pain 1 day post-operatively. They achieved an active straight leg raise earlier and underwent less lateral retinacular releases. Functional outcome and the range of knee movements were significantly better in group I up to 9 months post-operatively, but there was no significant difference between the groups at 1 year post-operatively or at final follow-up. Reduced access and visibility in group I prolonged the operation time and resulted in five technical errors on radiographic evaluation. Based on these results, the authors currently only use the mini-subvastus approach for minimally invasive TKA in selected cases.
Non-invasive Indices for the Estimation of the Anaerobic Threshold of Oarsmen This study compared four common non-invasive indices with an invasive index for determining the anaerobic threshold (AT) in 22 adult male rowers using a Concept2 rowing ergometer. A criterion-standard progressive incremental test (invasive method) measured blood lactate concentrations to determine the 4 mmol/l threshold (La4-AT) and Dmax AT (Dm-AT). This was compared with three indices obtained by analysis of respiratory gases and one that was based on the heart rate (HR) deflection point (HRDP) all of which used the Conconi test (non-invasive methods). In the Conconi test, the HRDP was determined whilst continuously increasing the power output (PO) by 25 W/min and measuring respiratory gases and HR. The La4-AT and Dm-AT values differed slightly with respect to oxygen uptake, PO and HR however, AT values significantly correlated with each other and with the four non-invasive methods. In conclusion, the non-invasive indices were comparable with the invasive index and could, therefore, be used in the assessment of AT during rowing ergometer use. In this population of elite rowers, Conconi threshold (Con-AT), based on the measurement of HRDP tended to be the most adequate way of estimating AT for training regulation purposes.
Hand-assisted Laparoscopic Surgery versus the Open Approach in Curative Resection of Rectal Cancer This prospective, randomized study compared the outcomes of hand-assisted laparoscopic surgery (HALS) with open surgery for the resection of rectal cancer. The main outcome measures were procedure time, blood loss, post-operative pain, time to oral intake, return of bowel function, length of hospital stay, morbidity and functional recovery. Patients in each group were similar with regard to general status, procedure types and the histopathological features of tumours. Procedure times were significantly longer with HALS versus open surgery. Analgesic requirements, surgical blood loss, time to first passing flatus, time to first oral fluids and post-operative hospital stay length were all significantly shorter in the HALS group. At a median follow-up of 16.3 months, local recurrence of tumour was not observed in either group. In this study, the HALS approach for curative resection of rectal cancer was safe and effective and may offer several potential advantages to patients in their post-operative recovery.
Seminal Plasma Zinc Level May be Associated with the Effect of Cigarette Smoking on Sperm Parameters The aim of this study was to investigate the effect of cigarette smoking on seminal plasma zinc levels and sperm parameters, and to examine the role of seminal plasma zinc. Semen samples from 79 non-smokers and 68 smokers were obtained. There was a significant decrease in seminal plasma zinc in smokers and a clear correlation between seminal plasma zinc levels and the extent of smoking. Sperm parameters (concentration, motility and morphology) among smokers were significantly lower in comparison to non-smokers. These parameters were also significantly decreased among smokers with abnormal zinc levels, while there was no significant difference between non-smokers with normal zinc and non-smokers with abnormal zinc levels. As previous studies have shown that seminal plasma zinc is associated with a decrease of anti-oxidant defences, seminal plasma zinc could be a contributor to the effects of cigarette smoking on sperm parameters. In conclusion, cigarette smoking can affect sperm parameters and this study may help towards providing a mechanistic explanation.
Experimental Study on Angiogenesis in a Rabbit VX2 Early Liver Tumour by Perfusion Computed Tomography Ten rabbits implanted with VX2 liver tumours were investigated by perfusion computed tomography (PCT) imaging 1 week (early) and 2 weeks (late) after tumour induction; 10 other rabbits were non-implanted controls. Time–density curves, perfusion parametric maps and perfusion parameters were obtained for tumour rim and normal tissue surrounding the tumour, and for liver tissue from the controls. In addition, microvessel density (MVD) and vascular endothelial growth factor (VEGF) were studied by immunohistochemistry 2 weeks after tumour implantation. A deconvolution mathematical model was used to calculate hepatic blood flow (HBF), hepatic blood volume (HBV), mean transit time (MTT), capillary vessel surface permeability (PS) and hepatic arterial index (HAI). At the tumour rim on the early PCT scan, MTT was significantly lower whereas HBF, HBV, HAI and PS were significantly higher than in surrounding normal tissue. There were no significant changes in perfusion parameters on the late PCT scan compared with the early scan. Significant linear correlations of MVD and VEGF were found with HBF, PS and HAI, but not with HBV or MTT. It is concluded that PCT imaging is useful for the evaluation of tumour angiogenesis and for the early detection of liver tumours.
The Beneficial Effect of n-3 Polyunsaturated Fatty Acids on Doxorubicin-induced Chronic Heart Failure in Rats
Expression of the Genes Encoding Human Leucocyte Antigens-A, -B, -DP, -DQ and -G in Gastric Cancer Patients This study compared the expression of the genes encoding human leucocyte antigens (HLA)-A, -B, -DP, -DR and -G in peripheral blood mononuclear cells (PBMCs) in gastric cancer patients and healthy controls. Using reverse transcription–polymerase chain reaction, levels of classical HLA-A, -B, -DP and -DR and non-classical HLA-G mRNA were studied in 43 gastric cancer patients and 22 controls. In addition, the levels of HLA-A,B,C and –G antigens on the surface of PBMCs were measured in 30 gastric cancer patients and 15 controls using flow cytometry. The mean fluorescence intensity of HLA-A,B,C antigen in the gastric cancer group was significantly lower than in controls. The HLA-G antigen was mainly present on CD4+CD8– T-lymphocytes. The percentage of CD4+CD8– T-lymphocytes positive for HLA-G antigen was significantly lower in the gastric cancer group compared with the healthy controls. Levels of HLA-A, -B and -G mRNA in the gastric cancer group were significantly lower than in controls. The HLA-G mRNA levels were significantly lower in gastric cancer of histological grades III and IV than in grades I and II. These data may provide a novel diagnostic and research tool for gastric cancer.
A Comparative Study of Transfection Efficiency between Liposomes, Immunoliposomes and Brain-specific Immunoliposomes This study investigated the transfection ability and efficiency of liposomes and immunoliposomes for exogenous gene delivery into the brain via the venous system. Four groups of rats underwent tail vein injection with one of the following: liposomes encapsulating pCMV (human cytomegalovirus promoter)-LacZ plasmid 80 micrograms (low dose) or 300 micrograms (high dose); general immunoliposomes encapsulating 80 micrograms transferrin receptor antibodies (OX26)-pCMV-LacZ plasmid; or brain-specific immunoliposomes encapsulating 80 micrograms OX26-pGFAP (glial fibrillary acidic protein promoter)-LacZ plasmid. A control group received no injected agent. The LacZ mRNA levels (1 h post-injection) and beta-galactosidase activity (48 h post-injection) in the brain and peripheral organs were assayed using real-time reverse transcription–polymerase chain reaction and histochemical staining, respectively. Both immunoliposomes delivered exogenous DNA containing the LacZ gene into the brain after venous injection, resulting in extensive LacZ expression in the brain. Furthermore, the brain-specific OX26-pGFAP-LacZ immunoliposome decreased the non-specific expression of LacZ in peripheral organs without affecting transfection efficiency in the brain. Thus, brain-specific immunoliposomes are an efficient and brain-specific targeting vector.
Effects of Ulinastatin and Cyclophosphamide on the Growth of Xenograft Breast Cancer and Expression of CXC Chemokine Receptor 4 and Matrix Metalloproteinase-9 in Cancers The aim of this study was to evaluate the effects of ulinastatin (UTI) and cyclophosphamide (CTX) as monotherapies and as combination therapy on the growth of mouse xenograft breast tumours. MCF-7 breast cancer cells were xenografted into 48 nu/nu nude mice in order to construct a breast cancer xenograft nude mouse model; mice were then untreated (control), or treated with CTX 0.1 g/kg every other day, UTI once a day at 25 000 U (low), 50 000 U (medium) or 100 000 U (high), or CTX + UTI (low), CTX + UTI (medium) or CTX + UTI (high) (n = 6 mice/group). Compared with controls, mice in each drug-treated group had a significantly reduced tumour weight, and protein and mRNA levels of CXC chemokine receptor 4 and matrix metalloproteinase-9 in both the UTI (low, medium and high doses) and CTX groups were significantly reduced, while levels in the UTI (low, medium and high doses) + CTX combination groups were significantly reduced compared with the CTX group and the UTI (low, medium, high) groups. Thus, both UTI and CTX can significantly inhibit xenograft tumours, and the UTI + CTX combination exhibited an additive effect that was superior to both CTX and UTI monotherapy.
Genetic Polymorphisms of Cytochrome P450 and Glutathione S-transferase Associated with Antituberculosis Drug-induced Hepatotoxicity in Chinese Tuberculosis Patients This study was designed to investigate the association of genetic polymorphisms of cytochrome P450 subtype 2E1 (CYP2E1) and glutathione S-transferase mu 1 (GSTM1) with susceptibility to antituberculosis drug-induced hepatotoxicity (ADIH) in Chinese tuberculosis patients. All patients were treated with a combination of isoniazid, rifampicin, pyrazinamide and ethambutol. Genomic DNA from 104 patients with ADIH and 111 without ADIH was analysed for the frequency of CYP2E1 RsaI and GSTM1 RsaI genotypes by polymerase chain reaction and restriction fragment length polymorphism. The association of polymorphisms with susceptibility to ADIH was calculated using the chi-squared-test and logistic regression analysis. The CYP2E1 RsaI polymorphisms were significantly associated with ADIH and the c1/c1 genotype was an independent risk factor for ADIH. Compared with the GSTM1 RsaI present genotype, the GSTM1 RsaI null genotype tended to increase susceptibility to ADIH, but the association with ADIH was not significant. The results indicate that CYP2E1 RsaI genotype c1/c1 is a potential risk factor for ADIH in the Chinese population. The tendency of the GSTM1 RsaI null genotype to increase susceptibility to ADIH needs further study.
Differences in Mitochondrial Proteins in the Eutopic Endometrium of Patients with Adenomyosis and Endometriosis Identified Using Surface-enhanced Laser Desorption/Ionization Time-of-flight Mass Spectrometry Adenomyosis and endometriosis have a similar pathogenesis; indeed, adenomyosis has been considered by some as a variant of endometriosis (‘internal endometriosis’). This study aimed to detect differences in mitochondrial proteins in eutopic endometrial samples from women with adenomyosis (n = 13) and endometriosis (n = 24), and from control patients (n = 29) using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) protein chip technology. A total of 82 and 78 mitochondrial protein peaks were found in adenomyosis and endometriosis individuals, respectively. Of these, 14 were common to women with adenomyosis and women with endometriosis, although only one of these (mass-to-charge [m/z] ratio 3499) was significantly different between the adenomyosis and endometriosis groups. It is concluded that, compared with control patients, there are differences in the mitochondrial proteins isolated from the eutopic endometrium of patients with adenomyosis and those with endometriosis. Although the changes in mitochondrial proteins in eutopic endometrium from patients with adenomyosis and endometriosis were largely similar, significant differences were also detected. Further identification of these proteins and elucidation of the differences will help towards the differential diagnosis of adenomyosis and endometriosis and new therapeutic approaches.
Growth Suppression of Human Laryngeal Squamous Cell Carcinoma by Adenoviral-mediated Interleukin-12 This study explored the inhibitory role of the adenoviral-mediated-interleukin (IL)-12 (Ad.mIL-12) gene in the growth of laryngeal squamous cell carcinoma (LSCC). Human epithelial type 2 (Hep-2) cells were transfected with Ad.mIL-12, and IL-12 gene expression of the cells was evaluated. The proliferation and apoptosis of Hep-2 cells in vitro were detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and flow cytometry. Experimental tumours in mice were injected intratumourally with the same recombinant adenoviruses and inhibition of tumour growth observed. Apoptosis in Hep-2 xenotransplants was detected using TUNEL (terminal deoxynucleotidyl transferase dUTP nick-end labelling) assay and transmission electron microscopy. The expression of IL-12 in Ad.mIL-12 transfected Hep-2 cells was significantly increased. In vitro, Ad.mIL-12 decreased the viability of and increased apoptosis in Hep-2 cells. Increased apoptosis was also seen in vivo. The mean weight and volume of tumours in Ad.mIL-12 treated mice were significantly lower than in the control group. It is concluded that Ad.mIL-12 can suppress LSCC growth and induce apoptosis.
Experimental Research on Wild-type p53 Plasmid Transfected into Retinoblastoma Cells and Tissues using an Ultrasound Microbubble Intensifier
Decreased Chaperone Activity of alpha-Crystallins in Naphthalene-induced Cataract Possibly Results from C-terminal Truncation Naphthalene-induced cataract has been extensively used to test potential anticataract drugs. Because the morphology as well as the toxic manifestations of naphthalene-induced cataract are reported to be similar to that of age-related cataract, naphthalene cataractogenesis in rats has been used as a valuable animal model to study the aetiology of age-related cataract in humans. This study aimed to determine whether the molecular chaperone activity of the alpha-crystallins was altered in naphthalene-induced cataract, and to clarify the possible mechanism for these changes. The data showed that the chaperone activity of the alpha-crystallins decreased in naphthalene-induced cataract. By mass spectrometry, C-terminal truncation of 16 amino acids and other post-translational modifications such as acetylation, phosphorylation, oxidation and carbamylation of the alpha-crystallins were detected. Furthermore, the results suggested that, at the proteomics level, naphthalene-induced cataract is a valuable animal model for the study of age-related cataract in humans.
Research NoteJ Int Med Res 2010;38 (3):1029-1033Effect of Gentamicin-absorbed Collagen in Wound Healing in Pilonidal Sinus Surgery: a Prospective Randomized Study Pilonidal sinus is a common disease that causes the loss of many working hours, but treatment is variable and problematic. The effect of gentamicin-absorbed collagen on healing, infection and recurrence, and length of hospital stay were examined after pilonidal sinus surgery. Patients undergoing surgical treatment for pilonidal sinus were randomly assigned into two groups each of 40 patients. Both groups were treated with excision and primary closure under local anaesthesia. Group 1 (control) received oral antibiotics for 7 days post-operatively. In group 2, prior to wound closure, gentamicin-absorbed collagen sponges were placed on the sacral fascia and these patients did not receive oral post-operative antibiotic therapy. Patients in group 2 had a significantly shorter mean wound healing time, significantly lower infection and recurrence rates, and a significantly shorter hospital stay than those in group 1. It is concluded that implantation of a gentamicin-containing collagen sponge on the wound area in pilonidal sinus decreased the rates of infection and recurrence, and shortened the hospital stay.
Documentation of Post-operative Nausea and Vomiting in Routine Clinical Practice This study investigated the quality of documentation of post-operative nausea and vomiting (PONV) by comparing incidences collected by a research team with those reported routinely by nursing personnel. A total of 560 patients passing through an interdisciplinary recovery room were included in the study. The overall recorded incidence of PONV over 24 h was 30.7%, which was in agreement with the predicted value of 32%calculated using incidences from published randomized controlled trials. Out of the total number of 86 cases of PONV in the recovery room only 36 (42%) were detected by nursing staff. Similarly, out of the total number of 129 cases of PONV on the ward over 24 h, only 37 (29%) were recognized by nursing staff during routine care. In conclusion, PONV in routine clinical care is likely to be underreported. To use PONV as a valid quality measure, patients need to be actively asked about nausea and vomiting at frequent intervals in a standardized fashion. A considerable proportion of patients experience PONV after discharge from the recovery room, so the assessment of PONV should cover at least 24 h post-operatively
Expression of the Actin-binding Proteins Indicates that Cofilin and Fascin are Related to Breast Tumour Size This study was designed to investigate the expression of four actin-binding proteins, alpha-actinin-4, cofilin 1, fascin and elongation factor 1-alpha2 (eEF1A2), in samples of breast cancer from 112 patients with different stages of breast cancer (stages T0 – T1, T2 and T3) compared with normal control tissues (n = 33). Levels of eEF1A2 and alpha-actinin-4 mRNA appeared to be unrelated to tumour size, except for a significant down-regulation of alpha-actinin-4 mRNA in T3 cases. Significant up-regulation of cofilin 1 mRNA was associated with stages T0 – T1 and T2; up-regulation seen at stage T3 was not significant compared with control tissue. Fascin mRNA levels were significantly reduced at all three tumour stages (T0 – T1, T2 and T3) compared with control tissue. In conclusion, some components of the actin cytoskeletal system might hold significant potential as targets in future cancer therapies.
CD8/MHC-I Complex is Specific but Not Sensitive for the Diagnosis of Polymyositis This study aimed to investigate immunostaining patterns for major histocompatibility complex class I (MHC-I) in different types of myopathies and to assess the diagnostic value of CD8/MHC-I complex for definite polymyositis. The study included 20 cases of definite polymyositis, 20 cases of dermatomyositis and 10 cases of dystrophies with muscle inflammation (inflammatory muscular dystrophy). Immunohistochemical staining with MHC-I antibody demonstrated the presence of MHC-I along the sarcolemma of scattered or small groups of non-necrotic fibres in both polymyositis and inflammatory muscular dystrophy, whereas intense sarcolemmal immunostaining for MHC-I was diffusely present in almost all fibres in dermatomyositis. Double immunofluorescence labelling for CD8 and MHC-I detected the CD8/MHC-I complex in 20% of polymyositis cases with mononuclear cell infiltrates. No CD8/ MHC-I complex was found in the dermatomyositis or inflammatory muscular dystrophy cases. The results suggest that MHC-I detection alone cannot be used as a reliable diagnostic test to differentiate polymyositis from dystrophies with secondary muscle inflammation. The CD8/MHC-I complex, although showing high specificity, is neither a sensitive nor an easy-to-handle diagnostic test for polymyositis.
Changes in Femoral Head Blood Supply and Vascular Endothelial Growth Factor in Rabbits with Steroid-induced Osteonecrosis The molecular aetiology of steroid-induced osteonecrosis (ON) is unclear. The aim of this study was to investigate changes in the femoral head blood supply and vascular endothelial growth factor (VEGF) protein levels following steroid-induced ON of rabbit femoral heads in the early stage of the disease, and to investigate a possible mechanism for ON. Using a classic protocol, ON was induced in 30 male 28-week old New Zealand white rabbits. An additional 15 untreated rabbits served as controls. Change of blood supply in the proximal femur was assessed by dynamic magnetic resonance imaging and microangiography. The VEGF protein and mRNA levels were assessed by immunohistochemistry and quantitative real-time polymerase chain reaction, respectively. After 6 weeks, the results indicated that VEGF protein and mRNA levels were significantly lower and femoral head blood supply had also decreased significantly in ON+ rabbits compared with controls. The down-regulation of VEGF may play a critical role in the disease process of ON.
The Diagnostic Utility of Maspin in the Distinction between Malignant Mesothelioma and Pulmonary Adenocarcinoma Immunohistochemistry is frequently employed to differentiate between malignant mesothelioma (MM) and pulmonary adenocarcinoma (AC) infiltrating the pleura, but there is uncertainty as to which antibodies are most useful. The present study investigated the presence of the serine protease, maspin, in epithelioid MMs and evaluated the diagnostic utility of maspin for the differential diagnosis between epithelioid MM and pulmonary AC with pleural involvement. The results showed more frequent maspin immunostaining among AC cases compared with MM cases. Maspin positivity was significantly higher among AC cases with respect to both the extent and intensity of staining. A significant difference also existed between the two tumour types with respect to the overall maspin score. Despite these findings, the sensitivity and specificity of maspin positivity to detect AC were only 59% and 73%, respectively, indicating that detection of maspin is of no value for the differential diagnosis of AC and MM.
Evaluation of the Correlation between Colour Power Doppler Flow Imaging and Vascular Endothelial Growth Factor in Breast Cancer
This study was designed to evaluate the correlation between blood flow, using colour power Doppler flow imaging [CPDI], and protein levels of vascular endothelial growth factor (VEGF), as measured by optical density (OD), in breast tumours. Breast cancer patients were observed pre-operatively using CPDI and VEGF protein levels were quantified by immunohistochemistry, and the correlation between the two was studied. The relationship between tumour angiogenesis and axillary lymph node (LN) metastasis was also analysed. Blood-flow grade was higher in the LN+ group than in the LN– group; grade II – III blood flow was 88.9% in the LN+ group. The VEGF protein levels in the LN+ group were also higher than in the LN– group. A significant positive correlation was observed between blood-flow grade and OD value for VEGF protein. Breast tumour angiogenesis was closely correlated with axillary LN metastasis. Higher blood flow was related to elevated VEGF protein levels and an increased risk of axillary node metastasis. CPDI could, therefore, indirectly demonstrate tumour angiogenesis before surgery, enabling planning of treatment and assessment of the prognosis.
Neuroprotective Effect of Gypenosides against Oxidative Injury in the Substantia Nigra of a Mouse Model of Parkinson’s Disease Oxidative injury has been implicated in the aetiology of Parkinson’s disease (PD) and gypenosides (GP), which are saponins with various bioactivities, have shown antioxidative effects in vitro. The present study was designed to evaluate the effect of GP on a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of PD. Acute administration of MPTP led to decreased glutathione content and reduced superoxide dismutase activity in the substantia nigra of the mice, which resulted in oxidative stress, loss of nigral dopaminergic neurons and motor dysfunction. Co-treatment with GP attenuated all the injuries induced by MPTP in a dose-dependent manner. The neuroprotective effect of GP may be attributed to increased antioxidation, as manifested by significantly increased glutathione content and enhanced superoxide dismutase activity in the substantia nigra. These results strongly indicate the possible therapeutic potential of GP as an antioxidant in PD.
Association of Vitamin D Binding Protein Variants with Susceptibility to Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation and it is thought that neutrophils play a major role in the disease pathogenesis. Genetic polymorphism of the vitamin-D-binding protein (VDBP) gene is considered one of the candidates for variation in susceptibility to COPD. To evaluate the potential influences of VDBP gene polymorphisms on COPD, a case–control study was conducted in the Han population of north-east China. The VDBP polymorphic site was genotyped in 100 COPD patients and 100 controls. Genotypes were determined by polymerase chain reaction–restriction fragment length polymorphism. A significantly higher proportion of VDBP-1F homozygosity was found in COPD patients, while the frequency of VDBP-2 homozygosity was significantly lower in COPD patients, which seemed to suggest that VDBP-2 homozygocity provided a protective effect. These data suggest that the VDBP gene may be involved in COPD susceptibility in Chinese Han population.
Clonal Status and Clinicopathological Features of Langerhans Cell Histiocytosis Some studies have demonstrated that Langerhans cell histiocytosis (LCH) is a neoplastic hyperplasia of Langerhans cells, however some researchers consider that clonality should be assessed in more patients with LCH, both at disease presentation and during the disease course. Monoclonality is a major characteristic of most tumours, whereas normal tissue and reactive hyperplasia are polyclonal. To elucidate the nature of Langerhans cells further, the present study investigated the clinicopathological features and clonality of three cases of LCH in female patients using laser microdissection and a clonality assay, based on X-chromosomal inactivation mosaicism in somatic tissues and polymorphism of the androgen receptor gene. The results indicated that LCH was composed of Langerhans cells with a characteristic morphological appearance, eosinophils, giant cells, neutrophils and foamy cells. Immunohistochemically, the Langerhans cells were positive for CD1a, S-100 protein and vimentin. The clonality assay demonstrated that the Langerhans cells formed a monoclonal population, showing that LCH is neoplastic. We conclude that LCH is characterized by clonal proliferation, although additional studies with larger sample sizes are required to prove this conclusively.
Clinical ReportJ Int Med Res 2010;38 (3):1106-1112The Influence of Complete Coronary Revascularization on Long-term Outcomes in Patients with Multivessel Coronary Heart Disease Undergoing Successful Percutaneous Coronary Intervention The influence of complete revascularization (CR) compared with incomplete revascularization (ICR) on long-term outcomes was assessed in patients with multivessel coronary heart disease undergoing successful percutaneous coronary intervention (PCI). A retrospective analysis of the clinical data, lesion type and PCI data was carried out in 324 patients with multivessel coronary heart disease (CR group, 99 patients; ICR group, 225 patients). Major adverse cardiac events (MACE) were recorded at follow-up (mean ± SD follow-up interval, 18 ± 7.1 months). There were no significant differences in clinical characteristics between the two groups at follow-up, although the CR group showed a non-significant tendency to a higher incidence of non-fatal myocardial infarction, cardiac death, repeated revascularization and MACE compared with the ICR group. In conclusion, the long-term prognosis for ICR was not inferior to that for CR in patients with multivessel coronary heart disease undergoing successful PCI.
Lentivirus-mediated Gene Transfer of Small Interfering RNA Against the Chemokine Receptor CXCR3 Suppresses Cytokine Indicators of Acute Graft Rejection in a Rat Model Despite improvements in immunosuppressive therapy, acute rejection remains an important cause of morbidity and late graft loss in patients undergoing liver transplantation. Increasing evidence supports an important role for chemokines and their receptors in transplant immunology. An acute liver graft rejection model in rats was used to study the role of the chemokine receptor CXCR3 in acute transplant rejection after liver transplantation by lentivirus-mediated gene transfer of small interfering RNA (siRNA) against CXCR3. Using reverse transcription–polymerase chain reaction it was first shown that three lentivirus–CXCR3 siRNA vectors inhibited the in vitro expression of CXCR3 in activated T-cells bearing CXCR3. Then, it was shown that treatment of the animals with lentivirus–CXCR3 siRNA before liver transplantation reduced CXCR3 mRNA and protein, and protein levels of interleukin (IL)-2, IL-4, IL-6 and IL-10 and interferon-gamma measured as indices of acute graft rejection. Based on the results from this animal model, targeting chemokines by the use of siRNA may become a feasible option for therapy after transplantation.
Transjugular Intrahepatic Portosystemic Shunt versus Endoscopic Sclerotherapy in the Elective Treatment of Recurrent Variceal Bleeding The present study was designed to compare elective transjugular intrahepatic portosystemic shunts (TIPS) and endoscopic sclerotherapy (EST) in terms of their efficacy in preventing recurrent bleeding from gastro-oesophageal varices in patients with advanced liver cirrhosis and portal hypertension. Of 96 patients with at least three gastro-oesophageal variceal rebleeds, 50 were treated with elective TIPS and 46 with EST. Recurrent variceal bleeding was significantly more frequent in patients receiving EST treatment compared with those receiving TIPS (45.7% versus 6.3%, respectively). Cumulative 1- and 4-year survival in the TIPS group was 83.0% and 73.5%, respectively, compared with 69.8% and 39.8% in the EST group, respectively. The rate of portosystemic encephalopathy was 33.3% in the TIPS group and 37.0% in the EST group. Elective TIPS was more effective than EST in the prevention of gastro-oesophageal variceal rebleeding in cirrhotic patients, it improved survival and it was associated with a similar rate of portosystemic encephalopathy.
Clinical NoteJ Int Med Res 2010;38 (3):1134-1141Clinical Analysis of Elderly Patients with Elderly-onset Type 2 Diabetes Mellitus in China: Assessment of Appropriate Therapy Patients with elderly-onset diabetes have specific characteristics. This study was designed to investigate these characteristics and to evaluate methods for appropriate control of glycaemia and cardiovascular risk factors in elderly-onset diabetes patients. A total of 155 elderly patients with type 2 diabetes mellitus were divided into those diagnosed at 65 years of age or over (elderly-onset group, 75 patients) and those diagnosed at less than 60 years of age (usual-onset group, 80 patients). Differences in clinical variables, diabetic complications, diagnosed comorbidities and the use of medications were analysed. Mean glycosylated haemoglobin, fasting plasma glucose and fasting insulin levels were significantly lower in the elderly-onset group than in the usual-onset group. The usual-onset group showed significantly greater homeostasis model assessment insulin resistance than the elderly-onset group. Microvascular complications and insulin use were significantly more common in the usual-onset group. In conclusion, insulin resistance was less severe in elderly-onset diabetes than in usual-onset diabetes. As hyperglycaemia was relatively mild or moderate, oral hypoglycaemic agents might be effective for elderly-onset diabetes.
Metabolic Syndrome: Prevalence and Risk Factors in Southern China This was a cross-sectional study to investigate the epidemiology of metabolic syndrome and the distribution of interrelated metabolic abnormalities in different population groups in Guangdong, southern China. Individuals were recruited according to the percentage of different occupational populations in southern China. The study cohort included 1206 subjects, and the prevalence and distribution of the components of metabolic syndrome were assessed using the National Cholesterol Education Program Adult Treatment Panel III 2005 criteria. The unadjusted rate of metabolic syndrome was 26.7%, and the prevalences of hypertension and diabetes were 38.0% and 4.3% respectively. Hypertension, diabetes, metabolic syndrome, abdominal obesity, elevated blood glucose and elevated blood pressure decreased significantly with increasing levels of life stress and anxiety. The prevalence of hypertension and metabolic syndrome in southern China is very high, and early identification and treatment of at-risk individuals may help target intervention to improve future cardiovascular health.
Urodynamic Study of Bladder Function for Patients with Lumbar Spinal Stenosis Treated by Surgical Decompression Lumbar spinal stenosis usually leads to different degrees of nerve damage, presenting with back and leg pain, and/or neurogenic bladder symptoms. To determine whether lumbar decompression improved urological function, bladder dysfunction was evaluated in this retrospective study of 26 patients with lumbar spinal stenosis who had undergone lumbar decompression surgery. Urodynamic study procedures were performed pre-operatively and 6 months post-operatively. The Japanese Orthopaedic Association score rating system and Oswestry Disability Index were employed for clinical evaluation. Following surgery, post-voiding residual urine, maximum cystometric capacity and maximum flow rate improved significantly. There was no statistically significant improvement in voided volume, bladder compliance, maximum detrusor pressure or upper urinary tract damage. Urodynamic study was important in the diagnosis of neurogenic bladder dysfunction, prevention of renal deterioration and assessment of post-operative effects after surgical decompression for patients with lumbar spinal stenosis.
Factors Associated with Multidrug-resistant Tuberculosis: Comparison of Patients Born Inside and Outside of the Czech Republic
Case ReportJ Int Med Res 2010;38 (3):1164-1169Malignant Atrophic Papulosis with Severe Gastrointestinal Perforation and Omental Necrosis: a Case Report Malignant atrophic papulosis (MAP) is a rare disease with an extremely grim prognosis, death being due to gastrointestinal perforation and neurological disorders. We report a severe case of MAP in a 37-year old woman. The patient had three emergent laparotomies in 3 months for recurrent acute peritonitis due to omental thrombosis resulting in necrosis, multiple intestinal and mesenteric lesions, and severe gastrointestinal perforations. Multiple papular skin lesions were present for 1 year prior to surgery. Pathological findings revealed MAP. Surgical intervention was successful and the patient recovered smoothly but later died of malnutrition and septicaemia.
CD20-positive T-cell Lymphoma with Indolent Clinical Behaviour T-cell lymphomas that are positive for CD20 are very rare and most reported cases have demonstrated an aggressive clinical course. An unusual case of a 57-year old female who presented with recurrent enlarged lymph nodes for 12 years is reported. The lymph nodes from both 1995 and 2007 showed effacement of the lymph node architecture by a diffuse and dense infiltrate of small lymphoid cells. In terms of T- and B-cell markers, these small lymphoid cells were immunohistochemically positive for CD2, CD3, CD5, CD43, CD45RO and CD20, and were negative for PAX5, CD79a and cyclin D1. Molecular genetic analysis showed T-cell receptor-gamma chain gene rearrangement. Recognition of this type of CD20-positive T-cell lymphoma is important for ensuring a correct diagnosis so that the patient can be offered the most appropriate therapy. The indolent behaviour of the present case is unusual and awaits further clinical follow-up and laboratory investigation.
Meta-analysisJ Int Med Res 2010;38 (3):760-768Tumour Necrosis Factor-alpha Polymorphisms and Hepatocellular Carcinoma: a Meta-analysis The genetic basis of susceptibility to hepatocellular carcinoma (HCC) is poorly understood. To summarize the quantitative association between polymorphisms of the tumour necrosis factor-alpha (TNFA) gene and HCC, a meta-analysis of relevant studies was performed. Ten case–control studies involving 1421 HCC cases were identified from the Medline®, Embase® and Current Contents® databases. Combined results based on all studies showed that patients with HCC had a significantly lower frequency of the TNFA gene polymorphism –308GG than healthy controls. When stratifying for race, results were similar among Asians and Caucasians. When comparing with hepatitis B virus infection cases, no statistical association was found. This meta-analysis suggests that TNFA –308GG gene polymorphism is associated with a modest decrease in the risk of HCC.
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