Kaohsiung Journal of Medical Sciences

Molecular markers associated with nonepithelial ovarian cancer in formalin-fixed, paraffin-embedded specimens by genome wide expression profiling

2012-04-09

Abstract: Nonepithelial ovarian cancer (NEOC) is a rare cancer that is often misdiagnosed as other malignant tumors. Research on this cancer using fresh tissues is nearly impossible because of its limited number of samples within a limited time provided. The study is to identify potential genes and their molecular pathways related to NEOC using formalin-fixed paraffin embedded samples. Total RNA was extracted from eight archived NEOCs and seven normal ovaries. The RNA samples with RNA integrity number >2.0, purity >1.7 and cycle count value <28 cycles were hybridized to the Illumina Whole-Genome DASL assay (cDNA-mediated annealing, selection, extension, and ligation). We analyzed the results using the GeneSpring GX11.0 and FlexArray software to determine the differentially expressed genes. Microarray results were validated using an immunohistochemistry method. Statistical analysis identified 804 differentially expressed genes with 443 and 361 genes as overexpressed and underexpressed in cancer, respectively. Consistent findings were documented for the overexpression of eukaryotic translation elongation factor 1 alpha 1, E2F transcription factor 2, and fibroblast growth factor receptor 3, except for the down-regulated gene, early growth response 1 (EGR1). The immunopositivity staining for EGR1 was found in the majority of cancer tissues. This finding suggested that the mRNA level of a transcript did not always match with the protein expression in tissues. The current gene profile can be the platform for further exploration of the molecular mechanism of NEOC.

The antinociceptive effect of acetaminophen in a rat model of neuropathic pain

2012-02-24

Abstract: Acetaminophen is one of the most popular and widely used analgesics for the treatment of pain and fever but few studies have evaluated its effects on neuropathic pain. This study examined the effect of acetaminophen on thermal hyperalgesia, mechanical and cold allodynia in a rat model of neuropathic pain. Male Sprague-Dawley rats were prepared by tightly ligating the left L5 and L6 spinal nerves to produce a model of neuropathic pain. Sixty neuropathic rats were assigned randomly into six groups. Normal saline and acetaminophen (25, 50, 100, 200 and 300 mg/kg) were administered intraperitoneally to these individual groups. Thermal hyperalgesia, mechanical and cold allodynia were examined at preadministration and at 15, 30, 60, 90, 120, 180, 240 and 360 min after administering the drug. Mechanical allodynia was quantified by measuring the paw withdrawal threshold to stimuli with von Frey filaments. Cold allodynia was quantified by measuring the frequency of foot lift after applying 100% acetone. Thermal hyperalgesia was quantified by measuring the thermal withdrawal threshold. The rotarod performance was measured to detect any drug-induced adverse effects, such as drowsiness. The hepatic and renal adverse effect was also assessed by measuring the serum levels of aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine. The paw withdrawal thresholds to mechanical stimuli and the thermal withdrawal threshold were increased significantly and withdrawal frequencies to cold stimuli were reduced by acetaminophen administration in a dose-dependent manner. Acetaminophen reduces thermal hyperalgesia, mechanical and cold allodynia in a rat model of neuropathic pain, and might be useful for managing neuropathic pain.

Clinical study of ammonium acid urate urolithiasis

2012-02-24

Abstract: Ammonium acid urate (AAU) urolithiasis is a rare condition; however, it is endemic in some countries, with an especially high incidence in Asia. This study was conducted to investigate the special presentation of patients with AAU urolithiasis in Taiwan. Reports of 3457 stones were retrospectively reviewed from January 2005 to January 2010 and 25 patients with urinary stones (0.7%) containing AAU crystals were identified. The clinical and biochemical presentation of all stones were compared to evaluate the specific comorbidities of AAU stones. AAU stones were observed in 11 males (44%) and 14 females (56%) with a mean age of 60.60 ± 16.81 years and mean body mass index of 25.55 ± 3.73 kg/m2. AAU stones were frequently observed in the bladder (44%) and they were significantly larger (mean size 1.90 cm) than the non-AAU stones (mean size 1.22 cm). Other significant comorbidities of AAU stones included chronic kidney disease (CKD) (60%), urinary tract infections (UTIs) (52%), irritable bowel syndrome (IBS) (36%), and gout (28%). In addition, there were also three patients with coexisting urothelial carcinoma (12%) in the AAU-stone group. Patients with AAU urolithiasis were predominantly female, older in age, had increased bladder presentation, larger stones and a high percentage of coexisting CKD, UTIs, IBS, gout, and even urothelial carcinoma. Therefore, it is important for clinicians to evaluate and protect renal function in patients with AAU urolithiasis.

Carbon dioxide insufflation during withdrawal of the colonoscope improved postprocedure discomfort: A prospective, randomized, controlled trial

Wen-Hsin Hsu, Meng-Shun Sun, Hoi-Wan Lo, Ching-Yang Tsai, Yu-Jou Tsai — 2012-02-24

Abstract: In colonoscopy, the question of when and how to use carbon dioxide (CO2) insufflation remains uncertain. Inspection for the pathological changes during colonoscopy takes place during the withdrawal of the scope. This study aimed to determine whether CO2 insufflation only at the withdrawal of the colonoscope has an effect comparable to that of CO2 usage throughout the course of the procedure. Symptomatic patients were randomized in three groups: (1) patients given air insufflation (A; n = 33); (2) patients given CO2 insufflation only at the time of scope withdrawal (CW; n = 33); and (3) patients given the CO2 insufflation (C; n = 34) for the whole course of the colonoscopy. Patients were requested to answer questionnaires about their pain score during, at the end, and 1 h after the colonoscopy by using a pain numerical scale ranging from 0 to 10. The disparities of the pain score were noted at the end of the procedure and 1 h after the procedure (p = 0.026 and p < 0.001, respectively). We further analyzed the scores between two of the three groups. Both CW (vs. A; procedure end: p = 0.012, 1 h after: p = 0.001) and C (vs. A; procedure end: p = 0.072, 1 h after: p < 0.001) showed less postprocedure pain when compared with the group A. The pain score between CW and C were similar at each time segment (procedure end: p = 0.555, 1 h after: p = 0.491). CO2 insufflation merely at the withdrawal of the colonoscope improved postprocedural abdominal discomfort and the effect was not inferior to that of full course CO2 insufflation.

Thermal welding versus cold knife tonsillectomy: A prospective randomized study

Metin Yilmaz, Mehmet Duzlu, Tolgahan Catli, Selin Ustun, Alper Ceylan — 2011-09-12

Abstract: This is a prospective randomized study conducted in a group of children who underwent two methods of tonsillectomy: thermal welding or cold knife tonsillectomy. Parameters, such as postoperative pain scores, intraoperative blood loss, operation time, and postoperative bleeding rates, were analyzed to find out which technique is better. Ninety-one children (aged between 2 years and 13 years) with recurrent tonsillitis, obstructive sleep apnea syndrome, or both were included in the study. According to the type of tonsillectomy procedure, the patients were divided into two groups: cold knife and thermal welding procedure. The two groups were compared on the basis of postoperative pain scores, intraoperative blood loss, operation time, and postoperative bleeding. Fifty-seven patients underwent thermal welding tonsillectomy and 34 had cold knife tonsillectomy. The mean pain score in thermal welding group was significantly lower (p<0.001). There was no remarkable blood loss intraoperatively in the thermal welding procedure. The operation time was not significantly different between two groups. No postoperative bleeding was encountered in the thermal welding group. Compared with the cold knife technique, thermal welding was found to be a relatively new and safe technique for tonsillectomy as it results in significantly less postoperative pain and no remarkable blood loss.

Tongue support of complete dentures in the elderly

Yu-Fen Chen, Yi-Hsin Yang, Ji-Hua Lee, Jen-Hao Chen, Huey-Er Lee, Tsau-Mau Chou — 2012-03-05

Abstract: This study aimed to evaluate the tongue’s role in supporting maxillary denture retention (MDR), in providing additional stabilization for the mandibular denture, and the tongue’s relationship with the oral health-related well being in elderly complete denture patients. Four hundred elderly individuals, 263 males and 137 females, were enrolled in this study. All were older than 65 years, and wore complete dentures. Intraoral examinations were performed in accordance with the 10 criteria embedded in the Functional Assessment of Dentures (FAD). Participants also received personal interviews and completed the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The associations between MDR (tongue support) with the mean OHIP-14 sum scores and FAD categories were analyzed using the t test or analysis of variance (ANOVA). Combinations of MDR (tongue support), MDR (resistance to vertical pull), and mandibular denture stability (anterior–posterior movement) were also assessed with the remaining FAD criteria and OHIP-14 domain scores. Individuals with adequate MDR (tongue support) were significantly associated with denture articulation, denture occlusion, MDR (resistance to vertical pull), maxillary denture stability (pronounced rocking), and mandibular denture stability (anterior–posterior movement). When individuals with adequate MDR (tongue support) were analyzed in conjunction with adequate MDR (resistance to vertical pull) and adequate mandibular denture stability (anterior–posterior movement), significant associations were observed with the mean OHIP-14 sum score and three individual OHIP-14 domains: functional limitation, physical pain, and physical disability (p ＜ 0.05). The mean OHIP-14 sum score was lower among individuals with both adequate MDR (tongue support) and inadequate MDR (resistance to vertical pull) than among participants with both inadequate MDR (tongue support) and inadequate MDR (resistance to vertical pull). MDR (tongue support) demonstrated significant differences from denture occlusion, denture articulation, MDR (resistance to vertical pull), maxillary denture stability (pronounced rocking), and mandibular denture stability (anterior–posterior movement). MDR (tongue support), in conjunction with both adequate MDR (resistance to vertical pull) and adequate mandibular stability (anterior–posterior movement), were significantly associated with the individuals’ oral health-related well being.

Quality of life of methylphenidate treatment-responsive adolescents with attention-deficit/hyperactivity disorder

Pin-Chen Yang, For-Wey Lung, Shyh-Shin Chiou, Cheng-Fang Yen, Jong-Ling Fuh — 2012-02-24

Abstract: Quality of life (QOL) in methylphenidate treatment-responsive adolescents with attention deficit/hyperactivity disorder (ADHD) was assessed. Patients were 12- to 18-year-old adolescents with ADHD (total n = 45) who had been on methylphenidate treatment for at least 3 months and were clinically judged to be improved. The self-completed Taiwanese Quality of Life Questionnaire for Adolescents (TQOLQA) was used, and the resulting measures were compared between adolescents with ADHD and: (1) community adolescents (n = 2316); (2) treatment-responsive adolescents with a chronic medical condition (i.e., adolescents with leukemia in its first and complete continuous remission for at least 3 years after chemotherapy) (n = 39). Patients’ cognitive profile and their daily executive functioning were also obtained for analysis. The QOL of the treated adolescents with ADHD was reported to be worse than that of both the community healthy adolescents and the adolescent leukemia survivors in the self-reported TQOLQA domain of “psychological well-being”. Treated adolescents with ADHD still had impaired executive skills in natural, everyday environments, and the scores for daily executive abilities could predict the QOL measures. Factors besides pharmacotherapy should be explored to further improve the QOL of medication-treated adolescents with ADHD.

Surgical treatment of melorheostosis: Report of two cases

2012-02-27

Abstract: Melorheostosis is a rare disease that usually burdens the patient with painful disability or soft tissue compromise. The treatment is usually symptomatic and conservative. Patients with severe and complicated forms of the disease may require surgery. Involvement of the distal part of a limb usually carries more morbidity, such as tumefaction pain, cosmetic and psychosocial or functional problems that render conservative treatment unsatisfactory to patients. In our series, surgical debulking or decompression of the mass effect provided prompt symptom relief.

Metachronous brain and intramedullary spinal cord metastases from nonsmall-cell lung cancer: A case report

2012-02-24

Abstract: A 44-year-old man had a brain tumor secondary to lung adenocarcinoma and underwent craniectomy to remove the brain tumor. After postoperative whole-brain radiation therapy, he underwent pneumonectomy followed by chemotherapy, mediastinal radiotherapy, and target therapy for lung cancer. Thirty-six months after the initial brain surgery, he suffered from neck pain and right upper limb numbness that rapidly progressed to upper extremity weakness and paralysis in 2 months. Magnetic resonance imaging demonstrated an intramedullary spinal cord lesion at the C4 level. Laminectomy and gross intramedullary tumor removal were performed. The patient’s neurological function improved after the operation. Nevertheless, 4 months after the intramedullary tumor removal, he began to show multiple metastases. Unfortunately, the patient died from respiratory failure 8 months after diagnosis with intramedullary spinal cord metastasis. In this case, early diagnosis and aggressive surgical treatment combined with postoperative radiotherapy and chemotherapy might have provided this patient with a prolonged survival and better quality of life.

Contractile peripapillary staphyloma mimicking morning-glory disc anomaly

Yu-Hung Lai, Gölge Acaroglu, Hwei-Zu Wang, Hsin-Tien Hsu — 2012-03-01

Although peripapillary staphyloma and morning glory disc anomaly are rarely encountered, accurate differential diagnosis based on disc appearance is essential because of their similar presentations . However, few cases of contractile peripapillary staphyloma and contractile morning glory disc anomaly have been reported. This study describes a rare case of contractile peripapillary staphyloma that phasically mimicked a morning glory disc anomaly.

International Society for Stem Cell Research 2011, ninth annual meeting in Toronto (June 15–June 18, 2011)

Hsiang-Jung Hsiao, Shang-En Huang, Chia-Chen Ku, Kazunari K. Yokoyama — 2012-04-09

The International Society for Stem Cell Research ninth annual meeting in 2011 was held in Toronto, Canada. The meeting began within an earnest welcome by the president, Elaine Fuchs. The initial session was named “Past, Present, and Future” to showcase a historical perspective of stem cell research, and then presented information on how to implement stem cell based therapeutic strategies in humans. The marketing of stem cell therapies before their safety and efficacy have been demonstrated is an ongoing issue. Irving Weissman (Stanford University School of Medicine, USA) emphasized the importance of clear nomenclature in establishing the definition of any particular adult stem cell line. Single-cell clonality in conjunction with transplantation, as employed in the hematopoietic stem cell (HSC) field, he argued, is absolutely required for a rigorous definition of stem cells. He laid out a set of criteria that should be in place before marketing proceeds: (1) preclinical proof of principle; (2) verification of data in independent laboratories; (3) review by involvement of a medical ethics committee to protect the rights of human donors and their samples; and (4) approval by an official regulatory body such as the U.S. Food and Drug Administration (FDA).