Quality-of-life measures in Taiwanese adults with symptomatic gallstone disease.

PURPOSE: The objective of this study was to investigate the association of quality-of-life status with baseline laboratory findings among Taiwanese adults having symptomatic gallstone disease. METHODS: A prospective quality-of-life survey was administered at a tertiary referral medical center among 102 consecutive adults with symptomatic gallstone disease. Patients underwent regular laboratory testing at admission and were evaluated using the 36-Item Short-Form Health Survey (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI). Correlation and regression models were used to investigate quality-of-life predictors. RESULTS: Compared with the general Taiwanese adult population, patients having symptomatic gallstone disease had significantly poorer performance on all eight SF-36 subscales (P < 0.001). Total GIQLI showed moderate to strong correlation with all eight SF-36 subscale scores (gamma = 0.29 ~ 0.62, P < 0.05). In multivariate analysis, serum levels of direct bilirubin (beta = -32.6, P = 0.001) and alkaline phosphatase (beta = -13.6, P = 0.032) were predictive of worse total GIQLI (adjusted R (2) = 0.183). CONCLUSIONS: Symptomatic gallstone disease may considerably affect patient quality of life in terms of general health status and gastrointestinal-specific measures. Before gallstone surgery, serum levels of direct bilirubin and alkaline phosphatase significantly correlated with quality-of-life measures and can be used to evaluate patient well-being at admission.

Equol Pretreatment Protection of SH-SY5Y Cells against Aß (25-35)-Induced Cytotoxicity and Cell-Cycle Reentry via Sustaining Estrogen Receptor Alpha Expression.

ß-amyloid formation in the brain is one of the characteristics of Alzheimer's disease. Exposure to this peptide may result in reentry into the cell cycle leading to cell death. The phytoestrogen equol has similar biological effects as estrogen without the side effects. This study investigated the possible mechanism of the neuron cell-protecting effect of equol during treatment with Aß. SH-SY5Y neuroblastoma cells were treated with either 1 µM S-equol or 10 nM 17ß-estradiol for 24 h prior to 1 µM Aß (25-35) exposure. After 24 h exposure to Aß (25-35), a significant reduction in cell survival and a reentry into the cell cycle process accompanied by increased levels of cyclin D1 were observed. The expressions of estrogen receptor alpha (ERα) and its coactivator, steroid receptor coactivator-1 (SRC-1), were also significantly downregulated by Aß (25-35) in parallel with activated extracellular signal-regulated kinase (ERK)1/2. However, pretreatment of cells with S-equol or 17ß-estradiol reversed these effects. Treatment with the ER antagonist, ICI-182,780 (1 µM), completely blocked the effects of S-equol and 17ß-estradiol on cell viability, ERα, and ERK1/2 after Aß (25-35) exposure. These data suggest that S-equol possesses a neuroprotective potential as it effectively antagonizes Aß (25-35)-induced cell cytotoxicity and prevents cell cycle reentry in SH-SY5Y cells. The mechanism underlying S-equol neuroprotection might involve ERα-mediated pathways.

Validation assessment of the Chinese (Taiwan) version of the Gastrointestinal Quality of Life Index for patients with symptomatic gallstone disease.

BACKGROUND: Symptomatic gallstone is one of the most common diseases in Taiwan. The aim of this study was to develop a Mandarin Chinese outcomes measure for the assessment on quality of life among gallstone patients. MATERIALS AND METHODS: The Gastrointestinal Quality of Life Index (GIQLI) is a valid, disease-specific measure for the evaluation of health status and treatment effectiveness for adults with chronic gastrointestinal condition. The GIQLI was translated into Mandarin Chinese using a parallel model. The Chinese (Taiwan) version of the GIQLI (CGIQLI) was administered to 102 patients with symptomatic gallstone disease in a prospective manner; the CGIQLI then was validated according to established criteria for reliability, validity, and longitudinal sensitivity. RESULTS: The CGIQLI demonstrates good test-retest reliability (r = 0.92, P = 0.001) and internal consistency (Cronbach's alpha = 0.92). The CGIQLI significantly correlates with the Mandarin Chinese (Taiwan) version of the generic 36-Item Short-Form Health Survey (SF-36). The standardized response mean for the CGIQLI total score is 0.96, indicating excellent sensitivity to clinical change in the study group. CONCLUSION: This validation study demonstrated that the performance characteristics of the CGIQLI are equivalent to the English version, the GIQLI. This study demonstrates that the CGIQLI is a valid tool to evaluate adults with chronic gastrointestinal problems among the Chinese-speaking population.

Involvement of Bcl-2 family, cytochrome c and caspase 3 in induction of apoptosis by beauvericin in human non-small cell lung cancer cells.

Beauvericin (BEA), a cyclic hexadepsipeptide from Codyceps cicadae, possesses anti-convulsion, anti-arrhythmia, sedation, and anti-tumor activities. It has been reported that BEA induces apoptosis in several cancer cell lines. However, the molecular mechanism underlying the BEA-induced apoptotic process is not yet clearly understood. In the present study, the intracellular signaling pathways of BEA-induced apoptosis in human non-small cell lung cancer (NSCLC) A549 cells were investigated using morphological analysis and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) technique. In this study, BEA-induced apoptosis in human NSCLC A549 cells demonstrated a BEA concentration- and treatment time-dependent manner. This BEA-induced apoptosis in human NSCLC A549 cells was also accompanied by the up-regulation of Bax, Bak, and p-Bad and down-regulation of p-Bcl-2, but no effect on the levels of Bcl-X(L) or Bad proteins. Moreover, the BEA treatment resulted in a significant reduction of mitochondrial membrane potential, increase in the release of mitochondrial cytochrome c (cyt c), and activation of caspase 3. Furthermore, treatment with caspase 3 inhibitor (z-DEVD-fmk) was capable to prevent the BEA-induced caspase 3 activity and cell death. These results clearly demonstrate that the induction of apoptosis by BEA involves multiple cellular/molecular pathways and strongly suggest that pro- and anti-apoptotic Bcl-2 family proteins, mitochondrial membrane potential, mitochondrial cyt c, and caspase 3, they all participate in BEA-induced apoptotic process in human NSCLC A549 cells.

Evaluation of biodegradable elastic scaffolds made of anionic polyurethane for cartilage tissue engineering.

Biodegradable polyurethane (PU) was synthesized by a water-based process. The process rendered homogenous PU nanoparticles (NPs). Spongy PU scaffolds in large dimensions were obtained by freeze-drying the PU NP dispersion. The spongy scaffolds were characterized in terms of the porous structure, wettability, mechanical properties, degradation behavior, and degradation products. The capacity as cartilage tissue engineering scaffolds was evaluated by growing chondrocytes and mesenchymal stem cells (MSCs) in the scaffolds. Scaffolds made from the PU dispersion had excellent hydrophilicity, porosity, and water absorption. Examination by micro-computed tomography confirmed that PU scaffolds had good pore interconnectivity. The degradation rate of the scaffolds in phosphate buffered saline was much faster than that in papain solution or in deionized water at 37°C. The biodegradable PU appeared to be degraded via the cleavage of ester linkage The intrinsic elastic property of PU and the gyroid-shape porous structure of the scaffolds may have accounted for the outstanding strain recovery (87%) and elongation behavior (257%) of the PU scaffolds, compared to conventional poly(d,l-lactide) (PLA) scaffolds. Chondrocytes were effectively seeded in PU scaffolds without pre-wetting. They grew better and secreted more glycosaminoglycan in PU scaffolds vs. PLA scaffolds. Human MSCs showed greater chondrogenic gene expression in PU scaffolds than in PLA scaffolds after induction. Based on the favorable hydrophilicity, elasticity, and regeneration capacities, the novel biodegradable PU scaffolds may be superior to the conventional biodegradable scaffolds in cartilage tissue engineering applications.

In vitro biocompatibility of magnetic thermo-responsive nanohydrogel particles of poly(N-isopropylacrylamide-co-acrylic acid) with Fe3O4 cores: effect of particle size and chemical composition.

Biocompatibility is a critical factor in the design and development of candidate materials for biomedical use. This paper reports on the in vitro biocompatibility of magnetic stimuli-sensitive nanohydrogel particles composed of magnetite cores in poly(N-isopropylacrylamide-co-acrylic acid) shells referred to Fe(3)O(4)/P(NIPAAm-co-AAc). The AAc concentration and polymerization time were varied to fabricate magnetic nanoparticles with various AAc levels (1.80-2.37%) and particle sizes (74-213 nm). The P(NIPAAm-co-AAc) shell exhibited thermo-sensitive properties and the Fe(3)O(4) core constituted 2.25-4.10% of the particles by weight. After a 2-day incubation of L929 cells with extract media that had been conditioned with various test samples, the cellular responses were monitored in terms of cell viability and growth. The Live/Dead assays showed that high levels of cellular viability (97.3-98.1%) were observed in all groups, indicating that none of the nanoparticles were cytotoxic. However, the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymetho-xyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assays demonstrated that the activity of mitochondrial dehydrogenase varied significantly in cultures exposed to different magnetic nanohydrogel particles. The murine fibroblasts exposed to the NIP-(AAc5.1-Fe)-2 sample, which contained the highest AAc content and largest particle sizes, were the least metabolically active. In contrast, the activity levels in the cultures treated with the low AAc content and small size particles (NIP-(AAc2.6-Fe)-1) were not significantly different from those in the control group. Our findings suggest that smaller magnetic stimuli-sensitive nanohydrogel particles with a lower AAc content may have little inhibitory impact on cell proliferation. Overall, the in vitro biocompatibilities of the nanoparticles depend on the chemical composition and size of the Fe(3)O(4)/P(NIPAAm-co-AAc) particles.

Changes in quality-of-life following laparoscopic cholecystectomy in adult patients with cholelithiasis.

BACKGROUND: The aim of this study was to evaluate changes in quality-of-life following laparoscopic cholecystectomy (LC) in adults with cholelithiasis. METHODS: Patients were evaluated with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI) preoperatively and 12 months after LC. Outcome predictors were analyzed using correlation and regression statistics. RESULTS: Ninety-nine patients were enrolled (male/female, 32:67, age 49.8 +/- 13.7 years old). At baseline, patients performed inferiorly to general population in all SF-36 general health dimensions (p < 0.0001). Postoperatively, the "role-physical", "role-emotional", and "bodily pain" dimensions of health significantly improved. There were significant improvements in GIQLI "total", "physical well-being", "mental well-being", "gastrointestinal digestion", and "defecation" subscales scores. Serum direct bilirubin level and drainage tube indwelling were significant predictors for quality-of-life improvement following LC. CONCLUSIONS: LC can greatly reduce gastrointestinal symptoms to improve quality-of-life for patients with cholelithiasis. Patients with severe baseline conditions may benefit from greater quality-of-life improvement following LC.

Induction of calcium influx from extracellular fluid by beauvericin in human leukemia cells.

Beauvericin, a cyclic hexadepsipeptide, is a mycotoxin that can induce cell death in human lymphoblastic leukemia CCRF-CEM cells. Our previous data have shown that beauvericin induces cell death in CCRF-CEM cells in a dose- and time-dependent manner, and that this beauvericin-induced cell death can be prevented by administration of intracellular calcium chelator-BAPTA. Therefore, the intracellular Ca2+ concentration ([Ca2+]i) may play an important role in beauvericin-induced cell death in CCRF-CEM cells. In this study, the effect of beauvericin on [Ca2+]i and the possible mechanism responsible for the changes of [Ca2+]i in CCRF-CEM cells were investigated. Beauvericin caused a rapid and sustained [Ca2+]i rise in a dose-dependent manner. Excess extracellular Ca2+ facilitated beauvericin-induced [Ca2+]i rise by adding 1 mM CaCl2 in the bathing medium. On the other hand, beauvericin-induced [Ca2+]i rise was prevented in Ca2+-free Tyrode's solution by 200 microM EGTA. In addition, beauvericin-induced [Ca2+]i rise was also attenuated by intracellular Ca2+ chelator-BAPTA/AM. It is worthy to note that neither the voltage-dependent Ca2+ channel blocker, nimodipine, nor depletion of intracellular Ca2+ with thapsigargin, an endoplasmic reticulum Ca2+ pump inhibitor, has any effect on beauvericin-induced [Ca2+]i rise. The data from present study indicate that beauvericin acts as a potent Ca2+ mobilizer by stimulating extracellular Ca2+ influx CCRF-CEM cells.