Association between psoriasis and chronic obstructive pulmonary disease: a population-based study in Taiwan.

BACKGROUND: Psoriasis is regarded as a systemic inflammatory disease, having been linked in recent studies, to a wide range of systemic disorders. Previous studies have reported a positive correlation between psoriasis and chronic obstructive pulmonary disease (COPD); however, no studies have been conducted on an ethnic Chinese population. METHODS: We conducted a population-based study, using a representative cohort from the National Health Insurance database in Taiwan, between 2004 and 2006. The risk of COPD was compared between patients with psoriasis and a matched reference cohort. This study included 2096 psoriasis patients and 8384 randomly selected controls. RESULTS: After adjusting for sociodemographic characteristics and selected chronic diseases, the hazard ratio (HR) for COPD in psoriasis patients was 2.35 (95% confidence interval (CI): 1.42-3.89) compared with the control group in 18 months of follow-4 up. Men (HR = 2.38, 95% CI: 1.36-4.18) and patients with psoriasis over 50 years of age (HR = 2.19, 95% CI: 1.27-3.77) were more likely to contract COPD. CONCLUSIONS: We concluded that psoriasis patients were at a greater risk of developing COPD with significantly lower COPD-free survival rates than the comparison cohort (P < 0.001). Physicians should be aware of this potential risk to reduce comorbidity and mortality.

Expression profile of metastasis-related genes in invasive oral cancers.

We used suppression subtractive hybridization (SSH) and oligonucleotide microarray to differentiate expression profiles of metastasis-related genes and to evaluate their clinical significance in patients with invasive oral cancer (OCa). Overexpression of the specific genes was confirmed by reverse transcription-PCR (RT-PCR). Cells expressing the gene were identified by immunohistochemistry in pathology specimens. Clinical correlation and significance were analyzed statistically. Using these methods, we detected increased expressions of MMP-1, -3, -7, -9, -10 and interleukin (IL)-8 in invasive OCa. Moreover, our data showed that overexpressions of MMP-1, -3, -7, -10 and IL-8 were associated with reduced survival.

Expression of short-form oncostatin M receptor as a decoy receptor in lung adenocarcinomas.

Oncostatin M (OSM) is a member of the interleukin-6 (IL-6) family of cytokines, and binds to the OSM receptor (OSMR) to inhibit cancer growth. Four forms of OSMR have been identified: leukemia inhibitory factor receptor (LIFR), OSMR beta, short-form OSMR (OSMRs) and soluble OSMR (sOSMR). In this study, we examined the type and expression of OSMR in lung adenocarcinomas (LADCs). Expression of OSMR was determined by reverse transcription-polymerase chain reaction (RT-PCR), immunoblotting, immunohistochemistry and confocal immunofluorescent microscopy (CIM). Our results showed that, among the four forms of OSMR, OSMRs was mainly expressed in LADC, and expression level of OSMRs correlated with patient survival. CIM revealed that OSMRs was localized on the cell membrane of LADC cell lines in vitro. OSMRs acts as a decoy receptor by reducing the inhibitory effect of OSM on cell growth. Decrease in OSMRs expression by siRNA increased cell sensitivity to OSM, and ectopic expression of OSMRs reduced cell sensitivity to OSM. These results suggest that expression of OSMRs, which operates as a decoy receptor for OSM, is correlated with disease progression and adverse prognosis in patients with LADC.

Genetic algorithm for the efficient selection of disyllabic word lists used in Mandarin speech discrimination tests.

Speech audiometric tests have been widely used for advanced hearing diagnoses and in rehabilitation. However, there are no standardised speech tests for more than 90% of the world's population, who do not speak English. A major problem in the design of a speech audiometric test is that the selection of test materials is subject to multiple criteria, and its complexity rises dramatically as the structure of test items changes from phonemic or monosyllabic forms to disyllabic or polysyllabic forms. A genetic algorithm is presented that can automatically select a set of disyllabic words from a large Mandarin corpus. The selection accords with the following principal criteria for the items constituting a speech discrimination test: similarity in structure, familiarity to the subjects, and a phonemically balanced composition. The performance of the genetic algorithm was evaluated by computation of the distance between a target vector, specifying the desired distribution of initial and final syllables and tone patterns for daily disyllabic word usage, and the vector derived by the search results of the algorithm. The use of the genetic algorithm was illustrated by its application to the selection of test lists from two Mandarin corpora. The results showed that, for a given corpus, at least 12 disyllabic word lists with a distance of less than 20 could be generated within 72 h. The genetic algorithm performed an efficient, robust and low-complexity search of the problem space and can be easily modified to adapt to the material selection of other languages.

Water-soluble hexasulfobutyl [60] fullerene inhibits plasma lipid peroxidation by direct association with lipoproteins.

Free radicals can induce lipid peroxidation, leading to the formation of atherosclerosis. A new class of water-soluble C60 derivative, hexasulfobutyl [60] fullerene [C60-(CH2CH2CH2CH2SO3Na)6; (FC4S)], comprising six sulfobutyl functional groups covalently bound on a C60 cage, is a potent free radical scavenger. This study sought to define the effect of FC4S in protecting plasma from peroxidation. At concentrations of 10-100 microM, FC4S efficiently protected plasma against Cu2+-induced oxidation, as shown by maintenance of apoprotein B integrity and decrease in oxidative products levels, conjugated diene, and thiobarbituric acid-reactive substances. Addition of FC4S to both plasma and isolated lipoproteins, including very low density, low-density, and high-density lipoproteins, resulted in an increased mobility of the lipoprotein on agarose gel electrophoresis. This was attributed to FC4S associating with the lipoproteins because of the negative charge of the sulfonate groups after hydrolysis in the electrophoretic buffer. When lipoprotein was oxidized by 2,2-azobis (2,4-dimethyl-valeronitrile), which produces peroxyl radicals within lipoprotein, but not in the aqueous phase, the FC4S still efficiently inhibited lipoprotein oxidation. These data substantiate that FC4S acts efficiently in protecting plasma lipid from oxidation by associating with lipoprotein to scavenge free radicals in both the aqueous and lipophilic phases.

Lidocaine-induced CNS toxicity--a case report.

Lidocaine is the first local anesthetic of the amide type to be introduced to clinical practice. It is a versatile drug and in anesthesia, is the most commonly used local anesthetic because of its aptness of potency, rapid onset, moderate duration of action and topical activity. It is relatively safe and useful in many other clinical settings. Unfortunately, systemic intoxication and psychotic reaction associated with its use often occur because of its popularity and wider safety margin, for which guide in use is often ignored and overdose becomes commonplace. Moreover, due to its universality in use seldom reports have recently dealt with lidocaine, particularly regarding its toxic reaction. Here, we present a case of lidocaine intoxication occurring during circumcision for a reviewal of the problem. A healthy young male, weighing 65 kg, underwent circumcision for phimosis under penile block with 2% lidocaine which totaled 600 mg. Twenty minutes after injection the patient developed headache, tinnitus, visual and auditory disturbances. Muscle twitching over the mouth angles, trismus and rigidity of extremities were also noted. Later in the course he became restless, agitative, hallucinative, talkative, and verbose with repetitious words. The whole course of the disorder lasted about 5 h. It was believed that lidocaine-induced CNS intoxication, manifested by psychotic reaction broke out. Treatment with thiopental was not very impressive. Also, we took this opportunity to discuss and review the toxic reaction associated with the use of lidocaine, its risk factors, mechanism, treatment and prevention. The complicated associations of lidocaine-induced CNS toxic reaction with central control of behavior and the neurotransmitter systems (adrenergic, dopaminergic and serotonin) were also touched.

Neuromuscular interactions between succinylcholine and esmolol in the rat.

To study the neuromuscular interactions between succinylcholine (Sch) and esmolol, we determined the dose-response relationship of Sch and the neuromuscular actions of the 3xED90 dose of Sch, both prior to and following esmolol pretreatment. Twenty rats were anaesthetized with urethane. Train-of-four stimulation was applied every 12 s to the sciatic nerve, and the electromyogram (EMG) of the tibialis anterior muscle was measured. The results showed that the potency of Sch decreased with esmolol pretreatment. The ED50 of Sch increased significantly, from 191 ug/kg to 227 ug/kg after esmolol infusion, p < 0.05. The duration of EMG depression achieved by the 3xED90 dose of Sch decreased significantly with esmolol pretreatment (12 min vs 14 min p < 0.05), and also the onset time was significantly longer (43 sec vs 28 sec, p < 0.05). There were no significant difference between groups with regard to the maximal block or recovery index. The results of two methods of study demonstrated that the pharmacological interaction between Sch and esmolol is antagonistic instead of potentiating.

[Incidence of venous air embolism in parturients during cesarean section with regional anesthesia].

The purpose of the study is to probe the situation of venous air embolism (VAE) and the accompanying complications occurring in Chinese parturients in Taiwan during Cesarean section. Sixty ASA physical status class I-II parturients who were subjected to cesarean section under regional anesthesia were evaluated. The sensor of the Doppler device was placed on the anterior chest to detect the rumbles of air when it came to pass, and simultaneously the signs and symptoms following VAE were observed. Our results demonstrated that the usual or normal Doppler heart sound changed in 38 parturients out of 60 (63.3%), and the alteration occurred very often when the uterus was being incised (81.6%), or sutured (97.4%), and concurred strong correlation with such signs and symptoms such as chest tightness or precordial pain (78.9%), shortness of breath (60.5%), and change of heart rate or blood pressure (86.8%). The method of anesthesia (spinal or epidural block) did not have effect on the occurrence of VAE, but different surgical approaches and different positions in which the patients were posed during operation did apparently bring about VAE of variable degree. Besides, supplying of oxygen could mitigate the symptoms produced by VAE. Consequently, the application of Doppler monitor during Cesarean section can detect VAE earlier and more efficiently and thus provides information timely treatment.

In vitro analysis of extracellular matrix production by porcine glomerular mesangial and vascular smooth muscle cells.

Proliferation potential and extracellular matrix production were compared in cultured porcine glomerular mesangial cells and arterial and venous smooth muscle cells. Mesangial and arterial smooth muscle cells proliferated more rapidly than venous smooth muscle cells. In immunofluorescence studies, mesangial and arterial smooth muscle cells stained strongly for collagen types I, III, and V; venous smooth muscles showed weaker staining for collagens III and V. Total collagen synthesis in cultured mesangial and arterial smooth muscle cells was lower than in venous smooth muscle cells. Electrophoretic analysis showed type I collagen predominated in all cell types, although levels were highest in mesangial and arterial smooth muscle cells. Collagen V (alpha 3) occurred only in venous smooth muscle cells. Mesangial and arterial smooth muscle cells showed cellbound fibronectin and laminin, which also were secreted into the medium. Venous smooth muscle cells secreted fibronectin, but all laminin was cell bound. The findings suggest a strong similarity between mesangial and arterial smooth muscle cells.

Immunocytochemistry of intermediate filaments in cultured arterial smooth muscle cells: differences in desmin and vimentin expression related to cell of origin and/or plating time.

The objective of this study was to determine whether intermediate filament expression, including desmin and vimentin, in cultured smooth muscle cells (SMCs) is related to cyto-differentiation or proliferation. Using antibodies to desmin and vimentin, we studied by immunoperoxidase technique the distribution of these proteins in subcultured SMCs derived from porcine aorta and coronary artery. In addition, the proliferative potentiality of the cells was estimated by the incorporation of [3H]thymidine into DNA. The frequency of desmin-positive cells in coronary arterial SMCs of 3 and 6 population doubling levels was significantly higher as compared to findings with the aortic SMCs and depended on the plating time. No difference was evident at the 12 population doubling level. In contrast, vimentin was present in the majority of both aortic and coronary arterial SMCs. With regard to the localization of vimentin, two cell types were observed, one had reaction products to vimentin in both perinuclear and cell-peripheral areas (type-I cell), the other only in the cell-peripheral region (type-II cell). The relative proportion of the type-I and -II cells varied with the period of culture. Most of the SMCs showed the type-I cell on the first day and the number of type-II cells was increased on the sixth day. Quiescent SMCs in serum-free media had the same percentage of desmin-positive cells and frequency distribution of type-I and -II cells as did the proliferating SMCs incubated in media containing 5% serum. These results suggest that intermediate filament expression, including desmin and vimentin in cultured SMCs, is related to cell origin and/or plating time, but not to the proliferating activity, per se.

[Glomerular ultrastructures and prognosis of the patients with urinary abnormalities found by school screening program].

Detailed histopathological study were performed and compared with clinical features in 120 children with serial renal biopsies who were found by school screening program. 41 cases (34.2%) of IgA nephropathy (IgAN), 26 cases (21.7%) of thin membrane disease (TMD) and 22 cases (18.3%) of normal glomeruli [( Normal]) accounted for 74.2% of all biopsies. 81 cases (67.5%) were revealed to be minor glomerular abnormalities by light microscopy and which contained 26 cases (32.1%) of TMD, 22 cases (27.2%) of [Normal] and 19 cases (23.4%) of IgAN. The frequency and the severity of proteinuria was significantly higher in IgAN than in TMD and [Normal] (P less than 0.01, P less than 0.05). Hematuria was significantly greater in [Normal] than in IgAN. In the 71 follow-up cases, no patient went to renal insufficiency, moreover, urinary abnormalities had disappeared in 25.4% of the patients including IgAN, TMD, [Normal], nonIgA proliferative glomerulonephritis, incomplete foot process disease and MPGN. [Normal] consisted of stationary or exercised urinary abnormality.