Endovascular repair of spontaneous isolated dissection of the superior mesenteric artery.

AIM: To present our experience of the clinical management of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and analyse the clinical features, imaging findings, and treatment outcomes. MATERIALS AND METHODS: In this retrospective study, eight consecutive patients with symptomatic SIDSMA were treated in Chang Gung Memorial Hospital between April 2007 and April 2010; among these patients, six underwent endovascular stent placement. The clinical manifestations, imaging findings, endovascular stent placement outcome, and follow-up results of the patients were retrospectively analysed. RESULTS: Eight patients were diagnosed with SIDSMA by contrast-enhanced computer tomography. One patient died due to comorbidity before angiography. Six patients underwent percutaneous endovascular stent placement in the superior mesenteric artery (SMA): four patients with bare stents and two with stent grafts. Because it was not appropriate to perform stent implantation in the remaining patient, he received only conservative treatment. All seven patients had an uneventful recovery and the follow-up period was 16 month, ranging from 1 to 35 months. CONCLUSION: For patients with symptomatic SIDSMA, endovascular repair is a feasible treatment choice with a high success rate and good clinical outcome.

EZH2 promotes neoplastic transformation through VAV interaction-dependent extranuclear mechanisms.

Recently, we reported that the histone methyltransferase, EZH2, controls leukocyte migration through interaction with the cytoskeleton remodeling effector, VAV, and direct methylation of the cytoskeletal regulatory protein, Talin. However, it is unclear whether this extranuclear, epigenetic-independent function of EZH2 has a profound impact on the initiation of cellular transformation and metastasis. Here, we show that EZH2 increases Talin1 methylation and cleavage, thereby enhancing adhesion turnover and promoting accelerated tumorigenesis. This transforming capacity is abolished by targeted disruption of EZH2 interaction with VAV. Furthermore, our studies demonstrate that EZH2 in the cytoplasm is closely associated with cancer stem cell properties, and that overexpression of EZH2, a mutant EZH2 lacking its nuclear localization signal (EZH2ΔNLS), or a methyl-mimicking Talin1 mutant substantially promotes JAK2-dependent STAT3 activation and cellular transformation. Taken together, our results suggest a critical role for the VAV interaction-dependent, extranuclear action of EZH2 in neoplastic transformation.

The B-cell-specific Src-family kinase Blk is dispensable for B-cell development and activation.

The B-cell lymphocyte kinase (Blk) is a src-family protein tyrosine kinase specifically expressed in B-lineage cells of mice. The early onset of Blk expression during B-cell development in the bone marrow and the high expression levels of Blk in mature B cells suggest a possible important role of Blk in B-cell physiology. To study the in vivo function of Blk, mice homozygous for the targeted disruption of the blk gene were generated. In homozygous mutant mice, neither blk mRNA nor Blk protein is expressed. Despite the absence of Blk, the development, in vitro activation, and humoral immune responses of B cells to T-cell-dependent and -independent antigens are unaltered. These data are consistent with functional redundancy of Blk in B-cell development and immune responses.

Imaging findings in mandibular primitive neuroectodermal tumour: a report of a rare case and review of the literature.

Primitive neuroectodermal tumours (PNETs) are aggressive undifferentiated tumours that occur mainly in the central nervous system (CNS). Reviewing the literature, only six cases of primary PNET of the mandible have been reported. These rare tumours are usually overlooked in clinical practice. An 18-year-old woman who presented with dental caries and left cheek swelling was initially diagnosed with facial cellulitis, but the swelling persisted despite adequate intravenous antibiotic therapy. Subsequent ultrasound and MR examinations revealed a tumour originating from the left mandibular ramus. The ultrasonography-guided percutaneous core needle biopsy confirmed the diagnosis of peripheral PNET. The radiographic features of mandibular PNETs are similar to those of PNETs in other regions, except for haemorrhage, necrosis and calcification. In addition, this is the first reported case with sonographic and MR images of this rare tumour, and the first case that was diagnosed based on the ultrasonography-guided percutaneous core needle biopsy. Using these image characteristics, mandibular PNETs can be diagnosed more accurately.

Prevalence and related risk factors of betel quid chewing by adolescent students in southern Taiwan.

The prevalence and related risk factors of betel quid chewing among adolescent students were studied in a junior high school (group 1) and in a vocational school (group 2) in southern Taiwan. Group 1 consisted of 3548 participants (89.7% response rate) and group 2 of 1358 (97.6% response rate). The students were asked to complete a questionnaire anonymously. In the junior high school 1.9% of students including all grades (13-15 years old) and both sexes was found to be a current betel quid chewer and 14% was an ex-chewer, whereas 10.2% of vocational school students (16-18 years old) was a current chewer and 31% was an ex-chewer. The prevalence of betel chewing was significantly higher among boys than girls. A high proportion of chewers was also a smoker and alcohol drinker. A statistical analysis of sociodemographic factors showed that male students who smoked tobacco, consumed alcohol and were friends or classmates of students who were betel quid chewers, were the likeliest adolescents to chew betel quid.

Bartter syndrome and focal segmental glomerulosclerosis: a possible link between two diseases.

We describe a patient with signs and symptoms of classic Bartter syndrome. The patient tested negative for all known genetic abnormalities associated with this tubular disorder. Proteinuria was found within 1 year after the diagnosis of Bartter syndrome. A renal biopsy performed 6 months later, when her kidney function was normal, revealed focal segmental glomerulosclerosis (FSGS). We propose a link between stimulation of the renin-angiotensin system and sclerotic changes in the glomerulus. This lesion may explain previous reports of kidney failure in patients with Bartter syndrome.

[The prevalence of amphetamine use in adolescent students: self-reported and urine analysis].

The prevalence of amphetamine use was studied using an anonymous questionnaire given to 3548 adolescent students aged 12--15, with a response rate of 98.6%. This questionnaire was developed and evaluated by the authors. A complete set of data was collected on 3200 subjects, making up 90.2% of all students surveyed. Eighty-five (2.7%) students admitted that they had used amphetamines; that is, 64 of the 1,584 male (4.0%), and 21 of the 1,616 female (1.3%) respondents. The life-time prevalence odds ratio estimation was elevated in male (POR = 3.2, 95% CI 1.9--5.3), as compared to female students. The life-time prevalence rates increased with age only among male students (P trend = 0.01). Seven hundred and twenty four male students were randomly tested for the presence of amphetamines in their urine using thin layer chromatography and fluorescence polarization immunoassay. Of six students who tested positive, five asserted that they had not used amphetamines. The point prevalence rate of amphetamine use based on the urine tests was 0.9% among the 652 students who had completed questionnaires. This rate was higher than on self-reported use of amphetamines (rate difference 0.9%, 95% CI 0.2--1.6%). In this group, 27 (4.1%) admitted that they had used amphetamines. The estimated overall life-time prevalence rate was at least 4.9% (32/652), with 95% CI between 3.2% and 6.6%.

[Risk factors related to the use of amphetamines in adolescent students].

The prevalence of amphetamine abuse among school children was studied by asking 3548 adolescent students (aged 12-15, response rate 98.6%) to complete a questionnaire anonymously, which was developed and evaluated by the authors. A complete set of data was collected for 3200 (90.2%) students. Eighty-five (2.7%) of them who admitted that they had used amphetamines constituted the case group. Non-users with negative urine tests formed the control group. Six independent factors were found to be related to amphetamine use when the answers were analyzed by stepwise logistic regression. The prevalence odds ratio estimation was elevated in: males compared females, students who did not live with both parents compared to those who lived with both parents, students with amphetamine-user friends compared to those with no-user friends, smokers compared to non-smoker, betel nut chewers compared non-chewers, and in students with positive attitudes compared to those with negative attitudes. The average starting age for smoking was 12.5 +/- 0.1 years; later this was followed by alcohol abuse, chewing of betel-nuts, and use of amphetamines. The average age of starting to use amphetamines was 13.5 +/- 0.2 years; a common reason given for using amphetamines was curiosity (65.4%). Many students (54.2%) obtained the amphetamine from their friends and most of them (85.2%) used it six months before responding to the questionnaire.