[shRNA-Mediated Suppression of γ-Synuclein Leading to Downregulation of p38/ERK/JNK Phosphorylation and Cell Cycle Arrest in Endometrial Cancer Cells].

In this study, we explored the effects of treating human endometrial cancer cells with γ-synuclein-specific short hairpin RNA (shRNA) and elucidated the associated mechanisms in vitro and in vivo through the p38, extracellular signal-regulated kinase (ERK), and c-Jun N-terminal kinase (JNK) signaling pathways. Cell proliferation and migration were assessed using CCK8, Transwell, and scratch wound healing assays. Flow cytometry and laser scanning confocal microscopy were used to detect cell cycle changes. Relative levels of phosphorylated and non-phosphorylated (p) p38, ERK1/2 and JNK1/2/3 were determined in vitro and in vivo using simple western blotting assays. Cell proliferation in the experimental group decreased significantly and cells transfected with shRNA showed reduced migration rates (P < 0.05). p-p38, p-ERK1/2, and p-JNK1/2/3 levels were downregulated in the experimental group in vitro and in vivo. Tumor volumes and weights in the experimental group were significantly lower (P < 0.05). Tumor formation time in the negative control group was significantly shorter (P < 0.05). Flow cytometry showed that the number of cells in the G1 and mitotic phases increased and that in the S phase decreased after SNCG silencing (P < 0.05). Confocal microscopy showed that the percentage of cells in the mitotic phase increased after SNCG gene silencing (P < 0.05). We conclude that shRNA-mediated suppression of γ-synuclein decreased the proliferation, migration, and tumorigenicity of endometrial cancer cells via downregulation of p38, ERK, and JNK phosphorylation. High SNCG expression is closely related to the growth cycle of endometrial cancer cells.

[Comparison of the short-term and long-term outcomes of laparoscopic surgery and open surgery for early-stage cervical cancer].

Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes. The short-term outcomes included surgical related outcomes and operative complications, and the long-term outcomes included quality of life (pelvic floor functions and sexual functions), survival and recurrence. Pelvic floor function and sexual function were assessed with the International Consultation on Incontinence Quesonnaire Female Lower Urinary tract(ICIQ-FLUTS) and the Female Sexual Function Inventory (FSFI), respectively. Survival rates were estimated by Kaplan-Meier analysis. The survival curves were compared with Log-rank test. Cox regression analysis was used to evaluaterisk factors for prognosis. Results: (1)The short-term outcomes : There were significant difference in operative time([(257±69) vs(238±56)min], estimated blood loss[(358±314) vs(707±431)ml], anus exhausting time[(2.5±0.9) vs (2.9±0.8)d], preserved days of catheter[(15±7) vs(18±9)d], and post-operative length of stay[(19±16) vs (30±21)d] between the laparoscopic surgery group and the opensurgery group(P<0.05). There was no significant difference in lymph nodes yielded[(21±9) vs (21±11)], left parametrial width[(2.5±0.8) vs (2.7±0.7)cm], right parametrial width [(2.6±0.3) vs (2.7±0.2)cm], vaginal cuff length[(2.4±0.7) vs (2.2±0.7)cm] between the laparoscopic surgery group and the opensurgery group(P>0.05). The intra-operative complications occurred in 8.1%(87/1 071)in the laparoscopic surgery group and in 10.7%(85/792)in the open surgery group(P>0.05). However, the complications of vascular injury in the laparoscopic surgery group[2.6%(28/1 071)]was lower than that in the open surgery group[7.7%(61/792), P<0.001]. The laparoscopic surgery exhibited lower post- operative complication rate [33.8%(362/1 071)vs 40.2%(318/792), P<0.05] and poorer wound healing rate [0.7%(7/1 071)vs 4.0%(32/792), P<0.05]. (2)The long-term outcomes(Hierarchical analysis): The overall incontinence in ICIQ-FLUTS questionnaire in nerve-sparing laparoscopic group [28.4%(67/236)] was lower than that in the open surgery group [35.9%(71/198), P=0.004] . However, There was no significant difference in degree of incontinence between the two groups(P>0.05). The overall sexual dysfunction in FSFI questionnaire after 12 months of postoperative in the nerve-sparing laparoscopic group [47.0%(111/236)]was lower than that in the open surgery group [58.6%(116/198), P=0.001], and the six different dimension scores in the laparoscopic surgery group were higher than that in the open surgery group (P<0.05). The recurrence rate was 3.5%(35/1 007)in the laparoscopicsurgery group and 4.7%(35/740)in the open surgery group(P>0.05). The 5-year OS was 94.0% for the laparoscopic surgery group and 90.2% for the open surgery group(P>0.05), and the 5-year DFS was 93.9% for the laparoscopic surgery group and 89.1% for the open surgery group(P>0.05). (3) Prognostic fators: In univariate analysis, tumor dimension, clinical stage, deep stromal invasion, LVSI, and retroperitoneal lymph node metastasis signficantly affected 5-year OS and 5-year DFS(P<0.05); In multivariate analyses, LVSI, deep stromal invasion and LN metastasis were independent prognostic factors(P<0.05). Conclusions: Laparoscopy can reduceestimated blood loss, accelerate postoperative recovery and improve the quality of life after surgery compared to laparotomy, and it ensures the same oncological results as open surgery. Laparoscopic approach is a safe and effective treatment for early-stage cervical cancer.

Abdominal wall mixed malignant germ cell tumor: a case report and review of literature.

Abdominal wall mass is not uncommon in clinic, but it is very rare that germ cell tumors (GCTs) arise in the abdominal wall. The authors review the case of a 34-year-old female with abdominal wall mixed malignant GCT composed of embryonal carcinoma and teratoma and combine the relative literature to explain why GCTs originate from anterior abdominal wall.

The clinical significance of CA19-9 in ovarian mature cystic teratoma.

OBJECTIVE: To evaluate the clinical significance of CA19-9 in patients with ovarian mature cystic teratoma (MCT). MATERIALS AND METHODS: A retrospective study was performed on 65 patients with pathologically-confirmed MCT and 80 patients with benign epithelial ovarian tumors. Serum tumor markers for all patients and tissue CA19-9 for MCTs were measured. The relationships between clinical characteris- tics of MCTs and CA19-9, as well as the correlation between serum and tissue level of CA19-9 in MCTs, were evaluated. RESULTS: The mean serum level of CA19-9 in MCTs was significantly higher than that in benign ovarian epithelial tumors (49.9 ± 73.4 IU/ml vs. 17.08 ± 24.8 IU/ml). CA19-9 was the only tumor marker with a mean serum level above the cut-off value and the elevation rate was 30.76% in MCTs. The positive tissue expression rate of CA19-9 in MCT patients were 50.9% and were higher than that of preoperative serum levels (50.9% vs. 32.7%). CONCLUSION: Serum CA19-9 has the highest positivity rate among other tumor markers in MCT. Elevated serum CA19-9 is not an uncommon finding MCT and could be used as a marker in the differential diagnosis of MCT in patients with pelvic mass.

Serum and tissue level of YKL-40 in endometrial cancer.

OBJECTIVE: Serum YKL-40 level is elevated in patients with several malignancies. This study was designed to assess the correlation between serum YKL-40 and the corresponding tissue expression in endometrial cancer (EC). MATERIALS AND METHODS: Preoperative serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA) from 41 patients with EC, 27 patients with uterine myoma, and 30 healthy women. YKL-40 protein expression in tissue was determined by immunohistochemistry for patients with EC and patients with uterine myoma. RESULTS: Median preoperative serum YKL-40 level was 157.2 microg/l (range 76.0 - 301.2) in EC compared with 86.6 microg/l (range 69.3 - 191.1) in uterine myoma, and 86.2 microg/l (range 52.1 - 201.1) in healthy women (p < 0.05). Of 41 patients with EC, 26 patients with elevated serum YKL-40 level statistically differed from the remaining 15 patients with normal serum YKL-40 level with respect to FIGO Stage, tumor grade, washing cytology, and serum CA125 (p < 0.05). In multivariate analysis, elevated serum YKL-40 significantly correlated with FIGO stage (p < 0.05) and tumor grade (p < 0.01). The percentage of positive YKL-40 tissue staining was higher in EC patients (34.1%, 14/41) than in uterine myoma patients (11.1%, 3/27) (p < 0.05) and was lower than that of elevated serum levels in EC (26/41, 63.4%) (p < 0.05). CONCLUSIONS: The elevated preoperative serum YKL-40 is related to stage and histologic grade of EC. The discordance between serum and tissue level of YKL-40 in EC indicates intrauterine tumor may not be the only source of serum YKL-40.

Effect of posture positions on the evaporative resistance and thermal insulation of clothing.

Evaporative resistance and thermal insulation of clothing are important parameters in the design and engineering of thermal environments and functional clothing. Past work on the measurement of evaporative resistance of clothing was, however, limited to the standing posture with or without body motion. Information on the evaporative resistance of clothing when the wearer is in a sedentary or supine posture and how it is related to that when the wearer is in a standing posture is lacking. This paper presents original data on the effect of postures on the evaporative resistance of clothing, thermal insulation and permeability index, based on the measurements under three postures, viz. standing, sedentary and supine, using the sweating fabric manikin-Walter. Regression models are also established to relate the evaporative resistance and thermal insulation of clothing under sedentary and supine postures to those under the standing posture. The study further shows that the apparent evaporated resistances of standing and sedentary postures measured in the non-isothermal condition are much lower than those in the isothermal condition. The apparent evaporative resistances measured using the mass loss method are generally lower than those measured using the heat loss method due to moisture absorption or condensation within clothing. STATEMENT OF RELEVANCE: The thermal insulation and evaporative resistance values of clothing ensembles under different postures are essential data for the ergonomics design of thermal environments (e.g. indoors or a vehicle's interior environment) and functional clothing. They are also necessary for the prediction of thermal comfort or duration of exposure in different environmental conditions.

"Skin-like" fabric for personal moisture management.

Personal moisture management fabrics that facilitate sweat transport away from the skin are highly desirable for wearer's comfort and performance. Here, we demonstrate a "skin-like" directional liquid transport fabric, which enables continuous one-way liquid flow through spatially distributed channels acting like "sweating glands" yet repels external liquid contaminants. The water transmission rate can be 15 times greater than that of best commercial breathable fabrics. This exceptional property is achieved by creating gradient wettability channels across a predominantly superhydrophobic substrate. The flow directionality is explained by the Gibbs pinning criterion. The permeability, mechanical property, and abrasion resistance (up to 10,000 cycles) of the fabric were not affected by the treatment. In addition to functional clothing, this concept can be extended for developing materials for oil-water separation, wound dressing, geotechnical engineering, flexible microfluidics, and fuel cell membranes.

Characterizing the transplanar and in-plane water transport of textiles with gravimetric and image analysis technique: Spontaneous Uptake Water Transport Tester.

Water absorption and transport property of textiles is important since it affects wear comfort, efficiency of treatment and functionality of product. This paper introduces an accurate and reliable measurement tester, which is based on gravimetric and image analysis technique, for characterising the transplanar and in-plane wicking property of fabrics. The uniqueness of this instrument is that it is able to directly measure the water absorption amount in real-time, monitor the direction of water transport and estimate the amount of water left on skin when sweating. Throughout the experiment, water supply is continuous which simulates profuse sweating. Testing automation could even minimise variation caused by subjective manipulation, thus enhancing testing accuracy. This instrument is versatile in terms of the fabrics could be tested. A series of shirting fabrics made by different fabric structure and yarn were investigated and the results show that the proposed method has high sensitivity in differentiating fabrics with varying geometrical differences. Fabrics with known hydrophobicity were additionally tested to examine the sensitivity of the instrument. This instrument also demonstrates the flexibility to test on high performance moisture management fabrics and these fabrics were found to have excellent transplanar and in-plane wicking properties.

Characterizing the transplanar and in-plane water transport properties of fabrics under different sweat rate: Forced Flow Water Transport Tester.

The water absorption and transport properties of fabrics are critical to wear comfort, especially for sportswear and protective clothing. A new testing apparatus, namely Forced Flow Water Transport Tester (FFWTT), was developed for characterizing the transplanar and in-plane wicking properties of fabrics based on gravimetric and image analysis technique. The uniqueness of this instrument is that the rate of water supply is adjustable to simulate varying sweat rates with reference to the specific end-use conditions ranging from sitting, walking, running to other strenuous activities. This instrument is versatile in terms of the types of fabrics that can be tested. Twenty four types of fabrics with varying constructions and surface finishes were tested. The results showed that FFWTT was highly sensitive and reproducible in differentiating these fabrics and it suggests that water absorption and transport properties of fabrics are sweat rate-dependent. Additionally, two graphic methods were proposed to map the direction of liquid transport and its relation to skin wetness, which provides easy and direct comparison among different fabrics. Correlation analysis showed that FFWTT results have strong correlation with subjective wetness sensation, implying validity and usefulness of the instrument.

The relationships of age changes in retinal pigment epithelium and Bruch's membrane.

PURPOSE: To study the correlations between age, Bruch's membrane (BM) thickness, retinal pigment epithelial (RPE) autofluorescence, and RPE residual body content. METHODS: Eight-millimeter-diameter macular discs from 88 unpaired human eye bank eyes were obtained within 72 hours of death, fixed in 10% neutral buffered formalin, and hemisected horizontally. One portion of the macular disc was embedded in paraffin and stained with periodic acid-Schiff for the measurement of BM thickness. RPE autofluorescence measurements were performed on unstained, deparaffinized sections. A second portion of the macular disc was prepared for electron microscopy to evaluate RPE residual body content. Linear and polynomial regression techniques were used to investigate the correlations between age, BM thickness, RPE autofluorescence, and RPE residual body content. RESULTS: Bruch's membrane thickness increased with age according to the linear model. RPE autofluorescence and RPE residual body content also increased with age, but the correlations were best approximated by a quadratic model. The correlations between RPE autofluorescence and residual body content and between BM thickness and RPE autofluorescence were best approximated by a linear regression model. There was considerable variation in these correlations between specimens and within the same age group. CONCLUSIONS: Although the changes in RPE and Bruch's membrane increased with age and there was a direct correlation between changes in the two tissues, there was considerable variation within each age group and between specimens. This probably reflects the multifactorial nature of the process.

Clinical features and treatment of seven patients with carcinoid tumor metastatic to the eye and orbit.

PURPOSE: To understand better the clinical features, treatment, and outcome of patients with carcinoid tumors metastatic to the eye and orbit. METHODS: We studied seven patients with carcinoid tumors metastatic to the eye and orbit who were initially examined at the Mayo Clinic between 1974 and 1992. Carcinoid tumors metastasized to the choroid of six eyes of four patients and unilaterally to the orbit in three additional patients. RESULTS: Decreased vision was the most frequent initial symptom with choroidal metastases. Choroidal metastases were treated with brachytherapy only, with brachytherapy and chemotherapy, with external beam irradiation and chemotherapy, or with chemotherapy only. The duration of follow-up of these four patients ranged from seven to eight years after the diagnosis of choroidal metastases. Two of the four patients died from tumor complications 7 1/2 and seven years after the diagnosis of choroidal metastases. Proptosis and limitation of ocular motility were the most common initial signs with orbital metastases. Orbital metastases were treated with external beam irradiation and chemotherapy, with chemotherapy only, or with external beam irradiation only. Duration of follow-up of these three patients ranged from one-half to two years after the diagnosis of orbital metastases. All three patients died from tumor complications during the follow-up period. CONCLUSIONS: Because of the relatively good prospects for long-term survival in patients with carcinoid tumors metastatic to the choroid, early detection and treatment of the metastases are important.

Clinicopathologic correlation of a case of adenocarcinoma of the retinal pigment epithelium.

PURPOSE/METHODS: We observed a clinicopathologic correlation of a case of adenocarcinoma of the retinal pigment epithelium. RESULTS/CONCLUSIONS: The ultrasonographic findings of this tumor demonstrated a collar button profile with high internal reflectivity. The ultrasonographic characteristics in this case reflected the variable vascularity and cystic spaces within the tumor.

Donor cornea bacterial contamination.

The incidence of culture-positive cornea rims from 446 consecutive donor corneas cultured at the Doheny Eye Institute between 1986 and 1988 was determined. Both the identity and antibiotic sensitivities of the contaminating organisms were reviewed. Sixty-three (14.1%) of 446 cornea rims were culture-positive, but none of the 63 patients who received these contaminated donor corneas developed endophthalmitis. Streptococcus (26 of 63), Propionibacterium (15 of 63), Stphylococcus (14 of 63) species and diptheroids (8 of 63) were the most common cornea rim contaminants, and in most cases were resistant to gentamicin (i.e., 21 of 26 or 81%, 9 of 15 or 60%, 10 of 14 or 71%, 4 of 8 or 50%, respectively). Virtually all of the gentamicin-resistant bacteria isolated from cornea rims were found to be sensitive to vancomycin. Eye banks should consider the addition of other antibiotics to storage media to reduce donor cornea contamination. Surgeons performing corneal transplantation should also consider these results when selecting antibiotics for use at the time of surgery and in the postoperative period.

Long-term follow-up of the Allen implant. 1967 to 1991.

PURPOSE: The objectives of this study are to determine the incidence of superficial tissue breakdown and/or exposure of the Allen implant, to identify potential risk factors for superficial tissue breakdown and/or exposure of the Allen implant, and to provide a comparison for future studies of other orbital implants. METHODS: The authors retrospectively studied 186 consecutive patients managed with enucleation and Allen implant placement from January 1967 through December 1991. Information was obtained from a review of the patients' records and from telephone and letter surveys. RESULTS: More than half of the patients had follow-up more than 5 years and approximately one third had follow-up of 10 or more years. The mean length of follow-up was 7.8 years. Two allen implants (1.1%) became exposed 5.3 and 11.5 years, respectively, after initial implant placement and were subsequently replaced by dermis fat grafts. Superficial tissue breakdown without implant exposure occurred over four additional Allen implants (2.2%); the patients satisfactorily were treated medically or surgically without the need for removal or replacement of the Allen implant. Most prostheses have horizontal and vertical excursions of 30 degrees or more. CONCLUSION: The satisfactory motility, the low incidence of superficial tissue breakdown, and the even lower incidence of exposed Allen implants observed in our long-term follow-up study provide evidence that the Allen implant is a satisfactory choice to replace the enucleated eye. The absence of implant exposure occurring before 5 years of follow-up underscores the need for long-term follow-up to properly evaluate newer orbital implants.

Immunologic responses in experimental cytomegalovirus labyrinthitis.

To better understand the pathogenesis of cytomegalovirus labyrinthitis, a guinea pig model was created. Following inoculation at several sites (cardiac, perilymph, and endolymphatic sac) in both seronegative and seropositive animals, the immunologic, histologic, and electrophysiologic responses were measured. Seronegative animals uniformly showed progressive hearing loss with marked inflammation and degeneration of neural elements. In animals inoculated into the endolymphatic sac, an associated endolymphatic hydrops developed in addition to deafness. Seropositivity protected the hearing, but endolymphatic sac inoculations resulted in mild hydrops due to local inflammation that was devoid of evidence of viral replication. The question of whether hearing loss was attributable to local inflammatory responses rather than the cytopathic effects of the virus was then examined. To test this hypothesis, animals were immunosuppressed with cyclophosphamide prior to intracochlear inoculation of cytomegalovirus. The immunosuppressed animals showed significantly better hearing than the controls, and this correlated directly with the degree of cellular infiltration of the scala tympani. These studies confirm the importance of host immune responses in the pathogenesis of hearing loss due to cytomegalovirus.