Body mass index and 20 specific cancers: re-analyses of dose-response meta-analyses of observational studies.

Background: Objectives were to provide an overview and understand the strength of evidence and extent of potential biases and validity of claimed associations between body mass index (BMI) and risk of developing cancer. Methods: We carried out an umbrella review and comprehensively re-analyzed the data of dose-response meta-analyses on associations between BMI and risk of 20 specific cancers (bladder, brain, breast, colonic, rectal, endometrial, gallbladder, gastric, leukemia, liver, lung, melanoma, multiple myeloma, non-Hodgkins lymphoma, esophagus, ovarian, pancreatic, prostate, renal, thyroid) by adding big data or missed individual studies. Convincing evidence for an association was defined as a strong statistical significance in fixed-effects and random-effects meta-analyses at P < 0.001, 95% prediction interval (PI) excluded null, there was no large between-study heterogeneity and no small study effects. Suggestive evidence was defined as meeting the significance threshold for the random summary effects of P < 0.05, but 95% PI included the null. Weak evidence was defined as meeting the significance threshold for the random summary effects at a P < 0.05, but 95% PI included the null and there was large between-study heterogeneity or there were small study effects. Results: Convincing evidence for an association with BMI was detectable for six cancers (leukemia, multiple myeloma, pancreatic, endometrial, rectal, and renal cell carcinoma). Suggestive evidence was detectable for malignant melanoma, non-Hodgkins lymphoma, and esophageal adenocarcinoma. Weak evidence was detectable for brain and central nervous system tumors, breast, colon, gall bladder, lung, liver, ovarian, and thyroid cancer. No evidence was detectable for bladder, gastric, and prostate cancer. Conclusions: The association of increased BMI and cancer is heterogeneous across cancer types. Leukemia, multiple myeloma, pancreatic, endometrial, rectal, and renal cell carcinoma are convincingly associated with an increased BMI by dose-response meta-analyses.

The Hsp90 inhibitor 17-(allylamino)-17-demethoxygeldanamycin increases cisplatin antitumor activity by inducing p53-mediated apoptosis in head and neck cancer.

The tumor suppressor p53 is often inactivated in head and neck cancer (HNC) through TP53 mutations or overexpression of mouse double minute 2 or mouse double minute X. Restoration of p53 function by counteracting these p53 repressors is a promising strategy for cancer treatment. The present study assessed the ability of a heat shock protein 90 (Hsp90) inhibitor, 17-(Allylamino)-17-demethoxygeldanamycin (17AAG), to induce apoptosis in HNC by restoring p53 function. The effect of 17AAG, alone or in combination with Nutlin-3a or cisplatin, was assessed in HNC cells using growth and apoptosis, immunoblotting, quantitative reverse transcription-polymerase chain reaction, and preclinical tumor xenograft models. 17AAG activated and stabilized p53 in HNC cells bearing wild-type TP53 by disrupting the p53-MDMX interaction. 17AAG upregulated p21 and proapoptotic gene expression, and promoted apoptosis in a concentration-dependent manner. Growth inhibition by 17AAG was highest in tumor cells with MDMX overexpression. The apoptotic response was blocked by inhibition of p53 expression, demonstrating that the effect of 17AAG depended on p53 and MDMX. 17AAG synergized in vitro with Nutlin-3a and in vitro and in vivo with cisplatin to induce p53-mediated apoptosis. 17AAG effectively induced p53-mediated apoptosis in HNC cells through MDMX inhibition and increased the antitumor activity of cisplatin synergistically, suggesting a promising strategy for treating HNC.

Novel alternative splicing by exon skipping in KIT associated with whole-body roan in an intercrossed population of Landrace and Korean Native pigs.

The KIT locus has been suggested to be a strong candidate region linked with whole-body roan in the F(2) population produced by intercrosses between Landrace and Korean Native pigs. In this manuscript, we report the finding of a novel alternative splicing event in the porcine KIT gene that results in the skipping of exon 5 in the I(Rn) allele. KIT mRNAs that lack exon 5 were identified in the large intestine and skin, suggesting that the mechanism responsible for the skipping of exon 5 may be tissue specific. A U(26) repeat in intron 5 showed complete linkage (LOD = 11.8) with the roan phenotype and absolute association with the black phenotype of the Korean Native pig (KNP) population samples, inferring that the repeat pattern may alter the complementary base-pairing-mediated looping-out of introns 4 and 5, which may mediate the exon 5-skipping event. Although the sample size in our study was relatively small, we speculate that the R3 allele containing the U(26) repeat is a causative element for the roan phenotype via alternative control of the exon skipping in our roan pedigree.

[Results of repair of SLAP lesion]. / Refixation von SLAP-Läsionen.

The surgical repair of SLAP lesions has become increasingly more common as the techniques and instrumentation have improved. However, there are few studies examining the results of repair of SLAP lesions. The goals of this paper are to summarize the recommended treatment for SLAP lesions and to report upon the studies available to date which report the results of SLAP repair.

Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty.

Twenty-two patients with infected total hip arthroplasty were treated with 2-stage arthroplasty, using a cement spacer impregnated with a combination of 3 thermostable antibiotics (vancomycin, gentamicin, and cefotaxime). Initially, implants were removed, and a spacer was inserted. Six to 12 weeks later, the spacer was removed, and the patients underwent reconstruction using cementless components. The patients were followed for an average of 41 months. One patient had a recurrence of infection and was treated with resection arthroplasty. The remaining 21 patients (95%) had no evidence of infection at the final follow-up. We recommend using the combination of these 3 antibiotics in the cement spacer for 2-stage reconstruction in infected hip arthroplasty when the causative organism is not identified in the culture of preoperative aspiration.

A simple method for the purification of an antimicrobial peptide in recombinant Escherichia coli.

A magainin derivative, designated MSI-344, was produced in Escherichia coli as fusion protein, by utilizing a truncated amidophsphoribosyltransferase of E. coli as a fusion partner. Bacterial cells transformed with the gene encoding the fusion protein were grown to a high cell density and induced with isopropyl-1-thio-b-D-galatoside (IPTG) to initiate product expression. The fusion protein was accumulated into cytoplasmic inclusion body and recombinant MSI-344 was released from the fusion partner by hydroxylamine treatment. Following cleavage of the fusion protein with hydroxylamine, the released MSI-344 was purified to homogeneity by cationic exchange chromatography. The final purity was at least 95% by reversed-phase high performance liquid chromatography (RP-HPLC). Purified recombinant MSI-344 was found to be indistinguishable from the synthetic peptide determined by amino acid sequences and antimicrobial activity assay.

Iliacus hematoma and femoral nerve palsy after revision hip arthroplasty: a case report.

Femoral nerve palsy occurred in a 65-year-old man after he had undergone a revision total hip arthroplasty using cementless components. The magnetic resonance imaging scan showed a mass in the iliacus muscle. The mass showed increased signal intensity on T1-weighted and T2-weighted spin-echo images and contained linear septa and a nodule. The gadolinium-enhanced T1-weighted image showed a rim of significant enhancement in the nodule. The findings of magnetic resonance images were suggestive of iliacus hematoma and of liposarcoma. The patient underwent surgery, and the mass was identified as an iliacus hematoma. The femoral nerve was stretched by the hematoma. After removal of the hematoma, the nerve palsy was improved completely. Iliacus hematoma may occur after total hip arthroplasty, even without anticoagulant therapy. The hematoma might appear to be a liposarcoma on magnetic resonance imaging scans.

Er:YAG laser skin resurfacing using repetitive long-pulse exposure and cryogen spray cooling: I. Histological study.

BACKGROUND AND OBJECTIVE: To evaluate histologically the characteristics of repetitive Er:YAG laser exposure of skin in combination with cryogen spray cooling (CSC), and its potential as a method of laser skin resurfacing. STUDY DESIGN/MATERIALS AND METHODS: Rat skin was irradiated in vivo with sequences of 10 Er:YAG laser pulses (repetition rate 20 Hz, pulse duration 150 or 550 micros, single-pulse fluence 1.3-5.2 J/cm(2)). In some examples, CSC was applied to reduce epidermal injury. Histologic evaluation was performed 1 hour, 1 day, 5 days, and 4 weeks post-irradiation. RESULTS: A sequence of ten 550-micros pulses with fluences around 2 J/cm(2) resulted in acute dermal collagen coagulation to a depth of approximately 250 microm, without complete epidermal ablation. CSC improved epidermal preservation, but also diminished the coagulation depth. Four weeks after irradiation, neo-collagen formation was observed to depths in excess of 100 microm. CONCLUSIONS: Dermal collagen coagulation and neo-collagen formation to depths similar to those observed after CO(2) laser resurfacing can be achieved without complete ablation of the epidermis by rapidly stacking long Er:YAG laser pulses. Application of CSC does not offer significant epidermal protection for a given dermal coagulation depth.

Subcutaneous and musculoskeletal sparganosis: imaging characteristics and pathologic correlation.

OBJECTIVE: To document the imaging characteristics of subcutaneous and musculoskeletal sparganosis. DESIGN AND PATIENTS: Ten patients with musculoskeletal sparganosis were examined, with a variety of imaging modalities including MRI (n=6), ultrasonography (n=8), plain radiography (n=7) and CT (n=1). Pathologic correlation was carried out in all cases. RESULTS: Nine lesions involved soft tissues, of which seven were in the thigh, two in the trunk and one involved a vertebral body. The majority of the lesions in soft tissue were confined to the subcutaneous layer but two extended deep into underlying muscles. Sonography revealed low-echoic serpiginous tubular tracts (8/8), and an intraluminal echogenic structure (4/8). MRI revealed multiple serpiginous tubular tracts and peripheral rim enhancement. Two patients showed perilesional soft tissue edema. Pathologically, the lesion consisted of a larva surrounded by three layers of inflammation: an inner epithelioid granulomatous cell layer, middle chronic inflammatory cell layers, and an outer fibrous layer. CONCLUSION: The study suggests that if serpiginous tubular tracts are seen at imaging studies, musculoskeletal sparganosis should be included in the differential diagnosis.

Multiple brown tumors in parathyroid carcinoma mimicking metastatic bone disease.

An unusual case of multiple brown tumors due to parathyroid carcinoma is reported. The patient presented with lower leg pain. Plain radiographs demonstrated multiple lytic lesions of the lower legs and a Tc-99m MDP bone scan depicted multiple areas of increased uptake suggesting skeletal metastases. Tc-99m sestamibi tumor scintigraphy showed multiple sites of tumor uptake in bones and a large area of increased uptake with a cystic component in the right lower pole of the thyroid gland. An open biopsy from the right tibial lesion revealed a brown tumor. A large parathyroid carcinoma with a necrotic cyst was removed. After parathyroidectomy and right thyroid lobectomy, the patient became free of bone pain and serum PTH levels normalized. A 9-month follow-up Tc-99m MDP bone scan demonstrated less intense uptake in the pelvis, tibia, and fibulae. Nine-month follow-up tumor imaging with Tc-99m MIBI revealed disappearance of the preoperative uptake of multiple brown tumor.

Gastric metastasis of mammary signet ring cell carcinoma--a differential diagnosis with primary gastric signet ring cell carcinoma.

Metastasis of breast carcinoma to the stomach is relatively uncommon, although metastasis to other organs such as lung, bone, and lymph nodes is not rare. It may cause difficulty in differentiating from primary gastric carcinoma. We report a case of signet ring cell carcinoma of the breast with metastasis to the stomach with illustrations of histologic findings of both lesions. The results of immunohistochemical stainining with GCDFP-15 (gross cystic disease fluid protein-15), that can be used to differentiate primary gastric signet ring cell carcinoma and metastatic mammary signet ring cell carcinoma, are described.

Monoclonal antibodies against Helicobacter pylori cross-react with human tissue.

BACKGROUND: H. pylori is a causative agent of chronic gastritis. However, the pathogenic mechanism by which H. pylori induces chronic inflammation and epithelial injuries in the gastric and duodenal mucosa is not well known. Investigators have recently reported that some monoclonal antibodies against H. pylori cross-react with the gastric epithelial cells. So, there exists the possibility that the autoimmune mechanism may be involved in the pathogenesis of chronic gastritis caused by H. pylori. The purpose of his study is to investigate whether the antibodies against H. pylori react with human tissues or not, using a large panel of monoclonal antibodies. MATERIALS AND METHODS: Two hundred and fourteen monoclonal antibodies against H. pylori were produced. An immunohistochemical staining of human tissues, including H. pylori-infected gastric mucosa, was performed using the antibodies. RESULTS: Of 214 monoclonal antibodies, 71 antibodies reacted with H. pylori in the gastric mucosa. Of 71 antibodies, 25 antibodies also reacted with gastric epithelial cells, 11 antibodies reacted with ductal cells of the salivary gland, 11 antibodies reacted with renal tubular cells, and 8 antibodies reacted with duodenal epithelial cells. The antibodies which showed cross-reactivity with gastric epithelial cells included those against urease, flagella, lipopolysaccharide, and heat shock protein of H. pylori. CONCLUSIONS: It is believed that the autoimmune reaction might be involved in the pathogenesis of chronic gastritis due to H. pylori infection, and that the autoimmune reaction induced by H. pylori infection might also be involved in the pathogenesis of various diseases in other organs.

Two cases of pachydermodactyly.

We report two cases of pachydermodactyly. Case 1 was a 16-year-old girl who complained of asymptomatic, bulbous, firm swellings which developed insidiously on both sides of the proximal interphalangeal (PIP) joint of her right middle finger. Case 2 was a 14-year-old boy with similar lesions on the sides of the PIP joints of the index and middle fingers of both hands. They both had histories of mild, repetitive mechanical trauma of the fingers. Radiologic findings showed soft tissue swellings without any bony or articular abnormalities. Histopathologic findings from the bulbous swellings revealed marked hyperkeratosis, slight epidermal hyperplasia, and a markedly thickened dermis with a deposition of mucinous material among the collagen fibers. Ultrastructural examinations of both cases showed decreased diameters of collagen fibrils. The lesions temporarily improved with intralesional injection of triamcinolone acetonide. Pachydermodactyly is more commonly found in boys and the affected fingers are more numerous in boys. Both of the present cases had the habit of rubbing and gripping their fingers unconsciously. Mechanical trauma of the fingers around puberty may play an important role in pachydermodactyly.

Bilateral signet-ring cell carcinoma of the breast: scintigraphic findings.

Signet-ring cell carcinoma of the breast, first recognized in 1976, behaves aggressively and is associated with a poor prognosis. The tumor is a rare type of breast cancer and often metastasizes to the gastrointestinal tract and female genital tract. The authors report a case of a 48-year-old woman with bilateral signet-ring cell carcinoma of the breasts with multiple skeletal metastases and gastric metastasis. The breast cancer was depicted on a Tc-99m MIBI scintimammogram.

Partial mastectomy with axillary lymph node dissection and radiotherapy as a new treatment modality of breast cancer (I).

This is the first preliminary report among two consecutive papers. Partial mastectomy(PM), axillary lymph node dissection(AD) and radiotherapy (RT) were performed on seventeen operable breast cancer patients who had been admitted from April 1991 to March 1992 to the department of surgery, Yongdong Severance Hospital for improved cosmetic appearance and better survival rate. Of seventeen patients, 47% were T1 lesion and 76% were stage I and II. Extensive intraductal component(EIC) within or around the tumor was also analyzed. Twenty nine per cent of the patients were EIC positive. The mean number of axillary lymph nodes was 21.5 after PM with AD and 20.5 after mastectomy. For radiotherapy, 4,500 rad was delivered to the breast parenchyma and 1,600 rad of boost to the primary tumor site using the electron beam method after surgery. All patients have since been living well without any local recurrence and were satisfied with breast preservation for the one-year follow-up period. We concluded that the PM, AD and RT can be another surgical treatment modality of breast cancer. A longer follow-up data will be followed on the second paper.