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1.
QJM ; 111(12): 867-873, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30215794

RESUMO

Background: Patients with renal infarction are vulnerable to thromboembolic complications with poor outcomes. There is limited report concerning the effect of anti-coagulant therapy in this population. Aim: To assess the impact of anti-coagulant therapy on outcomes in patients with renal infarction. Design: A retrospective cohort study of 101 renal infarction patients was conducted. Methods: The association between anti-coagulant therapy, all-cause mortality, thromboembolic complications and renal outcome was evaluated. Demographic data and comorbidities were collected for analysis. Anti-coagulant therapy was treated as a time-dependent variable. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multi-variate Cox proportional hazards models. Results: Fifty-seven (56.4%) patients with renal infarction received anti-coagulant therapy during the study period. The all-cause mortality rate was 7.56 per 100 patient-years. Age (HR 1.05, 95% CI 1.02-1.08) was a risk factor for all-cause mortality and anti-coagulant therapy was associated with a 92% improved survival (HR 0.08, 95% CI 0.02-0.34). Twelve (11.9%) thromboembolic events occurred following renal infarction. Current smoking (HR 10.37, 95% CI 1.60-67.43) had an adverse effect and anti-coagulant therapy (HR 0.14, 95% CI 0.03-0.73) had a significant protective impact on thromboembolic complications. There was no significant association between anti-coagulant therapy and long-term renal outcome in renal infarction patients including the monthly change in the estimated glomerular filtration rate (eGFR), the incidence of eGFR reduction of more than 50% and end-stage renal disease. Conclusion: Anti-coagulant therapy in patients with renal infarction was associated with better survival and reduced thromboembolic complications.


Assuntos
Anticoagulantes/uso terapêutico , Infarto/tratamento farmacológico , Falência Renal Crônica/mortalidade , Rim/irrigação sanguínea , Mortalidade , Adulto , Idoso , Comorbidade , Feminino , Taxa de Filtração Glomerular , Humanos , Incidência , Infarto/fisiopatologia , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Taiwan
2.
Stem Cell Res Ther ; 6: 239, 2015 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-26631265

RESUMO

INTRODUCTION: Pathophysiological changes associated with chronic kidney disease impair angiogenic processes and increase renal fibrosis. Progenitor-like cells derived from adult kidney have been previously used to promote regeneration in acute kidney injury, even though it remained unclear whether the cells could be beneficial in chronic kidney disease (CKD). METHODS: In this study, we established a CKD model by five-sixths nephrectomy and mouse kidney progenitor-like cells (MKPCs) were intravenously administered weekly for 5 weeks after establishing CKD. We examined the impact of MKPCs on the progression of renal fibrosis and the potential of MKPCs to preserve the angiogenic process and prevent endothelial mesenchymal transition in vivo and in vitro. RESULTS: Our results demonstrate that the MKPCs delayed interstitial fibrosis and the progression of glomerular sclerosis and ameliorated the decline of kidney function. At 17 weeks, the treated mice exhibited lower blood pressures, higher hematocrit levels, and larger kidney sizes than the control mice. In addition, the MKPC treatment prolonged the survival of the mice with chronic kidney injuries. We observed a decreased recruitment of macrophages and myofibroblasts in the interstitium and the increased tubular proliferation. Notably, MKPC both decreased the level of vascular rarefaction and prevented endothelial mesenchymal transition (EndoMT) in the remnant kidneys. Moreover, the conditioned medium from the MKPCs ameliorated endothelial cell death under hypoxic culture conditions and prevented TGF-ß-induced EndoMT through downregulation of phosphorylated Smad 3 in vitro. CONCLUSIONS: MKPCs may be a beneficial treatment for kidney diseases characterized by progressive renal fibrosis. The enhanced preservation of angiogenic processes following MKPC injections may be associated with decreased fibrosis in the remnant kidney. These findings provide further understanding of the mechanisms involved in these processes and will help develop new cell-based therapeutic strategies for regenerative medicine in renal fibrosis.


Assuntos
Diferenciação Celular , Rim/citologia , Células-Tronco Mesenquimais/citologia , Insuficiência Renal Crônica/terapia , Transplante de Células-Tronco , Células-Tronco , Animais , Capilares/citologia , Células Cultivadas , Meios de Cultivo Condicionados , Modelos Animais de Doenças , Endotélio Vascular/citologia , Feminino , Fibrose/prevenção & controle , Rim/patologia , Túbulos Renais/citologia , Camundongos , Camundongos Endogâmicos C57BL , Nefrectomia , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/patologia
3.
Oncogene ; 33(21): 2768-78, 2014 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-23792449

RESUMO

Although the contribution of the bone marrow mesenchymal stem cells (BM-MSCs) in cancer progression is emerging, their potential roles in prostate cancer (PCa) remain unclear. Here, we showed that PCa cells could recruit BM-MSCs and consequently the metastatic ability of PCa cells was increased. We also found that the increased metastatic ability of PCa cells could be due to the increased PCa stem cell population. Mechanism dissection studies found that the upregulation of Chemokine ligand 5 (CCL5) expression in BM-MSCs and PCa cells, after MSCs infiltrated into the PCa cells, subsequently downregulated androgen receptor (AR) signaling, which was due to inhibition of AR nuclear translocation. Interruption of such signaling led to suppression of the BM-MSCs-induced PCa stem cell population increase and thereby inhibited the metastatic ability of PCa cells. The PCa stem cell increase then led to the upregulation of matrix metalloproteinase 9, ZEB-1, CD133 and CXCR4 molecules, and enhanced the metastatic ability of PCa cells. Therefore, we conclude that the BM-MSCs-mediated increased metastatic ability of PCa cells can be due to the PCa stem cell increase via alteration of the CCL5-AR signaling pathway. Together, these results uncover the important roles of BM-MSCs as key components in the prostate tumor microenvironment to promote PCa metastasis and may provide a new potential target to suppress PCa metastasis by blocking BM-MSCs infiltration into PCa.


Assuntos
Quimiocina CCL5/genética , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Neoplásicas/metabolismo , Neoplasias da Próstata/patologia , Receptores Androgênicos/metabolismo , Antígeno AC133 , Animais , Antígenos CD/genética , Antígenos CD/metabolismo , Células da Medula Óssea/metabolismo , Linhagem Celular Tumoral , Quimiocina CCL5/metabolismo , Técnicas de Cocultura , Regulação Neoplásica da Expressão Gênica , Glicoproteínas/genética , Glicoproteínas/metabolismo , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Humanos , Metástase Linfática , Masculino , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Camundongos , Camundongos Nus , Transplante de Neoplasias , Peptídeos/genética , Peptídeos/metabolismo , Neoplasias da Próstata/metabolismo , Receptores CXCR4/genética , Receptores CXCR4/metabolismo , Transdução de Sinais , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Microambiente Tumoral , Regulação para Cima , Homeobox 1 de Ligação a E-box em Dedo de Zinco
4.
Oncogene ; 33(23): 2968-77, 2014 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-23851503

RESUMO

Gain of function of membrane receptor was a good strategy exploited by cancer cells to benefit own growth and survival. Overexpression of HER2 has been found to serve as a target for developing trastuzumab to treat 20-25% of breast cancer. However, little or none of the other membrane receptor was found to be useful as a potential target for breast cancer treatment since then. Here, we showed that amplified signaling of interleukin-17 receptor B (IL-17RB) and its ligand IL-17B promoted tumorigenicity in breast cancer cells and impeded acinus formation in immortalized normal mammary epithelial cells. External signal transmitted through IL-17RB activated nuclear factor-κB to upregulate antiapoptotic factor Bcl-2 and induced etoposide resistance. Elevated expression of IL-17RB had a stronger correlation with poor prognosis than HER2 in breast cancer patients. Interestingly, breast cancer patients with high expression of IL-17RB and HER2 had the shortest survival rate. Depletion of IL-17RB in trastuzumab-resistant breast cancer cells significantly reduced their tumorigenic activity, suggesting that IL-17RB and HER2 have an independent role in breast carcinogenesis. Furthermore, treatment with antibodies specifically against IL-17RB or IL-17B effectively attenuated tumorigenicity of breast cancer cells. These results suggest that the amplified IL-17RB/IL-17B signaling pathways may serve as a therapeutic target for developing treatment to manage IL-17RB-associated breast cancer.


Assuntos
Neoplasias da Mama/patologia , Carcinogênese , NF-kappa B/metabolismo , Receptores de Interleucina-17/antagonistas & inibidores , Receptores de Interleucina-17/metabolismo , Animais , Apoptose/efeitos dos fármacos , Comunicação Autócrina , Neoplasias da Mama/metabolismo , Carcinogênese/efeitos dos fármacos , Linhagem Celular Tumoral , Etoposídeo/farmacologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Interleucina-17/imunologia , Interleucina-17/metabolismo , Células MCF-7 , Neoplasias Mamárias Experimentais , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , NF-kappa B/antagonistas & inibidores , Comunicação Parácrina , Receptor ErbB-2/metabolismo , Transdução de Sinais/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
5.
Oncogene ; 32(9): 1193-201, 2013 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-22562243

RESUMO

Mitochondrial dysfunction has been a hallmark of cancer. However, whether it has a causative role awaits to be elucidated. Here, using an animal model derived from inactivation of SUV3, a mitochondrial helicase, we demonstrated that mSuv3+/- mice harbored increased mitochondrial DNA (mtDNA) mutations and decreased mtDNA copy numbers, leading to tumor development in various sites and shortened lifespan. These phenotypes were transmitted maternally, indicating the etiological role of the mitochondria. Importantly, reduced SUV3 expression was observed in human breast tumor specimens compared with corresponding normal tissues in two independent cohorts. These results demonstrated for the first time that maintaining mtDNA integrity by SUV3 helicase is critical for cancer suppression.


Assuntos
Neoplasias da Mama/genética , Transformação Celular Neoplásica/genética , RNA Helicases DEAD-box/genética , Genoma Mitocondrial , Instabilidade Genômica , Haploinsuficiência , Animais , Linhagem Celular Tumoral , Variações do Número de Cópias de DNA/genética , Perda do Embrião/genética , Feminino , Heterozigoto , Humanos , Estilo de Vida , Longevidade/genética , Camundongos
6.
Appl Radiat Isot ; 69(12): 1850-3, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21530281

RESUMO

This paper aims to evaluate the effective dose as well as equivalent doses of several organs of an adult hermaphrodite mathematical phantom according to the definition of ICRP Publication 60 for BNCT treatments of brain tumors in the epithermal neutron beam at THOR. The MCNP5 Monte Carlo code was used for the calculation of the average absorbed dose of each organ. The effective doses for a typical brain tumor treatment with a tumor treatment dose of 20 Gy-eq were evaluated to be 0.59 and 0.35 Sv for the LLAT and TOP irradiation geometries, respectively. In addition to the stochastic effect, it was found that it is also likely to produce deterministic effects, such as cataracts and depression of haematopoiesis.


Assuntos
Terapia por Captura de Nêutron de Boro , Neoplasias Encefálicas/radioterapia , Humanos , Método de Monte Carlo
7.
Oncogene ; 30(21): 2463-74, 2011 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-21258409

RESUMO

MicroRNAs (miRNAs) are involved in tumorigenecity by regulating specific oncogenes and tumor suppressor genes, and their roles in breast cancer stem cells (BCSCs) are becoming apparent. Distinct from the CD44(+)/CD24(-/low) sub-population, we have isolated a novel PROCR(+)/ESA(+) BCSC sub-population. To explore miRNA-regulatory mechanisms in this sub-population, we performed miRNA expression profiling and found miR-495 as the most highly upegulated miRNA in PROCR(+)/ESA(+) cells. Coincidently, high upregulation of miR-495 was also found in CD44(+)/CD24(-/low) BCSCs, reflecting its potential importance in maintaining common BCSC properties. Ectopic expression of miR-495 in breast cancer cells promoted their colony formation in vitro and tumorigenesis in mice. miR-495 directly suppressed E-cadherin expression to promote cell invasion and inhibited REDD1 expression to enhance cell proliferation in hypoxia through post-transcriptional mechanism. miR-495 expression was directly modulated by transcription factor E12/E47, which itself is highly expressed in BCSCs. These findings reveal a novel regulatory pathway centered on miR-495 that contributes to BCSC properties and hypoxia resistance.


Assuntos
Caderinas/genética , MicroRNAs/genética , Células-Tronco Neoplásicas/metabolismo , Fator 3 de Transcrição/genética , Fatores de Transcrição/genética , Animais , Sequência de Bases , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Caderinas/metabolismo , Hipóxia Celular , Linhagem Celular , Linhagem Celular Tumoral , Regulação para Baixo , Feminino , Perfilação da Expressão Gênica , Células HEK293 , Humanos , Immunoblotting , Neoplasias Mamárias Experimentais/genética , Neoplasias Mamárias Experimentais/metabolismo , Neoplasias Mamárias Experimentais/patologia , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Dados de Sequência Molecular , Regiões Promotoras Genéticas/genética , Ligação Proteica , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator 3 de Transcrição/metabolismo , Fatores de Transcrição/metabolismo , Transplante Heterólogo
8.
Br J Dermatol ; 164(1): 148-53, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21070198

RESUMO

BACKGROUND: Primary cutaneous amyloidosis (PCA) is a pruritic skin disorder most commonly seen in Southeast Asia and South America. Association of PCA with atopic dermatitis (AD) has been reported in the literature. However, no large-scale epidemiological study of PCA and its associations with other diseases has been conducted so far. OBJECTIVES: We aimed to provide overall demographic data and comorbidities of patients with PCA based on a nationwide database in Taiwan. METHODS: Cases of PCA were collected from records of National Health Insurance claims from 2000 to 2007. We analysed patients' gender, age when the diagnosis was first made, and the overall 8-year prevalence. We also investigated comorbidities. RESULTS: The overall 8-year prevalence of PCA was 7·87 per 10,000 persons. Although there was no significant gender difference in the prevalence of PCA, men and women showed a different peak age (men, 71-80 years; women, 41-50 years) and a different age distribution at diagnosis. The mean age at diagnosis of PCA was significantly younger for women than for men. Men sought medical assistance for PCA more frequently than women. There was a higher disease activity from May to September than during other months. PCA was strongly associated with AD (odds ratio 7·18). Patients with PCA had a higher comorbidity of hyperlipidaemia and diabetes mellitus. CONCLUSIONS: This is the first nationwide population-based epidemiological study of PCA. We demonstrate that PCA can be associated with other disorders, especially AD.


Assuntos
Amiloidose/epidemiologia , Dermatite Atópica/epidemiologia , Dermatopatias Metabólicas/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Taiwan/epidemiologia
9.
J Bone Joint Surg Br ; 92(11): 1580-5, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21037356

RESUMO

We evaluated the long-term outcome of patients with an osteosarcoma who had undergone prior manipulative therapy, a popular treatment in Asia, and investigated its effects on several prognostic factors. Of the 134 patients in this study, 70 (52%) patients had manipulative therapy and 64 (48%) did not. The age, location, and size of tumour were not significantly different between the groups. The five-year overall survival rate was 58% and 92% in the groups with and without manipulative therapy (p = 0.004). Both the primary and overall rates of lung metastasis were significantly higher in the manipulative group (primary: 32% vs 3%, p = 0.003; overall lung metastasis rate: 51.4% vs 18.8%, p < 0.001). Patients who had manipulative therapy had higher local recurrence rates in comparison to patients who did not (29% vs 6%, p = 0.011). The prognosis for patients with osteosarcoma who had manipulative therapy was significantly poorer than those who had not. Manipulative therapy was an independent factor for survival. This form of therapy may serve as a mechanism to accelerate the spread of tumour cells, and therefore must be avoided in order to improve the outcome for patients with an osteosarcoma.


Assuntos
Neoplasias Ósseas/terapia , Manipulações Musculoesqueléticas/efeitos adversos , Osteossarcoma/terapia , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Manipulações Musculoesqueléticas/métodos , Recidiva Local de Neoplasia/etiologia , Osteossarcoma/diagnóstico , Osteossarcoma/secundário , Prognóstico
10.
Br J Surg ; 97(10): 1541-6, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20645295

RESUMO

BACKGROUND: The aim of this study was to evaluate the effects of Roux-en-Y gastric bypass for morbid obesity on health-related quality of life (QOL) during the first year of follow-up. METHODS: The World Health Organization Quality of Life-Brief (WHOQOL-BREF) was administered 1 month before operation, and at 1, 3, 6 and 12 months after surgery. Body mass index, co-morbidities and operation-related complications were measured at these times. A mixed-effect model was constructed to analyse repeated measurements and determine the relationships between body mass index, WHOQOL-BREF scores and other variables. RESULTS: A total of 102 patients were enrolled. The mixed-effect model showed that the physical, psychological and social domains improved after bariatric surgery, with simultaneous reduction in weight and improvement in co-morbidities. There was a dip in scores in physical and psychological domains 3-6 months after surgery, significantly related to complications. All patients gradually improved between 6 and 12 months after surgery, reaching levels similar to those of healthy subjects. CONCLUSION: Health-related QOL improved dramatically after bariatric surgery, dipped slightly between 3 and 6 months, and improved again up to the end of the first year.


Assuntos
Derivação Gástrica/métodos , Nível de Saúde , Obesidade Mórbida/cirurgia , Qualidade de Vida , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
11.
Int J Tuberc Lung Dis ; 13(5): 620-5, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19383196

RESUMO

BACKGROUND: Tuberculosis (TB) continues to be a major global health problem. Extra-pulmonary TB (EPTB) manifests with protean symptoms, and establishing a diagnosis is more difficult than pulmonary TB (PTB). SETTING: A university-affiliated hospital in southern Taiwan. OBJECTIVE: To analyse the risk factors for EPTB compared with PTB. DESIGN: This retrospective study compared patients with EPTB and PTB in southern Taiwan by analysing their demographic data and clinical underlying diseases. Risk factors for EPTB were further analysed. RESULTS: A total of 766 TB patients were enrolled in this study, with 102 (13.3%) EPTB and 664 (86.7%) PTB cases. Of the 766 patients, 3% of PTB patients had EPTB, while 19.6% of EPTB patients also had PTB. The most frequently involved EPTB site was the bone and joints (24.5%). The incidence of EPTB vs. PTB decreased significantly for each decade increase in patient age. Multivariate logistic regression analysis showed that being female, not being diabetic, having end-stage renal disease and not smoking were independent risk factors for EPTB. CONCLUSION: This study defines the risk factors for EPTB compared with PTB. Awareness of these factors is essential for physicians to have a high index of suspicion for accurate and timely diagnosis.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia , Tuberculose/diagnóstico , Tuberculose/microbiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
12.
Clin Microbiol Infect ; 12(10): 986-91, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16961635

RESUMO

This retrospective study investigated the clinical significance and impact of Stenotrophomonas maltophilia bacteraemia in 49 haematology and oncology patients at a tertiary referral medical centre in Taipei between July 1999 and December 2003. Sixteen patients had 24 episodes of central venous catheter (CVC)-related bacteraemia, with the main clinical characteristics being a nosocomial bacteraemia (100%), preceding antibiotic therapy (94%), bacteraemia developed in a general ward (87%), immunosuppressive therapy (75%), in-situ CVC-related bacteraemia (75%), and neutropenia (63%). Only four (25%) patients had inflammatory signs at the CVC site following diagnosis of bacteraemia. Five patients had recurrent bacteraemia, with risk-factors being long-lasting (>10 days) neutropenia (p 0.036) and an initial failure to remove the CVC (p 0.001). These cases did not involve re-infection, as the same S. maltophilia strain was identified following random amplified polymorphic DNA (RAPD) analysis of the initial and subsequent isolates. However, relapses could occur after long latency periods (maximum, 200 days). Most patients were cured after removal of the CVC, even without appropriate antibiotic treatment. Physicians should have a high index of suspicion for CVC-related bacteraemia with haematology and oncology patients with CVCs and S. maltophilia bacteraemia. In addition to appropriate antibiotic therapy, removal of the CVC is crucial for successful treatment of CVC-related S. maltophilia bacteraemia and prevention of relapses.


Assuntos
Bacteriemia/etiologia , Bacteriemia/microbiologia , Cateterismo Venoso Central/efeitos adversos , Infecções por Bactérias Gram-Negativas/microbiologia , Stenotrophomonas maltophilia/isolamento & purificação , Adolescente , Adulto , Idoso , Criança , Feminino , Doenças Hematológicas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Fatores de Risco
13.
Infection ; 34(2): 75-80, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16703296

RESUMO

BACKGROUND: Fever of unknown origin (FUO) is a challenging problem worldwide. There was no prospective study of FUO in the past two decades in Taiwan. A prospective study was conducted. MATERIALS AND METHODS: The prospective study was undertaken from March 2001 to May 2002. All patients fulfilling the modified criteria for FUO, either admitted, referred or consulted in a medical center in southern Taiwan, were enrolled for analysis. RESULTS: A total of 94 cases met the criteria of FUO. The final diagnoses of FUO consisted of 54 infectious diseases (57.4%), 8 hematologic/neoplastic (8.5%), 7 noninfectious inflammatory (7.4%), 8 miscellaneous (8.5%) and 17 undiagnosed (18.1%) cases. The single most common cause of FUO was tuberculosis. Some infectious diseases, such as rickettsiosis and melioidosis, were rarely reported in western countries. Three patients with hemophagocytotic syndrome without ascertainable etiologies were present with FUO in this study. Between the patients with and those without a final diagnosis, the short-term survival (3 months) was compared by the Kaplan-Meier analysis, which revealed no difference. CONCLUSIONS: Mycobacteriosis is still the leading cause of FUO in Taiwan and it is important to identify this treatable disease from all causes of FUO. This study has showed geographical variation among the studies of FUO.


Assuntos
Febre de Causa Desconhecida/epidemiologia , Febre de Causa Desconhecida/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Transmissíveis/complicações , Doenças Transmissíveis/diagnóstico , Feminino , Febre de Causa Desconhecida/diagnóstico , Humanos , Inflamação/complicações , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/diagnóstico , Estudos Prospectivos , Taiwan/epidemiologia , Tuberculose/complicações , Tuberculose/diagnóstico
14.
Int J Clin Pract Suppl ; (147): 56-9, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15875624

RESUMO

CA 125, a glycoprotein derived from coelomic epithelium, is used primarily as a marker of epithelial ovarian cancer. However, elevated levels of serum CA 125 have also been detected in other benign and malignant disorders. This study describes a haemodialysis patient who contracted tuberculous peritonitis associated with hypercalcaemia, erythropoietin-resistant anaemia and elevated CA 125, which normalised gradually following antituberculosis treatment. Tuberculous peritonitis should be considered in the differential diagnosis of ascites with elevated serum CA 125. Additionally, CA 125 is a useful marker for monitoring response to tuberculous peritonitis treatment.


Assuntos
Antígeno Ca-125/sangue , Hipercalcemia/etiologia , Infecções Oportunistas/diagnóstico , Peritonite Tuberculosa/diagnóstico , Diálise Renal , Biomarcadores/sangue , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Infecções Oportunistas/complicações , Peritonite Tuberculosa/complicações
15.
J Bone Joint Surg Br ; 87(5): 704-9, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15855376

RESUMO

We reviewed 29 patients who had undergone intercalary resection for malignant tumours. Of these, 14 had received segmental allograft reconstruction and 15 extracorporeally-irradiated autograft. At a mean follow-up of 71 months (24 to 132), 20 were free from disease, five had died and four were alive with pulmonary metastases. Two patients, one with an allograft and one with an irradiated autograft, had a local recurrence. Reconstruction with extracorporeally-irradiated autograft has a significantly lower rate of nonunion (7% vs 43%, p = 0.031) but an insignificantly higher rate of fracture (20% vs 14%, p = 0.535) than that with segmental allograft. Using the Enneking functional evaluation system, the mean postoperative score for the patients without local recurrence was 87% (80% to 96%) and was similar in both groups. Extracorporeally-irradiated autograft could be an acceptable alternative for reconstruction after intercalary resection, especially in countries where it is difficult to obtain allografts.


Assuntos
Neoplasias Ósseas/cirurgia , Transplante Ósseo/métodos , Osteossarcoma/cirurgia , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Osso e Ossos/efeitos da radiação , Criança , Feminino , Fraturas Ósseas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Osteossarcoma/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Radiografia , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento
16.
J Bone Joint Surg Br ; 84(8): 1156-61, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12463662

RESUMO

Autogenous bone graft which has been either autoclaved or irradiated is commonly used in oriental countries as an alternative to allograft. We started to use the technique of extracorporeal irradiation of the resected specimen and reimplantation (ECIR) in 1991. There was, however, a high incidence of fracture of the irradiated bone and loss of articular cartilage. In an attempt to reduce these complications, we combined the irradiated autograft with a conventional arthroplasty. Between 1995 and 1998, 14 patients underwent limb salvage by this method. Seven had an osteosarcoma, two bony metastases, three a chondrosarcoma, one a malignant fibrous histiocytoma, and one a leiomyosarcoma. Ten tumours were located in the proximal femur, two in the proximal humerus, and two in the distal femur. One patient who had a solitary metastasis in the proximal part of the left femur died from lung metastases 13 months after operation. The remaining 13 patients were alive and without evidence of local recurrence or distant metastases at a mean follow-up of 43 months (28 to 72). Postoperative palsy of the sciatic nerve occurred in one patient, but no complications such as wound infection, fracture, or nonunion were seen. All host-irradiated bone junctions healed uneventfully within eight months. Using the Enneking functional evaluation system, the mean postoperative score for all 14 patients was 80% (57 to 93). The use of irradiated autograft prosthesis composites reduces the complications of ECIR and gives good functional results. It may be a good alternative in limb-salvage surgery, especially in countries where it is difficult to obtain allografts.


Assuntos
Artroplastia/métodos , Neoplasias Ósseas/cirurgia , Transplante Ósseo/métodos , Radiação Ionizante , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Osso e Ossos/efeitos da radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Terapia de Salvação , Transplante Autólogo , Resultado do Tratamento
17.
Eur J Clin Microbiol Infect Dis ; 21(10): 706-9, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12415468

RESUMO

A 69-year-old man with Sweet's syndrome and myelodysplastic syndrome presented with pneumonia and respiratory distress. He had been taking corticosteroids and methotrexate. The diagnosis of Legionnaires' disease was established by the isolation of Legionella pneumophila serogroup 6 from sputum and a fourfold seroconversion of Legionella antibodies to 1:512. Legionella pneumophila serogroup 6 was isolated from faucets in two homes owned by the patient. Strains of Legionella pneumophila serogroup 6 isolated from the patient's sputum and from one home were demonstrated to be genetically identical by pulsed-field gel electrophoresis but different from strains found in the other home and in a hospital outpatient clinic that he visited. This case illustrates an emerging public health issue concerning acquisition of community-acquired Legionnaires' disease from the homes of immunocompromised hosts. This is the first such case reported in Asia.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/etiologia , Hospedeiro Imunocomprometido , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/diagnóstico , Abastecimento de Água , Idoso , China , Infecções Comunitárias Adquiridas/imunologia , DNA Bacteriano/análise , Eletroforese em Gel de Campo Pulsado , Seguimentos , Humanos , Doença dos Legionários/imunologia , Masculino , Síndromes Mielodisplásicas/imunologia , Radiografia Torácica , Medição de Risco , Síndrome de Sweet/imunologia , Microbiologia da Água
18.
J Interferon Cytokine Res ; 21(10): 797-807, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11710991

RESUMO

Culture of an H-2(s)-restricted, bovine myelin basic protein (BMBP)-specific murine Th1 clone with the adenyl cyclase agonist forskolin (FSK) or isobutylmethylxanthine (IBMX), an inhibitor of cAMP catabolism, before culture with anti-CD3 or BMBP and antigen-presenting cells (APC) suppressed antigen or anti-CD3-induced proliferation and production of interferon-gamma (IFN-gamma). Other H-2(s)-derived or H-2(b)-derived clones specific for BMBP or keyhole limpet hemocyanin (KLH) were similarly affected. FSK did not affect the expression of CD4 or the T cell receptor (TCR) but did diminish levels of the phosphorylated (activated) mitogen-activated protein (MAP) kinases early response kinase-1 (ERK-1) and ERK-2. Immunoblotting of lysates from an FSK-treated Th1 clone with antibodies to a carboxy-terminal epitope of p56(lck), a signal transduction enzyme upstream from ERK-1 and ERK2, did not detect p56(lck) unless the lysates were reduced prior to electrophoresis. Immunoblotting of nonreduced lysates with antibodies to an amino-terminal epitope demonstrated p56(lck) with a lower apparent molecular weight, characteristic of oxidized proteins. Reduction restored the detection of p56(lck) by anticarboxy-terminal p56(lck) and to mobilities indistinguishable from controls detected by the antiamino-terminal p56(lck). N-acetylcysteine or catalase prevented FSK-induced suppression of antigen-induced proliferation and the loss of carboxy-terminal epitopes of p56(lck). An inhibitor of cAMP-dependent protein kinase A (PKA) or nitric oxide synthase (NOS) did not affect FSK-induced inhibition of antigen-induced proliferation. In contrast, inhibitors of PKA or NOS, but not catalase, prevented FSK-induced suppression of IFN-gamma production. Moreover, immunoblots of lysates precipitated with anti-p56(lck), phosphotyrosine, or CD4 demonstrated that in FSK-treated, anti-CD3-stimulated cells, p56(lck) is not associated with CD4 zeta chain, nor is p56(lck) or zeta chain phosphorylated. In vitro kinase assays demonstrated that p56(lck) from FSK-treated cells does not have kinase activity. Taken together, the results suggest that an elevation of intracellular cAMP (in the absence of antigen) creates an oxidative environment that oxidizes and inactivates p56(lck) by an H(2)O(2)-dependent, PKA-independent mechanism and inhibits the production of IFN-gamma by an NO, PKA-dependent mechanism. Thus, antigen-induced proliferation and IFN-gamma production in a Th1 clone are controlled separately by different cAMP-dependent, redox-based mechanisms.


Assuntos
AMP Cíclico/fisiologia , Interferon gama/biossíntese , Ativação Linfocitária , Receptores de Antígenos de Linfócitos T/fisiologia , Células Th1/imunologia , 1-Metil-3-Isobutilxantina/farmacologia , Animais , Complexo CD3/metabolismo , Antígenos CD4/metabolismo , Células Cultivadas , Células Clonais , Colforsina/farmacologia , Feminino , Ativação Linfocitária/efeitos dos fármacos , Proteína Tirosina Quinase p56(lck) Linfócito-Específica/antagonistas & inibidores , Proteína Tirosina Quinase p56(lck) Linfócito-Específica/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Oxirredução , Inibidores de Fosfodiesterase/farmacologia , Transdução de Sinais
19.
J Biochem Biophys Methods ; 48(3): 219-37, 2001 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-11384759

RESUMO

Ribosomal p90rsk is a kinase of central importance in transducing mitogenic signals from an activated receptor to the cell nucleus and for protein synthesis. Here, we analyze the optimal steps to fully describe this kinase in both normal neutrophils and leukemic cell lines. These are: (i) immunological analyses (immunoblotting and immunoprecipitation); (ii) enzyme activity assays (in vitro and "in-gel"); and (iii) immunobiochemical combination methods (immunoprecipitation/kinase assay, immunoprecipitation/"in-gel" assay and ion exchange chromatography/immunoblotting). For the enzyme assays, we describe a novel method to measure ribosomal p90rsk kinase activity "in-gel", based on a renatured-protein method that allows for the direct quantitation of enzyme activity. Finally, we present an algorithm that can be readily implemented to the quantification of the extent of stimulation of a kinase in response to a particular extracellular stimuli. In our case, it was found that activation of p90rsk was higher in proliferating leukemic cells than in mature neutrophils, indicating that a suppression of key signal transduction links could contribute to the maturational arrest typical of acute leukemia. All the techniques and strategies described here for p90rsk could be easily extrapolated to the study of any signal transduction molecule, provided it has a phosphotransferase activity.


Assuntos
Bioquímica/métodos , Proteínas Quinases S6 Ribossômicas/química , Algoritmos , Diferenciação Celular , Cromatografia por Troca Iônica , Relação Dose-Resposta a Droga , Células HL-60 , Humanos , Immunoblotting , Cinética , Leucemia/enzimologia , Neutrófilos/enzimologia , Testes de Precipitina , Desnaturação Proteica , Especificidade por Substrato , Fatores de Tempo
20.
J Leukoc Biol ; 69(3): 497-504, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11261799

RESUMO

Leukocyte-specific gene 1 protein (LSP1) is a cytoskeletal-associated protein of leukocytes that in vitro cross-links F-actin into extensively branched bundles of mixed polarity. In this study, we examined chemotaxis and superoxide production in neutrophils prepared from wild-type (WT) and Lsp1 knockout mice. Compared to WT neutrophils, Lsp1-/- neutrophils showed impairment in both migration speed and chemotaxis direction during chemokine KC-directed chemotaxis. When examined by confocal microscopy, chemotaxing Lsp1-/- neutrophils showed abnormal morphologies. They had discontinuous primary actin-rich cortexes and large membrane protrusions. When stimulated by phorbol 12-myristate 13-acetate (PMA), Lsp1-/- peritoneal neutrophils produce more superoxide than WT. The data presented suggest that LSP1 plays important roles in the regulation of neutrophil morphology, motility, and superoxide production.


Assuntos
Proteínas de Ligação ao Cálcio/fisiologia , Citocinas/fisiologia , Citoesqueleto/fisiologia , Neutrófilos/fisiologia , Actinas/metabolismo , Animais , Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Movimento Celular/fisiologia , Quimiocina CXCL1 , Quimiocinas , Quimiocinas CXC , Quimiotaxia de Leucócito/genética , Quimiotaxia de Leucócito/fisiologia , Corrente Citoplasmática/fisiologia , Camundongos , Camundongos Knockout , Proteínas dos Microfilamentos , Microscopia Confocal , Neutrófilos/citologia , Neutrófilos/metabolismo , Superóxidos/metabolismo
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