SIRT1, a class III histone deacetylase, regulates TNF-α-induced inflammation in human chondrocytes.

OBJECTIVE: The present study was performed to elucidate the possible role of SIRT1 signaling in joint inflammation in human articular chondrocytes. DESIGN: Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting were performed to detect gene products and proteins involved in tumor necrosis factor α (TNF-α)-induced inflammation and cartilage degradation in human primary chondrocytes. Matrix metalloproteinase (MMP)-2 and MMP-9 activity was evaluated by gelatin zymography. Overexpression and knockdown of SIRT1 were also performed to investigate whether SIRT1 is associated with the anti-inflammatory activity of resveratrol in chondrocytes. RESULTS: Resveratrol dose-dependently inhibited TNF-α-induced cyclooxygenase-2 (COX-2), MMP-1, MMP-3, MMP-13 and PGE(2) production in human chondrocytes. Moreover, MMP-2 and MMP-9 activity was increased by treatment with TNF-α; however, SIRT1 activation decreased the proinflammatory effects induced by TNF-α. In addition, treatment of SIRT1 activator and overexpression of SIRT1 inhibited the expression and activation of the main proinflammatory regulator NF-κB, which was increased by TNF-α. When SIRT1 was overexpressed in chondrocytes, the anti-inflammatory action of SIRT1 was similar to that exerted by resveratrol. CONCLUSIONS: SIRT1 activation deacetylates and inactivates NF-κB, and thereby, exerts an anti-inflammatory effect on chondrocytes, suggesting that SIRT1 activators could be explored as potential treatments for arthritis.

Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients.

OBJECTIVE: To evaluate the ultrasonographic features of adenoma malignum, a minimal deviation adenocarcinoma of the uterine cervix. METHODS: Eighteen consecutive patients with pathologically confirmed adenoma malignum were enrolled in this study at two institutions. Preoperative ultrasound examination was performed and the results were available in 11 patients. We analyzed retrospectively the gray-scale ultrasound findings for the following morphologic characteristics: cervical enlargement, as well as size, location and ultrasonographic characteristics of lesions. In five patients we also evaluated Doppler features with regard to intralesional vascularity. RESULTS: The cervix was enlarged in 73% (8/11) of cases. The mean greatest tumor diameter was 4.2 (range, 2.5-6.8) cm. In five (45%) cases, the cervix was completely infiltrated by the tumor. At gray-scale ultrasound examination, three (27%) tumors were multilocular lesions, four (36%) were multilocular lesions with solid components and four (36%) were solid lesions. In the multilocular lesions with or without a solid component, locules tended to be 1 cm or less in average diameter (86%, 6/7 cases) and there tended to be 11-20 in number (57%, 4/7 cases). In most (57%, 4/7) cases the locular fluid was homogeneously hypoechoic. Most (75%, 3/4) solid lesions manifested heterogeneous echogenicity. The five (100%) tumors examined with Doppler manifested moderate or abundant color content on color or power Doppler. CONCLUSIONS: Adenoma malignum can appear sonographically as solid, multilocular and multilocular solid cervical lesions. Awareness of its clinical and ultrasonographic features might improve diagnosis before surgery.

Measurement of compensatory hyperplasia of the contralateral kidney: usefulness for differential diagnosis of fetal unilateral empty renal fossa.

OBJECTIVE: To assess the usefulness of sonographic evaluation of compensatory hyperplasia of the contralateral kidney for the differential diagnosis of fetal unilateral empty renal fossa (ERF). METHODS: We retrospectively measured the ratio of the anteroposterior (AP) and transverse (TR) diameters of the contralateral kidney in 24 fetuses with unilateral ERF including 12 cases of unilateral renal agenesis, six cases of a unilateral pelvic kidney and six cases of a unilateral ectopic multicystic dysplastic kidney (MCDK). For the normal reference value, we calculated the AP : TR diameter ratios of both kidneys in 20 normal fetuses in the second and third trimesters. We calculated the accuracy of the AP : TR ratio to detect contralateral compensatory hyperplasia. RESULTS: The median (range) AP : TR diameter ratios of the normal kidneys were 0.84 (0.72-0.89) in the second trimester and 0.81 (0.65-0.89) in the third trimester. All cases of unilateral renal agenesis and ectopic MCDK showed the presence of compensatory hyperplasia, while no case of renal ectopy was seen with compensatory hyperplasia. The median (range) ratios for unilateral renal agenesis and ectopic MCDK were 1.0 (0.95-1.02) and 1.1 (1-1.25) in the second and third trimesters, respectively. The median ratios for a unilateral pelvic kidney were 0.8 (0.74-0.85) and 0.77 (0.74-0.84) in the second and third trimesters, respectively. Using 0.9 as the discriminating value, the sensitivity, specificity, and accuracy of the AP : TR diameter ratio for the prenatal diagnosis of compensatory renal hyperplasia was 100%. CONCLUSION: Sonographic evaluation of compensatory hyperplasia of the contralateral kidney may be useful for the differential diagnosis of a fetal unilateral ERF. Prospective studies are warranted.

Recurrent ovarian malignancy: patterns and spectrum of imaging findings.

Ovarian carcinoma is the most common cause of death from a gynecologic malignancy. The most important prognostic factors are the presence and magnitude of residual or recurrent disease after therapy. Recurrent ovarian malignancy usually manifests as pelvic masses in the surgical bed, peritoneal seeding, nodal recurrence and pleuropulmonary lesions, and liver metastasis. Pelvic recurrence involves the vaginal stump, parametria, urinary bladder, and/or bowel adjacent to the surgical bed. Peritoneal seeding presents as nodules on the peritoneal surface, most commonly around the liver or cul-de-sac, and mesenteric infiltration. Pseudomyxoma peritonei is the other form of peritoneal seeding. Nodal recurrence appears as enlarged paraaortic nodes, especially at the renal hilar level. Unusual manifestations include metastasis in the extrahepatic abdominal solid organs, bone metastasis, and abdominal wall lesion involving subcutaneous fat or muscle. Familiarity with the patterns and spectrum of imaging findings of recurrent ovarian malignancy will facilitate accurate diagnosis and prompt treatment.

Pelvic fistulas complicating pelvic surgery or diseases: spectrum of imaging findings.

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.

Poly(ethylene glycol)-poly(L-lactide) diblock copolymer prevents aggregation of poly(L-lactide) microspheres during ethylene oxide gas sterilization.

Sterilization procedure is one of the most important obstacles in the clinical applications of biodegradable microspheres. The microspheres prepared with poly(alpha-hydroxy acid) were severely aggregated during ethylene oxide (EO) gas sterilization, and could not be used in clinical applications. In this study, the effects of EO gas sterilization on the poly(L-lactide) (PLLA) microspheres were analyzed by nuclear magnetic resonance spectroscopy (1H-NMR), differential scanning calorimetry (DSC), gel permeation chromatography (GPC), scanning electron microscope (SEM) and size fractionation. The aggregation between the microspheres might be stimulated by high mobility of amorphous regions of PLLA on the microsphere surfaces since both water vapor and gas mixture can reduce glass transition temperature (Tg) of PLLA below the sterilization temperature. During EO gas sterilization, there were no changes in the molecular structure and the molecular weight of PLLA in microspheres, but there were changes in the crystallinity of PLLA in microspheres. In this study, poly(L-lactide)-poly(ethylene glycol) diblock copolymers (PLE) were blended with PLLA homopolymers in various ratios to design the microsphere suitable for EO gas sterilization. Aggregation of PLLA microspheres was markedly prevented when more than 4wt% of PLE was blended in the microspheres. This inhibition effect on aggregation may be due to the increased initial crystallinity of the microspheres, which help to maintain the microsphere morphology during EO gas sterilization.

The control of postoperative pain by EMG biofeedback in patients undergoing hysterectomy.

Electromyographic (EMG) measurements from the forehead and rectus abdominis areas were undertaken in a group of patients presenting for elective hysterectomy. The efficacy of EMG auditory feedback as a means of inducing relaxation so as to modify the dose of postoperative analgesia was examined and compared with the dose in subjects having EMG measurements without audiofeedback. Comparison was also made with a group of subjects who did not have EMG measurements. Subjects in those groups who were given relaxation instruction received less postoperative analgesia than subjects not receiving this treatment. A reduction in EMG activity was demonstrated with auditory feedback, but this did not relate directly to reduced analgesic administration after surgery.