NAB2-STAT6 fusion protein mediates cell proliferation and oncogenic progression via EGR-1 regulation.

Solitary fibrous tumors are rare mesenchymal tumors derived from soft tissues and vascular walls. NAB2-STAT6 fusion gene serves as a marker gene for this disease and consists of the truncated repressor domain of NGFI-A-Binding protein 2 (NAB2) and the intact activation domain of STAT6. In this study, we found that EGR-1 and the proliferation-related EGR-1 target gene IGF2 were upregulated in NIH-3T3 cells transfected with NAB2-STAT6. Additionally, p-Rb (Ser795) and cyclin D1 levels were upregulated, and cell proliferation was also enhanced. We identified that treatment with the IGF2 inhibitor reduced cell proliferation in NIH-3T3 cells transfected with NAB2-STAT6. The oncogenic progression was enhanced in NIH-3T3 cells transfected with NAB2-STAT6 compared with those transfected with the empty vector. Taken together, our study suggests that the NAB2-STAT6 fusion gene is associated with cell proliferation through EGR-1 transcriptional expression and IGF2 can be a drug target for the treatment of solitary fibrous tumors.

Illnesses Encountered During Medical Volunteering in Takeo Province, Cambodia.

Background and Objectives: Medical volunteering seeks to meet the clinical needs of underserved areas, but has been criticized for difficulties in addressing local health issues and resultant lack of sustainability. Our team has visited rural Cambodia annually since 2012. This study reports the illnesses encountered during the recent mission and share our experiences to improve the efficiency of medical volunteering. Materials and Methods: Infrastructure, such as public electricity or water, was unavailable, hence most medical care and records were hand-performed. We categorized (1) primary diagnoses (chief complaints) by duration of symptoms, and (2) primary and secondary diagnoses (illnesses that were not related to the chief complaint) by severity of illness since patients commonly reported multiple symptoms. Blood pressure and anthropometric values were also checked and analyzed. Results: We encountered 317 adult and 141 pediatric patients. Among adults, 61.3% had persistent chronic (>6 month) symptoms of their chief complaints. The commonest diagnoses of chronic symptoms were musculoarthritis (31.5%) and gastroesophageal reflux disease and/or gastritis (21.7%). Hypertension and/or cardiac problems were relatively common among males (13.6%). The most common diagnosis among the severest cases (specialized or intensive care recommended) was cardiac problems (14.8%), often with abnormalities in sonography or electrocardiogram. For children, the overwhelming majority of diagnoses were related to acute symptoms and low severity, and approximately half were cases of the common cold. Commonly prescribed drugs were antacids or mucosal protectors (31.3%), Non-steroidal anti-inflammatory drugs (NSAIDs) or other painkillers (27.6%), and antiparasites (17.7%) in adults, and NSAIDs (44.7%) and antiparasites (23.2%) in children. Among adults, 32.7% were diagnosed with hypertension, and body mass index (p = 0.003) and age (p < 0.001) were both correlated with hypertension and its grade. Conclusion: Our study offers practical help to volunteer health workers planning to visit Southeast Asia.

Visceral adiposity is associated with an increased risk of functional dyspepsia.

BACKGROUND: The relationship between visceral adiposity and the incidence of functional dyspepsia (FD) has not yet been studied. The purpose of the present study is to evaluate the association between visceral adiposity and the risk of FD. METHODS: This is a case-control study that compares the abdominal adipose tissue area between subjects with FD and control subjects without FD, who underwent abdomen computerized tomography (CT) for health examinations in a tertiary center. Retrospectively, a telephone survey was conducted to diagnose FD using the Rome III criteria. We measured various indices of obesity including body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area and the VAT/SAT ratio in order to evaluate the association between FD and abdominal adiposity. KEY RESULTS: A total of 363 subjects were included in the present study. FD was diagnosed in 90 subjects (24.8%). In the univariate analysis, WC, VAT area, TAT area, VAT/SAT ratio, and the presence of erosive esophagitis were significantly higher in the FD group than in the non-FD group. In the multivariate analysis, a higher VAT area (odds ratio (OR), 3.76; 95% confidence interval (CI), 1.24-11.40; highest quartile vs lowest quartile, p = 0.019) and VAT/SAT ratio (OR, 2.35; 95% CI, 1.27-4.32; highest quartile vs lowest quartile, p = 0.006) were independently associated with a risk of FD. CONCLUSION AND INFERENCES: Visceral adiposity as measured by the VAT area and VAT/SAT ratio is associated with an increased risk of FD.

Comparison of Fentanyl versus Meperidine in Combination with Midazolam for Sedative Colonoscopy in Korea.

BACKGROUND/AIMS: Combination of midazolam and opioids is used widely for endoscopic sedation. Compared with meperidine, fentanyl is reportedly associated with rapid recovery, turnover rate of endoscopy room, and quality of endoscopy. We compared fentanyl with meperidine when combined with midazolam for sedative colonoscopy. METHODS: A retrospective, cross-sectional, 1:2 matching study was conducted. Induction and recovery time were compared as the primary outcomes. Moreover, cecal intubation time, withdrawal time, total procedure time of colonoscopy, paradoxical reaction, adenoma detection rate, and adverse effect of midazolam or opioids were assessed as the secondary outcomes. RESULTS: A total of 129 subjects (43 fentanyl vs. 86 meperidine) were included in the analysis. The fentanyl group showed significantly more rapid induction time (4.5±2.7 min vs. 7.5±4.7 min, p<0.001), but longer recovery time (59.5±25.6 min vs. 50.3±10.9 min, p=0.030) than the meperidine group. In multivariate analysis, the induction time of the fentanyl group was 3.40 min faster (p<0.001), but the recovery time was 6.38 min longer (p=0.046) than that of the meperidine group. There was no difference in withdrawal time and adenoma detection rate between the two groups. CONCLUSION: The fentanyl group had more rapid sedation induction time but longer recovery time than the meperidine group.

Enhanced delivery of siRNA complexes by sonoporation in transgenic rice cell suspension cultures.

Small interfering synthetic double-stranded RNA (siRNA) was applied to suppress the expression of the human cytotoxic- T-lymphocyte antigen 4-immunoglobulin (hCTLA4Ig) gene transformed in transgenic rice cell cultures. The sequence of the 21-nucleotide siRNA was deliberately designed and synthesized with overhangs to inactivate the expression of hCTLA4Ig. The chemically synthesized siRNA duplex was combined with polyethyleneimine (PEI) at a mass ratio of 1:10 (0.33 microg siRNA:3.3 microg PEI) to produce complexes. The siRNA complexes (siRNA+PEI) were labeled with Cy3 in order to subsequently confirm the delivery by fluorescent microscopy. In addition, the cells were treated with sonoporation at 40 kHz and 419 W for 90 s to improve the delivery. The siRNA complexes alone inhibited the expression of hCTLA4Ig to 45% compared with control. The siRNA complexes delivered with sonoporation downregulated the production of hCTLA4Ig to 73%. Therefore, we concluded that the delivery of siRNA complexes into plant cells could be enhanced successfully by sonoporation.

Common Illnesses in Tropical Asia and Significance of Medical Volunteering.

This study was conducted to provide practical information for actual preparation of medical volunteering in tropical Asia, mainly the distribution of common illnesses encountered during mission. From 2012 to 2017, we visited two rural areas of Eastern Cambodia for medical volunteering missions, Cham Lak and Khsoem. Neither area has electricity or public water. We classified the common cases encountered during missions into six groups (upper respiratory infection, gastroenteritis, vaginitis and/or cystitis, dermatitis, work-related pain and parasite prevention) and assessed the distribution. In Cham Lak and Khsoem, 558 and 371 people were treated, respectively. The most commonly encountered cases in children under age of 18 were upper respiratory infection, followed by parasite control and dermatitis, in both areas. There was no significant difference in distribution between the two areas. For adults, the most common illnesses in Cham Lak area were vaginitis and/or cystitis, followed by gastroenteritis and work-related pain. In Khsoem area, the common illnesses were work-related pain followed by gastroenteritis, and upper respiratory infection. The distribution between the two areas differed significantly (p <0.001). The difference might be due to the water source and main crops of agriculture. Successful preparation of a medical volunteering needs deep understanding of the destination community.

A vegetarian diet does not protect against nonalcoholic fatty liver disease (NAFLD): A cross-sectional study between Buddhist priests and the general population.

BACKGROUND/AIMS: There is limited data that supports a role for a vegetarian diet in nonalcoholic fatty liver disease (NAFLD). The aim of this study is to evaluate the relationship between vegetarian diets and NAFLD, considering metabolic syndrome and obesity. MATERIALS AND METHODS: This is a cross-sectional, retrospective study comparing the prevalence of NAFLD of 615 Buddhist priests and age-, sex-, Body mass index (BMI)-and presence/absence of metabolic syndrome-matched controls who underwent routine health checkups in a health promotion center. Diagnosis and severity of NAFLD was determined based on ultrasonographic findings. RESULTS: The prevalence of NAFLD was not statistically significantly different between the Buddhist priests and the general population (29.9% vs. 25.05%, p=0.055). The Buddhist priest group had higher serum albumin, serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), and serum triglyceride levels and lower serum total bilirubin, serum fasting glucose, and serum high density lipoprotein (HDL) levels than the general population group. In univariate analysis and multivariate analysis, NAFLD was associated with old age, male gender, increased BMI, increased waist circumference, metabolic syndrome, high albumin, high glucose, high AST, high ALT, high gamma glutamyl transpeptidase (GGT), high triglycerides, low HDL, high low density lipoprotein (LDL), and high total cholesterol. CONCLUSION: The vegetarian diet does not protect against NAFLD.