Acupuncture for the Treatment of Taxane-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Trial.

OBJECTIVES: Some chemotherapy drugs can damage the nerves and cause peripheral neuropathy which is accompanied by severe neuropathic pain or gait impairment. The purpose of this study was to assess the feasibility and the safety of acupuncture for the treatment of peripheral neuropathy following chemotherapy in Korean breast cancer patients. DESIGN: This study was a prospective single-arm observational study using before and after measurements in breast cancer patients presenting with taxane-induced peripheral neuropathy. SETTINGS/LOCATION: This study was performed at East-West Medical Center at Daegu Catholic University Hospital, Daegu, South Korea. INTERVENTIONS: Acupuncture was administered 3 times a week for 4 consecutive weeks, for 25 ± 5 minutes at each session. OUTCOME MEASURES: The primary outcome measure was severity of CIPN using the Neuropathic Pain Symptom Inventory (NPSI) assessed by a self-administered questionnaire and Nerve Conduction Study (NCS) of extremities. The secondary outcome measure was quality of life (QoL) assessed by a self-administered questionnaire using the 36-Item Short From Health Survey (SF-36). RESULTS: Acupuncture significantly reduced the severity of CIPN assessed by NPSI score. Four weeks after the last treatment, the symptoms were not aggravated. According to NCS, 42.9% of participants showed improvement of sensory neuropathy. At the end of the treatment, SF-36 scores were significantly increased for variables including physical functioning, role limitations due to physical health problems, social functioning, and general health perceptions compared to those of baseline measurement. CONCLUSIONS: Acupuncture improved symptoms of CIPN and QoL in Korean women suffering from peripheral neuropathy after chemotherapy using taxane for breast cancer. The effects of acupuncture lasted for at least 1 month after the treatment.

Establishment of a platform of non-small-cell lung cancer patient-derived xenografts with clinical and genomic annotation.

BACKGROUND: Preclinical models that can better predict therapeutic activity in clinical trials are needed in this era of personalized cancer treatment. Herein, we established genomically and clinically annotated patient-derived xenografts (PDXs) from non-small-cell lung cancer (NSCLC) patients and investigated whether these PDXs would faithfully recapitulate patient responses to targeted therapy. METHODS: Patient-derived tumors were implanted in immunodeficient mice and subsequently expanded via re-implantation. Established PDXs were examined by light microscopy, genomic profiling, and in vivo drug testing, and the successful engraft rate was analyzed with the mutation profile, histology, or acquisition method. Finally, the drug responses of PDXs were compared with the clinical responses of the respective patients. RESULTS: Using samples from 122 patients, we established 41 NSCLC PDXs [30 adenocarcinoma (AD), 11 squamous cell carcinoma (SQ)], among which the following driver mutation were observed: 13 EGFR-mutant, 4 ALK-rearrangement, 1 ROS1-rearrangement, 1 PIK3CA-mutant, 1 FGFR1-amplification, and 2 KRAS-mutant. We rigorously characterized the relationship of clinical features to engraftment rate and latency rates. The engraft rates were comparable across histologic type. The AD engraft rate tended to be higher for surgically resected tissues relative to biopsies, whereas similar engraft rates was observed for SQ, irrespective of the acquisition method. Notably, EGFR-mutants demonstrated significantly longer latency time than EGFR-WT (86 vs. 37days, P = 0.007). The clinical responses were recapitulated by PDXs harboring driver gene alteration (EGFR, ALK, ROS1, or FGFR1) which regressed to their target inhibitors, suggesting that established PDXs comprise a clinically relevant platform. CONCLUSION: The establishment of genetically and clinically annotated NSCLC PDXs can yield a robust preclinical tool for biomarker, therapeutic target, and drug discovery.

Neogambogic Acid Suppresses Receptor Activator of Nuclear Factor κB Ligand (RANKL)-Induced Osteoclastogenesis by Inhibiting the JNK and NF-κB Pathways in Mouse Bone Marrow-Derived Monocyte/Macrophages.

BACKGROUND Neogambogic acid (NGA) is used in traditional Chinese medicine. The aim of this study was to investigate the effects of NGA on gene signaling pathways involved in osteoclastogenesis in mouse bone marrow-derived monocyte/macrophages (BMMs) and on bone resorption in vitro. MATERIAL AND METHODS Primary mouse BMMs were cultured with increasing concentrations of NGA. Real-time polymerase chain reaction was used to study the expression of mRNAs corresponding to gene products specific to receptor activator of NF-κB ligand (RANKL)-induced osteoclast differentiation, including tartrate-resistant acid phosphatase (TRAP), calcitonin receptor (CTR), cathepsin K (CTSK), and nuclear factor of activated T cells c1 (NFATc1). A cell counting kit-8 assay was used to evaluate cell proliferation. Western blotting and confocal immunofluorescence microscopy were used to investigate the signaling pathways. A bone resorption model was used to quantify bone resorption. RESULTS An NGA dose of ≤0.4 µg/ml had no significant effect on the proliferation of mouse BMMs in vitro (P>0.05); concentrations of between 0.1-0.4 µg/ml significantly inhibited RANKL-induced osteoclastogenesis (P<0.01) in a dose-dependent manner. Compared with the control group, NGA significantly reduced RANKL-induced bone resorption in vitro (P <0.01), and downregulated the expression of osteoclast-related mRNAs of TRAP, CTR, CTSK, and NFATc1. NGA suppressed the activation of JNK but not the p38 signaling pathway and significantly reduced NF-κB p65 phosphorylation and the nuclear transport of NF-κB molecules, which inhibited NFATc1 expression. CONCLUSIONS NGA suppressed RANKL-induced osteoclastogenesis by inhibiting the JNK and NF-κB pathways in mouse BMMs in vitro and reduced osteoclastic bone resorption.

Highly stable and imperceptible electronics utilizing photoactivated heterogeneous sol-gel metal-oxide dielectrics and semiconductors.

Incorporation of Zr into an AlOx matrix generates an intrinsically activated ZAO surface enabling the formation of a stable semiconducting IGZO film and good interfacial properties. Photochemically annealed metal-oxide devices and circuits with the optimized sol-gel ZAO dielectric and IGZO semiconductor layers demonstrate the high performance and electrically/mechanically stable operation of flexible electronics fabricated via a low-temperature solution process.

Effect of Draconis Sanguis-containing serum on NGF, BDNF, CNTF, LNGFR, TrkA, GDNF, GAP-43 and NF-H expressions in Schwann cells / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effect of Draconis Sanguis-containing serum on the expressions of NGF, BDNF, CNTF, LNG-FR, TrkA, GDNF, GAP-43 and NF-H in Schwann cells, and investigate the possible mechanism of Draconis Sanguis to promote peripheral nerve regeneration.</p><p><b>METHOD</b>SD rats were randomly divided into 2 groups: the Draconis Sanguis group (orally administered with Draconis Sanguis-containing balm solution) and the blank group (equivoluminal balm) to prepare Draconis Sanguis-containing serum and blank control serum. Schwann cells were extracted from double sciatic nerves of three-day-old SD rats, divided into 2 groups: the Draconis Sanguis group and the blank control group, and respectively cultured with 10% Draconis Sanguis-containing serum or blank control serum. The mRNA expressions of NGF, BDNF, CNTF and other genes in Schwann cells were measured by RT-PCR analysis 48 hours later.</p><p><b>RESULT</b>Most of the Schwann cells were bipolar spindle and arranged shoulder to shoulder or end to end under the microscope and identified to be positive with the immunocytochemical method. To compare with the blank group, mRNA expressions of NGF, LNGFR, GDNF and GAP-43 significantly increased (P < 0.01). Whereas that of BDNF decreased significantly (P < 0.05), and so did that of TrkA, CNTF (P < 0.01), with no remarkable difference in NF-H-mRNA.</p><p><b>CONCLUSION</b>Traditional Chinese medicine Draconis Sanguis may show effect in nerve regeneration by up-regulating mRNA expressions of NGF, LNGFR, GDNF and GAP-43 and down-regulating mRNA expressions of TrkA, BDNF and CNTF.</p>

The protective effect of ginko bilboa leaves injection on the brain dopamine in the rat model of cerebral ischemia/reperfusion injury.

BACKGROUND: Ginkgo Bilboa injection has had been clinically applied to restore the damaged cells and tissues due to the ischemia through improving the cerebral blood supply and decreasing the oxygen consumption. OBJECTIVE/AIM: To evaluate the Ginkgo Bilboa injection's therapeutic role towards ischemia/ reperfusion (I/R) injury through determination of monoamine neurotransmitter dopamine (DA) in corpus striatum. METHODS: After the incomplete global cerebral ischemia and reperfusion models were prepared, rats were randomly assigned into four groups: sham-operated group, ischemia-reperfusion group, nimodipine injection group, and Ginkgo Biloba injection group. The cerebrospinal fluid in the rat brain striatum at different time points was collected with microdialysis, and the level of monoamine neurotransmitters dopamineDA was determined by high performance liquid chromatography (HPLC) with electrochemical detector (ECD). RESULTS: The dopamineDA content in cerebral ischemia model group was significantly higher than that in the sham-operated group (P < 0.05) at the 30 min. However, the DA level in nimodipine injection group and Ginkgo Biloba injection group were lower than the model group (P < 0.05). The dopamineDA level in Ginkgo Biloba injection group gradually decreased, and was significantly different from the model group (P < 0.05). CONCLUSION: Ginkgo Biloba injection can could significantly inhibit brain I/R injury, as demonstrated by prevention of excessive release of dopamineDA in striatum.

Acupuncture for the treatment of hot flashes in patients with breast cancer receiving antiestrogen therapy: a pilot study in Korean women.

OBJECTIVES: Antiestrogen therapy can cause vasomotor symptoms similar to those occurring during menopause, including hot flashes. Recent studies suggest that acupuncture is effective in reducing vasomotor symptoms in patients with breast cancer receiving tamoxifen. The purpose of this study was to assess the feasibility and safety of acupuncture for treatment of hot flashes in Korean patients with breast cancer receiving antiestrogen therapy. DESIGN: This was a prospective single-arm observational study using before and after measurements. SETTINGS/LOCATION: The study was located at the East-West Medical Center at Daegu Catholic University Medical Center, Daegu, Korea. SUBJECTS: The subjects were 10 patients with breast cancer who were undergoing antiestrogen therapy with tamoxifen or anastrozole and who were suffering from hot flashes. INTERVENTIONS: Acupuncture was administered 3 times a week for 4 consecutive weeks, for 20±5 minutes at each session. OUTCOME MEASURES: The outcome measure was severity of hot flashes assessed by visual analogue scale (VAS) and total hot flash score. RESULTS: During treatment, severity of hot flashes was reduced by 70%-95% in all patients. Acupuncture significantly alleviated severity of hot flashes assessed by a visual analogue scale (F=30.261; p<0.001) as well as the total hot flash score (F=21.698; p=0.006). Four (4) weeks after the final treatment, symptoms were not aggravated. CONCLUSIONS: Acupuncture appeared to provide effective relief from hot flashes among Korean women receiving antiestrogen therapy after surgery for breast cancer, and the effects lasted for at least 1 month after termination of treatment. A randomized controlled prospective study with a larger sample size is required to clarify the role of acupuncture in the management of hot flashes in Korean patients with breast cancer.

Responses of root architecture development to low phosphorus availability: a review.

BACKGROUND: Phosphorus (P) is an essential element for plant growth and development but it is often a limiting nutrient in soils. Hence, P acquisition from soil by plant roots is a subject of considerable interest in agriculture, ecology and plant root biology. Root architecture, with its shape and structured development, can be considered as an evolutionary response to scarcity of resources. SCOPE: This review discusses the significance of root architecture development in response to low P availability and its beneficial effects on alleviation of P stress. It also focuses on recent progress in unravelling cellular, physiological and molecular mechanisms in root developmental adaptation to P starvation. The progress in a more detailed understanding of these mechanisms might be used for developing strategies that build upon the observed explorative behaviour of plant roots. CONCLUSIONS: The role of root architecture in alleviation of P stress is well documented. However, this paper describes how plants adjust their root architecture to low-P conditions through inhibition of primary root growth, promotion of lateral root growth, enhancement of root hair development and cluster root formation, which all promote P acquisition by plants. The mechanisms for activating alterations in root architecture in response to P deprivation depend on changes in the localized P concentration, and transport of or sensitivity to growth regulators such as sugars, auxins, ethylene, cytokinins, nitric oxide (NO), reactive oxygen species (ROS) and abscisic acid (ABA). In the process, many genes are activated, which in turn trigger changes in molecular, physiological and cellular processes. As a result, root architecture is modified, allowing plants to adapt effectively to the low-P environment. This review provides a framework for understanding how P deficiency alters root architecture, with a focus on integrated physiological and molecular signalling.

Brain activation patterns of motor imagery reflect plastic changes associated with intensive shooting training.

Evidence from previous studies has suggested that motor imagery and motor action engage overlapping brain systems. As a result of this observation that motor imagery can activate brain regions associated with actual motor movement, motor imagery is expected to enhance motor skill performance and become an underlying principle for physical training in sports and physical rehabilitation. However, few studies have examined the effects of physical training on motor imagery in beginners. Also, differences in neural networks related to motor imagery before and after training have seldom been studied. In the current study, using functional magnetic resonance imaging (fMRI), we investigated the question of whether motor imagery can reflect plastic changes of neural correlates associated with intensive training. In fact, motor imagery was used in this study as a tool to assess the brain areas involved in shooting and involved in learning of shooting. We discovered that use of motor imagery resulted in recruitment of widely distributed common cortical areas, which were suggested to play a role in generation and maintenance of mental images before and after 90 h of shooting training. In addition to these common areas, brain activation before and after 90 h of shooting practice showed regionally distinct patterns of activity change in subcortical motor areas. That is, basal ganglia showed increased activity after 90 h of shooting practice, suggesting the occurrence of plastic change in association with gains in performance and reinforcement learning. Therefore, our results suggest that, in order to reach a level of expertise, the brain would change through initial reinforcement of preexistent connections during the training period and then use more focused neural correlates through formation of new connections.

Neural correlates of motor imagery for elite archers.

Motor imagery is a mental rehearsal of simple or complex motor acts without overt body movement. It has been proposed that the association between performance and the mental rehearsal period that precedes the voluntary movement is an important point of difference between highly trained athletes and beginners. We compared the activation maps of elite archers and nonarchers during mental rehearsal of archery to test whether the neural correlates of elite archers were more focused and efficiently organised than those of nonarchers. Brain activation was measured using functional MRI in 18 right-handed elite archers and 18 right-handed nonarchers. During the active functional MRI imagery task, the participants were instructed to mentally rehearse their archery shooting from a first-person perspective. The active imagery condition was tested against the nonmotor imagery task as a control condition. The results showed that the premotor and supplementary motor areas, and the inferior frontal region, basal ganglia and cerebellum, were active in nonarchers, whereas elite archers showed activation primarily in the supplementary motor areas. In particular, our result of higher cerebellar activity in nonarchers indicates the increased participation of the cerebellum in nonarchers when learning an unfamiliar archery task. Therefore, the difference in cerebellar activation between archers and nonarchers provides evidence of the expertise effect in the mental rehearsal of archery. In conclusion, the relative economy in the cortical processes of elite archers could contribute to greater consistency in performing the specific challenge in which they are highly practised.

Mycosis Fungoides Palmaris et Plantaris in Children / 대한피부과학회지

Mycosis fungoides palmaris et plantaris (MFPP) is a rare form of mycosis fungoides that is confined to the palms and soles. The clinical manifestation of MFPP is often confused with inflammatory palmoplantar dermatoses. Mycosis fungoides is usually considered as a disease of middle age, but it is rarely developed at any age. A 10-year-old girl was referred to us with a 2-year history of recalcitrant palmoplantar dermatoses. Other clinics had treated her for more than 2 years, but all medical treatments turned out to have had no effect, despite her young age. She had not had any atopic dermatitis or allergic contact dermatitis. Histopathologic findings showed inflammatory cell infiltration and lymphocytic epidermotrophism. Monoclonal TCR-rearrangement was positive, so we diagnosed her as having MFPP. We tried to treat her with topical PUVA therapy and she improved within 3 months. Herein, we report on a case of mycosis fungoides Palmaris et plantaris in a 10-year-old girl that was treated successfully with topical PUVA.

A case of micropapillary breast cancer with endometrial metastasis / 대한내과학회지

Breast cancer is one of the most common cancers in women. Even if appropriate treatments are applied, metastasis can occur in any organ of the body. Uterine metastasis from an extrapelvic tumor such as breast cancer is very rare. A 62-year-old woman with breast cancer was treated with modified radical mastectomy after neoadjuvant chemotherapy and adjuvant chemoradiotherapy. A single lung metastasis developed at 2 years after surgery, and the patient underwent wedge resection followed by capecitabine chemotherapy. Afterwards, the patient was treated with gemcitabine/vinorelbine chemotherapy for skin metastasis. Recently, she complained of vaginal spotting for 3 weeks. MRI of the uterus revealed a 1.1 cm endometrial tumor with myometrial invasion. Biopsy confirmed papillary carcinoma that originated from previous breast cancer. Although she was treated by palliative radiotherapy to the uterus, docetaxel/cyclophosphamide and trastuzumab, disease progression was observed.

A case of Klebsiella psoas abscess due to diverticulitis and intestinal tuberculosis / 대한내과학회지

A 38-year-old male-to-female transgender patient who had undergone a transsexual operation 20 years earlier presented with right flank pain and chills. Abdominal CT scan and gastrografin colon enema revealed a right psoas abscess and an abnormal communication between the large bowel and this psoas abscess. She underwent a right hemicolectomy and was finally diagnosed as having a Klebsiella psoas abscess due to perforated diverticulitis and intestinal tuberculosis. Additional antibiotics and antituberculous medication were required. A secondary psoas abscess due to diverticulitis is rare, and to our knowledge, no case combined with intestinal tuberculosis has previously been reported. We present the case with a brief review of related reports.

A case of Klebsiella psoas abscess due to diverticulitis and intestinal tuberculosis / 대한내과학회지

A 38-year-old male-to-female transgender patient who had undergone a transsexual operation 20 years earlier presented with right flank pain and chills. Abdominal CT scan and gastrografin colon enema revealed a right psoas abscess and an abnormal communication between the large bowel and this psoas abscess. She underwent a right hemicolectomy and was finally diagnosed as having a Klebsiella psoas abscess due to perforated diverticulitis and intestinal tuberculosis. Additional antibiotics and antituberculous medication were required. A secondary psoas abscess due to diverticulitis is rare, and to our knowledge, no case combined with intestinal tuberculosis has previously been reported. We present the case with a brief review of related reports.

Study on the theory of "selection of distal acupoints" / 中国针灸

The meridians belong to zang-fu organs inside and connect with the extremities outside. They keep information exchange among different tissues and make various organs of the human body as an organic whole. If the meridians are blocked and the information exchange makes mistake, the body will produce pathologic changes. Because the location of the blocked part is difficult to identify, in this paper it is explained that selection of distal acupoints is the best way to dredge the nodes of disease, and the theoretical basis is closely related with the theories of "the root cause and symptoms of a disease", "Genjie", and "Jing, Xing, Shu, Jing, He", and also implies the thought of "to cure a disease must treat the root of the disease".

Clinical Features of Cholestatic Hepatitis / 영남의대학술지

BACKGROUND: Cholestatic hepatitis is failure of bile to reach the duodenum with hepatocellular damage and no demonstable obstruction of the major bile ducts. The prognosis of usually good with recovery in less than 4 weeks after withdrawal of the offending drug. However, a prolonged causes of Chronic liver disease is needed. MATERIALS AND METHODS: From January 1991 through January 2000, 14 patients diagnosed as cholestatic hepatitis by liver biopsy were included. The possible causative drug, clinical features, laboatory findings, and progression of cholestatic hepatitis were evaluated. The semiquantitative study of liver lesions was performed by two independent observers. RESULTS: Causes of cholestatic hepatitis are 5 cases of oriental medicine, 3 cases of anti-tuberculosis medication, 1 case of ticlopidine and antibiotics and 4 cases of unknown causes. The clinical features of cholestatic hepatitis were jaundice, itching, urine color change, and general weakness. During 6 to 50 months, LFT of 5 patients showed prolonged elevation. Elevated total cholesterol > or =250 mg/dL in 6 patients, pheripheral blood eosinophilia in 5 patients, auto-antibody positive in 6 patients were observed respectively. The biopsies showed intralobular bilirubinostasis with a mixed portal inflammatory infiltration. CONCLUSION: In chlestatic hepatitis, durations of abnormal LET are variable regardless of causative drugs. If chlestatic hepatitis progresses toward chronic course, viral hepatitis, primary biliary cirrhosis, and autoimmune hepatitis should be differentially diagnosed and sequential liver biopsies are needed.

Differential Findings of Color M-mode Doppler Echocardiography according to the In-hospital Congestive Heart Failure Following Actue Myocardial Infarction

BACKGROUND: Abnormalities of the left ventricular diastolic function can be classified by pulsed Doppler echocardiography, but sometimes it may be difficult to differentiate normal diastolic function from pseudonormalization. Heart failure caused by increased left ventricular filling pressure is rather associated with pseudonormalization or restrictive pattern than normal pattem or relaxation abnormality. We investigated the usefulness of color M-mode Doppler echocardiographic indexes in differentiating normal relaxation from pseudonormalization after acute myocardial infarction. METHOD: Echocardiographic examination including color M-mode Doppler was performed in 44 patients with acute myocardial infarction between 10 and 14 days after attack. 34 patients without in-hospital congestive heart failure(CHF) were assigned as group I, and 10 patients with in-hospital CHF as group II. Flow propagation slope(FPS), time difference(TD) between the occurrence of peak flow velocity in the apical region and at the mitral tip, and normalized time difference(nTD) by mitral and apical distance were measured with color M-mode Doppler echocardiography. RESULTS: FPS was lower in group II(group I, 42.0+/-20.6cm/sec vs group II, 27.8+/-8.0cm/ sec , p=0.065). Both groups had similar TD and nTD. FPS was compared in patients with E/ A ratio of mitral inflow greater than 1(22 patients of group I and 7 patients of group II). Patients with E/A) 1 in group II had significantly lower FPS(group I, 52.1+/-17.5cm/sec vs group II, 31.0+/-7.4cm/sec ; p(0.01). CONCLUSION: FPS was significantly decreased after acute myocardial infarction in patients with in-hospital CHF compared with patients without in-hospital CHF, even when E/A ratio of mitral inflow was greater than 1. Therefore, FPS was an useful index in differentiating normal relaxation from pseudonormalization.

Comparative Clinical Analysis of Surgical and Conservative Treatment for Hypertensive Intracerebral Hemorrhage

Hypertensive intracerebral hemorrhage(ICH) is one of the leading causes of death in Korea. However, there are too many controversies regarding the pathogenesis and proper management of this disease. The author investigated the role of surgical treatment in improving the outcome of hypertensive ICH by analyzing the results of surgical and conservative therapy performed in 339 patients with hypertensive ICH during the past 8 years from 1986 to 1993. The peak age incidence of patients with hypertensive ICH was in the sixth decade(29.2%), and 88.5% of the cases occurred after the fifth decade. There was no sexual preponderance. Winter was the most prevalent season. Location of the hemorrhage was putamen in 9.2%, thalamus in 23.6%, lobular in 14.5%, cerebellum in 11.2%, caudate nucleus in 5.9%, and brain stem in 4.7%. The Glasgow coma scale(GCS) on admission was 3-5 in 17.7%, 6-8 in 2.4%, 9-12 in 20.1%, and 13-15 in 39.8%. Surgery was performed in 127 patients(37.5%) and the remaining patients were treated conservatively. The surgery rate was the highest(52.7%) for patients with 6-8 GCS, and the volume of hemorrhage was 0-45 cc. The outcome of all patients at discharge was graded as good recovery in 24.2%, moderate disability in 33.0%, severe disability in 11.8%, vegetative state in 8.6% and death in 22.4%. The mortality rate was 42.7% for patients with a 3-8 GCS, 23.5% for 9-12 GCS, and 1.5% for 13-15 GCS. The mortality rate was 9.2% in cases with a hemorrhage volume of less than 15cc, while in those over 60cc, the mortality rate was 75%. The results of surgical and conservative treatment were compared in each subgroups because the method of treatment differed according to the GCS and the volume of hemorrhage. When the GCS was less than 8, and when the hemorrhage volume was over 30cc, better results were obtained with surgery than with of conservative management(P<0.025, P<0.01, respectively).