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BACKGROUND AND OBJECTIVES: There is a paucity of evidence on the value of intraperitoneal chemotherapy (IPC) following cytoreductive surgery (CRS) for colorectal peritoneal metastasis. This study aimed to evaluate the association between mitomycin C-IPC and survival outcomes following CRS. METHODS: The institutional databases of two tertiary hospitals were reviewed to identify patients who underwent CRS for colorectal peritoneal metastasis. The outcomes of patients who underwent CRS without IPC were compared with those of patients who underwent CRS plus early postoperative intraperitoneal chemotherapy (EPIC) or CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC). The primary endpoints were cancer-specific survival (CSS), progression-free survival (PFS), and peritoneal PFS (P-PFS). RESULTS: In 149 patients with peritoneal metastasis alone, EPIC and HIPEC use was significantly associated with better CSS, PFS, and P-PFS in the multivariate analysis. CSS was also significantly associated with perioperative systemic chemotherapy. Among 42 patients with both peritoneal and extraperitoneal metastases, CSS was independently related to the completeness of cytoreduction score, location of extraperitoneal metastasis, and grade 3-4 complications. CONCLUSIONS: Mitomycin C-IPC after CRS was associated with better survival outcomes than CRS alone in patients with resectable peritoneal metastasis of colorectal cancer. This study found that IPC had beneficial effects regarding P-PFS in patients with both peritoneal and extraperitoneal metastases.
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Neoplasias Colorretais , Hipertermia Induzida , Neoplasias Peritoneais , Humanos , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Mitomicina , Procedimentos Cirúrgicos de Citorredução , Estudos Retrospectivos , Neoplasias Colorretais/patologia , Terapia Combinada , Quimioterapia do Câncer por Perfusão Regional , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Taxa de SobrevidaRESUMO
We present high-resolution magnetic resonance imaging (MRI) at ultra-low field (ULF) with a proton Larmor frequency of around 120 kHz. The key element is a specially designed high-sensitivity sensing coil in the shape of a solenoid with a few millimeter gap between windings to decrease the proximity effect and, hence, increase the coil's quality ( Q ) factor and sensitivity. External noise is strongly suppressed by enclosing the sensing coil in a copper cylindrical shield, large enough not to negatively affect the coil's Q factor and sensitivity, measured to be 217 and 0.47 fT/Hz 1 / 2 , respectively. To enhance small polarization of proton spins at ULF, a strong pulsed 0.1 T prepolarization field is applied, making the signal-to-noise ratio (SNR) of ULF MRI sufficient for high-quality imaging in a short time. We demonstrate ULF MRI of a copper sulfate solution phantom with a resolution of 1 × 1 × 8.5 mm 3 and SNR of 10. The acquisition time is 6.3 min without averaging. The sensing coil size in the current realization can accommodate imaging objects of 9 cm in size, sufficient for hand, and it can be further increased for human head imaging in the future. Since the in-plane resolution of 1 × 1 mm 2 is typical in anatomical medical imaging, this ULF MRI method can be an alternative low-cost, rapid, portable method for anatomical medical imaging of the human body or animals. This ULF MRI method can supplement other MRI methods, especially when such methods are restricted due to high cost, portability requirement, imaging artifacts, and other factors.
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The development of nerve conduits with a three-dimensional porous structure has attracted great attention as they closely mimic the major features of the natural extracellular matrix of the nerve tissue. As low levels of reactive oxygen species (ROS) function as signaling molecules to promote cell proliferation and growth, this study aimed to fabricate protoporphyrin IX (PpIX)-immobilized cellulose (CEPP) monoliths as a means to both guide and stimulate nerve regeneration. CEPP monoliths can be fabricated via a simple thermally induced phase separation method and surface modification. The improved nerve tissue regeneration of CEPP monoliths was achieved by the activation of mitogen-activated protein kinases, such as extracellular signal-regulated kinases (ERKs). The resulting CEPP monoliths exhibited interconnected microporous structures and uniform morphology. The results of in vitro bioactivity assays demonstrated that the CEPP monoliths with under 0.54 ± 0.07 µmol/g PpIX exhibited enhanced photodynamic activity on Schwann cells via the generation of low levels of ROS. This photodynamic activation of the CEPP monoliths is a cell-safe process to stimulate cell proliferation without cytotoxic side effects. In addition, the protein expression of phospho-ERK increased considerably after the laser irradiation on the CEPP monoliths with low content of PpIX. Therefore, the CEPP monoliths have a potential application in nerve tissue regeneration as new nerve conduits.
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Celulose/química , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Protoporfirinas/farmacologia , Células de Schwann/citologia , Animais , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Regeneração Nervosa , Tecido Nervoso/química , Fosforilação , Protoporfirinas/química , Ratos , Espécies Reativas de Oxigênio/metabolismo , Células de Schwann/efeitos dos fármacos , Células de Schwann/metabolismo , Células de Schwann/efeitos da radiaçãoRESUMO
Influenza epidemics frequently and unpredictably break out all over the world, and seriously affect the breeding industry and human activity. Inactivated and live attenuated viruses have been used as protective vaccines but exhibit high risks for biosafety. Subunit vaccines enjoy high biosafety and specificity but have a few weak points compared to inactivated virus or live attenuated virus vaccines, especially in low immunogenicity. In this study, we developed a new subunit vaccine platform for a potent, adjuvant-free, and multivalent vaccination. The ectodomains of hemagglutinins (HAs) of influenza viruses were expressed in plants as trimers (tHAs) to mimic their native forms. tHAs in plant extracts were directly used without purification for binding to inactivated Lactococcus (iLact) to produce iLact-tHAs, an antigen-carrying bacteria-like particle (BLP). tHAs BLP showed strong immune responses in mice and chickens without adjuvants. Moreover, simultaneous injection of two different antigens by two different formulas, tHAH5N6 + H9N2 BLP or a combination of tHAH5N6 BLP and tHAH9N2 BLP, led to strong immune responses to both antigens. Based on these results, we propose combinations of plant-based antigen production and BLP-based delivery as a highly potent and cost-effective platform for multivalent vaccination for subunit vaccines.
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Adjuvantes Imunológicos/farmacologia , Vírus da Influenza A Subtipo H9N2/imunologia , Vacinas contra Influenza/imunologia , Lactococcus/virologia , Nicotiana/genética , Vacinas Combinadas/imunologia , Animais , Antígenos Virais/imunologia , Galinhas/imunologia , Retículo Endoplasmático/metabolismo , Hemaglutininas/química , Hemaglutininas/metabolismo , Imunidade/efeitos dos fármacos , Imunização , Camundongos , Extratos Vegetais/isolamento & purificação , Plantas Geneticamente Modificadas , Domínios Proteicos , Multimerização ProteicaRESUMO
OBJECTIVE: Clinical presentation of patients with mitral paravalvular leakage (PVL) varies from asymptomatic to heart failure related with hemolytic anemia or pulmonary hypertension. We aimed to investigate the structural and functional characteristics of mitral PVL by multimodal imaging and their association with the severity of hemolysis and hemodynamic significance. METHODS: A total of 74 patients with mitral PVL who underwent both cardiac computed tomography (CT) and echocardiography from March 2010 to December 2017 was investigated. Location and size of PVL, degree of left atrial (LA) calcification as measured by CT, and hemodynamic variables as measured by echocardiography were comprehensively analyzed. To investigate the degree of hemolysis and pulmonary hypertension, level of lactate dehydrogenase (LDH) and Doppler estimated systolic pulmonary artery pressure (SPAP) were used respectively. RESULTS: Level of LDH was not related to PVL perimeter and was variable, especially in patients with a small PVL. However, it was positively correlated with mean mitral regurgitation velocity. Additionally, SPAP was significantly correlated with PVL perimeter and LA calcium score. In multivariable analysis, mean mitral regurgitation velocity was significantly correlated with levels of LDH (ß = 0.345; p = 0.016), and PVL perimeter and LA calcium score were independently associated with SPAP (ß = 0.249; p = 0.036 and ß = 0.467; p < 0.001, respectively). CONCLUSIONS: Characteristics of mitral PVL and adjacent structures are associated with the severity of hemolysis and pulmonary hypertension. Evaluating the structural and functional characteristics of mitral PVL by complementary multimodal imaging would be important for understanding the clinical presentation and deciding optimal treatments for individual patients.
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Despite the availability of antibiotics and vaccines, many intractable infectious diseases still threaten human health across the globe. Uncontrolled infections can lead to systemic inflammatory response syndrome and the excessive production of inflammatory cytokines, known as a cytokine storm. As cytokines also play necessary and positive roles in fighting infections, it is important to identify nontoxic and anti-inflammatory natural products that can modulate cytokine production caused by infections. Rubi Fructus, the unripe fruits of Rubus coreanus Miquel, are known to possess antioxidative properties. In this study, the effect of the water extract of Rubi Fructus (RF) on the lipopolysaccharide (LPS)-induced inflammatory response in RAW 264.7 macrophages was investigated using biochemical and cell biology techniques. Our data indicated that RF inhibits p38 phosphorylation, intracellular calcium release, and the production of nitric oxide (NO), interleukin (IL)-6, monocyte chemotactic activating factor (MCP)-1, tumor necrosis factor (TNF)-α, leukemia inhibitory factor (LIF), lipopolysaccharide-induced CXC chemokine (LIX), granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), macrophage colony-stimulating factor (M-CSF), macrophage inflammatory protein (MIP)-1α, MIP-1ß, MIP-2, and regulated on activation, normal T cell expressed and secreted (RANTES) in LPS-treated macrophages. In addition, we observed decreasing mRNA expression of Chop, Camk2a, Stat1, Stat3, Jak2, Fas, c-Jun, c-Fos, Nos2, and Ptgs2 without cytotoxic effects. We concluded that RF demonstrated immunoregulatory activity on LPS-stimulated macrophages via an endoplasmic reticulum (ER) stress-induced calcium/CCAAT-enhancer-binding protein homologous protein (CHOP) pathway and the Janus kinase (JAK)/signal transducers and activators of transcription (STAT) pathway.
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Cálcio/metabolismo , Estresse do Retículo Endoplasmático/fisiologia , Ativação de Macrófagos/efeitos dos fármacos , Extratos Vegetais/farmacologia , Rubus/química , Fator de Transcrição CHOP/metabolismo , Animais , Anti-Inflamatórios , Citocinas/biossíntese , Frutas/química , Janus Quinases/metabolismo , Lipopolissacarídeos/farmacologia , Camundongos , Células RAW 264.7 , Fatores de Transcrição STAT/metabolismo , Transdução de Sinais/efeitos dos fármacos , ÁguaRESUMO
Acupuncture is a well-known traditional medical procedure in Korea and is being increasingly used to treat various conditions including pain control, especially among the older generation. However, several problems related to acupuncture have been reported. A 27-year-old woman expressed that she had back pain occurring despite her posture. She received acupuncture therapy 2 months prior. We discovered a needle-shaped foreign material near the T12 vertebra body in the retroperitoneum. We extracted 2 pieces of deteriorated broken needles by laparoscopy. Postoperatively, the woman was discharged within 5 days with no complications. We report a patient that received laparoscopy with a full recovery after having severe back pain caused by a broken needle which was stuck in the retroperitoneum.
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BACKGROUND: Except for data in the Korea Hemophilia Foundation Registry, little is known of the epidemiology of congenital bleeding disorders in Korea. METHODS: Data were obtained from the Korean Health Insurance Review and Assessment Service (HIRA) database. RESULTS: From 2010 to 2015, there were 2,029 patients with congenital bleeding disorders in the Korean HIRA database: 38% (n = 775) of these patients had hemophilia A (HA), 25% (n = 517) had von Willebrand disease (vWD), 7% (n = 132) had hemophilia B (HB), and 25% (n = 513) had less common factor deficiencies. The estimated age-standardized incidence rate (ASR) of HA and HB was 1.78-3.15/100,000 and 0.31-0.51/100,000, respectively. That of vWD was 1.38-1.95/100,000. The estimated ASR of HA showed increase over time though the number of new patients did not increase. Most patients with congenital bleeding disorders were younger than 19 years old (47.8%), and most were registered in Gyeonggi (22.1%) and Seoul (19.2%). CONCLUSION: This is the first nationwide population-based study of congenital bleeding disorders in Korea. This study provides data that will enable more accurate estimations of patients with vWD. This information will help advance the comprehensive care of congenital bleeding disorders. We need to continue to obtain more detailed information on patients to improve the management of these diseases.
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Transtornos Herdados da Coagulação Sanguínea/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Hemofilia A/epidemiologia , Hemofilia B/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Adulto Jovem , Doenças de von Willebrand/epidemiologiaRESUMO
Beyond the synthesis of typical nanocrystals, various breakthrough approaches have been developed to provide more useful structural features and functionalities. Among them, galvanic replacement, a structural transformation reaction accompanied by constituent element substitution, has been applied to various areas. However, the innovative improvement for galvanic replacement needs to be considered because of the limitation of applicable element pairs to maintain structural stability. To expand the boundary of galvanic-replacement-mediated synthesis, we have become interested in the Group 9 metallic element Ir, which is considered a fascinating element in the field of catalysis, but whose size and shape regulation has been conventionally regarded as difficult. To overcome the current limitations, we developed a hydrothermal galvanic-replacement-tethered synthetic route to prepare Ir-Ag-IrO2 nanoplates (IrNPs) with a transverse length of tens of nanometers and a rough surface morphology. A very interesting photoreactivity was observed from the prepared IrNPs, with Ag and IrO2 coexisting partially, which showed photothermal conversion and photocatalytic activity at different ratios against extinction wavelengths of 473, 660, and 808 nm. The present IrNP platform showed excellent photothermal conversion efficiency under near-infrared laser irradiation at 808 nm and also represented an effective cancer treatment in vitro and in vivo through a synergistic effect with reactive oxygen species (ROS) generation. In addition, computed tomography (CT) imaging contrast effects from Ir and IrO2 composition were also clearly observed.
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Antineoplásicos/farmacologia , Nanopartículas/química , Termodinâmica , Tomografia Computadorizada por Raios X , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/tratamento farmacológico , Antineoplásicos/química , Proliferação de Células/efeitos dos fármacos , Meios de Contraste/química , Meios de Contraste/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Feminino , Células HeLa , Humanos , Irídio/química , Irídio/farmacologia , Imagem Óptica , Tamanho da Partícula , Fototerapia , Espécies Reativas de Oxigênio/metabolismo , Prata/química , Prata/farmacologia , Propriedades de Superfície , Neoplasias do Colo do Útero/metabolismoRESUMO
PURPOSE: The enzyme 5-α reductase type 2 (5-AR 2) plays a key role in the development and maintenance of the prostate gland. We evaluated the level 5-AR 2 protein expression and the relationship between methylation of the 5-AR 2 gene-promoter and 5-AR 2 protein expression of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 37 prostate samples were evaluated. These included 22 samples from men undergoing transurethral prostate resections and 15 non-cancerous transition-zone human prostate tissue samples taken following radical prostatectomy. We quantified 5-AR 2 protein expression and gene-promoter methylation status using common assay procedures. Clinical variables included age, body mass index (BMI), prostate-specific antigen (PSA) levels, lipid profiles, and prostate volumes. Univariate and multivariate statistical analyses were performed followed by stepwise logistic regression modeling. RESULTS: We were able to extract DNA from 36 of the 37 tissue samples and 10 of these (28%) did not express the 5-AR 2 protein. In total, 26 patients (72%) had methylated 5-AR 2 promoter-regions. There was a strong correlation between methylation of the 5-AR 2 promoter-regions and low-absent 5-AR 2 protein expression (p = 0.0003). Increasing age significantly predicted methylation status and protein expression level (p = 0.013). CONCLUSIONS: The level of 5-AR 2 protein expression varies among prostate tissue samples. Methylation of the 5-AR 2 gene-promoter may account for low or absent expression of 5-AR 2 in adult human prostate tissues. Increased age correlates with increased 5-AR 2 gene-promoter methylation and decreased protein expression in men with BPH.
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3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , Metilação de DNA , Proteínas de Membrana/genética , Regiões Promotoras Genéticas , Hiperplasia Prostática/genética , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/metabolismo , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Humanos , Modelos Logísticos , Masculino , Proteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Hiperplasia Prostática/metabolismo , Ressecção Transuretral da PróstataRESUMO
Accumulating evidence does not yet confirm the effect of power line frequency magnetic field (MF) on human health and fertility. We recently reported that, at continuous 60 Hz MF exposure in mice, the dose given as magnetic flux density (tesla; T) and duration of exposure was related to induce testicular germ cell apoptosis. We aimed to characterize the effect of a 20-week continuous exposure to 60 Hz MF on the motility, morphology, and number of sperm as well as the apoptosis of testicular germ cell in rats. Sprague-Dawley rats were exposed for 20 weeks to 60 Hz MF of 2, 20, or 200 µT for 24 h/day with rats exposed to sham conditions, serving as the control. The exposure to 60 Hz MF of 2 and 20 µT had no effects on testicular in this study. The exposure to 60 Hz MF of 200 µT for 20 weeks induced increases of the apoptotic cells (P < 0.001) in germ cells and decreases of sperm numbers (P < 0.05). However, the MF did not significantly affect the body or testis mass, seminiferous tubule diameter, or the motility or morphology of sperm. This study concluded that exposure to 60 Hz MF of 200 µT can increase testicular germ cell apoptosis, especially spermatogonia, and reduce sperm count. Also compared to previous mice studies, rats are less sensitive than mice to exposure to 60 Hz MF. Bioelectromagnetics. 39:539-546, 2018. © 2018 Wiley Periodicals, Inc.
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Campos Magnéticos/efeitos adversos , Testículo/fisiologia , Animais , Masculino , Ratos , Ratos Sprague-Dawley , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Fatores de TempoRESUMO
The dry root of Angelica sinensis (Oliv.) Diels, also known as “female ginseng”, is a popular herbal drug amongst women, used to treat a variety of health issues and cardiovascular diseases. The aim of this study is to evaluate the detailed molecular mechanism for anti-inflammatory effects of Angelica sinensis root water extract (ASW). The anti-inflammatory effect of ASW on lipopolysaccharide (LPS)-induced RAW 264.7 mouse macrophages was evaluated by the tetrazolium-based colorimetric assay (MTT), Griess reagent assay, multiplex cytokine assay, real time reverse transcription polymerase chain reaction (RT-PCR), and Fluo-4 calcium assay. ASW restored cell viability in RAW 264.7 at concentrations of up to 200 µg/mL. ASW showed notable anti-inflammatory effects. ASW exhibited IC50 = 954.3, 387.3, 191.7, 317.8, 1267.0, 347.0, 110.1, 573.6, 1171.0, 732.6, 980.8, 125.0, and 257.0 µg/mL for interleukin (IL)-6, tumor necrosis factor (TNF)-α, monocyte chemotactic activating factor (MCP)-1, regulated on activation, normal T cell expressed and secreted (RANTES), granulocyte colony-stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), lipopolysaccharide-induced CXC chemokine (LIX), macrophage inflammatory protein (MIP)-1α, MIP-1β, MIP-2, IL-10, and intracellular calcium, respectively. Additionally, ASW inhibited the LPS-induced production of nitric oxide and the LPS-induced mRNA expression of CHOP (GADD153), Janus kinase 2 (JAK2), signal transducers and activators of transcription 1 (STAT1), first apoptosis signal receptor (FAS), and c-Fos, NOS2, and PTGS2 (COX2) in RAW 264.7 significantly (p < 0.05). Data suggest that ASW exerts an anti-inflammatory effect on LPS-induced RAW 264.7 via NO-bursting/calcium-mediated JAK-STAT pathway.
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Angelica sinensis/química , Anti-Inflamatórios/farmacologia , Medicamentos de Ervas Chinesas/farmacologia , Lipopolissacarídeos/farmacologia , Macrófagos/efeitos dos fármacos , Solventes/química , Água/química , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/isolamento & purificação , Sinalização do Cálcio/efeitos dos fármacos , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/metabolismo , Citocinas/metabolismo , Relação Dose-Resposta a Droga , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/isolamento & purificação , Regulação da Expressão Gênica , Mediadores da Inflamação/metabolismo , Janus Quinase 2/genética , Janus Quinase 2/metabolismo , Macrófagos/metabolismo , Camundongos , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo II/genética , Óxido Nítrico Sintase Tipo II/metabolismo , Fitoterapia , Plantas Medicinais , Células RAW 264.7 , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator de Transcrição STAT1/genética , Fator de Transcrição STAT1/metabolismo , Fatores de Tempo , Fator de Transcrição CHOP/genética , Fator de Transcrição CHOP/metabolismo , Receptor fas/genética , Receptor fas/metabolismoRESUMO
BACKGROUND: Emodin (3-methyl-1, 6, 8-trihydroxyanthraquinone) is a compound which can be found in Polygoni Multiflori Radix (PMR). PMR is the root of Polygonum multiflorum. PMR is used to treat dizziness, spermatorrhea, sores, and scrofula as well as chronic malaria traditionally in China and Korea. The anti-tumor property of emodin was already reported. However, anti-viral activity of emodin on macrophages are not fully reported. MATERIALS AND METHODS: Effects of emodin on RAW 264.7 mouse macrophages induced by polyinosinic-polycytidylic acid (poly I:C), a synthetic analog of double-stranded RNA, were evaluated. RESULTS: Emodin restored the cell viability in poly I: C-induced RAW 264.7 at concentrations of up to 50 µM. Emodin significantly inhibited the production of nitric oxide, IL-1α, IL-Ιß, IL-6, GM-CSF, G-CSF, M-CSF, MCP-1, MIP-1a, MIP-Ιß, MIP-2, RANTES, and IP-10 as well as calcium release and mRNA expression of signal transducer and activated transcription 1 (STAT1) in poly I:C-induced RAW 264.7 (P < 0.05). CONCLUSION: This study shows the inhibitory effect of emodin on poly I: C-induced RAW 264.7 via calcium-STAT pathway.
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Emodina/farmacologia , Fallopia multiflora/química , Macrófagos/efeitos dos fármacos , Raízes de Plantas/química , Animais , Cálcio/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Citocinas/antagonistas & inibidores , Macrófagos/metabolismo , Camundongos , Óxido Nítrico/antagonistas & inibidores , Poli I-C , Células RAW 264.7 , RNA de Cadeia Dupla , Fator de Transcrição STAT1/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacosRESUMO
BACKGROUND: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. METHODS: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O'Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. RESULTS: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 % confidence interval [CI] 2.028-10.474) and OS (HR 3.956, 95 % CI 1.127-13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. CONCLUSION: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Antígeno Carcinoembrionário/sangue , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Quimioterapia Adjuvante , Neoplasias do Colo/patologia , Feminino , Fluoruracila/administração & dosagem , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Oxaliplatina , Prognóstico , Pirimidinas/administração & dosagem , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: Myocardial dyskinesia caused by the accessory pathway and related reversible heart failure have been well documented in echocardiographic studies of pediatric patients with Wolff-Parkinson-White (WPW) syndrome. However, the long-term effects of dyskinesia on the myocardium of adult patients have not been studied in depth. The goal of the present study was to evaluate regional myocardial abnormalities on cardiac CT examinations of adult patients with WPW syndrome. MATERIALS AND METHODS: Of 74 patients with WPW syndrome who underwent cardiac CT from January 2006 through December 2013, 58 patients (mean [± SD] age, 52.2 ± 12.7 years), 36 (62.1%) of whom were men, were included in the study after the presence of combined cardiac disease was excluded. Two observers blindly evaluated myocardial thickness and attenuation on cardiac CT scans. On the basis of CT findings, patients were classified as having either normal or abnormal findings. We compared the two groups for other clinical findings, including observations from ECG, echocardiography, and electrophysiologic study. RESULTS: Of the 58 patients studied, 16 patients (27.6%) were found to have myocardial abnormalities (i.e., abnormal wall thinning with or without low attenuation). All abnormal findings corresponded with the location of the accessory pathway. Patients with abnormal findings had statistically significantly decreased left ventricular function, compared with patients with normal findings (p < 0.001). The frequency of regional wall motion abnormality was statistically significantly higher in patients with abnormal findings (p = 0.043). However, echocardiography documented structurally normal hearts in all patients. CONCLUSION: A relatively high frequency (27.6%) of regional myocardial abnormalities was observed on the cardiac CT examinations of adult patients with WPW syndrome. These abnormal findings might reflect the long-term effects of dyskinesia, suggesting irreversible myocardial injury that ultimately causes left ventricular dysfunction.
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Técnicas de Imagem de Sincronização Cardíaca/métodos , Tomografia Computadorizada Multidetectores/métodos , Síndrome de Wolff-Parkinson-White/diagnóstico por imagem , Adulto , Estudos de Casos e Controles , Meios de Contraste , Ecocardiografia , Técnicas Eletrofisiológicas Cardíacas , Feminino , Humanos , Iopamidol , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
This study was conducted to investigate arsenic (As) readsorption phenomenon in acid-treated soil using phosphate as a competing ion. Three field-aged soils (i.e., S1, paddy soil; S2, field soil; S3, forest soil) originally contaminated with As ranging from 30 to 59 mg/kg-soil were collected from a former smelter site. When 0.2M hydrochloric acid (HCl) alone was used as an extraction solution, As bound to iron (Fe) oxides was removed but significant amount of the released As was readsorbed onto residual Fe-oxides, yielding low As extraction efficiency of 11-27%. Readsorption of the released As seemed to occur preferentially on amorphous Fe-oxides. In contrast, As extraction efficiency was greatly increased by 0.2M HCl solution supplemented with monopotassium phosphate (KH2PO4), which was greatly influenced by the molar ratio of acid to phosphate. In addition, by the extraction solution with an optimal ratio of 0.2M HCl/0.1M KH2PO4, As extraction efficiency differed with soil types, showing 79.6, 44.1, and 61.0% in S1, S2, and S3, respectively. The reason can be ascribed to the blocking of the available As readsorption sites by phosphate ions, the sites seemed to mainly reside on the residual amorphous Fe-oxides in soil.
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Batch and column experiments were conducted to investigate sorption and transport of uranium (U) in the presence of saprolite derived from interbedded shale, limestone, and sandstone sequences. Sorption kinetics were measured at two initial concentrations (C0; 1, 10 µM) and three soil:solution ratios (Rs/w; 0.005, 0.25, 2 kg/L) at pH 4.5 (pH of the saprolite). The rate of U loss from solution (µmole/L/h) increased with increasing Rs/w. Uranium sorption exhibited a fast phase with 80% sorption in the first eight hours for all C0 and Rs/w values and a slow phase during which the reaction slowly approached (pseudo)equilibrium over the next seven days. The pH-dependency of U sorption was apparent in pH sorption edges. U(VI) sorption increased over the pH range 4-6, then decreased sharply at pH > 7.5. U(VI) sorption edges were well described by a surface complexation model using calibrated parameters and the reaction network proposed by Waite et al. (1994). Sorption isotherms measured using the same Rs/w and pH values showed a solids concentration effect where U(VI) sorption capacity and affinity decreased with increasing solids concentration. This effect may have been due to either particle aggregation or competition between U(VI) and exchangeable cations for sorption sites. The surface complexation model with calibrated parameters was able to predict the general sorption behavior relatively well, but failed to reproduce solid concentration effects, implying the importance of appropriate design if batch experiments are to be utilized for dynamic systems. Transport of U(VI) through the packed column was significantly retarded. Transport simulations were conducted using the reactive transport model HydroGeoChem (HGC) v5.0 that incorporated the surface complexation reaction network used to model the batch data. Model parameters reported by Waite et al. (1994) provided a better prediction of U transport than optimized parameters derived from our sorption edges. The results presented in this study highlight the challenges in defining appropriate conditions for batch-type experiments used to extrapolate parameters for transport models, and also underline a gap in our ability to transfer batch results to transport simulations.
Assuntos
Urânio/análise , Poluentes Químicos da Água/análise , Poluentes Radioativos do Solo/análiseRESUMO
INTRODUCTION: The mechanism of complex fractionated atrial electrogram (CFAE) in patients with atrial fibrillation (AF) remains controversial. This study investigated the relationship between CFAE and left atrial (LA) wall thickness. METHODS AND RESULTS: LA muscular wall thickness (excluding fat) was measured by cardiac computed tomography in 31 patients with AF (12 paroxysmal, 19 persistent) prior to catheter ablation procedures. Measurements were performed at 31 distinct LA locations: 3 at roof, 3 at floor, 9 at anterior wall, 9 at posterior wall, 3 at lateral wall, 3 at septum, and 1 at base of the anterior appendage. The range of LA wall thickness (LAWT) varied widely (average 2.4 ± 0.4 mm, range 1.5-3.1 mm) between patients. In addition, there were significant regional differences in LAWT. Each patient had an average of 7.3 ± 3.5 CFAE sites. The LA wall was thicker at CFAE sites (227 sites, 3.0 ± 1.0 mm) than at non-CFAE sites (734 sites, 2.2 ± 0.9 mm, P < 0.001). In 23 of 31 (74%) patients, the LA wall was thicker at CFAE area than at non-CFAE area. There was no difference in LAWT between sites where CFAE vanished and those where CFAE persisted after pulmonary vein isolation (PVI) among sites with CFAE before PVI. The LAWT > 2.5 mm predicted CFAE with a sensitivity of 70% and a specificity of 70%. CONCLUSION: The LAWT correlates well with CFAE areas, suggesting that one of the mechanisms of CFAE might be related to LAWT.
Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Técnicas Eletrofisiológicas Cardíacas/métodos , Átrios do Coração/fisiopatologia , Idoso , Cardiomegalia/diagnóstico , Cardiomegalia/fisiopatologia , Feminino , Átrios do Coração/patologia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Tecido Adiposo/diagnóstico por imagem , Fibrilação Atrial/diagnóstico , Técnicas Eletrofisiológicas Cardíacas , Átrios do Coração/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Fibrilação Atrial/fisiopatologia , Ecocardiografia , Feminino , Seguimentos , Átrios do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
The tuber of Liriope platyphylla Wang et Tang (Liliaceae), also known as Liriopis tuber, is famous in Oriental medicine owing to its tonic, antitussive, expectorant and anti-asthmatic properties. In the present study, the effects of Liriopis tuber water extract (LP) on proinflammatory mediators secreted from lipopolysaccharide (LPS)-induced cultured RAW 264.7 mouse macrophages were investigated. Nitric oxide (NO), prostaglandin E2 (PGE2) and intracellular calcium release were measured after 24 h incubation. Various cytokines and nuclear transcription factors (NF-κB and CREB) of LPS-induced RAW 264.7 were measured by a multiplex bead array assay based on xMAP technology. LP (up to 200 μg/mL) significantly decreased levels of nitric oxide (NO), interleukin (IL)-6, IL-10, IL-12p40, interferon-inducible protein-10, keratinocyte-derived chemokine, monocyte chemotactic protein-1, vascular endothelial growth factor, granulocyte macrophage-colony stimulating factor, platelet derived growth factor, PGE2, intracellular calcium, NF-κB and CREB in LPS-induced RAW 264.7 cells (p < 0.05). The results suggest that LP has immunomodulatory activity to reduce excessive immune reactions during the activation of macrophages by LPS. Further studies are needed to verify the precise mechanism regulating immunomodulatory activities of LP.