Leptin regulation of the p53-HIF1α/PKM2-aromatase axis in breast adipose stromal cells: a novel mechanism for the obesity-breast cancer link.

BACKGROUND/OBJECTIVES: Obesity (body mass index (BMI)⩾30 kg m-2) is associated with an increased risk of estrogen-dependent breast cancer after menopause. Levels of aromatase, the rate-limiting enzyme in estrogen biosynthesis, are elevated in breast tissue of obese women. Recently, the regulation of aromatase by the p53-hypoxia-inducible factor-1α (HIF1α)/pyruvate kinase M2 (PKM2) axis was characterized in adipose stromal cells (ASCs) of women with Li-Fraumeni Syndrome, a hereditary cancer syndrome that predisposes to estrogen-dependent breast cancer. The current study aimed to determine whether stimulation of aromatase by obesity-associated adipokine leptin involves the regulation of the p53-HIF1α/PKM2 axis. SUBJECTS/METHODS: Human breast ASCs were used to characterize the p53-HIF1α/PKM2-aromatase axis in response to leptin. The effect of pharmacological or genetic modulation of protein kinase C (PKC), mitogen-activated protein kinase (MAPK), p53, Aha1, Hsp90, HIF1α and PKM2 on aromatase promoter activity, expression and enzyme activity was examined. Semiquantitative immunofluorescence and confocal imaging were used to assess ASC-specific protein expression in formalin-fixed paraffin-embedded tissue sections of breast of women and mammary tissue of mice following a low-fat (LF) or high-fat (HF) diet for 17 weeks. RESULTS: Leptin-mediated induction of aromatase was dependent on PKC/MAPK signaling and the suppression of p53. This, in turn, was associated with an increase in Aha1 protein expression, activation of Hsp90 and the stabilization of HIF1α and PKM2, known stimulators of aromatase expression. Consistent with these findings, ASC-specific immunoreactivity for p53 was inversely associated with BMI in breast tissue, while HIF1α, PKM2 and aromatase were positively correlated with BMI. In mice, HF feeding was associated with significantly lower p53 ASC-specific immunoreactivity compared with LF feeding, while immunoreactivity for HIF1α, PKM2 and aromatase were significantly higher. CONCLUSIONS: Overall, findings demonstrate a novel mechanism for the obesity-associated increase in aromatase in ASCs of the breast and support the study of lifestyle interventions, including weight management, which may reduce breast cancer risk via effects on this pathway.

Age and gender differences in the relationship between hepatitis C infection and all stages of Chronic kidney disease.

Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages.

Predictors of bloodstream infection associated with permanently implantable venous port in solid cancer patients.

BACKGROUND: The purpose of this study is to characterize the risk factors of bloodstream infection (BSI) associated with the use of permanent implantable venous ports (Port-A) in solid cancer patients. METHODS: Solid cancer patients implanted with a Port-A were prospectively observed for the occurrence of Port-A-associated BSI (PABSI), defined as BSI without other identifiable infection foci. A PABSI risk score was developed using the Cox proportional hazards model. RESULTS: A total of 415 patients were registered; 88 PABSI episodes occurred in 58 patients (incidence1.05 per 1000 catheter-days). All but one patient had stage IV cancer. Independent predictors of PABSI occurrence included neutropenia, total parenteral nutrition (TPN), chronic steroid use, invasive procedures, postoperative antibiotics, and preoperative antibiotics. A PABSI risk score with a cut-off value of 0 (sensitivity 88.5%, specificity 64.3%) was defined for stage IV cancer patients as follows: neutropenia, +1.350; TPN, +1.256; chronic steroid use, +1.947; preoperative antibiotics, -0.970; postoperative antibiotics, +0.959; and invasive procedures, +1.098. The median PABSI-free survival was 4.47 months for patients with scores ≥ 0 but not reached for patients with scores <0 (P < 0.0001). CONCLUSION: The PABSI risk score can assist in identifying high-risk solid cancer patients and may assist in designing future preventive strategies.

ATXN8 -62 G/A promoter polymorphism and risk of Taiwanese Parkinson's disease.

BACKGROUND AND PURPOSE: We recently reported a novel -62 G/A polymorphism within ataxin 8 (ATXN8) gene promoter region, with -62 G displaying significantly higher luciferase activity compared with -62 A. Phenotypic variability in spinocerebellar ataxia type 8 (SCA8) has been suggested, and large SCA8 repeats were found in patients with Parkinson's disease (PD). We aimed to investigate the association of ATXN8 -62 G/A polymorphism with the risk of Taiwanese PD, and identify the trans-acting factor modulating the ATXN8 promoter activity. METHODS: A case-control study in a cohort of 569 PD cases and 547 ethnically matched controls was conducted by polymerase chain reaction (PCR) and restriction enzyme analysis. The trans-acting factor binding to the ATXN8 promoter was examined by chromatin immunoprecipitation (ChIP)-PCR assay, cDNA co-transfection and luciferase reporter assay. RESULTS: When genotype distribution was calculated by comparing the rare AA genotype with the GG + GA genotypes (recessive model), a significant difference was found (P = 0.035, 1 df). Individuals carrying AA genotype exhibited a decreased risk of developing PD (odds ratio: 0.73; 95% CI: 0.55-0.98, P = 0.035). After stratification by age, individuals over 60 years of age carrying AA genotype demonstrated a further decrease in the risk of developing PD (odds ratio: 0.64; 95% CI: 0.43-0.96, P = 0.030). ChIP-PCR and cDNA over-expression revealed that CCAAT/enhancer-binding protein alpha binds to the ATXN8 proximal promoter to upregulate ATXN8 expression in neuroblastoma SK-N-SH cells. CONCLUSIONS: Our data suggest that ATXN8 -62 G/A polymorphism plays a role in Taiwanese PD susceptibility.

Lack of efficacy to systemic chemotherapy for treatment of metaplastic carcinoma of the breast in the modern era.

Metaplastic carcinoma of the breast (MCB) is a rare subtype of breast cancer. Anecdotal reports are available regarding its response to systemic chemotherapy. We reviewed the records of patients diagnosed with MCB at National Taiwan University Hospital between 1988 and 2009. A total of 46 MCB cases were identified from 8,695 breast tumor patients who underwent biopsy or resection. About 11 of 25 patients with initial bulky disease (T3-4) received neoadjuvant chemotherapy before surgery, and 2 (18.2%) exhibited a partial response. About 12 of 18 patients who developed distant metastasis received palliative systemic chemotherapy. Of them, only 1 (8.3%), 1 (10%), and none (0%) responded to first-, second-, or third- and beyond line chemotherapy, respectively. None of the patients who received anthracyline- (n = 13), vinorelbine- (n = 7), or cyclophosphamide-based (n = 18) chemotherapy responded, whereas 3 (17.6%) of 17 patients who received taxane-based chemotherapy exhibited a partial response. Tumor response to systemic chemotherapy remains generally poor for MCB patients. Taxanes may have modest activity, but need to be validated in further studies.

Effects of varicocele upon the expression of apoptosis-related proteins.

Varicocele-associated apoptosis has been recognised as a cause of male infertility. Thus, we assessed the expression of somatic apoptosis-related proteins (the typical protein-dependent apoptosis markers) in ejaculated sperm plasma from both patients with varicocele and normal donors. We evaluated the relationships between certain apoptosis-related proteins and normal semen quality. Semen samples were obtained from 25 patients with varicocele and from 10 normal fertile controls. These samples were compared using computer-assisted semen analysis for motion parameters and manual analysis for morphology, and were also assayed for apoptosis-related protein activation including caspase-3, poly-ACP-ribose polymerase (PARP), the Bcl-2 family (Bcl-2, Bak) and p53 by means of immunoblot analysis. PARP, Bak and p53 were expressed substantially more in the sperm cells of the varicocele group when compared with the normal group (P < 0.05). The expression of caspase-3 and Bcl-2 did not appear to differ between these two study groups. An increased expression of PARP, Bak and p53 for varicocele-afflicted individuals indicated an increased participation by these agents in the regulating of apoptosis in the ejaculated semen from patients with varicocele, suggesting that certain protein-development apoptotic mechanisms might originate in the cytoplasmic droplet or within mitochondria of spermatocytes and then might function within the nucleus of the cell.

Drug-use pattern of Chinese herbal medicines in insomnia: a 4-year survey in Taiwan.

BACKGROUND AND OBJECTIVE: Insomnia is a common complaint in the general population. Interest in the use of alternative treatments for insomnia is increasing exponentially and is fairly common in Taiwan. We undertook a survey to define the drug utilization patterns of Chinese herbal medicines (CM) for insomnia in Taiwan. METHODS: The survey was conducted over a period of 4 years, from January 2003 to December 2006. Outpatients with primary insomnia and being treated with CM were studied. Core drug-use indicators were the number of CM items per prescription, the dosing frequency and duration of CM prescriptions, the most common prescribed CM herbs and CM formulae used. RESULTS: Six thousand eight hundred and sixty patients, using 37,046 CM herb items, were screened during the study period. The average CM items per prescription was 5.40. Most of prescriptions (95.23%) were prescribed for administration three times a day. The most often prescribed Chinese herbal products were Hong-Hwa (Carthamus tinctorius) and Jia-Wey-Shiau-Yau-San, which includes Angelica sinensis, Atractylodes macrocephala, Paeonia lactiflora, Bupleurum chinense, and Poria coco. CONCLUSION: This is the first extensive survey examining the drug utilization patterns of Chinese herbal medicines in the treatment of insomnia. Although the data were generated in Taiwan, the herbs and practices identified are likely to be widely generalizable wherever Chinese herbal remedies are used for insomnia. Multiple herbs and complex formulae were commonly used. The baseline data generated should be of use in informing subsequent studies, including those aimed at a thorough evaluation of the herbs' effectiveness.

Successful treatment of aortic root aneurysm after orthotopic heart transplantation: case report.

Aortic root aneurysm after orthotopic heart transplantation (HTx) is rare. It may originate from cystic medial necrosis of the donor heart aorta. Herein we have reported a 64-year-old man who received an orthotopic HTx due to dilated cardiomyopathy. Although asymptomatic, follow-up echocardiography revealed dilatation of the aortic root and severe aortic regurgitation at 3 years after the transplantation. He underwent a Bentall procedure with a prosthetic valved conduit. The post-operative course was uneventful. This case demonstrated that a heart-transplant recipient with a late aortic root aneurysm can be successfully treated with an excellent outcome.

Genetic variation in the developmental regulation of cortical avpr1a among prairie voles.

Early experiences can have enduring impacts on brain and behavior, but the strength of these effects can be influenced by genetic variation. In principle, polymorphic CpGs (polyCpGs) may contribute to gene-by-environment interactions (G × E) by altering DNA methylation. In this study, we investigate the influence of polyCpGs on the development of vasopressin receptor 1a abundance in the retrosplenial cortex (RSC-V1aR) of prairie voles (Microtus ochrogaster). Two alternative alleles ('HI'/'LO') predict RSC avpr1a expression, V1aR abundance and sexual fidelity in adulthood; these alleles differ in the frequency of CpG sites and in methylation at a putative intron enhancer. We hypothesized that the elevated CpG abundance in the LO allele would make homozygous LO/LO voles more sensitive to developmental perturbations. We found that genotype differences in RSC-V1aR abundance emerged early in ontogeny and were accompanied by differences in methylation of the putative enhancer. As predicted, postnatal treatment with an oxytocin receptor antagonist (OTA) reduced RSC-V1aR abundance in LO/LO adults but not their HI/HI siblings. Similarly, methylation inhibition by zebularine increased RSC-V1aR in LO/LO adults, but not in HI/HI siblings. These data show a gene-by-environment interaction in RSC-V1aR. Surprisingly, however, neither OTA nor zebularine altered adult methylation of the intronic enhancer, suggesting that differences in sensitivity could not be explained by CpG density at the enhancer alone. Methylated DNA immunoprecipiation-sequencing showed additional differentially methylated regions between HI/HI and LO/LO voles. Future research should examine the role of these regions and other regulatory elements in the ontogeny of RSC-V1aR and its developmentally induced changes.

Electrochemical modification of vertically aligned carbon nanotube arrays.

Electrochemical oxidation and reduction were utilized to modify vertically aligned carbon nanotube (CNT) arrays grown on a porous network of conductive carbon microfibers. Ultrafast and complete CNT opening and purification were achieved through electrochemical oxidation. Highly dispersed platinum nanoparticles were then uniformly and densely deposited as electrocatalysts onto the surface of these CNTs through electrochemical reduction. Using supercritical drying techniques, we demonstrate that the unidirectionally aligned and laterally spaced geometry of the CNT arrays can be fully retained after being subjected to each step of electrochemical modification. The open-tipped CNTs can also be electrochemically detached in full lengths from the supporting substrates and harvested if needed.

Genetic association of blaSHV-5 with transposable elements IS26 and IS5 in Klebsiella pneumoniae from Taiwan.

A cloned 5,248-bp EcoRI fragment from the Klebsiella pneumoniae transferable plasmid pKP53 (> 70 kb) containing bla(SHV-5) was sequenced. Insertion sequences IS26 and IS5 were found downstream from bla(SHV-5). The DNA sequences of the genetic environment surrounding bla(SHV-5) were homologous to plasmid p1658/97 from Escherichia coli, containing a truncated recF gene and a truncated deoR gene upstream and downstream from bla(SHV-5), respectively. RecF may be involved in bla(SHV-5) translocation to the plasmid by RecF-dependent recombination. This novel genetic environment may be associated with the successful proliferation and/or expression of SHV-5 in K. pneumoniae strains from Taiwan.

Estrogenic activity of a dieldrin/toxaphene mixture in the mouse uterus, MCF-7 human breast cancer cells, and yeast-based estrogen receptor assays: no apparent synergism.

The estrogenic activity of dieldrin, toxaphene, and an equimolar mixture of both compounds (dieldrin/toxaphene) was investigated in the 21-day-old B6C3F1 mouse uterus, MCF-7 human breast cancer cells, and in yeast-based reporter gene assays. Treatment of the animals with 17beta-estradiol (E2) (0.0053 kg/day x3) resulted in a 3.1-, 4.8-, and 7.8-fold increase in uterine wet weight, peroxidase activity, and progesterone receptor binding, respectively. In contrast, treatment with 2.5, 15 and 60 micromol/kg (x3) doses of toxaphene, dieldrin, or dieldrin/toxaphene (equimolar) did not significantly induce a dose-dependent increase in any of the E2-induced responses. The organochlorine pesticides alone and the binary mixture did not bind to the mouse uterine estrogen receptor (ER) in a competitive binding assay using [3H]E2 as the radioligand. In parallel studies, estrogenic activities were determined in MCF-7 cells by using a cell proliferation assay and by determining induction of chloramphenicol acetyl transferase (CAT) activity in MCF-7 cells transiently transfected with plasmids containing estrogen-responsive 5'-promoter regions from the rat creatine kinase B and human cathepsin D genes. E2 caused a 24-fold increase in CAT activity in MCF-7 cells transiently transfected with creatine kinase B and a 3.8-fold increase in cells transiently transfected with the human cathepsin D construct. Treatment of MCF-7 cells with dieldrin, toxaphene, or an equimolar mixture of dieldrin plus toxaphene (10(-8)-10(-5) M) did not significantly induce cell proliferation or CAT activity in the transient transfection experiment with both plasmids. The relative competitive binding of the organochlorine pesticides was determined by incubating MCF-7 cells with 10(-9) M [3H]E2 in the presence or absence of 2 x 10(-7) M unlabeled E2 (to determine nonspecific binding), toxaphene (10(-5) M), dieldrin (10(-5) M), and equimolar concentrations of the dieldrin plus toxaphene mixture (10(-5) M). The binding observed for [3H]E2 in the whole cell extracts was displaced by unlabeled E2, whereas the organochlorine pesticides and binary mixture exhibited minimal to nondetectable competitive binding activity. E2 caused a 5000-fold induction of beta-galactosidase (beta-gal) activity in yeast transformed with the human ER and a double estrogen responsive element upstream of the beta-gal reporter gene. Treatment with 10(-6)-10(-4) M chlordane, dieldrin, toxaphene, or an equimolar mixture of dieldrin/toxaphene did not induce activity, whereas 10(-4) M endosulfan caused a 2000-fold increase in beta-gal activity. Diethylstilbestrol caused a 20-fold increase in activity in yeast transformed with the mouse ER and a single estrogen responsive element upstream of the beta-gal reporter gene. Dieldrin, chlordane, toxaphene, and endosulfan induced a 1.5- to 4-fold increase in activity at a concentration of 2.5 x 10(-5) M. Synergistic transactivation was not observed for any equimolar binary mixture of the pesticides at concentrations of either 2.5 x 10(-5) M or 2.5 x 10(-4) M. The results of this study demonstrate that for several estrogen-responsive assays in the mouse uterus, MCF-7 human breast cancer cells, and yeast-based reporter gene assays, the activities of both dieldrin and toxaphene were minimal, and no synergistic interactions were observed with a binary mixture of the two compounds.

Oral and facial representation within the medullary and upper cervical dorsal horns in the cat.

Transganglionic transport of HRP was used to study the patterns of termination of somatic afferent fibers innervating oral and facial structures within the trigeminal nucleus caudalis and upper cervical dorsal horn of the cat. In separate animals, the superior alveolar, pterygopalatine, buccal, inferior alveolar, lingual, frontal, corneal, zygomatic, infraorbital, mental, mylohyoid, and auriculotemporal branches of the trigeminal nerve were traced in this experiment. The organization of the primary afferents innervating the oral structures is not uniform across laminae and at different rostrocaudal levels of the nucleus caudalis. The superior alveolar and pterygopalatine nerves mainly terminate in laminae I, II, and V at the level of the rostral one-third of the caudalis. By contrast, the lingual, inferior alveolar, and buccal nerve terminate in laminae I-V of, respectively, the rostral third, the entire length, and caudal two-thirds of the caudalis. In addition, the lingual, buccal, and pterygopalatine nerves terminate in the dorsal and middle parts of the interstitial islands or pockets of lamina I neuropil extending to the rostral levels parallel to the nucleus interpolaris. Mediolaterally, in laminae I, II, and V of the rostral third an extensive overlap of projections was found between the branches from each trigeminal division, and some overlap was observed between projections from the mandibular and maxillary divisions. On the other hand, the projections of primary afferents innervating the facial structures are arranged in a somatotopic fashion in rostrocaudal and mediolateral axes over the laminae (I-IV) through the nucleus caudalis and upper cervical dorsal horn. Fibers from the perioral and perinasal regions terminate most rostrally in caudalis, and fibers from progressively more posterior facial regions terminate at successively lower levels. A mediolateral somatotopic arrangement was observed, with fibers from the ventral parts of face ending in the medial regions and fibers from the progressively more dorsal parts of the face ending in successively more lateral regions of the medullary and upper cervical dorsal horns. Corneal afferent terminals are concentrated in the outer parts of lamina II at the levels of the rostral parts of the caudal two-thirds of the caudalis and the interstitial islands of lamina I. The maxillary division terminates first at the most caudal level of the caudalis, followed by the ophthalmic division descending as far as the C2 segment and the mandibular division reaching the most caudal level of the C2 segment.(ABSTRACT TRUNCATED AT 400 WORDS)

Oral and facial representation in the trigeminal principal and rostral spinal nuclei of the cat.

Transganglionic transport of horseradish peroxidase (HRP) was used to study the patterns of termination of somatic afferent fibers innervating oral and facial structures within the principal nucleus (Vp), nucleus oralis (Vo), and nucleus interpolaris (Vi). The primary trigeminal afferent fibers that innervate the oral cavity supplied by the pterygopalatine, superior alveolar, lingual, buccal, and inferior alveolar branches, as well as the facial skin supplied by the frontal, corneal, zygomatic, infraorbital, auriculotemporal, mylohyoid, and mental branches, were traced in this experiment. The results show that trigeminal afferent nerves that innervate the oral cavity project mainly to the principal nucleus, the rostrodorsomedial part (Vo.r) and dorsomedial division (Vo.dm) of pars oralis, and the dorsomedial region of pars interpolaris, while an extensive overlap of projections is found in the Vo.r, Vo.dm, and rostral Vi. The central processes of fibers innervating the anterior face (i.e., mental, infraorbital, and frontal nerves) terminate in the ventral division of principalis (Vpv), caudal region pars oralis (Vo.c), and ventrolateral Vi, with the largest numbers of terminals being found in the Vpv and Vi. In contrast, the central projection patterns of the corneal, zygomatic, mylohyoid, and auriculotemporal afferents are different from those of other afferent nerves examined, and present a discrete projection to the trigeminal sensory nuclear complex (TSNC). The corneal, mylohyoid, and auriculotemporal afferents mainly project to the restricted regions of principalis and caudal Vi, while zygomatic afferent nerve fibers project to the caudal third of pars interpolaris. The typical somatotopic organization with the face of the mouth open inverted is represented in the rostrocaudal midlevels of the Vpv and caudal pars interpolaris. The Vpd receives topographical projection from primary afferent nerves that innervate the oral structure only, while this projection was organized in a complicated manner. The relationship between the functional segregation and the cytoarchitectonic differentiation of the TSNC is discussed, particularly with respect to this somatotopic organization, combined with the characteristics of projecting cells in the TSNC.

Torsade de pointes due to consumption of Sauropus androgynus as a weight-reducing vegetable.

Sauropus Androgynus, known as cekur manis or sweet shoot, is a popular vegetable in Southeast Asia and is used as a weight-reducing vegetable in Taiwan. Three women who developed torsade de pointes after consuming large amounts of sauropus androgynus are described in this report.

Radiofrequency ablation therapy in concealed left free wall accessory pathway with decremental conduction.

An electrophysiologic study followed by transcatheter radiofrequency ablation therapy was performed in two adult patients with a permanent form of junctional tachycardia. Both patients had no structural heart disease and exhibited a normal resting ECG. The P wave during tachycardia was negative in leads 1, 3, and aVF, biphasic over V6, and positive in V1 and aVL in both patients, while the P-R/R-P interval ratio during tachycardia was 0.82 and 0.36, respectively, in both patients. Both patients displayed an eccentric atrial activation sequence with the earliest atrial activation occurring at the distal coronary sinus and a decremental retrograde conduction property during incremental ventricular pacing, suggesting the presence of a concealed slowly conducting left free wall accessory pathway. The tachycardia used the normal atrioventricular pathway for anterograde conduction and the concealed show left accessory pathway for retrograde conduction. It was terminated following adenosine administration in both patients; termination of tachycardia was due to a block in the retrograde accessory pathway in one patient and due to a block in the atrioventricular node in the other patient. Radiofrequency ablation was performed by the retrograde transaortic approach. The radiofrequency f4p4ent was delivered to the site of the earliest atrial activation during tachycardia at the ventricular aspect of the mitral annulus. The successful ablation site had a ventriculoatrial (VA) interval of 120 and 130 ms, respectively, and was located at the posterolateral and lateral aspects of the mitral annulus. Following ablation, there was no VA conduction; however, conduction through the normal atrioventricular pathway was noted during isoproterenol infusion in both patients. There was no induction of tachycardia. This study demonstrates that the permanent form of junctional tachycardia in adults can incorporate a concealed left free wall accessory pathway with a decremental property. Radiofrequency ablation therapy is effective and safe in this form of arrhythmia.

Inhibitory effect of stimulation of the anterior pretectal nucleus on the jaw-opening reflex.

The anterior pretectal nucleus (APT) has been recently implicated in sensorimotor integration and has been shown to have suppressive influences on tail flick behaviour and on nociceptive responses of spinal dorsal horn neurones in rats. The present study tested the effect of stimulation of the APT on the rat's digastric jaw-opening reflex elicited by orofacial stimuli. Either ipsilateral or contralateral electrical stimulation at histologically confirmed sites within and immediately subjacent to the APT produced a suppression of the reflex that had an onset of 20-30 ms, peaked around 50 ms and lasted for 200-300 ms; in some cases, a brief period of reflex facilitation preceded the onset of inhibition and the inhibition was sometimes followed by a facilitatory period. No prolonged period of suppression induced by electrical stimulation was noted in these anaesthetized rats. The injection of monosodium glutamate at comparable sites within and subjacent to APT induced reflex suppression that lasted several minutes. These findings represent the first documentation of APT-induced modulation in the trigeminal sensorimotor system, but support recent evidence suggesting the involvement of APT in sensorimotor integration and modulation.

Anterior pretectal nucleus-induced modulatory effects on trigeminal brainstem somatosensory neurons.

This study examined the effects of anterior pretectal nucleus (APT) conditioning stimulation on the activity of 92 functionally identified somatosensory brainstem neurons in the trigeminal (V) subnuclei oralis, interpolaris and caudalis of anesthetized rats. Conditioning stimulation inhibited most of the nociceptive neurons and some of the non-nociceptive neurons; facilitation was observed only in some non-nociceptive neurons. These data indicate that the ATP has modulatory effects on both nociceptive and non-nociceptive V somatosensory neurons.

Treatment of axillary bromhidrosis with superficial liposuction.

Axillary bromhidrosis or osmidrosis is a distressing problem that causes a serious personal and social handicap, especially in an Asian society. Surgical excision of the subcutaneous tissue, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice for several decades. However, the complications of partial necrosis of wound edges or hematoma, and the possibility of the obvious unsightly scars, are always problems. We report our method of treatment of modified superficial liposuction with subdermal scraping under local anesthesia with tumescent infiltration. By using two tiny stab wounds, these two steps of liposuction can be done in the two-directional crisscross pattern. From August of 1995 to May of 1997, 20 patients (16 women and 4 men) received this surgery for bilateral axillas on an outpatient basis. The follow-up period ranged from 6 months to 27 months, and the mean follow-up period was 14 months. Eighteen patients (90 percent) had excellent to good results. Complication included only one minor wound infection that was cured easily. Two patients experienced transient subdermal fibrotic bands in one side of the axilla, and one patient experienced axillary skin with marked induration and retraction. All of these symptoms disappeared after 1 month or so. This minimal incision operation has the advantages of a high success rate, low complication rate, tiny to invisible scars, no change of hair distribution pattern, minimal postoperative care with a short term of compressive dressing (less than 2 days), and rapid recovery for daily activity and exercise.