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The severe deterioration of a cement asphalt (CA) mortar layer may lead to the movement of the upper concrete slab and impair the safety of the speedy train. In this study, a test specimen simulating the structure of high-speed rail track slabs was embedded with delaminated cracks in various lateral sizes inside the CA mortar layer. Impact-echo tests (IE) were performed above the flawed and flawless locations. In present study, the IE method is chosen to assess defects in the CA mortar layer. Both traditional IE and normalized IE are used for data interpolation. The normalized IE are the simulated transfer function of the original IE response. The peak amplitudes in the normalized amplitude spectrum and the peak frequency in the traditional amplitude spectrum for the top concrete overlay were used to develop simple indicators for identifying the integrity of the CA mortar layer. The index was based on the difference of the experimental peak amplitude and frequency of the ones calculated from previously developed formulas for plates without substrates. As a result, the technique does not require an experimental baseline for the crack assessment. A field test and analysis procedure for evaluating high-speed rail slab systems are proposed.
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Norovirus is the most common cause of foodborne gastroenteritis, affecting millions of people worldwide annually. Among the ten genotypes (GI-GX) of norovirus, only GI, GII, GIV, GVIII, and GIX infect humans. Some genotypes reportedly exhibit post-translational modifications (PTMs), including N- and O-glycosylation, O-GlcNAcylation, and phosphorylation, in their viral antigens. PTMs have been linked to increased viral genome replication, viral particle release, and virulence. Owing to breakthroughs in mass spectrometry (MS) technologies, more PTMs have been discovered in recent years and have contributed significantly to preventing and treating infectious diseases. However, the mechanisms by which PTMs act on noroviruses remain poorly understood. In this section, we outline the current knowledge of the three common types of PTM and investigate their impact on norovirus pathogenesis. Moreover, we summarize the strategies and techniques for the identification of PTMs.
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Infecciones por Caliciviridae , Norovirus , Humanos , Fosforilación , Glicosilación , Norovirus/genética , Procesamiento Proteico-Postraduccional , Genotipo , FilogeniaRESUMEN
The water requirements of crops should be investigated to improve the efficiency of water use in irrigated agriculture. The main objective of the study was to assess the effects of water deficit stress on rice yields throughout the major cropping seasons. We analyzed rice yield data from field experiments in Taiwan over the period 1925-2019 to evaluate the effects of water-deficit stress on the yield of 12 rice cultivars. Weather data, including air temperatures, humidity, wind speed, sunshine duration, and rainfall were used to compute the temporal trends of reference evapotranspiration and crop water status (CWS) during rice growth stages. A negative CWS value indicates that the crop is water deficient, and a smaller value represents a lower water level (greater water-deficit stress) in crop growth. The CWS on rice growth under the initial, crop development, reproductive, and maturity stages declined by 96.9, 58.9, 24.7, and 198.6 mm in the cool cropping season and declined by 63.7, 18.1, 8.6, and 3.8 mm in the warm cropping season during the 95 years. The decreasing trends in the CWSs were used to represent the increases in water-deficit stress. The total yield change related to water-deficit stress on the cultivars from 1925-1944, 1945-1983, and 1996-2019 under the initial, crop development, reproductive, and maturity stages are -56.1 to 37.0, -77.5 to -12.3, 11.2 to 19.8, and -146.4 to 39.1 kg ha-1 in the cool cropping season and -16.5 to 8.2, -12.9 to 8.1, -2.3 to 9.0, and -9.3 to 8.0 in the warm cropping season, respectively. Our results suggest that CWS may be a determining factor for rice to thrive during the developmental stage, but not the reproductive stage. In addition, the effect of water-deficit stress has increasingly affected the growth of rice in recent years.
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Cambio Climático , Oryza , Tiempo (Meteorología) , Agricultura/métodos , AguaRESUMEN
BACKGROUND: The extent of the effect of antiviral therapy and its predictors in preventing hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) or B (CHB) remain unclear. METHODS: We conducted a systemic review and meta-analysis of published randomized controlled trials (RCTs) and cohort studies (CSs) up to December 2010. Preventive efficacy was measured as absolute reduction in 3- and 5-year cumulative incidence of HCC with antiviral therapy. Predictors for efficacy were identified by using meta-regression. RESULTS: Twenty-two studies (5 RCTs; 17 CSs) were included for analysis. Antiviral therapy reduced 5-year cumulative incidence of HCC by 7.8% (95% CI 4.6-11.1; p < 0.0001) in patients with CHC and by 7.1% (95% CI 4.1-10.2; p < 0.0001) in patients with CHB. The efficacy was significant as early as 3 years after antiviral therapy. While adjusting for available study-level, patient and virological factors, RCT and higher sustained virological response were identified as pertinent predictors of superior preventive efficacy in patients with CHC, whereas lower hepatitis B virus e antigen seropositivity was identified in patients with CHB. Antiviral therapy did not result in differential preventive efficacy between cirrhotic and noncirrhotic patients with CHC or CHB. CONCLUSION: Antiviral therapy can reduce 3- and 5-year cumulative incidence of HCC in patients with CHC or CHB.
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Antivirales/uso terapéutico , Carcinoma Hepatocelular/prevención & control , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Neoplasias Hepáticas/prevención & control , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/etiología , Estudios de Cohortes , Femenino , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Incidencia , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: The standard of chemotherapy regimens for advanced or metastatic gastric cancer and the clinical outcome were heterogeneous in Asian versus non-Asian countries. This study aimed to explore predictors of safety and efficacy of chemotherapy for patients with advanced or metastatic gastric cancer. METHODS: Treatment group-based meta-analysis and met a regression were performed to analyze results of randomized trials published since 2005 for advanced or metastatic gastric cancer patients who received systemic chemotherapy as first-line treatment. Data were extracted and synthesized according to the Cochrane guidelines. RESULTS: Twenty-five trials (8 Asian, 17 Western or international) with 56 treatment groups were analyzed. Asian trials reported a lower percentage of gastroesophageal junctional carcinoma, higher percentage of diffuse type histology, and more frequent use of second-line chemotherapy. Meta-analysis revealed significant heterogeneity both in treatment safety (grade 34 neutropenia and diarrhea) and efficacy [6-month progression-free survival(PFS) and 1-year overall survival (OS)]. Meta-regression analyses indicate that Asian trials are associated with an 8.2% lower incidence of grade 34 neutropenia and 2.1%lower incidence of grade 34 diarrhea. A lower percentage of patients with gastroesophageal junction carcinoma and the use of combination regimens predicted better PFS. The use of second-line chemotherapy predicts better 1-year OS,which will increase by 10% for every 10% increase inpatients who received second-line chemotherapy. CONCLUSION: Geographic region (Asian vs. non-Asian) is an independent predictor of safety in systemic therapy for gastric cancer.
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Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/epidemiología , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/epidemiología , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Asia/epidemiología , Carcinoma/tratamiento farmacológico , Carcinoma/epidemiología , Carcinoma/patología , Diarrea/inducido químicamente , Supervivencia sin Enfermedad , Neoplasias Esofágicas/patología , Europa (Continente)/epidemiología , Humanos , Neutropenia/inducido químicamente , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias Gástricas/patología , Resultado del Tratamiento , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND/PURPOSE: Globus pharyngeus and dysphagia are common complaints of patients referred to ear, nose, and throat (ENT) clinics. We aimed to establish an efficient method to rule out the presence of malignancy in patients with globus pharyngeus and dysphagia. METHODS: The use of flexible transnasal esophagoscopy (TNE) was evaluated in 30 patients with globus pharyngeus and 6 patients with dysphagia. The patients were immediately informed of the findings on TNE examination, and then treatments were planned. All patients were treated with lansoprazole for 2 weeks and provided education on lifestyle changes at the initial examination and at the 3-month follow-up. RESULTS: The patients reported an improvement in symptoms of globus pharyngeus after treatment (p<0.001). Follow-up TNE confirmed improvement with less dysphagia, erythema, and vocal cord edema evident (all p<0.001). CONCLUSION: The use of TNE and patient education are efficient management strategies for patients with symptoms of globus pharyngeus and dysphagia.
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Esofagoscopía , Educación del Paciente como Asunto , Enfermedades Faríngeas/terapia , 2-Piridinilmetilsulfinilbencimidazoles/uso terapéutico , Adulto , Anciano , Trastornos de Deglución/terapia , Femenino , Humanos , Lansoprazol , Estilo de Vida , Masculino , Persona de Mediana Edad , Inhibidores de la Bomba de Protones/uso terapéuticoRESUMEN
BACKGROUND & AIMS: Adjuvant anti-viral therapy after curative therapy for HCC has been studied extensively but the true clinical benefit and the predictors of efficacy remain unclear. METHODS: MEDLINE, PubMed, and the Cochrane library were searched until December 2008, plus the meeting abstracts of the American Association for the Study of Liver Disease 2005-2008. Randomized trials and cohort studies were included if the studies (1) enrolled HCC patients who had underlying chronic viral hepatitis B or C and had undergone curative surgery or ablation therapy; (2) consisted of one or more treatment arms with interferon-based therapy and a control arm of no anti-viral therapy; and (3) included recurrence-free survival of HCC as an endpoint. Meta-analysis and meta-regression were done according to the Cochrane guidelines. RESULTS: Thirteen studies (9 randomized trials and 4 cohort studies, totally 1180 patients) were eligible for meta-analysis. Surgery and ablation therapy were used in 9 and 8 studies, respectively. All studies used conventional interferon (natural or recombinant) as anti-viral therapy. Overall, interferon improved the 1-year, 2-year, and 3-year recurrence-free survival by 7.8% (95% CI 3.7-11.8%), 35.4% (95% CI 30.7-40.0%), and 14.0% (95% CI 8.6-19.4%), respectively (all p<0.01). Lower percentage of patients with multiple tumors and use of ablation therapy were independent predictors for better treatment efficacy. CONCLUSION: The quantitative estimation of treatment efficacy and the identification of predictive factors in this study will help design future clinical trials of adjuvant therapy for HCC.
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Carcinoma Hepatocelular , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Interferones/uso terapéutico , Neoplasias Hepáticas , Antivirales/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/virología , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/virología , Complicaciones Posoperatorias/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Regresión , Prevención SecundariaRESUMEN
Phyllanthus emblica is an edible nutraceutical and functional food in the Asia area with medicinal and nutritive importance. The fruit extract of P. emblica is currently considered to be one of the effective functional foods for flesh maintenance and disease treatments because of its antioxidative and immunomodulatory properties. We examined the antioxidant abilities of the fruit extract powder by carrying out 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging, iron reducing power, and metal chelating activity analysis and showed excellent antioxidative results. In 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the result showed that the samples had no cytotoxic effect on RAW 264.7 cells even at a high concentration of 2 mg/mL. To investigate its immunomodulatory function, our estimation was to treat it with lipopolysaccharide (LPS) in RAW 264.7 cells to present anti-inflammatory capacities. The extract decreased reactive oxygen species (ROS) production levels in a dose-dependent manner measured by flow cytometry. We also examined various inflammatory mRNAs and proteins, including nuclear factor-κB (NF-κB), inducible nitric oxide synthases (iNOS), and cyclooxygenase-2 (COX-2). In quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blotting assay, all three targets were decreased by the extract, also in a dose-dependent manner. In conclusion, P. emblica fruit extract powder not only lessened antioxidative stress damages, but also inhibited inflammatory reactions.
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BACKGROUND AND PURPOSE: To delineate the clinical manifestations in different age groups and to define the viral load in patients with Epstein-Barr virus-associated infectious mononucleosis (EBV-associated IM). METHODS: We reviewed data on 69 children with EBV-associated IM from November 2001 to October 2005. Clinical features were evaluated among four age groups: <3 years, 3 to 5 years, 6 to 9 years and 10 to 18 years. EBV viral load was measured by quantitative real-time polymerase chain reaction (PCR) in 13 patients with 15 specimens. RESULTS: Majority of the children were younger than 7 years of age (76.8%) and the male-to-female ratio was 1.6:1. The symptoms and signs included fever (91.3%), tonsillopharyngitis (88.4%), lymphadenopathy (78.3%) and hepatitis (75.4%). The younger age group had higher monocyte count, lower occurrence of hepatitis, and lower glutamic-oxaloacetic transaminase (GOT) and glutamic-pyruvic transaminase (GPT) levels than the older age group. The median (range) EBV viral load of peripheral blood mononuclear cells (PBMCs) and plasma in IM patients was 738 (0-7455) copies/mug DNA and 51 (0-957) copies/mL plasma, respectively. The PBMC detection rate was high in the early (within 10 days after onset) and late phase (>10 days after onset) [90-100%]. The plasma detection rate in the early phase (66.7%) was higher than that in the late phase (40%). CONCLUSIONS: The younger age group of EBV-associated IM patients had higher monocyte count, lower occurrence of hepatitis, and lower GOT and GPT levels than the older age group. The PBMC detection rate was almost equally high in both the early and late phases, while the plasma detection rate was higher in the early phase. Quantitative real-time PCR of EBV DNA is useful for diagnosing and monitoring EBV-associated IM, especially in younger children.
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Alanina Transaminasa/metabolismo , Herpesvirus Humano 4/aislamiento & purificación , Mononucleosis Infecciosa/fisiopatología , Mononucleosis Infecciosa/virología , Adolescente , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Niño , Preescolar , Femenino , Humanos , Lactante , Mononucleosis Infecciosa/epidemiología , Leucocitos Mononucleares/virología , Masculino , Taiwán/epidemiología , Carga ViralRESUMEN
Background: Several studies have shown that dexmedetomidine (DXM), a selective α2-adrenoceptor agonist, also has neuroprotective effects. However, its effect on impaired peripheral nerve regeneration has not been studied. Materials and Methods: Forty-five Sprague-Dawley rats were randomly assigned to three groups: group 1 (control SHAM), group 2 (sciatic nerve injury + normal saline), and group 3 (sciatic nerve injury + DXM). The rats of group 3 were subdivided into the following three groups: DXM 0.5, 6, and 20 µg·kg-1 (groups 3A, 3B, and 3C, resp.). The sciatic nerve injury was assessed for nerve regeneration at 2 and 6 weeks. Results: There were no differences between groups 2 and 3 in their sciatic functional index (SFI) values or histological findings at 2 weeks postinjury. However, SFI differences were statistically significant at 6 weeks postinjury in group 3. The gross findings with H&E staining showed that the number of axons was higher in group 3 than in group 2. There was no histological difference according to the DXM concentration. Conclusion: The coincidental functional and histological assessment results of this study suggest that DXM for 6 weeks positively affects damaged peripheral nerves.
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Analgésicos no Narcóticos/uso terapéutico , Dexmedetomidina/uso terapéutico , Regeneración Nerviosa/efectos de los fármacos , Neuropatía Ciática/tratamiento farmacológico , Neuropatía Ciática/fisiopatología , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Humanos , Ratas , Ratas Sprague-Dawley , Recuperación de la Función/efectos de los fármacos , Caminata/fisiologíaRESUMEN
Lifestyle factors are considered important for the pathogenesis of both nasopharyngeal and oropharyngeal carcinomas. In Taiwan, the incidence of nasopharyngeal carcinoma gradually decreased over the past 20 years, whereas that of oropharyngeal carcinoma increased rapidly. To compare the incidence trends of nasopharyngeal and oropharyngeal carcinomas in Taiwan, the age-period-cohort model was used to analyze epidemiologic data from 1981 to 2000 obtained from the Taiwan Cancer Registry. The calendar time period of 1986 to 1990 and the 1931 to 1940 birth cohort were used as reference groups for estimates of relative risk. For nasopharyngeal carcinoma, the incidence seemed to decrease in most age groups and was more prominent in women (30%) than in men (23%). For oropharyngeal carcinoma, the incidence increased in all age groups and was more prominent in men (391.4%) than in women (59.2%). Cohort effect was found for both nasopharyngeal and oropharyngeal carcinomas. The relative risk of nasopharyngeal carcinoma for the 1971 to 1980 birth cohort was 0.38 for women and 0.68 for men. The relative risk of oropharyngeal carcinoma for the 1971 to 1980 cohort was 45.67 for men and 2.69 for women. Change in lifestyle seemed to be an important factor for the difference in the incidence trend between nasopharyngeal and oropharyngeal carcinomas and between men and women.
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Neoplasias Nasofaríngeas/epidemiología , Neoplasias Orofaríngeas/epidemiología , Adulto , Factores de Edad , Anciano , Distribución de Chi-Cuadrado , Femenino , Humanos , Incidencia , Estilo de Vida , Masculino , Persona de Mediana Edad , Distribución de Poisson , Sistema de Registros , Factores de Riesgo , Taiwán/epidemiologíaAsunto(s)
Cálculos/diagnóstico , Cuerpos Extraños/diagnóstico , Cavidad Nasal , Adulto , Diagnóstico Tardío , Femenino , Humanos , PlásticosRESUMEN
Female invasive breast cancer (FIBC) in Taiwan is characterized by a striking recent increase of incidence and a relatively young median age (45-49 years) at diagnosis. The Westernization of lifestyle that is increasingly affecting younger generations of Taiwanese may have an important impact on this change. We compared epidemiologic data on FIBC in Taiwanese obtained from the Taiwan Cancer Registry with data for Caucasian Americans obtained from the database of the Surveillance, Epidemiology, and End Results Program for the period from 1980 to 1999. Age-specific incidence rates of FIBC were plotted by calendar year at diagnosis and by birth cohort for both populations. The individual effects of time period and birth cohort on the incidence trends of FIBC in both populations were evaluated using the age-period-cohort analysis. The incidence rate of FIBC was continuously increased in Taiwanese throughout the past 2 decades, whereas the increase of incidence was slowing down in Caucasian Americans. The incidence rates in Taiwanese women born after the 1960s were approaching that of Caucasian Americans. The age-period-cohort analysis showed a much stronger birth cohort effect on the incidence trend of FIBC in Taiwanese than in Caucasian Americans. This strong birth cohort effect corresponded to the Westernization of lifestyle in Taiwan since 1960. These findings indicate that a continued shift in the incidence and age distribution pattern of FIBC in Taiwanese toward that of Caucasian Americans should be anticipated.
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Neoplasias de la Mama/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Incidencia , Estilo de Vida , Modelos Lineales , Persona de Mediana Edad , Sistema de Registros , Taiwán/epidemiología , Estados Unidos/epidemiologíaRESUMEN
Atrial septal defect (ASD) closure is major therapy for patients with secundum ASD. Although surgical closure (SC) and transcatheter closure (TC) are usually performed in such patients, data on the long-term outcomes comparing TC and SC in adults are limited. Data on the participants of this cohort study were retrieved from Taiwan's National Health Insurance Research Database from 2004 to 2011. Secundum ASD patientsâ>â18 years of age who underwent TC or SC were initially enrolled, and those with associated comorbidities were excluded. After propensity score matching, the clinical outcomes between the TC and SC groups were analyzed. There were 595 patients recruited in the TC group and 308 patients in the SC group. The SC group had a higher incidence of systemic thromboembolism (Pâ<â0.001), ischemic stroke (Pâ=â0.002), and all-cause mortality (Pâ=â0.013) when compared with those of the TC group at the index hospitalization, and similar phenomena could also be seen in a around 4-year follow-up period after the procedures (systemic thromboembolism (Pâ<â0.001, HRâ=â11.48, 95% CI: 3.29-40.05), ischemic stroke (Pâ=â0.005, HRâ=â9.28, 95% CI: 1.94-44.39), and all-cause mortality (Pâ=â0.035, HRâ=â2.28, 95% CI: 1.06-4.89). In addition, atrial fibrillation (Pâ=â0.005) and atrial flutter (Pâ=â0.049) more frequently developed in the SC group than in the TC group at the index hospitalization. The adult secundum ASD patients had lower incidence rates of systemic thromboembolism, ischemic stroke, and all-cause mortality after TC than those after SC in the 4-year follow-up after procedures. Transcatheter ASD closure should therefore be given priority.
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Fibrilación Atrial , Cateterismo Cardíaco , Procedimientos Quirúrgicos Cardíacos , Defectos del Tabique Interatrial , Complicaciones Posoperatorias/epidemiología , Accidente Cerebrovascular , Tromboembolia , Adulto , Fibrilación Atrial/epidemiología , Fibrilación Atrial/etiología , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/métodos , Cateterismo Cardíaco/mortalidad , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/métodos , Procedimientos Quirúrgicos Cardíacos/mortalidad , Estudios de Cohortes , Femenino , Defectos del Tabique Interatrial/diagnóstico , Defectos del Tabique Interatrial/mortalidad , Defectos del Tabique Interatrial/cirugía , Defectos del Tabique Interatrial/terapia , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Análisis de Supervivencia , Taiwán/epidemiología , Tromboembolia/epidemiología , Tromboembolia/etiologíaRESUMEN
BACKGROUND: Cytokeratin 19 (CK19), a molecular marker of hepatic progenitor cells and cholangiocytes, is expressed in hepatocellular carcinomas (HCC), but not in normal hepatocytes. However, role of CK19 in HCC progression, especially when interacted with p53 and ß-catenin mutations, remained largely unknown. MATERIALS AND METHODS: From January 1983 to December 1997, 210 surgically resected, unifocal, primary HCCs were studied retrospectively. CK19 protein expression was detected by immunohistochemistry while mutations of p53 and ß-catenin genes were detected by direct DNA sequencing. RESULTS: CK19 protein expression was detected in 35.7% (75/210), p53 mutation in 47.2% (83/176) and ß-catenin mutation in 14.5% (27/186). The tumor size (p=0.0023), grade (p = 0.00093), tumor stage (p = 4 x 10-7), high α-fetoprotein (p=0.0004), p53 mutation (p = 0.024), absence of ß-catenin mutation (p = 0.0013), and CK19 expression (p = 3 x 10-5) were markers predictive of early tumor recurrence (ETR). CK19 expression, stage, and ETR were strong indicators of poor prognosis (all p < 0.0001). Importantly, combination analysis showed an additive unfavorable prognostic interaction of CK19 expression and p53 mutation. On the contrary, concurrent CK19 expression and ß-catenin mutation was rare and CK19 expression abolished the suppression effect of ß-catenin mutation on HCC progression. CONCLUSIONS: CK19 expression is associated with more aggressive HCC. CK19 cooperates with p53 mutation towards advanced disease. In contrast, CK19 expression and ß-catenin mutation play dramatic opposite roles in vascular invasion, ETR and the prognosis of HCC.
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Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/mortalidad , Genes p53 , Queratina-19/metabolismo , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/mortalidad , Mutación , Recurrencia Local de Neoplasia/genética , beta Catenina/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patología , Femenino , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Análisis de Secuencia de ADN , Tasa de Supervivencia , Factores de Tiempo , Adulto Joven , alfa-Fetoproteínas/metabolismo , beta Catenina/metabolismoRESUMEN
Myeloid sarcoma in a patient with myelodysplastic syndrome (MDS) manifesting as a non-healing tonsillar ulcer is an extremely rare occurrence. We report the case of a 57-year-old male smoker with a non-healing tonsillar ulcer who underwent tonsillectomy to rule out tonsillar carcinoma after failed antibiotic therapy. On postoperative day 2, he presented with a temperature of 40°C and white blood cell count of 34700/µL. Antibiotic therapy was begun; however, he died 1 day later due to pulmonary infection and septic shock. Though extremely rare, tonsillar involvement of MDS should be considered in the differential diagnosis of a non-healing tonsillar lesion. When definitive diagnosis requires a tissue sample, punch biopsy may be preferable to tonsillectomy in a patient who may be immunocompromised, and appropriate prophylactic antibiotics should be administered.
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Complicaciones Posoperatorias , Infecciones del Sistema Respiratorio/etiología , Sarcoma Mieloide/cirugía , Neoplasias Tonsilares/cirugía , Tonsilectomía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Choque Séptico/etiologíaRESUMEN
In clinical trials of systemic therapy for advanced hepatocellular carcinoma (HCC), Asian trials almost always reported poorer survival than non-Asian trials. This study sought to identify contributory factors for this geographic difference. A systematic review was done on randomized trials for unresectable HCC that used systemic therapy as an experimental arm and placebo or supportive care as control. Meta-analysis was performed with the consideration of fixed and random effects. Then, meta-regression was performed to identify predictors of patient survival in the control arm and the treatment effects (improvement in median survival). Fourteen trials (6 Asians, 8 non-Asians) were eligible for meta-analysis. The median survival of patients in the control arm, which indicated natural history of advanced HCC patients, was 3.57+/-1.88 months in Asian trials and 5.96+/-1.46 months in non-Asian trials (p=0.02). Independent predictors of better survival included non-Asian trials (p=0.0007), higher percentage of Child A cirrhosis (p=0.01) and hepatitis B (HBV)-related HCC (p=0.02). Sub-group analysis suggested that Asian trials tended to enroll patients with more advanced diseases. Independent predictors of better treatment effect included non-Asian trials, higher percentage of extra-hepatic metastasis, HBV-related HCC, and poorer trial quality. The quantitative estimation of the geographic difference can help design of future clinical trials of advanced HCC.
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Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Carcinoma Hepatocelular/patología , Humanos , Neoplasias Hepáticas/patología , Estadificación de Neoplasias , Selección de Paciente , Análisis de SupervivenciaRESUMEN
This study clinically and molecularly characterizes an adenovirus epidemic that broke out in Taiwan in April 2004. Clinical data on 325 children diagnosed with acute illness were collected between April 2004 and April 2005, and a diagnosis of adenovirus was confirmed by viral isolation. Polymerase chain reaction and restriction fragment length polymorphism were used to identify the adenovirus genotypes in 267 patients. There was a seasonal variation, with a peak incidence between November 2004 and January 2005 (p < 0.001). The median age was 52 months, range 1-210 months. Most cases (90.8%) were younger than 7 years old. Male-to-female ratio was 1.56:1. The most common clinical diagnosis was exudative tonsillitis (50.8%), followed by bronchitis/bronchiolitis (29.9%), conjunctivitis or pharyngoconjunctival fever (22.5%), and acute otitis media (16.3%). Adenovirus type 3 was found in 215 patients (80.5%). The other 52 patients had other genotypes: type 2 (10.1%), type 1 (6.0%), type 5 (1.9%), type 7 (0.7%), type 4 (0.4%), and type 6 (0.4%). Patients with type 3 were significantly older [age >52 months, adjusted odds ratio (OR) 8.55, 95% confidence interval (CI) 1.84-40, p = 0.006), their family members had a higher incidence of illness (adjusted OR 8.77, 95% CI 1.55-50, p = 0.01), they coughed (adjusted OR 6.37, 95% CI 1.54-26.3, p = 0.01), and they had a higher C-reactive protein (CRP) level (>2.87 mg/dL, adjusted OR 3.64, 95% CI 1.06-12.3, p = 0.04) than the 52 cases with other genotypes. In conclusion, this adenovirus outbreak, from late autumn to winter, was predominately caused by adenovirus type 3. Patients with this genotype were significantly older, had a higher incidence of cough and family transmission, and had higher CRP levels than those with other genotypes.
Asunto(s)
Infecciones por Adenovirus Humanos/epidemiología , Infecciones por Adenovirus Humanos/virología , Adenovirus Humanos/genética , Adenovirus Humanos/aislamiento & purificación , Infecciones por Adenovirus Humanos/diagnóstico , Adolescente , Antígenos Virales , Niño , Preescolar , ADN Viral/análisis , ADN Viral/aislamiento & purificación , Brotes de Enfermedades , Femenino , Humanos , Incidencia , Lactante , Masculino , Registros Médicos , Epidemiología Molecular , Análisis Multivariante , Faringe/virología , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Prevalencia , Taiwán/epidemiologíaRESUMEN
BACKGROUND: The purpose of the present paper was to evaluate the efficacy of probiotics (Lactobacillus casei rhamnosus, Lcr35) for treating children with chronic constipation and to compare its effect with magnesium oxide (MgO) and placebo. METHODS: This double-blind placebo-controlled, randomized study enrolled 45 children under 10 years old with chronic constipation. They were randomly assigned to receive Lcr35 (8 x 10(8) c.f.u./day; n = 18), MgO (50 mg/kg/day; n = 18), or placebo (n = 9) orally twice daily for 4 weeks. Lactulose use (1 mL/kg per day) was allowed when no stool passage for 3 days was noted. Glycerin enema was used only when no defecation was noted for >5 days or abdominal pain was suffered due to stool impaction. Bacterial cultures of stool were performed before and after treatment to evaluate the change of intestinal flora. Comparisons of the frequency of defecation, consistency of stool and the use of lactulose or enema during the period of treatment were made among the three groups. RESULTS: The patients who received MgO or probiotics had a higher defecation frequency (P = 0.03), higher percentage of treatment success (P = 0.01), less use of glycerin enema (P = 0.04) and less hard stool (P = 0.01) than the placebo group. There was no significant difference between MgO and probiotic groups in the aforementioned comparisons. The first effect of MgO (second week) on constipation was slightly earlier than that of probiotic (second to third week). Abdominal pain occurred less frequently in the probiotic group than in both the MgO and the placebo groups (P = 0.03). There was no statistically significant difference among the three groups in the use of lactulose, episodes of fecal soiling, and change of appetite. No adverse effect was noted in probiotic and placebo groups. Only one patient in the MgO group suffered from mild diarrhea. CONCLUSION: Lcr35 was effective in treating children with chronic constipation. There is no statistically significant difference in efficacy between MgO and Lcr35, but less abdominal pain occurred when using Lcr35. Study with larger case number and longer follow up is needed in the future.
Asunto(s)
Estreñimiento/terapia , Lacticaseibacillus casei , Probióticos , Niño , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Óxido de Magnesio/uso terapéutico , MasculinoRESUMEN
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of death in most countries of the world. In this study, associations between CVDs and polymorphisms of angiotensin-converting enzyme (ACE), atrial natriuretic peptide (ANP), beta(2)-adrenal receptor (B2AR) and endothelial nitric oxide synthase (ENOS) genes were explored in a community-based setting. METHODS: Between March and May 2001, 1740 subjects > or =35 years from the Matsu area in Taiwan were recruited to this study, representing 71.6% of the target population in Matsu. After informed consent was obtained during an interview, physical examination, resting ECG, serum biochemical profile and a questionnaire survey were used to obtain information. Genomic DNA was also collected and analyzed. Owing to technical limitations, 1186 samples were analyzed. Genetic polymorphisms of the genes in question were investigated using PCR and restriction fragment length polymorphism (RFLP). The distribution of allele frequencies for these genes was derived for stroke, coronary artery disease, hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia and overweight subgroups. RESULTS: The ENOS Glu298Asp polymorphism was associated with hypercholesterolemia (odds ratio 0.658, 95%CI 0.460-0.940; p=0.025) and the ACE D/I variant was associated with hypertriglyceridemia (odds ratio 0.722, 95%CI 0.536-0.973; p=0.033). Polymorphisms of the other genes were not associated with any of the disease groups. CONCLUSIONS: This community-based study reveals that genetic factors might play a role in the metabolism of lipids. The genetic risk for CVDs needs further investigation.