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1.
Gland Surg ; 13(8): 1408-1417, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39282037

RESUMEN

Background: Previous clinical trials have diminished the significance of lymph node (LN) metastasis and axillary surgery in breast cancer, particularly in cN0, postmenopausal estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative patients undergoing breast-conserving treatment (BCT). We assessed the replacement of axillary surgery with preoperative imaging modalities by analyzing the proportion of high nodal burden (HNB) patients with ≥3 LN metastases in these patients. Methods: We retrospectively identified 333 cN0, postmenopausal ER-positive/HER2-negative breast cancer patients who underwent BCT in two hospitals between January 2003 and December 2017. The proportion of LN metastasis patients and the number of metastatic LN were investigated. Risk factors of LN metastasis were analyzed and recurrence-free survival (RFS) was compared. Results: Axillary surgery confirmed LN metastasis in 81 (24.3%) of the cN0 patients. The clinical tumor size (cT) and age were factors associated with LN metastasis [cT: odds ratio (OR), 2.92, 95% confidence interval (CI): 1.69-5.05, P<0.001; age: OR, 0.33, 95% CI: 0.11-0.99, P=0.048]. However, HNB patients with ≥3 LN metastases were 15 (4.5%) of all the patients. There was statistically significant difference in the incidence of HNB between patients with cT1 tumors (3.6%) and those with cT2 tumors (7.4%) (P<0.001). Conclusions: In cN0, postmenopausal ER-positive/HER2-negative patients who underwent BCT, patients with cT1 tumors had lower rate of LN metastasis, and there were fewer instances of HNB. Therefore, in these patients, omission of axillary surgery including SLNB can be carefully considered.

2.
J Chest Surg ; 55(1): 98-100, 2022 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-35115428

RESUMEN

Unilateral pulmonary edema after minimally invasive cardiac surgery is a rare, but potentially life-threatening condition. However, the exact causes of unilateral pulmonary edema remain unclear. We experienced aggressive unilateral pulmonary edema followed by redo-resection of recurrent left atrial myxoma through a right mini-thoracotomy. Intraoperative veno-venous extracorporeal membrane oxygenation was applied after the termination of cardiopulmonary bypass, and separate mechanical ventilation using a double-lumen endotracheal tube was applied after surgery. The patient was successfully treated and discharged uneventfully.

3.
J Chest Surg ; 54(6): 547-550, 2021 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-34857673

RESUMEN

A 71-year-old male patient visited Yeungnam University Hospital with abnormal chest computed tomography (CT) findings. Chest CT revealed multiple lung nodules and a posterior mediastinal tumor, the diagnosis of which was confirmed surgically. Magnetic resonance imaging (MRI) of the abdomen showed multiple small nodules, which were diagnosed as cavernous hemangioma in the liver based on the pathology results of the mediastinal and lung masses in combination with MRI findings. Cavernous hemangiomas are benign tumors that can occur throughout the body, mainly in the skin and subcutaneous tissue. The liver is the most common internal organ containing hemangiomas, whereas they are very rarely found in the lungs or mediastinum.

4.
Semin Oncol ; 48(4-6): 283-291, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34836672

RESUMEN

PURPOSE: Lymphadenopathy (LAP) after COVID-19 vaccination in patients with a diagnosis of cancer has been challenging. We analyzed imaging and clinical features from early cases of axillary LAP in six COVID-19 vaccine recipients with a history of breast cancer. METHOD: Among the patients with a history of breast cancer and recent COVID-19 vaccine administration, six patients who showed isolated axillary LAP were gathered. Radiologic features were reviewed from breast ultrasound, chest computed tomography, and breast magnetic resonance imaging. Clinical and pathological information were obtained for analysis. RESULTS: The interval between ultrasound detection of LAP and last COVID-19 vaccine administration ranged from 14 to 28 days (mean 21.67 days). Round shape of the lymph node and irregular cortex were noted in 2 and 0 cases, respectively. Mean maximum cortical thickness, length to width ratio and interval aggravation in maximum cortical thickening were 4.2 mm, 1.34, and 2.81-fold with cut-off value of 3 mm, 1.5, 2.0-fold, respectively. CONCLUSION: We observed axillary LAP ipsilateral to a recent vaccine administration persisting longer than what the Centers for Disease Control and Prevention announced. In our patients, COVID-19 vaccine-related LAP tended to show increased cortical thickness without cortical irregularity. Oncologist as well as radiologist should be familiar with the fact that COVID-19 vaccines, regardless of vaccine type or dosage, can frequently cause ipsilateral axillary LAP, showing some suspicious features more often than others, and can persist longer than anticipated so that both over- and underdiagnosis can be avoided. We report our observations in six patients and provide an exhaustive review of the published literature.


Asunto(s)
Neoplasias de la Mama/complicaciones , Vacunas contra la COVID-19/efectos adversos , COVID-19/prevención & control , Linfadenopatía/inducido químicamente , Linfadenopatía/patología , Anciano , Femenino , Humanos , Linfadenopatía/complicaciones , Persona de Mediana Edad , SARS-CoV-2 , Estados Unidos
5.
J Chest Surg ; 54(6): 487-493, 2021 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-34815369

RESUMEN

BACKGROUND: Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. METHODS: Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), using 4 parameters: FVC, FVC%, FEV1, and FEV1%. RESULTS: The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV1%. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV1%. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV1 and predicted postoperative FEV1 analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). CONCLUSION: This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

6.
J Breast Cancer ; 24(6): 569-577, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34979601

RESUMEN

PURPOSE: Intraoperative frozen section biopsy is used to reduce the margin positive rate and re-excision rate and has been reported to have high diagnostic accuracy. A majority of breast surgeons in the Republic of Korea routinely perform frozen section biopsy to assess margins intraoperatively, despite its long turnaround time and high resource requirements. This study aims to determine whether omitting frozen section biopsy for intraoperative margin evaluation in selected patients is non-inferior to performing frozen section biopsy in terms of resection margin positivity rate. METHODS: This study is a phase III, randomized controlled, parallel-group, multicenter non-inferiority clinical trial. Patients meeting the inclusion criteria and providing written informed consent will be randomized to the "frozen section biopsy" or "frozen section biopsy omission" group after lumpectomy. Patients with clinical stage T1-T3 disease who are diagnosed with invasive breast cancer by core-needle biopsy and plan to undergo breast-conserving surgery will be included in this study. If a daughter nodule, non-mass enhancement, or microcalcification is identified on preoperative imaging, these features must be within 1 cm of the main mass for inclusion in the trial. The target sample size is 646 patients per arm. The primary endpoint will be the resection margin positive rate, and the secondary endpoints include the reoperation rate, operating time, residual cancer after reoperation, residual cancer after re-excision according to the frozen section biopsy result, resection volume, patient quality of life, and cost-effectiveness. DISCUSSION: This is the first randomized clinical trial utilizing frozen section biopsy for intraoperative margin evaluation and aims to determine the non-inferiority of omitting frozen section biopsy in selected patients compared to performing frozen section biopsy. We expect that this trial will help surgeons perform the procedure more efficiently while ensuring patient safety. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03975179; Clinical Research Information Service Identifier: KCT0004606.

7.
Int J Colorectal Dis ; 34(8): 1413-1420, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31267222

RESUMEN

PURPOSE: Antibiotics are widely used in the treatment of uncomplicated left-sided colonic diverticulitis. In Asian countries, however, right-sided colonic diverticulitis is more common than left-sided colonic diverticulitis. The aim of the present study was to evaluate the need for antibiotics in the treatment of uncomplicated right-sided colonic diverticulitis in an Asian population. METHODS: Patients were randomized to two management strategies: antibiotics and no antibiotics. At 4-6 weeks after discharge, the patients in both groups underwent computed tomography or were contacted by phone to confirm the effectiveness of the treatment. The primary end point was the treatment failure rate of the initial treatment, and secondary end points were the length of hospital stay and total admission costs. RESULTS: Patients were randomized to treatment with (61 patients) or without (64 patients) antibiotics. The rates of treatment failure in the antibiotics and no antibiotics groups were 1.7% and 4.6%, respectively, with no significant difference (P = 0.619). There was also no significant difference in the length of hospital stay between the groups (P = 0.983). Total admission costs were lower in the no antibiotics group than in the antibiotics group (US$1004.70 vs US$1112.40, respectively, P = 0.037). CONCLUSION: Conservative management of uncomplicated right-sided colonic diverticulitis without antibiotics shows similar treatment failure rates and length of hospital stay, and is associated with lower hospital costs, compared with standard antibiotic treatment. Therefore, conservative management can be considered as a safe treatment option. TRIAL REGISTRATION: ClinicalTrial.gov No. NCT02314013.


Asunto(s)
Antibacterianos/uso terapéutico , Diverticulitis del Colon/tratamiento farmacológico , Adulto , Temperatura Corporal , Diverticulitis del Colon/sangre , Femenino , Humanos , Recuento de Leucocitos , Masculino , Estudios Prospectivos , Recurrencia , Resultado del Tratamiento
8.
J Clin Invest ; 126(11): 4372-4386, 2016 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-27669460

RESUMEN

Obese, insulin-resistant states are characterized by a paradoxical pathogenic condition in which the liver appears to be selectively insulin resistant. Specifically, insulin fails to suppress glucose production, yet successfully stimulates de novo lipogenesis. The mechanisms underlying this dysregulation remain controversial. Here, we hypothesized that carbohydrate-responsive element-binding protein (ChREBP), a transcriptional activator of glycolytic and lipogenic genes, plays a central role in this paradox. Administration of fructose increased hepatic hexose-phosphate levels, activated ChREBP, and caused glucose intolerance, hyperinsulinemia, hypertriglyceridemia, and hepatic steatosis in mice. Activation of ChREBP was required for the increased expression of glycolytic and lipogenic genes as well as glucose-6-phosphatase (G6pc) that was associated with the effects of fructose administration. We found that fructose-induced G6PC activity is a major determinant of hepatic glucose production and reduces hepatic glucose-6-phosphate levels to complete a homeostatic loop. Moreover, fructose activated ChREBP and induced G6pc in the absence of Foxo1a, indicating that carbohydrate-induced activation of ChREBP and G6PC dominates over the suppressive effects of insulin to enhance glucose production. This ChREBP/G6PC signaling axis is conserved in humans. Together, these findings support a carbohydrate-mediated, ChREBP-driven mechanism that contributes to hepatic insulin resistance.


Asunto(s)
Factores de Transcripción Básicos con Cremalleras de Leucinas y Motivos Hélice-Asa-Hélice/metabolismo , Fructosa/toxicidad , Glucosa/biosíntesis , Resistencia a la Insulina , Insulina/metabolismo , Proteínas Nucleares/metabolismo , Transducción de Señal/efectos de los fármacos , Factores de Transcripción/metabolismo , Animales , Factores de Transcripción Básicos con Cremalleras de Leucinas y Motivos Hélice-Asa-Hélice/genética , Hígado Graso/inducido químicamente , Hígado Graso/genética , Hígado Graso/metabolismo , Hígado Graso/patología , Femenino , Proteína Forkhead Box O1/genética , Proteína Forkhead Box O1/metabolismo , Glucosa/genética , Intolerancia a la Glucosa/inducido químicamente , Intolerancia a la Glucosa/genética , Intolerancia a la Glucosa/metabolismo , Intolerancia a la Glucosa/patología , Glucosa-6-Fosfatasa/genética , Glucosa-6-Fosfatasa/metabolismo , Glucólisis/efectos de los fármacos , Glucólisis/genética , Humanos , Insulina/genética , Lipogénesis/efectos de los fármacos , Lipogénesis/genética , Masculino , Ratones , Ratones Noqueados , Proteínas Nucleares/genética , Transducción de Señal/genética , Factores de Transcripción/genética
9.
J Clin Invest ; 126(4): 1401-12, 2016 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-26974159

RESUMEN

The phosphatidylinositol 3-kinase (PI3K) signaling pathway is central to the action of insulin and many growth factors. Heterozygous mutations in the gene encoding the p85α regulatory subunit of PI3K (PIK3R1) have been identified in patients with SHORT syndrome - a disorder characterized by short stature, partial lipodystrophy, and insulin resistance. Here, we evaluated whether SHORT syndrome-associated PIK3R1 mutations account for the pathophysiology that underlies the abnormalities by generating knockin mice that are heterozygous for the Pik3r1Arg649Trp mutation, which is homologous to the mutation found in the majority of affected individuals. Similar to the patients, mutant mice exhibited a reduction in body weight and length, partial lipodystrophy, and systemic insulin resistance. These derangements were associated with a reduced capacity of insulin and other growth factors to activate PI3K in liver, muscle, and fat; marked insulin resistance in liver and fat of mutation-harboring animals; and insulin resistance in vitro in cells derived from these mice. In addition, mutant mice displayed defective insulin secretion and GLP-1 action on islets in vivo and in vitro. These data demonstrate the ability of this heterozygous mutation to alter PI3K activity in vivo and the central role of PI3K in insulin/growth factor action, adipocyte function, and glucose metabolism.


Asunto(s)
Hormona del Crecimiento , Resistencia a la Insulina/genética , Hígado/enzimología , Mutación Missense , Fosfatidilinositol 3-Quinasas/genética , Fosfatidilinositol 3-Quinasas/metabolismo , Sustitución de Aminoácidos , Animales , Péptido 1 Similar al Glucagón/genética , Péptido 1 Similar al Glucagón/metabolismo , Insulina/genética , Insulina/metabolismo , Secreción de Insulina , Lipodistrofia/enzimología , Lipodistrofia/genética , Lipodistrofia/patología , Hígado/patología , Ratones , Ratones Mutantes
11.
Am J Rhinol Allergy ; 27(1): 18-23, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23406592

RESUMEN

BACKGROUND: Nasal polyposis is associated with a chronic inflammatory condition of the sinonasal mucosa and involves myofibroblast differentiation and extracellular matrix (ECM) accumulation. Epigenetic modulation by histone deacetylase (HDAC) inhibitors including trichostatin A (TSA) has been reported to have inhibitory effects on myofibroblast differentiation in lung and renal fibroblasts. The purpose of this study was to investigate the inhibitory effect of TSA on myofibroblast differentiation and ECM production in nasal polyp organ cultures. METHODS: Nasal polyp tissues from 18 patients were acquired during endoscopic sinus surgery. After organ culture, nasal polyps were stimulated with TGF-beta1 and then treated with TSA. Alpha-smooth muscle actin (α-SMA), fibronectin, and collagen type I expression levels were examined by reverse transcription-polymerase chain reaction (PCR), real-time PCR, Western blot, and immunofluorescent staining. HDAC2, HDAC4, and acetylated H4 expression levels were assayed by Western blot. Cytotoxicity was analyzed by the terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling assay. RESULTS: The expression levels of α-SMA, fibronectin, and collagen type 1 were increased in nasal polyp after transforming growth factor (TGF) beta1 treatment. TSA-inhibited TGF-beta1 induced these gene and protein expression levels. Furthermore, TSA suppressed protein expression levels of HDAC2 and HDAC4. However, TSA induced hyperacetylation of histones H4. Treatment with TGF-beta1 with or without TSA did not have cytotoxic effect. CONCLUSION: These findings provide novel insights into the epigenetic regulation in myofibroblast differentiation and ECM production of nasal polyp. TSA could be a candidate of a therapeutic agent for reversing the TGF-beta1-induced ECM synthesis that leads to nasal polyp development.


Asunto(s)
Matriz Extracelular/efectos de los fármacos , Matriz Extracelular/enzimología , Inhibidores de Histona Desacetilasas/farmacología , Ácidos Hidroxámicos/farmacología , Miofibroblastos/efectos de los fármacos , Pólipos Nasales/enzimología , Pólipos Nasales/patología , Acetilación/efectos de los fármacos , Actinas/genética , Actinas/metabolismo , Apoptosis/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Fibronectinas/genética , Fibronectinas/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Histona Desacetilasa 2/genética , Histona Desacetilasa 2/metabolismo , Histona Desacetilasas/genética , Histona Desacetilasas/metabolismo , Humanos , Miofibroblastos/enzimología , Miofibroblastos/patología , Técnicas de Cultivo de Órganos , Proteínas Represoras/genética , Proteínas Represoras/metabolismo , Factor de Crecimiento Transformador beta1/inmunología
12.
Int Arch Allergy Immunol ; 159(4): 399-409, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22846744

RESUMEN

BACKGROUND: Chronic hypoxia is associated with remodeling in various organs. Reactive oxygen species (ROS) derived from NADPH oxidases (Nox), and transforming growth factor-ß(1) (TGF-ß(1)) have been implicated in the pathogenesis of hypoxia-induced remodeling. The aims of this study were to determine in hypoxia-stimulated nasal polyp-derived fibroblasts (NPDF) the effect of hypoxia on the differentiation of myofibroblasts, the role of ROS, the major Nox homolog mediating myofibroblast differentiation, and the role of TGF-ß(1). METHODS: Eight primary cultures of NPDF were established from nasal polyps, which were incubated under hypoxic conditions. Reverse transcription polymerase chain reaction for αSMA, Nox1, Nox3, Nox4, Nox5, and fibronectin mRNA was performed. Western blotting for α-SMA and fibronectin was done. ROS production was detected using a fluorometer. NPDF were pretreated with ROS scavengers and transfected with siNox4. The TGF-ß(1) protein level was measured by ELISA. The effect of treatment with TGF-ß(1) type I tyrosine kinase inhibitor SB431542 on myofibroblast differentiation was observed. RESULTS: Hypoxic stimulation of NPDF significantly increased α-SMA and fibronectin mRNA and protein expression. ROS production was increased by hypoxia, and ROS scavengers inhibited myofibroblast differentiation. Nox4 mRNA was the only Nox homolog increased by hypoxia. Transfection with siNox4 inhibited myofibroblast differentiation. TGF-ß(1) was secreted endogenously by hypoxic NPDF. SB431542 significantly inhibited myofibroblast differentiation. CONCLUSIONS: Hypoxia induces myofibroblast differentiation of NPDF through a signaling pathway involving Nox4-dependent ROS generation and TGF-ß(1). Therapies targeting Nox4 may be effective against remodeling of nasal polyps.


Asunto(s)
Miofibroblastos/enzimología , NADPH Oxidasas/metabolismo , Pólipos Nasales/enzimología , ARN Mensajero/biosíntesis , Actinas/biosíntesis , Adulto , Benzamidas/farmacología , Diferenciación Celular/efectos de los fármacos , Hipoxia de la Célula/genética , Dioxoles/farmacología , Femenino , Fibronectinas/biosíntesis , Depuradores de Radicales Libres/farmacología , Humanos , Isoenzimas/antagonistas & inhibidores , Isoenzimas/genética , Isoenzimas/metabolismo , Masculino , Miofibroblastos/efectos de los fármacos , Miofibroblastos/patología , NADPH Oxidasa 4 , NADPH Oxidasas/antagonistas & inhibidores , NADPH Oxidasas/genética , Pólipos Nasales/patología , Oxígeno/farmacología , Cultivo Primario de Células , ARN Interferente Pequeño/genética , Especies Reactivas de Oxígeno/metabolismo , Transducción de Señal/efectos de los fármacos , Factor de Crecimiento Transformador beta/biosíntesis , Factor de Crecimiento Transformador beta1/antagonistas & inhibidores , Factor de Crecimiento Transformador beta1/biosíntesis , Regulación hacia Arriba/efectos de los fármacos
13.
J Breast Cancer ; 14(1): 14-9, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21847389

RESUMEN

PURPOSE: αB-crystallin, a small heat shock protein, is an anti-apoptotic protein associated with aggressive tumor behavior. A recent study revealed that αB-crystallin is overexpressed in a metastatic variant of the GI101A human breast carcinoma cell line. The purpose of this study was to investigate whether αB-crystallin is related to other breast tumor markers and can predict a breast cancer prognosis. METHODS: Eighty-two patients who underwent breast cancer surgery at Hallym Sacred Heart Hospital were enrolled. αB-crystallin expression was determined by immunohistochemical staining. Estrogen receptor, progesterone receptor (PR), human epidermal growth factor receptor, lymphovascular invasion, histological grade, other tumor markers and time to recurrence were compared with αB-crystallin expression. RESULTS: αB-crystallin expression in breast cancer tissues was associated with PR (p=0.030), the number of metastatic lymph nodes (pN) (p=0.020), lymphovascular invasion (p=0.022), histological grade (p=0.004) and triple negative breast cancer (TNBC) (p=0.004). αB-crystallin expression significantly decreased time to recurrence (p=0.039). CONCLUSION: The results revealed a strong relationship between αB-crystallin and poor prognostic factors such as the number of metastatic lymph nodes (especially pN2), TNBC, and rapid time to recurrence. We believe that αB-crystallin could be a novel oncoprotein biomarker of a poor prognosis in breast cancer.

14.
J Korean Med Sci ; 26(7): 893-9, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21738342

RESUMEN

Thyroid carcinogenesis is accompanied by loss of thyroid-specific functions and refractory to radioiodine and thyroid stimulating hormone (TSH) suppression therapy. Redifferentiating agents have been shown to inhibit tumor growth and improve the response to conventional therapy. Polyphenol phytochemicals (PPs) in fruits and vegetables have been reported to inhibit cancer initiation, promotion, progression and induce redifferentiation in selected types. In this study we examined PPs induce redifferentiation in thyroid cancer cell lines. We investigated the effects of genistein, resveratrol, quercetin, kaempferol, and resorcinol on the F9 embryonal carcinoma cell differentiation model. The thyroid cancer cell lines, TPC-1, FTC-133, NPA, FRO, and ARO, displayed growth inhibition in response to genistein, resveratrol, quercetin. We further demonstrated that genistein decreased the dedifferention marker CD97 in NPA cells and resveratrol decreased CD97 in FTC-133, NPA, FRO cells and quercetin decreased CD97 in all cell lines. We observed increased expression of differentiation marker NIS in FTC-133 cells in response to genistein, and resveratrol but no change in NPA, FRO, ARO cells. Quercetin increased or induced NIS in FTC-133, NPA, FRO cells. These findings suggest that PPs may provide a useful therapeutic intervention in thyroid cancer redifferentiation therapy.


Asunto(s)
Antineoplásicos/farmacología , Carcinoma Embrionario/tratamiento farmacológico , Diferenciación Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Flavonoides/farmacología , Fenoles/farmacología , Neoplasias de la Tiroides/tratamiento farmacológico , Antígenos CD/metabolismo , Antineoplásicos/uso terapéutico , Carcinoma Embrionario/metabolismo , Línea Celular Tumoral , Flavonoides/uso terapéutico , Regulación Neoplásica de la Expresión Génica , Genisteína/farmacología , Genisteína/uso terapéutico , Humanos , Quempferoles/farmacología , Quempferoles/uso terapéutico , Modelos Biológicos , Fenoles/uso terapéutico , Polifenoles , Quercetina/farmacología , Quercetina/uso terapéutico , Receptores Acoplados a Proteínas G , Resorcinoles/farmacología , Resorcinoles/uso terapéutico , Resveratrol , Estilbenos/farmacología , Estilbenos/uso terapéutico , Simportadores/metabolismo , Neoplasias de la Tiroides/metabolismo
15.
Gen Hosp Psychiatry ; 32(5): 503-8, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20851271

RESUMEN

OBJECTIVE: Breast cancer patients can have biopsychosocial changes induced by distress related to the cancer diagnosis. This study investigated psychological characteristics and hypothalamic-pituitary-adrenal (HPA) axis function associated with depressive symptoms in breast cancer patients at the initial diagnosis. METHOD: Seventy-eight breast cancer patients were enrolled, and 61 patients were included in the final analysis. Patients were evaluated concerning psychological adjustment to cancer diagnosis, self-concept and depressive symptoms and given a dexamethasone suppression test before the main surgical treatment. RESULTS: Self-concept scale scores and fighting spirit factor scores of the Korean version of the Mental Adjustment to Cancer (KMAC) scale showed inverse correlations. Anxious preoccupation (AP) factor scores of the KMAC scale positively correlated with depressive symptom scores. Depressive symptom scores were significantly correlated with postdexamethasone serum cortisol levels. In multiple regression analysis, postdexamethasone serum cortisol and the KMAC-AP factor score had significant partial effects in the final model. CONCLUSION: Hypothalamic-pituitary-adrenal axis dysfunction and anxious coping to cancer diagnosis may be associated with depressive symptoms in breast cancer patients before treatment. Based on this analysis, we recommend psychotherapeutic interventions to increase adaptive mental coping strategy and to ameliorate psychological distress. Screening for HPA axis dysfunction and provision of depression treatment may prevent breast cancer patients from developing depressive symptoms.


Asunto(s)
Neoplasias de la Mama/fisiopatología , Neoplasias de la Mama/psicología , Trastorno Depresivo/fisiopatología , Trastorno Depresivo/psicología , Sistema Hipotálamo-Hipofisario/fisiopatología , Sistema Hipófiso-Suprarrenal/fisiopatología , Adaptación Psicológica , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/fisiopatología , Trastornos de Ansiedad/psicología , Nivel de Alerta/fisiología , Neoplasias de la Mama/diagnóstico , Estudios Transversales , Trastorno Depresivo/diagnóstico , Dexametasona , Femenino , Humanos , Hidrocortisona/sangre , Persona de Mediana Edad , Inventario de Personalidad/estadística & datos numéricos , Psicometría , Psicoterapia , Autoimagen
16.
Breast J ; 15(3): 223-9, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19645775

RESUMEN

Most anticancer agents activate nuclear factor kappa B (NF-kappaB), which can mediate cell survival, proliferation, and metastasis. Curcumin has been shown to inhibit the growth of various cancer cells, without toxicity to normal cells. The antitumor effects of curcumin could be due in part to the inactivation of NF-kappaB. We hypothesize that blocking NF-kappaB activity may augment paclitaxel cancer chemotherapy. In this study, we investigated whether the inactivation of NF-kappaB by curcumin would enhance the efficacy of paclitaxel for inhibiting breast cancer growth in vitro and in vivo. We confirmed that curcumin inhibited paclitaxel-induced activation of NF-kappaB and potentiated the growth inhibitory effect of paclitaxel in MDA-MB-231 breast cancer cells. The combination of curcumin with paclitaxel elicited significantly greater inhibition of cell growth and more apoptosis, compared with either agent alone. In an experimental breast cancer murine model using MDA-MB-231 cells, combination therapy with paclitaxel and curcumin significantly reduced tumor size and decreased tumor cell proliferation, increased apoptosis, and decreased the expression of matrix metalloprotease 9 compared with either agent alone. These results clearly suggest that a curcumin-paclitaxel combination could be a novel strategy for the treatment of breast cancer.


Asunto(s)
Antineoplásicos/farmacología , Curcumina/farmacología , Neoplasias Mamarias Experimentales/tratamiento farmacológico , Neoplasias Mamarias Experimentales/metabolismo , FN-kappa B/metabolismo , Paclitaxel/antagonistas & inhibidores , Animales , Apoptosis/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Sinergismo Farmacológico , Quimioterapia Combinada , Femenino , Inmunohistoquímica , Antígeno Ki-67/análisis , Neoplasias Mamarias Experimentales/patología , Ratones , Ratones Desnudos , Paclitaxel/farmacología , Ensayos Antitumor por Modelo de Xenoinjerto
17.
Arch Otolaryngol Head Neck Surg ; 134(11): 1182-6, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19015448

RESUMEN

OBJECTIVE: To investigate the expression and localization of neutrophil gelatinase-associated lipocalin (NGAL), an antimicrobial peptide, in the normal nasal mucosa and human nasal polyps. Neutrophil gelatinase-associated lipocalin has been identified as a key element in the innate host defense system. However, scant knowledge exists about the expression of NGAL in the human sinonasal tract. DESIGN: Prospective study. SETTING: Academic medical center. PATIENTS: Normal inferior turbinate mucosa was obtained from 10 patients who were undergoing augmentation rhinoplasty. The nasal polyps were obtained from 10 patients who were undergoing endoscopic sinus surgery for chronic rhinosinusitis with polyps. INTERVENTIONS: We performed semiquantitative reverse transcription-polymerase chain reaction, immunohistochemical staining, and Western blot analysis. MAIN OUTCOME MEASURES: We analyzed the expression of the NGAL messenger RNA (mRNA) and localization of the NGAL protein. RESULTS: The NGAL mRNA and NGAL protein were highly expressed in the nasal polyps. The ratio of NGAL mRNA to glyceraldehyde-3-phosphate dehydrogenase mRNA in the nasal polyps was greater compared with that in the normal turbinate mucosa (P = .002). The NGAL protein was observed in the epithelium, the infiltrating inflammatory cells, and the submucosal gland of the nasal polyps, but it was very rarely detected in the normal nasal mucosa. CONCLUSION: Expression of NGAL is upregulated in nasal polyps, and additional work is needed to reveal the possible role of NGAL in the defense systems of the nasal mucosa and the process of polyp formation.


Asunto(s)
Proteínas de Fase Aguda/genética , Lipocalinas/genética , Mucosa Nasal/patología , Pólipos Nasales/genética , Proteínas Proto-Oncogénicas/genética , Adulto , Western Blotting , Femenino , Expresión Génica/genética , Humanos , Lipocalina 2 , Masculino , Persona de Mediana Edad , Mucosa Nasal/cirugía , Pólipos Nasales/patología , Pólipos Nasales/cirugía , Estudios Prospectivos , ARN Mensajero/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Cornetes Nasales/patología , Cornetes Nasales/cirugía
18.
Arch Otolaryngol Head Neck Surg ; 134(10): 1094-8, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18936358

RESUMEN

OBJECTIVES: To investigate the expression of messenger RNA (mRNA) of the gene for pigment epithelium-derived factor (PEDF) (OMIM *172860) and PEDF protein and to localize the PEDF protein in the nasal mucosa of patients with allergic rhinitis and of control subjects. DESIGN: Investigation of PEDF mRNA and PEDF protein expression in the nasal mucosa using reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemical staining. PARTICIPANTS: We used inferior turbinate mucosal samples from 10 patients with allergic rhinitis and 10 matched healthy control subjects. INTERVENTIONS: We extracted PEDF mRNA from the inferior turbinate mucosa samples and performed reverse transcription-polymerase chain reaction analysis. We used Western blotting to analyze differences in expression levels of PEDF protein between patients with allergic rhinitis and healthy controls, and the PEDF protein was localized immunohistochemically. RESULTS: The expression levels of PEDF mRNA and PEDF protein in the nasal mucosa were significantly increased in patients with allergic rhinitis compared with those in nonallergic controls. The PEDF protein was expressed in the epithelium and submucosal glands. CONCLUSIONS: We found that PEDF protein is expressed in the human nasal mucosa, and its expression is increased in allergic rhinitis. These results suggest a possible contribution of PEDF to the chronic inflammation of the nasal mucosa in allergic rhinitis.


Asunto(s)
Proteínas del Ojo/genética , Regulación de la Expresión Génica , Factores de Crecimiento Nervioso/genética , Rinitis Alérgica Perenne/genética , Serpinas/genética , Adulto , Western Blotting , Estudios de Casos y Controles , Intervalos de Confianza , Proteínas del Ojo/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Mucosa Nasal/metabolismo , Mucosa Nasal/patología , Factores de Crecimiento Nervioso/metabolismo , ARN Mensajero/análisis , Valores de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Rinitis Alérgica Perenne/inmunología , Rinitis Alérgica Perenne/metabolismo , Factores de Riesgo , Sensibilidad y Especificidad , Serpinas/metabolismo
19.
Otolaryngol Head Neck Surg ; 139(3): 395-8, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18722220

RESUMEN

OBJECTIVES: To investigate the epidemiologic and microbiological characteristics of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infections in the otorrhea of chronic suppurative otitis media (COM) patients. DESIGN: Retrospective study of patients with newly identified MRSA infections from January 1998 through December 2006. A total of 2773 patients with a diagnosis of COM were included in this study. An antibiotic sensitivity test was performed for each isolate. RESULTS: The prevalence of MRSA in COM was 4.9 percent (137 of 2773 patients). The proportion of CA-MRSA rose from 0.7 percent in 1998 to 11.4 percent in 2006. However, the proportion of HA-MRSA did not change significantly, from 0.7 percent in 1999 to 1.3 percent in 2006. All of the CA-MRSA strains identified in our study were susceptible to trimethoprim/sulfamethoxazole (TMP/SMX). Rifampin susceptibility was also noted in 90 percent of the cases. CONCLUSIONS: CA-MRSA infections have risen dramatically in the past decade. CA-MRSA and HA-MRSA in COM differed in both clinical and microbiological aspects.


Asunto(s)
Otitis Media Supurativa/microbiología , Infecciones Estafilocócicas/epidemiología , Adolescente , Anciano , Niño , Preescolar , Enfermedad Crónica , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Humanos , Lactante , Resistencia a la Meticilina , Persona de Mediana Edad , Estudios Retrospectivos
20.
Ann Otol Rhinol Laryngol ; 117(5): 347-52, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18564531

RESUMEN

OBJECTIVES: We investigated the expression of oncostatin M messenger RNA (mRNA) and protein in normal submandibular glands and those with chronic obstructive sialadenitis and localized the expression of oncostatin M protein. METHODS: Submandibular glands from 10 patients with chronic obstructive sialadenitis as a study group and 10 normal submandibular glands as a control group were examined. Oncostatin M mRNA extracted from submandibular gland was used for reverse transcription-polymerase chain reaction and analyzed semiquantitatively. The difference in expression level of oncostatin M protein between the 2 groups was analyzed through Western blot analysis, and oncostatin M protein was localized immunohistochemically. RESULTS: The expression levels of oncostatin M mRNA and protein were significantly increased in the study group. The protein was predominantly localized in ductal epithelia and infiltrating inflammatory cells and was more strongly expressed in the study group also. CONCLUSIONS: Oncostatin M is expressed in both chronic obstructive sialadenitis and normal submandibular gland, and is up-regulated in chronic obstructive sialadenitis. These results suggest that oncostatin M is involved in the pathologic process of chronic obstructive sialadenitis. However, the physiologic role in normal glands, as well as a possible role in the development of chronic obstructive sialadenitis, remains to be elucidated.


Asunto(s)
Expresión Génica , Oncostatina M/genética , ARN Mensajero/genética , Sialadenitis/genética , Glándula Submandibular/metabolismo , Adulto , Biomarcadores/metabolismo , Western Blotting , Enfermedad Crónica , Constricción Patológica , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Oncostatina M/biosíntesis , Pronóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Sialadenitis/metabolismo , Sialadenitis/patología , Glándula Submandibular/patología
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