Predictive value of nodal maximum standardized uptake value of pretreatment [18F]fluorodeoxyglucose positron emission tomography imaging in patients with esophageal cancer.

We retrospectively reviewed 102 patients with esophageal cancer (97.1% squamous cell carcinoma, 96.1% stage III) received FDG-PET staging and were treated by chemoradiotherapy with or without resection to assess whether the pretreatment [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) maximum standardized uptake value (SUVmax) of the primary tumor and metastatic lymph nodes can predict the prognosis of patients with esophageal cancer. Receiver operating characteristic analysis was performed to find the cutoff values for primary tumor SUVmax and nodal SUVmax. The influence of clinical factors including primary tumor SUVmax and nodal SUVmax on local progression-free survival, nodal progression-free survival (NPFS), distant metastases-free survival (DMFS), and overall survival (OS) were evaluated using univariate and multivariate analyses. A total of 40 patients received esophagectomy after neoadjuvant chemoradiotherapy (trimodality), while 62 patients received definitive chemoradiotherapy (dCRT). The median follow-up was 26.4 months. The SUVmax of primary tumor had no significant predictive value on all outcomes, while the SUVmax of metastatic lymph nodes had predictive value on several outcomes. High nodal SUVmax (≥7) predicted for worse outcomes than low nodal SUVmax (<7) in the patients who received dCRT (two-year DMFS, 17% vs. 92%, P < 0.001; NPFS, 14% vs. 81%, P = 0.001; OS, 21% vs. 50%, P = 0.003), but not in those received trimodality. On multivariate analysis of patients receiving dCRT, nodal SUVmax was the strongest independent predictor on DMFS (hazard ratio [HR] 13.93, P < 0.001), NPFS (HR 3.99, P = 0.026), PFS (HR 2.90, P = 0.003), and OS (HR 3.80, P = 0.001). High pretreatment nodal SUVmax predicts worse treatment outcomes for the patients treated with dCRT.

Modified Blair method for ankle arthrodesis.

In this study, the ordinary Blair's ankle arthrodesis was modified by longitudinal oblique cutting to get the sliding bone graft, up side down grafting, and additional screw fixation at talar site with or without staples fixation of tibia-talar junction. The method of ankle arthrodesis was used on 34 cases from 1987 to 1990 with a 91.2% fusion rate and an average 5.6 months fusion time. The oblique cut bone graft provided larger contact surface to enhance bony fusion and the upside-down bone graft provided stronger tibia-talar bone bridge with thicker cortex for distal screw fixation and the distal screw fixation of bone graft to talus had the advantage of securing union and maintaining position. With such modifications, solid ankle arthrodesis could be obtained even without interarticular compression.

Association and interaction effect between VEGF receptor-2 (VEGFR-2) gene polymorphisms and dietary pattern on blood uric acid in Malays and Indians.

INTRODUCTION: Gout and hyperuricaemia attributed to genetic and lifestyle factors have been associated with several chronic diseases. This study aimed to determine the association and interaction effects between vascular endothelial growth factor receptor-2 (VEGFR-2) gene polymorphisms (rs1870377 and rs2071559) and dietary patterns on blood uric acid in Malay and Indian adults. METHODS: Dietary intakes of 153 Malays and 177 Indians were obtained using a food frequency questionnaire for the construction of dietary patterns using factor analysis. Genotyping of rs1870377 and rs2071559 was performed by real-time PCR using TaqMan probes. Anthropometric measurements, body mass index (BMI) and blood pressure and biomarkers, uric acid, glycated haemoglobin A1c (HbA1c), and blood lipids were determined. RESULTS: There were significant differences in the mean values for HbA1c (41 +/- 12 vs 45 +/- 8 mmol/mol, p < 0.001) and blood lipids levels (p < 0.05) between Malays and Indians. Significant correlations were obtained between uric acid with selected blood lipids (p < 0.05) and BMI in Malays (r = 0.362, p < 0.001) and Indians (r = 0.212, p < 0.01). Four dietary patterns were extracted from dietary intakes of all subjects: 'Vegetables diet'; 'Fruits diet' (FD); 'Animal protein and rice diet'; and 'Fast foods and preserved foods diet'. There were no significant associations between dietary patterns (p = 0.054-0.609) and VEGFR-2 gene polymorphisms (p = 0.348-0.778) with uric acid. In Malay subjects, the interaction of rs2071559 and FD had a borderline effect (p = 0.05) on blood uric acid after adjusting for potential confounders. CONCLUSION: The associations and gene-diet interactions involving VEGFR-2 gene polymorphisms and FD on uric acid provide new information on gout and hyperuricaemia risks in Malays.

Weight Status and Dietary Intake among Female Children and Adolescents Aged 6-17 Years in a Welfare Home, Kuala Lumpur.

A cross-sectional study was conducted among 13 female children and 40 adolescents residing in a welfare home. The objectives of this study were to determine underweight, overweight rates and body fat percentages as well as assess the dietary intake of energy, selected macro- and micro-nutrients among the subjects aged 6-17 years. The anthropometric measurements collected were Body Mass Index (BMI) and skinfold thickness of five body sites - triceps, subscapular, abdomen, suprailiac, and thigh. Dietary intake was assessed using a 24-hour dietary recall. This study indicated that the majority (75%) of the subjects were of normal weight, 21% were underweight and 4% were overweight. BMI and body fat percentages of the adolescents were found to be significantly higher than those of the children (t=-3.083, p=0.003; t=-7.321, p<0.001). A positive correlation between BMI and body fat percentage was also significant (r=0.791, p<0.001). In terms of dietary assessment, there were significant differences in percentage of RNI attainment between children and adolescents for energy, protein, iron, and folate (p<0.05). In conclusion, the majority of the children and adolescents had normal weight and average body fat percentages. Besides, all the children met the RNI requirements for all the studied nutrients while the adolescents met the RNI requirements for energy, protein, iron, and zinc with dietary calcium and folate slightly below the RNI requirements.