Taraxasterol inhibits TGF-β1-induced epithelial-to-mesenchymal transition in papillary thyroid cancer cells through regulating the Wnt/β-catenin signaling

Taraxasterol (TAR) is a kind of active compound extracted from dandelion and its molecular structure resembles steroid hormones. Recently, TAR has been reported to show an anti-tumor activity. However, the specific role of TAR in papillary thyroid cancer (PTC) has not been clarified. In this study, we investigated the effect of TAR on PTC cell migration, invasion and epithelial-to-mesenchymal transition (EMT) induced by TGF-β1. PTC cells were exposed to TGF-β1 (5 ng/mL) and then treated with different concentrations of TAR. We found that TAR showed no obvious cytotoxicity below 10 μg/mL but notably reduced migration and invasion of TGF-β1-treated PTC cells. Moreover, TAR treatment decreased MMP-2 and MMP-9 levels, and obviously affected the expression of EMT markers. We also observed that Wnt3a and β-catenin levels were significantly increased in TGF-β1-treated PTC cells while TAR inhibited these effects in a concentration-dependent manner. Additionally, activation of the Wnt pathway by LiCl attenuated the suppressive effect of TAR on TGF-β1-induced migration, invasion and EMT in PTC cells. Taken together, we highlighted that TAR could significantly suppress TGF-β1-regulated migration and invasion by reversing the EMT process via the Wnt/β-catenin pathway, suggesting that TAR may be a potential anti-cancer agent for PTC treatment.

Exploration of effect of Odanacatib on inhibiting orthodontic recurrence in rats and on CatK and IGF-1 mRNA

OBJECTIVE

This study aimed to investigate the inhibitory effect of Odanacatib on orthodontic recurrence in rats.

MATERIALS AND METHODS

Forty rats were selected to establish a planting anchorage molar movement model, and 50 g of force was used for the mesial movement of the right maxillary first molar. Forty rats were randomly divided into the observation group (n=20) and control group (n=20). Odanacatib (60 μl, 1.25 μM) was locally injected into the mucoperiosteum around the right maxillary first molar of rats in the experimental group, and an equal amount of normal saline was injected into rats in the control group. A Vernier caliper was used for measuring the recurrence movement distance and recurrence rate of rats, Micro-CT for scanning the bone mineral density (BMD) and bone volume fraction (BVF) of the alveolar bone, TRAP special staining for observing changes in osteoclasts and quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) for detecting the mRNA expressions of cathepsin K (CatK) and insulin-like growth factor 1 (IGF-1) in periodontal tissues.

RESULTS

After 3 weeks of modeling, the movement distance of the first molar of rats in the two groups was 1.16±0.19 mm. The molar movement distance and recurrence rate of rats were significantly higher in the control group than those in the observation group (p<0.05). The BMD and BVF of the alveolar bone of rats were markedly lower in the control group than those in the observation group (p<0.05). There was no statistically significant difference in the number of osteoclasts between the observation group (26.15±3.92) and the control group (27.01±2.74) (t=0.882, p=0.383). The CatK mRNA expression of rats was remarkably lower in the observation group than that in the control group (p<0.05). The IGF-1 mRNA expression of rats was significantly higher in the observation group than that in the control group (p<0.05).

CONCLUSIONS

By promoting the IGF-1 mRNA expression and increasing the BMD and BVF of the alveolar bone, Odanacatib inhibits orthodontic recurrence and has no effect on osteoclast activity.

Metastasis from endometrial carcinoma to bilateral breasts presenting as inflammatory breast lesions

BACKGROUND

Endometrial carcinoma rarely metastasizes to the bilateral breasts and presents as an inflammatory breast lesion. In this paper, we report a case of bilateral breast metastatic endometrial carcinoma and describe the clinical and pathological features. It is the second case of this kind of disease and the first case report with full clinical data.

CASE REPORT

A 56-year-old Chinese woman (G3, P3) with endometrial carcinoma received cytoreductive surgery and chemotherapy. Approximately 22 months later, she presented with pain in the right axillary region and edema of the right breast. The pathology report confirmed multifocal invasive papillary adenocarcinoma of the right mammary gland, consistent with endometrial carcinoma metastasis. Although she received many lines of chemotherapy, the disease still progressed and metastasized to the contralateral breast. Gefitinib (Iressa) improved symptoms temporarily.

CONCLUSIONS

Bilateral breasts metastasis of endometrial carcinoma is rare and difficult to treat. Molecular targeted therapy may be an effective treatment for breast metastasis.

[Primary Zweymuller total hip arthroplasty for osteoarthritis secondary to congenital acetabular dysplasia]

OBJECTIVE

To evaluate the effectiveness of Zweymuller prothesis in replacing osteoarthritis secondary to congenital dysplasia of the hip.

METHODS

From January 1996 to June 2000, Zweymuller prothesis was used to reconstruct 32 hips in 29 patients with congenital acetabular dysplasia(3 bilateral cases). All patients were female. According to the classification of Perner, 19 hips belonged to type I, 7 type II, 5 type III, and 1 type IV. The mean follow-up period was 27.5 months (6-53 months). The preoperative Harris hip score ranged from 25 to 59(average 44.5).

RESULTS

The pain was completely relieved, and the Harris hip score ranged from 63 to 97(average 85).

CONCLUSION

We consider that the Zweymuller total hip arthroplasty provides stable fixation of the cup in the presence of moderate acetabular dysplasia without structural bone grafting or cementing.

[Reconstruction of hip, knee, and ankle bony fused in non-functional position of ankylosing spondylitis patients]

OBJECTIVE

To evaluate the reconstruction of hip, knee and ankle joints with bony fusion at non-functional positions for patients with severe late-stage ankylosing spondylitis (AS).

METHODS

From January 1996 to May 1997, simultaneous ipsilateral total hip, knee and ankle replacement was performed under single anesthesia on 2 patients (3 sides) with multiple joint deformity including bony fusion at non-functional positions. They were followed for 29 months on average.

RESULTS

Satisfactory range of motion and function were observed. HSS knee score on average was improved by 45 points and Harris hip score by 37.7 points. There were no wound healing problems or late infection. No aseptic loosening was found.

CONCLUSIONS

Simultaneous ipsilateral total hip, knee and ankle replacement not only reduced cost for hospitalization, but also facilitated early rehabilitation. To our knowledge, this is the first report on this type of surgery, named ipsilateral tri-arthroplasty.

Clinical course of pediatric congenital inner ear malformations

OBJECTIVE

To determine any factors that could improve the early detection and management of congenital inner ear malformations.

STUDY DESIGN

A retrospective review was performed of all patients with a diagnosis of inner ear malformation at Loyola University Medical Center (LUMC) and the Hospital for Sick Children (HSC) between 1987 and 1995. Clinical records and audiometric data were accumulated. One neuroradiologist reviewed every temporal bone computed tomography (CT) scan.

METHODS

Forty-six pediatric patients with congenital inner ear anomalies evaluated at two tertiary care hospitals.

RESULTS

The average patient age at initial assessment was 25.7 months. A family history of hearing loss was noted in only five patients (12.8%). A major nonotological deformity was seen in 41% of patients. The average hearing threshold was 88 dB. All three patients with sudden hearing loss had vestibular aqueduct enlargement. Two of the three patients with common cavity anomalies had a history of recurrent meningitis. Twenty-seven patients had a vestibular aqueduct deformity, the most frequent radiographic abnormality in the series.

CONCLUSIONS

Because inner ear malformation was diagnosed after 24 months of age in a significant percentage of patients, we recommend increased parental education and vigilance by primary care practitioners. Universal newborn screening may be the key to earlier detection of these infants. For children with idiopathic sensorineural hearing loss, we recommend a temporal bone CT scan. Patients with vestibular aqueduct enlargement must be counseled about the risk of progressive sensorineural hearing loss, meningitis, and the need to avoid contact sports. Patients with common cavity abnormalities should be considered for exploratory tympanotomy and also educated about the risk for meningitis.

[The relationship between laminin-receptor and nm23 protein expression and its correlation with interstitial microvascular density and tumor metastasis in breast carcinoma]

OBJECTIVE

To study the relationship between 67,000 laminin, laminin-receptor (LN-R) and nm23 protein expression, interstitial microvascular density (MVD) and tumor metastasis in breast carcinomas.

METHODS

The expression of laminin (LN), LN-R, FVIIIRAg and nm23 protein were detected in 73 cases of breast carcinoma with immunohistochemical technique and analyzed.

RESULTS

A significant difference in LN expression was found in breast carcinoma according to their pathological grade. A positive relation exists between LN-R expression and lymph node metastasis. A positive relationship exists between the degree of LN-R and MVD expression. A significant difference in lymph node metastasis cases exists between nm23 protein positive expression group and negative expression group. When the expression of nm23 protein was inhibited, the degree of LN-R, MVD expression increased and positively related with lymph node metastasis.

CONCLUSION

LN-R expression enhancement, microvascular density increase and nm23 expression inhibition may be the reliable markers for predicting tumor metastasis and prognosis.

[Clinical analysis of 13 infected total knee replacements]

OBJECTIVE

To investigate the cause, treatment and its result of infected total knee replacements (TKRs).

METHODS

Between 1987 and 1999, 13 infected TKRs in 13 patients were treated with surgical debridement and one-stage or two-stage reimplantation. The preoperative average ROM of knees was 55 degrees and the average Hospital for Special Surgery (HSS) knee score was 36.5 points. Clinical results were evaluated after average follow-up for 3 years and 5 months. We analyzed the factors for TKR infection.

RESULTS

No recurrent infection was noted, and pain was significantly alleviated in all patients. The average ROM of knees was 85 degrees and the average HSS knee score was 73.5 points.

CONCLUSIONS

The high risk factors for TKR infection are rheumatoid arthritis, steroid administration, associated diabetes mellitus, hinged prosthesis and previous knee surgery. Early surgical debridement with intravenous antibiotics is necessary as soon as deep infection is detected. Two-stage reimplantation is more effective in eradicating deep infection than single debridement or one-stage reimplantation.

[Low-molecular-weight heparin for preventing deep-vein thrombosis after total joint arthroplasty]

OBJECTIVE

To evaluate the efficacy and safety of low-molecular-weight heparin (LMWH) in preventing deep-vein thrombosis (DVT) after total hip and knee replacement (THR, TKR).

METHODS

From November 1997 to March 1999, we performed total joint replacement for 47 control patients (34 knees, 28 hips) and for 31 patients (19 knees, 17 hips) who had been given low-molecular-weight heparin for preventing deep-vein thrombosis. All patients received venography of the operated limbs after operation.

RESULTS

DVT occurred in 19.4% of the LMWH patients (26.3% in TKR, 11.8% in THR) and the reduction was significant (P < 0.05) compared to the control group (48.4%, 55.9%, 39.3% respectively). The incidence of proximal DVT was also reduced significantly (P < 0.05) from 19.4% of the control group to 2.8% of the LMWH group.

CONCLUSION

Low-molecular-weight heparin can significantly reduce the incidence of deep-vein thrombosis after total joint replacement.

[Reinfusion of autologous shed blood after joint replacement]

OBJECTIVE

To evaluate the results of reinfusion of autologous shed blood after joint replacement.

METHODS

From February 1996 to March 1998, we selected 36 patients for 56 joint replacements. Apart from preoperative donation of autologous blood, all patients received transfusion of unwashed autologous drained blood from hips and knees after arthroplasty. The CBCIIConstaVac blood conservation system was used to salvage shed blood. Among the patients, 8 hips and 48 knees were involved. 12 patients had rheumatoid arthritis, 16 osteoarthritis, 5 ankylosing spondylitis, and 3 other arthritis.

RESULTS

36 patients received 24 260 ml (50%) autologous shed blood, 9 700 ml (20%) reserved autologous blood, and 14 600 ml (30%) allogenic blood. 15 patients experienced transient febrile reaction at the time of reinfusion, no other clinic abnormalities were discovered after reinfusion.

CONCLUSIONS

Reinfusion of autologous shed blood is a safe and effective to decrease the use of allogenic blood and avoid the complications of its transfusion.

Toronto's Hospital for Sick Children study of traumatic sudden sensorineural hearing loss

OBJECTIVE

Traumatic sudden sensorineural hearing loss (SHL) is by definition a hearing loss of greater or equal to 30 dB occurring within 3 days of trauma. The objective of this study was to assess the rate of traumatic sudden SHL. Etiology is discussed with statistical references, and appropriate treatment is proposed. A case study of an enlarged vestibular aqueduct illustrates the above.

METHOD

The authors retrospectively studied cases at The Hospital for Sick Children, Toronto, between the years 1980 and 1995. High-resolution CT scans of the temporal bones with bone algorithms and coronal/axial views were performed on all children presenting with SHL after 1988.

RESULTS

Of the 12 children studied, 9 had high-resolution CT scans, revealing a 33% incidence each of inner-ear malformations, temporal bone fractures, and other miscellaneous CT findings.

CONCLUSION

By corollary, the authors recommend a high index of suspicion for congenital temporal bone abnormalities in all cases of sudden sensorineural hearing loss, particularly those associated with trauma.

[One-stage reimplantation for the salvage of total knee arthroplasty complicated by infection]

One-stage reimplantation for the salvage of infected total knee arthroplasty in 8 patients was reviewed at an average follow-up of 20.1 months late infections occurred in 7 (87.5%) patients. The timing of the diagnosis of the infection after knee arthroplasty was of the prosthesis averaged 11.5 months. No one had recurrent infection and pain was relieved significantly in all patients. Our results suggest that one-stage reimplantation is a reasonably reliable procedure for the management of an infected prosthesis. The use of Gentamicin-impregnated bone cement and the Streptomicin bead mixed with Gentamicin improve the success of treating or preventing recurrence of the infection. Early one-stage reimplantation was needed as soon as the deep infection was defined in order to decrease more destruction of the bone.

[Total knee replacement of severe flexion contracture deformities greater than 60 degree]

The technique of total knee arthroplasty for the patients with severe flexion contractures of more than 60 degrees is not clear. Recently, We have performed 37 total knee arthroplasties in 23 patients with flexion contracture of more than 60 degrees (average 77.97 degrees). Among them, 14 knees (37.9%) with flexion contracture of more than 90 degrees, and 7 knees (18.0%) with 90 degrees flexion fusion deformities. Significant improvements occurred after averaged 4.3-year follow-up. Complications occurred in four patients: three had transient peroneal-nerve palsy, and one had temporary circulatory disturbance of the lower extremity. They recovered after conservative therapy. We consider that severe flexion contracture of more than 60 degrees is not a contraindication of TKR. Staged bone resection and thoroughly soft-tissue release of the posterior capsule and collateral ligament balance were the critical procedure. If necessary, additional distal femoral condyle resection with posterior cruciate ligment sacrifice can be considered.

[Simultaneous bilateral total knee replacement for the patients with serious rheumatoid disease]

This retrospective study reviews 57 patients with serious rheumatoid disease who had bilateral total knee arthroplasties simultanneously between 1987 and 1994. The short follow-up results revealed that there was no increase in complications in the patients with simultaneous bilateral procedures, and nearly identical postoperative results to those observed among patients with single joint replacement. Advantage of simultaneous bilateral total arthroplasty include reduction in hospital cost, the need for less invasive surgical event and the ability to rehabilitate the patient symmetrically.

[Clinical evaluation of intermittent administration of CDDP in advanced ovarian cancer]

We examined the effects of intermittent cisplatin therapy (ICDDPT) on advanced ovarian cancer patients (OCP). Most OCPs had received surgical removal of primary lesion, and histopathological analysis indicated epithelial tumors. Four OCPs were stage 3, three were stage 4 and one was stage 2 (n = 8). After surgical treatment and induction chemotherapy, ICDDPT with 20-25 mg/day CDDP was given for 3 or 5 days, every 3 months. During the intervals, maintenance immunochemotherapy with Tegafur and OK-432 was given. Following ICDDPT all patients are alive, the longest survival time being 3 years and 10 months. Three have survived at least 3 years, 1 for at least 2 years and 3 for at least 1 year. Adverse drug reaction (ADR) was analysed with reference to the total dose of CDDP, i.e. under 500 mg, over 500 mg-under 1,000 mg and over 1,000 mg. Abnormal laboratory findings in platelets (thrombocytopenia), Hb, BUN, Creatinine, GOT and GPT were observed at the all doses. These ADR were not increased with the increasing dose so that accumulative toxicity was not observed. Therefore ICDDPT was seen to be effective in treating OCP.