Interleukin-1β increases Angptl4 (FIAF) expression via the JNK signaling pathway in osteoblastic MC3T3-E1 cells

Angiopoietin-like protein 4 (Angptl4), also known as fasting-induced adiopogenic factor (FIAF), has recently been reported to influence bone metabolism. However, there have been few studies on regulatory factors other than hypoxia for Angptl4 in bone, and particularly in osteoblasts. Expression of interleukin-1β (IL-1β), a proinflammatory cytokine, is increased in serum or bone microenvironments in inflammatory bone diseases or estrogen deficient-conditions. The present study was conducted to determine whether Angptl4 expression in osteoblasts is affected by IL-1β and investigate its involvement in MAP kinase signaling pathways. Angptl4 RNA levels were increased by IL-1β treatment in murine MC3T3-E1 osteoblastic cells. Western blotting and immunofluorescent staining showed a corresponding increase in Angptl4 protein. IL-1β treatment of osteoblasts induced phosphorylation of mitogen-activated protein kinases (MAPKs) including extracellular regulated kinases (ERKs), p38, and c-Jun N-terminal kinase (JNK). Furthermore, SP600125, an inhibitor of JNK, significantly blocked the upregulation of Angptl4 by IL-1β. In contrast, treatment with an inhibitor of p38 MAP kinase (SB203580) or an ERK inhibitor (PD98059) produced responses similar to those seen with the DMSO control. Taken together, these results suggest that IL-1β increases Angptl4 expression through a mechanism dependent on the JNK-MAPK signaling pathway in MC3T3-E1 cells.

Remifentanil dose for laryngeal mask airway insertion with a single standard dose of propofol during emergency airway management in elderly patients

BACKGROUND

This study determined the dose of remifentanil to use during insertion of a Classic™ laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol.

METHODS

Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient's loss of consciousness. The dose of remifentanil was determined using Dixon's up-and-down method, starting at 0.5 µg/kg (a step size of 0.1 µg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness.

RESULTS

In total, 23 patients were recruited and the mean age ± standard deviation was 72 ± 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 ± 0.05 µg/kg. No patient needed more than 0.3 µg/kg.

CONCLUSIONS

Remifentanil 0.20 ± 0.05 µg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.

Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II-III breast cancer? A multicentre retrospective study (KROG 12-05)

BACKGROUND

To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II-III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT).

METHODS

We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated.

RESULTS

After a median follow-up period of 66.2 months (range, 15.6-127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0-is vs 1 vs 2-4) and the number of LNs sampled (<13 vs ≥13) were associated with DFS (P=0.0086 and 0.0012, respectively). There was no significant difference in survival outcomes according to ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled.

CONCLUSIONS

ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials.

Two cases of post-radiation osteosarcoma of the sacrum after pelvic irradiation for uterine cervical cancer

BACKGROUND

Post-radiation pelvic bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

CASE

A 59-year-old woman who had received pelvic irradiation for Stage IIB uterine cervical cancer 16 years before was diagnosed as having post-radiation osteosarcoma of the sacrum. Another 66-year-old woman who had received pelvic irradiation for Stage IIIB uterine cervical cancer seven years previously was also diagnosed as having pleomorphic sarcoma of the sacrum.

CONCLUSION

When a bone lesion is observed at a previously irradiated field, post-radiation sarcoma should be considered and differentiated from bone metastases.

Intraspinal primitive neuroectodermal tumor arising from the sacral spinal nerve root

An unusual case of intraspinal primitive neuroectodermal tumor arising from the sacral spinal nerve root is presented with the first documentation of myelographic, computed tomographic, and magnetic resonance imaging findings.

Pituitary adenoma presenting as post-traumatic oculomotor palsy: report of two cases

Two cases of oculomotor palsy occurring after head injury in a patient with an unsuspected pituitary adenoma are presented. A possible explanation for the appearance of this sign is suggested. The literature on post-traumatic oculomotor palsy is briefly reviewed.

A dominant form of adult neuronal ceroidlipofuscinosis (Kufs' disease) with an associated occipital astrocytoma: early diagnosis by cortical biopsy

A patient with a dominantly inherited form of Kuf's disease and an associated occipital astrocytoma is presented. This is the first reported case in which the diagnosis of Kufs' disease was made by a cortical biopsy several years before its expected clinical onset. The nosology of this disease, and its clinical, genetic, and histopathological characteristics are discussed. The establishment of an early diagnosis by cortical biopsy and its implications are considered.