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Wang MD, Yuan C, Wang KC, Wang NY, Liang YJ, Zhu H, Tong XM, Yang T. Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma: A prospective multicenter cohort study. Hepatobiliary Pancreat Dis Int 2024; 23:249-256. [PMID: 38040524 DOI: 10.1016/j.hbpd.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/16/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common and debilitating symptom experienced by patients with advanced-stage cancer, especially those undergoing antitumor therapy. This study aimed to evaluate the efficacy and safety of Renshenguben (RSGB) oral solution, a ginseng-based traditional Chinese medicine, in alleviating CRF in patients with advanced hepatocellular carcinoma (HCC) receiving antitumor treatment. METHODS In this prospective, open-label, controlled, multicenter study, patients with advanced HCC at BCLC stage C and a brief fatigue inventory (BFI) score of ≥ 4 were enrolled. Participants were assigned to the RSGB group (RSGB, 10 mL twice daily) or the control group (with supportive care). Primary and secondary endpoints were the change in multidimensional fatigue inventory (MFI) score, and BFI and functional assessment of cancer therapy-hepatobiliary (FACT-Hep) scores at weeks 4 and 8 after enrollment. Adverse events (AEs) and toxicities were assessed. RESULTS A total of 409 participants were enrolled, with 206 assigned to the RSGB group. At week 4, there was a trend towards improvement, but the differences were not statistically significant. At week 8, the RSGB group exhibited a significantly lower MFI score (P < 0.05) compared to the control group, indicating improved fatigue levels. Additionally, the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8 (P < 0.05). Subgroup analyses among patients receiving various antitumor treatments showed similar results. Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI, BFI, and FACT-Hep scores at week 8. No serious drug-related AEs or toxicities were observed. CONCLUSIONS RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period, with no discernible toxicities. These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.
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Affiliation(s)
- Ming-Da Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China
| | - Chen Yuan
- Department of Clinical Laboratory, Laboratory Medicine Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310000, China
| | - Ke-Chun Wang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China
| | - Nan-Ya Wang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China
| | - Ying-Jian Liang
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150007, China
| | - Hong Zhu
- Department of Medical Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Xiang-Min Tong
- Department of Clinical Laboratory, Laboratory Medicine Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310000, China; Department of Central Laboratory, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310006, China.
| | - Tian Yang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun 130021, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai 200438, China.
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Wang KC, Sun LY, Wang MD. Methodological considerations regarding a gene signature to predict microvascular invasion in hepatocellular carcinoma. J Hepatol 2022; 77:893-894. [PMID: 35526789 DOI: 10.1016/j.jhep.2022.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Ke-Chun Wang
- Department of HBP Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China; College of Basic Medicine, Naval Medical University, Shanghai, China; Department of Hepatic Surgery, The Third Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Li-Yang Sun
- Department of HBP Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China; Graduate School, Bengbu Medical College, Bengbu, China
| | - Ming-Da Wang
- Department of HBP Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China; Department of Hepatic Surgery, The Third Affiliated Hospital of Naval Medical University, Shanghai, China.
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Neveu ML, Kohn JR, Frost AS, Borahay MA, Simpson K, Wang KC, Wu HY, Patzkowsky KE. Unexpected Adenomyosis Among Hysterectomy for Benign Indications: A Review of Preoperative Characteristics and Imaging. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vey BL, Cook TS, Nagy P, Bruce RJ, Filice RW, Wang KC, Safdar NM. A Survey of Imaging Informatics Fellowships and Their Curricula: Current State Assessment. J Digit Imaging 2020; 32:91-96. [PMID: 30374655 DOI: 10.1007/s10278-018-0147-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In a 2016 survey of imaging informatics ("II") fellowship graduates, the surveyed fellowship graduates expressed the "opinion that II fellowships needed further formalization and standardization" Liao et al. (J Digit Imaging, 2016). This, coupled with the fact that the original published "standardized" curriculum is about 15 years out of date in our rapidly changing systems, suggests an opportunity for curriculum improvement. Before agreeing on improved structural and content suggestions for fellowships, we completed a current-state assessment of how each fellowship organizes its education and what requirements each have for fellowship completion. In this work, we aimed to collect existing information about imaging informatics fellowship curricula by contacting institutions across the country. A survey was completed by phone with the fellowship directors of existing imaging informatics fellowships across the country. Additionally, we collected existing documentation that outlines the curricula currently in use at institutions. We reviewed both the interview responses and documentation to assess overlapping trends and institutional differences in curriculum structure and content. All fellowships had suggested reading lists, didactic lectures, and a required project for each fellow. There were required practicum activities or teaching experience each in two fellowships, and one fellowship had a mandatory certification requirement for graduation. Curriculum topics in Technical Informatics or Business and Management were covered by a majority of institutions, while Quality and Safety and Research topics had inconsistent coverage across fellowships. Our plan is to reengage II fellowship directors to develop a core curriculum, which is part of the Society of Imaging Informatics in Medicine strategic plan.
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Affiliation(s)
- Brianna L Vey
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, USA.
| | - T S Cook
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - P Nagy
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, USA.,Division of Health Science Informatics, Johns Hopkins University School of Public Health, Baltimore, USA
| | - R J Bruce
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - R W Filice
- Department of Radiology, Medstar Georgetown University Hospital, Washington D.C., USA
| | - K C Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, USA
| | - N M Safdar
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, USA
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Abstract
Epigastric hernia involving the falciform ligament is exceptionally rare. Most reported cases are incisional hernia secondary to prior abdominal surgery. We report a case of primary falciform ligament herniation into the epigastric region repaired by the laparoscopic preperitoneal approach. In this case, an accompanying vessel along the herniated falciform ligament was identified. This finding provides a basis for the hypothesis of a perforating vessel piercing the linea alba and thereby creating a weak point for hernia protrusion (Moschowitz theory). The patient had an uneventful recovery and was discharged home on the postoperative day two. A laparoscopic preperitoneal approach is feasible for the repair of primary falciform ligament herniation. The magnified endoscopic view enables surgeons to achieve definite repair without missing occult defects.
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Affiliation(s)
- T J Liang
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,National Yang-Ming University, Taipei, Taiwan
| | - K C Wang
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - C C Tsai
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - I S Chen
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Frost AS, McMahon ME, Simpson K, Patzkowsky KE, Wu HY, Wang KC. Vaginal Cuff Closure: Tips for Ipsilateral Port Suturing. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wu HY, Kaczmarski K, Portnoy E, Wang KC, Simpson K, Patzkowsky KE. 1493 Preoperative Uterine Artery Embolization Prior to the Surgical Management of Fibroids: An Institutional Case Series. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wu HY, Yen TT, Singh B, Lau BD, Chaves KK, Maher J, Patzkowsky KE, Simpson K, Wang KC. Cell Salvage System use in Minimally Invasive Myomectomy. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Li YH, Wang KC, Chen PS, Chung HC, Wu HL. 3312Thrombomodulin expressed on vascular smooth muscle cell influences arterial injury-induced neointima formation in mouse. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Thrombomodulin (TM) is a cell membrane-bound anticoagulant protein that only expresses on endothelial cells in normal artery. Vascular smooth muscle cells (SMCs) start to exhibit TM after arterial injury. Our previous study demonstrated that vascular SMC-bound TM expression was associated with SMC synthetic phenotype. TM knockdown not only attenuated aortic SMCs proliferation but also reduced aortic SMC-mediated inflammation. In this study, we investigated the effect of vascular SMC-bound TM on arterial injury-induced neointima formation in mouse.
Methods and results
Because complete loss of TM in TM knockout transgenic mice causes embryonic lethality, we generated vascular SMC-specific TM-deficient mice (SM22-cretg/TMflox/flox) and their wild-type controls (SM22-cretg/TM+/+) using the Cre-loxP system to explore the role of vascular SMC membrane-bound TM in vivo. The blood pressure and body weight were similar between SM22-cretg/TMflox/flox mice and their wild-type controls. Carotid ligation caused neointima formation in mice. Immunofluorescence staining showed that there was large amount TM expression in the medial and neointimal cells at 4 weeks in SM22-cretg/TM+/+ mice after carotid ligation, but there was no TM staining could be found in SM22-cretg/TMflox/flox mice. There was a progressively increased neointima area from 2 to 4 weeks after carotid ligation both in SM22-cretg/TMflox/flox mice and SM22-cretg/TM+/+ mice, but the neointima area and neointima/media area ratio were significantly smaller in SM22-cretg/TMflox/flox mice than SM22-cretg/TM+/+ mice. Immunofluorescence staining showed that there were less Ki67-positive cells in the media and neointima in SM22-cretg/TMflox/flox mice indicating less proliferating cells in the arterial wall of TM-deficient mice. The α-smooth muscle actin-positive staining area was also larger in the SM22-cretg/TMflox/flox mice, suggesting TM deficiency of SMCs in medial lesion exhibited a more contractile status after carotid ligation.
Conclusions
Our results indicated that vascular SMC-bound TM not only mediated vascular SMC phenotype change and cell behavior but also significantly influenced arterial injury-induced neointima formation.
Acknowledgement/Funding
This study was sponsored by grants 104-2314-B-006-083-MY2 and 106-2314-B-006-045-MY3 from the Ministry of Science and Technology, Taipei, Taiwan.
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Affiliation(s)
- Y H Li
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - K C Wang
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - P S Chen
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - H C Chung
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - H L Wu
- National Cheng Kung University Hospital, Tainan, Taiwan
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Chaudhry A, Kamali A, Herzka DA, Wang KC, Carrino JA, Blitz AM. Detection of the Stellate and Thoracic Sympathetic Chain Ganglia with High-Resolution 3D-CISS MR Imaging. AJNR Am J Neuroradiol 2018; 39:1550-1554. [PMID: 29853521 DOI: 10.3174/ajnr.a5698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 04/19/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Despite the importance of the sympathetic nervous system in homeostasis and its putative role in various disease states, little is known regarding our ability to image the sympathetic chain and sympathetic chain ganglia, perhaps owing to their small size. In this retrospective study, we sought to evaluate the normal anatomy of the sympathetic chain ganglia and assess the detectability of the sympathetic chain and sympathetic chain ganglia on high-resolution 3D-CISS images. MATERIALS AND METHODS This study included 29 patients who underwent 3D-CISS MR imaging of the thoracic spine for reasons unrelated to abnormalities of the sympathetic nervous system. Patients with a prior spinal operation or visible spinal pathology were excluded. The sympathetic chain ganglia were evaluated using noncontrast 3D-CISS MR imaging. Statistical analyses included t tests and measures of central tendency. The Cohen κ statistic was calculated to evaluate interrater reliability. RESULTS The stellate ganglion and thoracic chain ganglia were identified in all subjects except at the T10-T11 and T11-T12 levels. The stellate ganglion was found inferomedial to the subclavian artery and anterior and inferior to the transverse process of C7 in all subjects. Thoracic sympathetic chain ganglia were identified ventral to the costovertebral junction in all subjects from T2 to T10. There was strong interobserver agreement for the detection of the sympathetic chain ganglia with κ > 0.80. The size, shape, and location of these structures corresponded with gross anatomic and surgical observations. CONCLUSIONS The thoracic sympathetic chain ganglia can be identified on precontrast 3D-CISS MR imaging. This technique may aid in the initial evaluation of stellate ganglion and/or sympathetic chain ganglia size and signal change for comparison in future studies.
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Affiliation(s)
- A Chaudhry
- From the Departments of Neuroradiology (A.C., A.K.)
| | - A Kamali
- From the Departments of Neuroradiology (A.C., A.K.)
| | - D A Herzka
- Department of Biomedical Engineering (D.A.H.), Johns Hopkins University, Baltimore, Maryland
| | - K C Wang
- Department of Diagnostic Radiology and Nuclear Medicine (K.C.W.), University of Maryland, School of Medicine, Baltimore, Maryland
- Imaging Service (K.C.W.), Baltimore VA Medical Center, Baltimore, Maryland
| | - J A Carrino
- Department of Radiology and Imaging (J.A.C.), Weill Cornell Medical College, Hospital for Special Surgery, New York, New York
| | - A M Blitz
- Radiology and Radiologic Sciences (A.M.B.), Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ligocki CC, Abadeh A, Wang KC, Adams-Webber T, Blanchette VS, Doria AS. A systematic review of ultrasound imaging as a tool for evaluating haemophilic arthropathy in children and adults. Haemophilia 2017; 23:598-612. [PMID: 28429878 DOI: 10.1111/hae.13163] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2016] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to semi-quantitatively assess the evidence on the value of ultrasound (US) for assessment of haemophilic arthropathy (HA) in children and adults based on the following questions: (1) Does early diagnosis of pathological findings, using available US techniques, impact the functional status of the joint? (2) Do current available US techniques have the ability to accurately detect pathological changes in target joints in haemophilic patients? (3) Does treatment (prophylaxis) improve US evidence of haemophilic arthropathy in children and adults? (4) Is there any association between various US scoring systems and other clinical/radiological constructs? Of the 6880 citations identified searching databases such as MEDLINE, Embase, CENTRAL and Web of Science, 20 articles investigating either the diagnostic accuracy of US and/or US scanning protocols and scoring systems for assessment of HA met the inclusion criteria for the study. Of these, 14 articles evaluating the diagnostic accuracy of US were assessed by two independent reviewers for reporting quality using the Standards for Reporting of Diagnostic Accuracy (STARD) tool and for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Using STARD, 1/14 studies (7%) was scored as of high reporting quality and 8/14 (57%), of moderate quality. Assessment with QUADAS-2 reported 2/14 (14%) studies as having high methodological quality and 6/14 (43%) as having moderate quality. There is fair evidence (Grade B) to recommend US as an accurate technique for early diagnosis of HA, to demonstrate that US scores correlate with clinical/US constructs and to prove an association between US findings and functional status of the joint. However, there is insufficient evidence (Grade I) to conclude that US-detectable findings in HA are sensitive to changes in therapy.
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Affiliation(s)
- C C Ligocki
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - A Abadeh
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - K C Wang
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - T Adams-Webber
- Hospital Library & Archive Services, The Hospital for Sick Children, Toronto, ON, Canada
| | - V S Blanchette
- Department of Hematology & Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - A S Doria
- Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq, Curitiba, Brazil
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Cohen SL, Senapati S, Gargiulo AR, Srouji SS, Tu FF, Solnik J, Hur HC, Vitonis A, Jonsdottir GM, Wang KC, Einarsson JI. Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial. BJOG 2016; 124:262-268. [PMID: 27362908 DOI: 10.1111/1471-0528.14179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine if higher-volume, fixed-dose administration of vasopressin further reduces blood loss at the time of minimally invasive myomectomy. DESIGN Randomised multicentre clinical trial. SETTING Tertiary-care academic centres in the USA. POPULATION Women undergoing conventional laparoscopic or robot-assisted laparoscopic myomectomy. METHODS All participants received the same 10-unit (U) dose of vasopressin, but were randomly assigned to one of two groups: (i) received 200 ml of diluted vasopressin solution (20 U in 400 ml normal saline), and (ii) received 30 ml of concentrated vasopressin solution (20 U in 60 ml normal saline). MAIN OUTCOME MEASURES The primary study outcome was estimated blood loss; the study was powered to detect a 100-ml difference. RESULTS A total of 152 women were randomised; 76 patients in each group. Baseline demographics were similar between groups. The primary outcome of intraoperative blood loss was not significantly different, as measured by three parameters: surgeon estimate (mean estimated blood loss 178 ± 265 ml and 198 ± 232 ml, dilute and concentrated groups respectively, P = 0.65), suction canister-calculated blood loss, or change in haematocrit levels. There were no vasopressin-related adverse events. CONCLUSION Both dilute and concentrated vasopressin solutions that use the same drug dosing demonstrate comparable safety and tolerability when administered for minimally invasive myomectomy; however, higher volume administration of vasopressin does not reduce blood loss. TWEETABLE ABSTRACT This randomised trial failed to show benefit of high-volume dilute vasopression.
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Affiliation(s)
- S L Cohen
- Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - S Senapati
- Division of Gynecological Pain and Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston IL & Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - A R Gargiulo
- Division of Reproductive Endocrinology and Infertility, Brigham and Women's Hospital, Boston, MA, USA
| | - S S Srouji
- Division of Reproductive Endocrinology and Infertility, Brigham and Women's Hospital, Boston, MA, USA
| | - F F Tu
- Division of Gynecological Pain and Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston IL & Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - J Solnik
- Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - H-C Hur
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - A Vitonis
- Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - G M Jonsdottir
- Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - K C Wang
- Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - J I Einarsson
- Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
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13
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Wang KC, Amirabadi A, Wang KC, Moineddin R, Jong R, Tomlinson C, Doria AS. Longitudinal assessment of bone loss using quantitative ultrasound in a blood-induced arthritis rabbit model. Haemophilia 2015; 21:e402-10. [PMID: 26178807 DOI: 10.1111/hae.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Osteoporosis is common in haemophilic arthropathy. Quantitative ultrasound (QUS) can be a suitable alternative for dual-energy x-ray absorptiometry for diagnosing osteoporosis in haemophiliacs due to its lack of ionizing radiation, and ease to use. AIM We investigated the intra- and inter-operator reliability of QUS, its responsiveness to bone growth, its ability to differentiate bone adjacent to blood-injected vs. control joints, and the effect of soft tissues on the speed of sound (SOS) QUS values in a juvenile white New Zealand rabbit model of blood-induced arthritis. METHODS Eight of 16 rabbits were injected with autologous blood (0.1 mL kg(-1) ) 8 times over a 17-week period, the remaining eight rabbits served as controls. SOS was measured at baseline, weeks 8 and 17 in vivo and after the bones were excised on week 17. RESULTS Intra- and inter-operator coefficients of variation for QUS data were <5% and intraclass correlation coefficients were >60% for 22/27 (81.5%) of bones assessed. The level of interval increase in SOS values from baseline to week 17 was significantly different in tibiae of injected, contralateral to injected and non-injected knee groups by anova (P = 0.01). In vivo (mean ± SD, 4147.17 ± 96.27 m s(-1) ) and postmortem (4457.85 ± 104.00 m s(-1) ) measurements on week 17 differed (P < 0.01) indicating an effect of soft tissues on SOS. CONCLUSION In conclusion, QUS' acceptable reliability, its responsiveness to growth-related changes and its ability to discriminate injected and non-injected joints make this technique a plausible candidate as a diagnostic tool for osteoporosis in the paediatric haemophilic population if these results are confirmed upon animal-human translation.
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Affiliation(s)
- K C Wang
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - A Amirabadi
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - K C Wang
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - R Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - R Jong
- Department of Pathology, Mount Sinai Hospital, Toronto, ON, Canada
| | - C Tomlinson
- Department of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
| | - A S Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
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Chen PC, Guo CH, Tseng CJ, Wang KC, Liu PJ. Blood trace minerals concentrations and oxidative stress in patients with obstructive sleep apnea. J Nutr Health Aging 2013; 17:639-44. [PMID: 24097016 DOI: 10.1007/s12603-013-0023-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with increased oxidative stress. Certain essential trace minerals have shown to play an important role in the maintenance of redox homeostasis. We determined the concentrations of trace minerals in OSA patients and assessed their relationships to OSA severity as indicated by the apnea/ hypopnea index (AHI). METHODS We enrolled 44 patients with newly diagnosed mild to moderate OSA and 20 without OSA. The following parameters were measured: polysomnographic values of nocturnal sleep; plasma trace minerals zinc (Zn), copper (Cu), iron (Fe), and erythrocyte selenium (Se); oxidative stress status; and plasma high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α). RESULTS Compared to controls matched for age, gender, and body mass index, OSA patients had lower concentrations of plasma Zn and erythrocyte Se and higher plasma concentrations of Cu and Fe. OSA patients had significantly higher plasma concentrations of hs-CRP, TNF-α, and malondialdehyde (MDA), and lower erythrocyte antioxidant enzyme glutathione peroxidase (GPx) and superoxide dismutase activities. Significant differences in all the above parameters were also found in patients with moderate OSA compared to those with mild OSA. Furthermore, AHI values correlated significantly with neck circumference, GPx activity, and MDA, hs-CRP, and TNF-α concentrations in OSA patients. AHI values were also negatively associated with concentrations of plasma Zn and erythrocyte Se, but were positively linked to plasma concentrations of Fe and Cu. CONCLUSIONS Abnormal concentrations of these trace minerals may reflect oxidative damage and inflammatory response, thus increasing the severity of OSA.
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Affiliation(s)
- P C Chen
- Po-Jen Liu, Department of Otolaryngology and Nutrition and Naturopathic center, Cheng-Ching Hospital, Taiwan Boulevard, Taichung 407, Taiwan, Republic of China. , Tel:886-4-2463-2000 ext. 53664, Fax:886-4-2463-5961
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Thawait SK, Chaudhry V, Thawait GK, Wang KC, Belzberg A, Carrino JA, Chhabra A. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 2010; 32:1365-72. [PMID: 20966057 DOI: 10.3174/ajnr.a2257] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
High-resolution MR imaging of peripheral nerves is becoming more common and practical with the increasing availability of 3T magnets. There are multiple reports of MR imaging of peripheral nerves in compression and entrapment neuropathies. However, there is a relative paucity of literature on MRN appearance of diffuse peripheral nerve lesions. We attempted to highlight the salient imaging features of myriad diffuse peripheral nerve disorders and imaging techniques for MRN. Using clinical and pathologically proved relevant examples, we present the MRN appearance of various types of diffuse peripheral nerve lesions, such as traumatic, inflammatory, infectious, hereditary, radiation-induced, neoplastic, and tumor variants.
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Affiliation(s)
- S K Thawait
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland, USA
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16
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Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR Am J Neuroradiol 2010; 31:1363-8. [PMID: 20133388 DOI: 10.3174/ajnr.a2002] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
MR imaging of peripheral nerves has been described in relation to abnormalities such as nerve injury, entrapment, and neoplasm. Neuroma formation is a known response to peripheral nerve injury, and here we correlate the MRN appearance of postinjury neuroma formation with intraoperative findings. We also present the MR imaging features of surgical treatment with a synthetic nerve tube and nerve wrap on postoperative follow-up imaging.
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Affiliation(s)
- A Chhabra
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA.
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17
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Chang PC, Wu HL, Lin HC, Wang KC, Shi GY. Human plasminogen kringle 1-5 reduces atherosclerosis and neointima formation in mice by suppressing the inflammatory signaling pathway. J Thromb Haemost 2010; 8:194-201. [PMID: 19874473 DOI: 10.1111/j.1538-7836.2009.03671.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
BACKGROUND Activation of vascular endothelial cells plays an important role in atherogenesis and plaque instability. Recent research has demonstrated that late-stage inhibition of plaque angiogenesis by angiostatin (kringle 1-4) reduces macrophage accumulation and slows the progression of advanced atherosclerosis. Kringle 1-5 (K(1-5)) is a variant of angiostatin that contains the first five kringle domains of plasminogen. OBJECTIVE To investigate whether K(1-5) has an inhibitory effect on early-stage atherosclerosis, using the apolipoprotein E (ApoE)-deficient mouse model and a carotid artery ligation model. METHODS ApoE-deficient mice received K(1-5) treatment for 4 weeks, and the severity of aortic atherosclerosis was measured. In the ligation model, the left common carotid arteries of C57BL/6 mice were ligated near the carotid bifurcation, and the mice received K(1-5) for 4 weeks. Human umbilical vein endothelial cells were pretreated with K(1-5) before tumor necrosis factor-alpha (TNF-alpha) treatment to explore the anti-inflammatory effect of K(1-5). RESULTS The areas of the lesion in the aortas of ApoE-deficient mice that received K(1-5) treatment were notably decreased, and the formation of carotid neointima in the C57BL/6 mice was decreased by treatment with K(1-5). Expression of TNF-alpha-induced intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 was inhibited by K(1-5) treatment, possibly via downregulation of translocation of nuclear factor-kappaB and expression of reactive oxygen species. CONCLUSIONS K(1-5) reduced atherosclerosis and neointima formation in mice, possibly through inhibition of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression in endothelial cells.
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Affiliation(s)
- P C Chang
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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18
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Riviello ED, Wang KC, Hochman ME, Sariban A, Da Rocha RC, Dogaru G, Christopher K. Vacuolization of tubules in gadolinium-associated acute renal failure. Rev Med Chir Soc Med Nat Iasi 2009; 113:108-115. [PMID: 21491811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
While gadolinium was initially thought to be a safe alternative to iodinated contrast agents for patients with chronic renal insufficiency, many reports of gadolinium-associated acute renal failure have now been recorded, particularly in patients with underlying renal insufficiency. In addition, animal models have demonstrated tubule vacuolization with experimental gadolinium administration that is similar to vacuolization seen with other contrast agents. We present a case of a patient with nephrotic-range proteinuria and chronic renal insufficiency, who developed acute renal failure following gadolinium administration undergoing furosemide stimulated diuresis. This case is the first report of pathologic tubule vacuolization in gadolinium-associated nephropathy in a human kidney biopsy. This case suggests a relationship between the pathogenesis of CIN with standard contrast media and CIN with gadolinium. Research is needed to better understand the pathologic findings and pathogenesis of gadolinium-associated nephrotoxicity.
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Affiliation(s)
- Elisabeth D Riviello
- Department of Medicine, Renal Division, Harvard Medical School, Brigham and Women's Hospital, Boston, USA
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19
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Ye X, Meeker HC, Kozlowski PB, Wegiel J, Wang KC, Imaki H, Carp RI. Pathological changes in the liver of a senescence accelerated mouse strain (SAMP8): a mouse model for the study of liver diseases. Histol Histopathol 2005; 19:1141-51. [PMID: 15375757 DOI: 10.14670/hh-19.1141] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Liver disease is characterized by fatty liver, hepatitis, fibrosis and cirrhosis and is a major cause of illness and death worldwide. The prevalence of liver diseases highlights the need for animal models for research on the mechanism of disease pathogenesis and efficient and cost-effective treatments. Here we show that a senescence-accelerated mouse strain (SAMP8 mice), displays severe liver pathology, which is not seen in senescence-resistant mice (SAMR1). The livers of SAMP8 mice show fatty degeneration, hepatocyte death, fibrosis, cirrhotic changes, inflammatory mononuclear cell infiltration and sporadic neoplastic changes. SAMP8 mice also show abnormal liver function tests: significantly increased levels of alanine amino-transferase (ALT) and aspartate aminotransferase (AST). Furthermore, titers of murine leukemia virus are higher in livers of SAMP8 than in those of SAMR1 mice. Our observations suggest that SAMP8 mouse strain is a valuable animal model for the study of liver diseases. The possible mechanisms of liver damage in SAMP8 mice are also discussed.
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Affiliation(s)
- X Ye
- NYS/Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314, USA.
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20
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Chauhan N, Wang KC, Wegiel J, Malik MN. Walnut Extract Inhibits the Fibrillization of Amyloid Beta-Protein, and also Defibrillizes its Preformed Fibrils. Curr Alzheimer Res 2004; 1:183-8. [PMID: 15975066 DOI: 10.2174/1567205043332144] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Fibrillar amyloid beta-protein (Abeta) is the principal component of amyloid plaques in the brains of patients with Alzheimer's disease. We have studied the effect of walnut extract on Abeta fibrillization by Thioflavin T fluorescence spectroscopy and electron microscopy. The walnut extract not only inhibited Abeta fibril formation in a concentration and time- dependent manner but it was also able to defibrillize Abeta preformed fibrils. Over 90% inhibition of Abeta fibrillization was observed with 5 microl of methanolic extract of walnut (MEOW) both after 2 and 3 days of incubation. The maximum defibrillization (91.6%) was observed when preformed Abeta fibrils were incubated with 10 microl of MEOW for 2 days. These results suggest that walnuts may reduce the risk or delay the onset of Alzheimer's disease by maintaining Abeta in the soluble form. Further studies showed that anti-amyloidogenic compound in walnut is an organic compound of molecular weight less than 10 kDa, which is neither a lipid nor a protein. Chloroform extract of walnut had no effect on Abeta fibrillization while MEOW and its 10 kDa filtrate inhibited Abeta fibrillization equally. It is proposed that polyphenolic compounds (such as flavonoids) present in walnuts may be responsible for its anti-amyloidogenic activity.
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Affiliation(s)
- Neha Chauhan
- NYS Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, USA.
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21
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Chang JS, Chiang LC, Chen CC, Liu LT, Wang KC, Lin CC. Antileukemic activity of Bidens pilosa L. var. minor (Blume) Sherff and Houttuynia cordata Thunb. Am J Chin Med 2002; 29:303-12. [PMID: 11527072 DOI: 10.1142/s0192415x01000320] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To evaluate the anti-leukemic activity of Bidens pilosa L. var. minor (Blume) Sherff and Houttuynia cordata Thunb., cytotoxicity tests with an XTT-based colorimetric assay were used. Five leukemic cell lines, namely L1210, U937, K562, Raji and P3HR1, were cultured with hot water extracts of B. pilosa var. minor or H. cordata. Hot water extracts of B. pilosa var. minor inhibited these five leukemic cells with IC50s between 145 microg/ml and 586 microg/ml. The effect was greatest on four cell lines, namely L1210, P3MR1, Raji and K562, with IC50s below 200 microg/ml and a selective index of more than 5. Hot water extract of H. cordata inhibited these five leukemic cells with IC50s between 478 microg/ml and 662 microg/ml. The selective index was between 1.5 and 2.1. B. pilosa var. minor was more effective than H. cordata in inhibiting most of the leukemic cells in our study. We suggest that B. pilosa L. var. minor (Blume) Sherff may prove to be a useful medicinal plant for treating leukemia.
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Affiliation(s)
- J S Chang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
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22
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Seol HJ, Wang KC, Kim SK, Kim H, Choe G, Chi JG, Cho BK. Intramedullary immature teratoma in a young infant involving a long segment of the spinal cord. Childs Nerv Syst 2001; 17:758-61. [PMID: 11862445 DOI: 10.1007/s003810100464] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2000] [Revised: 02/03/2001] [Indexed: 11/27/2022]
Abstract
Intramedullary teratoma is a rare lesion, located in the majority of cases in the lumbosacral area, and such lesions involving an extensive area of the spinal cord in young infants have seldom been reported. We present the case of a 3-month-old girl with an intramedullary spinal immature teratoma extending from C-5 to T-12, which was totally removed. The patient had suffered from paraplegia for 15 days, after which spinal MRI revealed a heterogeneously enhancing intramedullary lesion. Biopsy of the lesion demonstrated mature intestinal tissue. After total removal of the tumor, paraplegia and sphincter disturbances improved. Intramedullary teratoma should be included in the differential diagnosis of holocord tumors in young infants with rapidly progressing symptoms and if found should be radically excised. This case also emphasizes the importance of histological diagnosis and demonstrates the possibility of neurological recovery even in the case of paraplegia lasting for more than 1 month in a young infant.
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Affiliation(s)
- H J Seol
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
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23
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Chen GS, Chang CS, Kan WM, Chang CL, Wang KC, Chern JW. Novel lead generation through hypothetical pharmacophore three-dimensional database searching: discovery of isoflavonoids as nonsteroidal inhibitors of rat 5 alpha-reductase. J Med Chem 2001; 44:3759-63. [PMID: 11689062 DOI: 10.1021/jm010433s] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A hypothetical pharmacophore of 5 alpha-reductase inhibitors was generated and served as a template in virtual screening. When the pharmacophore was used, eight isoflavone derivatives were characterized as novel potential nonsteroidal inhibitors of rat 5 alpha-reductase. This investigation has demonstrated a practical approach toward the development of lead compounds through a hypothetic pharmacophore via three-dimensional database searching.
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Im SH, Wang KC, Kim SK, Oh CW, Kim DG, Hong SK, Kim NR, Chi JG, Cho BK. Childhood meningioma: unusual location, atypical radiological findings, and favorable treatment outcome. Childs Nerv Syst 2001; 17:656-62. [PMID: 11734983 DOI: 10.1007/s003810100507] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2000] [Revised: 07/01/2001] [Indexed: 11/26/2022]
Abstract
OBJECTS To investigate the characteristics of childhood meningioma, especially, locations, radiological findings, pathological features (including proliferative potential) and outcome, 11 children with meningiomas were retrospectively analyzed. RESULTS Unusual location, large size, frequent calcification, and cyst formation were characteristic radiological findings. Gross total resection was achieved in 8 patients, and there was recurrence in 2. Gamma knife radiosurgery was performed on residual and recurrent tumors. MIB-1 indices tended to be high in large tumors. Nine patients had a Karnofsky Performance Scale of more than 70 during the follow-up period of 10 months to 19.5 years. Surgical treatment rendered 4 of 5 epileptic patients seizure free. The childhood meningiomas examined had unusual locations, atypical radiological findings, and various proliferative potentials. CONCLUSIONS Complete resection is the treatment of choice. Gamma knife radiosurgery can be a good alternative for residual tumors and small recurrent tumors. The outcome of childhood meningiomas is good after surgery.
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Affiliation(s)
- S H Im
- Department of Neurosurgery, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
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25
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Dobrogowska DH, Vorbrodt AW, Wegiel J, Wang KC, Shoji M, Mondadori C, Polatis G, Giovanni A, Wisniewski HM. Cytochemical study of the involvement of cell organelles in formation and accumulation of fibrillar amyloid in the pancreas of NORbeta transgenic mice. Histol Histopathol 2001; 16:1047-56. [PMID: 11642724 DOI: 10.14670/hh-16.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Phosphatase ultrastructural cytochemistry was used to evaluate the participation of cytoplasmic organelles in the accumulation of fibrillar amyloid beta (Abeta) in exocrine acinar cells and in macrophages of the pancreas of transgenic mice overexpressing a carboxy-terminal fragment of Abeta protein precursor (ABPP). Nucleoside diphosphatase (NDPase) and glucose-6-phosphatase (G6Pase) were used as cytochemical markers of the endoplasmic reticulum (ER), thiamine pyrophosphatase (TPPase) as a marker of the Golgi apparatus (GA), and acid phosphatase (AcPase) as a marker of lysosomes. Monoclonal antibody 4G8 raised against the 17-24 aa sequence of human Abeta protein was used for immunogold localization of fibrillar Abeta. The results of this study indicate that the formation of Abeta in acinar cells occurs directly in the vacuolar areas of the rough ER (RER) without evident participation of the elements of the GA, whereas an intimate structural relation with primary lysosomes suggests their role in modification or digestion of the deposited amyloid. In macrophages, fibrillar amyloid was present in numerous cytoplasmic vacuoles located frequently in close proximity to flattened saccules of the ER. This structural pattern revealed similarity to that observed previously in microglial cells producing fibrillar PrP amyloid in scrapie-infected mice and Abeta in brains of human elderly patients and in Alzheimer's type brain pathology.
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Affiliation(s)
- D H Dobrogowska
- New York State Office of Mental Retardation and Developmental Disabilities, Institute for Basic Research in Developmental Disabilities, Staten Island 10314, USA
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26
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Abstract
The purpose of our study was to investigate the pattern of recurrence and the prognostic factors for recurrence of pediatric craniopharyngiomas after radical excision. A series of 36 patients with craniopharyngiomas (21 boys and 15 girls; age range 1-15 years; mean 7.3 years) were reviewed. All patients had undergone radical excision without radiotherapy. The mean follow-up period was 52 months (range 1-149 months). Tumors recurred in 14 patients within 83 months (mean 31.4 months). The overall 5-year recurrence-free survival rate was 55%. Regular neuroimaging follow-up detected tumor recurrence while the lesions were still small before symptoms developed (P<0.05). At the first surgical procedure, the optic nerve/chiasm (n=23) was the most common adhesion site. The most frequent sites of recurrence were the optic nerve/chiasm (n=6) and the pituitary fossa (n=6). Tumor location was the single significant clinical predictor of recurrence. The 5-year recurrence-free survival rate was 39% for those who had an intrasellar tumor component and 81% for those who did not (P<0.05). The Ki-67 labeling indices (LIs) of primary tumors did not have prognostic value for recurrence. Recurrent tumors tended to have higher Ki-67 LIs than their primary counterparts. On the basis of this study, we concluded that craniopharyngiomas with intrasellar components should be followed cautiously and the necessity for regular follow-up should be emphasized, even when the tumor is "totally" resected.
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Affiliation(s)
- S K Kim
- Division of Pediatric Neurosurgery, Cancer Research Institute, Seoul National University Children's Hospital, Korea
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27
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Abstract
The cerebellum is known to have an inhibitory effect on seizures. Nevertheless, cerebellar dysplastic lesions can be epileptogenic. A 4-month-old infant had paroxysmal facial contractions; tachypnea and nystagmoid eyeball and tremulous movements were occasionally combined. These evolved to stereotypic clinical patterns and frequencies, which increased despite administration of antiepileptic drugs (AEDs). Magnetic resonance imaging (MRI) demonstrated a mass arising from the superior cerebellar peduncle, although video-scalp EEG monitoring revealed no abnormal findings. Positron emission tomography with [(18)F]fluorodeoxyglucose revealed focal hypermetabolism in the same area identified by MRI. A depth electrode implanted in the mass revealed focal spike-and-wave discharges. The lesion was partly removed; pathologic diagnosis was ganglioglioma. Because of incomplete seizure control and residual tumor visible on MRI, a second operation was performed. After complete excision of the tumor, the patient became seizure free without AEDs. This case confirms the presence of seizure originating from the cerebellum and emphasizes the need for the complete removal of an epileptogenic lesion.
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Affiliation(s)
- J H Chae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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28
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Abstract
OBJECTS The aim of this study was to evaluate the role of surgical modality in children with brain tumors and intractable epilepsy. METHODS Twenty-three patients who were treated for brain tumors and intractable epilepsy between January 1985 and March 1998 were retrospectively reviewed. The most common tumors were dysembryoplastic neuroepithelial tumors (n=9), oligodendrogliomas (n=6), and gangliogliomas (n=5). Six patients exhibited cortical dysplasia. The mean duration of follow-up was 43.4 months (range 12 to 125 months). Seizure outcome was more favorable (Engel's classes I and II) in patients with a complete resection of tumor (14/14 vs 6/9 for incomplete resection; P<0.05). There was no significant difference in seizure outcome between lesionectomy (n=13) and epilepsy surgery (n=10). The likelihood of requiring postoperative antiepileptic drugs was not influenced by the extent of resection or type of surgery. CONCLUSIONS On the basis of this study, we conclude that the complete resection of these tumors can be an appropriate initial treatment for children with brain tumors who experience intractable epilepsy.
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Affiliation(s)
- S K Kim
- Division of Pediatric Neurosurgery and Clinical Research Institute, Seoul National University Children's Hospital and Neurological Research Institute, Korea
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29
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Tu YK, Yen CY, Yeh WL, Wang IC, Wang KC, Ueng WN. Reconstruction of posttraumatic long bone defect with free vascularized bone graft: good outcome in 48 patients with 6 years' follow-up. Acta Orthop Scand 2001; 72:359-64. [PMID: 11580124 DOI: 10.1080/000164701753542014] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We analyzed our clinical results in 48 patients (40 men) treated during 1990-1993 with free vascularized bone-graft reconstruction for bone defects, the follow-up being an average 6 (5-8) years. The bone defects were located in the femur (10), tibia (32), humerus (2), and forearm (4). We performed 41 fibula transfers, 4 iliac transfers, and 3 rib transfers in these patients. 3 patients required early revision surgery due to venous thrombosis. The average time needed for radiographic bone union was 4.2 months. Bone transfers to the lower extremity showed significantly more hypertrophy than those in the upper extremity. The functional outcome was good in 43 patients.
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Affiliation(s)
- Y K Tu
- Orthopedic Department, Chang Gung Memorial Hospital, Taiwan.
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30
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Kwon JW, Kim IO, Cheon JE, Kim WS, Chi JG, Wang KC, Yeon KM. Cerebellopontine angle ganglioglioma: MR findings. AJNR Am J Neuroradiol 2001; 22:1377-9. [PMID: 11498430 PMCID: PMC7975207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We present a case of cerebellopontine (CP) angle ganglioglioma in a young child with developmental delay and no trigeminal nerve symptoms. MR imaging demonstrated a mass of homogeneous low signal intensity in the left CP angle on T1-weighted images with no enhancement with gadolinium, and of relatively homogeneous high signal intensity on T2-weighted images.
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Affiliation(s)
- J W Kwon
- Department of Radiology, Institute of Radiation Medicine, MRC, Seoul National University College of Medicine, 28, Yongon-Dong, Chongno-Gu, Seoul, 110-744, Korea
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31
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Chung SK, Sim KB, Cho BK, Hong SK, Wang KC. Is the re-closure of surgically induced open neural tube defect the repetition of primary neurulation? An experimental study with chick embryos. Neurosci Lett 2001; 307:69-72. [PMID: 11427302 DOI: 10.1016/s0304-3940(01)01932-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
It is well known that surgically induced open neural tube defects (ONTDs) tend to re-close in early embryonic stages. To investigate whether the process of re-closure is a repetition of primary neurulation, the morphological changes of surgically induced ONTDs were chronologically examined in early chick embryos. Longitudinal incisions of 3-somite length were made in the neural tubes of chick embryos at Hamburger and Hamilton stage 18 or 19. About half of the embryos showed complete closure of the skin on surgical microscopic examination. The re-closed neural tubes showed no remarkable differences from the controls on histological examination. The process of re-closure involved a zipper-like (ventral to dorsal) closure in the transverse sections of neural tubes. The results indicate that the re-closure of surgically induced ONTDs does not repeat the process of natural primary neurulation.
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Affiliation(s)
- S K Chung
- Department of Neurosurgery, Wooridul Spine Hospital, 47 Chungdam-dong, Kangnam-gu, 135-100, Seoul, South Korea
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32
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Lee C, Kim DW, Jeon GS, Roh EJ, Seo JH, Wang KC, Cho SS. Cerebellar alterations induced by chronic hypoxia: an immunohistochemical study using a chick embryonic model. Brain Res 2001; 901:271-6. [PMID: 11368977 DOI: 10.1016/s0006-8993(01)02362-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A model of fetal aerogenic hypoxia was developed in which fertilized chicken eggs were half-painted with melted wax and incubated under normal conditions. The cerebellum of the hypoxic chick embryos at a later stage of development (E18-20) was analyzed immunochemically. Hypoxic insult resulted in considerable neurocytological deficits of the Purkinje cells and altered glial fibrillary acid protein (GFAP) immunoreactivity in the fetal cerebellum. Purkinje cells in the hypoxic embryos were marked by small cell size, poorly developed dendrites, low cell density, deletion and ectopia. On the other hand, enhanced GFAP immunoreactivity was found in astrocytes and Bergmann glia of the hypoxic embryos. Our results indicate that chronic hypoxia in the chick fetus can cause severe disorders of neuronal development as well as glial activation. We suggest that our hypoxic model of chick embryos could be an accessible animal model for further elucidating fetal hypoxia.
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Affiliation(s)
- C Lee
- Department of Anatomy, Seoul National University College of Medicine, 110-799, Seoul, South Korea
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Abstract
We present a case of intramedullary spinal gangliocytoma in a 7-year-old girl who presented with scoliosis and progressive weakness of both legs. The tumour involved the whole spinal cord and medulla oblongata and was composed of inner cystic and outer solid components. On MRI, the solid portion of the lesion showed strong enhancement at the thoracolumbar level and mild enhancement at the cervical and medullary levels. Histological examination of the surgical specimen showed neoplastic ganglion cells arranged irregularly in benign normocellular glial background, which made a diagnosis of gangliocytoma.
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Affiliation(s)
- Y H Choi
- Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea
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Kim SK, Wang KC, Cho BK, Jung HW, Lee YJ, Chung YS, Lee JY, Park SH, Kim YM, Choe G, Chi JG. Biological behavior and tumorigenesis of subependymal giant cell astrocytomas. J Neurooncol 2001; 52:217-25. [PMID: 11519851 DOI: 10.1023/a:1010664311717] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In spite of the benign nature of subependymal giant cell astrocytomas (SEGAs), some show massive hemorrhage, rapid growth, and tumor recurrence. This led us to investigate the biological behavior, cell dynamics, and tumorigenesis of SEGAs. All patients (4 men and 3 women; age range, 6-27 years; mean, 13.6 years) had features of tuberous sclerosis complex and obstructive hydrocephalus. One patient had intratumoral bleeding. In two patients, sequential neuroimaging showed a subependymal nodule growing to become a SEGA. All underwent surgical resection without radiation therapy. One tumor recurred and was treated surgically. There were no postoperative deaths. The presence of cytologic atypia, mitoses and vascular proliferation had no implication in terms of the clinical course. MIB-1 labeling indices were low (mean, 0.9), indicating low proliferative potential. Unexpectedly, bcl-2 staining was sparse and bax staining predominated in majority of cases. However, the mean value of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling index was low. Immunohistochemically, tumors were positive for both glial and neuronal markers. In the majority of our cases, the expression of p53 was low. Only one tumor was focally positive for tuberin. SEGAs have low proliferative potential and apoptotic activity, and exhibit features of mixed glial-neuronal differentiation. In contrast to p53, tuberin is suggested to be the tumor suppressor in this tumor.
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Affiliation(s)
- S K Kim
- Department of Neurosurgery, Seoul National University Hospital, Chongno-gu, Korea
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Abstract
Premature separation of the neuroectoderm from the ipsilateral surface ectoderm allowing mesenchymal tissue to invade into the central canal, or "premature dysjunction" theory, was proposed for the pathogenesis of dorsal type lumbosacral lipoma. To test this theory, the unilateral neural fold was incised using Hamburger and Hamilton stage 12 or 13 chick embryos. Among 35 embryos evaluated, 15 showed abnormal findings, and of these one showed findings which suggested lumbosacral lipoma: a back lump, blending of the neuroepithelium and mesenchyme through indistinct basement membrane and vertebral body abnormalities. The other 14 embryos showed abnormalities including blunt tails, open neural tube defects, incomplete closure of the dorsal neuroepithelium with intact skin, skin dimples, disorganized gray matter, scoliosis, ectopic neuroepithelium and an accessory spinal cord. The results revealed that the incision of the unilateral neural fold in the early chick embryo may produce a lesion suggestive of lumbosacral lipoma, a finding which supports the premature dysjunction theory. This method needs further refinement to overcome technical difficulties, high mortality, and a low yield before being adopted as an experimental model for lumbosacral lipoma.
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Affiliation(s)
- Y C Li
- Division of Pediatric Neurosurgery and Laboratory for Fetal Medicine Research, Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongnu-ku, Seoul 110-744, Korea
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Abstract
Posterior circulation infarction is uncommon in children. We describe the clinical presentation and radiological findings in two children with cerebellar infarction resulting from dissection of the vertebral artery. We emphasize that vertebral artery injury should be considered in a child with acute symptoms and signs of ischaemia in the posterior circulation. MRI and MRA may be helpful in the diagnosis of cerebellar infarction and vertebral artery abnormality.
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Affiliation(s)
- J E Cheon
- Department of Radiology, Seoul National University College of Medicine, and the Institute of Radiation Medicine, Korea
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Wang PH, Lee WL, Yuan CC, Chao HT, Liu WM, Yu KJ, Tsai WY, Wang KC. Major complications of operative and diagnostic laparoscopy for gynecologic disease. J Am Assoc Gynecol Laparosc 2001; 8:68-73. [PMID: 11172117 DOI: 10.1016/s1074-3804(05)60551-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
STUDY OBJECTIVE To compare complication rates of diagnostic and operative laparoscopy. Design. Retrospective study (Canadian Task Force classification II-2). SETTING One medical center and three teaching hospitals. PATIENTS Six thousand four hundred fifty-one women with various indications for laparoscopic diagnosis and/or laparoscopic surgery from January 1994 through June 1999. INTERVENTION Diagnostic and operative laparoscopies. MEASUREMENTS AND MAIN RESULTS Forty-two major complications occurred that directly resulted in one death. One patient had stomach injury, 3 had major vessel injuries, 5 had ureter injuries, 10 had intestinal injuries, and 23 had bladder injuries. The overall complication rate for all laparoscopies was 0.65% (42/6451); however, it rose to 0.80% (39/4865) for operative laparoscopy compared with 0.19% for diagnostic laparoscopy (3/1586; p <0.001, Fisher's exact test). CONCLUSION Laparoscopic surgery is appropriate for managing various gynecologic diseases and has an acceptable complication rate. However, operative laparoscopy should be performed carefully because its rate of complications is significantly higher than that of diagnostic laparoscopy, especially for laparoscopic-assisted vaginal hysterectomy. (J Am Assoc Gynecol Laparosc 8(1):68-73, 2001)
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Affiliation(s)
- P H Wang
- Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan
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Lai SW, Lin CC, Tan CK, Wang KC. Epidemiology of serum aminotransferase activities in the elderly. Yale J Biol Med 2001; 74:211-9. [PMID: 11697479 PMCID: PMC2588771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Our study used data collected in Chung-Hsing Village in May 1998 to explore the distribution of serum aminotransferase activities and the relationship between aminotransferase and its related factors in the elderly. METHODS All individuals aged 65 and over were recruited as study subjects. A total of 1093 persons, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 61.6 percent. However, only 586 subjects had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. In order to study the significant related factors of abnormal aminotransferase activities, the t-test, ANOVA, chi-square analysis, and multivariate logistic regression were used. RESULTS There were 66 percent men and 34 percent women. The mean age was 73.1 +/- 5.3 years. The mean values of aspartate aminotransferase (AST) were 29.3 +/- 14.5 u/l in men and 27.8 +/- 10.7 u/l in women (p > .05). The mean values of alanine aminotransferase (ALT) were 30.9 +/- 25.2 u/l in men and 26.3 +/- 12.6 u/l in women (p < .01). The abnormality rates of AST (> or = 40 u/l) were 10.5 percent in men and 12.2 percent in women (p > .05). The abnormality rates of ALT (> or = 40 u/l) were 16.7 percent in men and 12.6 percent in women (p > .05). After controlling for the other covariates, the multivariate logistic regression analysis showed that the significant related factor of abnormal AST was retirement status (odds ratio 4.4; 95 percent confidence interval = 1.5-13.3; p < .01). The significant related factors of abnormal ALT were obesity (odds ratio = 2.2; 95 percent confidence interval = 1.1-4.2; p < .05) and hypertriglyceridemia (odds ratio = 2.7; 95 percent confidence interval = 1.5-4.9; p < .01). CONCLUSIONS We raise the hypothesis that evidence of liver disease with abnormal ALT may co-vary with other indicators of chronic diseases. A large-scale investigation will be suggested in the future to demonstrate the causal-effect issue between abnormal ALT and obesity or hypertriglyceridemia.
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Affiliation(s)
- S W Lai
- Department of Community Medicine, China Medical College Hospital, Taichung City, Taiwan.
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Kim SK, Cho BK, Paek SH, Hong SJ, Kim HS, Hong SY, Choe G, Chi JG, Nam DH, Wang KC. The detection of p53 gene mutation using a microdissection technique in primary intracranial germ cell tumors. Int J Oncol 2001. [DOI: 10.3892/ijo.18.1.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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40
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Kim SK, Cho BK, Paek SH, Hong SJ, Kim HS, Hong SY, Choe G, Chi JG, Nam DH, Wang KC. The detection of p53 gene mutation using a microdissection technique in primary intracranial germ cell tumors. Int J Oncol 2001; 18:111-6. [PMID: 11115546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Using a microdissection technique, the contribution of the p53 mutation to tumorigenesis and prognosis in each histological subtype of the intracranial germ cell tumors (GCTs) was evaluated. Nineteen patients had primary intracranial GCTs, including 4 germinomas (GEs), 4 teratomas (TEs), 1 mixed tumor of GE and TE, and 10 mixed GCTs containing non-germinomatous malignant germ cell tumors (NG-MGCTs). After microdissection of specific subtypes, genomic DNA was screened for mutations in exons 5-8 of the p53 gene, using the dideoxyfingerprinting (ddF) followed by direct DNA sequencing. The direct sequencing revealed a total of six mutations in PCR products derived from the five cases (26%) which showed mobility shifts in ddF. Among the six mutations detected, four were missense mutations and two were silent. Missense mutations of the p53 gene tended to occur more frequently in the NG-MGCT component than in the GE or TE components (3/15 vs. 1/12 vs. 0/13). The incidence of missense mutations was not different between the survivors (3/13) and the deceased (1/6). This study suggests the possible role of the p53 gene in the tumori-genesis of NG-MGCT. However, p53 gene mutation did not correlate with the prognosis of NG-MGCT.
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Affiliation(s)
- S K Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
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41
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Liu JC, Lee CH, Lai JY, Wang KC, Hsu YC, Chang BV. Extracellular polymers of ozonized waste activated sludge. Water Sci Technol 2001; 44:137-142. [PMID: 11794644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Effect of ozonation on characteristics of waste activated sludge was investigated in the current study. Concentrations of cell-bound extracellular polymers (washed ECPs) did not change much upon ozonation, whereas the sum of cell-bound and soluble extracellular polymers (unwashed ECPs) increased with increasing ozone dose. Washed ECPs in original sludge as divided by molecular weight distribution was 39% < 1,000 Da (low MW), 30% from 1,000 to 10,000 Da (medium MW), and 31% > 10,000 Da (high MW). It was observed that the low-MW fraction decreased, and the high-MW fraction increased in ozonized sludge. The unwashed ECPs were characterized as 44% in low MW, 30% in medium MW, and 26% in high MW. Both low-MW and medium-MW fractions of unwashed ECPs decreased while high-MW fraction increased in ozonized sludge. The dewaterability of ozonized sludge, assessed by capillary suction time (CST) and specific resistance to filtration (SRF), deteriorated with ozone dose. The optimal dose of cationic polyelectrolyte increased with increasing ozone dose. The production rate and the accumulated amount of methane gas of ozonized sludge were also higher.
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Affiliation(s)
- J C Liu
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei
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42
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Wegiel J, Wang KC, Imaki H, Rubenstein R, Wronska A, Osuchowski M, Lipinski WJ, Walker LC, LeVine H. The role of microglial cells and astrocytes in fibrillar plaque evolution in transgenic APP(SW) mice. Neurobiol Aging 2001; 22:49-61. [PMID: 11164276 DOI: 10.1016/s0197-4580(00)00181-0] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ultrastructural reconstruction of 27 fibrillar plaques in different stages of formation and maturation was undertaken to characterize the development of fibrillar plaques in the brains of human APP(SW) transgenic mice (Tg2576). The study suggests that microglial cells are not engaged in Abeta removal and plaque degradation, but in contrast, are a driving force in plaque formation and development. Fibrillar Abeta deposition at the amyloid pole of microglial cells appears to initiate three types of neuropil response: degeneration of neurons, protective activation of astrocytes, and attraction and activation of microglial cells sustaining plaque growth. Enlargement of neuronal processes and synapses with accumulation of degenerated mitochondria, dense bodies, and Hirano-type bodies is the marker of toxic injury of neurons by fibrillar Abeta. Separation of amyloid cores from neurons and degradation of amyloid cores by cytoplasmic processes of hypertrophic astrocytes suggest the protective and defensive character of astrocytic response to fibrillar Abeta. The growth of cored plaque from a small plaque with one microglial cell with an amyloid star and a few dystrophic neurites to a large plaque formed by several dozen microglial cells seen in old mice is the effect of attraction and activation of microglial cells residing outside of the plaque perimeter. This mechanism of growth of plaques appears to be characteristic of cored plaques in transgenic mice. Other features in mouse microglial cells that are absent in human brain are clusters of vacuoles, probably of lysosomal origin. They evolve into circular cisternae and finally into large vacuoles filled with osmiophilic, amorphous material and bundles of fibrils that are poorly labeled with antibody to Abeta. Microglial cells appear to release large amounts of fibrillar Abeta and accumulate traces of fibrillar Abeta in a lysosomal pathway.
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Affiliation(s)
- J Wegiel
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
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43
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Abstract
Isoprenyl diphosphate synthases catalyze consecutive condensations of isopentenyl diphosphates with allylic primer substrates to form linear backbones for all isoprenoid compounds including cholesterol. These synthases are classified according to the final chain length of their end products and the stereochemistry of the newly formed double bonds. Mutagenesis and X-ray crystallography data have uncovered the basic catalytic and chain length determination mechanisms of E-isoprenyl diphosphate synthases and shed light on their possible evolutionary course. Although much less is known about the Z-isoprenyl diphosphate synthase family, successful cloning and subsequent crystallizations in the near future will no doubt bring more insight as researchers begin to unravel the essential components and precise reaction mechanisms of this cellular machinery.
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Affiliation(s)
- K C Wang
- University of California, San Francisco, School of Medicine, San Francisco, CA 94143, USA
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Wang KC, Cheng AL, Chuang SE, Hsu HC, Su IJ. Retinoic acid-induced apoptotic pathway in T-cell lymphoma: Identification of four groups of genes with differential biological functions. Exp Hematol 2000; 28:1441-50. [PMID: 11146166 DOI: 10.1016/s0301-472x(00)00546-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Retinoic acid (RA) has been used to induce the regression of refractory T-cell lymphoma. In vitro and in vivo studies have shown that RA exerts this effect through the induction of apoptosis. This study was designed to investigate the molecular pathway of RA-induced apoptosis in T-lymphoma cell lines.RA-induced apoptosis was verified by morphology, flow cytometry, and DNA ladder analysis. Differential display method using a combination of 12 poly(A)-anchored primers and 20 arbitrary primers was adopted for gene cloning. Total RNAs were extracted from H9 cell line at 0, 6, 12, and 24 hours after All-trans RA (ATRA) treatment and the serial expression patterns of the candidate fragments were recognized. The cloned gene fragments were then analyzed and confirmed by Northern blot analysis on H9 and SR786 cell lines.ATRA-induced apoptosis of T-cell lymphoma was protein synthesis-dependent. The execution or irreversible phase of apoptosis appeared to occur at 6-12 hours of RA treatment. Among the 60,000 arbitrarily displayed bands, 25 of 250 candidate fragments were selected for further cloning and sequencing. A total of 14 clones could be matched to known genes and were categorized into four groups: A) transcription factors: prothymosin, CA150, p78 serine/threonine kinase, IL-1beta-stimulating gene, glucocorticoid receptor, MLN64/CAB1, gastrin-binding protein, and polypeptide from glioblastoma; B) chaperone: 90 kDa heat shock protein; C) ion channel: chloride channel protein 3; and D) cytoskeleton: cytovillin2/ezrin and vimentin. Another two clones of genes were of unrecognized functions. The remaining 11 clones belonged to unmatched or novel genes. The expression of these genes varied, either upregulated or downregulated, in response to ATRA treatment.RA-induced apoptosis may involve a cascade of genes that are related to transcription regulation, stress response, housekeeping, and the execution of apoptosis. The clarification of the RA-induced apoptotic pathway will help us to understand the molecular mechanism of cancer differentiation agents.
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Affiliation(s)
- K C Wang
- Graduate Institute of Pathology, National Taiwan University Medical School, Taipei, Taiwan
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45
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Abstract
Visual loss with optic atrophy is common in osteopetrosis. The efficacy of optic nerve decompression in patients with osteopetrosis is still controversial. The purpose of this study is to report that visual deterioration in osteopetrosis can be completely reversed by early optic nerve decompression. An 8-year-old female patient with osteopetrosis was found to have reduced visual acuity on routine ophthalmologic examination. Extensive optic nerve decompression was performed. It not only included unroofing the optic canal, but also drilling away bone on both sidewalls of the optic nerve. Both optic nerves were decompressed during the same surgical procedure. Progressive loss of vision associated with osteopetrosis can be prevented by optic nerve decompression in the early stage of visual deterioration. When managing patients with osteopetrosis, the importance of careful and regular assessment of visual function should be stressed.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, Seoul National University, Seoul, Korea
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46
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Abstract
Incubation of 3beta-hydroxy-5,6alpha-cyclopropano-5alpha-cholestane (4), 3beta-hydroxy-5,6beta-cyclopropano-5beta-cholestane (5), and 3beta-hydroxy-5,6alpha-cyclopropano-5alpha-cholest-7-e ne (6) with Mycobacterium sp. (NRRL B-3805) gave a mixture of side chain cleaved 17-keto steroids as the major products in 52, 57, and 69% yields, respectively. Among these 17-keto steroids, the cyclopropyl ring eliminated product, androst-4-ene-3,17-dione (9), was isolated in 6, 4, and 8% yields, respectively. A cyclopropyl ring migration product, 6alpha,7alpha-cyclopropanoandrost-4-ene-3,17-dione (16), was isolated from the incubation mixture of 6 in 4% yield, also 10% yield of 16 was obtained when 5, 6alpha-cyclopropano-5alpha-androst-7-ene-3,17-dione (12) was incubated. The cyclopropyl ring opening and subsequent reduction followed by oxidation of the two major biotransformation products, 5, 6beta-cyclopropano-5beta-androsta-3,17-dione (10) and 5, 6alpha-cyclopropano-5alpha-androsta-3,17-dione (7), gave 6beta- and 6alpha-methylandrost-4-ene-3,17-dione in 60, and 45% yields, respectively.
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Affiliation(s)
- J L Yan
- School of Pharmacy, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road, Taipei 100, Republic of, Taiwan, China
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47
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Abstract
We report five cases of ganglioglioma in various locations. The tumours were removed with gross total resection in most cases without any further neurological deterioration. Without any additional treatment, no evidence of recurrence or regrowth of tumours was observed in the mean follow-up period of 4.1 years. We suggest that intramedullary spinal cord gangliogliomas be resected totally due to the high risk of recurrence and regrowth rate of the tumours with subtotal resection in the long term considering especially that these tumours affect predominantly young patients.
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Affiliation(s)
- C K Park
- Department of Neurosurgery, Seoul National University College of Medicine, South Korea
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Sim KB, Cho BK, Lee YJ, Lee MS, Wang KC. Chronological changes of re-closure capacity in surgically induced spinal open neural tube defects of chick embryos. Neurosci Lett 2000; 292:151-4. [PMID: 11018299 DOI: 10.1016/s0304-3940(00)01435-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To investigate the re-closure capacity of surgically induced spinal open neural tube defects (ONTD) and its correlation to the cell proliferation activity in embryonic stages, longitudinal incisions of 3- or 6-somite lengths were made in neural tubes of chick embryos at Hamburger and Hamilton stage 18-19, and the length of the ONTDs was measured on postoperative days 2, 3, 5, 7, and 10. The results demonstrated that re-closure occurred more actively when the incision length was shorter. The chronological changes in the re-closure capacity of the ONTDs paralleled the proliferative activity of the neural tube. We conclude that surgically induced spinal ONTDs may be remodeled in early chick embryos and that manipulation of cell dynamics can enhance the re-closure process in the embryonic spinal cord tissue.
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Affiliation(s)
- K B Sim
- Department of Neurosurgery, Wooridul Spine Hospital, Seoul, South Korea
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Wegiel J, Wang KC, Tarnawski M, Lach B. Microglia cells are the driving force in fibrillar plaque formation, whereas astrocytes are a leading factor in plague degradation. Acta Neuropathol 2000; 100:356-64. [PMID: 10985692 DOI: 10.1007/s004010000199] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ultrastructural three-dimensional reconstruction of human classical plaques in different stages of development shows that microglial cells are the major factor driving plaque formation by fibrillar amyloid-beta (Abeta) deposition. The amount of fibrillar Abeta released by microglial cells and the area of direct contact between amyloid and neuron determine the extent of dystrophic changes in neuronal processes and synapses. The volume of hypertrophic astrocytic processes separating fibrillar amyloid from neuron is a measure of the protective activation of astrocytes. On the bases of the volume of amyloid star, microglial cells, dystrophic neurites, and hypertrophic astrocytic processes, and spatial relationships between plaque components, three stages in classical plaque development have been distinguished: early, mature, and late. In early plaque, the leading pathology is fibrillar Abeta deposition by microglial cells with amyloid star formation. The mature plaque is characterized by a balance between amyloid production, neuronal dystrophy, and astrocyte hypertrophy. In late classical plaque, microglial cells retract and expose neuropil on direct contact with amyloid star, enhancing both dystrophic changes in neurons and hypertrophic changes in astrocytes. In late plaques, activation of astrocytes predominates. They degrade amyloid star and peripheral amyloid wisps. The effect of these changes is classical plaque degradation to fibrillar primitive and finally to nonfibrillar, diffuse-like plaques.
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Affiliation(s)
- J Wegiel
- Department of Pathological Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island 10314, USA.
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Lee BH, Cheong HI, Shin YS, Cho BK, Wang KC. The effect of C677T mutation of methylene tetrahydrofolate reductase gene and plasma folate level on hyperhomocysteinemia in patients with meningomyelocele. Childs Nerv Syst 2000; 16:559-63. [PMID: 11048629 DOI: 10.1007/pl00007298] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To evaluate the relationship between genotypes of methylene tetrahydrofolate reductase (MTHFR), and plasma folate and homocysteine (Hcy) levels in meningomyelocele, 21 Korean patients, 47 of their family members, and 43 healthy controls were recruited. The presence of C677T mutation in the MTHFR gene and plasma concentrations of folate/Hcy were investigated. The genotype frequency of C677T mutation was not higher in study groups (patients and family members). The plasma folate concentration showed no difference either between the study and the control groups or among MTHFR-genotypic groups. The plasma Hcy concentration in homozygotes in the study group was higher than that in the control group, and higher than that in heterozygotes when plasma folate levels were low (P=0.006). Although neither MTHFR genotype nor plasma folate/Hcy level plays a definite part on its own, they seem to have an additive effect on the occurrence of meningomyelocele. Our results support folate supplementation for the prevention of hyperhomocysteinemia and meningomyelocele.
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Affiliation(s)
- B H Lee
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
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