Cheong Ah OhDae Hoon KimSeung Jong OhMin Gew Choi...
673-678页
查看更多>>摘要：AIM:To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications.METHODS:From January 2008 through June 2008,669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study.Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates.The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications.Patients with other postoperative complications were excluded from the study.RESULTS:On the 5th postoperative day,the NRI showed a malnutrition rate of 84.6％ among postoperative patients.However,postoperative wound complications occurred in only 66/669 (9.86％) patients.Of the patients with wound complications,62/66 (94％)belonged to the malnourished group (NRI ＜ 97.5),and 4/66 (6％) patients to the non-malnourished group (NRI ≥ 97.5).The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI ＜ 97.5:0.653; 95％confidence interval:0.326-0.974; P =0.014) according to univariate analysis as well as multivariate analysis.CONCLUSION:This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.
Geum-Youn GwakTae Gun MoonDong Ho LeeByung Chul Yoo...
679-684页
查看更多>>摘要：AIM:To examine how High-mobility group box 1 (HMGB1)regulates hepatocyte apoptosis and,furthermore,to determine whether glycyrrhizin (GL),a known HMGB1 inhibitor,prevents HMGB1-induced hepatocyte apoptosis.METHODS:A human hepatocellular carcinoma cell line stably transfected with a bile acid transporter (Huh-BAT cells),were used in this study.Apoptosis was quantified using 4',6-diamidino-2-phenylindole dihydrochloride staining and the APO Percentage apoptosis assay,and its signaling cascades were explored by immunoblot analysis.Kinase signaling was evaluated by immunoblotting and by using selective inhibitors.It is also tried to identify hepatocyte apoptosis affected by the HMGB1 inhibitor,GL.RESULTS:HMGB1 increased cellular apoptosis in Huh-BAT cells.HMGB1 led to increased cytochrome c release from mitochondria into the cytosol,and induced the cleavage of procaspase 3.However,it did not affect the activation of caspase 8.HMGB1-induced caspase 3 activation was significantly attenuated by the p38 inhibitor SB203580.GL significantly attenuated HMGB1-induced hepatocyte apoptosis.GL also prevented HMGB1-induced cytochrome c release and p38 activation in Huh-BAT cells.CONCLUSION:The present study demonstrated that HMGB1 promoted hepatocyte apoptosis through a p38-dependent mitochondrial pathway.In addition,GL had an anti-apoptotic effect on HMGB1-treated hepatocytes.
查看更多>>摘要：AIM:To assess the significance of chromosome translocation t(11;18)(q21;q21),B-cell lymphoma 10 (BCL-10)protein and Helicobacter pylori (H.pylori) infection in gastric mucosa-associated lymphoid tissue (MALT) lymphoma in Colombia.METHODS:Fifty cases of gastric MALT lymphoma and their respective post-treatment follow-up biopsies were examined to assess the presence of the translocation t(11;18)(q21;q21) as identified by fluorescence in situ hybridization; to detect protein expression patterns of BCL10 using immunohistochemistry; and for evaluation of tumor histology to determine the correlation of these factors and resistance to H.pylori eradication.RESULTS:Infection with H.pylori was confirmed in all cases of gastric MALT lymphoma in association with chronic gastritis.Bacterial eradication led to tumor regression in 66％ of cases.The translocation t(11;18)(q21;q21) was not present in any of these cases,nor was there evidence of tumor transformation to diffuse large B-cell lymphoma.Thirty-four percent of the patients showed resistance to tumor regression,and within this group,7 cases,representing 14％ of all those analyzed,were considered to be t(11;18)(q21;q21)-positive gastric MALT lymphomas.Protein expression of BCL10 in the nucleus was associated with the presence of translocation and treatment resistance.Cases that were considered unresponsive to therapy were histologically characterized by the presence of homogeneous tumor cells and a lack of plasmacytic differentiation.Responder cases exhibited higher cellular heterogeneity and a greater frequency of plasma cells.CONCLUSION:Both t(11;18)(q21;q21)-positive MALT lymphoma cases and those with nuclear BCL10 expression are considered resistant to H,pylori eradication.It is suggested that chronic antigenic stimulation is not a dominant event in resistant cases.
查看更多>>摘要：AIM:To evaluate the clinical impact of multidetector computed tomography (MDCT) before double-balloon endoscopy (DBE) for patients with obscure gastrointestinal bleeding (OGIB).METHODS:A retrospective analysis of prospectively collected cases with DBE and MDCT for overt OGIB was conducted from April 2004 to April 2010 at Changhua Christian Hospital.We evaluated the clinical impact of MDCT on the subsequent DBE examinations and the diagnostic yields of both MDCT and DBE respectively.RESULTS:From April 2004 to April 2010,a total of 75 patients underwent DBE for overt OGIB.Thirty one cases received MDCT followed by DBE for OGIB.The overall diagnostic yields of DBE and MDCT was 93.5％ and 45.2％.The MDCT had a high diagnostic yield of tumor vs non-tumor etiology of OGIB (85.7％ vs 33.3％,P =0.014).Additionally,the choice of initial route of DBE was correct in those with a positive MDCT vs negative MDCT (100％ vs 52.9％,P =0.003).CONCLUSION:This study suggests MDCT as a triage tool may identify patients who will benefit from DBE and aid the endoscopist in choosing the most efficient route.
查看更多>>摘要：AIM:To investigate the efficacy and safety of imatinib dose escalation in Chinese patients with advanced gastrointestinal stromal tumor (GIST).METHODS:Advanced GIST patients previously failing 400 mg imatinib treatment were enrolled in this study.Patients received imatinib with dose escalation to 600mg/d,and further dose escalation to 800 mg/d if imatinib 600 mg/d failed.Progression-free survival,overall survival,clinical efficacy,c-kit/PDGFRA genotype and safety were evaluated.RESULTS:52 patients were enrolled in this study.For the 47 evaluable patients receiving imatinib (600 mg/d),the disease control rate was 40.4％,and the median progression-free survival for all patients was 17 wk (95％ CI:3.9-30.1).The median overall survival after dose escalation was 81 wk (95％ CI:36.2-125.8).Adverse events,mainly edema,fatigue,granulocytopenia and skin rash were tolerable.However,further dose escalation (800 mg/d) in 14 cases was ineffective,with disease progression and severe adverse events.Among 30 cases examined for gene mutations,patients with exon 9 mutations experienced a better progression-free survival of 47 wk.CONCLUSION:Imatinib dose escalation to 600 mg/d is more appropriate for Chinese patients and may achieve further survival benefit.
查看更多>>摘要：AIM:To investigate the effects of ESC-3 isolated from crocodile bile on the growth and apoptosis induction of human cholangiocarcinoma cells.METHODS:ESC-3 was isolated from crocodile bile by Sephadex LH-20 and RP-18 reversed-phase column.3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay was conducted to determine the effects of ESC-3 on the proliferation of human cholangiocarcinoma cell lines (QBC939,Sk-ChA-1 and MZ-ChA-1).Giemsa staining,Hoechst 33258 and acridine orange/ethidium bromide staining showed the morphological changes of Mz-ChA-1 cells exposed to ESC-3 at different concentrations.Flow cytometry with regular propidium iodide (PI) staining was performed to analyze the cell cycle distribution of Mz-ChA-1 cells and to assess apoptosis by annexin v-fiuorescein isothiocyanate (VFITC)/PI staining.Rh123 staining was used to detect the alteration of mitochondrial membrane potential (△Ψm).The protein levels of Bax,Bcl-2,Cdk2,cytochrome c and caspase-3 were further confirmed by Western blotting.RESULTS:ESC-3 significantly inhibited the growth of three human cholangiocarcinoma cell lines and arrested Mz-ChA-1 cell cycle at G0/G1 phase.Mz-ChA-1 cells showed typical apoptotic morphological changes after treated with ESC-3 (10 μg/mL) for 48 h.Cell death assay indicated that Mz-ChA-1 cells underwent apoptosis in a dose-dependent manner induced by ESC-3.In addition,ESC-3 treatment could downregulate the protein level of Bcl-2 and upregulate the Bax,leading to the increase in the ratio of Bax to Bcl-2 in Mz-ChA-1 cells.Meanwhile,cytochrome c was released from the mitochondria into the cytosol,which subsequently initiated the activation of caspase-3.All these events were associated with the collapse of the mitochondrial membrane potential.CONCLUSION:ESC-3,the active ingredient of crocodile bile,induced apoptosis in Mz-ChA-1 cells through the mitochondria-dependent pathway and may be a potential chemotherapeutic drug for the treatment of cholangiocarcinoma.
查看更多>>摘要：AIM:To explore the expression pattern of OCT4 in human esophageal squamous cell carcinoma and its significance in diagnosis and prognosis.METHODS:Using real-time polymerase chain reaction (PCR),Western blotting,immunocytochemistry and immunohistochemistry,the expression of OCT4 in three esophageal squamous cancer cell lines,KYSE70,KYSE140 and KYSE450,was characterized.OCT4 expression was investigated in a series of 153 esophageal squamous cell carcinoma samples using immunohistochemistry and explored its association with clinicopathological features.RESULTS:Immunohistochemically,OCT4 positive immunostaining was observed in cancer cell nuclei.OCT4 was variably expressed in three esophageal squamous cancer cell lines.Among 153 specimens,105 (68.7％)were negative or weakly positive for OCT4 staining;21 (13.7％) were moderately positive and 27 (17.6％)were strongly positive.Higher expression level of OCT4 was significantly associated with higher histological grade (P ＜ 0.001) and poor clinic outcome (P ＜ 0.001).CONCLUSION:The expression of OCT4 enables the tumor to have a higher degree of stemness,which in turn results in a poorer clinical outcome for patients with esophageal squamous cell carcinoma.
查看更多>>摘要：Pancreatic tuberculosis (TB) is a relatively rare disease that can mimic carcinoma,lymphoma,cystic neoplasia,retroperitoneal tumors,pancreatitis or pseudocysts.Here,I report the case of a 31-year-old immigrant Burmese woman who exhibited epigastralgia,fever,weight loss and an epigastric mass.The patient was diagnosed with pancreatic TB and acquired immunodeficiency syndrome,and was treated with antituberculous drugs and percutaneous catheter drainage without a laparotomy.The clinical presentation,radiographic investigation and management of pancreatic TB are summarized in this paper to emphasize the importance of considering this rare disease in the differential diagnosis of pancreatic masses concomitant with human immunodeficiency virus infection.I also emphasize the need for both histopathological and microbiological diagnosis via fineneedle aspiration.
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