This study evaluated the feasibility of screening mucosal recurrent nasopharyngeal carcinoma with narrow-band imaging (NBI) endoscopy.
One hundred and six patients were enrolled. All patients ...underwent conventional white-light (WL) endoscopic examination of the nasopharynx followed by NBI endoscopy. Biopsies were performed if recurrence was suspected.
We identified 32 suspected lesions by endoscopy in WL and/or NBI mode. Scattered brown spots (BS) were identified in 22 patients, and 4 of the 22 who had negative MRI findings were histopathologically confirmed to be neoplasias that were successfully removed via endoscopy. A comparison of the visualization in NBI closer view corresponded to histopathological findings in 22 BS, and the prevalence rates of neoplasias in tail signs, round signs, and irregularities signs were 0% (0/6), 0% (0/7), and 44.4% (4/9), respectively (p = 0.048). The sensitivity, specificity, and diagnostic capability were 37.5%, 92.9% and 0.652 for WL, 87.5%, 74.5% and 0.810 for NBI, and 87.5%, 87.8%, and 0.876 for NBI closer view, respectively. NBI closer view was effective in increasing specificity compared with NBI alone (87.8% vs. 74.5%, p < 0.05), and in increasing sensitivity and diagnostic capability compared to WL alone (87.5% vs. 37.5%, p < 0.05; 0.876 vs. 0.652, p = 0.0001).
Although NBI in endoscopy can improve sensitivity of mucosal recurrent nasopharyngeal neoplasias, false-positive (nonneoplasia BS) results may be obtained in areas with nonspecific inflammatory changes due to postradiation effects. NBI closer view not only can offer a timely, convenient, and highly reliable assessment of mucosal recurrent nasopharyngeal carcinoma, it can also make endoscopic removal possible.
Urine 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) is a specific biomarker of oxidative stress. We evaluated a modified LC–MS/MS assay for urine 8-oxodG and determined biological variation in ...healthy adults.
Untreated urine was injected into an isocratic LC–MS/MS system (positive-ion MRM mode). Urine 8-oxodG in 51 healthy volunteers was measured; within- and between-day variations in 23 healthy volunteers were investigated.
Dose–response was linear to 452
nmol/l; limit of detection
=
2.3
nmol/l; within-run and between-run CVs were <
3.0% and <
4.7%, respectively; recovery
=
97%–101%; accuracy
=
97.7–103.5%. Urine 8-oxodG (median, mean SD): 1.70, 1.700.60nmol/mmol creatinine (
n
=
51). Men had higher (
p
=
0.027) concentrations than women matched for age and body mass index: mean SD: 1.901.60;
n
=
26 vs. 1.500.55;
n
=
25. Within- and between-day variations were wide but random. No significant differences were seen overall across time-points within 1
day or at the same time-point across 5 consecutive days.
The method has advantages of speed and relative simplicity as it does not require sample pre-treatment for 8-oxodG extraction, the use of internal standard or gradient LC elution and has high linearity, specificity, precision and recovery. Biological variation in urine 8-oxodG is wide, but no within- or between-day differences at the group concentration were seen in healthy adults.
AIM： To investigate whether illness severity has an impact on gastric residual volume （GRV） in medical critically ill patients. METHODS： Medical intensive care unit （ICU） patients requiring ...nasogastric feeding were enrolled. Sequential Organ Failure Assessment （SOFA） score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship be-tween mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean APACHE Ⅱ score of all patients were evaluated and compared. RESULTS： Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased （P 0.001, analysis of variance）. Mean APACHE Ⅱ scores of all patients correlated with mean daily GRV （P = 0.011, Pearson correlation） during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV （P = 0.017, log rank test）. CONCLUSION： GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV.
This study investigated the effect of shock-wave therapy (SWT) on collagenase induced tendinopathy in the rabbit patellar tendon. Eighteen rabbits were treated by ultrasonography-guided injection of ...0.025 ml collagenase into the patellar tendon in both knees. After tendinopathy was confirmed at 3 weeks post-treatment by the histological examination, SWT was initiated to the right patellar tendon involving 1500 cycles at 0.29 mJ/mm
2 in two separated weekly courses from 4 weeks post-treatment. The rabbits were randomly divided into two groups, which were sacrificed at the 4th and 16th week after SWT, respectively. The histological examination, the mechanical and biochemical tests then were performed. The ultimate tensile load in the SWT tendon increased 7.03% at 4 week and 10.34% at 16 week after treatment as compared to the sham group. Hydroxyproline concentrations increased in the SWT tendons over both the 4 and 16 weeks after treatment. Moreover, the pyridinoline concentration increased at the 4th week but decreased at 16th week as compared to the sham group. The histological examination demonstrated increased blast-like tenocyte at the 4th week, while more mature tenocyte with neovasculization at the 16th week. The result obtained here validates the effectiveness of the SWT in the established tendinopathy. SWT may increase collagen synthesis and collagen crosslink formation during early healing process.
(1) Background: Post-transplant lymphoproliferative disorder (PTLD) is a hematological disease and occurs because of immunosuppression after organ transplantation. Only a few studies have reported ...PTLD in the nasopharynx. In most cases, PTLD developed after solid organ transplantation, and cases of PTLD after bone marrow transplantation, are uncommon. (2) Case presentation: We report the case of a 40-year-old woman with myelodysplastic disorder who underwent hematopoietic stem cell transplantation (HSCT). After 3 months, she developed low-grade fever, progressive nasal obstruction, and bloody rhinorrhea. Endoscopy revealed a mass completely occupying the nasopharynx. A polymorphic PTLD was diagnosed on the basis of histopathological examination results. Reduction in immunosuppression and low-dose radiotherapy were prescribed for treatment. After a 3-year follow-up, no recurrence of PTLD or myelodysplastic disorder was detected. (3) Conclusions: While nasopharyngeal PTLD is rare, a routine examination of the nasopharynx should be considered in the post-transplant follow-up of patients for early detection and treatment of PTLD.
Summary The aim of the study was to investigate the novel endoscopic findings in nasopharyngeal carcinoma (NPC) under narrow-band imaging (NBI) and to determine the reliability of screening NPC by ...NBI. A total of 79 adults underwent nasopharyngeal biopsy. We proposed five distinctly different findings that need to be examined by NBI: Type I: brownish spots, Type II: irregular microvascular pattern (IMVP), Type III: light crests, Type IV: side-difference, Type V: presence of either IMVP or side-difference, of which last three (Type III–V) were a new concept. The results of NPC diagnosis by detecting NBI Type V pattern, the false positive, false negative, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 6.7%, 2.9%, 97.1%, 93.3%, 91.7%, 97.7%, and 94.9%, respectively. On the other hand, there was a higher prevalence of Type I and IV patterns in T1 category NPC. The nasopharyngeal endoscopy coupled with NBI was able to provide a rapid, convenient, and highly reliable screening for high-risk populations.
•Erinacine A of Hericium erinaceus mycelium induces CRC cell cycle arrest.•Erinacine A activates the mTOR/NFκB and p21 pathway.•Erinacine A decreases the growth of CRC cells tumour xenograft in nude ...mice.
Hericium erinaceus is a well-known edible mushroom with valuable biological properties. Erinacine A is the major active agent of the diterpenoid compounds of the cultured mycelia of H. erinaceus. This agent has multiple physiological activities, including anti-tumourigenic activity. In this study, we investigated the molecular mechanisms by which erinacine A mediated the generation of reactive oxygen species (ROS), and we performed cell cycle arrest to clarify molecular changes in colorectal cancer cells (CRC). Treatment of DLD-1 cells with erinacine A resulted in the phosphorylation of c-Jun N-terminal kinase (JNK) and p70S6K, the activation of p50 and p-IKB-β protein levels, the downregulation of cell-cycle-related proteins (cyclin A, cdk2, cyclin E, cdk4, and cyclin D1), and the induction of p21. Furthermore, treatment with the N-acetyl cysteine (NAC) and mTOR inhibitor (rapamycin) abolished erinacine A-induced cell cycle G1 arrest and reversed the association of CDK2 with Cyclin E and CDK4 with Cyclin D1. Therefore, when DLD-1 cells were grown as xenografts in nude mice, treatment with erinacine A induced a significant dose-dependent decrease in tumour growth. Histochemical and immunohistochemical analysis revealed that erinacine A treatment significantly reduced the number of mitotic cells. These results suggest that erinacine A presents an antitumour potential for CRC by inhibiting the growth of tumour cells in vitro and in vivo. Thus, we have identified a novel erinacine A-inhibited proliferation by activating p70S6K and ROS production, cell-cycle-related p21 proteins that provide a new mechanism for erinacine A-inhibited cell growth in human CRC.
Epstein-Barr virus-positive diffuse large B-cell lymphoma is a provisional entity in the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues. Reports on the ...characteristics and clinical outcome of this disease in different geographic regions showed great disparities.
To define the clinical characteristics as well as the prognostic impact of Epstein-Barr virus infection on diffuse large B-cell lymphoma in Taiwan, we retrospectively investigated the Epstein-Barr virus status of 89 patients with newly diagnosed diffuse large B-cell lymphoma in our institute.
Using a cutoff point of positive nuclear staining of Epstein-Barr virus-encoded RNA-1-in situ hybridization in ≥20% of the examined cells, we identified 15 cases (16.9%) of the entire study cohort as Epstein-Barr virus-positive diffuse large B-cell lymphoma. The clinical and laboratory features were not different between Epstein-Barr virus-positive and -negative diffuse large B-cell lymphoma patients. Univariate analysis showed patients with diffuse large B-cell lymphoma that were either Epstein-Barr virus-positive or had activated B-cell-like features had an inferior overall survival. Older age, advanced stage and lymphoma with activated B-cell-like features or Epstein-Barr virus-encoded RNA positivity were independent prognostic factors affecting overall survival on multivariate analysis. Patients with two or three of these adverse-risk factors were considered high risk and fared far worse than patients with no or only one adverse factor.
Taken together, we demonstrated that a higher frequency of Epstein-Barr virus association was detected in a Taiwanese cohort of diffuse large B-cell lymphoma patients, and Epstein-Barr virus-encoded RNA positivity was shown to add important prognostic value in these patients.
Gastrointestinal metastases in lung cancer are extremely rare. The report presents a rare case of primary lung sarcomatoid carcinoma with both gastric and colonic metastases, and reviews the ...literature about endoscopic presentation of colonic metastases.
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