Methylation Signature for Prediction of Progression Free Survival in Surgically Treated Clear Cell Renal Cell Carcinoma

BACKGROUND: Little is known about epigenetic silencing of genes by promoter hypermethylation in renal cell carcinoma (RCC). The aim of this study was to identify prognostic methylation markers in surgically treated clear cell RCC (ccRCC). METHODS: Methylation patterns were assayed using the Infinium HumanMethylation450 BeadChip array on pairs of ccRCC and normal tissue from 12 patients. Using quantitative PSQ analysis, tumor-specific hypermethylated genes were validated in 25 independent cohorts and their clinical relevance was also verified in 152 independent cohorts. RESULTS: Using genome-wide methylation array, Zinc finger protein 278 (ZNF278), Family with sequence similarity 155 member A (FAM155A) and Dipeptidyl peptidase 6 (DPP6) were selected for tumor-specific hypermethylated genes in primary ccRCC. The promoter methylation of these genes occurred more frequently in ccRCC than normal kidney in independent validation cohort. The hypermethylation of three genes were associated with advanced tumor stage and high grade tumor in ccRCC. During median follow-up of 39.2 (interquartile range, 15.4–79.1) months, 22 (14.5%) patients experienced distant metastasis. Multivariate analysis identified the methylation status of these three genes, either alone, or in a combined risk score as an independent predictor of distant metastasis. CONCLUSION: The promoter methylation of ZNF278, FAM155A and DPP6 genes are associated with aggressive tumor phenotype and early development of distant metastasis in patients with surgically treated ccRCC. These potential methylation markers, either alone, or in combination, could provide novel targets for development of individualized therapeutic and prevention regimens.

Intra-Oral Factors Influencing Halitosis in Young Women

OBJECTIVES: The aim of this research was to determine intra-oral factors that affect halitosis in young women. METHODS: This study was performed between March 2014 to May 2014, and included 35 women in their 20s with good oral health. Correlation and logistic regression analyses were performed to investigate the change in halitosis immediately, and 1 hour after scaling. RESULTS: In both oral gas (OG) and extraoral gas (EG) groups, halitosis was reduced after scaling compared to before scaling. The logistic regression analysis of oral state factors in OG showed that as oral fluid [odds ratio (OR) = 0.792, p = 0.045] and dental plaque (OR = 0.940, p = 0.016) decreased by 1 unit, the OR in the OG group decreased (> 50). In addition, as glucose levels in the oral cavity (OR = 1.245, p = 0.075) and tongue coating index (OR = 2.912, p = 0.064) increased by 1 unit, the OR in the OG group increased (> 50). Furthermore, in the EG group, as oral fluid (OR = 0.66, p = 0.01) and dental plaque (OR = 0.95, p = 0.04) decreased, the OR in the EG group decreased (> 50) significantly. CONCLUSION: To control halitosis, it is necessary to increase oral fluid and decrease the amount of tongue plaque. Furthermore, maintaining a healthy oral environment, aided by regular scaling and removal of dental plaque, may significantly control halitosis.

Biomarker for the Prediction of Major Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Myocardial Infarction

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.