Preoperative ultra-hypofractionation radiotherapy in extremity/trunk wall soft tissue sarcoma - A meta-analysis of prospective studies.

PURPOSE: The neoadjuvant radiotherapy is now standard treatment in soft tissue sarcoma. Using ultra-hypofractionation radiotherapy shorten the treatment time. In the era of COVID pandemic, using less fraction to treat patient is an urgent need. Thus, we aim to use meta-analysis to investigate the clinical efficacy of preoperative stereotactic body radiotherapy. MATERIAL AND METHODS: PRISMA guideline was used in this study. PubMed, Cochrane and Embase were used. We include only prospective study. The main endpoint was set as wound complication rate. Other endpoints include R0 resection rate, overall survival, local control, and distant metastasis free survival. RESULTS: Seven studies were included. The pooled wound complication rate is 0.30 (95% CI=0.26-0.35). The pooled R0 resection rate is 0.87(95%CI: 0.74-0.94). The pooled 2-year overall survival is 0.86 (95%CI: 0.72-0.94). The pooled 2-year local control rate is 0.96(95%CI: 0.89-0.99). The pooled 2-year distant metastasis free survival is 0.60 (95%CI=0.50-0.70). CONCLUSION: Neoadjuvant ultra-hypofractionation radiotherapy in soft tissue sarcoma is a feasible and well tolerable treatment.

Effects of hemorrhagic shock in early and late partial posthepatectomy rats.

INTRODUCTION: The purpose of the study was to determine the compensatory function of the remnant liver as a blood reservoir after 70% hepatectomy in rats to counteract hemorrhagic shock and reperfusion. METHODS AND MATERIALS: One hour of hemorrhagic shock followed by 1 hour of resuscitation induced in normal rats (group I) was compared with animals that had undergone 70% hepatectomy at postoperative day 3 (group II) and day 7 (group III). We compared the total blood loss, the blood pressure before hemorrhagic shock, hemoglobin, hemotocrit, and mortality. Liver function such as aspartate transferase (AST), alanine transferase, and lactate dehydrogenase (LDH) were also compared among groups by one-way analysis of variance with post hoc correction. A P value less than .05 was regarded as significant. RESULTS: The results showed a lower volume of drawn blood induced hemorrhagic shock in group II compared with group I or group III hosts. The blood loss was 15.6+/-1.0, 5.68+/-2.5, and 13.2+/-1.6 mL for groups I, II, and III, respectively. The mortality due to hemorrhagic shock was significantly higher in group II compared with group I or group III. Liver function tests showed that the AST and LDH were significantly higher after resuscitation in group II. CONCLUSION: In the early postoperative period (day 3) after 70% hepatectomy, rats were more vulnerable to a high mortality after hemorrhagic shock compared with hosts in the late postoperative period (day 7). Significantly higher AST and LDH in group II indicated that the remnant liver was more injured after hemorrhagic shock in the early postoperative period.

The reaction of posttransplant denervated liver on the hemorrhagic shock in rats.

OBJECTIVE: The aims of the study were to determine the effects of denervation on the function of the liver transplantation as a blood reservoir and to define its vulnerability to ischemic-reperfusion (I/R) injury after hemorrhagic shock. MATERIALS AND METHODS: Hemorrhagic shock with a mean arterial blood pressure (MAP) of 40 to 50 mm Hg was induced by withdrawing blood at a rate of approximately 1 mL/min among 10 posttransplant denervated rats and 10 sham rats for 1 hour. The rats were then resuscitated by retransfusing the drawn blood with sacrifice under deep anesthesia at 1 hour after resuscitation. The total amount of blood required to achieve hemorrhagic shock was compared between groups as well as the vulnerability and reactions of the posttransplant denervated liver to I/R injury after hemorrhagic shock as assessed by gene expressions of c-jun, c-fos, tumor necrosis factor (TNF)-alpha, interleukin (IL)6, IL-10, and heat-shock protein 70 (HSP70). RESULTS: The volume of blood that had to be drawn to reach a MAP of 40 to 50 mm Hg was not significantly different between the groups. One hour of hemorrhagic shock followed by resuscitation resulted in significant increases in the genes expression of c-fos, TNF-alpha, IL-6, IL-10, and HSP70 in comparison to the control values, but no difference was observed between experimental and sham groups. CONCLUSION: We suggest that the function of the liver as a blood reservoir and the gene expressions of c-fos and pro- and anti-inflammatory cytokines, as well as the protective protein HSP70 in response to I/R injury, were not altered by liver transplantation.

Endothelin-1 increases glucose transporter glut1 mRNA accumulation in 3T3-L1 adipocytes by a mitogen-activated protein kinase-dependent pathway.

The mechanism of enhancing glucose transport by prolonged endothelin-1 (ET-1) treatment of 3T3-L1 adipocytes was examined. Western and Northern blot analyses indicated that ET-1 increased the amount of both GLUT1 protein and mRNA. The degradation rate of GLUT1 mRNA as measured in the presence of actinomycin D, nevertheless, was not significantly altered by ET-1. Whereas various inhibitors for distinct signalling pathways were tested, only the mitogen-activated protein kinase (MAPK) kinase inhibitor, PD98059, was found to decrease significantly the enhancing effect of ET-1. Similar extent of inhibition was observed in cells pretreated with pertussis toxin (PT). Immunoblot analysis revealed that ET-1 may stimulate a transient phosphorylation of p42/p44 MAPK and both PT and PD98059 inhibited this stimulation. In addition, the effect of ET-1 on GLUT1 mRNA accumulation was inhibited by PD98059 and cycloheximide, implying that a trans-activation was involved. Taken together, these results suggest that ET-1 may induce GLUT1 gene expression by a MAPK-dependent mechanism.

Persistent infection of a lymphoma cell line by herpes simplex virus.

The peripheral blood cells from a patient with a B-cell lymphoma were established in long-term tissue culture. Two years after establishment of the cells in culture they were infected with herpes simplex virus type 2 and the productivity and duration of viral persistence investigated. One week after infection the lymphoblastoid cells were productively infected and have remained so for a period of over 3 years. Expression of a viral glycoprotein antigen was evaluated by using a fluorescein-labeled monoclonal anti-herpes simplex virus type 2 antibody and revealed a spectrum of staining reactions grading from a lightly stippled to very intense pattern. Polymerase chain reaction analysis of the infected cells revealed the presence of the herpes simplex virus type 2 DNA polymerase gene in the infected cells that was absent from the uninfected lymphoblastoid cells. These results taken together with the long-term growth characteristics of both the infected and uninfected lymphoblastoid cells suggest that this cell line may be a good model system for studying viral infection, viral replication, viral latency, and clinical application for the isolation of human herpes virus.

Estimating the ozone formation potential of volatile aromatic compounds in vehicle tunnels.

Two vehicle tunnels located in the Taipei area were selected to study the ozone formation potential of volatile aromatic compounds (VACs). Air samples in the two tunnels were collected using canisters. Analysis of VACs was conducted with a gas chromatograph equipped with a mass spectrometer. The total VOCs concentrations in Zefun tunnel ranged from 483.5 to 1032.2 (micrograms/m3) which increased with the increase in traffic volume. In the Lishin tunnel, the total VACs concentration ranged from 356.6 to 1961.3 (micrograms/m3) which was not well correlated with the traffic volume. The most predominant VACs in these vehicle tunnels were toluene and xylenes. Although the traffic volume and types of vehicles were not exactly the same, the characteristic ratios of the VACs concentrations were found to be similar. These results indicated that the existence of a specific characteristic ratio of VAC concentration was affected by the mobile sources. The maximum ozone formation potential resulted from the vehicles in the Lishin motorcycle tunnel which had higher values than the Zefun tunnel and much higher than the SPECIATE databases in the US via weighting the maximum incremental reactivity (MIR) scale.

Phalloplasty in female-to-male transsexuals using free radial osteocutaneous flap: a series of 22 cases.

From July 1994 to December 1996, 22 cases of primary female transsexualism received phalloplasty using free radial forearm osteocutaneous flaps in The Veterans General Hospital, Taipei, Taiwan. Follow-up period ranged from 6 months to 35 months. No complete flap loss and one partial loss (10% reduction) were noted after operation. The urethrocutaneous fistula rate was 40.9%, needing fistula repair surgery. Urethral stricture was noted in three cases (13.7%). Significant donor forearm morbidity was noted in two cases (9.1%) including one who suffered from radius bone fracture. All preserved 'clitorises' had intact erotic sensation and all neophalli gained protective sensation within 9 months. No 'penile fracture' was noted. In nine cases that have regular sexual activities, the sexual performance was rated as satisfactory. We share our experience and recommend that the free radial forearm osteocutaneous tubing flap is a promising choice for phalloplasty in female-to-male transsexuals.

Synergistic effect of arachidonic acid and cyclic AMP on glucose transport in 3T3-L1 adipocytes.

The combined effect of arachidonic acid and cAMP on glucose transport was examined in 3T3-L1 adipocytes. In cells pre-treated with arachidonic acid and increasing concentrations of 8-bromo cAMP for 8 h, although either agent alone enhanced glucose uptake, the simultaneous presence of both agents dramatically increased 2-deoxyglucose uptake in a synergistic fashion. Insulin-stimulated glucose transport, on the other hand, was only slightly affected. The synergistic effect of these two agents was abolished in the presence of cycloheximide. Immunoblot analysis revealed that the contents of ubiquitous glucose transporter (GLUT1) in total cellular and plasma membranes were similarly augmented in cells pre-treated with both arachidonic acid and 8-bromo cAMP, to a greater extent than the additive effect of each agent alone. The content of GLUT4, on the other hand, was not altered under the same experimental conditions. In cells pre-treated with 4beta-phorbol 12beta-myristate 13alpha-acetate (PMA) for 24 h to down-regulate protein kinase C (PKC), the subsequent synergistic effect of arachidonic acid and 8-bromo cAMP was greatly inhibited. In addition, pre-treatment with both PMA and 8-bromo cAMP enhanced glucose transport in a similarly synergistic fashion. Thus the present study seems to indicate that arachidonic acid may act with cAMP in a synergistic way to increase glucose transport by a PKC-dependent mechanism. The increased activity may be accounted for by increased GLUT1 synthesis.

Epicanthoplasty with modified Y-V advancement procedure.

The presence of epicanthal folds and lack of supratarsal folds are unique features in most Asian eyelids. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is still an obstacle for surgeons to overcome. From January of 1989 to November of 1997, we used modified Y-V advancement procedures in 148 cases to correct epicanthal folds in Asian eyelids. Five of those cases involved congenital palpebral anomalies, including congenital entropion, congenital ptosis, and Down syndrome. There were few complications in our series. We believe that the modified Y-V advancement procedure causes minimum scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. This procedure can also be simultaneously combined with blepharoplasties and corrective procedures of eyelids.

Glans sculpting in phalloplasty--experiences in female-to-male transsexuals.

An aesthetically appealing neophallus with an urethral meatus at its tip is one of the goals of phalloplasty in female-to-male transsexuals. From July 1993 to December 1996, 20 cases of female-to-male transsexuals who had received sculpting of glans in four different ways were enrolled. Their photographs were collected and were scored by independent surgical and non-surgical assessors. The Norfolk procedure creates a more normal neoglans assessed by patients themselves and by the assessors. Split-thickness skin graft (SSG) produces a more normal-looking coronal sulcus than full-thickness skin graft (FTSG) in the Norfolk procedure.

Trisomy 8 in alveolar soft part sarcoma.

Cytogenetic studies were performed on an alveolar soft part sarcoma of a 6-year-old boy. An extra chromosome 8 was present in 26 of 28 metaphases analyzed.

Aggressive giant cell fibroblastoma with a balanced 17;22 translocation.

Cytogenetic analysis of an aggressive giant cell fibroblastoma in a 15-month-old male revealed the following balanced translocation: t(17;22)(q21.33;q13.1). This is the first cytogenetic report on this early childhood tumor.

Ultrastructure, ZIO-staining and chromaffinity of gerbil pinealocytes.

The ultrastructure and cytochemistry of the gerbil pineal gland were studied by the conventional electron microscopy, zinc iodide-osmium tetroxide (ZIO) staining and chromaffin reaction. Conventional electron microscopy revealed that the ultrastructure of gerbil pinealocytes are similar to other rodents, i.e., irregular cell contour with numerous cytoplasmic processes, round or oval nucleus and prominent nucleoli, elongated mitochondria with flattened and tubular cristae and dense matrix, well-developed Golgi apparatus and its associated structures, abundant elements of endoplasmic reticulum--both smooth and rough varieties, and bundles of microfilament and microtubule in the cytoplasm. Some pinealocyte processes contain numerous small clear and "slightly coated" vesicles. Numerous profiles of varicosities containing small dense-cored and clear vesicles were frequently encountered. After ZIO treatment, ZIO staining was preferentially localized in the cytoplasm of some, but not all, of the gerbil pinealocytes. Numerous small clear vesicles (30-50 nm in diameter) in the process of the pinealocytes or in the varicosities of the nerve fibers showed strong ZIO-philia. After chromaffin reaction treatment, the number and electron density of small clear and dense-cored vesicles in the profiles of nerve varicosities increased and this indicates that some of the small clear and dense-cored vesicles in the varicosities are reactive. It is thus concluded that (1) the vesicles in the pinealocytes may be rich in cystine and/or cysteine and possibly the organelle is involved in the sequestering calcium ion during the calcification of the pineal concretions, and (2) the small dense-cored and clear vesicles in the nerve fibers in the gerbil pineal parenchyma may contain both serotonin and primary biogenic amines.

Banding resolution of amniotic cell chromosome preparations for prenatal diagnosis.

Fifty consecutive routine female karyotypes of amniotic fluid cells were analyzed to determine: (1) the banding resolution of each metaphase in routine preparations, (2) whether all haploids in the same metaphase had the same level of banding resolution, and (3) which chromosomes showed the least/most variation in regard to banding resolution. For each karyotype, the number of dark bands for each right-hand-side chromosome were counted and compared with an ideogram (ISCN 1985). Banding resolution was separated into three groups: 400-band, 550-band, and 850-band. It was found that all 50 metaphases showed at least a 400-band resolution, and 1 metaphase showed a banding resolution between a 550-band and 850-band level. Although the chromosome preparations were sufficient for routine purposes, additional effort and banding techniques are required to detect small chromosomal abnormalities that require a higher level of resolution.

Trisomy 4 in a case of acute undifferentiated myeloblastic leukemia with hand-mirror cells.

A case of acute undifferentiated myelocytic leukemic with trisomy 4 is described. The patient is a 61-year-old woman who developed leukemia 4 1/2 years after receiving radiation therapy for uterine carcinoma. Many leukemic cells exhibited hand-mirror configuration after the bone marrow aspirate was left at room temperature overnight. The relationship between trisomy 4 and hand-mirror cells in acute myelocytic leukemia is unknown.

Neo-kyotorphin, an analgesic peptide isolated from human lung carcinoma.

A pentapeptide with analgesic activity has been isolated from human lung squamous cell carcinoma and from three other types of propagated tumors of human lung small-cell carcinoma (SCC), adenoma (AD) and large-cell carcinoma (LCC) in nude mice. The amino acid sequence of the peptide has been revealed to be H-Thr-Ser-Lys-Tyr-Arg-OH, which is exactly the same as that of neo-kyotorphin, an analgesic peptide originally isolated from bovine brain [(1982) Life Sci. 31, 1733]. No neo-kyotorphin could be isolated from normal lung tissue using the same procedures as those used for carcinomas. The results suggest that the presence of neo-kyotorphin in the lung carcinoma may represent the ectopic expression of peptide hormone. Our findings constitute the first example of a human lung carcinoma producing analgesic peptide.