Saikosaponin D Inhibits Lung Metastasis of Colorectal Cancer Cells by Inducing Autophagy and Apoptosis.

Saikosaponin D (SSD), derived from Bupleurum falcatum L., has various pharmacological properties, including immunoregulatory, anti-inflammatory, and anti-allergic effects. Several studies have investigated the anti-tumor effects of SSD on cancer in multiple organs. However, its role in colorectal cancer (CRC) remains unclear. Therefore, this study aimed to elucidate the suppressive effects of SSD on CRC cell survival and metastasis. SSD reduced the survival and colony formation ability of CRC cells. SSD-induced autophagy and apoptosis in CRC cells were measured using flow cytometry. SSD treatment increased LC3B and p62 autophagic factor levels in CRC cells. Moreover, SSD-induced apoptosis occurred through the cleavage of caspase-9, caspase-3, and PARP, along with the downregulation of the Bcl-2 family. In the in vivo experiment, a reduction in the number of metastatic tumor nodules in the lungs was observed after the oral administration of SSD. Based on these results, SSD inhibits the metastasis of CRC cells to the lungs by inducing autophagy and apoptosis. In conclusion, SSD suppressed the proliferation and metastasis of CRC cells, suggesting its potential as a novel substance for the metastatic CRC treatment.

Biochemical markers of bone turnover in benign paroxysmal positional vertigo.

OBJECTIVE: Several studies have suggested a possible relationship between recurrent benign paroxysmal positional vertigo (BPPV) and altered calcium homeostasis in the endolymph of the inner ear. The present study aimed to evaluate the association between Ca2+ and vitamin D status and BPPV occurrence as well as the status of bone biochemical markers in osteoporotic patients who were diagnosed with idiopathic BPPV. METHODS: The study included total 132 patients who were referred to our clinic between August 2008 and October 2013. Based on the bone mineral density (BMD) results, the subjects were divided into three groups: normal BMD (n = 34), osteopenia (n = 40) and osteoporosis (n = 58). The biochemical markers of bone turnover including serum Carboxy-terminal telopeptide of type I collagen (s-CTX), osteocalcin, alkaline phosphatase (ALP) and urinary free deoxypyridinoline (u-DPD), were analyzed, along with the serum Ca2+ and vitamin D levels. RESULTS: The mean serum calcium, phosphate and creatinine clearance levels were within the standard laboratory reference range. The incidence of vitamin D deficiency was 11.8% (4/34) in the normal BMD group, 15% (6/40) in the osteopenia group and 43.1% (25/58) in the osteoporosis group. There was a positive correlation between the 25(OH)D and BMD results in the patients with BPPV. Among the bone turnover markers, the osteocalcin and u-DPD levels were significantly elevated in the osteoporotic patients with BPPV. Multiple logistic regression analyses showed that osteoporosis and vitamin D deficiency were associated with BPPV. CONCLUSION: Our findings suggest that the prevalence of BPPV in osteoporotic patients is associated with vitamin D deficiency and high bone turnover rates at systemic level, which could disturb local Ca2+ homeostasis in the inner ear.

Hearing loss in postmenopausal women with low bone mineral density.

OBJECTIVE: Several studies suggested the possible relationship between decreased bone mineral density (BMD) of the temporal bone and hearing loss, primarily of the sensorineural type. The aim of the present study is to determine the relationship between BMD and hearing loss and to evaluate the systemic Ca(2+) and vitamin D status with relation to hearing sensitivity in the postmenopausal women who were diagnosed with primary osteoporosis. METHODS: The study involved a total of 324 patients who were referred between 2008 and 2013. Based on BMD scores, the subjects were divided into three groups: normal BMD (n=102), osteopenia (n=106) and osteoporosis (n=116). Hearing sensitivity was evaluated with audiometric tests along with serum Ca(2+) and vitamin D level. RESULTS: The age distribution among 3 groups was similar. Mean serum Ca(2+), phosphate, 25(OH)D and creatinine clearance were within the standard laboratory reference ranges in all patients. There was no difference in the proportion of vitamin D deficiency among groups. The typical type of hearing loss was sensorineural hearing loss (SNHL) and the patients with reduced BMD showed higher prevalence of SNHL than the patients with normal BMD. Pure-tone thresholds average was significantly higher in all frequencies in women with osteopenia/osteoporosis than women with normal BMD. Multiple logistic regression analyses showed that age and lumbar BMD were associated with the presence of hearing loss (>25dB). CONCLUSION: Our findings suggest that the presence of decreased BMD in postmenopausal women might be associated with the higher prevalence of age-related SNHL.

Unusual long-term complication of polyalkylimide hydrogel manifesting as nasal septal abscess.

Bio-Alcamid is a new synthetic polyacrylic hydrogel that contains alkylimide-amide groups and pyrogen-free water (96%) and has gained widespread use in cosmetic and reconstructive practice since being awarded a Conformite European certificate in 2001. According to the research on the efficacy and safety of the long-acting filler Bio-Alcamid in the early phases of development, Bio-Alcamid is nearly nontoxic and nonallergenic and has long in vivo persistence. It has been widely used because of its superior durability compared with short-acting fillers. Many published studies have examined only early-phase postoperative inflammatory responses. More recently, however, complications with delayed onsets ranging from several months to several years, such as inflammation and filler migration, have been emerging. Given the rapidly increasing application of long-term fillers, an increased incidence of complications is expected, and increasing awareness of its correct use and complication treatments is needed. To address this problem, we reviewed the safety of long-acting fillers on the basis of a rare case of surgical incision and drainage of a nasal septal abscess that developed in a patient 2 years after Bio-Alcamid was injected into the nasal region.

Psychological screening for the children with habitual snoring.

OBJECTIVES: Adenotonsillar hypertrophy is the major determinants of habitual snoring in pediatric population. Behavioral hyperactivity and schooling problems have been repeatedly reported in these children, and it may underlie more extensive behavioral disturbances, particularly for the obese children. The aim of the present study is to evaluate the incidence and characteristics of emotional and behavioral problems using outpatient-based psychological screening tools in the children with habitual snoring. METHODS: Total 235 patients and 170 controls, who aged 4-9 years were enrolled. Body mass index (BMI) z-score was obtained for age and gender and parental sleep-related breathing disorder (SRBD) questionnaire was used to assess severity of sleep-disordered breathing (SBD). Psychological assessment was performed using standardized questionnaires including Strength and Difficulties Questionnaire (SDQ), Children's Depression Inventory (CDI) and Screen for Child Anxiety Related Emotional Disorders (SCARED). RESULTS: Children presenting habitual snoring had significantly higher mean scores on almost all scales of SDQ, and SCARED than community controls. Around 20% of the children with habitual snoring, compared with 10-11% of controls had significant levels of distress that could adversely impact treatment outcomes. There was no interaction between obstructive sleep apnea severity and behavioral ratings. The scores for emotional distress and hyperactivity were more prominent in the obese children. Significant psychological distress or impairment in social interactions was observed in children with higher SRBD scores. CONCLUSIONS: Our findings suggest that the presence of habitual snoring in young children is associated wide spectrum of behavioral problems and the level of psychological distress might be evaluated at the time of the diagnosis.

Utility of psychological screening for the diagnosis of pediatric episodic vertigo.

BACKGROUND/OBJECTIVES: Childhood episodic vertigo has been reported to be associated with migraine or childhood periodic syndromes such as benign paroxysmal vertigo of childhood. There is discrete evidence that unexpected recurrent vertigo is associated with a high level of depression and anxiety in adults. However, only a few studies describe the frequency and characteristics of psychiatric comorbidity in vertiginous children. The aim of this study is to evaluate the incidence and characteristics of emotional and behavioral problems using outpatient-based psychological screening tools in children with episodic vertigo attacks. METHODS: A total of 105 patients and 138 controls, aged 4 to 17 years, were enrolled. All were identified with a primary complaint of recurrent episodic vertigo. All patients received a complete battery of audiological and vestibular tests. Psychological assessment was performed using standardized questionnaires, including Strength and Difficulties Questionnaire (SDQ), Children's Depression Inventory (CDI), and Screen for Child Anxiety Related Emotional Disorders (SCARED). RESULTS: Compared with community controls, children presenting vertigo attacks had significantly higher mean scores on almost all scales of SDQ, CDI, and SCARED, except two parameters, namely, prosocial behavior and separation anxiety. About half of the patients, compared to 10 to 11% of the controls, had significant levels of distress that could adversely impact treatment outcomes and might need psychiatric consultation. Significant distress or impairment in social interactions was more prominent in older ages. CONCLUSION: Our findings suggest that children/adolescents with recurrent episodic vertigo should be screened for possible associated psychological symptoms.