Alternative splicing directs two IL-20R2 isoforms and is responsible for the incomplete gene knockout via the exon I ablation.

Two heterodimeric receptors consisting of interleukin (IL)-20R2 are shared by three of the IL-20 family of cytokines, IL-19, IL-20 and IL-24. Along with IL-22, these cytokines are downstream effectors of IL-23 and have been implicated in keratinocyte functions and the pathogenesis of psoriasis. Surprisingly, whereas knocking out either the IL-23 or IL-22 gene abolished imiquimod-induced psoriatic phenotypes in mice, similar attempt for IL-20R2 had little effect. Here, we report that the apparent disparity may result from a new IL-20R2 isoform encoded by an alternatively spliced transcript which survived the previous attempt for IL-20R2 gene knockout via the exon I deletion.

Predictive role of RRM1 and BRCA1 mRNA expression on the clinical outcome of advanced non-small cell lung cancer.

This study aimed to evaluate the association between RRM1 and BRCA1 expressions and the therapeutic efficacy of platinum-based chemotherapy in non-small cell lung cancer patients in terms of their response and prognosis. In total, 377 patients agreed to participate in our study, and all of them received platinum-based combination chemotherapy between January 2008 and January 2009. The relative cDNA quantitation for RRM1 and BRCA1 was conducted using a fluorescence-based, real-time detection method, using ß-actin as a reference gene. The average age of the 377 patients was 64.6 years (range: 25.5-86.4 years), including 269 men and 108 women. Patients with high RRM1 expression benefited more from a platinum-containing regimen, and patients with high BRCA1 expression showed a high response rate to a platinum-containing regimen and reduced disease progression. Patients with high RRM1 expression were associated with a longer progression-free survival (PFS) and overall survival (OS) than those with low expression, and the hazard ratios (HRs) (95% confidence interval (CI)) were 0.67 (0.32-0.91) and 0.54 (0.30-0.95), respectively. Patients with high BRCA1 expression showed longer PFS and OS compared to those with low expression, and the HRs (95%CI) were 0.54 (0.30-0.95) and 0.62 (0.32-0.93), respectively. These results could be used in personalized chemotherapy decisions and to increase the response rate and prolonged survival, and could encourage exploration of the predictive value of other genes.

Intratympanic injection with dexamethasone for sudden sensorineural hearing loss.

OBJECTIVE: To investigate the efficacy of intratympanic steroid therapy in adults with sudden sensorineural hearing loss, and to analyse the factors associated with treatment outcome. DESIGN: Retrospective study of patients undergoing intratympanic steroid injection for sudden sensorineural hearing loss between 1 January 2006 and 30 June 2007 at a teaching hospital in Taipei, Taiwan. RESULTS: Patients who received intratympanic steroid therapy within seven days of disease onset achieved a significantly better response rate (76.1 per cent), compared with the delayed treatment group (50 per cent). The total response rate, after four steroid injections, was 68.9 per cent. Patients with low and mid-frequency hearing loss were more responsive to steroid treatment. Vertigo was a negative prognostic factor for recovery. There were no long-term sequelae of intratympanic steroid treatment. CONCLUSION: Intratympanic steroid injection may be a simple and effective treatment for patients with sudden sensorineural hearing loss.

Gene transfer of calcitonin gene-related peptide suppresses development of allograft vasculopathy.

OBJECTIVE: To explore suppression of allograft vasculopathy by transfer of the calcitonin gene-related peptide (CGRP). METHODS: The descending thoracic aortas from Lewis rats were grafted to the abdominal aortas of F344 rats, and the rats were randomized into 2 groups. A gene construct containing sequences from the adenoviral oncoprotein, the CGRP, and the enhanced green fluorescent protein was transferred into 1 group, and the sequences for the adenoviral oncoprotein and enhanced green fluorescent protein were transferred into a control group. Specimens were harvested at 4 and 8 weeks. Gene transfer was confirmed at fluorescence microscopy of frozen tissue sections, and expression was measured using reverse transcriptase-polymerase chain reaction. We determined the locations and levels of vascular cell adhesion molecule-1 (VCAM-1) and inducible nitric oxide synthase (iNOS) at immunohistochemistry and measured apoptosis. RESULTS: The CGRP gene was expressed only in the CGRP group at 4 weeks. The vascular luminal occlusion score in the CGRP group was lower than in the control group. The apoptotic index of the CGRP group was lower than in the control group only at 4 weeks. The VCAM-1 immunohistochemistry score in the CGRP group was lower than in the control group; however, the iNOS immunohistochemistry score in the CGRP group was lower than in the control group in the intima only at 4 weeks. CONCLUSION: The expression of CGRP effectively suppressed the development of allograft vasculopathy and encroachment by lymphocytes and inflammatory cells. This reduced the levels of VCAM-1 to inhibit apoptosis induced by iNOS; thus, the tissue of the allografted vessel was protected and rejection was averted.

Bacteriocins from lactic acid bacteria increases tumor necrosis factor-alpha expression in a rat kidney model of chronic rejection.

Chronic allograft dysfunction is the primary cause of graft loss after the first posttransplantation year. Bacteriocins are biologically active proteins exhibiting antimicrobial properties against other bacterial species, which are usually closely related to the producer organism. The objective of our study was to determine whether lactic acid bacterial bacteriocins were associated with tumor necrosis factor (TNF)-alpha observed in a rat kidney model of chronic rejection. Using a kidney model of chronic rejection in the rat, we administered cyclosporine (CsA) immunosuppression (5 mg/kg/d). One group of animals was treated with bacteriocins, and the other was left untreated. Grafts were harvested after transplantation for standard histological studies. The expression of TNF-alpha was demonstrated using immunohistochemistry of frozen sections of the grafts. We observed a greater increase in the expression of TNF-alpha among the group treated with bacteriocins compared with the untreated group. These results showed that lactic acid bacterial bacteriocins were associated with TNF-alpha in our kidney graft model.

Influence of diabetes mellitus on deep neck infection.

OBJECTIVE: To investigate the influence of hyperglycaemia on deep neck infection (DNI) and the differences between the diabetic and non-diabetic form of DNI. STUDY DESIGN AND SETTING: Retrospective review of 131 patients with DNI treated between 1993 and 2002 at Shin Kong Memorial Hospital, Taipei, Taiwan. RESULTS: Deep neck infection was significantly more prevalent in patients with diabetes mellitus (DM) over 60 years of age than in non-DM subjects of a similar age (p = 0.004). In the DM group, Klebsiella pneumoniae was the most common aerobic pathogen and tended to involve more than two anatomical spaces (p < 0.0001). Seventeen out of 18 patients (94.4 per cent) displayed an elevated (> or = 7 per cent) glycosylated haemoglobin level. The DM group had a significantly higher complication rate, longer hospital stay and tracheotomy rate than the non-DM group. CONCLUSIONS: Diabetic DNI differs from non-diabetic DNI in several aspects and is associated with a higher morbidity. A greater than normal haemoglobin A1c level was commonly observed.

Imprint cytology of nasopharyngeal biopsies.

OBJECTIVE: To use an instant cytologic diagnostic method to examine touch imprints of nasopharyngeal (NP) biopsies. This method aimed to ensure the adequacy of biopsied specimens for histologic examination. This paper describes the morphologic findings of NP lesions examined by this method. STUDY DESIGN: Imprints were made from NP biopsies from patients suspicious for nasopharyngeal carcinoma (NPC). These imprints were air dried, stained with Diff-Quik and examined immediately. The adequacy of the specimens was assessed, and the findings of the imprints were interpreted as positive-, negative- or suspicious for NPC. Repeat biopsies and cytologic studies were done as indicated. In selected cases, immunocytochemical staining was done to identify cells on the imprints. Histologic examination of the biopsied specimens served as the control. RESULTS: With this method we could interpret the imprints within five minutes of their receipt and determine if repeat biopsy was needed. In benign lesions, the imprints often contained many cells, most mature and reactive lymphocytes. These cells and the numerous lymphoglandular bodies (fragments of lymphoid cytoplasm) intermingled with the ciliated and squamous epithelial cells. In cases of NPC, the appearance was discrete, or clusters of, carcinoma cells or naked nuclei. They were less cellular than those of benign lesions. The lymphocytes were markedly depleted. Cells of dubious lineage were identified by the additional use of immunocytochemical studies. CONCLUSION: Cytologic examination of imprints of NP biopsies helps to determine the adequacy of the specimen for histologic examination. It is a rapid, practical method with high diagnostic accuracy.

Complications in acoustic neuroma surgery.

There has been a continuous lowering of mortality and morbidity rates in the 20th century, thanks to increasing experience and newer technology. Despite this, the readership should be aware of the hazards involved in this challenging field. Complications occur, and their incidence, mechanism, management, and prevention have been outlined here so physicians performing these procedures will be better prepared to manage them. We have found that the occurrence of complications can be greatly reduced through a team approach using the combined talents of a neurotologist, neurosurgeon, and frequently an internist. It is apparent from this article that the morbidity of removing larger tumors is significantly greater than the morbidity of removing small tumors. The recent introduction of MRI to the diagnostic armamentarium of the neurotologist may permit earlier detection and a further reduction of morbidity and mortality rates. Only continued study of prevention of complications will assure the improved quality of our results for patients undergoing microsurgical removal of acoustic neuromas.

The effect of high cholesterol, high fat diet on rabbit plasma beta-VLDL and its interaction with macrophage.

Rabbits were fed on 1% cholesterol and 10% rape seed oil (group A) or lard (group B). Plasma cholesterol and triglyceride level of group A was strikingly lower than that of group B. No difference was found in the lipid composition of beta-VLDLs between both groups. However, apo E content of beta-VLDL from group A was higher and apo B (higher molecular weight) was lower than that of group B respectively. beta-VLDL of group A caused greater accumulation of cholesterol in mouse peritoneal macrophage than that of group B. Therefore, we assume that the good effect of poly-unsaturated fatty acid on atherosclerosis results not from decreasing accumulation of cholesterol in macrophages but from enhancing elimination of beta-VLDL by the liver.