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2.
Medicina (Kaunas) ; 59(11)2023 Nov 10.
Article in English | MEDLINE | ID: mdl-38004033

ABSTRACT

Background and Objectives: The prevalence of chronic kidney disease (CKD) is approximately 10% of the population in many countries. CKD progresses to end-stage renal disease (ESRD), resulting in adverse outcomes, prolonged hospitalization, and increased healthcare costs. Therefore, reducing CKD progression to ESRD is recognized as an important health issue. Materials and Methods: Data from the study participants with stage 3 to stage 5 CKD (n = 7668) were collected from the National Health Insurance (NHI) program in Taiwan (1 November 2014 to 31 December 2020). CKD patients who had ingested or not ingested N-acetylcysteine (NAC) for three years were divided into the study group (NAC users; n = 165) and the control group (NAC non-users; n = 165) to explore whether NAC use could alleviate CKD progression and reduce the risks associated with hemodialysis in CKD patients. Results: The levels of serum creatinine (SCr) and estimated globular filtration rate (eGFR) were nearly unchanged and/or slightly changed in NAC users, but the SCr levels were slightly increased, and the eGFR levels were significantly decreased in NAC non-users at the six-month interval during the three years. A statistical difference was observed between the two groups for both levels from 12 months to 36 months. The incidence rate of hemodialysis was significantly lower in NAC users than in non-NAC users (4.8% vs. 12.7%, Wald test = 5.947, p = 0.015, OR = 34.9). These results indicated that NAC use may improve renal function of CKD patients by modulating SCr and eGFR and, in turn, reducing the risk of hemodialysis. Conclusions: We investigated whether NAC could be used to reduce CKD progression to ESRD. For the three-year retrospective study, the incidence rate of hemodialysis was significantly lower in NAC users than in non-NAC users via modulating SCr and eGRF levels. NAC use might be a useful clinical approach for reducing CKD progression to ESRD.


Subject(s)
Kidney Failure, Chronic , Renal Insufficiency, Chronic , Humans , Cohort Studies , Acetylcysteine/therapeutic use , Retrospective Studies , Glomerular Filtration Rate , Disease Progression , Risk Factors , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/drug therapy , Renal Insufficiency, Chronic/epidemiology , Kidney Failure, Chronic/epidemiology
5.
Int Urol Nephrol ; 52(8): 1523-1531, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32488758

ABSTRACT

BACKGROUND: It is unclear how the CHA2DS2-VASc score can predict subsequent chronic kidney disease (CKD) and end-stage renal disease (ESRD) among atrial fibrillation (AF) patients. METHODS: We identified incident AF patients without CKD between 2000 and 2013 from the National Health Insurance Research Database (NHIRD) of Taiwan and calculated the CHA2DS2-VASc score for each patient. Adjusted hazard ratio (HR) with 95% confidence interval (CI) was estimated from multivariate cause-specific Cox models to assess the risk of CKD and ESRD associated with the CHA2DS2-VASc score. RESULTS: A total of 8764 participants with AF who did not have CKD were included in the analysis. The mean age was 69.63 ± 13.48 years and 4800 (54.8%) were males. The adjusted HR of CKD displayed a stepwise increase with the increase in the CHA2DS2-VASc score. When compared with those with a CHA2DS2-VASc score of 0, the adjusted HRs of CKD were 1.57 (95% CI 1.09-2.26), 2.04 (95% CI 1.42-2.94), 2.48 (95% CI 1.70-3.62), 2.88 (95% CI 1.95-4.26), 3.29 (95% CI 2.18-4.95) and 4.00 (95% CI 2.61-6.13) for the AF patients with a CHA2DS2-VASc score of 1, 2, 3, 4, 5 and ≥ 6, respectively. Similarly, as the CHA2DS2-VASc score increased, the adjusted HR of ESRD showed a gradual increase. CONCLUSIONS: Patients with a higher CHA2DS2-VASc score were linked to a higher risk of CKD and ESRD in a dose-dependent effect, i.e. the incidence of CKD/ESRD increased with the increasing CHA2DS2-VASc score.


Subject(s)
Atrial Fibrillation/complications , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/etiology , Aged , Aged, 80 and over , Female , Humans , Incidence , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/etiology , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors
6.
J Gerontol A Biol Sci Med Sci ; 73(6): 828-834, 2018 05 09.
Article in English | MEDLINE | ID: mdl-28977377

ABSTRACT

Background: To evaluate the predictive validity of sarcopenia defined by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project among Asian older adults. Methods: Data of the I-Lan Longitudinal Aging Study were obtained for analysis. Overall, 1,839 community-dwelling people aged 50 years and older, capable of completing a 6-m walk, with life expectancy of more than 6 months, and not institutionalized at time of data collection were enrolled for study. Data for subjects aged 65 years and older were obtained for study. The outcome measures were all-cause mortality and a composite adverse outcome which includes hospitalizations, emergency department visits, institutionalization, and falls. Results: Data of 728 eligible elderly participants (73.4 ± 5.4 years; 52.9% males) were analyzed. The prevalence of FNIH-diagnosed sarcopenia was 9.5%: 11.9% males; 6.7% females. Participants having FNIH-defined sarcopenia were considerably older, frailer, more obese, with poorer physical performance than nonsarcopenic subjects (All p < .001); during mean follow-up of 32.9 ± 8.8 months, they also had 3.8 times higher risk of dying, independent of age, sex, multimorbidity, cognitive function, and nutritional status (hazard ratio = 3.8; 95% confidence interval = 1.26-11.45; p = .018). Moreover, sarcopenia defined by grip strength-BMI ratio (WeakBMI) showed stronger association with composite adverse outcomes than traditional handgrip strength (hazard ratio = 1.99; 95% confidence interval = 1.01-3.93; p = .047 vs hazard ratio = 1.80; 95% confidence interval = 0.89-3.62; p = .102 in fully-adjusted model). Conclusion: Among community-dwelling older people in Taiwan, participants with FNIH-defined sarcopenia had a significantly greater risk of all-cause mortality and composite falls, emergency department visits, institutionalization, and hospitalization.


Subject(s)
Geriatric Assessment , Independent Living , Sarcopenia/epidemiology , Aged , Female , Humans , Longitudinal Studies , Male , Predictive Value of Tests , Taiwan/epidemiology
7.
Geriatr Gerontol Int ; 17 Suppl 1: 44-49, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28436194

ABSTRACT

AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study. The Veteran Affairs Comprehensive Geriatric Assessment included demographic characteristics, Clinical Frailty Scale, Braden Scale, St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients Scale, Cumulative Illness Rating Scale for Geriatrics, Barthel Index, Instrumental Activities of Daily Living, Mini-Mental State Examination, Geriatric Depression Scale-5 and Mini-Nutritional Assessment - Short Form, as well as common geriatric syndromes. All patients were categorized into the home care group and institutional care group based on their living arrangement before GEMU admissions. Six-month mortality and decline in Barthel Index were defined as adverse clinical outcomes. RESULTS: Overall, data of 395 patients were used for analysis. The baseline comparisons showed that the institutional care group was more likely to be unmarried, have lower education, lower risk of falls and less polypharmacy, but more likely to experience functional decline at follow up than the home care group. Multivariate logistic regression showed that male (OR 3.59, 95% CI 1.04-12.38, P = 0.043) and higher Cumulative Illness Rating Scale for Geriatrics score (OR 4.08, 95% CI 1.49-11.19, P = 0.006) were associated with mortality, whereas the institutional care group (OR 0.30, 95% 0.09-0.99, P = 0.048) and lower Braden Scale (OR 0.80, 95% CI 0.67-0.94, P = 0.008) were protective against mortality. However, the institutional care group was independently associated with functional decline during the follow-up period (OR 2.19, 95% CI 1.12-4.29, P = 0.022). CONCLUSIONS: Institutional care was associated with lower 6-month mortality risk for patients with dementia or cognitive impairment after discharge from the GEMU, but this group was more likely to experience functional decline. Further prospective study is required to clarify the clinical impact of living arrangements on long-term outcomes when people with dementia or cognitive impairment are admitted to acute hospitals. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 44-49.


Subject(s)
Cognitive Dysfunction/therapy , Dementia/therapy , Environment , Homes for the Aged/statistics & numerical data , Hospitalization/statistics & numerical data , Activities of Daily Living , Aged , Aged, 80 and over , Cognitive Dysfunction/diagnosis , Cohort Studies , Databases, Factual , Dementia/diagnosis , Female , Frail Elderly , Geriatric Assessment/methods , Humans , Logistic Models , Male , Multivariate Analysis , Quality of Life , Retrospective Studies , Risk Assessment , Severity of Illness Index , Taiwan , Treatment Outcome
8.
Geriatr Gerontol Int ; 17 Suppl 1: 57-64, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28436193

ABSTRACT

AIM: The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan. METHODS: This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study. The medication lists for all participants were reviewed by the same physician, and the anticholinergic properties of the individual medications were evaluated by using the Anticholinergic Cognitive Burden scale. Cognitive decline was defined as the decrease of Mini-Mental State Examinations scores during the study period. RESULTS: Overall, 139 persons (50.7%) had exposure to anticholinergic drugs at baseline (designated as AC[+]), and the most frequently used anticholinergic drugs were cardiovascular drugs (48.2%), antipsychotics (21.6%), theophylline (20.1%), antidepressants (12.2%), gastrointestinal drugs (11.5%) and antihistamines (8.6%). After adjusting for covariates, AC(+) participants had a significantly higher risk for short-term cognitive decline (OR 2.69, 95% CI 1.36-5.31). After excluding 30 participants using antipsychotics, non-antipsychotics AC(+)participants still had a significantly higher risk for short-term cognitive decline (OR 2.24, 95% CI 1.26-3.99). CONCLUSIONS: Exposure to anticholinergic drugs significantly increased the risk for short-term cognitive decline among older men, and the adverse effects remained similar when antipsychotics were excluded for analysis. A further intervention study is required to evaluate whether reducing anticholinergic burden might improve cognitive function among older adults. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 57-64.


Subject(s)
Cholinergic Antagonists/adverse effects , Cognitive Dysfunction/chemically induced , Cognitive Dysfunction/epidemiology , Memory, Short-Term/drug effects , Polypharmacy , Aged , Aged, 80 and over , Cholinergic Antagonists/therapeutic use , Cognition/drug effects , Cognitive Dysfunction/physiopathology , Cohort Studies , Disease Progression , Dose-Response Relationship, Drug , Drug Therapy, Combination , Follow-Up Studies , Geriatric Assessment , Humans , Incidence , Logistic Models , Male , Multivariate Analysis , Retrospective Studies , Risk Assessment , Taiwan , Veterans/statistics & numerical data
9.
Arch Gerontol Geriatr ; 70: 214-218, 2017.
Article in English | MEDLINE | ID: mdl-28214764

ABSTRACT

AIM: To evaluate the prevalence of recurrent falls and their risk factors among older men living in the Veterans Homes in Taiwan. METHODS: This cross-sectional study enrolled 871 residents and all participants received the comprehensive geriatric assessment, including Barthel Index, Mini-Mental Status Examination (MMSE), Geriatric Depression Scale-5 questions (GDS-5), Mini-Nutrition Assessment Short Form (MNA-SF), the status of urinary incontinence, stool incontinence, polypharmacy, past history of falls, multimorbidity, and medication history. RESULTS: Overall, 871 subjects (mean age: 85.5±5.2years, all males) participated in this study, whereas 222(25.5%) of them had experienced falls in the past year, and 91 were recurrent fallers. Comparisons between non-fallers, single fallers and recurrent fallers disclosed that they were significantly different in the following characteristics: diabetes mellitus, chronic kidney disease, coronary artery disease, Charlson Comorbidity Index (CCI), Barthel Index, GDS-5, MNA-SF, polypharmacy, use of hypnotics, urinary incontinence, and stool incontinence (P for trend all <0.05). Multiple regression analysis identified that GDS-5 was significantly associated with single falls and recurrent falls (OR 1.256, 95% CI 1.094-1.441, P=0.001 for single fallers; OR 1.480, 95% CI 1.269-1.727, P<0.001 for recurrent fallers). Besides, urinary incontinence was the independently associated with recurrent fallers only (OR 2.369, 95% CI 1.449-3.817, P<0.001), but not single fallers. CONCLUSION: Urinary incontinence and depressive symptoms were independent associated factors for falls among older men living in the retirement communities. However, urinary incontinence was associated with recurrent falls, but not single falls. Intervention study is needed to reduce recurrent falls through management of urinary incontinence.


Subject(s)
Accidental Falls/statistics & numerical data , Aged, 80 and over , Cross-Sectional Studies , Depression/epidemiology , Housing for the Elderly , Humans , Male , Multivariate Analysis , Recurrence , Risk Factors , Taiwan/epidemiology , Urinary Incontinence/epidemiology , Veterans
11.
Rejuvenation Res ; 20(2): 111-117, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27651115

ABSTRACT

AIMS: To evaluate the prevalence of urinary incontinence (UI) and its association with frailty among men aged 80 years and older in Taiwan. METHODS: Residents living in four veterans retirement communities were invited for study and 440 men aged 80 years and older were enrolled. Comprehensive geriatric assessment was performed for them, which composed of Clinical Frailty Scale, Northern Health and Social Care Trust (HSC)-Continence Assessment Form, Charlson's Comorbidity Index (CCI), Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale-5 (GDS-5), and Mini-Nutritional Assessment-Short Form (MNA-SF). RESULTS: In this study, the overall prevalence of UI was 19.1% (mostly urgency incontinence and functional incontinence). Univariate analyses were performed to evaluate the associations between UI and other variables. Frailty was more common among subjects with UI than those without (60.7% vs 32.3%, p < 0.001). Besides, subjects with UI had more comorbidity (CCI: 1.40 ± 1.15 vs 0.89 ± 0.89, p < 0.001), poorer physical function (BI: 65.77 ± 33.39 vs 84.12 ± 24.08, p < 0.001; IADL: 3.46 ± 2.64 vs 4.41 ± 2.25, p = 0.003), more depressive symptoms (GDS-5: 1.83 ± 1.78 vs 1.18 ± 1.36, p = 0.02), poorer cognitive function (MMSE: 16.57 ± 7.65 vs 19.37 ± 6.82, p = 0.001), poorer nutritional status (MNA-SF: 10.0 ± 03.03 vs 11.23 ± 2.24, p = 0.001), more polypharmacy (66.7% vs 45.2%, p < 0.001) and higher chance of stool incontinence (22.6% vs 1.7%, p < 0.001). Multivariate logistic regression showed that UI was independently associated with frailty, (odds ratio [OR] = 2.1; 95% confidence interval [CI]: 1.2-3.6; p = 0.012), stool incontinence (OR = 14.4; 95% CI 5.2-39.7; p < 0.001) and depressive symptoms (OR = 1.30; 95% CI 1.10-1.54; p = 0.002). CONCLUSIONS: About one fifth of study subjects had UI (mostly urgency and functional incontinence type), which was significantly associated with frailty, stool incontinence and depressive symptoms. Further study is needed to evaluate the possibilities of reversing these geriatric syndromes by an integrated intervention program.


Subject(s)
Frail Elderly , Urinary Incontinence/complications , Aged, 80 and over , Cross-Sectional Studies , Demography , Humans , Male , Risk Factors , Taiwan
12.
J Formos Med Assoc ; 115(1): 51-3, 2016 Jan.
Article in English | MEDLINE | ID: mdl-25241286

ABSTRACT

Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up.


Subject(s)
Hysterectomy/adverse effects , Lasers, Solid-State/therapeutic use , Ligation/adverse effects , Postoperative Complications/diagnostic imaging , Ureter/injuries , Ureteral Obstruction/diagnostic imaging , Ureteral Obstruction/surgery , Aluminum/therapeutic use , Female , Humans , Iatrogenic Disease , Middle Aged , Myoma/surgery , Stents , Ureteral Obstruction/etiology , Ureteroscopy , Uterine Neoplasms/surgery , Yttrium/therapeutic use
13.
J Colloid Interface Sci ; 440: 179-88, 2015 Feb 15.
Article in English | MEDLINE | ID: mdl-25460704

ABSTRACT

A one-step process for the synthesis of hydrophilic carbon nanofibers (CNFs) through CO2 hydrogenation on NiNa/Al2O3 was developed for the loading and targeted delivery of the anticancer drug doxorubicin (DOX). CNFs that were synthesized on NiNa/Al2O3 for 9 h at 500 °C exhibited an adequate magnetic response and a large content of hydrophilic oxygen-containing functional groups on the carbon surface, resulting in excellent colloidal solution. The CNF material exhibited a highly efficient capacity for DOX adsorption, particularly at pH 9.0. The loading and release of DOX was strongly pH dependent, possibly due to electrostatic and π-π stacking interactions between DOX and CNF sample. The Langmuir isotherm and pseudo second-order kinetics of DOX-loaded CNFs were well-modeled for the process of DOX adsorption. DOX-loaded CNF targeted cancer cells more selectively and effectively than free DOX and exhibited a marked tendency to kill HeLa cancer cells and reduced toxicity to normal human primary fibroblast (HPF) cells.


Subject(s)
Carbon/chemistry , Drug Delivery Systems , Metal Nanoparticles/chemistry , Nanofibers/chemistry , Nickel/chemistry , HeLa Cells , Humans , Hydrophobic and Hydrophilic Interactions , Microscopy, Electron, Transmission , Spectrophotometry, Infrared
14.
Biomed Res Int ; 2014: 531508, 2014.
Article in English | MEDLINE | ID: mdl-24982890

ABSTRACT

BACKGROUND AND PURPOSE: The vasoconstrictor endothelin-1 (ET-1) has been implicated in the pathogenesis of cerebral vasospasm following subarachnoid hemorrhage (SAH). Previous results showed that CGS 26303, an endothelin converting enzyme (ECE) inhibitor, effectively prevented and reversed arterial narrowing in animal models of SAH. In the present study, we assessed the effect of CGS 26303 on neurological deficits in SAH rats. The involvement of vasoactive pathways downstream of ET-1 signaling in SAH was also investigated. METHODS: Sprague-Dawley rats were divided into five groups (n = 6/group): (1) normal control, (2) SAH, (3) SAH+vehicle, (4) SAH+CGS 26303 (prevention), and (5) SAH+CGS 26303 (reversal). SAH was induced by injecting autologous blood into cisterna magna. CGS 26303 (10 mg/kg) was injected intravenously at 1 and 24 hr after the initiation of SAH in the prevention and reversal protocols, respectively. Behavioral changes were assessed at 48 hr after SAH. Protein expression was analyzed by Western blots. RESULTS: Deficits in motor function were obvious in the SAH rats, and CGS 26303 significantly improved the rate of paraplegia. Expressions of rho-kinase-II and membrane-bound protein kinase C- δ and rhoA were significantly increased, while those of soluble guanylyl cyclase α 1 and ß 1 as well as protein kinase G were significantly decreased in the basilar artery of SAH rats. Treatment with CGS 26303 nearly normalized these effects. CONCLUSIONS: These results demonstrate that the rhoA/rho-kinase and sGC/cGMP/PKG pathways play pivotal roles in cerebral vasospasm after SAH. It also shows that ECE inhibition is an effective strategy for the treatment of this disease.


Subject(s)
Basilar Artery/enzymology , Basilar Artery/pathology , Guanylate Cyclase/metabolism , Receptors, Cytoplasmic and Nuclear/metabolism , Subarachnoid Hemorrhage/complications , Vasospasm, Intracranial/enzymology , Vasospasm, Intracranial/etiology , rho-Associated Kinases/metabolism , Animals , Basilar Artery/drug effects , Behavior, Animal , Cyclic AMP/metabolism , Cyclic GMP-Dependent Protein Kinases/metabolism , Disease Models, Animal , Endothelin-1/blood , Male , Organ Specificity/drug effects , Organophosphonates/pharmacology , Protein Kinase C-delta/metabolism , Protein Kinase Inhibitors/pharmacology , Protein Transport/drug effects , Rats, Sprague-Dawley , Signal Transduction/drug effects , Soluble Guanylyl Cyclase , Subarachnoid Hemorrhage/blood , Subarachnoid Hemorrhage/enzymology , Tetrazoles/pharmacology , Vasospasm, Intracranial/blood , rho-Associated Kinases/antagonists & inhibitors
15.
Biomed Res Int ; 2014: 506458, 2014.
Article in English | MEDLINE | ID: mdl-24877104

ABSTRACT

BACKGROUND: Central neurocytoma and oligodendroglioma are rare tumors of the central nervous system. However, diagnosis between these two types of tumors is challenging due to their many cytological and histological similarities. Death-associated protein kinase (DAPK) is a calcium/calmodulin-regulated serine/threonine protein kinase involved in many apoptosis pathways, and repressed expression of DAPK by promoter hypermethylation has been found in a variety of human cancers. The purpose of this study was to assess DAPK protein expression and promoter hypermethylation in central neurocytoma and oligodendroglioma. METHOD: Central neurocytoma and oligodendroglioma samples were obtained from age- and sex-matched patients. DAPK protein expression was performed using immunohistochemical assays in formalin-fixed, paraffin-embedded sections. DAPK promoter hypermethylation was carried out using bisulfite-modified genomic DNA in methylation-specific PCR followed by separation in agarose gels. FINDINGS: A statistically significant difference (P = 0.021) in DAPK promoter hypermethylation between central neurocytoma (76.9%) and oligodendroglioma (20%) was observed. High levels of DAPK protein expression were generally found in oligodendroglioma (90%), compared with 38.5% in central neurocytoma (P = 0.054; not statistically significant). There was an inverse correlation between DAPK protein expression and DAPK promoter hypermethylation in the cohort of 23 patients (P = 0.002). CONCLUSIONS: The results show that DAPK promoter hypermethylation and repressed expression of DAPK protein were more common in central neurocytoma than in oligodendroglioma. Thus, DAPK promoter hypermethylation could be useful for differential diagnosis between these two types of tumors, whereas DAPK protein expression might be less predictive. The role of DAPK promoter hypermethylation in the pathogenesis of central neurocytoma warrants further study.


Subject(s)
DNA Methylation , Death-Associated Protein Kinases/biosynthesis , Gene Expression Regulation, Enzymologic , Gene Expression Regulation, Neoplastic , Neurocytoma/enzymology , Oligodendroglioma/enzymology , Adolescent , Adult , Death-Associated Protein Kinases/genetics , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Neurocytoma/genetics , Neurocytoma/pathology , Oligodendroglioma/genetics , Oligodendroglioma/pathology
16.
Childs Nerv Syst ; 29(11): 2051-5, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23632690

ABSTRACT

PURPOSE: The prognosis of children with low-grade cerebellar astrocytoma who have partial resection of tumor is largely unpredictable. The purpose of this study was to review the long-term outcome of such patients. METHODS: The medical charts, imaging findings, operative notes, histopathological reports, and survival times of 12 patients with cerebellar astrocytoma were reviewed. RESULTS: Five patients had total resection and seven had partial resection. Nine patients had grade I histology and three patients had grade II. Follow-up duration ranged from 3 to 25 years. Among the seven patients with residual tumor, five had tumor progression, one had arrested tumor growth, and one had spontaneous tumor regression. Five patients with partial resection received radiotherapy and three had malignant transformation of tumor during follow-up. Six patients, including five who had partial resection, underwent a second operation. One patient with partial resection died of pneumonia 23 years after surgery. CONCLUSIONS: Patients with complete tumor resection had a better prognosis than patients with partial resection. For patients with partial resection, we recommend a "wait and see" policy with surveillance using MRI. The phenomenon of arrested tumor growth and spontaneous tumor regression in patients with cerebellar astrocytoma who have subtotal resection warrants further study.


Subject(s)
Astrocytoma , Cerebellar Neoplasms , Neoplasm Recurrence, Local , Neoplasm, Residual , Neurosurgical Procedures/methods , Adolescent , Astrocytoma/pathology , Astrocytoma/surgery , Cerebellar Neoplasms/pathology , Cerebellar Neoplasms/surgery , Child , Child, Preschool , Disease Progression , Female , Follow-Up Studies , Humans , Male , Neoplasm Grading , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm, Residual/pathology , Neoplasm, Residual/surgery , Neurosurgical Procedures/standards , Prognosis , Reoperation , Retrospective Studies , Treatment Outcome
17.
Cancer Res ; 73(8): 2505-17, 2013 Apr 15.
Article in English | MEDLINE | ID: mdl-23442323

ABSTRACT

Thyroid hormone (T(3)) signaling through the thyroid hormone receptor (TRα1) regulates hepatoma cell growth and pathophysiology, but the underlying mechanisms are unclear at present. Here, we have shown that the oncomir microRNA-21 (miR-21) is activated by T(3) through a native T(3) response element in the primary miR-21 promoter. Overexpression of miR-21 promoted hepatoma cell migration and invasion, similar to that observed with T(3) stimulation in hepatoma cells. In addition, anti-miR-21-induced suppression of cell migration was rescued by T(3). The Rac-controlled regulator of invasion and metastasis, T-cell lymphoma invasion and metastasis 1 (TIAM1), was identified as a miR-21 target additionally downregulated by T(3). Attenuation and overexpression of miR-21 induced upregulation and downregulation of TIAM1, respectively. TIAM1 attenuation, in turn, enhanced migration and invasion via the upregulation of ß-catenin, vimentin, and matrix metalloproteinase-2 in hepatoma cells. Notably, correlations between TRα1, miR-21, and TIAM1 expression patterns in animal models paralleled those observed in vitro. In the clinic, we observed a positive correlation (P = 0.005) between the tumor/nontumor ratios of TRα1 and miR-21 expression, whereas a negative correlation (P = 0.019) was seen between miR-21 and TIAM1 expression in patients with hepatoma. Our findings collectively indicate that miR-21 stimulation by T(3) and subsequent TIAM1 suppression promotes hepatoma cell migration and invasion.


Subject(s)
Carcinoma, Hepatocellular/genetics , Carcinoma, Hepatocellular/pathology , Gene Expression Regulation, Neoplastic/drug effects , Liver Neoplasms/genetics , Liver Neoplasms/pathology , MicroRNAs/genetics , Thyroid Hormones/pharmacology , Animals , Cell Line, Tumor , Cell Movement/drug effects , Cell Movement/genetics , Disease Models, Animal , Gene Expression Profiling , Gene Knockdown Techniques , Gene Order , Guanine Nucleotide Exchange Factors/genetics , Guanine Nucleotide Exchange Factors/metabolism , Hep G2 Cells , Humans , Male , Neoplasm Invasiveness , Rats , Receptors, Thyroid Hormone/genetics , Receptors, Thyroid Hormone/metabolism , Reproducibility of Results , Response Elements , T-Lymphoma Invasion and Metastasis-inducing Protein 1 , Triiodothyronine/pharmacology
18.
Cytokine ; 61(2): 413-8, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23260996

ABSTRACT

Transforming growth factor-beta 1 (TGF-ß1) has been reported to be a possible marker for a number of tumors, including brain tumors. The aim of this study was to measure the plasma levels of TGF-ß1 in patients with low- and high-grade astrocytomas before and after surgery. This prospective study included 14 patients with low-grade astrocytomas and 25 with high-grade astrocytomas who underwent tumor removal and 13 controls (patients who underwent cranioplasty for skull bone defects). Plasma levels of TGF-ß1 were measured in all subjects using enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve analysis showed that when the level of TGF-ß1 before tumor removal was ≥ 2.52 ng/ml, astrocytoma was predicted with a sensitivity of 94.9% and specificity of 100%. The mean plasma level of TGF-ß1 in both the low-grade and high-grade astrocytoma groups significantly decreased after tumor removal (p<0.05); there was no significant change in TGF-ß1 plasma level of the controls following surgery. Patients with high-grade astrocytomas had a significantly higher mortality rate than patients with low-grade astrocytomas (p=0.019) and significantly shorter survival (p=0.008). A positive correlation between TGF-ß1 level after tumor removal and tumor volume was only found in the high-grade astrocytoma group (γ=0.597, p=0.002). The findings show that plasma TGF-ß1 level was increased in patients with low-grade and high-grade astrocytoma, and that the levels significantly decreased after tumor removal in both groups. The results provide additional evidence that TGF-ß1 might be useful as a tumor marker for astrocytomas.


Subject(s)
Astrocytoma/blood , Astrocytoma/surgery , Transforming Growth Factor beta1/blood , Adolescent , Adult , Aged , Astrocytoma/pathology , Case-Control Studies , Child , Child, Preschool , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Grading , ROC Curve , Survival Analysis , Treatment Outcome , Young Adult
19.
Acta Neurochir Suppl ; 115: 239-46, 2013.
Article in English | MEDLINE | ID: mdl-22890675

ABSTRACT

Delayed cerebral vasospasm is a main cause of morbidity and mortality as well as poor outcome in patients following aneurysmal subarachnoid hemorrhage (SAH). In this study, the effect of the bronchodilator KMUP-3 (7-[2-[4-(4-nitrobenzene)piperazinyl]ethyl]-1,3-dimethylxanthine) on basilar artery narrowing, neurological outcome, and expression of rhoA/rho kinase II (ROCKII), rhoA, and protein kinase C (PKC) γ proteins were evaluated in a rat model of SAH. SAH was induced by double injection of autologous blood into the cistern magna on days 0 and 3. KMUP-3 was administered (0.3 mg/kg/day) by osmotic minipumps implanted subcutaneously (beginning day -3 in pretreatment group and at 1 h after the initiation of the first autologous blood injection in the treatment group). Neurological outcome was assessed by ambulation and placing/stepping reflex responses at 48 h after the second injection of autologous blood. Tissue morphology and protein expression were conducted on day 7 post-day 0 injection. Both KMUP-3 treatment regimens significantly improved neurological outcome and completely attenuated basilar artery narrowing as well as reduced the enhancement of ROCKII, rhoA, and PKCγ protein expression in rats subjected to SAH, compared with normal and untreated SAH rats. These results suggest that KMUP-3 may be a novel agent for the treatment of cerebral vasospasm following SAH.


Subject(s)
Bronchodilator Agents/therapeutic use , Piperidines/therapeutic use , Subarachnoid Hemorrhage/complications , Vasospasm, Intracranial/drug therapy , Vasospasm, Intracranial/etiology , Xanthines/therapeutic use , Animals , Disease Models, Animal , Drug Interactions , Gene Expression Regulation/drug effects , Hemodynamics/drug effects , Hemodynamics/physiology , Locomotion/drug effects , Male , Neurologic Examination , Protein Kinase C/metabolism , Rats , Rats, Sprague-Dawley , Reflex/drug effects , rho-Associated Kinases/metabolism , rhoA GTP-Binding Protein/metabolism
20.
J Phys Condens Matter ; 24(26): 266004, 2012 Jul 04.
Article in English | MEDLINE | ID: mdl-22677954

ABSTRACT

The electrical and magnetic properties of slightly Cu-deficient BiOCu(0.94)S are investigated using neutron diffraction, ac magnetic susceptibility, magnetization and electrical resistivity measurements. The Cu spins order in a ferromagnetic arrangement below T(C) = 250 K. An antiferromagnetic component develops below 180 K when the crystalline unit cell experiences a sharp thermal contraction upon cooling, resulting in a canted ferromagnetic spin arrangement at low temperatures. In the magnetically ordered state the electrical transport can be described using three-dimensional variable range hopping conduction. An applied magnetic field can effectively reduce the hopping barrier. Spin-charge couplings are clearly revealed when the resistivity departs from the hopping conduction and begins to increase with increasing temperatures above 250 K where the Cu spins become disordered.

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