Clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract.

BACKGROUND: Ingested foreign objects frequently require emergency removal. This study aimed to investigate the clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract and the risk factors for adverse events. METHODS: Adults (> 18 years) who underwent endoscopic management of ingested foreign bodies at two centers, one inland and one on the coast, between January 2008 and December 2017 were eligible. Clinical characteristics and procedure-related outcomes were retrospectively reviewed. Patients were divided into two groups, based on whether the foreign bodies were sharp or blunt in shape. RESULTS: A total of 853 patients aged 19-96 years were analyzed. Ingestion of fish bones was more common in the coastal area, whereas ingestion of food boluses was more common in the inland area. The duration of impaction ranged from 1 h to over 1 month and was significantly longer in patients who ingested blunt than sharp foreign bodies (15 vs. 5 h, p < 0.001). Most (98.9%) foreign bodies were successfully removed. Adverse events occurred in 31.2 % of patients, including ulcers (4.0%) and perforations (3.3 %). Multivariate analysis showed that age (odds ratio [OR] 1.015, p = 0.012), sharp foreign bodies (OR 5.133, p < 0.001), location in the esophagus (OR 2.723, p = 0.018), and duration of impaction (OR 1.431, p < 0.001) were factors associated with adverse events. CONCLUSIONS: Early recognition and timely endoscopic removal of ingested foreign bodies, particularly in elderly patients and those with sharp foreign bodies, may improve clinical outcomes.

Colonic Intramucosal Cancer in the Interposed Colon Treated with Endoscopic Mucosal Resection: A Case Report and Review of Literature.

Colon interposition is a surgical procedure used for maintenance of luminal conduit after esophagectomy. Although epithelial neoplasia, such as adenoma and adenocarcinoma, may develop in the interposed colon, there are only few case reports on the condition. Due to the rarity of this condition, there is no definite consensus on recommending screening endoscopy for the early detection of neoplasia in the interposed colons. Here, we report a case of intramucosal adenocarcinoma in an interposed colon. Initial endoscopic resection for this tumor failed to accomplish complete resection. A subsequent endoscopic resection was performed 1 month later and complete resection was achieved. Based on our experience and recommendation on screening endoscopy for gastric cancer in Korea, we suggest that regular screening esophagogastroduodenoscopies should be performed following esophagectomy to detect early neoplasia in the stomach and interposed colon and avoid adverse results induced by delayed detection.

Sulforaphane induces apoptosis in human hepatic cancer cells through inhibition of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase4, mediated by hypoxia inducible factor-1-dependent pathway.

The anti-cancer activity of sulforaphane (SFN) has recently been investigated in several cancer cell lines, including human hepatic cancers. However, the mechanism of SFN-induced cell death in human hepatic cancer cells is still not well understood. The aim of the present work is to explore the possible mechanisms of SFN-induced apoptosis in hepatocellular carcinoma cells using proteomic analysis. A two-dimensional electrophoresis (2-DE)-based-proteomic analysis was employed for identification of possible target-related proteins of SFN-induced apoptosis. Among eleven proteins identified as regulated, we focused on the down-regulation of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase4 (PFKFB4) protein, which has been known as a key modulator of glycolysis. We also showed that SFN down-regulated the expression of the transcriptional factor, hypoxia inducible factor-1α (HIF-1α), which strongly regulates PFKFB4 expression. In order to obtain a broad understanding of the correlation of HIF-1α and SFN, we observed the inhibition of the activity of mitogen-activated protein kinases, regulators of HIF-1α activity. Our findings suggest that SFN is a potent inducer of apoptosis in hepatocellular carcinoma cells via PFKFB4-inhibition pathways. HIF-1 pathway inhibition may be mediated by the inhibition of mitogen-activated protein kinases.

Mesenchymal stem cells' interaction with skin: wound-healing effect on fibroblast cells and skin tissue.

Mesenchymal stem cells (MSCs) are multipotent progenitor cells with the ability to secrete growth factors. Because wound healing is associated with fibroblast cells and extracellular matrix (ECM) in the dermis and epidermis, we used fibroblast cells to resolve the question of whether or not MSCs regulate wound healing in vitro via a regenerative function. Using a cell proliferation assay, we demonstrated that conditioned media (CM) obtained from MSCs significantly enhanced the cell survival ability of fibroblast cells. Moreover, by measurement of mRNA and protein, we observed that CM also promoted the production or secretion of collagen, elastin, and fibronectin. To better understand the effects of ECM-related wound healing, we measured the level of collagen-degradative enzyme (matrix metalloprotease-1), and observed that CM suppressed matrix metalloprotease-1 expression. For the determination of oxidative stress, which has an influence on wound healing, we performed the superoxide dismutase and glutathione peroxidase assays; our results suggested that CM inhibited the oxidative stress of fibroblast cells. In order to widely investigate the wound-healing effects of MSCs, we performed in vivo experiments, and observed that MSCs stimulated wound healing. In summary, the results of this study suggest that MSCs inhibit the loss of fibroblast cells and ECM, and accumulation of oxidative stress. We found that MSCs stimulate wound healing in vitro and in vivo, suggesting that MSCs have the potential to enhance wound healing.

Proteome profiling of arsenic trioxide-treated human hepatic cancer cells.

BACKGROUND: Arsenic trioxide (As(2)O(3)), a major compound in traditional Chinese medicine, is known to be an effective anticancer agent in acute promyelocytic leukemia (APL). The effects of As(2)O(3) on human hepatocellular carcinoma (HCC) SK-Hep-1 cells were studied employing proteomics-based methodologies. MATERIALS AND METHODS: Using 1-dimensional electrophoresis (1DE) and liquid chromatography electrospray ionization quadruple time-of-flight analysis, the whole proteomes of the control and As(2)O(3)-treated cells were profiled. RESULTS: In all, 207 and 62 proteins, which were specifically found in control and As(2)O(3)-treated cells, respectively, were classified with their biological processes by gene ontology (GO) annotation. The GO data indicated that 16 proteins were closely associated with apoptotic mechanisms. As(2)O(3)-induced DNA damage and oxidative stress that accompanied apoptosis in SK-Hep-1 cells were observed using comet assay and 5-and-6-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate fluorescence microscopy, respectively. CONCLUSION: The anticancer activities of As(2)O(3) may be mediated by DNA damage- and reactive oxygen species-induced apoptotic mechanisms which involve the proteins identified in this study.

Proteomic identification of anti-cancer proteins in luteolin-treated human hepatoma Huh-7 cells.

Luteolin has been shown to exhibit anti-cancer activity against several forms of cancers, including human hepatic cancers. Many in vitro studies have reported anti-oxidant effects of luteolin. Here, we demonstrate using ROS (reactive oxygen species) detection in the human hepatocellular carcinoma cell line, Huh-7, that anti-cancer action of luteolin are mediated through an increasing in intracellular ROS levels. To identify proteins potentially involved in this mechanism, a two-dimensional electrophoresis (2-DE)-based-proteomic approach was employed. Proteomic analysis revealed that several proteins were associated with the anti-cancer effects of luteolin. Interestingly, these proteins included peroxiredoxin 6 (PRDX6) and prohibitin (PHB), which are implicated in ROS metabolism and apoptosis. Western blot analyses confirmed the expression of these proteins in Huh-7 cells following luteolin application. On the basis of these results, we suggest that PRDX6 and PHB are key targets of luteolin that the mechanism of luteolin-induced apoptosis in Huh-7 cells is mediated through effects involving intracellular ROS.