Role of serine/threonine kinase 33 methylation in colorectal cancer and its clinical significance.

Serine/threonine kinase 33 (STK33) is a novel protein that has been the focus of an increasing number of studies in recent years; however, the role of STK33 in tumorigenesis remains controversial. Previous studies have demonstrated that STK33 is overexpressed in several human cancers and exerts a pro-tumorigenic effect through the promotion of cell proliferation. However, the role of STK33 in colorectal cancer (CRC), which is one of the most aggressive human malignancies, remains unclear. The aim of the current study was to investigate the methylation status of STK33 in CRC and to determine its clinical significance. The results demonstrated that STK33 was hypermethylated in CRC cell lines and promoted the proliferation of CRC cells. In addition, the methylation status and expression of STK33 in 94 pairs of cancer and noncancerous tissues obtained from patients with CRC was investigated. STK33 methylation was significantly increased in cancer tissues when compared with adjacent noncancerous tissues (P<0.001). STK33 methylation was associated with lymph node metastasis (P<0.05), tumor invasion (P<0.05), distant metastases (P<0.01) and tumor stage (P<0.01). Reduced STK33 mRNA and protein expression in CRC was associated with STK33 hypermethylation (P<0.001). In addition, patients with hypermethylated STK33 exhibited shorter overall survival rates when compared with those with unmethylated STK33 (P<0.01). In conclusion, the results of the current study suggest that STK33 hypermethylation may be a promising novel biomarker for the diagnosis, prognosis and suitable treatment of CRC.

Endovascular repair of a tuberculous aneurysm of descending thoracic aorta.

Tuberculous aortic aneurysm (TBAA) is an extremely rare clinical event with life-threatening implication. Management for this condition is challenging and its therapeutic option has not been yet established. A few recent reports described endovascular repair rather than open surgery as the method for treatment. Although this remains controversial, endovascular exclusion has been gaining acceptance for some surgeons. We present a case of TBAA who was treated by endovascular stent grafting for a descending thoracic aortic aneurysm with simultaneous anti-tuberculous medication. The outcome was favorable.

Inflammatory abdominal aortic aneurysm: clinical features and long term outcome in comparison with atherosclerotic abdominal aortic aneurysm.

BACKGROUND: Inflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA. METHODS: Between 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared. RESULTS: The two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711). CONCLUSIONS: Despite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.

[The comparison of operative and non-operative treatment for acute embolism of upper extremity artery].

OBJECTIVE: To compare surgical and non-surgical therapy of the upper extremity after acute arterial occlusion. To analyze the relation between prognosis and relevant factors of different therapeutic methods. METHODS: Sixty patients with acute upper extremity arterial embolism treated between January 1990 and October 2007 were retrospectively studied in The First Hospital of China Medical University. RESULTS: There were 60 patients, 32 men and 28 women, with a mean age of 63 years (21 - 86 years). Among them, 31 underwent thrombembolectomies with the Fogarty catheter and 29 received anti-coagulation and thrombolytic therapy. Therapeutic effects were evaluated by Cooley's standard. Therapeutic efficacy was better in the surgical group than in the non-surgical group (P < 0.05). There was no relationship between post-operative ischemic recovery and pre-operative ischemia severity and the site of embolism in the surgical group, while there were significant relationships in the nonsurgical group. The result of Cox proportional hazard regression model showed that the age and Cooley's standard of the patient was correlated with survival time. CONCLUSIONS: A more active surgical approach is better for the treatment of acute arterial occlusion of the upper extremity.

[Clinico-epidemiological features of infrarenal abdominal aortic aneurysm and relevant prognostic factors].

OBJECTIVE: To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm (AAA) and relevant prognostic factors. METHODS: The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged (62 +/- 15), hospitalized 1988 -2007 were analyzed. RESULTS: In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years. The rupture rate of the male AAA patients was 14.4%, significantly higher than that of the female AAA patients (6.5%, P < 0.05). The rupture rate of the AAA aged patients > or = 65 was 3.6%, significantly lower than that of the AAA patients < 65 (17.7%, P < 0.01). The aneurysm diameter of the patients with hyperextension was (6.1 +/- 3.3) cm, significantly lower than that of the patients without hypertension [(6.8 +/- 2.3) cm. P < 0.05]. The general 5-year survival rate was 70.1%. The 5-year survival rates of the female patients, patients > or = 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients < 65, and patients with hypertension or coronary heart disease (all P < 0.05). Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors (all P < 0.05). CONCLUSION: The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.