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European journal of medical research [journal]
- Sputum myeloperoxidase in chronic obstructive pulmonary disease. [JOURNAL ARTICLE]
- Eur J Med Res 2014 Mar 3; 19(1):12.
Airway inflammation, especially neutrophilic airway inflammation, is a cardinal pathophysiologic feature in chronic obstructive pulmonary disease (COPD) patients. The ideal biomarkers characterizing the inflammation might have important potential clinical applications in disease assessment and therapeutic intervention. Sputum myeloperoxidase (MPO) is recognized as a marker of neutrophil activity. The purpose of this meta-analysis is to determine whether sputum MPO levels could reflect disease status or be regulated by regular medications for COPD.Studies were identified by searching PubMed, Embase, the Cochrane Database, CINAHL and www.controlled-trials.com for relevant reports published before September 2012. Observational studies comparing sputum MPO in COPD patients and healthy subjects or asthmatics, or within the COPD group, and studies comparing sputum MPO before and after treatment were all included. Data were independently extracted by two investigators and analyzed using STATA 10.0 software.A total of 24 studies were included in the meta-analysis. Sputum MPO levels were increased in stable COPD patients when compared with normal controls, and this increase was especially pronounced during exacerbations as compared with MPO levels during the stable state. Theophylline treatment was able to reduce MPO levels in COPD patients, while glucocorticoid treatment failed to achieve the same result.Sputum MPO might be a promising biomarker for guiding COPD management; however, further investigations are needed to confirm this.
- Recurrent lymphocytic myocarditis in a young male with ulcerative colitis. [Journal Article]
- Eur J Med Res 2014; 19(1):11.
Awareness of myocarditis in association with inflammatory bowel diseases is crucial as it bears a rare but serious risk for mortality. This report describes the case of a young Caucasian male, whose heart biopsy was tested negative for giant cells and bacterial or viral genomes or proteins. He was experiencing severe lymphocytic myocarditis (other than mesalamine-induced) along with cardiogenic shock during ulcerative colitis exacerbation. This is an extremely rare, if not unique, clinical constellation. We chose to study the epidemiologic grounds and all major aspects of differential pathogenesis and treatment of this serious health problem.
- Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound: a retrospective study of 32 cases. [JOURNAL ARTICLE]
- Eur J Med Res 2014 Feb 21; 19(1):10.
To explore the clinical characteristics of congenital cervical atresia.This retrospective analysis included 32 cases of congenital cervical atresia treated from March 1984 to September 2010. The anatomic location, ultrasonic features, surgical treatments, and outcomes were recorded.Based on clinical characteristics observed during preoperative ultrasound and intraoperative exploration, congenital cervical atresia was divided into four types. Type I (n = 22/32, 68.8%) is incomplete cervical atresia. Type II (n = 5/32, 15.6%) defines a short and solid cervix with a round end; the structure lacked uterosacral and cardinal ligament attachments to the lower uterine body. Type III (n = 2/32, 6.3%) is complete cervical atresia, in which the lowest region of the uterus exhibited a long and solid cervix. Type IV (n = 3/32, 9.4%) defines the absence of a uterine isthmus, in which no internal os was detected, and a blind lumen was found under the uterus.Observations of clinical characteristics of congenital cervical atresia based on the anatomy and ultrasound may inform diagnosis and treatment strategy.
- Aberrant ADAM10 expression correlates with osteosarcoma progression. [Journal Article]
- Eur J Med Res 2014; 19(1):9.
Osteosarcoma is the most common type of bone cancer and is notorious for its rapid progression. The Notch signaling pathway has recently been shown to be involved in osteosarcoma. As a major sheddase of Notch receptors, ADAM10 has been implicated in many types of cancers, but its role in osteosarcoma has not been investigated. Previous studies have shown that the expression of CD31 was significantly elevated in metastatic osteosarcoma; however, its expression in nonmetastatic groups is not known. In addition, the mysterious multinucleated giant cell in giant cell-rich osteosarcoma was previously regarded as an osteoclast-like cell, but its exact identity is unclear.Tissue chip samples from 40 cases of nonmetastatic osteosarcoma were stained for cytoplasmic ADAM10, activated Notch1 and CD31. Osteoclasts in tumor sections were also stained for tartrate-resistant acid phosphatase (TRAP).Immunofluorescence staining revealed that ADAM10 expression significantly increased with the progression of osteosarcoma as well as in osteoblastic osteosarcoma, whereas the expression of the Notch intracellular domain (NICD) and CD31 was not significantly altered between different pathological stages. In addition, multinucleated giant cells in giant cell-rich osteosarcoma were also found to coexpress CD31, ADAM10 and NICD, but were negative for TRAP staining.Our results highlight the importance of ADAM10 in the progression of osteosarcoma and suggest that the protein might be a potential therapeutic target in osteosarcoma treatment. This study also demonstrates that the multinucleated giant cell is an angiogenic tumor cell, rather than an osteoclast, and involves ADAM10/Notch1 signaling activation.
- The analysis of a reference value for baroreflex sensitivity and cardiovascular autonomic neuropathy prevalence in a Chinese population. [JOURNAL ARTICLE]
- Eur J Med Res 2014 Feb 12; 19(1):8.
Cardiovascular autonomic neuropathy (CAN) is rapidly growing in all populations worldwide. Baroreflex sensitivity (BRS) is easily applied as a diagnostic test to a large number of individuals in the general population. However, no study has reported the normal reference values of BRS for the CAN diagnostic test in a Chinese population. The aim of this study was to estimate the normative reference value of BRS, and assess CAN prevalence in our cross-sectional dataset.We conducted a large-scale, community-based, cross-sectional study in a Chinese population. We performed data analysis on 2,092 subjects. Cardiovascular autonomic function was assessed using spontaneous BRS. A total of 349 healthy subjects were used to perform analysis for the reference value for BRS. The CAN prevalence was calculated in the overall sample, and in patients with diabetes mellitus, patients with hypertension and patients with metabolic syndrome.In the overall sample, the reference value for total power (TP.brs) was more than 1.96 ms/mmHg. The cut-off points of 1.74 ms/mmHg and 2.53 ms/mmHg were set as high frequency (HF.brs) and low frequency (LF.brs), respectively. CAN diagnostic tests based on the reference value were performed. The estimated CAN prevalence in the overall sample was 20.41% using the BRS test. CAN prevalence was 33.18%, 28.69% and 28.57% in patients with diabetes mellitus, patients with hypertension and patients with metabolic syndrome, respectively.Our findings provided reference values for BRS. Estimated CAN prevalence was high in this Chinese population, which has become a major public health problem in China.
- Left ventricular remodeling with preserved function after coronary microembolization: the effect of methylprednisolone. [Journal Article, Research Support, Non-U.S. Gov't]
- Eur J Med Res 2014; 19(1):7.
The objective of this study was to evaluate changes in left ventricular ejection fraction (LVEF) and left ventricular remodeling after coronary microembolization (CME) and to investigate the protective effects of methylprednisolone (MTP).CME was induced by injection of microspheres (42 μm Dynospheres) into left anterior descending artery of mini swine. The animals were divided into two groups. Group 1 (n = 9) received 120,000 microspheres and Group 2 (n = 7) received 120,000 microspheres following intravenous administration of 30 mg/kg MTP. Contrast-enhanced magnetic resonance imaging (CeMRI) was performed at baseline, 6 h after intervention, and 1 week later.In Group 1, LVEF was significantly decreased at 6 h but recovered 1 week. This was accompanied by continuing left ventricular remodeling. In Group 2, LVEF remained unchanged at all assessment times. LVEF measured at 6 h and 1 week after CME in Group 1 and Group 2 was 0.39 ± 0.06 and 0.44 ± 0.04, and 0.44 ± 0.04 and 0.48 ± 0.03, respectively (Both P >0.05). Hyperenhancement at the anterior wall of the left ventricle was shown by MRI at 6 h in Group 1 but not in Group 2. The hyperenhanced area in Group 1 was 7.77 ± 1.49% of left ventricular mass.The consequence of CME is left ventricular dilation with preserved LVEF. Pretreatment with MTP appears to have a cardioprotective effect on left ventricular remodeling.
- Increased CD44s and decreased CD44v6 RNA expression are associated with better survival in myxofibrosarcoma patients: a pilot study. [Journal Article]
- Eur J Med Res 2014; 19(1):6.
New prognostic markers may be of value in determining survival and informing decisions of adjuvant treatment in the heterogeneous group of soft tissue sarcomas known as malignant fibrous sarcomas (MFS). Increased CD44 expression has been associated with a better outcome in cancers such as bladder tumors and could potentially relate to cell-cell interaction as a marker for potential invasion/metastasis. The aim of this pilot study was to determine if there is a correlation between the expression rate of CD44 in adult patients with MFS and clinical outcomes.The clinical outcome of 34 adult MFS patients (19 males and 15 females, average age 62 years, median 63 years, range: 38-88 years) who underwent surgical treatment were evaluated. Twenty-five of these patients had additional adjuvant radiotherapy. Extracted RNA from sarcoma tissues was used to measure the transcripts of CD44s (standard form) and isoform expression.The pooled data for each variant of CD44 was divided in half at the median expression value into two equally sized groups (low and high). Survival modeling and multivariate analysis were used with these two groups to determine if there were differences in survival times and whether this was independent of known factors such as tumor stage/grade, patient age and resection margin status.High CD44s and low of CD44v6 expression significantly correlated with an improved outcome (P <0.05 and P <0.02, respectively) whereas CD44v8 and hCD44 (isoforms) did not. Differences in survival were apparent within 6-12 months of operation with >30% difference in survival between low/high expressions at 5 years. These finding were independent of the other measured MFS survival predictors, though the group was homogenous.High CD44s and low CD44v6 expression may be an independent predictor of improved survival in MFS patients in this pilot data. This is contrary to other MFS data, which did not account for the CD44 isoforms but is confirmed by data from other cancer types. Further investigation is needed to confirm CD44 isoform expression data as a relevant survival biomarker and whether it could be used to inform clinical decisions such as adjuvant therapy.
- Association of methylenetetrahytrofolate reductase (MTHFR) C677T and A1298C polymorphisms with the susceptibility of childhood acute lymphoblastic leukaemia (ALL) in Chinese population. [Journal Article]
- Eur J Med Res 2014; 19(1):5.
The aim of this study was to investigate the relationship between the polymorphisms of the methylenetetrahytrofolate reductase (MTHFR) gene and susceptibility to childhood acute lymphoblastic leukemia (ALL).A case-control study was conducted among 98 children with ALL and 93 age- and sex- matched non-ALL controls. Genotyping of MTHFR C677T and A1298C polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The odds ratios (ORs) of MTHFR genotypes were used to assess the associations of these polymorphisms with childhood ALL susceptibility.No significant differences were observed for frequencies of the 677CC, 677CT and 677TT genotypes between patients and controls. Frequencies of the 1298AA, 1298 AC and 1298CC genotypes between the two groups were significantly different. The risk of ALL with the 1298C allele carriers (AC + CC) was elevated by 1.1 times compared with the AA genotype [OR = 2.100; 95% CI (1.149; 3.837); P = 0.015].The MTHFR A1298C polymorphism is associated with susceptibility to childhood ALL in the Chinese population.
- Prenatal ultrasonography and Doppler sonography for the clinical investigation of isolated ventricular septal defects in a late second-trimester population. [Journal Article, Research Support, Non-U.S. Gov't]
- Eur J Med Res 2014; 19(1):3.
The purpose of this study was to evaluate the efficacy of prenatal ultrasonography and Doppler sonography in detecting isolated ventricular septal defects (VSDs) in a late-second-trimester population.Fetal echocardiography, Doppler ultrasound, and biometry were used to evaluate 2,661 singleton fetuses (1,381 male fetuses and 1,280 female fetuses) between 1 August 2006 and 31 May 2010. The efficacy of each fetal biometry, Doppler ultrasound, and nasal bone length (NBL) measurement was evaluated in all of the fetuses. A standard fetal echocardiographic evaluation, including two-dimensional gray-scale imaging and color and Doppler color flow mapping, was performed on all fetuses.We detected isolated VSDs in 124 of the 2,661 singleton fetuses between 19 and 24 weeks of gestation. The prevalence of isolated VSDs in the study population was 4.66%. A multiple logistic regression analysis indicated that short fetal NBL (odds ratio = 0.691, 95% confidence interval: 0.551 to 0.868) and the pulsatility index (PI) of the umbilical artery (odds ratio = 8.095, 95% confidence interval: 4.309 to 15.207) and of the middle cerebral artery (odds ratio = 0.254, 95% confidence interval: 0.120 to 0.538) are significantly associated with isolated VSDs.Late-second-trimester fetal NBL, umbilical artery PI, and middle cerebral artery PI are useful parameters for detecting isolated VSDs, and can be used to estimate the a priori risk of VSDs in women at high risk and at low risk of isolated VSDs.
- Retrospective analysis of the frequency of centrofacial telangiectasia in systemic sclerosis patients treated with bosentan or ilomedin. [Journal Article]
- Eur J Med Res 2014; 19(1):2.
Bosentan is a dual endothelin receptor antagonist initially introduced for the treatment of pulmonary arterial hypertension and recently approved for the treatment of digital ulcers in patients with systemic sclerosis (SSc). Our clinical observations indicate that bosentan therapy may be associated with an increased frequency of centrofacial telangiectasia (TAE). Here, we sought to analyze the frequency of TAE in patients with SSc who were treated with either bosentan or the prostacyclin analog iloprost.We conducted a retrospective analysis in 27 patients with SSc undergoing therapy with either bosentan (n = 11) or iloprost (n = 16). Standardized photodocumentations of all patients (n = 27) were obtained at a time point ten months after therapy initiation and analyzed. A subgroup of patients (bosentan: n = 6; iloprost: n = 6) was additionally photodocumented prior to therapy initiation, enabling an intraindividual analysis over the course of therapy.After ten months of therapy patients with SSc receiving bosentan showed a significantly (P = 0.0028) higher frequency of centrofacial TAE (41.6 ± 27.8) as compared to patients with SSc receiving iloprost (14.3 ± 13.1). Detailed subgroup analysis revealed that the frequency of TAE in the bosentan group (n = 6 patients) increased markedly and significantly (P = 0.027) by 44.4 after ten months of therapy (TAE at therapy initiation: 10.8 ± 5.1; TAE after ten months of therapy: 55.2 ± 29.8), whereas an only minor increase of 1.9 was observed in the iloprost group (n = 6 patients; TAE at therapy initiation: 18.3 ± 14.5; TAE after ten months of therapy: 20.2 ± 15.5), yet without reaching statistical significance (P = 0.420).The use of bosentan may be associated with an increased frequency of TAE in patients with SSc. Patients should be informed about this potential adverse effect prior to therapy. Treatment options may include camouflage or laser therapy.