Antiemetic effects of combined methylprednisolone and tropisetron in mastectomy

BACKGROUND

Combined dexamethasone and tropisetron have been reported more effective than a single drug therapy in preventing postoperative nausea and vomiting (PONV). However, the safety use of dexamethasone has been questioned recently because of the risk of secondary adrenal deficiency. Therefore, we hypothesized that combined tropisetron and methylprednisolone, a short-lasting corticoid, might provide effective prophylaxis of PONV with less effect on endogenous cortisol level.

METHODS

In this study, 224 women undergoing modified radical mastectomy under general anesthesia were randomly divided into three groups: 1) receiving 10 mg tropisetron alone (T, N.=76); 2) 10 mg tropisetron and 8 mg dexamethasone (TD, N.=73); or 3) 10 mg tropisetron and 40 mg methylprednisolone (TM, N.=75) intravenously. Serum cortisol level, episodes of PONV and the need for rescue antiemetic medication were recorded during first 3 days after surgery.

RESULTS

Serum cortisol significantly decreased in group TD (5.42±1.87 μg/dL), compared with group TM (14.38±2.01 μg/dL, P<0.01) and group T (19.52±1.53 μg/dL, P<0.001) in the first day postoperatively. In the first 24 hours, the incidence of vomiting was significantly higher in group T (15.8%), compared with group TD (5.5%, P<0.05) and group TM (5.3%, P<0.05), respectively. The overall request for a rescue antiemetic of group T was significantly higher, compared with group TD and group TM (P<0.05).

CONCLUSION

Methylprednisolone-tropisetron combination is more effective than tropisetron alone, and as equally effective as dexamethasone-tropisetron combination for preventing acute PONV in mastectomy.

CpG ODN-induced matrix metalloproteinase-13 expression is mediated via activation of the ERK and NF-κB signalling pathways in odontoblast cells

AIM

To investigate the effects of CpG ODN (CpG oligodeoxynucleotides) to model the action of bacterial challenge on pulpal matrix metalloproteinase-13 (MMP-13) expression and elucidate the associated intracellular signalling pathways.

METHODOLOGY

Real-time PCR was used to detect the effects of CpG ODN on MMP-13 mRNA expression levels in a murine odontoblast-lineage cell line (OLCs). The possible involvement of TLR9/MyD88, NF-κB or MAPK pathways involved in the CpG ODN-induced MMP-13 expression was examined by real-time PCR, transient transfection, luciferase activity assay and ELISA. Western blotting was performed to assay the phosphorylation of ERK at a range of time points.

RESULTS

MMP-13 was constitutively expressed in OLCs, and their exposure to CpG ODN significantly increased MMP-13 expression. Pre-treatment of OLCs with the inhibitory peptide MyD88, or chloroquine, attenuated the CpG ODN-induced expression of MMP-13. Treatment of the OLCs with CpG ODN increased NF-κB-luciferase activity. This activity was decreased by the over-expression of a nondegrading mutant of IκBα (IκBαSR), although enhanced by the over-expression of NF-κB p65. MMP-13 expression induced by CpG ODN was markedly suppressed by NF-κB inhibitors (pyrrolidine dithiocarbamate, PDTC), IκBα phosphorylation inhibitors (Bay 117082) or IκB protease inhibitor (L-1-tosylamido-2-phenylethyl chloromethyl ketone, TPCK). The inhibitor of ERK1/2, U0126, but not inhibitors of p38 MAPK and JNK, SB203580 and SP600125, decreased CpG ODN-mediated MMP-13 expression.

CONCLUSION

The CpG ODN-induced MMP-13 expression in OLCs is mediated through TLR9, NF-κB and the ERK pathway indicating that potentially the recognition of CpG ODN by TLR9 on odontoblasts may regulate the remodelling of injured dental pulp and hard tissues by inducing MMP-13 expression.

Distribution-free models for longitudinal count responses with overdispersion and structural zeros

Overdispersion and structural zeros are two major manifestations of departure from the Poisson assumption when modeling count responses using Poisson log-linear regression. As noted in a large body of literature, ignoring such departures could yield bias and lead to wrong conclusions. Different approaches have been developed to tackle these two major problems. In this paper, we review available methods for dealing with overdispersion and structural zeros within a longitudinal data setting and propose a distribution-free modeling approach to address the limitations of these methods by utilizing a new class of functional response models. We illustrate our approach with both simulated and real study data.

Evaluation of plasma and tissue S100A4 protein and mRNA levels as potential markers of metastasis and prognosis in clear cell renal cell carcinoma

OBJECTIVES

To investigate levels of S100A4 protein in plasma and S100A4 mRNA in tumours from patients with clear cell renal cell carcinoma (CCRCC), and correlate these with metastasis, survival and levels of vascular endothelial growth factor (VEGF).

METHODS

Plasma S100A4 and VEGF protein concentrations were measured using enzyme-linked immuno sorbent assays in 39 healthy subjects and 68 consecutive patients with untreated CCRCC. Levels of S100A4 and VEGF mRNA in tumour and matched control (healthy) tissue samples were measured using realtime quantitative reverse transcription- polymerase chain reaction. Findings were analysed with respect to clinico pathological characteristics.

RESULTS

Plasma VEGF concentrations were higher in patients with CCRCC than in healthy subjects. S100A4 and VEGF mRNA levels were up-regulated in CCRCC tumour tissue compared with control tissue samples. Logistic regression analysis revealed that up-regulated tumour S100A4 and VEGF mRNA levels were independent risk factors for the presence of invasion and/or metastasis.

CONCLUSIONS

S100A4 and VEGF are associated with tumour invasion and metastasis, and may be useful prognostic markers in patients with CCRCC. S100A4 and VEGF may represent potential targets for therapeutic intervention.

Lactobacillus amylophilus D14 protects tight junction from enteropathogenic bacteria damage in Caco-2 cells

Enterotoxigenic Escherichia coli and Salmonella Typhimurium could adhere to epithelial tissue and destroy cell junctions, leading to intestinal inflammation and diarrhea. Lactobacillus could prevent the adhesion of pathogens to host cells and protect the mucosal barrier. The objective of this study was to investigate the protective effects of Lactobacillus amylophilus D14 on Caco-2 cells against the invasion of enterotoxigenic Escherichia coli K88 and Salmonella Typhimurium SL1344. We found that with a reduction in dextran permeability and an increase in transepithelial electrical resistance, L. amylophilus D14 could ameliorate the damage to cell integrity caused by pathogens. Furthermore, L. amylophilus D14 reduced the expression of phosphorylated extracellular signal-regulated protein kinase and phospho-c-jun N-terminal kinase, and it decreased the secretion of IL-8. The abilities of the Lactobacillus to protect the cell junctions were then evaluated on Caco-2 cells. Increased expression and amelioration distribution of tight junction proteins (zonula occludens-1, claudin-1, and E-cadherin) were observed when the cells were cocultured with pathogens and Lactobacillus simultaneously. Lactobacillus amylophilus D14 may influence the mitogen-activated protein kinase pathway to regulate the correct assembly of the tight junction and adherens junction, protecting the cell junctions and mucosal barrier damaged by enterotoxigenic E. coli K88 or Salmonella Typhimurium SL1344 infection.

LPS induces IL-8 expression through TLR4, MyD88, NF-kappaB and MAPK pathways in human dental pulp stem cells

AIM

To evaluate the effects of lipopolysaccharide (LPS) on interleukin-8 (IL-8) and related intracellular signalling pathways in human dental pulp stem cells (hDPSCs).

METHODOLOGY

Human pulp tissues were isolated from human impacted third molars, and the hDPSCs were cultured and characterized. The effects of LPS on IL-8 and Toll-like receptor 4 (TLR4) gene expression in hDPSCs were investigated using real-time quantitative RT-PCR and ELISA. Whether TLR4/MyD88/NF-кB was involved in the LPS-induced up-regulation of IL-8 in hDPSCs was determined using transient transfection, luciferase assay and ELISA. The involvement of MAPKs in the LPS-induced up-regulation of IL-8 in hDPSCs was investigated via transient transfection, luciferase assay, ELISA and western blot. The data were statistically analysed using Student's t-test or one-way anova followed by the Student-Neumann-Keuls test.

RESULTS

Cells exposed to LPS not only displayed an enhanced expression of TLR4 but also showed an elevated IL-8 gene expression; exposure to LPS also resulted in the induction of IL-8 gene transcription via promoter activation. The LPS-induced IL-8 promoter activation was inhibited through dominant-negative mutations in TLR4 and MyD88, but not in TLR2. The LPS-induced IL-8 protein release was attenuated through the administration of TLR4-neutralizing antibody or MyD88 inhibitory peptide and a dominant-negative mutation in IκBα. In contrast, IL-8 protein release was enhanced through the expression of NF-κB p65. Treatment with PDTC, TPCK or Bay117082 effectively antagonized LPS-induced IL-8 protein release. Moreover, both the promoter activity and the LPS-induced release of IL-8 were diminished upon the administration of U0126 and SB203580, but not SP600125. Moreover, the exposure to LPS activated ERK1/2 and p38 MAPK phosphorylation in cells.

CONCLUSIONS

This study reports the LPS-mediated transcriptional and post-translational up-regulation of IL-8, which is a process that also involves TLR4, MyD88, NF-κB and MAPK.

C-reactive protein levels are associated with the progression of atherosclerotic lesions in rabbits

Elevated plasma levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular disease. CRP immunoreactive protein is also detected in the lesions of atherosclerosis. However, it is not known whether the CRP contents of atherosclerotic lesions are associated with the initiation and progression of atherosclerosis. To examine this hypothesis, we investigated different types of atherosclerotic lesions of rabbits fed with a cholesterol-rich diet for 6, 12, 16, and 28 weeks and examined their relationship with CRP. We measured the aortic atherosclerotic area, macrophages, and smooth muscle cells along with CRP contents in the lesions. Atherosclerotic lesions of aortas began to form at 6 weeks and were characterized by accumulation of macrophages in the intima, and lesions became more fibrotic in the advanced stage. Both plasma CRP levels and the lesional CRP contents were associated with the lesion size. Our results suggest that plasma CRP, as well as lesional CRP, associated with the formation and progression of atherosclerotic lesions.

Association of β-cell function and insulin sensitivity with fasting and 2-h plasma glucose in a large Chinese population

AIM

Our aim was to provide a quantitative analysis of the changes in the principal determinants of insulin sensitivity and secretion in relation to fasting plasma glucose (FPG) or 2-h plasma glucose (2h PG) in a Chinese population with a wide range of glucose tolerance.

METHODS

A total of 5728 adults spanning the entire range of glucose tolerance were included. Insulin sensitivity was measured by Matsuda insulin sensitivity index (ISI(M)) and homeostasis model assessment of 1/homeostasis model assessment of insulin resistance (HOMA-IR). β-Cell function adjusted by insulin sensitivity was assessed from disposition index (DI) at early-phase DI(30) and total DI(120). The exponential curve was established as the best fit for the relationship between insulin sensitivity or β-cell function and FPG or 2h PG.

RESULTS

Relative to the trend classified as increasing 2h PG, hepatic insulin sensitivity and insulin secretion showed a decreasing trend to a substantial degree as FPG increased. A 1 mmol/l increase in FPG and 2h PG concentration was associated with a -22 and -21% decline in ISI(M), -16 and -4% in 1/HOMA-IR, -38 and -35% in DI(30) and -36 and -26% in DI(120). The decay constant of ISI(M) and DI(30) in IFG or ISI(M), 1/HOMA-IR, DI(30) and DI(120) in IGT was lower than that in normal glucose tolerance. Significant interactions between sex and glucose levels determining DI were found.

CONCLUSIONS

We conclude that impairment of insulin sensitivity and insulin secretion contributes to both FPG or 2h PG hyperglycaemia in a Chinese population, but that the decline in insulin secretion is more pronounced with increasing fasting than 2h PG.

Discovery of Potato Rot Nematode, Ditylenchus destructor, Infesting Garlic in Ontario, Canada

Potato rot nematode, Ditylenchus destructor Thorne, 1945, is a serious nematode pest in a number of root and tube crops, primarily in potatoes, and is an internationally quarantined pest (2). In garlic, it was only reported in Japan (3). In 2011, a survey was conducted for the stem and bulb nematode, Ditylenchus dipsaci (Kühn) Filipjev in Ontario, Canada. PCR analysis revealed that a population of Ditylenchus from one garlic (Allium sativum) bulb sample in a 0.81-ha field (2-acre) in the Ottawa area had a significantly longer ITS1 (approximately 100 bp) than that of D. dipsaci. Subsequent morphology and DNA sequencing concluded that the population was Ditylenchus destructor, a quarantine species in Canada. Twenty females and twenty males were fixed and permanently mounted for morphological studies. The main diagnostic characters matched the description of D. destructor by Thorne (4). The female stylets had strong knobs, 11.1 ± 0.9 (10 to 12) μm long, lateral fields with six distinct lines in the middle section of the body, excretory pore 4.7 ± 1.3 (3 to 6) μm posterior to the hemizonid, esophageal base bulb overlaps dorsally with the intestine, post-vulval uterine sac extends up to two-thirds of the vulva-anus distance, and tail terminus finely rounded. A total of 20 nematode individuals were used for the molecular studies. They had 5-bp differences with the ITS1 (GenBank Accession No. EF208210; 650 bp) sequence of an isolate from Sihong County, China. The sequence of the partial 18S gene (GenBank Accession No. AY593912; 864 bp) was identical to the sequence of an isolate of D. destructor in the Netherlands. The detection of stem and bulb nematode was also confirmed from the field. Infested garlic plants were stunted and the basal bulbs became dark and somewhat rotten. Prior to this finding in Canada, D. destructor was only reported in a few isolated locations in the province of Prince Edward Island (PEI) in 1946 (1). The nematodes in PEI were effectively controlled. Another suspected case in British Columbia was not confirmed since the infested field had been known to be infested with D. dipsaci. To our knowledge, this is the first report of D. destructor on the mainland of Canada. The infested field has been subjected to strict quarantine measures to prevent the spread of the pest. Reference: (1) A. D. Baker et al. Sci. Agric. 26:138, 1946. (2) EPPO. No. 123. Data Sheets on Quarantined Organisms. Bulletin OEPP/EPPO Bull. 8, 1978. (3) T. Fujimura et al. Jpn. J. Nematol. 8:22, 1989. (4) G. Thorne. Proc. Helminthol. Soc. Wash. 12:27, 1945.

Synovial chondromatosis of the temporomandibular joint: MRI findings with pathological comparison

OBJECTIVES

The aim of this retrospective study was to characterize MRI findings of synovial chondromatosis in the temporomandibular joint (TMJ) by correlation with their pathological findings.

METHODS

22 patients with synovial chondromatosis in unilateral TMJ were referred for plain MRI prior to surgical management and pathological examinations. Parasagittal and coronal proton density-weighted imaging and T₂ weighted imaging were performed for each case.

RESULTS

MRI demonstrated multiple chondroid nodules and joint effusion in all patients (100%) and amorphous iso-intensity signal tissues within expanded joint space and capsule in 19 patients (86.4%). On T₂ weighted imaging, signs of low signal nodules within amorphous iso-intensity signal tissues were used to determine the presence of attached cartilaginous nodules in pathology, resulting in 100% sensitivity, 60% specificity and 90.9% accuracy. Signs of low and intermediate signal nodules within joint fluids were used to detect loose cartilaginous nodules and resulted in 80% sensitivity, 42.9% specificity and 68.2% accuracy.

CONCLUSIONS

MRI of synovial chondromatosis in TMJ was characterized by multiple chondroid nodules, joint effusion and amorphous iso-intensity signal tissues within the expanded space and capsule. The attached cartilaginous nodules in pathology were better recognized than the loose ones on MRI. Plain MRI was useful for clinical diagnosis of the disorder.

Osteosarcoma of the jaws: demographic and CT imaging features

OBJECTIVE

The aim of this study was to evaluate the patient demographic and CT imaging findings of primary osteosarcoma of the jaws.

METHODS

88 primary osteosarcomas of the jaws histopathologically diagnosed during 1997-2007 were reviewed. 21 cases of CT images were reviewed.

RESULTS

Of 88 patients, 51 (58%) had tumours in the mandible and 37 (42%) in the maxilla. The mean age was 37.8 years (range 9-80 years). The male-to-female ratio was 1.32:1. The mean age of patients with mandibular lesions was 41.04 years and in those with maxillary lesions it was 33.3 years. CT imaging findings were available in 21 patients. In the maxilla (n = 9), all tumours (100%) arose from the alveolar ridge. In the mandible (n = 12), most tumours (9 cases, 75%), arose from the ramus and/or condyle. All except two lesions had the epicentrum within the medullary cavity of the involved bone. The presence of periosteal reaction was demonstrated in 13 cases (62%). Soft-tissue extension was present in 18 lesions (86%), with calcification identified in 13 (72%).

CONCLUSIONS

This study provides age, sex distribution, location and CT imaging features of primary osteosarcoma of the jaws.

Electron cotunneling transport in gold nanocrystal arrays

We describe current-voltage (I-V) characteristics of alkyl-ligated gold nanocrystals ~5 nm arrays in a long screening length limit. Arrays with different alkyl ligand lengths have been prepared to tune the electronic tunnel coupling between the nanocrystals. For long ligands, electronic diffusion occurs through sequential tunneling and follows activated laws, as a function of temperature σ∝e(-T(0)/T) and as a function of electric field I∝e(-E(0)/E). For better conducting arrays, i.e., with small ligands, the transport properties cross over to the cotunneling regime and follow Efros-Shklovskii laws as a function of temperature σ∝e(-(T(ES)/T)(1/2) and as a function of electric field I∝e(-(E)(ES)/E)(1/2). The data show that electronic transport in nanocrystal arrays can be tuned from the sequential tunneling to the cotunneling regime by increasing the tunnel barrier transparency.

Secondary chondrosarcoma in the mandibular condyle

We report the case of a woman who had secondary chondrosarcoma in an osteochondroma in the left mandibular condyle, presenting as a large lobulated bone density mass in the left condyle process, to illustrate the clinical characteristics and imaging findings.