Effects of TNF-α polymorphisms on asthma risk: a systematic review and meta-analysis

BACKGROUND

Several studies have examined associations between TNF-α polymorphisms and asthma risk, but the results have been conflicting.

METHODS

A search was performed of the PubMed, EMBASE, and Wanfang databases. Data were extracted and pooled ORs with 95% CIs were calculated.

RESULTS

Fifty-four studies were included. A significant association between the TNFA-308A/G polymorphism and asthma susceptibility was observed for AA + AG vs GG (OR, 1.39; 95% CI, 1.23-1.58; P < .001). This polymorphism was also significantly associated with asthma risk in whites (OR, 1.47; 95% CI, 1.25-1.73; P < .001), atopic asthma risk (OR, 1.38; 95% CI, 1.16-1.65; P < .001), pediatric asthma risk (OR, 1.48; 95% CI, 1.23-1.79; P < .001), and adult asthma risk (OR, 1.35; 95% CI, 1.21-1.52; P < .001).There was also a significant association between the TNFA -857C/T polymorphism and asthma risk in the recessive model (OR, 1.25; 95% CI, 1.10-1.43; P < .001). In the subgroup analyses, asthma risk was significantly increased in Asians (OR, 1.23; 95% CI, 1.07-1.41; P = .004) and atopic individuals (OR, 1.33; 95% CI, 1.13-1.57; P < .001). No significant association was found for the TNFA-238A/G polymorphism. There were insufficient data to evaluate the associations between TNFA -1031T/C and -863C/A polymorphisms and asthma risk.

CONCLUSIONS

This meta-analysis suggests that TNFA -308A/G and -857C/T polymorphisms are risk factors for asthma.

Recovery of white matter tracts in regions of peritumoral FLAIR hyperintensity with use of restriction spectrum imaging

BACKGROUND AND PURPOSE

DTI is being increasingly used to visualize critical white matter tracts adjacent to brain tumors before neurosurgical resection. However, brain tumors, particularly high-grade gliomas, are typically surrounded by regions of FLAIR hyperintensity that include edema, which increase isotropic diffusion, degrading the ability of standard DTI to uncover orientation estimates within these regions. We introduce a new technique, RSI, which overcomes this limitation by removing the spherical, fast diffusion component introduced by edema, providing better analysis of white matter architecture.

MATERIALS AND METHODS

A total of 10 patients with high-grade gliomas surrounded by FLAIR-HI that at least partially resolved on follow-up imaging were included. All patients underwent RSI and DTI at baseline (FLAIR-HI present) and at follow-up (FLAIR-HI partially resolved). FA values obtained with RSI and DTI were compared within regions of FLAIR-HI and NAWM at both time points.

RESULTS

RSI showed higher FA in regions of FLAIR-HI and NAWM relative to DTI, reflecting the ability of RSI to specifically measure the slow, restricted volume fraction in regions of edema and NAWM. Furthermore, a method by time interaction revealed that FA estimates increased when the FLAIR-HI resolved by use of standard DTI but remained stable with RSI. Tractography performed within the region of FLAIR-HI revealed the superior ability of RSI to track fibers through severe edema relative to standard DTI.

CONCLUSIONS

RSI improves the quantification and visualization of white matter tracts in regions of peritumoral FLAIR-HI associated with edema relative to standard DTI and may provide a valuable tool for neurosurgical planning.

1,25-dihydroxyvitamin D3 inhibits nuclear factor kappa B activation by stabilizing inhibitor IκBα via mRNA stability and reduced phosphorylation in passively sensitized human airway smooth muscle cells

Excessive activation of nuclear transcription factor-κB (NF-κB) is involved in human airway smooth muscle cells (HASMCs) activities in asthma. We investigated the effects of 1,25 - dihydroxyvitamin D3 [1,25 - (OH) 2D3] on the NF- κB signaling pathway in passively sensitized HASMCs and the molecular mechanisms involved. HASMCs were treated with either healthy controls' serum, asthma patients' serum or pretreated with 1,25 - (OH) 2D3 prior to treatment with asthmatics' serum. At 1 h after serum treatment: electrophoretic mobility shift assay (EMSA) was used to detect NF-κB DNA binding activity; immunocytochemical staining was used to observe the nuclear translocation of NF-κB p65; Western blots were used for NF-κB p65, IκBα, and phospho-IκBα protein levels and the nuclear translocation of NF-κB p65; real-time quantitative PCR was used for NF-κB p65 and IκBα mRNA expressions; and actinomycin D treatment was used to determine IκBα mRNA stability. Our major findings were: (1) 1,25 - (OH) 2D3 significantly reduced asthma serum passively sensitized HASMCs NF-κB DNA binding activity and inhibited the nuclear translocation of NF-κB p65; (2) 1,25 - (OH) 2D3 increased the stability of IκBα mRNA with reduced IκBα phosphorylation in asthma serum passively sensitized HASMCs and significantly increased IκBα expression in these HASMCs. Inhibiting NF-κB signalling with 1,25 - dihydroxyvitamin D3 may be a therapeutic approach for controlling HASMC-related remodelling in asthma.

The role of immunohistochemistry in the diagnosis of hyalinizing clear cell carcinoma of the minor salivary gland: a case report

A case of hyalinizing clear cell carcinoma (HCCC) of the minor salivary glands of the oral cavity is reported. A 52- year-old woman presented with a growing mass at the base of the tongue. The patient underwent complete resection of the tumour. The histological picture was characterized by trabeculae or solid nests of proliferating cells with a clear cytoplasm, surrounded by a hyalinizing stroma. Tumour cells were immunoreactive for Cytokeratins 5, 6, 7, 8, 14, 17 and 18. No reactivity was observed for cytokeratin 20, vimentin, S- 100 protein, smooth-muscle actin, muscle-specific actin, and calponin. These findings confirmed the diagnosis of HCCC of minor salivary glands of the oral cavity. The clinical presentation, the immunohistochemical pattern and the role of cytokeratins in the differential diagnosis of HCCC are discussed with a review of the literature.

Examining chronic kidney disease management in a single center

AIMS

The management of patients with chronic kidney disease in outpatient clinics was assessed for the ability to achieve targets of care advocated in clinical practice guidelines.

METHODS

272 records of outpatients with increased serum creatinine (> or = 1.5 mg/dl for women, > or = 2.0 mg/dl for men) were reviewed for details of their assessment and management. Prevailing data on blood pressure, anemia, bone disease and lipid status as well as therapeutic changes were evaluated.

RESULTS

The subjects were aged 64 +/- 18 years, serum creatinine 2.6 +/- 1.1 mg/dl, and calculated GFR (MDRD formula) 19.2 +/- 9.9 ml/min. Median UproV was 1.0 (0.024 - 12.4) g/day. Causes of CKD were diabetes (33.5%), HTN (8.8%), GN (19.5%), and adult PKD (3.3%). Treatment targets were BP < 130/85 mmHg, Hct > or = 36%, serum Ca++ > or = 8.5 mg/dl, serum Po4 < 4.5 mg/dl and cholesterol < 200 mg/dl. Of the patients with abnormal findings, mean values for SBP were 153 +/- 17 mmHg, DBP 93 +/- 6 mmHg, Hct 31.7 +/- 2.9%, Ca++ 8.0 +/- 0.7 mg/dl, PO4 5.6 +/- 1.0 mg/dl, and cholesterol 236 +/- 37 mg/dl. Only a minority of patients with abnormal values had their treatment altered. Furthermore, only 54% of patients with hypertension were treated with either ACEi or ARB therapy. Finally, only 6% of patients with hypercholesterolemia had fasting lipid levels measured.

CONCLUSION

This data suggests that treatment of patients with CKD has improved, but that many opportunities exist to optimize their care.

Perflubron emulsion reduces inflammation during extracorporeal circulation

The recovery from cardiac surgery and cardiopulmonary bypass can be complicated by an acute inflammatory response. Circulating blood through an extracorporeal circuit (ECC) contributes to this complication. Perfluorocarbon-based blood substitutes (PFCs) are under investigation for use as a component of the ECC "prime" solution, because PFCs increase the oxygen-carrying capacity of the diluted blood. Some PFCs may provide the additional benefit of attenuating the ECC-induced inflammatory response. Earlier, we reported that perflubron emulsion (PFE, Alliance Pharmaceutical Corp.) reduced neutrophil (PMN) activation in vivo. However, the potential of PFE to reduce ECC-induced PMN activation has not been investigated. In this study, we used a small-scale ECC model to quantify the extent of PMN activation during circulation and to examine if PFE treatment attenuated PMN activation. ECC circuits were filled with a mixture of blood and Plasmalyte. Two groups were studied: an untreated group containing blood plus PlasmaLyte and a treated group in which some of the Plasmalyte was substituted with PFE (4.5 g/100 ml). Hematology and measures of whole blood PMN activation were made from blood samples taken periodically throughout the 120-min ECC circulation period. We found, for the untreated group, a significant decrease in the number of circulating PMNs and an increase in PMN activation with time. PMN activation was demonstrated as a significant increase in the expression of the PMN adhesion protein CD11b (P < 0.05) and an increase in PMN oxygen free radical production (reactive oxygen species (ROS)). After 120 min of circulation, the PMNs remained capable of a significant response to a second inflammatory stimulus, but PFE treatment significantly attenuated the fMLP-induced increase in PMN ROS at t = 120 min (P < 0.05). These results suggest that PFE may have dual utility in cardiac surgery, to increase oxygen delivery and to serve as an antiinflammatory agent.

Work stress among six professional groups: the Singapore experience

Recent developments in stress research have called for attention to how social structures influence the stress and coping processes. This paper examines the experience of work stress among professionals in Singapore and argues that workers' experiences in the workplace are influenced not only by individual personality and job nature, but also by structural forces shaping the profession, the social organization of work institutions and the development of the economy. Data were collected from a survey of professionals in Singapore conducted in 1989-1990. The sample consisted of 2570 men and women from six different professions and para-professions, namely general practitioners, lawyers, engineers, teachers, nurses and life insurance personnel. Results showed that performance pressure and work-family conflicts were perceived to be the most stressful aspects of work. These two stressors also significantly contributed to the experience of overall work stress. Further, stress arising from work-family conflicts, performance pressure and poor job prospects was negatively associated with the level of work satisfaction. These findings were discussed in the contexts of increasing professionalization and de-professionalization and the growing emphases on productivity and efficiency in a quickly developing economy.

Validation of a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary flow reserve: comparison with intracoronary Doppler flow wire

OBJECTIVES

We tested the hypothesis that coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD) as assessed by a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) is in agreement with CFR measurements assessed by intracoronary Doppler flow wire.

BACKGROUND

Contrast-enhanced transthoracic second harmonic echo Doppler is a novel noninvasive method to detect blood flow velocity and reserve in the LAD. However, it has not yet been validated versus a gold-standard method.

METHODS

Twenty-five patients undergoing CFR assessment in the LAD by Doppler flow wire were also evaluated by contrast-enhanced transthoracic Doppler to record blood flow in the distal LAD at rest and during hyperemia obtained by adenosine i.v. infusion. In five patients CFR was evaluated twice (before and after angioplasty).

RESULTS

As a result of the combined use of i.v. contrast and second harmonic Doppler technology, feasibility in assessing coronary flow reserve equaled 100%. The agreement between the two methods was high. In fact, in all but five patients the maximum difference between the two CFR measurements was 0.38. Overall, the prediction (95%) interval of individual differences was -0.69 to +0.72. Reproducibility of CFR measurements was also high. The limits of the agreement (95%) between the two measurements were -0.32 to +0.32.

CONCLUSIONS

Coronary flow reserve in the LAD as assessed by contrast-enhanced transthoracic echo Doppler along with harmonic mode concurs very closely with Doppler flow wire CFR measurements. This new noninvasive method allows feasible, reliable and reproducible assessment of CFR in the LAD.

[The three-dimensional titanium miniplate rigid fixation in the treatment of fracture of maxilla]

The three-dimensional (3-D) Titanium miniplate system is one of the newest internal rigid fixation for the maxillo-mandibular surgery in recent years. The geometry of the plate assures a good stability in the three-dimensions of the fracture sits. Thirty patients suffering from maxillo-mandibular fractures had been operated on using the 3-D Titanium miniplates since 1991. The group of the patient included 16 cases of mandibular fractures, 8 cases of maxillary fractures and 6 cases of maxillo-mandibular fracture. All of the patient had very good result without any complication. The follow-up was 6 months to 3 years. The 3-D Titanium miniplate as an ideal easy to use, good resistance against torque forces and, compact forms of the miniplate were the some of the advantages. Clinical examples had been provided to illustrate the actual usage of the 3-D miniplate in the field of the surgical treatment for the maxillo-mandibular fracture. It is the author's opinion that the internal rigid fixation by 3-D Titanium miniplates is a promising method of treating fractures of the maxilla and is to be better tolerated by the patients and surgeons.

Stress in the life course: a life history approach

This article examines the relationship between stress and distress in the life course, emphasizing the time elapsed between the event and measurement of psychological distress. Stressors are conceptualized as either distal or proximal based on how recently they occurred. Distal stressors are further classified as status changes or undesirable life changes. Using a life history calendar approach, we examine stressors occurring over a 15-year-period. We explore whether distal stressors affect current depressive symptomatology above and beyond the effect of more recent stressors and how these stressors vary in frequency and affect over 3 empirically defined age groups. While some events decrease in frequency over age, others occur consistently across age groups. Most important, distal stressors significantly impact current depressive symptomatology, independent of proximal stressors. Types of distal stressors affecting depression vary over age, indicating that the stage of life at which a stressor occurs is a significant determinant of the stressor's effect on depression.

Stimulation of megakaryocytopoiesis in mice by human modified C-reactive protein (mCRP)

The prototypic human acute phase reactant, C-reactive protein (CRP), and a structurally modified form of CRP (mCRP) were studied as agents which could stimulate thrombopoiesis in both in vitro and in vivo mouse models. mCRP, but not the widely studied (native) pentameric form of CRP, demonstrated significant megakaryocyte colony-stimulating activity. This activity was measured in plasma clot cultures incubated with pokeweed mitogen-stimulated spleen cell conditioned medium (PWM-SCM). mCRP increased the number of mouse megakaryocyte colonies in a dose-dependent manner. While significantly more colonies were observed in mCRP-treated cultures compared to controls, the kinetics of megakaryocyte growth and maturation were similar to those measured in cultures stimulated with PWM-SCM lacking mCRP. A low level of megakaryocyte growth-promoting activity was noted when mCRP was added to plasma clot cultures not incubated with spleen cell conditioned medium. However, the most striking activity of mCRP was in potentiating stimulated megakaryocyte colony formation (i.e., as a Meg-POT factor). In in vivo experiments, mCRP injected subcutaneously into normal mice resulted in significant increases in blood platelet numbers compared to control mice receiving sham injections. These results suggest that a modified form of CRP has thrombopoietic activity in both in vitro and in vivo mouse models, Therefore, one important biological role for CRP during an acute-phase response might be to contribute, after a structural modification, to the hematopoietic regulation of blood platelets.

Urban stress in China

The stress-distress model is examined in the context of a Chinese urban center, Tianjin. Conceptually, the relationship between stress (as reflected in life events) and distress (as reflected in depressed symptoms) is hypothesized to hold across societies. At the same time, the measures of stress must reflect the social reality of a particular community of society. In the case of urban China, the politically-imposed stratification system arranges individuals and family lives around work units. These work units dictate all aspects of the life of the worker and his or her family, ranging from housing, major purchases, access to local and distance facilities, schooling and employment for children, to retirement pension and funeral expenses. As a result, relationships in the work context are expected to produce stress-inducing conflicts. Results from a community survey of Tianjin residents in 1986 support both the generality of the stress-distress model and the specificity of the effects of work-related stressors.

Work and family roles and psychological well-being in urban China

A theoretical framework that delineates the relationships between work and family roles and psychological well-being is derived from U.S. research and utilized to examine the relationships of work and family stress with psychological well-being in urban China. Data from a sample of 733 married and employed individuals in urban Shanghai confirm the general model of the link between work and family stress and psychological distress. Due to the centrality of work roles for the Chinese, work stress exerts a stronger relationship on psychological well-being than does family stress. Furthermore, the Chinese are more vulnerable to stress arising from interpersonal conflicts than from role demands. In addition, gender differences are found in the relationship between role stress and distress. Women tend to experience more family demands than men. Women's mental health status is tied similarly to stress arising from work and family roles, whereas men are more vulnerable to work stress than family stress. However, Chinese women do not report significantly greater generalized distress than men.

[Surgical repair of laparocele with expanded PTFE: technicalities]

Surgical repair of ventral hernias may often be quite difficult; however, the use of prosthesis, now generally accepted by many surgeons, has improved the results of such type of surgery. The Authors experience confirm the safety of the expanded PTFE and its versatility of employment, obtaining good functional and aesthetic results.

Treatment tolerance of elderly cancer patients entered onto phase II clinical trials: an Illinois Cancer Center study

PURPOSE

Past research that has compared cancer treatment tolerance between elderly and nonelderly cancer patients has been contradictory. Some investigators concluded that there is no difference between the groups, while others demonstrated elderly patients experienced less tolerance to treatment. As a result, some physicians discriminate against elderly cancer patients by not entering them onto clinical trials out of a belief that they will not tolerate the therapy.

METHODS

An analysis was performed using the Illinois Cancer Center (ICC) data base, which contains treatment information for all patients registered onto phase II trials. A maximum of 672 cases was available for evaluation of 11 treatment-related variables.

RESULTS

The results demonstrated no significant differences between elderly and nonelderly patients for the following seven treatment-related variables: performance status (PS), number of dose reductions, number of treatment interruptions, total days of delay, best response, reason off-study, and number of grade 3 or greater toxicities. Minor differences were detected for number of courses and number of dose escalations.

CONCLUSION

Based on these results, elderly patients should not be denied access to cancer clinical trials relative to age alone.

Use of the fast Fourier transform method for analyzing linear and equispaced Fizeau fringes

The Fourier transform method is applied to analyze the initial phase of linear and equispaced Fizeau fringes. We develop an algorithm for high-precision phase measurement by using the Fourier coefficient that corresponds to the spatial frequency of the Fizeau fringes, and we describe methods for determining the fringe carrier frequency. Errors caused by carrier frequency fluctuation and data truncation are studied theoretically and by computer simulation. To demonstrate the method we apply it to the real-time calibration of a piezoelectric transducer mirror in a Twyman-Green interferometer.