Adult height and cancer mortality in Asia: the Asia Pacific Cohort Studies Collaboration

BACKGROUND

The observation that taller people experience an increased risk of selected cancers is largely restricted to Caucasian cohorts. These associations may plausibly differ in Asian populations. For the first time, we make direct comparison in the same analyses of the associations between height and a series of malignancies in Australasian (Caucasian) and Asian populations.

METHODS

Analyses were based on the Asia Pacific Cohort Studies Collaboration of 506 648 study participants (408 381 Asia, 98 267 Australasia) drawn from 38 population-based cohort studies. Cox proportional hazards regression was used to estimate the relationship between height and cancer rates.

RESULTS

A total of 3 272 600 person-years of follow-up gave rise to 7497 cancer deaths (4415 in Asia; 3082 in Australasia). After multiple adjustments and left censoring, taller individuals experienced increased rates of carcinoma of the intestine (men and women); all cancers, liver, lung, breast, 'other' malignancies (all women); and cancers of the prostate and bladder (men). No consistent regional (Asia versus Australasia) or sex differences were observed.

CONCLUSIONS

In the present study, taller men and women had an elevated risk of selected malignancies. These associations did not differ appreciably between Asian and Caucasian populations.

Profiling of factor VIII mutations in Korean haemophilia A

Haemophilia A (HA) is an X chromosome-linked inherited bleeding disorder caused by heterogeneous mutations of coagulation factor VIII (FVIII). Although more than 900 mutations of FVIII gene are reported in the HAMSTeRS database, the mutation data regarding the FVIII gene in the Korean population is currently insufficient. The aim of this study was to profile the mutations of FVIII in Korean HA, 38 unrelated Korean HA male patients were examined. Peripheral blood samples were obtained from the patients. Long distance-PCR was performed for the identification of inversions in intron 22 and intron 1. Then gross exon deletion was examined to the inversion-negative patients by multiplex-PCR. Finally, direct sequencing was performed on exons 1-26, 5'- and 3'-UTR. We identified 33 mutations from the 38 patients. These included 15 inversions in intron 22 (39.5%), one inversion in intron 1 (2.6%), one gross exon deletion (2.6%), five deletions (13.2%), two insertions (5.3%), six missense (15.8%) and three nonsense mutations (7.9%). Mutation types for five patients (13.2%) were not identified in this study. We determined that the most common defect in FVIII in this study was an inversion mutation in intron 22; this is consistent with the findings of other studies. For the first time in Korean HA, a patient with intron 1 inversion was found. In addition, we report eight novel mutation types which never been reported in HAMSTeRS database. The mutation data in this study should prove useful as a reference for the diagnosis of HA and the detection of carriers in the Korean population.

Effect of fiber structure on dialysate flow profile and hollow-fiber hemodialyzer reliability: CT perfusion study

BACKGROUND

Uniform dialysate distributions in hollow-fiber hemodialyzers facilitate effective solute removal, and the fiber structure inside hemodialyzers plays a significant role in determining dialysate flow distribution and dialysis efficiency. The authors analyzed the effects of undulated fibers on dialysate flow profiles and hemodialyzer reliability using a perfusion CT technique.

METHOD

Using a multi-detector row CT unit, perfusion studies were performed on two different types of hemodialyzers: (A) straight fiber configuration; (B) undulated fiber configuration (wavy-shaped fibers). Deconvolution theory was used for image processing to derive dialysate flows, dialysate volumes, and mean transit time distributions. Three-dimensional perfusion maps for the two types of hemodialyzers were reconstructed using high resolution images and these parameters were compared at hemodialyzer midsections.

RESULTS

Dialysate maldistributions were observed in both types of hemodialyzer. However, dialysate flow distributions were more uniform in the undulated-fiber hemodialyzer, whereas more complex flow distributions developed in straight-fiber hemodialyzer. Reliability as determined using intraclass correlation coefficients was markedly higher for the hemodialyzer containing undulated fiber (0.968 vs. 0.496 for type A and type B, respectively).

CONCLUSIONS

The undulated-fiber type was found to have more uniform, consistent dialysate flow profiles. It is believed that this type of hemodialyzer will be found helpful for measurement and prescription of the delivered hemodialysis dose due to its better consistency.

Identification of the normal appendix in healthy adults by 64-slice MDCT: the value of adding coronal reformation images

The aim of this study was to assess retrospectively the value of adding coronal reformation images to the identification of the normal appendix using 64-slice multidetector CT (MDCT). 200 consecutive healthy adults with no history of abdominal surgery underwent abdominal CT using 64-slice MDCT without oral contrast administration and were enrolled in the study. Two gastrointestinal radiologists first interpreted the axial images only; after a 2-week interval, they then interpreted both the axial and the coronal images while blinded to the first interpretation. The identification of the normal appendix was interpreted using a four-point scale: 1, not identified; 2, identified with low confidence; 3, probably identified; 4, definitely identified. Agreement between the readers was determined with the use of weighted kappa statistics. Differences in confidence ratings for identification of the appendix were determined with the Wilcoxon signed rank test. The agreement between the readers was higher when both axial and coronal images were reviewed (kappa = 0.85) than when only the axial scans images were reviewed (kappa = 0.43). The mean confidence scores for the identification of the normal appendix by the two readers were significantly higher when both the axial and coronal images were reviewed (mean, 3.81+/-0.498 and 3.83+/-0.485 for the two readers, respectively) than when only the axial images were reviewed (mean, 3.27+/-0.819 and 3.47+/-0.856, respectively) (all p<0.01). Therefore, adding coronal reformation images to 64-slice MDCT significantly improves inter-reader agreement and confidence in the identification of the normal appendix.

Cytokine array after cyclosporine treatment in rats

OBJECTIVES

Long-term treatment with cyclosporine (CsA) results in chronic nephrotoxicity, which is known to be mediated by several cytokines including transforming growth factor-betal. Cytokines are known to play an important role in innate immunity, apoptosis, angiogenesis, cell growth, and differentiation. They are known to be involved in most disease processes, including cancer, cardiac disease, and nephrotoxicity. To evaluate changes of cytokines in a rat model of CsA-induced chronic nephrotoxicity, we performed a cytokine array.

METHODS

Experiments were performed on two groups of rats; normal control group and CsA-treated group. Cytokine array in rat serum was performed using Cytokine Antibody Array I kit from RayBiotech.

RESULTS

Serum creatinine, urine creatinine, and creatinine clearance increased in the CsA-treated group. Among the several cytokines, the expressions of the lipopolysaccharide-induced CXC chemokine (LIX), monocyte chemoattractant protein 1 (MCP-1), nerve growth factor (beta-NGF), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the CsA-treated group were increased above that of cytokines in the control group. The density of the LIX in controls was 0.62, and in the CsA-treated group was 1.24. The density of the MCP-1 in controls was 0.68, and in CsA-treated, 1.43. The density of the beta-NGF in controls was 0.62, and that in CsA-treated, 1.24. The density of the TIMP-1 in controls 1.13, and in CsA-treated, 1.40.

CONCLUSIONS

Our data suggested that among several cytokines elevated levels of the LIX, MCP-1, beta-NGF, and TIMP-1 are the contributing factors to CsA-induced nephropathy.

Effects of cyclosporine on the production of the reactive oxygen species in the glial cells

OBJECTIVES

After organ transplantation, some patients suffer mild neurological symptoms such as tremor to severe complications including seizures and encephalopathy. Among the immunosuppressants, cyclosporine (CsA) can induce neurological side effects. However, the mechanisms of encephalopathy by CsA are not fully understood. We measured the production of reactive oxygen species (ROS) in the glioma cells after CsA treatment.

METHODS

CsA (2.5 mmol/L) added to glioma cells was incubated for 60 minutes at 37 degrees C. ROS production was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2',7'-dichlorofluorescin using VICTOR3 multilabel counter.

RESULTS

CsA resulted in ROS production by glioma cells. The ROS production increased with the time of exposure to CsA.

CONCLUSIONS

These findings indicated that CsA may contribute to neurological side effects via ROS production.

The production of reactive oxygen species in tacrolimus-treated glial cells

OBJECTIVE

After organ transplantation, some patients suffer from mild neurological symptoms, such as tremor, to severe complications, including seizures and encephalopathy. These neurological side effects can be caused by immunosuppressants such as tacrolimus. However, the mechanism of encephalopathy by tacrolimus is not fully understood.

METHODS

We measured the production of reactive oxygen species (ROS) in glioma cells after tacrolimus treatment. Tacrolimus added to glioma cells was incubated for 60 minutes at 37 degrees C. The production of ROS was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2',7'-dichlorofluorescin using VICTOR3TM multilabel counter.

RESULTS

Tacrolimus resulted in the production of the ROS in glioma cells. The production of the ROS was increased in time-dependent fashion.

CONCLUSIONS

These findings indicated that the tacrolimus may contribute the neurological side effects by ROS production.

Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration

BACKGROUND

Although the dangers of smoking, and the benefits of quitting, are well established and understood in the West, smoking remains popular among Asian men. We investigated the associations between smoking (including ex-smoking) and major causes of mortality in Asian men and women, and compared with Australians and New Zealanders (ANZ).

METHODS

An overview of 34 cohort studies in the Asia Pacific region involving 512 676 individuals (81% from Asia), followed up for a median of 6.7 years (20 804 deaths).

RESULTS

Mortality rates for cause-specific and all causes of mortality were systematically higher for current compared with never smokers. Hazard ratios (HR) for overall and cause-specific mortality comparing current-smokers with never smokers, ex- smokers with current-smokers and comparing numbers of cigarettes smoked per day, were higher for ANZ than Asia (p<0.001). For overall mortality, the HR (95% CI) comparing current-smoking with not was 1.37 (1.23 to 1.53) and 1.33 (1.26 to 1.40) in Asian men and women respectively. The corresponding figures in ANZ were 1.95 (1.81 to 2.09) and 1.85 (1.69 to 2.02). The HR for quitting in ANZ was 0.67 (0.63 to 0.71) and 0.66 (0.58 to 0.74) in men and women respectively. Quitting smoking had a significant benefit among Asian men, the HR was 0.88 (0.81 to 0.97) after ignoring the first 3 years of follow-up. There was no evidence of benefit for Asian women, for whom ex-smoking is rare.

CONCLUSIONS

Allowing for the recent uptake of smoking in Asia, its effects are comparable to those observed in ANZ. Stringent tobacco control measures and smoking cessation strategies are urgently required in Asia.

Case of adult mumps infection after renal transplantation

Viruses are the most common cause of opportunistic infections, important complications of transplantation. Mumps infection in renal transplant recipients is uncommon. This report focused on a 23-year-old woman who received immunosuppressive therapy based on tacrolimus, prednisolone, and mycophenolate mofetil for renal transplantation. Sixteen months after transplantation, she was admitted with pain and swelling in both infra-auricular areas. Laboratory findings demonstrated positive mumps IgM and IgG antibodies and an increased serum amylase level. Computed tomography revealed both parotid glands to be diffusely enlarged. After the diagnosis of mumps parotitis, the patient's immunosuppression was reduced and the clinical course was satisfactory.

Local recurrence after curative resection in patients with colon and rectal cancers

BACKGROUND AND AIMS

There are a range of rates and a number of prognostic factors associated with the local recurrence of colorectal cancer after curative resection. The aim of this study was to identify the potential prognostic factors of local recurrence in patients with colon and rectal cancers.

MATERIALS AND METHODS

A retrospective review of 1,838 patients who underwent curative resection of non-metastatic colorectal cancer was conducted. The patients were treated between 1994 and 2004, and had a minimum follow-up of 3 years.

RESULTS

There were 994 patients with colon cancer and 844 patients with rectal cancer. The median duration of follow-up was 60.9 +/- 24.5 months. With respect to colon cancer, the local recurrence rate was 6.1% (61 patients). With respect to rectal cancer, 95 patients had a local recurrence (11.3%), the rate of which was statistically greater than the local recurrence rate for colon cancer (p < 0.001). The overall recurrence rate was 16.4% (301 patients), and the local recurrence rate, with or without systemic metastases, was 8.5% (156 patients). Local recurrences occurred within 2 and 3 years in 59.9% and 82.4% of the patients, respectively. In patients with colon and rectal cancer, the pathologic T stage (p = 0.044 and p = 0.034, respectively), pathologic N stage (p = 0.001 and p < 0.001, respectively), and lymphovascular invasion (p = 0.013 and p = 0.004, respectively) were adverse risk factors for local recurrence. The level of the anastomosis from the anal verge was an additional prognostic factor (p = 0.007) in patients with rectal cancer.

CONCLUSION

Compulsive follow-up care of patients with colon and rectal cancers is needed for 3 years after curative resection, especially in patients who have adverse risk factors for local recurrence.

Registration of sheep brain MR images for cell tracking using ferrite-composite micro-beads as markers

In the recent molecular imaging studies of the magnetic resonance imaging field, in-vivo cell tracking is becoming an issue for the observation of cell therapy and disease behavior. In order to perform cell tracking, high resolution images and long-term studies are required, because those images make better performance than low resolution images in the recognition of cells and cells are traced at least two weeks. Image registration is an essential image processing technique for long-term imaging. In this study, we proposed the image registration technique using ferrite-composite micro- beads which could be used as substitutes for the cells labeling MR contrast agent such as superparamagnetic iron oxide (SPIO) nanoparticles. Registration of sheep brain images tagging micro-beads was performed with the sufficient accuracy for cell tracking.

Imaging findings of idiopathic localized dilatation of the ileum

We report imaging findings in a case of idiopathic localized dilatation of the ileum (ILDI). CT revealed a large cystic mass containing air in the pelvic cavity. Sonography showed a cystic lesion with internal echo in the pelvic cavity. In addition, slow peristaltic movement was seen in the lesion. Small bowel series showed a bilobular dilatation of the ileum with two narrow transitions connecting the proximal and distal bowel loops.

Pseudotumour in the bladder as a complication of total hip replacement: ultrasonography, CT and MR findings

We report a pseudotumour in the urinary bladder following total hip replacement with review of the literature. Pseudotumour in the urinary bladder as a late complication of total hip replacement is an extremely rare condition. In this case, cross-sectional imaging modalities including sonography, CT and MR showed a hypervascular polypoid mass in the urinary bladder and adjacent wall thickening with a band connecting between the mass and the acetabulum. Histopathological diagnosis confirmed acute and chronic inflammation with calcification.

Expression of nitric oxide synthase isoforms in the testes of pigs

This study examined the expression of three isoforms of nitric oxide synthase (NOS) in the testes of pigs. Immunohistochemical studies demonstrated the presence of nNOS, eNOS and iNOS in interstitial cells, primary spermatocytes and spermatids. Positive immunoreactions for eNOS and iNOS were detected in peritubular myoid cells. Some vascular endothelial cells were positive for nNOS and eNOS. The expression of nitrotyrosine was detected in interstitial cells. In addition, the histochemical study revealed that all the interstitial cells were stained positively for NADPH-diaphorase, although some spermatids and vascular endothelial cells displayed moderate enzymatic activity. These findings suggest that three isoforms of NOS are expressed in the testis of pig and that they play important roles in the biology of interstitial cells that produce testosterone, as well as in spermatogenesis in the seminiferous tubules.

Direct measurement of antiferromagnetic domain fluctuations

Measurements of magnetic noise emanating from ferromagnets owing to domain motion were first carried out nearly 100 years ago, and have underpinned much science and technology. Antiferromagnets, which carry no net external magnetic dipole moment, yet have a periodic arrangement of the electron spins extending over macroscopic distances, should also display magnetic noise. However, this must be sampled at spatial wavelengths of the order of several interatomic spacings, rather than the macroscopic scales characteristic of ferromagnets. Here we present a direct measurement of the fluctuations in the nanometre-scale superstructure of spin- and charge-density waves associated with antiferromagnetism in elemental chromium. The technique used is X-ray photon correlation spectroscopy, where coherent X-ray diffraction produces a speckle pattern that serves as a 'fingerprint' of a particular magnetic domain configuration. The temporal evolution of the patterns corresponds to domain walls advancing and retreating over micrometre distances. This work demonstrates a useful measurement tool for antiferromagnetic domain wall engineering, but also reveals a fundamental finding about spin dynamics in the simplest antiferromagnet: although the domain wall motion is thermally activated at temperatures above 100 K, it is not so at lower temperatures, and indeed has a rate that saturates at a finite value-consistent with quantum fluctuations-on cooling below 40 K.

The role of lifestyle risk factors on mortality from colorectal cancer in populations of the Asia-Pacific region

Although colorectal cancer is one of the leading malignancies worldwide, there are few data on aetiological relationships from the Asia-Pacific region. Therefore, a collaborative study was conducted involving over half a million subjects from 33 cohort studies in the region. Age-adjusted death rates from colorectal cancer, over an average of 6.8 years follow-up, were 12 and 14 per 100,000 person-years among Asian women and men, respectively; corresponding values in Australasia were 31 and 41. Height was strongly associated with death from colorectal cancer: an extra 5 cm of height was associated with 10% (95%confidence interval, 3% - 18% additional risk, after adjustment for other factors. Smoking increased risk by 43% (9% - 88%), although no significant dose-response relationship was discerned (p>0.05). Other significant (p <0.05) risk factors were body mass index and lack of physical activity. There was no significant effect on colorectal cancer mortality for alcohol consumption, waist circumference, fasting blood glucose or diabetes, although the latter conferred a notable 26% additional risk. Height may be a biomarker for some currently unknown genetic, or environmental, risk factors that are related both to skeletal growth and mutanogenesis. Understanding such mechanisms could provide opportunities for novel preventive and therapeutic intervention.

Low-grade fibromyxoid sarcoma of the colon

Low-grade fibromyxoid sarcoma is a recently recognised soft tissue neoplasm. It is rare and has a tendency to arise from deep soft tissue of the lower extremities. An origin from the colon has not been reported in the medical literature. We report the low-grade fibromyxoid sarcoma originating from the colon in a 43-year-old male patient, treated by right hemicolectomy and nephrectomy.

Cytometry microchip using polymer-based saltbridge electrodes

We developed a cytometry glass chip using polymer-based saltbridge electrodes. Saltbridge electrodes were placed at lateral sides of channel to increase the sensitivity and robustness of detection. The dimension of saltbridge electrodes which are exposed to channel was 50mum by 20mum (width, height). The saltbridge electrode was formed at a specific position in a predefined shape by photopolymerization technique. UV light sensitive monomer DMAC (dially dimethyl ammonium chloride) was used for polymerization. Polymer-based saltbridge electrode enabled the DC impedance analysis of the channel for cytometry. Moreover, the lateral positioning of saltbridge electrode is easily accomplished by photopolymerization technique. We validated the detection sensitivity of developed chip using 10mum fluorescent bead.

Automated quantification of retinal nerve fiber layer atrophy in fundus photograph

Quantitative analysis of the retinal nerve fiber layer (RNFL) defect is prerequisite in the early detection and management of glaucoma. A new automatic quantification method to evaluate the degree of RNLF defect has been proposed in this paper. Simple image processing technique is applied to locate optic disc and intensity of the pixels around optic disc is plotted. The area with RNFL defect can be easily determined by comparing the intensity plot of the RNFL and the first derivative of the intensity plot. Through analysis of the plot, thickness of RNFL also can be postulated.

Importance of skin resistance in the reverse iontophoresis-based noninvasive glucose monitoring system

Utilization of the changes in skin resistance during reverse iontophoresis is proposed to detect severe perspiration as well as to correct the glucose estimation. Developed system consists of the amperometric biosensor unit, the electrode unit, a constant current driver circuit and a microcontroller-based control. Performance of the developed system was evaluated by the in-vitro skin model which was specially designed for reverse iontophoresis system.

Three dimensional reconstruction of conventional stereo optic disc image

Stereo disc photograph was analyzed and reconstructed as 3 dimensional contour image to evaluate the status of the optic nerve head for the early detection of glaucoma and the evaluation of the efficacy of treatment. Stepwise preprocessing was introduced to detect the edge of the optic nerve head and retinal vessels and reduce noises. Paired images were registered by power cepstrum method and zero-mean normalized cross-correlation. After Gaussian blurring, median filter application and disparity pair searching, depth information in the 3 dimensionally reconstructed image was calculated by the simple triangulation formula. Calculated depth maps were smoothed through cubic B-spline interpolation and retinal vessels were visualized more clearly by adding reference image. Resulted 3 dimensional contour image showed optic cups, retinal vessels and the notching of the neural rim of the optic disc clearly and intuitively, helping physicians in understanding and interpreting the stereo disc photograph.