The characterization and management of Castleman's disease

OBJECTIVE

Castleman's disease (CD) is a rare disorder of unknown aetiology characterized by lymph node enlargement. This study evaluated the clinical features, diagnosis and outcomes of surgical treatment in patients with CD.

METHODS

The medical records of 10 patients with histologically confirmed CD who underwent surgery between 2003 and 2008 were retrospectively reviewed. Study endpoints were survival and recurrence.

RESULTS

The age of disease onset ranged from 11 to 63 years (median 38 years). Of the 10 patients included in the study, eight were diagnosed with localized (unicentric) CD and two with multicentric CD. All eight patients with localized (unicentric) CD were asymptomatic. Histological evidence indicated the hyaline vascular form of CD in eight patients and the plasmacytic form in the remaining two patients. The primary treatment was complete surgical resection in nine cases, and these patients were alive with no evidence of recurrence or exacerbation at the time of writing (June 2011).

CONCLUSIONS

Localized (unicentric) CD is usually of the hyaline vascular form and complete surgical excision of the tumour allows full recovery in most cases.

Expression of microRNAs during chondrogenesis of human adipose-derived stem cells

OBJECTIVES

MicroRNAs (miRNAs) play an important role in the regulation of chondrogenesis of mesenchymal stem cells, but their expression still remains unknown in human adipose-derived stem cells (hADSCs). In this study the miRNA expression profile during chondrogenic differentiation of hADSC and the potential mechanism whereby miRNAs may affect the process of chondrogenesis are considered.

METHODS

hADSCs were isolated and cultured. The expression of chondrogenic proteins was detected using enzyme-linked immunosorbent assay (ELISA). miRNA expression profiles before and after chondrogenic induction were obtained using miRNA microarray essay and differently expressed miRNAs were primarily verified using quantitative real-time polymerase chain reaction (qRT-PCR). Putative targets of the miRNAs were predicted using online software programs MiRanda, TargetScan and miRBase.

RESULTS

Twelve miRNAs were found to be differentially expressed pre- and post-chondrogenic induction by over a two-fold change, including eight up-regulated miRNAs (miR-193b, miR-199a-3p/hsa-miR-199b-3p, miR-455-3p, miR-210, miR-381, miR-92a, miR-320c, and miR-136), and four down-regulated miRNAs (miR-490-5p, miR-4287, miR-BART8*, and miR-US25-1*). qRT-PCR analysis further confirmed these results. Predicted target genes of the differentially expressed miRNAs were based on the overlap of at least two online prediction algorithms, with the known functions of regulating chondrogenic differentiation, self-renewal, signal transduction and cell cycle control.

CONCLUSIONS

In this study we have identified a group of miRNAs and their target genes, which may play important roles in regulating chondrogenic differentiation of hADSCs. Our results provide the basis for further investigation into the molecular mechanism of chondrogenesis in hADSCs and their differentiation for cartilage engineering.

A review of monochromatic excimer light in vitiligo

Phototherapy is a mainstay of vitiligo treatment and has varying rates of efficacy. Narrowband ultraviolet (UV) B (NB-UVB) and UVA have been used for decades, but it is only recently that monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. The specific 308-nm radiation wavelength is delivered in a targeted form by the xenon-chloride excimer laser and is also available in an incoherent form that is commonly referred to as the excimer lamp. MEL administered by both laser and lamp has shown efficacy superior to NB-UVB for the treatment of vitiligo and induces more changes at the cellular level than conventional UVB modalities. The excimer laser is effective in adults and children with vitiligo in all skin types as monotherapy or in combination with other established vitiligo therapeutics. Treatment regimens studied included excimer laser two to three times weekly for up to 36 weeks. Patients commonly achieved > 75% repigmentation. The laser has also been used in combination with topical corticosteroids, calcineurin inhibitors and vitamin D analogues, as well as surgery, thus further expanding treatment options for patients with vitiligo. The excimer lamp has been used for treatments one to three times a week for up to 24 weeks and was found to be equal to excimer laser in a head-to-head comparison. It has also been used in combination with topical corticosteroids and oral vitamin E. Both MEL modalities have a limited adverse side-effect profile. Long-term effects are yet to be determined; however, based on available data on UVB phototherapy as well as the properties of MEL devices, there is probably only a minimal increased malignancy risk.

Dexmedetomidine versus Midazolam for Conscious Sedation in Postoperative Patients Undergoing Flexible Bronchoscopy: A Randomized Study

OBJECTIVE: This prospective randomized study evaluated the efficacy and patient tolerance of dexmedetomidine compared with midazolam for sedation in postoperative patients undergoing flexible bronchoscopy. METHODS: A total of 198 postoperative patients were randomized to receive dexmedetomidine ( n = 99) or midazolam ( n = 99) to produce conscious sedation for bronchoscopy. Peripheral oxygen saturation, heart rate and systolic and diastolic arterial pressures were recorded before, during and after the procedure. Patient tolerance was recorded using various visual analogue scales. RESULTS: The mean lowest peripheral oxygen saturation was significantly lower in the midazolam group than in the dexmedetomidine group. Heart rate and systolic arterial pressure were both significantly higher during bronchoscopy in the midazolam group than in the dexmedetomidine group. Bronchoscopy was well tolerated in both groups; there was no between-group difference in patient discomfort scores or in the percentage of patients who would accept repeat bronchoscopy. CONCLUSIONS: Compared with midazolam, dexmedetomidine provided better oxygen saturation and was equally well tolerated for conscious sedation in postoperative patients undergoing bronchoscopy.

Assessment of the CKD-EPI equation to estimate glomerular filtration rate in adults from a Chinese CKD population

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was introduced to estimate glomerular filtration rate (GFR) in chronic kidney disease (CKD) patients based on serum creatinine. The CKD-EPI equation shows better accuracy compared with the current gold standard equation, the Modification of Diet in Renal Disease (MDRD) equation, but it has not been externally validated in Chinese patients. This study compared the CKD-EPI equation with the original MDRD equation and two Chinese MDRD-based equations for estimating GFR in 200 Chinese CKD patients. The (99m)Tc-diethylenetriamine penta-acetate ((99m)Tc-DTPA) method was used to determine actual GFR. The CKD-EPI equation produced GFR estimates that were more consistent with the (99m)Tc-DTPA GFR than did the MDRD equations. The precision and accuracy of the CKD-EPI equation were significantly higher than those of the MDRD equations. In conclusion, the CKD-EPI equation was superior to the existing MDRD equations in terms of estimating GFR and we recommend its clinical use in Chinese CKD patients.

Immature dendritic cells expressing indoleamine 2,3-dioxygenase suppress ovalbumin-induced allergic airway inflammation in mice

BACKGROUND

Proliferation of activated CD4+ T lymphocytes is inhibited by indoleamine 2,3-dioxygenase (IDO).

OBJECTIVE

We undertook the present study to test the hypothesis that IDO-expressing immature DCs (imDCs) can restore immune tolerance in mice suffering from allergic airway inflammation.

METHODS

imDCs were generated from murine bone marrow cells using granulocyte-macrophage colony-stimulating factor.The imDCs were subsequently transfected with an IDO expression vector (pEGFP-N1-IDO). Surface marker expression, including CD11c, MHCII, CD80, and CD86, was analyzed using flow cytometry. IDO-expressing imDCs were injected into the trachea of ovalbumin (OVA)-sensitized mice, and lung histopathology and cytokine expression in bronchoalveolar lavage fluid were assessed. The splenic CD4+ T cells of OVA-sensitized mice were isolated and co-cultured with pEGFP-N1-IDO-expressing imDCs, and apoptosis of CD4+ T cells was detected using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay.

RESULTS

Expression of IDO in imDCs did not alter cell surface molecule expression. We observed marked lung inflammation, elevated total cell and eosinophil count, and altered cytokine levels in OVA-sensitized mice. These parameters improved upon inoculation with IDO-expressing imDCs. Co-culture with IDO-expressing imDCs also induced apoptosis, inhibited IL-4 and IL-5 expression, and upregulated IFN-gamma expression in CD4+ T cells.

CONCLUSIONS

IDO-expressing imDCs induced T(H)2 cell apoptosis and reduced T(H)2 cell activation and allergic airway inflammation in OVA-sensitized mice. Thus, upregulation of IDO expression may provide a novel immunointervention strategy for asthma treatment.

Co-production of lactic acid and chitin using a pelletized filamentous fungus Rhizopus oryzae cultured on cull potatoes and glucose

AIMS

This paper developed a novel process for lactic acid and chitin co-production of the pelletized Rhzious oryzae NRRL 395 fermentation using underutilized cull potatoes and glucose as nutrient source.

METHODS AND RESULTS

Whole potato hydrolysate medium was first used to produce the highest pelletized biomass yield accompanying the highest chitin content in biomass. An enhanced lactic acid production then followed up using batch, repeated batch and fed batch culture with glucose as carbon source and mixture of ammonia and sodium hydroxide as neutralizer. The lactic acid productivity peaked at 2.8 and 3 g l(-1 )h(-1) in repeated batch culture and batch culture, respectively. The fed batch culture had the highest lactate concentration of 140 g l(-1).

CONCLUSIONS

Separation of the biomass cultivation and the lactic acid production is able to not only improve lactic acid production, but also enhance the chitin content. Cull potato hydrolysate used as a nutrient source for biomass cultivation can significantly increase both biomass yield and chitin content.

SIGNIFICANCE AND IMPACT OF THE STUDY

The three-step process using pelletized R. oryzae fermentation innovatively integrates utilization of agricultural residues into the process of co-producing lactic acid and chitin, so as to improve the efficiency, revenues and cost of fungal lactic acid production.

1,2,3-Triazole-boranes: stable and efficient reagents for ketone and aldehyde reductive amination in organic solvents or in water

Air, moisture and thermally stable 1,2,3-triazole-borane complexes were developed as new practical reagents for ketone/aldehyde amination with high efficiency and excellent substrate diversity.

Polar metabolite of cholesterol induces rat cognitive dysfunctions

24-hydroxycholesterol, a major polar metabolite of brain cholesterol, has neurotoxic effects. However, little is known about the effects of this polar metabolite on the CNS. In the present study, the effects of 24-hydroxycholesterol on behavior changes were investigated. Rats were divided into three groups: (i) a control group; (ii) a sham group: 0.5 ml PBS was infused into the cerebral ventricle; (iii) a model group: 0.5 ml 24-hydroxycholesterol (10 microM) was infused into the cerebral ventricle. 24-hydroxycholesterol can obviously impair rats' acquisition and probe trial in the Morris Water Maze task. Compared with rats in the sham group, rats in the model group had longer escape latency time and traveled more distance, and performed worse in the probe trial task manifested by spending less time in the annulus and training quadrant, which probably was attributed to the neuronal degeneration in hippocampal CA1 area induced by 24-hydroxycholesterol as examined by histological assay and apoptotic assay. Our results revealed that the polar metabolites, such as 24-hydroxycholesterol, exert neurotoxic effects and exacerbate the neuron injury with their abnormal accumulation. These findings suggest that measures taken promptly to eliminate or inhibit the accumulation of polar metabolites should be a potential strategy to prevent neurological dysfunctions and promote the recovery of functional deficits after neurotoxic insult.

Chromosomal aberrations and gene expression profiles in non-small cell lung cancer

Alterations in genomic content and changes in gene expression levels are central characteristics of tumors and pivotal to the tumorigenic process. We analyzed 23 non-small cell lung cancer (NSCLC) tumors by array comparative genomic hybridization (array CGH). Aberrant regions identified included well-characterized chromosomal aberrations such as amplifications of 3q and 8q and deletions of 3p21.31. Less frequently identified aberrations such as amplifications of 7q22.3-31.31 and 12p11.23-13.2, and previously unidentified aberrations such as deletion of 11q12.3-13.3 were also detected. To enhance our ability to identify key acting genes residing in these regions, we combined array CGH results with gene expression profiling performed on the same tumor samples. We identified a set of genes with concordant changes in DNA copy number and expression levels, i.e. overexpressed genes located in amplified regions and underexpressed genes located in deleted regions. This set included members of the Wnt/beta-catenin pathway, genes involved in DNA replication, and matrix metalloproteases (MMPs). Functional enrichment analysis of the genes both overexpressed and amplified revealed a significant enrichment for DNA replication and repair, and extracellular matrix component gene ontology annotations. We verified the changes in expressions of MCM2, MCM6, RUVBL1, MMP1, MMP12 by real-time quantitative PCR. Our results provide a high resolution map of copy number changes in non-small cell lung cancer. The joint analysis of array CGH and gene expression analysis highlights genes with concordant changes in expression and copy number that may be critical to lung cancer development and progression.

Discovery and preliminary structure-activity relationship studies of novel benzotriazine based compounds as Src inhibitors

We report the discovery and preliminary SAR studies of a series of structurally novel benzotriazine core based small molecules as inhibitors of Src kinase. To the best of our knowledge, benzotriazine template based compounds have not been reported as kinase inhibitors. The 3-(2-(1-pyrrolidinyl)ethoxy)phenyl analogue (43) was identified as one of the most potent inhibitors of Src kinase.