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Hung S.-H.,Taipei Medical University Hospital | Lee J.-Y.,Sijhih Cathay General Hospital | Tseng H.,Taipei Medical University
Auris Nasus Larynx | Year: 2012

Objective: Metastatic neck nodes are commonly described as "heterogenous" or "inhomogenous" on computed tomographic (CT) images, and this remains a highly subjective issue. The purpose of this study is to justify classical criteria and to develop novel supplemental methods for diagnosing a positive neck node on CT scans. Methods: Fifty-four patients with H&N SCC were separated into two groups according to their neck nodal status. CT scan digital images were used and the lymph node borders were selected by a radiologist. Lymph node images from the pathologically proven N- (negative for cervical metastases) group were compared to the N+ (positive for cervical metastases) group. Image-analysis software, ImageJ, was used to record and compare various characteristics collected from the images. Results: The image-analysis comparisons shows, the area (size) of the lymph node in the N+ group is much larger than the N- group (474.02 VS.81.55mm2) (P<0.01). There are no significant differences with regards to distribution of pixel values between the two groups (P=0.79). The lacunarity, a parameter used to describe gappiness or inhomogeneity, of the N+ group was significantly higher than the N- group (P=0.026). Conclusions: While size of the lymph node remains an important factor in the interpretation of a clinically suspicious lymph node metastasis on CT scan images, the distribution of pixel values could not clarify a heterogeneous state. Nevertheless, 'lacunarity' proves to be a more accurate parameter which correlates better to the subjective heterogeneity. © 2012 Elsevier Ireland Ltd. Source

Tasi C.K.,Sijhih Cathay General Hospital
International journal of surgical pathology | Year: 2012

Lymph node status is pivotal in the staging process of cancer. With regards to colorectal cancer, lymph node retrieval is always laborious. Sometimes, it is also a challenge to recover a minimum of 12 lymph nodes from the pericolorectal tissue. Among many proposed adjunctive solutions, GEWF solution (glacial acetic acid, ethanol, distilled water, and formaldehyde) has been introduced recently and suggested to be superior. To further evaluate its efficiency, the pericolorectal tissue, which has been reexamined extensively in the conventional condition, was refixed into GEWF solution in this study. More lymph nodes were found in 75% (n = 6) of the 8 experimental cases, and 50% (n = 4) of them had 12 or more yielded lymph nodes eventually. In addition, no adverse influences on the expressions of immunohistochemical and special stains were seen. These data support the reliability and effectiveness of GEWF solution in improvement of lymph node yield. Source

Hou C.-H.,National Taiwan University Hospital | Lin F.-L.,Sijhih Cathay General Hospital | Hou S.-M.,Shin Kong Wu Ho Su Memorial Hospital | Liu J.-F.,Central Laboratory
Molecular Cancer | Year: 2015

Background: Osteosarcoma is the most common primary malignant tumor in children and young adults, and its treatment requires effective therapeutic approaches because of a high mortality rate for lung metastasis. Epithelial to mesenchymal transition (EMT) has received considerable attention as a conceptual paradigm for explaining the invasive and metastatic behavior during cancer progression. The cysteine-rich angiogenic inducer 61 (Cyr61) gene, a member of the CCN gene family, is responsible for the secretion of Cyr61, a matrix-associated protein that is involved in several cellular functions. A previous study showed that Cyr61 expression is related to osteosarcoma progression. In addition, Cyr61 could promote cell migration and metastasis in osteosarcoma. However, discussions on the molecular mechanism involved in Cyr61-regulated metastasis in osteosarcoma is poorly discussed. Results: We determined that the expression level of Cyr61 induced cell migration ability in osteosarcoma cells. The Cyr61 protein promoted the mesenchymal transition of osteosarcoma cells by upregulating mesenchymal markers (TWIST-1 and N-cadherin) and inhibiting the epithelial marker (E-cadherin). Moreover, the Cyr61-induced cell migration was mediated by EMT. The Cyr61 protein elicited a signaling cascade that included αvβ5 integrin, Raf-1, mitogen-activated protein kinase (MEK), extracellular signal-regulated kinase (ERK), and Elk-1. The reagent or gene knockdown of these signaling proteins could inhibit Cyr61-promoted EMT in osteosarcoma. Finally, the knockdown of Cyr61 expression obviously inhibited cell migration and repressed mesenchymal phenotypes, reducing lung metastasis. Conclusion: Our results indicate that Cyr61 promotes the EMT of osteosarcoma cells by regulating EMT markers via a signal transduction pathway that involves αvβ5 integrin, Raf-1, MEK, ERK, and Elk-1. © 2014 Hou et al.; licensee BioMed Central Ltd. Source

Wang W.-H.,Fu Jen Catholic University | Tsai K.-Y.,Sijhih Cathay General Hospital
Otolaryngology - Head and Neck Surgery (United States) | Year: 2015

Objective. To compare the difference between white light (WL) and narrow-band imaging (NBI) endoscopy in evaluating patients who had reflux laryngitis and esophagitis. Study Design. Retrospective review of medical records and endoscopic images. Setting. Outpatient clinic. Subjects and Methods. There were 102 consecutive patients with reflux esophagitis (mean age, 48 6 11 years) who had office-based transnasal esophagoscopy (TNE) with WL and NBI views, including 60 men (59%) and 42 women (41%). We compared WL and NBI endoscopy in observing the laryngeal and esophageal epithelium. The nasopharynx, base of the tongue, epiglottis, hypopharynx, larynx, esophagus, gastroesophageal junction, and stomach were examined, and all procedures were digitally recorded. All patients were evaluated with WL and NBI views to determine the reflux finding score (RFS) in the larynx and Los Angeles (LA) classification grade in the esophagus. Results. The NBI views were more sensitive than the WL views in the erythema/hyperemia, vocal cord edema, and global RFS scores. The NBI view facilitated the identification of the erythema/hyperemia change representing dilation or proliferation of microvessels caused by epithelial inflammation. The global RFS score was significantly associated with severity of LA grade only with the NBI view. Conclusion. The endoscopic findings with the NBI view permit an easier identification of the RFS parameters of laryngeal erythema/vocal cord edema, which have a stronger correlation with the severity of reflux esophagitis, than the WL view. The importance of NBI in the evaluation of reflux laryngitis and gastroesophageal reflux disease deserves further study. © 2015 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Source

Shen C.-H.,Graduate Institute of Medical science | Tsai R.-Y.,Tri Service General Hospital | Shih M.-S.,Veterans General Hospital | Lin S.-L.,Graduate Institute of Medical science | And 3 more authors.
Anesthesia and Analgesia | Year: 2011

BACKGROUND: In the present study we examined the effect of the tumor necrosis factor (TNF)-α antagonist etanercept on the antinociceptive effect of morphine in morphine-tolerant rats. METHODS: Male Wistar rats were implanted with 2 intrathecal catheters, and 1 was connected to a mini-osmotic pump for either morphine (15 μg/h) or saline (1 μL/h) infusion for 5 days. On day 5, either etanercept (5 μg, 25 μg, and 50 μg/10 μL) or saline (10 μL) was injected via the other catheter after morphine infusion was discontinued. Three hours later, morphine (15 μg/10 μL, intrathecally) was given and tail-flick latency was measured to evaluate the antinociceptive effect of morphine. Rats were then killed and their spinal cords were removed for quantitative real-time polymerase chain reaction and immunohistochemistry to measure proinflammatory cytokines expression. RESULTS: We found that acute etanercept (50 μg) treatment preserved a significant antinociceptive effect of morphine in morphine-tolerant rats. In addition, the expression of TNFα mRNA was increased by 2.5-fold, interleukin (IL)-1β mRNA increased by 13-fold and IL-6 mRNA by 111-fold in the dorsal spinal cord of morphine-tolerant rats. The increase in TNFα, IL-1β, and IL-6 mRNA expression was blocked by 50 μg etanercept pretreatment. The immunohistochemistry analysis revealed that 50 μg etanercept suppressed proinflammatory cytokines expression and neuroinflammation in the microglia. CONCLUSIONS: The present study demonstrates that etanercept restores the antinoceptive effect of morphine in morphine-tolerant rats by inhibition of proinflammatory cytokine TNF-α, IL-1β, and IL-6 expression and spinal neuroinflammation. The results suggest that etanercept could also be an adjuvant therapy for morphine tolerance, which extends the effectiveness of opioids in clinical pain management. Copyright © 2011 International Anesthesia Research Society. Source

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