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BackgroundWhile efficacy of combination treatment with methotrexate (MTX), sulfasalazine (SSZ) and hydroxychloroquine (HCQ) (triple therapy') has been shown in clinical trials, few studies have examined its longevity in a real-life setting.

C.-H. Wen, C.-H. Lin, S.-C. Tsao, Y.-C. Su, M.-H. Tsai and C.-Y. Chai Micronucleus scoring in liver fine needle aspiration cytology Objective: This study evaluated the role of the micronucleus (MN) in liver fine needle aspiration (FNA) cytology. Methods: Histological features of 75 cases of hepatocellular carcinoma (HCC), of which 25 were well differentiated, 37 moderately differentiated and 13 poorly differentiated, and 58 benign hepatic lesions (total, 133 cases) were correlated with MN expression observed in FNA smears reported as benign (n = 40), atypical (n = 14), suspicious (n = 30) and malignant (n = 49). Results: Stepwise increases in the MN score (0.4 ± 0.6, 1.2 ± 1.3, 6.3 ± 4.2 and 14.3 ± 8.8) correlated with the degree of cytological abnormality: benign, atypia, suspicious and malignant, respectively. The mean MN scores for well-, moderately and poorly differentiated HCC were 5.4 ± 2.2, 11.5 ± 4.5 and 24.9 ± 9.1, respectively, which was significantly different between malignant and suspicious (P

Objectives: To determine whether the standard techniques of measuring tumour size could be applied to the measurement of nasopharyngeal carcinoma. Study design: A retrospective review of case notes from the Buddhist Tzu Chi Dalin General Hospital archives was performed. Settings: The Buddhist Tzu Chi Dalin General Hospital is a teaching hospital in Taiwan. Participants: All patients with nasopharyngeal carcinoma were included. Main outcome measures: Ninety-eight patients with newly diagnosed nasopharyngeal carcinoma were treated with high-dose radiotherapy and chemotherapy were enrolled in this study. Computed tomography-derived primary tumour volume, bidimensional measurement and unidimensional measurement were recorded. Intrarater reliability was measured. To examine the validity of various measurements, we estimated the Spearman’s correlation co-efficients between those measurements and the gold standard value (primary tumour volume measurement with summation of area techniques). Univariate and multivariate analyses were performed and Kaplan–Meier survival curves constructed. Results: There was a significant association between primary tumour volume and bidimensional measurement with respect to tumour size at diagnosis (Spearman’s correlation co-efficient = 0.845, P

It has been documented that sex hormone may play a role in the pathogenesis of murine lupus. To determine the effect of tamoxifen (TAM) on NZB/W F1 female mice, a total dose of 800 microg (22 mg/kg body weight) of TAM was administered subcutaneously every 2 weeks. The control mice were injected with peanut oil only. After treatment with TAM for 5 months, the mice were killed and immunological parameters were evaluated. The results suggest that NZB/W F1 mice treated with TAM had less severe proteinuria and increased survival rate compared to controls. Flow cytometric analysis of splenocytes revealed a significantly lower percentage of B cells and CD5+ B cells in the TAM-treated group. There was a significantly lower serum level of soluble tumour necrosis factor (TNF) receptor I and II molecules in the TAM-treated mice. Immunohistological study showed that control mice had severe immune complex deposition in the kidney. In contrast, TAM-treated mice had much less pathological change. In summary, this study demonstrated that TAM treatment might be able to alleviate the symptoms of lupus nephritis, influence B-cell count, modulate the expression of cytokine receptors and thereby subsequently affect immune function. Further studies to determine the cellular mechanisms in lupus nephritis may increase our understanding of this complex disease and provide additional targets for therapeutic intervention.

The use of closed-loop implantable telemetry devices [1,2] is increasing as recent clinical studies have shown their efficiency and usefulness in detecting and treating various cardiac arrhythmias. In this paper, we present a single-chip closed-loop system providing closed-loop feedback of sensed cardiac patterns. This device promises more optimized stimulation parameters to cure rapid arrhythmias compared with open-loop devices. Our system incorporates more functionality comparing with the conventional micro-stimulators, yet consumes less power. It is powered by implanted rechargeable batteries periodically charged by radio-frequency (RF) coupling. This improvement of the powering system can prevent improper device operation or shutdown due to RF coupling and loading variations. Furthermore, this system eliminates the need for periodic surgery for battery replacement and improves quality of life of the patient.

The effect of hypoxia on the production and release of vasoactive substances from endothelial cells of pulmonary artery (PAECs) and aorta (AECs) was studied. The results indicated that the overall effect of the long half-life vasoactive substances released from PAECs and AECs was vasoconstrictive. The long half-life lipid-soluble substances produced by PAECs and AECs were vasodilative, and did not change in hypoxia. However, the long half-life water-soluble heat-unstable and heat-stable ones were vasoconstrictive. Hypoxia could reduce the release of the former and promote that of the latter which might be peptides. The PAECs could release specific long half-life mediator which was pulmonary artery-constrictive, water-soluble, heat-unstable, and not related to hypoxia. Hypoxia inhibited the production of PGI2, a short half-life vasodilator, in PAECs, but not in AECs.

Increasing the specificity of chemotherapy may improve the efficacy of cancer treatment. Toward this aim, we developed a strain of bacteria to express enzymes for selective prodrug activation and non-invasive imaging in tumors. beta-glucuronidase and the luxCDABE gene cluster were expressed in the DH5alpha strain of Escherichia coli to generate DH5alpha-lux/betaG. These bacteria emitted light for imaging and hydrolyzed the glucuronide prodrug 9ACG to the topoisomerase I inhibitor 9-aminocamptothecin (9AC). By optical imaging, colony-forming units (CFUs) and staining for betaG activity, we found that DH5alpha-lux/betaG preferentially localized and replicated within CL1-5 human lung tumors in mice. The intensity of luminescence, CFU and betaG activity increased with time, indicating bacterial replication occurred in tumors. In comparison with DH5alpha-lux/betaG, 9AC or 9ACG treatment, combined systemic administration of DH5alpha-lux/betaG followed by 9ACG prodrug treatment significantly (P

Effects of cigarette smoke extract (CSE) and some vasoactive mediators on the production of PGI2 and TXA2 in normoxic and hypoxic pulmonary artery endothelial cells (PAECs) in culture were studied. The production of PGI2 in PAECs was inhibited by hypoxia or verapamil, but promoted by angiotensin II (A II), noradrenaline (NE) or platelet activating factor (PAF), while that of TXA2 slightly increased except when treated with PAF. The effect of AII, NE, PAF and verapamil, however, was not influenced by hypoxia. CSE inhibited the production of PGI2 in normoxic PAECs but did not further reduce 6-keto-PGF1 alpha in hypoxic PAECs medium. The results suggest that a) the production of PGI2 during hypoxia might be stimulated by vasoactive mediators produced during hypoxia, not by hypoxia directly; b) the production and release of PGI2 were related to intracellular calcium; c) the augmented production of PGI2 might be one of the mechanisms in the pulmonary vasodilating role of PAF; and d) prostaglandin production might be associated with the alteration of hypoxic pulmonary vasoreactivity after cigarette smoking.