Modeling psychological well‐being and family relationships among retired older people in Taiwan

Well‐being is an important indicator of an individual's quality of life, especially for retired people. In the present study, we investigated the psychological well‐being (PWB) of retired Taipei (Taiwan) older people and its associations with sex, family relationships, and health status. A structured questionnaire was used to measure demographics, family relationships, and perceived health status, as well as Ryff's PWB Scales. Data were analyzed from 268 retired olderpeople recruited from social service centres and public parks from September to November 2010. The Multiple Indicators Multiple Causes model demonstrated a very good fit of Ryff's PWB Scales and their relations to sex, family relationships, and perceived health status. The link with PWB was stronger for family relationships than for perceived health. The Mandarin translation of Ryff's PWB Scales was found to be suitable and easy to administer to Taiwanese olderpeople. The findings suggest that nurses should note that improving family relations will facilitate the PWB of retired olderpeople, which results in better outcomes of care.     

A study on sequence variations in pre‐S/surface,X and enhancer II/core promoter/precore regions of occult hepatitis B virus in non‐B,non‐C hepatocellular carcinoma patients in Taiwan

This study was to investigate the clinical significance and virologic factors of occult hepatitis B virus (HBV) infection in hepatocellular carcinoma (HCC) patients without hepatitis B surface antigen (HBsAg) or anti‐hepatitis C virus (non‐B, non‐C) in Taiwan. Serum HBV DNA (occult HBV) was detected in 90 of 222 non‐B, non‐C HCC patients and 24 of 300 non‐B, non‐C controls without HCC. Of 90 occult HBV‐infected HCC patients, the sequences of HBV pre‐S/surface, X and enhancer II/core promoter/precore genes were analyzed from 40 patients. Direct sequencing of such genes was also performed in 24 non‐B, non‐C controls without HCC and 40 HBsAg‐positive HCC controls. Compared with non‐B, non‐C controls without HCC, non‐B, non‐C subjects with HCC had significantly higher prevalence of occult HBV (p < 0.0001). Moreover, M1I and Q2K in pre‐S2 gene and G1721A were more common in occult HBV‐infected patients with HCC than in those without HCC. Compared with the HBsAg‐positive HCC controls, occult HBV‐infected HCC patients had higher frequencies of M1I and Q2K in pre‐S2 gene, G185R and S210N in surface gene, A36T and A44L in X gene, and G1721A in enhancer II gene, and had lower rates of pre‐S deletions and A1762T/G1764A, A1846T, G1896A and G1899A in core promoter/precore genes. Multivariate analysis showed Q2K in pre‐S2 gene, G1721A and A1846T were independent factors for occult HBV‐infected HCC. Our study suggested that the virological factors of HBV related to HCC were different between occult HBV‐infected and HBsAg‐positive patients. The G1721A, M1I and Q2K in pre‐S2 gene may be useful viral markers for HCC in occult HBV carriers. © 2009 UICC     

Expression of neurotrophic factors in neonatal rats after peripheral inflammation.

Neonatal peripheral inflammatory insult might result in the alteration of neuronal development in the nociceptive circuit. During early postnatal period, neurotrophins play important roles in neural development and sensory nerve innervation in the central and peripheral nervous systems. In this study, we investigated mRNA expression for neurotrophic factors and their receptors in the dorsal root ganglia of rat pups during postnatal life after peripheral inflammation induced by injection of complete Freund's adjuvant (CFA) into hind paw on postnatal day 1. Our results showed that mRNA expression levels of alpha-calcitonin gene-related peptides, tropomyosin-related kinase-A (trkA), p75 neurotrophin receptor (p75(NTR)), and brain-derived neurotrophic factor (BDNF) elevated significantly after CFA treatment. Such an increase began 1 day after CFA treatment and lasted 2 to 3 days for trkA, p75(NTR), and BDNF. In contrast, there was no change in mRNA expression levels for neurotrophin-4/5, beta-nerve growth factor (beta-NGF), trkB, glial cell line-derived neurotrophin factor, and receptor protein tyrosine kinase protein. Our study demonstrated that neonatal peripheral inflammatory insult might result in molecular changes of neurotrophic factors, particularly in NGF receptors and BDNF, in the process of neuronal development and plasticity in primary afferents during early neonatal period. PERSPECTIVE: Neonatal peripheral inflammation model has been used for the exploration of neuropathic pain mechanism for years. This work provided further detailed information about possible neurotransmitters and peptides involved in this process. This might also lead to future clinical application.     

Online assessment of patients' views on hospital performances using Rasch model's KIDMAP diagram

Background  

To overcome the drawback of individual item-by-item box plots of disclosure for patient views on healthcare service quality, we propose to inspect interrelationships among items that measure a common entity. A visual diagram on the Internet is developed to provide thorough information for hospitals.     

HeartMate left ventricular assist device for long-term circulatory support.

We describe three successful cases of HeartMate left ventricular assist device (LVAD; Thermo Cardiosystems, Woburn, MA, USA) implantation in patients with end-stage heart failure for long-term circulatory support. Patient 1 was a 34-year-old woman with postpartum cardiomyopathy. Patients 2 and 3 were both males with dilated cardiomyopathy, 50 years and 21 years of age, respectively. They all presented in cardiogenic shock with decreased sensorium and anuria. Temporary mechanical support with an intra-aortic balloon pump or extracorporeal membrane oxygenation (ECMO) was needed for life support. Because bleeding and right ventricular failure often occur after HeartMate LVAD implantation, we used a Vascutek tube (Vascutek Ltd, Inchinnan, Scotland) graft to wrap inflow and outflow valve conduits and ECMO as a bridge to HeartMate LVAD implantation. Following surgery, cardiac output increased from 2.70, 2.06 and 2.53 L/min to 4.50, 5.80 and 5.00 L/min in the three patients. HeartMate LVAD can provide safe and stable long-term circulatory support without the need for anticoagulation. One of the patients remained on HeartMate for 287 days before undergoing successful heart transplantation. Patients with HeartMate LVAD are ambulatory and may be discharged while awaiting heart transplantation. Heart function may recover after long-term ventricular unloading with HeartMate LVAD.     

Overexpression of Sp1 leads to p53‐dependent apoptosis in cancer cells

Numerous studies have documented that Sp1 expression level were elevated in various human cancers. However, the promoters of many pro‐apoptotic genes have been found to contain the Sp1 binding elements and are activated by Sp1 overexpression. To better understand the role and the mechanism of increased Sp1 levels on apoptosis, we used adenovirus to ectopically express GFP‐Sp1 protein in various cancer cell lines. First, in HeLa and A549 cells, we found that Sp1 overexpression suppressed the cell growth and increased the detection of sub‐G1 fraction, caspase‐3 cleavage, and annexin‐V signal revealed that apoptosis occurred. Furthermore, when cells entered the mitotic stage, the cell apoptosis was induced by Sp1 overexpression through affecting mitotic chromatin packaging. We also verified that p53 protein was accumulated and activated the p53‐dependent apoptotic pathways in the wild‐type p53 cells but not in the p53‐mutated or p53‐deleted cell lines when these cells were infected with adeno‐GFP‐Sp1 virus. In addition, A549 (p53^+/+) cells could be protected from apoptosis under Sp1 overexpression when p53 was knockdown by p53 shRNA. Finally, H1299 (p53^?/?) cell viability was significantly inhibited by adeno‐GFP‐Sp1 virus infection in the expression of p53. In conclusion, p53 was an essential factor for Sp1 overexpression‐induced apoptotic cell death in transforming cells. © 2009 UICC     

In vitro evaluation of flavopiridol, a novel cell cycle inhibitor, in bladder cancer

Purpose: To determine the in vitro effects of flavopiridol on bladder cancer cell lines, immortalized urothelial cell lines, and normal urothelial cells well characterized for defects in p53, pRb, and p16. Methods: Growth inhibition was assessed via an MTT assay and apoptosis via DAPI nuclear staining. Cell cycle analysis was performed via propidium iodide staining and fluorescent activated cell sorting (FACS). Multidrug-resistant cells were generated by continuous exposure to doxorubicin. Results: Growth inhibition was not correlated with inactivation of p53, pRb, or p16. All cells experienced G2/M arrest within 24 h of flavopiridol exposure. Modest apoptosis was observed but required 72 h of continuous drug exposure to become evident. There was no obvious synergistic or antagonistic toxicity when flavopiridol was combined with radiotherapy or cisplatin dosed at the IC₅₀ despite the observation that radiotherapy and flavopiridol led to more profound G2/M arrest than either agent alone. Doxorubicin-resistant cells, demonstrated to overexpress the MDR1 multidrug-resistance protein were equally as sensitive to flavopiridol as the parental cells. Conclusions: Flavopiridol is a novel cell cycle inhibitor that may be a useful agent in bladder cancers with tumor suppressor gene alterations and/or multidrug resistance. Received: 7 July 1998 / Accepted: 28 October 1998