TVT vs Monarc: a comparative study

Following the success of the tension-free vaginal tape (TVT), there has been considerable interest in technique modifications such as the transobturator approach for implant placement. We attempted to elucidate possible anatomical and clinical differences between the two methods in a retrospective cohort study. One hundred and fourteen women who had undergone TVT or Monarc implantation were assessed by or under the supervision of the senior author, with identical tensioning technique. They were followed up by an interview, uroflowmetry, and translabial 3D ultrasound. There were significant differences for patient satisfaction (P=0.013), subjective overall cure/improvement (P=0.0018), and the symptom of poor stream (P=0.03), all favoring the Monarc group. On imaging Monarc tapes appeared more proximal at rest (P=0.006) and Valsalva (P=0.002) and remained further from the symphysis pubis on Valsalva (P=0.01). At 9 months follow-up, there was no significant difference as regards to cure rates for stress incontinence between the two suburethral slings. Monarc tapes are located more proximally and may be less obstructive, judging from a lower incidence of symptoms of voiding dysfunction. Patient satisfaction and overall subjective cure/improvement were higher after Monarc. In summary, the Monarc is an effective TVT alternative, achieving cure of stress incontinence by similar means. It may be less obstructive, resulting in improved patient satisfaction.     

Comparative study of gene expression during tooth eruption and orthodontic tooth movement in mice

Objective:  The aim of this study was to understand tooth eruption by comparing the gene expression during tooth eruption and orthodontic tooth movement (OTM).
Materials and methods:  Orthodontic force was applied on maxillary molars for 2, 4, 7 and 14 days to study tooth movement. Mice at PN 0, 7, 10, 15 and 21 were fixed to observe tooth eruption. Comparative study of two procedures was assessed by haematoxylin and eosin, tartrate-resistant acid phosphatase staining and in situ hybridization for matrix metalloproteinase ( Mmp ) 2 , 13 , bone sialoprotein ( Bsp ) and osteocalcin ( Ocn ).
Results:  Tartrate-resistant acid phosphatase activity and expression of Mmp2 , 13 were obviously detectable in the compression region during OTM. They were also identified in the occlusal and apical region of alveolar bone during tooth eruption. Strong expression of Bsp and Ocn was detectable at the tension side during OTM. These genes were also expressed in the inner lateral region of alveolar bone adjacent to the tooth, but absent in the inner surface of the occlusal and root apical regions during tooth eruption.
Conclusion:  The process of alveolar bone metabolism during developmental eruption and OTM shares the same mechanism. Internal force, as the orthodontic force for OTM, may be initiating factor for tooth eruption.     

Ability to predict breast cancer in Asian women using a polygenic susceptibility model

Recently identified susceptibility alleles from Genome-Wide Association Studies (GWAS) for breast cancer provide an option to stratify women for their breast-cancer risk based on these alleles. This may allow greater precision in targeting preventive efforts at genetically high-risk groups. Given the variation in allele frequencies between populations, the utility of such risk-stratification may vary in different populations. We examined the possibility for individualized disease risk stratification based on common breast cancer risk alleles, and its potential impact on population-based screening in a population of Asian women. We assigned allele frequencies based on available data from the Singapore Genome Variation project and tested the utility of 13 previously validated single nucleotide polymorphisms in predicting risk using simulation and originally reported relative risks. We also tested how these markers performed collectively in distinguishing risk groups and evaluated their possible use for individualized mammography screening. Our analysis suggests that the risk profile generated by 13 single nucleotide polymorphisms as identified through GWAS provides different risk profiles between ethnic groups (population genetic mean relative risk = 0.698, 0.617, 0.661, 0.743 for Caucasians, Singapore Chinese, Singaporean Malays, and Singaporean Indians, respectively) but that it does not provide sufficient discrimination to be useful in individualized prevention. Furthermore, these markers are not useful in risk stratification for population-based screening programs due to both cost and under-diagnosis of breast cancers in the general population. The clinical use of single, common, low-penetrance genes for breast cancer risk prediction in an Asian setting is currently limited.     

Complete genome sequence analysis of dengue virus type 2 isolated in Brunei

In a previous study, we have reported the detection and isolation of dengue virus in Brunei (Osman, O., Fong, M.Y., Devi, S., 2007. A preliminary study of dengue infection in Brunei. JJID 60 (4), 205-208). DEN-2 was the predominant serotype followed by DEN-1. The full genomic sequences of 3 DEN-2 viruses isolated during the 2005-2006 dengue incident in Brunei were determined. Twenty-five primer sets were designed to amplify contiguous overlapping fragments of approximately 500-600 base pairs spanning the entire sequence of the viral genome. The amplified PCR products were sent for sequencing and their nucleotides and the deduced amino acids were determined. All three DEN-2 virus isolated were clustered in the Cosmopolitan genotype of the DEN-2 classification by Twiddy et al. This work constitutes the first complete genetic characterization of three Brunei DEN-2 virus strains.     

Intron 2 (T/C) CYP46 polymorphism is associated with Alzheimer's disease in Chinese patients

BACKGROUND: Cholesterol metabolism has been implicated in the pathophysiology of Alzheimer's disease (AD), and cholesterol-related genes are plausible candidate genes for AD. Genetic association of CYP46A1 polymorphisms with AD had been under extensive investigations; however, observations on intron 2 T-->C (rs754203) generated inconclusive results. OBJECTIVE: To analyse an independent data set in a Chinese population to see whether the polymorphic site rs754203 of the CYP46A1 gene is associated with AD. METHODS: We analysed 130 sporadic AD patients and 110 healthy controls of the Southern Chinese origin. RESULTS: An association between the genotype frequency and AD was suggested in the general population (p = 0.047, odds ratio, OR = 1. 61, 95% confidence interval, CI = 0.96-2.70), while the association was most significant in the apolipoprotein E (ApoE) epsilon4-negative group (p = 0.004, OR = 2.54, 95% CI =1.31-4.95). Linkage disequilibrium block prediction results also favoured this association. Consistent with previous reports, intron 3 C-->T (rs4900442) polymorphism did not show any evidence of association; in our data set ApoEepsilon4 was confirmed to be a genetic risk factor for AD (p = 0.0016, OR = 2.76, 95% CI = 1.50-5.11).     

Epidemiology of colorectal cancer in Asia

The prevalence of colorectal cancer is increasing in Asia. However, the age‐standardized rate has reached a plateau in some countries. Some studies have shown a male predominance difference and increasing risk in the elderly, but not in the younger population. ‘Right shifting’ of colorectal cancer, not accountable by difference in age or the indications for endoscopic examination, has also been noted. Westernized diet is associated with colorectal cancer, but controversy remains on how it causes colorectal cancer. Alcohol consumption, obesity, diabetes mellitus, consumption of red and processed meat and cigarette smoking are linked to bowel cancer epidemiologically. Only high dietary calcium has a consistent negative (or ‘protective’) effect. The efficacy of fish oil, vitamin D, soy, phytoestrogens, folate, methionine, riboflavin and vitamin B6 has not been established. Aspirin and non‐steroidal anti‐inflammatory drugs use decrease risk of colorectal cancer after 5–10 years of use. There is no evidence for a detrimental effect of proton pump inhibitors or benefit of statins in colorectal cancer. In conclusion, there is a rising trend and prevalence of colorectal cancer in Asia. Dietary modification or supplementation may not be effective in preventing colorectal cancer. Surveillance of colorectal cancer in high‐risk groups, according to current recommendation, is probably most effective.     

Polymorphisms of CR1, CLU and PICALM confer susceptibility of Alzheimer's disease in a southern Chinese population

In this case-controlled study, we tested susceptible genetic variants for Alzheimer's disease (AD) in CR1, CLU and PICALM from genome-wide association studies (GWAS) in a southern Chinese population. Eight hundred twelve participants consisting of 462 late-onset Alzheimer's disease (LOAD) patients and 350 nondemented control subjects were recruited. We found by multivariate logistic regression analysis, that single nucleotide polymorphisms (SNPs) in CR1 (rs6656401 adjusted allelic p = 0.035; adjusted genotypic p = 0.043) and CLU (rs2279590 adjusted allelic p = 0.035; adjusted genotypic p = 0.006; rs11136000 adjusted allelic p = 0.038; adjusted genotypic p = 0.009) were significantly different between LOAD patients and nondemented controls. For PICALM, LOAD association was found only in the APOE ε4 (−) subgroup (rs3851179 adjusted allelic p = 0.028; adjusted genotypic p = 0.013). Our findings showed evidence of CR1, CLU, and PICALM and LOAD susceptibility in an independent southern Chinese population, which provides additional evidence for LOAD association apart from prior genome-wide association studies in Caucasian populations.