Cervicogenic headache

Eleven female patients with cervicogenic headache (mean age, 43 years; range, 25-59 years) have been examined with the pupillometer. The pupillary diameter was examined in the basal state (that is, the status before pharmacologic stimulation) and after topically administered tyramine (2%), phenylephrine (1%), and hydroxyamphetamine (1%). A total of 51 tests were performed, 35 in the asymptomatic period and 16 during pain attacks. In a control group consisting of 26 age-matched women a total of 39 tests were carried out. Before pharmacologic stimulation (that is, in the "basal state") the pupils were smaller in the asymptomatic (pain-free) period than during pain attacks in the patients and also as compared with that of control individuals. The anisocoria (the difference in pupillary size in the same individual) observed was not significantly different between the patient group and control individuals either in the basal state (before pharmacologic stimulation) or after pharmacologic stimulation. The mydriasis resulting from the instillation of the three sympathicomimetic drugs was symmetrical in both controls and patients both during and between the pain attacks. This finding is in clear contrast to what is found in cluster headache, in which there is a "Horner-like" syndrome on the symptomatic side. These two headaches thus seem to differ essentially with regard to this variable.     

CCR7 and VEGF-C: Molecular Indicator of Lymphatic Metastatic Recurrence in pN0 Esophageal Squamous Cell Carcinoma after Ivor-Lewis Esophagectomy?

Background

Esophageal squamous cell carcinoma (ESCC) is a malignant tumor with a high incidence of lymph node metastasis. This study was undertaken to investigate the expression of CCR7 and VEGF-C in pN0 ESCC and its relationship with lymphatic metastatic recurrence.

Methods

The expression of CCR7 and VEGF-C was examined by RT-PCR and immunohistochemistry. The recurrence rates were calculated by the Kaplan?CMeier method and their difference was determined by log rank analysis. Cox regression analysis was performed to determine the independent risk factors.

Results

In 99 patients, CCR7 mRNA expression was observed in 42 patients with a 3?year recurrence rate of 57.1?%; VEGF-C mRNA expression was observed in 52 patients with a 3?year recurrence rate of 53.8?%; and coexpression of CCR7 mRNA and VEGF-C mRNA was observed in 22 patients with a 3?year recurrencrate of 63.6?%. Neither CCR7 mRNA nor VEGF-C mRNA expression was observed in 27 patients with a 3?year recurrence rate of 22.2?%. The recurrence rates of patients with positive expression of CCR7 mRNA and/or VEGF-C mRNA were significantly higher than in patients without expression of both CCR7 mRNA and VEGF-C mRNA. We achieved better concordance between RT-PCR and immunohistochemistry detection of both markers. The Cox regression analysis showed tumor T classification, positive expression of CCR7/VEGF-C mRNA, and positive expression of CCR7/VEGF-C protein in tumor tissues to be independent risk factors for 3?year recurrence.

Conclusions

Patients with positive expression of CCR7 and/or VEGF-C have a higher recurrence rate than patients without expression of both CCR7 and VEGF-C. CCR7 and VEGF-C may become molecular indicators of disease in patients vulnerable to lymphatic metastatic recurrence.     

Pulmonary hypertension in hereditary haemorrhagic telangiectasia

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disorder characterised by vascular malformations in predominantly the brain, liver and lungs. Pulmonary hypertension (PH) is increasingly recognised as a severe complication of HHT. PH may be categorised into two distinct types in patients with HHT. Post-capillary PH most often results from a high pulmonary blood flow that accompanies the high cardiac output state associated with liver arteriovenous malformations. Less frequently, the HHT-related gene mutations in ENG or ACVRL1 appear to predispose patients with HHT to develop pre-capillary pulmonary arterial hypertension. Differentiation between both forms of PH by right heart catheterisation is essential, since both entities are associated with severe morbidity and mortality with different treatment options. Therefore all HHT patients should be referred to an HHT centre.     

Development of a magnetite-gene complex for gene transfection

The key to successful gene therapy is to find a suitable method and carrier for transfection to allow a gene to be transferred into a cell and integrated into the target gene. The aim of this study was to determine whether biomagnetic material could be combined with the nucleic acid for gene transfection. Dextran-coated iron oxide nanoparticles (DCIONPs) were prepared and mixed with the plasmid pGenesil-1 containing the test gene, which expresses enhanced green fluorescent protein (eGFP). PGenesil-1 empty vector was used as a control. The binding ability was assessed by electrophoresis of the DNA on agarose gels and quantification using BANDSCAN software. Using different gene carriers, Lipofectamine 2000, Sofast, and DCIONPs, the large intestine cancer (Lovo) cell line was transfected in vitro with or without a magnetic field. The expression of eGFP was observed by fluorescence microscopy, and the transfection efficiency was compared. The results showed there was a rapid increase in combining rate when the quality ratio of DCIONPs and pGenesil-1 ascended from 1∶1 to 5∶1. However, the combining rate increased less rapidly as the quality ratio continued ascending. The expression of eGFP showed that the early transfection rate could be improved by applying a magnetic field. In conclusion, the DCIONPs we synthesized are able to carry plasmid DNA and enhance the early transfection efficiency when using a magnetic field.