Prognostic implications of Fas-ligand expression in nasopharyngeal carcinoma

BACKGROUND: In nasopharyngeal carcinoma (NPC), Fas-ligand (Fas-L)-mediated apoptosis might contribute to the immune privilege of tumors. In some cancers, dysregulation of Fas-L protein in tumors might lead to disease progression. The purpose of this study was to evaluate the correlations between Fas-L expression and the clinical outcomes in patients with NPC. METHODS: We recruited 78 patients with primary NPC, classified clinical stages according to the 1997 American Joint Committee on Cancer staging system, and assessed Fas-L with immunohistochemical methods. RESULTS: Forty-one (53%) of 78 patients were Fas-L-positive. The prevalence was 0%, 57%, 58%, and 82% from stages I to IV, respectively (p <.001). Fas-L expression was associated with the N classification (p=.05) but not the T classification. Patients with positive Fas-L expression had a lower rate of disease-free survival and overall survival (p=.01 for all log-rank tests). CONCLUSION: Patients with NPC with Fas-L-positive tumors had higher clinical stages and lymph node metastasis at diagnosis and poorer disease-free survival and overall survival; therefore, Fas-L expression may be a potential biomarker of prognosis.     

Primary hemangiopericytoma of the tibia: MR and angiographic correlation

The Magnetic Resonance Imaging (MRI) appearances of primary osseous hemangiopericytoma (HPC) have been rarely described. We report on a 46-year-old Chinese man with primary osseous HPC of the right tibia. The characteristic vascular distribution of this tumor, presenting with a ”spoke-wheel” appearance on MR images and with angiographic correlation, is described. Although not pathognomonic, this MR appearance may be an important finding in suggesting the diagnosis of osseous HPC. Received: 3 March 1999 Revision requested: 26 April 1999 Revision received: 13 September 1999 Accepted: 15 September 1999     

Hemolysis and thrombocytopenia following oxaliplatin administration

Oxaliplatin is a platinum derivative with an overall excellent safety profile that has a major role in the treatment of colorectal cancer. With a proven role now in the adjuvant setting, rare but potentially life‐threatening toxicities become a more significant issue. We report here a case of significant postinfusion hemolysis and thrombocytopenia in a patient undergoing adjuvant chemotherapy for stage III colon cancer, and review the literature. Six cases of hemolysis following oxaliplatin treatment have previously been reported, all in the setting of advanced colorectal cancer, with one case resulting in death. In three of the seven reports (including the present case), warning signs of low grade hemolysis were apparent during preceding cycles, with fever and/or back pain during the infusion being the most common feature. Our case appears to be the first reported with a direct antiglobulin test‐negative hemolysis with thrombocytopenia, with each of the previous reports postulating an autoimmune basis. Hemolysis and/or thrombocytopenia are potentially life‐threatening complications of oxaliplatin chemotherapy. With the increasing use of oxaliplatin in the adjuvant setting, clinicians need to be aware of this entity and the possible clinical warning signs that may be evident in preceding cycles.     

疣状黄瘤样脂溢性角化病

疣状黄瘤是在增生性皮损中发生的黄瘤样真皮浸润，非常罕见，已报道见于不同的新生物样和炎症性疾病。作者报道1例72岁男性患者，腹部见一1cm大小黑色结节，无自觉症状。组织病理学检查示典型的棘层肥厚型脂溢性角化病，可见特征性的基底细胞样角质形成细胞增生及假性角囊肿；棘层肥厚的表皮间可见真皮乳头伴多数黄瘤细胞聚集；未见乳头瘤样增生、角化不全和中性粒细胞浸润等典型疣状黄瘤的组织学特征。泡沫细胞的CD68和弹性蛋白染色阳性，而角蛋白和S100染色阴性。巢式PCR未扩增出人类乳头瘤病毒DNA。患者血脂正常。脂溢性角化病中的疣状黄瘤样改变提示疣状黄瘤可能是发生于许多常见皮肤病中的一种反应性现象。     

肝豆状核变性基因类型与临床表型关系研究

目的 了解中国人肝豆状核变性（Wilson‘s disease,WD)患者的P型ATP7B基因突变的分布类型与发生情况,研究WD患者临床表现型和基因型之间的关系。方法 采用生化酶测定,聚合酶链反应,单链构象多态性分析,限制性内切酶图谱和DNA序列分析等分子生物学技术,对57例无亲缘关系家庭的60例WD患者进行ATP7B基因突变的检测。结果 60例中52例有不同程度的肝脏损害症状（87%）,其中30例临床表现为单纯肝脏损害症状,12例为肝脏合并神经系统症状,10例肝脏合并其他症状;7/60例表现为单纯神经系统症状;1例5岁,无临床症状,经DNA序列分析确认基因突变11种,其中错义突变类型5种（R778L,V1140A,G943S,V1106I和V1216M）,碱基缺失1种（1384de117),多态性变化5种（IVS4-5T/C,A2495G,C2310G,IVS18 6C/T和IVS20 5A/G）,WD患者52/114个778位点的精氨酸被置换为亮氨酸（R778L）,R778L基因突变发生率为45.6%,52例WD伴肝脏损害的患者中38例存在R778L基因突变（占73%）,其中14例为R778L纯合型,24例为杂合型。2例V1106I基因突变类型的携带者均为迟发型WD患者(1.7%)。3例已知ATP7B基因突变类型（R778L/V1106I,R778L/V1216M和R778L/R778L）的铜-ATP酶活性较正常对照分别下降44.55%,88.23%和69.49%。结论 1384de117和V1140A为ATP7B新基因突变类型,WD患者的最常见R778L基因突变类型在本组的发生率为45.6%。在临床表现有肝损害的患者中,73%的患者携带R778L基因突变的等位基因。     

Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report

A 3-year-old boy presented at the Taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. Endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. Magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.     

Effect of Bak Foong pills on exocrine pancreatic-bile secretion

We have recently demonstrated that Bak Foong Pills (BFP), a well-known Chinese medicine widely used for treating gynecological disorders, stimulates human colonic epithelial anion secretion, which was mediated by intracellular cAMP and Ca(2+). The present study further investigated the effect of BFP on exocrine pancreatic-bile secretion using in vivo and in vitro approaches. Duodenal infusion of BFP ethanol extract (1 g/kg) in rats produced increases in the volume and protein output of pancreatic-bile juice, but did not affect its pH. Surgical ablation of vagal neural pathway slightly reduced the effect of BFP on the protein output and volume, indicating that the vagal nerve pathway was not the major player in medicating the effect of BFP on exocrine pancreatic-bile secretion. Using CAPAN-1 cell line, a human pancreatic duct cell line, in conjunction with the short-circuit current (I(SC)) measurements, we further demonstrated that BFP could directly stimulate pancreatic HCO(3)(-) secretion. Basolateral addition of BFP (600 microg/ml) produced averaged charges transported of 2100+/-382.5 microC/cm(2), which was blocked by apical addition of Cl(-) channel blocker. Removal of HCO(3)(-) from the Krebs-Henseleit (K-H) solution inhibited the BFP-induced I(SC) by more than 95%. The present results suggest that BFP could improve digestive function by stimulating pancreatic protein and HCO(3)(-) secretion.     

Effects of Bak Foong Pills and Menoease Pills on white blood cell distribution in old age female rats

This study examined the effects of Bak Foong Pills (BFP) and the new BFP-derived post-menopause formula, Menoease Pills (MBFP), on the distribution of peripheral white blood cells (WBC) between BFP/MBFP-treated and non-treated rats. Eighteen months old female SD rats were used to mimic post-menopausal and old age animal models. The percentage distribution of lymphocytes, monocytes and granulocytes were measured using flow cytometry with and without treatments of BFP or MBFP. Results showed that WBC distribution in old age rats were significantly different from that of adult rats, suggesting that as the animal aged, their WBC distributions were altered. Old age rats were observed to have much lower percentages of lymphocytes, but higher percentages of granulocytes when compared to the adult rats, indicating possible attenuated immunity. Following treatment with BFP or MBFP, WBC populations were found to be redistributed back into the ranges observed in adult animals. Furthermore, MBFP, was found to alter WBC distribution in a dose-dependent manner. When compared to estrogen (E(2)), a well documented regulator of immune function, results showed that MBFP was able to show significantly greater effects on WBC redistribution compared to E(2). However, in ovariectomised (ovx) old age rats, neither MBFP nor E(2) treated groups showed any changes in WBC redistribution. These results indicate that MBFP may share similarities to E(2). Indeed, the effect of MBFP and E(2) seems to require intact ovaries, which are believed to be necessary for the modulation of WBC distributions and immune functions. Overall, our findings suggest that BFP and MBFP may be able to regulate WBC population in old age female rats, and thus, indicate their potential role on improving the attenuated immunity evident in post-menopausal and elderly women.     

Relationship between academic scores and performance on national qualified examination for registered professional nurses (NQEX-RPN)

PURPOSE: The purpose of this study is to identify the relationship between the academic scores of school subjects and the performance in national qualified examination for registered professional nurses (NQEX-RPN). METHODS: One hundred and seventy-seven graduates of the two-year Associate Degree in Nursing at one of the junior college of nursing in Taipei, Taiwan were included in this study. Information of student academic records and NQEX-RPN results were reviewed. The data were entered into the statistical software (JMP-IN 3.2.1, SAS Institute Inc.) for analysis. RESULTS: (1) In total, 34 subjects (16 nursing subjects and 18 non-nursing subjects) were included in this two-year nursing curriculum. Nine nursing subjects were statistical significant and were positively related with the performance in NQEX-RPN. (2) Year 1 grade point average (GPA) of nursing subjects was significantly correlated with the performance in NQEX-RPN but not Year 2 GPA. (3) The performance of two subjects in NQEX-RPN, namely Fundamental Nursing and Psychiatric-Community Nursing, were not significantly correlated with their related school subjects. CONCLUSION: The academic scores in only half of the nursing subjects were found to be weakly associated with the performance in NQEX-RPN, although the association was statistically significant. Also, performance in NQEX-RPN was not associated with the final year GPA. Thus, the nursing curriculum and teaching contents may need to be redesigned in order to match with NQEX-RPN.