Periodontal status of adults with systemic sclerosis: case-control study

Background: Systemic sclerosis (SSc) is a systemic autoimmune disease that affects connective tissue in the skin, blood vessels, and major organs of the body. This project aims to compare the periodontal status of dentate Hong Kong Chinese with and without SSc. Methods: Thirty‐six non‐smoking adults with SSc (one male and 35 females: aged 50.6 ± 11.7 years; free from Sjögren syndrome) attending a teaching hospital were age‐ and sex‐matched to systemically healthy controls attending a dental hospital. Both groups had similar demographic characteristics but a lower proportion of patients with SSc were working or studying (P <0.05). Twenty‐three (32%) of all participants were regular dental attendees. Orthopantomogram radiographs were taken. Participants were surveyed and periodontally examined. Results: Both groups had a similar number of erupted teeth, proportion of sites with detectable plaque, and mean full‐mouth clinical attachment level, whereas controls had less bleeding on probing (49.3% ± 22.6% versus 78.4% ± 19.6%; P <0.001) and a shallower mean full‐mouth probing depth (1.92 ± 0.44 mm versus 2.52 ± 0.58 mm; P <0.001). Radiographically, patients with SSc had wider periodontal ligament spaces (0.36 ± 0.06 mm versus 0.33 ± 0.03 mm; P <0.01). Conclusions: Hong Kong Chinese adults with SSc seem to exhibit higher levels of periodontal inflammation and wider radiographic periodontal ligament spaces than age‐ and sex‐matched controls. Future studies are warranted to further investigate any associations between these periodontal features and SSc.     

Intrahepatic expression of HBcAg and delta antigen in anti-HBe positive HBsAg carriers with acute exacerbation or chronic active liver disease

Intrahepatic expression of HBcAg and hepatitis delta antigen (HDAg) was studied in 43 patients with acute exacerbation AE and 37 with chronic active liver disease CALD, in order to evaluate the role of hepatitis B virus (HBV) replication and hepatitis delta virus (HDV) superinfection in development of AE or CALD in anti-HBe positive HBsAg carriers in Taiwan, and the results were compared with 37 patients with only minor hepatitic activity. Only 8.1% of patients with minor hepatitic activity were HBcAg positive, and none were HDAg positive. In contrast, 41.8% and 32.6% of patients with AE were positive for HBcAg and HDAg, respectively, and the other 25.6% were negative for both. The clinical features of AE showed no difference in relation to HBcAg and HDAg activity in the liver except that patients without HBcAg and HDAg were predominantly older adults. These patients might be supposed to have non-A, non-B hepatitis (NANB) virus superinfection, as many reports have shown a predominance of older patients in acute NANB hepatitis. Of the patients with CALD, 40.5% were HBcAg positive, 27.0% were HDAg positive, and 32.5% were positive for neither. Histological features of CALD were identified in 83.3% and 100% of patients with HBcAg and HDAg activity, respectively, but only in 26.1% of those without HBcAg and HDAg. The etiology of CALD in the latter group remains unclear. Furthermore, some of the anti-delta seropositive patients with AE or CALD expressed HBcAg rather than HDAg in the liver.(ABSTRACT TRUNCATED AT 250 WORDS)     

Production and characterization of monoclonal antibodies cross‐reactive with major aflatoxins

Monoclonal antibodies cross‐reactive with four major aflatoxins (AFs) were produced by fusion of P3/NS‐1/1‐AG4–1 murine myeloma cells with spleen cells isolated from a BALB/c mouse that had been immunized with aflatoxin B3‐hemisuccinate conjugated to bovine serum albumin. Six stable clones were obtained. Isotyping by enzyme‐linked immunosorbent assay (ELISA) revealed that the antibodies produced by all but two of the clones were of the IgG₁ type. Of the remaining clones, one produced IgG₂₁, and the other IgA. Competitive radioimmunoassay using tritiated AFB₁ as the marker ligand revealed that two clones produced antibody that cross‐reacted well with both AFB₁ and AFG₁; one clone produced an antibody that had good specificity toward AFB₁. The relative cross‐reactivities (RCR) of antibody produced by clone 575B8F12 for AFB₁, AFB₂, AFG₁, and AFG₂ were 100, 5, 153, and 6, respectively. The RCR of antibody produced by clone 575G4H7 for the above AFs were 100, 40, 153, and 40, respectively. The RCR of antibody produced by clone 585D4D6 for the above AFs were 100, 40, 152, and 23, respectively. Antibodies produced by the other three clones were inadequate for immunoassay because their affinities for the AFs were 100 times less than the three clones described above.     

Human placental multipotent mesenchymal stromal cells modulate trophoblast migration via Rap1 activation

Introduction

Little is known about the interaction between human placental multipotent mesenchymal stromal cell (hPMSC) and trophoblast. We hypothesize that hPMSCs produce hepatocyte growth factor (HGF) which may interact with trophoblasts and regulate their migration during placentation.

Methods

hPMSCs were isolated from term placentas and conditioned medium was collected after 2 days of culture in hypoxic (<1% O₂) or control (20% O₂) conditions. Selective agonist and inhibitor or siRNA for protein kinase A (PKA) or Rap1 were combined with Rap1-GTP pull down assays, flow cytometry, integrin β1 activation assays and adhesion and migration studies to investigate HGF signaling effects in trophoblasts. The hPMSC abundance and HGF level in preeclamptic placentas were compared with gestational age-matched controls.

Results

HGF was expressed by hPMSCs and was decreased in hypoxia. HGF induced cAMP production and Rap1 activation in trophoblasts, which in turn activated integrin β1. The HGF and PKA activator 6-Bnz-cAMP induced Rap1 activation with increased trophoblast adhesion and migration. The alterations were inhibited by PKA inhibitor H89 or Rap1 siRNA. HGF and cAMP expression were reduced in preeclamptic placentas. hPMSC number was decreased in preeclamptic placenta compared to controls (0.68 ± 0.1% vs. 1.32 ± 0.5%; P = 0.026). hPMSC conditioned medium enhanced trophoblast migration which was inhibited by c-Met blocking antibody, but migration was reduced by conditioned medium from hPMSC cultured in hypoxia.

Conclusions

hPMSCs secrete HGF and increase trophoblast cAMP production. The cAMP effector PKA modulates adhesion and migration of trophoblast via signaling to Rap1 and integrin β1.     

High success rate and considerable adverse events of pelvic prolapse surgery with Prolift: A single center experience

ObjectivesThe aim of this study was to analyze short-term outcomes of pelvic prolapse surgery using Prolift transvaginal mesh in a teaching hospital.Materials and MethodsThirty-four patients who received prolapse surgery with Prolift were followed up for 7–26 months. Assessment included pre- and postoperative Pelvic Organ Prolapse Quantification (POP-Q) stage, and Urogenital Distress Inventory (UDI)-6, and Incontinence Impact Questionnaire (IIQ)-7 scores. Surgical characteristics and adverse events during follow-up were also recorded.ResultsObjective and subjective data were available for 29 patients. The overall anatomical success rate was 96.5 % (28/29) after a mean of 18 ± 6.3 months follow-up. The POP-Q, UDI, and IIQ all improved significantly after surgery. Uterine sparing prolapsed surgery with Prolift unexpectedly yielded a cure rate of 100%. Ten adverse events occurred during and after prolapse surgery with dyspareunia (3/34) as the most common, followed by bladder injury (2/34).ConclusionsProlapse surgery with Prolift yielded a good anatomical outcome and satisfactory symptom improvement at different periods of follow-up, especially in uterus-sparing prolapse surgery. However, adverse events were not uncommon, and patients should be fully informed of all possible adverse events prior to surgery.     

Concomitant trocar-guided transvaginal mesh surgery with a midurethral sling in treating advanced pelvic organ prolapse associated with stress or occult stress urinary incontinence

ObjectiveThe purpose of this study was to evaluate the efficacy and feasibility of concomitant trocar-guided transvaginal mesh (TVM) surgery with a midurethral sling (MUS) for treating women with advanced pelvic organ prolapse (POP) and stress urinary incontinence (SUI) or occult SUI (OSUI).Materials and methodsEighty-nine women with advanced POP and SUI or OSUI were retrospectively enrolled. The Total Prolift and Tension-free Vaginal Tape-Obturator Systems were used for trocar-guided TVM surgery and MUS. Patients received regular follow-up at 1 week, and 1 month, 3 months, 6 months, and 12 months postoperatively, and then annually thereafter. The endpoints were the success rate for POP, and perioperative and postoperative complications. Functional outcomes were the presence of voiding difficulty, persistent or de novo overactive bladder symptoms, postoperative SUI, and paresthesia.ResultsThe median follow-up period was 35 months (range, 12–50 months). Within the follow-up period, 84 patients (94.4%) were objectively cured, five patients (5.6%) had vaginal apical mesh exposure, 29 individuals (32.6%) had persistent or de novo overactive bladder symptoms, six individuals (22.5%) had de novo SUI (two were found by urodynamics), and nine individuals (10.1%) had voiding difficulties (two were found by urodynamics). In addition, the vaginal hysterectomy group had greater blood loss, longer operation times, and a higher mesh erosion rate compared to the uterine suspension group.ConclusionConcomitant trocar-guided TVM surgery and MUS with the use of total Prolift and Tension-free Vaginal Tape-Obturator offer good efficacy in treating women with advanced POP and SUI or OSUI. The vaginal hysterectomy group had more perioperative complications.     

Application of traditional Chinese medicine in the treatment of infertility

The philosophy and practice of traditional Chinese medicine (TCM) have been evolving for thousands of years in China, Japan and other Asian countries. TCM is now generating popular interest worldwide for reproductive health care and disease prevention, including applications for treating infertility and improving sexual function. This review focuses on the application of TCM for infertility patients, and provides a critical reflection on the efficacy and safety of selected Chinese herbal formulas. It has been claimed that some formulas produce high clinical pregnancy rates with few or no side effects, as well as improving the general well-being of patients. The need for randomized control trials and research into possible mechanisms of action, effective doses, contraindications and toxicity is self-evident. However, the task is enromous in view of the number of herbal products currently available on the market; yet among these products are undoubtedly some that will prove to be safe and beneficial.     

ERK在ALR抑制免疫过程中的变化及意义

目的观察肝再生增强因子(ALR)对外周血单核细胞增殖时ERK的影响,以探明ALR免疫抑制相关机理。方法梯度离心法分离健康人外周单核细胞,用ConA 5μg/ml刺激细胞增殖,选定最佳研究时间;观察不同剂量ALR抑制功能,选用最佳抑制剂量;利用Western blot检测ALR抑制细胞增殖时ERK的磷酸化改变。结果 ConA刺激细胞增殖最佳时间是60 h,ALR能抑制细胞增殖,并呈剂量依赖关系,30μg/ml ALR抑制效果最显著;ALR对单核细胞无直接增殖作用。ConA能引起ERK含量和磷酸化明显增加,ALR则抑制ConA对ERK的刺激,以抑制ERK2最明显。结论 ALR可能通ERK的含量和抑制ERK2的磷酸化抑制细胞增殖。