Association between Dietary Patterns and Serum Hepatic Enzyme Levels in Adults with Dyslipidemia and Impaired Fasting Plasma Glucose

We investigated the association between dietary patterns and serum hepatic enzyme levels in adults with dyslipidemia and impaired fasting glucose in Taiwan. A total of 15,005 subjects (5452 men and 9553 women) aged 35–69 years were selected. Two major dietary patterns were identified by principal component analysis: Western dietary pattern and Mediterranean dietary pattern. Subjects in the highest quartile (Q4) of the Western dietary pattern showed an increased risk of elevated serum alanine aminotransferase (ALT) levels (OR: 1.24, 95% CI: 1.06–1.45, p-trend = 0.01). Fur-thermore, in the highest quartile of the Western dietary pattern, subjects with high waist circum-ference were observed to have a greater risk for developing abnormal serum ALT levels compared to those in the lowest quartile (Q1) (OR: 1.43, 95% CI: 1.04–1.97, p-trend = 0.01). In the highest quartile of the Western dietary pattern, only women were at an increased risk for having abnormal serum ALT levels (OR: 1.28, 95% CI: 1.04–1.59, p-trend = 0.03). By contrast, in the highest quartile of the Mediterranean dietary pattern, only men were at a reduced risk for having abnormal serum gamma-glutamyl transferase (GGT) levels (OR: 0.72, 95% CI: 0.53–0.97, p-trend = 0.048). We report a positive association between the Western dietary pattern and abnormal serum ALT levels.     

Reproductive Health Services for Adolescents With Hearing Impairment in Indonesia: Expectations and Reality

ObjectivesReproductive health education is essential for adolescents with hearing impairment. Since they communicate using specialized language (i.e., sign language), specialized reproductive health services in sign language is a necessity. This study aimed to describe the needs, availability, and expectations of reproductive health services among adolescents with hearing impairment. MethodsThis study used a qualitative approach. It was carried out at a school for children with special needs in the city of Denpasar, Bali, Indonesia. Data were collected by in-depth interviews. The informants were 6 adolescents with hearing impairment aged 16-17 years and 4 other key informants, including school staff and health officers. The data were then analyzed using the thematic method. ResultsWe found that the informants had insufficient knowledge regarding reproductive health. There was no specific subject in the curriculum regarding this issue. Teachers did not specifically provide reproductive health information. The health service unit in the school had not been utilized well for this purpose. Furthermore, no reproductive health services were provided due to the limited number of healthcare workers who could use sign language. ConclusionsThe awareness and intentions of adolescents with hearing impairment regarding access to reproductive health services remain low. Health service units at schools should be optimized to enable schools to provide reproductive health information and services for these adolescents.     

In vitro growth inhibition of Plasmodium falciparum by sera from tropical splenomegaly syndrome patients

Sera from tropical splenomegaly syndrome (TSS) and non-TSS patients from the same village were examined for their ability to inhibit the in vitro growth of Plasmodium falciparum. Using synchronized malaria cultures, sera from both groups inhibited parasite development only if added before merozoite reinvasion of erythrocytes had occurred. There was no significant difference in the degree or apparent mechanism of inhibition caused by TSS and non-TSS sera. These results suggest that the aberrant immune response that results in TSS may not be associated with the elaboration of unique serum factors that differentially inhibit growth of the parasite in vitro.     

Antibody-mediated killing of suppressor T lymphocytes as a possible cause of macroglobulinemia in the tropical splenomegaly syndrome.

To investigate the pathogenesis of macroglobulinemia in the tropical splenomegaly syndrome (TSS), we assessed the functional activity of B lymphocytes and T cell subsets in a pokeweed mitogen-driven assay of immunoglobulin synthesis. Mononuclear cells from patients with TSS produced more IgM than cells from village or from distant controls. This appeared to result from a decrease in the number and/or activity of suppressor T cells of the T8+ phenotype. The lack of functional suppressor T lymphocytes was associated with the presence in sera from patients with TSS of IgM antibodies that specifically killed T8+, 9.3-, 60.1+ T cells from normal donors. These results support the hypothesis that macroglobulinemia in TSS results from defective immunoregulatory control of B cell function, and that this may be caused by lysis of suppressor T cells by specific lymphocytotoxic antibodies produced by patients with this syndrome.     

Treatment of As(III)-Laden Contaminated Water Using Iron-Coated Carbon Fiber

This work presents the fabrication, characterization, and application of iron-coated carbon fiber (Fe@CF), synthesized in a facile in situ iron reduction, for As(III) removal from an aqueous solution. The physico-chemical properties of the composite were characterized using Brunauer–Emmett–Teller (BET) surface area, scanning electron microscopy (SEM), X-ray diffraction (XRD), and Fourier-transform infrared (FTIR) spectroscopy. Adsorption studies were evaluated in batch experiments with respect to reaction time, the dose of adsorbent, As(III) initial concentration, pH, and co-existing ions. The results showed that the BET surface area and pore volume of Fe@CF slightly decreased after Fe coating, while its pore size remained, while the SEM and XRD analyses demonstrated that the Fe was successfully anchored on the CF. A maximum As(III) adsorption of 95% was achieved with an initial As concentration of 1.5 mg/L at optimum conditions (30 min of reaction time, 1 g/L of dose, 1 mg/L of As(III) concentration, and pH 3.5). Since the treated effluents could not meet the strict discharge standard of ≤10 μg/L set by the World Health Organization (WHO), a longer reaction time is required to complete the removal of remaining As(III) in the wastewater effluents. As compared to the other adsorbents reported previously, the Fe@CF composite has the highest As(III) removal. Overall, the findings suggested that the use of Fe@CF as an adsorbent is promising for effective remediation in the aquatic environment.     

Vertigo due to cerebellar cavernous malformation: A case report

Central vertigo is a result of vestibular structure dysfunction in the central nervous system. Currently, misdiagnoses between peripheral and central lesions are frequent, and diagnostic testing costs are high. Identifying the characteristics of these 2 conditions is challenging. We can provide better treatment if we can establish a diagnosis earlier. Cerebral cavernous malformation (CCM) at the cerebellum is a cerebellar lesion that causes symptoms of central vertigo. We report a patient, 20th years old, female, with vertigo for 1 month before being admitted. Vertigo was getting worse, and when the patient arrived at our hospital, vertigo was accompanied by headache, right and left abducens nerve palsy, horizontal nystagmus bidirectional, vertical nystagmus, and weakness on the right side of the body. A brain magnetic resonance imaging (MRI) was performed before surgery and shows a lesion suggestive of CCM at the cerebellum with a hemorrhagic component inside and non-communicating hydrocephalus. There is no vascular malformation based on digital subtraction angiography result. MRI is the most sensitive and specific modality for detecting CCM, whereas cerebral angiography rarely detects this malformation. The patient got surgical treatment, with suboccipital decompression procedures and CCM excision. The histopathological results after surgical treatment revealed a cerebral cavernous malformation. Vertigo, headache, double vision, and weakness on the right side of the body were resolved after surgery.     

HPV16-E6/E7 Oncogene Mutation and p53 Expression among Indonesian Women with Cervical Cancer

Objective: To characterize HPV16 E6/E7 mutation and its association with p53 expression among Indonesian women with cervical cancer. Methods: This is a cross-sectional study involving 31 Indonesian women with pathologically proven cervical cancer and HPV16 infection. Data about the clinical characteristics of the study population were obtained from the medical records. Biopsy specimen of the cervical cancer mass from each study participant was obtained for DNA isolation. The ORFs of E6 and E7 genes were amplified using specific primer designed according to K02718/HPV16R gene sequence obtained from GenBank. Sequencing was performed using software program MEGA10. HPV16 E6 and E7 prototype sequences for nucleotide alignment (HPv16. P, GenBank Access code: NC_001526) was selected from European variant. The sequence of nucleotide and amino acid was aligned using software program BioEdit. p53 expression was evaluated through immunohistochemistry and quantified using immunoreactivity score (IRS). Results: Twelve subjects (38.7%) present with E6 and E7 mutation. Median age, parity, stage and histologic type of the tumour did not associate with E6/E7 mutation. E6 and E7 mutation rate was 25.8% (8/31) and 12.9% (4/31), respectively. Seven single nucleotide changes were identified within the E6 and E7 oncogenes, including four non-synonymous and three synonymous mutations. E6 T27C was the most prevalent mutation (16.1%). Nonsynonymous mutations were more prevalent within E7 gene (9.6%) (N29T, N29S, and R77C). Median IRS did not differ between HPV16-E6/E7 variants and wildtype (p value = 0.990). There was no association between E6/E7 mutations and p53 expression in Indonesian women with cervical cancer (PR 1.4, 95% CI: 0.29-6.77, p value = 0.704). Conclusions: HPV16 E6 mutation was more prevalent than E7 mutation among Indonesian women. There was no association between E6/E7 mutation and p53 expression level.     

HER3 and downstream pathways are involved in colonization of brain metastases from breast cancer

Introduction

Metastases to the brain from breast cancer have a high mortality, and basal-like breast cancers have a propensity for brain metastases. However, the mechanisms that allow cells to colonize the brain are unclear.

Methods

We used morphology, immunohistochemistry, gene expression and somatic mutation profiling to analyze 39 matched pairs of primary breast cancers and brain metastases, 22 unmatched brain metastases of breast cancer, 11 non-breast brain metastases and 6 autopsy cases of patients with breast cancer metastases to multiple sites, including the brain.

Results

Most brain metastases were triple negative and basal-like. The brain metastases over-expressed one or more members of the HER family and in particular HER3 was significantly over-expressed relative to matched primary tumors. Brain metastases from breast and other primary sites, and metastases to multiple organs in the autopsied cases, also contained somatic mutations in EGFR, HRAS, KRAS, NRAS or PIK3CA. This paralleled the frequent activation of AKT and MAPK pathways. In particular, activation of the MAPK pathway was increased in the brain metastases compared to the primary tumors.

Conclusions

Deregulated HER family receptors, particularly HER3, and their downstream pathways are implicated in colonization of brain metastasis. The need for HER family receptors to dimerize for activation suggests that tumors may be susceptible to combinations of anti-HER family inhibitors, and may even be effective in the absence of HER2 amplification (that is, in triple negative/basal cancers). However, the presence of activating mutations in PIK3CA, HRAS, KRAS and NRAS suggests the necessity for also specifically targeting downstream molecules.