A Japanese case of Behçet’s disease complicated by recurrent optic neuropathy involving both eyes: a third case in the English literature

Abstract

We report a case of acute optic neuropathy with Behçet’s disease (BD) in a 27-year-old man. The patient experienced two episodes of acute optic neuropathy in one year. The first was in the right eye and the second was in the left eye. In both episodes, several months before acute optic neuropathy developed, oral and genital ulcers, erythema nodosa and epididymitis were noted. The patient was diagnosed with BD. High-dose systemic corticosteroid resulted in clinical improvement in both episodes. Neurological involvement in BD is well known. Brainstem disturbance, meningomyelitis and palsy involving cranial nerves VI, VII have been reported. However, optic neuropathy in BD is very rare. This case suggests that optic neuropathy can affect both eyes and be recurrent. This case provides clinical insight into optic nerve involvement in BD.     

Mature ovarian teratoma as a possible cause of fever and clinical exacerbation in Behçet's disease: a case report

Abstract

Behçet's disease (BD) is a chronic relapsing systemic vasculitis of unknown etiology. BD is very rarely associated with neoplastic diseases. We report the case of a 39-year-old woman who had been treated for BD for 3 years. She presented with relapsing oral and genital lesions and persistent high-grade fever which had lasted for 1 month. The possible cause of the exacerbation of BD and fever in this patient was a mature ovarian teratoma. To our knowledge this is the first report of a patient with BD associated with a ovarian teratoma.     

A pH-triggered delayed-release chronotherapeutic drug delivery system of aceclofenac for effective management of early morning symptoms of rheumatoid arthritis

Abstract

Context: Rheumatoid arthritis (RA) is differentiated as an early morning exacerbation of the core arthritis condition associated with increase in pain and stiffness in joints and necessitate for medication. Objective: The aim of the present work was to develop and optimise a pH-triggered delayed-release colon-specific aceclofenac microspheres and to accomplish chronotherapy of RA. Methods: A 3-factor, 3-level Box–Behnken design (BBD) was used to optimise selected variables. Developed formulation was evaluated for in vivo delayed response and anti-arthritis activity in rats. Results: The particle size and encapsulation efficacy of these microspheres were 117.36?±?10.54?µm and 85.06?±?5.85%, respectively. Optimised formulation was analysed by SEM, DSC, X-RPD and FTIR. The in vivo evaluation reveled delayed anti-inflammatory activity in carrageenan-induced rats and anti-arthritic activity in freund’s adjuvant-induced arthritis rats. Conclusion: The optimised aceclofenac microspheres formulation is potential for the chronotherapy of early morning symptoms of RA.     

替吉奥联合奥沙利铂或奈达铂同步放疗治疗局部进展期食管鳞癌的临床观察

目的 比较替吉奥联合奥沙利铂（OXA）或奈达铂（NDP）同步放疗治疗局部进展期食管鳞癌的临床疗效和相关不 良反应。方法 选择局部进展期食管鳞癌患者72 例,随机分为观察组（38 例）和对照组（34 例）,两组均采用同步放化疗。观察组采用替吉奥联合OXA 治疗,OXA 剂量为130mg/m2,静脉滴注,d1,替吉奥40mg/m2,早晚各1 次口服,d1~14。对照组采用NDP,剂量为80mg/m2,静脉滴注,d1,其余治疗方法同观察组。两组患者放、化疗同时开始,3周为1 个疗程,共化疗2个疗程。比较两组患者治疗后的临床疗效、生存期及不良反应情况。结果 观察组和对照组近期总有效率分别为81.6%和82.4%,两组比较无统计学差异（P＞0.05）;观察组和对照组患者1、2、3 年生存率分别为86.8%、57.9%、28.9%和85.3%、55.9%、29.4%,两组比较均无统计学差异（均P ＞0.05）。观察组患者外周神经毒性反应发生率高于对照组（P＜0.05）;而在骨髓抑制、放射性食管炎及放射性肺炎等其他方面的不良反应发生率均类似于对照组,两组比较均无统计学差异（均P＞0.05）。结论在局部进展期食管癌同步放化疗中,替吉奥联合OXA 方案与替吉奥联合NDP 方案患者的近期有效率与远期生存率相当,有效性和耐受性都较好,值得进一步 前瞻性探索。     

替吉奥胶囊单药联合放疗治疗晚期胃癌的临床观察

目的 观察替吉奥胶囊（S-1）单药化疗联合同步放疗治疗晚期胃癌的疗效及毒副反应。方法83例晚期胃癌患者均接受同步放化疗,依据化疗方案分为治疗组（n=43）和对照组（n=40）。两组放疗计划均为：6MV X线照射,DT 40～50Gy,4～5周完成。治疗组于放疗第1天开始口服S-1 40～60mg,每天2次,6周为1周期;对照组于放疗第1天开始行一线方案（如ECF、DCF、FOLFOX、FOLFIRI等）化疗2个周期以上。评价两组胃癌患者的疗效及毒副作用。结果82例患者可评价疗效,治疗组中1例因消化道不良反应退出。治疗组获CR 3例,PR 21例,SD 14例,PD 4例,RR为57.1％（24／42）;对照组获CR 2例,PR 15例,SD 15例,PD 8例,RR为42.5％（17／40）;两组RR的差异无统计学意义（P＞0.05）。治疗组的进食梗阻、疼痛等主观症状改善率为81.0％（34／42）,高于对照组的50.0％（20／40）,差异有统计学意义（P=0.008）。治疗组和对照组治疗后1年生存率分别为23.8％（10／42）和20.0％（8／40）,差异无统计学意义（P＞0.05）。全组患者的主要毒副反应为血液学毒性、肝功能损害、放射性胰腺炎和胃肠道反应。治疗组3～4级白细胞减少、1～2级转氨酶升高和3～4级恶心呕吐的发生率均低于对照组（P＜0.05）。结论 S-1联合放疗可以提高晚期胃癌患者生活质量,不良反应能够耐受,值得临床进一步探讨。     

Auditory-perceptual analysis of voice in abused children and adolescents

IntroductionAbused children and adolescents are exposed to factors that can trigger vocal changes.ObjectiveThis study aimed to analyze the prevalence of vocal changes in abused children and adolescents, through auditory-perceptual analysis of voice and the study of the association between vocal changes, communication disorders, psychiatric disorders, and global functioning.MethodsThis was an observational and transversal study of 136 children and adolescents (mean age 10.2 years, 78 male) who were assessed by a multidisciplinary team specializing in abused populations. Speech evaluation was performed (involving the aspects of oral and written communication, as well as auditory-perceptual analysis of voice, through the GRBASI scale). Psychiatric diagnosis was performed in accordance with the DSM-IV diagnostic criteria and by applying the K-SADS; global functioning was evaluated by means of the C-GAS scale.ResultsThe prevalence of vocal change was 67.6%; of the patients with vocal changes, 92.3% had other communication disorders. Voice changes were associated with a loss of seven points in global functioning, and there was no association between vocal changes and psychiatric diagnosis.ConclusionThe prevalence of vocal change was greater than that observed in the general population, with significant associations with communication disorders and global functioning. The results demonstrate that the situations these children experience can intensify the triggering of abusive vocal behaviors and consequently, of vocal changes.     

Assessment of cardiovascular risk and social framework of Cape Verdean university students studying in Portugal

Introduction

The migration of African populations to Europe poses problems of adaptation that may increase the risk of cardiovascular disease. We assessed the cardiovascular risk of Cape Verdean university students studying in Portugal (CV-PT) compared to Cape Verdean university students in Cape Verde (CV-CV) and to Caucasian university students in Portugal (PT-PT).

Triptolide inhibits human breast cancer MCF-7 cell growth via downregulation of the ERα-mediated signaling pathway

Aim:

To investigate the anticancer mechanisms of triptolide, a diterpenoid isolated from the plant Tripterygium wilfordii Hook F, against human breast cancer cells and the involvement of the estrogen receptor-α (ERα)-mediated signaling pathway in particular.

Methods:

Human breast cancer ERα-positive MCF-7 cells and ERα-negative MDA-MB-231 cells were tested. PrestoBlue assay was used to evaluate the cell viability. The levels of ERα mRNA and protein were detected with real-time PCR and immunoblotting, respectively. Mouse models of MCF-7 or MDA-MB-231 xenograft tumors were treated with triptolide (0.4 mg·kg⁻¹·d⁻¹, po) or a selective estrogen receptor modulator tamoxifen (mg·kg⁻¹·d⁻¹, po) for 3 weeks, and the tumor weight and volume were measured.

Results:

Triptolide (5–200 nmol/L) dose-dependently inhibited the viability of both MCF-7 and MDA-MB-231 cells, with a more potent inhibition on MCF-7 cells. Knockdown of ERα in MCF-7 cells by siRNA significantly attenuated the cytotoxicity of triptolide, whereas overexpression of ERα in MDA-MB-231 cells markedly enhanced the cytotoxicity. Triptolide dose-dependently decreased the expression of ERα in MCF-7 cells and MCF-7 xenograft tumors. Furthermore, treatment of MCF-7 cells with triptolide inhibited the phosphorylation of ERK1/2 in dose- and time-dependent manners. In the mice xenografted with MCF-7 cells, treatment with triptolide or tamoxifen resulted in significant reduction in the tumor weight and volume. Similar effects were not obtained in the mice xenografted with MDA-MB-231 cells.

Conclusion:

The anticancer activity of triptolide against ERα-positive human breast cancer is partially mediated by downregulation of the ERα-mediated signaling pathway.     

紫杉醇联合替吉奥胶囊治疗晚期食管癌的临床疗效观察

目的观察紫杉醇联合替吉奥胶囊治疗晚期食管癌的临床疗效和不良反应。方法选择37例晚期食管癌患者,予紫杉醇175 mg/m2,d1,静脉滴注3 h;替吉奥胶囊服用剂量按体表面积<1.25 m2者剂量40毫克/次;体表面积1.25~1.5 m2者剂量50毫克/次;体表面积>1.5 m2者剂量60毫克/次;均每日2次,早晚餐后口服,连服14 d,21 d为1个周期。结果疗效可评价患者36例,其中完全缓解(CR)1例,部分缓解(PR)14例,病情稳定(SD)11例,病情进展(PD)10例,有效率(CR+PR)为41.7%;疾病控制率(CR+PR+SD)为72.2%;中位疾病进展时间(m TTP)及中位生存时间分别为7.4个月、10.6个月,1年生存率为36.1%。化疗的主要不良反应为脱发及骨髓抑制,其中Ⅲ~Ⅳ度中性粒细胞减少发生率为16.7%。结论紫杉醇联合替吉奥胶囊治疗晚期食管癌疗效肯定,且耐受性较好。     

Echocardiographic assessment of atrial function in patients with hypertrophic cardiomyopathy with and without paroxysmal atrial fibrillation

Introduction and objectivesHypertrophic cardiomyopathy (HCM) is accompanied by pathophysiological changes that predispose to the development of atrial fibrillation (AF). This arrhythmia impacts negatively on the morbidity, mortality and quality of life of these patients. Our objective was to evaluate the behavior of left atrial function, by means of atrial strain (derived from speckle tracking) and volumetric analysis by three-dimensional echocardiography, in patients with HCM with paroxysmal AF.MethodWe analysed left atrial function in 53 patients with HCM, 25 of whom were paroxysmal AF carriers (mean age 61.7±9.9 years; 56% female) compared with 28 members of the control group (mean age 60.5±10 years; 53.6% female) who were matched especially for sex, age and other demographic data.ResultsIt was observed that patients with HCM and a history of paroxysmal AF had lower left atrial emptying fractions than individuals in the control group; and the active atrial emptying fraction was a factor independently associated with the presence of this arrhythmia (p=0.018; odds ratio=0.93). Moreover, we found a significant reduction of the left atrial strain in all its components in the total sample of patients, with no difference between the groups.ConclusionsMeasurements of atrial emptying fractions by three-dimensional echocardiography allowed differentiating patients with HCM with and without paroxysmal AF.