Prosthetic management of a growing patient with Russell-Silver syndrome: a clinical report

Russell-Silver syndrome (RSS) is a congenital disease characterized by short stature due to growth hormone deficiency, physical asymmetry, inverted triangular face, micrognathia, prominent forehead, and hypodontia. This case report presents a prosthetic management of a 6-year-old patient with Russell-Silver syndrome treated with overdentures on the maxilla and the mandible using the remaining primary teeth. Subsequent and comprehensive dental management considering the growth and development of a young patient will be necessary.     

Molecular targeted therapy for advanced hepatocellular carcinoma

Systemic anticancer therapy for hepatocellular carcinoma (HCC) is limited by intrinsic drug resistance and accompanying liver dysfunction. However, recent advances in molecular targeted therapy (MTT) have shed light on the treatment of advanced HCC. A recent randomized, placebo-controlled trial demonstrated that sorafenib, a multi-target tyrosine kinase inhibitor, prolonged overall survival and time-to-progression in patients with advanced HCC. This breakthrough highlights the potential of MTT targeting hepatocarcinogenic pathways, such as the Raf/MAPK/ERK pathway, angiogenic pathways and the EGFR signaling pathway. This review discusses the current status and the potential of developing novel MTTs for advanced HCC.     

DTNBP1 haplotype influences baseline assessment scores of schizophrenic in-patients

Dysbindin gene (DTNBP1) has been associated with schizophrenia, but literature findings are inconsistent, and further analyses are required. This study is aimed to investigate if a set of DTNBP1 variations might influence clinic psychotic phenotype or treatment response in a sample of 240 Korean schizophrenic in-patients. Four variants have been selected (rs3213207; rs1011313; rs16876759; rs2619522) on the basis of previous findings of association with schizophrenia, bipolar disorder and antidepressant response. Single marker analysis gave marginal results. Haplotype analysis identified a significant association between A–A (rs3213207(A/G), rs1011313(A/G)) haplotype and lower PANSS total and positive scores at baseline (p = 0.01; 0.02) and at discharge (p = 0.008; 0.005). Covariate analysis revealed a more stable significant association between A–A haplotype and baseline scores. These results suggest a protective effect of A–A haplotype on psychotic positive symptoms at baseline.     

In vitro inducible nitric oxide synthesis inhibitory active constituents from Fraxinus rhynchophylla

Bioassay-guided fractionation of an H2O extract of the barks of Fraxinus rhynchophylla has furnished two inducible nitric oxide synthase (iNOS) inhibitory compounds, ferulaldehyde (1) and scopoletin (3) together with a coumarin, fraxidin (2). Compounds 1 and 3 showed inhibition of nitric oxide (NO) synthesis in a dose-dependent manner by murine macrophage-like RAW 264.7 cells stimulated with interferon-gamma (IFN-gamma) plus lipopolysaccharide (LPS). The inhibition of NO synthesis of 1 was reflected in the decreased amount of iNOS protein, as determined by Western blotting.     

Capitolunate arthrodesis with scaphoid and triquetrum excision

A retrospective two-center outcome study was designed to evaluate the results of capitolunate arthrodesis with scaphoid and triquetrum excision mainly for scapholunate advanced collapse patterns of arthritis. Fourteen wrists in 14 patients were evaluated objectively by standard parameters and subjectively by the Short Musculoskeletal Functional Assessment at an average of 28 months after surgery (range, 14-51 months). All patients were men between the ages of 20 and 70 years (average, 49 years). Two patients had a painful nonunion and one had persistent pain despite conversion to a solid wrist arthrodesis. One patient had x-ray evidence of progressive radiolunate narrowing, but only occasional pain. Postoperative wrist flexion-extension arc was 53 degrees and radioulnar deviation arc was 18 degrees. Grip and pinch strengths were 71% and 75%, respectively, of the normal contralateral wrist. The results of our study indicate that capitolunate arthrodesis with scaphoid and triquetrum excision is comparable to other motion-preserving operative procedures for scapholunate advance collapse.     

Recent advances in non-surgical treatment for advanced hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is one of the most common cancers and is the leading cause of cancer death in Taiwan. Curative surgery is feasible for only about 30% of patients. Transarterial embolization or chemoembolization (TAE/TACE) has been demonstrated to provide a survival benefit compared with supportive care for HCC patients with adequate liver reserves, tumors confined to the liver, and no evidence of portal vein thrombosis. Percutaneous ethanol injection (PEI) may provide long-term disease control if the extent of liver tumors is limited (3 or less in number and less than 3 cm in diameter). The relative efficacy of TAE/TACE, PEI, and other locoregional treatment modalities, such as radiofrequency ablation or cryosurgery, remains unclear. Radiotherapy has been used mostly as a salvage therapy in combination with other locoregional modalities. Despite the incorporation of 3-dimensional conformal technology, radiation-induced liver injury remains an important problem, especially for patients with hepatitis B-related cirrhosis. Systemic therapy is difficult for HCC because of the underlying cirrhosis and accompanying hypersplenism and peripheral cytopenia. HCC is typically resistant to most cytotoxic agents. Biochemical modulation with high-dose tamoxifen may sensitize HCC cells to doxorubicin-induced apoptosis and improve the clinical response to doxorubicin in patients with advanced HCC. Thalidomide, which inhibits angiogenesis induced by vascular endothelial growth factor and basic fibroblast growth factor, can produce a response in some HCC patients. Future research on drug therapy for HCC will focus on identification of tumor-specific targets.     

Criticisms of drugs in early development for the treatment of depression: what can be improved?

Major depressive disorder (MDD) is a common and debilitating mental illness, which leads to serious functional impairment in patients, and treatment-wise, there are currently a number of different classes of antidepressants already on the market. However, emerging evidence from numerous clinical trials has confirmed that there is still an unmet need for antidepressant efficacy in terms of response and remission. Approximately only 30% of patients with MDD may remit after adequate treatment with antidepressants in clinical practice. The drawbacks of the currently available antidepressants also include inadequate overall efficacy, safety issues and the lag prior to onset of clinical improvement. The need for new agents with novel mechanisms of action has led to the development of several newer antidepressants including vilazodone, edivoxetine, ketamine, atomoxetine and vortioxetine, which have been approved for the treatment of MDD. However, the efficacy and safety of these next-generation antidepressants, in clinical trials, are still unsatisfactory. This paper provides a brief updated overview of the progress and critical limitations in the development of novel antidepressants.     

Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012

Objectives:

Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women.

Methods:

This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 women (aged 30 to 65 years). The risk of entering menopause and experiencing early menopause (before age 48) related to smoking were assessed using a Cox proportional hazards model.

Results:

The menopausal age among smokers was 0.75 years lower than that among non-smokers (p<0.001). The results of the Cox proportional hazards model showed pre-correction and post-correction risk ratios for entering menopause related to smoking of 1.26 (95% confidence interval [CI], 1.09 to 1.46) and 1.27 (95% CI, 1.10 to 1.47), respectively, and pre-correction and post-correction risk ratios for experiencing early menopause related to smoking of 1.36 (95% CI, 1.03 to 1.80) and 1.40 (95% CI, 1.05 to 1.85), respectively.

Conclusions:

Smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher.     

A role for cysteinyl leukotrienes in airway remodeling in a mouse asthma model.

Airway inflammation and remodeling in chronic asthma are characterized by airway eosinophilia, hyperplasia of goblet cells and smooth muscle, and subepithelial fibrosis. We examined the role of leukotrienes in a mouse model of allergen-induced chronic lung inflammation and fibrosis. BALB/c mice, after intraperitoneal ovalbumin (OVA) sensitization on Days 0 and 14, received intranasal OVA periodically Days 14-75. The OVA-treated mice developed an extensive eosinophil and mononuclear cell inflammatory response, goblet cell hyperplasia, and mucus occlusion of the airways. A striking feature of this inflammatory response was the widespread deposition of collagen beneath the airway epithelial cell layer and also in the lung interstitium in the sites of leukocytic infiltration that was not observed in the saline-treated controls. The cysteinyl leukotriene(1) (CysLT(1)) receptor antagonist montelukast significantly reduced the airway eosinophil infiltration, mucus plugging, smooth muscle hyperplasia, and subepithelial fibrosis in the OVA-sensitized/challenged mice. The presence of Charcot-Leyden-like crystals in airway macrophages and the increased interleukin (IL)-4 and IL-13 mRNA expression in lung tissue and protein in BAL fluid seen in OVA-treated mice were also inhibited by CysLT(1) receptor blockade. These data suggest an important role for cysteinyl leukotrienes in the pathogenesis of chronic allergic airway inflammation with fibrosis.