Expression of CD44s, CD44v5, CD44v6 and CD44v7-8 in betel quid chewing-associated oral premalignant lesions and squamous cell carcinomas in Taiwan

Aberrant expression of the cell surface adhesion molecule CD44 and its variant forms has been shown to be associated with the invasive and metastatic potential of cancer cells, and with poor prognosis in several types of cancers. Expression of CD44 standard (CD44s) and variant (CD44v) forms in oral squamous cell carcinoma (SCC), epithelial dysplasia (ED), epithelial hyperkeratosis (EH) and normal buccal mucosa (NBM) have been examined using antibodies to CD44s, CD44v5, CD44v6 and CD44v7-8. Positive CD44s, CD44v5, CD44v6 and CD44v7-8 staining was detected in all the specimens from NBM, EH and ED. Positive staining of CD44s, CD44v5, CD44v6 or CD44v7-8 was detected in 55 (88.7%), 48 (77.4%), 59 (95.2%) and 22 (35.5%) of the 62 SCC specimens, respectively. The positive staining of CD44v7-8 in oral SCC was significantly less than that in NBM ( P <0.01). No significant correlation was found between CD44v7-8 expression and daily or total consumption of betel quids or cigarettes by the SCC patients. The 5-year survival rate for patients with CD44v7-8-positive tumours was significantly higher than that for the CD44v7-8-negative group ( P <0.03). These results indicate that loss of CD44v7-8 expression may be a valuable factor for determining prognosis in oral SCC patients.     

Evaluation of unpredictable critical conditions of patients treated in the observation unit of the Emergency Department

We evaluated unpredictable critical conditions of patients treated in the Emergency Department (ED) observation unit, who were transferred into the emergency resuscitation room from January 1 through June 30, 2001. A total of 175 patients were observed for the following critical conditions: dyspnea (51 patients; 29.14%), hypotension (28; 16.00%), chest pain (18; 10.29%), dysrhythmia (15; 8.57%), hematemesis (15; 8.57%), altered mental status (12; 6.85%), shock (10; 5.71%), coma (8; 4.57%), apnea (5; 2.86%), hematochezia (3; 1.72%), seizure (3; 1.72%), and others (7; 4.00%). The 27 patients who had cardiopulmonary resuscitation (CPR), endotracheal tube intubation, or cardioversion/defibrillation in the ED suffered an in-ED mortality of 25.9% (7) and an in-hospital mortality of 59.2% (16). The remaining 148 patients who received appropriate treatment, except for the above, had a lower in-hospital mortality (20.28%, 30 patients) (p < 0.05). We should limit the number of patients in the observation unit to avoid overloading, and classify patients according to their clinical conditions. We should determine whether or not they have definite diagnoses or are waiting for hospital admission while receiving simple treatments. The observation unit must be provided with well-trained staff and suitable physical facilities with support services, and rapid specialty consultations must be available.     

Racial and Socioeconomic Disparities in Access and Utilization of Adrenal Metastasectomy

World Journal of Surgery - There is substantial evidence that resecting adrenal metastases can be safely accomplished and extend overall survival in select patients. However, patient access to this...     

Duplicated FoxA genes in the leech Helobdella: Insights into the evolution of direct development in clitellate annelids

Background: As an adaptation to the land, the clitellate annelid had reorganized its embryogenesis to develop “directly” without the ancestral planktonic larval stage. To study the evolution of gut development in the directly developing clitellates, we characterized the expression pattern of the conserved gut gene, FoxA, in the embryonic development of the leech. Results: The leech has three FoxA paralogs. Hau‐FoxA1 is first expressed in a subset of endoderm cells and then in the foregut and the midgut. Hau‐FoxA2 is expressed in the stomodeum, which is secondarily derived from the anterior ectoderm in the clitellates rather than the tissue around the blastopore, the ancestral site of mouth formation in Phylum Annelida. Hau‐FoxA3 is expressed during the morphogenesis of segmental ganglia from the ectodermal teloblast lineages, a clitellate‐specific trait. Hau‐FoxA1 and Hau‐FoxA2 are also expressed during the morphogenesis of the leech‐specific front sucker. Conclusions: The expression patterns suggested that Hau‐FoxA1 carries out most of the conserved function in the endoderm and gut development, while the other two duplicates appear to have evolved unique novel functions in the directly developing clitellate embryos. Therefore, neofunctionalization and co‐option of FoxA might have made a significant contribution to the evolution of direct development in Clitellata. Developmental Dynamics 247:763–778, 2018. © 2018 Wiley Periodicals, Inc.     

M2 macrophage subset decrement is an indicator of bleeding tendency in pediatric dengue disease

Background/purpose

Dengue disease is widespread in tropical and sub-tropical regions. Severe dengue infection is characterized by plasma leakage, fluid accumulation, severe bleeding, or vital organ impairment. Bleeding is a critical complication of dengue disease. However, the biomarkers of dengue disease are still unknown. Macrophages have a distinct polarization phenotype related to M1/M2 classification. Macrophage polarization toward the pro-inflammatory M1 phenotype is considered critical for efficient antiviral immune responses, whereas the anti-inflammatory M2 phenotype is considered essential for tissue remodeling. We investigated macrophage polarization patterns in the peripheral blood of pediatric patients with dengue disease.

Vancomycin-resistant Enterococcus faecium at a university hospital in Taiwan, 2002–2015: Fluctuation of genetic populations and emergence of a new structure type of the Tn1546-like element

Background/purposes

Vancomycin resistance increased significantly to 31.3% among Enterococcus faecium in 2006 and remained high thereafter at a university hospital in Taiwan. A longitudinal study was retrospectively conducted to characterize these vancomycin-resistant E. faecium (VRE-fm).

Characteristics of children with Kawasaki disease requiring intensive care: 10 years' experience at a tertiary pediatric hospital

Background/Purpose

Kawasaki disease (KD) is a febrile systemic vasculitis, and some patients may develop serious complications requiring intensive care. We aim to ascertain the clinical presentations and outcomes of these patients.

Resistance to first- and second-line antituberculosis drugs in Southern Taiwan: Implications for empirical treatment

Background

Multidrug-resistant and extensively drug-resistant tuberculosis infections cause public health concerns worldwide. Local epidemiologic data about the drug resistance of Mycobacterium tuberculosis isolate (Mtb) is critical to guide appropriate empirical therapy to cure patients and restrain the spread of tuberculosis.

High levels of soluble GPR56/ADGRG1 are associated with positive rheumatoid factor and elevated tumor necrosis factor in patients with rheumatoid arthritis

Background

GPR56/ADGRG1 is a member of the adhesion-class G protein-coupled receptor (aGPCR) family important in brain development, oncogenesis and tumor metastasis. Like other aGPCRs, GPR56 is cleaved at the GPCR proteolysis site (GPS) motif into an N-terminal fragment (NTF) and a C-terminal fragment (CTF). Existence of soluble GPR56 (sGPR56) has been shown in vitro, however the underlying mechanism and its pathophysiologic role remains undetermined.

Impact of pneumococcal conjugate vaccine in children on the serotypic epidemiology of adult invasive pneumococcal diseases in Taiwan

Background

Invasive pneumococcal disease (IPD) causes significant morbidity and mortality, especially in children and older adults. Pneumococcal 7-valent and 13-valent conjugate vaccines (PCV7 and PCV13) were introduced in Taiwan in 2005 and 2011, respectively, for children. This study was conducted to evaluate the impact of PCV administered in children on adult IPD.