Wan Yu Lo

Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results

BackgroundSince the introduction of laparoscopic colectomy, improved short-term surgical results have been noted in the literature. Therefore, efforts have shifted to reducing the invasiveness of laparoscopic surgery, resulting in the invention of single-incision laparoscopic surgery (SILS). Due to its comparable capabilities and feasibility, the implementation of SILS has rapidly grown in different fields. However, few studies discuss its true benefit compared with conventional laparoscopy. This study is the first to use SILS colectomy as an approach for malignant colon cancer. The goal of this cohort series is to compare the short-term surgical outcomes between SILS and conventional right hemicolectomy.MethodsThis was a case-control study comparing SILS right hemicolectomy patients to traditional laparoscopic right hemicolectomy. The inclusion criteria were only ascending colon cecal lesions. Cases of obstruction or perforation that required emergent operation or previous abdominal surgery were excluded. These patients were specifically matched in regard to patient’s age, gender, perioperative condition, surgical indication, and tumor size. No consideration or analysis of operative parameters and outcomes was made until this group was definitively selected as the best comparison cohort based on preoperative variables only.ResultsA total of 18 patients were included for SILS and the other 21 patients were completed by conventional laparoscopic right hemicolectomy. The SILS and traditional laparoscopic groups were similar in regard to age, gender, body mass index, and perioperation outcomes. Initial oncologic results were no different, including equal length of distal cut margin, numbers of harvested lymph nodes, and TMN stage. Three patients in the SILS colectomy group were converted (16.6%), and there were no conversions in the traditional laparoscopic colectomy group.ConclusionsOur preliminary experience with SILS right hemicolectomy demonstrated the safety of the procedure and its feasibility in malignant colon cancer. Although SILS right hemicolectomy may provide a subjective cosmetic advantage, there was no benefit in the short-term surgical outcomes. SILS is very situational, requires more effort from the surgeon, and may not offer more patient comfort. More experience with SILS and prospective trials are needed to validate it as a more favorable alternative to conventional laparoscopic colectomy.

S100A8 Is Identified as a Biomarker of HPV18-Infected Oral Squamous Cell Carcinomas by Suppression Subtraction Hybridization, Clinical Proteomics Analysis, and Immunohistochemistry Staining

The purpose of this work is to differentiate between the Human papillomaviruses 18 positive (HPV18+) and negative (HPV18-) oral squamous cell carcinomas (OSCC) in oral cancer patients with cancer-associated oral habits (betel quid chewing, cigarette smoking, and alcohol drinking). Both gene and protein expression profiles of HPV18+ and HPV18- OSCC were compared: we then further explored the biological effect of HPV in oral cancer. Suppression subtraction hybridization (SSH), clinical proteomics analysis, and immunohistochemistry (IHC) staining were carried out in the HPV18+ and HPV18- OSCC groups. HPV typing detection revealed that 11 OSCC tissues from 82 patients were positive for HPV18. The SSH experiment showed that 4 cancer-associated genes were highly transcribed within 11 cDNA libraries of HPV18+ OSCC, including poly(ADP-ribose)polymerase I (PARP1), replication protein A2 (RPA2), S100A8, and S100A2. Clinical proteomics analysis indicated that there was over 10-fold overexpression of Stratifin, F-actin capping protein alpha-1 subunit (CapZ alpha-1), Apolipoprotein A-1 (ApoA-1), Heat-shock protein 27 (HSP27), Arginase-1, p16INK4A, and S100 calcium-binding protein A8 (S100A8) in HPV18+ OSCC. Interestingly, the results from SSH and protemics analysis showed that S100A8 was overexpressed in HPV18+ OSCC. Moreover, IHC staining demonstrated that S100A8 was up-regulated in HPV18+ OSCC tissues. Our results suggest that S100A8 plays an important role in oral carcinogenesis following HPV18 infection; therefore, S100A8 may be a powerful biomarker of HPV18 as well as a potential therapeutic target for HPV18+ OSCC patients. The study is the first to identify S100A8 as a biomarker in HPV-associated cancer. Furthermore, this is also the first study to discover a biomarker by combining SSH, clinical proteomics, and IHC stain analysis in oral cancer-associated research.

Ferulic acid inhibits nitric oxide-induced apoptosis by enhancing GABA B1 receptor expression in transient focal cerebral ischemia in rats

AbstractAim:Ferulic acid (4-hydroxy-3-methoxycinnamic acid, FA) provides neuroprotection against apoptosis in a transient middle cerebral artery occlusion (MCAo) model. This study was to further investigate the anti-apoptotic effect of FA during reperfusion after cerebral ischemia.Methods:Rats were subjected to 90 min of cerebral ischemia followed by 3 or 24 h of reperfusion after which they were sacrificed.Results:Intravenous FA (100 mg/kg) administered immediately after middle cerebral artery occlusion (MCAo) or 2 h after reperfusion effectively abrogated the elevation of postsynaptic density-95 (PSD-95), neuronal nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), nitrotyrosine, and cleaved caspase-3 levels as well as apoptosis in the ischemic cortex at 24 h of reperfusion. FA further inhibited Bax translocation, cytochrome c release, and p38 mitogen-activated protein (MAP) kinase phosphorylation. Moreover, FA enhanced the expression of gamma-aminobutyric acid type B receptor subunit 1 (GABAB1) in the ischemic cortex at 3 and 24 h of reperfusion. In addition, nitrotyrosine-positive cells colocalized with cleaved caspase-3-positive cells, and phospho-p38 MAP kinase-positive cells colocalized with nitrotyrosine- and Bax-positive cells, indicating a positive relationship among the expression of nitrotyrosine, phospho-p38 MAP kinase, Bax, and cleaved caspase-3. The mutually exclusive expression of GABAB1 and nitrotyrosine revealed that there is a negative correlation between GABAB1 and nitrotyrosine expression profiles. Additionally, pretreatment with saclofen, a GABAB receptor antagonist, abolished the neuroprotection of FA against nitric oxide (NO)-induced apoptosis.Conclusion:FA significantly enhances GABAB1 receptor expression at early reperfusion and thereby provides neuroprotection against p38 MAP kinase-mediated NO-induced apoptosis at 24 h of reperfusion.

Uncaria rhynchophylla and Rhynchophylline Inhibit c-Jun N-Terminal Kinase Phosphorylation and Nuclear Factor-κB Activity in Kainic Acid-Treated Rats

Our previous studies have shown that Uncaria rhynchophylla (UR) can reduce epileptic seizures. We hypothesized that UR and its major component rhynchophylline (RH), reduce epileptic seizures in rats treated with kainic acid (KA) by inhibiting nuclear factor-kappaB (NF-kappaB) and activator-protein-1 (AP-1) activity, and by eliminating superoxide anions. Therefore, the level of superoxide anions and the DNA binding activities of NF-kappaB and AP-1 were measured. Sprague-Dawley (SD) rats were pre-treated with UR (1.0 g/kg, i.p.), RH (0.25 mg/kg, i.p.), or valproic acid (VA, 250 mg/kg, i.p.) for 3 days and then KA was administered intra-peritoneal (i.p.). The results indicated that UR, RH, and VA can reduce epileptic seizures and the level of superoxide anions in the blood. Furthermore, KA was demonstrated to induce the DNA binding activities of NF-kappaB and AP-1. However, these inductions were inhibited by pre-treatment with UR, RH, or VA for 3 days. Moreover, UR and RH were shown to be involved in the suppression of c-Jun N-terminal kinase (JNK) phosphorylation. This study suggested that UR and RH have antiepileptic effects in KA-induced seizures and are associated with the regulation of the innate immune system via a reduction in the level of superoxide anions, JNK phosphorylation, and NF-kappaB activation.

Uncaria rhynchophylla Upregulates the Expression of MIF and Cyclophilin A in Kainic Acid-Induced Epilepsy Rats: A Proteomic Analysis

Uncaria rhynchophylla (Miq) Jack (UR) is a traditional Chinese herb and is used for the treatment of convulsive disorders, including epilepsy. Our previous study has shown that UR, as well as its major component rhynchophylline (RH), has an anticonvulsive effect and this effect is closely related to its scavenging activities of oxygen free radicals. The purpose of the present study was to investigate the effect of (UR) on the expression of proteins using a proteomics analysis in Sprague-Dawley (SD) rats with kainic acid (KA)-induced epileptic seizures. We profiled the differentially expressed proteins on two-dimensional electrophoresis (2-DE) maps derived from the frontal cortex and hippocampus of rat brain tissue 24 hours after KA-induced epileptic seizures. The results indicated that macrophage migration inhibitory factor (MIF) and cyclophilin A were under expressed in frontal cortex by an average of 0.19- and 0.23-fold, respectively. In the frontal cortex, MIF and cyclophilin A were significantly decreased in the KA group and these decreases were confirmed by the Western blots. However, in the hippocampus, only cyclophilin A was significantly decreased in the KA group. In addition, in real-time quantitative PCR (Q-PCR), MIF and cyclophilin A gene expressions were also significantly under expressed in the frontal cortex, and only the cyclophilin A gene was also significantly under expressed in the hippocampus in the KA group. These under expressions of MIF and cyclophilin A could be overcome by the treatment of UR and RH. In conclusion, the under expressions of MIF and cyclophilin A in the frontal cortex and hippocampus in KA-treated rats, which were overcome by both UR and UH treatment, suggesting that both MIF and cyclophilin A at least partly participate in the anticonvulsive effect of UR.

Clinical efficacy of acupuncture as an adjunct to methadone treatment services for heroin addicts: A randomized controlled trial

Scant scientific evidence supports the efficacy of acupuncture in the treatment of opiate dependence. The purpose of this study was to examine the effectiveness of acupuncture for heroin addicts on methadone maintenance by measuring the daily consumption of methadone, variations in the 36-item Short Form Health Survey-36 (SF-36) and Pittsburgh Sleep Quality Index (PSQI) scores, and heroin craving. Sixty heroin addicts were randomly assigned to true acupuncture (electroacupuncture at the Hegu [LI4] and Zusanli [ST36] acupoints, as well as acupuncture at the Ear Shenmen) or sham acupuncture (minimal acupuncture at the Hegu and Zusanli acupoints without electrical stimulation and superficial acupuncture at the Ear Shenmen), twice weekly for 4 weeks. From week 2 onwards, the daily dose of methadone was reduced by a significantly greater amount with true acupuncture compared with sham acupuncture. True acupuncture was also associated with a greater improvement in sleep latency at follow-up. All adverse events were mild in severity. Acupuncture appears to be a useful adjunct to methadone maintenance therapy (MMT) in heroin addiction.

Identification of biomarkers to improve diagnostic sensitivity of sporadic colorectal cancer in patients with low preoperative serum carcinoembryonic antigen by clinical proteomic analysis

BACKGROUND Colorectal cancer (CRC) is the third most common type of cancer worldwide. Carcinoembryonic antigen (CEA) assays usually give false negative results. To improve the diagnosis of primary sporadic CRC, there is an urgent need to identify new biomarkers. METHODS We used laser pressure catapulting and proteomics to analyze overexpressed cancer associated proteins from 48 sporadic CRC patients with low preoperative serum CEA (LPSC) (<5 ng/ml). Real-time Q-PCR was used to identify the target gene transcripts. Immunoblots were carried out to validate the biomarkers. RESULTS Alpha-enolase, HSP27 and macrophage migration inhibitory factor (MIF) were overexpressed in all tumor tissues from 48 LPSC CRC patients, as assessed by 2DE image analysis. The genes were also overexpressed at the transcript level in all tumor tissues from the same patients. In the immunoblot assay, only serum levels of Alpha-enolase and MIF were significantly overexpressed in the LPSC group compared to the mean levels in the control group. Combined with the determinations of preoperative CEA levels, screening for serum Alpha-enolase and MIF were shown to improve the diagnosis of primary CRC. CONCLUSIONS Serum Alpha-enolase and MIF may be potential biomarkers that can be used to improve clinical predication of primary CRC with LPSC.

Urinary cytidine as an adjunct biomarker to improve the diagnostic ratio for gastric cancer in Taiwanese patients

BACKGROUND Gastric cancer is a major public health concern as the fourth most common cancer, and it is of particular relevance as the second most common cause of cancer death worldwide. We caparisoned the urinary nucleoside concentrations between the gastric patients and healthy volunteers that try to evaluate the diagnostic value in the gastric cancer. METHOD Urinary nucleosides from 49 gastric patients and 40 healthy volunteers were evaluated by high-performance liquid chromatography/electrospray ionization-tandem mass spectrometry (HPLC/ESI-MS/MS) under optimized conditions as determined in our previous study. RESULTS The mean concentrations of 5 urinary nucleosides, cytidine, 3-methylcytidine (m3C), 1-methyladenosine (m1A), adenosine, and inosine, were found to be elevated in cancer patients, but only cytidine showed a significant elevation. Moreover, cytidine concentrations were significantly elevated by an average of 1.42-fold in patients with late stage (S3+4) disease. Combining the determined concentrations of preoperative serum alpha-fetoprotein (AFP, cutoff of 20 μg/l) or carbohydrate antigen 19-9 (CA19-9, cutoff of 37 U/ml) with the mean urinary cytidine concentration was shown to improve the diagnostic ratio (sensitivity) for gastric cancer from 16.3% (8/49 patients) to 38.8% (8+11/49 patients) or from 28.6% (14/49 patients) to 51.0% (14+11/49 patients), respectively. CONCLUSIONS Urinary cytidine may be an important adjunct biomarker for gastric cancer.

Association Between Genetic Polymorphism of the MIF Gene and Colorectal Cancer in Taiwan

Colorectal cancer (CRC) is the highest leading cause of cancer‐related mortality in Taiwan. Macrophage migration inhibitory factor (MIF) has recently been defined as a novel protumorigenic factor that promotes cell proliferation, migration, and invasion. The aim of the present study is to identify the association between MIF gene polymorphism and CRC.