Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases

published_or_final_versio

Relationship between mitral leaflets angles, left ventricular geometry and mitral deformation indices in patients with ischemic mitral regurgitation: imaging by echocardiography and cardiac magnetic resonance

Chronic ischemic mitral regurgitation (IMR) is associated with a markedly worse prognosis after myocardial infarction (MI).The study aimed to evaluate the relationship between anterior and posterior mitral leaflet angle (MLA) values, left ventricle remodeling and severity of ischaemic mitral regurgitation (IMR). Methods: Forty-two patients (age 63.5 ± 9.7 years, 36 men) with chronic IMR (regurgitant volume, RV > 20 ml; >6 months after MI) underwent transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging. Anterior and posterior MLA, determined by echocardiography, were correlated with indices of LV remodeling, mitral apparatus deformation and IMR severity by CMR. The anterior and posterior MLA was 25.41 ± 4.28 and 38.37 ± 8.89° (mean ± SD). In 5 patients (11.9%) the posterior MLA was ≥45°. There was a significant correlation between anterior MLA and RV (r = 0.74, P = 0.01). For patients with RV > 30 ml this correlation was stronger (r = 0.97, P = 0.005) and, in addition, there was a correlation between the RV and posterior MLA (r = 0.90, P = 0.037), between tenting area and posterior MLA (r = 0.90, P = 0.04), and between tenting area and anterior MLA (r = 0.82, P = 0.08). With regard to LV remodeling parameters, there was weaker but significant correlation between posterior MLA and LV end-diastolic volume index (r = 0.35, P = 0.031), LV end-systolic volume index (r = 0.37, P = 0.021), stroke volume (r = 0.35, P = 0.03), sphericity index (r = 0.33, P = 0.041). Anterior MLA correlated with wall motion score index (r = 0.41, P = 0.019). Besides, there was a correlation between posterior MLA and left atrial volume (r = 0.41, P = 0.012). Measurement of anterior and posterior MLA may play an important role in evaluating patients with IMR

Therapeutic decision-making for patients with fluctuating mitral regurgitation

Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in MR and systolic pulmonary artery pressure during exercise. Identifying patients who have dynamic MR, and understanding the mechanisms underlying the condition, can potentially influence revascularization strategies (such as the surgical restoration of coronary blood flow) and interventional treatment (including cardiac resynchronization therapy and new approaches targeted to the mitral valve)

To study the effect of NEK2 on chromosome instability in hepatocellular carcinoma

Poster PresentationExtra centrosomes have long been observed in cancer cells and it has been shown that extra centrosomes are able to mechanistically promote chromosome instability, aneuploidy and cancer invasiveness. However, extra centrosomes without tumourigenesis have been observed in normal polyploid hepatocytes. Polyploidy has been described in the liver for over a century. About 50% of the adult hepatocytes in humans and up to 90% in mice are polyploid naturally. The mechanisms that allow hepatocytes to divide with extra centrosomes and aneuploidy normally or develop hepatocellular carcinoma (HCC) are poorly understood. NIMA-related kinase 2 (NEK2) expression is found to be elevated in tissues of HCC patients and is associated with poor prognosis and drug resistance. NEK2 is a conserved serine / threonine kinase important for centrosome regulation and mitotic spindle formation during cell cycle. It is involved in multiple cellular functions and is able to interact with different binding partners. It regulates centrosome separation by directly phosphorylating the linker components C-NAP1 and ROOTLETIN, which are proteins constituting the basal bodies of specific cell types. Several reports have shown that NEK2 is associated with multiple pathways including Hippo, NFkB and Wnt. Yet, the molecular function of NEK2 in HCC progression remains unknown. Our evidence showed NEK2 mRNA and protein levels were elevated in liver cancer cells. Overexpression of NEK2 promotes HCC cell growth and cell migration. Cell cycle analysis showed an increased content of DNA in NEK2 overexpressing cell lines suggesting NEK2 contribute to aneuploidy in HCC cells. NEK2 overexpression drove early centrosome splitting in a proportion of both HepG2 and SMMC-7721 inducible cell lines. We found that a ROOTLETIN isoform, called TAX1BP2 and which is a putative tumor suppressor in HCC, is a substrate of NEK2. Hence, I am interested to understand the pathogenic roles of NEK2 in cancer, and to develop better therapeutic strategy for HCC

代謝綜合征及其相關指標與結直腸腺瘤發生的關係

目的：探討代謝綜合徵及其相關指標與結直腸腺瘤發生的關係。方法回顧性分析2014年1月至2015年6月間在香港大學深圳醫院接受結腸鏡檢查的289例患者臨床資料，其中130例結腸鏡檢查未發現異常（正常組）；159例經病理證實為結直腸腺瘤（腺瘤組）。比較兩組患者代謝綜合徵相關指標（包括體質指數、腰圍、臀圍、血糖、甘油三酯、高密度脂蛋白、膽固醇）的水平，並分析代謝綜合徵及其相關代謝性疾病與結直腸腺瘤發生的關係。結果兩組患者在性別、年齡、吸煙史、長期飲酒史、規律運動、結直腸癌家族史及長期服用非甾體類抗炎藥物史方面的差異均無統計學意義（P＞0．05） 。與正常組相比，腺瘤組患者的體質指數大[（23．5±3．2） kg／m2比（22．7±2．8） kg／m2， t＝1．97， P＝0 ．050]，腰圍長[（83．4±10．3） cm比（79．6±13．8） cm， t＝2．46， P＝0．015]，血清高密度脂蛋白[（1 ．3±0．3） mmol／L比（1．2±0．3） mmol／L， t＝2．03， P ＝0．044]及膽固醇水平高[（5．4±1．0） mmol／L比（5．0±1．1） mmol／L， t＝2．39， P＝0．018]；而兩組患者臀圍、腰圍臀圍比、空腹血糖及甘油三酯水平的差異均無統計學意義（均P＞0．05）。代謝綜合徵[69．8％（37／53）比51．7％（122／236）， P ＝0．017]、超重或肥胖[65．1％（56／86）比50．7％（ 103／203），P ＝0．025]、高血壓[67．3％（37／55）比52．1％（122／234），P ＝0．046]及高膽固醇血症[66．7 ％（64／96）比49．2％（95／193），P ＝0．005]患者結直腸腺瘤發生率明顯更高。結論代謝綜合徵患者發生結直腸腺瘤的風險增加，其機制可能與血清膽固醇和高密度脂蛋白水平升高所致的膽固醇分解代謝增強有關。有必要加強對代謝綜合徵，尤其是中心型肥胖及高膽固醇血症的人群進行結腸鏡篩查，以早期發現、早期治療結直腸腺瘤