Overexpression of p53 in hepatocellular carcinomas: A clinicopathological and prognostic correlation

Overexpression of the p53 tumour suppressor gene is one of the most common abnormalities in primary human cancers and appears to be a result of point mutation within a highly conserved region of the gene with subsequent encoding for a mutant, more stable, protein. In this study, 71 surgically resected hepatocellular carcinomas (HCC) were examined to study the expression of the p53 gene, its relation with clinicopathological parameters and its prognostic significance. Using immunohistochemical detection for mutant p53 protein with monoclonal antibody PAb1801, p53 overexpression was found in 22 tumours (31%) but in none of the non-tumorous liver specimens. Overexpression of p53 was more frequent in tumours with poor cellular differentiation (P = 0.01), in tumours > 5 cm in diameter (P = 0.05), and in those with giant cells present (P = 0.03) and, less significantly, of massive type of Eggel's classification (P = 0.06). It did not have any significant correlation with hepatitis B or C status, background liver disease or serum α-fetoprotein levels, nor was it related to tumour invasiveness (venous permeation, direct liver invasion and tumour microsatellite formation). In addition, the presence of p53 mutant protein did not influence tumour recurrence or patients' survival rates. The data suggested that p53 mutation in HCC was associated with a later stage of oncogenesis. However, it was not apparently related to tumour invasiveness/aggressiveness and prognosis.link_to_subscribed_fulltex

Role of computed tomography in the management of recurrent pyogenic cholangitis

link_to_subscribed_fulltex

Pancreatic phlegmon: What is it?

In a retrospective study of 264 patients with acute pancreatitis, 22 were identified as having phlegmon by combined radiologic and clinical criteria. The radiologic criteria consisted of demonstration of abnormal lesion on computed tomography scan which was composed of masses of mixed density, free of extraluminal gas and lacking a well-defined wall. The clinical criteria was that the clinical course was free of sepsis. Half of the group thus identified had severe pancreatitis as defined as having three or more poor prognostic signs. Fever, leukocytosis, and serum amylase elevation persisted for a longer period than usual. Complication was infrequent but the lesion could persist for 3 to 4 months without producing symptoms. This is a relatively benign condition and surgery should be avoided.link_to_subscribed_fulltex

Alimentary tract and pancreas: Management of complicated acute pancreatitis: Impact of computed tomography

The usefulness of computed tomography (CT) in guiding the management of 43 patients who had a complicated clinical course of acute pancreatitis was retrospectively studied. The CT scans were performed when patients had persistent fever, leucocytosis, hyperamylasaemia, palpable abdominal masses or when there was organ failure. The CT scans showed normal findings in six patients, features of pancreatic abscess in three patients, pseudocysts in three patients and inflammatory masses (a mixture of sterile inflammation and necrosis) in 31 patients. Patients with pancreatic abscesses underwent emergency laparotomy, drainage and debridement; patients with pseudocysts had delayed drainage unless complication occurred; patients with normal CT scan or findings of inflammatory masses were managed conservatively. For patients undergoing conservative management, repeated CT scanning and percutaneous aspiration of the inflammatory mass was performed when pancreatic sepsis was strongly suspected. By this approach, basing on careful clinical and CT scan surveillance, five patients with pancreatic sepsis (pancreatic abscess and localized abscess collection in pseudocyst) underwent emergency surgery and four survived, while 25 patients with inflammatory masses were successfully managed conservatively and some who may have been operated on clinical grounds were spared unnecessary early debridement surgery.link_to_subscribed_fulltex

Prognostic significance of proliferating cell nuclear antigen expression in hepatocellular carcinoma

Background. Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in G 1/S-phase of the cell cycle and therefore is related to cell proliferative activity. In an attempt to evaluate its prognostic significance and clinicopathologic correlation in patients with hepatocellular carcinoma (HCC), the proliferative activity was studied using immunohistochemical staining with monoclonal antibody to PCNA. Methods. Seventy-two patients (64 men, 8 women; mean age, 52 years [range, 24-77 years]) having HCC surgically resected were studied. Tumor and nontumor tissues were selected from each case and stained with PCNA antibody. Tumor and nontumor PCNA (T-PCNA and NT- PCNA) scores were assessed by counting the positive staining nuclei per 1000 cells. Results. The T-PCNA score ranged from 10 to 894 per 1000 cells (mean ± standard deviation = 333 ± 263). It was found to be significantly and positively associated with positive margin (P = 0.003), direct liver invasion by tumor (P = 0.021), and venous permeation (P = 0.020), features directly or indirectly related to tumor invasiveness. However, it had no significant association with tumor size, cellular differentiation, or patients' hepatitis B surface antigen (HBsAg) status. When the tumors were stratified into two groups with a T-PCNA score less than or equal to 200 and a T-PCNA score greater than 200, those patients with a T-PCNA score less than or equal to 200 had significantly longer disease-free survival (DFS) and actual survival (AS) rates than those with scores greater than 200 (median DFS and AS, 34.6 and 49.3 months and 7.7 and 19.1 months, respectively; P = 0.019 and 0.035 for DFS and AS, respectively). T-PCNA and NT-PCNA scores had no significant correlation with the HBsAg status of the patients. Conclusions. Proliferative activity in HCC, as defined by PCNA immunohistochemical analysis, is significantly related to tumor invasiveness. It is also a potentially valuable prognostic factor in patients with this tumor.link_to_subscribed_fulltex

Effect of Tai Chi on depressive symptoms amongst Chinese older patients with depressive disorders: A randomized clinical trial

link_to_subscribed_fulltex

Low-Frequency Visual Entrainment Enhances Bilateral Resting-State FMRI Connectivity in Primary Sensory Cortices.

Electronic Poster Session: Neuro - Functional MRI: Miscellaneous - abstract no. 4602Entrainment is known to alter or synchronize brain rhythm and may enhance task performance. However, whether and how sensory entrainment may modulate the long-range brain functional networks are unknown. We investigated the effects of frequency-dependent visual entrainment on resting state functional connectivity in distinct sensory cortical networks. Our findings provide the first and direct evidence that only low frequency visual entrainment can modulate the long-range non-visual sensory networks. They suggest that the entrained neural oscillation at low frequency can actively contribute to the long-range interactions between primary sensory cortical functional networks that underlie the brainwide connectivity measured by resting-state fMRI