Serial Ultrasonography for Early Detection and Follow-up of Heterotopic Ossification in Stroke

Heterotopic ossification (HO) is a common complication in patients with neurologic deficits. Once developed, limited range of motion may occur and interfere with rehabilitation programs. Early diagnosis is crucial but difficult because radiographs may be negative, and similar clinical symptoms could appear in deep venous thrombosis, cellulitis, and osteomyelitis. A three-phase bone scan can detect the disease early, but it has high radiation and low specificity. Magnetic resonance imaging (MRI) may also assist in diagnosis, but is costly and has some contraindications. Ultrasonography has been used in HO detection and is safe, economical, easily accessible, and involves no radiation exposure. However, a few studies have described its use in HO, especially in serial follow-ups. We report a case with HO clinical symptoms, but the MRI results created a necrotizing fasciitis suspicion. Serial ultrasonography images implied the formation of HO rather than necrotizing fasciitis. Ultrasonography images serve as a good initial screening tool for HO and are useful for following up such dynamic disease processes

Hypoalbuminemia in peritoneal dialysis patients

This study aimed to determine the factors that were associated with hypoalbuminemia in peritoneal dialysis (PD) patients. End-stage renal disease patients who had received PD at the National Taiwan University Hospital for more than three months were included and divided into two groups. Patients who had mean serum albumin levels greater or equal to 3.5g/dL were allocated to Group 1, while those who had mean serum albumin levels less than 3.5g/dL were allocated to Group 2. Demographic characteristics, clinical parameters and laboratory data were then compared between the two groups. Logistic regression was also performed to identify the factors that were associated with hypoalbuminemia. There were 359 patients (mean age 54.3 years, male 46.5%) included. Group 2 patients (10.3%) were older (P=0.0536), had lower body mass index (P=0.0008), lower total Kt/V (P=0.0060), and lower levels of hemoglobin (P=0.0268), blood urea nitrogen (P=0.0501), creatinine (P<0.0001), triglyceride (P=0.0014), potassium (P=0.0028), phosphorus (P=0.0036), but higher levels of C-reactive protein (P=0.0194). More Group 2 patients had high or high-average peritoneal equilibration test (PET) (P=0.0199). Using logistic regression, factors that were found to be associated with hypoalbuminemia were total Kt/V (P=0.0015), hemoglobin (P=0.0019), creatinine (P<0.0001), triglyceride (P=0.0060), and potassium (P=0.0126). In conclusion, hypoalbuminemia in our PD patients was associated with total Kt/V as well as levels of hemoglobin, creatinine, triglyceride, and potassium

Therapeutic Effect of Repurposed Temsirolimus in Lung Adenocarcinoma Model

Lung cancer is one of the major cause of cancer-related deaths worldwide. The poor prognosis and resistance to both radiation and chemotherapy urged the development of potential targets for lung cancer treatment. In this study, using a network-based cellular signature bioinformatics approach, we repurposed a clinically approved mTOR inhibitor for renal cell carcinomans, temsirolimus, as the potential therapeutic candidate for lung adenocarcinoma. The PI3K-AKT-mTOR pathway is known as one of the most frequently dysregulated pathway in cancers, including non-small-cell lung cancer. By using a well-documented lung adenocarcinoma mouse model of human pathophysiology, we examined the effect of temsirolimus on the growth of lung adenocarcinoma in vitro and in vivo. In addition, temsirolimus combined with reduced doses of cisplatin and gemcitabine significantly inhibited the lung tumor growth in the lung adenocarcinoma mouse model compared with the temsirolimus alone or the conventional cisplatin–gemcitabine combination. Functional imaging techniques and microscopic analyses were used to reveal the response mechanisms. Extensive immunohistochemical analyses were used to demonstrate the apparent effects of combined treatments on tumor architecture, vasculature, apoptosis, and the mTOR-pathway. The present findings urge the further exploration of temsirolimus in combination with chemotherapy for treating lung adenocarcinoma