Serum ferritin levels and polycystic ovary syndrome in obese and nonobese women

AbstractObjectiveThe aim of this study is to evaluate serum ferritin levels and polycystic ovary syndrome (PCOS)-related complications in obese and nonobese women.Materials and methodsThis retrospective study included 539 (286 with PCOS and 253 without PCOS).ResultsSerum ferritin correlated with menstrual cycle length, sex hormone-binding globulin, total testosterone, androstenedione, triglyceride, and total cholesterol in both obese and nonobese women. Obese women with high ferritin levels exhibited higher insulin resistance, impaired glucose tolerance, and liver enzymes (glutamic oxaloacetic transaminase, glutamic pyruvic transaminase) than obese women with low ferritin levels. However, among nonobese women, insulin resistance and risk of diabetes were not significantly different between the high and low ferritin groups. Independent of obesity, hypertriglyceridemia was the major metabolic disturbance observed in women with elevated serum ferritin levels.ConclusionElevated serum ferritin levels are associated with increased insulin resistance and risk of diabetes in obese women but not in nonobese women. However, higher serum ferritin levels were correlated with a greater risk of hyperglyceridemia in both obese and nonobese women. Therefore, hypertriglyceridemia in women with PCOS might be associated with iron metabolism

In vitro study of the tocolytic effect of oroxylin A from Scutellaria baicalensis root

Scutellariae Radix is one of the well-known tocolytic Chinese herbs. Oroxylin A is isolated from the root of Scutellaria baicalensis. The main syndrome of preterm birth is caused by uterus contractions from excitatory factors. Administration of tocolytic agents is a strategy to prevent the occurrence of preterm births. The aim of this study was to investigate the effects of oroxylin A on contractions of uterine strips isolated from non-pregnant female Wistar rats (250~350 g). Contractions of the uterus were induced with acetylcholine (Ach) (1 μM), PGF2α (0.1 μM), oxytocin (10-3 U/ml), KCl (56.3 mM), tetraethylammonium (TEA; 1 and 10 mM), 4-aminopyridine (4-AP; 5 mM), glipizide (30 μM), a nitric oxide synthase (NOS) inhibitor (LNNA; 10-3M), a β-receptor blocker (propranolol; 10 μM), and a cyclooxygenase inhibitor (indomethacin; 60 μM). The inhibitory effects of the amplitude and frequency of spontaneous contractions by oroxylin A were antagonized with Ach (IC50 22.85 μM), PGF2α (IC5027.28 μM), oxytocin (IC50 12.34 μM), TEA; 1 and 10 mM (IC50 52.73 and 76.43 μM), 4-AP (IC50 67.16 μM), and glipizide (IC5027.53 μM), but oroxylin A was not influenced by Ca2+-free medium, LNNA, propranolol, or indomethacin. Otherwise, oroxylin A-mediated relaxation of the rat uterus might occur through opening of uterine calcium-dependent potassium channels or adenosine triphosphate potassium channel activation. This suggests that oroxylin A is the tocolytic principle constituent of Scutellariae Radix, and oroxylin A may provide a lead compound for new tocolytic drug development in the future

Incarcerated Vaginal Pessary: A Rare Complication

SummaryObjectiveA patient with uterine prolapse (procidentia uteri) received a vaginal pessary, which became incarcerated in the vaginal wall.Case ReportA 70-year-old female patient had been treated for uterine prolapse by insertion of a ring-shaped silicone pessary for about 3 to 4 years. The patient neglected the pessary, which unfortunately became incarcerated in the vaginal wall; it was impossible to remove. Finally, the pessary was displaced after cutting it into two pieces under general anesthesia.ConclusionAfter having inserted a vaginal pessary, patients need to be instructed on its regular removal and cleaning to prevent complications such as infection, ulceration, and incarceration

Epigallocatechin-3-gallate-mediated cardioprotection by Akt/GSK-3β/caveolin signalling in H9c2 rat cardiomyoblasts

Background: Epigallocatechin-3-gallate (EGCg) with its potent anti-oxidative capabilities is known for its beneficialeffects ameliorating oxidative injury to cardiac cells. Although studies have provided convincing evidence tosupport the cardioprotective effects of EGCg, it remains unclear whether EGCg affect trans-membrane signalling incardiac cells. Here, we have demonstrated the potential mechanism for cardioprotection of EGCg againstH2O2-induced oxidative stress in H9c2 cardiomyoblasts.Results: Exposing H9c2 cells to H2O2 suppressed cell viability and altered the expression of adherens and gapjunction proteins with increased levels of intracellular reactive oxygen species and cytosolic Ca2+. These detrimentaleffects were attenuated by pre-treating cells with EGCg for 30 min. EGCg also attenuated H2O2-mediated cell cyclearrest at the G1-S phase through the glycogen synthase kinase-3β (GSK-3β)/β-catenin/cyclin D1 signalling pathway.To determine how EGCg targets H9c2 cells, enhanced green fluorescence protein (EGFP) was ectopically expressedin these cells. EGFP-emission fluorescence spectroscopy revealed that EGCg induced dose-dependent fluorescencechanges in EGFP expressing cells, suggesting that EGCg signalling events might trigger proximity changes of EGFPexpressed in these cells.Proteomics studies showed that EGFP formed complexes with the 67 kD laminin receptor, caveolin-1 and -3,β-actin, myosin 9, vimentin in EGFP expressing cells. Using in vitro oxidative stress and in vivo myocardial ischemiamodels, we also demonstrated the involvement of caveolin in EGCg-mediated cardioprotection. In addition,EGCg-mediated caveolin-1 activation was found to be modulated by Akt/GSK-3β signalling in H2O2-induced H9c2cell injury.Conclusions: Our data suggest that caveolin serves as a membrane raft that may help mediate cardioprotectiveEGCg transmembrane signalling

Prognosis of ductal adenocarcinoma of pancreatic head with overexpression of CD44

SummaryBackgroundThe long-term survival rate of patients with pancreatic ductal adenocarcinoma (PDAC) is very low. Cancer stem cells have been identified in PDAC based on the expression of the surface markers CD24, CD44, CD133, and epithelial specific antigen. The prognosis of PDAC may be related to the presence or absence of tumor cells with cancer stem cell surface markers.MethodsEighty-six PDAC patients (51 male and 35 female patients) who underwent surgical treatment at Chang Gung Memorial Hospital—Lin-Kou Medical Center, Lin-Kou, Taiwan between 1998 and 2007 were included in this study. The patients' ages ranged from 30 years to 84 years. All their surgical specimens showed invasive ductal cancer. Immunohistochemical staining with CD44 antibodies was performed. The differences in clinical data, cell types of tumors, tumor staging, and survival rates between patients with CD44− (Group A; n = 33) and CD44+ (Group B; n = 53) were compared.ResultsClinical data, cell types of tumors, and tumor staging between the two groups showed no significant differences. The 3- and 5-year survival rates were, respectively, 51.5% and 19.8% in patients with CD44− tumor cells and 4.0% and 2.0% in those with CD44+ tumor cells. The differences were statistically significant (p < 0.0001). The median overall survival times of the two groups were also different (36.9 months vs. 12.2 months, p < 0.0001). Multivariate analysis showed that the CD44 as well as lymph node status, and differentiation of tumor cells were prognostic factors for patients with PDAC.ConclusionThe results suggested that CD44 expression in patients with PDAC after surgery was significantly associated with decreased survival, whereas patients with CD44− tumor cells survived significantly longer

Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma

<p>Abstract</p> <p>Background</p> <p>Pancreatic adenosquamous carcinoma (ASC) is a rare pancreatic malignancy subtype. We investigated the clinicopathological features and outcome of pancreatic ASC patients after surgery.</p> <p>Methods</p> <p>The medical records of 12 patients with pancreatic ASC undergoing surgical treatment (1993 to 2006) were retrospectively reviewed. Survival data of patients with stage IIB pancreatic adenocarcinoma and ASC undergoing surgical resection were compared.</p> <p>Results</p> <p>Symptoms included abdominal pain (91.7%), body weight loss (83.3%), anorexia (41.7%) and jaundice (25.0%). Tumors were located at pancreatic head in 5 (41.7%) patients, tail in 5 (41.7%), and body in 4 (33.3%). Median tumor size was 6.3 cm. Surgical resection was performed on 7 patients, bypass surgery on 3, and exploratory laparotomy with biopsy on 2. No surgical mortality was identified. Seven (58.3%) and 11 (91.7%) patients died within 6 and 12 months of operation, respectively. Median survival of 12 patients was 4.41 months. Seven patients receiving surgical resection had median survival of 6.51 months. Patients with stage IIB pancreatic ASC had shorter median survival compared to those with adenocarcinoma.</p> <p>Conclusion</p> <p>Aggressive surgical management does not appear effective in treating pancreatic ASC patients. Strategies involving non-surgical treatment such as chemotherapy, radiotherapy or target agents should be tested.</p

Isolated pancreatic metastasis from rectal cancer: a case report and review of literature

Isolated pancreatic metastases from a non-pancreatic primary malignancy are very rare. Studies have shown that resection of metastases is of proven benefit in some types of tumors. We report a case of 76-year-old Taiwanese woman with rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and abdominoperineal resection 2 years ago presenting with an asymptomatic mass at the pancreatic tail on a routine follow up abdominal computed tomography scan. The patient underwent distal pancreatectomy and splenectomy under the preoperative impression of a primary pancreatic malignancy. Histological examination of the surgical specimen showed metastatic adenocarcinoma. Immunohistochemical studies confirmed the diagnosis of pancreatic metastasis from rectal adenocarcinoma. Postoperative chemotherapy in the form of oral capecitabine was given. The patient is alive and disease free 12 months after the surgery. In a patient presenting with a pancreatic mass with history of a non-pancreatic malignancy, a differential diagnosis of pancreatic metastasis should be considered. Surgical resection of a solitary pancreatic mass is justified not only to get the definitive diagnosis but also to improve the survival