• Title/Summary/Keyword: Luminal A

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Long-Term Efficacy of Anti-Tumor Necrosis Factor Agents in Pediatric Luminal Crohn's Disease: A Systematic Review of Real-World Evidence Studies

  • Rheenen, Hanna van;Rheenen, Patrick Ferry van
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.121-131
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    • 2020
  • Purpose: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review. Methods: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation. Results: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83-97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67-91% and 61-85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy. Conclusion: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.

Clinicopathologic Features and Molecular Subtypes of Breast Cancer in Young Women (Age ≤35)

  • Goksu, Sema Sezgin;Tastekin, Didem;Arslan, Deniz;Gunduz, Seyda;Tatli, Ali Murat;Unal, Dilek;Salim, Derya;Guler, Tunc;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6665-6668
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    • 2014
  • Introduction: Breast cancer in young women is a relatively rare disease; however it tends to be more aggressive and is the leading cause of cancer death in this population. The aim of this study is to investigate the clinical and biological features of breast cancer arising in young Turkish breast cancer patients. Materials and Methods: Patients with breast cancer aged 35 or less (${\leq}35$ years) were selected for the study. In total 211 cases were included. Pathologic features; histologic subtypes, grade, lymphovascular invasion, axillary involvement, and stage were recorded for each. Results: The most common subtype was luminal B (36.5%), followed by luminal A (30.8%), triple negative (23.2%) and HER2+(9.5%) subtypes. Twelve percent of the patients had stage 4, 32.7% had stage 3, 46.4% had stage 2, and 6.2% had stage 1 disease at the time of diagnosis. Mean tumour diameter was 3.87 cm (range 0.3-13 cm). The axillary lymph nodes were positive in 74.4% of the patients, while lympho-vascular invasion was seen in 56.4%. Some 9.5% of patients had grade 1, 51.2% had grade 2, and 31.8% had grade 3 tumors. Conclusions: Young women with breast cancer in Turkey are more likely to present with luminal B subtype. Tumors in young women are more likely to present with advanced disease, to be high grade and and to have more lymphovascular invasion. Further research should focus on whether we need new treatment strategies for young patients with breast carcinoma.

Analysis of the Gene Expression by Laser Capture Microdissection (III) -Microarray Analysis of the Gene Expression at the Mouse Uterine Luminal Epithelium of the Implantation Sites during Apposition Period- (Laser Capture Microdissection을 이용한 유전자 발현 연구 (III) -생쥐 착상 부위 자궁 내강상피 조직에서 배아 병치 기간 동안 일어나는 유전자 발현에 관한 Microarray 분석-)

  • Yoon, Se-Jin;Jeon, Eun-Hyun;Park, Chang-Eun;Ko, Jung-Jae;Choi, Dong-Hee;Cha, Kwang-Yul;Kim, Se-Nyun;Lee, Kyung-Ah
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.4
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    • pp.323-335
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    • 2002
  • Object: The present study was accomplished to obtain a gene expression profile of the luminal epithelium during embryo apposition in comparison of implantation (1M) and interimplantation (INTER) sites. Material and Method: The mouse uterine luminal epithelium from IM and INTER sites were sampled on day 4.5 (Day of vaginal plug = day 0.5) by Laser Captured Microdissection (LCM). RNA was extracted from LCM captured epithelium, amplified, labeled and hybridized to microarrays. Results from microarray hybridization were analyzed by Significance Analysis of Microarrays (SAM) method. Differential expression of some genes was confirmed by LCM followed by RT-PCR. Results: Comparison of IM and INTER sites by SAM identified 73 genes most highly ranked at IM, while 13 genes at the INTER sites, within the estimated false discovery rate (FDR) of 0.163. Among 73 genes at IM, 20 were EST/unknown function, and the remain 53 were categorized to the structural, cell cycle, gene/protein expression, immune reaction, invasion, metabolism, oxidative stress, and signal transduction. Of the 24 structural genes, 14 were related especially to extracellular matrix and tissue remodeling. Meanwhile, among 13 genes up-regulated at INTER, 8 genes were EST/unknown function, and the rest 5 were related to metabolism, signal transduction, and gene/protein expression. Among these 58 (53+5) genes with known functions, 13 genes (22.4%) were related with $Ca^{2+}$ for their function. Conclusions: Results of the present study suggest that 1) active tissue remodeling is occurring at the IM sites during embryo apposition, 2) the INTER sites are relatively quiescent than IM sites, and 3) the $Ca^{2+}$ may be a crucial for apposition. Search for human homologue of those genes expressed in the mouse luminal epithelium during apposition will help to understand the implantation process and/or implantation failure in humans.

Stenosis of calcified carotid artery detected on Panoramic Radiography (파노라마방사선사진에서 석회화가 발견되는 경동맥의 협착 정도)

  • Cho, So-Yang;Oh, Won-Mann;Yoon, Suk-Ja;Yoon, Woong;Lee, Jae-Seo;Palomo, Juan M.;Kang, Byung-Cheol
    • Imaging Science in Dentistry
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    • v.39 no.3
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    • pp.157-161
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    • 2009
  • Purpose : This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. Materials and Methods : This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Results : Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Conclusion : Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

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High-Resolusion Magnetic Resonance Imaging of Carotid Atherosclerotic Plaque (경동맥 죽상경화반의 고해상도 자기공명영상)

  • Byun, Woo-Mok;Cho, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.143-150
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    • 2004
  • A thromboembolic stroke is believed to be precipitated by a rupture of vulnerable atheromatous plaques. Until recently the assessment of a further risk of stroke in high-risk patients in whom atherosclerosis has presented with a transient ischaemic attack (TIA), has been confined to a quantitative assessment of the luminal patency of the internal carotid artery. These traditional stratification parameters are no longer believed to be the most accurate predictors of a thrombo-embolism. This is because the process of vessel wall remodeling can maintain a luminal patency, and consequently, quite large friable plaques may remain unidentified. Accordingly, there is a need for an improved risk assessment. The fibrous cap of a vulnerable plaque is thinner, and an intraplaque hemorrhage and inflammation can occur during the development of atherosclerotic plaque. Several imaging methods for identifying vulnerable plaques have been developed. Recently, high resolution magnetic resonance (MR) imaging has emerged as an accurate non-invasive tool that can characterize the carotid plaque components in vivo. A High resolution carotid magnetic resonance is capable of distinguishing an intact, thick fibrous cap from a thin and ruptured cap in carotid plaque. In addition, a plaque MR can identify the active inflammation and detect a hemorrhage. High resolution carotid MR imaging is a valuable noninvasive method for quantifying the plaque components and identifying vulnerable plaque.

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Morphology of the Dart and the Dart Sac in the Land Snail Nesiohelix samarangae

  • Byun, In-Seon;Jo, Yong-Hun;Lee , Yong-Seok;Jeong, Kye-Heon
    • The Korean Journal of Malacology
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    • v.20 no.1
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    • pp.1-6
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    • 2004
  • An anatomical and ultrastructural study on the dart sac and the dart of a Korean snail Nesiohelix samarangae was conducted to understand their morphological characteristics with the help of the light microscope and electron microscopes, TEM and SEM. Nesiolelix samarangae had two darts which are pure white structures 6-8 mm in length, tapering from 0.6-0.8 mm to 0.15-0.3 mm. The dart sac had a long conic lumen subdivided into two by a septal wall, and the darts were centrally embedded in the thick muscular layers of the sac. The darts occupied each of the two luminal spaces one per each. The convexed surfaces of the darts had many crystal buds in the shape of the petals. Otherwise, the convexed surfaces of the darts had numerous crystal buds in the shape of candle or topaz. The luminal surface of the dart sac was covered with a single columnar epithelium. The epithelial cells possessed microvilli on their free surface.

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Protection of Mercury induced Acute Respiratory Injury by Inhaled Oxidizing Agent (수은에 의한 급성호흡손상시 산화물질의 억제효과)

  • 황태호
    • Journal of Life Science
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    • v.11 no.3
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    • pp.259-265
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    • 2001
  • Mercury vapor inhalation-induced acute respiratory failure(ARF) has been reported to be fatal. This study was designed to observe the possible mechanism of inhaled mercury vapor poisoning in the respiratory system. Sixty percent of rats(12/20) exposed to mercury vapor were dead within 72 hours of exposure whereas all the rats(20/20) exposed to mercury vapor combined with dithiothreitol(DTT) vapor survived. The histological observation showed that ARF was a direct cause of the death induced by mercury vapor inhalation, which was significantly circumvented by DTT vapor. Cyclic AMP mediated chloride secretion was inhibited by luminal side but not serosal side sulfhydryl blocking agents (Hf$^{2+}$ $\rho$-chloromercuribenzoic acid or $\rho$-chloromercuriphenyl sulfonic acid) in a dose-dependent manner in a primary cultured rat airway monolayer. The inhibitory component of cAMP induced chloride secretion was completely restored by luminal side DTT(0.5mM). these results suggest that the oxidized form(Hg$^{2+}$) of mercury vapor(Hg0) contribute to ARF and subsequent death. The finding is important as it can provide important information regarding emergency manipulation of ARF patients suffering from by mercury vapor poisoning.ing.

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Expression of doc-1 in Pregnant Uterus of the Mouse (임신한 생쥐 자궁에서의 doc-1 발현)

  • Cheon, Yong-Pil
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.4
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    • pp.295-302
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    • 2002
  • Uterine cells carry out proliferation and differentiation for preparation the embryonic implantation during pregnancy. Therefore regulation of the cell proliferation is an essential step for uterine preparation, but there is not much information about the proliferation related genes in pregnant uterus. To identify these implantation specific genes, a PCR-select cDNA subtraction method was employed and got a few genes. One of the identified genes is a novel gene encoding oral tumor suppressor doc-1. To detect the doc-1 expression on the pregnant uterus, dot blotting, RT-PCR, and in situ hybridization were employed. Dot blotting revealed that doc-1 mRNA expression increase after implantation. During normal pregnancy, doc-1 mRNA expression was detected as early as day 1 of pregnancy with RT-PCR. Its expression was increased about 15 times after embryonic implantation. doc-1 transcript was localized in luminal epithelial cells but it was very faint during preimplantation. After starting the implantation, it localized in the stromal cells; heightened expression of doc-1 correlates with intense stromal cell proliferation surrounding the implanting blastocyst on day 6 morning. However in the decidualized cells, the intensity of localized doc-1 mRNA was weak. From those results, it is revealed that doc-1 express at pregnant uterus of the mouse. In addition it is suggested that doc-1 is the gene regulating the proliferation of the luminal epithelial cells and stromal cells during early implantation and decidualization.

Relationship between Tamoxifen and Sex Steroid Hormones on Uterus and Implantation in Rat (흰쥐 자궁 및 착상에 있어서 Tamoxifen과 성스테로이드 호르몬의 상호관계)

  • Han, H.J;Yoo, K.Y.;Kwun, J.K.;Yang, I.S.
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.2
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    • pp.93-102
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    • 1988
  • These studies were undertaken to examine the relationship between tamoxifen and sex steroid hormones in rat uterine morphology and the effect of tamoxifen on sex steroid hormone levels, implantation and myometrial contraction. The results obtained were as follows : 1) The increase in height of the luminal epithelium caused by tamoxifen treatment was blocked by progesterone. The increase in height of luminal epithelium caused by $estradiol-17{\beta}$ treatment was blocked by tamoxifen. 2) When a single dose of tamoxifen(10, 20, $40{\mu}g$) was given on Day 2 of pregnancy, implantation was prevented. Plasma $estradiol-17{\beta}$ level fell in a dose-dependent manner but plasma progesterone level was constant. 3) In vitro, tamoxifen decreased rat uterine contractility in a dose-dependent manner.

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MicroRNA-orchestrated pathophysiologic control in gut homeostasis and inflammation

  • Lee, Juneyoung;Park, Eun Jeong;Kiyono, Hiroshi
    • BMB Reports
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    • v.49 no.5
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    • pp.263-269
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    • 2016
  • The intestine represents the largest and most elaborate immune system organ, in which dynamic and reciprocal interplay among numerous immune and epithelial cells, commensal microbiota, and external antigens contributes to establishing both homeostatic and pathologic conditions. The mechanisms that sustain gut homeostasis are pivotal in maintaining gut health in the harsh environment of the gut lumen. Intestinal epithelial cells are critical players in creating the mucosal platform for interplay between host immune cells and luminal stress inducers. Thus, knowledge of the epithelial interface between immune cells and the luminal environment is a prerequisite for a better understanding of gut homeostasis and pathophysiologies such as inflammation. In this review, we explore the importance of the epithelium in limiting or promoting gut inflammation (e.g., inflammatory bowel disease). We also introduce recent findings on how small RNAs such as microRNAs orchestrate pathophysiologic gene regulation.