Search

Objectives: In this study, we assess the possible influence of soybean isoflavone (genistein) and other flavonoids (quercetin and catechin) on breast cancer chemoprevention. We design in-vitro and in-vivo experiments to analyze the effect of genistein, quercetin and catechin on cell proliferation, cell migration, and angiogenesis of breast cancer cells. Methods: In cell proliferation experiment, MCF-7 cells, SKBR-3 cells, and HUVEC cells were treated with genistein and other flavonoids (catechin and/or quercetin) for 48[Formula: see text]h to assess the influence on cell growth of normal and breast cancer cells. In cell motility test, we analyze the effect of isoflavone and flavonoids on migration ability of MCF-7 cells by 16[Formula: see text]h and SKBR-3 cells by 24[Formula: see text]h in two different concentrations (1.25[Formula: see text][Formula: see text]g/ml and 2.5[Formula: see text][Formula: see text]g/ml). In the in-vivo experiment, SKBR-3 cells mixed with PBS and catechin, respectively, were injected subcutaneously into nude mice, then we investigated the effect of catechin on cell growth by observing subcutaneous tumor size changes after 15 days. Results: The results suggest that genistein and quercetin can significantly inhibit proliferation of breast cancer cells, and their inhibitory effects are independent of estrogen receptor. In cell motility tests, all of the three phytochemicals were effective in the inhibition of cell migration on two breast cancer cell lines, except for quercetin on cell migration of SKBR-3 cell line. In the in-vitro experiment, catechin showed stimulatory effect on cell proliferation of HUVEC cell line, which may consider positive effect on angiogenesis, rather than inhibitory effect. However, in the in-vivo experiment, it showed no significant change in tumor size between the groups of with and without catechin treatment. Conclusions: According to our study, the results suggest that isoflavone and flavonoids tend to inhibit cell growth and metastasis of breast cancer cells. Our in-vivo experiment does not reach a significant result, and it may be due to lower catechin concentration. Under in-vivo environment, we should also consider the possible metabolic forms of catechin that cause different result from the in-vitro study.

We analyzed the changes in mitochondrial DNA (mtDNA) copy numbers and the shifting of mtDNA D310 sequence variations (D310 mutation) with their relationships to pathological status and the expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2/neu), tumor-suppressor protein p53 and cellular proliferation protein Ki-67 in breast invasive ductal carcinoma (BIDC), respectively. Fifty-one paraffin-embedded BIDCs and their paired non-cancerous breast tissues were dissected for DNA extraction. The mtDNA copy number and mtDNA D310 sequence variations were determined by quantitative real-time polymerase chain reaction (q-PCR) and PCR-based direct sequencing, respectively. The expression levels of ER, PR, HER-2/neu, p53 and Ki-67 were determined by immunohistochemical (IHC) staining. Compared to the paired non-cancerous breast tissues, 24 (47.1%) BIDCs had elevated mtDNA copy numbers and 29 (56.9%) harbored mtDNA D310 mutations. Advanced T-status (p=0.056), negative-ER (p=0.005), negative-PR (p=0.007), positive-p53 (p=0.050) and higher Ki-67 (p=0.004) expressions were related to a higher mtDNA copy ratio. In addition, advanced T-status (p=0.019) and negative-HER-2/neu expression (p=0.061) were associated with mtDNA D310 mutations. In conclusion, higher mtDNA copy ratio and D310 mutations may be relevant biomarkers correlated with pathological T-status and the expression levels of ER, PR, HER-2/neu, p53 and Ki-67 in BIDCs.

Objective Few studies address quality of care in pay-for-performance (P4P) programs from the perspective of patients' perceptions. This study aimed to examine and compare the patient assessment of diabetes chronic care as perceived by diabetic patients enrolled and not enrolled in a P4P program from the patients' self-reported perspectives. Design A cross-sectional study with case and comparison group design. Setting A large-scale survey was conducted from February to November 2013 in 18 healthcare institutions in Taiwan. Participants A total of 1458 P4P ( n = 1037) and non-P4P ( n = 421) diabetic patients participated in this large survey. The Chinese version of the Patient Assessment of Chronic Illness Care (PACIC) instrument was used and patients' clinical outcome data (e.g. HbA1c, LDL) were collected. Intervention None. Main Outcome Measures Five subscales from the PACIC were measured, including patient activation, delivery system design/system support, goal setting/tailoring, problem solving/contextual and follow-up/coordination. Patient clinical outcomes were also measured. Multiple linear regression and logistic regression models were used and controlled for patient demographic and health institution characteristics statistically. Results After adjusting for covariates, P4P patients had higher overall scores on the PACIC and five subscales than non-P4P patients. P4P patients also had better clinical processes of care (e.g. HbA1c test) and intermediate outcomes. Conclusions Patients who participated in the program likely received better patient-centered care given the original Chronic Care Model. Better perceptions of diabetic care assessment also better clinical outcomes. The PACIC instrument can be used for the patient assessment of chronic care in a P4P program.

Little is known about the exposure profiles of melamine in children. We evaluated the association of clinical findings, exposure patterns and biomarkers with nephrolithiasis in children with potential exposure to melamine.A case-control study was conducted in children aged 0-16 years with potential exposure to contaminated dairy products. Cases were defined as nephrolithiasis detected by renal ultrasonography. On the basis of different brands of contaminated dairy products consumed, subjects were classified into high exposure, low exposure and control groups with estimated melamine exposure levels of higher than 2.5 ppm, 0.05-2.5 ppm and lower than detection limits0.05 ppm. We measured urine melamine for those with nephrolithiasis and age-matched and gender-matched controls within the subset of the study population.The duration of consumption of contaminated products was longer in children with nephrolithiasis in the high exposure group than in controls (median (IQR) 12.0 (3.3-24.0) vs 6.0 (4.0-7.0) months; p = 0.048). High melamine exposure levels were significantly associated with nephrolithiasis (OR 61.04 (95% CI 12.73 to 292.84)). The risk was found to increase with estimate melamine exposure levels (p for trend0.001). Two among 10 affected subjects with nephrolithiasis showed elevated urine melamine levels. In comparison, levels of all 20 controls were lower than the detection limit.The risk of melamine-associated nephrolithiasis was related to duration of consumption of contaminated products and estimated melamine exposure levels. Though urine melamine was not a sensitive test, it might serve as an exposure biomarker in melamine-associated nephrolithiasis.

This study investigated the advantage of photoluminescent bioceramic (PLB) irradiation on meridian channels of abnormal meridian currents, as well as the normalization of meridian current levels that may represent the participants' physiologic conditions.Statistical analysis of survey data.Forty-six patients with abnormal meridian current in the gallbladder (GB).The effects on the meridian currents were measured by an electrodermal instrument after PLB irradiation was applied to the GB and other specific acupuncture points. Each meridian was categorized into six physiologic levels to evaluate effectiveness after the PLB irradiation: 1, extremely low; 2, moderately low; 3, normally low; 4, normally high; 5, moderately high; and 6, extremely high level. The positive effect of PLB treatment for each meridian could be defined as the normalized ability of the meridian level from the extreme values (1, 2, 5, or 6) approaching the normal levels (3 or 4).Participants with higher average meridian current (Amc36 μA) calculated from the currents of 24 Ryodoraku points could be significantly normalized after the PLB treatment (p=0.0241). A significant positive effect was seen in comparison with the negative effect of PLB on the GB meridian (McNemar test, p=0.00004) (n=46×2 for left and right GB meridians). A patient with benign facial tremor was treated by PLB for 1 month; PLB improved the facial tremor and normalized effects on Amc and meridian current levels at the GB, lung, small intestine, bladder, and kidney.A method was proposed to evaluate the normalization effect of a noninvasive PLB technique on the 12 meridians. PLB acupuncture on the specific meridian points could show the normalization ability of Amc and GB meridian for the participants.

Introduction Receptor-mediated estrogen activation participates in the development and progression of breast cancer. Estrogen receptor (ER)-α polymorphism has been found to be associated with breast cancer and clinical features of the disease in Caucasians. Epidemiologic studies have revealed that age–incidence patterns of breast cancer in Asians differ from those in Caucasians. Genomic data for ER-α in either population is therefore of value in the clinical setting for that ethnic group. Methods A case–control study was conducted to establish a database of ER-α polymorphisms in a Taiwanese population in order to compare Western and Taiwanese (Asian) distributions and to evaluate ER-α polymorphism as an indicator of clinical outcome. The ER-α gene was scanned in a Taiwanese clinical breast cancer group (189 patients) and in healthy individuals (177 healthy control individuals). PCR single-strand conformation polymorphism technology was employed and real-time PCR melting curve analysis was performed. Results Three sites of silent single nucleotide polymorphism (SNPs) were found, as reported previously in Western studies, but at significantly different frequencies. Among the three SNPs, the frequency of allele 1 (TCT → TCC) in codon 10 was significantly lower in breast cancer patients (32.0%) than in control individuals (40.4%; P = 0.018). We found that allele 1 (ACG → ACA) in codon 594 was less common in breast cancer patients with a family history of breast cancer (5.9%) than in those without such a history (19.6%; P = 0.049). Individually, both allele 1 in codon 325 (CCC → CCG) and allele 1 in codon 594 exhibited a reverse association with the occurrence of lymph node metastasis. Furthermore, incorporation of both SNP markers further increased predictive accuracy. Conclusions Our data suggest that ER-α polymorphisms are correlated with various aspects of breast cancer in Taiwan. ER-α genotype, as determined during presurgical evaluation, might represent a surrogate marker for predicting breast cancer lymph node metastasis.

Introduction: During the past few years in Taiwan, there has been a rapid growth of autologous fat grafting procedures performed for cosmetic reasons. We retrospectively demonstrate Complications of Autologous Fat Grafting in the breast, based on clinical presentations and breast MRI imaging. We also discuss the possible method of early detection of complications. Material and method: Twenty-one ethnic Chinese (Taiwanese) women were transferred for delicate breast MRI study in the past year. These patients had suffered different signs and symptoms following the procedure. Clinical and image information were collected from the hospital database. Results: Breast MRI successfully detected all viable fat tissues and complicated lesions of the breasts. The image findings corresponded to the clinical presentation and were used in therapeutic decision making. Fat necrosis with granuloma formations caused by graft rejection was the main complications. The most severe complication was an abscess formation and impending sepsis. Management procedures included operation or drainage; received oral antibiotics; and received clinical observation. Discussion and Conclusion: MRI is capable of detecting the surviving fat graft tissues, and to distinguish degree of malignancy from benign lesions. In complicated cases, the highest incidences showed granuloma formations and fat necrosis. However, laboratory data such as CRP, IgE and complement (C3 &C4) levels only reflected some of the infectious cases and could not be used as monitoring parameters. Breast MRI is an ideal tool for early detection of autologous fat complications without causing indistinguishable conclusions from malignancy. Breast MRI should be performed as early as possible for this complication, so that help for early treatment can be planned.

Vascular inflammatory process has been suggested to play a key role in the initiation and progression of atherosclerosis, a major complication of diabetes mellitus. Recent studies have shown that brazilin exhibits antihepatotoxic, antiplatelet, cancer preventive, or anti-inflammatory properties. Thus, we investigated whether brazilin suppresses vascular inflammatory process induced by high glucose (HG) in cultured human umbilical vein endothelial cells (HUVEC). HG induced nitrite production, lipid peroxidation, and intracellular reactive oxygen species formation in HUVEC cells, which was reversed by brazilin. Western blot analysis revealed that brazilin markedly inhibited HG-induced phosphorylation of endothelial nitric oxide synthase. Besides, we investigated the effects of brazilin on the MAPK signal transduction pathway because MAPK families are associated with vascular inflammation under stress. Brazilin blocked HG-induced phosphorylation of extracellular signal-regulated kinase and transcription factor NF-κB. Furthermore, brazilin concentration-dependently attenuated cell adhesion molecules (ICAM-1 and VCAM-1) expression induced by various concentrations of HG in HUVEC. Taken together, the present data suggested that brazilin could suppress high glucose-induced vascular inflammatory process, which may be closely related with the inhibition of oxidative stress, CAMs expression, and NF-κB activation in HUVEC. Our findings may highlight a new therapeutic intervention for the prevention of vascular diseases.

We investigated the effects of a room temperature-emitting far infrared ray ceramic material (BIOCERAMIC) on computer work-related pain and coldness. Thirty-two computer users reporting complaints in upper extremities and shoulders were assigned to play 30-cycles of specially-designed computer game. Each subject was provided with a normal and BIOCERAMIC-made mouse for the game on two different days. When using BIOCERAMIC mouse for the computer game, the most significant improvements among the upper extremity complaints were for wrist, finger, forearm, and partially shoulder soreness. Greater differences in surface temperatures of mouse and hand in BIOCERAMIC group were seen. The most significant difference occurred when using both the BIOCERAMIC cover and bracelet were found to reduce pain sensations. It was concluded that pain intensity and disability were significantly reduced after using BIOCERAMIC mouse for the game. The effect remained during follow-up when using BIOCERAMIC mouse cover and bracelet during their usual computer work.

Background Tuberculosis (TB) control remains a challenge in Malawi despite the National TB Control Program since 1984. This study aimed at measuring patient and health system delays and identifying factors associated with these delays. Methods A cross-sectional survey of 588 pulmonary TB patients was conducted in three TB centres in Blantyre, Lilongwe, and Mzuzu, between July and December 2011 using a semi-structured questionnaire. Patient delay was defined as the time interval between the onset of TB symptom(s) (a common symptom being coughing) to the first visit to any health provider. Health system delay was the interval from the first care-seeking visit at any health provider to the initiation of anti-tuberculosis treatment. Participants were invited to participate in the study during intensive phase of treatment. The characteristics associated with patient and health system delays were analyzed. Results The median patient delay was 14 days for both new and retreatment TB cases (interquartile range [IQR] 14 – 28 and 7 – 21, respectively). The median health system delay was 59 days (IQR 26 – 108) for new and 40.5 days (IQR 21–90) for retreatment cases. Factors associated with longer patient delay in new cases included primary education (adjusted odds ratio [AOR] 2.2, 95% CI 1.3 – 3.9) and knowledge that more than three weeks of coughing is a sign of TB (AOR 1.9, 1.1 – 3.3). In retreatment cases, distance >10 Km (AOR 3.3, 1.1 – 9.6) and knowledge that more than three weeks of coughing is a sign of TB (AOR 3.7, 1.3 – 10.7; p < 0.05) were significant factors. Making the first visit to a health centre (OR 1.9, 0.9 – 3.8) or a drug store/ traditional healer (OR 5.1, 1.1 – 21.7) in new TB cases were associated with a longer health system delay (p < 0.05) while smear negative (OR 6.4, 1.5 – 28.3), and smear unknown or not done (OR 6.1, 1.3 – 26.9) among retreatment cases were associated with a longer health system delay (p < 0.05). Conclusions Effective management and new diagnostic techniques are needed especially among retreatment cases. It is also needed to address geographic barriers to accessing care and increasing TB awareness in the community.

The mechanisms of acupuncture remain poorly understood, but it is generally assumed that measuring the electrical conductivity at various meridians provides data representing various meridian energies. In the past, noninvasive methods have been used to stimulate the acupuncture points at meridians, such as heat, electricity, magnets, and lasers. Photoluminescent bioceramic (PLB) material has been proven to weaken hydrogen bonds and alter the characteristics of liquid water. In this study, we applied the noninvasive PLB technique to acupuncture point irradiation, attempting to detect its effects by using electrical conductivity measurements. We reviewed relevant literature, searching for information on meridians including their wave-induced flow characteristics.

The rapid rise of diabetes in Asia and Africa is surpassing that of western countries. Diabetes incurs a significant financial burden on patients and national economies. Consequently, factors such as a miserable life-long treatment of hypoglycemic therapy and the possibility of drug intolerance necessitate a search for non-pharmacological alternatives to reduce the requirement of anti-diabetic drugs. Photoluminescence refers to materials that absorb light energy and then release that energy in the form of light. In this study, Photoluminescence of Bioceramic Materials (PLB) was applied to control hyperglycemia and glycosuria in diabetes from the bench to the clinical bedside examination. The PLB treatments resulted in a tendency to promote glucose diffusion into C2C12 cell line and show a significant decrease in glycosuria in STZ (streptozotocin) induced diabetic rats. The possible mechanisms of the PLB effects on hyperglycemia also correlate with our previous publication and include molecular diffusion, calcium dependent nitric oxide, suppression of oxidative stress and autonomous nervous system regulation. In the future, PLB may have the role of clinical applications on ameliorating hyperglycemia and improving diabetes-related complications.

BIOCERAMIC have been found to modulate various biological effects. Our earlier published research on various cell lines demonstrated that BIOCERAMIC promoted microcirculation, upregulated calcium-dependent nitric oxide and calmodulin, and exerted an antioxidant effect by increasing hydrogen peroxide scavenging ability. The development of pain relief systems requires most possible minimum doses and methods for effective local control of pain, so as to protect liver and renal function. There is also clinical necessary to develop targeted delivery of estrogen inhibitor in the breast using a local drug release system, to protect the breast from the increased cancer risk associated with the use of estrogen therapy. We compared the viscosity of BIOCERAMIC irradiated water and control water, and found that BIOCERAMIC might weaken the hydrogen bonds. Such breaks are caused by the loss of hydrogen bond covalence resulting from electron rearrangement. The purposes of this study were thus to investigated a transdermal drug delivery model using Franz cell apparatus for Indomethacin and Tamoxifen. The results showed that BIOCERAMIC enhanced the diffusion and permeability of the drugs. Therefore, we suggest that BIOCERAMIC might enhance the penetration performed by hydrogen bond weakening due to physical induction, and may facilitate local drug delivery in transdermal systems.

Chronic Venous Insufficiency (CVI) in the lower limb is commonly associated with varicose veins. In Asian countries, demand has increased for Medical Elastic Compression Stockings (MECS) as conservative treatment for varicose veins and CVI; however, their efficacy requires further investigation. The legs of 726 Taiwanese participants were measured, and MECS were designed and manufactured accordingly. Manufacturing processes included “fixation of the elastic fiber,” “design of the fabric,” “application of techniques for high-pressure stockings,” and “application of techniques for configuration.” Further techniques used for the production of functional MECS included “elastic yarn composite techniques,” “incremental pressure fabric weaving,” and “pressure shaping of fabrics.” Parameters for the mechanical testing of MECS included size measurement, extensibility, practical elongation, compression, and residual pressure on corresponding points of the leg. Clinical assessments and Magnetic Resonance Imaging (MRI) analyses using noncontract-enhanced Magnetic Resonance Venous (MRV) techniques were also performed on 100 participants with varicose veins pre-and post-MECS use. The average circumferences and lengths of specific points of the lower legs of the 726 participants were smaller than U.S. measurements by approximately 12% to 19%. This suggested that Taiwanese - and possibly Asian - MECS should not be manufactured according to Western sizes. Subjective clinical questionnaire results included relief of symptoms of heaviness of the legs, spasticity in the evenings, and convulsion during sleep. According to MRV analyses, deep venous blood flow increased significantly (relief of high pressure), and available hemoglobin in the deep vein increased (reduced tissue hypoxia) post-MECS use. Our findings provide important reference material for the establishment of Taiwanese and Asian standards for MECS. Results from clinical and MRV analyses confirmed the efficacy of prolonged use of MECS, with results indicating that 4 h/d and 112 h of use is sufficient to improve deep venous insufficiency.

Background and Aims□ Maternal employment during pregnancy has been considered to be associated with prematurity and low birth weight. However, little is known about the effect of maternal employmen...

BackgroundHow to decide the proper time to do laparotomies for acute appendicitis patients is sometimes very difficult, especially in areas with no imaging diagnostic tools. The Alvarado scoring system (ASS) is a convenient and inexpensive decision making tool; however, its accuracy needs to be improved. The decision tree is the most frequently used data mining technology for diagnostic model building. This study used a decision tree to modify the ASS and to prioritize the variables.MethodsWe collected 532 patients who underwent appendectomy. Patients who had undergone incidental appendectomy were excluded from the study. The decision tree algorithm was constructed with the data mining workbench Clementine version 8.1. It is a top-down algorithm designed to generate a decision tree model with entropy. The algorithm chooses the best decision node with which to separate different classes from empirical data. The Wilcoxon signed rank test, Student t test and χ2 test were used for statistical analysis.ResultsAmong the 532 patients recruited into the study, 420 had acute appendicitis and 112 had normal appendix. Women with acute appendicitis were older than their male counterparts (p < 0.001). All patients had right lower quadrant tenderness. The new model was constructed with decision tree technology, and the accuracy of the diagnostic rate was better than that of ASS (p < 0.001). The sensitivity and specificity of the new model were 0.945 and 0.805, respectively.ConclusionThe new model is more convenient and accurate than ASS. Right lower quadrant tenderness is an inclusion criterion for acute appendicitis diagnosis. Migrating pain and neutrophil count > 75% were significant factors for acute appendicitis diagnosis if ASS score < 6. Although the criteria of nausea/vomiting and white blood cell count > 10,000/dL were significantly different between acute appendicitis and normal appendix, there was no significant contribution of entropy change below the “neutrophil count > 75%“ nodes in the model. So they were erased from the decision tree model. Further studies need to be conducted to investigate why older women are at higher risk for acute appendicitis.

Previous research has identified that ceramic far infrared (cFIR)-emitting material can modulate various biological processes, particularly those involving hydrogen peroxide scavenging and antioxidant activities. The present study treated MCF-10A cells with 50 and 100 μM hydrogen peroxide before incubating them for 24 h on the top of The present study treated MCF-10A cells with 50 and 100 μM hydrogen peroxide before incubating them for 24 h on the top of cFIR or control powder. cFIR or control powder. Cells were also treated with ionizing radiation from a fluoroscopic X-ray source to induce cell damage and cultured for 48 h beneath cFIR or control powder. The effects of cFIR on cell survival were evaluated using XTT and MTT assays. A total accumulated radiation dose of 1 Gy to 2 Gy was sufficient to cause cell damage and reduce cell viability. In both the hydrogen peroxide toxicity and radiation exposure experimental models, the cFIR groups demonstrated significantly higher cell survival rates than those of the control groups (p＜0.05). Considering the relationship between indirect-ionizing-radiation- and oxidative-stress-induced cell damage and the accumulation of free radicals, these results indicate that the protection of cFIR against ionizing radiation is predominantly through an antioxidant mechanism. cFIR-emitting material has potential use in reducing radiation damage caused by medical instruments and radiation pollution.