Objective: This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. Methods: We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. Results: This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. Conclusion The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Objective: This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. Methods: We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. Results: This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. Conclusion The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

Sesquiterpene lactones, a class of natural compounds abundant in the Asteraceae family, have gained attention owing to their diverse biological activities, and particularly their anti-proliferative effects on human cancer cells. In this study, we systematically investigated the structure-activity relationship of ten sesquiterpene lactones with the aim of elucidating the structural determinants for the STAT3 inhibition governing their anti-proliferative effects. Our findings revealed a significant correlation between the STAT3 inhibitory activity and the anti-proliferative effects of sesquiterpene lactones in MDA-MB-231 breast cancer cell lines. Among the compounds tested, alantolactone and isoalantolactone emerged as the most potent STAT3 inhibitors, highlighting their potential as candidates for anticancer drug development. Through protein-ligand docking studies, we revealed the structural basis of STAT3 inhibition by sesquiterpene lactones, emphasizing the critical role of hydrogen-bonding interactions with key residues, including Arg609, Ser611, Glu612, and Ser613, in the SH2 domain of STAT3. Furthermore, our conformational analysis revealed the decisive role of the torsion angle within the geometry-optimized structures of sesquiterpene lactones in their STAT3 inhibitory activity (R=0.80, p<0.01). These findings not only provide preclinical evidence for sesquiterpene lactones as promising phytomedicines against diseases associated with abnormal STAT3 activation, but also highlight the importance of stereochemical aspects in their activity.

Advances in imaging modalities have provided useful information in diagnosing ampullary lesions such as adenoma and adenocarcinoma. Endoscopic retrograde cholangiopancreaticography (ERCP) have a role in the diagnosis of unexposed intra-ampullarylesion. We report an interesting case of adenocarinoma of the ampulla of Vater presenting as idiopathic recurrent pancreatitis. A 56 years old woman was referred due to idiopathic recurrent pancreatitis for 2 years. She presented abdominal pain and upper abdominal tenderness. Magnetic resonance cholangiopancreaticography (MRCP) revealed minimal bile and pancreatic ductal dilatation without obstruction. Subsequent ERCP revealed a small polypoid lesion which was exposed after endoscopic sphincterotomy. Endoscopic biopsy showed papillary adenoma with low grade dysplasia. Additional endoscopic papillectomy was performed. Endoscopic biopsy done 3 months later showed papillary adenoma with high grade dysplasia. Pylorus preserving pancreatoduodenectomy was done and final pathology was well differentiated adenocarcinoma. The patient was recovered well but received adjuvant chemotherapy due to metastatic lymph nodes.
Abdominal Pain ; Adenocarcinoma* ; Adenoma ; Ampulla of Vater ; Bile ; Biopsy ; Chemotherapy, Adjuvant ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Dilatation ; Female ; Humans ; Lymph Nodes ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pancreatitis* ; Pathology ; Pylorus ; Sphincterotomy, Endoscopic

Brunner's gland adenoma is a rare benign tumor that is usually asymptomatic and it the result of a benign proliferation of the Brunner's glands of the duodenum. In symptomatic patients, the common clinical presentation is gastrointestinal bleeding and obstructive symptoms. A 48-year-old man presented with abdominal discomfort and vomiting. The endoscopic examination revealed a large pedunculated polypoid mass arising in the bulb and it was prolapsing through the pylorus into the antrum, and this all resulted in a ball-valve obstruction. After endoclips were applied at the peduncle of the mass, this polyp was simply and successfully cut with using an IT-knife without bleeding or perforation. We report here on a case of Brunner's gland adenoma that caused a ball-valve obstruction, and the tumor was removed by a simple and easy method with using endoclips and an IT-knife.
Adenoma ; Brunner Glands ; Duodenum ; Hemorrhage ; Humans ; Middle Aged ; Polyps ; Pylorus ; Vomiting

PURPOSE: We investigated the relationship between BRCA mutations and the distribution of familial cancers other than breast or ovary in high-risk breast cancer patients. METHODS: Patients with breast cancer who had at least one of the following risk factors were enrolled: reported family history of breast or ovarian cancer; 40 years of age or younger age at diagnosis; bilateral breast cancer; or male gender. Genetic testing for BRCA mutation and questionnaires about personal and family histories of malignancies were performed. RESULTS: Among the 238 eligible patients, 49 (20.6%) patients had BRCA1/2 mutations, which were more frequent in patients with multiple risk factors (p<0.0001). There were 271 members of 156 (65.5%) families who had histories of other primary cancer. The distribution of the families was 119 (63.0%) and 37 (75.5%) in the BRCA-negative and positive group, respectively (p=0.0996). Multiple familial cancers occurred in 70 families, which were significantly more frequent in BRCA-positive families (p=0.0034). By ordinal logistic regression, the occurrence of multiple familial cancers was associated with BRCA mutations (p=0.0045), not with other risk factors. The most common site of disease was the stomach, which is the most common in nationwide. And the proportional incidence of pancreatic cancer (6.8%) was significantly higher than that of nationwide cancer statistics (2.4%, p=0.0137). CONCLUSION: BRCA mutations in high-risk breast cancer patients were associated with multiple risk factors and multiple family members with other primary cancers. Genetic counseling based on accurate information should be provided to families with BRCA mutation carriers.
Breast ; Breast Neoplasms ; Female ; Genetic Counseling ; Genetic Testing ; Humans ; Incidence ; Logistic Models ; Male ; Ovary ; Pancreatic Neoplasms ; Risk Factors ; Stomach ; Surveys and Questionnaires

Extracellular interleukin 1 alpha (IL-1α) released from keratinocytes is one of the endpoints for in vitro assessments of skin irritancy. Although cells dying via primary skin irritation undergo apoptosis as well as necrosis, IL-1α is not released in apoptotic cells. On the other hand, active secretion has been identified in interleukin-1 receptor antagonist (IL-1ra), which was discovered to be a common, upregulated, differentially-expressed gene in a microarray analysis performed with keratinocytes treated using cytotoxic doses of chemicals. This study examined whether and how IL-1ra, particularly extracellularly released IL-1ra, was involved in chemically-induced keratinocyte cytotoxicity and skin irritation. Primary cultured normal adult skin keratinocytes were treated with cytotoxic doses of chemicals (hydroquinone, retinoic acid, sodium lauryl sulfate, or urshiol) with or without recombinant IL-1ra treatment. Mouse skin was administered irritant concentrations of hydroquinone or retinoic acid. IL-1ra (mRNA and/or intracellular/extracellularly released protein) levels increased in the chemically treated cultured keratinocytes with IL-1α and IL-1β mRNAs and in the chemically exposed epidermis of the mouse skin. Recombinant IL-1ra treatment significantly reduced the chemically-induced apoptotic death and intracellular/extracellularly released IL-1α and IL-1β in keratinocytes. Collectively, extracellular IL-1ra released from keratinocytes could be a compensatory mechanism to reduce the chemically-induced keratinocyte apoptosis by antagonism to IL-1α and IL-1β, suggesting potential applications to predict skin irritation.
Adult ; Animals ; Apoptosis* ; Epidermis ; Hand ; Humans ; In Vitro Techniques ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1* ; Interleukin-1alpha ; Keratinocytes* ; Mice ; Microarray Analysis ; Necrosis ; RNA, Messenger ; Skin ; Sodium Dodecyl Sulfate ; Tretinoin