Background: and Purpose While excessive daytime sleepiness can predate Parkinson’s disease in late-life, its association with parkinsonian-like (P-L) symptoms in middle age are unknown. Since neurodegeneration can appear decades before a diagnosis of Parkinson’s disease, identifying clinical features associated with this early progression is important. The purpose of this study was to determine the association of daytime sleepiness with P-L symptoms in a population-based sample of middle-aged Korean adults. Methods: During 2013 and 2014, daytime sleepiness and P-L symptoms were assessed in 2,063 males and females aged 50–64 years who were participating in the Korean Genome and Epidemiology Study. The severity of daytime sleepiness was quantified by the score on the Epworth Sleepiness Scale (ESS). Self-reported P-L symptoms included nine motor disorders commonly associated with Parkinson’s disease. Participants with parkinsonism and related conditions are excluded. Results: The prevalence of excessive daytime sleepiness (ESS score >10) was 7.0%. The frequencies of P-L symptoms ranged from 0.5% (for “trouble buttoning buttons”) to 18.4% (for “handwriting smaller than it once was”). After adjustment for covariates and multiple testing, the relative odds of P-L symptoms comparing the 80th and 20th percentiles of ESS scores was 1.6 (p=0.001) for “voice is softer than it once was,” 2.1 (p<0.001) for “balance when walking is poor,” and 1.5 (p=0.002) for “loss of facial expression.” The prevalence of excessive daytime sleepiness increased from 6.3% to 19.8% when the number of symptoms increased from zero to three (p=0.004). Conclusions In Korean adults aged 50–64 years, daytime sleepiness is significantly associated with P-L symptoms. Whether coexisting daytime sleepiness and P-L symptoms predate extrapyramidal and other impairments in later life warrants further investigation.

BACKGROUND: We have previously demonstrated that phorbol myristate acetate (PMA)-induced increases in melanoma cell binding to endothelial cells derived from human dermis (HDMEC) are not mediated via known cell adhesion molecules and may be affected through microvessel-specific novel proteins not previously described on endothelial cells. OBJECTIVE: This study was performed to identify new molecules which may play a role in HDMEC-melanoma cells binding. METHODS: We have generated a monoclonal antibody(Mab) against PMA-stimulated HDMEC. A Mab was evaluated functionally through melanoma cell-endothelial cell adherence assay and characterized by Western immunoblot. RESULTS: Mab EM-71 recognized a molecule with expression levels in vitro that could be upregulated by PMA(EM-71 molecule). The expression of EM-71 molecule on HDMEC was increased in a dose-dependent manner by PMA only, but not affected by interleukin 1 alpha(IL-lα) or tumor necrosis factor alpha(TNFα) PMA augmented melanoma cell adherence to HDMEC, which is coincident with an increase in EM-71 molecule expression on HDMEC by PMA. Mab EM-71 partially inhibited up to 59% of the increased melanoma cell binding to PMA-stimulated HDMEC and failed to block melanoma cell binding to IL-lα or TNFα-stimulated HDMEC. Western immunoblots of lysates of HDMEC demonstrated a 200 kDa protein on HDMEC. CONCLUSION: This study demonstrates that EM-71 molecule may play a partial role in melanoma binding to PMA-stimulated HDMEC.
Blotting, Western ; Cell Adhesion Molecules ; Dermis ; Endothelial Cells* ; Humans* ; In Vitro Techniques ; Interleukin-1 ; Melanoma* ; Tetradecanoylphorbol Acetate ; Tumor Necrosis Factor-alpha

No abstract available.
Animals ; Magnetic Resonance Spectroscopy* ; Rats* ; Skin*

Mammary gland development and function would not be possible without tissue-specific stem cells. The mammalian reproductive cycles of pregnancy-associated proliferation, lactational differentiation, apoptosis and remodelling following weaning may occur many times during a female's reproductive years. Such processes necessitate a population of tissue-specific stem cells that have a near unlimited capacity to generate the short-lived, differentiated breast cells. In contrast to the functional cells, breast stem cells must last throughout the life of an organism. Because of this longevity, stem cells may accumulate genetic alterations that eventually lead to cancer. Breast tumors contain a population with stem-cell characteristics. Current tumour therapy modalities target proliferative cells, and be successful in causing tumor regression. Targeting these tumor stem cells will be an important goal of future research.
Apoptosis ; Breast Neoplasms ; Breast* ; Longevity ; Mammary Glands, Human ; Neoplastic Stem Cells ; Stem Cells* ; Weaning

BACKGROUND/AIMS: Transient receptor potential vanilloid-1 (TRPV1) is a candidate for mediating acid-induced symptoms in the esophagus. We conducted studies to determine if the presence of acid in the mucosa/submucosa and direct activation of TRPV1 by capsaicin elicited symptoms in normal healthy subjects. We also studied the presence of TRPV1 receptors in the esophagus. METHODS: Unsedated endoscopy was performed on healthy subjects with no symptoms. Using a sclerotherapy needle, normal saline (pH 2.0-7.5) was injected into the mucosa/submucosa, 5 cm above the Z line. In a separate group of healthy subjects, injection of capsaicin and vehicle was also studied. Quality of symptoms was reported using the McGill Pain Questionnaire, and symptom intensity using the visual analogue scale (VAS). Immunohistochemistry was performed on 8 surgical esophagus specimens using TRPV1 antibody. RESULTS: Acid injection either did not elicit or elicited mild symptoms in subjects at all pH solutions. Capsaicin but not the vehicle elicited severe heartburn/chest pain in all subjects. Mean VAS for capsaicin was 91 ± 3 and symptoms lasted for 25 ± 1 minutes. Immunohistochemistry revealed a linear TRPV1 staining pattern between the epithelial layer and the submucosa that extended into the papillae. Eighty-five percent of papillae stained positive for TRPV1 with a mean 1.1 positive papillae per high-powered field. CONCLUSIONS: The mechanism of acid-induced heartburn and chest pain is not the simple interaction of hydrogen ions with afferents located in the esophageal mucosa and submucosa. TRPV1 receptors are present in the lamina propria and their activation induces heartburn and chest pain.
Capsaicin* ; Chest Pain ; Endoscopy ; Esophagus ; Healthy Volunteers ; Heartburn ; Hydrogen-Ion Concentration ; Immunohistochemistry ; Mucous Membrane ; Needles ; Negotiating ; Pain Measurement ; Protons ; Sclerotherapy

Objective: Primary sarcoma of the cervix is rare and is associated with worse outcomes as compared to other histologies. The purpose of this study was to identify national treatment patterns and outcomes based on histological subtype using the National Cancer Database (NCDB). Methods: The NCDB was queried for patients with cervical cancer from 2004–2015. Clinico-demographic treatment details were obtained and compared between patients with squamous cell carcinoma (SCC), adenocarcinoma, and sarcoma of the cervix. Multivariable Cox regression and the Kaplan-Meier method was used to examine survival. Results: 107,177 patients met inclusion criteria including 81,245 (75.8%) women with SCC, 24,562 (22.9%) women with adenocarcinoma, and 1,370 (1.3%) women with sarcoma. Of the patients with cervical sarcoma, 680 (49.6%) patients had carcinosarcoma or malignant mixed Müllerian tumor, 255 (18.6%) patients had leiomyosarcoma, 197 (14.4%) patients had adenosarcoma, 28 (2.0%) patients had endometrial stromal sarcoma (ESS), 85 (6.2%) patients had rhabdomyosarcoma, and 125 (9.1%) patients had sarcoma not otherwise specified (NOS). Patients with sarcoma were older and more likely to be treated primarily with surgery. On multivariable Cox regression, sarcoma had decreased overall survival (OS) as compared to patients with SCC (hazard ratio=2.17; 95% CI=1.99–2.37; p<0.001). Among patients with sarcoma, 5-year OS was 89.2% for adenosarcoma, 66.2% for rhabdomyosarcoma, 55.6% for leiomyosarcoma, 45.8% for ESS, 31.6% for carcinosarcoma, and 29.2% for sarcoma NOS. Conclusions Primary cervical sarcomas have inferior outcomes compared to SCC and adenocarcinoma. Sarcoma NOS and carcinosarcoma have the worst prognosis among sarcoma subtypes.

Objective: Melanoma comprises 5% to 10% of vulvar cancers and prognosis is poor. The purpose of this study was to identify prognostic factors and treatment patterns for vulvar melanoma using the National Cancer Database (NCDB). Methods: The NCDB was queried for patients with invasive vulvar melanoma from 2004–2015. Descriptive statistics were generated to describe clinical and treatment details.Multivariable Cox regression and the Kaplan-Meier method were used to examine overall survival (OS). Results: 1,917 patients with vulvar melanoma met inclusion criteria. Median follow-up time was 32 months (range, 0–151 months). Older age, larger tumor size, advanced disease stage, increased Charlson-Deyo comorbidity score, and care at a non-academic center were independent predictors for decreased OS. Surgical management of the primary site, lymph node surgery, and insurance provided a significant survival benefit. Use of immunotherapy for vulvar melanoma has increased over time. Two-year OS with immunotherapy in patients with distant metastatic disease was higher, although this did not reach statistical significance (33% vs. 12%, p=0.054). Conclusions Vulvar melanoma has a poor prognosis for those with regional and distant metastatic disease. Extent of disease, tumor size, and patient age are important prognostic factors. Other favorable factors included insurance and surgical management. The use of immunotherapy has increased over time and may improve survival in those with distant disease. These data support further investigation into the role of immunotherapy for vulvar melanoma to optimize outcomes.

House dust mite sensitized asthmatics are advised to practice allergen avoidance. Charcoal pillows are used in Korea with unsubstantiated claims regarding their efficacy in alleviating asthma symptoms. We tested the effects of activated charcoal on breeding of house dust mites in culture. Twenty live adult house dust mites (Dermatophagoides pteronyssinus) were inoculated, 10 replicates, on culture media containing 0%, 1%, 3%, 5%, 10%, and 20% activated charcoal and incubated at 25 degrees C and a relative humidity of 75%. After four weeks, the mean numbers of live house dust mites were 286, 176, 46, 16, 7, and 0 for the 0%, 1%, 3%, 5%, 10%, and 20% charcoal-containing culture media, respectively. Thus, activated charcoal suppresses breeding of house dust mites and offers a new promising method for house dust mite control.
Pyroglyphidae/*drug effects/*growth & development ; *Pesticides ; Dose-Response Relationship, Drug ; Charcoal/*administration & dosage ; Breeding ; Animals

No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans

BACKGROUND AND PURPOSE: Vascular shear stress is essential for maintaining the morphology and function of endothelial cells. We hypothesized that shear stress in the internal carotid artery (ICA) may differ between patients with ischemic stroke and healthy control subjects. METHODS: ICA shear stress was calculated in 143 controls and 122 patients with ischemic stroke who had a normal ICA or an ICA with <50% stenosis. The stroke group included patients who presented with a first-ever or recurrent ischemic stroke but excluded cardioembolic stroke and uncertain etiologies. Of the 122 patients, 107 (87.7%) and 15 (12.3%) patients were categorized as first-ever and recurrent stroke, respectively. RESULTS: Carotid diameters were significantly larger, and both peak-systolic and end-diastolic velocities were significantly lower in patients with ischemic stroke than in controls (all p values <0.05). Mean values of peak-systolic and end-diastolic shear stress in both ICAs were significantly lower in patients with ischemic stroke in models that adjusted for age, sex, and vascular risk factors (p for trend <0.05). The ICA shear stress was lowest in patients with recurrent stroke or the subtype of small-vessel occlusion. Higher peak-systolic and end-diastolic shear stresses in both ICAs were independently and negatively associated with ischemic stroke after adjusting for potential confounders (all p values <0.05). CONCLUSIONS: ICA shear stresses were significantly lower in patients with ischemic stroke than in control subjects. Future studies should attempt to define the causal relationship between carotid arterial shear stress and ischemic stroke.
Carotid Arteries* ; Carotid Artery, Internal ; Constriction, Pathologic ; Endothelial Cells ; Hemodynamics ; Humans ; Risk Factors ; Stroke*