PURPOSE: Most surviving pediatric osteosarcoma patients experience osteoporosis, bone pain, and pathologic fracture during and after therapy. The aim of this study was to evaluate the efficacy and side effects of pamidronate therapy in these patients. METHODS: Nine osteosarcoma patients (12.8±1.6 years of age; 5 boys and 4 girls) who had a history of nontraumatic fracture or severe pain after completing chemotherapy were included. Intravenous pamidronate (1.5 mg/kg) was given every 6 weeks for 4 to 6 cycles. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy x-ray absorptiometry. Clinical outcomes including acute side effects were also evaluated. RESULTS: After pamidronate treatments, all patients experienced decreased pain. Seven of 9 patients could walk without a crutch. The BMD of lumbar spine was increased by 0.108±0.062 mg/cm2 after 8.4±1.0 months (n=8, P=0.017) and the mean z-score improved from -2.14±0.94 to -1.76±0.95 (P=0.161). Six patients (67%) had an acute-phase reaction, and 2 patients had symptomatic hypocalcemia. CONCLUSION: Pamidronate appears to be safe and effective for the treatment of osteosarcoma in children with low BMD and bone pain.
Absorptiometry, Photon ; Acute-Phase Reaction ; Bone Density* ; Child ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Hypocalcemia ; Osteoporosis ; Osteosarcoma* ; Spine

PURPOSE: Laparoscopic gastrectomy is widely used to treat early gastric cancer. The advantages of totally laparoscopic distal gastrectomy (TLDG) are unproven, and some concerns remain regarding the early surgical outcomes due to its technical difficulty. We compared the early surgical outcomes and acute inflammatory response between patients undergoing TLDG and laparoscopy-assisted distal gastrectomy (LADG) for treatment of early gastric cancer. METHODS: We performed a retrospective study on 212 consecutive patients who underwent laparoscopic distal gastrectomy for gastric cancer between January 2008 and June 2014. A total of 179 LADG cases and 33 TLDG cases were included. After age, sex, body mass index, and American Society of Anesthesiologists physical status score were matched using propensity score matching (PSM), we compared the short-term surgical outcomes between the LADG and TLDG groups. RESULTS: The TLDG group had a shorter hospital stay (9.5 days vs. 11.0 days, P = 0.046) and less blood loss (116.6 mL vs. 141.5 mL, P = 0.031) than those in the LADG group. There were no differences in the preoperative WBC count and CRP level and the other clinical data between the two groups after PSM. Postoperative WBC count, serum CRP level, and decrease rate of WBC count in the TLDG group were significantly lower than those in the LADG group. CONCLUSION: The short-term outcomes of TLDG revealed better than that of LADG in this study. Therefore, TLDG is one of the safe and feasible procedure for the treatment of early gastric cancer.
Acute-Phase Reaction ; Body Mass Index ; Gastrectomy* ; Humans ; Laparoscopy ; Length of Stay ; Propensity Score ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: The purpose of this study was to compare serum amyloid A (SAA) protein levels with high-sensitive C-reactive protein (hs-CRP) levels as markers of systemic inflammation in patients with chronic periodontitis. The association of serum titers of antibodies to periodontal microbiota and SAA/hs-CRP levels in periodontitis patients was also studied. METHODS: A total of 110 individuals were included in this study. Patients were assessed for levels of hs-CRP and SAA. Nonfasting blood samples were collected from participants at the time of clinical examination. The diagnosis of adipose tissue disorders was made according to previously defined criteria. To determine SAA levels, a sandwich enzyme-linked immunosorbent assay was utilized. Paper points were transferred to a sterile tube to obtain a pool of samples for polymerase chain reaction processing and the identification of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia. The serum level of IgG1 and IgG2 antibodies to P. gingivalis, A. actinomycetemcomitans, and T. forsythia was also determined. RESULTS: SAA and hs-CRP levels were higher in periodontitis patients than in controls (P<0.05). In bivariate analysis, high levels of hs-CRP (>3 mg/L) and SAA (>10 mg/L) were significantly associated with chronic periodontitis (P=0.004). The Spearman correlation analysis between acute-phase proteins showed that SAA positively correlated with hs-CRP (r=0.218, P=0.02). In the adjusted model, chronic periodontitis was associated with high levels of SAA (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.6-18.2; P=0.005) and elevated hs-CRP levels (OR, 6.1, 95% CI, 1.6-23.6; P=0.008). Increased levels of serum IgG2 antibodies to P. gingivalis were associated with high levels of SAA (OR, 3.6; 95% CI, 1.4-8.5; P=0.005) and high concentrations of hs-CRP (OR, 4.3; 95% CI, 1.9-9.8; P<0.001). CONCLUSIONS: SAA and hs-CRP concentrations in patients with chronic periodontitis are comparably elevated. High serum titers of antibodies to P. gingivalis and the presence of periodontal disease are independently related to high SAA and hs-CRP levels.
Acute-Phase Proteins ; Adipose Tissue ; Aggregatibacter actinomycetemcomitans ; Antibodies ; C-Reactive Protein* ; Chronic Periodontitis ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Forsythia ; Humans ; Immunoglobulin G ; Inflammation ; Microbiota ; Periodontal Diseases ; Periodontitis* ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; Serum Amyloid A Protein*

OBJECTIVETo explore whether the amount of lipocalin-2 in the biofluid could reflect the onset of sepsis-induced acute lung injury (ALI) in mice.

METHODSLipopolysaccharide (LPS, 10 mg/kg) injection or cecal ligation and puncture (CLP) was performed to induce severe sepsis and ALI in C57 BL/6 male mice randomly divided into 5 groups (n=10 in each group): group A (intraperitoneal LPS injection), group B (intravenous LPS injection via tail vein), group C (CLP with 25% of the cecum ligated), group D (CLP with 75% of the cecum ligated), and the control group (6 sham-operation controls plus 4 saline controls). All the mice received volume resuscitation. Measurements of pulmonary morphological and functional alterations were used to identify the presence of experimental ALI. The expressions of lipocalin-2 and interleukin (IL)-6 in serum, bronchoalveolar lavage fluid (BALF), and lung tissue were quantified at both protein and mRNA levels. The overall abilities of lipocalin-2 and IL-6 tests to diagnose sepsis-induced ALI were evaluated by generating receiver operator characteristic curves (ROC) and computing area under curve (AUC).

RESULTSIn both group B and group D, most of the main features of experimental ALI were reproduced in mice, while group A and group C showed septic syndrome without definite evidence for the presence of ALI. Compared with septic mice without ALI (group A+group C), lipocalin-2 protein expression in septic mice with ALI (group B+group D) was significantly up-regulated in BALF (P<0.01) and in serum (P<0.01), and mRNA expression boosted in lung tissues (all P<0.05). Lipocalin-2 tests performed better than IL-6 tests in recognizing sepsis-induced ALI cases, evidenced by the larger AUC of the former (BALF tests, 0.8800 versus 0.6625; serum tests, 0.8500 versus 0.7000). Using a dual cutoff system to diagnose sepsis-induced ALI, BALF lipocalin-2 test exhibited the highest positive likelihood ratio (13.000) and the lowest negative likelihood ratio (0.077) among the tests of lipocalin-2 and IL-6 in blood and BALF. A statistically significant correlation was found between lipocalin-2 concentration in BALF and that in serum (Spearman r=0.8803, P<0.0001).

CONCLUSIONSLipocalin-2 expression is significantly up-regulated in septic ALI mice compared with those without ALI. Lipocalin-2 tests with a dual cutoff system could be an effective tool in distinguishing experimental ALI cases.

Acute-Phase Proteins ; metabolism ; Animals ; Base Sequence ; Bronchoalveolar Lavage Fluid ; DNA Primers ; Lipocalin-2 ; Lipocalins ; metabolism ; Lung Injury ; complications ; diagnosis ; Male ; Mice ; Mice, Inbred C57BL ; Oncogene Proteins ; metabolism ; Real-Time Polymerase Chain Reaction ; Sepsis ; complications

OBJECTIVETo determine the safety and efficacy of fresh frozen plasma (FFP) infusion for the treatment of hereditary angioedema (HAE).

METHODSThe medical records of patients with HAE admitted to Peking Union Medical College Hospital who had received FFP infusion during 2004 and 2010 were reviewed and PubMed database from 1966 to the present were searched using the following hereditary angioedema and fresh frozen plasma. The patient's age, sex, body location of HAE attacks, the dose of FFP infusion, time of beginning to improvement, time to complete remission, complication, C1 inhibitor activity, and outcome were analyzed.

RESULTSA total of 13 enrolled patients (7 male and 6 female) received 16 times of FFP infusion, including 2 patients undergoing FFP infusion in Peking Union Medical College Hospital and 11 patients reported in the literature. The mean dosage of FFP infusion was 586∓337 mL. Two cases suffered from worsening abdominal pain and one case experienced skin rash. Only 1 patient had no improvement in symptom owing to transfusion related reaction. There was a definite improvement in symptom 49∓19 minutes after beginning FFP infusion. The remission time decreased from 61.7∓27.0 hours to 3.3 (2.0, 12.0) hours after FFP infusion. FFP infusion was effective for both type I and type II HAE.

CONCLUSIONFFP seems to be safe and effective for acute attacks of HAE.

Acute-Phase Reaction ; therapy ; Adolescent ; Adult ; Aged ; Angioedemas, Hereditary ; blood ; therapy ; Blood Transfusion ; methods ; Child ; Female ; Humans ; Male ; Middle Aged ; Plasma ; physiology ; Retrospective Studies ; Transfusion Reaction ; Treatment Outcome ; Young Adult

The purpose of our study was to investigate changes in immunological parameters induced by weaning stress (including milk restriction) in calves. Fifteen Holstein calves were subjected to weaning at 6 weeks of age. Blood samples were collected at -14, -7, -2, 1, 3, and 5 days post-weaning (DPW; 0 DPW = 42 days). Weaning caused significant (p < 0.01) increases in the neutrophil (NE):lymphocyte (LY) ratio at 5 DPW with a significant (p < 0.05) reduction of LYs. The concentration of acute-phase proteins (haptoglobin and serum amyloid A) also increased significantly (p < 0.05) at 3 and 5 DPW compared to -2 DPW. Levels of the iron-binding protein lactoferrin decreased significantly (p < 0.05) after weaning. Serum tumor necrosis factor-alpha and cortisol levels were elevated (p < 0.05) at 3 DPW, while those of serum interferon-gamma decreased (p < 0.05) at 1 and 3 DPW compared to levels observed before weaning. Weaning significantly (p < 0.05) decreased the percentage of CD25+ T cells in the peripheral blood. In conclusion, weaning stress affected the NE:LY ratio along with the levels of acute phase proteins, lactoferrin, cortisol, and inflammatory cytokines in the peripheral blood of calves. Weaning stress may induce an acute phase response possibly through the elevation of cortisol production and modulation of inflammatory cytokines.
Acute-Phase Proteins/*immunology/metabolism ; Acute-Phase Reaction/immunology/*veterinary ; Animals ; Cattle/*immunology ; Female ; Flow Cytometry ; Haptoglobins/analysis/immunology ; Hydrocortisone/blood/immunology ; Interferon-gamma/blood/immunology ; Lactoferrin/analysis/immunology ; Leukocyte Count/veterinary ; Leukocytes/cytology/*immunology ; Male ; Serum Amyloid A Protein/analysis/immunology ; Stress, Physiological/*physiology ; Tumor Necrosis Factor-alpha/blood/immunology ; Weaning

OBJECTIVE: Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. This study was designed to analyze the rate of acute phase reaction (APR) following Zoledronate 5 mg administration in patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks and to compare naive IV 5 mg Zoledronate. METHODS: Between July 2009 and October 2010, 27 patients with osteoporosis who were treated with prior oral bisphosphonate for at least 2 weeks, and maximum 52 weeks (average 18.5 weeks) and were between 42-and 85-year-old at the time of study participation. We prospectively evaluated APR, including fever, flu-like symptoms, headache, arthralgia, and myalgia, after 5 mg zoledronate by questionnaire. Additionally we assessed a visual analogue scale (VAS) by 4-point categorical scale. RESULTS: In this study of 27 patients with osteoporosis, the frequency of APR, flu-like symptom and myalgia were 14.8% and 7.4% and fever, arthralgia, and headache were 3.7% respectively. In VAS, all reactions were mild. The rate of APR rate in this study was statistically decreased compared to previous reports with zoledronate 5 mg IV in bisphosphonate-naive patients. CONCLUSION: Prior oral bisphosphonate administration for at least 2 weeks could significantly reduce the APR of IV zoledronate 5 mg.
Acute-Phase Reaction ; Aged, 80 and over ; Arthralgia ; Diphosphonates ; Fever ; Headache ; Humans ; Imidazoles ; Osteoporosis ; Prospective Studies ; Surveys and Questionnaires

To find out which biomaterial had the best biocompatibility, we compared the acute phase reaction of common biomaterials preparing for vascular grafts with the material of polyurethane modified by silk fibroin (SF-PU(1:1)). After transplanted the materials of dacron, polyterafluoroethylene (e-PTFE), polyurethane (PU), SF-PU(1:1) in rat muscle for one week, we studied the influence of different biomaterials on the histocompatibility by using rat acute toxicity test, test of local reaction in muscle, tissue section staining, WBC and PLT count. As a result, dacron had the worst histocompatibility. The other biomaterials had slight local inflammatory reaction. The WBC and PLT was nearly the same with the blank except dacron. e-PTFE, pure PU and SF-PU(1:1) had the better histocompatibility than traditional dacron. Especially SF-PU(1:1) had the best histocompatibility. Because of the better physical properties and histocompatibility of SF-PU( 1:1), the prospect of preparing small-diameter vascular grafts with SF-PU was cheerful.
Acute-Phase Reaction ; Animals ; Biocompatible Materials ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; Female ; Fibroins ; chemistry ; Implants, Experimental ; Macromolecular Substances ; chemistry ; Male ; Materials Testing ; methods ; Muscle, Skeletal ; physiology ; Polyurethanes ; chemistry ; Prosthesis Design ; Random Allocation ; Rats ; Rats, Sprague-Dawley

In a previous search for the differentially expressed genes in keratinocyte differentiation, we identified neutrophil gelatinase-associated lipocalin (NGAL) as a calcium- induced gene. In this study, we further verified the expression of NGAL in cultured keratinocytes as well as in several skin diseases. Reverse transcription-polymerase chain reaction (RT-PCR), Western blot, and ELISA clearly showed that NGAL expression was markedly increased in calcium-induced keratinocyte differentiation in vitro. However, in our previous report, NGAL expression was not detected in normal skin tissue except for hair follicle by in situ hybridization and immunohistochemistry, indicating the difference of cell status between in vitro and in vitro conditions. Interestingly, NGAL expression was highly increased in psoriasis-like inflammatory disorders (lichen planus and pityriasis rubura pilaris) and skin cancers (keratoacanthoma and squamous cell carcinoma), implying that NGAL may be related with the epidermal hyperplasia. Collectively, these results reveal the potential importance of NGAL in the maintenance of skin homeostasis.
Acute-Phase Proteins/*biosynthesis ; Calcium/*metabolism ; Cell Differentiation ; Culture Media ; Culture Media, Conditioned ; Enzyme-Linked Immunosorbent Assay ; *Gene Expression Regulation ; Homeostasis ; Humans ; Keratinocytes/enzymology ; Lipocalins/*biosynthesis ; Models, Biological ; Proto-Oncogene Proteins/*biosynthesis ; Psoriasis/enzymology ; Reverse Transcriptase Polymerase Chain Reaction ; Skin/*metabolism ; Skin Neoplasms/enzymology

Carotid artery stenting is widely performed for extracranial carotid artery stenosis. In-stent thrombosis is a rare but potentially devastating complication. We present a case of acute in-stent thrombosis immediately following stent insertion and post-balloon dilatation in a 64-year-old male. Thrombosis was successfully treated by intravenous tirofiban, a glycoprotein IIb/IIIa receptor inhibitor.
Acute-Phase Reaction/*drug therapy/*pathology ; Angiography ; Carotid Artery Diseases/*drug therapy/*pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Stents ; Thrombosis/*drug therapy/*pathology ; Tyrosine/*analogs & derivatives/therapeutic use