Background: Glutamate decarboxylase 1 (GAD1) which serves as a rate-limiting enzyme involving in the production of γ-aminobutyric acid (GABA), exists in the GABAergic neurons in the central nervous system (CNS).Little is known about the relevance of GAD1 to nasopharyngeal carcinoma (NPC).Through data mining on a data set derived from a published transcriptome database, this study first identified GAD1 as a differentially upregulated gene in NPC.We aimed to evaluate GAD1 expression and its prognostic effect on patients with early and locoregionally advanced NPC.Methods: We evaluated GAD1 immunohistochemistry and performed an H-score analysis on biopsy specimens from 124 patients with nonmetastasized NPC receiving treatment.GAD1 overexpression was defined as an H score higher than the median value.The findings of such an analysis are correlated with clinicopathological behaviors and survival rates, namely disease-specific survival (DSS), distant-metastasis-free survival (DMeFS), and local recurrence-free survival (LRFS) rates.Results: GAD1 overexpression was significantly associated with an increase in the primary tumor status (p < 0.001) and American Joint Committee on Cancer (AJCC) stages III-IV (p = 0.002) and was a univariate predictor of adverse outcomes of DSS (p = 0.002), DMeFS (p < 0.0001), and LRFS (p = 0.001).In the multivariate comparison, in addition to advanced AJCC stages III-IV, GAD1 overexpression remained an independent prognosticator of short DSS (p = 0.004, hazard ratio = 2.234), DMeFS (p < 0.001, hazard ratio = 4.218), and LRFS (p = 0.013, hazard ratio = 2.441) rates.Conclusions: Our data reveal that GAD1 overexpression was correlated with advanced disease status and may thus be a critical prognostic indicator of poor outcomes in NPC and a potential therapeutic target to facilitate the development of effective treatment modalities.
This study aimed to investigate the prognostic significance of DSG3 and its association with response to neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer.Data mining of a publicly available dataset was performed to find genes associated with CCRT response. Immunohistochemistry was applied to evaluate DSG3 expression. The relationships between DSG3 expression and various clinicopathological parameters and survival were analyzed.The DSG3 gene was significantly associated with CCRT response. The expression of DSG3 negatively correlated with poorer tumor regression (p < 0.001) and had an independent negative impact on disease-specific survival (p = 0.011), local recurrence-free survival (p = 0.031) and metastasis-free survival (p = 0.029).DSG3 was a key prognostic factor and predictor for CCRT response in rectal cancer patients.
Quality of life is increasingly used as a primary outcome measure in studies that are designed to evaluate the effectiveness of treatment in cancer survivors.Analyze the symptom distress, depression, and quality of life in colorectal cancer patients and explore the relationship of related variables with changes in QoL (quality of life) during and after treatment.A cross-sectional study design was used for the present study. Patients (N = 138) with colorectal cancer were recruited from a district hospital in southern Taiwan. Data were collected using a self-report questionnaire. Questionnaire scales included the M.D. Anderson Symptom Inventory-Taiwan Form, the Center for Epidemiologic Studies Depression Scale, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 Version 3 in Chinese as well as a demographic and disease-related variables datasheet. Descriptive data were presented using percentage, mean, and standard deviation. Chi-square test, independent t-test, one-way ANOVA, and hierarchical multiple regression were used for inferential statistics.The post-treatment group showed a significantly higher average global health QOL score (68.68 vs. 59.54; p < .05). Hierarchical regression showed that the impact factor of quality of life has a depressive effect in many dimensions. The second most significant variable was symptom distress. Symptoms interfered with life activity functions and family income and impacted negatively on patient treatment. In survivorship, depressive tendencies was the variable that was most affected, followed by recurrence, symptoms interference, and surgical treatment, respectively. When controlling for the relevant variables, these predictors accounted for 38.5% and 40.9% of the total variance of global health quality of life.This study demonstrates that personal characteristics variables, depressive tendencies, and symptom distress all impact on the quality of life of colorectal cancer patients in terms of receiving treatment and survivorship. These findings imply that healthcare professionals must provide appropriate emotional support in order to decrease depression tendency at different stages. Thus, these patients should receive nursing interventions that effectively decrease depression and symptom distress and enhance quality of life at different disease stages.不同時期結直腸癌病人症狀困擾、憂鬱與生活品質關係之探討.癌症及其治療計畫常對病人的生活品質產生影響，不同的癌症病程階段所產生之身、心不適症狀及身心調適與生活品質間常有持續性的相關性，而生活品質已被視為癌症治療成效的重要指標。因此醫療人員若能暸解病人在病程階段的生活品質差異，將有助於在不同時期提供更適切的醫療照護。.分析治療期與存活期之結直腸癌病人症狀困擾、憂鬱與生活品質之差異以及生活品質重要影響因素之探討。.採橫斷性研究設計，以方便取樣選取南部某區域醫院138位結直腸癌病人為研究對象，使用「台灣版安德森症狀困擾量表」、「流行病學研究中心憂鬱症狀量表」、「歐洲癌症治療與研究組織之生活品質問卷」及「基本屬性相關變項」結構式問卷進行資料收集。資料以百分比、平均數、標準差呈現描述性統計資料，並以卡方檢定、獨立樣本t檢定、單因子變異分析及階層複迴歸進行推論性統計。.存活期病人整體健康生活品質顯著高於治療期（68.68 vs. 59.54, p < .05）。階層複迴歸分析顯示，生活品質各構面之影響因子，治療期病人以憂鬱傾向與最多構面有關，其次依序為症狀困擾，症狀干擾生活活動功能、及家庭月收入。存活期病人則以憂鬱傾向與最多構面有關，其次依序為是否復發、症狀干擾生活活動功能及是否接受手術治療。當控制相關顯著變項後，治療期與存活期病人生活品質之解釋變異量在整體健康生活品質分別為38.5%及40.9%。.本研究結果發現結直腸癌病人生活品質除與基本屬性相關變項有相關外，憂鬱傾向與症狀困擾對治療期的生活品質影響較多，而存活期的病人則以憂鬱傾向與生活品質之構面有相關。臨床照護上針對不同時期的癌症病人皆應給予情緒支持以改善憂鬱傾向，針對治療期的病人則應多給予症狀處置之衛教，協助緩解其症狀困擾、憂鬱，以提高病人在不同時期之生活品質。.
Barotraumas of the colorectum caused by high-pressure compressed air are rare and may cause potentially fatal outcomes. Herein, we present a case of perforation of the sigmoid colon and serosal tear of the rectum caused by high-pressure compressed air. Because of early diagnosis and surgical intervention, the patient had uneventful post-operative recovery, and no complications were noted.
We present the case of a 66-year-old man with a history of synchronous transverse and sigmoid colon cancer, who had undergone surgery 11 months before a follow-up scan. F-18 FDG PET/CT at that time showed no other abnormality. His serum carcinoembryonic antigen (CEA) level returned to normal after surgery. An elevated serum CEA level during the follow-up and F-18 FDG PET/CT showed a solitary hypermetabolic nodule on the patient's urinary bladder. Owing to the intense urinary radioactivity, the nodule was difficult to visualize on the early image but was easily seen on the delayed image after forced diuresis. His bladder tumor was surgically excised; it tested positive for adenocarcinoma, consistent with the colon tumor.
In this study, we sought to explore the prevalence of depression and fatigue in colorectal cancer patients during and after treatment to examine how these variables affect quality of life (QoL). In total, 170 patients with colorectal cancer participated in this study. The study population was divided into two groups: one receiving treatment and another that had finished treatment. The results showed that depression and fatigue measurements were higher in patients receiving treatment. Depression was a strong and significant predictor of QoL in both groups, whereas fatigue was not, with the exception of the symptom score. These findings underscore the importance of early detection and management of depression and fatigue during the treatment and survival stages of patients with colorectal cancer. Our findings indicate that health care professionals should provide appropriate nursing intervention to decrease depression and fatigue and enhance patient QoL.
Oral sodium phosphate (OSP) for bowel preparation before colonoscopy has been widely prescribed for many years. However, its safety, especially the possible renal damage, gradually raised concern in recent years. Here, we report a diabetic patient on metformin, developing lactic acidosis and acute renal failure after taking OSP for colonoscopy. This patient recovered after emergency hemodialysis. OSPbowel cleansing may be contraindicated in patients on metformin for diabetes mellitus.
Ureteral avulsion is an uncommon yet severe complication of ureteroscopy. Among 8336 patients who received ureteroscopic procedures in our hospital from December 2001 to December 2011, we encountered two cases of ureteral avulsion. The first of these experienced disruption at the ureteropelvic junction due to extraction of the tubular ureter from the urethra, which was corrected by immediate open surgery to reposition and anastomose the ureter. The second patient sustained a proximal ureteral disruption following retrieval of the ureteroscope, which was wedged in the narrow lumen of the proximal ureter, and led to simultaneous extraction of the distal ureter. Immediate surgical intervention was performed to maintain ureteral continuity. Mild hydronephrosis was observed in kidneys that were ipsilateral to the ureteral avulsion in both patients. However, no physical discomfort or loss of renal function was indicated after 12 months.
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