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1.  Intrathoracic caudate lobe of the liver: A case report and literature review 
Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.
PMCID: PMC4009555  PMID: 24803833
Intrathoracic liver; Pulmonary sequestration; Supradiaphragmatic ectopic liver
3.  Ethanol Extracts of Fruiting Bodies of Antrodia cinnamomea Suppress CL1-5 Human Lung Adenocarcinoma Cells Migration by Inhibiting Matrix Metalloproteinase-2/9 through ERK, JNK, p38, and PI3K/Akt Signaling Pathways 
Cancer metastasis is a primary cause of cancer death. Antrodia cinnamomea (A. cinnamomea), a medicinal mushroom in Taiwan, has shown antioxidant and anticancer activities. In this study, we first observed that ethanol extract of fruiting bodies of A. cinnamomea (EEAC) exerted a concentration-dependent inhibitory effect on migration and motility of the highly metastatic CL1-5 cells in the absence of cytotoxicity. The results of a gelatin zymography assay showed that A. cinnamomea suppressed the activities of matrix metalloproteinase-(MMP-) 2 and MMP-9 in a concentration-dependent manner. Western blot results demonstrated that treatment with A. cinnamomea decreased the expression of MMP-9 and MMP-2; while the expression of the endogenous inhibitors of these proteins, that is, tissue inhibitors of MMP (TIMP-1 and TIMP-2) increased. Further investigation revealed that A. cinnamomea suppressed the phosphorylation of ERK1/2, p38, and JNK1/2. A. cinnamomea also suppressed the expressions of PI3K and phosphorylation of Akt. Furthermore, treatment of CL1-5 cells with inhibitors specific for PI3K (LY 294002), ERK1/2 (PD98059), JNK (SP600125), and p38 MAPK (SB203580) decreased the expression of MMP-2 and MMP-9. This is the first paper confirming the antimigration activity of this potentially beneficial mushroom against human lung adenocarcinoma CL1-5 cancer cells.
PMCID: PMC3291113  PMID: 22454661
4.  Building-Related Symptoms among Office Employees Associated with Indoor Carbon Dioxide and Total Volatile Organic Compounds 
This study investigated whether sick building syndrome (SBS) complaints among office workers were associated with the indoor air quality. With informed consent, 417 employees in 87 office rooms of eight high-rise buildings completed a self-reported questionnaire for symptoms experienced at work during the past month. Carbon dioxide (CO2), temperature, humidity and total volatile organic compounds (TVOCs) in each office were simultaneously measured for eight office hours using portable monitors. Time-averaged workday difference between the indoor and the outdoor CO2 concentrations (dCO2) was calculated as a surrogate measure of ventilation efficiency for each office unit. The prevalence rates of SBS were 22.5% for eye syndrome, 15.3% for upper respiratory and 25.4% for non-specific syndromes. Tiredness (20.9%), difficulty in concentrating (14.6%), eye dryness (18.7%) were also common complaints. The generalized estimating equations multivariate logistic regression analyses showed that adjusted odds ratios (aORs) and 95% confidence interval (CI) per 100 ppm increase in dCO2 were significantly associated with dry throat (1.10, 95% CI = (1.00–1.22)), tiredness (1.16, 95% CI = (1.04–1.29)) and dizziness (1.22, 95% CI = (1.08–1.37)). The ORs for per 100 ppb increases in TVOCs were also associated with upper respiratory symptoms (1.06, 95% CI = (1.04–1.07)), dry throat (1.06, 95% CI = (1.03–1.09)) and irritability (1.02, 95% CI = (1.01–1.04)). In conclusion, the association between some SBS symptoms and the exposure to CO2 and total VOCs are moderate but may be independently significant.
PMCID: PMC4483674  PMID: 26024357
carbon dioxide; indoor air quality; sick-building syndrome; volatile organic compounds
5.  Timeframe for return to driving for patients with minimally invasive knee arthroplasty is associated with knee performance on functional tests 
This study hopes to establish the timeframe for a safe return to driving under different speed conditions for patients after minimally invasive total knee arthroplasty and further explores how well various kinds of functional tests on knee performance can predict the patients’ braking ability.
14 patients with right knee osteoarthritis were included in the present study and instructed to perform three simulated driving tasks at preoperative, 2 weeks postoperative and 4 weeks postoperative.
The results showed that the total braking time at 4 week postoperative has attained the preoperative level at the driving speed 50 and 70 km/hr but not at the driving speed 90 km/hr. It had significantly improving in knee reaction time and maximum isometric force at 4 weeks postoperative. Besides, there was a moderate to high correlation between the scores of the step counts and the total braking time.
Summary, it is recommended that driving may be resumed 4 weeks after a right knee replacement but had to drive at low or moderate speed and the best predictor of safety driving is step counts.
PMCID: PMC4058450  PMID: 24913312
Knee Osteoarthritis; Total knee arthroplasty; Braking reaction time; Knee functional test
6.  Chilaiditi syndrome presenting as chest pain in an adult patient: a case report 
A patient with chest contusion and rib fractures presented with severe chest pain. The plain film of his chest showed suspicion of pneumoperitoneum. We present this case to show how to get a correct diagnosis and then avoid unnecessary surgery.
Case presentation
A 64-year-old Taiwanese man presented to the emergency department complaining of severe right chest pain after a traffic accident. Chest radiography showed right fifth to eighth rib fractures and was suspicious for free air under the bilateral hemi-diaphragm. Computed tomography of the abdomen revealed interposition of bowel loops between the liver and diaphragm. The patient was treated with oral analgesics and then regularly followed in the outpatient department.
Awareness of Chilaiditi’s sign is of paramount importance when free air under the diaphragm is seen in a patient (particularly an older patient) who does not exhibit signs of peritoneal irritation on physical examination. Emergent laparotomy should be delayed and a computed tomography scan should be done first. No inappropriate surgical intervention is needed.
PMCID: PMC3977941  PMID: 24629087
Chilaiditi syndrome; Pneumoperitoneum; Subdiaphragmatic colon
7.  Influence of Working Memory Task and Time on Postural Control of Children with Attention Deficit Hyperactivity Disorder 
[Purpose] To investigate how balance changes develop across time under different conditions (with or without a memory task) for children with Attention Deficit Hyperactivity Disorder (ADHD). [Subjects and Methods] The participants were 11 children with ADHD and 12 normal children. To determine their static balance ability, a force plate was used to measure the center of the pressure trajectory. [Results] The length of the sway path became slightly greater in both groups when an additional memory task was added, but the difference was not statistically significant. However, it was interesting to note a significant difference in memory task ability across groups with increasing time. The ADHD group showed a decrease sway path with increasing time for the memory task, but in the control group it increased. [Conclusion] At first, the memory task interfered with ADHD children’s performance; however, the memory task may improve their performance after a few seconds.
PMCID: PMC3976000  PMID: 24707081
Attention-deficit/hyperactivity disorder (ADHD); Sway path; Mental task
8.  The Functional Influences of Common ABCB1 Genetic Variants on the Inhibition of P-glycoprotein by Antrodia cinnamomea Extracts 
PLoS ONE  2014;9(2):e89622.
Antrodia cinnamomea is a traditional healthy food that has been demonstrated to possess anti-inflammatory, antioxidative, and anticacer effects. The purpose of this study was to evaluate whether the ethanolic extract of A. cinnamomea (EEAC) can affect the efflux function of P-glycoprotein (P-gp) and the effect of ABCB1 genetic variants on the interaction between EEAC and P-gp. To investigate the mechanism of this interaction, Flp-In™-293 cells stably transfected with various genotypes of human P-gp were established and the expression of P-gp was confirmed by Western blot. The results of the rhodamine 123 efflux assay demonstrated that EEAC efficiently inhibited wild-type P-gp function at an IC50 concentration of 1.51±0.08 µg/mL through non-competitive inhibition. The IC50 concentrations for variant-type 1236T-2677T-3435T P-gp and variant-type 1236T-2677A-3435T P-gp were 5.56±0.49 µg/mL and 3.33±0.67 µg/mL, respectively. In addition, the inhibition kinetics of EEAC also changed to uncompetitive inhibition in variant-type 1236T-2677A-3435T P-gp. The ATPase assay revealed that EEAC was an ATPase stimulator and was capable of reducing verapamil-induced ATPase levels. These results indicate that EEAC may be a potent P-gp inhibitor and higher dosages may be required in subjects carrying variant-types P-gp. Further studies are required to translate this basic knowledge into clinical applications.
PMCID: PMC3934917  PMID: 24586917
9.  Risk factors of postoperative recurrences in patients with clinical stage I NSCLC 
Despite advances in radiation therapy, chemotherapy, and newly developed molecular targeting therapies, long-term survival after resection for patients with NSCLC remains less than 50%. We investigated factors predicting postoperative locoregional recurrences and distant metastases in patients with clinical stage I non-small-cell lung cancer (NSCLC) after surgical resection.
All patients with clinical stage I NSCLC, who underwent surgical resection between January 2002 and June 2006, were reviewed retrospectively. Multiple logistic regression analyses were used to identify independent risk factors for patients with locoregional recurrences and distant metastases.
A total of 261 patients were eligible. Overall survival was significant related to locoregional recurrences (P = 0.03) and distant metastases (P <0.001). There were significant differences of locoregional recurrence in tumor differentiation (P = 0.032) and advanced pathological stage (P = 0.002). In the group of distant metastases, there were significant differences in tumor differentiation (P = 0.035), lymphovascular space invasion (P = 0.031). Among the relationship between pattern of distant metastasis and clinicopathologic variables in patients with clinical stage I NSCLC, SUVmax (P = 0.02) and tumor size (P = 0.001) had significant differences. According to multiple logistic regression analysis, tumor differentiation is the only risk factor of postoperative outcome for locoregional recurrence and serum CEA (>3.5 ng/mL) is the predictor of distant metastasis.
Tumor differentiation and serum CEA were predictors of postoperative relapse for clinical stage I NSCLC after surgical resection. Risk factors of postoperative recurrence in patients with clinical stage I NSCLC may enable us to optimize the patient selection for postoperative adjuvant therapies or neoadjuvant treatment before surgery.
PMCID: PMC3895770  PMID: 24410748
Non-small cell lung cancer; Locoregional recurrence; Distant metastasis; Carcinoembryonic antigen
10.  A Chinese herbal formula "Gan-Lu-Yin" suppresses vascular smooth muscle cell migration by inhibiting matrix metalloproteinase-2/9 through the PI3K/AKT and ERK signaling pathways 
This study was to explore the effects of Gan-Lu-Yin (GLY) on the migration of vascular smooth muscle cells (VSMCs) induced by fetal bovine serum and on neointima formation in a rat model of carotid artery balloon injury.
VSMCs were treated with different concentrations of GLY, and then analyzed with Flow cytometric analysis, zymography, transwell, and western blotting. SD rats received balloon-injury were analyzed with H&E staining.
Our results showed that GLY significantly decreased the thickness of neointima. The inhibition by non-cytoxic doses of GLY of VSMCs migration was through its negative regulatory effects on phosphorylated ERK1/2, PI3K/AKT, and FAK. The data showed that GLY can inhibit the migration of VSMCs cells, and might block injury-induced neointima hyperplasia via the inhibition of VSMCs migration, without inducing apoptosis.
These observations provide a mechanism of GLY in attenuating cell migration, thus as a potential intervention for restenosis.
PMCID: PMC3475136  PMID: 22920190
Chinese herbs; Gan-Lu-Yin; Migration; Restenosis; Vascular smooth muscle cell
11.  A Novel Inhibitor of Human La Protein with Anti-HBV Activity Discovered by Structure-Based Virtual Screening and In Vitro Evaluation 
PLoS ONE  2012;7(4):e36363.
Over 350 million people worldwide are infected with hepatitis B virus (HBV), a major cause of liver failure and hepatocellular carcinoma. Current therapeutic agents are highly effective, but are also associated with development of viral resistance. Therefore, strategies for identifying other anti-HBV agents with specific, but distinctive mechanisms of action are needed. The human La (hLa) protein, which forms a stabilizing complex with HBV RNA ribonucleoprotein to promote HBV replication, is a promising target of molecular therapy.
This study aimed to discover novel inhibitors of hLa that could inhibit HBV replication and expression.
A multistage molecular docking approach was used to screen a Specs database and an in-house library against hLa binding sites. Sequential in vitro evaluations were performed to detect potential compounds with high scores in HepG2.2.15 cells.
Of the 26 potential compounds with high scores chosen for experimental verification, 12 had HBV DNA inhibition ratios of less than 50% with P<0.05. Six had significant inhibition of HBV e antigen (HBeAg) levels, and 13 had significant inhibition of HBV surface antigen (HBsAg) levels by in vitro assays. Compounds HBSC-11, HBSC-15 and HBSC-34 (HBSC is system prefix for active compounds screened by the library) were selected for evaluation. HBSC-11 was found to have an obvious inhibitory effect on hLa transcription and expression.
Our findings suggest that anti-HBV activity of HBSC-11 may be mediated by a reduction in hLa levels. In addition, our data suggest the potential clinical use of hLa inhibitors, such as HBSC-11, for treating HBV infection.
PMCID: PMC3338670  PMID: 22558448

Results 1-11 (11)