Milk Fat Globule-Epidermal Growth Factor-Factor 8 (MFG-E8) as a Novel Biomarker for Periodontal Disease

AIM: To detect the presence of milk fat globule-epidermal growth factor-factor 8 (MFG-E8) in human gingival crevicular fluid (GCF) and to determine its potential role as a biomarker for periodontal disease activity. MATERIALS & METHODS: GCF was collected from a total of 230 sites from with seven subjects with gingivitis, twelve subjects with chronic moderate periodontitis, fourteen subjects with chronic severe periodontitis, six subjects with localized severe periodontitis as well as seven clinically healthy subjects. Subjects from the severe periodontitis group received nonsurgical therapy and were re-evaluated after 4 weeks. GCF was re-collected from thirty sites in five subjects at that point. Pocket reduction surgery was performed on the same subgroup and GCF was collected again at the 4-month postoperative appointment. GCF collection was performed using paper strips and analyzed for the presence of MFG-E8 and cytokines using multiplexing magnetic bead immunoassays (Luminex xMAP with MagPlex beads). Each sample was tested using an MFG- E8 kit, a human cytokine/chemokine kit and a human bone panel kit. RESULTS: MFG-E8 was detected at higher levels in sites with gingivitis and gingival health as compared to all periodontitis groups, suggesting that MFG-E8 production is down regulated in periodontitis. Consistent with this notion, MFG-E8 was found to significantly increase following non-surgical therapy of subjects with severe periodontitis. Furthermore, the levels of MFG-E8 significantly increased after surgical treatment correlating with decreased probing pocket depths. IL-1α, IL-1β, RANKL, OPG, IL-6 and IL-17A were detected at levels consistent with those found in earlier studies. In the periodontitis treatment subgroup, the levels of RANKL, IL-6 and IL-17A decreased with decreasing probing pocket depths. CONCLUSIONS: MFG-E8 was detected in human GCF collected from healthy, gingivitis and periodontitis subjects using a magnetic bead-based immunoassay. The levels of MFG-E8 were negatively related to the level of gingival inflammation and increased after both non-surgical and surgical treatment of periodontal disease. These data suggest the potential of MFG-E8 as a novel biomarker of periodontal disease

Milk Fat Globule-Epidermal Growth Factor-Factor 8 (MFG-E8) as a Novel Biomarker for Periodontal Disease

AIM: To detect the presence of milk fat globule-epidermal growth factor-factor 8 (MFG-E8) in human gingival crevicular fluid (GCF) and to determine its potential role as a biomarker for periodontal disease activity. MATERIALS & METHODS: GCF was collected from a total of 230 sites from with seven subjects with gingivitis, twelve subjects with chronic moderate periodontitis, fourteen subjects with chronic severe periodontitis, six subjects with localized severe periodontitis as well as seven clinically healthy subjects. Subjects from the severe periodontitis group received nonsurgical therapy and were re-evaluated after 4 weeks. GCF was re-collected from thirty sites in five subjects at that point. Pocket reduction surgery was performed on the same subgroup and GCF was collected again at the 4-month postoperative appointment. GCF collection was performed using paper strips and analyzed for the presence of MFG-E8 and cytokines using multiplexing magnetic bead immunoassays (Luminex xMAP with MagPlex beads). Each sample was tested using an MFG- E8 kit, a human cytokine/chemokine kit and a human bone panel kit. RESULTS: MFG-E8 was detected at higher levels in sites with gingivitis and gingival health as compared to all periodontitis groups, suggesting that MFG-E8 production is down regulated in periodontitis. Consistent with this notion, MFG-E8 was found to significantly increase following non-surgical therapy of subjects with severe periodontitis. Furthermore, the levels of MFG-E8 significantly increased after surgical treatment correlating with decreased probing pocket depths. IL-1α, IL-1β, RANKL, OPG, IL-6 and IL-17A were detected at levels consistent with those found in earlier studies. In the periodontitis treatment subgroup, the levels of RANKL, IL-6 and IL-17A decreased with decreasing probing pocket depths. CONCLUSIONS: MFG-E8 was detected in human GCF collected from healthy, gingivitis and periodontitis subjects using a magnetic bead-based immunoassay. The levels of MFG-E8 were negatively related to the level of gingival inflammation and increased after both non-surgical and surgical treatment of periodontal disease. These data suggest the potential of MFG-E8 as a novel biomarker of periodontal disease

Midgut pain due to an intussuscepting terminal ileal lipoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1.</p> <p>Case presentation</p> <p>A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 × 2.5 × 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up.</p> <p>Conclusion</p> <p>This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.</p

Risk factors associated with symptomatic cholelithiasis in Taiwan: a population-based study

<p>Abstract</p> <p>Background</p> <p>Cholelithiasis has become a major health problem in Taiwan. The predominant type of gallstone found in Asian populations differs from that in the West, indicating possible differences in the etiology and risk factors for cholelithiasis. The aim of this study is to investigate the risk factors for cholelithiasis using data representative of the general population.</p> <p>Methods</p> <p>We performed a population-based, case-control study in which we analyzed medical data for 3725 patients newly diagnosed with cholelithiasis and 11175 gender- and age-matched controls with no history of cholelithiasis, using information obtained from the 2005 Registry for Beneficiaries of the National Health Insurance Research Database. Coexisting medical conditions were included in the analysis. Relative risks were estimated by adjusted odds ratio (OR) and 95% confidence interval (CI) using a multivariate logistic regression analysis.</p> <p>Results</p> <p>After controlling for the other covariates, multivariate logistic regression analysis identified the following as risk factors for cholelithiasis (in descending order of contribution): Among all patients - hepatitis C (OR = 2.78), cirrhosis (OR = 2.47), hepatitis B (OR = 2.00), obesity (OR = 1.89), and hyperlipidemia (OR = 1.54); Among women - hepatitis C (OR = 3.05), cirrhosis (OR = 1.92), obesity (OR = 1.91), menopause (OR = 1.61), hepatitis B (OR = 1.54), and hyperlipidemia (OR = 1.49). Diabetes mellitus appeared to have a marked influence on the development of cholelithiasis but was not identified as a significant independent risk factor for cholelithiasis.</p> <p>Conclusions</p> <p>The risk factors for cholelithiasis were obesity, hyperlipidemia, hepatitis B infection, hepatitis C infection, and cirrhosis in both genders, and menopause in females. Despite differences in the predominate type of gallstone in Asian versus Western populations, we identified no unique risk factors among the population of Taiwan.</p

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

Small bowel obstruction after hand-assisted laparoscopic sigmoid colectomy for cancer

Hand-assisted laparoscopic surgery (HALS) was introduced as a bridge towards totally laparoscopic procedures. Some concerns are raised regarding its long-term complications such as incisional hernia and adhesive small bowel obstruction. A woman was admitted with colicky central abdominal pain, distension and vomiting. She had a hand-assisted laparoscopic sigmoid colectomy for cancer 6 years earlier. Clinical examination revealed a well-healed periumbilical scar with no evidence of incisional hernia. The abdomen was distended with exaggerated bowel sounds. A CT scan showed dilated loops of small bowel with a transitional zone and distally collapsed bowel. A diagnostic laparoscopy revealed a twisted segment of small bowel that was adherent to the anterior abdominal wall at the hand-port closure site. This segment was released laparoscopically without the need for a resection. Adhesive small bowel obstruction to the hand-port site closure may occur years after HALS and can simply be relieved by laparoscopic exploration