Background/purpose: Various treatment regimens have been attempted to improve oral lichen planus (OLP) lesions; however, a complete cure has not been found. The most commonly employed and useful agents for treating OLP are topical corticosteroids. The aim of this study was to determine if the use of prednisolone plus traditional medicinal herbs could improve OLP symptoms, reduce recurrent severity, and prolong the time to flare-up, thus providing evidence for future prospective randomized clinical trials. Materials and methods: A retrospective study of 78 patients with OLP was conducted. The resources of 2 hospital departments (Oral and Maxillofacial Surgery and Chinese Medicine) were combined to treat these patients. Thirty OLP patients (group A) were given a low dose (20 mg/d) of prednisolone plus 3 medicinal herbs (gan-lu-yin, jia-wei-xiao-yao-san, and zhibai-di-huang-wan), 26 OLP patients (group B) were administered prednisolone alone, and 22 OLP patients (group C) were administered the medicinal herbs only. Differences among the patient groups were compared after a 4-week treatment course and after follow-up observations which occurred at 6 and 12 months.
Existing therapies for symptoms related to painful clicking of the temporomandibular joint (TMJ) have rarely met with complete success and predicting prognosis remains difficult. Few studies have reported the efficacy of maxillary flat occlusal splints (MFOSs) for the treatment of painful clicking of the TMJ, and few studies have evaluated the predisposing factors that influence the clinical outcomes of MFOSs. The aim of this study was to investigate the treatment efficacy of MFOSs for painful clicking of the TMJ, and to determine the factors influencing TMJ therapy with MFOSs. We conducted a retrospective study of 109 patients suffering from unilateral clicking concurrent with preauricular area pain for at least 2 months between 2004 and 2008. Seventy-five patients were treated with an MFOS, while 34 patients did not receive MFOS therapy. Clicking score, pain-free maximal mouth opening, pain score, duration of the clicking sounds, age and bruxism were recorded during treatment and involved into the reviews. The degree of joint clicking was determined by a stethoscope placed in the anterolateral area of the external auditory canal and was divided into four grades. Data were analyzed using a Mann-Whitney U test, Fisher's exact test, and Student's t test. Results showed statistically significant differences in treatment outcomes between the MFOS-treated and control groups in clicking index, maximal mouth opening, pain and complete remission rates of symptoms within 1 year. Furthermore, for patients treated with MFOS, there were statistically significant differences in the clinical outcomes between those with a high clicking index and those with a low index before treatment. Factors significantly correlated with successful outcomes of MFOS included nocturnal bruxism, patient age and duration of clicking. MFOSs can be used to treat patients with painful clicking of the TMJ and related symptoms. The severity of clicking, bruxism, age and duration of clicking are all important factors influencing treatment outcomes with MFOSs.
Background: Alpha-methylacyl-CoA racemase (AMACR) is a key enzyme responsible for the metabolism of branched-chain fatty acids. It has been found to be an important prognostic factor in numerous types of cancers. This study was aimed to investigate the expression of AMACR and its prognostic significance in patients with oral squamous cell carcinoma (SCC).Methods: Analysis of publicly available microarray data of oral SCC revealed that AMACR was significantly upregulated in tumor tissue compared with normal mucosa. We further assessed the protein expression of AMACR in 164 patients with oral SCC by immunohistochemistry. The prognostic impact of AMACR expression and its association with various clinicopathological parameters were statistically analyzed.Results: AMACR overexpression was significantly associated with advanced tumor status (P=0.001), advanced nodal status (P=0.036), increased vascular invasion (P=0.026) and increased perineural invasion (P=0.004). Patients with high expression level of AMACR had significantly worse disease-specific survival (DSS), distant metastasis-free survival (DMFS) and local recurrence-free survival (LRFS) (all P<0.0001). In multivariate analysis, AMACR overexpression was also an independent negative prognostic factor for DSS (hazard ratio [HR]: 4.410, 95% confidence interval [CI]: 2.285-8.511, P<0.001), DMFS (HR: 5.157, 95% CI: 2.756-9.651, P<0.001) and LRFS (HR: 4.462, 95% CI: 2.429-8.198, P<0.001).Conclusions: High expression of AMACR was not only a key adverse prognostic factor but also a potential therapeutic target in oral SCC.
Abstract:Mounting evidence has shown an increased risk of gestational diabetes mellitus (GDM) in association with elevated exposure to air pollution. However, limited evidence is available concerning the effect of specific air pollutant(s) on GDM incidence. We conducted this case-control study on 6717 mothers with GDM diagnosed in 2006-2013 and 6717 age-and year of delivery-matched controls to further address the risk of GDM in relation to specific air pollutant. Both cases and controls were selected from a cohort of 1-million beneficiaries of Taiwan's National Health Insurance program registered in 2005. Maternal exposures to mean daily air pollutant concentration, derived from 76 fixed air quality monitoring stations within the 12-week period prior to pregnancy and during the 1st and 2nd trimesters, were assessed by the spatial analyst method (i.e., ordinary kriging) with the ArcGIS software. After controlling for potential confounders and other air pollutants, an increase in pre-pregnancy exposure of 1 inter-quartile range (IQR) for PM 2.5 and SO 2 was found to associate with a significantly elevated odds ratio (OR) of GDM at 1.10 (95% confidence interval (CI) 1.03-1.18 and 1.37 (95% CI 1.30-1.45), respectively. Exposures to PM 2.5 and SO 2 during the 1st and 2nd trimesters were also associated with significantly increased ORs, which were 1.09 (95% CI 1.02-1.17) and 1.07 (95% CI 1.01-1.14) for PM 2.5 , and 1.37 (95% CI 1.30-1.45) and 1.38 (95% CI 1.31-1.46) for SO 2 . It was concluded that higher pre-and post-pregnancy exposures to PM 2.5 and SO 2 for mothers were associated with a significantly but modestly elevated risk of GDM.
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