[show abstract][hide abstract] ABSTRACT: Deregulation of promyelocytic leukemia zinc finger protein (PLZF), a tumor suppressor gene, was reported in different types of solid tumors. This study for the first time explored the reduced expression of PLZF and its effects in non-small-cell lung cancer (NSCLC) carcinogenesis. PLZF was found to be down-regulated by 62.8% in 87.1% of 154 paired NSCLC samples by quantitative real-time PCR, and its expression was found to be associated with the sex of the patient (P=0.02). Further analysis showed that down-regulation of PLZF in 35.6% NSCLC samples (31 out of 87) was triggered by hypermethylation in the promoter region. This was validated by demethylation analysis using the A549 cell line. Dual-luciferase reporter assay indicated that CTCF binding to the promoter region could activate PLZF transcription. Overexpression of PLZF in both A549 and LTEP lung cancer cell lines was found to inhibit proliferation and increase apoptosis. Therefore, reduced expression of PLZF was found to be common in NSCLC. PLZF down-regulation was partially correlated with hypermethylation in the promoter region. Decreased levels of PLZF expression may contribute to the pathogenesis of NSCLC by promoting cell survival. Therefore, the restoration of PLZF expression may serve as a new strategy for NSCLC therapy.-Wang, X., Wang, L., Guo, S., Bao, Y., Ma, Y., Yan, F., Xu, K., Xu, Z., Jin, L., Lu, D., Xu, J., Wang, J.-C. Hypermethylation reduces expression of tumor-suppressor PLZF and regulates proliferation and apoptosis in non-small-cell lung cancers.
[show abstract][hide abstract] ABSTRACT: The occurrence of aortic regurgitation (AR) attributable to Behçet's disease is rare, but it brings extraordinary complexity to surgical intervention due to the high risk of postoperative morbidity as the result of valve dehiscence or pseudoaneurysms caused by fragile aortic structures and inflamed tissue. The high rate of prosthetic valve detachment after aortic valve replacement is one of the most serious consequences of aortic regurgitation in Behçet's disease, which results in severe aortic annular destruction, presenting a big challenge to cardiac surgeons. Under this condition, a conventional surgical technique is necessary to be modified for improving postoperative prognosis of patients. In this paper, we described the surgical treatment of 5 patients with Behçet's aortitis and report their long-term outcomes.
The Annals of thoracic surgery 08/2012; 94(2):e55-7. · 3.74 Impact Factor
[show abstract][hide abstract] ABSTRACT: The left subclavian artery (LSA) is usually difficult to manipulate in total aortic arch replacement procedures if it is displaced by huge false lumens in the ascending aorta or right hemiarch. We summarize our experience of selectively ligating the deeply located LSA in total aortic arch replacement and stented "elephant trunk" implantation procedures for Stanford type A aortic dissection.
Data of 29 patients with deep LSA undergoing total arch replacement and stented "elephant trunk" implantation from January 2008 to June 2010 were reviewed. The LSA was ligated because of the difficult exposure (21 males, 8 females, age 19 to 55). Collateral circulation of the circle of Willis and bilateral vertebral arteries were assessed thoroughly by preoperative imaging and intraoperative observations. If collateral circulation was sufficient, LSA was ligated; if insufficient, an additional bypass graft was created from the ascending aorta to the left axillary artery.
Twenty-eight patients survived the operation with 1 early death. Postoperative blood pressures were lower in the left arm than in the right (78±17.3 vs 126±3.7 mm Hg, p<0.01), but oxygen saturation, skin temperature, and strength of the left hand were normal. The surviving patients have been followed for 16.6±9.0 months (6 to 36) and none had symptoms of LSA steal syndrome or arm ischemia.
Ligation of the LSA after strict evaluation of collateral circulation could be safe for type A dissection patients if the exposure is insufficient, and this method can simplify the operation significantly.
The Annals of thoracic surgery 11/2011; 93(1):110-4. · 3.74 Impact Factor
[show abstract][hide abstract] ABSTRACT: Ascending aortic replacement and reinforced reduction aortoplasty are 2 optional procedures for the treatment of fusiform ascending aneurysms. This study was designed to compare the early and late results of these 2 options.
Between January 2000 and January 2008, 71 patients with fusiform ascending aortic aneurysms and aortic valve disease underwent reinforced reduction aortoplasty associated with aortic valve replacement (RRA group, n = 32) or ascending aortic replacement combined with aortic valve replacement (AAR group, n = 39). Patients requiring other concomitant cardiac procedures were excluded. Perioperative events and late results were compared.
The variables of the 2 groups were similar, except age and preoperative diameter of the ascending aorta. Despite the nearly identical perioperative morbidity in the 2 groups, mean cardiopulmonary bypass time and aortic crossclamping time were shorter in the RRA group. The follow-up period was between 1 and 8 years (mean, 3 years and 4 months). The 5-year survival rate was 90.7% ± 6.4% versus 87.0% ± 6.3%, respectively. Although there was a significant increase in aortic sinus diameters in the AAR group, all aortic sinus diameters were within the acceptable range. There was no increase in proximal aortic arch diameters in the 2 groups.
For the treatment of fusiform ascending aortic aneurysms, both procedures can result in favorable and comparable late results in appropriate patients. Furthermore, reinforced reduction aortoplasty should be encouraged more because of its significant operative simplicity and safety if only the quality of the aortic wall is acceptable.
The Journal of thoracic and cardiovascular surgery 03/2011; 141(3):738-43. · 3.41 Impact Factor