Biomedical subjects

Chen-Hsen Lee

Publications and source records attributed to Chen-Hsen Lee.

53 records · Page 3Linked to original sources

PubMed2004

Magnolol alters the course of endotoxin tolerance and provides early protection against endotoxin challenge following sublethal hemorrhage in rats.

The endotoxin tolerance induced by sublethal hemorrhage (SLH) is associated with an initial surge of proinflammatory cytokines such as TNF-alpha. Magnolol, a potent antioxidative herb, is hypothesized to suppress TNF-alpha production after SLH and to alter or attenuate subsequent endotoxin tolerance. A prospective, randomized experimental study was performed. Male Sprague-Dawley rats were randomly segregated into one of four groups. Rats in the Sham/Veh and Sham/Mag groups received a sham operation for SLH and treatment with vehicle or magnolol, respectively. Rats in the SLH/Veh and SLH/Mag groups received SLH and treatment with vehicle or magnolol, respectively. Animals were subjected to endotoxin challenge (EC) at 12, 24, or 36 h after these procedures. Cytokines (TNF-alpha and IL-10), lipid peroxidation, and superoxide dismutase (SOD) activity were measured in lung tissue following SLH. Plasma cytokines were assessed after SLH or EC at different time points, and survival analyses were performed after EC. Plasma and tissue TNF-alpha increased after SLH; this increase was significantly suppressed by magnolol. Additionally, a significant increase in plasma and tissue IL-10 after SLH was observed in the SLH/Mag group. Lipid peroxidation and SOD activity increased after SLH; magnolol suppressed the lipid peroxidation but not the SOD activity. If EC was performed 12 or 24 h after SLH, greater survival with decreased TNF-alpha and increased IL-10 in plasma was observed in the SLH/Mag group. If EC was performed 24 or 36 h after SLH, greater survival with decreased plasma TNF-alpha was observed in the SLH/Veh group. In conclusion, magnolol induces an antiinflammatory response and provides early protection against EC following SLH; however, magnolol attenuates the protraction of endotoxin tolerance and inhibits late protection against EC following SLH.

Animals↗

PubMed2004

Postoperative quality of life among patients with thyroid cancer.

BACKGROUND: Thyroid cancer patients have a survival rate of over 90% after thyroidectomy. However, quality of life with a generic focus has rarely been studied in thyroid cancer survivors. AIM: This paper reports a study to examine and describe factors associated with quality of life among patients with thyroid cancer after operation. METHODS: Adult patients who had a thyroidectomy for cancer between January 1999 and June 2001 in a Taiwan city participated in the study. Telephone interviews was completed with 146 (67%) of those 218 eligible, asking about sociodemographic variables, disease/treatment characteristics and social support. Quality of life was measured by the Chinese version of the Quality of Life Index. Multivariate analyses were performed using multiple linear regressions. RESULT: The regression model showed that patients at 19-36 months after operation had lower quality of life compared with those within 18 months of operation. Current symptoms of fatigue and chills were negatively associated with quality of life. Those who rated the impact of operational scar on activities as 'high' had lower quality of life scores. Social support from families and friends had positive effects on quality of life. The model r2 was 48.1%. CONCLUSIONS: Nurses could improve quality of life among patients with thyroid cancer by strengthening their social support and educating them in self-management of uncomfortable symptoms. Surgeons should consider types of operation in which the scar would be less likely to influence the patients' activities.

Female↗

PubMed2003

Surgery in Taiwan.

Taiwan is an island located southeast of the Asian continent. Surgery in Taiwan has changed rapidly during the past 20 years. Approximately 4500 surgeons (including orthopedic surgeons, neurosurgeons, and urologists) serve a population of 23 million on this 36000-km(2) island. Much progress has been made in the development of basic science surgical research, the use of new technology, and the improvement of the quality of care of our patients. National Health Insurance was launched in 1995 and has had a great impact on the clinical practice of surgery. To attract more medical graduates to the specialty of surgery and enrich the resources of manpower, reasonable reimbursement and a new education program with efficient core content but no prolongation of the training period are needed.

Education, Medical↗

PubMed2003

Tetrodotoxin poisoning.

Tetrodotoxin (TTX) poisoning, although uncommon, is frequently seen in Taiwan, Japan, and Southeast Asia. It is rare but significant in the United States as well. Only three cases have been reported in the EM literature. We report an outbreak of six cases of TTX poisoning from eating puffer fish. On April 17, 2001, an outbreak of TTX poisoning occurred among Mainland Chinese fishermen who shared puffer fish on their boat in the Taiwan Strait. All six cases were middle-aged men (aged 32-49 yr). Onset of symptoms began approximately 2 to 3 hours after ingestion; symptoms included orolingual numbness, acroparesthesia, and breathlessness. As a result of delayed transportation and initial resuscitation, one patient presented in full cardiac arrest, with recovery of spontaneous circulation after successful cardiopulmonary resuscitation. With the exception of this patient, the initial acid-base abnormalities were inconsistent with severity of illness and mild hypercapnia was common (4 out of 5). The patient who presented in full arrest died 1 day after admission as a result of intractable bradycardia (complete atrioventricular block), a finding rarely mentioned in the literature, despite intravenous atropine and dopamine infusion. The remaining patients survived without significant sequelae and were discharged after short-term observation and supportive care, although some had neurologic and cardiopulmonary manifestations (muscle weakness, hypotension, hypoxemia, and hypercapnia). Some mildly hypoventilated patients recovered well without endotracheal intubation and ventilatory support. Favorable outcomes in most patients can be obtained if aggressive supportive treatment is provided in time. Thus, appropriate prehospital and ED ventilatory support (the implementation of a bag-valve mask or endotracheal intubation with good ventilatory support) is mandatory for those patients with respiratory failure. Most patients experience onset of symptoms within 6 hours of ingestion, but a few have a delayed onset up to 20 hours. Therefore, for those TTX-intoxicated patients without immediate prominent respiratory insufficiency, at least 24 hours of intensive monitoring of their respiratory state is necessary because of the different susceptibility and unpredictability of an individual course.

Adult↗

PubMed2003

Alcohol intoxication increases morbidity in drivers involved in motor vehicle accidents.

We prospectively examined the correlation of alcohol intoxication with injury severity, morbidity, and mortality in drivers involved in motor vehicle accidents in a prospective cohort study. The study enrolled 923 injured patients, of whom 421 were legally intoxicated (blood alcohol concentration [BAC] > or = 50 mg/dL) and 502 were not intoxicated (BAC < 50 mg/dL). The intoxicated drivers had a significantly higher injury severity score (ISS), lower Glasgow Coma Score, lower systolic blood pressure; higher rate in old age, male sex, greater rate of habitual drinking, greater lack of use of safety gear, and greater accident-related morbidity. After logistic regression analysis, alcohol intoxication was not associated with severe injury (ISS > or = 9); however, alcohol intoxication analyzed either as a preinjury or postinjury risk factor, was one of the predictors for morbidity. Severe head injury was the only predictor of mortality. In conclusion, although alcohol intoxication is not associated with an increased incidence of severe injury or mortality in drivers involved in motor vehicle crashes, it is one of the significant predictors for morbidity after injury.

Accidents, Traffic↗

PubMed2003

Magnolol alters cytokine response after hemorrhagic shock and increases survival in subsequent intraabdominal sepsis in rats.

Magnolol is a Chinese herb that has potent antioxidant effects. This study evaluated the effect of magnolol in the treatment of severe injury using a two-hit model in Sprague-Dawley rats. Hemorrhagic shock followed by resuscitation was performed. Intra-abdominal sepsis was induced by cecal ligation puncture. The rats were randomly segregated into the following three groups: group 1 (sham group) rats were sham-operated; group 2 (untreated group) rats received hemorrhagic shock and resuscitation and cecal ligation puncture 24 h later; and group 3 (treated group) rats were treated with magnolol and subjected to the same procedures as group 2. Plasma cytokine levels and tissue cytokine contents of lung, including tumor necrosis factor alpha (TNFalpha) and interleukin (IL)-10 were assayed after hemorrhagic shock and sepsis. Pulmonary injury study was performed using Evans blue dye and survival analysis was performed after development of sepsis. Plasma and tissue TNFalpha levels increased after hemorrhagic shock. Magnolol treatment blunted the TNFalpha levels in plasma and tissue. The plasma IL-10 level increased after hemorrhagic shock, whereas the tissue level of IL-10 did not change. Magnolol treatment did not alter the plasma level of IL-10 but did increase tissue level. After sepsis, TNFalpha levels in both plasma and tissue of magnolol-treated animals were significantly lower than those in untreated animals, whereas plasma and tissue IL-10 levels were not significantly different between treated and untreated groups. Pulmonary injury study showed that magnolol-treated rats had decreased pulmonary permeability after the onset of sepsis. Survival analysis showed that survival rate was significantly higher in the treated group. In conclusion, magnolol modifies the cytokine response after hemorrhagic shock and resuscitation; the proinflammatory cytokine response is suppressed. The modified cytokines response induced by magnolol may result in decreased tissue injury and increased survival in subsequent intra-abdominal sepsis.

Animals↗

PubMed2003

Hypothermic retrograde jugular perfusion reduces brain damage in rats with heatstroke.

OBJECTIVE: To determine whether direct retrograde ice saline infusion in the jugular vein without cardiopulmonary bypass protects rat brains after heatstroke. DESIGN: Randomized, controlled, prospective study. SETTING: University physiology research laboratory. SUBJECTS: Sprague-Dawley rats (270-320 g, males). INTERVENTIONS: Rats were randomized into three groups and given a) no resuscitation after onset of heat stroke (HS, n = 8); b) ice saline infusion in the femoral vein after onset of heat stroke (HS + F, n = 8); or c) retrograde ice saline infusion in the external jugular vein after onset of heat stroke (HS + J, n = 8). Rats were exposed to an ambient temperature of 43 degrees C after vessel cannulation. Their mean arterial pressure, heart rate, colonic temperature, and brain temperature were continuously recorded. Survival time and brain pathology were checked. MEASUREMENTS AND MAIN RESULTS: Although colonic temperature decreased 0.8-1.0 degrees C 15 mins after heatstroke in all groups, no treatment-related changes in colonic temperature were noted in any group. However, significant changes were observed in brain temperature. Fifteen minutes after heatstroke, brain temperature was 37.6 +/- 0.4 degrees C, 36.1 +/- 0.4 degrees C, and 33.6 +/- 0.8 degrees C in HS, HS + F, and HS + J, respectively. Survival time was 16.1 +/- 2.1, 33.0 +/- 3.8, and >120 mins in these groups, respectively. Neuron damage score was significantly lower in HS + J and without lateralization. CONCLUSIONS: We successfully demonstrated that direct retrograde hypothermic perfusion via the jugular vein without cardiopulmonary bypass protected the brain after heat stroke. This technique cooled the brain but did not significantly interfere with body temperature.

Animals↗

PubMed2003

The management of well-differentiated thyroid cancer with end-stage renal disease.

The occurrence of thyroid cancer in patients with endstage renal disease is rare. We have had the experience of treating two such patients. The problems, encountered in these patients, were the enlarged parathyroid glands at the time of total thyroidectomy and the treatment of these patients with 131I when the biologic halflife of radioiodine increases after hemodialysis. Both patients were treated by total thyroidectomy and postoperative administration of 131I, either empirically or dosimetrically, and are living and well, 9 yr and 7 yr after operations, respectively.

Carcinoma, Papillary↗

PubMed2003

Percutaneous dilatational tracheostomy versus open tracheostomy--a prospective, randomized, controlled trial.

BACKGROUND: Percutaneous dilatational tracheostomy has gained popularity, but its superiority to open tracheostomy is unclear. The object of this study was to compare procedure time, complication, safety and cost-effect between the percutaneous dilatational tracheostomy (PDT) and the conventional open tracheotomy (OT). METHODS: A prospective randomized clinic trial was conducted in a general Intensive Care Unit of an University-based hospital. Eighty-three consecutive patients who needed elective tracheostomies were selected for this study. PDT was performed using the Ciaglia method with OT as control group. Age, gender, operative data, complications and mortality were recorded for analysis. RESULTS: The procedure time was 22.0 +/- 12.1 minutes in PDT group, and 41.5 +/- 5.9 minutes in OT group, with significant statistical difference (p < 0.001). The incidences of complications were not different between both groups. Ages, gender or days of pre-tracheostomy intubation showed no difference between two groups. CONCLUSIONS: The PDT appears to be a simple, safe and time-saving bedside procedure. It can be recommended when an elective tracheostomy is needed in a critical patient.

Adult↗

PubMed2002

Evaluation of staff workload during resuscitation of trauma patients.

OBJECTIVE: Evaluating the medical staff workload during resuscitation of trauma patients is one of the important quality assurance activities to provide adequate medical manpower, especially for patients with life-threatening or severe injuries. Nevertheless, there is no method available to measure and calculate the amount of workload during resuscitation. We sought to develop a new framework of Workload Scoring System (WSS) to evaluate and quantify the medical staff workload during resuscitation. METHODS: From July 1996 to July 1998, the records of 11,800 trauma patients were prospectively collected from our computer-stored medical record system. The Workload Scoring System points with reference to age, different triage category on the basis of triage version of the Revised Trauma Score (RTS), level category on the basis of Injury Severity Score (ISS), and Abbreviated Injury Scale (AIS) in six body regions were calculated to survey the medical staff workload. RESULTS: The WSS points were 18.51 +/- 0.80 for triage I, 11.88 +/- 0.17 for triage II, and 6.90 +/- 0.04 for triage III trauma patients. The WSS points were 23.10 +/- 0.67 for Level I, 20.34 +/- 0.25 for Level II, 12.87 +/- 0.08 for Level III, and 6.03 +/- 0.02 for Level IV trauma patients. There were statistically significant differences among triage I, II, and III trauma patients, and among Level I, II, III, and IV trauma patients (p < 0.01). The worse the physiologic status and the greater the anatomic damage, the more medical staff workload was needed. Multiple regression with linear model may predict WSS points as an equation of -8.920 + 1.375 ISS + 1.785 RTS + 0.424 Age (r2 = 0.621), which accounts for 62.1% of the variance in WSS points. CONCLUSION: WSS provides a valuable tool to measure and quantify the medical staff workload during resuscitation as a function of -8.920 + 1.375 ISS + 1.785 RTS + 0.424 Age. The greatest benefit of this methodology is to forecast the expected medical staff workload to allocate sufficient medical manpower to provide the desired trauma care.

Analysis of Variance↗

PubMed2002

Acute mountain sickness in Jade Mountain climbers of Taiwan.

BACKGROUND: Although there are more than 200 peaks higher than 3000 m in the Taiwan Alps, no data on the incidence of acute mountain sickness (AMS) are available. This study investigated the incidence of AMS in Jade Mountain climbers. METHODS: The study was performed at the entrance of Jade Mountain, the highest peak (3952 m) in Taiwan. A standardized form was used to collect information. All the recorders had previously been trained in the management of high altitude illness. The Lake Louise consensus was used for the diagnosis of AMS. RESULTS: There were 93 trekkers (18 females and 71 males) who were surveyed. Four records with incomplete data were excluded, leaving 89 records for analysis. The ages ranged from 20-68 yr, with an average age of 41.1 +/- 11.2 SD. All subjects had a home residence below 1 km. The most common high altitude symptoms were headaches. Some 25 trekkers (28%) [corrected] met the diagnoses of AMS. The most common site of the AMS cases feeling their worst symptoms was in the midway overnight hut, and not on the summit. The lower the O2 saturation recorded at the entrance (2659 m) of Jade Mountain, the higher the score of the Lake Louise Acute Mountain Sickness Score (LLAMSS). CONCLUSIONS: Acute mountain sickness is a common problem in Taiwan summit climbers. In our study, 28% [corrected] of the Jade Mountain trekkers met the diagnosis of AMS; however, the incidence of AMS was lower than that of other studies at similar altitudes.

Acute Disease↗

PubMed2002

Benign diffuse islet cell disease in adults: a comparison of the results from distal and arterial stimulated venous sampling-guided pancreatectomies.

BACKGROUND: Adequate surgical treatment of hypoglycemia caused by benign diffuse islet cell disease (BDICD) is not associated with predictable results. Arterial stimulation and venous sampling (ASVS) has been reported to establish the diagnosis of BDICD, as well as serve as a guide to resection. The purpose of this study is to determine the efficacy of this method for the treatment of benign diffuse islet cell disease. METHODS: We retrospectively reviewed 38 adults with symptomatic hyperinsulinemic hypoglycemia treated by a single surgeon from 1982 to 1998. Nine of them had pathologic evidence of BDICD. We demonstrated the clinical presentations, serum level of fasting blood sugar, insulin and C-peptide before and after operations, pathological results, and outcomes of distal pancreatectomy in 5 patients and ASVS-guided pancreatectomies in 4 patients with BDICD. RESULTS: Five patients (4 females and 1 male) who received distal pancreatectomy (Group 1) were aged from 19 to 75, and were culled from a group of 30 patients with spontaneous hyperinsulinemic hypoglycemia. Two had the multiple endocrine neoplasia (MEN) 1 syndrome. The follow-up was from 7 to 16 years. Three patients (including 1 MEN 1 patient) became diabetic. Another 1 is euglycemic, and the other MEN 1 patient developed recurrent disease. Four patients (2 males and 2 females, Group 2), found in a group of 8 patients with hyperinsulinemic hypoglycemia, had ASVS-guided pancreatectomies. Their ages ranged from 29 to 69 years. The area of the pancreas supplied by the splenic artery was removed in all patients. Follow-up from half to 2 years showed that all the patients had normal fasting levels of glucose, normal levels of insulin and C-peptide, and no more hypoglycemic attacks. CONCLUSIONS: Arterial stimulation venous sampling is a useful guide for pancreatectomy to treat adult patients with BDICD. Data from this small sample of patients suggest that the results may be superior to those obtained by "blind" distal pancreatectomy.

Adult↗

PubMed2002

Mycotic aneurysm of thoracic aorta with aortoesophageal fistula mimicking the esophageal tumor with bleeding--a case report.

An aortoesophageal fistula is a rare but fatal disease, most commonly associated with thoracic aortic aneurysm. Early diagnosis and emergency surgical intervention are mandatory for survival. We reported a case of mycotic aneurysm of thoracic aorta with aortoesophageal fistula, presenting with intermittent hematemesis, tarry stool and sepsis. Initially, misdiagnosis of esophageal submucosal tumor with bleeding was made clinically and endoscopically. With contrast-enhanced spiral computed tomography (CT) scan the diagnosis was confirmed. The pathogenesis, clinical presentation, endoscopic feature and imaging findings were reviewed.

Aged↗

PubMedDate not supplied

Gray-scale and color Doppler ultrasonographic manifestations of papillary thyroid carcinoma: analysis of 51 cases.

UNLABELLED: The purpose of this study is to assess the specific ultrasonic characteristics of papillary thyroid carcinoma and to determine the relative frequency of various patterns of papillary carcinoma on gray-scale ultrasonography (US) and color Doppler ultrasonography (CDU). METHODS: We retrospectively reviewed US features in 51 patients with confirmed papillary thyroid carcinoma. The features were analyzed based on tumor size, echogenicity, echotexture, boundary, margin, shape, and calcification pattern on gray-scale US imaging, and on patterns of vascularity on CDU. We obtained the relative frequency of features and classified these features into three categories: common (> or =50% of lesions), less common (>10% but <50%), and uncommon (< or =10%). Individual differences and combinations of features were also analyzed. RESULTS: In total, 67 nodules were enrolled in our study. The sizes of 76% of nodular lesions were <20.0 mm. Common US features of papillary carcinoma included: a homogeneous hypoechoic solid picture; a poorly defined boundary; an irregular margin; the absence of halo; the absence of calcifications or microcalcifications; and mixed perinodular and intranodular blood flow patterns. Less common features included: a heterogeneous hypoechoic or very hypoechoic picture; microcalcifications; a well-defined boundary; a regular margin; a halo with uneven thickness or an incomplete halo; and a taller-than-wide shape. Uncommon features included: an isoechoic picture; solid with cystic components; coarse calcifications; mixed coarse calcifications and microcalcifications; "inferno"-type blood flow; and absence of blood flow. On average, each nodule had 4.9 US features considered common, 1.8 US features considered less common, and 0.4 US feature considered uncommon. Features such as predominantly cystic composition, hyperechoic texture, and hypoechoic halo with even thickness were never found in our study. The top two common manifestations of papillary carcinoma were solid architecture and mixed perinodular and intranodular blood flow signals. CONCLUSION: All lesions in our series had a predominantly solid characteristic on gray-scale US.

Adult↗

PubMedDate not supplied

Acute urinary retention in the elderly: an unusual presentation of appendicitis with a high perforation risk.

BACKGROUND: Urological manifestations are rare in acute appendicitis. Although acute urinary retention (AUR) is more commonly found in elderly patients, any previous cases reported have been under the age of 30. OBJECTIVE: The aim of this study was to investigate the incidence, clinical presentation, and results of adult appendicitis patients presenting with AUR. AUR is defined as the sudden inability to urinate with obstructive symptoms. METHODS: A retrospective case note review of 480 adult patients (>/=18 years) with appendicitis, diagnosed at the Veterans General Hospital-Taipei over a 3-year period, was carried out. RESULTS: Six patients (1.3% of the adults or 3.9% of the elderly patients), 5 men and 1 woman averaging 71.5 years of age, presented with AUR. Associated existing diseases were benign prostatic hyperplasia in 2 of the males and surgical repair for uterine prolapse in the only female. The mean duration from initial gastrointestinal symptoms to AUR was 1.7 days. The quantity of residual urine ranged from 180 to 450 ml. All patients had persistent right lower quadrant tenderness and hematuria. Five (83.3%) were found to have a perforated appendix at operation, and their average hospital stay was 14.7 (8-29) days. CONCLUSIONS: AUR may occur as an initial presentation in acute complicated appendicitis in the elderly. It has been reported that the prolonged hospital stay might be related to the delayed diagnosis and resulting complications arising in these patients. Primary care physicians need to be reminded that this common genitourinary complaint may arise in patients with acute appendicitis. When confronted with a geriatric patient presenting with AUR, one should entertain an alternative diagnosis and a reexamination of the patient is mandatory.

Acute Disease↗

PubMedDate not supplied

Comparison of the proliferation and differentiation ability between adult rat retinal stem cells and cerebral cortex-derived neural stem cells.

Recent studies have demonstrated that retinal stem cells (RSCs) and stem cells of the central nervous system both exhibited the abilities of self-renewal, proliferation and differentiation into multilineage. In the present study, we compared the proliferation and differentiation abilities between RSCs and cerebral corticex-derived neural stem cells (CNSCs) of adult rats. Stem cells isolated from pigmented ciliary margins of eyes and cerebral cortical tissues of adult rats were cultured in 96-well plates that contained serum-free medium with epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF). In contrast to RSCs, which stopped proliferating after the 8th week, the total cell count of neurospheres in CNSCs increased twofold at the 5th week and more than fourfold at the 10th week after in vitro culture. In contrast, RSCs stopped proliferating after 8 weeks of culture. After adding 2% fetal calf serum and withdrawing EGF and bFGF from the culture medium, the percentages of nestin-positive cells(20.6 +/- 2.7%), microtubule-associated-protein-2-positive neurons (33.2 +/- 3.9%) and glial-fibrillary-acidic-protein-positive glial cells(51.3 +/- 6.2%) in the differentiated CNSCs were significantly higher than those in the differentiated RSCs (10.2 +/- 1.9, 22.3 +/- 1.3 and 44.6 +/- 5.1%, respectively; p < 0.05). We also found that the combination of transforming growth factor beta type III with retinoic acid played an important role in the induction of CNSCs to differentiate into opsin-positive cells. Our data demonstrated that CNSCs displayed a higher ability of proliferation and retinal lineage. This report also offers an alternative protocol of cell reproduction for producing retinal cells.

Animals↗

PubMedDate not supplied

Effects of clodronate on cancer growth and Ca2+ signaling of human thyroid carcinoma cell lines.

Clodronate, one of the halogenated bisphosphonates, was found to inhibit the cell growth of endocytic macrophages, osteoclasts and several cancer cells through diverse mechanisms. Cytosolic Ca2+ signaling had previously been suggested as an apoptotic signal to certain cancer cells. Whether clodronate has an anti-cancer effect and induces the Ca2+ signal in thyroid cancer cells remains unknown. In this study, the effects of clodronate, including growth inhibition and cytosolic Ca2+ signaling, were examined and analyzed on ARO, SW579, WRO and TT thyroid cancer cell lines. Clodronate decreased the growth of these cells in a dose-dependent manner and was more effective on slow growing cells. Clodronate treatment transiently increased cytosolic Ca2+ on slow growing SW579 thyroid cancer cells but not on the fast growing ARO cells. The results from this study implied that clodronate-mediated cell growth inhibition in slow growing thyroid cancer cells might correlate with a Ca2+ signaling pathway.

Antimetabolites↗