Decreased gene expression of human beta-defensin-1 in the development of squamous cell carcinoma of the oral cavity

The aim of this study was to investigate the gene expression of human beta-defensin-1, -2, -3 (hBD-1, -2, -3), interleukin-1beta, tumour necrosis factor-alpha and cyclooxygenase-2 in oral squamous cell carcinoma (OSCC) compared to benign and premalignant lesions as well as healthy controls. Biopsies of healthy gingiva (n=5), irritation fibroma (n=5), leukoplakia (n=5) and OSCC (n=5) were obtained during routine surgical procedures. RNA was extracted according to standard protocols and transcripts of hBD-1, -2, -3, interleukin-1beta, tumour necrosis factor-alpha and cyclooxygenase-2 were analysed by real-time polymerase chain reaction. The expression of hBD-1 was reduced in all lesions (5-fold in irritation fibroma and 2.5-fold in leukoplakia), but most significantly (50-fold) in OSCC. hBD-1 appears to play a role in the development of OSCC. The loss of its function might contribute to the malignant progression of these tumours.

Cardiac history, prior depression and personality predict course of depressive symptoms after myocardial infarction

BACKGROUND

Although many studies have focused on post-myocardial infarction (MI) depression, there is limited information about the evolution and determinants of depressive symptoms in the first year post-MI. Therefore we examined (1) the course of depressive symptoms during the first year post-MI and (2) the predictors of these symptom trajectories.

METHOD

To assess depressive symptoms, 287 patients completed the Beck Depression Inventory during hospitalization for MI, and 2, and 12 months post-MI. Personality was assessed with the Type-D scale during hospitalization. We used latent class analysis to examine the evolution of depressive symptoms over a 1-year period and multinomial logit regression analyses to examine predictors of these symptom trajectories.

RESULTS

The course of depressive symptoms was stable during the first year post-MI. Four groups were identified and classified as non-depressed [40%, intercept (IC) 2.52], mildly depressed (42%, IC 6.91), moderately depressed (14%, IC 13.73) or severely depressed (4%, IC 24.54). In multivariate analysis, cardiac history (log OR(severe) 2.93, p=0.02; log OR(moderate) 1.81, p=0.02; log OR(mild) 1.46, p=0.01), history of depression (log OR(severe) 4.40, p<0.001; log OR(moderate) 1.97, p=0.03) and Type-D personality (log OR(severe) 4.22, p<0.001; log OR(moderate) = 4.17, p<0.001; log OR(mild) 1.66, p=0.02) were the most prominent risk factors for persistence of depressive symptoms during the first year post-MI.

CONCLUSIONS

Symptoms of depression tend to persist during the first year post-MI. Cardiac history, prior depression and Type-D personality were identified as independent risk factors for persistence of depressive symptoms. The results of this study strongly argue for routine psychological screening during hospitalization for acute MI in order to identify patients who are at risk for chronicity of depressive symptoms and its deleterious effects on prognosis.

Propionic acid accumulation and degradation during restart of a full-scale anaerobic biowaste digester

The methane formation rate of 300 m(3) of sludge from a full scale biowaste reactor, that was stored without feeding for six weeks during a maintenance period, was about 60% of the methanogenic activity before maintenance. The 300 m(3) sludge was then pumped back into the biowaste reactor. On the third day, after refilling of the stored biowaste suspension, anaerobic conditions were obtained and feeding was started by addition of 36.1 m(3) of fresh biowaste suspension (=11.3 tons biowaste). The pH dropped from originally pH 7.7 to pH 7.3 and later on to pH 6.8, which was considered the minimum allowed pH for methanogenesis to recover. Maximum concentrations of acetate (1.78 gl(-1)), n-butyrate (0.57 gl(-1)) and n-valerate (0.44 gl(-1)) accumulated during the following days with feeding of 11.8 tons on day 5 and twice 6.5 tons on days 7 and 9, respectively. Thereafter, acetate, n-butyrate and n-valerate were degraded completely, whereas the concentration of propionate was still increasing. Propionic acid was the dominant fatty acid during the restart period and reached its maximum concentration of 6.2 gl(-1) 17 days after start of feeding. This high level of propionate was degraded completely in about 5 days with maximum degradation rates of 2.14 gl(-1)d(-1), and the pH of the anaerobic sludge increased from 7.1 to 7.4. During restart, the methane content of the biogas increased successively to 65%. Samples that were taken at different time intervals during the restart phase of the methane reactor showed different fatty acid degradation capabilities. After 10 days, when acetate and n-butyrate still accumulated in the methane reactor the maximum acetate degradation rate was 1.52 gl(-1)d(-1) and the n-butyrate degradation rate was 0.51 gl(-1)d(-1). Oxidation of n-valerate caused an increase of propionate, which was degraded after a lag phase of 6 days with a maximum rate of 0.6 gl(-1)d(-1). In the samples taken after 16 and 23 days, the propionate degradation rate increased to 1.42 gl(-1)d(-1) and 1.55 gl(-1)d(-1), respectively, and the lag phase for propionate degradation was reduced or had disappeared completely. The maximum propionate degradation rate was measured in the methane reactor in the fourth week after restart. The synthrophic propionate oxidizing bacteria were apparently the most suffering bacteria during sludge storage. If the propionate oxidizing bacteria could be kept active and the propionate degrading activity of the biowaste suspension of 6.16 gl(-1)d(-1) before the maintenance period could be maintained, then accumulation of 6.2 gl(-1) propionate in the methane reactor after restart could be avoided and full activity reached even earlier.

Fat transforms ascorbic acid from inhibiting to promoting acid-catalysed N-nitrosation

BACKGROUND

The major potential site of acid nitrosation is the proximal stomach, an anatomical site prone to a rising incidence of metaplasia and adenocarcinoma. Nitrite, a pre-carcinogen present in saliva, can be converted to nitrosating species and N-nitroso compounds by acidification at low gastric pH in the presence of thiocyanate.

AIMS

To assess the effect of lipid and ascorbic acid on the nitrosative chemistry under conditions simulating the human proximal stomach.

METHODS

The nitrosative chemistry was modelled in vitro by measuring the nitrosation of four secondary amines under conditions simulating the proximal stomach. The N-nitrosamines formed were measured by gas chromatography-ion-trap tandem mass spectrometry, while nitric oxide and oxygen levels were measured amperometrically.

RESULTS

In absence of lipid, nitrosative stress was inhibited by ascorbic acid through conversion of nitrosating species to nitric oxide. Addition of ascorbic acid reduced the amount of N-nitrosodimethylamine formed by fivefold, N-nitrosomorpholine by >1000-fold, and totally prevented the formation of N-nitrosodiethylamine and N-nitrosopiperidine. In contrast, when 10% lipid was present, ascorbic acid increased the amount of N-nitrosodimethylamine, N-nitrosodiethylamine and N-nitrosopiperidine formed by approximately 8-, 60- and 140-fold, respectively, compared with absence of ascorbic acid.

CONCLUSION

The presence of lipid converts ascorbic acid from inhibiting to promoting acid nitrosation. This may be explained by nitric oxide, formed by ascorbic acid in the aqueous phase, being able to regenerate nitrosating species by reacting with oxygen in the lipid phase.

Hormone replacement therapy, body mass, and the risk of colorectal cancer among postmenopausal women from Germany

Previous studies have reported inconsistent results regarding the modifying effect of hormone replacement therapy (HRT) on the association of body mass index (BMI) and the risk of colorectal cancer (CRC) among postmenopausal women. We assessed the use of HRT and BMI in 208 postmenopausal women with histologically confirmed incident CRC and 246 controls in a population-based case–control study in Germany (DACHS study). Ever use of HRT was strongly associated with reduction of CRC risk (adjusted odds ratio 0.41, 95% confidence interval 0.25–0.67). Among nonusers of HRT, risk of CRC was strongly increased in women with BMI 27 to <30 kg m⁻² (2.76, 1.07–7.12) and obese women (3.30, 1.25–8.72), when compared with women with BMI <23 kg m⁻² (P for trend <0.01). BMI was not associated with risk of CRC among HRT users (P for interaction <0.01). In contrast to most other studies, a positive association of BMI and CRC risk was found among nonusers of HRT, but not among users of HRT. The reasons for the inconsistency of results regarding the potential risk modifying effect of postmenopausal hormones in the association of BMI with CRC remain inconclusive and require further study.

The Contracts (Rights of Third Parties) Act 1999

This article describes how the cost and inconvenience of collateral warranties can be avoided by inserting provisions giving rights to third parties in construction contracts. Those third party rights are now enforceable following the introduction of the Contracts (Rights of Third Parties) Act 1999.

Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole

Seventy-one allograft recipients receiving voriconazole, in whom complete clinical, microbiologic and pharmacokinetic data were available, were studied to determine the efficacy of voriconazole in preventing fungal infections. The length of voriconazole therapy was 6-956 days (median 133). The total number of patient-days on voriconazole was 13 805 ( approximately 38 years). A total of 10 fungal infections were seen in patients on voriconazole (18% actuarial probability at 1 year): Candida glabrata (n=5), Candida krusei (n=1), Cunninghamella (n=1), Rhizopus (n=2) and Mucor (n=1). Two of the four zygomycosis cases were preceded by short durations of voriconazole therapy, but prolonged itraconazole prophylaxis. The plasma steady-state trough voriconazole levels around the time the infection occurred were <0.2, <0.2, 0.33, 0.55, 0.63 and 1.78 microg/ml in the six candidiasis cases. Excluding the four zygomycosis cases, all the six candidiasis cases were seen among the 43 patients with voriconazole levels of < or =2 microg/ml and none among the 24 with levels of >2 microg/ml (P=0.061). We conclude that voriconazole is effective at preventing aspergillosis. However, breakthrough zygomycosis is seen in a small proportion of patients. The role of therapeutic voriconazole monitoring with dose adjustment to avoid breakthrough infections with fungi that are otherwise susceptible to the drug needs to be explored prospectively.

Adjuvant chemoradiation therapy for pancreatic adenocarcinoma: Impact of family history on outcome

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Background: The objective of the current study was to examine the impact of a family history of pancreatic adenocarcinoma (PCA) on the outcome of patients receiving adjuvant chemoradiation therapy (CRT) following pancreaticoduodenectomy (PD). Patients and Methods: Between August 1993 and February 2005, 902 patients underwent PD for pancreatic adenocarcinoma. Following PD, 405 patients received no adjuvant CRT, while 346 patients received CRT. Another 151 patients were excluded because they received protocol treatment, neoadjuvant CRT, or were lost to follow-up. Patients who received adjuvant CRT were treated with 5-FU (97.4%) based CRT (median dose 50 Gy) and maintenance 5-FU or gemcitabine. Survival was estimated using the Kaplan-Meier method and differences in survival were examined using the log-rank test. Cox regression analysis was used to control for family history. Results: Of the 751 patients included in the study, 158 (21%) patients had a known family history of pancreatic adenocarcinoma (only one family member n=119; >=2 either first or second degree relatives, n=39). Clinicopathologic characteristics of patients with a family history of PCA were similar to those of patients who did not have a family history (age, race, positive lymph node status, primary tumor size, and proportion receiving adjuvant CRT; all P>0.05). In an analysis of the entire patient cohort, adjuvant CRT was associated with an improvement in median overall survival compared with no adjuvant CRT (21.0 months vs. 14.6 months, respectively; P= 0.001). Family history of PCA (>=1 family member) was not associated with overall survival (positive family history, 20.0 months vs. negative family history, 17.3 months; P = 0.12). Family history of PCA also did not modify the effect of CRT on overall survival. Specifically, on multivariate analysis, after stratifying on family history (>=1 family member), CRT remained significantly associated with an improved survival (Hazard ratio=0.71; P=0.001). Conclusion: Adjuvant 5-FU based CRT improves the median survival of patients with resected pancreatic adenocarcinoma. The improvement in median survival associated with adjuvant CRT was independent of a familial history of pancreatic adenocarcinoma.

No significant financial relationships to disclose.

Briefing: How recent case law affects the conduct of an expert

This article is intended to be a guide for those asked to be expert witnesses in legal proceedings, focusing particularly on the effect of recent case law in this area. It is not a substitute for looking directly at the terms of part 35 of the Civil Procedure Rules and the accompanying practice direction, nor the Protocol for the Instruction of Experts to Give Evidence in Civil Claims prepared by the Civil Justice Council.

Immune regulatory functions of human beta-defensin-2 in odontoblast-like cells

AIM

To investigate the effects of human beta-defensins on the expression of genes involved in the host immune response of the dental pulp.

METHODOLOGY

Human odontoblast-like cells were cultured in Dulbecco's modified Eagle's medium. Cells were stimulated by recombinant human beta-defensins (rhBDs) up to 4 h. RNA was extracted followed by cDNA synthesis (oligo-(dT)-primer). Samples were analysed by real-time polymerase chain reaction (PCR) technology. Genes of interest were: human beta-defensin-1, -2, interleukin (IL)-6, IL-8, tumour necrosis factor-alpha, cyclooxygenase-2, leukotriene-A4-hydrolase, cytosolic phospholipase-A-2 (cPLA(2)), and dentine sialophosphoprotein. Gene expression of beta-actin served as internal standard for normalizing real-time PCR data. Two-way anova and the paired t-test were applied for comparison of the gene expression.

RESULTS

In odontoblast-like cells rhBD-2 stimulation led to a down-regulation of the gene expression of hBD-1 (P < 0.05), whilst the mRNA expression of IL-6 (P < 0.05), IL-8 (P < 0.05) and cPLA(2) was increased in response to rhBD-2.

CONCLUSION

The results of the present study suggest immune regulatory functions of human beta-defensin-2 in odontoblast-like cells.

Drug-enhanced spinal stimulation for pain: a new strategy

Neuropathic pain is notoriously difficult to manage and only a few classes of drugs may provide adequate benefits. Thus, in many cases spinal cord stimulation (SCS) is considered; however, in this group of patients, between 30-50% of the cases offered a percutaneous SCS trial may fail to obtain a satisfactory effect. Additionally, a certain number of patients with a good initial effect, report that after a period the benefits are reduced necessitating additional peroral drug therapy. Based on animal studies of transmitters and receptors involved in the effects of SCS in neuropathic pain, the GABA-B receptor seems to play a pivotal role for the effect and, moreover, the agonist baclofen injected intrathecally in rats potentiated the SCS effect in animals not responsive to SCS per se. Based on these and further studies, 48 patients with neuropathic pain and inadequate response to SCS were given intrathecal (i.t.) baclofen (ITB) in bolus doses as an adjuvant. In this group 7 patients enjoyed such a good effect that they were implanted with both SCS and drug delivery systems for ITB. Four additional cases received baclofen pumps alone. Some other patients were given intrathecal (i.t.) adenosine in combination with SCS and initially preferred this to baclofen. The chronic use of this drug in a pump however proved to be technically problematic and all the adenosine cases were eventually terminated. At follow-ups, in average 32 and 67 months after start of SCS + baclofen therapy, more than 50% still enjoy a very good effect. The daily dose of baclofen needed to maintain the effects was approximately doubled during the observation period. There were few and mild side-effects. However, in a group of three patients with peroral baclofen therapy and SCS, complaints of side-effects were common and this therapy was terminated. Informal reports from collegues support the negative experience with additional peroral baclofen. In conclusion, in patients with neuropathic pain demonstrating inadequate response to SCS (small VAS reduction; short duration) a trial of intrathecal baclofen in combination with SCS may be warranted.

Magnetisch basierte Steigerung der Nanopartikelaufnahme in Tumorzellen: Kombination von magnetisch induzierter Zellmarkierung und magnetischer Wärmebehandlung

PURPOSE

Magnetic nanoparticles (MNP) are known to be versatile tools in diagnostic and interventional radiology. The goal of the present study was to assess whether MNP can be selectively accumulated on human adenocarcinoma cells in vitro using an external magnetic field (magnetically induced cell labeling) and whether these labeled tumor cells can then be destroyed after being exposed to an alternating magnetic field (magnetically induced heating). In this context, a long-term goal is to combine these two developing methods to achieve an additive effect in tumor therapy.

MATERIALS AND METHODS

BT-474 cells were incubated until confluence. Magnetic nanoparticles (0.32 mg Fe/ml culture medium) were then added and the flask was exposed to an external magnetic field gradient (magnetically induced cell labeling, 56 or 83 mT magnets) for 24 hours in order to label the tumor cells with nanoparticles. Cells without both MNP and magnetic labeling as well as cells with MNP incubation but without magnetic labeling served as controls. After MNP incubation, the magnetically labeled cells (5 x 10 (7) cells/ml) were exposed to an alternating magnetic field for 5.45 minutes (frequency 400 kHz, amplitude 24.6 kA/m). The combination effect of both magnetic labeling and magnetic heating was assessed by determining the temperature increase. The amount of MNP accumulated within the cells was determined by measuring the iron content via atomic absorption spectrometry. For statistical analysis mean values and standard deviations of temperature increases and iron contents were calculated and the differences were analyzed using the Student's t-test.

RESULTS

A significant temperature increase (p < 0.01) during magnetic heating of 41.76 +/- 4.60 K was detected after magnetic labeling of the cells (5 x 10 (7) cells/ml, 83 mT) incubated with MNP. In comparison, the cells incubated with MNP but without magnetic labeling revealed a temperature increase of 32.03 +/- 3.33 K, naked cells of only 2.69 +/- 0.34 K.

CONCLUSION

The results demonstrated the magnetically based enhancement of cellular uptake of nanoparticles by tumor cells, resulting in the intensification of the generated temperature increase during magnetic heating. Consequently, magnetic nanoparticles are shown to be valuable tools for the combination of magnetically based therapy modalities.

Secondary electron emission of carbonaceous dust particles

In this paper we present measurements of the secondary electron emission yield (gamma) of a carbonaceous dust particle material, which was grown in argon diluted acetylene plasmas. One aim was to reach a better understanding of charging and discharging processes of dust particles in complex plasmas due to secondary electron emission and consequently to try to explain the anomalous behavior of electron density observed in afterglows of pulsed rf plasmas. We compared the results of a simple model and of a Monte Carlo simulation to the previously measured time dependence of the electron density in complex plasma afterglow. It was found that the value of the intrinsic secondary electron yield from the carbonaceous dust material is too low to explain the increase of electron density in the afterglow. It is, however, possible that the electrons charging the particles are weakly attached so that they may be released with high efficiency by ion bombardment due to field induced emission or by other mechanisms.

Heat shock induces the synthesis of the inflammatory mediator leukotriene B4 in human pulp cells

AIM

To measure the synthesis of leukotriene B4 (LTB4) in cultures of human dental pulp cells induced by heat shock.

METHODOLOGY

Primary pulp cells (PC) and dental pulp stem cells (DPSC) were cultivated under appropriate conditions. For the characterization of PC the expression of dentine sialophosphoprotein (DSPP) was evaluated by reverse transcription-polymerase chain reaction. Thermal stimulation of cell cultures was performed at temperatures of 37, 38, 39, 40, 42 and 45 degrees C for stimulation times of 5 and 30 s. LTB4 was quantified by reversed-phase high-performance chromatography and differences between the LTB4 concentrations of controls and heat stimulated cells were analysed with Friedman analysis of variances by ranks and multiple comparisons (P < 0.05).

RESULTS

Both cell cultures expressed DSPP under the conditions of the present experiment. The analysis revealed significantly enhanced LTB4 synthesis following thermal stimulations at 38, 39, 40, 42 and 45 degrees C compared with unstimulated controls for both PC and DPSC.

CONCLUSION

The present study demonstrated the capability of pulp cells to synthesize the arachidonic acid mediator LTB4 in response to heat shock. LTB4 has the capacity to induce inflammatory reactions and to sensitise afferent nociceptive nerve endings. LTB4 synthesis is induced by minor temperature changes, which are relevant for various clinical situations.