<Emphasis Type="Italic">Metallothionien 3</Emphasis> expression is frequently down-regulated in oesophageal squamous cell carcinoma by DNA methylation

Background  

Metallothionein 3 (MT3) inhibits growth in a variety of cell types. We measured MT3 gene expression by RT-PCR, and DNA methylation in the MT3 promoter by combined bisulphite restriction analysis, in four oesophageal cancer cell lines and the resected oesophagus from 64 patients with oesophageal squamous cell carcinoma (SCC).     

Objective assessment of urinary incontinence in women: comparison of the one-hour and 24-hour pad tests

OBJECTIVE: To compare the performance and clinical usefulness of the one-hour and 24-hour pad tests in terms of the relationship with reported symptoms and urodynamic diagnosis. METHODS: 341 women aged 40 years and over reporting lower urinary tract symptoms who were recruited to a nurse led continence service, and went on to receive urodynamics, a one-hour and a 24-hour pad test and completed a urinary diary. RESULTS: For both pad tests, there was a significant difference in the amount of urine leaked between the different urodynamic diagnoses (p<0.0001, for the one-hour and p=0.001 for the 24-hour test). Women with sphincter incompetence leaked significantly more than women with detrusor instability, or those with no abnormality. There was a significant difference between the proportion of women dry on a one-hour pad test and those dry on a 24-hour pad test (26.0% versus 38.4%, difference 12.4%; CI 5.5; 19.4). There is a positive relationship between amount of urine leakage and symptom severity expressed in terms of number of incontinent episodes for both pad tests. CONCLUSION: Both pad tests bore little relationship to the underlying urodynamic diagnosis but there was a positive relationship with symptom severity. The 24-hour pad test appears to be clinically a more useful too than the one-hour test. The two types of pad test are probably assessing incontinence in different ways. We suggest that the minimum data set should include structured questions, diaries and the 24-hour pad test.     

Thinking beyond CPOE to integrated IT strategy and management

There is a tremendous amount of pressure driving organizations to implement computerized provider order entry. To unlock the greatest value, a more enterprise-wide strategic approach to healthcare IT is needed.     

Supplemental beta-carotene, smoking, and urinary F2-isoprostane excretion in patients with prior early stage head and neck cancer

Supplemental beta-carotene has been shown to increase lung cancer risk in recent chemoprevention trials, especially in current smokers. Several possible mechanisms for this effect have been suggested based upon in vitro and animal studies, but mechanistic data from human studies to explain the excess risk are lacking. beta-Carotene has both antioxidant and prooxidant effects in vitro; therefore, we evaluated whether or not high-dose supplemental beta-carotene might have prooxidant effects in vivo, especially in current smokers taking high-dose supplemental beta-carotene for several years (median 4.0 yr). Urine samples (n = 55 total) were collected from both smokers and nonsmokers participating in a multiyear randomized chemoprevention trial of supplemental beta-carotene (50 mg/day) versus placebo. Samples were analyzed by GC/MS for total isoprostanes and for 8-iso-prostaglandin F2 (8-iso-PGF2), stable end products of lipid peroxidation in vivo. Smokers had higher levels of both total isoprostanes and 8-iso-PGF2. Smokers and nonsmokers randomized to beta-carotene had nonsignificantly lower concentrations of total isoprostanes and of 8-iso-PGF2 [mean +- SD 8-iso-PGF2/ml = 2.00 +- 1.72 (placebo smoker); 1.72 +- 1.66 (beta-carotene smoker); 1.22 +- 0.68 (placebo nonsmoker); 0.97 +- 0.62 (beta-carotene nonsmoker)]. These results indicate that supplemental beta-carotene, even when given at high doses for many years, does not have prooxidant effects in either smokers or nonsmokers, as measured by urinary excretion of F2-isoprostanes.     

Stress and immune responses of nestling tree swallows (Tachycineta bicolor) and eastern bluebirds (Sialia sialis) exposed to nonpersistent pesticides and p,p'-dichlorodiphenyldichloroethylene in apple orchards of southern Ontario, Canada

To determine the relative effects of pesticides in current use and persistent residues of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), we examined endocrine and immune responses in tree swallow (Tachycineta bicolor) and eastern bluebird (Sialia sialis) chicks from pesticide-sprayed apple orchards and reference sites in southern Ontario, Canada, during 2000 to 2001. Nests were exposed to as many as seven individual pesticide applications and up to five mixtures of pesticides during the egg-incubation and chick-rearing stage. Eggs collected from sprayed orchards contained higher p,p'-DDE concentrations than eggs from reference sites. In 16-d-old tree swallows, no significant differences were found in body mass, basal corticosterone concentration, or the corticosterone stress response following a 10-min restraint of chicks sampled from sprayed orchards and reference sites. Challenge with adrenocorticotrophic hormone (ACTH), however, produced a higher level of corticosterone secretion in tree swallow chicks from sprayed orchards relative to chicks from reference sites. Multiple regression analysis revealed no correlation between corticosterone concentrations and exposure to pesticide sprays or p,p'-DDE in tree swallow chicks. In contrast, bluebird chicks from sprayed orchards were less responsive to challenge with ACTH and a significant negative association was found between the response to ACTH challenge and p,p'-DDE concentration in eggs. The phytohemagglutinin (PHA)-induced cutaneous basophil hypersensitivity response was similar between exposure groups in both tree swallow and bluebird nestlings. Examination of immune organs revealed that tree swallow chicks from sprayed orchards had significantly greater thymic lymphocyte density and cortical/ medullary ratios and significant splenic B-cell hyperplasia relative to reference chicks. Our results indicate that modulation in the hypothalamus-pituitary-adrenal axis in songbird chicks tested are most associated with high p,p'-DDE egg concentrations. An alteration in the endocrine or immune system may compromise songbird survival immediately after fledging or during migration.