GSTP1 polymorphisms and gastric cancer in a high-risk Chinese population

Objectives: In a population-based case–control study in Yangzhong, China, we investigated the relationship between genetic polymorphisms of GSTP1 and susceptibility to gastric cancer and its premalignant lesion, chronic gastritis. The possible gene–gene interactions between GSTP1 polymorphisms and GSTM1, GSTT1 genes were explored. Methods: Epidemiologic data were collected by standard questionnaire from 133 gastric cancer cases, 166 chronic gastritis cases, and 433 cancer-free population controls. Blood samples for Helicobacter pylori and molecular marker assays were collected from 84 gastric cancer cases, 146 chronic gastritis, and 429 population controls. GSTP1 polymorphisms were determined by the PCR-RFLP method and H. pylori infection was measured by the ELISA method. Associations between certain GSTP1 genotypes and both gastric cancer and chronic gastritis were assessed by odds ratios (ORs) and 95% confidence intervals (CIs) derived from logistic regression. Results: The distributions of three GSTP1 genotypes, Ile/Ile, Ile/Val, and Val/Val, were similar in gastric cancer cases, chronic gastritis, and controls. After adjusting for age, gender, education, body mass index, pack-year of smoking, alcohol drinking, H. pylori infection, salt and fruit intakes, the adjusted ORs of Val/Val were 1.3 (95% CI: 0.1–11.2) for gastric cancer and 0.9 (95% CI: 0.2–4.8) for chronic gastritis. Combining the Val alleles (Val/Val and Ile/Val) into one group, no association was observed between GSTP1 and both gastric cancer and chronic gastritis. In addition, the allelism at the GSTP1 locus did not increase gastric cancer and chronic gastritis risks associated with the GSTM1 or GSTT1 genotypes. Conclusion: Our data suggest that the GSTP1 genotype seems not to be associated with the risk of gastric cancer and chronic gastritis in a high-risk Chinese population.     

A holder for standardized radiological detection of ulnar capsule-ligament lesions of the thumb base joint

AIM OF THE STUDY: To evaluate the usefulness of a self-constructed holding device for standardized, investigator-independent radiodiagnostics for ulnar capsulo-ligamentous lesions of the thumb metacarpophalangeal joint compared to the uninjured side. MATERIAL AND METHODS: A holding device for stress roentgenograms was constructed. Normal abduction arcs were evaluated in 20 degrees flexion in 28 healthy volunteers. The investigator-dependent variance was assessed. The study group comprised 123 consecutive patients (68 male, 55 female, aged 7 to 68 years, mean age 30 years). RESULTS: The normal arc of abduction was calculated to be 12 degrees (range 3 degrees to 24 degrees), while the mean individual difference in side by side comparison in volunteers was 0.3 degree (SD 2.69 degrees, range 0 degree-8 degrees). A rupture was diagnosed in 47 patients; 41 were operated. The preoperative diagnoses confirmed correct in all operated patients. A difference of greater than 6 degrees is indicative of a rupture with a sensitivity of 66.7% and a specificity of 96.9%. CONCLUSIONS: In summary, the holding device is useful for the practical work. Individual differences of less than 4 degrees are negative, between 4 degrees and 7 degrees questionable positive, between 7 degrees and 12 degrees are positive and over 12 degrees proof indicator of a rupture of the ulnar collateral ligament of the thumb metacarpophalangeal joint.     

Vascular and hepatocellular peroxynitrite formation during acetaminophen toxicity: role of mitochondrial oxidant stress.

Peroxynitrite may be involved in acetaminophen-induced liver damage. However, it is unclear if peroxynitrite is generated in hepatocytes or in the vasculature. To address this question, we treated C3Heb/FeJ mice with 300 mg/kg acetaminophen and assessed nitrotyrosine protein adducts as indicator for peroxynitrite formation. Vascular nitrotyrosine staining was evident before liver injury between 0.5 and 2 h after acetaminophen treatment. However, liver injury developed parallel to hepatocellular nitrotyrosine staining between 2 and 6 h after acetaminophen. The mitochondrial content of glutathione disulfide, as indicator of reactive oxygen formation determined 6 h after acetaminophen, increased from 2.8 +/- 0.6% in controls to 23.5 +/- 5.1%. A high dose of allopurinol (100 mg/kg) strongly attenuated acetaminophen protein-adduct formation and prevented the mitochondrial oxidant stress and liver injury after acetaminophen. Lower doses of allopurinol, which are equally effective in inhibiting xanthine oxidase, were not protective and had no effect on nitrotyrosine staining and acetaminophen protein adduct formation. In vitro experiments showed that allopurinol is not a direct scavenger of peroxynitrite. We conclude that there is vascular peroxynitrite formation during the first 2 h after acetaminophen treatment. On the other hand, reactive metabolites of acetaminophen bind to intracellular proteins and cause mitochondrial dysfunction and superoxide formation. Mitochondrial superoxide reacts with nitric oxide to form peroxynitrite, which is responsible for intracellular protein nitration. The pathophysiological relevance of vascular peroxynitrite for hepatocellular peroxynitrite formation and liver injury remains to be established.     

The diagnostic significance of an assay for 'total' hepatitis C core antigen.

A measurable serological response to hepatitis C infection is delayed on average until 70 days after infection. In addition, it may not occur in some immunocompromised people. Detection of free hepatitis C (HCV) core antigen in blood has enabled diagnosis in the pre-seroconversion period. The ability to detect 'total' HCV core antigen, both free and antibody bound, would widen its use for confirming anti-HCV antibody positive patients and monitoring a therapeutic response. This study has evaluated a prototype 'total' HCV core antigen immunoassay. Sera from 145 HCV negative blood donors gave a mean value of 54.9 (+/-46.2) pg/ml based on recombinant antigen standards. Using these figures, the HCV core antigen cut-off was set as 200 pg/ml. Two hundred blood donors sera with indeterminant (a single-band on recombinant immunoblot assay) HCV antibody statuses gave fully concordant HCV core antigen results compared to their polymerase chain reactions (PCRs)--three positive, and 197 negative. HCV core antigen and PCR results were compared for 59 sera from 19 HCV positive liver disease patients. The HCV core antigen results were in complete agreement with their PCRs for the nine patients always PCR positive and the three continuously negative. For six patients on antiviral therapy whose qualitative PCRs changed from positive to negative, the HCV core antigen results paralleled the PCR results. The only discrepant results were from one patient whose PCR results went from negative to positive. 'Total' HCV core antigen testing will greatly improve the scope of diagnostic tests for hepatitis C.     

Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States

The purpose of the present study was to identify the factors that influence the selection of hydrocodone and oxycodone as primary drugs of abuse in opioid-dependent subjects (n = 3520) entering one of 160 drug treatment programs around the country. Anonymous, self-administered surveys and direct qualitative interviews were used to examine the influence of demographic characteristics, drug use patterns, and decision-related factors on primary opioid selection. Our results showed that oxycodone and hydrocodone were the drugs of choice in 75% of all patients. Oxycodone was the choice of significantly more users (44.7%) than hydrocodone (29.4%) because the quality of the high was viewed to be much better by 54% of the sample, compared to just 20% in hydrocodone users, who cited acetaminophen as a deterrent to dose escalation to get high and hence, its low euphoric rating. Hydrocodone users were generally risk-averse women, elderly people, noninjectors, and those who prefer safer modes of acquisition than dealers (ie, doctors, friends, or family members). In contrast, oxycodone was a much more attractive euphorigenic agent to risk-tolerant young, male users who prefer to inject or snort their drugs to get high and are willing to use more aggressive forms of diversion. Prevention and treatment approaches, and pain physicians, should benefit from these results because it is clear that not all drug abusers share the same characteristics, and the decision to use one drug over another is a complex one, which is largely attributable to individual differences (eg, personality, gender, age, and other factors).     

<Emphasis Type="Bold">Les apports des Plans cancer dans l’amélioration des pratiques professionnelles en oncogériatrie : le point de vue des professionnels</Emphasis> (in partie I : Les apports des Plans cancer au service de l’amélioration des pratiques professionnelles)

Having successfully gone through the onset of pilot units in oncogeriatrics, which turned into regional coordination units, the oncogeriatric practice is nowadays a part of oncologists’ routine practice. In the light of our experience in this development, we present a global outlook on the advances and pitfalls of changing practices in oncogeriatrics as well as the stakes in the years to come.