Chemoprevention of oral cancer by green tea

Green tea has been a popular beverage for many centuries. Only recently, however, has the anti-cancer power of green tea constituents been unveiled. Green tea polyphenols are found to induce apoptosis (programmed cell death) in many types of tumor cells, including oral cancer cells. However, mechanisms that enable normal cells to evade the apoptotic effect still are not understood. In this study, cell growth and invasion assays combined with apoptosis assays were used to examine the effects of green tea extracts, green tea polyphenols, and the most potent green tea polyphenol, (-)-epigallocatechin-3-gallate (EGCG), on normal human keratinocytes and oral carcinoma cells. The results showed that green tea and its constituents selectively induce apoptosis only in oral carcinoma cells, while EGCG was able to inhibit the growth and invasion of oral carcinoma cells. These differential responses to green tea and its constituents between normal and malignant cells were correlated with the induction of p57, a cell cycle regulator. These data suggest that the chemopreventive effects of green tea polyphenols may involve a p57 mediated survival pathway in normal epithelial cells, while oral carcinoma cells undergo an apoptotic pathway. Therefore, regular consumption of green tea could be beneficial in the prevention of oral cancer.     

Autoimmune bullous dermatoses: a review

Bullous dermatoses can be debilitating and possibly fatal. A selection of autoimmune blistering diseases, including pemphigus vulgaris, paraneoplastic pemphigus, bullous pemphigoid, cicatricial pemphigoid, dermatitis herpetiformis and linear IgA dermatosis are reviewed. Pemphigus vulgaris usually starts in the oral mucosa followed by blistering of the skin, which is often painful. Paraneoplastic pemphigus is associated with neoplasms, most commonly of lymphoid tissue, but also Waldenstr?m's macroglobulinemia, sarcomas, thymomas and Castleman's disease. Bullous pemphigoid is characterized by large, tense bullae, but may begin as an urticarial eruption. Cicatricial (scarring) pemphigoid presents with severe, erosive lesions of the mucous membranes with skin involvement in one third of patients focused around the head and upper trunk. Dermatitis herpetiformis is intensely pruritic and chronic, characterized by papulovesicles and urticarial wheals on the extensor surfaces in a grouped or herpetiform, symmetric distribution. Linear IgA dermatosis is clinically similar to dermatitis herpetiformis, but it is not associated with gluten-sensitive enteropathy as is dermatitis herpetiformis.     

Characterization of tissue resistance during a dorsally directed translational mobilization of the glenohumeral joint

OBJECTIVES: To quantify forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint, to determine the relationship of tissue resistance to the load-displacement relation of the glenohumeral joint, and to determine the safety of the forces applied by the therapists during dorsal glide translational mobilization. DESIGN: A fresh cadaver shoulder specimen mounted on a 6-axis load cell was used to register forces applied by therapists during dorsal glide translational mobilization of the glenohumeral joint in a test-retest pattern. SETTING: Biomechanics laboratory. PARTICIPANTS: Twelve experienced orthopedic physical therapists. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Forces exerted by therapists during passive dorsal glide translational mobilization in the loose-packed position and in the end range of abduction, with different grades of movements. The movements did not include any manipulation or thrust-type procedures. Simulated dorsal glide procedures were performed by the material testing system to construct the load-displacement curve of the glenohumeral specimen. The corresponding locations of the forces applied by therapists were interpolated and plotted on the load-displacement curve. RESULTS: The peak force values measured during mobilization were characterized by large intertherapist variability: coefficients of variation ranged from 40.97% to 77.49%. Test-retest reliability for intrasession measures was high (ICC(2,1) range,.90-.94); intersession reliability was poor (ICC(2,1) range,.01-.54). The mean forces ranged from 18.36 to 38.76N. When interpolated to the load-displacement curve, the mean peak forces obtained fell mostly in the toe and the linear elastic regions of the load-displacement curve. CONCLUSION: Force parameters measured during dorsal glide mobilization were characterized by large intertherapist variability with high intrasession and poor intersession test-retest reliability. The mobilization forces applied by experienced orthopedic physical therapists fall safely in the toe and the linear elastic regions of the load-displacement curve.     

Increased hepatic peroxisome proliferator-activated receptor-gamma coactivator-1 gene expression in a rat model of intrauterine growth retardation and subsequent insulin resistance

Uteroplacental insufficiency and subsequent intrauterine growth retardation (IUGR) increase the risk of type 2 diabetes in humans and rats. Unsuppressed endogenous hepatic glucose production is a common component of the insulin resistance associated with type 2 diabetes. Peroxisome proliferator-activated receptor-gamma coactivator-1 (PGC-1) mediates hepatic glucose production by controlling mRNA levels of glucose-6-phosphatase (G-6-Pase), phosphoenolpyruvate carboxykinase (PEPCK), and fructose-1,6-bisphosphatase (FBPase). We therefore hypothesized that gene expression of PGC-1 would be increased in juvenile IUGR rat livers, and this increase would directly correlate with hepatic mRNA levels of PEPCK, G-6-Pase, and FBPase, but not glucokinase. We found that IUGR hepatic PGC-1 protein levels were increased to 230 +/- 32% and 310 +/- 47% of control values at d 0 and d 21 of life, respectively. Similarly, IUGR hepatic PGC-1 mRNA levels were significantly elevated at both ages. Concurrent with the increased PGC-1 gene expression, IUGR hepatic mRNA levels of G-6-Pase, PEPCK, and FBPase were also significantly increased, whereas glucokinase mRNA levels were significantly decreased. These data suggest that increased PGC-1 expression and subsequent hepatic glucose production contribute to the insulin resistance observed in the IUGR juvenile rat.     

Improvement of clinical outcome by early nephrology referral in type II diabetics on hemodialysis

OBJECTIVES: To evaluate the influence of early nephrology referral on clinical outcome in type II diabetes mellitus patients on maintenance hemodialysis dialysis. PATIENTS AND METHODS: This study retrospectively analyzed the type II diabetic patients entering our PD program from February 1988 to June 2001. Patients who were presented to a nephrologist more than 6 months before starting dialysis were defined as early referral (ER). Patients were considered late referral (LR) if they were transferred to the nephrology department within 6 months before initial dialysis. RESULTS: Hundred and fifteen type II diabetic patients receiving HD for at least 3 months were enrolled in this study. Sixteen of the 53 patients (46.1%) were in the ER group and 62 of the 115 (53.9%) were in the LR group. In univariate analysis by Cox proportional hazards mode, the early referral (Exp (Coef) = 0.423, p < 0.01), good glycemic control (Exp (Coef) = 0.16, p < 0.05), and age at dialysis (Exp (Coef) = 1.026, p < 0.05 (had significantly influenced the patient survival. The residual renal function in the ER group, estimated by creatinine clearance (Ccr), significantly exceeded that of the LR group (ER vs. LR: 4.46 +/- 1.56 vs. 2.51 +/- 1.70 mL/min, p < 0.001). The patients with early referral had significantly better survival (p < 0.05). Five-year survival improved significantly in the early referral group compared to the late referral group (ER: 72.4%; LR: 35.2%, p < 0.05). CONCLUSIONS: We demonstrate that the time of referral before starting dialysis is a predictor of survival for type II diabetics on HD. Patients with early referral are associated with longer survival. The beneficial effect might be associated with the timely initiation of the chronic HD program. These results suggest that early referral before dialysis is important in determining the long-term prognosis in type II diabetics on HD.     

Demographics of 353 laparoscopic renal donor and recipient pairs at the Johns Hopkins Medical Institutions

BACKGROUND AND PURPOSE: The demographics of laparoscopic donor nephrectomy (LDN) have not been characterized in detail. The aim of this study was to review our LDN experience with respect to donor and recipient demographic characteristics and trends. PATIENTS AND METHODS: Over a 6-year period, 353 patients underwent LDN. A retrospective chart review was performed to identify the donor and recipient demographic characteristics and trends associated with the procedure. RESULTS: Among the donors, the mean age was 41 years, with a predominance of females (59.2%), whites (76.2%), and blood relations (72%). Siblings were the most common related-donor-to-recipient relationship, and spouses were the most common unrelated relationships. Among the recipients, the mean age was 43 years, with a predominance of males (58.4%), whites (73.7%), and dialysis-dependent patients (55%). Diabetes mellitus and hypertension were the most common causes of end-stage renal failure. With the introduction of laparoscopy, there was a nearly twofold increase in the total number of live renal donations, and there was a significant expansion in the unrelated-donor pool. CONCLUSIONS: Laparoscopic harvest of donated kidneys is associated with new trends that may help alleviate the current organ shortage.