Chemoprevention of liver cancer by plant polyphenols

Primary liver cancer or hepatocellular carcinoma (HCC) is one of the most frequent tumors representing the fifth commonest malignancy worldwide and the third cause of mortality from cancer. Currently, the treatments for HCC are not so effective and new strategies are needed for its fight. Chemoprevention, the use of natural or synthetic chemical agents to reverse, suppress or prevent carcinogenesis is considered an important way for confronting HCC. Many of the chemopreventive agents are phytochemicals, namely non-nutritive plant chemicals with protective or disease preventive properties. In this review, we focus on plant polyphenols, one of the most important classes of phytochemicals, their chemopreventive properties against HCC and discuss the molecular mechanisms accounting for this activity.     

Peripheral Neurostimulation for the Treatment of Refractory Cluster Headache,Long-Term Follow-Up: Case Report

Introduction: Cluster headache is a headache syndrome characterized by periodic episodes of intense headache with spontaneous remission. There are recent reports utilizing occipital nerve stimulation for the successful management of medically refractory cases of cluster headache. Methods: The case of an 18‐year‐old boy with chronic, refractory, recurrent cluster headaches is presented. He was treated surgically with combined occipital, supraorbital, and infraorbital nerve stimulation. Results: Prior to operation, the patient suffered three to four episodes of cluster headache per day, for four years. After implantation of occipital, supraorbital, and infraorbital nerve stimulators, the patient averages at most three to four headaches per month, at 36‐month follow‐up. Conclusion: Peripheral neurostimulation is safe and efficacious in the management of chronic, medically refractory cluster headache syndrome. The efficacy of treatment was found to be persistent after three years.     

Operation of the voltage sensor of a human voltage- and Ca2+-activated K+ channel

Voltage sensor domains (VSDs) are structurally and functionally conserved protein modules that consist of four transmembrane segments (S1–S4) and confer voltage sensitivity to many ion channels. Depolarization is sensed by VSD-charged residues residing in the membrane field, inducing VSD activation that facilitates channel gating. S4 is typically thought to be the principal functional component of the VSD because it carries, in most channels, a large portion of the VSD gating charge. The VSDs of large-conductance, voltage- and Ca²⁺-activated K⁺ channels are peculiar in that more gating charge is carried by transmembrane segments other than S4. Considering its “decentralized” distribution of voltage-sensing residues, we probed the BK_Ca VSD for evidence of cooperativity between charge-carrying segments S2 and S4. We achieved this by optically tracking their activation by using voltage clamp fluorometry, in channels with intact voltage sensors and charge-neutralized mutants. The results from these experiments indicate that S2 and S4 possess distinct voltage dependence, but functionally interact, such that the effective valence of one segment is affected by charge neutralization in the other. Statistical-mechanical modeling of the experimental findings using allosteric interactions demonstrates two mechanisms (mechanical coupling and dynamic focusing of the membrane electric field) that are compatible with the observed cross-segment effects of charge neutralization.     

The role of the facial nerve latency test in the prognosis of Bell's Palsy

Eighty patients with idiopathic facial nerve palsy were evaluated by the facial nerve latency test. Depending on the latency time, the patients were classified into the following four groups: group A patients had normal latency times (3.25 msec); group B patients had slightly extended latency times (4 to 7 msec) and a mean of 5.6 msec; group C patients had extended latency times (10 to 14 msec) and a mean of 10.2 msec; and group D patients displayed complete disappearance of evoked compound muscle action potential (no responses). Under the same therapeutic regimen, it was determined that, when the latency time was normal or close to normal, the functional recovery of the nerve was complete or almost complete, and the recovery time was short. When the latency time was extended or there was no response, the functional recovery of the nerve was either incomplete or absent.     

Modified anatrophic nephrolithotomy for complete staghorn calculus disease -- does it still have a place?

OBJECTIVE: To report our experience with open surgery for the management of complete staghorn calculi using a modified anatrophic nephrolithotomy technique. MATERIAL AND METHODS: Between 1990 and 2001, 24 patients underwent anatrophic nephrolithotomy in our department. Bilateral complex stone disease was present in 9 patients, so that a total of 33 procedures were carried out. Preoperative evaluation included excretory urography (intravenous pyelography) and routine laboratory study in all patients and in 9 patients renal function was assessed using (99m)Tc dimercaptosuccinic acid renal scans before and 6 months after surgery. Postoperative follow-up consisted of kidney-ureter-bladder (KUB), ultrasound (U/S), urinalysis and urine culture. RESULTS: The mean operative time was 180 min, mean blood loss was 500 ml and renal ischemia time ranged between 10 and 35 min. Deep vein thrombosis occurred on the 5th postoperative day in an obese female patient. No other operative or postoperative complications were observed. Mean hospital stay was 8.2 days (range 7-12 days). The stone-free rate was 83.3%. Long-term follow up demonstrated stone fragments <4 mm in diameter in 4 patients (16.6%). Renal function remained unchanged or slightly improved in 15 patients; a slight worsening of renal function was noted in 9 patients (from an average of 39% before to 35% after the procedure). CONCLUSIONS: Anatrophic nephrolithotomy, although a major operative procedure, remains the most appropriate method for the one-stage management of a selected group of patients harboring large staghorn calculi with infundibular stenosis, and is associated with the highest stone-free rates.     

Assessment of patient effective radiation dose and associated radiogenic risk from extracorporeal shock-wave lithotripsy

The aim of the present study was to calculate patient effective dose and associated radiogenic risk from fluoroscopy guided extracorporeal shock-wave lithotripsy procedures. Fluoroscopy required during extracorporeal shock-wave lithotripsy was classified in two types identified by beam orientation: antero-posterior and 30 degrees anterior-oblique projected exposures. Duration of each exposure was monitored in 124 patients undergoing extracorporeal shock-wave lithotripsy treatment for ureteral stones. The dose from a kidney-ureter-bladder radiograph and the dose per min of fluoroscopy along antero-posterior and anterior-oblique projections were measured at 13 organs/tissues using an anthropomorphic phantom and thermoluminescence dosimetry. A radio-opaque object was placed in the phantom to simulate an ureteral stone at the proximal and distal ureter. The total effective dose in male and female patients with proximal ureteral stones was 1.71 mSv and 1.82 mSv, respectively. The corresponding values for male and female patients with distal ureteral stones was 0.76 mSv and 1.62 mSv, respectively. In the United States, the theoretical sex-averaged radiogenic excess of fatal cancers was estimated to be 140 per million and 85 per million of patients treated for proximal and distal ureteral stone, respectively. The average radiogenic risk for genetic defect associated to treatments of proximal and distal ureteral stones was found to be 2.5 and 24.4 per million of births, respectively. The radiation risk from a typical fluoroscopy guided extracorporeal shock-wave lithotripsy treatment of ureteral stones is low. Presented data may be used to determine patient effective dose from extracorporeal shock-wave lithotripsy procedures performed in any laboratory.     

Expression of peroxisome proliferator activated receptor-gamma in non-small cell lung carcinoma: correlation with histological type and grade

For the metastasis and invasion of cancer cells, destruction of extracellular matrix is essential. In this process, collagen is broken down by some matrix metalloproteinases. Matrix metalloproteinase 2 (MMP2) is able to cleave type IV collagen, and membrane-type-1-matrix metalloproteinase (MT1-MMP) induces activation of proMMP2. We investigated the expressions of MT1-MMP and MMP2 and their relation to both clinicopathologic parameters and clinical outcome in non-small cell lung carcinomas (NSCLC). Eighty-nine specimens of NSCLC were examined using in situ hybridization and immunohistochemistry. Each metalloproteinase was expressed within the cytoplasm of tumor cells with or without stromal cells in NSCLC. Tumors in which tumor cells strongly stained for MT1-MMP mRNA or protein made up more than 50% of the tumor area were found in 44 and 26% of cases, respectively. The corresponding values for MMP-2 mRNA and protein, were 51 and 26%. Our analysis of clinicopathological findings revealed a significant positive relationship between MT1-MMP mRNA and p-M. The correlation between MMP2 protein-staining status and overall survival rate reached significance in the univariate analysis. However, an association was not demonstrated in the multivariate analysis. The detection of MT1-MMP and MMP2 is likely to be of limited value in informing the prognosis in NSCLC.