Vimentin silencing effect on invasive and migration characteristics of doxorubicin resistant MCF-7 cells

Chemotherapy is one of the well-known treatments in cancer therapy. The effectiveness of chemotherapy is limited by several factors one of which is the emergence of multidrug resistance (MDR). One of the major mechanisms of MDR is the activity of several ATP binding cassette (ABC) transporters that pump drugs out of the cells. Doxorubicin intercalates and inhibits DNA replication; it is a powerful chemotherapeutic agent. However, it causes development of MDR in tumor cells. Vimentin is a type III intermediate filament protein that is expressed frequently in epithelial carcinomas correlating with invasiveness and also poor prognosis of cancer. There are several studies that have shown the connection between expression level of vimentin and invasiveness of tumor cells. In this study, MCF-7 cell line which is a model for human mammary carcinoma, and a doxorubicin resistant subline (MCF-7/Dox) were used. The resistant subline was previously obtained by stepwise selection in our laboratory. In the resistant cells, high levels of vimentin expression were observed. The main purpose of this study was to investigate changes in invasive and migration characteristics of MCF-7/Dox cell line, after transient silencing of vimentin gene by specific siRNA.     

Impact of early versus late enteral nutrition on cell mediated immunity and its relationship with glucagon like peptide-1 in intensive care unit patients: a prospective study

Introduction

Glucagon-like peptide-1 (GLP-1) originates from the gastrointestinal system in response to the presence of nutrition in the intestinal lumen and potentiates postprandial insulin secretion. Also, it acts as an immune-modulator which has influences on cell-mediated immunity.The aim of this study was to determine the impact of early enteral nutrition versus late enteral nutrition on plasma GLP-1 levels and the relationship between GLP-1 changes and cell-mediated immunity.

Materials and methods

The study was designed as a prospective, single-blinded study and carried out in the neurology intensive care unit (ICU) of a university hospital. Twenty-four naive patients with acute thromboembolic cerebrovascular events, with National Institute of Health (NIH) stroke scores between 12 and 16, were included. Any condition interfering with GLP-1 and immunity was regarded as exclusion criterion. Two patients died, and two dropped out of the study due to complicating conditions.Patients were randomly subjected to early enteral feeding within the first 24 hours (Group 1), or late enteral feeding, beginning 48 hours after admission (Group 2) via a nasogastric tube. Calculated daily energy requirement was supplemented with parenteral nutrition, starting on the first study day for both groups. Blood samples were obtained before, and at 5, 15, 30, 60 and 120 minutes after the first enteral feeding for GLP-1 assays; this procedure was repeated on the third day. Before and 24 hours after the first enteral feeding, samples were also taken for immunological analysis. Clinical observations were recorded.Pre- and post-feeding plasma GLP-1 changes between the two groups and within groups were evaluated. Lymphocyte subgroup changes before and 24 hours after the first enteral feeding in relation to GLP-1 changes were sought as well.

Results

Group 1 and Group 2 exhibited similar GLP-1 levels in the pre-feeding and post-feeding periods for both the first time and the third day of enteral feeding. Also, no significant change in pre-/post-feeding GLP-1 levels was observed within groups. T-helper and T-regulatory cells increased, T-cytotoxic cells decreased significantly in Group 1 (P = 0.02; P = 0.036; P = 0.0019), but remained the same in Group 2 after enteral feeding. Positive but statistically insignificant clinical effects in terms of predisposition to infections (10% vs 40%) and median time of ICU stay (10 vs 15 days) were observed in Group 1.

Conclusions

Depending on our findings, we propose that early enteral feeding may cause amelioration in cell-mediated immunity via factors other than GLP-1 in ICU patients with acute thromboembolic stroke. However, the possible deleterious effects of parenteral nutrition cannot be ruled out.     

Therapeutic plasma exchange in patients with neurological diseases: Multicenter retrospective analysis

Therapeutic plasma exchange (TPE), is a procedure, changing pathologic substances in the plasma of patients with replacement fluid. TPE has an increasing list of indications in recent years such as neurological, connective tissue, hematological, nephrological, endocrinological and metabolic disorders. We report our multicenter data about therapeutic plasma exchange in patients with neurological diseases. Six University Hospitals’ aphaeresis units medical records about neurologic diseases were reviewed retrospectively. Hundred and fifteen patients and 771 TPE sessions from six aphaeresis units’ were included to this study. Of the 115 patients, 53 (46%) were men and 62 (54%) were women. The median age was 50 (range: 5–85) years. Of these patients 58.3% were Guillain–Barre syndrome (GBS), 17.4% were acute disseminated encephalomyelitis (ADEM), 10.4% were chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), 7% were multiple sclerosis, 6.1% were myasthenia gravis (MG) and 0.9% were Wilson disease (WD). The median number of TPE sessions per patient was 5 (range 1–72). Human albumin was used as a replacement fluid in 66% and fresh frozen plasma was used in 34% of cases. TPE was done through central venous catheters in 66%, and peripheral venous access in 34% of patients. Some complications were seen in patients (18.3%) during TPE sessions. These complications were, complications related to catheter placement procedure (8.7%), hypotension (3.5%), hypocalcaemia (3.5%) and allergic reactions (1.7%). The complication ratios were 2.7% in total 771 TPE procedures. TPE procedure was terminated in 6% of sessions depending on these complications. Overall responses to TPE were noted in 89.5% of patients.In conclusion; Therapeutic plasma exchange is an effective treatment option in several neurologic diseases.     

Does the diameter of an endometrioma predict the extent of pelvic adhesions associated with endometriosis?

OBJECTIVE: To correlate ovarian endometrioma diameter with the extent of pelvic adhesions. STUDY DESIGN: Forty women with unilateral ovarian cysts thought to be endometriomas were prospectively recruited. The interventions were transvaginal ultrasound to measure the size of the ovarian endometrioma and a laparoscopic surgical procedure, including detailed pelvic assessment. Main outcome measures were pelvic adhesion scores using the American Fertility Society revised classification of endometriosis. RESULTS: Thirty-two women met the inclusion criteria. Twelve had an endometrioma < 3 cm in diameter; 12, 3-5 cm; and 8, > 5 cm. Adhesion scores from various anatomic areas did not differ across these 3 groups. No correlation between the size of the endometrioma and associated pelvic adhesions was found using multiple regression analysis. CONCLUSION: The size of an endometrioma measured by transvaginal ultrasound does not correlate with the extent of adhesive disease. Small (< 3 cm) endometriomas may be associated with a considerable degree of pelvic adhesions.     

Placebo-controlled randomized comparison of vaginal with rectal misoprostol in the prevention of postpartum hemorrhage

AIM: To compare vaginally administered misoprostol to rectally administered misoprostol and placebo in a prospective randomized placebo-controlled study. METHODS: One hundred and fifty women with singleton vaginal deliveries were randomized (50 women in each arm) to receive 400-microg misoprostol tablets (crushed and suspended in a microenema) intravaginally, or 400-microg misoprostol tablets rectally, or two placebo lactose tablets rectally. The medication was administered immediately after delivery of the placenta. Women with profuse hemorrhage and delayed placental separation (>30 min) were excluded. Our outcome measures were postpartum blood loss 1 h after administration, and change in hemoglobin and hematocrit values from baseline to postpartum day 1. Analysis of variance and chi-squared tests were used to compare the outcome variables between groups. RESULTS: One hundred and twenty-six women were available for analysis. Baseline characteristics were similar across the groups. The number of excluded subjects, the estimated blood loss, and the drop in hemoglobin and hematocrit values did not differ between the three groups (P > 0.05). CONCLUSIONS: Misoprostol administered vaginally or rectally at a dosage of 400 microg following placental separation was not effective for decreasing postpartum bleeding in women without excessive hemorrhage.