Fungal endophthalmitis in a tertiary care cancer center: a review of 23 cases

Few data exist on the etiology, presentation, prognosis, and management of fungal endophthalmitis (FE) in cancer patients. FE cases were identified by reviewing the ophthalmology reports and microbiology cultures of patients at The University of Texas M. D. Anderson Cancer Center. We retrospectively reviewed the medical records and obtained information related to malignancy, fungal infection and its management, visual outcome, and mortality. We compared FE caused by Candida spp. (CE) to FE caused by molds (ME). Of the 102 cancer patients with a fungal infection for whom an ophthalmology consult was requested, 23 met the criteria for definite (N = 6) or probable (N = 17) FE (8 with CE, 15 with ME). All of the patients with ME had hematologic malignancies, whereas half of the patients with CE had solid tumor (P = .008). Only patients with CE had a history of surgery within 30 days of FE diagnosis (38%, P = .03). Fungal pneumonia [17 (74%)] and disseminated infection [14, (61%)] were common. The most common presenting symptoms were decreased vision [16 (70%)] and ocular pain [14 (61%)]. All treated patients received systemic antifungals (combination therapy in 72% of the cases). Seven patients (30%) underwent vitrectomy. Only one patient received intraocular injection of amphotericin B along with systemic antifungals. Four-week mortality was high [13 (57%)], especially in ME (73%, P = .04). Among the eight surviving patients where visual acuity could be assessed, visual outcome improved or remained stable in five (63%). FE in cancer patients occurs in the setting of severe, frequently disseminated opportunistic mycoses, is caused predominantly by hyalohyphomycetes, and is a marker for high 4-week mortality.     

Obesity-dependent association of TNF-LTA locus with type 2 diabetes in North Indians

Six common genetic variants (rs2229094, rs1041981, rs1800630, rs1800629, rs361525, and rs1800610) in the TNF-LTA locus encoding the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF-α) and lymphotoxin-α have been shown to be associated with various metabolic traits including susceptibility to type 2 diabetes, metabolic syndrome, insulin resistance, and increased body mass index (BMI) in Caucasians from different geographic locations and have yielded mixed results. We tested for the association of these variants with type 2 diabetes in North Indians by studying 2,115 participants comprising of 1,073 type 2 diabetes patients and 1,042 controls. We report the association of a promoter region variant of TNF: rs1800630 and non-synonymous LTA variant: rs2229094 with type 2 diabetes [OR = 0.83 (95% CI 0.72–0.95), P = 0.005 and OR = 0.86 (95% CI 0.75–0.98), P = 0.02, respectively]. Although these associations were BMI-dependent, no interactive effect of BMI and variants on type 2 diabetes was detectable. Further, the haplotype carrying all the six major alleles conferred susceptibility to type 2 diabetes [OR = 1.23 (95% CI 1.06–1.42), P = 0.005; P _permuted = 0.02], with the effect much enhanced in non-obese subjects [OR = 1.45 (95% CI 1.19–1.78), P = 2 × 10⁻⁴: P _permuted = 3 × 10⁻⁴]. The minor allele of rs2229094 was associated with lower hsCRP, BMI, and waist circumference (WC), while the minor allele of rs1800630 showed association with lower BMI and WC (all P < 0.01). This is the first report demonstrating association of rs1800630 and rs2229094 with type 2 diabetes in any population, suggesting an important role of the TNF-LTA locus in type 2 diabetes in North Indians.     

Role of Polymorphic Variants of MTR Gene A2756G and SHMT1 Gene C1420T in the Development of Prostatic Cancer in Residents of the Western Siberian Region of Russia

Allelic variants of folate cycle enzyme genes can contribute to predisposition to cancer. The impact of polymorphic loci A2756G of MTR gene and of C1420T of SHMT1 gene for the risk of prostatic cancer was studied in residents of West Siberia. The frequency of alleles of these loci in patients (N = 371) and controls (N = 285) was determined and the data were statistically processed. No statistically significant association with prostatic cancer was detected for any of the studied loci.     

Fibrinogen Beta-Chain -C148T Polymorphism is Associated with Increased Fibrinogen, C-Reactive Protein, and Interleukin-6 in Patients Undergoing Coronary Artery Bypass Grafting

The fibrinogen beta-chain (FGB) -C148T polymorphism is linked with plasma fibrinogen concentration in the general population. We examined whether the -C148T polymorphism is associated with pre- and early postoperative levels of fibrinogen, C-reactive protein (CRP), and interleukin-6 (IL-6) in 243 consecutive patients undergoing coronary artery bypass grafting (CABG) surgery. Plasma inflammatory markers were measured prior to and 5–7 days after surgery. The -C148T polymorphism was analyzed with the restriction fragment-length polymorphism method. The genotype distribution was as follows: CC—142 (58%), CT—85 (35%), and TT—16 (7%). Carriers of the -148T allele had higher preoperative plasma fibrinogen (4.42 ± 0.14 vs. 4.07 ± 0.11 mg/L, p = 0.04) and CRP levels (7.49 ± 1.2 vs. 4.26 ± 1.0 mg/L, p = 0.04) compared with non-carriers; 5 to 7 days after CABG, patients carrying -148T allele had increased CRP (70.4 ± 5.0 vs. 51.6 ± 4.25 mg/L, p = 0.005) and IL-6 levels (22.34 ± 2.64 vs. 15.53 ± 2.28 pg/L, p = 0.05), but not fibrinogen, compared with the remaining subjects. In-hospital nonfatal stroke occurred more frequently in -148T allele carriers (4% vs. 0%, p = 0.02). No genotype-associated differences were found in the occurrence of postoperative myocardial infarction and death. Presence of the -148T allele has also been associated with longer intensive care stay and intubation time (p = 0.01). Multivariate analysis identified the CT+TT genotype as an independent predictor of pre- and postoperative CRP levels. The results indicate that the presence of the -148T FGB allele determines higher pre- and postoperative levels of inflammatory markers, which might be associated with in-hospital clinical outcomes.     

Prevalence of human leukocyte antigen (HLA) DRB1 alleles in Kuwaiti children with juvenile rheumatoid arthritis

The prevalence of human leukocyte antigen (HLA) DR alleles has been determined in 69 Kuwaiti Arab children with juvenile rheumatoid arthritis (JRA) and compared to that in 212 ethnically matched normal healthy controls using a PCR–sequence specific primers (PCR‐SSP) method. A very high incidence of DR3 was detected in JRA patients compared to the controls (P < 0.0001, RR = 2.235). The high incidence of HLA‐DR3 in JRA patients was accounted for mainly by an excess of DRB1*0307 (P < 0.05, RR = 3.072) and DRB1*0308 (P < 0.009, RR = 2.663) compared to the controls. Moreover, DR3 was more prevalent when patients with ANA‐positive JRA were analysed separately; 73% compared to 58% for the whole JRA patient group. The frequency of DR1 was also higher in the JRA group compared to controls (P = 0.019, RR = 3.585). Although the incidence of some alleles was higher in the control group (DR13 and DR7), none reached a statistically significant level. All the patients with iridocyclitis had either a DR1 or DR3 allele, except for one child. The frequency of DRB1*03 was found to be much higher in the polyarticular subtype of Kuwaiti JRA cases compared to the oligoarticular subgroup and the controls. Also, a non‐significant increase in the frequency of the DRB1*04, *11 and *15 alleles was detected in the polyarticular subtype of the Kuwaiti JRA cases compared to the controls.     

Prevalence of toxin genes in consecutive clinical isolates of <Emphasis Type="Italic">Staphylococcus aureus</Emphasis> and clinical impact

Even if Panton–Valentine leukocidin (PVL), toxic shock syndrome toxin-1 (TSST-1), staphylococcal enterotoxins (SEB and SEC), and exfoliative toxins (ETA and ETB) may be associated with severe infections, the clinical significance of their presence in clinical isolates of Staphylococcus aureus remains poorly documented. In this study, we evaluated the prevalence of toxin genes and the relationship between their presence and the severity of infection. We screened for the presence of these six toxin genes among 186 consecutive S. aureus clinical isolates (resistant or not to methicillin) during a two-month period. We compared the toxin gene profile between strains recovered from patients presenting uncomplicated infections (n = 151) and from patients suffering from severe infections (n = 35). At least one toxin gene was detected in 55 (29.6%) isolates as follows: pvl (n = 1), tst + sec (n = 5), seb (n = 19), seb + sec (n = 1), sec (n = 28), and eta (n = 1). The proportion of toxin-producing strains among patients with uncomplicated infections (27.8%) and patients with severe infections (37.1%) was not statistically different (p = 0.3044), even if the severity of infection tended to be associated with the presence of sec (p = 0.0655). Although the prevalence of toxin genes was relatively high herein, no statistically significant association between the severity of infection and the presence of toxin genes was observed.     

Muscle activation of the knee extensors following high intensity endurance exercise in cyclists

This study was conducted to assess the effects in trained cyclists of exhausting endurance cycle exercise (CE) on maximal isometric force production, surface electromyogram (EMG) and activation deficit (AD) of the knee extensors. Ten male subjects made four isometric maximal voluntary contractions (MVC) of the knee extensor muscles immediately prior (pre), 10 min after (post) and 6 h after completion of CE. The CE consisted of 30 min of exercise on a stationary cycle ergometer at an intensity corresponding to 80% of maximal oxygen uptake (V˙O_2max) followed by four × 60-s periods at 120% of V˙O_2max. Two MVC were performed with recording of surface EMG from the knee extensors, whilst an additional two MVC were completed with percutaneous electrical muscle stimulation (EMS; 25 pulses at 100 Hz with the maximal tolerable current) superimposed over the maximal voluntary contraction force (MVF) but without EMG (to avoid interference). The MVF, integrated EMG (iEMG), and AD [calculated as the difference between MVF and the electrically stimulated force (ESF) during the EMS contractions] were statistically analysed. The MVF was significantly reduced (P < 0.05) post and 6-h post compared to pre-CE level. The iEMG was significantly reduced (P < 0.05) post and 6 h post CE. The ESF was also reduced, whilst AD was significantly increased (P < 0.05) post and 6-h post CE compared to the pre CE. These results suggest that the level of exercise stress administered in this study was sufficient to impair the central and peripheral mechanisms of force generation in knee extensors for a period of 6-h. Athletes engaged in concurrent training (strength and endurance) should consider this effect in exercise programming. Accepted: 22 September 1999     

Effects of different after-loads and knee angles on maximal explosive power of the lower limbs in humans

Maximal explosive power during two-leg jumps was measured on four sedentary subjects [mean age 43.0 (SD 10.3) years, mean height 1.74 (SD 0.04) m, mean body mass 73.5 (SD 1.3) kg] using a sledge apparatus with which both force and speed could be directly measured. Different after-loads were obtained by positioning the sledge at five different angles (SA, α) in respect to the horizontal so that m · g · sin α (where m is the sum of body mass and the mass of the sledge seat, g the acceleration due to gravity) decreased (on average) from 78% body mass at 30° to 27% body mass at 10°, thus simulating conditions of low gravity. The subjects were asked to jump maximally, without counter movement, starting from 70°, 90°, 110°, and 140° of knee angle (KA); the protocol being repeated at 10°, 15°, 20°, 25° and 30° SA. The average (W˙ _mean ⁺) power output during concentric exercise (CE) was found to decrease when the starting KA was increased, but to be unaffected by SA (i.e. by the after-load, the simulated low g). The higher values of W˙ _mean ⁺ were recorded at 90° KA [15.01 (SD 1.46) W · kg⁻¹, average for all subjects at all SA]. The subjects were also asked to perform counter movement (CMJ) and rebound jumps (RE) at the same SA as for CE. In CMJ and RE maximal power outputs were also found to be unaffected by the SA; W˙ _mean ⁺ amounted to 16.03 (SD 0.28) W · kg⁻¹ in CMJ and 16.88 (SD 0.36) W · kg⁻¹ in RE (average for all subjects at all SA). In CE, CMJ and RE, the instantaneous force at the onset of the positive speed phase (F _i) was found to increase linearly with SA (i.e. with increasing m · g · sin α), and the difference between F _i in CMJ or RE and F _i in CE (F _i in CMJ minus F _i in CE and F _i in RE minus F _i in CE) was unaffected by SA. This indicated that both maximal power and the elastic recoil were unaffected by simulated low g ranging from 1.71 m · s⁻² (at 10° SA) to 4.91 m · s⁻² (at 30° SA). Accepted: 9 March 2000     

Influence of sympatho-vagal balance on airway responsiveness in athletes

The increased prevalence of airway hyper-responsiveness (AHR) observed among athletes suggests that high-level training may contribute to the development of AHR. We investigated the possible influence of the sympatho-vagal balance on this phenomenon in 40 athletes and 10 sedentary controls. Each subject filled out a respiratory questionnaire, had a methacholine challenge, and measurements were made of their baseline plasma catecholamines [epinephrine (E), norepinephrine (NE) and dopamine (DA)] as a reflection of sympathetic tone, and their heart rate variability (SDNN: standard deviation of all normal-to-normal intervals) as an indicator of parasympathetic tone. The athletes had a 45% prevalence of AHR (defined as PC₂₀ < 16 mg/ml, where PC₂₀ is the concentration of methacholine inducing a 20% fall in the forced expiratory volume in 1 s, FEV₁) with a mean PC₂₀ of 21.2 mg/ml compared with 10% prevalence (mean PC₂₀: 74.4 mg/ml) in sedentary subjects (P < 0.01). Plasma catecholamine values were not significantly different between the two groups (all P > 0.05), but the estimated parasympathetic tone was higher in athletes (P=0.01). When data from all subjects were analyzed together, plasma E and NE correlated with PC₂₀ (r=0.39, P=0.005 and r=0.29, P < 0.005) but DA and SDNN did not (both P > 0.05). However, the ratios E/SDNN, NE/SDNN and DA/SDNN showed significant correlations with PC₂₀ (r=0.42, P < 0.01; r=0.33, P < 0.005 and r=0.31, P < 0.05, respectively). This study suggests that the sympatho-vagal balance may contribute to the increased AHR in the population studied but this influence alone cannot explain the higher prevalence of AHR in athletes. Accepted: 26 July 2000     

Genetic Association of IL-10 Gene Promoter Polymorphism and HIV-1 Infection in North Indians

Introduction  Cytokines play a significant role in host immune defense. IL-10 is an anti-inflammatory, immunomodulatory cytokine that can both stimulate and suppress the immune response and inhibits HIV-1 replication in vivo. Interindividual variations in IL-10 production were genetically contributed to polymorphisms within IL-10 promoter region. Aims  The aim of this study was to investigate the association of IL-10 gene promoter −1082 G/A, −819 C/T, and 592 C/A polymorphism on HIV-1 transmission /progression in North Indian individuals. Patients and Methods  A total of 180 HIV-1 seropositive (HSP) stratified on the basis of disease severity (stage I, II, and III), 50 HIV-1 exposed seronegative (HES) and 305 HIV-1 seronegative (HSN) individuals were genotyped for IL-10 gene promoter by polymerase chain reaction-restriction fragment length polymorphism. A suggestive evidence of association was obtained for IL-10 592 C/A promoter polymorphism at the level of allele and genotype distribution. The frequency of IL-10 592 A allele and genotype was significantly increased in HSP compared to HSN (p = 0.013; OR = 1.412 and p = 0.034; OR = 1.685 respectively). Further comparison in between different clinical stages of HIV-1 infected patients of IL-10 592 A allele and genotype revealed a significant increase in its frequency in the stage III compared with those together in stage I (p = 0.004, OR = 2.181 and p = 0.002, OR = 4.156, respectively). This study reports for the first time that IL-10 gene promoter 592 C/A polymorphism may be a risk factor for HIV-1 transmission/progression in HIV-1 infected North Indian individuals.     

Bacteremia caused by <Emphasis Type="Italic">Brevundimonas</Emphasis> species at a tertiary care hospital in Taiwan, 2000–2010

We investigated clinical and microbiological characteristics of 30 patients with Brevundimonas bacteremia treated at a tertiary care hospital in Taiwan during 2000–2010. All the 30 bacteria isolates were confirmed to the species level by 16S rRNA sequencing analysis. Minimum inhibitory concentrations (MICs) of 11 antimicrobial agents against these isolates were determined by the agar dilution method. Seventeen (57%) patients had underlying malignancy, 12 (40%) had undergone central catheter placement, and 13 (43%) had received chemotherapy within the previous three months. Eight (27%) patients had community-acquired bacteremia and the remaining 22 patients (73%) had healthcare-associated bacteremia. The overall 14-day and 30-day mortality rates were 13% and 17%, respectively. Among the 30 isolates, B. vesicularis constituted most commonly (n = 22, 63%), followed by B. nasdae (n = 5) and B. diminuta (n = 3). All isolates were susceptible to piperacillin-tazobactam and amikacin, while all were resistant to ciprofloxacin and colistin. Tigecycline (MICs at which 90% of isolates are inhibited [MIC₉₀] was 0.12 mg/L) and doripenem (MIC₉₀ of 1 mg/L) both possessed good in vitro activities. In conclusions, Brevundimonas should be considered a pathogen that can cause bacteremia in immunocompromised hosts. Piperacillin-tazobactam, amikacin, doripenem, and tigecycline exhibit good in vitro activities against these ciprofloxacin- and colistin-resistant Brevundimonas species.     

Phenotypic analysis of peripheral lymphocyte subpopulations in hydatid patients

Peripheral T-lymphocytes were analyzed in three groups of people: (1) individuals with current liver hydatid disease (hydatid patients, n = 20), (2) persons who had undergone surgical cyst removal at least 2 years previously (recovered patients, n = 9), and (3) a control group of healthy volunteers (uninfected controls, n = 13). Group 1 was subdivided according to cyst status, relapse of disease, and the presence or absence of symptoms. Percentages of lymphocytes expressing CD3, CD4, CD8, CD56, CD25, CD45RA, CD45RO, and HLA-DR were determined. Symptomatic patients had proportionally fewer CD3+ CD8+ lymphocytes than the control group (P=0.038). Hydatid patients with active cysts had proportionally more natural killer cells (CD56+ CD8−) than the control group (P = 0.028). Received: 31 May 1999 / Accepted: 8 May 1999     

Lipid and lipoprotein profiles, cardiovascular fitness, body composition, and diet during and after resistance, aerobic and combination training in young women

The purpose of this study was to evaluate the effects of various modes of training on the time-course of changes in lipoprotein-lipid profiles in the blood, cardiovascular fitness, and body composition after 16 weeks of training and 6 weeks of detraining in young women. A group of 48 sedentary but healthy women [mean age 20.4 (SD 1) years] were matched and randomly placed into a control group (CG, n=12), an aerobic training group (ATG, n=12), a resistance training group (RTG, n=12), or a cross-training group that combined both aerobic and resistance training (XTG, n=12). The ATG, RTG and XTG trained for 16 weeks and were monitored for changes in blood concentrations of lipoprotein-lipids, cardiovascular fitness, body composition, and dietary composition throughout a 16 week period of training and 6 weeks of detraining. The ATG significantly reduced blood concentrations of triglycerides (TRI) (P < 0.05) and significantly increased blood concentrations of high-density lipoprotein-cholesterol (HDL-C) after 16 weeks of training. The correlation between percentage fat and HDL-C was 0.63 (P < 0.05), which explained 40% of the variation in HDL-C, while the correlation between maximal oxygen uptake (V˙O_2max) and HDL-C was 0.48 (P < 0.05), which explained 23% of the variation in HDL-C. The ATG increased V˙O_2max by 25% (P < 0.001) and decreased percentage body fat by 13% (P < 0.05) after 16 weeks. Each of the alterations in the ATG had disappeared after the 6 week detraining period. The concentration of total cholesterol (TC), TRI, HDL-C and low density lipoprotein-cholesterol in the blood did not change during the study in RTG, XTG and CG. The RTG increased upper and lower body strength by 29% (P < 0.001) and 38%, respectively. The 6 week detraining strength values obtained in RTG were significantly greater than those obtained at baseline. The XTG increased upper and lower body strength by 19% (P < 0.01) and 25% (P < 0.001), respectively. The 6 week detraining strength values obtained in XTG were significantly greater than those obtained at baseline. The RTG, XTG and CG did not demonstrate any significant changes in either V˙O_2max, or body composition during the training and detraining periods. The results of this study suggest that aerobic-type exercise improves lipoprotein-lipid profiles, cardiorespiratory fitness and body composition in healthy, young women, while resistance training significantly improved upper and lower body strength only. Accepted: 9 April 2000     

Aldosterone-induced changes in the cardiac L-type Ca2+ current can be prevented by antioxidants in vitro and are absent in rats on low salt diet

Mineralocorticoid receptor (MR) activation modulates cardiac L-type Ca²⁺ current (I _CaL) and transient outward K⁺ current (I _to). The exact circumstances of MR activation, however, remain elusive. Here, we investigate the influence of corticosteroids on MR-mediated changes in cellular electrophysiology. In vitro incubation of adult rat ventricular myocytes with the MR agonist aldosterone (100 nM, 24 h) increased I _CaL density by 34% (n = 16; p < 0.01). This effect was abrogated by co-incubation with the MR antagonist spironolactone (10 μM). To investigate whether an increase in serum aldosterone concentration is sufficient for an increase in I _CaL in vivo, rats were subjected to low Na⁺ diet (LSD, 0.013% Na⁺) for 28 days. This increased serum aldosterone concentration from 0.19 ± 0.04 nM (n = 6) in control animals (0.3% Na⁺, CSD) to 16.1 ± 2.1 nM (n = 6; p < 0.0001). Strikingly, I _CaL density was similar in both CSD and LSD rats (−12.9 ± 0.9 pA pF⁻¹, n = 18 and −13.7 ± 1.1 pA pF⁻¹, n = 16, respectively), as was I _to density. In vitro, the glucocorticoid corticosterone (1 μM) also increased I _CaL and this effect was blocked by spironolactone (10 μM). Co-incubation with corticosterone (1 μM, the normal serum concentration) and aldosterone (100 nM, mimicking low Na⁺ intake) did not further increase I _CaL compared to corticosterone alone. Moreover, co-incubation of myocytes with N-acetylcysteine (10 mM) prevented the aldosterone (100 nM) or corticosterone (1 μM)-induced increase in I _CaL. In conclusion, an increase in serum aldosterone concentration in response to LSD is not sufficient for an increase in I _CaL density in cardiomyocytes in vivo. This is supported in vitro by the absence of an effect of aldosterone on I _CaL in the presence of a physiological concentration of corticosterone. Moreover, the cellular redox state may modulate MR activation. Michael Wagner and Elena Rudakova contributed equally to this work.     

LYVE-1 upregulation and lymphatic invasion correlate with adverse prognostic factors and lymph node metastasis in neuroblastoma

Neuroblastoma (NB) accounts for 15% of all childhood cancer deaths. The majority of patients have widespread lymphatic and/or haematogenous metastases at diagnosis, but lymphangiogenesis has not been well documented. Sixty-seven NBs were immunostained for the lymphatic endothelial marker, LYVE-1, and the lymphatic density (LD) and lymphatic invasion (LI), were counted in LYVE-1-expressing lymphatics. LYVE-1-stained lymphatic vessels and LI were present in 26/67 (39%) and 14/67 (21%) of the NBs, respectively. Central LD (CLD) and LI were higher in NBs from stage 4 (p = 0.012, p = 0.004, respectively), high-risk group (p = 0.030, p = 0.002), NBs with high mitosis karyorrhexis index (MKI) (p = 0.011, p = 0.005), unfavourable histology group (p = 0.040, p = 0.017) and distant lymph node metastasis (LNM) (p < 0.001 for each). Marginal LD (MLD) was higher in patients with LNM (p < 0.001). CLD and MLD correlated with LI (p < 0.001 each). Total LYVE-1 protein levels, quantified by a sensitive enzyme-linked immunosorbent assay (n = 55), were also higher in NBs from patients with stage 4 disease (p = 0.046), high-risk group (p = 0.028), MYCN-amplified NBs (p = 0.034) and LNM (p = 0.038). Kaplan–Meier analysis showed that the presence of CLD was associated with both worse OS at 5 years (77% [95% CI: 62–87%] versus 60% [95% CI: 32–80%], p = 0.062) and EFS (74% [95% CI: 58–85%] versus 43% [95% CI: 15–69%], p = 0.070) and LI with OS (71% [95% CI: 57–81%] versus 56% [95% CI: 26–78%], p = 0.055). Significant upregulation of LYVE-1 and the presence of LI in patients with stage 4 and high-risk disease, MYCN-amplification and LNM suggests that LYVE-1 may have value as predictors of outcome.     

AN ANALYSIS OF HLA CLASS II GENE POLYMORPHISM IN BRITISH AND GREEK IDIOPATHIC MEMBRANOUS NEPHROPATHY PATIENTS

Fifty-two British and 29 Greek idiopathic membranous nephropathy (IMN) patients were analysed for DRB, DQA1, DQB1 and DPB1 gene polymorphism using second exon amplification and sequence-specific oligonucleotides (SSO). In addition 100 British and 92 Greek controls were analysed. A highly significant increased frequency of the DRB 1*0301 allele was found in IMN patients from Britain (80%), when compared to controls (27%, OR 10.6, P= 0.000004). A lower frequency of DRB 1 *0301 was observed in Greek IMN patients (33%), but this was just significant before correction, when compared to Greek controls (15%, OR 3, P= 0.02). The DRB3 allele most often associated with DRB 1 *0301 was DRB3*0101 (OR 4.2, P= 0.00025) in British patients and DRB3*0201/2 (OR 11, P=0.006) in Greek patients. In Greek IMN patients a decrease in DR16 was found (OR 0.08, P=0.004), and the overall incidence of DR2 was significantly lowered when both sets of IMN patients were combined (OR 0.21, χ² 17.6, P= 0.00013). The incidence of DQA1 *0501 was raised in both Greek (96%vs. 66%, OR 9.7, χ² 6.9, P= 0.009) and British IMN (85%vs. 45%, OR 7.4, χ² 20, P= 0.00007) patients. This gives some support to a proposal for a major role for this allele in IMN. However, DQB1 *0201 was also raised in both Greek (50%vs. 21%, OR 3.6, χ² 8.1, P= 0.005) and British (90%vs. 44%, OR 10, χ² 21.7, P=0.00004) IMN patients. The DQA1*0102 allele was significantly lowered in Greek IMN patients (15%vs. 32%, OR 0.05, 12.2, P=0.0008), probably reflecting a lowering in the DR16 haplotype. No significant difference was observed in the frequencies of DPB alleles in patients and controls. It is concluded that DRB 1*0301 has the strongest association with British Caucasoid IMN. The Greek Caucasoid IMN association with DRB 1*0301 is weaker, and a role for other alleles has not been eliminated.     

Influence of IL1B polymorphism on CpG island hypermethylation in Helicobacter pylori-infected gastric cancer

Helicobacter pylori infection can induce aberrant CpG island hypermethylation in gastric mucosal epithelial cells. Single nucleotide polymorphisms of proinflammatory cytokine genes encoding for interleukin 1B (IL1B), IL6, and IL8 have been demonstrated to be associated with an increased risk of gastric cancer. To identify the influence of host genetic factors in CpG island hypermethylation induced by H. pylori infection, we analyzed H. pylori-infected chronic gastritis (n = 111) and gastric cancer samples (n = 78) for the methylation status of eight genes previously shown to be hypermethylated in chronic gastritis and single nucleotide polymorphisms of IL1B, IL6, and IL8. The methylation levels were then compared between different genotypes. Gastric cancers from patients with the IL1B-511T/T allele showed significantly higher methylation levels in five genes as compared with gastric cancers from IL1B-511 C carriers (P < 0.05). An increased level of hypermethylation in association with the IL1B-511T/T allele was observed in chronic gastritis samples, but the association was not statistically significant. These findings suggest that the IL1B-511T/T allele is associated with enhanced hypermethylation of multiple CpG island loci, which might contribute to an increase in the risk for gastric cancer in individuals with H. pylori infection and IL1B-511T/T allele.     

PI3-Kinase-dependent electrogenic intestinal transport of glucose and amino acids

Intestinal glucose and amino acid transport is stimulated by the serum- and glucocorticoid-inducible kinase isoforms SGK1, SGK2, and SGK3 and protein kinase B which are, in turn, stimulated following activation of the phosphoinositol-3 kinase (PI3 kinase). The present study has been performed to explore whether pharmacological inhibition of the PI3 kinase affects electrogenic jejunal transport of glucose and amino acids. In Ussing chamber experiments, glucose (20 mM), phenylalanine (20 mM), glutamine (20 mM), cysteine (20 mM), and proline (20 mM) generated lumen negative currents (I _glc, I _phe, I _gln, I _cys, and I _pro), respectively, which gradually declined following application of the PI3 kinase inhibitor Wortmannin (1 μM). Within 40 min, Wortmannin treatment significantly decreased I _glc by 39 ± 10% (n = 5), I _phe by 70 ± 7% (n = 4), I _gln by 69 ± 8% (n = 4), I _cys by 67 ± 8% (n = 6), and I _prol by 79 ± 12% (n = 3). A similar decline of I _glc was observed following application of the PI3 kinase inhibitor LY294002 (50 μM). Exposure to the inhibitors did not significantly alter transepithelial potential difference and resistance in the absence of substrates for electrogenic transport. The observations suggest that the electrogenic transport of glucose and several amino acids requires the continued activity of PI3 kinase. R. Rexhepaj and F. Artunc shared first authorship.     

KiSS-1 overexpression as an independent prognostic marker in hepatocellular carcinoma: an immunohistochemical study

The KiSS-1 gene has been reported to play an important role as a metastasis suppressor gene in various human malignancies. However, there is little information about its possible role in hepatocellular carcinoma (HCC). In this study, we evaluated the prognostic significance of the expression of KiSS-1 and its receptor AXOR12 in 142 HCC tissue specimens by immunohistochemistry. By using a cutoff level of 50%, immunoreactivity of KiSS-1 and AXOR12 was found in 6 (4%) and 11 (8%) HCCs. The expression of KiSS-1 and AXOR12 in HCC correlated with each other (r = 0.42, p < 0.0001) and with the expression in corresponding, surrounding liver tissue (both r = 0.35, p < 0.0001). Positive AXOR12 immunoreactivity in HCC correlated with advanced pT-stage of tumors and low tumor grading (r = 0.18, p = 0.032; r = −0.18, p = 0.029). High KiSS-1 expression in HCC had a statistically significant influence on diminished disease-free and overall survival in uni- (p = 0.006 and p = 0.002) and multivariate analysis (r = 2.874, p = 0.027 and r = 2.913, p = 0.026). In this study, we report for the first time that elevated KiSS-1 expression level in HCC correlates with worsened clinical outcome, as an independent prognostic marker for the aggressiveness of HCC.     

Hydrogen Peroxide in Exhaled Breath Condensate (EBC) vs Eosinophil Count in Induced Sputum (IS) in Parenchymal vs Airways Lung Diseases"

We compared exhaled breath condensate (EBC) and induced sputum (IS) for assessing inflammation in pulmonary diseases in patients with obstructive lung disease (n = 20), persistent cough >6 months (n = 20), interstitial lung disease (n = 25) and controls (n = 10). EBC was collected by suspending a Teflon perfluoroalkoxy tube installed in an ice-filled container and connected to a polypropylene test tube. IS was recovered after 20’ inhalation of 3% saline with an ultrasonic nebulizer, and 300 cells were differentially counted in cytospin Giemsa-stained slides. H₂0₂ was measured by a method based on oxidation of phenolsulfonphthalein (phenol red) mediated by horseradish peroxidases and H₂0₂. Pulmonary function tests were performed by conventional methods. H₂0₂ levels in EBC and % eosinophils in IS were significantly different between groups. A positive and significant correlation was found between % eosinophils in IS and the levels of H₂0₂ in EBC for each group and for all patients combined.