Targeting metastasis-initiating cancer stem cells in gastric cancer with leukaemia inhibitory factor

Gastric cancer's (GC) bad prognosis is usually associated with metastatic spread. Invasive cancer stem cells (CSC) are considered to be the seed of GC metastasis and not all CSCs are able to initiate metastasis. Targeting these aggressive metastasis-initiating CSC (MIC) is thus vital. Leukaemia inhibitory factor (LIF) is hereby used to target Hippo pathway oncogenic members, found to be induced in GC and associated with CSC features. LIF-treated GC cell lines, patient-derived xenograft (PDX) cells and/or CSC tumourspheres underwent transcriptomics, laser microdissection-associated proteomics, 2D and 3D invasion assays and in vivo xenograft in mice blood circulation. LIFR expression was analysed on tissue microarrays from GC patients and in silico from public databases. LIF-treated cells, especially CSC, presented decreased epithelial to mesenchymal transition (EMT) phenotype and invasion capacity in vitro, and lower metastasis initiation ability in vivo. These effects involved both the Hippo and Jak/Stat pathways. Finally, GC's high LIFR expression was associated with better clinical outcomes in patients. LIF treatment could thus represent a targeted anti-CSC strategy to fight against metastatic GC, and LIFR detection in primary tumours could constitute a potential new prognosis marker in this disease.

Gestational anaemia and severe acute maternal morbidity: a population-based study

Anaemia is frequently diagnosed during pregnancy. However, there are few data regarding its incidence, and the association with severe maternal morbidity remains uncertain and potentially biased in high-resource countries. The purpose of this study was to explore the association between gestational anaemia and severe acute maternal morbidity during and after delivery. We performed a cohort-nested case-control analysis from the epidemiology of severe maternal mortality (EPIMOMS) prospective study conducted in six French regions (2012-2013, n = 182,309 deliveries). There were 1669 women with severe acute maternal morbidity during or after delivery, according to a standardised definition obtained by expert consensus. The control group were randomly selected among women without severe morbidity who delivered in the same health centres (n = 3234). We studied the association between gestational anaemia and severe acute maternal morbidity during or after delivery overall, by cause, and by mode of delivery, using multivariable logistic regression and multiple imputation. Gestational anaemia was significantly more frequent in women with severe acute maternal morbidity (25.3%) than in controls (16.3%), p < 0.001, and mostly mild in both groups. After adjustment for confounders, women with gestational anaemia were at increased risk of overall severe acute maternal morbidity during and after delivery (adjusted OR (95%CI) 1.8 (1.5-2.1)). This association was also found for severe postpartum haemorrhage (adjusted OR (95%CI) 1.7 (1.5-2.0)), even after omitting the transfusion criterion (adjusted OR (95%CI) 1.9 (1.6-2.3)), and for severe acute maternal morbidity secondary to causes other than haemorrhage or pregnancy-related hypertensive disorders (adjusted OR (95%CI) 2.7 (1.9-4.0)). These results highlight the importance of optimising the diagnosis and management of anaemia during pregnancy.

The role of bradykinin in neonatal hemodynamic effects of ACE inhibition

Angiotensin-converting enzyme (ACE) inhibitors exert their effects by inhibiting angiotensin II (AII) production, but also by inhibiting bradykinin (BK) degradation. In order to clarify whether BK is involved in the systemic effects of ACE inhibition in the newborn period, we investigated the effect of perindoprilat (20 microgram/kg i.v.) in newborn rabbits, with or without the blockade of BK beta(2)-receptors (Hoe 140, 300 microgram/kg s.c.). The bolus infusion of perindoprilat resulted in a marked fall in mean arterial blood pressure (MBP) and a slight decrease in heart rate. BK receptor blockade had no effect on the perindoprilat-induced hypotension but the negative chronotropic effect of ACE inhibition was partly prevented by pretreatment with Hoe 140. We therefore conclude that BK is not involved in neonatal blood pressure regulation but that the ACE inhibition-induced neonatal bradycardia is at least partly BK- mediated.

The spleen at risk after penetrating trauma

In contrast to blunt splenic trauma where nonsurgical management is an option, splenorrhaphy is the current preferred approach for penetrating trauma. Splenectomy, however, may be required because of hemodynamic instability, the extent of the trauma, or when a pancreatic injury requires distal pancreatectomy. We evaluated our attempts at splenic preservation in 69 patients (1988-1992) in whom the spleen was at risk for removal. Fifty-seven patients had penetrating injury to the spleen and 12 patients had distal pancreatectomy. Splenic Trauma (n = 57): 6 patients (mean Abdominal Trauma Index 45) died within 24 hours of extensive injuries. All had splenectomy. Thirty-seven of the remaining 51 (72.5%) had successful splenorrhaphy, 85% with stab wounds (SWs) and 65.5% with gunshot wounds (GSWs). Splenic salvage was 100%, 100%, 92%, 37%, and 0%, respectively, for grades I-V injuries. Absorbable mesh splenorrhaphy improved splenic salvage in grade III and IV injuries from 67% and 0% in previous years (1983-1987) to 92% and 37% in recent years (1988-1992), p < 0.01. The use of the mesh did not increase septic complications, even in the presence of enteric perforation. Distal Pancreatectomy (n = 12): 1 died intraoperatively. The spleen was not injured in 6 and was preserved in all 6. The overall 54.5% splenic salvage rate was achieved without increasing morbidity or the number of transfusions.

CONCLUSIONS

(1) Splenorrhaphy should be possible in the great majority of stable patients after penetrating trauma. (2) Absorbable mesh is a valuable adjunct that may facilitate the repair of more severe grades of splenic trauma.(ABSTRACT TRUNCATED AT 250 WORDS)

Radical oxidation reactions of the purine moiety of 2'-deoxyribonucleosides and DNA by iron-containing minerals

The radical oxidation capability of several classes of iron minerals, including biotite, hematite, magnetite, minette, nemalite, pyrite, vivianite and two chrysotiles (asbestos), was investigated by using a double experimental approach. One involved the electron spin resonance spin-trapping measurement of organic radicals obtained by the reaction of activated oxygen species, released upon incubation of the minerals in phosphate buffered solutions with formate used as the target molecule. In addition, the formation of mineral-mediated oxidation purine decomposition products, including 7,8-dihydro-8-oxo-2'-deoxyguanosine and 7,8-dihydro-8-oxo-2'-deoxyadenosine, was searched within nucleosides and DNA by using specific and sensitive HPLC electrochemical assays. Emphasis was placed on the mechanistic aspects of the radical oxidation reactions involved in the formation of the two C(8) hydroxylated purine decomposition products.

Man-made mineral fibers and lung cancer: an hypothesis

Epidemiological data have revealed significant excesses of lung cancer among workers exposed to some types of man-made mineral fibers (MMMF), but inhalation experiments performed on rats have failed to reveal the origin of these excesses. Some of these materials, however, are able, in aqueous media, to exhibit surface oxidizing properties after reduction of oxygen by a radical pathway. Tests have been carried out with 12 MMMF samples collected from various sources without prior knowledge of their origin, to determine their oxidizing surface activity in relation to their divalent iron content. Some of these fibers were obtained from factories included in an epidemiological investigation. Only fibers coming from plants where excesses of lung cancer were observed are classified as active in an oxidative process and, consequently, probably toxic in biological media by an oxidative stress mechanism. We therefore propose an hypothesis of a causal relationship between these oxidizing properties and the ability of the materials to induce lung cancer.

Production of free radicals arising from the surface activity of minerals and oxygen. Part I. Iron mine ores

The excess incidence of lung cancers observed in many metal mines probably is not only correlated with radioactivity but also with the inhaled dusts. In an attempt to determine a possible mechanism of carcinogenicity related to the surface activity of dusts, using the spin-trapping agent and ESR spectroscopy, one can demonstrate that some mineral dusts from iron ore mines are very active in an oxidative process in aqueous medium, implying the formation of radical oxygen species on reducing surface sites of the solid. This reducing surface activity of the dusts depends on the presence of Fe2+ ion in the lattice and on the process of activation and passivation of the surface sites. The more simple process of activation is the dissolution of the oxidized coating on the particle surface. Among the oxides, oxyhydroxides, carbonates, and silicates, the magnesium-iron phyllosilicates (chlorite, biotite, berthierine) appear the most active. The siderite FeCO3 is also active, but the iron oxides and oxyhydroxides are generally nonactive.

Production of free radicals arising from the surface activity of minerals and oxygen. Part II. Arsenides, sulfides, and sulfoarsenides of iron, nickel, and copper

The excess incidence of lung cancers observed in metallic mines other than iron mines probably can be correlated not only to radioactivity, but also to dust pollution. The present work investigates the role of surface properties of sulfides and arsenides, which are present in metal mines, in oxidizing mechanisms capable of inducing oxidative stress and, possibly, of participating in carcinogenesis. Using added spin-trapping agent followed by ESR spectroscopy, it was observed that nickel and copper arsenides can be very active in the oxidation of formate or DMSO, by reducing the oxygen dissolved in a cell-free medium. Sulfides, on the other hand, are not active, except for the iron sulfides, which are very active as an air-aged powder. The process of activation and rendering the particle surface passive was investigated. Surface dissolution and moderate grinding were found to be activating factors, while air-aging generally rendered the particle surface passive. The critical factor in determining activity is the availability of reducing species of iron, copper, or nickel on the surface of the minerals.

[Hospitals transfers of children of Maghreb countries. Reflections on current problems and short- and long-term solutions]

Every year, several thousands of North African children receive transfers to France for hospitalization. The need for these medical transfers is linked to a rapidly expending population, improving diagnostic techniques and inadequate therapeutic technology. Affected children are referred most often for cardiac and oncological diseases. Efforts have been made to discern the medical indications for such transfers, to facilitate the acceptance by social aid agencies and to provide the best possible psychosocial and educational settings for the children involved. Yet, many problems remain, such as advanced disease states and associated diseases at the time of transfer, affective disorders, worsened by the prolonged stay in hospital. Solutions must be found for these problems. Examples would include close collaboration between referred North African and French medical teams, and the existence in France of cultural environment sensitive to the needs to the North African patients. Because transfers are responsible for a high financial and affective cost, and for a dependent relationship between countries, long-term solutions must be considered and could include the transfer of technology and cooperation in research rather than medical care.

Respiratory function is impaired less by transverse than by median vertical supraumbilical incisions

Respiratory function in the first four days after elective cholecystectomy has been compared in 15 women in whom abdominal incision was transverse and 15 in whom it was median vertical. Ventilatory function (vital capacity and forced expiratory volume in one second) and blood gas tensions (partial pressures of oxygen and of carbon dioxide in arterial blood, arterial whole-blood carbon dioxide, and alveolo-arterial oxygen tension difference) were determined on the day before operation and on the first, second and fourth postoperative days. Ventilatory function was depressed postoperatively in all the patients, but the depression was significantly less, and of significantly shorter duration, after the transverse than after the median vertical approach. Significant changes in blood gas tensions were noted postoperatively after both incisions, but without significant difference between the two groups.