SMOKING JEOPARDIZED MITOCHONDRIAL FUNCTION VITIATING LIPID PROFILE

Smoking has increasingly reported as deleterious behavior associated with serious problems, ranging from mood changes to cancer. The basic and common landmark associated with these disorders is derangement of mitochondrial quasi-equilibrium. This study aimed to identify the role of smoking in modulation of lipid profile in the view of mitochondrial dysfunctionality. To do so, smokers were recruited, serum lipid profile, serum pyruvate, and serum lactate were determined to confirm the link between serum lipid profile and smoking induced lactate to pyruvate ratio. The recruited subjects were sub-classified into three groups; G1 includes smokers for up to 5 years, G2 includes smokers for 5-10 years, and G3 includes smokers for more than 10 years alongside the control non-smokers group. The results confirmed that lactate to pyruvate has significantly (p<0.05) increased in smoker groups (G1, G2, G3) compared to control group and smoking has significantly increased LDL and TG with no effects on cholesterol or HDL levels in G1 group alongside minimal or no changes associated with G2 or G3 compared to control group. In conclusion, smoking impacted lipid profile in smokers during initial stages of smoking, however, the effect started to be tolerated with continuous smoking after 5 years with obscure mechanism. Nonetheless, pyruvate/lactate modulation due to restoration of mitochondrial quasi-equilibrium might be the cause. Cigarette cessation campaign should be advocated to ensure smoking-free society.

Recurrent Laryngeal Nerve Paralysis Following Thyroidectomy: Analysis of Factors Affecting Nerve Recovery

OBJECTIVES

Paralysis of the recurrent laryngeal nerves (RLNs), albeit decreased over the years, leaves the surgeon helpless as there is not much that can be done once it occurs. Nimodipine has been suggested as a remedy that could accelerate the recovery of the nerve. Our study aimed to examine the factors that affect the recovery rate (RR) and time to recovery (TTR) of post-thyroidectomy RLN paralysis, with an emphasis on the use of nimodipine.

METHODS

A total of 197 patients who had undergone thyroid and parathyroid surgeries were retrospectively reviewed from October 2016 to August 2019. Patients who had RLN paralysis following surgery were assessed. The medical records were retrospectively analyzed to look for possible factors that may influence RLN recovery.

RESULTS

A total of 289 nerves were at risk. Temporary RLN paralysis rate was 7.9% while 1.7% was permanent. Age (odds ratio [OR] = 4.8) and intra-operative extra-thyroid extension (OR = 9.0) were independent risk factors for RLN paralysis. The rate of recovery was 82.1%. Loss of signal (LOS; P = .066) was a factor trending for an impact on RR but not nimodipine (P > .05). The mean TTR was 32 days. LOS, nimodipine, and steroid use, among others, were factors trending for an impact on the TTR.

CONCLUSION

Although not reaching statistical significance, nimodipine and steroids might influence TTR but not the RR. Larger studies are warranted to address the effect of nimodipine on the outcome of RLN paralysis.

LEVEL OF EVIDENCE

4 Laryngoscope, 2022.

Use of the comprehensive geriatric assessment for the prediction of postoperative complications in elderly patients with head and neck cancer

BACKGROUND

To determine the efficacy of preoperative Comprehensive Geriatric Assessment (CGA) in predicting postoperative complications in elderly patients undergoing head and neck cancer surgery.

METHODS

Medical records of patients aged ≥70 who underwent elective head and neck cancer surgery were reviewed. CGA scores were prospectively collected prior to surgery and analyzed to determine their association with postoperative complications.

RESULTS

Of the 65 patients enrolled in this study, 34 (52.3%) with deficits in two or more preoperative CGA domains were categorized as "frail." Fourteen patients (21.5%) experienced postoperative complications. Age was not a risk factor for the complications (p = 0.504). The multivariate analysis indicated that major postoperative complications were significantly associated with frailty (odds ratio [OR] = 21.9, p = 0.039), operation time (OR = 39, p = 0.048), and estimated blood loss (OR = 19.8, p = 0.043).

CONCLUSIONS

Frailty assessed by preoperative CGA, but not chronological age, was significantly associated with major postoperative complications in elderly patients undergoing head and neck cancer surgery.

Expression of VP1 protein of serotype A and O of foot-and-mouth disease virus in transgenic sunnhemp plants and its immunogenicity for guinea pigs

Recently, transgenic plants expressing immunogenic proteins of foot-and-mouth disease virus (FMDV) have been used as oral or parenteral vaccines against foot-and-mouth disease (FMD). They exhibit advantages like cost effectiveness, absence of processing, thermostability, and easy oral application. FMDV VP1 protein of single serotype has been mostly used as immunogen. Here we report the development of a bivalent vaccine with tandem-linked VP1 proteins of two serotypes, A and O, present in transgenic forage crop Crotalaria juncea. The expression of the bivalent protein in the transgenic plants was confirmed by Western blot analysis. Guinea pig reacted to orally or parenterally applied vaccine by humoral as well as cell-mediated immune responses including serum antibodies and stimulated lymphocytes, respectively. The vaccine protected the animals against a challenge with the virus of serotype A as well as O. This is the first report on the development of a bivalent FMD vaccine using a forage crop.

KEYWORDS

foot-and-mouth disease; sunnhemp; Agrobacterium tumefaciens; FMDV-VP1 gene; serotype O and A; in planta transformation; transgenic plants; bivalent vaccine.

Impact of the Pro12Ala polymorphism of the PPARγ2 gene on diabetes and obesity in a highly consanguineous population

BACKGROUND

The peroxisome proliferator-activated receptors (PPARs) are members of the nuclear hormone receptor subfamily of transcription factors. It has been reported that they play important roles in obesity and the development of type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

This case-control study was carried out among 764 Qatari patients with diabetes and 764 healthy subjects above 20 years of age at Primary Healthcare Clinics (PHCs) from January 2011 to December 2012. Face-to-face interviews were based on a questionnaire that included variables such as age, sex, sociodemographic status, body mass index (BMI) and other clinical parameters. The Pro12Ala in the PPARγ2 gene was detected on the LightCycler using two specific probes. Univariate and multivariate statistical analysis were performed.

RESULTS

The study revealed that in the diabetes group, Pro/(10.2% vs 9.4%; P = 0.606) and Ala/Ala (1.4% vs 0.9%; P = 0.343) were higher than in controls, whereas Pro/Pro (88.4% vs 89.7%;P = 0.413) was lower in diabetes patients, but no significant difference was observed among the genotype groups. In obese patients with diabetes, Pro/Pro (89% vs 89.9%;P = 0.792) and Pro/Ala (8.9% vs 10.1%;P = 0.671) were lower than in obese healthy subjects. No homozygous Ala/Ala was found in obese healthy subjects, whereas 6 Ala/Ala homozygotes were in obese diabetes group. But in diabetes group, obese patients had higher homozygous of Pro/Pro (89.3% vs 87.8%;P = 0.523) and Ala/Ala (1.8% vs 1.2%;P = 0.771) compared to non-obese patients.

CONCLUSION

The current study did not reveal an association between the Pro12Ala polymorphism of the PPAR γ2 gene and type 2 diabetes (T2D) in Qatari's population.

The role of ultrasonography in detection and localization of radiolucent foreign body in soft tissues of extremities

INTRODUCTION

Retained non-radiopaque foreign body inside soft tissue can be a cause of prolonged morbidity. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but both of CT and MRI are expensive and not easily available.

METHODS

Twenty three patients were evaluated with ultrasonography (8 MHz linear probe) and X-ray for clinically suspicious non-radiopaque foreign body in soft tissue of extremities. Clinical presentation, duration of symptoms, anatomical location and foreign bodies retrieved after surgical explorations were recorded.

RESULTS

X-ray could not detect any foreign body in all 23 patients. Ultrasound findings were suggestive of foreign body in 19 patients (male: female=2:1, mean age 31.68+/-11.8 years, range 12 - 54 years) which was confirmed after surgical exploration except in one where only foreign body granuloma was found. 4 (21%) were not aware of prick injury. Fifteen patients had attempted removal of foreign body themselves or at medical shop or local health post. Interval between injury / symptoms appearance to hospital ranged from 4-56 days. Foot and ankle was involved in 10 (52.6%), calf in 3 (15%), dorsum of hand in 2 (10.5%), palm in 2 (10.5%), shoulder in 1 (5.2%) and knee in 1 (5.2%) case. Foreign bodies retrieved were wood in 12 (63%), thorn in 4 (21%) and bamboo twig in 2 (10.5%) patients.

CONCLUSION

Plain X-ray isn't sensitive for detection of non-radiopaque foreign body in soft tissue. Ultrasonography is sensitive and specific for detection and localization of foreign body which should be included in evaluation for clinically suspicious retained non-radiopaque foreign body in soft tissue of extremities.

The Role of Ultrasonography in Detection and Localization of Radiolucent Foreign Body in Soft Tissues of Extremities

INTRODUCTION:Retained non-radiopaque foreign body inside soft tissue can be a cause of prolonged morbidity. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but both of CT and MRI are expensive and not easily available.METHODS:Twenty three patients were evaluated with ultrasonography (8 MHz linear probe) and X-ray for clinically suspicious non-radiopaque foreignbody in soft tissue of extremities. Clinical presentation, duration of symptoms, anatomical location and foreign bodies retrieved after surgical explorations were recorded.RESULTS:X-ray could not detect any foreign body in all 23 patients. Ultrasound findings were suggestive of foreign body in 19 patients (male: female=2:1, mean age 31.68+/-11.8 years, range 12 - 54 years) which was confirmed after surgical exploration except in one where only foreign bodygranuloma was found. 4 (21%) were not aware of prick injury. Fifteen patients had attempted removal of foreign body themselves or at medical shop or local health post. Interval between injury / symptoms appearance to hospital ranged from 4-56 days. Foot and ankle was involved in 10 (52.6%), calf in 3 (15%), dorsum of hand in 2 (10.5%), palm in 2 (10.5%), shoulder in 1 (5.2%) and knee in 1 (5.2%) case. Foreign bodies retrieved were wood in 12 (63%), thorn in 4 (21%) and bamboo twig in 2 (10.5%) patients.CONCLUSION:Plain X-ray isn't sensitive for detection of non-radiopaque foreign body in soft tissue. Ultrasonography is sensitive and specific fordetection and localization of foreign body which should be included in evaluation for clinically suspicious retained non-radiopaque foreign body in softtissue of extremities.KEYWORDS:non-radiopaque foreign body; sensitivity; specificity; ultrasonography

Sensitization of pancreatic cancer cells to ApoG2 induced killing by curcumin

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Background: In pancreatic cancer, several important survival molecules such as NF-kappa B and Bcl-2 or Bcl-XL are highly activated. Thus agents that inhibit NF-KappaB activation, together with agents that inhibit Bcl-2 or Bcl-XL protein function, may lead to enhanced cell killing. ApoG2, a new derivative of natural product gossypol, is a potent small molecule inhibitor of Bcl-2 and Bcl-XL proteins. Curcumin, an active ingredient from the rhizome of the plant, Curcuma longa, has anti-inflammatory and anti-cancer activities and works by inactivation of NF-Kappa B activity. In this study we have investigated the effects of curcumin on ApoG2 induced apoptosis. Methods: The BxPC-3 human pancreatic cancer cell line was used in this study. ApoG2 was dissolved in DMSO at 1 mM stock solution, and curcumin was dissolved in DMSO at 20 mM stock solution. Cell viability was determined by the standard MTT assay and apoptosis was measured by histone/DNA ELISA method. Results: Pretreatment of human pancreatic cell line BxPC-3 with curcumin sensitizes ApoG2 induced cell killing. In the dose escalation with ApoG2 at 48 hrs on MTT assay, 250 nM showed 75% cell viability, while 2.5 uM of curcumin at 72 hrs showed 80% cell viability. Pretreatment with curcumin for 24 hrs followed by ApoG2 at 48 hrs showed 55% cell viability (p = 0.0005). Apoptosis by histone/DNA ELISA showed 4-fold induction of cell death with ApoG2 at 48 hrs, 7-fold induction of cell death with curcumin at 72 hrs. However, pretreatment with curcumin for 24 hrs followed by ApoG2 at 48 hrs showed 10-fold induction in apoptosis compared to the control. Conclusions: From these results, we conclude that curcumin enhanced ApoG2 induced cell growth inhibition and apoptosis of BxPC-3 cells.

No significant financial relationships to disclose.

Expression of inflammatory modulator COX-2 in pancreatic ductal adenocarcinoma and its relationship to pathologic and clinical parameters

Despite the exceedingly poor prognosis of pancreatic cancer, it is often histologically well to moderately differentiated. The apparent resistance to conventional therapeutic modalities is poorly understood and may be related to the molecules involved in its progression or its propensity for perineurial invasion. Cyclooxygenase-2 (COX-2) is an inducible enzyme homologous to COX-1 that is responsible for production of prostaglandins at sites of inflammation. It is activated by a variety of growth factors and tumor promoters, and it has been implicated in cancer progression. It may also have a role in the resistance to therapy. Anti-COX-2 agents have been documented to have antitumor activity, and some are now being tested in the therapy for various cancers, including those of the pancreas. Experience regarding the rate of COX-2 expression in pancreatic cancer and its relationship to the clinical and biologic parameters is very limited. In this study, immunohistochemical stains for COX-2 have been performed on 120 cases of pancreatic ductal adenocarcinoma. The stains were scored according to the percentage (0: no staining, 1: < 10%, 2: 10-50%, and 3: >50% of the cells staining) and intensity (0 for no staining, 1 for mild staining, and 2 for dark staining) of staining. Based on the combined score for each case, they were divided into low expressors (percentage and intensity < or =1) and high expressors (percentage or intensity >1). In addition to global scoring for each case, the glandular and solid (poorly differentiated) components, when present, were scored separately. The global scores were correlated with clinical and biologic parameters. Seventy-four percent of the cases exhibited expression of COX-2 and 53% were high expressors. No significant association was observed when comparing the global COX-2 expression to survival, tumor size, stage, and vascular invasion. Increased perineural invasion was found to be significantly associated with COX-2 expression (p < 0.05). Increased expression was also more common in the glandular component as compared with the solid component of the tumors (68% versus 35%, p < 0.05). Of the 34 patients who received radiotherapy, 9 were low expressor (median survival 19.5 months) and 25 were high expressors (median survival 14 months). The difference in survival was not statistically significant.

Clinical relevance of precore and basal core promoter variants of hepatitis B virus during natural hepatitis B e antigen seroconversion may be overstated

BACKGROUND

Clinical relevance of nucleotide changes in precore and basal core promoters in the hepatitis B virus genome during hepatitis B e antigen seroconversion may be overstated. The authors investigated the existence and changes in the relative proportion of variants to wild virus that occur with seroconversion.

METHODS

Sera from 30 school-aged long-term hepatitis B virus carriers, including 11 tested before and after seroconversion during 1 to 8 years of follow-up, were evaluated for variations in nucleotide sequences of the basal core promoter (T1762 and A1764), precore region (A1869), and carboxyl-terminus of the X region of the hepatitis B virus genome using an amplification refractory mutation detection system with mutant-specific primers.

RESULTS

All variants were found to already exist before seroconversion at various wild-type/mutant ratios. The positive rates of these variants were not changed with loss of hepatitis B e antigen. Although there was a relative increase in the concentration of these mutants in wild-type/mutant mixed populations, most patients with only a wild-type population maintained the same pattern after loss of hepatitis B e antigen.

CONCLUSIONS

Our results indicate that hepatitis B virus exists as a quasi species, and correlations of nucleotide sequences with clinical and serologic findings must be done with caution.

Neutron and photon clonogenic survival curves of two chemotherapy resistant human intermediate-grade non-Hodgkin lymphoma cell lines

BACKGROUND

The potential role of neutron therapy in the management of intermediate-grade non-Hodgkin lymphoma (IGNHL) has not been examined because of the belief that the anticipated radiobiological effectiveness (RBE) would be uniformly very low.

PURPOSE

To determine the fast neutron RBE for two chemotherapy-resistant IGNHL cell lines.

METHODS AND MATERIALS

Conventional soft agar clonogenic survival curves following irradiation by 60Co and fast neutron were established for two IGNHL cell lines. These cell lines, WSU-DLCL2 and SK-DHL2B, were found in previous studies to be able to repair sublethal damage, and were also resistant to L-Pam and doxorubicin chemotherapy.

RESULTS

When the surviving fraction after 2 Gy photon was chosen as the biological endpoint, the RBE for WSU-DLCL2 and SK-DHL2B measured 3.34 and 3.06. Similarly, when 10% survival was considered, the RBE for these two cell lines measured 2.54 and 2.59. The RBE, as measured by the ratios alpha neutron/alpha photon, for WSU-DLCL2, SK-DHL2B cell lines are 6.67 and 5.65, respectively. These results indicate that the RBE for these IGNHL cell lines is higher than the average RBE for cell lines of other histological types.

CONCLUSION

Fast neutron irradiation may be of potential value in treating selected cases of IGNHL.

Radiobiological characterization of two human chemotherapy-resistant intermediate grade non-Hodgkin's lymphoma cell lines

Intermediate grade non-Hodgkin's lymphoma (IGNHL) is generally considered a radiosensitive tumor that can be controlled with moderate radiation doses. Cell-survival curves of cell lines derived from IGNHL have been typically described to exhibit small or no shoulder, implying inability to accumulate or repair sublethal radiation damage. We characterize in this report the clonogenic radiation survival curves of two human IGNHL cell lines, WSU-DLCL2 and SK-DHL2B, established from patients who expired after having exhibited chemotherapy resistance of their tumors. The cells were irradiated with 60Co radiation at a dose rate of 85-100 cGy/min and cell survival data were analyzed according to the linear quadratic model. The alpha/beta values for WSU-DLCL2 and SK-DHL2B cells are 2 and 8.6, respectively. The corresponding SF2 are 0.42 and 0.35, respectively. Both cell lines are able to repair radiation-induced sublethal damage. These data indicate that these cells are only moderately radiosensitive.

Effect of dolastatin 10 on human non-Hodgkin's lymphoma cell lines

It is crucial to incorporate new and more potent antineoplastic agents in treating non-Hodgkin's lymphoma since standard chemotherapy fails to cause a significant increase in the survival rate. A potential chemotherapeutic agent is dolastatin 10; hence, the objective of our study is to investigate the effect of the antiproliferative agent dolastatin 10 on different grades of non-Hodgkin's lymphoma cell lines. All cell lines exposed to dolastatin 10 initiated an apoptosis process. Alteration of oncogenes and their product may direct the entry of the cells into apoptosis, among these oncogenes are bcl-2 and c-myc. All cell lines tested expressed c-myc and bcl-2 proteins. However, 24 h after exposing the cell lines to 1 ng/ml dolastatin 10, bcl-2 expression was abolished but there was no significant change in c-myc protein expression. The contradictory roles of c-myc in cell proliferation and death require that other gene(s) products regiment the outcomes of c-myc activity on a cell. A possible candidate for such a modifying gene is bcl-2, whose product prolongs cell survival and blocks apoptosis. Given the above, dolastatin 10 induction of cell arrest is the initiating signal to downregulate the antiapoptotic bcl-2 and reactivate the apoptotic pathway. The reductions in bcl-2 may stabilize the c-myc proliferative action and induce apoptosis.

Antisense oligodeoxyribonucleotide down-regulation of bcl-2 gene expression inhibits growth of the low-grade non-Hodgkin's lymphoma cell line WSU-FSCCL

The BCL-2 gene product is involved in preventing apoptosis. The t(14,18) chromosomal translocation, which results in a fusion messenger RNA containing the entire coding region of BCL-2 and a portion of the immunoglobulin heavy chain gene, is commonly found in follicular lymphoma and appears to play a role in lymphomagenesis by inhibiting cell death. We tested the hypothesis that downregulation of BCL-2 would decrease accumulation of follicular lymphoma cells by treating the t(14,18)-carrying follicular lymphoma cell line WSU-FSCCL in vitro with antisense oligodeoxyribonucleotides (ODNs) directed against BCL-2. We found dose-dependent, sequence-specific inhibition of cell accumulation by an antisense unmodified ODN directed at codons 2 to 7, which downregulated BCL-2 protein levels. This effect was near maximal at an ODN concentration of 40 micrograms/mL (6.9 mumol/L), with minimal toxicity by control sense, reverse, and mutated antisense ODN at the same concentration. The pre-B leukemia cell line REH showed no sequence-specific growth inhibition by the antisense ODN at these concentrations, and BCL-2 protein levels were not altered. These data suggest that WSU-FSCCL may be useful in a murine model to optimize antisense ODN for potential therapeutic utility.

Prothymosin alpha gene expression correlates with proliferation, not differentiation, of HL-60 cells

Accumulating evidence suggests that prothymosin alpha has an as yet undefined intracellular, perhaps intranuclear, function related to cell proliferation. Prothymosin alpha mRNA and/or peptide levels increase when cells are stimulated to proliferate. Because proliferation and differentiation events are often inversely correlated, we examined prothymosin alpha gene expression during proliferation and differentiation of HL-60 myeloid leukemia cells. Steady-state levels of prothymosin alpha mRNA, which are high in exponentially growing HL-60, decrease within hours after induction of HL-60 to differentiate along the neutrophil pathway with dimethylsulfoxide (DMSO) or along the macrophage lineage with either tetradecanoylphorbol acetate (TPA) or bryostatin 1. The decline in prothymosin alpha mRNA in response to these differentiation signals parallels that of c-myc mRNA under the same conditions. We then determined whether the downregulation of prothymosin alpha and c-myc mRNA were due to differentiation or cessation or proliferation. Recombinant human gamma-interferon induces monocytic differentiation of HL-60, but permits continued proliferation, and, under these conditions, expression of prothymosin alpha, as well as of c-myc, mRNA remains elevated. We conclude that prothymosin alpha and c-myc expression are coregulated in differentiating HL-60 and that their expression correlates with the proliferative state of HL-60 cells, rather than with the differentiated state.

Propagation of Waldenström's macroglobulinemia cells in vitro and in severe combined immune deficient mice: utility as a preclinical drug screening model

Waldenström's macroglobulinemia (WM) represents an indolent incurable human B-cell tumor. We have successfully established a permanent cell line, WSU-WM, without growth factors or viral transformation, from the pleural effusion of a 60-year-old man with IgM kappa WM. Phenotypic characterization of WSU-WM shows IgM lambda and expression of other B-cell markers. Karyotypic analysis shows a male chromosome complement with several clonal aberrations, including t(8;14)(q24;q32). Molecular characterization shows deletion of kappa and rearrangement of lambda light chain genes indicating a class switching. Both the secretory (s mu) and membrane (m mu) components of IgM are expressed. In addition, the breakpoint on 8q24 is downstream of exon 3 of the c-myc oncogene. WSU-WM grows in liquid culture and soft agar. When cells were injected subcutaneously in immune deficient mice, six of seven SCID mice developed subcutaneous tumors as opposed to three of seven in the athymic nude mice. When a WSU-WM SCID tumor was passaged in vivo in the SCID mice, the take rate was 100%. This xenograft model and a soft agar disk-diffusion assay were used to test the efficacy of standard chemotherapy agents against this tumor in vivo and in vitro, respectively. The cell line and the assays described herein can be used as a model to facilitate the discovery of new therapeutic agents or modalities for this disease.