Human papillomavirus in esophageal squamous cell carcinoma in Colombia and Chile

AIM: To examine the presence of human papillomavirus (HPV) in esophageal squamous cell carcinoma (ESCC) specimens collected from Colombia and Chile located in the northern and southern ends of the continent, respectively. METHODS: We examined 47 and 26 formalin-fixed and paraffin-embedded ESCC specimens from Colombia and Chile, respectively. HPV was detected using GP5+/GP6+ primer pair for PCR, and confirmed by Southern blot analysis. Sequencing analysis of L1 region fragment was used to identify HPV genotype. In addition, P16INK4A protein immunostaining of all the specimens was conducted. RESULTS: HPV was detected in 21 ESCC specimens (29%). Sequencing analysis of L1 region fragment identified HPV-16 genome in 6 Colombian cases(13%) and in 5 Chilean cases (19%). HPV-18 was detected in 10 cases (21%) in Colombia but not in any Chilean case. Since Chilean ESCC cases had a higher prevalence of HPV-16 (without statistical significance), but a significantly lower prevalence of HPV-18 than in Colombian cases (P = 0.011) even though the two countries have similar ESCC incidence rates, the frequency of HPV-related ESCC may not be strongly affected by risk factors affecting the incidence of ESCC. HPV-16 genome was more frequently detected in p16 positive carcinomas, although the difference was not statistically significant. HPV-18 detection rate did not show any association with p16 expression. Well-differentiated tumors tended to have either HPV-16 or HPV-18 but the association was not statistically significant. HPV genotypes other than HPV-16 or 18 were not detected in either country. CONCLUSION: HPV-16 and HPV-18 genotypes can be found in ESCC specimens collected from two South American countries. Further studies on the relationship between HPV-16 presence and p16 expression in ESCC would aid understanding of the mechanism underlying the presence of HPV in ESCC.

Risk factors of gastric cancer specific for tumor location and histology in Cali,Colombia

AIM: To examine histology- and tumor-location specific risk factors of gastric cancer (GC). METHODS: This was a case-control study. The study subjects were 216 GC patients newly diagnosed during the period 2000-2002 and 431 controls selected from non-cancer patients matching in age, gender, and hospital. We obtained information on lifestyles, dietary habits, and others by a questionnaire. RESULTS: The subjects who were not eldest among his/her siblings were at a slightly elevated GC risk (OR 1.3; 95% CI 0.8-2.0). Salting meals before tasting was related to an increased GC risk (OR 3.5; 95% CI 1.6- 7.3). Frequent consumptions of fruits (OR 0.3; 95% CI 0.1-1.0) and vegetables (OR 0.3; 95% CI 0.1-1.0) were related to decreased GC risks. On the other hand, frying foods (OR 1.9; 95% CI 1.0-3.6) and cooking with coal (OR 1.8; 95% CI 1.3-2.6) were related to increased GC risks. Neither Lauren’s histological classification (intestinal and diffuse types) nor tumor location significantly affected those associations except birth order. The subjects who were not eldest among his/her siblings had an increased risk of GCs in the distal and middle thirds, and their ORs were 1.7 (95% CI 1.0-2.8) and 1.9 (95% CI 0.8-4.3), respectively. The corresponding OR in the upper third stomach was 0.3 (95% CI 0.1-0.9). The differences of those three ORs were statistically significant (P = 0.010). CONCLUSION: The present study shows that birth or- der, salt intake, consumption of fruits and vegetables, the type of cooking, and cigarette smoking are related to GC risk. In histology and tumor-location specific analy- ses, non-eldest person among their siblings is related to an increased GC risk in the distal and middle thirds of the stomach, and is related to a decreased GC risk in the cardia.

E-cadherin and beta-catenin expression in Epstein-Barr virus-associated gastric carcinoma and their prognostic significance

AIM: To examine the role of E-cadherin and beta- catenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas (EBV-GCs). METHODS: We compared the frequency of E-cadherin and beta-catenin expression in 59 EBV-GCs and 120 non-EBV-GCs, and examined the association between patients' prognosis and the expressions of these proteins. RESULTS: Neither the cellular-membranous nor the cytoplasmic E-cadherin expression showed any difference between EBV-GCs and non-EBV-GCs. On the other hand, loss of membranous expression of beta- catenin occurred more frequently in non-EBV-GCs than EBV-GCs [odds ratio = 0.41; 95% confidence interval (CI), 0.19-0.90]. Furthermore, the nuclear and/or cytoplosmic expression of beta-catenin was seen more frequentlyin EBV-GCs than non-EBV-GCs (odds ratio = 2.23; 95% CI, 0.97-5.09), and was observed in a larger proportion of carcinoma cells of EBV-GCs than non-EBV-GCs (P = 0.024). Survival analysis for non-EBV-GC revealed that lymph node metastasis was significantly associated with poor prognosis (P < 0.001). Among EBV- GCs, the depth of invasion (P = 0.005), lymph node metastasis (P = 0.004) and an intestinal type by Lauren classification (hazard ratio = 9.47; 95% CI, 2.67-33.6) were significantly associated with poor prognosis. On the other hand, nuclear and/or cytoplasmic expression of beta-catenin was associated with a better prognosis in patients with EBV-GC (hazard ratio = 0.32; 95% CI, 0.11-0.93). CONCLUSION: We observed more frequent preservation of beta-catenin in cell membrane and accumulation in nuclei and/or cytoplasm in EBV-GCs than in non-EBV- GCs. Factors involved in the prognosis of EBV-GCs and non-EBV-GCs are different in the two conditions.

The Association between Activity of Daily Living and the Combination of Alzheimer’s Disease and Cataract in Elderly Requiring Nursing Care

Some clinical and epidemiological studies have suggested that Alzheimer’s Disease (AD) and cataract, may share common pathogenetic mechanisms, subsequently a positive association between the prevalence of AD and cataract, although other studies found no significant relationship between dementia and visual impairment including cataract in the elderly. Little is known about the association between Activity of Daily Living (ADL) and the combination of AD and cataract. To examine the association between ADL and the combination of AD and cataract, we performed a national survey in nursing care institutions in Japan, examining the decreased ADL in elderly with and without AD and cataract for 453 elderly aged 85.0 ± 8.13 years. The proportion, 43.5% of AD in subjects without cataract was significantly higher than that, 23.5% with cataract. Almost all ADL in AD with cataract was significantly lower than that without cataract, although all ADL in cataract patients receiving surgery in AD was significantly (all p < 0.002) higher than that in cataract patients without surgery in AD, as was confirmed by the multiple regression analysis incorporating into the relevant factors as independent variables. These results showed that ADL scores including cognitive functions decreased by cataract were increased by the surgery in the patients with AD. A significantly negative association between AD and cataract seen in our data, which was inconsistent with the previous result, might lead to the necessities of the clinical diagnosis for slight severity of cataract for patients with AD.

The Relationship between Gait Asymmetry and Respiratory Function in Stroke Patients: A Pilot Study

INTRODUCTION: Gait asymmetry can become very pronounced in patients who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. OBJECTIVE: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. METHODS: This study employed a cross-sec- tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were evaluated by spirometry. We examined the relation between SI or LI and the respiratory function/respiratory muscle strength in patients with stroke. RE- SULTS: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = ﹣0.386, r = ﹣0.392, r = ﹣0.446;p < 0.05). CONCLUSION: The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.

Pancreatolithiasis with an anatomic variant of Wirsung duct:a case report

Introduction In contrast to familiar developmental anomalies,such as pancreatobiliary maljunction and pancreas divisum,a double orifice of the ampulla of Vater is a much more rare congenital malformation.We encountered a patient with pancreatolithiasis associated with anatomic variation of Wirsung duct showing a single major duodenal papilla with a double orifice and no minor papilla.