Alcohol and hepatocellular carcinoma:A review and a point of view

It is well recognized that one cause of chronic liver disease and hepatocellular carcinoma(HCC)is alcohol consumption.Research in Italy and the United States concludes that the most common cause of HCC(responsible for 32%to 45%of HCC)is alcohol.It has recently been shown that a significant relationship between alcohol intake,metabolic changes,and hepatitis virus infection does exist.Alcohol may be a factor in the development of HCC via direct(genotoxic)and indirect mechanisms(cirrhosis).There is only one way of diagnosing HCC,which is early identification through surveillance,when curative treatments become possible.After stopping alcohol intake the risk of liver cancer decreases by 6%to 7%a year,and an estimated time period of 23 years is also needed.Therefore,surveillance is also important in former drinkers and,in our opinion,independently from the presence of compensated cirrhosis.In cases of very early stage(VES)and early stage with portal hypertension,liver transplantation is the optimal option;and in cases of associated disease,percutaneous ethanol injections,radiofrequency and microwave ablation are the ideal treatments.Despite the possibility of detecting microvascular invasion with HR,several studies and some randomized controlled trials revealed that overall survival and DSF rates in patients with VES HCC are much the same after ablation and HR.Therefore,ablation can be regarded as a firstline choice for patients with VES HCC.It is important to emphasize that the choice of treatment should be weighed carefully in the context of a multidisciplinary cancer team.

Polymorphisms of the oxidant enzymes glutathione S-transferase and glutathione reductase and their association with resistance of Plasmodium falciparum isolates to antimalarial drugs

Objective:To investigate the association between amplification of the two regulatory genes controlling glutathione(GSH) levels,glutathione reductase(PfGR) and glutathione S-transferase (PfGST) genes and sensitivity of Plasmodium falciparum(P.falciparum) isolates collected from different malaria endemic areas of Thailand to standard antimalarial drugs.Methods:A total of 70 P.falciparum isolates were collected from endemic areas of multi-drug resistance (Tak,Chantaburi and Ranong Provinces) during the year 2008-2009.The in vitro assessment of antimalarial activity of P.falciparum clones(K1- and Dd2 chloroquine resistant and 3D7- chloroquine sensitive) and isolates to chloroquine,quinine,mefloquine and arteusnate was performed based on SYBR Green modified assay.Results:68(97.14%),11(15.71%) and 28(40%) isolates respectively were classified as chloroquine-,quinine- and mefloquine-resistant isolates. With this limited number of P.falciparum isolates included in the analysis,no significant association between amplification of PfGST gene and sensitivity of the parasite to chloroquine, quinine,mefloquine and quinine was found.Based on PCR analysis,Dd2,Kl and 3D7 clones all contained only one copy of the PfGST gene.All isolates(70) also carried only one copy number of PfGST gene.There appears to be an association between amplification of PfGR gene and chloroquine resistance.The 3D7 and Dd2 clones were found to carry only one PfGR gene copy, whereas the K1 clone carried two gene copies.Conclusions:Chloroquine resistance is likely to be a consequence of multi-factors and enzymes in the GSH system may be partly involved. Larger number of parasite isolates are required to increase power of the hypothesis testing in order to confirm the involvement of both genes as well as other genes implicated in glutathione metabolism in conferring chloroquine resistance.

Anti-Oxidative, Anti-Hyperglycemic and Lipid-Lowering Effects of Aqueous Extracts of <i>Ocimum sanctum</i>L. Leaves in Diabetic Rats

The present study was conducted to investigate the effect of aqueous extracts of Ocimum sanctum L. leaves on blood glucose, serum lipid profile and anti-oxidative activity to protect various risk organs in DM rats. Ocimum sanctum L. leaves were extracted using water, then the total phenolic content was determined. Three groups of male Wistar rats were used including normal control rats, DM rats and DM rats daily fed with aqueous extracts of Ocimum sanctum L. leaves (AQOS) for three weeks. DM rats were induced by intraperitoneal injection of streptozotocin (65 mg/kgbw). The results show that three weeks of diabetic induction increased blood glucose, serum lipid profile and serum levels of AST, ALT, ALP, LDH, CK-MB, creatinine and BUN. AQOS significantly decreased blood glucose, serum lipid profile and serum levels of AST, ALT, ALP, LDH, CK-MB, creatinine and BUN. The low level of serum insulin was also raised by AQOS. AQOS suppressed high TBARS level and raised the activities of antioxidant enzymes in the liver, kidney and cardiac tis- sues. Histopathological results show that AQOS preserved the liver, kidney and myocardial tissues. It can be concluded that AQOS had anti-hyperglycemic, anti-hyperlipidemic, and free radical sca- venging effects providing organ protection from diabetes. The phenolic compounds contained in AQOS might be responsible for these activities.

Assessment of in vitro sensitivity of Plasmodium vivax fresh isolates

Objective:To compare the applicability of the SYBK Grcen-Ⅰ assay with the standard schizont maturalion assay,for determination of sensitivity of Plasmodium vivax(P.vivax) to chloroquine and a new antifolale WR 99210.Methods:The study was conducted at Mae Tao Clinic for migrant workers,Tak Province during April 2009 to July 2010.A total of 64 blood samples(1 mL blood collected into sodium heparinized plastic tube) were collected from patients with monoinfection with P.vivax malaria prior to treatment with standard regimen of a 3-day chloroquine. In vitro sensitivity of P.vivax isolates was evaluated by schizont maturation inhibition and SYBR Green-Ⅰ assays.Results:A total of 30 out of 64 blood samples collected from patients with P.vivax malaria were successfully analyzed using both the microscopic schizont maturation inhibition and SYBR Green-I assays.The failure rates of the schizont maturation inhibition assay(50%) and the SYBR Green-I assay(54%) were similar(P=0.51).The median IC_(10)s,IC_(50)s and IC_(90)s of both chloroquine and WR99210 were not significantly different from the clinical isolates of P.vivax tested.Based on the cut-off of 100 nM,the prevalences of chloroquine resistance determined by schizont maturation inhibition and SYBR Green-I assays were 19 and 11 isolates,respectively.The strength of agreement between the two methods was very poor for both chloroquine and WR992I0.Conclusions:On the basis of this condition and its superior sensitivity,the microscopic method appears better than the SYUK Green-I Green assay for assessing in vitro sensitivity of fresh P.vivax isolates to antimalarial drugs.