Telomere length is a prognostic factor for overall survival in colorectal cancer.

AIM: The aim of this study was to determine whether telomere length is an independent prognostic factor for the prevention and survival of colorectal cancer. METHOD: Terminal restriction fragment (TRF) length was determined by Southern blot in tumours and paired normal tissue samples from 147 patients with sporadic colorectal cancer who had undergone surgery. The TRF length ratio (TRFLR) was determined as the ratio between the length of the patient's tumour and normal tissue.The classification and regression tree technique was used to determine optimal cut-off values (≤ 1 or > 1). RESULTS: Mean TRF length was 6.79 Kbp (1.19-13.99) in tumour tissue and 7.81 Kbp (3.63-15.70) in normal mucosa (P < 0.001). Mean TRFLR was 0.88. Telomere length and telomere length ratio were not correlated with any clinicopathological factors. In univariate analysis, overall survival was related to N stage (lymph node +/-; P = 0.002), TNM classification (P = 0.019) and TRFLR (≤ 1 or > 1; P = 0.014). In multivariate analysis, overall survival was significantly associated with TRFLR and N stage. Colorectal cancer patients with TRFLR ≤ 1 and negative lymph node involvement had a higher overall survival rate. CONCLUSION: Telomere length ratio is an independent prognostic factor for survival in colorectal cancer patients, and the telomere lengths in the normal and tumour mucosa of the same patient present with parallel behaviour.

Repetitive mucosal trauma promotes colon cancer in experimental rat model.

OBJECTIVE: To investigate the effect of repetitive mucosal trauma, anastomosis and intestinal content on experimental colonic carcinogenesis as there is the possibility than non-specific colon lesions can promote cancer. MATERIAL AND METHOD: We performed to sixty female Sprague-Dawley rats a 4 cm colon loop defunctionalization with double colostomy (traumatic site). Intestinal continuity was restored with an end-to-end colo-colic silk anastomosis. The surviving 47 rats were divided in 3 groups: Group A: 27 rats treated with DMH. Group B: 10 rats treated with EDTA and Group C: Control of 10 rats. Animals were sacrificed 31-32 weeks after surgery for macro and micropathological studies. RESULTS: In group A appeared 60 tumours: 44 in the functional colon, 20 of them in the anastomotic site; 8 in the non traumatised defunctionalized segment and 18 in the traumatised segment (p < 0.05). CONCLUSIONS: a) Continuous microtraumas on colonic mucosa in rats are cancer promotional factors; b) silk suture in anastomosis promotes cancer.

Traumatismos repetitivos sobre la mucosa promueven cáncer / Repetitive mucosal trauma promotes cancer in experimental rat model of colonic carcinogenesis

Objetivo: investigar el efecto de traumatismos repetitivos sobre la mucosa del colon en un modelo de carcinogénesis colónica experimental, ya que es posible que lesiones colónicas inespecíficas sean promotoras de cáncer. Material y método: a 60 ratas hembra Sprague-Dawley les realizamos una desfuncionalización colónica de 4 cm con doble colostomía, restableciendo la continuidad intestinal con sutura término-terminal de seda. Las 47 ratas supervivientes se dividieron aleatoriamente en 3 grupos: Grupo A: 27 ratas tratadas con dimetilhidracina (DMH). Grupo B: 10 ratas tratadas con EDTA y Grupo C: Control de 10 ratas. Se sacrificaron los animales a las 31-32 semanas después de la cirugía para estudio macro y microscópico. Resultados: en el grupo A aparecieron 70 tumores: 44 en colon funcional, 20 de ellos en el lugar de la anastomosis. 26 tumores en el segmento desfuncionalizado, 18 de ellos en su zona traumatizada (p< 0,05). No hubo tumores en los otros grupos. Conclusiones: a) los microtraumatismos continuos en la mucosa del colon son factores promotores de cáncer en la rata; b) la sutura de seda en la anastómosis es un factor promotor de cáncer (AU)

[Acute pancreatitis associated with hepatotoxicity induced by amoxicillin-clavulanic acid]. / Pancreatitis aguda asociada a hepatotoxicidad por amoxicilina-clavulánico.

A 25-year old man suffered from acute pancreatitis and cholestatic acute hepatitis simultaneously after 4 weeks of an antibiotic treatment withdrawal (amoxicillin plus clavulanic acid) which was given for pharyngitis. Other potential etiological causes of both acute pancreatitis and liver disease, were excluded. The causal relationship between amoxicillin plus clavulanic acid and cholestatic hepatitis is well know, but no data has been reported regarding acute pancreatitis. The medical literature is reviewed and the mechanisms of toxicity are discussed.

[Cirrhosis caused by amiodarone]. / Cirrosis causada por amiodarona.

A woman who had been taking amiodarone--400 mg/day--for over nine years, developed cirrhosis. Electron microscopy showed phospholipid-laden lysosomal lamellar bodies containing myelin figures. A review is made about the reported cases of amiodarone-induced cirrhosis, including detailed histological findings. We conclude that periodical clinical and biochemical monitoring must be made in patients receiving treatment with amiodarone, and that the pathophysiologic mechanism responsible for the amiodarone toxicity still remains unclear.

Comparative study of two high doses of lymphoblastoid interferon in the treatment of chronic hepatitis C: influence on the levels of ALT, viraemia and histologic activity.

Ninety consecutive patients with chronic hepatitis C were included in a randomized, uncontrolled trial to compare the efficacy of two treatment regimens, 10 MU (group A) vs 5 MU (group B), of lymphoblastoid interferon, in a step-down schedule for 24 weeks. All of the patients had antibodies against the hepatitis C virus, and all but one were HCV RNA positive in serum. The origin of the infection was attributed to blood transfusion in 30 patients and classified as sporadic in 60 patients. During treatment reduction in the ALT levels as well as the elimination of viraemia was observed in both treated groups, although these changes did not correlate significantly with the interferon dose. Nine months after the end of therapy, a sustained response was achieved in 13.6% (12/88) of the patients. Relapse in group B (87.5%) was significantly higher than in group A (59.1%). The percentage of cases which remained with undetectable HCV RNA was significantly higher for the sustained responders (66.7%) than for the non-responders (11.8%) and relapser patients (2.4%). Repeated liver biopsies showed an overall significant reduction of all the subindices of histological activity from patients with sustained response, except for fibrosis. In short: the 10 MU dosing regimen of lymphoblastoid interferon was as efficient as the 5 MU dose as it brought about a similar improvement in ALT levels, histological activity and elimination of viraemia, albeit 10 MU proved significantly more effective in the prevention of a relapse among the responders after 24 weeks therapy.