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Apr 24
Determining If A Smoker Is At Risk For Lung Cancer By Testing Urine
Researchers may have uncovered why lung cancer afflicts some smokers and not others, according to data presented at the American Association for Cancer Research 100th Annual Meeting 2009.

"A history of smoking has always been thought of as a predictor of lung cancer, but it is actually not very accurate," said Jian-Min Yuan, Ph.D., M.D., associate professor of public health at the University of Minnesota. "Smoking absolutely increases your risk, but why it does so in some people but not others is a big question."

Yuan and colleagues hypothesized that the presence of the metabolite NNAL in a patient's urine might predict risk of lung cancer. This metabolite has been shown to induce lung cancer in laboratory animals, but the effect in humans had not yet been studied.

Researchers collected data from 18,244 men enrolled in the Shanghai Cohort Study and 63,257 men and women from the Singapore Chinese Health Study. In addition to in-person interviews to assess levels of cigarette smoking, dietary and other lifestyle factors, researchers collected blood and urine samples from more than 50,000 patients.

To evaluate the impact of NNAL, researchers identified 246 current smokers who later developed lung cancer and 245 smokers who did not develop lung cancer during the 10-year period following initial interview and collection of urine samples.

Levels of NNAL in the urine were divided into three groups. Compared to those with the lowest levels, patients with a mid-range level of NNAL had a 43 percent increased risk of lung cancer, while those at the highest level had a more than two-fold increased risk of lung cancer after taking into account the effect of number of cigarettes per day, number of years of smoking, and urinary levels of cotinine on lung cancer risk.

Levels of nicotine in the urine were also calculated. Those with the highest levels of nicotine and NNAL had an 8.5-fold increase in the risk of lung cancer compared with smokers who had the lowest levels after accounting for smoking history.

Apr 24
The Benefit Of Grapes May Be More Than Skin Deep
Can a grape-enriched diet prevent the downhill sequence of heart failure after years of high blood pressure?

A University of Michigan Cardiovascular Center study suggests grapes may prevent heart health risks beyond the simple blood pressure-lowering impact that can come from a diet rich in fruits and vegetables. The benefits may be the result of the phytochemicals - naturally occurring antioxidants - turning on a protective process in the genes that reduces damage to the heart muscle.

The study, performed in laboratory rats, was presented at the 2009 Experimental Biology convention in New Orleans.

The researchers studied the effect of regular table grapes (a blend of green, red, and black grapes) that were mixed into the rat diet in a powdered form, as part of either a high- or low-salt diet. Comparisons were made between rats consuming the grape powder and rats that received a mild dose of a common blood pressure drug. All the rats were from a research breed that develops high blood pressure when fed a salty diet.

After 18 weeks, the rats that received the grape-enriched diet powder had lower blood pressure, better heart function, and fewer signs of heart muscle damage than the rats that ate the same salty diet but didn't receive grapes.

Rats that received the blood pressure medicine, hydrazine, along with a salty diet also had lower blood pressure, but their hearts were not protected from damage as they were in the grape-fed group.

"There are the small changes that diet can bring, but the effect of grape intake on genes can have a greater impact on disease down the road," said E. Mitchell Seymour, M.S., who led the research as part of his doctoral work in nutrition science at Michigan State University. He manages the U-M Cardioprotection Research Laboratory, which is headed by U-M cardiac surgeon Steven Bolling, M.D.

Heart cells, like other cells in the body, make an antioxidant protein called glutathione, which is one of our first defenders against damaging oxidative stress. High blood pressure causes oxidative stress in the heart and lowers the amount of protective glutathione. However, intake of grapes actually turned on glutathione-regulating genes in the heart and significantly elevated glutathione levels.

This may explain why the hearts of grape-fed animals functioned better and had less damage.

Although the current study was supported in part by the California Table Grape Commission, which also supplied the grape powder, the authors note that the commission played no role in the study's design, conduct, analysis or the preparation of the journal article for publication. Seymour also receives funding from the National Heart, Lung and Blood Institute, part of the National Institutes of Health, through a National Research Service Award.

Bolling said the latest results take research on the health benefits of grapes "a step further" by examining the mechanisms impacted by antioxidant-rich grapes.

The rats in the study were from a strain called Dahl rats, which have been specially bred to all be susceptible to salt-induced hypertension. The animals are similar to Americans who have elevated blood pressure related to diet, and who develop heart failure over time because of prolonged hypertension.

Each group of 12 rats was fed the same weight of food each day with powdered grapes making up 3 percent of the diet (by weight) for rats that received grapes as part of either a low-salt or high-salt diet. The rats that received hydrazine were fed it through their water supply in a dose that has been previously shown to be effective in reducing blood pressure.

Such naturally occurring chemicals have already been shown in other research, including previous U-M studies, to reduce other potentially harmful molecular and cellular activity in the body.

In all, the researchers say, the study further demonstrates that a grape-enriched diet can have broad effects on the development of hypertension and the risk factors that go with it. Whether the effect can be replicated in humans, they say, remains to be seen.

Apr 24
DNA's Unconventional 'Architecture' Reveals A Secret To Night Vision
Researchers have discovered an important element for making night vision possible in nocturnal mammals: the DNA within the photoreceptor rod cells responsible for low light vision is packaged in a very unconventional way, according to a report in the April 17th issue of Cell, a Cell Press publication. That special DNA architecture turns the rod cell nuclei themselves into tiny light-collecting lenses, with millions of them in every nocturnal eye.

"The conventional architecture seen in almost all nuclei is invariably present in the rod cells of diurnal mammals, including primates, pigs and squirrels," said Boris Joffe of Ludwig-Maximilians University Munich. "On the other hand, the unique inverted architecture is universally present in nocturnal mammals," for instance, mice, cats and deer.

That architecture has important ramifications for the optical properties of those cells, added Jochen Guck of the University of Cambridge. "Diurnal nuclei are basically scattering obstacles," he said. "In nocturnal animals, they are little lenses. In one case, light is scattered in all directions and in the other it is focused in the forward direction," meaning that even at night, what little light there is can travel deeper into the eye where it can be perceived.

Coming to the realization that the structure of the nuclei of rod cells might have something to do with animals' behavior at night versus during the day took a great leap and an interdisciplinary team, Joffe added. That's because biologists typically think of DNA and its packaging into chromatin in terms of its effect on gene activity. "We tried every other possible explanation," Joffe added. "The idea that it had something to do with vision was a daring idea. People laughed at first."

In non-dividing cells, DNA is associated with proteins to form the so-called chromatin, with more condensed "heterochromatin" at the periphery and less condensed "euchromatin" in the interior. Although cell type-specific variants of nuclear architecture can differ notably in details, the researchers explained, the pattern described above is nearly universal and is conserved in both single-celled and multicellular organisms. The reason for the evolutionary stability of nuclear architecture is most probably the important role that the spatial arrangement of chromatin plays in regulating nuclear functions, they said.

Given that notion, the team took great interest in the fact that the nuclei of mouse rod cells shows essentially the opposite, inverted pattern. The central portion of their nuclei is occupied by a large mass of heterochromatin, while transcription factors that control the activity of genes are enriched at the nuclear periphery.

Mice aren't born with those unusual rod cells, they now report. Rather, the conventional nuclear architecture in their rod cells is completely transformed over the animals' first few weeks into the inverted pattern.

The inverted nuclear architecture found in mice is also present in other nocturnal animals, they found. "Our data revealed a wholly unexpected but very clear correlation between the rod nuclear architecture and lifestyle that was further supported by data on nearly forty animals," the researchers said. "Nocturnal mammals had the inverted pattern, while the diurnal ones showed the conventional one."

The correlation between the inverted nuclear architecture and night vision suggested that the inverted pattern might have an optical ramification, they said. After all, nocturnal mammals see at light intensities a million times lower than those available during the day, and their rod photoreceptors are known to possess a light sensitivity down to the level of a few photons. This high sensitivity demands a large number of rod cells, which increases the thickness of the retinas' outer nuclear layer (ONL). The optimization of light transmission through the ONL could therefore provide crucial advantages for nocturnal vision.

Indeed, measurements of how individual nuclei taken from the rod cells of nocturnal animals interact with light show that they act as collecting lenses. Computer simulations indicate that columns of such nuclei like those found in nocturnal animals' retinas would channel light efficiently toward the light-sensing rod outer segments.

The importance of this special nuclear arrangement comes only when you consider the columns, Guck said. "If each nuclei scattered light, it would all be over. The inversion in nocturnal animals makes sure that light is passed from one nucleus to the next. It is handed down so that it doesn't scatter."

The results show that despite the strong evolutionary conservation of the conventional pattern, nuclear architecture in rod cells was modified several times in the evolution of mammals, Joffe said.

"Taken together, paleontological, molecular, and morphological data strongly suggest (1) that the inverted pattern appeared very early in the evolution of mammals as an adaptation to nocturnal vision in this primarily nocturnal group of animals, (2) that, correspondingly, the conventional pattern was repeatedly reacquired in mammals that readopted a diurnal lifestyle, and (3) that restoration of the conventional architecture most likely demanded selective pressure for the conventional nuclear architecture," the researchers wrote. "Comparison of the inverted and conventional patterns can therefore highlight the advantageous features that predetermine the nearly universal prevalence of the conventional nuclear architecture."

Apr 24
Removing The Adverse Side Effects From An Effective Drug
Nicotinic acid is one of the most effective drugs for raising levels of "good" cholesterol and lowering levels of "bad" cholesterol and other lipids (fats), thereby reducing the risk of heart attack. However, patients often stop taking the drug due to one specific side effect, flushing of the skin that often includes an intense burning and itching sensation. A way to separate the beneficial effects of nicotinic acid from the flushing response has now been elucidated in mice by Robert Lefkowitz and colleagues, at Duke University Medical Center, Durham.

In the study, analysis of human cell lines determined a signaling pathway by which nicotinic acid could initiate the flushing response. This pathway involved the recruitment of beta-arrestin proteins to the GPR109A receptor to which nicotinic acid binds. Interestingly, mice lacking beta-arrestin1 showed a decreased flushing response when treated with nicotinic acid, but the drug retained its beneficial effects on the levels of lipids in the blood. The authors therefore suggest that designing a drug that binds GPR109A but does not stimulate the recruitment of beta-arrestin1 might result in a therapeutic that has beneficial effects on lipid levels without the side effect of flushing.

Apr 24
Acupuncture Eases Radiation-Induced Dry Mouth In Cancer Patients
Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M. D. Anderson Cancer Center report in the current online issue of Head & Neck.

Xerostomia develops after the salivary glands have been exposed to repeated doses of therapeutic radiation. People who have cancers of the head and neck typically receive large cumulative doses, rendering the salivary glands incapable of producing adequate saliva, said Mark S. Chambers, M.S., D.M.D., a professor in the Department of Dental Oncology. Saliva substitutes, lozenges and chewing gum bring only temporary relief, and the commonly prescribed medication, pilocarpine, has short-lived benefits and bothersome side effects of its own.

"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Chambers, the study's senior author. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."

M. Kay Garcia, LAc, Dr.P.H., a clinical nurse specialist and acupuncturist in M. D. Anderson's Integrative Medicine Program and the study's first author, noted that patients with xerostomia may also develop nutritional deficits that can become irreversible.

Garcia, Chambers and their team of researchers conducted a pilot study to determine whether acupuncture could reverse xerostomia. Acupuncture therapy is based on the ancient Chinese practice of inserting and manipulating very thin needles at precise points on the body to relieve pain or otherwise restore health. In traditional Chinese medicine, stimulating these points is believed to improve the flow of vital energy through the body. Contemporary theories about acupuncture's benefits include the suggestion that needle manipulation stimulates natural substances that dilate blood vessels and increase blood flow to different areas of the body.

The M. D. Anderson study included 19 patients with xerostomia who had completed radiation therapy at least four weeks earlier. The patients were given two acupuncture treatments each week for four weeks. The acupuncture points used in the treatment were located on the ears, chin, index finger, forearm and lateral surface of the leg. All patients were tested for saliva flow and asked to complete self-assessments and questionnaires related to their symptoms and quality of life before the first treatment, after completion of four weeks of acupuncture, and again four weeks later.

The twice weekly acupuncture treatments produced highly statistically significant improvements in symptoms. Measurement tools included: the Xerostomia Inventory, asking patients to rate the dryness of their mouth and other related symptoms; and the Patient Benefit Questionnaire, inquiring about issues such as mouth and tongue discomfort; difficulties in speaking, eating and sleeping; and use of oral comfort aids. A quality-of-life assessment conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.

"In this pilot study, patients with severe xerostomia who underwent acupuncture showed improvements in physical well-being and in subjective symptoms," Dr. Chambers said. "Although the patient population was small, the positive results are encouraging and warrant a larger trial to assess patients over a longer period of time."

Garcia said that a phase III, placebo-controlled trial is planned and is currently under review. She also noted that in other studies, the M. D. Anderson researchers are examining whether acupuncture can prevent xerostomia in patients treated for head and neck cancer, not just treat it.

Apr 21
Moms Who Breastfeed Less Likely To Develop Heart Attacks Or Strokes
The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease, report University of Pittsburgh researchers in a study published in the May issue of Obstetrics & Gynecology.

"Heart disease is the leading cause of death for women, so it's vitally important for us to know what we can do to protect ourselves," said Eleanor Bimla Schwarz, M.D., M.S., assistant professor of medicine, epidemiology, and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh. "We have known for years that breastfeeding is important for babies' health; we now know that it is important for mothers' health as well."

According to the study, postmenopausal women who breastfed for at least one month had lower rates of diabetes, high blood pressure and high cholesterol, all known to cause heart disease. Women who had breastfed their babies for more than a year were 10 percent less likely to have had a heart attack, stroke, or developed heart disease than women who had never breastfed.

Dr. Schwarz and colleagues found that the benefits from breastfeeding were long-term - an average of 35 years had passed since women enrolled in the study had last breastfed an infant. "The longer a mother nurses her baby, the better for both of them," Dr. Schwarz pointed out. "Our study provides another good reason for workplace policies to encourage women to breastfeed their infants."

The findings are based on 139,681 postmenopausal women enrolled in the Women's Health Initiative study of chronic disease, initiated in 1994.

Apr 21
Risk Of Vibration-Induced Vascular Injuries Linked To Vibration Frequency Differences
Speaking on April 19 at the Experimental Biology 2009 meeting in New Orleans, Dr. Kristine Krajnak, a team leader in the Engineering and Control Technologies Branch of the Health Effects Laboratory Division of NIOSH in Morgantown, West Virginia, described results from the first study to directly link the different physical responses of tissue that occur with exposure to different vibration frequencies with biological mechanisms underlying the development of vascular dysfunction. Her presentation is part of the scientific program of The American Physiological Society.

The study, along with results of other studies conducted by NIOSH, supports the importance of reducing job-related exposure to vibration. Ongoing research is evaluating the effectiveness of anti-vibration devices, such as anti-vibration gloves and tools.

Higher frequency vibrations produced by an electric sander (greater than 100 Hz) are smoother than the slower vibrations of an electric hand drill (approximately 63 Hz) and therefore are less likely to cause users discomfort.

Don't let that fool you into not using protective devices that can reduce your exposure to vibration, she says. The new research study conducted at the National Institute for Occupational Safety and Health (NIOSH) suggests that exposure to high and low frequencies cause different physiological responses, but both may affect the risk of developing vibration-induced peripheral vascular dysfunction.

Of the 1.1 to 1.5 million U.S. workers exposed to hand transmitted vibration on a fairly regular basis, approximately half eventually develop some disorder such as Vibration White Finger, in which a single finger or sometimes the entire hand turns white and numb when exposed to the cold, due to restricted blood flow.

Workers also may experience reductions in tactile sensitivity, grip strength, and/or manual dexterity. Earlier studies have shown that risk goes up with frequency and duration of exposure, although NIOSH studies are underway to determine why certain people appear more susceptible to shorter exposure durations.

Dr. Krajnak's team looked at two aspects of vibration injury about which very little is known: the mechanisms of injury and the differences in response to frequency of vibration. The researchers used rats, since the tissues, nerves and arteries of rat-tails are similar to those in human fingers and the tails are known to respond to vibration in a way similar to that seen in fingers.

For four hours a day (the longest time a human can be exposed to workplace vibration according to U.S. and international standards) for 10 days, 15 rats (five in each group) were placed in a container where their tails were vibrated at either 63, 125 or 250 Hz. One control group of five rats accompanied them to the experimental area, to make sure any results seen were not related to noise or change of locale. A second control group stayed in their home cages, uninvolved in the activity.

After the last exposure, the scientists examined the tail arteries for changes. Neither control group had changes, suggesting the changes seen were directly related to the effects of vibration. The rats that experienced high frequency (125 and 250 Hz) vibration had higher levels of measures of oxidative stress, while rats that experienced the lower frequency (65 Hz) vibration showed higher levels of pro-inflammatory factors.

Apr 21
Human Lung Tumors Destroy Anti-Cancer Hormone Vitamin D, Pitt Researchers Find
Human lung tumors have the ability to eliminate Vitamin D, a hormone with anti-cancer activity, a new study from the University of Pittsburgh Cancer Institute (UPCI) suggests. Results of the study, Abstract Number 2402, are being presented at the 100th annual meeting of the American Association for Cancer Research (AACR), April 18 to 22, in Denver.

"High levels of Vitamin D help the body produce proteins with anti-tumor activity," explained principal investigator Pamela Hershberger, Ph.D., a research assistant professor in UPCI's Department of Pharmacology and Chemical Biology. "We've discovered that lung cancer cells make an enzyme called CYP24, which counteracts the positive effects of Vitamin D. To better study it, we developed the first radioactive-free assay that measures the amount of Vitamin D in tissues and blood."

According to Dr. Hershberger, this test is sensitive enough to have clinical potential. "We hope this new assay will help identify the best approaches to maintain therapeutic levels of Vitamin D in tissues," she said.

Lung cancer is the leading cause of cancer death in the United States in both men and women, killing 160,000 people annually, and remains one of the most difficult cancers to treat. The five-year survival rate remains low, and better treatments are much needed. According to Dr. Hershberger, it is possible that one day Vitamin D could be used as a chemopreventive agent to improve patient outcomes.

This study was supported by UPCI's Lung Cancer Specialized Program of Research Excellence.

Apr 21
A Potential Therapeutic Target For Gastric Cancer
Gastric cancer (GC) is the fourth most common malignancy and the second most frequent cause of cancer-related death in the world. The carcinogenesis of GC involved numerous genetic and epigenetic alterations, as well as many environmental risk factors. Environmental pollutants such as polycyclic aromatic hydrocarbons (PAHs) and halogenated hydrocarbons (HAHs) are well-known carcinogens that play important roles in GC development. The toxic effects of PAHs and HAHs are mediated by a conserved signaling pathway that binds and activates the aryl hydrocarbon receptor (AhR). AhR is a ligand-activated transcription factor and can mediate the carcinogenic and other toxic effects of a variety of environmental pollutants. Many studies in recent years have demonstrated a close relationship between AhR and tumorigenesis. However, the role of AhR in gastric tumorigenesis is still unclear.

A research team led by Dr Min-Hu Chen from China addressed this problem. Their study was published on April 14, 2009 in the World Journal of Gastroenterology.

In this study, RT-PCR, real-time PCR, and Western blotting were performed to detect AhR expression in 39 GC tissues and five GC cell lines. AhR protein was detected by immunohistochemistry (IHC) in 190 samples: 30 chronic superficial gastritis (CSG), 30 chronic atrophic gastritis (CAG), 30 intestinal metaplasia (IM), 30 atypical hyperplasia (AH), and 70 GC. The AhR agonist tetrachlorodibenzo-para-dioxin (TCDD) was used to treat AGS cells. MTT assay and flow cytometric analysis were performed to measure the viability, cell cycle and apoptosis of AGS cells.

They found that AhR expression was significantly increased in GC tissues and GC cell lines. IHC results indicated that the levels of AhR expression gradually increased, with the lowest levels in CSG, followed by CAG, IM, AH and GC. AhR expression and nuclear translocation were significantly higher in GC than in precancerous tissues. TCDD inhibited proliferation of AGS cells via induction of growth arrest at the G1-S phase.

Apr 21
Physical Illness And Depression - Special MJA Supplement
A supplement in this edition of the Medical Journal of Australia examines the multiplying effect of depression and physical illness.

Supported by "beyondblue: the national depression initiative", the supplement includes research and commentary from leading mental health experts from throughout Australia.

Professor of Psychological Medicine at Monash University, David Clarke, said the supplement addresses the complex relationship between depression and physical illness.

" Every clinician knows that depression is common in people with a physical illness," Prof Clarke said.

"But the enormous impact of depression has been freshly highlighted over recent years.

"Recent World Health Organization (WHO) world health surveys indicated that depression produced the greatest decrement in health of any chronic disease, and the comorbid state of depression incrementally worsened health more than any other disease combination."

Studies published in the supplement present evidence establishing a strong connection between physical illness and depression and anxiety, including effects on outcomes.

The experts agree that research is a key priority.

"It is the same person who is depressed, has the physical illness and is socially isolated, so it is not possible to deal effectively with any one of these aspects alone," Prof Clarke said.

"However, health care administration - at both government and health service levels - separates physical care from mental health care.

"This is not effective, efficient or cheap.

"It is now time to put into place structures that integrate physical and psychosocial health care. Such models do exist, but they need commitment and money to introduce and evaluate."

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