CHRNA9 polymorphisms and smoking exposure synergize to increase the risk of breast cancer in Taiwan.

Previous studies indicated that smoking exposure is associated with an increased risk of breast cancer, and α9-nicotine acetylcholine receptors (α9-nAChRs) are involved in breast tumorigenesis. However, no studies have explored the joint effect of α9-nAChRs (CHRNA9) genes and cigarette smoking exposure on breast cancer risk. A case-control study was conducted on 737 breast cancer patients and 719 age-matched healthy controls. Three single-nucleotide polymorphisms (SNPs) of CHRNA9 located in the promoter region were genotyped and compared between cases and controls to identify those SNPs associated with breast cancer susceptibility. A dual-luciferase reporter assay was used to analyze the promoter activities of these SNPs of the CHRNA9 gene. After a Bonferroni correction, the G allele of the CHRNA9 rs7329797 SNP was significantly associated with an increased risk of developing breast cancer compared with A/A genotype carriers (odds ratio, 1.8; 95% confidence interval, 1.2-2.6). A multiplicative interaction between passive smoking exposure and the CHRNA9 rs73229797 SNP on the risk of breast malignancy was observed. A functional assay further showed that rs73229797 was associated with increased promoter activity of the CHRNA9 gene. Our findings support a significant interaction effect existing between the CHRNA9 gene and smoking exposure on the risk of breast cancer development.

Using a nurse invented T-Bar device in a rehabilitation program improved the range of motion for rotator cuff repair patients.

AIMS AND OBJECTIVES: This study investigates the effects on patient outcomes of using a T-bar in rehabilitation programs in shoulder arthroscopic surgical procedure patients. BACKGROUND: Orthopaedic nurses play an important role in facilitating restoration of patients' range of motion shoulder function. Conventionally, nurses instruct patients to use the unaffected arm to hold the surgical arm when performing range of motion. However, patients often have difficulty performing the entire range of motion efficiently in this manner. Therefore, nurses have invented a T-bar device to help patients perform range of motion in a rehabilitation program. DESIGN: A repeated-measure, quasi-experimental study. METHOD: Sixty-eight participants were recruited from four orthopaedic wards of a medical center in Taipei, Taiwan. Of the patients meeting the inclusion criteria for the study, 33 were assigned to the experimental group and 35 to the comparison group. Both groups had the same shoulder rehabilitation program including identical activities, duration and frequency, except that the experimental group used the nurse invented T-bar device to facilitate range of motion while the comparison group used a conventional method. Data were collected when patients were admitted, five days and four weeks after the surgery. Outcome indicators were shoulder range of motion, muscle power and the American Shoulder and Elbow Society Shoulder Index. Statistical methods used for analysis included mean, standard deviation and repeated measures anova. RESULTS: All the participants completed the study. Results showed a significant improvement in shoulder abduction after surgery in experimental group versus the comparison group. No significant differences were found in other outcomes. CONCLUSIONS: The nurse invented T-bar device used in the rehabilitation program was effective in helping restore the abduction function of rotator cuff repair patients in our preliminary study. RELEVANCE TO CLINICAL PRACTICE: Using a T-bar in the rehabilitation program to improve range of motion may be considered for patients with shoulder surgery.

Activation of ventrolateral medulla neurons by arginine vasopressin via V1A receptors produces inhibition on respiratory-related hypoglossal nerve discharge in the rat.

Arginine vasopressin (AVP) is an important neurohormone in the regulation of many aspects of central nervous system, yet its modulation on the respiratory function remains largely unknown. The aims of this study were to investigate the modulation of phrenic (PNA) and hypoglossal nerve activity (HNA) by central administration of AVP and to identify the involvement of AVP V1A receptors in this modulation. Animals were anesthetized with urethane (1.2 g/kg, i.p.), paralyzed with gallamine triethiodide (5 mg/kg, i.v.), and artificially ventilated. The rat was then placed on a stereotaxic apparatus in a prone position. PNA and HNA were monitored at normocapnia in hyperoxia. Microinjection of AVP into the medial ventrolateral medulla (VLM) and/or rostral ventral respiratory group (rVRG) produced a dose-dependent inhibition on both PNA and HNA, whereas the microinjection of AVP into the region of lateral VLM resulted in a similar inhibition of these nerve activities and a pressor response. Systemic administration of phentolamine abolished the pressor effect but did not affect the inhibition of PNA and HNA evoked by AVP injection into the lateral VLM and/or rVRG, suggesting that AVP-induced inhibition of PNA and HNA was not due to the side effect of pressor response. These cardiopulmonary modulations were totally abolished by the central pretreatment of AVP V1A receptor antagonist. Our results suggested that AVP may activate neurons located at the VLM and/or rVRG via the AVP V1A receptor to inhibit respiratory-related HNA and thus to regulate upper airway aperture.

Cardiopulmonary response to vasopressin-induced activation on V1A receptors in the lateral ventrolateral medulla in the rat.

The aim of the study was to examine whether or not arginine vasopressin (AVP) might modulate cardiopulmonary functions by acting on the lateral area of the ventrolateral medulla (VLM) in the rat. The rat was anesthetized, bilaterally vagotomized, paralyzed, ventilated, and then placed on a stereotaxic instrument in a prone position. Activity of the phrenic nerve (PNA) was monitored at normocapnia and hypercapnia in hyperoxia. Microinjection of AVP into the lateral region of the VLM resulted in a brief apnea followed by a significant decrease in PNA amplitude and a concomitant significant increase in blood pressure. The inhibition of PNA with AVP treatment could be partly attenuated by hypercapnia but not by phentolamine. Both inhibition of PNA and pressor response with AVP microinjection into the lateral VLM were totally abolished after pretreatment with AVP V1A receptor antagonist. These results suggest that a vasopressinergic pathway projects to the lateral VLM and modulates cardiopulmonary functions via AVP V1A receptors on neurons within the lateral VLM.

Arginine vasopressin produces inhibition upon respiration without pressor effect in the rat.

The purpose of the current study was to examine where arginine vasopressin (AVP) inhibits respiration by direct action on the areas of the ventrolateral medulla (VLM) in the rat. The animal was anesthetized by urethane (1.2 g/kg, i.p.), paralyzed with gallamine triethiodide, and artificially ventilated. Catheterization of the femoral artery and vein, and bilateral vagotomy were performed. The rat was then placed upon a stereotaxic instrument in a prone position. The phrenic nerve was separated and cut peripherally. Phrenic nerve activity (PNA) was monitored at normocapnia and hypercapnia in hyperoxia. Microinjection of AVP into various subregions of the VLM was then performed. In response to AVP microinjection, a transient period of apnea and then a significant decrease in PNA amplitude were observed. Arterial blood pressure was unchanged. This inhibition of PNA with AVP treatment was site-specific, attenuated by raising CO2 concentration, and totally abolished by pretreatment with AVP V1A receptor antagonist. Data of the present study indicate that endogenous resource of AVP may produce an inhibitory effect upon respiration via AVP receptors presented on neurons within the VLM.