Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review.

Background: Early initiation of breastfeeding is important for establishing continued breastfeeding. However, previous research report that cesarean section (C-section) may hinder early initiation of breastfeeding. Despite this, there is currently a lack of literature that examines the rates of breastfeeding after both cesarean section and vaginal birth globally. Research aims: The objective of this scoping review was to systematically assess the available literature on the rate of early initiation of breastfeeding within the first hour and exclusive breastfeeding up to 6 months after C-section and vaginal birth, as well as any other factors associated with initiation and exclusive breastfeeding. Methods: We adhered to the PRISMA extension guidelines for scoping reviews in conducting our review. In August 2022, we carried out an electronic database search on CINALH, PubMed, EMBASE, and Cochrane Library, and also manually searched the reference list. Results: A total of 55 articles were included in the scoping review. The majority of these studies found that mothers who delivered vaginally had higher rates of breastfeeding compared to those who underwent a C-section, at various time points such as breastfeeding initiation, hospital discharge, one month, three months, and six months postpartum. Notably, there was a significant difference in the rate of early initiation of breastfeeding between the two groups. However, at 3 and 6 months after delivery the gap of exclusive breastfeeding rate between C-section and vaginal delivery is narrow. Breastfeeding education, health care providers support, and mother and baby bonding are other factors associate with initiation and exclusive breastfeeding. Conclusions: The rate of breastfeeding initiation after C-section has remained low to date. This is due in part to insufficient knowledge about and support for breastfeeding from healthcare providers.

Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study.

BACKGROUND: Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan. METHODS: This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks' gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors. RESULTS: Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4). CONCLUSIONS: 13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.

Women's experiences of breastfeeding after a cesarean section: A meta-synthesis.

AIM: The World Health Organization and United Nations Children's Fund recommend the early initiation of breastfeeding within the first hour postpartum for successful exclusive breastfeeding. However, cesarean section is a risk factor for unsuccessful early initiation of breastfeeding. Herein, we aim to explore women's experiences of breastfeeding after a cesarean section. METHODS: We used the Joanna Briggs Institute framework in this meta-synthesis. We searched articles published from 1990 to 2022 on PubMed, CINAHL, Cochrane library, PsycInfo, and EMBASE to identify qualitative studies on women's experiences of breastfeeding after a cesarean section. We used the Critical Appraisal Skills Programme checklist for qualitative studies to assess the quality of the included studies. RESULTS: Seven qualitative studies from five countries met the inclusion criteria, representing the views of 194 women who underwent cesarean sections. Six new categories were integrated into the women's experiences of breastfeeding after a cesarean section as follows: (i) Perceived values of breastfeeding, (ii) Emotional vulnerability in breastfeeding, (iii) Physical difficulties in breastfeeding, (iv) Inconvenient conditions in breastfeeding, (v) Inadequate resources for breastfeeding, and (vi) Support systems to enable breastfeeding. CONCLUSIONS: We provide evidence showing that knowledge of the specific breastfeeding mechanism and provision of the most appropriate postsurgical care by healthcare providers just after a cesarean section can reduce the barriers to post-cesarean breastfeeding. Moreover, effective hospital policies and family support can result in the initiation of positive breastfeeding outcomes. Future studies that consider the cultural aspects of breastfeeding practice may generate additional insights into providing optimal postpartum care.

Effects of e-learning on the support of midwives and nurses to perinatal women suffering from intimate partner violence: A randomized controlled trial.

AIMS: To examine the effects of e-learning on intimate partner violence (IPV) knowledge, preparatory/reinforcing behaviors for supporting IPV victims, and IPV screening of midwives and nurses. METHODS: Participants were randomly assigned to the intervention group (IG: e-learning) and control group (CG: no e-learning). The primary outcome was the mean change in knowledge score. The secondary outcomes were the mean number of types of practiced preparatory/reinforcing behaviors and the proportions of participants who practice screening. Unpaired t tests were performed in intention-to-treat analysis. RESULTS: Of the 88 participants, 45 were randomly assigned to the IG and 43 to the CG. For the post-1-test, the IG had a mean change in the knowledge score of 8.5 points with a significant difference from the 1.4 points in the CG (mean difference [MD] 7.1, 95% CI [4.1, 10.1]). The mean change between the pre-test and the post-2-test was significantly larger in the IG (7.9 points) than in the CG (1.3 points) (MD 6.6, 95% CI [3.3, 9.9]). The mean number of types of practiced behaviors at the post-1-test and post-2-test was significantly higher in the IG than in the CG (MD 1.4, 95% CI [0.1, 2.8]). There was no significant difference in the proportions of participants who practice screening between the two groups postintervention. CONCLUSIONS: The e-learning effectively improved knowledge and promoted preparatory/reinforcing behaviors.

Continuous hemofiltration model using porcine blood for comparing filter life.

The purpose of the present study was to establish a continuous hemofiltration model using porcine blood to compare filter life. Continuous hemofiltration (CHF) experiments were performed using an in vitro hemofilter evaluation system utilizing porcine blood containing trisodium citrate in addition to nafamostat mesilate as anticoagulants. The lifetime of the hemofilter was evaluated using the transmembrane pressure and the pressure drop across the hemofilter at varying trisodium citrate concentrations. The porcine blood used in this experiment was considered to be in a slightly hypercoagulable state because of the continuous contact with non-biological materials and calcium inflow from substitution fluid. Blood containing 7 or 8 mM of trisodium citrate and nafamostat mesilate could be effectively used to compare the lifetimes of hemofilters utilized under the same conditions. In this CHF model using porcine blood, the plugging of the hollow fibers occurred shortly after the plugging of the membrane pores. In conclusion, a CHF model using porcine blood can be established by adjusting the concentration of trisodium citrate added to the blood.

[Simple Formula to Predict Residual Amount of Continuously Infused Rocuronium in the Body].

BACKGROUND: When antagonism is performed using sugammadex after continuous infusion of rocuronium, if the total amount of residual rocuronium can be esti- mated prior to performing antagonism, antagonism without excess or deficiency of sugammadex will be made possible. We therefore prepared a simple formula to predict residual amount of rocuronium in the body, which can be easily applied in clinical setting, and veri- fied it using Tivatrainer©. METHODS: 1. Pharmacokinetics of rocuronium was simulated, using a 3-compartment model. The following assumptions were made to derive the simple for- mula : when rocuronium is continuously infused to reach the steady state plasma concentration, an equal concentration in each compartment is reached. Only the amounts of rocuronium infused to the central com- partment and rocuronium excreted from there are thus considered, and these two amounts are in balance. For pharmacokinetic parameters, we referred to V. Saldien, Anesth Analg 2003 ; 97 : 44-9. 2. The prepared simple formula was verified using Tivatrainero. We considered a model in which initial boluses of 0.3, 0.6, 0.9, and 1.2 mg · kg(-1) were adminis- tered, and continuous infusion began at 30 minutes at the rate of 0.2, 0.3, 0.4, 0.5, 0.6, and 0.8 mg - kg-1 - hr-1. Patients with body weight of 50, 60, 70, and 80 kg were investigated. RESULTS: 1. The derived simple formula was as fol- lows : Q=0.74 X R Q Total residual amount of rocuronium (mg) R Dose per hour (mg · hr(-1)) 2. The predicted value of the total residual amount obtained from the simple formula was consistent with the value predicted by Tivatrainer© with a high preci- sion within the error of 1.4%. Convergence time until the stable state was reached varied depending on the condition. However, it took approximately 150 minutes after the beginning of continuous infusion.for the error between values predicted by the simple formula and Tivatrainer© to stabilize within 5 mg. CONCLUSIONS: We prepared a simple formula to esti- mate the total residual amount of rocuronium at a steady state. The value predicted by the simple for- mula agreed with the value predicted by Tivatrainer) with a high precision.

[Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade. It was also judged prudent to avoid prolonged perioperative immobilization, which might compress vulnerable peripheral nerves. For Patient 1, general anesthesia was induced with propofol, remifentanil, and sevoflurane, and was maintained with sevoflurane and remifentanil. For Patients 2 and 3, general anesthesia was induced and maintained with propofol and remifentanil. For tracheal intubation, under careful monitoring with peripheral nerve stimulators, minimal doses of rocuronium (0.6-0.7 mg x kg(-1)) were administered. When sugammadex was administered to reverse the effect of rocuronium, all patients rapidly regained muscular strength. Postoperative courses were satisfactory without sequelae.

Effects of increased surface coverage of polyvinylpyrrolidone over a polysulfone hemofilter membrane on permeability and cell adhesion during continuous hemofiltration.

The purpose of the present study was to evaluate the adhesiveness of blood cells and the solute removal performance change of modified polysulfone membranes which have increased polyvinylpyrrolidone (PVP) coverage over their surface. Continuous hemofiltration (CHF) experiments for 24 h were carried out using an ex vivo hemofilter evaluation system to compare a modified polysulfone hemofilter (SHG) with the conventional polysulfone hemofilter (SH). The 25 and 50 % cutoff values of the sieving coefficient of dextran after CHF and the protein concentration in the filtrate was higher in SHG, indicating that less fouling occurred in the SHG membrane. Adhesion of blood cells after 24 h of CHF was significantly higher in the case of SH than in the case of SHG. Blood cell adhesion and membrane fouling were reduced with the use of a polysulfone membrane modified with increased PVP coverage over the surface.

Hypoxia enhances the induction of human amniotic mesenchymal side population cells into vascular endothelial lineage.

Human amniotic mesenchymal side population (hAM-SP) cells have pluripotency and weak immunogenicity, and have promising roles in the field GAPDH of regenerative medicine. The aim of the present study was to determine whether hypoxic conditions induce the differentiation of hAM-SP cells into the vascular endothelial lineage. Mesenchymal cells were isolated from enzyme-treated amniotic membranes and stained with Hoechst 33342. The hAM-SP cells were negatively sorted by FACS and cultured in induction medium containing vascular endothelial growth factor (VEGF) under normoxic (20% O2) or hypoxic (1% O2) conditions for 1 or 2 weeks. The expression of endothelial markers such as kinase domain region (KDR), fms-like tyrosine kinase (Flt)-1, von Willebrand factor (vWF), vascular endothelial (VE)-cadherin and human vascular cell adhesion molecule (VCAM) at the gene and protein level was evaluated by real-time PCR and fluorescent immunostaining, respectively. The gene expression of KDR, Flt-1, VE-cadherin and vWF peaked after 2 weeks of culture. The protein expression of KDR and VE-cadherin was also enhanced after 2 weeks of culture under hypoxic conditions. To confirm the involvement of hypoxia-inducible factor (HIF) in the induction under hypoxic conditions, the expression of genes which are known to be upregulated by HIF was analyzed by DNA microarray. The expression of these genes increased under hypoxic conditions. hAM-SP cells cultured under hypoxic conditions differentiated into the vascular endothelial lineage, probably due to upregulation of the gene expression associated with angiogenesis through activation of the HIF system.

Downregulation of anti-oncomirs miR-143/145 cluster occurs before APC gene aberration in the development of colorectal tumors.

Accumulating data indicate that some microRNAs (miRNAs or miRs) can function as tumor suppressors or oncogenes and as such are important in cancer development. We previously reported that miR-143 and -145 are frequently downregulated in colon adenomas and cancers, acting as tumor suppressors. In this present study, we investigated the relationship between the downregulation of the miR-143/145 cluster and genetic aberrations of adenomatous polyposis coli (APC), which are early genetic events in the development of colorectal tumors. The expression levels of both miRs were determined by performing real-time PCR on tissue samples of familial adenomatous polyposis (FAP), colorectal adenoma, colorectal cancer, and paired non-tumorous tissues. Also, the expression of C- or N-terminus of the APC protein and that of the p53 protein in these tissues were examined immunohistochemically. Our data clearly indicated that the decreased expression of miR-143 and -145 frequently occurred before APC gene aberrations. The downregulation of miR-143 and -145 is thus an important genetic event for the initiation step in colorectal tumor development.

Examination of serum pepsinogen in functional dyspepsia.

BACKGROUND/AIMS: Although serum pepsinogen (PG) is considered as a marker of gastric atrophy, it also reflects gastric acid secretion, which closely influences dyspeptic symptoms. We investigated serum PG levels and PGI/PGII ratios in dyspeptic patients, in relation to various different subtypes of symptoms including Rome III classifications. METHODOLOGY: Serum PGs were measured in 75 subjects with dyspeptic symptoms and 42 asymptomatic healthy subjects. RESULTS: PG II level was significantly higher (p=0.0001) and PG I/II ratio was significantly lower (p<0.0001) in subjects with H. pylori infection than those without, while no associations were found between PG levels and usage of H2 receptor antagonists or proton-pump inhibitors. In all subjects with pain in stomach, abdominal bloating and PDS-like symptoms according to Rome III criteria, presented significantly higher levels of PGI, compared to subjects without symptoms (p=0.043, 0.015 and 0.037, respectively). In addition, burning sensation and abdominal pain presented significantly higher PGI/II ratios (p=0.0005 and 0.003, respectively), and higher PGI/II ratio was also positively correlated with a number of symptoms (p=0.04). When subjects were divided according to H. pylori infection status, higher PGI/II ratio was significantly associated with abdominal pain in H. pylori negative subjects (p=0.03), while higher PGI level was significantly associated with functional esophageal disorders (FEG) according to Rome III criteria, and higher number of dyspeptic symptoms in H. pylori positive subjects (p=0.016). CONCLUSIONS: Our data suggest that subjects with higher PGI level, and PG I/II ratio are more likely to develop several dyspeptic symptoms.

Role of heat-shock protein (HSP) 70-2 genotype in peptic ulcer in Japanese population.

BACKGROUND/AIMS: There have been reports showing the protective role of inducible heat-shock protein (HSP) 70 in gastric epithelial cells. An A to G transition at the 1267 position HSP70-2 gene has been shown to be associated with a different level of HSP70 mRNA expression. We aimed to clarify the effect of HSP70-2 polymorphism on the risk of peptic ulcer diseases in a Japanese population. METHODOLOGY: A total of 519 subjects participated in this study. All subjects underwent upper gastroscopy. Restriction fragment length polymorphism analysis was performed for polymorphisms at 1267 of HSP70-2 gene in all the subjects. RESULTS: After gastroscopy, 109, 53 and 357 subjects were diagnosed as gastric ulcer, duodenal ulcer and non-ulcer subjects, respectively. Although, there were no significant differences of HSP70-2 genotype distributions among nonulcer subjects, overall ulcer, gastric and duodenal ulcers when the subjects were divided into two groups according to age distribution, logistic regression analysis showed that the BB genotype increased the risk of duodenal ulcer in subjects 60 years and older. (Gender, status of H. pylori infection and NSAID use adjusted OR=3.12, 95%CI=1.33-7.35, p=0.009). CONCLUSIONS: It appears that polymorphism of HSP70-2 gene is not directly associated with the susceptibility to peptic ulcer diseases but BB genotype is associated with an increased risk of duodenal ulcer in older subjects in the Japanese population.

Correlation between magnifying narrow band imaging and histopathology in gastric protruding/or polypoid lesions: a pilot feasibility trial.

BACKGROUND: Several study showed usefulness of microscopic capillaries, seen by magnifying narrow band imaging (NBI) endoscopy for predicting histopathology among superficial depressed or flat elevated gastric neoplasia (GN). Here we assessed the diagnostic efficacy of magnifying NBI for predicting histopathology among gastric protruding/or polypoid lesions. METHODS: Using endoscopic pictures of magnifying NBI from 95 protruding/or polypoid lesions (19 fundic gland polyps: FGP, 47 hyperplastic polyps: HP, and 29 GN), fine mucosal patterns were classified into four categories: small round, prolonged, villous or ridge, and unclear patterns, and micro vascular patterns were classified into five categories: honey comb, dense vascular, fine net work, core vascular, and unclear patterns. RESULTS: Most suggestive micro vascular patterns for predicting FGP, and HP were honeycomb (sensitivity 94.7%, specificity 97.4%), and dense vascular patterns (sensitivity 93.6%, specificity 91.6%), respectively. Fine net work, core vascular, and unclear patterns presented higher specificity (97%, 100%, and 100%) for predicting GN, and diagnostic efficacy of combined of those patterns was favorable (sensitivity 86.2%, specificity 97.0%). CONCLUSION: Micro vascular patterns by using magnifying NBI provides meaningful information for predicting the histopathology of gastric protruding/or polypoid lesions.

Effect of genetic polymorphisms related to DNA repair and the xenobiotic pathway on the prognosis and survival of gastric cancer patients.

BACKGROUND: A number of association studies have focused on the effect of polymorphisms related to DNA repair or the xenobiotic pathway, on the susceptibility to gastric cancer (GC). Here, the possible association between common polymorphisms in the X-ray repair cross-complementing groups (XRCC) 1, and glutathione-S-transferase (GST) genes and various clinicopathological characteristics, including overall survival, in GC patients were evaluated. PATIENTS AND METHODS: XRCC1 Arg399Gln, and Arg194Trp, GSTP1 Ile104Val, and GSTT1, GSTM1 null polymorphisms were determined in 130 GC patients. RESULTS: XRCC1 codon 194 Trp carriers (Trp/Trp + Arg/Trp) held a significantly higher risk of venous invasion (OR = 3.76, 95%CI = 1.05-13.51, p = 0.043). A similar trend was also found for the XRCC1 codon 194 Trp/Trp genotype (OR = 2.15, 95% CI = 0.87-5.34, p = 0.099). The frequencies of the XRCC1 codon 399 Gln/Gln and Arg/Gln genotypes tended to be lower in lymphatic invasion-positive GC (XRCC1 codon 399 Gln/Gln: OR = 0.27, 95% CI = 0.06-1.15, p = 0.075, Gln/Gln + Arg/Gln: OR = 0.46, 95% CI = 0.20-1.06, p = 0.069), while the frequencies of the XRCC1 codon 194 Trp/Trp genotype tended to be higher in lymphatic invasion-positive GC (XRCC1 codon 194 Trp/Trp: OR = 7.70, 95% CI = 0.95-62.60, p = 0.056). The patients with the GSTT1 null genotype showed significantly better overall survival than the patients with the GSTT1 present genotype (p = 0.019). CONCLUSION: XRCC1 codon 194 Trp carrier status is correlated with more aggressive biological behavior of GC, such as venous invasion, and the GSTT1 null genotype is associated with better survival in GC patients.

Effect of IL-1ß and TNF-α polymorphisms on the prognosis and survival of gastric cancer patients.

So far, a number of association studies have focused on the effect of polymorphisms in IL-1ß and TNF-α genes on the susceptibility to gastric cancer (GC). Here, we evaluate the possible association between common polymorphisms in the IL-1ß and TNF-α genes with various clinicopathological characteristics, including overall survival of GC patients. Restriction fragment length polymorphism analysis was performed for IL-1ß-31(T > C) and IL-1ß-511(C > T) and TNF-α-857 (C > T) polymorphisms in 130 GC patients. IL-1ß-31CC and IL-1ß-511TT genotypes held a significantly lower risk of lymphatic invasion (IL-1ß-31CC vs. others: adjusted OR = 0.39, 95% CI = 0.15-0.96, P = 0.04, IL-1ß-511TT vs. others: adjusted OR = 0.23, 95% CI = 0.08-0.67, P = 0.007). The IL-1ß-31CC and IL-1ß-511TT genotypes were weakly associated with reduced risk of venous invasion (IL-1ß-31CC vs. others: adjusted OR = 0.35, 95% CI = 0.12-1.05, P = 0.06, IL-1ß-511TT vs. others: adjusted OR = 0.32, 95% CI = 0.08-1.20, P = 0.09). The IL-1ß-511TT genotype was also weakly associated with reduced risk of lymph node metastasis (IL-1ß-511TT vs. others: adjusted OR = 0.42, 95% CI = 0.17-1.04, P = 0.06). When the TNF-α-857CT and TNF-α-857-TT genotypes were considered as T carrier, the patients with TNF-α-857T carrier showed significantly better overall survival than patients with CC genotype (P = 0.011). GC patients who have both IL-1ß-31 CC and IL-1ß-511 TT genotypes and have at least one of protective genotypes (IL-1ß-31 CC, IL-1ß-511 TT, TNF-α-857 T carrier) were also associated with better prognostic factors, such as lymphatic and venous invasion better survival. IL-1ß-31CC, IL-1ß-511TT genotype, and TNF-α-857T carrier may have protective effect against GC progression.

Gastrointestinal Stromal Tumor of the Stomach with Narrow Stalk-Like Based, Uneven Protruding Appearance Presenting with Severe Acute Anemia despite Small Size.

We report the case of a 56-year-old woman who had a gastrointestinal stromal tumor (GIST) of the stomach. She was admitted to our hospital for epigastric pain, nausea, and severe acute anemia (hemoglobin level 4.3 g/dl). Esophagogastroduodenoscopy revealed a narrow stalk-like based, hemorrhagic and uneven protruding lesion in the lesser curvature of the gastric upper corpus. Although the tumor was less than 2 cm in diameter and was probably a benign GIST according to histology, laparoscopy-assisted local resection was needed because the patient had continuous severe anemia and epigastric pain. Histological assessment showed that the elongated spindle-like tumor cells originated from the intrinsic muscle layer, and was shown with growth to the mucosal side, cropping out to the surface in most areas of the protruding lesion. Only a small part of the tumor was within nontumoral gastric mucosa. Most of the tumor cells demonstrated immunoreactivity for KIT and CD34 in the cytoplasm but not for αSMA, S100, and desmin. Mitotic activity (0/50 high power field) and the labeling index for MIB-1 (about 1%) were low. The GIST of the stomach described in this report was a rare case with a narrow stalk-like based, uneven protruding mass presenting with severe acute anemia despite small size.

Association between cyclin D1 polymorphism with CpG island promoter methylation status of tumor suppressor genes in gastric cancer.

BACKGROUND: CpG island hypermethylation of tumor suppressor genes is highly involved in gastric carcinogenesis, and enhanced cell proliferation could accelerate this process. Cyclin D1 regulates cell cycle function and may play a role in methylation-related carcinogenesis. AIMS: We investigated the association between Cyclin D1 gene G870A polymorphism and the methylation status of tumor suppressor genes in gastric cancer. METHODS: Polymorphisms at G870A in the Cyclin D1 gene were genotyped, and methylation status of the p14, p16, DAP-kinase, and CDH1 genes were determined by methylation-specific-polymerase chain reaction in 139 gastric cancer tissues. CIHM high was defined as three or more methylated CpG islands. RESULTS: Although no association was found between methylation status and different stages and Lauren's subtypes, patients with CIHM of DAP-kinase showed significantly worse survival than those without (p = 0.017). In addition, the number of methylated sites was also associated with survival curves (p = 0.0397). The 870G carrier a significantly lower prevalence of CIHM high compared to the AA genotype in advanced-stage gastric cancer (adjusted OR = 0.32, p = 0.047). A weak correlation between the same genotypes and CIHM of p14 were found in the same subtype (adjusted OR = 0.32, p = 0.052). The mean methylation number was significantly lower in G carriers than in AA genotypes in advanced-stage gastric cancer (p = 0.017). CONCLUSIONS: Genetic polymorphism of CCND1 is associated with CIHM status in gastric cancer, especially in the advanced stage, but is independent of clinico-pathological features.

Association between IL-17A, -17F and MIF polymorphisms predispose to CpG island hyper-methylation in gastric cancer.

CpG island hyper-methylation (CIHM) is one of the major events in the gastric carcinogenesis. IL-17A, -17F and MIF have a crucial role in the gastric inflammation and carcinogenesis. Recently, we showed that the genetic polymorphisms of MIF-794-CATT repeat are associated with CIHM status in the non-neoplastic gastric mucosa. Consequently, the CIHM status in the gastric cancer tissue, in relation to IL-17A (-197G>A), -17F (7488T>C), and MIF (-173G>C and -794 tetranucleotide repeats) polymorphisms was investigated. Gastric cancer tissues were obtained from 102 patients. CIHM of p14, p16, DAP-kinase and CDH1 genes were determined by methylation-specific polymerase chain reaction (MSP). CIHM high was defined as three or all CpG islands methylated. We employed the PCR-SSCP (multiplex PCR for IL-17A and -17F) method to detect the gene polymorphisms. We did not find significant association between CIHM status and IL-17F (7488T>C) and MIF (-173G>C) polymorphisms. However, concerning the IL-17A (-197G>A) polymorphism, we found that IL-17A G carrier (GG+GA) held a significantly higher risk of CIHM of p16 (OR=11.22, 95% CI=1.38-91.17, p=0.024) and CIHM high (OR=3.51, 95% CI=1.15-10.68, p=0.027). An association was also found between the 7-CATT repeat carrier (5/7 + 6/7 + 7/7) of the MIF polymorphism (-794-CATT) and reduced risk of CIHM of CDH1 (OR=0.36, 95% CI=0.14-0.92, p=0.032). No association was found between CHIM status and homozygote genotypes of each repeat (-794-CATT 5/5, 6/6, and 7/7). The present results provided evidence that the genetic polymorphisms of IL-17A, and MIF-794-CATT repeat are associated with CIHM status in the gastric cancer. Genetic polymorphisms of IL-17A, and MIF-794-CATT repeat may be involved in methylation-related carcinogenesis in the stomach.