Polycomb-dependent repression of the potassium channel-encoding gene KCNA5 promotes cancer cell survival under conditions of stress.

Relapse after clinical remission remains a leading cause of cancer-associated death. Although the mechanisms of tumor relapse are complex, the ability of cancer cells to survive physiological stress is a prerequisite for recurrence. Ewing sarcoma (ES) and neuroblastoma (NB) are aggressive cancers that frequently relapse after initial remission. In addition, both tumors overexpress the polycomb group (PcG) proteins BMI-1 and EZH2, which contribute to tumorigenicity. We have discovered that ES and NB resist hypoxic stress-induced death and that survival depends on PcG function. Epigenetic repression of developmental programs is the most well-established cancer-associated function of PcG proteins. However, we noted that voltage-gated potassium (Kv) channel genes are also targets of PcG regulation in stem cells. Given the role of potassium in regulating apoptosis, we reasoned that repression of Kv channel genes might have a role in cancer cell survival. Here we describe our novel finding that PcG-dependent repression of the Kv1.5 channel gene KCNA5 contributes to cancer cell survival under conditions of stress. We show that survival of cancer cells in stress is dependent upon suppression of Kv1.5 channel function. The KCNA5 promoter is marked in cancer cells with PcG-dependent chromatin repressive modifications that increase in hypoxia. Genetic and pharmacological inhibition of BMI-1 and EZH2, respectively, restore KCNA5 expression, which sensitizes cells to stress-induced death. In addition, ectopic expression of the Kv1.5 channel induces apoptotic cell death under conditions of hypoxia. These findings identify a novel role for PcG proteins in promoting cancer cell survival via repression of KCNA5.

[Czech bariatry in 2010]. / Ceská bariatrie v roce 2010.

INTRODUCTION: It is only during the past two decades, when obesity has become to be considered a pandemic disorder. However, in 1953 Varco performed jejunoileal bypass as the world's first bariatric surgical procedure. 30 years later, Pesková performed the first bariatric surgery--a gastroplasty--in Czechoslovakia. From 1984 she started to perform fixed gastric bandages, through laparotomic app- roach at that time. The first laparoscopic fixed bandage in Czechoslovakia was performed in 1993. Over the years, the number of surgical procedures to treat morbid obesity, as well as the number of bariatric surgeons, continued to increase. In 2004, Czech Bariatric Section of the Czech Surgical Society and the Czech Society of Obesitology of the Czech Medical Association of J. E. Purkyne, were established. MATERIAL AND METHODS: 170 bariatric surgeries were performed in the Czech Republic in 1999. The majority of procedures included fixed gastric bandage, rarely, adjustable bandage was performed. At that time, bariatric procedures were performed at five sites only. However, over the past 10 years, bariatric surgery has largely developed in the Czech Republic. The exact number of bariatric procedures completed per year was unknown, therefore, 21 surgical clinics, at which bariatric procedures are performed, were contacted from January to June 2010. Heads of the clinics were asked to provide basic data on surgical treatment of obesity. The aim of the study was to analyze the situation in bariatric surgery in the Czech Republic at the end of 2009. A total of 18 clinics (85.8%) joined the study and provided their own statistical data. 14 of them perform over 20 bariatric procedures a year. RESULTS: The analysis data showed that, in 2009, a total of 1558 bariatric procedures were completed at 18 surgical clinics and approximately 1600 procedures were performed in the whole Czech Republic. However, out of the total, over 230 patients were foreigners. In 99% of bariatric procedures in morbid obese subjects, laparoscopic approach was used. CONCLUSION: Over the ten year period, the number of clinics performing over 20 bariatric procedures a year increased from five to 14 clinics and the number of bariatric procedures increased from 170 to 1600 procedures a year. It is 900% increase, compared to the year 1999! Nevertheless, compared to other countries, e.g. Austria, the number of bariatric procedures does not correspond with prevalence rates of obesity in the Czech Republic.

Bypass gástrico convencional y laparoscópico en el tratamiento de la obsesidad mórbida. Evaluación comparativa de la calidad de vida por medio del Test de Baros / Laparoscopic or open gstric bypass for the treatment of morbid obesity. Comparative bariatric evaluation of the quality of life

La obesidad mórbida representa un problema mundial cuya prevalencia se encuentra en aumento, sólo el enfoque quirúrgico ha demostrado resultados persistentes en cuanto a la pérdida de peso de manera permanente. Objetivo: evaluación del impacto social de la pérdida de peso en el paciente obeso posterior al tratamiento quirúrgico por medio de un bypass laparoscópico o convencional y análisis de costos operativos.

Morbid obesity represents a health-related problem rising all over the world, just the surgical management has demonstrted persistent and constant outcome in weight lose. Objective: Evaluations of the social impact and operative cost in weight lose obese morbid patients after laparoscopic or open gastric bypass.

Bypass gástrico convencional y laparoscópico en el tratamiento de la obsesidad mórbida. Evaluación comparativa de la calidad de vida por medio del Test de Baros / Laparoscopic or open gstric bypass for the treatment of morbid obesity. Comparative bariatric evaluation of the quality of life

La obesidad mórbida representa un problema mundial cuya prevalencia se encuentra en aumento, sólo el enfoque quirúrgico ha demostrado resultados persistentes en cuanto a la pérdida de peso de manera permanente. Objetivo: evaluación del impacto social de la pérdida de peso en el paciente obeso posterior al tratamiento quirúrgico por medio de un bypass laparoscópico o convencional y análisis de costos operativos.(AU)

Morbid obesity represents a health-related problem rising all over the world, just the surgical management has demonstrted persistent and constant outcome in weight lose. Objective: Evaluations of the social impact and operative cost in weight lose obese morbid patients after laparoscopic or open gastric bypass.(AU)

Czech exercise program for dialysis and transplant patients, 10 years experience.

In Czechia an exercise program was created in 1993 for the dialysis and transplanted patients to counteract the high cardiovascular mortality (>60%), the polymorbidity of the older patients, the reduced social adaptation and decreasing employment status, and to save costs of social compensation and assisted care. The goals of the rehabilitation management are a cooperation of the groups caring for CKD patients: nephrologists, nurses, dieticians, exercise physiologists, care providers, government. The aim is to improve quality of life by maximizing characteristics and behaviour of the patients with the above-mentioned methods of therapy, social service and education. Additionally to the out-patient and in-centre training groups in 1995 a Czech Sport Club of Dialysis and Transplant Patients was founded, and some members were able to participate in national and international games of dialysis (EDTSF) or transplanted (WTGF) people.

Vascular and nerve disorders at exposure to hand-held vibrating tools related to ISO 5349.

The authors present the results of the investigation of peripheral nerves of the hand in a group of 30 glass cutters, 21 metal grinders, 10 blacksmiths and 24 workers who worked with nailers. The measurements of vibrotactile sensitivity were carried out by Vibrometry System Brüel & Kjaer Type 9627. The vibrotactile perception thresholds (VPT) were measured in frequency range from 8 to 500 Hz. The same investigations were carried out in 103 healthy subjects with no previous work-exposure to vibration or shocks. Further electromyographic examination was carried out in all members of exposed groups. The results of measurements VPT have proved reliability and high sensitivity of this method for the early detection of light disorders of peripheral nerves of the hand due to vibration. All the workers also passed investigation of vascular system of fingers. Simultaneously the measurement of vibration and shocks of single types of hand-held tools used by workers was done. The results of measurement have been worked up according to ISO 5349 (1) that enables to determine the beginning of the incidence of disorders of the hands and arms on the base of measured values of vibration and shocks. The results of the vascular system investigation have been compared with the results of the assessment of exposure according to ISO 5349. The conformity has been proved in the case of hand-transmitted vibrations not in the case of shocks.

Concentrations of mercury, cadmium, lead and copper in fruiting bodies of edible mushrooms in an emission area of a copper smelter and a mercury smelter.

Four metals were determined by AAS techniques in 56 samples of 23 wild mushroom species collected in a heavily polluted area in eastern Slovakia in 1997 and 1998. The area has been contaminated from historical polymetallic ores mining and smelting and by emissions from a mercury smelter between 1969 and 1993 and from a copper smelter since 1951. No significant differences in metal concentrations (P < 0.05) were found in four species when comparing the periods 1992-1993 and 1997-1998. Considerable contamination of most species was observed mainly for mercury and cadmium. The highest levels of mercury, up to 50 mg kg-1 dry matter, were found in Boletus reticulatus, Lycoperdon perlatum and Marasmius oreades, and of cadmium up to 20 mg kg-1 dry matter in Xerocomus chrysenteron and Lycoperdon perlatum. The latter species also had extremely high lead and copper concentrations in hundreds of milligrams per kilogram dry matter. Concentrations of mercury and copper in caps of four Boletaceae species were significantly (P < 0.05) higher than those in stipes.

Impulsive vibration and exposure limit.

Several cases of exposure to hand-transmitted shocks in two different factories were studied with an intention to improve our knowledge about the influence of the impulsive components of vibration on human being. Two types of shocks affecting the workers could be distinguished, i.e., shocks having small amount of energy at frequencies higher than 100 Hz and shocks having relatively high frequency components up to 1000 Hz. An exposure to the hand-arm shocks of both types was measured and assessed in accordance with the international standard ISO 5349. Health condition of workers was examined. Carpal tunnel syndrome was found among the workers of the workshop in wood industry, who work with staple gun. The investigation of the health condition of about 60 forge workers up to now did not confirm the severity of hand-arm shocks as it had been assessed according to the Annex A of the ISO 5349. The exposure to hand-arm shocks in the forge leads to the incidence of occupational diseases and disorders, which however, differ from the diseases normally reported as a consequence of the hand-arm vibration and shocks. It seems obvious that for the assessment of shock exposure, the ISO 5349 is not quite suitable in its present form.

Management of acute pyelonephritis in an emergency department observation unit.

STUDY OBJECTIVES: To determine whether moderately to severely ill patients with acute pyelonephritis can be treated successfully on an outpatient basis, and whether any aspect of history, physical examination, or initial laboratory data predicts failure of outpatient therapy and the need for hospitalization. DESIGN: Retrospective chart review of all patients with a diagnosis of acute pyelonephritis seen during a three-year period. SETTING: Emergency department observation unit of an urban teaching hospital serving residents of the city and county of Denver. TYPE OF PARTICIPANTS: Women between the ages of 15 and 50 with symptoms, physical examination, and initial laboratory data consistent with a diagnosis of pyelonephritis. INTERVENTIONS: Patients received IV antibiotics, rehydration, analgesics, and antiemetics in an observation unit for up to 12 hours, when they were either admitted to the hospital or discharged home on oral antibiotics. MEASUREMENTS AND MAIN RESULTS: Sixty-three of 87 patients (72%) with acute pyelonephritis were managed successfully as outpatients, nine (22%) were hospitalized directly from the observation unit because they were considered to be too ill to go home, and five (6%) returned with persistent symptoms after ED therapy and were hospitalized. No clinical or laboratory variable predicted success or failure of ED observation unit therapy at the time of initial presentation. CONCLUSION: In selected patients, the observation unit may be used to initiate therapy for acute pyelonephritis. Those with an adequate clinical response to initial treatment may be discharged on oral antibiotic therapy with appropriate follow-up.