Particularly interesting new cysteine-histidine rich protein (PINCH), involved in cell spreading, motility and proliferation, has been shown to enhance radioresistance in colon cancer cell lines. The expression of PINCH in relation to radiation was studied in co-cultured colon cancer cells. Furthermore, the clinical significance between PINCH and radiotherapy (RT) was analyzed in rectal cancer patients with or without RT. The relative PINCH expression in colon cancer (KM12C) cells cultured separately and in co-culture was examined by western blotting and real-time PCR, and was analyzed over a period of 8 and 24 h after radiation. PINCH expression was immunohistochemically examined in 137 primary rectal tumors for which 65 cases did not receive RT and 72 cases received RT. PINCH expression tended to decrease from that in the separately cultured KM12C cells without radiation to that in cells with radiation at 8 h (P=0.060); while in the co-cultured cells, no significant difference was found (P=0.446). In patients with RT, strong PINCH expression was related to worse survival, when compared to patients with weak expression, independent of TNM stage, degree of differentiation, age and p53 status (P=0.029, RR 4.03, 95% CI 1.34‑12.1). No survival relationship for the patients without RT was observed (P=0.287). A statistical interaction analysis between PINCH, RT and survival showed a trend towards significance (P=0.057). In conclusion, PINCH predicts survival in rectal cancer patients with RT, but not in patients without RT. The expression of PINCH may be regulated by radiation and by environmental factors surrounding the cells.
IntroductionEmergency medicine (EM) is a growing field in Sub-Saharan Africa. Characterising the current capacity of hospitals to provide emergency care is important in identifying gaps and future directions of growth. This study aimed to characterise the ability of emergency units (EU) to provide emergency care in the Kilimanjaro region in Northern Tanzania.MethodsThis was a cross-sectional study conducted at 11 hospitals with emergency care capacity in three districts in the Kilimanjaro region of Northern Tanzania assessed in May 2021. An exhaustive sampling approach was used, whereby all hospitals within the three-district area were surveyed. Hospital representatives were surveyed by two EM physicians using the Hospital Emergency Assessment tool developed by the WHO; data were analysed in Excel and STATA.ResultsAll hospitals provided emergency services 24 hours a day. Nine had a designated area for emergency care, four had a core of fixed providers assigned to the EU, two lacked a protocol for systematic triage. For Airway and Breathing interventions, oxygen administration was adequate in 10 hospitals, yet manual airway manoeuvres were only adequate in six and needle decompression in two. For Circulation interventions, fluid administration was adequate in all facilities, yet intraosseous access and external defibrillation were each only available in two. Only one facility had an ECG readily available in the EU and none was able to administer thrombolytic therapy. For trauma interventions, all facilities could immobilise fractures, yet lacked interventions such as cervical spinal immobilisation and pelvic binding. These deficiencies were primarily due to lack of training and resources.ConclusionMost facilities perform systematic triage of emergency patients, though major gaps were found in the diagnosis and treatment of acute coronary syndrome and initial stabilisation manoeuvres of patients with trauma. Resource limitations were primarily due to equipment and training deficiencies. We recommend the development of future interventions in all levels of facilities to improve the level of training.
Background: Particularly interesting new cysteine-histidine rich protein (PINCH) connected to integrins of the cell surface, is involved in cell spreading, motility and proliferation. The expression of PINCH and its relationship to outcome have been studied, however, the clinical significance between PINCH and preoperative radiotherapy (RT) in tumors is unknown. In this study, PINCH expression and its relationship to RT, clinical, histological and biological factors were investigated in rectal cancer patients, and in colon cancer and fibroblast cell lines. Material and Methods: PINCH expression was immunohistochemically examined at the invasive margin and inner tumour area in 137 primary rectal adenocarcinomas (72 cases without RT and 65 cases with RT). PINCH expression in colon cancer (KM12C) and fibroblast (CCD18 Co) cell lines was examined by real time PCR. The KM12C and CCD 18 Co cell lines, cultured separately and co-cultured, were analyzed over time at 8h, 24h, 48h and 72h after radiation. Results: In patients without RT, strong PINCH expression at the invasive margin of tumors was related to worse survival, compared to patients with weak expression, independent of both TNM stage and differentiation (p = 0.03). No survival relationship in patients with RT was observed (p = 0.64). Real time PCR analyzes showed that KM12C irradiated cells tended to have a higher expression of PINCH at 24h compared to cells without radiation, while in co-cultured KM12C cells, PINCH tended to increase at 8h. PINCH seemed to increase at 8h in CCD 18 Co cells with radiation compared to cells without radiation, while in co-cultured CCD 18 Co cells, PINCH seemed to be lower at 8h in radiated cells than in non-radiated cells. Conclusions: PINCH expression at the invasive margin was an independent prognostic factor in patients without RT. RT might up-regulate the expression of PINCH, which may help us to select the best-suited patients for RT in the future. The levels of PINCH differ when separately cultured and co-cultured cells were compared, which might indicate that PINCH is involved in the crosstalk between tumor cells and their surrounding fibroblasts. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 740. doi:1538-7445.AM2012-740
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