In a retrospective analysis, we found that despite similar rates of colorectal tumor analysis, minority patients are less likely to be recommended for genetic evaluation or to undergo germline testing for Lynch syndrome. Improvements in institutional practices in follow up after tumor testing could reduce barriers to diagnosis of Lynch diagnosis in minorities.
γ-Glutamylcysteine (γ-GC) is an intermediate molecule of the glutathione (GSH) synthesis pathway. In the present study, we tested the hypothesis that γ-GC pretreatment in cultured astrocytes and neurons protects against hydrogen peroxide (H2O2)-induced oxidative injury. We demonstrate that pretreatment with γ-GC increases the ratio of reduced:oxidized GSH levels in both neurons and astrocytes and increases total GSH levels in neurons. In addition, γ-GC pretreatment decreases isoprostane formation both in neurons and astrocytes, as well as nuclear factor erythroid 2-related factor 2 (Nrf2) nuclear translocation in astrocytes in response to H2O2-induced oxidative stress. Furthermore, GSH and isoprostane levels significantly correlate with increased neuron and astrocyte viability in cells pretreated with γ-GC. Finally, we demonstrate that administration of a single intravenous injection of γ-GC to mice significantly increases GSH levels in the brain, heart, lungs, liver, and in muscle tissues in vivo. These results support a potential therapeutic role for γ-GC in the reduction of oxidant stress-induced damage in tissues including the brain.
Background and Aims:
Forceps margin biopsy and polypectomy specimen margins have been used to assess for polypectomy resection adequacy. Inter-observer reliability of both methods has not been well described.
Patients and Methods:
Interpretability of polypectomy specimens for the presence of residual neoplasia at the margin was assessed by two blinded pathologists. Next, concordance of forceps margin biopsies interpretations between three blinded pathologists was evaluated by calculation of inter-observer kappa.
Results:
Rates of polypectomy specimen margin interpretability were low, 24/92 (26%) pathologist A, and 28/92 (30.4%) pathologist B. Concordance of forceps margin biopsies interpretations (n=129) between pathologists was high. Two internal pathologists showed substantial agreement in margin biopsy interpretations (kappa 0.779, 95% CI 0.543, 0.912). The concordance remained strong after biopsies were reviewed by a third external pathologist (kappa score 0.829, 95% CI 0.658, 0.924). There was complete agreement on 123/129 (95.3%) for presence of neoplasia between all three pathologists.
Conclusion:
The majority of polypectomy specimen margins were uninterpretable by pathologists for the presence of residual neoplasia. Forceps margin biopsy shows strong inter-observer reliability in adenomatous lesions.
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