Expression of CK-19 and CEA mRNA in peripheral blood of gastric cancer patients

Aim: To investigate the clinical and pathological relevance of detection of circulating tumor cells (CTC) in the peripheral blood of gastric carcinoma patients before operation. Patients and Methods: Fifty patients with gastric adenocarcinoma were analysed prospectively. Patients were divided into two groups according to the extent of the tumor. Group I (unresectable) consisted of 22, and group II (resectable) consisted of 28 patients. Peripheral blood samples were collected pre-operatively from all 50 patients as well as from ten healthy controls and analyzed for carcinoembryonic antigen (CEA) and cytokeratin-19 (CK-19) messenger ribonucleic acids (mRNAs). Tumor localisation, stage, presence of signet cell formation, nodal metastases, serousal and lymphovascular invasion were recorded for all patients. Results: Expression of CK-19 was detected in 24 (48%), and CEA in 10 (20%) cases. Nine patients (40%) in group I and 15 (53.6%) in group II were positive for CK-19 expression. CEA expression was more frequent among group I patients (6 vs. 4 cases). There was no significant difference between the groups in the expression of CK-19 and CEA mRNA, tumor localisation, presence of signet formation, and presence and extent of nodal metastases. Patients with major vascular invasion (MVI) expressed significantly higher levels of CTC mRNA compared to those without MVI (p = 0.023 for CEA, and p = 0.009 for CK-19). The median 1 and 2-year survival was 9.5 and 10.5 months for group I, and 20 and 28.5 months for group II, respectively (p = 0.001). The mean survival was 6.7 months for patients with MVI, and 30.2 months for those without MVI (p = 0.0001). Conclusions: High levels of CTCs were observed in patients with MVI invasion, rather than other causes of unresectability. It can be suggested that expression of both CEA and CK-19 in the peripheral blood of gastric cancer patients are strong predictors of MVI and significantly worse survival rates. Copyright © Experimental Oncology, 2010

Grayanotoxin (mad honey) - Ongoing consumption after poisoning

Background: Some honey types in certain geographical regions may cause toxic effects on people. This type of honey is known as “mad honey” in Turkey. The toxic ingredient of this honey is called Grayanotoxin I. The consumption of mad honey can cause severe bradycardia, hypotension, dizziness, nausea and vomiting. Aims: Our study is aimed at analysing patients diagnosed with mad honey poisoning and their behaviour towards the consumption of this honey after diagnosis. Study Design: Cross sectional study. Methods: This cross-sectional study was based on complaints and findings of mad honey poisoning. Patient information and findings at the time of admission were compared with those at one month after discharge through telephone interviews. They were asked if either they or their relatives had continued consuming the same honey. Frequency data such as gender, purpose of honey consumption, first complaints and continuance of honey consumption are shown as number (n) and percentage (%). A Chi Square test was conducted to determine the difference between groups. Results: 38 patients were participated in this study; 18 of the patients had to be followed up in a coronary intensive care unit. We were able to reach 34 patients by phone after discharge. It was found that 12 of 16 patients discharged after emergency unit observation or their close relatives were continuing to consume mad honey, whereas 16 (88.9%) of the 18 patients under coronary intensive care had discontinued consuming mad honey. The difference in the continuation of mad honey consumption between patient groups followed-up in the intensive care unit and those discharged after emergency observation was statistically significant. Conclusion: Hazards associated with and serious consequences following the consumption of mad honey must be clearly explained to patients who are found to be consuming mad honey