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ABSTRACT: Early epidemiologic studies have hinted at an anticancer role for multiple antioxidant compounds that are present in fresh produce. These substances target reactive oxygen and nitrogen species and potentially reduce oxidative damage to DNA that results in mutagenic change and potentially the initiation of cancer, disease and aging. It is tempting to believe that these compounds, through their in vitro actions as observed in cancer cell lines and certain animal experiments, may have the same anticarcinogenic role in humans. This article summarizes the relationship between fresh produce and antioxidant supplements and cancer risks from recent epidemiologic studies as well as identifying worrying trends and future directions for research into this most controversial field. Recent molecular data suggest that certain antioxidants may contribute towards oncogenesis.
Future Oncology 05/2012; 8(5):535-48. · 3.16 Impact Factor
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Future Oncology 09/2009; 5(7):915-7. · 3.16 Impact Factor
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Shonit Punwani,
Manuel Rodriguez-Justo,
Alan Bainbridge,
Rebecca Greenhalgh,
Enrico De Vita,
Stuart Bloom, Richard Cohen,
Alastair Windsor,
Austin Obichere,
Anika Hansmann,
Marco Novelli,
Steve Halligan,
Stuart A Taylor
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ABSTRACT: To validate proposed magnetic resonance (MR) imaging features of Crohn disease activity against a histopathologic reference.
Ethical permission was given by the University College London hospital ethics committee, and informed written consent was obtained from all participants. Preoperative MR imaging was performed in 18 consecutive patients with Crohn disease undergoing elective small-bowel resection. The Harvey-Bradshaw index, the C-reactive protein level, and disease chronicity were recorded. The resected bowel was retrospectively identified at preoperative MR imaging, and wall thickness, mural and lymph node/cerebrospinal fluid (CSF) signal intensity ratios on T2-weighted fat-saturated images, gadolinium-based contrast material uptake, enhancement pattern, and mesenteric signal intensity on T2-weighted fat-saturated images were recorded. Precise histologic matching was achieved by imaging the ex vivo surgical specimens. Histopathologic grading of acute inflammation with the acute inflammatory score (AIS) (on the basis of mucosal ulceration, edema, and quantity and depth of neutrophilic infiltration) and the degree of fibrostenosis was performed at each site, and results were compared with MR imaging features. Data were analyzed by using linear regression with robust standard errors of the estimate.
AIS was positively correlated with mural thickness and mural/CSF signal intensity ratio on T2-weighted fat-saturated images (P < .001 and P = .003, respectively) but not with mural enhancement at 30 and 70 seconds (P = .50 and P = .73, respectively). AIS was higher with layered mural enhancement (P < .001), a pattern also commonly associated with coexisting fibrostenosis (75%). Mural/CSF signal intensity ratio on T2-weighted fat-saturated images was higher in histologically edematous bowel than in nonedematous bowel (P = .04). There was no correlation between any lymph node characteristic and AIS.
Increasing mural thickness, high mural signal intensity on T2-weighted fat-saturated images, and a layered pattern of enhancement reflect histologic features of acute small-bowel inflammation in Crohn disease.
Radiology 07/2009; 252(3):712-20. · 5.73 Impact Factor
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Stuart A Taylor,
Shonit Punwani,
Manuel Rodriguez-Justo,
Alan Bainbridge,
Rebecca Greenhalgh,
Enrico De Vita,
Alastair Forbes, Richard Cohen,
Alastair Windsor,
Austin Obichere,
Anika Hansmann,
Janaki Rajan,
Marco Novelli,
Steve Halligan
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ABSTRACT: To determine mural perfusion dynamics in Crohn disease by using dynamic contrast material-enhanced magnetic resonance (MR) imaging and to correlate these with histopathologic markers of inflammation and angiogenesis.
Ethical permission was given by the University College London Hospital ethics committee, and informed consent was obtained from all participants. Eleven consecutive patients with Crohn disease (eight female patients, three men; mean age, 39.5 years; range, 16.4-66.6 years) undergoing elective small-bowel resection were recruited between July 2006 and December 2007. Harvey-Bradshaw index, C-reactive protein (CRP) level, and disease chronicity were recorded. Preoperatively, dynamic contrast-enhanced MR imaging was performed through the section of bowel destined for resection, and slope of enhancement, time to maximum enhancement, enhancement ratio, the volume transfer coefficient K(trans), and the extracellular volume fraction v(e) were calculated for the affected segment. Ex vivo surgical specimens were imaged to facilitate imaging-pathologic correlation. Histopathologic sampling of the specimen was performed through the imaged tissue, and microvascular density (MVD) was determined, together with acute and chronic inflammation scores. Correlations between clinical, MR imaging, and histopathologic data were made by using the Kendall rank correlation and linear regression.
Disease chronicity was positively correlated with enhancement ratio (correlation coefficient, 0.82; P = .002). Slope of enhancement demonstrated a significant negative correlation with MVD (correlation coefficient, -0.86; P < .001). There was a negative correlation between CRP level and slope of enhancement (correlation coefficient, -0.77; P = .006). Neither acute nor chronic inflammation score correlated with any other parameter.
Certain MR imaging-derived mural hemodynamic parameters correlate with disease chronicity and angiogenesis in Crohn disease, but not with histologic and clinical markers of inflammation. Data support the working hypothesis that microvessel permeability increases with disease chronicity and that tissue MVD is actually inversely related to mural blood flow.
Radiology 03/2009; 251(2):369-79. · 5.73 Impact Factor
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ABSTRACT: The vascular type of Ehlers-Danlos syndrome, type IV, is associated with severe complications, including arterial rupture and visceral perforation. However, to our knowledge, there has been only one previous report of splenic rupture caused by a spontaneous hemorrhage in type IV Ehlers-Danlos syndrome. We report another case of this uncommon complication, occurring in a 35-year-old woman who presented after the sudden onset of acute abdominal pain. Patients should be stabilized quickly in the intensive care unit and the most timesaving surgical techniques used. Moreover, tissues must be handled with great care intraoperatively in view of their extreme fragility. Despite prompt and appropriate treatment, the prognosis is often dismal.
Surgery Today 02/2009; 39(1):52-4. · 1.22 Impact Factor
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Future Oncology 01/2009; 4(6):741-4. · 3.16 Impact Factor
