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Eitan Israeli
available for the same tumor samples, inherited risk loci for
Science 2018; 362: eaav1898
types. When the data were integrated with other omics data

chromatin landscape in 410 TCGA samples from 23 cancer
associated with clinical prognosis were discovered.
to profile chromatin accessibility to determine the accessible
Doppler showed a mild residual leak
survival differences were identified, and non-coding mutations
cancers. Corces and co-authors used a recently modified assay
septum [g] TTE apical view highlighted by color
resource of molecular data on a large variety of human
enhancers driving molecular subtypes of cancer with patient
the device at the level of the interventricular
cancer predisposition were revealed, transcription factors and
The Cancer Genome Atlas (TCGA) provides a high-quality
(St. Jude Medical, USA) [f] TTE apical view showed
G
F
E
A 20 mm Amplatzer Post-MI VSD Occluder
TM
Cancer chromatin accessibility landscape
artery to advance the 12F delivery system [E]
subsequently positioned in the right pulmonary
Capsule
Stiff TM ST-1 guidewire (Boston Scientific, USA) was
using a balloon tip catheter, and an Amplatz Super
transfemoral venous route. The defect was crossed
closure device using a transeptal access via the
Eitan Israeli
were responsible for promoting Treg induction in the intestine.
percutaneous VSD closure with the insertion of the
Sci Immunol 2018; 3: eaat6975
galactan polysaccharides derived from the cell wall of B. bifidum
D
apex and a 14 mm defect size [D] The steps of the
colitis and Crohn’s disease.
generation of regulatory T cells (Tregs) in the intestine. β-glucan/
showed a VSD with sufficient distance from the
probiotic strain, Bifidobacterium bifidum, promotes the
dysbiosis associated with gastrointestinal disorders, including
45 degree and cranial 25 degree ventriculogram
than live microbes, could potentially be used to treat microbial
in the gut. Verma and colleagues examined how a particular
through the VSD [C] The left anterior oblique at a
express Toll-like receptor 2. Thus, microbial components, rather
also plays a vital role in modulating functions of immune cells
with color Doppler showed left-to-right shunt
This process was dependent on intestinal dendritic cells that
Besides supporting host metabolism, our intestinal microbiota
septal defect (VSD) [B] TTE apical view highlighted
view showed the presence of a large ventricular
Deconstructing probiotics
[A] Transthoracic echocardiogram (TTE) apical
septal defect: a deadly complication
Capsule
C
A
B
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13. Rutberg H, Borgstedt-Risberg M, Gustafson P, Unbeck M. Adverse events in
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2018
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Original articles
LETTERS Department of Medicine, Montreal Heart Institute, Montreal, Canada Cardiology Division, Geneva University Hospital, Geneva, Switzerland 720 2 1 Florian Rey MD , Thibault Ronchard MD PharD , Jawad Chaara MD and Stéphane Noble MD first Transcatheter Closure Still a Deadly Complication 30 years after the post-Myocardial Infarction Ventricular Septal
IMAJ • VOL 20 • nOVeMber 2018 20 2018
#
Editorial Board of cancer stem cells (CSCs) and/or bone Preoperative MetS is a strong predictor for
Potential Impact of Active marrow-derived stem cells (BMDSCs), in CRC mortality. MetS appears to be an inde-
Helicobacter pylori Infection biopsy specimens was found in a high pro- pendent predictor for CRC recurrence, and
Yehuda Shoenfeld MD FRCP with or without Concomitant portion of CRA patients accompanied with is associated with an increased recurrence
Editor in chief Metabolic Syndrome on Colorectal moderate/severe dysplasia (88%) and CRC risk equally in non-metastatic CRC.
Cancer Invasion and Mortality patients with moderate/severe degree of Thus, casting additional light in the
Joshua Shemer MD and Gad Keren MD malignancy (91%) [3]. CD44 plays a criti- uncertain pathophysiological mechanisms
Associate Editors To the Editor: cal role in oncogenesis, differentiation, and underlying H. pylori with or without con-
ased on serology, Shmuely and col- lymph node metastasis and is predictive of comitant MetS in CRC invasion and mor-
Abu-Shakra Mahmoud, MD Israeli Eitan, PhD B leagues [1] concluded that Helicobacter the prognosis and mortality for various car- tality, our results, as well as those of others,
Afek Arnon, MD Katz Amos, MD CRATER pylori infection (Hp-I) may be a risk factor cinomas including gastric cancer and CRC. have indicated that Hp-I impacts colorectal
Amital Howard, MD Kopolovic Yuri, MD Arik Eldar MD for all-cause mortality among colorectal Comparable pictures were also obtained for oncogenesis and progression by causing
Atar Dan, MD Kotler Moshe, MD cancer (CRC) patients who are evaluated proliferation marker Ki-67 (Ki-67 correlates a possible chronic inflammatory mucosal
Ashkenazi Shai, MD Mittelman Moshe, MD Photo of the “Giant Crater” also known as “Ramon by positron emission tomography/com- with the degree of malignancy, CRC invasive- damage, comparable to upper gastrointesti-
puted tomography imaging.
nal tract (UGT) infections, thereby promot-
ness, metastatic behavior, patient survival,
Balbir-Gurman Alexandra, MD Niv Yaron, MD Crater” in the Israel’s Negev region at dawn in June 2011 However, the serological test does not and the risk of relapse), anti-apoptotic Bcl-2 ing CRC invasion, metastasis, and mortality
Baniel Jack, MD Ophir Avinoam, MD discriminate between current and past infec- (Bcl-2 polymorphism could be a risk factor [3]; inducing an exaggerated gastrin and
Barzilai Asher, MD Raanani Pia, MD r. Arik Eldar has been a family physician for more than tions. Apart from past infection that might of CRC poor prognosis), and CD45 (assess- progastrin release that may be predictive
Belhassen Bernard, MD Rivkind Avraham, MD Dthree decades. He was born in Haifa and lives and works even be more applicable for oncogenesis, ing mainly T and B lymphocytes locally) of aggressive CRC behavior (progastrin
Bentur Yedidia, MD Salai Moshe, MD in the upper Galilee region and Golan Heights areas of Israel. such a distinction is crucial because only immunohistochemical expressions [2,3]. expression by stage IV tumors is consider-
Ben Yehuda Dina, MD Seidman Daniel, MD He became interested in photography as he tried to under- current Hp-I induces humoral and cellular Metabolic syndrome (MetS) is closely ably greater than stage IIa tumors); stimulat-
Birkenfeld Shlomo, MD Sherer Yaniv, MD stand how the beautiful scenes that he saw with his naked immune responses that provoke or perpetu- related to insulin resistance, and Hp-I has ing CSCs or recruiting BMDSCs, similar to
Blachar Yoram, MD Sofer Shaul, MD eye could look completely different through the eye (lens) ate chronic inflammatory processes in gas- been proposed to be a contributing factor UGT Hp-I-associated chronic inflamma-
Ciechanover Aaron, MD Sonnenblick Moshe, MD of the camera. He believes the answer lies in the fact that the trointestinal tract with potential oncogenic [2]. In a systematic review, we reported an tion, atrophic gastritis, hyperplasia, meta-
Eidelman Leonid, MD Talmi Yoav, MD human eye mixes what it sees with the emotions of the heart sequelae including metastases and mortality. association between Hp-I and insulin resis- plasia, dysplasia, and BMDSCs recruitment
Glick Shimon, MD Toubi Elias, MD and passion, while the camera shows stark reality. That said, Many neoplasms, such as CRC, arise at the tance, the major underlying mechanism that may facilitate tumor progression, lymph
Goddard Gisele, MD Tur-Kaspa Ran, MD as a photographer, he makes the reality his own and creates sites of chronic inflammation and infection; responsible for the MetS. Both Hp-I and node metastasis, and mortality [3]; and
Grossman Ehud, MD Weingarten Michael, MD something beautiful and unique. In taking photographs Arik and chronic inflammation via the nuclear MetS are widespread globally and there is affecting MetS parameters, oncogenes, and 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Magenta
Grotto Itamar, MD Yinnon Amos, MD tried to minimize the gap between his inner vision and the factor kappa B pathway promotes CRC inva- growing evidence for a potential association immune surveillance processes that may 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Yellow #131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Black 131118-COHANIM - 131118-COHANIM | 1 - B | 18-11-13 | 11:24:13 | SR:-- | Cyan
Gurman Gabriel, MD Yosefy Chaim, MD outer scene. sion, metastasis, and mortality. between Hp-I and insulin resistance syn- be involved in CRC invasiveness, meta-
Halevy Sima, MD Zimlichman Eyal, MD The photograph Crater was taken using a Nikon COOLPIX Our studies [2,3] comprised 50 CRC drome or MetS and its related morbidity [2]. static behavior, mortality, and the risk of
P510 digital camera, standing on the western edge of the cra- patients, 25 patients with colorectal adeno- In Israel, the probability of MetS appears relapse [2,3] .
ter, shooting straight toward the sun as it was beginning to mas (CRA), and 10 controls. Based on to be significantly increased in relation to Therefore, because active Hp-I, with
Copyright © 2018 rise in the east. histology, the practical gold standard for Hp-I and upper gastrointestinal patholo- or without concomitant MetS, might be
Israel Medical Association Journal current Hp-I diagnosis, our research showed gies, thereby suggesting that long-term involved in all-cause invasion and mortality
email: aeldar@012.net.il
significantly higher presence of Hp-I in the gastric inflammation caused by H. pylori among CRC patients, H. pylori eradication
Manuscript and Production Editor CRA (68%) group and CRC (84%) group could play a role in metabolic homeostasis might inhibit or delay CRC progression
Judi Felber
compared to controls (30%). With regard and oncogenesis [4]. Specifically, the risk of and thus large-scale studies are required.
Editorial Secretary to the features of histological severity in synchronous CRC is considerably increased
Tovy Malkin CRA group, presence of Hp-I was observed by gastric cancer occurrence, especially in Jannis Kountouras MD PhD ,
1
in 50% of patients with mild dysplasia and MetS patients; and screening for synchro- Michael Doulberis MD DVM PhD ,
1,2
80% of patients with moderate/severe dys- nous CRC is highly recommended for Stergios A. Polyzos MD PhD ,
3
plasia. Likewise, presence of Hp-I in the gastric cancer patients with MetS [2]. MetS Apostolis Papaefthymiou MD ,
4
Address: Israel Medical Association Journal (IMAJ), 2 Twin Towers, CRC group was observed in 89% of patients is significantly associated with overall and Nikolaos Kapetanakis MD PhD ,
1
11th floor, 35 Jabotinsky St., P.O. Box 3566, Ramat Gan 5251108, Israel
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Tel: (972-3) 610-0418, Fax: (972-3) 751-9673, email: imaj@ima.org.il with mild and 83% with moderate/severe advanced CRC. It also confers an increased Stergios Arapoglou MD PhD ,
grade (including stage IV) dysplasia, also risk of CRC incidence and mortality in Ioannis Venizelos MD PhD ,
1
The Israel Medical Association Journal (IMAJ) is the successor of the Israel
1
Journal of Medical Sciences that was initiated in 1965 by Prof. Moshe mentioned by the authors [1]. Noteworthy, both genders [2]. Moreover, relative data Elizabeth Vardaka PhD , Georgios
Prywes. During the 32 years of publication. Prof. Prywes served as its H. pylori presence was documented by indicate that Hp-I with concomitant MetS Kotronis MD , Sotirios Anastasiadis MD 1
1
editor-in-chief.
immunohistochemical stain in CRA and could further increase the risk of colorec- and Panagiotis Katsinelos MD PhD
1
All advertisements in this issue are put forward at the sole responsibility CRC tissues. In addition, presence of Hp-I tal neoplasms. The occurrence of MetS is
of the advertisers. Similarly, all articles are the responsibility of the authors with accompanying immunohistochemical associated with a twofold increased risk 1 Department of Medicine, Second Medical Clinic,
alone. The Israel Medical Association and the editors of "IMAJ" are not To enter the IMAJ website Ippokration Hospital, Aristotle University of PERFECTOR
accountable for the contents of any advertisement or article. scan this sign expression of CD44, which is an indicator of CRC mortality and tumor recurrences. Thessaloniki, Thessaloniki, Macedonia, Greece
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