Taking training into your own hands

The Young Diabetologists' Forum (YDF) is a group designed and run by specialist trainees in endocrinology and diabetes that aims to provide high quality educational events. The YDF recognised that not all trainees in the specialty had equitable access to training opportunities and resolved to try and remedy the situation. This article describes the history and evolution of the YDF into an organisation representing over 400 trainees in endocrinology and diabetes, providing up to seven training events per year and with a budget of over pounds 200,000. As well as offering education and training another key purpose of the YDF is to give trainees from around the country the opportunity to meet up and exchange thoughts and ideas. The overall aim of the organisation is to improve the lives of people with diabetes by helping to ensure that future specialists are fully equipped for their role.

Decreased levels of CCR3 in CD4+ lymphocytes of rheumatoid arthritis patients

OBJECTIVES

To evaluate the expression of CCR3 receptors as well as CCR3 agonists, including eotaxin-2 and RANTES, among patients suffering from rheumatoid arthritis and healthy controls, as a possible pathogenetic mechanism in inflammatory joint disease.

METHODS

Twenty-two patients and 13 healthy controls were recruited and clinically evaluated. CCR3 expression on CD4+ lymphocytes and mononuclear cells was evaluated by FACS analysis after staining with human CD4 APC (bioscience) and human CCR3 (CD193)PE. Levels of eotaxin-2 and RANTES were analysed by ELISA.

RESULTS

A significant decrease was observed in the level of CD4+ cells expressing the CCR3 receptor in serum of RA patients (0.96+/-0.5) as compared with healthy controls (1.48+/-0.6) (p<0.05). A significant decrease in serum eotaxin-2 levels was evident among RA patients suffering from active disease, defined by a DAS-28 score above 5.5, compared with RA patients with lower activity scores (2.1+/-1.6 vs. 7.0+/-5.1; p=0.01). A significant decrease was evident in the number of CCR3 expressing Monocytes among RA patients treated with steroids and anti TNF-a medications as compared with RA patients not receiving such treatment.

CONCLUSIONS

CCR3 is differentially expressed on inflammatory cells in RA, while eotaxin-2, a potent CCR3 agonist, is differentially expressed in active disease. Anti-inflammatory medications may down-regulate CCR3 expression in RA. The CCR3-CCR3 agonist pathway may thus have a pathogenic role in RA and may be a future target for novel treatment modalities.

Pheochromocytoma in pregnancy: a case report and review of literature

Hypertension is a common problem in pregnancy that can result in significant maternal and fetal morbidity and mortality. The common causes include pre-eclampsia, gestational hypertension and essential hypertension. Although phaeochromocytoma is a rare cause of hypertension in pregnancy, it can lead to potentially life-threatening cardiovascular complications for the mother and increased fetal mortality if left undiagnosed and untreated. The diagnosis can be confirmed by measurement of plasma and urinary catecholamines and their metabolities followed by radiological localization of the tumour. Surgical resection of the tumour after adequate pre-operative control of hypertension using sequential alpha- followed by beta-blockers is the definitive treatment. In pregnancy, depending on the gestation at which diagnosis is made, the optimal timing for surgery is during the late first or early second trimester. When the pregnancy is more advanced, medical management followed by combined caesarean section and tumour resection closer to term is preferred.

Protective effect of eotaxin-2 inhibition in adjuvant-induced arthritis

Eotaxin-2 is a potent chemoattractant for eosinophils, basophils and T helper type 2 (Th2) lymphocytes. The eotaxin-2/CCL24 receptor CCR3 is expressed in human brain, skin, endothelium and macrophages. The aim of the current study was to evaluate the protective effect of a monoclonal anti-eotaxin-2 antibody on the development of adjuvant-induced arthritis in rats (AIA). Adjuvant arthritis was induced in Lewis rats by intradermal injection of incomplete Freund's adjuvant +Mycobacterium tuberculosis. Rats were treated by intraperitoneal (i.p.) injection with three monoclonal antibodies against eotaxin-2 (G7, G8, D8) three times per week. Controls were treated with total mouse immunoglobulin G (IgG), methotrexate (MTX) or phosphate-buffered saline (PBS). Arthritis severity was evaluated by measuring ankle swelling, arthritic score, whole animal mobility and body weight. Sample joints were obtained for pathological evaluation and postmortem X-ray of ankle joints was performed to document erosions. Significant inhibition of arthritis was observed in rats treated with anti-eotaxin-2 antibodies compared to those treated with immunoglobulin or PBS. Inhibition was manifest in ankle diameter, arthritic score and mobility score. The antibody marked D8 showed the greatest efficacy. The effect was observed both in animals treated before the appearance of arthritis and in those where treatment was begun after development of joint inflammation. Combined treatment with D8 and MTX caused additional protection. Significant reduction of inflammation in D8-treated animals was also demonstrated in pathological and X-ray examinations. Inhibition of eotaxin-2 by monoclonal antibodies has a significant protective effect in adjuvant arthritis. These results may introduce a novel therapeutic target in rheumatoid arthritis and additional inflammatory joint disorders.

Abstract 681: Knockdown of connective tissue growth factor and treatment with temozolomide inhibited invasion, angiogenesis, and tumorigenesis of human glioblastomas

Connective tissue growth factor (CTGF) is a putative proto-oncogene and plays a crucial role in endothelial cell migration and tumor angiogenesis. CTGF is highly upregulated in proliferating endothelial cells and glioblastoma cells. In this investigation, we examined whether knockdown of CTGF at the mRNA level and treatment with temozolomide (TMZ) could inhibit cell invasion, angiogenesis, and growth of human glioblastoma SNB-19 and T98G cells in vivo. The cells were stably transfected with a plasmid vector carrying the human CTGF siRNA cDNA and then treated with 10 μM TMZ for 48 h. Semiquantitative PCR, Western blotting, and immunohistochemical staining demonstrated 80% downregulation of CTGF both at mRNA and protein levels after stable transfection. Matrigel invasion, cell migration from spheroids, and cell proliferation studies demonstrated significant inhibition of cell invasion, migration, and proliferation, respectively, of both cell lines after downregulation of CTGF and treatment with TMZ. In vitro and in vivo angiogenesis assays demonstrated inhibition of network formation of endothelial cells and neovascularization under the dorsal skin of nude mice, respectively, after knockdown of CTGF and treatment with TMZ. Both subcutaneous and intracerebral tumorigenesis in nude mice was markedly reduced in CTGF downregulated cells after TMZ treatment. Mechanistic studies demonstrated significant reduction of PCNA, VEGF, c-Myc, CDK2, CDK4, and cyclin D1 and upregulation of the cell cycle inhibitors p21Waf1 and p27Kip1. Flow cytometric analysis showed cell cycle arrest at G2/M phase in both cell lines after CTGF knockdown and TMZ treatment. Taken together, our study indicates that the CTGF knockdown and TMZ treatment effectively prevents cell invasion, migration, angiogenesis, and growth of glioblastomas in vivo. Therefore, CTGF knockdown during TMZ treatment offers a novel and potential therapeutic strategy for controlling the growth of glioblastomas. This investigation was supported in part by the R01 grants (CA-91460 and NS-57811) from the National Institutes of Health (Bethesda, MD).

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 681.

Abstract 578: Combination of 4-HPR and EGCG induces apoptosis and inhibits angiogenesis and tumorigenesis of neuroblastoma SH-SY5Y and SK-N-DZ cells

Neuroblastomas are extracranial, malignant solid tumors in childhood with a dismal prognosis. N-(4-Hydroxyphenyl) retinamide (4-HPR) is a synthetic retinoid that induces apoptosis in tumor cells. (-)-Epigallocatechin-3-gallate (EGCG) is a potent antioxidant abundant in green tea with anticancer properties. In the present investigation, we have studied the combined effect of 4-HPR and EGCG to induce apoptosis and to inhibit angiogenesis and tumor progression of human neuroblastoma malignant SH-SY5Y and SK-N-DZ cells in vivo. The cells were treated with 1 μM 4-HPR, 10 μM EGCG, or combination of both and subjected to MTT assay and TUNEL staining. Western blotting was performed for molecules involved in both receptor and mitochondria mediated apoptotic pathways. Angiogenesis and subcutaneous tumor growth studies were performed in immunocompromised mice. Treatment with combination of 4-HPR and EGCG resulted in more than 70% apoptosis and 80% inhibition in cell proliferation in both cell lines. Apoptosis was associated with induction of both receptor and mitochondria mediated pathways. Our in vivo angiogenesis studies demonstrated significant inhibition of neovascularization after treatment with either agent alone and complete inhibition after treatment with combination of both agents. Studies also demonstrated marked suppression of subcutaneous tumorigenesis and solid tumor formation after treatment with combination of 4-HPR and EGCG. In conclusion, our studies demonstrated that treatment with combination of 4-HPR and EGCG effectively induced apoptosis and inhibited cell proliferation, angiogenesis, and growth of neuroblastomas in vivo. Therefore, the combination of 4-HPR and EGCG could be used as a potential therapeutic regimen for effectively controlling the growth of human malignant neuroblastomas. This investigation was supported in part by the R01 grants (NS-57811 and CA-91460) from the National Institutes of Health (Bethesda, MD).

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 578.

Knockdown of hTERT and concurrent treatment with interferon-gamma inhibited proliferation and invasion of human glioblastoma cell lines

Human telomerase reverse transcriptase (hTERT) is the catalytic component of telomerase that facilitates tumor cell invasion and proliferation. Telomerase and hTERT are remarkably upregulated in majority of cancers including glioblastoma. Interferon-gamma (IFN-gamma) modulates several cellular activities including cell cycle and multiplication through transcriptional regulation. The present investigation was designed to unravel the molecular mechanisms of the inhibition of cell proliferation, migration, and invasion of human glioblastoma SNB-19 and LN-18 cell lines after knockdown of hTERT using a plasmid vector based siRNA and concurrent treatment with IFN-gamma. We observed more than 80% inhibition of cell proliferation, migration, and invasion of both cell lines after the treatment with combination of hTERT siRNA and IFN-gamma. Our studies also showed accumulation of apoptotic cells in subG1 phase and an increase in cell population in G0/G1 with a reduction in G2/M phase indicating cell cycle arrest in G0/G1 phase for apoptosis. Semiquantitative and real-time RT-PCR analyses demonstrated significant downregulation of c-Myc and upregulation of p21 Waf1 and p27 Kip1. Western blotting confirmed the downregulation of the molecules involved in cell proliferation, migration, and invasion and also showed upregulation of cell cycle inhibitors. In conclusion, our study demonstrated that knockdown of hTERT and concurrent treatment with IFN-gamma effectively inhibited cell proliferation, migration, and invasion in glioblastoma cells through downregulation of the molecules involved in these processes and cell cycle inhibition. Therefore, the combination of hTERT siRNA and IFN-gamma offers a potential therapeutic strategy for controlling growth of human glioblastoma cells.

Genistein induces receptor and mitochondrial pathways and increases apoptosis during BCL-2 knockdown in human malignant neuroblastoma SK-N-DZ cells

The potent antiapoptotic molecule Bcl-2 is markedly up-regulated in a majority of cancers, including neuroblastoma. Genistein is an isoflavone with antitumor properties. The present study sought to elucidate the molecular mechanism of genistein-induced apoptosis and also to examine the effect of genistein in increasing apoptosis during Bcl-2 knockdown in human malignant neuroblastoma SK-N-DZ cells. The cells were transfected with Bcl-2 siRNA plasmid vector, treated with 10 microM genistein, or the combination, and subjected to TUNEL staining and FACS analysis. Semiquantitative and real-time RT-PCR experiments were performed for examining expression of Fas ligand (FasL), tumor necrosis factor-alpha (TNF-alpha), Fas-associated death domain (FADD), and TNFR-1-associated death domain (TRADD). The cell lysates were analyzed by Western blotting for levels of molecules involved in both receptor- and mitochondria-mediated apoptotic pathways. Treatment with the combination of Bcl-2 siRNA and genistein resulted in more than 80% inhibition of cell proliferation. TUNEL staining and FACS analysis demonstrated apoptosis in 70% of cells after treatment with the combination of both agents. Apoptosis was associated with increases in Bax:Bcl-2 ratio, mitochondrial release of cytochrome c, and activation of caspases through the mitochondria-mediated apoptotic pathway. Genistein triggered the receptor-mediated apoptotic pathway through upregulation of TNF-alpha, FasL, TRADD, and FADD and activation of caspase-8. Combination of Bcl-2 siRNA and genistein triggered a marked increase in cleavage of DFF45 and PARP that resulted in enhanced apoptosis. Our study demonstrates that Bcl-2 knockdown during genistein treatment effectively induced apoptosis in neuroblastoma cells. Therefore, this strategy could serve as a potential therapeutic regimen to inhibit the growth of human malignant neuroblastoma.

Psychosis due to non-bacterial thrombotic endocarditis

Non-bacterial thrombotic endocarditis or marantic endocarditis is an uncommon and frequently terminal condition. We report non-bacterial thrombotic endocarditis presenting as a psychotic illness. The underlying cause was found to be adenocarcinoma of the lung. The patient was nursed on a specialist joint medical/psychiatric unit. Many medical illnesses can present with psychosis in older people: this is the first case report of this presentation in non-bacterial thrombotic endocarditis.

Broiler performance and in vivo viscosity as influenced by a range of xylanases, varying in ability to effect wheat in vitro viscosity

1. Exogenous enzymes such as xylanase are used in diets for broilers to eliminate anti-nutritive effects caused by the presence of non-starch polysaccharides (NSP). It has been proposed that the mechanism by which xylanases exert their effect is through reducing in vivo viscosity within the broiler digestive tract. Previous research has reported that in vitro viscosity was a reasonable predictor of in vivo viscosity and that this method could be used to assess the efficacy of xylanases. 2. The objective of this study was to examine the response of broilers offered a wheat-based diet supplemented with a range of xylanases, varying in ability to reduce in vitro viscosity. 3. A total of 18 xylanases (Syngenta Animal Nutrition) were used to investigate the effect of xylanase on wheat in vitro viscosity. For the in vitro viscosity assay, pepsin was dissolved in either 005 or 01 M hydrochloric acid (HCl). 4. A wheat-based diet was formulated, produced and split into 7 batches; xylanase (500 U/kg) was sprayed onto 6 of the batches and the 7th was the control. This was repeated three times to produce a total of 21 diets, 18 of which contained xylanase. 5. The experiment was conducted in three consecutive trials. Each trial utilised 63 male, Ross broilers from 7 to 28 d of age. Dry matter intake (DMI), liveweight gain (LWG) and gain:feed were determined weekly. Excreta were collected from d 14 to 21 for determination of apparent metabolisable energy (AME). Oil and neutral detergent fibre (NDF) digestibility and ileal digestibility of dry matter (DM) and starch were determined. 6. Regression analyses were applied to the mean intestinal viscosity against DMI, LWG, gain:feed and the ratio of metabolisable energy to gross energy (ME:GE). To compare xylanases across the three trials, the data were subjected to REML analysis (Genstat 5). 7. When 01 M HCl was used for dissolution of pepsin, considerable reductions in in vitro viscosity were achieved for the majority of the xylanases-to values less than 12% of the control treatment. When 005 M HCl was used for the dissolution of pepsin, initial viscosity values were lower and the reduction in in vitro viscosity less dramatic than that observed with 01 M HCl. 8. With the exception of diets containing xylanases 9003 and 7162, significant reductions in in vivo viscosity were observed for diets containing xylanase in comparison to the control diet. 9. In terms of gain:feed, ME:GE and AME the xylanases ranked best were 2230 and 9003. Xylanase 2230 also resulted in the highest values for ileal DM and starch digestibility. 10. There were weak but significant relationships between in vitro viscosity and in vivo jenjunal digesta viscosity when in vitro viscosity was determined using either 01 or 005 M HCl (r(2)= 0287 and 0240, respectively). 11. The relationship between jejunal viscosity and DMI was significant (P < 005) but relatively poor (r(2)= 023). There were also significant (P < 005) relationships between jejunal digestal viscosity and gain:feed and ME:GE (r(2)= 034 and 028, respectively). 12. In conclusion, in vitro viscosity may be of some use in predicating xylanase response in vivo.

Large area high efficiency broad bandwidth 800 nm dielectric gratings for high energy laser pulse compression

We have demonstrated broad bandwidth large area (229 mm x 114 mm) multilayer dielectric diffraction gratings for the efficient compression of high energy 800 nm laser pulses at high average power. The gratings are etched in the top layers of an aperiodic (Nb0.5Ta0.5)2O5-SiO2 multilayer coating deposited by ion beam sputtering. The mean efficiency of the grating across the area is better than 97% at the center wavelength and remains above 96% at wavelengths between 820 nm and 780 nm. The gratings were used to compress 5.5 J pulses from a Ti:sapphire laser with an efficiency above 80 percent.

Combination of hTERT knockdown and IFN-gamma treatment inhibited angiogenesis and tumor progression in glioblastoma

PURPOSE

The limitless invasive and proliferative capacities of tumor cells are associated with telomerase and expression of its catalytic component, human telomerase reverse transcriptase (hTERT). IFN-gamma modulates several cellular activities, including signaling pathways and cell cycle, through transcriptional regulation.

EXPERIMENTAL DESIGN

Using a recombinant plasmid with hTERT siRNA cDNA, we downregulated hTERT during IFN-gamma treatment in human glioblastoma SNB-19 and LN-18 cell lines and examined whether such a combination could inhibit angiogenesis and tumor growth in nude mice. In vitro angiogenesis assay was done using coculture of tumor cells with human microvascular endothelial cells. In vivo angiogenesis assay was done using diffusion chambers under the dorsal skin of nude mice. In vivo imaging of intracerebral tumorigenesis and longitudinal solid tumor development studies were conducted in nude mice.

RESULTS

In vitro and in vivo angiogenesis assays showed inhibition of capillary-like network formation of microvascular endothelial cells and neovascularization under dorsal skin of nude mice, respectively. We observed inhibition of intracerebral tumorigenesis and s.c. solid tumor formation in nude mice after treatment with combination of hTERT siRNA and IFN-gamma. Western blotting of solid tumor samples showed significant downregulation of the molecules that regulate cell invasion, angiogenesis, and tumor progression.

CONCLUSIONS

Our study showed that the combination of hTERT siRNA and IFN-gamma effectively inhibited angiogenesis and tumor progression through the downregulation of molecules involved in these processes. Therefore, the combination of hTERT siRNA and IFN-gamma is a promising therapeutic strategy for controlling the growth of human glioblastoma.

A single-nucleotide polymorphism in the MDR1 gene as a predictor of response to neoadjuvant chemotherapy in breast cancer

BACKGROUND

The single-nucleotide polymorphism (SNP) 3435C > T in exon 26 of the MDR1 gene has been shown to correlate with the functioning of P-glycoprotein. We studied the frequency of SNP in exon 26 of the MDR1 gene in breast cancer and its role in predicting response to neoadjuvant chemotherapy in breast cancer.

PATIENTS AND METHODS

Ninety-six patients with locally advanced breast carcinoma were enrolled. Genotyping of exon 26 of the MDR1 gene was performed, and computed tomography scans were performed before and after neoadjuvant chemotherapy. Response to 3 cycles of the 5-fluorouracil/doxorubicin/ cyclophosphamide (FAC) regimen was assessed. The prevalence of SNP was compared with that of historical controls. Association of the response was compared with the genotypes.

RESULTS

The frequency of genotypes was different from that of healthy sex-matched historical controls. Prevalence of TT genotype was significantly increased in breast cancer patients (P = .025). The patients with TT genotype had 2.26 times the chance of responding to neoadjuvant chemotherapy when compared with patients with the CC genotype (P = .44).

CONCLUSION

Significantly higher prevalence of 3435TT genotype in exon 26 of the MDR1 gene in patients with breast cancer might suggest the possibility of increased breast cancer susceptibility. The genotypes did not show any significant association to response to chemotherapy in the population studied.

Musculoskeletal injuries among Malaysian badminton players

INTRODUCTION

The purpose of this study was to investigate the pattern of musculoskeletal injuries sustained by Malaysian badminton players.

METHODS

This is a retrospective case notes review of all badminton players who attended the National Sports Institute (NSI) Clinic, Kuala Lumpur, Malaysia, and were diagnosed with musculoskeletal injuries.

RESULT

In a two and a half year period, from January 2005 to June 2007, 469 musculoskeletal injuries were diagnosed among badminton players at the NSI Clinic. The mean age of the players who attended the clinic was 19.2 (range 13-52) years. Approximately 60 percent of the injuries occurred in players younger than 20 years of age. The majority of injuries (91.5 percent) were categorised as mild overuse injury and mostly involved the knee.

CONCLUSION

The majority of the injuries sustained by badminton players in this study were due to overuse, primarily in the knee. The majority of the injuries were diagnosed in younger players and occurred during training/practice sessions. There was no difference in terms of incidence and types of injuries between the genders.

Emergence of acoustic waves from vorticity fluctuations: impact of non-normality

Chagelishvili et al. [Phys. Rev. Lett. 79, 3178 (1997)] discovered a linear mechanism of acoustic wave emergence from vorticity fluctuations in shear flows. This paper illustrates how this "nonresonant" phenomenon is related to the non-normality of the operator governing the linear dynamics of disturbances in shear flows. The non-self-adjoint nature of the governing operator causes the emergent acoustic wave to interact strongly with the vorticity disturbance. Analytical expressions are obtained for the nondivergent vorticity perturbation. A discontinuity in the x component of the velocity field corresponding to the vorticity disturbance was originally identified to be the cause of acoustic wave emergence. However, a different mechanism is proposed in this paper. The correct "acoustic source" is identified and the reason for the abrupt nature of wave emergence is explained. The impact of viscous damping is also discussed.