Genetic divergence in the clonal evolution of breast cancer

The progression of ductal carcinoma in situ (DCIS) to infiltrating and metastatic cancer of the breast is thought to be a consequence of clonal expansions of neoplastic cells with progressively more genetic alterations. To study this progression, we first dissected multiple foci from each of 23 breast tumors with DCIS only and 20 cases with synchronous DCIS and infiltrating cancer. We than tested microsatellite markers by PCR for allelic losses in the individual foci for loci on chromosomes 6q, 9p, 11q, 13q, 16q, 17q, and 17p. The patterns of allelic losses identified in the in situ cancers were generally conserved in the synchronous infiltrating tumors, supporting the paradigm that the infiltrating tumors are clonally derived from the in situ lesions. However, in 8 (40%) of the 20 cases with synchronous in situ and invasive cancer, heterogeneous patterns of allelic loss at one or more chromosomal loci were observed in adjacent DCIS foci. Moreover, some of the allelic losses recognized in in situ portions of the tumors were not conserved in the clonal progression to the synchronous invasive tumor. Such allelic loss heterogeneity was noted in only 1 of the 20 infiltrating tumors and only 3 of the 23 cases of DCIS without invasion that were studied in a similar manner. This heterogeneity indicated genetic divergence during the clonal evolution of breast cancer, particularly at the time when in situ cancers progress to invasive cancers.

A multicenter analysis of the first experience with FK506 for induction and rescue therapy after pancreas transplantation

Between May 1, 1993 and April 5, 1995, 154 pancreas allograft recipients at 9 institutions were given FK506 posttransplant. Three groups were studied: (1) recipients given FK506 initially for induction and maintenance therapy (n = 82), (2) recipients switched to FK506 for antirejection or rescue therapy (n = 61), and (3) recipients converted to FK506 for other reasons (n = 11). Of 82 patients in the induction group, 7 (9%) had simultaneous bone marrow (BM) and pancreas-kidney (SPK-BM) transplants, 54 (66%) had SPK transplants without BM, 14 (17%) had pancreas transplants alone (PTA), and 7 (9%) had pancreas after previous kidney transplants (PAK). All but 1 recipient was given quadruple immunosuppression (anti-T cell agents plus azathioprine and prednisone) for induction. The median FK506 starting dose was 4 mg/day p.o.; the median average FK506 blood level, 12 ng/ml. The most common side effects were neurotoxicity (16%), nephrotoxicity (13%), and gastrointestinal toxicity (9%). New-onset diabetes mellitus requiring permanent insulin therapy did not occur. Of 61 transplants in the rescue group, 44 (72%) were SPK, 11 (18%) PTA, and 6 (10%) PAK. All but 3 (95%) of the recipients had been on cyclosporine-azathioprine-prednisone triple immunosuppression before substitution of FK506 for cyclosporine; 46% of the recipients had one, and 54% > or = 2, rejection episodes preconversion. The most common side effects were nephrotoxicity (25%), neurotoxicity (23%), and gastrointestinal toxicity (21%). Two recipients were reconverted to cyclosporine because of transient hyperglycemia, and one recipient is on insulin. In the induction group, patient survival at 6 months was 90% for SPK, 100% for PTA, and 100% for PAK. According to a matched-pair analysis, pancreas graft survival for SPK recipients at 6 months was 87% for FK506 versus 70% for cyclosporine recipients (P = 0.04); for PTA recipients, 84% versus 66% (P = n.s.); and for PAK recipients, 80% versus 14% (P = 0.11). When technical failures and death with functioning grafts were censored, pancreas graft survival remained significantly better in the FK506 group. The incidence of first reversible rejection episodes by 6 months in FK506 recipients was 35% for SPK, 40% for PTA, and 20% for PAK. Of 75 pancreas grafts, 64 are currently functioning; in 5 recipients the pancreas failed (1 from rejection); 6 recipients died with a functioning pancreas graft. There were 3 posttransplant lymphomas (all EBV-positive); 2 recipients died and 1 is alive after subtotal colectomy and transplant pancreatectomy. In the antirejection rescue group, patient survival rates at 6 months were 91% for SPK, 100% for PTA, and 80% for PAK (P = n.s.). Pancreas graft survival rates at 6 months were 90% for SPK, 72% for PTA, and 40% for PAK. The incidence of first reversible rejection episodes after conversion to FK506 at 6 months was 44% in SPK, 54% in PTA, and 50% in PAK. Of 61 pancreas grafts, 51 are currently functioning; in 7 recipients the pancreas failed (5 from rejection); 3 recipients died with a functioning graft. There were no posttransplant lymphomas in the rescue group. This multicenter survey shows that FK506 in pancreas transplantation is associated with (1) a low rate of graft loss from rejection when used for induction therapy, (2) a high rate of graft salvage when used for rescue or rejection therapy, and (3) a very low rate of new-onset insulin-dependent diabetes mellitus. These encouraging results are tarnished by 3 posttransplant lymphomas in the induction group; a possible explanation is overimmunosuppression, but further (randomized) studies are necessary to analyze the long-term risk-benefit ratio of FK506 after pancreas transplantation.

Effects of mellow and frenetic music and stimulating and relaxing scents on walking by seniors

Previous research has yielded an inconclusive picture of the effects of music and scent on walking. Few laboratory studies have detected a beneficial effect of music; olfactory research has shown performance is positively affected for repetitive tasks but not yet on walking. The influence of these two types of stimuli in efficiency of exercise among seniors was assessed by measuring distance walked on an indoor course. Using a 3 x 3 factorial design [mellow music in 4:4 time, frenetic music in 2:8 time, and white noise by stimulating, relaxing, and control scent conditions], each of 20 volunteers from a senior center received nine randomized, 90-sec. exercise trials. Walking distance was reduced by mellow music but unaffected by stimulating music; there was no effect of scent.

Mellow and frenetic antecedent music during athletic performance of children, adults, and seniors

Previous research has yielded a contradictory picture of the effects of music on athletic performance. While athletes frequently report using music while training or during or before an event, laboratory studies have generally not detected a beneficial effect of music. The influence of music, judged mellow and frenetic, played before exercise was assessed by measuring stationary bicycle mileage. 60 volunteers from three age groups (child, adult, and senior) and with two levels of prior activity (high and low) were subjects. Each participant received three randomized 2-min. exercise trials, each preceded by 1-min. exposure to mellow music, frenetic music, or white noise. Mileage in both music conditions was significantly higher than that during the white-noise control trial except among the senior subjects. No significant differences between frenetic and mellow music were noted.

The non-random pattern of insertion of IS2 into the hemB gene of Escherichia coli

The hemB gene of Escherichia coli has been identified as a hot spot for the insertion of the transposable element IS2. The insertional specificity of IS2 is still unclear. This study reports on the attempt to sequence a statistically significant number of insertions in hemB, in order to determine whether there might be a basis for future studies to determine a molecular basis of IS2 insertional specificity. The results indicate that IS2 inserts in a non-random manner into a 240 bp segment at the 5' end of the gene (region I). Twenty-one of 24 insertions occurred in region I. Three insertions have been identified in the two middle 250 bp segments of the 975 bp gene, and none in the 3' terminal segment. A seventeen bp sequence showing 88.2% identity with a segment of IS2, 221 bp from the 3' terminus has been identified in region I. Four instances of repeated insertion between the same pair of nucleotides have been observed at four different sites.

P53 and Ki-67 immunoreactivity in human prostate cancer and benign hyperplasia

Mutation of the p53 gene is one of the commonest genetic abnormalities found in solid human tumours. This gene is probably concerned with the control of cellular proliferation and in view of this we carried out a study of human prostate cancer and benign prostatic hyperplasia, comparing the expression of mutated p53 with measurement of growth fractions as assessed by staining with Ki-67. A series of 29 patients with prostate cancer (CaP) were compared with 34 men with benign hyperplasia (BPH); 22 of 29 prostate cancers (76%) contained Ki-67 immunoreactivity compared with 10 of 34 (29%) BPH. With respect to p53 staining, significantly more prostate cancers (17%) were stained than BPH (0%). The mean Ki-67 score in cancers positive for p53 (4.3%) was greater than that found in cancers negative for p53 (1.2%), but no statistically significant relationship was found between tumour grade and Ki-67 staining. The use of Ki-67 and p53 staining may allow identification of tumours with a higher rate of cell growth and may permit development of prognostic factors.

p53, c-erbB-2 and the Epidermal Growth Factor Receptor in the Benign and Malignant Prostate

Expression of the p53, the epidermal growth factor receptor (c-erbB-1) and c-erbB-2 protein was studied in 34 men with benign prostatic hyperplasia and 29 men with locally advanced prostate cancer by means of an immuno-histochemical method. Strong staining for p53 was found in five of 29 prostate cancers (17%; mean 21% +/- 7% of malignant cells stained in the positive tumours), but no staining was found in benign prostatic hyperplasia (p less than 0.05). On the other hand, the epithelium in benign glands was stained positively for c-erbB-2 in 18% (6/34) and for the epidermal growth factor receptor in 88% (30/34); whereas malignant epithelium stained strongly for c-erbB-2 in 21% (6/29) and for the epidermal growth factor receptor in only 17% (5/29). Prostate cancer was associated with a significant decrease in epidermal growth factor receptor staining (p less than 0.0001) and a significant increase in p53 staining (p less than 0.05). Most of the tumours were advanced and no significant relationship was observed between tumour stage and grade and expression of p53, the epidermal growth factor receptor or c-erbB-2. These findings demonstrate that altered expression of the epidermal growth factor receptor and p53 protein occurs in prostate cancer, but were not associated with other features of prognostic importance such as stage or grade.

The case for samples of anonymized records from the 1991 census

"The census of population represents a rich source of social data. Other countries have released samples of anonymized records from their censuses to the research community for secondary analysis. So far this has not been done in Britain. The areas of research which might be expected to benefit from such microdata are outlined, and support is drawn from considering experience overseas. However, it is essential to protect the confidentiality of the data. The paper therefore considers the risks, both real and perceived, of identification of individuals from census microdata. The conclusion of the paper is that the potential benefits from census microdata are large and that the risks in terms of disclosure are very small. The authors therefore argue that the Office of Population Censuses and Surveys and the General Register Office of Scotland should release samples of anonymized records from the 1991 census for secondary analysis."

The sample of anonymised records

The author describes the purchase of two samples of anonymized records from the 1991 United Kingdom census and the creation of a center at the University of Manchester to act both as distributor of these data to the academic community and as a focus for research on substantive and methodological topics connected with census microdata. She "describes the legal problems and public sensitivities involved, makes comparisons with other countries' handling of census data, [and] describes the information to be released and the broad types of usage envisaged."

Cell cycling in bladder carcinoma determined by monoclonal antibody Ki67

Current methods of predicting prognosis in transitional cell carcinoma of the bladder fail to provide consistently reliable information about future tumour behaviour. The monoclonal antibody Ki67 recognises an antigen present in actively dividing cells and Ki67 reactivity has been shown to correlate with conventional prognostic indicators in several tumours. In this study, Ki67 antibody was used to determine the proportions of cells undergoing active division in 26 transitional cell carcinomas of the bladder. The proportion of cells stained in muscle invasive tumours (12.3 +/- 5.4%) was significantly greater than in superficial tumours (4.3 +/- 1.9%) and poorly differentiated tumours showed significantly greater proportions of cells staining compared with well or moderately well differentiated tumours. These results show that Ki67 reactivity correlates with high tumour stage and poor differentiation. Ki67 staining provides an easy method of determining tumour cell turnover that might provide additional prognostic information.

Pattern of postprandial carbohydrate metabolism and effects of portal and peripheral insulin delivery

The importance of portal insulin delivery in the regulation of postprandial carbohydrate metabolism is uncertain. To address this question, three groups of dogs were studied: one group in which pancreatic venous drainage was transected and reanastomosed (portal insulin delivery), one in which the pancreatic drainage was transected and anastomosed to the inferior vena cava (peripheral insulin delivery), and one that received only a sham operation. Plasma insulin was greater (P less than 0.05) during peripheral insulin delivery than in either the portal or sham groups, respectively, before and after meal ingestion. On the other hand, C-peptide concentrations did not differ between groups, resulting in a higher (P less than 0.001) insulin to C-peptide ratio in the peripheral group. This indicated that the hyperinsulinemia in the peripheral group was due to decreased insulin clearance rather than increased insulin secretion. Isotopically determined splanchnic uptake of ingested glucose, postprandial suppression of hepatic glucose release, incorporation of CO2 into glucose (a qualitative measure of gluconeogenesis), and total-body glucose uptake were virtually identical in all groups. Similarly, plasma lipid, beta-hydroxybutyrate, and lactate concentrations did not differ between groups. Our data indicate that, despite differences in systemic insulin concentration, portal and peripheral insulin delivery comparably regulate hepatic and extrahepatic carbohydrate metabolism after meal ingestion.

The Cerium(IV)-Induced Decomposition of Peroxymonosulfate: Acid Dependence and Peroxydisulfate Formation

An improved rate law for the CeIV-induced decomposition of HOOSO3- in aqueous H2SO4 has been established by study of the rate as a function of acidity. In aqueous HClO4 the rate is much faster but a rate law could not be obtained. Peroxydisulfate, by a variant of the AsIII and FeII analysis of the redox system, has been shown to be formed in the amount of half of the CeIV lost. A free-radical chain mechanism is postulated.

Research policy and review 23. The view of academic social scientists on the 1991 U.K. Census of Population: a report of the Economic and Social Research Council Working Group

This is a report on the survey conducted for the United Kingdom Census Office by the Economic and Social Research Council (ESRC) concerning the 1991 census. "The primary task was to solicit views on the priority which [academic social scientists] attached to the proposed topics to be covered by the Census and to ascertain their views on the changes in question wording which are under consideration.... Views were also sought on different methods for giving academics access to individual-level data from the 1991 Census."

"A-wave" liver

The finding and timing of hepatic pulsations can provide important information regarding the status of right heart structures and function. We report a 54-year-old woman with idiopathic dilated cardiomyopathy, who had prominent hepatic presystolic pulsations ("A-wave" liver). The clinical findings and the venous and hepatic pulse recordings are presented and discussed in terms of clinical pathophysiology and significance.

Carbohydrate residues in non-malignant prostatic epithelium as revealed by lectins

Non-neoplastic prostatic epithelium from 39 patients obtained at transurethral resection for outflow tract obstruction and 5 normal prostates from men under 35 years of age obtained at postmortem were formalin-fixed and paraffin-embedded. The distribution of 8 lectin receptors were studied using a peroxidase anti-peroxidase method and an avidin-biotin method. Con A, WGA, and PNA bound to most epithelial cells. Con A and WGA also showed major stromal binding. Approximately 5% to 10% of cells bound UEA1, GS1, DBA, SBA and BPA. No major differences in lectin receptor expression were observed between normal and hyperplastic epithelium with either of the immunohistochemical techniques except that hyperplastic cells stained more strongly than normal epithelium.

Detection of blood group antigens in frozen sections of prostatic epithelium

The detection of blood group antigens (BGA) in non-malignant prostates by previous workers has been at best inconsistent. BGA have not before been detected in prostatic carcinomas. In this preliminary study, a variety of anti-BGA reagents, with known specificities that involve the carbohydrate backbone in addition to the BGA specific terminal monosaccharides, were used to study the expression of the A and H (O) BGA in cryostat sections of 16 patients with benign prostatic disease and nine with prostatic cancer. Positive staining, appropriate to the patients' blood group, was seen in all of the benign tissues when anti-BGA reagents that included specificity against type 2 backbone structures were used. Staining was absent, however, if the reagent had only type 1 specificity. The anti-A and anti-H (O) reagents which gave the best staining patterns in benign tissues were used in malignant tissues. No cancer was found to express A antigen but eight of the nine prostatic cancers were positive for the H (O) antigen irrespective of blood group. Using fresh frozen material and appropriate reagents, BGA may be reproducibly detected in the epithelium of all non-malignant prostates, suggesting that a significant component of BGA is probably lipid-based on type 2 carbohydrate backbone chains. Further studies of changes in BGA expression in prostatic cancer are warranted.

Epidermal growth factor receptors in non-small cell lung cancer

The epidermal growth factor receptor is homologous to the oncogene erb-beta and is the receptor for a class of tumour growth factors (TGF-alpha). The clinical correlations with its expression were studied in 77 non-small cell lung cancers (NSCLC). They were stained for epidermal growth factor receptor (EGFr) by means of an indirect immunoperoxidase technique using a monoclonal antibody against the receptor. Normal lung tissue and normal bronchus were stained for comparison. Cancer tissue showed significantly increased staining compared to normal lung (P less than 0.05). Staining for EGFr in 40 squamous carcinomas was significantly stronger than in 37 specimens of other types of NSCLC (P less than 0.05), and staining in stage three NSCLC was stronger than in stage 1 and 2 (P less than 0.05). These results suggest that the presence of a high intensity of staining for EGF receptor is associated with spread of human non-small cell lung cancer and this receptor may be a suitable target for therapy.

Precision of dual photon absorptiometry measurements

One of the important uses of bone absorptiometry is to examine the rate of bone mineral change in order to evaluate therapy and to identify individuals who need therapy. Generally, this involves comparing the difference between two scans obtained months to years apart. This study investigates the precision of dual photon absorptiometry using a human torso phantom, normal subjects, and abnormal patients. These studies showed that bone mineral calculated as g/cm2 was more precise than g/cm. Reanalysis of the same scan by the same individual produced an average error equivalent to that produced by scanning and analyzing the same subject on multiple occasions. Interobserver analysis error was essentially equal to the intraobserver error. In order to obtain maximum precision, care must be taken that the integrated area of a repeat scan is identical to the previous scan. Our findings indicate that to be confident (95%) of a real change between two scans a difference of at least 5.6% must be measured.

Relaxation times of normal and atrophied muscle

Magnetic resonance imaging is being used to investigate physiological changes induced by microgravity. Using human (bed rest) and animal (tail suspension) models simulating zero gravity, muscle atrophy was studied. Despite significant physiological changes in muscle mass, distribution of blood flow, and muscle water, no changes in muscle proton relaxation times were found at several different resonant frequencies (6, 10, 20, and 200 MHz). These results suggest that observed changes in relaxation times as reported in pathologic studies are likely due to the pathological changes and not the accompanying muscle atrophy.

Bone and muscle atrophy with suspension of the rat

A modification of the Morey tail suspension model was used to determine atrophic responses of rat bone and muscle with 14-90 days unloading of the hindlimbs. Bone uptake of methylene diphosphonate followed a phasic pattern similar to changes in bone formation rate in immobilized dogs and rats. Increased uptake at 60 days (P = 0.01, femur) indicated an increased bone metabolism. Regional densitometry demonstrated a preferential loss of bone mineral in the trabecular mass (P = 0.02) at 30 days and in the cortical shaft by 90 days (P = 0.03). Maximal muscle atrophy occurred within 14-30 days. The gastrocnemius was less severely affected by suspension than by immobilization techniques, whereas the soleus atrophied (by weight) similarly, suggesting that muscle atrophy in the suspension model is distinctly different from immobilization atrophy. One significant response of skeletal muscle to suspension was an altered blood distribution. Muscle blood distribution changes reflect the hypodynamic state of muscle that continues to contract but probably at an altered rate in response to altered functional demands.

Epidermal-growth-factor receptors in human bladder cancer: comparison of invasive and superficial tumours

The presence of epidermal-growth-factor (EGF) receptors in normal and neoplastic human urothelium was studied in 12 control patients and in 48 patients with transitional cell carcinoma of the bladder, 24 with invasive (pT3) and 24 with superficial tumours (9 pT1, 15 pTa). EGF receptors were identified on frozen sections by means of an indirect immunoperoxidase technique with a monoclonal antibody against the EGF receptor. Significantly more invasive tumours (21 of 24) than superficial (7 of 24) were stained positively for the EGF receptor (X2 = 14.49; p less than 0.001). Significantly more poorly differentiated tumours (18 of 21) than moderately differentiated tumours (10 of 27) were EGF-receptor positive (X2 = 9.6; p less than 0.01). No control sample stained positively for the EGF receptor. These findings suggest that the presence of a high intensity of staining for the EGF receptor in human bladder tumours is associated with poor differentiation and with invasion.

Identification and characterization of species of the family Bacteriodaceae by polyacrylamide gel electrophoresis

Polyacrylamide gel electrophoresis was used to compare protein profiles of members of the family Bacteriodacceae. Cell-free extracts were prepared and the protein components separated by multistage polyacrylamide gel electrophoresis. The profiles were distinct and reproducible thus allowing identification of species, subspecies, and minor strain differences. Lyophilization of the cell-free extracts did not alter the major protein components. The results indicate that the techniques used may be useful in conjunction with conventional tests in identification at the species level.