A physiologic events' cascade: irritable bowel syndrome may even terminate with chronic gastritis

When specifically asked, about one third of people report recurrent upper abdominal discomfort, and irritable bowel syndrome (IBS) and chronic gastritis (CG) maybe the most frequently diagnosed ones among all. Consecutive patients with upper abdominal discomfort applying to the Internal Medicine Polyclinic were included into the study. IBS was diagnosed according to Rome II criteria and CG was diagnosed histologically. All cases with IBS were compared with the age and sex-matched randomly selected cases without IBS. One hundred and fifty-six patients with IBS and 179 patients without IBS were studied. CG was detected in 72.4% (113 cases) of cases with IBS, and only 36.3% (65 cases) in patients without IBS (p < 0.001). IBS probably is a cascade of many physiological events, being initiated by infection, inflammation, psychological disturbances-like many stresses and eventually leading to dysfunctions of gut and other systems of the body via a low-grade inflammatory process. CG may be one of the terminating points of the physiological events' cascade, IBS. This may explain the high prevalence of IBS in society. Keeping in mind this association will be helpful during prevention, treatment, and follow up of these common pathologies in Primary Health Centers and Internal Medicine and Gastroenterology Polyclinics for physicians.

Practical cut off values to determine body mass index

We tried to understand whether there are significant cut off values simply determining body mass index (BMI). The study was performed in Internal Medicine Polyclinics on consecutive check up patients aged between 15 and 70 years to see possible consequences of excess weight on health and to avoid debility induced weight loss in elders. Insulin using diabetics and patients with devastating illnesses were excluded to avoid their possible effects on weight. Cases were subdivided into three groups according to their body weights as under 65, between 65 and 85, and above 85 kg groups and prevalences of underweight, normal weight, overweight, and obesity were determined. Sensitivity, specificity, and positive and negative predictive values of body weights to determine BMI were calculated. The study included 954 cases (566 females). Sensitivity of 65 kg as a cut off value to detect normal weight was 61.0%, specificity 94.3%, positive predictive value 82.9%, and negative predictive value was 97.6%. Similarly, sensitivity, specificity, and positive and negative predictive values of 65 and 85 kg to detect overweight cases were 71.5%, 63.3%, 56.2%, and 77.1% respectively. So both values were statistically significant to detect normal weight, overweight and obese individuals (p = 0.000 for both). Although BMI is probably a more valuable parameter to show weight status, the cut off values of 65 and 85 kg, as an easier way, have significant places, too.

Host range and infectivity of Heterorhabditis bacteriophora (Heterorhabditidae) from Ukraine

Entomopathogenic nematodes (EPNs) in the genera Steinernema and Heterorhabditis (Rhabditida: Steinernematidae and Heterorhabditidae, respectively) represent a most promising group of pathogens that are lethal to many soil-inhabiting insects. Ukraine has Lagged behind of Eastern European countries in apply studies of entomopathogenic nematodes. Recently, Heterorhabditis bacteriophora were extracted from soils in the Central Forest Steppe areas of Ukraine using Galleria mellonella traps and identified with PCR. Infection were carried out in Laboratory to determine the host range, specificity and virulence of H. bacteriophora ukr. isol. It was shown that this nematode infected a wide range of insect species. Of the 14 tested insects which belong to four orders , all were susceptible to nematode species with mortality ranges from 12 to 96%. Infectivity did differ within each host. The most favorable hosts were Lepidopterans and coleopterans. The virulence of H. bacteriophora was measured by one-on-one bioassay. H. bacteriophora caused 60% mortality at 5 infective juveniles per Galleria mellonella larvae. LD50 values were 3 +/- 1. Nematodes reproduced and completed their cycle with IJ production in all four orders. H. bacteriophora ukr. isoL.. developed preferably in immature insect stage. Percentage of emergence form cadavers that produced progeny were higher for Lepidoptera and Coleopteran species. Progeny production were not related to the biomass of the cadavers. Because of wide range of insect species Heterhorobditis bacteriophora ukr. isol. has potential for control economically important pests in Ukraine. Further studies should be focused at ecological characterization of isolated H. bacteriophora and carrying out survey of entomopathogenic nematodes.

Immunoexpression of HER family, neuregulin, MAPK and AKT in invasive ductal carcinomas of the breast

BACKGROUND

The purpose of this study was to investigate the frequency of expression of the erbB/HER family of growth factor receptors, their ligand neuregulinalpha (NRGalpha) and the most important pathways activated by HER receptors that are mitogen-activated protein kinase (MAPK) and serine/threonine kinase (AKT) in invasive ductal carcinomas of the breast, not otherwise specified (IDC-NOS).

METHODS

59 of the IDC-NOS of the breast were studied for ER, PR, EGFR, c-erbB-2, c-erbB-3, c-erbB-4, neuregulin Ab-3, phospho-AKT, and phospho-p44/42 map kinase using the streptavidin-biotin horseradish method.

RESULTS

Of the 59 tumours, 44 (75%) were ER+, 37 (63%) PR+, four (7%) EGFR+, seven (12%) c-erbB-2+, seven (12%) c-erbB-3+ and 14 (24%) c-erbB-4+alpha. Strong cytoplasmic and/or nuclear immunoexpression was revealed in 17 (29%) cases for NRGalpha, 13 (22%) cases for p-AKT, and nuclear immunoexpression with p-MAPK was found in 17 (29%) cases.

CONCLUSION

The results suggest that high-grade breast carcinomas are not only associated with ER/PR- negativity, but seem to be activated by receptor tyrosine kinase growth factors.

Survival and secondary malignancy rates for adjuvant radiation therapy versus observation in stage I testicular seminoma: A Surveillance, Epidemiology, and End Results (SEER) analysis

5020

Background: The standard adjuvant treatment for men with stage I testicular seminoma remains controversial within the literature. We analyzed survival and secondary malignancy rates in men with stage I seminoma who underwent adjuvant radiation therapy (RT) or observation (OB) following orchiectomy. Methods: Data was obtained from the Surveillance, Epidemiology, and End Results program (SEER) of the U.S. National Cancer Institute from 1973 - 2003. The primary end points were overall survival (OS) and cause-specific survival (CSS). Multivariate Cox regression models were utilized to study the significance of clinical variables: age at diagnosis, laterality of primary disease, race (white, black, American Indian, Asian/pacific islander) and radiation group. Standardized incidence ratios (observed-to-expected [O/E] ratio) and absolute excess risks of secondary malignancies were also assessed for each subgroup. Results: Out of 6,764 patients eligible for analysis, 5,265 were treated with RT and 1,499 with OB. After a median follow up of 7.6 years, the 5-, 10- and 20- year OS rates for the RT versus OB were 97.9 vs. 95.0; 92.2 vs. 92.2; and 83.6 vs. 84.1 (p= 0.005), respectively. The CSS rates for the same time periods were 99.6 vs. 98.7; 99.2 vs. 98.7; and 99.2 vs. 98.7 (p= 0.002), respectively. Adjuvant RT was associated with improved CSS on multivariate analysis with HR 0.37 (CI 0.19–0.70, p= 0.002). Overall, 312 patients developed secondary malignancies which was significantly higher than the endemic rate (O/E 1.43, p<0.05). RT patients had an increased rate of secondary malignancies when compared with the OB population (O/E 1.93, p<0.05). RT population were at excess risk for contralateral testicular, pancreatic, and hematologic malignancies (p<0.05). Conclusions: Within this large United States population analysis, adjuvant RT was associated with improved CSS for men with stage I testicular seminoma. The incidence of secondary malignancies was also found to be significantly increased for the RT group. Further studies are needed to determine if modern RT techniques and field-size reductions may lead to improvements in the therapeutic ratio.

No significant financial relationships to disclose.

Clinical outcome of node-negative (NN) breast cancer (BC) patients

11102

Background: Breast cancer patients (pts) with NN disease have diverse clinical outcomes. An optimal treatment decision- making tool has not been defined for this heterogeneous group. Methods: We identified pts with NN disease who have been treated between 1998–2006 in our department. We recorded the clinical/pathological, treatment characteristics and analyzed their survival outcome. High risk (HR) was defined as having at least one of the following features: age<35 yr-old, pts with grade 3 tumors (tms), ER and PR negative tms, tm size >2 cm. Results: Out of 597 early BC pts, 275 pts with NN disease were identified, 190 pts with HR, 85 with low risk (LR) features.The median age was 51 (26–83). The median follow up was 40 months (4–120 months). 47% pts were premenopausal. 31% pts had breast conserving surgery (BCS).58/29% pts had grade 2/3 tms. 34% pts with BCS or T3 tms received adjuvant radiotherapy. All receptor positive pts received adjuvant endocrine therapy (ET). In the HRNN group, 5% pts had tms>5cm, 51/40% pts had grade 2/3 tms, 43% pts had ER/PR negative tms. In the LRNN group 25/74% pts had grade 1/2 tms, no pt had receptor negative tm. 86%/51% pts received adjuvant chemotherapy (CT) in the HR and LRNN groups. 12%/48% pts received adjuvant ET alone in the HR and LRNN groups. 5pt in the HR and 1 pt in the LR group received no adjuvant systemic therapy due to their comorbidities and/or negative receptor status. So far, 14 pts had relapsed (8 from the HR, 6 from the LR group) and 3 pts died due to BC (1 from the HR, 2 from LR group). The 5-yr DFS was %94 in the HR and was %90 in the LR groups. HRNN pts had %98 and LRNN pts had %95 5-yr OS. Conclusion: It seems that prognostic information based merely on clinical/pathological characteristics might not accurately quantify the risk of recurrence and death, so that the decisions about adjuvant chemotherapy in NN breast cancer patients. Prospective evaluation of the performance of the new genomic prognostic tools compared to traditional prognostic factors is needed in order to more clearly define the HR vs LR subsets of NNBC pts.

No significant financial relationships to disclose.

Survival outcomes for multiple myeloma over three decades: A Surveillance, Epidemiology, and End Results (SEER) analysis

8019

Background: There is limited data regarding survival outcomes for multiple myeloma in the literature. The purpose of this study was to analyze how patient characteristics and decade of treatment affect overall survival (OS) and cause-specific survival (CSS) for patients within a large United States (US) population database. Methods: Data were obtained from the Surveillance, Epidemiology, and End Results Program (SEER) of the US National Cancer Institute for the years 1973–2003. Patient characteristics (gender, race, age) and year of diagnosis were analyzed by multivariate Cox regression analysis for both OS and CSS endpoints. Results: 40,538 patients were included in the analysis. The mean age at diagnosis was 68.3 (median 69) years. Mean survival for the entire cohort was 41 (median 24) months. Females had better OS than males, hazard ratio (HR) 0.91 (CI 0.89–0.93, P = 0.0001), and CSS, HR 0.96 (CI 0.93–0.98, P = 0.004). There were no significant differences in OS between white and black race (P = 0.34), but black race was associated with improved CSS, HR 0.89 (CI 0.86–0.93, P = 0.0001). Younger age (age <40, 41–60, 61–70, and 71–80) was associated with improved OS and CSS (all P = 0.0001). Early treatment decade (1973–1985) was associated with diminished OS and CSS on multivariate analysis with HR 1.11 (CI 1.08–1.14, P = 0.0001) and HR 1.12 (CI 1.08–1.16, P = 0.001), respectively. Conclusions: This is the largest reported population analysis of survival outcomes for multiple myeloma. It covers three decades of care in the United States. This study reveals that improved OS and CSS are associated with younger age, female gender, and recent decade of treatment. We believe that survival improvement in recent treatment decades may be due to advances in supportive care and/or earlier diagnosis as the standard treatment for myeloma did not significantly change during this time period. Follow up studies may show dramatic improvements in survival outcomes due to modern myeloma therapies in this decade.

No significant financial relationships to disclose.

[Table: see text]

Chromatin assembly factor 1 ensures the stable maintenance of silent chromatin states in Arabidopsis

Newly synthesized DNA is rapidly assembled into mature nucleosomes by the deposition of pre-existing and nascent histones, and some parts of this process are facilitated by chromatin assembly factor 1 (CAF-1). Loss-of-function mutants of CAF-1 in Arabidopsis, fasciata (fas), show a variety of morphological abnormalities and unique defects in gene expression in the meristems. In order to clarify the implications of CAF-1 in the maintenance of chromatin states in higher eukaryotes, we investigated transcriptional gene silencing (TGS) of various genes in fas mutants. Here, we show that TGS of endogenous CACTA transposons was released in a stochastic manner in fas. Other endogenous silent genes, a transposon AtMu1 and a hypothetical gene T5L23.26 at a heterochromatin knob, were also transcriptionally activated, and the activation of the three different silent loci at different chromosomal sites occurred non-concomitantly with each other. Furthermore, TGS of the silent beta-glucuronidase (GUS) transgene was also de-repressed randomly in fas. We conclude that CAF-1 ensures the stable inheritance of epigenetic states through growth and development in Arabidopsis.

Nephrogenic adenoma of the ureter: case report

Nephrogenic adenoma is a rare metaplastic benign lesion of urothelium in response to genitourinary tract procedures, chronic infection, trauma, urinary calculi and immunosuppressive therapy after renal transplantation. It has been reported to occur throughout the urinary tract especially, in the urinary bladder. We report a case of nephrogenic adenoma arising from the lower end of the right ureter with clinical and radiological features suspicious of carcinoma.

Effect of obesity on P-wave dispersion and QT dispersion in women

OBJECTIVE

The aim of this study was to investigate the effect of obesity on dispersion of P-wave duration and QTc interval in obese women.

METHODS

Forty-two obese women (Body mass index (BMI)=40+/-3 kg/m(2), mean age 45+/-9 years) and compared age-matched (BMI=22+/-1 kg/m(2), mean age 41+/-6 years) twenty-five non-obese women were included in our study. Maximum and minimum P-wave duration, P-wave dispersion (difference between the maximum and the minimum P-wave duration), maximum and minimum QTc interval, and QTc dispersion (the difference between the maximum and the minimum QTc interval) were measured from 12-lead ECG. ECG's were transferred to a personal computer via a scanner and then used for magnification of 400 times by Adobe Photoshop software.

RESULTS

There was significant difference in BMI (40+/-3 vs 22+/-1 kg/m(2), P<0.001, respectively) between obese and non-obese women. Obese women had higher Max. P-wave duration (116+/-11 vs 94+/-14 ms, P<0.001), P-wave dispersion (51+/-15 vs 26+/-11 ms, P<0.001), Max. QTc interval (449+/-38 vs 419+/-30 ms, P<0.001) and QTc dispersion (57+/-23 vs 38+/-15 ms, P<0.001) compared to non-obese women. A significant correlation was found between BMI and Max. P-wave duration (r=0.584, P<0.001), P-wave dispersion (r=0.621, P<0.001), Max. QTc interval (r=0.410, P<0.001), and QTc dispersion (r=0.429, P<0.001). In the linear regression analysis, compared to co-morbidity factors such as age, hypertension, diabetes mellitus and smoking, there was significant association between only BMI and electrocardiographic values (P-wave and QTc dispersion).

CONCLUSION

We concluded that obesity caused significant increase in P-wave and QTc dispersion. Therefore, obese women may not only be under the risk of ventricular arrhythmias, but also they may under the risk of atrial arrhythmias.

HPV DNA frequency and subset analysis in human breast cancer patients' normal and tumoral tissue samples

Viruses are known to be associated with human malignancies, e.g., Epstein-Barr virus, human papillomavirus (HPV) and human T-cell leukemia virus type I. We conducted a prospective study to define the role of HPV in breast cancer. The malignant and normal breast tissue samples of 50 consecutive breast cancer patients were obtained postoperatively. DNA extracted from all tissues was amplified with the polymerase chain reaction using HPV primers. HPV 11, 16, 18, 33 subtypes were searched in HPV-DNA positive samples. Thirty-seven samples (74%) of tumoral breast tissue expressed HPV-DNA, 16 normal breast tissue samples (32%) were positive as well. There was a significant difference in HPV-DNA positivity between normal and tumoral breast tissue samples. HPV 18 was detected in 20 of the HPV-DNA positive tumoral tissue (54.4%) and in 9 of the HPV-DNA positive normal tissue (56.3%). HPV-33 also was detected in 35 (94.6 %) of the HPV-DNA positive tumoral tissue and in 14 (87.5 %) of the HPV-DNA positive normal tissue samples. HPV DNA was significantly associated with breast tumor tissue compared to normal breast tissue. Additional studies looking at HPV and HPV subtypes are needed to clarify the etiological role of the HPV in breast cancer.

Increased frequency of homologous recombination and T-DNA integration in Arabidopsis CAF-1 mutants

Chromatin assembly factor 1 (CAF-1) is involved in nucleo some assembly following DNA replication and nucleotide excision repair. In Arabidopsis thaliana, the three CAF-1 subunits are encoded by FAS1, FAS2 and, most likely, MSI1, respectively. In this study, we asked whether genomic stability is altered in fas1 and fas2 mutants that are lacking CAF-1 activity. Depletion of either subunit increased the frequency of somatic homologous recombination (HR) in planta approximately 40-fold. The frequency of transferred DNA (T-DNA) integration was also elevated. A delay in loading histones onto newly replicated or repaired DNA might make these DNA stretches more accessible, both to repair enzymes and to foreign DNA. Furthermore, fas mutants exhibited increased levels of DNA double-strand breaks, a G2-phase retardation that accelerates endoreduplication, and elevated levels of mRNAs coding for proteins involved in HR-all factors that could also contribute to upregulation of HR frequency in fas mutants.

A giant adrenal pseudocyst: case report and review of the literature

A 45-year-old woman whose MR images revealed a lobulated, complicated cyst with septations on the superior pole of left kidney underwent retroperitoneoscopic cyst marsupialization. In pathologic examination beneath the atrophic adrenal gland, hyalinized, calcification foci cyst wall without any surrounding epithelium was seen microscopically. It was reported to be "adrenal pseudocyst".

Seroprevalence of hepatitis C in patients with type 2 diabetes mellitus and non-diabetic on haemodialysis

Type 2 diabetes mellitus (DM) has emerged as the commonest cause of end-stage renal disease. Haemodialysis (HD) treatment constitutes a high-risk environment for the transmission of hepatitis C virus (HCV). The aim of this study was to establish a potential relationship between type 2 DM and HCV infection in HD patients. Of the 267 HD patients, 67 (25.1%) had type 2 DM and 200 (74.9%) were with diverse aetiology for end-stage renal disease. The serum markers of HCV infection were tested by a second-generation enzyme-linked immunosorbent assay test for antibodies and by qualitative reverse-transcription polymerase chain reaction technique for viral RNA. The overall prevalence of anti-HCV antibodies and HCV RNA was found to be 12.7% (34/267) and 10.1% (27/267), respectively. Patients with type 2 DM were found to have a higher HCV prevalence compared with non-diabetic patients [20.8% (14/67) vs. 10% (20/200)] (p < 0.05). The mean period on dialysis of anti-HCV-positive patients with type 2 DM was shorter than that observed for anti-HCV-positive non-diabetic patients (43.9 +/- 9.8 months vs. 59.7 +/- 28.4 months) (p < 0.05). This study has shown that although the period on dialysis of diabetic patients are shorter than non-diabetic patients, the prevalence of HCV in HD patients with type 2 DM is higher than that detected in non-diabetic HD patients.

Comparison of xenografting in SCID mice and LIVE/DEAD assay as a predictor of the developmental potential of cryopreserved ovarian tissue

This study compared the predictive value of the LIVE/DEAD fluorescence viability assay to xenotransplantation in SCID mice, regarding the developmental potential of cryopreseved human ovarian tissue for fertility preservation purposes. The thawed ovarian tissue of ten patients was partly examined by LIVE/DEAD viability staining or histologically examined after transplantation and gonadotropin stimulation in 30 SCID mice. The LIVEIDEAD assay showed 87.1 +/- 3.5% (mean +/-SD, n=10) viable follicles (intact oocyte and more than 50% of granulosa cells alive). Histological examination showed follicles in all developmental stages in the transplanted grafts. The total number of follicles found was much lower than with the LIVE/DEAD assay (8.9 +/- 3.1 versus 54.4 +/- 20.0, p < 0.001). If the LIVE/DEAD assay yields > approximately 85% viable follicles, it can be assumed that the follicles in the cryopreserved tissue have maintained their developmental potential. This assay is, therefore, a suitable diagnostic method before an intended retransplantation.

Cell-cycle-dependent regulation of oxidative stress responses and Ca2+ permeable channels NtTPC1A/B in tobacco BY-2 cells

Plants are always exposed to the menace of oxidative stress and protect themselves by activating a variety of defense responses. However, molecular mechanisms for oxidative stress-induced gene expression are largely unknown. We here studied the roles of the oxidative stress-responsive putative voltage-dependent Ca(2+) permeable channels, NtTPC1A and NtTPC1B, and cell cycle in H(2)O(2)-induced expression of antioxidant enzymes, glutathione peroxidase (GPX) and ascorbate peroxidase (APX), in tobacco BY-2 cells. H(2)O(2)-induced [Ca(2+)](cyt) rise and expression of GPX and APX were inhibited by the cosuppression of NtTPC1A/B as well as Al ion, a specific blocker for NtTPC1s, and enhanced by overexpression of AtTPC1, suggesting that NtTPC1s are the major Ca(2+)-permeable channels activated by H(2)O(2) and that Ca(2+) influx via NtTPC1s is involved in induction of H(2)O(2)-triggered gene expression. Oxidative stress-induced signal transduction mechanisms were highly dependent on the phases of the cell cycle; H(2)O(2)-induced [Ca(2+)](cyt) rise and expression of GPX and APX as well as the level of NtTPC1s transcripts correlated with each other and were maximal at G1 phase. In contrast, the cell cycle-dependence of hypoosmotic shock-induced [Ca(2+)](cyt) rise that is known to be independent of NtTPC1s was almost reverse and maximal at S phase. These results suggest that the cell cycle-dependent regulation of oxidative stress-induced [Ca(2+)](cyt) rise and expression of NtTPC1s contribute to the cell cycle dependence of H(2)O(2)-induced expression of peroxidases. Various Ca(2+)-mediated signal transduction pathways are differentially regulated by the cell cycle.

Gamma probe-guided surgery for revision thyroidectomy: in comparison with conventional technique

Reoperative thyroid surgery may be required in patients who undergo any procedure less than total or near total thyroidectomy. The aim of this study was to investigate advantages of gamma-probe guided revision thyroidectomy (GGRT) over conventional revision thyroidectomy (CRT) in patients with differentiated thyroid carcinoma (DTC). GGRT was assessed according to the TSH values, complication rates and the incidence of carcinoma in residual thyroid tissue. In this randomised prospective clinical trial, 25 patients with differentiated thyroid carcinoma who had previously undergone surgery for benign multinodular goiter were included in the study. GGRT was performed in 11 (44%) patients (Group 1) and CRT in 14 (65%) (Group 2). The intraoperative mean ratio of thyroid activity to background activity (T/B) was detected as 5.1 +/- 1.4 and the mean ratio of thyroid bed activity to background activity after excision (Tbed/B) was 1.3 +/- 0.3, (p < 0.01). Although the incidence of carcinoma in residual thyroid tissue was higher in group 1 (4/11) in comparison to group 2 (1/14), it was not statistically significant. The elevation of the TSH concentration at the first post-operative month was significantly higher in group 1 in comparison with group 2 (18 +/- 25 5 +/- 3 mlU/l), (p < 0.02). These results indicate that intraoperative gamma probe application may be beneficial to detect and remove residual thyroid tissue in revision thyroidectomy.

Lipid peroxidation at various estradiol concentrations in human circulation during ovarian stimulation with exogenous gonadotropins

The aim of our study was to investigate the correlation between serum malondialdehyde levels and serum estradiol concentrations in healthy human female subjects. Nine hundred and fifty-five blood samples, from infertile women undergoing controlled ovarian hyperstimulation treatment with recombinant follicle-stimulating hormone, were collected for estradiol and malondialdehyde measurements. Five groups were formed according to serum estradiol levels: Group I (< 50 pg/ml), group II (50 - 299 pg/ml), group III (300-999 pg/ml), group IV (1000-1999 pg/ml) and group V (> or = 2000 pg/ml). One-way analysis of variance was used for comparisons. Mean malondialdehyde concentrations were 1.74 +/- 0.24 mmol/ml (group I), 1.53 +/- 0.20 mmol/ml (group II), 1.69 +/- 0.24 mmol/ml (group III), 1.77 +/- 0.21 mmol/ml (group IV) and 1.86 +/- 0.20 mmol/ml (group V), respectively. Mean serum malondialdehyde level at physiological estradiol concentrations (50-199 pg/ml, group II) was significantly (p < 0.01) lower than the mean malondialdehyde levels in other groups. Mean malondialdehyde concentrations among the remaining groups did not significantly differ. Our findings suggest that in vivo lipid peroxidation might be increased when circulating estradiol concentrations are below (< 50 pg/ml) or above (> 300 pg/ml) the physiological limits. High blood estradiol levels in human female subjects during ovarian stimulation with exogenous gonadotropins could be associated with increased serum malondialdehyde concentrations.

BRU1, a novel link between responses to DNA damage and epigenetic gene silencing in Arabidopsis

DNA repair associated with DNA replication is important for the conservation of genomic sequence information, whereas reconstitution of chromatin after replication sustains epigenetic information. We have isolated and characterized mutations in the BRU1 gene of Arabidopsis that suggest a novel link between these underlying maintenance mechanisms. Bru1 plants are highly sensitive to genotoxic stress and show stochastic release of transcriptional gene silencing. They also show increased intrachromosomal homologous recombination and constitutively activated expression of poly (ADP-ribose) polymerase-2 (AtPARP-2), the induction of which is associated with elevated DNA damage. Bru1 mutations affect the stability of heterochromatin organization but do not interfere with genome-wide DNA methylation. BRU1 encodes a novel nuclear protein with two predicted protein-protein interaction domains. The developmental abnormalities characteristic of bru1 mutant plants resemble those triggered by mutations in genes encoding subunits of chromatin assembly factor (CAF-1), the condensin complex, or MRE11. Comparison of bru1 with these mutants indicates cooperative roles in the replication and stabilization of chromatin structure, providing a novel link between chromatin replication, epigenetic inheritance, S-phase DNA damage checkpoints, and the regulation of meristem development.

Unstable thin films: new questions

We consider recent developments in the theory and modelling of unstable thin films, pointing out some recently suggested alternative routes and methods to account for phenomena such as nucleations and density fluctuations.

Expression of NM23 and tenascin in invasive ductal carcinomas of the breast

OBJECTIVE

In this series of ductal carcinoma of the breast, immunoexpression of antimetastasis gene nm23 and tenascin was examined and the role in prognosis was investigated by correlation with the tumour grade and stage, and ER/PR immunoexpression.

MATERIAL AND METHODS

In this study 27 ductal carcinomas of the breast were analysed for expression of tenascin and nm23 antimetastasis genes by immunohistochemistry.

RESULTS

The results of our study revealed a statistically significant correlation between nm23-H1 immunoexpression and lymph node metastasis. We also found a statistically significant correlation between tenascin and nm23-H1 immunoexpression. Our results suggest that tenascin limits tumour spread.

CONCLUSION(S)

Antimetastasis gene expression can be used in predicting lymph node metastasis in ductal carcinomas of the breast.

Drug resistance in epithelial ovarian cancer: P-glycoprotein and glutation S-transferase. Can they play an important role in detecting response to platinum-based chemotherapy as a first-line therapy

OBJECTIVE

Drug resistance is important for the treatment of ovarian cancer. P-glycoprotein and glutation S-transferase as resistance markers play an important role in the effectivity of chemotherapeutical agents. The role of P-glycoprotein and glutation S-transferase in the treatment of epithelial ovarian cancer is not well understood. We investigated the relation between P-glycoprotein and glutation S-transferase level for response to platinum-based chemotherapy in epithelial ovarian cancer.

MATERIAL AND METHODS

We reviewed 30 cases diagnosed as epithelial ovarian cancer and treated with platinum-based chemotherapy in the Department of Obstetrics and Gynecology, Akdeniz University School of Medicine. The material was attained from initial parafin-embeded blocks stained for P-glycoprotein and glutation S-transferase. The cases that were diagnosed and treated before attending our clinic were not enrolled in the study.

RESULTS

Mean age was 58.2 (25-70) and mean gravida 4.1 (0-10). Twenty-four patients (80%) were glutation S-transferase positive. Three cases (10%) out of 30 had positive reaction for P-glycoprotein. No difference was revealed regarding chemotherapy response rate among the cases showing glutation S-transferase positivity and P-glycoprotein negativity.

CONCLUSION

Detection of glutation S-transferase and P-glycoprotein levels in epithelial ovarian cancer tissue is not important for response to platinum-based chemotherapy as a first line.

Parathyroid agenesis: prenatal ultrasonographic features and pathological findings

We report a girl with parathyroid agenesis. The gross anomaly of the long bones was diagnosed prenatally by ultrasound. Pregnancy was terminated at 24 weeks of gestation. There were no other apparent system anomalies except parathyroid gland agenesis and long bone abnormalities. This case is the first reported case of parathyroid agenesis with normal thyroid glands and other systems.

Her-2/neu gene amplification compared with HER-2/neu protein overexpression on ultrasound guided core-needle biopsy specimens of breast carcinoma

Genomic amplification and oncoprotein overexpression of Her-2/neu was studied on ultrasound core needle biopsy specimens of the infiltrative ductal carcinomas of the breast. We performed two colour fluorescence in situ hybridization (FISH) for Her-2/neu and chromosome 17 and compared the FISH results with the immunohistochemical overexpression of Her-2/neu protein by 2 antibodies (DAKO HercepTest and the BioGenex monoclonal antibody AM 134-5M). Furthermore, following radical mastectomy with axillary dissection, Her-2/neu status of the patients were compared with the well known histopathological prognostic factors such as histologic grade, tumor stage, lympho/ vascular invasion, surgical margin status and Paget s disease. Amplification was demonstrated 27% of the cases. Her-2/neu protein overexpression was detected in 47% and 80% of the cases with CB11 and HercepTest respectively. We revealed statistically significant association between the tumor, oncoprotein expression and oncogene amplification (p<0.05). The results of our study showed that combination of IHC and FISH methods enhances the evaluation of tumor genetics at both gene and protein level for the analysis of Her-2/neu in breast carcinoma.

Prevalence of hepatitis C virus and hepatitis G virus in patients with non-Hodgkin's lymphoma

Hepatitis C virus (HCV) and hepatitis G virus (HGV) belong to the same family of flaviviridea. A causative role of HCV infection in the pathogenesis of non-Hodgkin's lymphoma (NHL) has been discussed widely. Little is known about the possible association between NHL and HGV discovered recently. In this study, anti-HCV and HGV-RNA prevalence were investigated in a group of 70 patients with NHL. The results were compared to a control group of 70 age- and sex-matched healthy subjects. One patient in each group (1.4%) was found to be anti-HCV-positive; the difference was not statistically significant (P > 0.05). Five subjects in the patient group (7.1%) were positive for HGV-RNA, while a single subject was positive in the control group (1.4%); the difference was not statistically significant (P > 0.05). Odds ratios for anti-HCV and HGV-RNA were 1 and 5.30, respectively. Our findings suggest that neither HCV nor HGV are causative or contributing factors in the aetiopathogenesis of NHL.

Antimetastasis gene expression and numerical chromosomal abnormalities of chromosomes 1 & 17 in serous tumours of the ovary

OBJECTIVE(S)

The aim of this study was to examine the expression of the antimetastasis gene nm23 and numerical changes on chromosome 1 and 17 in ovarian tumours.

METHODS

In this study 20 serous cystadenocarcinomas, ten borderline and five benign tumours were analysed for expression of the nm23 antimetastasis gene by immunohistochemistry and for numerical chromosomal abnormalities of chromosomes 1 and 17 by interphase cytogenetics.

RESULTS

Strong intracytoplasmic immunoreactivity with the antimetastasis gene was observed in late stage carcinomas but not in benign or borderline tumours or in lymph node metastases. Numerical abnormalities were only observed in carcinomas.

CONCLUSION(S)

These sets of data are consistent with the majority of benign and borderline tumours lacking invasive potential. Odds Ratio (OR) assessment indicates that the presence of numerical aberrations correlates with immunopositivity.

Prognosis and treatment of primary adenocarcinoma and adenosquamous cell carcinoma of the uterine cervix

PURPOSE

To evaluate a cohort of women with primary invasive carcinomas of the uterine cervix, and to compare the biological characteristics and behavior of a cohort of adenosquamous carcinomas with a cohort of adenocarcinomas and squamous cell carcinomas.

METHODS

One hundred and fourteen cases of primary invasive cervical carcinoma presenting between 1 January 1987 and 31 December 1997 were studied. Sixteen (14%) women with adenosquamous cell carcinomas and eight (7%) adenocarcinomas were compared with 90 (79%) women with squamous cell carcinomas. Patients with Stage Ib and IIa were treated by radical hysterectomy and pelvic lymph node dissection. All patients with stage IIb and over were treated by radiation. Patients with bulky, large, barrel-shaped lesions were selected for treatment by a combination of radiation and extrapelvic hysterectomy.

RESULTS

The corrected survival rate for stage Ib patients with adenosquamous cell carcinoma was only 27.2%, compared with a 92.2% corrected survival rate for squamous cell, and a 100% corrected survival rate for adenocarcinoma.

CONCLUSION

There is a higher proportion of adenosquamous cell and adenocarcinoma of the cervix than generally appreciated. The epidemiological risk factors associated with adenosquamous carcinomas of the cervix are more similar to those of squamous cell carcinomas than of adenocarcinomas. The survival difference between two groups is explained by effects of clinical stage, nodal spread, and vascular space involvement.

Prevalence of human papillomavirus (HPV) DNA in larynx and lung carcinomas

In this retrospective study, we investigated the HPV DNA occurrence in 21 laryngeal and 26 primary lung squamous cell carcinomas. Nonisotopic in situ hybridization (NISH) technique was performed with commercially available digoxigenin-labelled DNA probes for HPV screening. Subtyping for HPV subtypes 6/11, 16/18 and 31/33 was also performed. We observed HPV DNA signals in 10 (47.6%) cases of laryngeal SCC and in only 3 (11.5%) cases of lung SCC. Typing showed signals of HPV 6/11, 16/18 and 31/33 infection in 80%, 40%, 30% of the laryngeal carcinomas, respectively. In the lung, we demonstrated type 16/18 positivity in two and type 6/11 in one of the HPV-positive cases. We found a statistically significant correlation between HPV infection and tumour recurrence (p < 0.035) in laryngeal carcinomas, but not between HPV presence and tumour stage or grade in neither larynx nor lung.

Response of human pulpal tissue to orthodontic extrusive applications

The aim of this study was to investigate histologically the human pulp response to orthodontic extrusive force applications. In group 1, 20 teeth were extruded with the use of a fixed sectional orthodontic appliance. In group 2, 20 teeth were extruded by means of 1/4-inch 4.5-oz elastics. The test periods were 10 and 40 days. None of the teeth in the groups showed any inflammatory reactions or reparative dentin formation at the test periods. Five teeth from the elastics group and two teeth from the sectional appliance group showed large and numerous pulp stones in the serial sections (17.5% of all cases). Seven teeth from the sectional appliance group and two teeth from the elastics group showed odontoblast aspiration into the dentin tubules (22.5%). The results of the study showed that the extrusive forces applied in this study did not cause significant pathological changes in human pulp tissue.

Effect of granulocyte-macrophage colony-stimulating factor on treatment of acute osteomyelitis. An experimental investigation in rats

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine that affects the various developmental steps of hematopoietic cells and enhances the phagocytic activity of these cells. The effect of GM-CSF on acute osteomyelitis, developed in rats, was investigated. For this purpose, osteomyelitis was firstly developed through the direct inoculation of Staphylococcus aureus into rat tibial metaphysis. Twenty-four rats in which diagnosis of osteomyelitis was histopathologically established were divided into two groups. Antibiotic only was given to the first group, and antibiotic as well as GM-CSF to the second group. Rats were followed up for 3 months with plain radiographs and scintigraphic methods using 67Ga-citrate. Material obtained from the rats that had been killed at the end of the 3rd month were histopathologically investigated. One rat in the first group died. In another rat, chronic osteomyelitis developed and fracture was observed. In 12 rats of the second group, physical examination, plain radiographs, and histopathologic findings were normal. In scintigraphic studies with 67Ga-citrate, when the pre- and posttreatment value of the same groups were evaluated by the Mann-Whitney U-test, the mean values at 48 h after treatment were found to be significant (P < 0.05), indicating a decrease in the 2nd group (experimental group). In conclusion, the antibiotics were effective in the elimination of infection only together with neutrophils. In this manner, infections may be eliminated by strengthening the host's defense mechanism as well as by administering antibiotics. We believe that an adequate number of long-term studies will shed light on this issue. Besides we consider that this factor will be more important in the study of chronic osteomyelitis.

Congenital vulvar teratoma in a newborn

The most common site of teratomas in neonates is in the sacrococcygeal region. Herein the authors describe a congenital teratoma, and to their knowledge it is the first reported case of vulvar site in a newborn. Tumor was removed on the fourth day of life, and she was completely normal 18 months after the operation. Because of possible malignancy or recurrence, complete surgical excision of the tumor and careful follow-up is the treatment of choice. J Pediatr Surg 36:620-621.

Trisomy 14 with thrombocytosis and monocytosis

It has been reported that trisomy 14 is associated with myeloid malignancies, but a case with increased platelet count has also been reported. However, the clinical significance of trisomy 14 is still uncertain. We report a patient with trisomy 14 with thrombocytosis and a gradual increase in monocytosis. He was treated with hydroxyurea, cytarabine and aclarubicin in low doses and his quality of life was maintained for a period of about 1 year from blastic crisis. Hydroxyurea, cytarabine or aclarubicin in low doses may be the treatment of choice for trisomy 14 patients with respect to the patients' quality of life.

Severe and prolonged febrile myalgia in familial Mediterranean fever

Familial Mediterranean fever (FMF) is characterized by recurrent attacks of fever and serositis. Typical attacks of FMF last 3 to 5 days. Fever and myalgia are not always improved by colchicine therapy and sometimes require steroid therapy. We present two cases of severe prolonged febrile myalgia where steroid therapy was needed.

FASCIATA genes for chromatin assembly factor-1 in arabidopsis maintain the cellular organization of apical meristems

Postembryonic development of plants depends on the activity of apical meristems established during embryogenesis. The shoot apical meristem (SAM) and the root apical meristem (RAM) have similar but distinct cellular organization. Arabidopsis FASCIATA1 (FAS1) and FAS2 genes maintain the cellular and functional organization of both SAM and RAM, and FAS gene products are subunits of the Arabidopsis counterpart of chromatin assembly factor-1 (CAF-1). fas mutants are defective in maintenance of the expression states of WUSCHEL (WUS) in SAM and SCARECROW (SCR) in RAM. We suggest that CAF-1 plays a critical role in the organization of SAM and RAM during postembryonic development by facilitating stable maintenance of gene expression states.

Energetic components of cooperative protein folding

A new lattice protein model with a four-helix bundle ground state is analyzed by a parameter-space Monte Carlo histogram technique to evaluate the effects of an extensive variety of model potentials on folding thermodynamics. Cooperative helical formation and contact energies based on a 5-letter alphabet are found to be insufficient to satisfy calorimetric and other experimental criteria for two-state folding. Such proteinlike behaviors are predicted, however, by models with polypeptidelike local conformational restrictions and environment-dependent hydrogen-bondinglike interactions.

Reduced levels of 1,25-dihydroxyvitamin D(3) in rat dams and offspring after exposure to a reconstituted PCB mixture

Previous studies revealed effects of polychlorinated biphenyls (PCBs) and other polyhalogenated hydrocarbons on steroid hormone levels and hormone-dependent functions including behavior. In the present study serum concentrations of the vitamin D(3) metabolites 25-hydroxycholecalciferol (25-D) and 1,25-dihydroxycholecalciferol (1,25-D) were determined in rat dams and offspring after exposure to a PCB mixture that was reconstituted according to the congener pattern found in human breast milk. Unmated females were exposed to diets adulterated with 0; 5; 20; or 40 mg PCBs/kg diet. Exposure started 50 days prior to mating and was terminated at birth. Gestational exposure reduced serum concentrations of 1,25-D in dams in a dose-dependent manner. Concentration of 25-D was also decreased at the time of delivery, but not at weaning. Determination of 1,25-D in offspring at weaning revealed reductions in both high-exposure groups. Levels of 25-D were diminished only at the highest exposure level. Internal PCB concentrations in adipose tissue and brains exhibited a linear relation to dosages in diet. Concentrations of PCBs in brains were similar in dams and offspring at birth, but decreased at the end of lactation in dams. In offspring, values increased during this period because of continued exposure via the milk. In the adipose tissue, PCB levels were much lower in offspring than in dams. To our knowledge, this is the first report of PCB-induced effects on vitamin D(3) metabolites. In dams, reductions were seen even at the lowest exposure level used. Further studies are needed to evaluate the biological significance of these reductions in pregnant dams and possible consequences for the developing offspring.

Hematological Values of Healthy Adult Population Living at Moderate Altitude (1869 m, Erzurum, Turkey)

In this study, the normal hematological values in healthy adults living in Erzurum area in Turkey at moderate altitude (1869 m above sea level), and the effect of moderate altitude on these hematological values was investigated. The study population comprised of 929 females and 1204 males aged between 17-95. The mean values for red blood cell and leukocyte counts, and hemoglobin level were significantly higher in males than in females (p<0.0001), whereas platelet count was significantly higher in females than in males (p<0.0001). ›n conclusion, we could not find an increase in the number of red blood cells as well as other hematological parameters in healthy adults living in Erzurum area. Hematological values in this study were similar to those reported in the previous studies carried out with those living under 1869 m.