Vascular endothelial growth factor gene polymorphisms in patients with colorectal cancer

BACKGROUND

Angiogenesis plays an important role in tumor progression. The vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis. In the present study we evaluated single nucleotide polymorphisms (SNPs) -2578C > A, -1154G > A, and +936C > T in the VEGF gene, and their prognostic value for patients operated on for colorectal cancer (CRC).

PATIENTS AND METHOD

VEGF polymorphisms have been analyzed in 177 patients who had undergone surgical resection at Hospital Clínico San Carlos. The analysis of these polymorphisms was performed with specific probes for each nucleotide in a multiplex reaction using real-time PCR.

RESULTS

We only found a statistically significant relationship for one of these three polymorphisms, +936C > T, with gender and tumor location; 10.7% of patients heterozygotes for this SNP had tumors located in proximal colon, 35.2% in distal segment and 54.1% in rectum (p = 0.03). Patients with the +936T/T genotype had 100% overall survival (OS).

CONCLUSION

Patients with a +936T/T genotype showed increased survival, therefore the +936C > T SNP could be a useful marker in the follow-up and clinical management of patients with colorectal cancer.

Mechanism of phase separation generation in Ge-based solar cell tunnel junctions

Enhanced performance, reduced cost and compact dimensions are a prerequisite for novel products in the solar industry. III-V based multi-junction heterostructures are promising devices to give an answer to make a substancial step in the photovoltaic technology. However, such heterostructures need tunnel junctions to connect the different active layers and so ternary alloys are needed to tune the energy gap. In the present contribution, artefacts generated by ternary alloying are investigated by transmission electron microscopy (TEM). Composition modulation in In0.015Ga0.985As/In0.3Ga0.7P/Al0.3Ga0.7As/In0.3Ga0.6Al0.1P/In0.3Al0.7P/In0.015Ga0.985As heterostructures grown on Ge subtrates is observed. This should affect the spectral sensitivity of the active layer. But, as a probably more important consequence, this observed modulation is shown to also generate modulation in the Al0.3Ga0.7As tunnel junction. This behaviour is anomalous in standard AIGaAs thick epilayers grown on GaAs substrates. In the present case, it could strongly affect the carrier transport imposing an important handicap to their potential application within electro-optical components.

Association between total immunoglobulin E and antibody responses to naturally acquired Ascaris lumbricoides infection and polymorphisms of immune system-related LIG4, TNFSF13B and IRS2 genes

The 13q33-34 region harbours a susceptibility locus to Ascaris lumbricoides, although the underlying genes are unknown. Immunoglobulin (Ig)E and IgG confer protective immunity and here we sought to investigate in an endemic population whether LIG4, TNFSF13B and IRS2 genes influence IgE and IgG levels against Ascaris and the ABA-1 allergen as a putative resistance marker. Mite-allergic asthmatic patients were analysed for potential relationships between Ascaris predisposition and allergy. One thousand and sixty-four subjects from Cartagena, Colombia, were included. Single nucleotide polymorphisms (SNPs) were genotyped using TaqMan assays. Antibody levels were measured by enzyme-linked immunosorbent assay. Linear and logistic regressions were used to model effects of genotypes on antibody levels. The GG genotype of LIG4 (rs1805388) was associated with higher IgE levels to Ascaris compared with other genotypes. TNFSF13B (rs10508198) was associated positively with IgG levels against Ascaris extract and IgE levels against ABA-1. In asthmatics, IRS2 (rs2289046) was associated with high total IgE levels. Associations held up after correction by population stratification using a set of 52 ancestry markers, age, sex and disease status. There was no association with asthma or mite sensitization. In a tropical population, LIG4 and TNFSF13B polymorphisms are associated with specific IgE and IgG to Ascaris, supporting previous linkage studies implicating the 13q33 region. Our results suggest that genes protecting against parasite infections can be different to those predisposing to asthma and atopy.

Perceived Motivational Climate, Sportsmanship, and Students' Attitudes toward Physical Education Classes and Teachers

The purpose of this study was to examine the relations among students' perceptions of motivational climate, sportsmanship attitudes, and attitudes toward content and teachers in physical education. 910 secondary school students ages 13 to 16 years ( M = 14.3, SD =1.1) completed Spanish translations of L'Echelle de Perception du Climat Motivational by Biddle, et al., the Multidimensional Sportspersonship Orientations Scale by Vallerand, et al., and the Student Attitudes toward Teacher and Program in Physical Education by Luke and Cope. Structural Equation Modeling showed that perceived mastery climate is a predictor of students' attitudes toward teacher and content and positive sportsmanship attitudes. In contrast, perceived performance climate was not a predictor or mainly predicted negatively the students' attitudes toward the physical education teacher, content, and sportsmanship attitudes. These findings are discussed with regard to the implications for physical educators.

the Deleterious Effect of Cognitive Impairment, Negative Symptoms and Functional Disability on Quality of Life in Chronic Schizophrenia

Aims:

To examine the relative contributions of psychiatric symptoms, functional disability, neuropsychological functioning and sociodemographic variables to quality of life (QOL) in patients with chronic schizophrenia.

Method:

We examined 165 hospitalised patients with long term schizophrenia (DSM-IV). Measures of psychiatric symptoms included depression (Calgary depression Scale), insight (David Insight Scale), symptom severity (BPRS) and PANSS (Positive and Negative Symptom Scale). Neuropsychological battery included tests for verbal memory, executive functioning, verbal fluency, working memory, motor speed and processing speed. Functional disability was assessed with the Disability Assessment Schedule (DAS-WHO) and Quality of life was assessed with the Quality of Life Scale.

Results:

Age, years of evolution, negative symptoms, insight and neuropsychological variables (except motor speed) all were significantly related to level of quality of life. in a multiple regression analysis, entering the neuropsychological functioning, functional disability and negative symptoms generated a model which accounted for a 74.9% of the variance in QOL. Functional disability, as expected, accounted for 56% of the variance, whereas Processing Speed explained an additional 6.2%. Symptom Severity and Verbal Fluency predicted 3.7% and 3.5% of the variance, respectively. Negative symptoms, Verbal Memory and Vocabulary, were also significant predictors in the model, but had less predictive value. However, Positive Symptoms and Sociodemographic Variables did not significantly contribute to predict quality of life.

Conclusion:

Our findings support the predictive value of neuropsychological functioning, functional disability and severity of negative symptoms in long term quality of life in schizophrenia.

Specificity of Cognitive Deficits in Psychosis; Initial Presentation and Course of Alterations among Different Diagnoses

Objective:

To describe possible differences in the initial cognitive profile between schizophrenia and non-schizophrenia first episode psychosis patients.

Method:

We assessed attention, working memory, and executive functioning in 57 first episode psychosis patients at baseline and at a one-year follow-up.

Results:

No significant differences were detected in the cognitive profile among schizophrenia (n=20) and non-schizophrenia (n=37) patients at baseline or at the one-year follow-up. For the overall group, significant reductions in the percentage of omission and commission errors for the sustained attention task (p< 0.001 and p=0.001 respectively), in the total time to complete the Stroop-I task (p< 0.001), in the percentage of omission errors for the working memory task (p=0.001), and in the percentage of perseverative errors for the WCST (p< 0.001) were detected, as well as a significant increase in the number of categories completed in the WCST (p< 0.001). The other cognitive variables analyzed remained stable (4 of the 10 variables tested). The pattern of change was similar for schizophrenia and non-schizophrenia patients in the areas of attention and working memory. For executive functioning, the non-schizophrenia group showed a more beneficial pattern of change.

Conclusions:

Our results indicate a lack of specificity of cognitive alterations related to the degree of affectation, at least during the first year after instauration of treatment. The course of cognitive deficits in first episode psychosis showed significant improvements over this period, being the patter of change in executive functioning slightly more beneficial for patients with a non-schizophrenia psychosis.

[The lymphocyte: protagonism in the new era of the biological therapies]

Psoriasis is a systemic type T cell mediated immune system chronic inflammatory skin disease. These cells play an important role in the immune system and in the inflammatory response that determines the development and maintenance of the psoriasis lesions. However, greater understanding of the pathophysiology of this disease has led to the development of specific and selective biological treatments. Efalizumab is a humanized IgG1 monoclonal antibody that binds to the Leukocyte-Function-Associated Antigen 1 (LFA-1). When it binds to the CD11a--alpha subunit of LFA1--it inhibits the binding of this ligand to the intercellular adhesion molecule 1. This inhibits several processes related with the T cells that are fundamental in the pathogenesis of psoriasis: activation of the T cells in the lymph nodes, the migration of the T cells towards the dermis and epidermis and finally the reactivation of these in the inflammatory focus. The clinical studies have demonstrated that efalizumab, administered subcutaneously only once a week, provides a clinical benefit as well as improvement in the quality of life in patients with psoriasis with chronic, moderate or severe plaques. Long-term treatment studies suggest that continuous therapy with efalizumab is more beneficial in the maintenance of the improvement of the response and demonstrate that efalizumab may be administered safely for prolonged periods. Given its efficacy, rapid onset action, safety profile due to its selective action mechanism and convenience in its subcutaneous self-administration weekly, efalizumab offers a new therapeutic option, especially of interest for the treatment of psoriasis.

Hepatic disease as the first manifestation of progressive myoclonus epilepsy of Lafora

BACKGROUND

Lafora disease (LD; progressive myoclonus epilepsy type 2; EPM2) is an autosomal recessive disorder caused by mutations in the EPM2A and EPM2B genes. LD is characterized by the presence of strongly PAS-positive intracellular inclusions (Lafora bodies) in several tissues. Glycogen storage disease type IV (GSD-IV; Andersen disease) is an autosomal recessive disorder characterized by cirrhosis leading to severe liver failure. GSD-IV has been associated with mutations in the glycogen branching enzyme gene (GBE). Histopathologic changes of the liver in both diseases show an identical appearance, although cirrhosis has never been described in patients with LD. We report a LD family in which the proband presented severe liver failure at onset of the disease.

METHODS

Clinical histories, physical and neurologic examination, laboratory tests, EEGs, MRI of the brain, and liver or axillary skin biopsies were performed in the two affected siblings. The diagnosis was confirmed by molecular genetic analysis of the EPM2A, EPM2B, and GBE genes and loci.

RESULTS

During the first decade of life, abnormalities in liver function tests were detected in the two affected siblings. The proband's liver dysfunction was severe enough to require liver transplantation. Subsequently, both sibs developed LD. Mutation analysis of EPM2A revealed a homozygous Arg241stop mutation in both patients.

CONCLUSIONS

This is the first description of severe hepatic dysfunction as the initial clinical manifestation of LD. The phenotypic differences between the two affected siblings suggest that modifier genes must condition clinical expression of the disease outside the CNS.

Development and characterization of a murine monoclonal antibody specific for the P1.15 PorA proteins from vaccine strain B:4,7:P1.19,15 of Neisseria meningitidis

Neisseria meningitidis isolates are conventionally classified by serosubtyping, which characterizes the reactivities of the PorA outer membrane protein variable-region epitopes with monoclonal antibodies (MAbs). New murine hybridomas, secreting specific MAbs against PorA of N. meningitidis serogroup B, were generated using conventional hybridoma procedures. Using outer membrane protein as antigen, we obtained two positive clones, and one of them we characterized. This MAb reacted, on whole-cell enzyme-linked immunosorbent assay (ELISA) and immunoblotting, only with strain subtype P1.15 and its IgG2b isotype. This MAb demonstrated bactericidal activity against the homologous strain in the presence of human complement.

mRNA expression of MAGE-A3 gene in leukemia cells

Leukemia-associated antigens such as proteins encoded by MAGE genes might provide tools for immunotherapy of leukemia. Positive and negative results of MAGE-A gene expression in hematological malignancies have been reported. This led us to study MAGE-A gene expression in human leukemias using RT-PCR. Among 115 leukemias from various subtypes, 14/34 (41.17%) AML were positive for one of the three genes analyzed (MAGE-A1 1/32; MAGE-A3 10/32; MAGE-B2 3/12). Expression was also detected in 23/76 (30.26%) B-cell ALL patients (MAGE-A1 2/53; MAGE-A3 20/53; MAGE-B2 1/32). One of these patients expressed both MAGE-A1 (weak signal) and -A3 (strong signal) genes. Other patient with CML were positive for MAGE-B2 (1/5, 20%). MAGE-A3 expression data were corroborated by real time RT-PCR through determination of MAGE-A3 transcript levels. We concluded that the MAGE-A3 gene is expressed at the mRNA level in a proportion of human leukemias.

Thrombolysis and neuroprotection in cerebral ischemia

Stroke is a major cause of death and disability worldwide. The resulting burden on society grows with the increase in the incidence of stroke. The term brain attack was introduced to describe the acute presentation of stroke and emphasize the need for urgent action to remedy the situation. Though a large number of therapeutic agents, like thrombolytics, NMDA receptor antagonists, calcium channel blockers and antioxidants, have been used or are being evaluated, there is still a large gap between the benefits of these agents and the properties of an ideal drug for stroke. So far, only thrombolysis with rtPA within a 3-hour time window has been shown to improve the outcome of patients with ischemic stroke. Understanding the mechanisms of injury and neuroprotection in these diseases is important to target news sites for treating ischemia. Better evaluation of the drugs and increased similarity between the results of animal experimentation and in the clinical setting requires critical assessment of the selection of animal models and the parameters to be evaluated. Our laboratory has employed a rat embolic stroke model to investigate the combination of rtPA with citicoline as compared to monotherapy alone and investigated whether neuroprotection should be provided before or after thrombolysis in order to achieve a greater reduction of ischemic brain damage.

[Telemedicine and follow up of peritoneal dialysis patients]

Mean-term experience in the use of Telemedicine in Peritoneal Dialisis (PD) patients is limited as well as its cost-benefit. The main objective of this work is to evaluate Telemedicine utility in mean-long term control of stable PD patients, analyzing if the televisit (TV) could substitute 50% of the programed inhospital consults (HC) the time spent in both visit modalities, the quality of patient-personel contact as well as how image and sound have been perceived. Visit resolution was analyzed taking into account the need of HC after a TV; We also have studied if it would be possible to retrain patients in the dialisis technique with telemedicine, and we have checked the patient perceived quality and calculate the real and social costs.

METHODS

during 18 months, the system has been implanted to 19 patients with 7 +/- 4 follow up (range 3-17). A Falcon videoconference kit at patient's place was used, connected to the home television set. In the hospital there was a computer with a videoconference card, webcam and software meeting point which permits the control of patient's camera from the hospital. Both are connected by a 3RDSI line system. A monthly programmed HC or TV has been made. If more controls had been required, they have been made by TV Time spent was recorded on each TV and patients and staff questionary were inquired.

RESULTS

(a)

PATIENTS

mean age 44 +/- 8 years, 13 (68%) male. 12 (63%) had elemental educational level and 7 (37%) mean-superior. 17 (89%) were actively working. The PD technique was: CAPD 6 (32%) and APD13 (68%). (b) Televisits: 103 TV have been made. 22 +/- 9 minutes were spent on each TV less than in the HC, 33 +/- 8 minutes (p < 0.01). There were technical problems related with lines in 21 TV, but only in 4 the connection was not possible. 92 TV (89%) were made on time, 99 (96%) had a good image quality and 96 (93%) had a correct sound. 100% of patients perceived TV as close to HC. In 90 TV (87%) medical treatment was modified. Only in 4 cases (3.9%) patients needed an hospital visit. According to patient's valuation, TV replaced correctly to HC in 97 instances (94%) and in 97 (97%) in staff opinion. In all cases (100%) catheter exit site could be evaluated as well as edema presence. Retraining was possible in all cases. There was a save in nurse's time and patient's time and also, a save in physical hospital space. Initial investment apart, the daily cost increment was scarce (1.5 Euro) taking into account that there is a save in time for patients and personnel, save in physical space in hospital and in sanitary transport.

CONCLUSION

Telemedicine is useful from the clinical point of view in the mean-term for stable patients in PD. Daily cost increment is scarce and there is a save in time for patients and personnel, save in physical space in hospital and in sanitary transport.