Predictive values of clinical and pathological parameters for malignancy of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) possess a wide spectrum of biological properties, from indolent to highly aggressive. In this study, we evaluated a set of clinical and pathological parameters for their predicative values for malignancy of GISTs by retrospective reviews of tumor specimens and their relevant medical records from 840 patients. All GIST cases were first assigned as malignant if they met any of the following criteria: gross spreads, including liver metastassis and/or peritoneal dissemination, microscopic spreads, including lymph node metastasis, infiltrations to vascular, fat, nerve and muscularis mucosal tissues, or relapse. The remaining cases were recorded as biological behavior uncertain. This initial assignment revealed a set of five morphological features to be associated with malignancy. They were: mitotic counts greater than 10 per 50HPFs (P<0.0001), muscularis propria infiltration (P<0.0001), coagulative necrosis (P<0.0001), perivascular growth pattern (P=0.005), and severe nuclear atypia (P=0.014). Therefore, a new classification system, including criteria of 2 gross spreads, 5 microscopic spreads, and 5 histopathological parameters was developed. All the GIST cases were re-classified into a group of 485 malignant tumors, and a group of 355 nonmalignant tumors. Patient follow-up data revealed 5-year disease-free and overall survival rates as high as 99.3% and 100% for the nonmalignant group, but low rates of 43.9% and 59.7% for the malignant group. These results demonstrated a correlation of the new classification with clinical outcomes. Therefore, this set of 12 parameters has predictive values for malignancy of GISTs, and is potentially useful in the grading of the tumors.

Cloning and Partial Characterization of a β-1,3-glucanase Gene from Strawberry

Plant pathogenesis-related proteins, including beta-1,3-glucanses, are believed to be involved in plant defense mechanisms. We have cloned a beta-1,3-glucanse gene from strawberry (Fragaria x ananassa Duch). This gene, designated FaBG2-1, is a Class II glucanase gene composed of two exons and one intron. The location of a 397-base intron in the gene was confirmed by sequencing a partial cDNA clone obtained by using a rapid amplification of cDNA ends procedure. Also, based on the cDNA sequence, the transcription start site of FaBG2-1 was assigned to a -54G residue. Genomic Southern blot analysis indicated that FaBG2-1 is a member of a multi-gene family. Reverse transcriptase-polymerase chain reaction analysis revealed that this beta-1,3-glucanase gene is expressed constitutively in strawberry leaves.

Farnesyltransferase inhibitors as radiation sensitizers

PURPOSE

The inhibition of activated Ras combined with radiotherapy was identified as a potential method for radiosensitization.

MATERIALS AND METHODS

Immunoblotting was used to control for prenylation inhibition of the respective Ras isoforms and for changes in activity of downstream proteins. Clonogenic assays with human and rodent tumour cell lines and transfected cell lines served for the testing of radiosensitivity. Xenograft tumours were treated with farnesyl transferase inhibitors and radiation and assayed for ex vivo plating efficiency, regrowth of tumours and EF5 staining for detection of hypoxia. Concurrent treatment with L-778,123 and radiotherapy was performed in non-small cell lung cancer (NSCLC) and head and neck cancer (HNC) patients.

RESULTS

Blocking the prenylation of Ras proteins in cell lines with Ras activated by mutations or receptor signalling resulted in radiation sensitization in in vitro and in vivo. The PI3 kinase downstream pathway was identified as a contributor to Ras-mediated radiation resistance. Additionally, increased oxygenation of xenograft tumours was observed after FTI treatment. Combined treatment in a phase I study was safe and effective in NSCLC and HNC.

CONCLUSIONS

Tumour cells with activated Ras were sensitized to radiation. Unravelling the underlying mechanisms promises to lead to even more specific drugs with higher potency and safety.

The role of EGFR MAbs C225 in breast cancer stem cells

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Background: The epithermal growth factor receptor(EGFR) signaling pathways has been implicated in self-renewal of breast cancer stem cells. It has been proved that the EGFR tyrosine kinase inhibitor-gefitinib significantly decreased the mammosphere- forming efficiency(MFE) in ductal carcinoma in situ (DCIS) derived cancer cells. We investigated the response of breast cancer stem cells in breast cancer cell line MCF-7 to EGFR MAbs C225(cetuximab). Methods: Cells were used for nonadherent (i.e.,mammosphere) culture and were divided into four groups according to the different culture medium whether or not including exogenous EGF and MAbs C225. MFE was calculated as the number of mammospheres (≥60um) and was expressed as a percentage. We Compared the percentage of CD44+/CD24- cells from the four groups, and measured the levels of the Wnt and Notch-3 gene expression of the four groups. Results: There was no significant difference of MFE between groups. In the presence of exogenous EGF, MAbs C225 significantly decreased the MFE and the percentage of CD44+/CD24- cells of mammospheres compared with exogenous EGF alone(0.7% versus 1.5%, P < 0.001 and 4% versus 11%P < 0.001;respectively). In the absence of exogenous EGF, MAbs C225 aslo statistically decreased the MFE and the percentage of CD44+/CD24- cells of mammospheres compared with that of lacking exogenous EGF and MAbs C225(0.53% versus 1.3%,P = 0.003 and 9% versus 3%, P < 0.01;respectively). And we observed that the Notch-3 gene expression was compensativly increased in the two groups of addition of MAb C225. No significant differences of Wnt gene expression were observed between groups. Conclusions: EGFR MAbs C225 could disrupt mammoshpere formation and decrease the percentage of CD44+/CD24- cells of mammoshpere cells. The expression of Notch-3 is increased with the EGFR antagonistics in breast cancer stem cells.

No significant financial relationships to disclose.

Phase I study of chidamide (CS055/HBI-8000), a novel histone deacetylase inhibitor, in patients with advanced solid tumors and lymphomas

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Background: Chidamide (CS055/HBI-8000) is a new benzamide type of histone deacetylase (HDAC) inhibitor with low nanomolar activity against HDAC1, 2, 3 and 10. This Phase I study evaluated the safety and tolerability of chidamide in patients (pts) with advanced solid tumors and lymphomas. Methods: 31 pts with refractory or relapsed advanced solid tumors (22) and lymphomas (9) were enrolled in this study. Escalating doses of 5, 10, 17.5, 25, 32.5 and 50 mg Chidamide (each with 3 to 7 pts) were administered orally either twice or three times per week for 4 consecutive weeks every 6 weeks. Results: No dose limiting toxicities (DLTs) were identified in the 2 x per week cohorts (22 pts) up to 50 mg; G2 and G3 hematological toxicities (leukopenia/neutropenia and thrombocytopenia) were observed at 50 mg. DLTs were reported as G3 diarrhea or vomiting in 2 pts in the 3 x per week cohort at 50 mg. Common adverse events were G1/G2, fatigue (n = 11), thrombocytopenia (n = 9), anorexia (n = 8), nausea/vomiting (n = 7), leukopenia/neutropenia (n = 6), hypochromia (n = 6), and diarrhea (n = 5). No cystitis, pericarditis, pericardial effusion or prolonged QTc intervals were observed. Single dose PK analysis in pts with 25, 32.5 and 50 mg revealed T1/2 of 16.8–18.3 h, Tmax of 1–2 h in most cases, and a dose-related increase in Cmax and AUC. Multiple dose PK analysis in pts with 32.5 mg 3 x per week suggested drug accumulation with this regimen. Significant induction of histone (H3) acetylation was observed in peripheral white blood cells, which lasted for 2–3 days in most pts after single dosing. 25 pts with total treatment cycles of 49 (range 1–6) were evaluable for efficacy. 4 pts with T-cell lymphomas (4/5 evaluable) and 1 pt with submandibular adenoid cystic carcinoma achieved PR, and 11 pts (2 B-cell lymphomas and 9 solid tumors) experienced SD. Conclusions: Chidamide was well-tolerated in pts with advanced solid tumors and lymphomas in the tested regimens. In addition, the compound exhibited a relatively long half-life, a long-lasting biomarker response and encouraging antitumor activity at well-tolerated doses. The overall phase I results recommend the 2 x per week regimen for phase II studies.

[Table: see text]

Expression of CD24 as a predictor of prognosis of hepatocellular carcinoma after operation

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Background: CD24 expression has previously been reported in hepatocellular carcinoma (HCC), although little is known about its prognostic significance. The aim of this study is to evaluate the relation of CD24 expression and its prognostic significance in HCC. Methods: CD24 expression in stepwise metastatic HCC cell lines and tumor tissues from 50 HCC patients was investigated by quantitative real-time reverse transcription-PCR and Western blot analyses. The role of CD24 was investigated by depletion CD24 expression in HCC cells through small-interfering RNA. Tumor tissue microarrays of 314 HCC patients who underwent resection between 1997 and 2000 were used to detect the expressions of CD24, β-catenin and PCNA expression. The prognostic significance was assessed using Kaplan-Meier survival estimates and log-rank tests. Results: CD24 was overexpressed in the high metastatic HCC cell line and in tumor tissues of recurrent patients. Depletion of CD24 caused a notable decrease in cell proliferation, migration and invasiveness in vitro. CD24 was confirmed as an independent predictor for overall survival (p<0.001) and relapse-free survival (p<0.001), regardless of recurrence time, AFP level, TNM stage and Edmondson stage. High expression of CD24 in HCC tissues was significantly associated cytoplasmic/nuclear accumulation of β-catenin (p=0.023), high tumor proliferate status (p=0.018) and diffused intrahepatic recurrence and distance metastasis (p=0.026). Adjuvant TACE after operation reduced the early recurrence (≤1 year) in CD24+ HCC patients (p=0.024), while there had no significant changes in CD24- patients (p=0.284). Conclusions: High expression levels of CD24 were related with high invasive and metastatic potential, high tumor proliferation status and activation of Wnt/β-catenin pathway. The expression of CD24 provides new prognostic information about HCC prognosis and targeted therapy to CD24+fraction in HCC may comprise a promising anti-recurrence strategy for HCC patients after surgery.

No significant financial relationships to disclose.

Data acquisition system using six degree-of-freedom inertia sensor and ZigBee wireless link for fall detection and prevention

Fall detection and prevention require logged physiological activity data of a patient for a long period of time. This work develops a data acquisition system to collect motion data from multiple patients and store in a data base. A wireless sensor network is built using high precision inertia sensors and low power Zigbee wireless transceivers. Testing results prove the system function properly. Researchers and physicians can now retrieve and analyze the accurate data of the patient movement with ease.

Assessment of mitral valve volume by quantitative three-dimensional echocardiography in patients with rheumatic mitral valve stenosis

BACKGROUND

Thickening of mitral leaflets in rheumatic mitral valve stenosis is well described in necropsy studies; however, volume computation of the thickening mitral leaflets has not been attempted. 4trial fibrillation is one of the complications of rheumatic mitral stenosis. Quantitative assessment of thickened mitral valve and its relation to clinical complications is clinically desirable.

HYPOTHESIS

The study was undertaken to compare measurement of mitral valve volume in normal subjects and in patients with rheumatic mitral valve stenosis.

METHODS

An HP Sonos 2500 echocardiographic system with 5 MHz multiplane transesophageal transducer was used for data acquisition, and TomTec Echoscan computer setup was used to off-line volume computation. Study subjects included 10 normal subjects (mean age 44.8 years) and 36 patients with rheumatic mitral valve stenosis (22 female, 14 male) with an age range of 25 to 69 years (mean age 47 +/- 9.6 years). Mitral valve volumes were compared between the normal subjects and patients with mitral valve stenosis, and further comparison was made between the sinus rhythm (SR) and atrial fibrillation (AF) groups in patients with mitral valve stenosis. In all study subjects, the mitral valve area (MVA) was determined by two-dimensional echocardiography.

RESULTS

Quantitative three-dimensional (3-D) echocardiography showed that mitral valve volume was significantly larger in patients with mitral valve stenosis than in normal subjects (9.0 +/- 2.2 and 4.5 +/- 0.7 ml, respectively, p < 0.001). When patients with mitral valve stenosis were divided into the SR and AF groups, mitral valve volume was found to be significantly larger in the AF group than in the SR group (9.76 +/- 2.2 ml. and 7.72 +/- 1.5 ml, respectively, p < 0.01) and patients in the AF group tended to be older (p < 0.05) with larger left atrial diameter (LAD) (p < 0.01). However, MVA between the two groups showed no statistical significance (1.1 +/- 0.43 and 1.0 +/- 0.34 cm2, respectively, p > 0.2). When the study subjects were divided into two groups (< 50 and > or = 50 years) according to age, the comparison of mitral valve volume between these two groups (9.37 +/- 2.18 and 8.56 +/- 2.14 ml, p > 0.2) showed no statistical significance.

CONCLUSIONS

Quantitative 3-D echocardiography can be applied for the measurement of mitral valve volume in vivo. Patients with rheumatic mitral valve stenosis with atrial fibrillation have a propensity to have a larger mitral valve volume and are older than the patients with sinus rhythm; however, the age per se does not seem to be a cause for larger mitral valve volume.

Analysis of 10 independent samples provides evidence for association between schizophrenia and a SNP flanking fibroblast growth factor receptor 2

We and others have previously reported linkage to schizophrenia on chromosome 10q25-q26 but, to date, a susceptibility gene in the region has not been identified. We examined data from 3606 single-nucleotide polymorphisms (SNPs) mapping to 10q25-q26 that had been typed in a genome-wide association study (GWAS) of schizophrenia (479 UK cases/2937 controls). SNPs with P<0.01 (n=40) were genotyped in an additional 163 UK cases and those markers that remained nominally significant at P<0.01 (n=22) were genotyped in replication samples from Ireland, Germany and Bulgaria consisting of a total of 1664 cases with schizophrenia and 3541 controls. Only one SNP, rs17101921, was nominally significant after meta-analyses across the replication samples and this was genotyped in an additional six samples from the United States/Australia, Germany, China, Japan, Israel and Sweden (n=5142 cases/6561 controls). Across all replication samples, the allele at rs17101921 that was associated in the GWAS showed evidence for association independent of the original data (OR 1.17 (95% CI 1.06-1.29), P=0.0009). The SNP maps 85 kb from the nearest gene encoding fibroblast growth factor receptor 2 (FGFR2) making this a potential susceptibility gene for schizophrenia.

FLIP and the death effector domain family

Death effector domains (DEDs) are protein interaction modules found in a number of proteins known to regulate apoptosis from death receptors. The core DED family members that orchestrate programmed cell death from death receptors include the adaptor protein FADD, the initiator caspases procaspases-8 and -10 and the regulatory protein c-FLIP. Through homotypic DED interactions, these proteins assemble into the death-inducing signaling complex (DISC) to regulate initiator caspase activation and launch the apoptotic proteolytic cascade. A considerable body of evidence, however, is revealing that the same core group of DED-containing proteins also paradoxically promotes survival and proliferation in lymphocytes and possibly other cell types. This review delves into recent findings regarding these two opposing functional aspects of the core DED proteins. We discuss the current effort expanding our structural and biochemical view of how DED proteins assemble into the DISC to fully activate initiator caspases and execute cell death, and finally we examine details linking the same proteins to proliferation and describe how this outcome might be achieved through restricted activation of initiator caspases.

Disinfection of maxillofacial silicone elastomer using a novel antimicrobial agent: recombinant human beta-defensin-3

Maxillofacial silicone elastomer, when used as a prosthesis, is in contact with wound surfaces and mucosa, and tends to be contaminated with microorganisms from a patient's saliva and blood. The aim of the study was to evaluate the efficacy of human beta-defensin-3 (HBD3) on the reduction of two resistant bacteria species from the surface of maxillofacial silicone elastomer. HBD3 cDNA was amplified from total RNA, which had been extracted from human gingival epithelium by means of reverse-transcription polymerase chain reaction (RT-PCR). Following this, the cDNA fragments were recombined in a prokaryotic expression vector. The constructed expression vectors pET-32a/HBD3 were transformed into Escherichia coli to obtain recombinant protein. After protein purification and refolding, the product was verified in classic antimicrobial experiments against Staphylococcus aureus and Candida albicans. Specimens made of silicone elastomer A-2186, which had been contaminated with S. aureus or C. albicans, were immersed in rHBD3 or 5.25% sodium hypochlorite (a positive control) for 5 min, 10 min, 30 min, or 60 min. The active recombinant HBD3 obtained in the current study eliminated the S. aureus and C. albicans microorganism from the surface of the maxillofacial elastomer after a 30-min immersion. There was no statistically significant difference between the rHBD3 group and the sodium hypochlorite 5.25% group. In conclusion, rHBD3 exhibits antibacterial activity against oral pathogenic strains that adhere to maxillofacial elastomer, and may, thus, contribute to the prevention of infections caused by S. aureus and C. albicans.

Adhesive growth of pancreatic islet cells on a polyglycolic acid fibrous scaffold

BACKGROUND

The use of cultured pancreatic islet cells for diabetes treatment offers several advantages. In theory, cultured cells show greater purity and lower immunogenicity. However, cultured islet cells display a low survival rate in vitro. In the present study we grew islet cells on a polyglycolic acid (PGA) fibrous scaffold to promote cell adhesion, growth, and viability during prolonged culture.

METHODS

Islets isolated from Wistar rat pancreata were digested with collagenase and purified by the Ficoll method. Cells were grown in culture with or without PGA scaffolds. Islet cell purity was determined using a dithizone stain; viability and survival rates were determined using an AO-PI stain. The insulin-secretion index was detected using radioimmunodetection and the growth on an adhesive scaffold analyzed using an inverted microscope and scanning electron microscope (SEM).

RESULTS

In contrast to the scaffold-free control group, cells cultured on PGA scaffolds exhibited improved morphology, less cell death, and prolonged survival times. Cell viability and survival rates were significantly increased in scaffolded cells when compared to control cells (P < .05). Increased insulin secretion was observed in the culture solution of scaffolded cells following stimulation with low glucose (5.6 mmol/L) versus high glucose (16.7 mmol/L). The secretion indices of the two groups were significantly different (P < .05). Islet cell growth, as observed under SEM, was tightly circumvolute, adhesive, and three-dimensional.

CONCLUSIONS

The present results demonstrated that islet cells can successfully grow and survive in culture on a PGA scaffold. These cells exhibited enhanced viability, survival, and insulin secretion.

Differentiation of mouse nuclear transfer embryonic stem cells into functional pancreatic beta cells

AIMS/HYPOTHESIS

Therapeutic cloning has been reported to have potential in the treatment of several degenerative diseases. However, it has yet to be determined whether mouse nuclear transfer-embryonic stem cells (NT-ESCs) can be differentiated into pancreatic beta cells and used to reverse diabetes in an animal model.

METHODS

We first used the somatic nuclear transfer technique to generate mouse NT-ESCs and then developed a chemically defined stepwise protocol to direct the NT-ESCs into functional pancreatic beta cells. We examined the gene expression pattern of the differentiated NT-ESCs and transplanted the NT-ESC-derived insulin-producing cells into recipient diabetic mice.

RESULTS

Four mouse NT-ESC lines were first established using an improved nuclear transfer technique and insulin-producing cells were efficiently generated from NT-ESCs by mimicking pancreatic in vivo development. Most of the insulin-producing cells that we generated co-produced pancreatic and duodenal homeobox 1, but not glucagon at the final stage of this differentiation method, which differed from the insulin and glucagon co-production reported by other groups. The differentiated NT-ESCs were able to release insulin in response to glucose stimuli and normalise the blood glucose level of diabetic mice for at least 2 months.

CONCLUSIONS/INTERPRETATION

These results demonstrate the potential of therapeutic cloning for cell therapy of type 1 diabetes in a mouse model.

Endogenous hydrogen sulfide is involved in regulation of respiration in medullary slice of neonatal rats

The purpose of the present study was to verify our assumption that rhythmic respiratory activity may be regulated by endogenous hydrogen sulfide (H(2)S) in the medullary slices of neonatal rats. We found that a moderate concentration of donor of H(2)S, NaHS, mainly induced diphasic respiratory responses indicated by changes of discharge frequency (DF) of hypoglossal rootlets, an initial inhibitory stage followed by a later excitatory one. Cystathionine beta-synthase (CBS) substrate, cysteine (CYS), exerted similar effects. CBS inhibitor, NH(2)OH, could eliminate both inhibitory and excitatory effects in the two stages induced by CYS. K(ATP) channel blocker, glibenclamide (Gl), could eliminate the decrease in DF in the initial stage, but not the increase in the later one. On the other hand, adenyl cyclase (AC) inhibitor, SQ-22536 (SQ) could eliminate the increase in DF in the later stage, but not the decrease in the initial one, of the rootlets caused by NaHS. Co-application of Gl and SQ eliminated both inhibitory and excitatory effect induced by NaHS. The cAMP level was increased in the later stage but not in the initial one by NaHS, and the increase in the cAMP level could be eliminated by SQ. It can be concluded that the endogenous H(2)S could be produced through the CBS-H(2)S pathway and could be involved in the control of the central rhythmic respiration in the in vitro medullary slices of neonatal rats by opening K(ATP) channels and activating AC-cAMP pathway of the neurons.