Isolation and Investigation of Presumptive Murine Lacrimal Gland Stem Cells

PURPOSE

Aqueous tear deficiency due to lacrimal gland insufficiency is one of the major causes of dry eye disease. In severe cases, such as Sjogren's syndrome, Stevens-Johnson syndrome, or ocular cicatricial pemphigoid, therapy with artificial tears is often insufficient to relieve severe discomfort, prevent progressive ocular surface disease, or enable visual rehabilitation by corneal transplantation. Cell or organ generation from stem cells, resulting in tear-like secretion, presents an option as a suitable alternative treatment. To obtain deeper insights into lacrimal gland stem cells we analyzed murine lacrimal glands for markers of pluripotency, self-renewal, and differentiation.

METHODS

A special, patented technique with mechanical and enzymatic digestion was used to generate high numbers of cells in vitro from murine lacrimal glands. These presumptive "murine lacrimal gland stem cells" ("mLGSCs") can be propagated as monolayer cultures over multiple passages. By means of RT-PCR, Western blot, and immunohistochemistry, markers of pluripotency and differentiation were demonstrated. Hanging drop culture was used to build organoid bodies from mLGSCs to investigate their spontaneous differentiation in three-dimensional culture with histology, immunohistochemistry, and transmission electron microscopy methods.

RESULTS

Isolated mLGSCs were cultured over more than 65 passages. Murine lacrimal gland stem cells expressed markers of pluripotency such as Nanog, Sox2, Kruppel-like factor 4 (Klf4), as well as early-lineage markers of all three germ layers. Three-dimensional culture of these cells revealed their ability to differentiate into various cell types.

CONCLUSIONS

Our results suggest that mLGSCs were isolated and cultured successfully. These cells have the ability to differentiate into all three germ layers. The results provide further insights into lacrimal gland stem cell physiology for engineering of a lacrimal gland construct to treat severe cases of tear deficiency in the future.

Gigahertz Quantized Charge Pumping in Bottom-Gate-Defined InAs Nanowire Quantum Dots

Semiconducting nanowires (NWs) are a versatile, highly tunable material platform at the heart of many new developments in nanoscale and quantum physics. Here, we demonstrate charge pumping, that is, the controlled transport of individual electrons through an InAs NW quantum dot (QD) device at frequencies up to 1.3 GHz. The QD is induced electrostatically in the NW by a series of local bottom gates in a state of the art device geometry. A periodic modulation of a single gate is enough to obtain a dc current proportional to the frequency of the modulation. The dc bias, the modulation amplitude and the gate voltages on the local gates can be used to control the number of charges conveyed per cycle. Charge pumping in InAs NWs is relevant not only in metrology as a current standard, but also opens up the opportunity to investigate a variety of exotic states of matter, for example, Majorana modes, by single electron spectroscopy and correlation experiments.

Puerperal influence of bovine uterine health status on the mRNA expression of pro-inflammatory factors

After parturition, uterine bacterial infections lead to inflammatory processes such as subclinical/clinical endometritis with high prevalence in dairy cows. Endometrial epithelial cells participate in this immune response with the production of pro-inflammatory factors. The objective of the present study was to evaluate the endometrial mRNA expression pattern of pro-inflammatory factors during a selected postpartum (pp) period. Dairy cows with three different uterine health conditions on days 24-30 pp (healthy: n = 11, subclinical endometritis: n = 10, clinical endometritis: n = 10) were sampled using the cytobrush technique. Subsequently, each cow was sampled 3 more times in weekly intervals (days 31-37 pp; days 38-44 pp; days 45-51 pp). Samples were subjected to mRNA analysis performed by RT-qPCR. Additionally, an analysis of cultivable bacteria was performed at the early/late stage of the selected puerperal period. mRNA expression of 16 candidate genes was analyzed by using two different approaches. The first approach referred to the initial grouping on days 24-30 pp to reveal long-term effects of the uterine health on the subsequent puerperal period. The second approach considered the current uterine health status at each sampling to elucidate the impact of different points in time. Long-term effects seem to appear for chemokines, prostacyclin synthase and prostaglandin D2 synthase. If related to the current uterine health, the majority of candidate genes were significantly higher expressed in endometritic cows on days 45-51 pp in contrast to earlier stages of the puerperium. Microbiological analysis revealed the significantly higher prevalence of Trueperella pyogenes findings in cows with clinical endometritis on days 24-30 pp, but no correlations were found on days 45-51 pp. In conclusion, a strong immune response to subclinical/clinical endometritis in the late puerperium may be related to the negative impact of these conditions on reproductive performance in dairy cows.

A software tool for prediction of prosthesis failure at the carpometacarpal joint of the thumb

Early recognition of prosthesis failure is difficult. A tool that helps to identify faulty prosthesis - a cause of early implant loosening - is needed. The aim of this study was to detect early implant loosening by applying a software program EBRA (Ein-Bild-Röntgen-Analyse). EBRA was applied to the radiographs of a series of 76 patients, with a total of 102 thumb carpometacarpal joint de la Caffinière prostheses, with an average follow-up of 14.5 months (range 0.5-24). The data were used to draw graphs of cup migration and inclination over time. Corresponding regression lines of migration and inclination in relation to time were made up to the point of loosening. The gradient of regression was calculated for all implants. The gradient of regression on the x and y axes differed significantly between stable and loose implants. Loose and stable implants showed significantly different cup migration on the x and y axes over time. EBRA proved to be a reliable tool to visualize cup migration in the trapeziometacarpal joint and to predict implant failure.

NIK is required for NF-κB-mediated induction of BAG3 upon inhibition of constitutive protein degradation pathways

Recently, we reported that induction of the co-chaperone Bcl-2-associated athanogene 3 (BAG3) is critical for recovery of rhabdomyosarcoma (RMS) cells after proteotoxic stress upon inhibition of the two constitutive protein degradation pathways, that is, the ubiquitin-proteasome system by Bortezomib and the aggresome-autophagy system by histone deacetylase 6 (HDAC6) inhibitor ST80. In the present study, we investigated the molecular mechanisms mediating BAG3 induction under these conditions. Here, we identify nuclear factor-kappa B (NF-κB)-inducing kinase (NIK) as a key mediator of ST80/Bortezomib-stimulated NF-κB activation and transcriptional upregulation of BAG3. ST80/Bortezomib cotreatment upregulates mRNA and protein expression of NIK, which is accompanied by an initial increase in histone H3 acetylation. Importantly, NIK silencing by siRNA abolishes NF-κB activation and BAG3 induction by ST80/Bortezomib. Furthermore, ST80/Bortezomib cotreatment stimulates NF-κB transcriptional activity and upregulates NF-κB target genes. Genetic inhibition of NF-κB by overexpression of dominant-negative IκBα superrepressor (IκBα-SR) or by knockdown of p65 blocks the ST80/Bortezomib-stimulated upregulation of BAG3 mRNA and protein expression. Interestingly, inhibition of lysosomal activity by Bafilomycin A1 inhibits ST80/Bortezomib-stimulated IκBα degradation, NF-κB activation and BAG3 upregulation, indicating that IκBα is degraded via the lysosome in the presence of Bortezomib. Thus, by demonstrating a critical role of NIK in mediating NF-κB activation and BAG3 induction upon ST80/Bortezomib cotreatment, our study provides novel insights into mechanisms of resistance to proteotoxic stress in RMS.

Histone acetyltransferase inhibitors block neuroblastoma cell growth in vivo

We have previously described novel histone acetyltransferase (HAT) inhibitors that block neuroblastoma cell growth in vitro. Here we show that two selected pyridoisothiazolone HAT inhibitors, PU139 and PU141, induce cellular histone hypoacetylation and inhibit growth of several neoplastic cell lines originating from different tissues. Broader in vitro selectivity profiling shows that PU139 blocks the HATs Gcn5, p300/CBP-associated factor (PCAF), CREB (cAMP response element-binding) protein (CBP) and p300, whereas PU141 is selective toward CBP and p300. The pan-inhibitor PU139 triggers caspase-independent cell death in cell culture. Both inhibitors block growth of SK-N-SH neuroblastoma xenografts in mice and the PU139 was shown to synergize with doxorubicin in vivo. The latter also reduces histone lysine acetylation in vivo at concentrations that block neoplastic xenograft growth. This is one of the very few reports on hypoacetylating agents with in vivo anticancer activity.

Analysis of effects of climate change on runoff in an urban drainage system: a case study from Seoul, Korea

Both water quantity and quality are impacted by climate change. In addition, rapid urbanization has also brought an immeasurable loss of life and property resulting from floods. Hence, there is a need to predict changes in rainfall events to effectively design stormwater infrastructure to protect urban areas from disaster. This study develops a framework for predicting future short duration rainfall intensity and examining the effects of climate change on urban runoff in the Gunja Drainage Basin. Non-stationarities in rainfall records are first analysed using trend analysis to extrapolate future climate change scenarios. The US Environmental Protection Agency Storm Water Management Model (SWMM) was used for single event simulation of runoff quantity from the study area. For the 1-hour and 24-hour durations, statistically significant upward trends were observed. Although the 10-minute duration was only nearly significant at the 90% level, the steepest slope was observed for this short duration. Moreover, it was observed that the simulated peak discharge from SWMM increases as the short duration rainfall intensity increases. The proposed framework is thought to provide a means to review the current design of stormwater infrastructures to determine their capacity, along with consideration of climate change impact.

Lack of anti-factor Xa assay standardization results in significant low molecular weight heparin (enoxaparin) dose variation in neonates and children

INTRODUCTION

Enoxaparin is a frequently used anticoagulant in children. Unlike in adults, consensus guidelines recommend therapeutic monitoring to a target anti-factor Xa level of 0.5-1 U mL(-1) . Therapeutic ranges are not well correlated with clinical outcomes (e.g. thrombosis or hemorrhage), and assays are not standardized. Owing to limited reagent supplies, our clinical laboratory conducted a validation process and switched anti-FXa assays. Although the assays correlated well with each other, anti-FXa values were, on average, 33% higher with the new assay. The target anti-FXa range was not altered. We evaluated how this change in anti-FXa assays influenced enoxaparin dosing (mg kg(-1) ).

METHODS

Enoxaparin dosing and anti-FXa values for all patients started on enoxaparin for the 6 months before and after assay change were retrospectively compiled and analyzed with a Student's t-test.

RESULTS

One hundred and nine children were started on enoxaparin before assay change, and 104 after assay change. The mean therapeutic enoxaparin dose (mg kg(-1) ) was significantly lower in subjects aged < 3 months (P = 0.01) and 3 months to 2 years (P < 0.0001), but not in subjects aged > 2 years (P = 0.18), after assay change. The median number of enoxaparin dose changes required to achieve the target range was significantly reduced after assay change, from 1 to 0 (P = 0.004).

CONCLUSIONS

The current pediatric practice of dose adjustment to achieve and maintain a target anti-FXa range is vulnerable to assay determination, which may provide false reassurance of efficacy and safety and represent misappropriation of time and resources. These data support a pediatric randomized controlled clinical trial comparing the safety and efficacy of enoxaparin weight-based dosing with or without dose titration based on anti-FXa.

[Scaphoid surgery]

Fracture of the scaphoid is the second most common fracture of the wrist. It requires a precise diagnosis and an individual therapy tailored to the patient. Computed tomography has assumed the central role in diagnostics and is obligatory to perform both verification and planning of treatment. Stable fractures can be treated conservatively while unstable fractures should be surgically stabilized. For this procedure different countersink compression screws are available. The fracture of the proximal pole must be considered separately because it is associated a very high rate of nonunion. No and incorrect treatment of fresh scaphoid fractures are the most common reasons for developing scaphoid nonunion. Depending on the location and perfusion, different surgical procedures including transplantation of avascular or vascularized bone grafts can be performed for treatment of scaphoid nonunion.

S3 guideline for chronic pancreatitis - diagnosis, classification and therapy for the radiologist

Chronic pancreatitis shows an increasing prevalence and incidence mainly in the Western Hemisphere. Early diagnosis and therapy are frequently delayed because of non-specific symptoms as well as non-specific blood values. The German Society of Digestive and Metabolic Diseases (DGVS) organized the preparation and publication of an interdisciplinary S3 level guideline with the support of the German Radiological Society (DRG) as 1 of 11 contributing societies. In this article we present and discuss the main topics of the guideline regarding the diagnosis, differential diagnosis and therapy of complications of this complex chronic disease with a focus on clinical and scientific radiologists.

KEY POINTS

• Ultarsound represents the perfect first line imaging modality • For further diagnostic werk up MRI with MRCP are recommended for the differential diagnosis of pancreatic cancer • For clinical studies the modified (CT, MRI) Cambridge classification is recommended.

Crucial factors for the acceptance of a computerized national medication list: insights into findings from the evaluation of the Austrian e-Medikation pilot

OBJECTIVE

The objective of this paper is to present crucial factors among registered doctors and pharmacists for acceptance of the Austrian 'e-Medikation' system which is aimed at providing, on a national level, complete and recent information on all the medication that were prescribed or dispensed to a patient.

METHODS

As the accompanying formative evaluation study of the pilot project showed different overall acceptance rates among participating physicians and pharmacists, a decision tree analysis of 30 standardized survey items was performed to identify crucial acceptance factors.

RESULTS

For the physicians' group, only two items (fear of improper data use and satisfaction with software support) were crucial for overall e-Medikation acceptance. The analysis of the pharmacists' data resulted in five crucial factors primarily focusing on functional aspects and the perceived benefits of e-Medikation.

CONCLUSION

The results indicate that the acceptance among physicians and pharmacists depends on quite different factors. This must be taken into account during the planned rollout of e-Medikation or of comparable products.

Prevalence of carpal tunnel syndrome and wrist osteoarthritis in long-term paraplegic patients compared with controls

We compared functional and structural changes in the hands, in particular the prevalence of carpal tunnel syndrome, in 56 paraplegic patients who had been wheelchair dependent for over 25 years with a group of able-bodied volunteers (with matching criteria for gender and age). The hands were assessed by clinical examination, electrophysiology, disabilities of the arm shoulder and hand score and magnetic resonance imaging. Hand function was worse and wrist pain was experienced more often in the paraplegic patients, and they also had a significantly higher prevalence of carpal tunnel syndrome both clinically and electrophysiologically. The prevalence of wrist and trapeziometacarpal osteoarthritis was significantly higher in the right hand.

Chromo-pharmacophores: photochromic diarylmaleimide inhibitors for sirtuins

Controlling the activity of sirtuins is of high biomedical relevance as the enzymes are involved in cancer, neurodegeneration and other diseases.

Pyrido- and benzisothiazolones as inhibitors of histone acetyltransferases (HATs)

We present structure–activity studies on pyrido- and benzisothiazolones as histone acetyltransferase (HAT) inhibitors. Distinct subtype-selectivity profiles were obtained in vitro that correlate with cytotoxicity profiles on cancer cells.

Einfluss ungleichmäßiger Eigenspannungen in Wälzlagerringen vor dem Härten auf Formabweichungen nach dem Härten∗

Der vorliegende Beitrag beschreibt, welchen Einfluss ungleichmäßige Eigenspannungen in Wälzlagerringen vor dem Härten auf die Unrundheit bzw. Ovalität von Ringen (Werkstoff 100Cr6) nach dem Härten haben können. Insbesondere werden die Auswirkungen unterschiedlicher Herstellverfahren auf die Ausbildung von Eigenspannungen erläutert. Daneben wird ein Verfahren angegeben, wie sich der Einfluss der Herstellstufen, einschließlich des Härtens, unterscheiden lässt.

Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency

BACKGROUND

Vitamin D has effects on the innate and adaptive immune system. In asthmatic children low vitamin D levels are associated with poor asthma control, reduced lung function, increased medication intake, and exacerbations. Little is known about vitamin D in adult asthma patients or its association with asthma severity and control.

METHODS

Clinical parameters of asthma control and 25-hydroxyvitamin D (25(OH)D) serum concentrations were evaluated in 280 adult asthma patients (mean ± SD: 45.0 ± 13.8 yrs., 40% male, FEV1 74.9 ± 23.4%, 55% severe, 51% uncontrolled).

RESULTS

25(OH)D concentrations in adult asthmatics were low (25.6 ±11.8 ng/ml) and vitamin D insufficiency or deficiency (vitamin D <30 ng/ml) was common (67%). 25(OH)D levels were related to asthma severity (intermittent: 31.1 ± 13.0 ng/ml, mild: 27.3 ± 11.9 ng/ml, moderate: 26.5 ± 12.0 ng/ml, severe: 24.0 ± 11.8 ng/ml, p = 0.046) and control (controlled: 29.5 ± 12.5 ng/ml, partly controlled 25.9 ± 10.8 ng/ml, uncontrolled: 24.2 ± 11.8 ng/ml, p = 0.030). The frequency of vitamin D insufficiency or deficiency was significantly higher in patients with severe or uncontrolled asthma and was associated with a lower FEV1 (vitamin D <30 vs. ≥30 ng/ml 2.3 ± 0.9 L vs. 2.7 ± 1.0 L, p = 0.006), higher levels of exhaled NO (45 ± 46 ppb vs. 31 ± 37 ppb, p = 0.023), a higher BMI (28.3 ± 6.2 vs. 25.1 ± 3.9, p < 0.001), and sputum eosinophilia (5.1 ± 11.8% vs. 0.5 ± 1.0%, p = 0.005). The use of oral corticosteroids or sputum eosinophilia was associated with a 20% or 40% higher risk of vitamin D insufficiency or deficiency.

CONCLUSIONS

25(OH)D levels below 30 ng/ml are common in adult asthma and most pronounced in patients with severe and/or uncontrolled asthma, supporting the hypothesis that improving suboptimal vitamin D status might be effective in prevention and treatment of asthma.

Evaluation of overland flow model for a hillslope using laboratory flume data

Comprehensive modelling of overland flow requires models for both rill and interrill area overland flow. Evaluation of a physically based mathematical model for simulating overland flow generated on rill and interrill areas of hillslope was done using a data set gathered from a laboratory experimental setup. A rainfall simulator has been constructed together with a 6.50 m × 1.36 m erosion flume that can be given adjustable slopes in both longitudinal and lateral directions. The model was calibrated and validated using the experimental results from the setup of the flume having 5% lateral and 10% longitudinal slopes where rainfall intensities of 105 and 45 mm/hr were induced with the use of nozzles. Results show that for the given slope combination, the model was capable of simulating the flow coming from the rill and interrill areas for the two different rainfall intensities. It was found that significantly more of the flow occurred in the form of the rill flow. The model studied here can be used for the better prediction of overland flow and can also be used as a building block for an associated erosion and sediment transport model.

Hypoxia supports reprogramming of mesenchymal stromal cells via induction of embryonic stem cell-specific microRNA-302 cluster and pluripotency-associated genes

Pluripotency is characterized by specific transcription factors such as OCT4, NANOG, and SOX2, but also by pluripotency-associated microRNAs (miRs). Somatic cells can be reprogrammed by forced expression of these factors leading to induced pluripotent stem cells (iPSCs) with characteristics similar to embryonic stem cells (ESCs). However, current reprogramming strategies are commonly based on viral delivery of the pluripotency-associated factors, which affects the integrity of the genome and impedes the use of such cells in any clinical application. In an effort to establish nonviral, nonintegrating reprogramming strategies, we examined the influence of hypoxia on the expression of pluripotency-associated factors and the ESC-specific miR-302 cluster in primary and immortalized mesenchymal stromal cells (MSCs). The combination of hypoxia and fibroblast growth factor 2 (FGF2) treatments led to the induction of OCT4 and NANOG in an immortalized cell line L87 and primary MSCs, accompanied with increased doubling rates and decreased senescence. Most importantly, the endogenous ECS-specific cluster miR-302 was induced upon hypoxic culture and FGF2 supplementation. Hypoxia also improved reprogramming of MSCs via episomal expression of pluripotency factors. Thus, our data illustrate that hypoxia in combination with FGF2 supplementation efficiently facilitates reprogramming of MSCs.

[Total wrist fusion with vascularized fibula graft after tumor resection of the distal radius]

OBJECTIVE

Total tumor resection and defect resconstruction by vascularized fibula graft and total wrist fusion.

INDICATIONS

Primary extended bone tumors of the distal radius.

CONTRAINDICATIONS

Tumor infiltration of the whole carpus or of the neurovascular structures.

SURGICAL TECHNIQUE

En bloc resection of the tumor including the biopsy scar. Raising of a microvascular fibula graft including the peroneal vessels. Defect reconstruction using the fibula and stabilization of the total wrist fusion with a locking compression plate (LCP).

POSTOPERATIVE MANAGEMENT

Functional therapy of the fingers is possible, below elbow cast for 6 weeks. Weight bearing after 12 weeks according to bone healing.

RESULTS

The operation technique described for preservation of the extremity in primary extended bone tumors of the distal radius was performed in our clinic in 2 patients since 2009. Tumor-free and pain-free hand function was found at the 2.5-year follow-up examinations. The patients had free range of motion of the fingers and preserved sensorimotor function. The MSTS (Musculoskeletal Tumour Society) scores by Enneking were 80% and 70%.

The 'difficult' polyp: pitfalls for endoscopic removal

Adenomatous polyps are early neoplasias of colorectal cancer (adenoma-carcinoma sequence). The majority of adenomas or early invasive cancers (T1sm1) can be resected by endoscopy. Endoscopic resection techniques include classic loop polypectomy, endoscopic mucosectomy with preceding lifting of the (almost flat) lesion, endoscopic submucosal dissection and transanal microsurgical resection, an alternative to endoscopic submucosal dissection in the rectum. Endoscopic polyp removal should always aim to resect the lesion in 'one piece' and avoid, whenever possible, 'piecemeal resection'. One-piece polypectomy is the basis for a precise histopathological analysis and for proving complete removal of the lesion. Preceding injection of saline solution into the submucosa to lift the targeted polyp is a therapeutic modality to remove even-flat and flat-depressed adenomas. In addition, a positive lifting sign is regarded as a criterion of lower superficial malignancy. Lifting of a polyp can be negatively influenced by an already advanced cancer (T1sm3/T2) in the deep parts of the submucosa as well as by scars and connective tissue in the upper two layers of the colorectal wall. Hence, a negative lifting sign may lead to incorrect macroscopic evaluation of the lesion before removal. Endoscopic submucosal dissection is mostly performed in large laterally spreading tumors in the rectum and in the preanal region. The technique has a relatively long learning curve and is somewhat time consuming. A 'difficult polyp' may be characterized by: (1) the size (>3 cm), pedunculated or sessile (Ip/Is); (2) morphological type (classification of Paris 2003), in particular the flat type II lesions IIa-c flat, flat depressed; laterally spreading tumors and the large sessile-serrated lesions; and (3) the difficult assessment of the grade of malignancy before removal [e.g. dysplasia-associated lesions or masses (DALMs), sporadic adenoma, colitis carcinoma]. Chromoendoscopy (with indigo carmine) represents an adequate method to differentiate advanced flat and depressed type II lesions from those with lower malignancy, and to better identify DALMs and sporadic adenomas in patients with long-lasting ulcerative colitis. To reduce the risk of resection (hemorrhage 0-6%, perforation 0.2%; Munich Polyp Study 2005) the application of hemoclips to visible vessels or injection of adrenaline (1:10,000) in the polyp stalk before removal are methods to prevent bleeding. In case of immediate bleeding, the treatment with hemoclips, injection (adrenaline or fibrin sealant) or endoloops are efficacious to manage this problem. Small perforations can be treated at once by the application of hemoclips, or, in case of larger or difficult leakages by Ovesco clips to avoid surgical interventions.

Radio frequency charge parity meter

We demonstrate a total charge parity measurement by detecting the radio frequency signal that is reflected by a lumped-element resonator coupled to a single InAs nanowire double quantum dot. The high frequency response of the circuit is used to probe the effects of the Pauli exclusion principle at interdot charge transitions. Even parity charge transitions show a striking magnetic field dependence that is due to a singlet-triplet transition, while odd parity transitions are relatively insensitive to a magnetic field. The measured response agrees well with cavity input-output theory, allowing accurate measurements of the interdot tunnel coupling and the resonator-charge coupling rate g(c)/2π~17 MHz.

Rapamycin-induced apoptosis is p53-independent in human prostate carcinoma PC-3 cells

We have investigated the mechanisms of rapamycin-induced growth inhibition and apoptosis in the PC-3 prostate carcinoma cell line. Rapamycin induced apoptosis as well as the expression of p21(waf1) mRNA and protein, independent of p53. Rapamycin treatment also resulted in: a decrease in cdk2 kinase activity; an increase in hypophosphorylated retinoblastoma protein (pRb); a dephosphorylation of p70 S6 kinase; and, growth-arrest in G(1)-phase of cell cycle. These data suggest that rapamycin-induced growth arrest and apoptosis occur through the p53-independent induction of p21(waf1). Since this induction occurred soon after rapamycin treatment, possibly, the early induction of p21(waf1) and G(1)-arrest are important components of the mechanism by which rapamycin induces apoptosis in PC-3 cells.

High frequency failure of the Moje thumb carpometacarpal joint arthroplasty

Arthroplasty is one of several options for treating symptomatic osteoarthritis of the thumb carpometacarpal joint. There are various hemi- and total arthroplasties available on the market. We report our experience of treating 12 patients with the Moje Acamo CMC1 prosthesis. We reviewed all the patients at a mean of 50 months postoperatively. All patients presented with loosening, migration or tilting of one or both implant components. Nine patients were symptomatic enough to warrant revision surgery with removal of the implant leaving a pseudarthrosis. At the last follow-up, five patients (42%) had already received revision surgery. All patients still possessing an implant showed progressive signs of implant loosening, although some of them had no symptoms. In order to assess their overall disadvantage compared with patients treated by primary trapeziectomy, the outcomes of these two groups were compared (matched pairs). The outcomes after revision surgery were comparable with those of primary trapeziectomy. We no longer use the Moje Acamo CMC1 implant and recommend that patients who have received this implant should be monitored carefully both clinically and radiologically.

The DNA methylation landscape of small cell lung cancer suggests a differentiation defect of neuroendocrine cells

Small cell lung cancer (SCLC) is a disease characterized by aggressive clinical behavior and lack of effective therapy. Owing to its tendency for early dissemination, only a third of patients have limited-stage disease at the time of diagnosis. SCLC is thought to derive from pulmonary neuroendocrine cells. Although several molecular abnormalities in SCLC have been described, there are relatively few studies on epigenetic alterations in this type of tumor. Here, we have used methylation profiling with the methylated-CpG island recovery assay in combination with microarrays and conducted the first genome-scale analysis of methylation changes that occur in primary SCLC and SCLC cell lines. Among the hundreds of tumor-specifically methylated genes discovered, we identified 73 gene targets that are methylated in >77% of primary SCLC tumors, most of which have never been linked to aberrant methylation in tumors. These methylated targets have potential for biomarker development for early detection and therapeutic management of SCLC. SCLC cell lines had a greater number of hypermethylated genes than primary tumors. Gene ontology analysis indicated a significant enrichment of methylated genes functioning as transcription factors and in processes of neuronal differentiation. Motif analysis of tumor-specific methylated regions identified enrichment of binding sites for several neural cell fate-specifying transcription factors including NEUROD1, HAND1, ZNF423 and REST. We hypothesize that two potential mechanisms, loss of cell fate-determining transcription factors by methylation of their promoters and functional inactivation of their corresponding genomic-binding sites by DNA methylation, can promote a differentiation defect of neuroendocrine cells thus enhancing the ability of tumor progenitor cells to transition toward SCLC.