Prognostic factors for colorectal cancer patients with pulmonary metastases

e15107

Background: Pulmonary is the second common metastastic site of CRC with a good survival after metastasectomy, however the general situation of pulmonary metastases from CRC has received little attention, especially for unresectable ones. The aim of this study was to determine factors that may influence survival and disease free interval from primary radical surgery to pulmonary metastases (DFI). Methods: From 01/2000 to 11/2008, a total of 206 pts with pulmonary metastases (colon72, rectal ca131, 3 unknown) were collected retrospectively and the clinical data were analyzed using Kaplan-Meier survival curves, univariate and multivariate analysis. Results: 128 pts (62.1%) had lung disease as the first metastatic site and 33 pts (26.7%) had synchronous liver involvement. Only 17 patients (8.3%) followed pulmonary metastatic resection, and others underwent palliative medical treatment including the chemotherapy and intervention. Median survival was 16.0 months (range 12.240–19.760) with a 18% 5-year survival. Of the totally 160 patients who had synchronous pulmonary metastases after radical primary tumor surgery, the mDFI was 20 months (range 16.738–23.262) months. Rectal cancer had a high chance (65%) for lung recurrence with longer DFI (21 vs 14 mo, P=0.02), but no difference of survival was shown compared to colon cancer. Factors that significantly predicted a poor prognosis on univariate analysis included vessel invasion (P=0.022) and high T stage (P=0.009), but neither of them was the independent prognostic factors after multivariate analysis. The factors influencing the DFI of metachronous pulmonary metastases included primary tumor site, pathological morphology, tumor infiltration stage and regional lymph node stage (P<0.05). There was a trend of better survival of patients receiving resection surgery after pulmonary metastases than receiving chemotherapy alone though no statistical significant was reached (mOS:34 vs 16 mo, P=0.125). But to patients who receiving metastatic site resection, chemotherapy after surgery improved the survival (P=0.042). Conclusions: No independent prognostic factors of survival had been found. The invasive tumor with high stage may have a shorter disease free interval of pulmonary metastases after primary surgery.

No significant financial relationships to disclose.

Fabrication and biological characteristics of beta-tricalcium phosphate porous ceramic scaffolds reinforced with calcium phosphate glass

The fabrication process, compressive strength and biocompatibility of porous beta-tricalcium phosphate (beta-TCP) ceramic scaffolds reinforced with 45P(2)O(5)-22CaO-25Na(2)O-8MgO bioglass (beta-TCP/BG) were investigated for their suitability as bone engineering materials. Porous beta-TCP/BG scaffolds with macropore sizes of 200-500 muicrom were prepared by coating porous polyurethane template with beta-TCP/BG slurry. The beta-TCP/BG scaffolds showed interconnected porous structures and exhibited enhanced mechanical properties to those pure beta-TCP scaffolds. In order to assess the effects of chemical composition of this bioglass on the behavior of osteoblasts cultured in vitro, porous scaffolds were immersed in simulated body fluid (SBF) for 2 weeks, and original specimens (without soaked in SBF) seeded with MC3T3-E1 were cultured for the same period. The ability of inducing apatite crystals in simulated body fluid and the attachment of osteoblasts were examined. Results suggest that apatite agglomerates are formed on the surface of the beta-TCP/BG scaffolds and its Ca/P molar ratio is approximately 1.42. Controlling the crystallization from the beta-TCP/BG matrix could influence the releasing speed of inorganic ions and further adjust the microenvironment of the solution around the beta-TCP/BG, which could improve the interaction between osteoblasts and the scaffolds.

Relation between nuclear envelope and nuclear lamina in nuclear assembly in vitro

Xenopus laevis egg extracts cell-free nuclear assembly system was used as an experimental model to study the process of nuclear lamina assembly in nuclear reconstitution in vitro. The experimental results showed that lamin was involved in the nuclear assembly in vitro. The assembly of nuclear lamina was preceded by the assembly of nuclear matrix, and probably, inner nuclear matrix assembly provided the basis for nuclear lamina assembly. Inhibition of normal assembly of nuclear lamina, by preincubating egg extracts cell-free system with anti-lamin antibodies, resulted in abnormal assembly of nuclear envelope, suggesting that nuclear envelope assembly is closely associated with nuclear lamina assembly.

The oligopeptide (opp) gene cluster of Streptococcus mutans: identification, prevalence, and characterization

INTRODUCTION

The Opp system is an ATP-binding cassette-type transporter formed by membrane-associated proteins required for the uptake of oligopeptides in bacteria. In gram-positive bacteria, the Opp system, and particularly the oligopeptide-binding protein (OppA), has been shown to be involved in different aspects of cell physiology, including intercellular communication and binding to host proteins.

METHODS

In the present study we began to investigate the Opp system of Streptococcus mutans, the main etiological agent of dental caries.

RESULTS

Five opp genes (oppABCDF) organized in a single operon were identified in the genome of the S. mutans UA159 strain. Amino acid sequence analyses showed that the S. mutans OppA is closely related to an ortholog found in Streptococcus agalactiae. Incubation of S. mutans UA159 cells with an anti-OppA-specific serum did not inhibit biofilm formation on polystyrene plates. Moreover, S. mutans UA159 derivatives carrying deletions on the oppA or oppB genes did not show significant growth impairment, increased sensitivity to aminopterin, or defective capacity to form biofilms on polystyrene wells in the presence or not of saliva. Remarkably, only two out of three laboratory strains and one out of seven clinical strains recovered from tooth decay processes harbored a copy of the oppA gene and expressed the OppA protein.

CONCLUSION

Collectively, these results indicate that, in contrast to other Streptococcus species, the S. mutans Opp system, and particularly the OppA protein, does not represent an important trait required for growth and colonization.

Strategies to design inhibitors of Clostridium botulinum neurotoxins

Botulinum neurotoxins (BoNTs), produced by spore-forming anaerobic Clostridium botulinum, are the most toxic substances known. They cause the life-threatening disease botulism, characterized by flaccid muscle paralysis. While the natural cases of botulism are rare, due to their extreme toxicity and easy production, BoNTs have become potential biowarfare agents, and create maximum fear among populations concerned with bioterror agents. The only available antidote against BoNTs is equine antitoxin. Equine antitoxin can only target the toxins at extracellular level, and can not reverse the paralysis caused by botulism. In addition, equine antibody can cause severe hypersensitivity reactions, and is limited to be used for prophylaxis treatment. BoNTs are large proteins with three distinct domains, the binding domain, the translocation domain, and the enzymatic domain with highly specific endopeptidase activity to cleave the proteins involved the neurotransmitter release. Targeting any of these domains can inhibit the functions of BoNT. Humanized monoclonal antibodies, small peptides and peptide mimetics, receptor mimics, and small molecules targeting the endopeptidase activity have emerged as potential new inhibitors against BoNTs. With the structure of BoNT resolved, molecular modeling and rational design of potent antidotes against botulism is on the horizon. An area that has not been explored for designing the antidotes against botulism is aptamers, which have been successfully developed as therapeutics in several areas. This review will focus on some of these new strategies to design effective antidotes against botulism. The strategies reviewed in this article can be easily applied to design inhibitors for other bacterial toxins.

Systemic and Myocardial Oxygen Transport Responses to Brain Death in Pigs

BACKGROUND

Brain death is associated with profound disturbances of systemic and myocardial oxygen transport, but little is known regarding the acute response of systemic oxygen consumption (VO(2)).

METHODS

Brain death was induced in 6 pigs (30.6 +/- 3.0 kg) by balloon inflation into the cranial cavity. VO(2) was continuously measured by respiratory mass spectrometry. Blood pressures and gases were measured from the aorta, superior vena cava, and coronary sinus, with arterial epinephrine and norepinephrine, prior to brain death, at 1, 10, and 90 minutes after brain death. Cardiac output (CO), systemic vascular resistance (SVR), oxygen delivery (DO(2)), oxygen extraction (EO(2)), and myocardial oxygen (mEO(2)) and lactate extractions (mE(1ac)) were calculated. Left ventricular contractility was assessed by micromanometer tipped catheters.

RESULTS

VO(2) increased from 4.8 +/- 0.9 to 6.3 +/- 0.9 mL/min/kg 1 minute after brain death (P < .001), and subsequently decreased to below baseline at 90 minutes (P < .001). Left ventricular contractility, CO, and DO(2) increased 1 minute after brain death (P < .001), followed by a rapid decrease to baseline within 10 minutes (P < .001). SVR and EO(2) decreased after brain death (P < .01) and remained low. Lactate remained unchanged. mE(1ac) decreased after brain death despite a decrease in mEO(2) (P < .01), and returned to baseline at 90 minutes.

CONCLUSIONS

The initial surge in VO(2) after brain death is offset by the greater increase in DO(2), thus tissue perfusion remains adequate. The lower than baseline VO(2) and SVR at the end of the study period may indicate general metabolic and hemodynamic compromise. The information regarding the profound metabolic alterations imposed by brain death may have implications for management of brain death donors.

The discovery of tetrahydrofluorenones as a new class of estrogen receptor beta-subtype selective ligands

Synthesis and derivatization of a series of substituted tetrahydrofluorenone analogs giving potent, ERbeta subtype selective ligands are described. Several analogs possessing ERbeta binding affinities comparable to 17beta-estradiol but with greater than 75-fold selectivity over ERalpha are reported.

Assessment of the relationship between cerebral and splanchnic oxygen saturations measured by near-infrared spectroscopy and direct measurements of systemic haemodynamic variables and oxygen transport after the Norwood procedure

OBJECTIVES

To evaluate the clinical utility of near-infrared spectroscopic (NIRS) monitoring of cerebral (ScO2) and splanchnic (SsO2) oxygen saturations for estimation of systemic oxygen transport after the Norwood procedure.

METHODS

ScO2 and SsO2 were measured with NIRS cerebral and thoracolumbar probes (in humans). Respiratory mass spectrometry was used to measure systemic oxygen consumption (O2). Arterial (SaO2), superior vena caval (SvO2) and pulmonary venous oxygen saturations were measured at 2 to 4 h intervals to derive pulmonary (Qp) and systemic blood flow (Qs), systemic oxygen delivery (DO2) and oxygen extraction ratio (ERO2). Mixed linear regression was used to test correlations. A study of 7 pigs after cardiopulmonary bypass (study 1) was followed by a study of 11 children after the Norwood procedure (study 2).

RESULTS

Study 1. ScO2 moderately correlated with SvO2, mean arterial pressure, Qs, DO2 and ERO2 (slope 0.30, 0.64. 2.30, 0.017 and -32.5, p < 0.0001) but not with SaO2, arterial oxygen pressure (PaO2), haemoglobin and O2. Study 2. ScO2 correlated well with SvO2, SaO2, PaO2 and mean arterial pressure (slope 0.43, 0.61, 0.99 and 0.52, p < 0.0001) but not with haemoglobin (slope 0.24, p > 0.05). ScO2 correlated weakly with O2 (slope -0.07, p = 0.05) and moderately with Qs, DO2 and ERO2 (slope 3.2, 0.03, -33.2, p < 0.0001). SsO2 showed similar but weaker correlations.

CONCLUSIONS

ScO2 and SsO2 may reflect the influence of haemodynamic variables and oxygen transport after the Norwood procedure. However, the interpretation of NIRS data, in terms of both absolute values and trends, is difficult to rely on clinically.

Comparative studies on the roles of mediator molecules in expression of the suppressor activity of Mycobacterium avium complex-induced immunosuppressive macrophages against T cell and B cell mitogenic responses

Mycobacterium avium complex-induced immunosuppressive macrophages (MAC-MPhis) exhibit suppressor activity against concanavalin A-induced T cell mitogenesis (T cell Con A mitogenesis). We examined the profiles of the MAC-MPhi-mediated suppression of lipopolysaccharide-induced B cell mitogenesis (B cell LPS mitogenesis) and found the following. First, although N(G)-monomethyl-L-arginine and carboxy-PTIO effectively blocked the MAC-MPhi's suppressor activity against T cell Con A mitogenesis, MAC-MPhi's action against B cell LPS mitogenesis was only weakly affected by these NO-reducing agents. Second, B cell LPS mitogenesis was remarkably more susceptible to MAC-MPhi-derived reactive oxygen intermediates than T cell Con A mitogenesis. Third, B cell LPS mitogenesis was less susceptible to the inhibitory effects of the other MAC-MPhi-derived suppressor mediators, including free fatty acids, TGF-beta and prostaglandin E(2), than T cell Con A mitogenesis. Fourth, MAC-MPhi's suppressor activity was strongly dependent on B7-1 like molecule-mediated cell contact with target cells only in the case of T cell Con A mitogenesis. Therefore, there are significant differences in the modes of suppressor action of MAC-MPhis against T cell and B cell mitogenesis.

Targeted nNOS gene transfer into the cardiac vagus rapidly increases parasympathetic function in the pig

Nitric oxide (NO) derived from neuronal nitric oxide synthase (nNOS) facilitates cardiac vagal neurotransmission and bradycardia in vitro. Here we provide evidence of rapid (within 9 h) protein expression and increased vagal responsiveness in vivo following targeted gene transfer of nNOS into the cardiac vagus of the pig. Right vagi were injected with vector encoding nNOS (Ad.nNOS) or saline, while left vagi received an injection of vector encoding enhanced green fluorescent protein (Ad.eGFP). Enhanced nNOS protein expression was detected exclusively in the right vagus nerve, with no evidence of iNOS expression. This was associated with increased baroreflex sensitivity and greater heart rate responsiveness to right vagal stimulation. In contrast, responsiveness of left vagi, or sham-injected right vagi remained constant over the same time period. Basal heart rate was unchanged following gene transfer, suggesting no change in vagal tone. These results support the pre-/post-ganglionic synapse as a site for NO-mediated facilitation of vagal bradycardia in the pig. In addition they demonstrate in vivo that functional gene expression induced with adenoviral vectors occurs earlier than first thought, and may therefore, provide a novel intervention to acutely modulate the neural control of cardiac excitability.

Endothelial nitric oxide synthase dysfunction in diabetic mice: importance of tetrahydrobiopterin in eNOS dimerisation

AIMS/HYPOTHESIS

Impaired nitric oxide (NO) bioactivity and increased superoxide (SO) production are characteristics of vascular endothelial dysfunction in diabetes. The underlying mechanisms remain unknown. In this regard, we investigated the role of tetrahydrobiopterin (BH4) bioavailability in regulating endothelial nitric oxide synthase (eNOS) activity, dimerisation and SO production in streptozotocin-induced diabetic mice.

METHODS

Mouse aortas were used for assays of the following: (1) aortic function by isometric tension; (2) NO by electronic paramagnetic resonance; (3) SO by lucigenin-enhanced chemiluminescence and dihydroethidine fluorescence; (4) total biopterin and BH4 by high-performance liquid chromatography; and (5) eNOS protein expression and dimerisation by immunoblotting.

RESULTS

In diabetic mouse aortas, relaxations to acetylcholine and NO levels were significantly decreased, but SO production was increased, in association with reductions in total biopterins and BH4. Although total eNOS levels were increased in diabetes, the protein mainly existed in monomeric form. Conversely, specifically augmented BH4 in diabetic endothelium preserved eNOS dimerisation, but the expression remained unchanged.

CONCLUSIONS/INTERPRETATION

Our results demonstrate that BH4 plays an important role in regulating eNOS activity and its functional protein structure, suggesting that increasing endothelial BH4 and/or protecting it from oxidation may be a rational therapeutic strategy to restore eNOS function in diabetes.

Effect of endodontic procedures on enterococci, enteric bacteria and yeasts in primary endodontic infections

AIM

To detect enterococci, enteric bacteria and yeast species from the canals of teeth with primary endodontic infections before and after canal preparation and to test the antibiotic susceptibility of enterococcal strains isolated from infected root canals.

METHODOLOGY

Twenty-five single-rooted teeth with pulp necrosis, intact pulp chambers and periradicular lesions were selected for study. Samples were collected from canals before and after instrumentation. Amongst isolated microorganisms from infected root canals only enterococci, enteric bacteria and yeasts were identified by biochemical tests. The in vitro antimicrobial susceptibility of isolated enterococci strains was evaluated by the Etest system.

RESULTS

Microorganisms were isolated from 92% of the samples following intracoronal access, 22% were enterococci, enteric bacteria or yeast species. After biomechanical preparation, these species were no longer detected. After 7 days without intracanal dressing, 100% of the canals contained microorganisms, 52% of which were target species. However, after using paramonochlorophenol [PRP (2.0 g), Rinosoro and polyethylene glycol (400 equal parts up to 100 mL)] as an intracanal dressing for 7 days, enteric bacteria and yeasts were not detected; only enterococci were still present. All strains of enterococci were susceptible to ampicillin, but exhibited variable susceptibility to rifampin and ciprofloxacin.

CONCLUSIONS

Enterococci, enteric bacteria and yeasts were present in primary endodontic infections. Enterococci, particularly Enterococcus faecalis and E. faecium were resistant to removal by root canal preparation followed by intracanal dressing.

In vitro antimicrobial effect of bacteriophages on human dentin infected with Enterococcus faecalis ATCC 29212

This study assessed the effect of bacteriophages on the viability of Enterococcus faecalis. Human dental roots were inoculated with a suspension of E. faecalis at three different multiplicities of infection - 0.1, 1.0 and 10.0. The phage lysate was able to significantly inhibit bacteria growth when incubated at the multiplicities of infection of 1.0, 10.0 and 0.1. The dental roots were also inoculated with bacteria for 6 days to allow bacterial penetration into the teeth tubules. Addition of the phage lysate to the roots following the 6-day incubation period led to a substantial reduction in bacteria viability. Phage therapy may be an important alternative for the treatment of root canal infections refractory to conventional endodontic therapy.

Impaired regulation of neuronal nitric oxide synthase and heart rate during exercise in mice lacking one nNOS allele

We tested the hypothesis that a single allele deletion of neuronal nitric oxide synthase (nNOS) would impair the neural control of heart rate following physical training, and that this phenotype could be restored following targeted gene transfer of nNOS. Voluntary wheel-running (+EX) in heterozygous nNOS knockout mice (nNOS(+/-), +EX; n= 52; peak performance 9.1 +/- 1.8 km day(-1)) was undertaken and compared to wild-type mice (n= 38; 9.5 +/- 0.8 km day(-1)). In anaesthetized wild-type mice, exercise increased phenylephrine-induced bradycardia by 67% (measured as heart rate change, in beats per minute, divided by the change in arterial blood pressure, in mmHg) or pulse interval response to phenylephrine by 52% (measured as interbeat interval change, in milliseconds, divided by the change in blood pressure). Heart rate changes or interbeat interval changes in response to right vagal nerve stimulation were also enhanced by exercise in wild-type atria (P < 0.05), whereas both in vivo and in vitro responses to exercise were absent in nNOS(+/-) mice. nNOS inhibition attenuated heart rate responses to vagal nerve stimulation in all atria (P < 0.05) and normalized the responses in wild-type, +EX with respect to wild-type with no exercise (-EX) atria. Atrial nNOS mRNA and protein were increased in wild-type, +EX compared to wild-type, -EX (P < 0.05), although exercise failed to have any effect in nNOS(+/-) atria. In vivo nNOS gene transfer using adenoviruses targeted to atrial ganglia enhanced choline acetyltransferase-nNOS co-localization (P < 0.05) and increased phenylephrine-induced bradycardia in vivo and heart rate responses to vagal nerve stimulation in vitro compared to gene transfer of enhanced green fluorescent protein (eGFP, P < 0.01). This difference was abolished by nNOS inhibition (P < 0.05). In conclusion, genomic regulation of NO bioavailability from nNOS in cardiac autonomic ganglia in response to training is dependent on both alleles of the gene. Although basal expression of nNOS is normal, polymorphisms of nNOS may interfere with neural regulation of heart rate following training. Targeted gene transfer of nNOS can restore this impairment.

Comparative antimicrobial activities of gatifloxacin, sitafloxacin and levofloxacin against Mycobacterium tuberculosis replicating within Mono Mac 6 human macrophage and A-549 type II alveolar cell lines

Mycobacterium tuberculosis (MTB) is capable of invading not only macrophages (Mphis) but also type II pneumocytes. In this study, we compared the antimicrobial activities of fluoroquinolones, including gatifloxacin, sitafloxacin and levofloxacin, against the MTB replication in the Mono Mac 6 human Mphi cell line (MM6-Mphis) and the A-549 human type II alveolar epithelial cell line (A-549 cells). When test quinolones were added at the MIC (0.125, 0.06 and 0.25 mg/l for gatifloxacin, sitafloxacin and levofloxacin, respectively) to the culture media of MTB-infected cells, these drugs exerted growth-inhibitory activity against intracellular organisms in the order of sitafloxacin > gatifloxacin > levofloxacin. On the other hand, when test quinolones were added at Cmax in the blood (1.7, 1.0 and 2.0 mg/l for gatifloxacin, sitafloxacin and levofloxacin, respectively), these drugs exhibited bactericidal activity against intracellular MTB in the order of gatifloxacin > sitafloxacin > or = levofloxacin. In addition, when test drugs were added at 1/8 C(max) to 1/2 C(max), the efficacy was in the order of sitafloxacin > gatifloxacin > levofloxacin. Thus, it appears that the MIC values of fluoroquinolones are not always predictive of their antimicrobial activity against intracellular MTB. In this context, it was also found that intracellular uptake of these quinolones by MM6-Mphis and A-549 cells was in the order of sitafloxacin > gatifloxacin > levofloxacin. This implies that the cellular permeability of these quinolones is an important factor that determines their efficacy to eliminate intracellular MTB organisms.

Molecular characterization of a distinct potyvirus from whitegrass in China

Apotyvirus isolated from perennial whitegrass ( Pennisetum centrasiaticum Tzvel.) in North China was characterized at the molecular level. The 3' terminal nucleotide (nt) sequence of 1669 nt of the viral RNA genome has been determined, which covered the coding region of the C-terminal part of the large nuclear inclusion protein (NIb, RNA polymerase), capsid protein (CP) gene and the 3' nontranslated region (NTR). The CP gene consisted of 909 nt (including the stop codon) encoding 302 amino acid residues, and the 3' NTR was 241 nt in length excluding the polyadenylated tract. Sequence comparison of the amino acids of CPs showed that this virus was most closely related to Sorghum mosaic virus and Maize dwarf mosaic virus with percent identities of 77% to 78% while that of the 3' NTRs suggested that it was most closely related to Zea mosaic virus with identity of 72%. This virus isolate was to some extent closely related to other members of the Sugarcane mosaic virus subgroup of potyviruses for the CP amino acid sequences. Phylogenetic analyses of the sequences indicated that this virus isolate represented a distinct potyvirus, and the name Pennisetum mosaic virus (PenMV) is proposed.

Efficacy of a 0.5% chlorhexidine gel on the control of gingivitis in Brazilian mentally handicapped patients

OBJECTIVE

To evaluate the effectiveness of a 0.5% chlorhexidine gel on the reduction of interdental gingival bleeding.

MATERIAL AND METHODS

Forty-three mentally handicapped subjects, living in an institution (Casas André Luiz, Brazil), were enrolled in a double-blind randomised clinical trial. The subjects were randomly divided into two groups: test (chlorhexidine gel) and control (placebo gel). The gel was applied with trays, twice a day, over a period of 8 weeks. The interdental bleeding index (IBI) was recorded before and after the period in which the gel was used.

RESULTS

Statistical analysis showed that baseline IBI scores were similar (p=0.82) for test and control groups (55.6% and 54.5%, respectively). After 8 weeks, a statistically significant (p<0.001) decrease in IBI means took place in the test group (33.2%). The control group presented a small increase (60.6%) in IBI scores. The difference between groups was significant at the end of the study (p<0.001).

CONCLUSION

The results indicated that the use of a 0.5% chlorhexidine gel was effective in reducing interdental gingival bleeding in special patients.

Neuronal nitric oxide synthase gene transfer promotes cardiac vagal gain of function

Nitric oxide (NO) generated from neuronal nitric oxide synthase (NOS-1) in intrinsic cardiac ganglia has been implicated in parasympathetic-induced bradycardia. We provide direct evidence that NOS-1 acts in a site-specific manner to promote cardiac vagal neurotransmission and bradycardia. NOS-1 gene transfer to the guinea pig right atrium increased protein expression and NOS-1 immunolocalization in cholinergic ganglia. It also increased the release of acetylcholine and enhanced the heart rate (HR) response to vagal nerve stimulation (VNS) in vitro and in vivo. NOS inhibition normalized the HR response to VNS in the NOS-1-treated group compared with the control groups (enhanced green fluorescent protein and sham) in vitro. In contrast, an acetylcholine analogue reduced HR to the same extent in all groups before and during NOS inhibition. These results demonstrate that NOS-1-derived NO acts presynaptically to facilitate vagally induced bradycardia and that upregulation of NOS-1 via gene transfer may provide a novel method for increasing cardiac vagal function.

Effect of Cervitec on mutans streptococci in plaque and on caries formation on occlusal fissures of erupting permanent molars

The aim of this study was to evaluate the effect of Cervitec on the abundance of mutans streptococci (MS) in occlusal dental plaque and on 2-year caries increment of partly erupting first permanent molars. Sixteen healthy schoolchildren aged 6-8 years, with at least 2 sound contralateral partly erupted permanent molars, received diet counselling and daily parental supervised toothbrushing with a fluoride dentifrice. Stimulated saliva samples were collected at baseline and after 1 year to evaluate MS levels. In a split-mouth design, Cervitec varnish was applied to one of the teeth at baseline and after 3 and 6 months, while the other tooth in the same jaw was a control. At the 9-month follow-up the teeth were in occlusal contact. At this time, varnish was not applied. At 3 and 6 months after the first application of varnish a significant suppression of MS was observed in plaque. Caries investigations, performed at baseline and every 3 months during the 2 years after the start of the study, showed that all the teeth treated with the varnish were free of caries after 2 years, whereas 8/16 control teeth developed incipient caries. In conclusion, our results suggest that treatment with Cervitec reduces MS in plaque on erupting permanent molars and can lead to a significant decrease in caries incidence.

Role of the disulfide cleavage induced molten globule state of type a botulinum neurotoxin in its endopeptidase activity

Botulinum neurotoxins are produced by anaerobic Clostridium botulinum in an inactive form. The endopeptidase activity of type A botulinum neurotoxin (BoNT/A) is triggered by reduction of its disulfide bond between its heavy chain and light chain. By using circular dichroism spectroscopy, we show that, upon reduction of BoNT/A and under physiological temperature (37 degrees C), the BoNT/A loses most of its native tertiary structure, while retaining most of its secondary structure. This type of structure is characterized as a molten globule type conformation, which was further confirmed for BoNT/A by the characteristic binding of 1-anilinonaphthalene-8-sulfonic acid. Under nonreducing conditions where the interchain disulfide bond is intact, the enzymatically inactive BoNT/A did not show a molten globule type of structure. A temperature profile of the structure and enzyme activity of BoNT/A revealed that, under reducing conditions, there was a strong correlation in the existence of the molten globule structure and optimum endopeptidase activity at about 37 degrees C.

[Effect of hypertonic saline solution on the viscoelasticities of erythrocyte membrane in rats subjected to hemorrhagic shock]

We have studied the effect of hypertonic saline solution on the viscoelasticities of erythrocyte membrane in hemorrhage-shocked rats using micropippette aspiration technique. Wistar rats were randomly divided into three groups of 0.9% NaCl(NS), 7.5% NaCl (HS) and 5% NaCl-3.5% NaAc (HSA), respectively. The animals were bled to reach a mean arterial pressure of 5.3 kPa in 10 minutes and maintained in shock for 90 minutes. 4 ml/kg NS, HS and HSA was given intravenously and respectively in 5 minutes following hemorrhagic shock. The blood was collected to determine the viscoelasticities of erythrocyte membrane at baseline, shock and after treatment. The results showed that the elastic moduli and viscous coefficients of erythrocyte membrane were increased obviously following hemorrhagic shock. HS raised elastic moduli and reduced viscous coefficients significantly compared with NS after treatment. The elastic moduli and viscous coefficients of erythrocyte membrane were decreased remarkably in HSA group than in NS and HS group. These data suggested that HSA could improve the viscoelasticities of erythrocyte membrane significantly in rats subjected to hemorrhagic shock.

[Impacts of chemotherapy on long-term survival of patients with advanced epithelial ovarian cancer]

OBJECTIVE

To investigate the role of first-line chemotherapy in the management of advanced epithelial ovarian cancer (AEOC) and the effects on long-term survival epithelial.

METHODS

From January 1986 to December 1997, 348 cases of stage III and IV epithelial ovarian cancer treated at our institute were reviewed retrospectively, and the patients were divided into optimal and suboptimal groups according to the size of residual disease after primary cytoreduction. Survival was calculated by Kaplan-Meier method with difference in survival estimated by Log-rank test. Long-term survival (5 years) determining factors were identified by Logistic regression model.

RESULTS

The median age was 55 years (range, 20-82 years). In the optimal group, there was a significant difference in survival between patients with and without intraperitoneal chemotherapy, with an estimated median survival of 46 months and 36 months respectively (chi2 = 7.39, P = 0.0065). In the suboptimal group, the estimated median survival was 22 months in patients with more than 6 cycles of chemotherapy, 11 months in those less than 6 cycles (chi2 = 4.31, P = 0.0380). Neoadjuvant chemotherapy, tumor grade were independent prognostic factors of survival in this group. Size of residual disease, intraperitoneal chemotherapy, and tumor grade were determinants of long-term survival of AEOC.

CONCLUSIONS

Multi-courses ( > 6) of platinum-based intravenous chemotherapy prolonged the survival of patients with suboptimal cytoreduction. Intraperitoneal chemotherapy was one of the dominant long-term survival determinants, and mainly on those with size of residual disease less than 1 cm.

Evaluation of the diagnostic criteria for the localization of acquired arteriovenous fistulas by color Doppler flow imaging

OBJECTIVE

To evaluate the diagnostic criteria for the localization of acquired arteriovenous fistulas (AVFs) by color Doppler flow imaging (CDFI) based on the features of their hemodynamic changes.

METHODS

The shape and hemodynamic changes of involved vessels which could be helpful to localize the sites of fistulas were studied according to the observation of 10 cases of acquired AVFs.

RESULTS

The sites of the fistulas could be shown by two-dimensional ultrasonography and color flow imaging in 40% and 80% cases, respectively. In all cases, turbulent high-velocity flow was present at the sites of the fistulas, low resistant flow was present in the arteries proximal to the fistulas, and artery-like flow was detected in the veins.

CONCLUSION

CDFI was accurate for the localization of acquired AVFs, which were mainly localized by their hemodynamic changes shown by pulse Doppler ultrasound.

Cyanide complexes of iron corrolates: spin delocalization and autoreduction

Complex formation of (7,13-dimethyl-2,3,8,12,17,18-hexaethylcorrolato)iron chloride, [(7,13-Me(2)Et(6)C)FeCl], with cyanide ion in dimethylformamide, DMF-d(7), was studied by (1)H NMR spectroscopy. It is found that a bis-cyanide complex is formed initially, in which the electron configuration is a low-spin Fe(III) corrolate(2-*). This complex is not stable, and it is readily reduced with an excess of cyanide in the solution. The reduction occurs at the corrole ring instead of on the iron center giving the monocyanide complex of the low-spin Fe(III) corrole, [(7,13-Me(2)Et(6)C)FeCN](-). Thus, this is a case where an axial ligand serves as a reducing agent of the macrocycle and not of the metal.

Characterization of the prfA virulence gene cluster insertion site in non-hemolytic Listeria spp.: probing the evolution of the Listeria virulence gene island

The prfA virulence gene cluster is present between prs and ldh in the pathogenic L. monocytogenes and L. ivanovii, but absent from the non-pathogenic L. innocua and L. welshimeri. To probe the evolution of this virulence gene cluster, we sequenced the prs-ldh intergenic region in L. welshimeri and L. innocua. Two ORFs (ORFA and ORFB) were found in both species as well as in L. monocytogenes. Another ORF of unknown function (ORFZ) was found in L. monocytogenes and L. innocua, while two unique ORFs were present in L. welshimeri. ORFA and ORFB showed significant functional constraint, suggesting that further investigations in the functions of these genes, including possible roles in horizontal gene transfer or sequence deletion, are warranted. DNA sequences homologous to Tn1545 integration consensus sequences were found downstream of prs and ORFB, thus defining the likely junctions of the virulence gene island and indicating that the prs-ldh intergenic region may represent a Tn insertion hot spot. Our results are consistent with the hypothesis that a combination of horizontal gene transfer and deletion events mayhave been involved in the evolution of the prfA virulence gene cluster in Listeria.

Tumor necrosis factor modulates fibroblast apoptosis, PMN recruitment, and osteoclast formation in response to P. gingivalis infection

P. gingivalis is an important oral pathogen, which has been closely linked to periodontal disease as well as lesions of endodontic origin. Both infections are associated with a decrease in fibroblast numbers, formation of an inflammatory infiltrate, and bone resorption. The goal of this study was to investigate the role that the host response plays in the capacity of P. gingivalis to stimulate fibroblast apoptosis, PMN recruitment, and osteoclastogenesis. This was accomplished by the use of an in vivo calvarial model in mice with targeted deletion of TNF receptors p55 and p75 and matched wild-type mice. The results indicate that P. gingivalis induces fibroblast apoptosis in vivo and establish for the first time that this involves the stimulation of a host response. Moreover, bacteria-stimulated PMN recruitment and osteoclastogenesis were also dependent upon the host response. The results suggest that much of the damage caused by P. gingivalis infection, including fibroblast apoptosis, at least under some circumstances, results from stimulation of the host response rather than the direct effect of bacterial products. Furthermore, this may represent a more general mechanism by which bacterial challenge induces apoptosis of matrix-producing cells through the induction of TNF.

[Clinicopathological and molecular genetic analysis in Chinese typical hereditary nonpolyposis colorectal cancer pedigrees]

OBJECTIVE

To investigate the clinicopathological and molecular genetic characteristics of Chinese hereditary nonpolyposis colorectal cancer (HNPCC) pedigrees.

METHODS

Four Chinese HNPCC pedigrees were studied using microdissection, microsatellite instability analysis, immunohistochemistry staining and direct DNA sequencing for hMSH2 and hMLH1 genes.

RESULTS

All five tumor tissues from 4 probands showed high level of microsatellite instability at more than 2 loci(RER + phenotype). Three of 4 cases lost hMSH2 protein expression and one case showed no hMLH1 protein expression. Three pathological germline mutations (2 on hMSH2 and 1 on hMLH1) were identified.

CONCLUSIONS

Chinese typical HNPCC kindreds showed relatively frequent germline mutations of mismatch repair genes. Microsatellite instability analysis and immunohistochemistry staining might be the effective screening methods before direct DNA sequencing for the detection of mismatch repair genes. It is necessary to establish clinical criteria and molecular diagnostic strategies more suitable for Chinese HNPCC kindreds.

Telomerase activity and homozygous deletions of the p16 gene in liver metastases of colorectal carcinoma

OBJECTIVE

To study the interaction between telomerase activity and abnormalities of the p16 gene in liver metastases of colorectal carcinoma.

METHODS

Telomerase activity was detected by a non-isotopic PCR-based telomeric repeat amplification protocol (TRAP) assay, and homozygous deletions of the p16 gene were detected by a semiquantitative multiplex polymerase chain reaction in tissue samples from 24 liver metastases of colorectal carcinoma and 5 primary colorectal carcinomas.

RESULTS

Telomerase activity was observed in 19 (79.2%) of 24 liver metastases of colorectal carcinoma. Telomerase activity was also observed in all 5 primary colorectal carcinomas and in 3 of their liver metastatic samples. The incidence of telomerase activity in liver metastases of colorectal carcinoma was not significantly correlated to tumor diameter, number of tumors, cirrhosis, and HBsAg. Homozygous deletions of the p16 gene were found in 9 of 24 (37.5%) liver metastases of colorectal carcinoma. Homozygous deletions of the p16 gene were observed in 2 of the 5 primary colorectal carcinomas and in 1 of the matching liver metastatic cancers. There was a correlation between telomerase activity and homozygous deletions of the p16 gene.

CONCLUSIONS

There is a correlation between telomerase activity and homozygous deletions of the p16 gene in liver metastases of colorectal carcinoma, suggesting its crucial role in liver metastases. However, telomerase activation and homozygous deletions of the p16 gene might not be the initiating event in liver metastases of colorectal carcinoma.

Subgingival occurrence and antimicrobial susceptibility of enteric rods and pseudomonads from Brazilian periodontitis patients

The occurrence and in vitro antimicrobial sensitivity of isolates of enteric rods and pseudomonads were examined in 80 periodontitis patients, 17 to 58 years of age, in São Paulo, Brazil. Speciation and in vitro antimicrobial susceptibility testing were performed using the BBL Crystal enteric/nonfermenter system and the Etest for amoxicillin/clavulanic acid, ciprofloxacin and doxycycline. A total of 30 strains were isolated from 25 (31.2%) of the study subjects. Pseudomonas aeruginosa occurred in nine patients, Serratia marcescens in seven, and five other species were recovered in lower prevalence. All study organisms demonstrated high susceptibility to ciprofloxacin but exhibited variable susceptibility patterns to the other antimicrobial agents tested. In conclusion, the high occurrence of enteric rods and pseudomonads in these subjects may be important in the pathogenesis of periodontitis, and ciprofloxacin might be the antibiotic of choice to eradicate these pathogens from periodontal pockets.

Nitric oxide synthase (nNOS) gene transfer modifies venous bypass graft remodeling: effects on vascular smooth muscle cell differentiation and superoxide production

BACKGROUND

Pathological vascular remodeling in venous bypass grafts (VGs) results in smooth muscle cell (SMC) intimal hyperplasia and provides the substrate for progressive atherosclerosis, the principal cause of late VG failure. Nitric oxide (NO) bioactivity is reduced in VGs, in association with increased vascular superoxide production, but how these features relate to pathological VG remodeling remains unclear. We used gene transfer of the neuronal isoform of nitric oxide synthase (nNOS) to investigate how increased NO production modulates vascular remodeling in VGs and determined the effects on late VG phenotype.

METHODS AND RESULTS

New Zealand White rabbits (n=60) underwent jugular-carotid interposition bypass graft surgery with intraoperative adenoviral gene transfer of nNOS or beta-galactosidase. Vessels were analyzed after 3 days (early, to investigate acute injury/inflammation) or 28 days (late, to investigate SMC intimal hyperplasia). In early VGs, nNOS gene transfer significantly increased NOS activity and substantially reduced adhesion molecule expression and inflammatory cell infiltration. In late VGs, recombinant nNOS protein was no longer evident, but there were sustained effects on VG remodeling, resulting in a striking reduction in SMC intimal hyperplasia, a more differentiated intimal SMC phenotype, and reduced vascular superoxide production.

CONCLUSIONS

Intraoperative nNOS gene transfer has sustained favorable effects on VG remodeling and on the vascular phenotype of mature VGs. These findings suggest that early, transient modification of the response to vascular injury is a powerful approach to modulate VG biology and highlight the potential utility of NOS gene transfer as a therapeutic strategy in VGs.

[Effects of surface pattern of polymers on adhesion characteristics of transformed human embryonic tendon cells]

Effects of surface pattern of polymers on adhesion characteristics of transformed human embryonic tendon cells (THETCs) have been examined by using a micropipette aspiration technique, which is a cellular mechanical method. The results showed that the adhesion characteristics of THETCs depend on the surface pattern of polymers, and the adhesion force of THETCs to porous films is higher than that to non-porous films and fibers. The adhesion force bears relationships with the aperture of porous films and has a stronger dependence on the large aperture (150-500 microns) than on the small aperture (< 150 microns) of porous films. The adhesion force of THETCs to fibers is increased slightly with the diameter of fibers (P > 0.05). These demonstrate that the tissue-engineered tendon scaffolds made of porous polymer foam with specially designated aperture, or of polymer fiber with specially designated diameter, may serve as a good attachment substrate for THETCs.

[The effect of Paeonol on erythrocyte deformability determined by micropipette aspiration technique]

OBJECTIVE

The effect of Paeonol (PAE) on erythorcyet(RBC) deformability was studied in order to provide experimental data for the application in clinic and the evaluation in pharmacological action.

METHODS

Micropipette Aspiration Technique was used to determine the RBC deformation length. The method of calculation was also simplified and a new apparent deformation Index(ADI) was defined.

RESULTS

PAE could increase the ADImin and ADImax and decrease Tmax significantly.

CONCLUSION

PAE has the effect of deformational ability on RBC. Micropipette aspiration technique is a feasible method for determining the effect of traditional Chinese medicine on erythrocyte deformability.

[Impact of quantitative and qualitative pathogen culture on the outcome of ventilator-associated pneumonia]

OBJECTIVE

To evaluate the impact diagnostic methods with either quantitative culture (QC) or qualitative routine culture (RC) on the outcome of VAP.

METHODS

A prospective, controlled clinical trial in 93 consecutive VAP episodes of 31 patients receiving mechanical ventilation was conducted. VAP episodes were randomly and crossly divided into QC (43 episodes, underwent FOB-PSB-QC) and RC group (50 episodes, underwent ETA-RC). Empirical antibiotic treatment was given according to the attending physician and modified according to the results of culture and sensitivity. The outcomes of VAP were assessed.

RESULTS

There were no differences with regard to mortality, super-infection rate, antibiotic resistance rate and cost of antibiotics when comparing QC versus RC diagnostic methods and management based on two diagnostic strategies. Inappropriate initial empirical antibiotic treatment led to a higher mortality (17.7%) when compared with those with appropriate treatment.

CONCLUSION

The present study demonstrates that the outcome of VAP is probably more dependent on the adequacy of the initial antibiotic treatment than on the use of either diagnostic sampling.

[Effects of Fas ligand expression on pancreatic islet allografts]

OBJECTIVE

To investigate the immune privilege of islet allgrafts induced by the Fas ligand (FasL) expressed by co-transplanted testicular Sertoli cells and the effects of FasL gene transfected into islet cells on pancreatic islet allografts.

METHODS

The allogeneic islets and testicular cells from rats were co-transplanted into diabetic recipients. Pancreatic islet cells were firstly infected with the recombinant adenovirus AdV-FasL and then transplanted into the diabetic recipients. Allograft survival, islet function and apoptosis of infiltrative lymphocytes in allografts and gene-transfected islet allografts were observed.

RESULTS

All the animals receiving islet allografts alone returned to a diabetic status in several days (mean survival time = 6.3 +/- 0.56 days). When the number of testicular cells co-transplanted with islets increased to 1 x 10(7), all the animals remained normoglycemic throughout the follow-up period (P < 0.05). Sertoli cells expressing FasL induced apoptosis of infiltrative lymphocytes in the allografts. In the group of FasL gene transfection, the rejection of allografts was accelerated and the allograft survival time shortened to 3.4 +/- 0.24 days (P < 0.05). Pancreatic islets infected with AdV-FasL demonstrated positive staining for FasL at the 24th hour and increased intensity at the 48th hour after transplantation. After the transplantation, apoptosis of FasL-transfected islet cells occurred.

CONCLUSIONS

Co-transplantation of testicular Sertoli cells expressing FasL and islets can induce apoptosis of activated lymphocytes and allows long-term survival of allogeneic islets because of immune privilege. However, direct expression of FasL by islet allografts infected with AdV-FasL accelerates the islet rejection by islet cell apoptosis and granulocytic infiltration.

[Clinical study of the sentinel lymph node of patients with laryngeal and hypopharyngeal carcinomas]

OBJECTIVE

To investigate the methods of detecting the sentinel lymph node of laryngeal and hypopharyngeal carcinomas and its predictive value in the cervical metastasis of the carcinoma.

METHODS

In 29 patients who suffered from laryngeal or hypopharyngeal carcinoma with NO neck, the patent blue was injected into the surrounding tissue of the tumor during the operation to identify the sentinel lymph nodes. The sentinel lymph nodes were dyed blue. The frozen histopathology was done during the operation, the lymph nodes at the ipsilateral side of the neck were dissected completely, and the routine histopathology was done as the gold standard to study the predictive value of the sentinel lymph node in the metastasis of the cervical node.

RESULTS

Of 29 patients, 28 patients' sentinel lymph nodes were detected successfully during operation. There was an average of 2.5 lymph nodes per side per patient. Most of the sentinel lymph nodes were in the level II and level III regions of the ipsilateral side of the neck, and there were bilateral sentinel nodes in patients suffered from superglottic carcinoma. Three patients' sentinel lymph nodes were found to be positive in the frozen inspection, and the routine histopathology confirmed the result. The micrometastasis rate was 10.7% (3/28). There were no metastatic lymph nodes found in patients who were negative for the sentinel lymph nodes during the operative frozen histopathology. The predicted value of the sentinel lymph nodes to the cervical lymph node metastasis was 100 per cent.

CONCLUSION

There is a very important predicted value of sentinel lymph nodes in the cervical metastasis of patients suffered from laryngeal and hypopharyngeal carcinomas. It could reduce the neck dissection in patients with laryngeal and hypopharyngeal carcinomas.

[Comparative effects of decreasing viscosity in different preparations of Chinese angelica root and ginseng]

OBJECTIVE

To compare the effects of different preparations of Chinese angilica root and ginseng on decreasing whole blood viscosity and plasma viscosity in rats.

METHOD

The hemorheological method was used in vivo or in vitro and a Decreasing Viscosity Index (DIV) was defined as a comparative scalar.

RESULTS

In the effect of the groups of Chinese angilica root on decreasing viscosity, the effect of whole root group was the best and the effect of main root group was better than that of the tributary root group. Meanwhile the same effect of transplant wild ginseng group was greater than that of dried raw ginseng group.

CONCLUSION

This work provided some fundamental evidences for clinical application and pharmacological data for the quality evaluation.

Phylogenetic analysis based on 18S rRNA gene and matK gene sequences of Panax vietnamensis and five related species

Panax vietnamensis was discovered recently in Vietnam. Its bamboo-like rhizomes, called Vietnamese Ginseng, have attracted considerable attention because of their specific pharmacological activities. In order to define the taxonomic position of this new species and include it in the molecular authentication of Ginseng drugs, the 18S ribosomal RNA gene and matK gene sequences of P. vietnamensis were determined and compared with those of its related taxa, P. japonicus var. major and P. pseudo-ginseng subsp. himalaicus, besides previously reported P. ginseng, P. japonicus and P. quinquefolius. The 18S rRNA gene sequences were found to be 1809 bps in length. The sequence of P. vietnamensis was identical to that of P. quinquefolius, and presented one base substitution from those of both P. japonicus var. major and P. pseudo-ginseng subsp. himalaicus. The matK gene sequences of 6 taxa were found to be 1509 bps in length. The sequence of P. vietnamensis differed from those of P. japonicus var. major, P. pseudo-ginseng subsp. himalaicus, P. ginseng, P. japonicus and P. quinquefolius at 4, 5, 9, 9 and 10 nucleotide positions, respectively. The phylogenetic tree reconstructed by the combined 18S rRNA-matK gene analysis using the maximum parsimony method showed that P. vietnamensis was sympatric with other Panax species and had a close relationship with P. japonicus var. major and P. pseudo-ginseng subsp. himalaicus.

[Airway inflammation and macrophage inflammatory protein-1alpha, gelatinase B level in patients with COPD]

OBJECTIVE

To investigate the levels of macrophage inflammatory protein-1alpha (MIP-1alpha) and gelatinase-B (MMP-9) in bronchial alveolar lavage fluids (BALF) and supernatants of the cultured alveolar macrophages (AM) in patients with chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD).

METHODS

Bronchial alveolar lavage (BAL) was performed bronchoscopically in CB group, COPD group, and control group. Total cells were counted using hemacytometer. Differential cell counts were made with Wright's stained cell smear. The levels of MIP-1alpha, MMP-9 in BALF and in supernatants of cultured AMs were measured by ELISA.

RESULTS

The numbers of AMs and neutrophils in BALF in patients with CB and COPD groups were significantly higher than those in control group (P < 0.05). The levels of MIP-1alpha and MMP-9 in BALF and the supernatants of cultured AMs in patients with CB and COPD groups were higher than those in control group (P < 0.05). The levels of MIP-1alpha and MMP-9 in BALF were positively correlated with those in the supernatants of cultured AMs (r = 0.253, P < 0.05; r = 0.529, P < 0.01). The number of AMs in BALF was positively correlated with the level of MIP-1alpha and MMP-9 in BALF (r = 0.558, P < 0.01; r = 0.405, P < 0.01). Both AMs counts and the levels of MIP-1alpha, MMP-9 in BALF were inversely correlated with FEV(1.0)%pred (r = -0.322, P < 0.05; r = -0.319, P < 0.05; r = -0.616, P < 0.01). The levels of MIP-1alpha and MMP-9 in supernatants of the culture AMs were increased significantly after LPS stimulation (P < 0.05).

CONCLUSION

AMs, which may be the most important cellular source of MIP-1alpha and MMP-9 in COPD, accelerate MIP-1alpha and MMP-9 accumulation in the lung, which exaggerates inflammation process in the airway.

[Ovarian carcinoma presents as distant metastases without detectable tumors of the origin disease at the first presentation]

OBJECTIVE

To study the characteristics, therapies and prognosis of the patients with epithelial ovarian cancer (EOC) that are initially categorized as extra-abdominal adenocarcinoma of unknown primary.

METHODS

Twenty-five patients with EOC, who were treated in the Cancer Hospital of Fudan University from Jan. 1986 to Dec. 1997, and manifesting as extra-peritoneal or liver parenchyma metastases at the time of presentation, without detectable ovarian tumors, were retrospectively studied.

RESULTS

Supraclavicular and inguinal lymph node metastases were common in this group of patients, with 6 and 5 cases respectively, and 6 patients with more than two sites metastases simultaneously. 16 patients (64%) were optimally surgical debulked. 20 patients with stage IV EOC initially presenting as extra-abdominal metastases experienced a better prognosis, with an estimated median survival of 24 months. Of whom the median survival was 30 months in patients presenting with pleural effusion or supraclavicular lymph node metastases Vs. 19 months in those with other sites spread (P = 0.0264).

CONCLUSIONS

The prognosis of such cases, particularly for those with supraclavicular lymphadenopathy or malignant pleural effusion, is a lot better than other stage IV EOC patients, probably because of most of the patients initially presenting with distant metastases being generally in a good condition competent for aggressive surgery or multi-cycle chemotherapy.

bcl 10 gene mutation in hepatocellular carcinoma

OBJECTIVE

To detect the mutation frequency of the bcl 10 gene in the early and advanced stages of hepatocellular carcinoma (HCC).

METHODS

Genome DNA samples were extracted from 46 cases of fresh HCC tumor tissues and their non-tumor adjacent tissues. Polymerase chain reaction-single strand conformation polymorphism method was used to detect point mutations of the three exons of the bcl 10 gene. For each individual exon, six random samples from those showing abnormal DNA bands were sequenced to verify those mutations. The relationship between serum alpha-fetoprotein (AFP) level and bcl 10 mutation, between the tumor size and bcl 10 mutation was also analyzed.

RESULTS

Among the 46 samples, 26 cases (56.5%) were found to have mutations in exon 1, 5 out of the 6 cases were shown to have 5744 C-->G mutation by sequencing; 25 cases (54.3%) were found to have mutations in exon 2, 4 out of the 6 cases were shown to have 11,311 T deletion mutation by sequencing. Twenty-one cases (45.7%) were found to have mutations in exon 3, all of the 6 cases selected for sequencing were shown to have 14,116 C-->T mutation. Statistical analysis showed that neither serum alpha-fetoprotein level nor the size of hepatocellular carcinoma has a significant relationship with bcl 10 mutation.

CONCLUSION

The bcl 10 gene has a high mutation frequency in liver cancer.