Using an abnormal increase in postexercise systolic blood pressure to diagnose coronary artery disease in gerontal patients

Data from 66 patients ≥ 60 years old with suspected coronary artery disease (CAD) were studied to determine the diagnostic value of an abnormal increase in postexercise systolic blood pressure (SBP) for detecting CAD in gerontal patients. Treadmill exercise testing (TET) and selective coronary angiography (CAG) were carried out and SBP was measured pre-TET and at each minute during a 6-min post-TET recovery phase. Abnormal increase in postexercise SBP was defined as a higher SBP compared with that measured earlier during the 6-min post-TET period. An abnormal increase of ≥ 7 mmHg in postexercise SBP had a statistically significantly better specificity, and also showed higher sensitivity and accuracy, than ST-segment depression ≥ 1 mV in identifying gerontal patients with CAD. The combination of ST-segment depression and abnormal SBP resulted in further improvement of the specificity for detecting CAD. It is concluded that measurement of abnormal increase in postexercise SBP may be a sensitive indicator of gerontal CAD.

The role of serum basic fibroblast growth factor, estradiol and urine basic fibroblast growth factor in differentiating infantile haemangiomas from vascular malformations

OBJECTIVE

To investigate the role of serum basic fibroblast growth factor (bFGF), estradiol (E2) and urine bFGF in differentiating infantile haemangiomas from vascular malformations.

METHOD

Between October 2007 and January 2009, 97 patients with haemangiomas and 25 patients with vascular malformations who had not been treated previously were included in this prospective study. Forty-eight patients with cleft lip and/or palate were selected as controls. The age of all subjects ranged from 1 to 30 months. The serum and urine levels of bFGF were determined by enzyme-linked immunosorbent assay (ELISA). The serum levels of E2 were examined via radioimmunoassay. All data were analysed with SPSS 11.5 software package.

RESULTS

The concentration of serum and urine bFGF was significantly different among the three groups (haemangiomas, vascular malformations and controls) (P = 0.027, P = 0.001). Significantly different urine bFGF levels were found in patients with proliferating and involuting haemangiomas (P = 0.04). The serum E2 levels were significantly higher in patients with haemangiomas than vascular malformations (P = 0.001) and controls (P = 0.001).

CONCLUSION

Serum bFGF and E2 as well as urine bFGF can be used to supplement the clinical diagnosis of congenital vascular anomalies. Urine bFGF combined with serum E2 may be the most potential markers for diagnosing haemangiomas and determining the proliferating stage of haemangiomas.

Influencing factors on the size uniformity of self-assembled SiGe quantum rings grown by molecular beam epitaxy

The size uniformity of self-assembled SiGe quantum rings, which are formed by capping SiGe quantum dots with a thin Si layer, is found to be greatly influenced by the growth temperature and the areal density of SiGe quantum dots. Higher growth temperature benefits the size uniformity of quantum dots, but results in low Ge concentration as well as asymmetric Ge distribution in the dots, which induces the subsequently formed quantum rings to be asymmetric in shape or even broken somewhere in the ridge of rings. Low growth temperature degrades the size uniformity of quantum dots, and thus that of quantum rings. A high areal density results in the expansion and coalescence of neighboring quantum dots to form a chain, rather than quantum rings. Uniform quantum rings with a size dispersion of 4.6% and an areal density of 7.8×10(8) cm(-2) are obtained at the optimized growth temperature of 640°C.

Bias-dependent conductive characteristics of individual GeSi quantum dots studied by conductive atomic force microscopy

The bias-dependent electrical characteristics of individual self-assembled GeSi quantum dots (QDs) are investigated by conductive atomic force microscopy. The results reveal that the conductive characteristics of QDs are strongly influenced by the applied bias. At low (-0.5 to - 2.0 V) and high (-2.5 to - 4.0 V) biases, the current distributions of individual GeSi QDs exhibit ring-like and disc-like characteristics respectively. The current of the QD's central part increases more quickly than that of the other parts as the bias magnitude increases. Histograms of the magnitude of the current on a number of QDs exhibit the same single-peak feature at low biases, and double- or three-peak features at high biases, where additional peaks appear at large-current locations. On the other hand, histograms of the magnitude of the current on the wetting layers exhibit the same single-peak feature for all biases. This indicates the conductive mechanism is significantly different for QDs and wetting layers. While the small-current peak of QDs can be attributed to the Fowler-Nordheim tunneling model at low biases and the Schottky emission model at high biases respectively, the large-current peak(s) may be attributed to the discrete energy levels of QDs. The results suggest the conductive mechanisms of GeSi QDs can be regulated by the applied bias.

Characterization of self-organized TiO2 nanotubes on Ti-4Zr-22Nb-2Sn alloys and the application in drug delivery system

In this study, the self-organized TiO(2) nanotubes grown by anodization of Ti-4Zr-22Nb-2Sn at different potentials, concentration of NH(4)F and anodization time was investigated. The morphology of nanotubes was observed by FE-SEM. The drug-loaded nanotubes were also fabricated in aqueous media containing minocycline hydrochloride. They were characterized by SEM, XPS and FT-IR. The results showed that the drug of minocycline hydrochloride (MH) was loaded in the nanotubes. The release effects were studied in phosphate buffer solution (PBS). The release rate of MH from TiO(2) nanotubes with shorter tube length in PBS was lower than the one of MH from longer nanotubes. The sustaining release time could last at least 150 h. Hence, it is a promising method to eliminate the harmful reactions by carrying drug in the tubes when the titanium alloys were used as biomedical implants.

Mutations in the beta-myosin heavy chain gene in southern Chinese families with hypertrophic cardiomyopathy

In this study, 14 unrelated hypertrophic cardiomyopathy (HCM) probands were scanned by polymerase chain reaction-single-strand conformation polymorphism analysis and DNA sequencing. Three mis-sense mutations of the beta-myosin heavy chain gene, MYH7, were found: valine (Val) 606 methionine (Met), arginine (Arg) 694 leucine (Leu), and Arg 723 glycine (Gly). All are reported here for the first time in Chinese subjects. The results showed that: Val606Met is an intermediate malignancy mutation; Arg694Leu is a novel mutation with a benign phenotype; and the Arg723Gly mutation is linked to malignancy - it can lead not only to HCM but also to dilated cardiomyopathy at various ages. The clinical symptoms associated with Arg723Gly emerged early and caused more severe clinical manifestation and poorer prognosis in females than in males. Mis-sense mutations were not detected in the myosin binding protein C, cardiac, cardiac troponin T type 2, or cardiac troponin I type 3 genes. The MYH7 gene may be an HCM mutation hotspot in the Chinese and have unique features in this study population.

Treatment of municipal wastewater using a contact oxidation filtration separation integrated bioreactor

A new contact oxidation filtration separation integrated bioreactor (CFBR) was used to treat municipal wastewater. The CFBR was made up of a biofilm reactor (the upper part of the CFBR) and a gravitational filtration bed (the lower part of the CFBR). Polyacrylonitrile balls (50mm diameter, 237 m(2)/m(3) specific surface, 90% porosity, and 50.2% packing rate) were filled into the biofilm reactor as biofilm attaching materials and anthracite coal (particle size 1-2mm, packing density 0.947 g/cm(3), non-uniform coefficient (K(80)=d(80)/d(10))<2.0) was placed into the gravitational filtration bed as filter media. At an organic volumetric loading rate of 2.4 kg COD/(m(3)d) and an initial filtration velocity of 5m/h in the CFBR, the average removal efficiencies of COD, ammonia nitrogen, total nitrogen and turbidity were 90.6%, 81.4%, 64.6% and 96.7% respectively, but the treatment process seemed not to be effective in phosphorus removal. The average removal efficiency of total phosphorus was 60.1%. Additionally, the power consumption of the CFBR was less than 0.15 kWh/m(3) of wastewater treated, and less than 1.5 kWh/kg BOD(5) removal.

Dietary sodium deprivation evokes activation of brain regional neurons and down-regulation of angiotensin II type 1 receptor and angiotensin-convertion enzyme mRNA expression

Previous studies have indicated that the renin-angiotensin-aldosterone system (RAAS) is implicated in the induction of sodium appetite in rats and that different dietary sodium intakes influence the mRNA expression of central and peripheral RAAS components. To determine whether dietary sodium deprivation activates regional brain neurons related to sodium appetite, and changes their gene expression of RAAS components of rats, the present study examined the c-Fos expression after chronic exposure to low sodium diet, and determined the relationship between plasma and brain angiotensin I (ANG I), angiotensin II (ANG II) and aldosterone (ALD) levels and the sodium ingestive behavior variations, as well as the effects of prolonged dietary sodium deprivation on ANG II type 1 (AT1) and ANG II type 2 (AT2) receptors and angiotensin-convertion enzyme (ACE) mRNA levels in the involved brain regions using the method of real-time polymerase chain reaction (PCR). Results showed that the Fos immunoreactivity (Fos-ir) expression in forebrain areas such as subfornical organ (SFO), paraventricular hypothalamic nuclei (PVN), supraoptic nucleus (SON) and organum vasculosum laminae terminalis (OVLT) all increased significantly and that the levels of ANG I, ANG II and ALD also increased in plasma and forebrain in rats fed with low sodium diet. In contrast, AT1, ACE mRNA in PVN, SON and OVLT decreased significantly in dietary sodium depleted rats, while AT2 mRNA expression did not change in the examined areas. These results suggest that many brain areas are activated by increased levels of plasma and/or brain ANG II and ALD, which underlies the elevated preference for hypertonic salt solution after prolonged exposure to low sodium diet, and that the regional AT1 and ACE mRNA are down-regulated after dietary sodium deprivation, which may be mediated by increased ANG II in plasma and/or brain tissue.

Composition and strain measurements of Ge(Si)/Si(001) islands by HRTEM

The distributions of the composition and the strain in the Ge(Si)/Si(001) coherent islands grown by molecular-beam epitaxy are investigated by digital analysis of high resolution transmission electron microscopy (HRTEM) micrographs. Local composition and strain are obtained from the measurement of the lattice displacement based on the Poisson's formula and Vegard's law. The analysis suggests that the islands have high Ge content at the island's central region. The island is partially relaxed by the substrate deformation and strain concentrated around the edge of islands. The alloying of the islands was found due to the Si surface diffusion.

Conductive atomic force microscopy studies on the transformation of GeSi quantum dots to quantum rings

Conductive atomic force microscopy has been employed to study the topography and conductance distribution of individual GeSi quantum dots (QDs) and quantum rings (QRs) during the transformation from QDs to QRs by depositing an Si capping layer on QDs. The current distribution changes significantly with the topographic transformation during the Si capping process. Without the capping layer, the QDs are dome-shaped and the conductance is higher at the ring region between the center and boundary than that at the center. After capping with 0.32 nm Si, the shape of the QDs changes to pyramidal and the current is higher at both the center and the arris. When the Si capping layer increases to 2 nm, QRs are formed and the current of individual QRs is higher at the rim than that at the central hole. By comparing the composition distributions obtained by scanning Auger microscopy and atomic force microscopy combined with selective chemical etching, the origin of the current distribution change is discussed.

SmgGDS is up-regulated in prostate carcinoma and promotes tumour phenotypes in prostate cancer cells

SmgGDS is a guanine nucleotide exchange factor with the unique ability to activate multiple small GTPases, implicating it in cancer development and progression. Here, we investigated the role of SmgGDS in prostate cancer by studying the expression of SmgGDS in benign and malignant prostatic tissues. We also probed SmgGDS function in three prostate carcinoma cell lines using small interfering RNA (siRNA). Immunohistochemical analysis revealed that SmgGDS levels were elevated in prostatic intraepithelial neoplasia (PIN), prostate carcinoma, and metastatic prostate carcinoma. In addition, expression of SmgGDS positively correlated with that of cyclooxygenase-2 (COX-2), a protein believed to promote the development of prostate carcinoma. Reduction of SmgGDS expression in prostate carcinoma cells inhibited proliferation and migration, irrespective of androgen receptor status. These effects were accompanied by a reduction in COX-2 expression and in activity of NF-kappaB, a known regulator of COX-2. Taken together, these findings suggest that SmgGDS promotes the development and progression of prostate cancer, possibly associated with NF-kappaB-dependent up-regulation of COX-2.

Malignant solitary fibrous tumors of the head and neck: a clinicopathological study of nine consecutive patients

Malignant solitary fibrous tumor (MSFT) is one of the angiosarcomas arising from or resembling the components of blood vessels. Because of its rarity, the diagnosis is difficult. Between 1998 and 2008, 24 patients were diagnosed as having hemangiopericytomas (16) and solitary fibrous tumors (8). Nine of them were confirmed to be MSFT and treated at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. All patients were treated with surgery as the primary modality. Eight patients received postoperative adjuvant radiation therapy. The average follow-up duration was 4.6 years (range: 6 months-10 years). Of the nine patients reviewed in this study, three died of locoregional or distant metastasis, six survived 6 months-6 years (four survived over 4 years). The size of primary tumor, the number of mitoses per 10 high powered fields and cervical lymph node metastasis seemed to be correlated with poor prognosis in MSFT patients, although the small number of patients did not permit the performance of statistical analysis.

Distribution of Baseline Sensitivities to Natural Product Physcion Among Isolates of Sphaerotheca fuliginea and Pseudoperonospora cubensis

The ethanol extract from rhubarb was commercialized in China (Veguard, Physcion, 5 g/liter AS) for control of cucumber powdery mildew (Sphaerotheca fuliginea) and cucumber downy mildew (Pseudoperonospora cubensis). To provide the basic data for the risk assessment of resistance to this product, physcion was selected to represent the active ingredients to establish baseline sensitivity of powdery mildew and downy mildew populations. For powdery mildew, 262 isolates of S. fuliginea from nine regions and, for downy mildew populations, 116 isolates of P. cubensis from six regions were collected in China during 2004 and 2005 and tested for sensitivity. In addition, the sensitivity of a powdery mildew isolate was monitored for 15 asexual generations under selection pressure with physcion. The results showed that there was no significant difference among regions in the frequency distribution of baseline sensitivity to this ingredient for either cucumber powdery mildew isolates or cucumber downy mildew isolates. Baseline sensitivity was distributed as a normal unimodal curve with a mean median (50%) effective concentration (EC₅₀) of 0.304 μg/ml for powdery mildew population and mean EC₅₀ of 0.501 μg/ml for downy mildew population. The variation of sensitivity to physcion was low because the range factor (maximum EC₅₀/minimum EC₅₀ of isolates within population) varied from 1.63 to 3.42 among powdery mildew populations and from 1.70 to 2.38 among downy mildew populations. The powdery mildew isolate XZ4 did not decrease sensitivity under the selection pressure of physcion at the dose of EC₇₀ for 15 generations.

Sterol regulatory element binding transcription factor 1 expression and genetic polymorphism significantly affect intramuscular fat deposition in the longissimus muscle of Erhualian and Sutai pigs

Two experiments were performed to elucidate the role of sterol regulatory element binding transcription factor 1 (SREBF1) in i.m. fat (IMF) deposition in pigs. In Exp. 1, LM samples were removed from 4 male and 4 female Erhualian piglets at 3, 20, and 45 d of age, and SREBF1 mRNA expression level and IMF content were measured. Intramuscular fat content and expression of SREBF1 mRNA was greater (P < 0.05) in females than males at all 3 stages of age, providing initial evidence that the level of SREBF1 mRNA expression is related to IMF deposition in muscle of suckling pigs. Additionally, in Exp. 2 there was a positive correlation between the SREBF1 mRNA level and IMF content (r = 0.67, P < 0.01) in 100 Sutai finishing pigs, a synthetic line produced by crossing Erhualian and Duroc pigs. Single-strand conformation polymorphism (SSCP) analysis of the reverse transcription PCR products of the SREBF1 gene revealed 3 genotypes in Sutai pigs with frequencies of 50% for AA, 36% for AB, and 14% for BB, respectively. Both SREBF1 mRNA level and IMF content in muscle were greater (P < 0.05) in AB and BB animals than in AA animals, whereas no difference in backfat thickness was observed among the 3 genotypes. Sequencing analysis identified 2 SNP at T1006C and C1033T within the open reading frame of the SREBF1 gene (NM_214157). Although both are silent mutations, they affected the secondary structure of SREBF1 mRNA. These results suggest that SREBF1 might play an important role in regulation of muscle fat deposition during postnatal growth of pigs. The SNP identified in the SREBF1 gene suggest that it could be used as a genetic marker to improve IMF content in pigs.

Computer image analysis of intramuscular adipocytes and marbling in the longissimus muscle of cattle1

The deposition of fat in muscle, recognized by the consumer as marbling, is an important meat quality trait. The objective of the study was to provide additional insights into the quantitative extent of marbling by means of computer image analysis. Fifty-one F(2) generation German Holstein and Charolais crossbreed cattle, 18 mo of age, were used to determine relationships among marbling traits, adipocyte size, and the amount of adipose tissue in different depots. Differences were recorded among the size of i.m. adipocytes in different groups of marbling flecks, divided according to the location in the muscle cross-section and to the size of the marbling flecks. The results showed positive correlation between i.m. adipocyte size and the weight of s.c. fat, intestinal fat, omental fat, and perirenal fat (r = 0.50, 0.61, 0.70, and 0.63, respectively, P < 0.001). The i.m. adipocyte size was correlated with i.m. fat content, number of marbling flecks, proportion of marbling fleck area, and total length of marbling flecks (r = 0.71, 0.44, 0.62, and 0.55, respectively, P < 0.01). The number of marbling flecks was also correlated with i.m. fat content, proportion of marbling fleck area, and total length of marbling flecks (r = 0.58, 0.62, and 0.91, P < 0.01, respectively). The ventral marbling flecks had a 5-fold larger fleck area, 4-fold more adipocytes, and larger adipocytes (P < 0.001). Larger marbling flecks contained larger adipocytes (P < 0.001). Moreover, compared with the small marbling flecks, there was a 48-fold larger fleck area and 26-fold more adipocytes in the large marbling flecks. The results indicate that i.m. fat deposition increases concurrently with the other fat depots but is still independent. Furthermore, the i.m. fat is preferentially deposited in the ventral area of LM. Although the i.m. adipocyte size has an important effect on the traits of marbling flecks, cell number plays a greater role in i.m. fat deposition than cell size.

Characterization of a method for profiling gene expression in cells recovered from intact human prostate tissue using RNA linear amplification

Coupling array technology to laser capture microdissection (LCM) has the potential to yield gene expression profiles of specific cell populations within tissue. However, remaining problems with linear amplification preclude accurate expression profiling when using the low nanogram amounts of RNA recovered after LCM of human tissue. We describe a novel robust method to reliably amplify RNA after LCM, allowing direct probing of 12K gene arrays. The fidelity of amplification was demonstrated by comparing the ability of amplified RNA (aRNA) versus that of native RNA to identify differentially expressed genes between two different cell lines, demonstrating a 99.3% concordance between observations. Array findings were validated by quantitative polymerase chain reaction analysis of a randomly selected subset of 32 genes. Using LCM to recover normal (N=5 subjects) or cancer (N=3) cell populations from intact human prostate tissue, three differentially expressed genes were identified. Independent investigators have previously identified differential expression of two of these three genes, hepsin and beta-microseminoprotein, in prostate cancer. Taken together, the current study demonstrates that accurate gene expression profiling can readily be performed on specific cell populations present within complex tissue. It also demonstrates that this approach efficiently identifies biologically relevant genes.

cDNA microarray analysis assists in diagnosis of malignant intrarenal pheochromocytoma originally masquerading as a renal cell carcinoma

Intrarenal pheochromocytoma (paraganglioma) is a very rare tumour. Its diagnosis is often difficult to establish because of its rarity and its histological similarity to renal cell carcinoma (RCC). Recently, we examined the molecular signatures of different subtypes of kidney tumours by using cDNA microarray. The signature pattern for one tumour, which was originally diagnosed as granular cell RCC, was clearly distinct from that of any other subtype of kidney tumour, and led us to re-evaluate the case. Haematoxylin and eosin staining revealed histological features suggestive of pheochromocytoma, and immunohistochemical studies showed positive staining for neuroendocrine markers but not for keratin. A germline missense mutation, D119E, in the familial paraganglioma related gene succinate dehydrogenase subunit D (SDHD), was subsequently identified. The treatment modality was revised and radiotherapy was given, to which the patient responded, leading to a reduction in tumour size of 25% within the first month. To our knowledge, this is the first report of an intrarenal pheochromocytoma that was diagnosed with the assistance of cDNA microarray analysis.

Topoisomerase IIalpha in Wilms' tumour: gene alterations and immunoexpression

BACKGROUND

Topoisomerase IIalpha (topoIIalpha) is an essential enzyme gene in regulating DNA structure and cell proliferation and is encoded by the TOP2A. Using cDNA microarray analysis, TOP2A has been reported to be one of the top genes overexpressed in Wilms' tumour.

AIM

To evaluate the role of TopoIIalpha in Wilms' tumorigenesis and its prognostic value.

METHODS

TOP2A gene copy numbers were determined using the fluorescence in situ hybridisation technique, and protein expression levels of TopoIIalpha by immunostaining in 39 samples of primary and 18 samples of metastatic Wilms' tumour.

RESULTS

TOP2A gene amplification was detected only in anaplastic Wilms' tumours, and none of the Wilms' tumours showed deletion of the TOP2A gene. TopoIIalpha protein overexpression was detected in 97% of Wilms' tumours, and correlated strongly with proliferation, as measured by Ki-67 (r = 0.85). The high TopoIIalpha expression was associated with the presence of vascular invasion, prominent apoptosis, metastases and adverse clinical outcomes (p<0.05).

CONCLUSIONS

Our findings suggest that TopoIIalpha overexpression in Wilms' tumours is caused by a change at the transcription level, except for anaplastic Wilms' tumours, in which gene amplification was present. High levels of TopoIIalpha protein are correlated with tumour aggressiveness. The assessment of TopoIIalpha expression in Wilms' tumour may have prognostic value.

Decreased annexin I expression in prostatic adenocarcinoma and in high-grade prostatic intraepithelial neoplasia

AIMS

To analyse annexin I expression in prostatic carcinoma. Annexin I belongs to a family of structurally related calcium and phospholipid-binding proteins implicated in signal transduction, DNA replication, cell proliferation and apoptosis. The decreased expression of annexin I, II and VII proteins has been reported in different types of cancer.

METHODS AND RESULTS

Using immunohistochemistry, we analysed annexin I expression in 77 cases of prostatic adenocarcinoma (Gleason score 6, N = 40; Gleason scores 7-8, N = 27; and Gleason scores 9-10, N = 10) and high-grade prostatic intraepithelial neoplasia (PIN, N = 50). Immunoreactivity of annexin I in tumour cells was evaluated as negative (< 5% of cells), focally positive (5-25% of cells) or positive (> 25% of cells). In contrast to positive staining in adjacent benign prostatic epithelium, annexin I expression was decreased (focally positive) in 76% of cases of high-grade PIN (P < 0.0001) and was decreased or absent in 81% of prostatic adenocarcinomas (P < 0.0001). Annexin I expression in all higher grade tumours (Gleason scores 7-10) was only focally positive or absent.

CONCLUSIONS

Expression of annexin I inversely correlates with the increasing histological grade of prostatic adenocarcinoma. By showing a progressive loss of annexin I expression in high-grade PIN, intermediate-grade and high-grade cancer, our findings suggest that the loss of annexin I expression occurs early in prostatic tumorigenesis and becomes more prominent throughout tumour progression. The loss of expression of annexin I may serve as a useful marker of prostate cancer development and progression.

Alpha-methylacyl-CoA racemase: a multi-institutional study of a new prostate cancer marker

AIM

To test whether alpha-methylacyl-CoA racemase (AMACR) is a sensitive and specific marker of prostate cancer.

METHODS AND RESULTS

The expression levels of AMACR mRNA were measured by real-time polymerase chain reaction. A total of 807 prostatic specimens were further examined by immunohistochemistry specific for AMACR. Quantitative immunostaining analyses were carried out by using the ChromaVision Automated Cellular Imaging System and the Ariol SL-50 Imaging System, respectively. AMACR mRNA levels measured in prostatic adenocarcinoma were 55 times higher than those in benign prostate tissue. Of 454 cases of prostatic adenocarcinoma, 441 were positive for AMACR, while 254 of 277 cases of benign prostate were negative for AMACR. The sensitivity and specificity of AMACR immunodetection of prostatic adenocarcinomas were 97% and 92%, respectively. Both positive and negative predictive values were 95%. By automatic imaging analyses, the AMACR immunostaining intensity and percentage in prostatic adenocarcinomas were also significantly higher than those in benign prostatic tissue (105.9 versus 16.1 for intensity, 45.7% versus 0.02% and 35.03% versus 4.64% for percentage, respectively).

CONCLUSIONS

We have demonstrated the promising features of AMACR as a biomarker for prostate cancer in this large series and the potential to develop automated quantitative diagnostic tests.

Characterizing prostatic adenocarcinomas in men with a serum prostate specific antigen level of <4.0 ng/mL

OBJECTIVE

To characterize prostate cancer in men undergoing radical prostatectomy who have a prostate-specific antigen (PSA) level of < 4.0 ng/mL, hypothesizing that a low PSA is not caused by diminished tumour production of PSA, nor does it signify clinically insignificant disease.

PATIENTS AND METHODS

Seventy-nine men (mean age 59.3 years, range 43-77) with a PSA level of < 4.0 ng/mL were identified from 702 who had a radical prostatectomy between 1994 and 2000. Demographic and clinical data were analysed; pathological specimens were evaluated by routine haematoxylin and eosin staining and immunohistochemistry with anti-PSA antibody, for both pathological staging and grading, and for the presence of PSA production. Tumours were classified as 'clinically insignificant' if the tumour volume was < 0.5 mL and the Gleason score < 7.

RESULTS

The mean (SD, range) preoperative PSA level was 3.04 (0.85, 0.8-3.8) ng/mL Indications for biopsy included an abnormal digital rectal examination (61%), a PSA velocity of > 0.75 ng/mL/year (12%), a strong family history of prostate cancer (3%), obstructive urinary symptoms (2%), or no obvious indication (23%). Thirty-eight (48%) tumours were clinically insignificant. Of 41 clinically significant cancers, 13 had a final Gleason score of > or = 7, 20 had extraprostatic extension and 11 had a tumour volume of > or = 10 mL Of the 79 prostate cancer specimens 78 stained strongly for PSA; the exception was a Gleason 9 tumour. With a mean (range) follow-up of 3.5 (0.18-6) years only one patient had a biochemical recurrence (PSA > or = 0.1 ng/mL).

CONCLUSIONS

Most prostate cancers in men with a PSA level of < 4.0 ng/mL are clinically significant and PSA-producing. Many of these tumours are high-grade, high-volume and extraprostatic. We are currently exploring factors to explain why serum PSA is not elevated in these men, including tumour location, pattern of invasion and microvessel density.

Clusterin as a possible predictor for biochemical recurrence of prostate cancer following radical prostatectomy with intermediate Gleason scores: a preliminary report

Disease recurrence following radical prostatectomy is a major concern in prostate cancer patients. Gleason scores are useful in predicting recurrence. Low Gleason scores are usually associated with long disease-free intervals, while high Gleason scores are suggestive of early recurrence. However, prediction of recurrence has been difficult with intermediate Gleason scores. Clusterin is a ubiquitous secretory sulfated glycoprotein. It is also an antiapoptotic mediator in prostate cancer. The objective of the present study is to determine if clusterin can serve as a predictive biomarker for recurrence of prostate cancer with intermediate Gleason scores in patients following radical prostatectomy. Prostatic specimens with Gleason score of 6 (3+3) or 7 (3+4) were obtained from the archival bank. Three groups of specimens were investigated. The first group was from nine patients who developed recurrent disease according to a persistent rise of serum PSA within 3 years following radical prostatectomy. Those in the second group and the third group were from patients who showed no evidence of disease recurrence for at least 5 y (11 patients) and 10 y (eight patients), respectively following the surgery. Histological sections were subjected to immunohistochemical staining using a monoclonal antibody specific for clusterin. The staining intensity was scored as 0, 1, 2, and 3, with 0 being no staining, 1 showing less than 25% positive staining, 2 being 25-50% positive, and 3 showing greater than 75% positive staining. One-way ANOVA with Bonferroni correction was used for statistical analysis. Evaluation of the scores of clusterin staining was carried out according to four specific areas in each specimen. They were (a) benign epithelial cells, (b) malignant epithelial cells (cancer epithelia), (c) stromal cells surrounding benign cells, and (d) stromal cells surrounding malignant cells (cancer stroma). Staining score in prostatic epithelial cells, benign as well as malignant, showed no significant relationship among the three patient groups. However, when staining scores in stromal cells were compared, there was a significant difference between patients with recurrent disease and those showed no evidence of disease recurrence for at least 10 y. Results of this preliminary study support the important role of clusterin in the stromal component for prostate cancer progression. Clusterin immunostaining may be useful to aid the prediction of chance of disease recurrence in patients with Gleason score 6 or 7 prostate cancer following radical prostatectomy. Further studies with a large number of cases are warranted to verify this preliminary finding.

Class II histone deacetylases: structure, function, and regulation

Acetylation of histones, as well as non-histone proteins, plays important roles in regulating various cellular processes. Dynamic control of protein acetylation levels in vivo occurs through the opposing actions of histone acetyltransferases and histone deacetylases (HDACs). In the past few years, distinct classes of HDACs have been identified in mammalian cells. Class I members, such as HDAC1, HDAC2, HDAC3, and HDAC8, are well-known enzymatic transcriptional corepressors homologous to yeast Rpd3. Class II members, including HDAC4, HDAC5, HDAC6, HDAC7, and HDAC9, possess domains similar to the deacetylase domain of yeast Hdal. HDAC4, HDAC5, and HDAC7 function as transcriptional corepressors that interact with the MEF2 transcription factors and the N-CoR, BCoR, and CtBP corepressors. Intriguingly, HDAC4, HDAC5, and probably HDAC7 are regulated through subcellular compartmentalization controlled by site-specific phosphorylation and binding of 14-3-3 proteins; the regulation of these HDACs is thus directly linked to cellular signaling networks. Both HDAC6 and HDAC9 possess unique structural modules, so they may have special biological functions. Comprehension of the structure, function, and regulation of class II deacetylases is important for elucidating how acetylation regulates functions of histones and other proteins in vivo.