A novel mutation of dipeptidyl aminopeptidase-like protein-6 in a family with suspicious idiopathic ventricular fibrillation

BACKGROUND

Sudden cardiac death (SCD) occurs in a broad spectrum of cardiac pathologies and is an important cause of mortality in the general population. Idiopathic ventricular fibrillation (IVF) is a rare but important factor resulting in SCD. It is diagnosed in a resuscitated cardiac arrest victim underlying unknown cause, with documented ventricular fibrillation. Previous studies have demonstrated that mutations in dipeptidyl aminopeptidase-like protein-6 (DPP6) and cardiac sodium channel Nav1.5 (SCN5A) are the most important genetic factors involve in IVF.

AIM

By using whole sequencing to identify the genetic lesion of a family with suspicious idiopathic ventricular fibrillation.

DESIGN

Prospective genetic study.

METHODS

In this study, we employed whole-exome sequencing in combination with arrhythmia-related gene filtering to identify the genetic lesion for a family suffering from suspicious IVF, syncope and SCD. We then generated the plasmids of DPP6-pcDNA3.1+ (WT and c.1578G>C/p.Q526H). Kv4.3-pcDNA3.1+ was co-transfected together with/without DPP6-pcDNA3.1+ (WT and/or c.1578G>C/p.Q526H) into HEK293 cells to perform the patch clamp experiments.

RESULTS

A novel missense mutation (c.1578G>C/p.Q526H) of DPP6 was identified and co-segregated with affected patients in this family. Patch clamp experiments suggested that this novel mutation might result in a gain of function and disturb the efflux of potassium ion.

CONCLUSION

Our study not only reported the second missense mutation of DPP6 in heart disease and expanded the spectrum of DPP6 mutations, but also contribute to the genetic diagnosis and counseling of families with suspicious IVF, syncope and SCD.

Intravoxel Incoherent Motion MR Imaging in the Differentiation of Benign and Malignant Sinonasal Lesions: Comparison with Conventional Diffusion-Weighted MR Imaging

BACKGROUND AND PURPOSE

Intravoxel incoherent motion is a promising method for the differentiation of sinonasal lesions. This study aimed to evaluate the value of intravoxel incoherent motion in the differentiation of benign and malignant sinonasal lesions and to compare the diagnostic performance of intravoxel incoherent motion with that of conventional DWI.

MATERIALS AND METHODS

One hundred thirty-one patients with histologically proved solid sinonasal lesions (56 benign and 75 malignant) who underwent conventional DWI and intravoxel incoherent motion were recruited in this study. The diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values derived from intravoxel incoherent motion and ADC values derived from conventional DWI were measured and compared between the 2 groups using the Student t test. Receiver operating characteristic curve analysis, logistic regression analysis, and 10-fold cross-validation were performed to evaluate the diagnostic performance of single-parametric and multiparametric models.

RESULTS

The mean ADC and D values were significantly lower in malignant sinonasal lesions than in benign sinonasal lesions (both P < .001). The mean f value was higher in malignant lesions than in benign lesions (P = .003). Multiparametric models can significantly improve the cross-validated areas under the curve for the differentiation of sinonasal lesions compared with single-parametric models (all corrected P < .05 except the D value). The model of D+f provided a better diagnostic performance than the ADC value (corrected P < .001).

CONCLUSIONS

Intravoxel incoherent motion appears to be a more effective MR imaging technique than conventional DWI in the differentiation of benign and malignant sinonasal lesions.

Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer: a multicenter randomized phase III trial

Background

The optimal chemotherapy regimen administered currently with radiation in patients with stage III non-small cell lung cancer (NSCLC) remains unclear. A multicenter phase III trial was conducted to compare the efficacy of concurrent thoracic radiation therapy with either etoposide/cisplatin (EP) or carboplatin/paclitaxel (PC) in patients with stage III NSCLC.

Patients and methods

Patients were randomly received 60-66 Gy of thoracic radiation therapy concurrent with either etoposide 50 mg/m2 on days 1-5 and cisplatin 50 mg/m2 on days 1 and 8 every 4 weeks for two cycles (EP arm), or paclitaxel 45 mg/m2 and carboplatin (AUC 2) on day 1 weekly (PC arm). The primary end point was overall survival (OS). The study was designed with 80% power to detect a 17% superiority in 3-year OS with a type I error rate of 0.05.

Results

A total of 200 patients were randomized and 191 patients were treated (95 in the EP arm and 96 in the PC arm). With a median follow-up time of 73 months, the 3-year OS was significantly higher in the EP arm than that of the PC arm. The estimated difference was 15.0% (95% CI 2.0%-28.0%) and P value of 0.024. Median survival times were 23.3 months in the EP arm and 20.7 months in the PC arm (log-rank test P = 0.095, HR 0.76, 95%CI 0.55-1.05). The incidence of Grade ≥2 radiation pneumonitis was higher in the PC arm (33.3% versus 18.9%, P = 0.036), while the incidence of Grade ≥3 esophagitis was higher in the EP arm (20.0% versus 6.3%, P = 0.009).

Conclusion

EP might be superior to weekly PC in terms of OS in the setting of concurrent chemoradiation for unresectable stage III NSCLC.

Trial registration ID

NCT01494558.

[Analgesic effect and related mechanism of peripheral acupoints electroacupuncture on superficial partial-thickness burn rats]

Objective: To observe the analgesic effect and related mechanism of peripheral acupoints electroacupuncture on superficial partial-thickness burn rats. Methods: Eighty SD rats were divided into sham injury group (SI), pure burn group (PB), electroacupuncture group (E), and sham electroacupuncture group (SE) according to the random number table, with 20 rats in each group. Right posterior leg of rats in group SI were sham injured, while superficial partial-thickness scald (hereinafter referred to as burn) model was reproduced on the right posterior leg of rats in the latter three groups. Electroacupuncture of peripheral acupoints of right posterior leg of rats (equivalent to Zusanli point and Sanyinjiao point of human) in group E were performed from post injury hour (PIH) 12 on, while rats in group SE were treated with sham electroacupuncture, with 30 min each time, one time a day for 3 days. Before injury and at PIH 12, 24, 36, 48, 60, and 72, the threshold of mechanical pain of 5 rats in each group was tested, and the threshold of heat pain of another 5 rats in each group was tested. At PIH 48, brain tissue of 5 rats in each group was obtained to observe the morphology and distribution of astrocytes with positive expression of glia fibrillary acidic protein (GFAP) in periaqueductal gray (PAG) area by immunohistochemical staining, and the number of astrocytes was calculated. At the same time, brain tissue of the rest 5 rats in each group was obtained to determine the expression of GFAP of astrocytes in PAG area with Western blotting. Data were possessed with analysis of variance of repeated measurement, one-way analysis of variance, and SNK test. Results: (1) Compared with that in group SI, the threshold of mechanical pain of rats in groups PB and SE had no significant change before injury and at PIH 12 (with P values above 0.05), but was significantly decreased from PIH 24 to 72 (with P values below 0.05); while the threshold of mechanical pain of rats in group E was significantly decreased from PIH 36 to 72 (with P values below 0.05). The threshold of mechanical pain of rats in group E was significantly higher than that in groups PB and SE at PIH 24 (with P values below 0.05). (2) Compared with that in group SI, the threshold of heat pain of rats in groups PB and SE had no significant change before injury (with P values above 0.05), but was significantly decreased from PIH 12 to 72 (with P values below 0.05); while the threshold of heat pain of rats in group E was significantly decreased from PIH 12 to 60 (with P values below 0.05). The threshold of heat pain of rats in group E was significantly higher than that in groups PB and SE from PIH 24 to 48 (with P values below 0.05). (3) The distribution of astrocytes with positive expression of GFAP in PAG area of rats in group SI was diffuse. The cell volume was small with cell body unobvious, and the projections were sparse, fine and short. The distribution of astrocytes with positive expression of GFAP in PAG area of rats in group PB was relatively concentrated. The cell body was hypertrophy and swelling, and the projections were increased and extended. The morphology and distribution of astrocytes with positive expression of GFAP in PAG area of rats in groups SE and E was similar to that in group PB. The numbers of astrocytes with positive expression of GFAP in PAG area of rats in groups SI, PB, E, and SE were 44±4, 39±4, 27±4, and 36±5, respectively. The number of astrocytes with positive expression of GFAP in PAG area of rats in group PB was significantly less than that in group SI (P<0.05), but similar to that in group SE (P>0.05). The number of astrocytes with positive expression of GFAP in PAG area of rats in group E was significantly less than that in groups PB and SE (with P values below 0.05). (4) The expressions of GFAP of astrocytes in PAG area of rats in groups SI, PB, E, and SE were 1.11±0.16, 0.66±0.15, 0.34±0.06, and 0.56±0.09, respectively. The expression of GFAP of astrocytes in PAG area of rats in group PB was significantly lower than that in group SI (P<0.05), but similar to that in group SE (P>0.05). The expression of GFAP of astrocytes in PAG area of rats in group E was significantly lower than that in groups PB and SE (with P values below 0.05). Conclusions: Electroacupuncture of peripheral acupoints can release the pain followed superficial partial-thickness burn in rats at early stage, and the possible mechanism is that it reduces the activation of astrocytes in PAG area.

CAMK2γ in intestinal epithelial cells modulates colitis-associated colorectal carcinogenesis via enhancing STAT3 activation

Inflammation is one of the major risk factors for cancer. Here, we show that calcium/calmodulin-dependent protein kinase II gamma (CAMK2γ) in intestinal epithelial cells (IECs) modulates inflammatory signals and promotes colitis-associated cancer (CAC) in mice. We have identified CAMK2γ as a downstream target of colitis-induced WNT5a signaling. Furthermore, we have shown that CAMK2γ protects against intestine tissue injury by increasing IEC survival and proliferation. CAMK2γ knockout mice displayed reduced CAC. Furthermore, we used bone marrow transplantation to reveal that CAMK2γ in IECs, but not immune cells, was crucial for its effect on CAC. Consistently, transgenic over-expression of CAMK2γ in IECs accelerated CAC development. Mechanistically, CAMK2γ in IECs enhanced epithelial STAT3 activation to promote survival and proliferation of colonic epithelial cells during CAC development. These results thus identify a new molecular mechanism mediated by CAMK2γ in IECs during CAC development, thereby providing a potential new therapeutic target for CAC.

Microstructural study of the lunate in stage III Kienböck's disease with micro-computed tomography imaging

Seventeen fresh lunates with stage III Kienböck's disease were scanned with micro-computed tomography. Four regions of interest were selected to measure trabecular parameters, which were compared with those from normal lunates. Within the three regions in the distal surface, there was more compact trabecular bone in the middle region when compared with the palmar and dorsal regions. In the central part, the trabeculae of the Kienböck's lunates were much thicker than those in normal lunates. The diameters of the palmar nutrient foramina of the Kienböck's lunates were significantly smaller than those in normal lunates. In affected lunates, the bony disruptions were mostly located in the palmar or dorsal areas, which were shown from trabecular bone structure analysis to be structurally weaker. This leads to separation of the distal part of the fractured bone, disruption of the blood supply, poor bone remodelling and proneness to secondary fracture and eventual collapse.

Microstructural study of the lunate in stage III Kienböck's disease with micro-computed tomography imaging

Seventeen fresh lunates with stage III Kienböck's disease were scanned with micro-computed tomography. Four regions of interest were selected to measure trabecular parameters, which were compared with those from normal lunates. Within the three regions in the distal surface, there was more compact trabecular bone in the middle region when compared with the palmar and dorsal regions. In the central part, the trabeculae of the Kienböck's lunates were much thicker than those in normal lunates. The diameters of the palmar nutrient foramina of the Kienböck's lunates were significantly smaller than those in normal lunates. In affected lunates, the bony disruptions were mostly located in the palmar or dorsal areas, which were shown from trabecular bone structure analysis to be structurally weaker. This leads to separation of the distal part of the fractured bone, disruption of the blood supply, poor bone remodelling and proneness to secondary fracture and eventual collapse.

Oscillation in tissue oxygen index during recovery from exercise

It was hypothesized that an oscillation of tissue oxygen index (TOI) determined by near-infrared spectroscopy during recovery from exercise occurs due to feedback control of adenosine triphosphate and that frequency of the oscillation is affected by blood pH. In order to examine these hypotheses, we aimed 1) to determine whether there is an oscillation of TOI during recovery from exercise and 2) to determine the effect of blood pH on frequency of the oscillation of TOI. Three exercises were performed with exercise intensities of 30 % and 70 % peak oxygen uptake (V(.)o(2)peak) for 12 min and with exercise intensity of 70 % V(.)o(2)peak for 30 s. TOI during recovery from the exercise was analyzed by fast Fourier transform in order to obtain power spectra density (PSD). There was a significant difference in the frequency at which maximal PSD of TOI appeared (Fmax) between the exercises with 70 % V(.)o(2)peak for 12 min (0.0039+/-0 Hz) and for 30 s (0.0061+/-0.0028 Hz). However, there was no significant difference in Fmax between the exercises with 30 % (0.0043+/-0.0013 Hz) and with 70 % V(.)o(2)peak for 12 min despite differences in blood pH and blood lactate from the warmed fingertips. It is concluded that there was an oscillation in TOI during recovery from the three exercises. It was not clearly shown that there was an effect of blood pH on Fmax.