Colonization and spreading dynamics of Lactiplantibacillus plantarum spoilage isolates on wet surfaces

The role of lactic acid bacteria, including Lactiplantibacillus plantarum, in food spoilage is well recognized, while the behavior of these non-motile bacteria on wet surfaces, such as those encountered in food processing environments has gained relatively little attention. Here, we observed a fast colony spreading of non-motile L. plantarum spoilage isolates on wet surfaces via passive sliding using solid BHI agar media as a model. We investigated the effect of physical properties of agar hydrogel substrate on the surface spreading of six L. plantarum food isolates FBR1-6 and a model strain WCFS1, using increasing concentrations of agar from 0.25 up to 1.5% (w/v). Our results revealed that L. plantarum strain FBR2 spreads significantly on low agar concentration plates compared to the other strains studied here (with a factor of 50-60 folds higher surface coverage), due to the formation of very soft biofilms with high water content that can float on the surface. The fast-spreading of FBR2 colonies is accompanied by an increased number of cells, elongated cell morphology, and a higher amount of extracellular components. Our finding highlights colonization dynamics and the spreading capacity of non-motile bacteria on surfaces that are relatively wet, thereby revealing an additional hitherto unnoticed parameter for non-motile bacteria that may contribute to contamination of foods by fast surface spreading of these bacteria in food processing environments.

Rapid Spreading of a Droplet on a Thin Soap Film

We study the spreading of a droplet of surfactant solution on a thin suspended soap film as a function of dynamic surface tension and volume of the droplet. Radial growth of the leading edge (R) shows power-law dependence on time with exponents ranging roughly from 0.1 to 1 for different surface tension differences (Δσ) between the film and the droplet. When the surface tension of the droplet is lower than the surface tension of the film (Δσ > 0), we observe rapid spreading of the droplet with R ≈ t^α, where α (0.4 < α < 1) is highly dependent on Δσ. Balance arguments assuming the spreading process is driven by Marangoni stresses versus inertial stresses yield α = 2/3. When the surface tension difference does not favor spreading (Δσ < 0), spreading still occurs but is slow with 0.1 < α < 0.2. This phenomenon could be used for stretching droplets in 2D and modifying thin suspended films.

Structure engineering of filled protein microbeads to tailor release of oil droplets in gastric digestion

Oil-soluble components can be encapsulated in an O/W1/W2 microsystem, in which they are dissolved in oil droplets dispersed in a gelled microbead (W1), which forms a barrier between the oil droplets and the aqueous continuous phase (W2). We investigated the rate and mechanism of breakdown of protein microbeads in a simulated gastric system, and studied the influence of microbead protein concentration, gelling method (cold-set, slow and fast heat-set), and further processing (freeze-drying), on the breakdown process. Breakdown rate decreased with increasing protein content of the beads, for the same method of production. Due to the porosity of the slowly-heated heat-set beads, breakdown occurred evenly throughout the entire bead. Cold-set microbeads of 10% protein broke down slightly slower than the heat-set microbeads of 15%. The denser surface of the 10% beads slowed down the diffusion of the enzymes into the bead's interior, causing the beads to be broken down from the outside inward. All these beads broke down within one hour. Increasing the rate of temperature increase during the heating step dramatically slowed breakdown. There was no significant breakdown of rapidly heated beads within 138 minutes, even though no difference in microstructure between rapidly and slowly heated beads was visible with electron microscopy. Freeze-drying of the beads also slowed their breakdown. After 132 minutes more than half the measured particle volume of were intact beads. Freeze-drying changed the microstructure of the beads irreversibly: rehydrating the dried beads did not result in a breakdown behaviour similar to that of unprocessed beads.

Quality of life from a randomized trial of open and endovascular repair for abdominal aortic aneurysm

Background

Long-term survival is similar after open or endovascular repair of abdominal aortic aneurysm. Few data exist on the effect of either procedure on long-term health-related quality of life (HRQoL) and health status.

Methods

Patients enrolled in a multicentre randomized clinical trial (DREAM trial; 2000–2003) in Europe of open repair versus endovascular repair (EVAR) of abdominal aortic aneurysm were asked to complete questionnaires on health status and HRQoL. HRQoL scores were assessed at baseline and at 13 time points thereafter, using generic tools, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36®) and EuroQol 5D (EQ-5D™). Physical (PCS) and mental component summary scores were also calculated. Follow-up was 5 years.

Results

Some 332 of 351 patients enrolled in the trial returned questionnaires. More than 70 per cent of questionnaires were returned at each time point. Both surgical interventions had a short-term negative effect on HRQoL and health status. This was less severe in the EVAR group than in the open repair group. In the longer term the physical domains of SF-36® favoured open repair: mean difference in PCS score between open repair and EVAR −1·98 (95 per cent c.i. −3·56 to −0·41). EQ-5D™ descriptive and EQ-5D™ visual analogue scale scores for open repair were also superior to those for EVAR after the initial 6-week interval: mean difference −0·06 (−0·10 to −0·02) and −4·09 (−6·91 to −1·27) respectively.

Conclusion

In this study EVAR appeared to be associated with less severe disruption to HRQoL and health status in the short term. However, during longer-term follow-up to 5 years, patients receiving open repair appeared to have improved quality of life and health status.

Safety and long-term effects of renal denervation: Rationale and design of the Dutch registry

BACKGROUND

Percutaneous renal denervation (RDN) has recently been introduced as a treatment for therapy-resistant hypertension. Also, it has been suggested that RDN may be beneficial for other conditions characterised by increased sympathetic nerve activity. There are still many uncertainties with regard to efficacy, safety, predictors for success and long-term effects. To answer these important questions, we initiated a Dutch RDN registry aiming to collect data from all RDN procedures performed in the Netherlands.

METHODS

The Dutch RDN registry is an ongoing investigator-initiated, prospective, multicentre cohort study. Twenty-six Dutch hospitals agreed to participate in this registry. All patients who undergo RDN, regardless of the clinical indication or device that is used, will be included. Data are currently being collected on eligibility and screening, treatment and follow-up.

RESULTS

Procedures have been performed since August 2010. At present, data from 306 patients have been entered into the database. The main indication for RDN was hypertension (n = 302, 99%). Patients had a mean office blood pressure of 177/100 (±29/16) mmHg with a median use of three (range 0-8) blood pressure lowering drugs. Mean 24-hour blood pressure before RDN was 157/93 (±18/13) mmHg. RDN was performed with different devices, with the Simplicity™ catheter currently used most frequently.

CONCLUSION

Here we report on the rationale and design of the Dutch RDN registry. Enrolment in this investigator-initiated study is ongoing. We present baseline characteristics of the first 306 participants.

Protein Aggregates May Differ in Water Entrapment but Are Comparable in Water Confinement

Aggregate size and density are related to gel morphology. In the context of the water distribution in complex food systems, in this study, it was aimed to investigate whether protein aggregates varying in size and density differ in entrapped and confined water. Heat-set soy protein aggregates (1%, v/v) prepared in the presence of 3.5 mM divalent salts increased in size and decreased in apparent density following the salt type order MgSO4, MgCl2, CaSO4, and CaCl2. In the absence of applied (centrifugal) forces, larger and less dense aggregates entrap more water. When force is applied from larger and more deformable aggregates, more water can be displaced. Entrapped water of ∼8-13 g of water/g of protein is associated with (pelleted) aggregates, of which approximately 4.5-8.5 g of water/g of protein is not constrained in exchangeability with the solvent. The amount of confined water within aggregates was found to be independent of the aggregate density and accounted for ∼3.5 g of water/g of protein. Confined water in aggregates is hindered in its diffusion because of physical structure constraints and, therefore, not directly exchangeable with the solvent. These insights in the protein aggregate size and deformability in relation to water entrapment and confinement could be used to tune water holding on larger length scales when force is applied.

Origin of water loss from soy protein gels

Water holding (WH) of soy protein gels was investigated to identify which length scales are most contributing to WH when centrifugal forces are applied. More specifically, it was attempted to differentiate between the contributions of submicron and supramicron length scales. MgSO4 and MgCl2 salt specificities on soy protein aggregation (submicron contribution) were used to create different gel morphologies (supramicron contribution). Obtained results showed that the micrometer length scale is the most important contribution to WH of gels under the applied deformation forces. WH of soy protein gels correlated negatively with Young's modulus and positively with recoverable energy. The occurrence of rupture events had only a limited impact on WH. The ease by which water may be removed from the gel, but not the total amount, seemed to be related to the initial building block size. These insights could be exploited in product development to predict and tune oral perception properties of (new) products.

High amounts of broccoli in pasta-like products: nutritional evaluation and sensory acceptability

Pasta and noodles were enriched with concentrations of broccoli powder (BP) up to 30% (v/v). To ensure the benefits from the broccoli nutrients, their leakage during cooking should be prevented. Such leakage is determined by the microstructure. In a previous study we have shown that the microstructure can change dramatically in such broccoli-enriched products. In this article we investigated the amount of nutrients retained within the product. As a representative of nutrients we have chosen glucosinolates (GLs). Therefore, we have investigated the concentration of these phytochemicals in dried and cooked pasta and noodles. We have found that glucosinolates present in the pasta and noodles increase linearly with the volume fraction of BP up to 20%. At 30% BP the retained amount of GLs was equal to that of 20% BP and did not increase further. Therefore incorporation of 30% BP does not lead to additional health benefits over incorporation of 20% BP. We conclude that the nutritional function of our pasta-like products can be improved by enrichment up to 20% broccoli. This value is much higher than that found in common commercial products (which is a few percent). In this article we also briefly address the sensory acceptability of such products. Up to 20% broccoli the products turned out to remain acceptable. Combining this with our results on texture analysis we conclude that the GLs release, sensory acceptability and textural properties are related via the microstructure.

Life-saving therapy for haemorrhaging liver adenomas using selective arterial embolization

BACKGROUND

Emergency treatment for patients with a ruptured hepatocellular adenoma is controversial. The aim of this study was to evaluate management with selective arterial embolization.

METHODS

The study included 11 consecutive patients treated for ruptured hepatocellular adenomas between 2001 and 2006. After initial haemodynamic support, all patients received selective embolization of branches of the hepatic artery. The primary outcome was effectiveness in stopping the bleeding. Secondary outcomes were complications and changes in tumour size after embolization.

RESULTS

A single embolization brought haemorrhaging under control in ten patients; one patient needed three embolizations. None of the patients required emergency surgery. In the follow-up of 19 (range 7-49) months, no general or hepatobiliary complications were observed. All 25 adenomas, including those without signs of haemorrhaging in the same liver lobe, were either smaller or not detectable on computed tomography or magnetic resonance imaging after embolization, with the median diameter decreasing from 7.0 to 2.5 cm (P < 0.001).

CONCLUSION

Selective embolization of the hepatic artery is a safe and adequate first approach in the management of patients with haemorrhaging hepatocellular adenomas. Furthermore, arterial embolization reduces the size of adenomas in the liver.

Exploring imperfect squeezing flow measurements in a Teflon geometry for semisolid foods

The method of imperfect lubricated squeezing flow in a Teflontrade mark geometry has been explored for the characterization of elongational behavior of custard and mayonnaise. Two Newtonian products, one of low (0.07 Pas) and one of high (18 Pas) shear viscosity, were used as references. Measurements of custards and mayonnaises did not behave according to either the theory of lubricated or nonlubricated squeezing flow, as there were effects of the initial sample height and compression speed. Also, calculated values for the flow index were not as we had expected. The same was true for the Newtonian samples. An important factor explaining the effect of compression speed was the presence of a certain amount of friction, rendering both lubricated theory and nonlubricated theory nonapplicable. Correcting for (pseudo-) thixotropic behavior of custard and mayonnaise appears to be an effective way of obtaining realistic values for the flow index. The presence of buoyancy also affected the results, especially in the case of low viscous products and the effect of initial sample height. Other factors that played a role in the results were yield stress for custard and mayonnaise and instrumental artifacts associated with the imperfect setup of the measurement, especially for the highly viscous products. Quantitatively correcting the results for all of these factors is not possible at this point. Although the imperfect squeezing flow technique in a Teflon geometry is a very practical way to measure semisolids such as custard and mayonnaise under (partly) elongational deformation, the results should be regarded as more qualitative than quantitative.

A novel technique for auxiliary partial liver transplantation with reno-portal anastomosis and avoidance of the hepatoduodenal ligament

Auxiliary liver transplantation (ALT) is a treatment for acute liver failure when regeneration of the native liver is possible or for metabolic disorders. In selected cases ALT and orthotopic liver transplantation (OLT) have similar survival when ALT is performed in the orthotopic position (auxiliary partial orthotopic liver transplantation, APOLT). Drawback of ALT with portal vein to portal vein anastomosis is the frequent occurrence of thrombosis, compromising both graft and native liver, and the necessity of a significant resection. To avoid division of portal flow we performed ALT with an end-to-end anastomosis between the graft portal vein and the left renal vein of the recipient (reno-portal ALT, REPALT). The hepatic artery was anastomosed to the aorta using an iliac arterial graft conduit. The bile duct was anastomosed to the stomach. In the two cases presented here excellent immediate graft function occurred with rapid regeneration of the graft and without early vascular complications.

Effect of starvation on Fos and neuropeptide immunoreactivities in the brain and pituitary gland of Xenopus laevis

In mammals complex interactions between various brain structures and neuropeptides such as corticotropin-releasing factor (CRF) and urocortin 1 (Ucn1) underlay the control of feeding by the brain. Recently, in the amphibian Xenopus laevis, CRF- and Ucn1-immunoreactivities were shown in the hypothalamic magnocellular nucleus (Mg) and evidence was obtained for their involvement in food intake. To gain a better understanding of the brain structures controlling feeding in X. laevis, the effects of 16 weeks starvation on neurones immunoreactive (ir) to Fos and neuropeptides in various brain structures were quantified. In the Mg, compared to controls, starved animals showed fewer neurones immunopositive for Fos (-55.9%), Ucn1 (-44.0%), cocaine and amphetamine-regulated transcript (CART) (-94.3%) and metenkephalin (ENK) (-65.0%), whereas CRF-ir neurones were 2.1 times more numerous. These differences were mainly apparent in the ventral part of the Mg, followed by the medial and dorsal part of the nucleus. In the neural lobe of the pituitary gland a 22.5% lower optical density of CART-ir was observed. In the four other brain structures investigated, starvation had different effects. The dorsomedial part of the suprachiasmatic nucleus showed 5.9 times more NPY-ir cells and in the ventromedial thalamic area a lower number of NPY-ir cells (-33.6%) was found, whereas the Edinger-Westphal nucleus contained fewer CART-ir cells (-42.2%); no effect of starvation was seen in the ventral hypothalamic nucleus. Our results support the hypothesis that in X. laevis, the Mg plays a pivotal role in feeding-related processes and, moreover, that starvation also has neuropeptide- and brain structure-specific effects in other parts of the brain and in the pituitary gland, suggesting particular roles of these structures and their neuropeptides in physiological adaptation to starvation.

Investigating the permanent electric dipole moment of β-lactoglobulin fibrils, using transient electric birefringence

Amyloid fibrils, which are polymeric assemblies of protein molecules, have been intensively studied on a structural level, yet due to complications such as the disorder within the molecules, several aspects of their structure remain mysterious. Similarly, the kinetics of assembly are not well understood. Here we investigate the electric dipole moment of beta-lactoglobulin fibrils, a model amyloid fibril system, by applying the technique of transient electric birefringence. This moment appears to be large, and comparable to the total moment of the constituent protein monomers if they were joined in a chain, head-to-tail, without changing conformation, suggesting an ordered joining of monomers in the fibril. Such an ordered assembly may have implications for the assembly mechanism of beta-lactoglobulin fibrils in particular, and amyloid fibrils in general.

Electric birefringence study of an amyloid fibril system: the short end of the length distribution

In this article, a system of amyloid fibrils, based on the protein beta-lactoglobulin, is studied by transient electric birefringence. Single pulses of an electric field were applied to the solution, and the initial rise and subsequent decay of birefringence analysed. The decay takes place on a range of relaxation times, and therefore contains information about the length distribution of fibrils in the system. The information can be extracted using theories of the electric polarisability of polyelectrolyte rods, since the fibrils are an example of these. Despite the long-standing complications of such theories, useful quantitative information about the system can still be obtained. Using the Fixman model of polyelectrolyte polarisability, we obtain a measurement of the short end of the length distribution which shows the fibril concentration as a function of length rising linearly from 0.02-2 microm. The short end of the length distribution was unobtainable in our previous study using rheo-optics (S.S. Rogers et al., Macromolecules 38, 2948 (2005)), but reasonable agreement between the two techniques shows they are complementary.

[Percutaneous radiologic thermocoagulation treatment of liver, kidney and lung tumours]

Percutaneous image-guided radiofrequency ablation is mainly used for treatment of tumours in the skeleton, the liver, kidney and lung, in patients who are no (longer) candidates for surgical treatment. Sterile placement of the radiofrequency electrode, which is coupled to a radio-frequency generator, is image-guided. Heating causes cell-death. It has been shown in the literature that radiofrequency ablation is a safe and effective treatment method for local tumor control.

Compatibility of gelatin and dextran in aqueous solution

The temperature-composition phase diagrams of aqueous solutions of gelatin and dextran, which show liquid/liquid phase segregation, were explored at temperatures above the gelation temperature of gelatin. The compositions of the coexisting phases were found to show practically no dependence on temperature between 40 and 80 degrees C. Also, the total polymer concentration at which phase separation occurred was found to be nearly independent of temperature. These observations suggest an entropy-driven phase separation. An explanation in terms of depletion, reversible clustering, and subsequent transient network formation of gelatin at temperatures well above the temperature of gelation is suggested. Phase separation is found to be accompanied by strong fractionation of the molar mass distribution in the two phases.

Pacemaker lead endocarditis: A rare diagnosis with a varied presentation

We present a patient with a pacemaker lead endocarditis who showed no signs of pocket infection but with high fever and signs of infection in the routine laboratory tests. A diagnosis of pacemaker lead endocarditis must be considered in all patients with fever and infection parameters who have a pacemaker inserted, not only in the first weeks after implantation but also late after implantation, as long as no other cause of infection has been found. Transthoracal echocardiography alone is not sensitive enough to establish the correct diagnosis. Transoesophageal echocardiography (TEE) is mandatory to demonstrate the presence or absence of a vegetation on a pacemaker lead.

Phase-separation-induced fractionation in molar mass in aqueous mixtures of gelatin and dextran

An overview of the effects of phase separation of aqueous mixtures of gelatin and dextran on the fractionation in molar mass of these two components is given. Molar mass distributions in coexisting phases were investigated using size exclusion chromatography with multiangle laser light scattering. The initial molar mass of the native material, concentration, and temperature were varied. The results show a strong fractionation in molar mass for both components. The molar mass of the native material and concentration appeared to be the only factors that affected the final molar mass distributions, temperature having no effect. The results show that in the molar mass range where fractionation is the strongest, i.e., roughly below the maximum in the distribution, fractionation is governed by a Boltzmann factor e(-deltaG/kT), where deltaG denotes the free energy involved in transferring a polymer with a certain length from the enriched to the depleted phase, and in this case turns out to be proportional to the molar mass. Comparison of the results of phase separation with results on dialysis shows that water affinity is not the driving force for the phase separation of gelatin and dextran in aqueous solution. The gelation properties of gelatin in both phases were also determined. The gelation properties of gelatin in the coexisting phases differ from those of native gelatin. In particular, the gelatin in the gelatin-poor phase shows strong differences compared to the native material.

Evidence for a bias toward intracellular antigens in the local humoral anti-tumor immune response of a colorectal cancer patient revealed by phage display

Many patients with colorectal carcinoma (CRC) mount a cellular as well as a humoral immune response to the tumor. To investigate the nature and specificity of the humoral immune response in a CRC patient, lymphocytes infiltrating the primary colorectal tumor and lymph nodes draining the tumor were used as antibody variable (V)-gene pools for the construction of phage antibody repertoires. These libraries were first validated by selection on the antigen tetanus toxoid and shown to contain antibodies that were probably derived from both naive and memory B cells. The repertoires were then screened for the presence of antibodies directed to CRC by selection on the cell line CaCo2. For comparison, the same selections were performed with a phage antibody repertoire made from B cells of healthy donors. Striking differences were observed in the panel of specificities selected from these different repertoires: although a large panel of antibodies reactive with patient-derived primary tumors was obtained from the immune repertoires, none of these discriminated between normal colonic epithelium and colon cancer and none were reactive with cell-surface antigens. However, selections using the non-immune library did result in numerous antibodies that recognized cell surface markers on CaCo2. These data suggest a bias in the local humoral immune response in this CRC patient, directed primarily toward intracellular epithelial-cell specific target antigens.

Constitutive equations for an elastic material with anisotropic rigid particles

In this paper we have derived constitutive equations for an elastic material with anisotropic rigid particles. We have included a dependence on the Finger tensor B and the orientation tensor Q in the expression for the free energy of the system. With this expression for the free energy we have derived an expression for the stress tensor up to second order in both these variables. We have shown that the elastic modulus in this expression depends on Q, and this dependence leads to an effective elastic modulus that depends on the strain. We have calculated the explicit form of the equation for the stress tensor for a deformation in the xy plane with a strain equal to -gamma. For fully isotropic materials with Q=0 this expression reduces to an equation containing only odd powers of gamma. The inclusion of a non-zero value for the orientation tensor leads to an additional set of terms in the equation, all proportional to Qxy (the xy component of the tensor Q), and all proportional to even powers of gamma. We have qualitatively compared these expressions with Fourier transform (FT) rheological measurements of xanthan gels, at concentrations above and below the order-disorder transition. In FT rheometry an oscillatory deformation is applied in the nonlinear regime, and the resulting stress response is analyzed in Fourier space. In the 2% (w/w) xanthan system (disordered state) only odd harmonics were found in the stress response, whereas in the 4% (w/w) xanthan gel (ordered state) even harmonics could be detected. As predicted by our theory, the intensity of these even harmonics first increased with increasing gamma, until a maximum value was reached. Beyond this maximum the intensity decreased continuously with increasing gamma.

Identification of colon tumour-associated antigens by phage antibody selections on primary colorectal carcinoma

Immunotargeting of solid tumours using antibodies has become a valuable tool for the detection of cancer metastases and the treatment of minimal residual disease. However, only few tumour antigens useful for targeting have been described to date. To identify cell-surface targets on colorectal carcinoma (CRC), we selected a large, human phage antibody repertoire on freshly isolated colon tumour cells. Two antibodies were identified that reacted with epithelial cell-restricted cell-surface antigens, whereas one clone preferentially reacted with stromal cells. These antigens are tumour-associated antigens, as shown by their uniform expression in tumours of different patients and of different differentiation stages and by their limited expression on normal tissues. The pattern of reactivity in immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA) suggests that these antigens are different from previously identified tumour-associated antigens (e.g. Ep-CAM or c-ERB-2). This phage antibody-based method may lead to the cloning of novel tumour antigens that are useful for the immunotargeting of solid tumours.

Early experience with intravascular ultrasound in evaluating the effect of statins on femoropopliteal arterial disease: hypothesis-generating observations in humans

The purpose of this study was to compare the vascular response seen with intravascular ultrasound (IVUS) at 1-year follow-up between statin-treated and non-statin-treated patients. Patients (n = 10) undergoing percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery were studied with IVUS immediately after PTA and at 1-year follow-up. In nondilated matched vascular segments, the change in lumen, vessel, and plaque volume was assessed. In balloon-dilated matched vascular segments, the change in lumen, vessel, and plaque area was assessed. A comparison was made between statintreated (n = 5) and non-statin-treated patients (n = 5) in lumen, vessel, and plaque changes. At follow-up, both statin-treated and non-statin-treated patients showed a similar increase in plaque volume at the nondilated segment (+4% and +2%, respectively). In statin-treated patients the plaque volume increase was compensated by an increase in vessel volume (+2%), resulting in an increase in lumen volume (+1%). In non-statin-treated patients, on the other hand, the increase in plaque volume was associated with a decrease in vessel volume (-2%), resulting in a decrease in lumen volume (-4%). At the balloon-dilated segment a similar trend in changes of lumen, vessel, and plaque was encountered. Differences between both groups of patients were not statistically significant. Despite the nonsignificant nature of the observation, this small retrospective IVUS study may generate the hypothesis that statin therapy may contribute to superior long-term lumen dimensions by inducing positive vascular remodeling both in nondilated and balloon-dilated vascular segments.

Reproducibility of calcified lesion quantification: a longitudinal intravascular ultrasound study

In view of a prospective intravascular ultrasound (IVUS) study, the reproducibility of the extent of the calcified lesion in IVUS images derived from separate pull-back maneuvers was assessed. Patients (n = 34) were imaged with IVUS before and after percutaneous transluminal angioplasty (PTA) and at 1-y follow-up. In the presence of a calcified lesion, the largest arc and the length of the matched calcified lesions was assessed. Interobserver differences in arc measurements were low (< or = 0.7%), with low coefficients of variation (< or = 5.8%). Similarly, interexamination differences in arc and length measurements were small (< or = 1.1%), with low coefficients of variation (< or = 3.2%). At follow-up, a nonsignificant increase in both the arc (1.9%) and length (1.7%) of the calcified lesion was observed. This study showed that measurements of the calcified lesion are highly reproducible; changes seen at 1-y follow-up were not significant. We conclude that IVUS may be used to monitor the effect of medical intervention on the extent of the calcified lesion in a longitudinal study.

Model systems to study the parameters determining the success of phage antibody selections on complex antigens

Phage antibody display technology offers a powerful tool for the isolation of specific antibodies to defined target antigens. Most selection strategies described to date have relied on the availability of purified and often recombinant antigen, providing the possibility to perform selections on a well-defined antigen source. However, when the target antigen cannot be purified (e.g., an integral membrane protein), or if the antigen is unknown (e.g., when searching for novel markers on cells or tissues), panning of phage antibody libraries has to be performed on complex antigen sources such as cell surfaces or tissue sections, or even by in vivo selection methods. This provides a series of technical and experimental challenges. One focus of our research is to select antibodies directed to novel cancer-induced antigens expressed by tumours and by the tumour vasculature. To understand the parameters governing selection on complex antigen sources and to assess the efficiency of these phage library selections, we have set up two model selection systems in which both tumour cells and vascular endothelial cells serve as target "antigen". We describe a model based on phage antibodies directed to the tumour antigen epithelial glycoprotein-2, to compare phage antibody selections on a range of different antigen sources including purified and recombinant antigen, whole live cells, tissue cryosections and in vivo grown solid tumours. Secondly, we describe a model based on a phage antibody directed against the endothelial cell inducible adhesion molecule E-selectin. We compare selections on cultured cell monolayers with selections on cell suspensions immobilised on columns, to determine which selection approach is most suitable for the identification of novel tumour endothelial cell markers. Our data provide insight into the efficiency and thus potency of different selection strategies and show that there are very large differences in the recovery and enrichment of binding phage between the different methods tested. Our results further demonstrate the feasibility of phage antibody selections on whole, intact cells and show that these may sometimes compare favourably to selections on purified antigen. Selections on endothelial cells immobilised on columns compare favourably with selections on cell-monolayers; the most favourable conditions for both selection procedures are described. The implications of our data for phage antibody selections on these different complex antigen sources using either non-immune or immune phage antibody repertoires are discussed. The use of model systems such as the ones described here will help to determine optimal experimental conditions for phage library selections on complex antigens and aid in developing more powerful selection procedures for target discovery.

High-affinity recombinant phage antibodies to the pan-carcinoma marker epithelial glycoprotein-2 for tumour targeting

The tumour-associated antigen epithelial glycoprotein-2 (EGP-2) is a promising target for detection and treatment of a variety of human carcinomas. Antibodies to this antigen have been successfully used in patients for imaging of small-cell lung cancer and for adjuvant treatment of minimal residual disease of colon cancer. We describe here the isolation and complete characterization of high-affinity single-chain variable fragments (scFv) to the EGP-2 antigen. First, the binding kinetics of four murine whole antibodies directed to EGP-2 (17-1A, 323/A3, MOC-31 and MOC-161) were determined using surface plasmon resonance (SPR). The MOC-31 antibody has the lowest apparent off-rate, followed by MOC-161 and 323/A3. The V-genes of the two MOC hybridomas were cloned as scFv in a phage display vector and antigen-binding phage were selected by panning on recombinant antigen. The scFvs compete with the original hybridoma antibodies for binding to antigen and specifically bind to human carcinomas in immunohistochemistry. MOC-31 scFv has an off-rate which is better than those of the bivalent 17-1A and 323/A3 whole antibodies, providing it with an essential characteristic for tumour retention in vivo. The availability of these high-affinity anti-EGP-2 antibody fragments and of their encoding V-genes creates a variety of possibilities for their future use as tumour-targeting vehicles.

MR imaging of hyaline cartilage at 0.5 T: a quantitative and qualitative in vitro evaluation of three types of sequences

OBJECTIVE

To identify an optimal pulse sequence for in vitro imaging of hyaline cartilage at 0.5 T.

MATERIALS AND METHODS

Twelve holes of varying diameter and depth were drilled in the cartilage of two pig knees. These were submerged in saline and scanned with a 0.5-T MR system. Sixteen T1-weighted gradient echo (GE), two T2-weighted GE, and 16 fast spin echo sequences were used, by varying repetition time (TR), echo time (TE), flip angle (FA), echo train length, profile order, and by use of fat saturation. Contrast-to-noise ratios (CNR) of cartilage versus saline solution and cartilage versus subchondral bone were measured. Cartilaginous lesions were evaluated separately by three independent observers. Interobserver variability and correlation between the quantitative and qualitative analyses were calculated.

RESULTS

The mean CNRs of two specimens of cartilage versus saline solution ranged from 6.3 (+/- 2.1) to 27.7 (+/- 2.5), and those of cartilage versus subchondral bone from 0.3 (+/- 0.2) to 22.5 (+/- 1.4). The highest CNR was obtained with a T1-weighted spoiled 3D-GE technique (TR 65 ms, TE 11.5 ms, FA 45 degrees). The number of lesions observed per sequence varied from 35 to 69. Observer agreement was fair to good. The T1-weighted spoiled GE sequences with a TR of 65 ms, TE of 11.5 ms and FA of 30 degrees and 45 degrees were significantly superior to the other 34 sequences in the qualitative analysis.

CONCLUSION

T1-weighted spoiled 3D-GE sequences with a TR of 65 ms, a TE of 11.5 ms, and a FA of 30-45 degrees were found to be optimal for in vitro imaging of cartilage at 0.5T.

Severe limb defects and craniofacial anomalies in a fetus conceived during acitretin therapy

We describe a 20-week-old fetus with multiple congenital anomalies exposed to acitretin in the first trimester of pregnancy. Acitretin and its ethylester etretinate are both vitamin A congeners; drugs of this group are well-known teratogenic agents. Since the marketing of acitretin only one report on human teratogenicity associated with acitretin has been published. The present male fetus showed severe symmetric anomalies of upper and lower limbs, craniofacial anomalies, ear anomalies, and an atrioventricular septal defect (ASD). Although the craniofacial anomalies resemble the abnormalities described in classical "retinoic acid embryopathy," limb anomalies were seldomly reported after maternal use of vitamin A congeners. However, in laboratory animals limb defects were frequently observed after retinoid exposure in utero. This case emphasizes again that extreme care and precaution are needed before prescribing a potentially teratogenic drug to a fertile woman.

Fracture of the thumb sesamoid bone: a report of three cases and a review of the English-language literature

Fracture of the sesamoid bone of the thumb is a rare injury. In this report three additional cases with fracture of an ulnar sesamoid bone of the thumb are reported. The anatomic considerations, the mechanisms of injury, the differential diagnoses, and management are discussed with the English-language literature.

Does ex vivo labelling of proliferating cells in colonic and vaginal mucosa reflect the S-phase fraction in vivo?

The ex vivo labelling of DNA-synthesizing epithelial cells in colonic and vaginal mucosa was compared with in vivo labelling. For this purpose, in vivo S-phase cells were labelled with [3H]thymidine (Tdr) and ex vivo labelling was continued by culturing tissue specimens in bromodeoxyuridine (BrdU). Various methods of tissue culture were employed in order to improve diffusion of medium (and BrdU) in the tissue. BrdU and 3H-TdR labelling were evaluated by immunohistochemistry and autoradiography respectively. Ex vivo labelling resulted in a patchy distribution of labelled cells, which did not correspond with the 3H-TdR labelling pattern obtained in vivo. Under the described conditions ex vivo labelling does not appear to be a reliable for estimation of the proliferative activities in vivo.

Low dose aminoglutethimide without hydrocortisone for the treatment of advanced postmenopausal breast cancer

One hundred and one postmenopausal patients with advanced breast cancer were enrolled in a randomized phase II clinical trial to investigate the clinical and hormonal response to aminoglutethimide administered at daily doses of 2 x 125 mg, 3 x 125 mg or 2 x 250 mg, with no addition of hydrocortisone. Among 71 evaluable patients 25% showed objective tumor response (three complete, 15 partial), at all three dose levels and irrespective of the major tumor site. Previous treatment with Tamoxifen had been successful in 75%. Out of the 18 responding patients 10 had estrogen receptor positive, four had estrogen receptor negative tumors; the receptor status was unknown in four other patients. Progression-free interval was more than 700 days in 50% of the responders. Drowsiness caused early drug withdrawal in one patient. Side-effects were very mild, comparing favorably with standard therapy of 250 mg aminoglutethimide q.i.d. plus hydrocortisone. Plasma estrogen levels were reduced by all doses to the same 50% or less as in patients on standard treatment. In nine out of 27 patients a further decrease of estrone levels could be monitored with clinically improved results in five. Plasma cortisol and mineralocorticoids remained normal throughout more than 6 months. The original role of hydrocortisone administration to suppress a reflex rise of ATH in 'medical adrenalectomy' with standard dose aminoglutethimide is no longer tenable. Further phase III comparative clinical results pending, low dose aminoglutethimide as an aromatase inhibitor may at present be considered as an appropriate second-line endocrine treatment with low toxicity and expense.

Culturing and xenografting of primary colorectal carcinoma cells: comparison of in vitro, and in vivo model and primary tumor

In a series of 61 primary colorectal carcinomas, we attempted to determine which primary tumor characteristics correlated with the possibility to continuously maintain tumor cells in vitro or in vivo, and to what extent the characteristics of a primary tumor were maintained in vitro or as xenograft. Four continuous cell lines and 10 serially transplantable tumors were obtained. Only one cell line could be maintained both in vitro and in vivo. Tumors that had metastized and tumors in the proximal colon showed a higher success for in vivo and in vitro growth. DNA analysis showed that in most xenografts the DNA index was identical to that the primary tumor. However, in some cases tumor cell subpopulations were lost or genetically variant new subpopulations were generated. In general, the degree of differentiation in the xenografts corresponded with the least differentiated areas in the primary tumor. Xenografts appeared to display comparable of antigen expression.