Limited TCR repertoire and ENTPD1 dysregulation mark late-stage COVID-19

T cell exhaustion and dysfunction are hallmarks of severe COVID-19. To gain insights into the pathways underlying these alterations, we performed a comprehensive transcriptome analysis of peripheral-blood-mononuclear-cells (PBMCs), spleen, lung, kidney, liver, and heart obtained at autopsy from COVID-19 patients and matched controls, using the nCounter CAR-T-Characterization panel. We found substantial gene alterations in COVID-19-impacted organs, especially the lung where altered TCR repertoires are noted. Reduced TCR repertoires are also observed in PBMCs of severe COVID-19 patients. ENTPD1/CD39, an ectoenzyme defining exhausted T-cells, is upregulated in the lung, liver, spleen, and PBMCs of severe COVID-19 patients where expression positively correlates with markers of vasculopathy. Heightened ENTPD1/CD39 is paralleled by elevations in STAT-3 and HIF-1α transcription factors; and by markedly reduced CD39-antisense-RNA, a long-noncoding-RNA negatively regulating ENTPD1/CD39 at the post-transcriptional level. Limited TCR repertoire and aberrant regulation of ENTPD1/CD39 could have permissive roles in COVID-19 progression and indicate potential therapeutic targets to reverse disease.

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Transcriptome profiling of COVID-19 autoptic tissue and PBMC was carried out

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There is limited TCR repertoire in lung, kidney and PBMC of severe COVID-19 cases

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There are increased CD39 levels in PBMC of severe COVID-19 patients

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High HIF-1a and STAT-3 and low CD39-antisense might be linked with CD39 increase

COVID-19 tissue atlases reveal SARS-CoV-2 pathology and cellular targets

COVID-19, which is caused by SARS-CoV-2, can result in acute respiratory distress syndrome and multiple organ failure^1-4, but little is known about its pathophysiology. Here we generated single-cell atlases of 24 lung, 16 kidney, 16 liver and 19 heart autopsy tissue samples and spatial atlases of 14 lung samples from donors who died of COVID-19. Integrated computational analysis uncovered substantial remodelling in the lung epithelial, immune and stromal compartments, with evidence of multiple paths of failed tissue regeneration, including defective alveolar type 2 differentiation and expansion of fibroblasts and putative TP63⁺ intrapulmonary basal-like progenitor cells. Viral RNAs were enriched in mononuclear phagocytic and endothelial lung cells, which induced specific host programs. Spatial analysis in lung distinguished inflammatory host responses in lung regions with and without viral RNA. Analysis of the other tissue atlases showed transcriptional alterations in multiple cell types in heart tissue from donors with COVID-19, and mapped cell types and genes implicated with disease severity based on COVID-19 genome-wide association studies. Our foundational dataset elucidates the biological effect of severe SARS-CoV-2 infection across the body, a key step towards new treatments.

Light-Mediated Cross-Coupling of Anomeric Trifluoroborates

Stereoselective reactions at the anomeric carbon constitute the cornerstone of preparative carbohydrate chemistry. Here, we report stereoselective C-arylation and etherification reactions of anomeric trifluoroborates derived from BMIDA esters. These reactions are characterized by high anomeric selectivities for 2-deoxysugars and broad substrate scope (24 examples), including disaccharides and trifluoroborates with free hydroxyl groups. Taken together, this new class of carbohydrate reagents adds the palette of anomeric nucleophile reagents suitable for efficient installation of C-C bonds.

A single-cell and spatial atlas of autopsy tissues reveals pathology and cellular targets of SARS-CoV-2

The SARS-CoV-2 pandemic has caused over 1 million deaths globally, mostly due to acute lung injury and acute respiratory distress syndrome, or direct complications resulting in multiple-organ failures. Little is known about the host tissue immune and cellular responses associated with COVID-19 infection, symptoms, and lethality. To address this, we collected tissues from 11 organs during the clinical autopsy of 17 individuals who succumbed to COVID-19, resulting in a tissue bank of approximately 420 specimens. We generated comprehensive cellular maps capturing COVID-19 biology related to patients' demise through single-cell and single-nucleus RNA-Seq of lung, kidney, liver and heart tissues, and further contextualized our findings through spatial RNA profiling of distinct lung regions. We developed a computational framework that incorporates removal of ambient RNA and automated cell type annotation to facilitate comparison with other healthy and diseased tissue atlases. In the lung, we uncovered significantly altered transcriptional programs within the epithelial, immune, and stromal compartments and cell intrinsic changes in multiple cell types relative to lung tissue from healthy controls. We observed evidence of: alveolar type 2 (AT2) differentiation replacing depleted alveolar type 1 (AT1) lung epithelial cells, as previously seen in fibrosis; a concomitant increase in myofibroblasts reflective of defective tissue repair; and, putative TP63+ intrapulmonary basal-like progenitor (IPBLP) cells, similar to cells identified in H1N1 influenza, that may serve as an emergency cellular reserve for severely damaged alveoli. Together, these findings suggest the activation and failure of multiple avenues for regeneration of the epithelium in these terminal lungs. SARS-CoV-2 RNA reads were enriched in lung mononuclear phagocytic cells and endothelial cells, and these cells expressed distinct host response transcriptional programs. We corroborated the compositional and transcriptional changes in lung tissue through spatial analysis of RNA profiles in situ and distinguished unique tissue host responses between regions with and without viral RNA, and in COVID-19 donor tissues relative to healthy lung. Finally, we analyzed genetic regions implicated in COVID-19 GWAS with transcriptomic data to implicate specific cell types and genes associated with disease severity. Overall, our COVID-19 cell atlas is a foundational dataset to better understand the biological impact of SARS-CoV-2 infection across the human body and empowers the identification of new therapeutic interventions and prevention strategies.

Copper-Catalyzed Oxidative Acetalization of Boronic Esters: An Umpolung Strategy for Cyclic Acetal Synthesis

A protocol for the acetalization of boronic esters is described. The reaction is catalyzed by copper, and the conditions proved to be mild and were amenable to a variety of functional groups. We expanded the Chan-Lam coupling to include C(sp³) nucleophiles and converted them into corresponding acetals. This method allows for the orthogonal acetalization of substrates with reactive, acid-sensitive functional groups.

Beyond Reward Prediction Errors: Human Striatum Updates Rule Values During Learning

Humans naturally group the world into coherent categories defined by membership rules. Rules can be learned implicitly by building stimulus-response associations using reinforcement learning or by using explicit reasoning. We tested if the striatum, in which activation reliably scales with reward prediction error, would track prediction errors in a task that required explicit rule generation. Using functional magnetic resonance imaging during a categorization task, we show that striatal responses to feedback scale with a "surprise" signal derived from a Bayesian rule-learning model and are inconsistent with RL prediction error. We also find that striatum and caudal inferior frontal sulcus (cIFS) are involved in updating the likelihood of discriminative rules. We conclude that the striatum, in cooperation with the cIFS, is involved in updating the values assigned to categorization rules when people learn using explicit reasoning.

A conjugate Lewis base-Brønsted acid catalyst for the sulfenylation of nitrogen containing heterocycles under mild conditions

A new Lewis base/Brønsted acid approach allows for the sulfenylation of N-heterocycles under exceedingly mild conditions.

Dissociating motivation from reward in human striatal activity

Neural activity in the striatum has consistently been shown to scale with the value of anticipated rewards. As a result, it is common across a number of neuroscientific subdiscliplines to associate activation in the striatum with anticipation of a rewarding outcome or a positive emotional state. However, most studies have failed to dissociate expected value from the motivation associated with seeking a reward. Although motivation generally scales positively with increases in potential reward, there are circumstances in which this linkage does not apply. The current study dissociates value-related activation from that induced by motivation alone by employing a task in which motivation increased as anticipated reward decreased. This design reverses the typical relationship between motivation and reward, allowing us to differentially investigate fMRI BOLD responses that scale with each. We report that activity scaled differently with value and motivation across the striatum. Specifically, responses in the caudate and putamen increased with motivation, whereas nucleus accumbens activity increased with expected reward. Consistent with this, self-report ratings indicated a positive association between caudate and putamen activity and arousal, whereas activity in the nucleus accumbens was more associated with liking. We conclude that there exist regional limits on inferring reward expectation from striatal activation.

Theories of willpower affect sustained learning

Building cognitive abilities often requires sustained engagement with effortful tasks. We demonstrate that beliefs about willpower-whether willpower is viewed as a limited or non-limited resource-impact sustained learning on a strenuous mental task. As predicted, beliefs about willpower did not affect accuracy or improvement during the initial phases of learning; however, participants who were led to view willpower as non-limited showed greater sustained learning over the full duration of the task. These findings highlight the interactive nature of motivational and cognitive processes: motivational factors can substantially affect people's ability to recruit their cognitive resources to sustain learning over time.

MLK3 is critical for breast cancer cell migration and promotes a malignant phenotype in mammary epithelial cells

The malignant phenotype in breast cancer is driven by aberrant signal transduction pathways. Mixed-lineage kinase-3 (MLK3) is a mammalian mitogen-activated protein kinase kinase kinase (MAP3K) that activates multiple MAPK pathways. Depending on the cellular context, MLK3 has been implicated in apoptosis, proliferation, migration and differentiation. Here we investigated the effect of MLK3 and its signaling to MAPKs in the acquisition of malignancy in breast cancer. We show that MLK3 is highly expressed in breast cancer cells. We provide evidence that MLK3's catalytic activity and signaling to c-jun N-terminal kinase (JNK) is required for migration of highly invasive breast cancer cells and for MLK3-induced migration of mammary epithelial cells. Expression of active MLK3 is sufficient to induce the invasion of mammary epithelial cells, which requires AP-1 activity and is accompanied by the expression of several proteins corresponding to AP-1-regulated invasion genes. To assess MLK3's contribution to the breast cancer malignant phenotype in a more physiological setting, we implemented a strategy to inducibly express active MLK3 in the preformed acini of MCF10A cells grown in 3D Matrigel. Induction of MLK3 expression dramatically increases acinar size and modestly perturbs apicobasal polarity. Remarkably, MLK3 expression induces luminal repopulation and suppresses the expression of the pro-apoptotic protein BimEL, as has been observed in Her2/Neu-expressing acini. Taken together, our data show that MLK3-JNK-AP-1 signaling is critical for breast cancer cell migration and invasion. Our current study uncovers both a proliferative and novel antiapoptotic role for MLK3 in the acquisition of a malignant phenotype in mammary epithelial cells. Thus, MLK3 may be an important therapeutic target for the treatment of invasive breast cancer.

Homosexuality, birth order, and evolution: toward an equilibrium reproductive economics of homosexuality

The survival of a human predisposition for homosexuality can be explained by sexual orientation being a polygenetic trait that is influenced by a number of genes. During development these shift male brain development in the female direction. Inheritance of several such alleles produces homosexuality. Single alleles make for greater sensitivity, empathy, tendermindedness, and kindness. These traits make heterosexual carriers of the genes better fathers and more attractive mates. There is a balanced polymorphism in which the feminizing effect of these alleles in heterosexuals offsets the adverse effects (on reproductive success) of these alleles' contribution to homosexuality. A similar effect probably occurs for genes that can produce lesbianism in females. The whole system survives because it serves to provide a high degree of variability among the personalities of offspring, providing the genotype with diversification and reducing competition among offspring for the same niches. An allele with a large effect can survive in these circumstances in males, but it is less likely to survive in females. The birth order effect on homosexuality is probably a by-product of a biological mechanism that shifts personalities more in the feminine direction in the later born sons, reducing the probability of these sons engaging in unproductive competition with each other.

Role of faulty visual search in the satisfaction of search effect in chest radiography

RATIONALE AND OBJECTIVES

The authors tested the hypothesis that satisfaction of search effect, which is associated with the failure to detect native chest abnormalities in the presence of simulated nodules, is caused by reduced gaze on the native abnormalities.

MATERIALS AND METHODS

Gaze dwell time of 20 radiologists was recorded for the region around abnormalities on images. Ten radiographs were reviewed, nine of which contained native abnormalities. Each image was seen with and without a simulated nodule.

RESULTS

The decrease in the rate of true-positive findings in the detection of native abnormalities on images that contained simulated nodules confirmed the occurrence of a satisfaction of search effect. Gaze times on native abnormalities (up to the time of report of the abnormalities) were the same for images with nodules in which native abnormalities were missed (gaze time, 9.4 seconds) as they were for images without nodules in which native abnormalities were detected (gaze time, 9.5 seconds). Gaze time on missed native abnormalities was not affected by the presence (7.80 seconds) or absence (7.45 seconds) of nodules.

CONCLUSION

Reduction in gaze dwell time on the missed abnormalities is not the cause of satisfaction of search errors in chest radiographs.

Mismatch repair by efficient nick-directed, and less efficient mismatch-specific, mechanisms in homologous recombination intermediates in Chinese hamster ovary cells

Repair of single-base mismatches formed in recombination intermediates in vivo was investigated in Chinese hamster ovary cells. Extrachromosomal recombination was stimulated by double-strand breaks (DSBs) introduced into regions of shared homology in pairs of plasmid substrates heteroallelic at 11 phenotypically silent mutations. Recombination was expected to occur primarily by single-strand annealing, yielding predicted heteroduplex DNA (hDNA) regions with three to nine mismatches. Product spectra were consistent with hDNA only occurring between DSBs. Nicks were predicted on opposite strands flanking hDNA at positions corresponding to original DSB sites. Most products had continuous marker patterns, and observed conversion gradients closely matched predicted gradients for repair initiated at nicks, consistent with an efficient nick-directed, excision-based mismatch repair system. Discontinuous patterns, seen in approximately 10% of products, and deviations from predicted gradients provided evidence for less efficient mismatch-specific repair, including G-A-->G-C specific repair that may reflect processing by a homologue of Escherichia coli MutY. Mismatch repair was > 80% efficient, which is higher than seen previously with covalently closed, artificial hDNA substrates. Products were found in which all mismatches were repaired in a single tract initiated from one or the other nick. We also observed products resulting from two tracts of intermediate length initiated from two nicks.

Design and development of an electromechanical ultrasound probe holder for urodynamics testing

A prevalent difficulty in urodynamics studies employing ultrasonography is associated with the manual application of the imaging transducer to the perineum. We have developed an electromechanically operated device for remote positioning of an ultra-sound probe during voiding studies of the lower urinary tract. The mechanical arm holds the probe inside a funnel that is mounted underneath a modified portable commode on which the patient is seated. External manually operated mechanical slides are used to translate the probe along the three primary axes for initial lateral and vertical positioning. Backwards/forwards and left/right pivoting of the transducer is then accomplished via linear stepper motors that are operated with a hand-held controller. A preliminary evaluation has shown that the device is easy to use, safe, and allows excellent visualization of the bladder outlet and proximal urethra in both male and female patients. The capability to remotely adjust the imaging angle allows the patient to void in a more private setting behind a drawn curtain, thereby minimizing the psychological distress associated with this test and facilitating the acquisition of more physiological test results.

Cause of satisfaction of search effects in contrast studies of the abdomen

RATIONALE AND OBJECTIVES

Extraintestinal abnormalities visible without contrast material on abdominal radiographs are reported less frequently when contrast examinations are performed. Gaze dwell time was used to determine whether this difference is due to failure by observers to scan plain-film regions of contrast studies or discounting of plain-film abnormalities that were actually scanned.

METHODS

Patients were included whose contrast studies had elicited the largest reductions in positive responses compared with their plain-film studies in a previous detection experiment. Gaze of 10 radiologists was studied.

RESULTS

Significantly less time was spent gazing at non-contrast regions of contrast examinations than at the corresponding regions of radiographs. Errors with radiographs were based primarily on failures of recognition and decision making, whereas errors with contrast studies were based primarily on faulty scanning.

CONCLUSION

Satisfaction of search errors on contrast examinations are caused by reduction in scanning of noncontrast regions.

X-ray structure of a DNA decamer containing 7,8-dihydro-8-oxoguanine

We have determined the x-ray structure of a DNA fragment containing 7,8-dihydro-8-oxoguanine (G(O)). The structure of the duplex form of d(CCAGOCGCTGG) has been determined to 1.6-A resolution. The results demonstrate that GO forms Watson-Crick base pairs with the opposite C and that G(O) is in the anti conformation. Structural perturbations induced by C.G(O)anti base pairs are subtle. The structure allows us to identify probable elements by which the DNA repair protein MutM recognizes its substrates. Hydrogen bond donors/acceptors within the major groove are the most likely element. In that groove, the pattern of hydrogen-bond donors/acceptors of C.G(O)anti is unique. Additional structural analysis indicates that conversion of G to G(O) would not significantly influence the glycosidic torsion preference of the nucleoside. There is no steric interaction of the 8-oxygen of G(O) with the phospho-deoxyribose backbone.

Reported myopia in opposite sex twins: a hormonal hypothesis

Two studies have reported poor vision in opposite sex twins (evidenced by wearing glasses or low visual acuity, both of which are interpreted here as evidence of myopia), whereas none have reported an absence of such effects. If these reports are replicable, it would suggest a hormonal effect. There is one report of higher testosterone levels in those suffering from high myopia. A possible mechanism would be if sex hormones in opposite sex pairs transfer from one fetus to the other. There is evidence that sex hormones can cross the placenta, and reports of sex differences in the development of opposite sex twins are consistent with such transfers. If different parts of the eye respond differentially to sex hormones, eyes developing in the unusual hormonal environment of opposite sex twins would be expected to have high myopia rates.

Analysis of the effect of hormones on opposite-sex twin attitudes

Numerous reports in the literature suggest that hormones may transfer from one fetus to another, in humans as in animals. In a large sample of over seven thousand Australian adult twins, it was found that opposite-sex females showed a statistically significant tendency to hold more masculine attitudes than did same-sex female twins. This may be due to post-natal social interaction, but could also be caused by the transfer of testosterone from the male to the female fetus in opposite-sex twins.

The role of cell cycle redistribution in radiosensitization: implications regarding the mechanism of fluorodeoxyuridine radiosensitization

PURPOSE

Radiosensitization has previously been demonstrated in a human colon cancer cell line (HT-29) following a 2 h exposure to low, clinically relevant concentrations (0.05-0.5 microM) of fluorodeoxyuridine (FdUrd) (15). The sensitizer enhancement ratio value (measured at 10% survival) plateaued at approximately 1.7 between 16 and 32 h following removal of drug. Parallel studies investigating the effect of FdUrd on the distribution of cells throughout the cell cycle found that the percentage of cells in early S-phase increased to approximately 70% during the same period that maximal radiosensitization was noted. As a follow-up to these findings, experiments have been designed to investigate the contribution of this early S-phase delay to radiosensitization.

METHODS AND MATERIALS

Synchronized populations of HT-29 cells have been obtained with three separate techniques. Two involve the induction of a reversible metaphase arrest (with high pressure N2O or colcemid) followed by a shakeoff of mitotic cells. The third uses a plant amino acid, mimosine, to induce a reversible block at the G1/S boundary. Flow cytometry was used to analyze the degree of synchrony based on bromodeoxyuridine (BrdUrd) uptake and propidium iodide (PI) staining. Radiation survival curves were obtained on these synchronized populations to investigate changes in radiosensitivity through the cell cycle. Additionally, levels of thymidylate synthase (TS), the primary target of FdUrd cytotoxicity, were measured in each phase of the cell cycle using the TS 106 monoclonal antibody against human TS.

RESULTS

Synchronization with mitotic shakeoff produced relatively pure populations of cells in G1; however, the degree of synchrony in early S-phase was limited both by cells remaining in G1 and by cells progressing into late S-phase. These techniques failed to reveal increased radiosensitivity in early S-phase at 10% survival. An 18 h exposure to mimosine resulted in populations that more closely resembled the early S-phase enrichment following FdUrd exposure and revealed increased radiosensitivity during early S-phase. TS levels were noted to be only 1.3 times higher in S phase than in G0/G1.

CONCLUSION

Radiation survival data from cells synchronized with mitotic shakeoff techniques suggest that early S-phase delay is unlikely to be the primary mechanism of FdUrd radiosensitization. In contrast, the increased sensitivity seen in early S-phase with mimosine synchronized cells is similar to that seen with FdUrd. Although confounding biochemical pertubations cannot be ruled out, these data continue to suggest an association between early S-phase enrichment and radiosensitization. The significance of TS inhibition as a mechanism of FdUrd radiosensitization remains unclear.

4-Hydroxytamoxifen, an active metabolite of tamoxifen, does not alter the radiation sensitivity of MCF-7 breast carcinoma cells irradiated in vitro

The effect of 4-hydroxytamoxifen (4OH-TAM), the potent anti-estrogenic metabolite of tamoxifen, on the radiosensitivity of MCF-7 cells irradiated in vitro was determined. Radiation dose response curves were generated for MCF-7 cells maintained and irradiated in phenol red-free medium containing 10(-10) M estradiol (E2) with or without 10(-7) M 4OH-TAM. Immediately after irradiation cells were transferred to medium containing 10(-10) ME2 supplemented with bovine serum to stimulate colony formation. Estradiol-stimulated cell proliferation was inhibited by 10(-7) M 4OH-TAM, but radiation sensitivity was not significantly altered (p > 0.3). Continued incubation in the absence of E2 for an additional 24 hours after irradiation likewise failed to alter the radiosensitivity of 4OH-TAM-treated MCF-7 cells. These studies indicate that growth-inhibitory concentrations of the anti-estrogen 4OH-TAM do not modify the in vitro radiation sensitivity of this line of human breast carcinoma cells.

Deoxyribonucleoside triphosphate pools and thymidine chemosensitization in human T-cell leukemia

Thymidine kills cells by depleting dCTP stores. The present experiments tested whether deoxycytidine, by replenishing dCTP pools, could prevent thymidine cytotoxicity and thymidine's enhancement of carboplatin killing in two human T-cell acute leukemia cell lines. MOLT3 and JM cells were exposed to combinations of thymidine, deoxycytidine, and carboplatin and then assessed for survival, the magnitude of thymidine-carboplatin chemosensitization, and changes in deoxyribonucleoside triphosphate pools. For both cell lines, deoxycytidine (up to 144.5 micrograms/ml x 24 h) completely restored dCTP pools but only partially protected against thymidine cytotoxicity (100-1000 micrograms/ml x 24 h) and thymidine-carboplatin sensitization (up to 60 micrograms carboplatin/ml during the last hour of thymidine). This contrasts with complete protection in prior studies using other cell types. Thymidine alone markedly increased dTTP and dGTP pools and decreased dCTP; dATP pools underwent a sharp decline which has not been observed before in any cell line. In subsequent studies 0.0336-137.3 micrograms deoxyadenosine/ml partially prevented cytotoxicity and carboplatin sensitization by 300 micrograms thymidine/ml. Together, deoxycytidine and deoxyadenosine completely prevented thymidine-carboplatin sensitization even though dATP and dCTP pools were not entirely returned to normal. These findings are discussed in regard to the unusual sensitivity of T-cell malignancies to thymidine toxicity, mechanisms of cytotoxicity and chemosensitization by thymidine, and the possibility of thymidine selectively sensitizing T-cell malignancies to killing by alkylating agents.

Low pH does not affect the dose response for 5'-amino-5'-deoxythymidine modulation of IdUrd DNA incorporation and radiosensitization in a human bladder cancer cell line

We report that coincubation of 647V cells for one cell cycle with low concentrations (30 microM) of 5'-amino-5'-deoxythymidine increased IdUrd DNA incorporation and radiosensitivity at low extracellular pH (pHe 6.8) in a fashion similar to treatment at normal pHe. IdUrd DNA incorporation is inhibited by high (300 microM) 5'-AdThd concentrations at both normal and low pHe (7.4 and 6.8), resulting in no significant radiosensitization. These results at low pHe were not anticipated based on previously published studies of 5'-AdThd modulation of thymidine kinase (TK) activity and nucleoside cellular uptake. Our results suggest that regulation of intracellular pH (pHi) during the course of one cell cycle negates the 5'-AdThd dose-dependent modulation of TK activity demonstrated previously. Flow cytometric measurement of pHi in 647V cells showed that normal pHi (pH 7.4) was maintained in 647V cells over a 12- to 24-h exposure to low pHe (pH 6.8). Thus the concomitant use of IdUrd and high concentrations of 5'-AdThd (> 30 microM) is unlikely to result in selective in vivo radiosensitization of human tumors under conditions which are intermittently or chronically acidic. However, low concentrations of 5'-AdThd may prove to be an effective in vivo modulator of IdUrd radiosensitization of human tumors under both normal and acidic conditions.

On the correlation of myopia and intelligence

A pleiotropic relationship between intelligence and myopia has been shown to exist. Large eyes (as measured by axial length) have been shown to lead to myopia, and large brains have been shown to be more intelligent. I hypothesized that the myopia/intelligence relationship could arise because a single genetically controlled mechanism affects both brain size and eye size. This hypothesis has testable implications.

Linear-quadratic analysis of radiosensitization by halogenated pyrimidines. I. Radiosensitization of human colon cancer cells by iododeoxyuridine

Radiosensitization by iododeoxyuridine (IdU) is a method of enhancing cell killing in the radiotherapy of human cancers, especially for tumors that proliferate faster than the surrounding normal tissues, such as might appear in brain or liver. We have investigated in vitro the relationship between the amount of thymidine replacement by IdU and the resulting radiosensitization in two human colon cancer cell lines, HCT 116 and HT 29, with differing inherent sensitivities to X rays. The results show that an increase in the initial slope of the cell survival curve was the predominant mode of radiosensitization. In this situation, the emphasis on changes in the initial slope suggest the use of a survival curve model that contains the initial slope as a defined variable, which the traditional single-hit, multitarget model does not. We present our analyses mainly in terms of alpha (initial slope) and changes in surviving fraction at 2 Gy and also as a modified form of sensitizer enhancement ratio that describes the dose-modifying factor of IdU at a single radiation dose of 2 Gy (SER 2 Gy). Iododeoxyuridine is an effective radiosensitizer in both cell lines, but IdU appears especially effective in increasing the initial slope of the more radioresistant line, the HT 29 cells.

Linear-quadratic analysis of radiosensitization by halogenated pyrimidines. II. Radiosensitization of human colon cancer cells by bromodeoxyuridine

As a continuation of the studies in Part I (Miller, Fowler, and Kinsella, Radiat. Res. 131, 000-000, 1992), which examined the radiosensitizing effects of iododeoxyuridine (IdU), similar experiments with bromodeoxyuridine (BrdU) were conducted concurrently to characterize its effects on the shape of the radiation survival curves of cells of two human colon cancer cell lines, HT 29 and HCT 116. The efficiency of radiosensitization by BrdU, expressed as a function of percentage thymidine replacement, was lower when compared to IdU in both cell lines. However, the major radiosensitizing effect of BrdU was manifest as an increase in the initial slope (alpha), just as observed for IdU. However, with BrdU, in contrast to IdU, an increase in curvature (repairable damage) was also evident. Cells of the more radiosensitive line, HCT 116, showed less sensitization by either BrdU or IdU than cells of the more radioresistant line, HT 29. These results were consistent with the proposed mechanism of radiosensitization being an increase in the single-hit character of low-LET radiation. It follows that the radiosensitizing effects of both analogs were largest in the low-dose region of the survival curve.

Radiosensitization by fluorodeoxyuridine: effects of thymidylate synthase inhibition and cell synchronization

The combination of fluoropyrimidines and radiation has resulted in increased control of colorectal cancer in the clinic, but the basic mechanism of the interaction is not understood clearly. Preliminary work in our laboratory showed that 2-h exposures of HT 29 human colon carcinoma cells to relatively low levels of 5-fluorodeoxyuridine resulted in extended thymidylate synthase inhibition after the drug was removed (up to 30 h after treatment with 0.5 microM 5-fluorodeoxyuridine). The low cytotoxicity associated with this treatment simplified efforts to test the effects of extended thymidylate synthase inhibition on radiosensitivity of HT 29 cells. Although thymidylate synthase was completely inhibited at the end of the 2-h exposure, an increase in the radiosensitivity of the cells was not evident until 16 h after the removal of drug. Flow cytometric analysis showed that cells accumulated in early S phase over time, and the increase in radiation sensitivity of the entire population followed the increase of the proportion of cells in early S, a relatively radiosensitive phase of the cell cycle. This treatment schedule was compared with 24-h continuous exposure, and we found that the same maximum increase in radiosensitivity was achieved by both treatment strategies. However, more cytotoxicity was associated with continuous exposure. This study provides evidence that radiosensitization by 5-fluorodeoxyuridine is in part due to alteration of cell kinetics and redistribution of cells throughout the cycle. This information may be useful in the design of less toxic combined chemo- and radiotherapy treatment strategies by limiting systemic exposure to fluoropyrimidines.

Modulation of IdUrd-DNA incorporation and radiosensitization in human bladder carcinoma cells

5' Amino-5'-deoxythymidine (5'-AdThd) has been demonstrated previously to antagonize dTTP-mediated feedback inhibition of purified thymidine kinase from 647V, a human bladder cancer cell line. Low concentrations of 5'-AdThd (3-30 microM) have also been shown to stimulate cellular uptake of iododeoxyuridine (IdUrd) in 647V cells at clinically relevant IdUrd concentrations (2 microM). We report that the combination of 30 microM 5'-AdThd plus 2 microM IdUrd results in a significant increase of IdUrd replacement of thymidine (dThd) (18%) in the DNA of 647V cells over that obtained by exposure to 2 microM IdUrd alone (7.9%). However, increasing the 5'-AdThd concentration to 300 microM inhibited the incorporation of IdUrd into DNA (3%). IdUrd-induced radiosensitization of 647V cells, as measured by clonogenic survival, was enhanced by coincubation with 30 microM 5'-AdThd, while 300 microM 5'-AdThd reduced the IdUrd radiosensitization. Additionally, radiation-induced single strand break generation when IdUrd was incorporated into 647V DNA, as measured by rapid alkaline elution, was also enhanced by coincubation with 30 microM 5'-AdThd, while 300 microM 5'-AdThd resulted in a decrease in the number of single strand breaks produced. In T24, another bladder cancer cell line, and SV-HUC-TT1, a tumorigenic cell line derived from SV-HUC, 3-10 microM 5'-AdThd was also able to enhance IdUrd replacement of dThd in DNA. However, no stimulation of dThd replacement by 5'-AdThd occurred in SV-HUC, a prototypic "normal" bladder urothelial cell line. Since 5'-AdThd is not a substrate for mammalian thymidine kinase and has little or no cytotoxicity in vitro and in vivo, it may be a selective modulator of IdUrd radiosensitization of human bladder carcinoma and should be tested in vivo.

The use of VP16 and cisplatin in the treatment of Merkel cell carcinoma

A 70-year-old male with regionally recurrent Merkel cell cancer obtained a complete remission with three cycles of VP16 and cisplatin. His response was consolidated with local radiation therapy. Two additional patients have been reported to have responded to the same combination. Chemotherapy consisting of either cyclophosphamide, vincristine, and doxorubicin or VP16 and cisplatin should be considered in locally recurrent Merkel cell cancer.

Interaction of deoxyuridine with fluorouracil and dipyridamole in a human colon cancer cell line

We have reported previously that dipyridamole increases the toxicity of 5-fluorouracil and alters fluorouracil metabolism in HCT 116 cells, producing a selective increase in fluorodeoxyuridine monophosphate (FdUMP) levels by blocking the efflux of fluorodeoxyuridine. Dipyridamole also blocks deoxyuridine efflux and prolongs the intracellular half-life of deoxyuridine monophosphate (dUMP). The significance of the effect of dipyridamole on FdUMP and dUMP levels was explored further. In cell growth experiments, 1-50 microM deoxyuridine enhanced the cytotoxicity of 5 microM fluorouracil in a dose-dependent manner, and greater than or equal to 10 microM deoxyuridine increased the augmentation of fluorouracil toxicity produced by 0.5 microM dipyridamole. The effect of deoxyuridine on [6-3H]fluorouracil metabolism was studied. After 4 hr, 25 microM deoxyuridine increased the amount of [3H]FdUMP formed 2- to 4-fold relative to that of fluorouracil +/- dipyridamole alone. The mechanism by which deoxyuridine increased FdUMP was examined by measuring the distribution of [2'-3H]deoxyuridine metabolites following exposure of 25 microM deoxyuridine +/- 5 microM fluorouracil. Tritium appeared in the FdUMP peak at 4 and 24 hr in cells exposed to fluorouracil and deoxyuridine, indicating that [3H]deoxyribose was transferred to fluorouracil. A large buildup of [3H]dUMP was seen in cells exposed to fluorouracil plus deoxyuridine for 4 and 24 hr compared to exposure to [3H]deoxyuridine alone, suggesting that dUMP may also inhibit catabolism of FdUMP. Since the increased FdUMP levels produced by dipyridamole did not appear to correlate with further depletion of thymidine triphosphate pools, the incorporation of [3H]fluorouracil metabolites into nucleic acids was monitored by cesium sulfate density centrifugation. Fluorouracil-RNA increased as a function of time (1, 2 and 13 pmol/10(6) cells after 4, 8 and 24 hr), but fluorouracil-DNA was detected only after 24 hr (0.5 pmol/10(6) cells). Dipyridamole however, did not appear to alter the pattern of incorporation of fluorouracil into either RNA or DNA. Perturbations of endogenous dUMP levels by fluorouracil and dipyridamole were then studied. In cells exposed to fluorouracil alone, dUMP pools were unchanged from control at 2 hr, but they had increased 9-fold by 4 hr (3362 pmol/10(6) cells). Simultaneous exposure to fluorouracil and dipyridamole resulted in a 1.5-fold (566 pmol/10(6) cells) and 13.6-fold (5049 pmol/10(6) cells) increase over control dUMP levels after 2 and 4 hr respectively. The dUMP pools continued to enlarge through 24 hr. The effect of fluorouracil on DNA fragility was examined.(ABSTRACT TRUNCATED AT 400 WORDS)

Central serous choroidopathy misdiagnosed as a manifestation of multiple sclerosis

Visual loss secondary to macular disease can be differentiated from optic nerve lesions relatively easily in the office by simple and reliable noninvasive means. The diagnosis of a medically or surgically treatable lesion can obviate for the patient the often unnecessary anxiety and expense of more extensive studies.

Sarcoidosis mimicking glioma: case report and review of intracranial sarcoid mass lesions

Sarcoidosis may rarely cause a discrete intracranial mass lesion. We report a case originally diagnosed as a malignant glioma because of the uneven enhancement and marked white matter edema seen on computerized tomography. Twenty-two reported cases are analyzed, together wih our own. Major signs and symptoms are similar to those of other intracranial masses. Coexistent meningeal or hypothalamic involvement is often present, but extracranial sarcoidosis may be absent. The radiologic appearance varies and does not permit distinction from neoplasms or other granulomatous diseases. Treatment with steroids alone seems to be the best choice for initial therapy.

CT in the evaluation of spine trauma

Fifteen patients admitted for spine trauma in an 8 month period were studied with computed tomography (CT). All the patients had initial routine plain film screening, and 10 of 15 were also examined with conventional tomography. Five patients sustained vertical fall, axial-load injuries in the thoracolumbar junction region; two others suffered missile injury to the spine. CT provided more information than plain films in all these patients due to its superior imaging of bony detail and its ability to assess soft-tissue damage. In four of these patients, conventional tomography was done but contributed no additional information. Eight other patients sustained complex fractures of the cervical spine. In all but one, the combination of plain films and CT allowed complete evaluation of the injury. In one patient, conventional tomography showed an additional linear fracture one vertebral level below the main region of injury. Plain films and CT allow complete, safe, rapid, easily interpretable evaluation of spine trauma patients in the acute setting. Conventional tomography yields no additional clinically vital information in the acute evaluation of spine trauma, when plain films are abnormal. Its current ability to show finer bony detail than CT can be reserved for evaluating equivocal plain film and CT findings or more complete evaluation (if indicated) after the patient is clinically stable.

The role of computed tomography in the evaluation of neck masses

Application of computed tomography (CT) to neck masses has received little attention. The authors reviewed 10 cervical masses studied with CT as well as conventional imaging modalities. CT was extremely useful in defining both the osseous and soft-tissue extent of the lesion. In several instances, CT was able to show the relationship of the tumor to the spinal canal. When combined with angiography, CT demonstrated the relationship of the major cervical vascular channels to the lesion. Pathological conditions included neurofibroma, chordoma, branchial cleft cyst, neuroblastoma, lymphoma, neurilemmoma, and metastatic carcinoma.

The angiographic features of extraabdominal desmoid tumors

Extraabdominal desmoid tumors are nonencapsulated locally invasive neoplasms of fibrous tissue. The angiographic features include arterial stretching, neovascularity, and tumor staining (4 of 6 cases in this series). Although benign, these tumors are difficult to cure because they tend to recur locally.

Duodenal involvement with Crohn's disease: a spectrum of radiographic abnormality

The clinical and radiographic features of 22 cases of duodenal Crohn's disease were analyzed. The presenting clinical findings in the majority suggested peptic disease rather than regional enteritis. There was no cases of isolated duodenal Crohn's disease but a spectrum of radiographic abnormalities was produced by duodenal involvement with Crohn's disease which simulated a variety of clinical entities. A radiographic examination of the small bowel or colon was useful to confirm a diagnosis of Crohn's disease when duodenal abnormalities were suggestive.

Extra-axial posterior fossa lesions simulating intra-axial lesions on computed tomography

Differentiation of extra- from intra-axial posterior fossa lesions is sometimes not possible on computed tomography. Six cases are presented wherein the lesion appeared to be intra-axial on computed tomograms yet angiographically and surgically proved to be extra-axial. False localization on computed tomography occurs with slowly growing masses which burrow into brain parenchyma.

Dissociation of prelycopersene pyrophosphate synthetase from phytoene synthetase complex of tomato fruit plastids

The partially purified phytoene synthetase enzyme complex obtained from tomato fruit plastids dissociates into two or more subunit species on chromatography in low ionic strength buffer on DEAE-cellulose. One of these subunits prelycopersene pyrophosphate synthetase, has a molecular weight of approximately 40,000, whereas the phytoene synthetase complex has a molecular weight of 200,000. The prelycopersene pyrophosphate synthetase catalyzes the conversion of isopentenyl pyrophosphate to geranylgeranyl and prelycopersene pyrophosphates. The identities of these substances were established by thin layer chromatography in several solvent systems. The formation of both geranylgeranyl and prelycopersene pyrophosphates by this enzyme supports earlier results with cruder enzyme systems which suggested that these compounds are intermediates in the synthesis of phytoene.