Androgen receptor: Structure, signaling, function and potential drug discovery biomarker in different breast cancer subtypes

The Androgen Receptor (AR) is emerging as an important factor in the pathogenesis of breast cancer (BC), which is the most common malignancy worldwide. >70 % of AR expression in primary and metastatic breast tumors has been observed which suggests that AR may be a new marker and a potential therapeutic target among AR-positive BC patients. Biological insight into AR-positive breast cancer reveals that AR may cross-talk with several vital signaling pathways, including key molecules and receptors. Downstream signaling of AR might also affect many clinically important pathways that are emerging as clinical targets in BC. AR exhibits different behaviors depending on the breast cancer molecular subtype. Preliminary clinical research using AR-targeted drugs, which have already been FDA-approved for prostate cancer (PC), has given promising results for AR-positive breast cancer patients. However, since AR positivity's prognostic and predictive value remains uncertain, it is difficult to identify and stratify patients who would benefit from AR-targeted therapies alone. Thus, the need of the hour is to target the androgen receptor as a monotherapy or in combination with other conventional therapies which has proven to be an effective clinical strategy for the treatment of prostate cancer patients, and these therapeutic strategies are increasingly being investigated in breast cancer. Therefore, in this manuscript, we review the role of AR in various cellular processes that promote tumorigenesis and aggressiveness, in different subtypes of breast cancer, as well as discuss ongoing efforts to target AR for the more effective treatment and prevention of breast cancer.

Integrating mental health into climate change education to inspire climate action while safeguarding mental health

Climate change is the greatest threat humanity faces, and puts at risk the mental health and wellbeing of children and young people. Climate change education must equip children and young people with the knowledge, skills and resilience to live in an uncertain future, sustainably take relevant climate action and work in climate careers. As attention on climate change education grows, this is a critical moment for the mental health community to ensure mental health and wellbeing considerations are embedded. Critically, appropriate integration of mental health can enable these very necessary goals of equipping children and young people to live and work in a future where climate change looms large. This paper explores why promoting good mental health and wellbeing and building psychological resilience can help achieve climate change education outcomes, and why not doing so risks harming children and young people's mental health. It also explores how integrating discussions about emotions, mental health, and coping strategies within climate change education can be a route into wider discussions about mental health, to support children and young people in the context of rising mental health needs. Learning from an existing approach to promoting good mental health and wellbeing in schools (the 'whole school approach') provides the opportunity to explore one avenue through which such an integrated approach could be implemented in practice. Identifying appropriate mechanisms to integrate mental health into climate change education will require co-design and research with educators and young people, and addressing systemic barriers facing the schools sector.

Localized Delivery of Erlotinib Using Liposomal Gel Formulations for the Treatment of Oral Squamous Cell Carcinoma

Oral cancer accounts for more than 350000 cases worldwide with 90% of them being oral squamous cell carcinomas (OSCC). The current treatment modalities of chemoradiation have poor outcomes along with harmful effects to neighbouring healthy tissues. The present study aimed to deliver Erlotinib (ERB), locally at the site of tumor arising in the oral cavity. ERB was encapsulated in liposomal formulations (ERB Lipo) and optimized using full factorial, 3² experimental design. The optimized batch was then coated with chitosan to obtain CS-ERB Lipo and were characterized further. Both liposomal ERB formulations had size less than 200nm and PDI less than 0.4. Zeta potential was upto -50mV for ERB Lipo and upto + 25mV for CS-ERB Lipo indicating stable formulation. Liposomal formulations were freeze dried and loaded into gel to study in-vitro release and chemotherapeutic evaluation. CS-ERB Lipo showed sustained release upto 36 h from gel as compared to control formulation. In-vitro cell viability studies showed potent anti-cancer activity on KB-cells. In-vivo studies showed better pharmacological efficacy in terms of tumor volume reduction for ERB LIPO gel (49.19%) and CS-ERB Lipo gel (55.27%) as compared to plain ERB Gel (38.88%) applied locally. Histology also revealed that formulation could alleviate dysplasia condition to hyperplasia. The locoregional therapy of ERB Lipo gel and CS-ERB Lipo gel thus show promising outcome in improving pre-malignant and early-stage oral cavity cancers.

TGF-β at the crossroads of multiple prognosis in breast cancer, and beyond

Transforming growth factor β (TGF-β), a pluripotent cytokine and a multifunctional growth factor has a crucial role in varied biological mechanisms like invasion, migration, epithelial-mesenchymal transition, apoptosis, wound healing, and immunosuppression. Moreover, it also has an imperative role both in normal mammary gland development as well as breast carcinogenesis. TGF-β has shown to have a paradoxical role in breast carcinogenesis, by transitioning from a growth inhibitor to a growth promoter with the disease advancement. The inter-communication and crosstalk of TGF-β with different signaling pathways has strengthened the likelihood to explore it as a comprehensive biomarker. In the last two decades, TGF-β has been studied extensively and has been found to be a promising biomarker for early detection, disease monitoring, treatment selection, and tumor progression making it beneficial for disease management. In this review, we focus on the signaling pathways and biological activities of the TGF-β family in breast cancer pathogenesis and its role as a circulatory and independent biomarker for breast cancer progression and metastasis. Moreover, this review highlights TGF-β as a drug target, and the underlying mechanisms through which it is involved in tumorigenesis that will aid in the development of varied therapies targeting the different stages of breast cancer.

Anatomical reconstruction of proximal coronary artery stenosis in children

OBJECTIVES

Timing and method of surgical reconstruction for non-sclerotic proximal coronary artery stenosis, occuring de-novo or post coronary artery transfer, are evolving. We have pursued a technique of anatomical reconstruction of ostial and short segment proximal coronary artery stenosis and atresia in children, using patch plasty or interposition vein graft. Herein, we discuss the medium- to long-term outcome.

METHODS

Nine consecutive children undergoing ten left main coronary artery reconstructions using autologous great saphenous vein patch (n = 4), autologous pericardium (n = 4), xenopericardium (n = 1) or great saphenous vein interposition graft (n = 1) were retrospectively analysed. Complementary wedge resection of the stenotic coronary ostium was performed in chronic cases.

RESULTS

The aetiology of coronary artery stenosis was post arterial switch operation (n = 6), Takayasu`s arteritis (n = 1), idiopathic left main coronary artery atresia (n = 1) and anomalous origin of the left coronary artery from the pulmonary artery (n = 1). Median age and weight at operation were 0.15 (range 0.01-13.1) years and 4.4 (range 3 -13.1) kilograms, respectively. Survival was 100% at median follow-up of 12.6 (range 1-19.2) years. All patients showed normal left ventricular ejection fraction on transthoracic echocardiogram. In one patient, kinking of the proximal left circumflex artery resulted in non-significant obstruction. In all other cases, follow-up catheter angiography revealed unobstructed coronary arteries. Cardiac magnetic resonance tomography showed no significant perfusion deficit in any child.

CONCLUSIONS

Anatomical reconstruction of the proximal left coronary artery using autologous saphenous vein may allow optimal restoration of physiological coronary blood flow, keeping the option of future coronary bypass operation open.

Abstract P5-03-09: Phenotypic modulation of mammary stem cells by CAPE (caffeic acid phenethyl ester)

Background: Over 30% of cancer patients and up to 60% of breast cancer patients routinely use alternative formulations, commonly in combination with allopathic treatment, which may be linked with fewer adverse events. The naturopathic formulation propolis, and its active component Caffeic Acid Phenethyl Ester (CAPE), is a widely available honeybee product with an extended safety history credited with anti-inflammatory, antioxidant, and antitumor properties. We have previously shown that CAPE, inhibits growth of MCF-7 (ER+/PR+) and MDA-231 (TNBC) cells by cell cycle arrest and apoptosis; inhibits mdr-1 gene expression, NF-kB, and VEGF (1). In addition, CAPE inhibits the growth and tumorigenic potential of breast cancer stem cells derived from MDA-231 cells (2). We have demonstrated that CAPE, which is structurally similar to the hydroxamic acid class of HDAC inhibitors, mediates its effects on breast cancer through epigenetic modifications via histone deacetylase inhibition (unpublished data). We hypothesized that CAPE would inhibit mammary stem cells, which was tested in primary mouse mammary epithelial cells and a human breast epithelial cell line.

Materials and Methods: Single mammary epithelial cells were isolated from Balb/c mice and cultured for 8 days in Ultra Low Attachment 96 well plates using mammosphere media containing 5%FBS and 5% Matrigel (3). The first generation of mammospheres were dissociated into single cells and recultured in the presence of CAPE for 8 days in secondary and tertiary passages. Alternatively, a Let7c-miRNA reporter expressed in MCF10a non-malignant human mammary epithelial cells were sorted to isolate Let7c-negative cells and placed in mammosphere culture and similarly treated with CAPE for 7 to 10 days. The mammospheres were stained with luminal marker K18 and basal marker K14 and examined using immunofluorescent microscopy.

Results: CAPE treatment results in a dose dependent decrease in mammosphere forming efficiency (MFE) of mammospheres obtained from a primary culture of mammary gland derived epithelial cells as well as those derived from the MCF10A cell line. Furthermore, MFE of tertiary cultures is reduced even after CAPE is removed. Interestingly, mammospheres shifted from predominantly K14 to K18 positive in those mammospheres that formed at the lowest CAPE treatment concentration.

Conclusion: CAPE inhibits mammosphere formation from normal mouse mammary gland and from a non-malignant human mammary cell line. The mechanism of CAPE effects may lie in its established role in inducing cell cycle arrest, apoptosis or via epigenetic mechanisms, among others. Interestingly, CAPE causes a shift from a basal to a luminal cell phenotype in mammospheres, suggesting an effect on lineage commitment.

References

1) *Wu J, *Omene C, Karkaszka J, et al. CANCER LETTERS. 2011 Sep 1;308(1):43-53. Epub 2011 May 13. (* Share 1st authorship)

2) Omene C, Wu J, Frenkel K. INVESTIGATIONAL NEW DRUGS. 2012 Aug;30(4):1279-88. Epub 2011 May 3.

3) Guo W, Keckesova Z, Donaher JL, et al. CELL. 2012 Mar 2;148(5):1015-28.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-03-09.

Paediatric ventricular assist devices: current achievements

In chronic cardiomyopathy, mechanical circulatory support plays an increasingly important role for children as the shortage of suitable donor hearts increases times on the transplant waiting list. Ventricular assist devices (VADs) for adults have evolved dramatically over the last decade, both as a bridge to transplantation and for permanent support. In contrast, VADs designed for children, especially for all age groups, are still in their infancy. The Medos HIA and the Berlin Heart Excor are specially designed for children with a body surface area <1.2 m2. Increased experience with existing paediatric VADs and the introduction of third-generation VADs for the paediatric age group offer new possibilities for children suffering from end-stage heart failure. We review the literature on this topic, summarise the indications and contraindications for long-term support VADs and describe the decision-making algorithm used at our institution for use of long-term VADs in children.

Abnormal interhemispheric connectivity in neonates with D-transposition of the great arteries undergoing cardiopulmonary bypass surgery

BACKGROUND AND PURPOSE

Neonates with severe CHD require CPB within the first days of life. White matter injury can occur before surgery, and this may impair the long-term neurodevelopmental and psychosocial outcome. The purpose of this study was to assess the microstructural development of the CC in infants with CHD before and after CPB for transposition of the great arteries.

MATERIALS AND METHODS

Fifteen patients with CHD and 11 age-matched HC were recruited. We separately quantified the parallel (E1) and perpendicular (E23) diffusions, the ADC, and FA of the genu of the CC and splenium of the CC before and after surgery.

RESULTS

In presurgical measures of the genu of the CC, higher E23 (P = .018), higher ADC (P = .026), and lower FA (P = .033) values were measured compared with those in HC. In the postsurgery scans, the genu of the CC had higher E23 (P = .013), higher ADC (P = .012), and lower FA (P = .033) values compared with those in HC. There was no significant difference in any DTI indices between the pre- and postsurgical groups.

CONCLUSIONS

We report abnormal microstructural development in the genu of the CC of infants with d-TGA before and after CPB. High E23, high ADC, and low FA values in the genu of the CC may be explained by abnormal axonal pruning, thinner myelin sheaths, smaller axonal diameters, or more oligodendrocytes. It appears that the genu of the CC is more vulnerable than the splenium of the CC in patients with CHD and may serve as a biomarker to identify infants at highest risk for adverse neurodevelopmental outcome.

Transforming growth factor beta 2: a predictive marker for breast cancer

Dual role of TGF-beta signaling in breast tumorigenesis as an inhibitor in early stages and promoter in advanced stages has been well established and known as TGF-beta switch. However, the biological mechanisms needs to be explored. Aim of the present study was to look for the usefulness of TGF-beta as a predictive marker for breast cancer and to offer a better predictability to identify patients likely to benefit from antiTGF-beta strategies. Circulatory as well as transcript levels of TGF-beta2 were estimated from 118 pretherapeutic breast cancer patients using ELISA and q-PCR with ddCt method. Multifactorial analysis was performed to correlate the results to clinico-pathological prognosticators and Kaplan-Meier survival analysis with a median follow-up of 49 months was also evaluated. Circulating TGF-beta2 was similar in control and breast cancer patients. TGF-beta2 was significantly upregulated in advanced tumors compared to early tumors. An inverse correlation was observed between TGF-beta2 protein and mRNA; nevertheless both exhibited significant correlations with clinico-pathological prognosticators. Higher expression of TGF-beta2 mRNA was connected to an early relapse in advanced stage than early stage patients. It is the first report to evaluate circulatory and transcript levels exhibiting TGF-beta switch and confirming the utility of TGF-beta2 as an important predictive marker for breast cancer.

Abstract 1754: Transforming growth factor beta as potential prognostic biomarker of breast cancer: Evidence of ‘TGF-β switch’

Purpose:

Transforming growth factor-beta (TGF-β1, β2, β3) and its receptors, potent inhibitors of normal epithelial cell proliferation also play a dual role from suppressor to promoter during later stages of breast neoplasia and metastases. No clinical studies have reported the levels of circulatory and tumor tissue TGF-β/TβR/SMAD markers to correlate TGF-β pathway in breast cancer progression. Multifactorial analysis is likely to offer a better predictability and identify patients likely to benefit from anti TGF-β strategies.

Experimental Design:

This prospective study was designed to evaluate prognostic value of TGF-β, TβR and SMAD in 120 randomly enrolled pre-therapeutic breast cancer patients from Gujarat Cancer & Research Institute, India. Circulating TGF-β levels (β1, β2, β3) were evaluated from patients with known clinicopathologic prognosticators compared to 87 healthy individuals. Gene expression of TGF-β (1, 2, 3), their cognate receptors (TβR-I, II, III) and signaling mediators SMAD (3, 4, 7) from breast tumors and non-involved tissue were determined by Real Time PCR. Kaplan-Meier Survival analysis with a median follow-up of 49 months was performed. Comparisons were made between early and advanced breast cancer to correlate with ‘TGF-β switch’.

Results:

Circulatory TGF-β1 was higher in advanced stage patients than early stage. Higher levels of TGF-β1 correspond with patients in category of &gt;40-≤60 age, premenopausal, grade-I tumors, ductal carcinomas, moderate + poor differentiated tumors, lymphatic permeation, lymphocytic infiltration, absence of vascular permeation, necrosis and stromal involvement. Reduced overall survival was associated with high TGF-β1. TGF-β1 expression was higher in advanced (31.6%) than early stages (16.7%). TGF-β2 mRNA was higher in 47.6% early and 39.5% advanced stage. Serum TGF-β3 was higher in patients than control. TGF-β3 was downregulated in 97.6% early and 92.1% advanced tumors. TβR-I downregulation of early 85.71%, decreased to 76.32% in advanced stage. TβR-I upregulation correlated reduction in overall survival. TβR-II was downregulated in early tumors and 6.58% advanced tumors showed upregulation. Advanced tumor patients with lower TβR-II relapsed faster than early stage. Notably, TβR-III was downregulated in 30.95% early tumors while 69.05% exhibited an upregulation. TβR-III upregulation was associated with reduced RFS in advanced than early stage patients. All SMAD were downregulated in 88% patients. ERα was upregulated in 44.5% and ERβ downregulated in 97.3% patients. TGF-β2 showed 1.49 fold upregulation in ER negative tumors.

Conclusions:

The present comprehensive study is the first clinical report of Indian breast cancer patients, indicating the dual role of TGF-β and suggests its potential as a prognostic marker for breast cancer. [Support: ICMR, GCS to ST, Fulbright-Nehru India DPR Fellowship #15094403 to HD]

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1754.

Early results of balloon dilatation of the stenotic bovine jugular vein graft in the right ventricular outflow tract in children

The aim of this study was to evaluate the early results of interventional balloon dilatation of stenotic bovine jugular vein (BJV) grafts implanted for reconstruction of the right ventricular outflow tract (RVOT) in children.

METHODS

From May 2001 to December 2005, 153 BJV grafts were implanted in children in our institution. An average of 16.9 (7.6-41.1) months after implantation, 17 balloon dilatations in a significant stenosis proximal (n = 1), distal anastomosis (n = 8), BJV valve (n = 3), or at multiple sites (n = 5) were performed in 15 children (male:female = 9:6) with a mean age of 3.9 (0.8-13.0) years. Balloon diameter was 75-133.3% (mean 100.3) of the original BJV size. Mean follow-up was 8.8 (2 days to 22.8 months) months.

RESULTS

In 10 interventions (58.8%) the instantaneous peak gradient was reduced below 50 mmHg. A balloon diameter > or =100% of the original BJV size correlated significantly with a successful intervention. No major complications, two minor (nonobstructive floating membranes at the dilatation site and one septicemia) occurred afterward. Freedom from reintervention after 6 months was 58.2% for all, 77.8% for dilatations of the proximal anastomosis and mixed stenotic lesions, and 33.3% for the distal anastomosis.

CONCLUSION

Balloon dilatation of stenotic BJV grafts is safe and can significantly reduce the pressure gradient in two-thirds of interventions. Balloon diameters above the original graft size should be aimed for. The most frequent stenosis of the distal anastomosis tends to renarrow early after dilatation. Nevertheless, balloon dilatation should be considered in nearly every stenotic graft to gain time until a surgical or interventional graft exchange.

Low cell pH depresses peak power in rat skeletal muscle fibres at both 30 degrees C and 15 degrees C: implications for muscle fatigue

Historically, an increase in intracellular H(+) (decrease in cell pH) was thought to contribute to muscle fatigue by direct inhibition of the cross-bridge leading to a reduction in velocity and force. More recently, due to the observation that the effects were less at temperatures closer to those observed in vivo, the importance of H(+) as a fatigue agent has been questioned. The purpose of this work was to re-evaluate the role of H(+) in muscle fatigue by studying the effect of low pH (6.2) on force, velocity and peak power in rat fast- and slow-twitch muscle fibres at 15 degrees C and 30 degrees C. Skinned fast type IIa and slow type I fibres were prepared from the gastrocnemius and soleus, respectively, mounted between a force transducer and position motor, and studied at 15 degrees C and 30 degrees C and pH 7.0 and 6.2, and fibre force (P(0)), unloaded shortening velocity (V(0)), force-velocity, and force-power relationships determined. Consistent with previous observations, low pH depressed the P(0) of both fast and slow fibres, less at 30 degrees C (4-12%) than at 15 degrees C (30%). However, the low pH-induced depressions in slow type I fibre V(0) and peak power were both significantly greater at 30 degrees C (25% versus 9% for V(0) and 34% versus 17% for peak power). For the fast type IIa fibre type, the inhibitory effect of low pH on V(0) was unaltered by temperature, while for peak power the inhibition was reduced at 30 degrees C (37% versus 18%). The curvature of the force-velocity relationship was temperature sensitive, and showed a higher a/P(0) ratio (less curvature) at 30 degrees C. Importantly, at 30 degrees C low pH significantly depressed the ratio of the slow type I fibre, leading to less force and velocity at peak power. These data demonstrate that the direct effect of low pH on peak power in both slow- and fast-twitch fibres at near-in vivo temperatures (30 degrees C) is greater than would be predicted based on changes in P(0), and that the fatigue-inducing effects of low pH on cross-bridge function are still substantial and important at temperatures approaching those observed in vivo.

Automatic segmentation of pancreatic images using ISODATA alorithm

14149

Background: Pancreatic cancer is the second most common gastrointestinal malignancy in the United States, where it ranks 4th among all deaths caused by cancers. Early detection of pancreatic cancer remains a challange. Methods: MR images with different T1 and T2 weighting from the anatomical regions with the same imaging parameters were obtained. ISODATA segmentation algorithm, a multivariate method was used to reliable detect the various clusters in the data sets. Results: In all the four subjects, the pancreatic region was found to be from a different (and unique) cluster. This cluster covered the pancreatic region in all the four subjects. Conclusions: The ISODATA algorithm presented could detect the pancreatic region without manual tracing.

No significant financial relationships to disclose.

Hornhaut-Pachymetrie und Augeninnendruck

Just recently studies on glaucoma have emphasised the significance of intraocular pressure in the diagnosis of glaucoma and the importance of intraocular pressure reduction in the management of glaucoma. Central corneal thickness appears to play an important role in the exact measurement of intraocular pressure and in the diagnostic assessment of glaucoma. Numerous studies have verified that corneal thickness shows systematic differences in different forms of glaucoma. Since deviations of corneal thickness from normal can possibly result in an artificial change of Goldmann applanation values, it would be a most important source of error in the diagnosis of glaucoma to ignore central corneal thickness. Corrections of intraocular pressure measured with applanation tonometry can be achieved in various ways but there is considerable divergence in the results. The absence of a generally accepted algorithm for the correction of intraocular pressure measured with applanation tonometry should not prevent us from a wide application of pachymetry, since it delivers valuable additional information on the individual risk of glaucoma.

Hornhautdickenmessung bei Glaukompatienten

BACKGROUND

For the past 5 decades, Goldmann's applanation tonometry has been the basis for measurement of intraocular pressure. In this process, it is assumed that the corneal architecture-and particularly corneal thickness-does not have significant influence on the applanation tonometry. The aim of this study was to assess central corneal thickness in patients with primary open angle glaucoma (POWG), normal tension glaucoma (NDG), and ocular hypertension (OHT) compared to the central corneal thickness of control subjects.

METHOD

In 200 consecutive glaucoma patients corneal pachymetry was performed with the Orbscan II system and a pachymetry map was obtained. Simultaneously, corneal pachymetry was also performed in 200 age- and sex-matched control subjects. To avoid diurnal variations the pachymetry measurements were performed at the same time of the day.

RESULTS

The central corneal thickness (CCT) distribution turned out to be a near-Gaussian curve in patients with glaucoma and in the control subjects. The mean CCT in glaucoma patients was 561+/-49.4 micro m with a minimum of 448 micro m and a maximum of 732 micro m. In control subjects the mean CCT was 555.9+/-34.6 micro m with a minimum of 480 micro m and a maximum of 635 micro m. Further evaluation of CCT of glaucoma patients demonstrated that the CCT in patients with POWG was 559.5+/-43.5 micro m, in patients with NDG was 530.3+/-51.1 micro m and with OHT was 624.2+/-25.4 micro m.

CONCLUSIONS

Central corneal thickness in patients with OHT was significantly greater, and in patients with NDG significantly lower, compared to control subjects. In defining the desired intraocular pressure in glaucoma patients, in the future CCT measurements should be considered along with intraocular pressure measurement and visual field analysis.

Fiber type and temperature dependence of inorganic phosphate: implications for fatigue

Elevated levels of P(i) are thought to cause a substantial proportion of the loss in muscular force and power output during fatigue from intense contractile activity. However, support for this hypothesis is based, in part, on data from skinned single fibers obtained at low temperatures (< or =15 degrees C). The effect of high (30 mM) P(i) concentration on the contractile function of chemically skinned single fibers was examined at both low (15 degrees C) and high (30 degrees C) temperatures using fibers isolated from rat soleus (type I fibers) and gastrocnemius (type II fibers) muscles. Elevating P(i) from 0 to 30 mM at saturating free Ca(2+) levels depressed maximum isometric force (P(o)) by 54% at 15 degrees C and by 19% at 30 degrees C (P < 0.05; significant interaction) in type I fibers. Similarly, the P(o) of type II fibers was significantly more sensitive to high levels of P(i) at the lower (50% decrease) vs. higher temperature (5% decrease). The maximal shortening velocity of both type I and type II fibers was not significantly affected by elevated P(i) at either temperature. However, peak fiber power was depressed by 49% at 15 degrees C but by only 16% at 30 degrees C in type I fibers. Similarly, in type II fibers, peak power was depressed by 40 and 18% at 15 and 30 degrees C, respectively. These data suggest that near physiological temperatures and at saturating levels of intracellular Ca(2+), elevated levels of P(i) contribute less to fatigue than might be inferred from data obtained at lower temperatures.

Transitional cell carcinoma arising within a paratubal cyst: report of a case

We report the clinical and morphologic features of a transitional cell carcinoma (TCC) that arose within a paratubal cyst of the right broad ligament. This case represents only the second report of a TCC arising in the broad ligament and the first with documented origin within a paratubal cyst. A possible explanation for this tumor's histogenesis as it relates to the more common transitional cell neoplasms of the ovary is presented.

Toxic megacolon in cytomegalovirus colitis

We report a case of toxic megacolon manifesting in cytomegalovirus (CMV) colitis in a 55-yr-old man with steroid-dependent chronic obstructive pulmonary disease. He presented to the hospital with increasing dyspnea and low-grade fever. His hospital course was characterized by the poor response of his symptoms to treatment, and by the subsequent development of intermittent hematochezia and, eventually, acute abdomen. The surgical specimen showed dilatation of the cecum and ascending colon with a solitary mucosal ulcer in the latter. The major histologic changes were limited to the area of ulceration. In addition to classical CMV inclusions. vasculitis manifested in two forms, namely, leukocytoclastic type and fibrinoid necrosis. The patient died shortly thereafter, due to multi-organ system failure. To our knowledge, this represents the first reported case of toxic megacolon due to CMV infection without underlying inflammatory bowel disease. The pathogenesis of toxic colonic dilatation remains unknown.

Meckel syndrome with polysplenia: case report and review of the literature

A 19-week gestation female fetus had multiple anomalies suggesting Meckel syndrome with polysplenia. In over 200 reported cases of Meckel syndrome, only 2 similar cases are documented. Both were male infants, one with bilateral left-sidedness (polysplenia), the other with bilateral right-sidedness (M-anisosplenia). Meckel syndrome is a complex MCA (multiple congenital anomaly) syndrome. Thus, the finding of polysplenia is to be interpreted as another such midline anomaly, rather than as a causally independent malformation.

Adenocarcinoma in situ of the cervix. Clinicopathologic observations of 11 cases

Adenocarcinomas in situ (AIS) of the cervix represent less than 1% of all primary adenocarcinomas of the cervix; 11 cases from the Magee-Women's Hospital (1969-1984) are described. The patients' ages ranged from 25 to 81 years (average 48.5 years). One patient was nulliparous and the others had one to five children. The most common presenting symptom was postmenopausal or other abnormal vaginal bleeding. The AIS were diagnosed as follows: a positive, suspicious, or dysplastic Pap smear in seven cases; in three, the AIS was an incidental finding during a hysterectomy; and one case was diagnosed in an endocervical curettage. Most of the AIS were in or near the transformation zone, having two distinct histologic glandular patterns with tall columnar or large ballooned cells (Types I and II respectively). In three cases an associated in situ squamous cell carcinoma or severe dysplasia of the cervix was seen. Two patients had associated well-differentiated adenocarcinoma of the endometrium and a third had endometrial hyperplasia. One lesion stained strongly positive for carcinoembryonic antigen and all others were negative. Eight patients underwent total abdominal hysterectomy and bilateral salpingo-oopherectomy (TAH-BSO), two had total abdominal hysterectomy (one with salpingo-oophorectomy), and one 25-year-old was treated by deep conization only. All patients, except one who died with associated adenocarcinoma of the cecum, were alive 8 to 127 months after treatment.

Transforming growth factors induce markers of neoplasia in cultured adult rat bladder

Transforming growth factors alpha and beta (TGF-alpha and TGF-beta) isolated from normal mouse kidney induced gross morphological changes in rat urothelial cells maintained in organ culture. These morphological effects are similar to those observed after long-term treatment of rat bladder organ cultures with the carcinogen N-methyl-N-nitrosourea (MNU) or the promoting agents sodium saccharin and sodium cyclamate. Cultures were treated continuously with 5-25 micrograms/ml of Bio-Gel P-30-purified TGF containing both TGF-alpha and TGF-beta between days 1 and 14 in culture, or with 5 micrograms/ml from days 28 to 42. Controls received 1-10 ng/ml epidermal growth factor (EGF) or control medium. Untreated controls retained a normal urothelium throughout the period of study. Mature superficial-type cells covered most of the surface and less mature forms appeared on the cut sides and damaged areas where cells followed the normal pattern of urothelial differentiation. EGF at 5 and 10 ng/ml caused necrosis of the entire urothelium but at 1 and 2 ng/ml had minimal effects on histology and scanning electron microscopical appearance up to 14 days in culture. Crude P-30-purified TGFs induced a series of dose-related changes from 4 days, which were maximal at 8 days and persisted or decreased between 8 and 14 days. These included hyperplasia, loss of epithelial polarity, hyperchromasia and elongation of basal cells between the overlying cell layers to reach the culture surface. Scanning electron microscopy showed the appearance at the culture surface of immature cells with gross surface abnormalities including large numbers of blebs, stubby microvilli and long pleomorphic microvilli. Immature cells on the sides of the culture and in damaged areas developed similar features. At crude TGF doses of 10 micrograms/ml many superficial cells were rounded, some became cystic and epithelial necrosis was observed. Cultures treated with h.p.l.c.-purified TGF-beta at 80 ng/ml in the presence of 2 ng/ml EGF showed similar effects to those treated with 5 micrograms/ml P-30-purified TGF. Fully differentiated cultures treated from 28 to 42 days with crude TGF, showed changes similar to those seen in early cultures. However, histological changes, particularly basal cell elongation were more widespread and there was an abnormal development of globular processes between the membrane ridges of mature superficial cells. Neither crude TGF nor EGF stimulated growth in soft agar of isolated epithelial cells from freshly killed rats or organ cultures pretreated for 7 days with EGF or TGF.(ABSTRACT TRUNCATED AT 400 WORDS)

Suppression of the transformed phenotype in somatic cell hybrids

Somatic cell hybrids between mouse mammary tumour cells (TA3B) and diploid rat embryo fibroblasts (REF) or between TA3B and Syrian hamster sarcoma cells (BI) were examined for the in vitro characteristics of transformed cells as soon as possible after cell fusion. Unlike the parental tumour cells as three of four TA3B X REF and five BI X TA3B independent hybrid lines had low colony-forming efficiencies in agar, exhibited density-dependent inhibition of growth and did not form colonies on confluent monolayers of 3T3 cells, demonstrating that the transformed phenotype was suppressed in these hybrids. In addition tests of some of the hybrid lines for tumour production in nude mice showed that this was also suppressed. Suppression was more stable in the TA3B X REF than in the BI X TA3B hybrids, variants of the BI X TA3B hybrids with the properties of transformed cells could be readily isolated by subculturing cells that had grown in agar. Tumour growth selected for hybrids with the characteristics of transformed cells, and derivatives of the hybrids selected to show the transformed phenotype readily produced tumours. These correlations suggest that the transformed phenotype and malignancy may be under the same control in these cells. The phenomenon of suppression may be explained by the hypothesis that neoplastic transformation results from recessive mutations in genes which control the normal phenotype. On this model the finding of suppression in hybrids between two different tumour lines is interpreted as complementation and indicates that the mutations are not the same in all cell lines.