Dem-Aging: autophagy-related pathologies and the "two faces of dementia"

Neuronal ceroid lipofuscinosis (NCL) is an umbrella term referring to the most frequent childhood-onset neurodegenerative diseases, which are also the main cause of childhood dementia. Although the molecular mechanisms underlying the NCLs remain elusive, evidence is increasingly pointing to shared disease pathways and common clinical features across the disease forms. The characterization of pathological mechanisms, disease modifiers, and biomarkers might facilitate the development of treatment strategies.The DEM-AGING project aims to define molecular signatures in NCL and expedite biomarker discovery with a view to identifying novel targets for monitoring disease status and progression and accelerating clinical trial readiness in this field. In this study, we fused multiomic assessments in established NCL models with similar data on the more common late-onset neurodegenerative conditions in order to test the hypothesis of shared molecular fingerprints critical to the underlying pathological mechanisms. Our aim, ultimately, is to combine data analysis, cell models, and omic strategies in an effort to trace new routes to therapies that might readily be applied in the most common forms of dementia.

OP0049 COMPARISON OF BASELINE DISEASE ACTIVITY AND PATIENT (PT)-REPORTED OUTCOMES (PROS) BETWEEN PTS WITH PSORIATIC ARTHRITIS AND AXIAL INVOLVEMENT (AXIAL PSA) AND AXIAL SPONDYLOARTHRITIS (AXIAL SPA) FROM THE CORRONA PSA/SPA REGISTRY

Background:

Although pts with axial PsA and axial SpA share some common clinical characteristics, there are also potential differences that may influence disease assessment and treatment response. Identifying differences between the two pt populations is important for assessment of disease characteristics and severity as well as informing treatment decisions. There has been little comparative characterization of these conditions in a US population.

Objectives:

To compare characteristics of pts with axial PsA and axial SpA.

Methods:

Pts ≥18 years of age diagnosed with axial PsA or axial SpA at enrollment in the prospective, multicenter, observational Corrona PsA/SpA Registry between March 2013 and August 2020 were included. Enrollment visit demographics, clinical characteristics, treatment history, disease activity measures, and PROs were compared between disease groups. Continuous measures were reported using means and standard deviations; means for disease groups were compared using two-sample t tests or Wilcoxon rank sum tests. Categorical measures were reported as frequencies and percentages; frequencies in disease groups were compared using chi-square or Fisher exact tests.

Results:

A total of 1044 pts (470 with axial PsA and 574 with axial SpA) were identified (Table). Pts with axial PsA were older with a higher percentage being female vs pts with axial SpA. Time since symptom onset and diagnosis were shorter for pts with axial PsA vs axial SpA (12.0 vs 15.6 years [P<0.001] and 6.8 vs 8.3 years [P=0.01]). Pts with axial PsA were less likely than pts with axial SpA to have current or historical uveitis (4% vs 14% [P<0.001]) or inflammatory bowel disease (5% vs 10% [P=0.005]). Prior biologic synthetic disease-modifying antirheumatic drug (bDMARD) and conventional synthetic DMARD use was more prevalent in the axial PsA vs axial SpA groups (64% vs 52% [P<0.001]/59% vs 32% [P<0.001]), while mean dactylitis (measured by Dactylitis Count) and enthesitis (measured by Spondyloarthritis Research Consortium of Canada [SPARCC] Enthesitis Index) counts were higher (0.4 vs 0.1 [P<0.001]/1.7 vs 1.2 [P<0.001]). Mean pt-reported pain and spinal pain were lower in pts with axial PsA vs axial SpA (49.4 vs 53.9 [P=0.015]/40.8 vs 49.7 [P<0.001]) (Figure). The proportion of pts with morning stiffness along with mean fatigue and work impairment scores were similar between disease groups.

Table.Baseline demographics and clinical characteristicsAxial PsAN=470Axial SpAN=574P valueAge (years), mean ± SD51.6 ± 13.247.7 ± 14.0<0.001Female, n (%)265 (57)248 (44)<0.001White, n (%)428 (94)507 (91)0.089Years since symptom onset, mean ± SD12.0 ± 11.615.6 ± 12.1<0.001Years since diagnosis, mean ± SD6.8 ± 9.08.3 ± 10.50.010HLA-B27 positive status, n/n (%)52/189 (28)214/295 (73)<0.001Abnormal CRP, n (%)88 (19)140 (24)0.033Uveitis, n (%)20 (4)80 (14)<0.001IBD, n (%)25 (5)59 (10)0.005Dactylitis count, mean ± SD0.4 ± 1.50.1 ± 0.7<0.001SPARCC enthesitis count, mean ± SD1.7 ± 2.91.2 ± 2.4<0.001Morning stiffness, n (%)439 (95)537 (96)0.923BASDAI (0–10), mean ± SD4.8 ± 2.54.9 ± 2.40.463BASDAI Q2 (0–10): spinal pain, mean ± SD5.0 ± 2.95.7 ± 2.9<0.001BASDAI Q3 (0–10): peripheral pain/swelling, mean ± SD4.5 ± 2.94.0 ± 3.10.010Modified BASDAI (0–10), mean ± SD5.0 ± 2.55.4 ± 2.40.013Prior bDMARDs, n (%)300 (64)299 (52)<0.001Prior csDMARDs, n (%)275 (59)181 (32)<0.001Prior prednisone use, n (%)54 (12)73 (13)0.611Prior NSAID use, n (%)52 (11)46 (8)0.115

Conclusion:

Findings from this descriptive real-world analysis suggest there may be meaningful differences between pts with axial SpA and axial PsA but future studies are needed to better understand these differences.

Acknowledgements:

Medical writing services provided by Alan Saltzman of Fishawack Facilitate Ltd, part of Fishawack Health, and funded by AbbVie.

This study was sponsored by Corrona, LLC. Corrona has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Crescendo, Eli Lilly and Company, Genentech, Gilead, GSK, Janssen, Merck, Momenta Pharmaceuticals, Novartis, Pfizer, Regeneron, Roche, Sun, UCB, and Valeant. The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship.

Disclosure of Interests:

Philip J Mease Speakers bureau: AbbVie, Amgen, Janssen, Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, BMS, Boehringer Ingelheim, Celgene, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, Novartis, Pfizer, Sun, and UCB, Grant/research support from: AbbVie, Amgen, BMS, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Sun, and UCB, Maya Marchese Employee of: Corrona, Robert McLean Employee of: Corrona, Taylor Blachley Employee of: Corrona, Laura Anatale-Tardiff Employee of: Corrona, Christopher Saffore Shareholder of: AbbVie, Employee of: AbbVie, Elizabeth Lesser Shareholder of: AbbVie, Employee of: AbbVie, Alexis Ogdie Consultant of: Amgen, AbbVie, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, National Psoriasis Foundation, Pfizer, and Novartis

Complete transmural gastric migration of PTFE mesh after surgery for a recurrent hiatal hernia

Complications directly associated with the use of prosthetic materials in large hiatal hernia repair are rarely cited events in the literature. We herein report a case of a 47 year-old woman who came to our attention for a subacute onset of severe dysphagia and weight loss. She previously underwent laparotomic Nissen fundoplication with PTFE dual-mesh cruroplasty for a large recurrent hiatal hernia. With the clinical suspicious of "Tight Nissen", an endoscopy was performed and revealed a circular stenosis in the lower esophagus, a rotation of the stomach and, surprisingly, the presence of PTFE mesh free-moving in the gastric lumen With the use of rattooth forceps, the foreign body was removed and, after few days, the patient underwent a surgical debridement of hiatal scar tissue and a gastropexy procedure. In conclusion, dysphagia may manifest during the early postoperative period after mesh repair antireflux surgery, but such dysphagia usually resolves; if it doesn't or if it worsens, mesh migration must be excluded.

The canalicular system and the osteoblast domain in human secondary osteons

The lacunar-canalicular system in human secondary osteons was examined by two complementary techniques: light microscopy analysis of undecalcified thick sections and the SEM cortex-fractured surface technique. Unlike the earlier definitions of 'osteoblastic domain' presented as the matrix volume produced by osteoblasts in the process of osteon infilling, this study measured the domain by the length of osteoblast dendritic processes. The domain extension was defined along radial vectors advancing from the reversal line towards the central canal. According to their lengths, domains were divided into three classes: peripheral, intermediate and internal. The mean length of peripheral domains was significantly shorter than those of the intermediate and internal domains. This suggests that the infilling process is modulated by an initial preparatory phase characterised by osteoblast adhesion to the wall of the cutting cone, and a limited matrix synthesis, followed by a regular matrix volume apposition organised in concentric layers. In addition to the radial canaliculae arranged along converging vectors in planes perpendicular to the central canal, we distinguished a further class of canaliculae, the equatorial canaliculae originating from the major perimeter of the lacuna and spreading out radially in the plane of the same lacuna (therefore, perpendicularly to the radial canaliculae). The whole lacunar-canalicular network was structured as a closed system around the vascular axis of the central canal with very few canaliculae crossing the reversal line and connecting the neighbouring osteons. These anatomical observations contribute to our knowledge of lacunar-canalicular system development.

Cobalt, chromium and molybdenum ions kinetics in the human body: data gained from a total hip replacement with massive third body wear of the head and neuropathy by cobalt intoxication

INTRODUCTION

A patient with a total hip replacement developed optic, acoustic and peripheral neuropathy from metal ions intoxication, due to the wear products released from the prosthesis. Subsequently the kinetics of the metal ions was studied.

MATERIALS AND METHODS

Massive wear and acute intoxication allowed a study of the metal ions kinetics and of EDTA treatment.

RESULTS

Plasma and other organic fluids were saturated by each of the metal ions released from the exposed surface according to the solubility of each ion; a larger fraction of Co ions was bound within red cells, while the plasmatic fraction appeared more movable. In a patient with a prosthesis subjected to wear, the ions released are from the prosthetic and from the debris surface (spread in the body). The latter is a function of the number and size of particles.

DISCUSSION

Revision of the prosthesis from the point of view of the metal ions kinetics corresponded to a reduction of the releasing surface because of debris washed out by irrigation and tissue excision; however, the metal particles spread by lymphatic circulation continued to release ions even though the source of wear had been removed. Early diagnosis of high metal wear can be ascertained with mass spectrometry and after revision high levels of metal ions can only be reduced with repeated chelating treatment. It is preferable not to revise fractured ceramic components with a polyethylene-metal articulation.

Environmental factors and benthic Oligochaeta (Annelida, Clitellata) assemblages in a stretch of the Upper São Francisco River (Minas Gerais State, Brazil)

The Oligochaeta forms an important part of the macroinvertebrates inhabiting sediments of lotic ecosystems. It has an important role in the cycling of matter and energy transfer in these environments. The aim of this study is to analyse limnological variables, their influence on the structure and diversity of benthic oligochaete taxocenosis in a stretch of the Upper São Francisco River and its tributary the Piumhi River. Samples were taken in two climatic periods, the dry season in October 2006 and 2007 and the rainy season in March 2007 and 2008 at three points along the Piumhi River and six points along the São Francisco River. The sediment of the São Francisco consisted predominantly of sand and clay, whereas the sediment of the Piumhi was mainly sandy. Six species of oligochaete occurred in the Piumhi River while seven were found in the São Francisco. Of these, Pristina synclites Stephenson, 1925, Pristina americana Cernosvitov, 1937, Bothrioneurum sp. Stolc, 1888 and Limnodrilus hoffmeisteri Claparede, 1862 occurred in the sediment of both rivers. L. hoffmeisteri showed the highest numerical abundance in the Piumhi River and Brinkhurstia americana (Brinkhurst, 1964) and L. neotropicus Cernosvitov, 1939 were the most abundant species in the São Francisco River. The highest oligochaete density was recorded in the Piumhi during the dry seasons. Canonical correspondence analyses (CCA) of sediment characteristics explained most of the data variability and the association of the presence of oligochaete species in the Piumhi and São Francisco Rivers with the limnological variables (grain size composition and total nitrogen and phosphorus concentrations in the sediment).

Neuropathic pain following hip resurfacing due to a transneural suture

A 60-year-old man developed severe neuropathic pain and foot-drop in his left leg following resurfacing arthroplasty of the left hip. The pain was refractory to all analgesics for 16 months. At exploration, a PDS suture was found passing through the sciatic nerve at several points over 6 cm and terminating in a large knot. After release of the suture and neurolysis there was dramatic and rapid improvement of the neuropathic pain and of motor function. This case represents the human equivalent of previously described nerve ligation in an animal model of neuropathic pain. It emphasises that when neuropathic pain is present after an operation, the nerve related to the symptoms must be inspected, and that removal of a suture or irritant may lead to relief of pain, even after many months.

Feeding patterns of the aquatic grasshopper Cornops aquaticum (Bruner) (Orthoptera: Acrididae) in the middle Paraná river, Argentina

The aquatic grasshopper Cornops aquaticum (Bruner) is native to South America and inhabits lowlands from southern Mexico to Central Argentina and Uruguay. This grasshopper is host-specific to aquatic plants of the genera Eichhornia and Pontederia. The objectives of this study were to analyze the feeding patterns of the aquatic grasshopper C. aquaticum in relationship to development stages and sex and to determine the food consumption rate in their host plant, Eichhornia crassipes. Samples were collected from April 2006 to May 2007 in different floodplain lakes of the Middle Parana River. The average consumption was greater in the females (0.127 g food/day ± 0.051) than in the males (0.060 g food/day ± 0.025). The feces of 361 nymphs and adults of this locust were examined and the most common tissue fragments found were of the water hyacinth (E. crassipes). In the initial nymphal stages (I, II and III), an exclusive consumption of E. crassipes was registered, while in the IV and V stages the choice included also other macrophytes. In summary, C. aquaticum presents polyphagy in the field, feeding on six macrophytes of different classes and families.

Progress in endoscopic imaging of gastrointestinal tumors

STATE OF THE ART

New technologies in the form of high-magnification or "zoom" endoscopy complemented by chromoscopic agents or Narrow Band Imaging permit early detection of neoplastic lesions, particularly flat and depressed types. Detailed characteristics of the mucosal surface can be obtained, enabling an in vivo "optical biopsy" to make an instant diagnosis at endoscopy, previously possible only by using histological or cytological analysis. Advances in fiber optics, light sources, detectors, and molecular biology have led to the development of several novel methods for tissue evaluation in situ.

PERSPECTIVES

Promising imaging techniques include fluorescence endoscopy, optical coherence tomography, confocal microendoscopy, molecular imaging, and light scattering and Raman spectroscopy.

CONCLUSIONS

These techniques probably are able to replace conventional biopsy in the near future, but the endoscopists should become increasingly more familiar with histopathologic findings.

Flexible endoscopic Zenker's diverticulotomy: cap-assisted technique vs. diverticuloscope-assisted technique

BACKGROUND AND STUDY AIM

The standard treatment for a Zenker's diverticulum is diverticulotomy, either using the endostapling approach or by surgery. Flexible endoscopic diverticulotomy has similar efficacy and is associated with fewer complications but this technique is still under investigation. The aim of this study was to compare the technical results and efficacy of two flexible endoscopic diverticulotomy techniques.

PATIENTS AND METHODS

A total of 39 patients with a Zenker's diverticulum were treated using either cap or diverticuloscope assistance to expose the septum, which was then cut with a needle-knife and endocut currents. The severity of symptoms was graded according to their frequencies before the procedure, after 1 month, and to June 2006.

RESULTS

Of the 39 patients enrolled into the study, 28 patients were treated with the cap and 11 with the diverticuloscope, the two groups showing no statistical difference in baseline features. The median length of the Zenker's diverticulum was 4 cm (range 2-8 cm). The procedure time was significantly longer with the cap than with diverticuloscope assistance (P = 0.002). Complications occurred in 9/28 patients in the cap group and in none of the patients in the diverticuloscope group (P = 0.04); the perforations that occurred in five patients (18%) were managed endoscopically and conservatively. The median inpatient stay was 3 days (range 2-8 days). The clinical remission rate, evaluated using a pool of symptoms, was significantly higher after the diverticuloscope-assisted procedure compared with the cap technique (82% vs. 29%, P = 0.004). Multivariate analysis showed that the diverticuloscope-assisted technique was the only significant prognostic factor for efficacy (odds ratio 13.09, 95% CI 2.07-82.53).

CONCLUSION

The use of the soft diverticuloscope to expose and fix the septum seems to be the optimal approach in terms of increasing the safety and clinical efficacy of flexible endoscopic diverticulotomy.

Capsule endoscopy in patients with chronic abdominal pain

BACKGROUND

Patients with chronic abdominal pain consult gastroenterologists frequently, requiring a large number of examinations.

AIM

To assess the diagnostic yield of capsule endoscopy in patients with chronic abdominal pain of unknown origin and negative diagnostic work-up.

PATIENTS

From January 2002 to September 2004, 16 patients (10 female; mean age 42.7 years) who complained of chronic abdominal pain were referred to our unit for capsule endoscopy.

METHODS

Chronic abdominal pain was defined as continuous or almost continuous, for at least 3 months and without criteria for other gastrointestinal disorders. All patients had a previous diagnostic work-up including abdominal ultrasonography, oesophagogastroduodenoscopy, colonoscopy and small bowel follow through, performed within 2 months.

RESULTS

Capsule endoscopy was normal in 12 patients (75%). Small bowel abnormalities were found in three patients, but were considered irrelevant. In one patient (6.3%), capsule endoscopy revealed ileal erosions and inflammation and was retained in a stricture undetected by radiology. This patient underwent elective surgery which revealed an ileal carcinoid neoplasm.

CONCLUSIONS

Capsule endoscopy identified a specific cause of chronic abdominal pain in only one patient. Capsule endoscopy is a safe procedure but does not seem to play an important role in the evaluation of patients with chronic abdominal pain of unknown origin.

Nonendoscopic transnasal placement of a wireless capsule for esophageal pH monitoring: feasibility, safety, and efficacy of a manometry-guided procedure

BACKGROUND AND STUDY AIMS

The aim of the study was to evaluate the safety, feasibility, and efficacy of transnasal placement of the Medtronic Bravo capsule for wireless esophageal pH monitoring.

PATIENTS AND METHODS

Forty patients with symptomatic gastroesophageal reflux disease were prospectively evaluated. All patients underwent upper gastrointestinal endoscopy and esophageal manometry. The Bravo capsule was then introduced transnasally and released 5 cm above the upper margin of the lower esophageal sphincter. Serial radiographs were performed weekly until capsule release.

RESULTS

Of the 40 patients who were evaluated, 38 (95 %) were eligible to undergo the procedure. Transnasal placement proved impossible in one patient (2.5 %). Overall, a total of 39 procedures were performed in 38 patients (the procedure was repeated in one patient because of accidental intragastric fixation). Esophageal placement was successful in 36/39 procedures (92.3 %). The mean duration of the procedure was 10 minutes (range 5 - 16 minutes). Adverse events were noted in five of the 39 procedures (12.8 %), mild epistaxis in two patients (5.1 %) and pharyngeal irritation in three patients (7.7 %). After the procedure, a slight "foreign body" sensation was reported by 20 of the 36 patients (55.5 %) who had undergone successful esophageal placement; two patients (5.5 %) experienced severe retrosternal pain necessitating endoscopic removal of the capsule. At the end of the study, 34 of the 38 patients (89.5 %) stated that they would be willing to undergo the test again if necessary.

CONCLUSIONS

Transnasal placement of the Bravo pH capsule is safe, well tolerated, does not require sedation, and avoids endoscopy and its complications.

A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule

BACKGROUND AND STUDY AIMS

The current visualization of small-bowel strictures using traditional radiological methods is associated with high radiation doses and false-negative results. These methods do not always reveal small-bowel patency for solids. The aim is to assess the safety of the Given patency system and its ability to detect intestinal strictures in patients with strictures that are known or suspected radiologically.

MATERIALS AND METHODS

The Given patency capsule is composed of lactose, remains intact in the gastrointestinal tract for 40-100 hours post ingestion, and disintegrates thereafter. A total of 34 patients with small-bowel stricture were prospectively enrolled; 30 had a previous diagnosis of Crohn's disease, three had adhesion syndrome and in one ischemic enteritis was suspected. Of the patients, 15 (44.1 %) had previously undergone surgery. Following ingestion, the capsule was monitored for integrity and transit time, using a specially designed Given scanner and also radiologically. Seventeen patients had been enrolled with the intent of using the patency capsule as a preliminary test in patients with small-bowel strictures before undergoing video capsule endoscopy.

RESULTS

30 patients (88.2 %) retrieved the capsule in the stool; it was intact in 20 (median transit time 22 hours), and disintegrated in 10 patients (median transit time 53 hours). Six patients complained of abdominal pain which disappeared within 24 hours. The scanner successfully indicated the presence of the capsule in 94 % of cases. Ten patients underwent video capsule endoscopy following the patency capsule examination; in all of these the video capsule passed through the small-bowel stricture.

CONCLUSIONS

This feasibility study has shown that the Given patency capsule is a safe, effective, and convenient tool for assessment of functional patency of the small bowel. It can indicate functional patency even in cases where traditional radiology indicates stricture.

Role of desmopressin in the treatment of a case of septic shock refractory to catecholamines

The authors describe a case of septic shock refractory to high-dose catecholamines after adequate volemic filling, rapidly corrected with the administration of desmopressin at a dose of 0.02 U/min. There are, in the literature, several cases of septic shock refractory to high-dose catecholamines successfully treated with arginine-vasopressin, a selective V1 agonist. This agent can potentially induce coronary vasoconstriction and presents a very difficult weaning, that imposes a slow reduction of the infusion amount. On the contrary, desmopressin does not present those adverse effects and is able to maintain a high renal blood flow, for its prevalent action on V2 instead of V1 receptors.

[Treatment of the ingrown toenail by phenol cauterization (ASLUF)]

BACKGROUND

The aim of this study was to evaluate the clinical and the ethiopatogenetic aspects of the ingrown toenail, treated by usual surgical technique versus phenol wedge cauterization (ASLUF).

METHODS

From June 1990 to June 1999, 388 patients (218 male and 170 female patients, age range 9-90 years) were treated by 413 wedge ablation, surgical or chemical. After the operation, patients were controlled after 2 days, 1 week, 1 month, 6 months and 1 year. 109 patients were treated by usual surgical treatment, 260 patients by phenol cauterization (ASLUF), 19 by total ablation.

RESULTS

23 patients presented again ingrown toenail in the same place after few months, 20 patients after surgical treatment and 3 patients after phenol cauterization. All 23 patients were treated again without problems.

CONCLUSIONS

In our personal opinion, the treatment of ingrown toenail is necessary soon, without the routine use of antibiotic therapy and the total ablation of the nail is not necessary. On this basis phenol wedge cauterization is the most suitable treatment for ingrown toenail with good cosmetic results, lower recurrence rate and from the functional point of view.

Dynamics of the reactivity to MBP in multiple sclerosis

Though many lines of evidence support the importance of myelin basic protein (MBP) in the pathogenesis of experimental autoimmune encephalomyelitis (EAE), its role in multiple sclerosis (MS) is still debated as well as the significance of epitope spreading in disease progression. We characterised the response to MBP in eight MS subjects and three of these were followed over time. In one case, the follow up lasted over a 6-year period. Clonal expansion, clonal persistence and epitope spreading against other MBP determinants was detected irrespective of disease course. In one patient we identified a novel T-cell receptor variable gene (BV28S2) which may be involved in the selection of MBP determinants, as suggested by experiments performed in the presence of mismatched antigen presenting cells (APC) between two subjects compatible for HLA-DR2 subtype but differing for the epitope recognised. Our findings do not sustain a role for the response to MBP effecting on clinical course and suggest that a novel TCR gene may be involved in the recognition of unusual self antigens.

Treatment of v-Ki-ras-transformed SVC1 cells with low retinoic acid induces malignancy reversion associated with ras p21 down-regulation

The effect of nontoxic, low concentrations (10(-8) M) of retinoic acid (RA) for a relatively long time (28 days) on a Kirsten ras-virus transformed cell line (Ki-SVC1), derived from the rat seminal vesicle epithelium, was investigated. In these experimental conditions, the cell treatment with RA induced a decrease of the proliferation rate, apoptosis and a marked reduction of both anchorage-independent growth and tumorigenicity. These biological responses were either preceded or associated with important changes in adenylate cyclase/protein kinase C signaling pathways, the activation of important apoptosis-linked genes and a marked decrease of the v-Ki-ras p21 protein. The significance of these findings is discussed.

Inhibition of antithrombin by protein SV-IV normalizes the coagulation of hemophilic blood

The aim of the study was to evaluate the effect of the protein Seminal Vesicle Protein No. 4 (SV-IV), a potent inhibitor of antithrombin III (antithrombin), on the coagulation of blood obtained from patients affected by hemophilia A. In the coagulating blood of these patients, the antithrombin/thrombin ratio was found to be markedly higher (about 44) than in normal individuals (about 4. 4). This high ratio was related to the low efficiency of thrombin-generating reactions induced by the factor VIII deficiency and to the high levels of free (not bound to serine proteases) antithrombin present in the hemophilic serum (antithrombin concentration was the same in normal and hemophilic plasma). The elevated concentration of free antithrombin in hemophiliacs was primarily a consequence of a reduced consumption caused by the scarce availability in the hemophilic serum of factors Xa and IIa, which are serine proteases possessing strong binding affinity for antithrombin. Addition of SV-IV to coagulating hemophilic blood reduced markedly the serum antithrombin and thrombin-antithrombin complexes, normalizing, as a consequence, the clotting time and other coagulation parameters. Similar results were obtained by using appropriate concentration of factor VIII.

Germination response and viability of Orobanche crenata Forsk. seeds subjected to temperature treatment

Orobanche crenata is a chlorophyll-lacking holoparasite that subsists on the roots of plants, inflicting severe damage to legume crops (broad bean, pea, lentil, vetch, grass pea, chickpea) in the Mediterranean and Middle East regions. Laboratory studies were conducted to determine the effects of high temperatures [20˚C (control), 38˚C, 40˚C, 42˚C, or 44 0.5˚C] on seed germination of O. crenata in relation to different duration of temperature treatments (12 or 24 h), seed age (57 or 94 months), and root extracts (Vicia faba major cv. 45 NS and V. faba minor cv. Sikelia). The seed viability response to temperature (20–100˚C) in relation to 2 seed ages (57 or 93 months) was also investigated. The increase in temperature exposure of seed from 20˚C to 30˚C, 40˚C, 42˚C, and 44˚C determined a significantly progressive reduction in the germination percentage, which was 21, 13, 6, 0, and 0%, respectively. This reduction in germination was due mainly to an increase in the secondary dormancy, since viability of the same seed, checked by tetrazolium test, ranged between 60% and 99%. Seed viability linearly decreased with increasing seed exposure temperature until reaching zero at 80˚C.

Genotoxicity testing of potassium canrenoate in cultured rat and human cells

Potassium canrenoate (PC), a competitive aldosterone antagonist used as a diuretic and in the treatment of hypertension, was examined for its capacity to produce genotoxic effects in cultured rat and human cells. At subtoxic concentrations (10-90 microM) PC was found to induce a dose-dependent degree of DNA fragmentation, as detected by the Comet assay, and of DNA repair synthesis, as measured by quantitative autoradiography, in primary cultures of hepatocytes from rat and human donors of both genders. In rat hepatocytes both DNA fragmentation and DNA repair were more marked after 3 h than after 20 h exposure and in cultures from females than from males. In human hepatocytes from one male and two female donors, PC caused a similar effect in terms of DNA fragmentation, whereas DNA repair was detected in cultures from only two of the same three donors and was less marked than in rat hepatocytes. A modest but statistically significant increase in micronucleated cells was present in primary cultures of replicating rat hepatocytes exposed to 10 or 30 microM PC for 48 h, the response being, in this case also, more evident in females than in males. In contrast, PC did not induce micronucleus formation in human hepatocytes from two female donors. Any evidence of DNA fragmentation and micronucleus formation was absent in cultured human lymphocytes. Taken as a whole these findings support the hypothesis that hepatocytes activate PC to DNA-damaging reactive species. PC induced the observed genotoxic effects at concentrations close to those produced in humans by the administration of therapeutic doses, but these effects were as a whole more marked in rat than in human hepatocytes. Since PC shares the 17-hydroxy-3-oxopregna-4,6-diene structure with cyproterone acetate, chlormadinone acetate and megestrol acetate, previously found to be genotoxic to both rat and human hepatocytes, the potential carcinogenic hazard of this type of steroids cannot be neglected.

Muscle test comparisons of congruent and incongruent self-referential statements

This study investigated differences in values of manual muscle tests after exposure to congruent and incongruent semantic stimuli. Muscle testing with a computerized dynamometer was performed on the deltoid muscle group of 89 healthy college students after repetitions of congruent (true) and incongruent (false) self-referential statements. The order in which statements were repeated was controlled by a counterbalanced design. The combined data showed that approximately 17% more total force over a 59% longer period of time could be endured when subjects repeated semantically congruent statements (p < .001). Order effects were not significant. Over-all, significant differences were found in muscle-test responses between congruent and incongruent semantic stimuli.

Personality assessment of patients with complex regional pain syndrome type I

OBJECTIVE

There is controversy regarding the importance of psychological/psychiatric factors in the development of the Complex Regional Pain Syndrome (CRPS). Our objective was to determine whether CRPS type I patients were psychiatrically different from other chronic pain patients, with particular attention to personality pathology.

DESIGN

A standardized clinical assessment of all major psychiatric categories, including personality disorders, was performed on 25 CRPS type I patients and a control group of 25 patients with chronic low back pain from disc-related radiculopathy.

MEASURES

Both sections of the Structured Clinical Interview for the Diagnostic and Statistical Manual (3rd ed., rev.) and the visual analog scale.

RESULTS

Both groups were similar in terms of pain intensity and duration. Statistical analysis showed both groups to have a significant amount of major psychiatric comorbidity, in particular major depressive disorder, and a high incidence of personality disorders. Therefore, intense chronic pain was associated with significant psychiatric comorbidity in both groups and in similar proportions.

CONCLUSION

The high incidence of personality pathology in both groups may represent an exaggeration of maladaptive personality traits and coping styles as a result of a chronic, intense, state of pain.

[Giant diverticulum of the duodenum. Case report]

The authors describe the case of a 49-year-old man with a giant diverticulum of the duodenum, with apparently scarce symptoms, pointed out by gastroscopy and X-ray of the upper gastrointestinal duct with barium meal. The removal of the lesion, obtained after surgical operation, showed a diverticulum with a 6 cm diameter, with signs of diverticulitis; the histological test did not point out is degenerative lesions. A survey of the recent literature on the matter is presented.

SV-IV, a major protein secreted from rat seminal vesicle epithelium, promotes lymphocyte cytotoxic activity against the lymphoblastoid Raji cell line in human peripheral blood mononuclear cells

The treatment of human peripheral blood mononuclear cells (PBMC) with micromolar concentrations of SV-IV, a major protein secreted from the rat seminal vesicle epithelium, promotes in this cell population a marked cytotoxic activity against the Raji lymphoblastoid cell line. This activity is apparently due to cell-to-cell contact interactions. The expression of HLA DR on Raji cells has a modulatory effect on the SV-IV-induced cytotoxic activity. The experimental evidence strongly suggests that the cytotoxic effector cells are functionally activated NK cells.

A peptide derivative (1-70 fragment) of protein SV-IV accelerates human blood coagulation in vitro by selective inhibition of the heparin-induced antithrombin III activation process

The effect of two peptide derivatives of the rat SV-IV (SV-IV/A: 1-70 fragment; SV-IV/B: 71-90 fragment) on human blood coagulation was investigated. The SV-IV/A fragment was found to possess the same procoagulant activity of the native protein, whereas SV-IV/B retained only a very small fraction of the activity. The results obtained strongly suggest that the procoagulant activity of SV-IV/A is due, like SV-IV, to a selective inhibition of the antithrombin III (AT III) activation process induced by heparin, an essential cofactor of AT III. The main data supporting this hypothesis are the following: 1) the concentration of active serum AT III decreases when SV-IV/A is present in the clotting system; 2) the plasma treatment with SV-IV/A reduces the concentration of AT III, but not that of other plasma serine protease inhibitors; 3) the recalcification time (RT) of the plasma treated with a rabbit anti-AT III polyclonal antiserum is not modified by SV-IV/A; 4) the presence of SV-IV/A in a reaction mixture containing pure fibrinogen, alpha-thrombin, heparin, and AT III neutralizes the thrombin inhibition induced by AT III; 5) the concentration of the thrombin-AT III complexes, occurring in sera obtained from CaCl2-coagulated plasma, is markedly reduced in the presence of SV-IV/A; 6) appropriate concentrations of heparin neutralize the inhibitory effect of either SV-IV/A or SV-IV on the AT III activity in vitro.

[Rupture of the duodenum caused by closed abdominal trauma]

A duodenal lesion due to blunt abdominal trauma is an infrequent eventi which makes important diagnostic and therapeutic problems. The preoperative diagnosis is not always easy, especially with retroperitoneal lesion or in injured patients. A plain abdominal radiography or a duodenal radiography with soluble contrast medium helps to achieve a proper diagnosis. Prognosis strictly depends on time between injury and surgical procedures. We report two successfully treated lesions of fourth duodenal due to a blunt abdominal trauma.

ras oncogene-induced transformation of a rat seminal vesicle epithelial cell line produces a marked increase of adenylate cyclase and protein kinase C activities

Cells transformed by Kirsten murine sarcoma virus (Ki-MSV) have basal adenylate cyclase activity (AC) higher than control cells and comparable level of forskolin-stimulated AC activity. Moreover, a higher protein kinase C (PKC) activity was found to be present in the transformed cells. The molecular mechanism underlying the increase of AC activity was investigated. Our findings strongly suggest that this biochemical event is due to a marked decrease of the alpha i negative control of the enzyme, even though the alpha i of transformed cells appears to possess fully functional domains interacting with both the effector enzyme and the agonist-activated receptor.

Insulin resistance and hyperinsulinemia induce hyperandrogenism in a young type B insulin-resistant female

An adolescent female with type B insulin resistance and hyperandrogenemia is described. Evidence presented suggests that hyperinsulinemia leads to an increase in serum total and free testosterone. Support for this hypothesis is noted during an in vivo experiment in which large doses of regular insulin (305 U/kg-day) were infused iv, and multiple serum total testosterone measurements obtained. After 35 days of iv insulin therapy, the serum total testosterone values rose from 4.9 nmol/L (142 ng/dL) to 22.8 nmol/L (660 ng/dL), and the ovarian volume increased 2-fold. Basal (9.8 nmol/L; 282 ng/dL) and stimulated (16.8 nmol/L; 481 ng/dL) androstenedione measurements were elevated, and the dehydroepiandrosterone/androstenedione ratio was low, suggesting increased 3 beta-hydroxysteroid dehydrogenase activity. After resolution of the insulin-resistant state and the concomitant hyperinsulinemia, the serum total testosterone values returned to normal. This case illustrates that long term hyperinsulinemia leads to elevation of serum total testosterone.

Transglutaminase in cell proliferation and transformation

Transglutaminase (TGase) activity was reduced in intact mitogen-stimulated human peripheral blood lymphocytes (PBL) when compared to intact resting PBL. Moreover, a treatment of the same quiescent immunocompetent cells with purified liver TGase and Ca2+ completely suppressed the mitogen-induced blast transformation. A decrease in TGase activity in neoplastically transformed seminal vesicle epithelial cells with respect to their normal parent counterpart was also observed. Our data support the notion of a possible implication of TGase in cell proliferation and transformation.

A contribution to the taxonomy of the aquatic Oligochaeta (Naididae) of South America

The number of South American species of the family Naididae has yet to be determined. Some 27 species are discussed here, and a list of South American species in 15 genera is presented. Nais simplex, Dero (Aulophorus) vagus, and Pristinella acuminata are new to the list. Nais raviensis is regarded as a member of the genus Dero in accordance with recent literature. The subfamily Stylarinae, thought to be the oldest in the family, is scarce or absent in the region, in contrast to austral or southern distributions for supposedly more primitive families or primitive genera in other families.

Radiation response characteristics of human cells in vitro

Improvements in tissue culture techniques and growth media have made it possible to culture a range of cells of human origin, both normal and malignant. The most recent addition to the list are endothelial cells from umbilical cord veins. Interesting results in radiosensitivity studies of these human cells have been obtained, some of which may have implications in radiation therapy. (i) Repair of potentially lethal damage (PLDR) has been observed in all cell lines investigated; cells of normal origin repair PLD at least as well as malignant cells, which makes clinical trials of PLDR inhibitors of doubtful usefulness. (ii) No apparent correlation can be made between the extent of PLDR and the traditional radioresponsiveness of a particular tumor type. Indeed, if anything, it could appear to have an inverse correlation since the most resistant tumor cells show the smallest amount of PLD repair. (iii) Dose-rate effects appear to be better predictors of radiosensitivity than PLDR capacity. (iv) Sublethal damage repair, manifest by a dose-rate effect, has also been observed in all human cell lines tested. Cells of normal tissue origin, including fibroblasts and endothelial cells, exhibit a dose-rate effect that is intermediate between that for cells from traditionally resistant tumors (melanoma and osteosarcoma) and cells from more sensitive tumors (neuroblastoma and breast).