The transcription factor ChREBP Orchestrates liver carcinogenesis by coordinating the PI3K/AKT signaling and cancer metabolism

Cancer cells integrate multiple biosynthetic demands to drive unrestricted proliferation. How these cellular processes crosstalk to fuel cancer cell growth is still not fully understood. Here, we uncover the mechanisms by which the transcription factor Carbohydrate responsive element binding protein (ChREBP) functions as an oncogene during hepatocellular carcinoma (HCC) development. Mechanistically, ChREBP triggers the expression of the PI3K regulatory subunit p85α, to sustain the activity of the pro-oncogenic PI3K/AKT signaling pathway in HCC. In parallel, increased ChREBP activity reroutes glucose and glutamine metabolic fluxes into fatty acid and nucleic acid synthesis to support PI3K/AKT-mediated HCC growth. Thus, HCC cells have a ChREBP-driven circuitry that ensures balanced coordination between PI3K/AKT signaling and appropriate cell anabolism to support HCC development. Finally, pharmacological inhibition of ChREBP by SBI-993 significantly suppresses in vivo HCC tumor growth. Overall, we show that targeting ChREBP with specific inhibitors provides an attractive therapeutic window for HCC treatment.

Enhanced Renewal of Erythroid Progenitors in Myelodysplastic Anemia by Peripheral Serotonin

Tryptophan as the precursor of several active compounds, including kynurenine and serotonin, is critical for numerous important metabolic functions. Enhanced tryptophan metabolism toward the kynurenine pathway has been associated with myelodysplastic syndromes (MDSs), which are preleukemic clonal diseases characterized by dysplastic bone marrow and cytopenias. Here, we reveal a fundamental role for tryptophan metabolized along the serotonin pathway in normal erythropoiesis and in the physiopathology of MDS-related anemia. We identify, both in human and murine erythroid progenitors, a functional cell-autonomous serotonergic network with pro-survival and proliferative functions. In vivo studies demonstrate that pharmacological increase of serotonin levels using fluoxetine, a common antidepressant, has the potential to become an important therapeutic strategy in low-risk MDS anemia refractory to erythropoietin.

Amplification of the C-MYC Oncogene in Non-small Cell Lung Cancer

Fresh non-small cell lung carcinoma surgical specimens were taken from 17 patients and 3 controls and screened for genetic abnormalities of the c-myc oncogene. Southern blot hybridization analysis demonstrated two- to fivefold amplification of the c-myc gene in 10 cases, i.e., 7 of 13 epidermoid lung carcinomas, 2 of 3 adenocarcinomas and 1 of 1 osteogenic sarcoma metastatic to the lung. Two- to fivefold amplification was observed in tissues from stage III and IV epidermoid carcinomas and adenocarcinomas of the lung. A correlation between cancer stage and c-myc gene amplification was found.

Note: Multiscale scanning probe microscopy

Combining the nanoscopic and macroscopic worlds is a serious challenge common to numerous scientific fields, from physics to biology. In this paper, we demonstrate nanometric resolution over a millimeter range by means of atomic-force microscopy using metrological stage. Nanometric repeatability and millimeter range open up the possibility of probing components and materials combining multiscale properties i.e., engineered nanomaterials. Multiscale probing is not limited to atomic-force microscopy and can be extended to any type of scanning probe technique in nanotechnology, including piezoforce microscopy, electrostatic-force microscopy, and scanning near-field optical microscopy.

Polarimetric interferometer for nanoscale positioning applications

We propose and demonstrate a displacement control method at the subnanometric scale based on a Michelson interferometer combined with a polarimeter and a phase-locked loop electronic board. Step by step displacements with a step value of 5 nm are presented. A repeatability of 0.47 nm is obtained from back and forth displacements over 1 mum range. We show that a residual ellipticity of less than 10 degrees on the polarization state leads to a positioning error of less than 1 nm. Such system could be used over millimeter range displacements in a controlled surrounding environment leading to numerous applications in nanometrology.

Local complications of hydatid disease involving thoracic cavity: imaging findings

Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although it can involve almost every organ of the body, lung involvement follows in frequency the hepatic infestation in adults and is the predominating site in children. Radiologically, hydatidosis usually demonstrates typical findings, but many patients are at risk of developing various complications of hydatid disease with atypical imaging findings and these are rarely described in the literature. In this pictorial review, the imaging features of local complications of hydatid disease involving the thorax including intrapulmonary or pleural rupture, infection of the ruptured cysts, reactions of the adjacent tissues, thoracic wall invasion and iatrogenic involvement of pleura are described. Additionally, imaging characteristics of transdiaphragmatic thoracic involvement of hepatic hydatid disease are presented. To prevent the development of subsequent catastrophic results, all radiologists need to be aware of the atypical imaging appearances of complications of pulmonary hydatid disease.

Enlarged atomic force microscopy scanning scope: novel sample-holder device with millimeter range

We propose a homemade sample-holder unit used for nanopositionning in two dimensions with a millimeter traveling range. For each displacement axis, the system includes a long range traveling stage and a piezoelectric actuator for accurate positioning. Specific electronics is integrated according to metrological considerations, enhancing the repeatability performances. The aim of this work is to demonstrate that near-field microscopy at the scale of a chip is possible. For this we chose to characterize highly integrated optical structures. For this purpose, the sample holder was integrated into an atomic force microscope. A millimeter scale topographical image demonstrates the overall performances of the combined system.

Utility of intraoperative frozen section examination in thoracic surgery. A review of 721 cases

AIM

Intraoperative frozen section examination (FSE) is an important tool for determining how extensive a surgical procedure needs to be. In this study we reviewed the indications for FSE, the correlation between FSE and postoperative histopathology, and the contribution of intraoperative FSE in determining the extent of the surgical procedure.

METHODS

A total of 744 FSE performed in 721 patients between January 1995 and January 2004 were reviewed retrospectively. The FSE were divided into 7 groups according to the indications of the request for frozen section. False positivity and false negativity were evaluated.

RESULTS

The indications for FSE included intraoperative diagnosis of pulmonary masses (311, 41.8%), determination of N2 status with mediastinoscopy and mediastinotomy (153, 20.6%), staging of pulmonary carcinomas during the operation (86, 11.6%), assessment of the margin of bronchial surgical resection following pulmonary resection (54, 7.2%), presence of solitary pulmonary nodules (75, 10.1%), presence of mediastinal masses (39, 5.2%), and pleural thickening (26, 3.5%). When compared to postoperative paraffin sections, FSE was found to have a 1.9% (8) rate of false negatives and a 0.2% (1) rate of false positives (P < 0.001).

CONCLUSIONS

Intraoperative FSE in thoracic surgery is a rather reliable method. When FSE indicates malignancy, it is a valuable guide in directing the extent of the ongoing surgical procedure. However, when FSE indicates a benign lesion, surgeons should interpret this in the light of the patient's clinical and radiological features and the lesion's macroscopic nature when deciding how extensive an operation needs to be.

Surgical treatment of pulmonary hydatid cysts in children

OBJECTIVE

Hydatid disease is a parasitosis and endemic in many sheepraising areas; it is still an important health problem in Turkey. We report our experience with childhood hydatid cyst and discuss the concepts of treatment.

METHODS

The clinical courses of 128 children with thoracic and liver hydatid cyst operated on from 1994 to 2000 were reviewed. The group consisted of 71 boys and 57 girls aged from 8 months to 16 years. Intact cysts were found in 144 patients and ruptured cysts in 68.

RESULTS

In the postoperative course we have encountered 20 perioperative complications in 16 patients. The most common complication was residual pleural space and delayed air leakage, which occurred in 9 patients. There was no early death.

CONCLUSION

Surgery is the treatment of choice for most patients with pulmonary hydatid disease. The aim of surgery is evacuation of the cyst, removal of the endocyst, and management of the residual cavity. Conservative surgical methods that preserve lung parenchyma should be preferred.

Neurogenic tumours of the mediastinum: a report of 60 cases

OBJECTIVES

To analyze retrospectively 60 patients (13 infants and children, 47 adults--21 men and 39 women) with mediastinal neurogenic tumours admitted to Atatürk Centre for Chest Disease and Chest Surgery, Ankara, Turkey between 1988 and 1999. This comprised 21.2% of 283 patients who had surgical operations for all mediastinal masses during the same period.

PATIENTS AND METHODS

The patients ranged from four to 67 years of age. Thirteen patients were younger than 15 years and 47 were 15 years of age or older. Medical records were reviewed for demographic data, clinical presentation, diagnostic investigations, operative procedures, and tumour location and invasion. Postoperative morbidity and mortality were noted as well as long term follow-up. The clinical investigations included chest x-ray and computed tomography of the thorax in all patients, and spinal magnetic resonance imaging and bronchoscopical examination in some. Clinical variables were compared.

RESULTS

The tumours had the following characteristics: 42 (70%) were nerve sheath tumours; 15 (25%) were autonomic ganglion tumours; two (3.6%) were paragangliomas; and one (1.4%) was a malignant peripheral neuroectodermal tumour (Askin's tumour). Nerve cell tumours comprised the majority of tumours in infants and children (nine of 13, 69%), whereas the nerve sheath tumours were most frequent in adults (39 of 47, 83%). There were 48 benign and 12 (20%) malignant tumours when all age groups were considered; the malignancy rate was 61.5% (eight of 13) in children and 8.5% (four of 47, P<0.05) in adults. All patients were operated via a posterolateral thoracotomy. Surgical resection of the tumour was complete in 56 of 60 patients (93.3%). Resection of malignant tumours was grossly incomplete in four cases (four of 12, 33.3%). All benign tumours were totally excised. There were two major complications (respiratory failure and pulmonary emboli) and 14 minor complications in the perioperative period. The mean follow-up period was five years and seven months. Tumours recurred in 5.3% (three of 56) of patients who had a complete resection initially. There were no late deaths related to benign tumours.

CONCLUSIONS

Complete resection of tumours can be performed safely by a thoracotomy approach and is important for achieving satisfactory long term survival in most mediastinal neurogenic tumours.

Childhood chronic pleural empyema: a continuing surgical challenge in developing countries

BACKGROUND

Surgical treatment may be necessary in childhood chronic pleural empyema.

METHODS

Over a 21-year period 642 children with pleural empyema were hospitalized and 104 of them underwent surgical treatment. The records of the children who underwent surgery for the treatment of empyema were retrospectively reviewed to describe the role, indications, and results of surgical treatment of childhood chronic pleural empyema.

RESULTS

Etiologic diseases or conditions leading to empyema were pneumonia in 69 patients, tuberculosis in 13, hydatid cyst in eight, postpneumonectomy empyema in five, and other causes in nine patients. Indications for surgery were severe pleural thickening in 54 cases (51.9%), trapped lung in 36 cases (34.6%), loculated empyema in eight cases (7.7%) and broncho-pleural fistula in six cases (5.8%). Operations performed were decortication in 90 patients, pulmonary resection and decortication in seven, muscle flap closure in five, and pneumonectomy in two. Success rates in the treatment of nonspecific and tuberculous empyema were 93% and 54%, respectively.

CONCLUSIONS

Surgical treatment is still necessary in childhood pleural empyema in developing countries, and success rates are very high in nonspecific pleural empyema and acceptable in tuberculous pleural empyema.

Mediastinal cystic lymphangioma: report of two cases

Cystic lymphangioma is an extremely rare mediastinal benign tumor characterized by congenitally enlarged lymphatic vessels. It is often diagnosed incidentally because it is only symptomatic when it grows to be very large. We present two cases of mediastinal cystic lymphangioma and review the literature.

Pleurectomy/decortication for palliation in malignant pleural mesothelioma: results of surgery

OBJECTIVE

Surgery can only offer palliation in an attempt to slow the progression of malignant pleural mesothelioma (MPM). We want to assess the effectiveness and safety of pleurectomy/decortication in establishing a tissue diagnosis, and controlling pleural fluid accumulation and symptoms in patients with MPM.

METHODS

We reviewed our pleurectomy results in 100 patients with MPM over a 19 year period. Major symptoms were chest pain, cough and dyspnea, and radiographic findings included pleural mass, pleural fluid and constriction of involved hemithorax.

RESULTS

Approximately two thirds of the patients underwent surgery prior to tissue diagnosis. Eighty-nine patients had stage I and stage II disease, 8 and 81%, respectively. The patients underwent subtotal (44%) or total pleurectomy (56%). The surgical mortality rate was 1% (1/100) and the morbidity rate was 22%. Morbidity included prolonged air leak (n = 12), empyema (n = 6), reaccumulation of pleural fluid (n = 2) and wound infection (n = 2). Palliative results included dyspnea and cough relief in all patients, chest relief in 60 (85%) and pleural fluid control in 52 (96%) patients. Median survival was 17 months in MPM patients.

CONCLUSIONS

We conclude that pleurectomy/decortication safely provides both tissue diagnosis and effective of pleural effusion and symptoms and therefore excellent palliation in patients with MPM.

The effects of hemodialysis on duodenal and gastric mucosal changes in uremic patients

From March 1992 to July 1992, 30 uremic patients (15 dialysed, 15 non-dialysed) and 15 non-uremic patients who had dyspeptic complaints were compared in terms of gastric and duodenal diseases. Gastritis and duodenitis graded as I, II and III were not found different in three groups (p > 0.05). Although the incidence of peptic ulcer disease is very high in both groups of uremic patients in comparison with the controls, there was no significant difference between two uremic groups (p > 0.05). Also the prevalence of gastritis determined histologically was not different in dialysed and non-dialysed uremic patients (p > 0.05). The incidence of the histologically proven gastritis was found higher in uremic patients than in non-uremic patients (p < 0.05). But, there were no significant differences among the three groups with regard to the rate of histologically proved duodenitis (p > 0.05). Gastrin levels, urea positivity, the incidence of gastritis and duodenitis and peptic ulcers did not differ in both uremic groups. However, these values were found significantly high in the uremic patients when compared to non-uremics. These findings showed serum gastrin levels, H.-pylori-infection, gastritis and duodenal disease in the uremic patients to be higher than those of the control group. Moreover, no effect of hemodialysis treatment on these results was observed.

[Incidence of oral candidiasis in diabetic patients]

Yeast infections play an important role in diabetics. Therefore poorly controlled diabetics and diabetics who have high levels of serum glucose carry a high risk. In the present study, 52 diabetics aged between 17-75 years old have been investigated by means of the incidence of oral candida and have been compared with control group of 33 healthy individuals. In poorly controlled diabetics, the rate of candida growth found high. It is also observed that this ratio is higher in type I than type II, and candida growth rate increased as well as serum glucose level. All of these results are found to be statistically important.

[Meningococcal meningitis in adults]

The clinical and laboratory findings, and the results of treatment of 16 Meningococcal meningitis cases, who were hospitalized, are investigated, and discussed with the literature. On application all of the patients had headache, meningeal irritation findings, and fever (% 75), nausea and vomiting (% 62.5), rash (% 56.25), unconsciousness (% 50), coma state (% 31.25), Herpes labialis (% 31.25), affecting of cranial nerves (% 12.5), arthritis (% 12.5), and carditis (% 6.25). At the peripheric blood examinations, all had leucocytosis, and neutrophilia. In the direct examination of the cerebrospinal-fluid, in 15 patients gram negative diplococci were seen, and in 11 patients the microorganisms grew on culture. The patients were given Crystalized-Penicillin in doses of 20-30 million IU/day. In the two cases some complications, resistance, and allergy developed, so the treatment changed. Only a patient died, and in the other cases no relapse and sequel were seen.