The Prognostic Significance of Eukaryotic Translation Initiation Factors (eIFs) in Endometrial Cancer

Whilst the role of eukaryotic translation initiation factors (eIFs) has already been investigated in several human cancers, their role in endometrial cancer (EC) is relatively unknown. In the present retrospective study, 279 patients with EC (1180 samples) were included (mean age: 63.0 years, mean follow-up: 6.1 years). Samples were analysed for expression of 7 eIFs subunits (eIF2α, eIF3c, eIF3h, eIF4e, eIF4g, eIF5, eIF6) through immunohistochemistry and western blotting. Fifteen samples of healthy endometrium served as controls. Density and intensity were assessed and mean combined scores (CS) calculated for each patient. Upon immunohistochemistry, median eIF5 CS were significantly higher in EC as compared with non-neoplastic tissue (NNT, p < 0.001), whilst median eIF6 CS were significantly lower in EC (p < 0.001). Moreover, eIF5 (p = 0.002), eIF6 (p = 0.032) and eIF4g CS (p = 0.014) were significantly different when comparing NNT with EC grading types. Median eIF4g CS was higher in type II EC (p = 0.034). Upon western blot analysis, eIF4g (p < 0.001), peIF2α (p < 0.001) and eIF3h (p < 0.05) were significantly overexpressed in EC, while expression of eIF3c was significantly reduced in EC as compared with NNT (p < 0.001). The remaining eIFs were non-significant. Besides tumour stage (p < 0.001) and patient’s age (p < 0.001), high eIF4g CS-levels were independently associated with poor prognosis (HR: 1.604, 95%CI: 1.037–2.483, p = 0.034). The other eIFs had no prognostic significance. Notably, the independent prognostic significance of eIF4g was lost when adding tumour type. Considering the difficulties in differentiating EC type I and II, eIF4g may serve as a novel prognostic marker indicating patient outcome.

Clinical and Biological Significance of ESR1 Gene Alteration and Estrogen Receptors Isoforms Expression in Breast Cancer Patients

The amplification of estrogen receptor alpha (ERα) encoded by the ESR1 gene has been described as having a prognostic role in breast cancer patients. However, increased dosage of the ESR1 gene (tested by real-time PCR) is also observed in ER-negative breast cancers, which might suggest the expression of alternative isoforms of ERα (other than classical ERα of 66 kDa). In the current work, we have investigated the ESR1 gene dosage in 402 primary breast cancer patients as well as the expression of ERα isoforms—ERα66 and ERα36—on mRNA and protein levels. The obtained results were correlated with clinicopathological data of the patients. Results showed that increased ESR1 gene dosage is not related to ESR1 gene amplification measured by fluorescent in situ hybridization (FISH), but it correlates with the decreased expression of ERα66 isoform (p = 0.01). Interestingly, the short ER isoform ERα36 was expressed in samples with increased ESR1 gene dosage, suggesting that genomic aberration might influence the expression of that particular isoform. Similarly to ESR1 increased gene dosage, high ERα36 expression was linked with the decreased disease-free survival of the patients (p = 0.05), which was independent of the status of the classical ERα66 level in breast tumors.

Sensitive detection of caspase-3 enzymatic activities and inhibitor screening by mass spectrometry with dual maleimide labelling quantitation

There is a great need to develop sensitive and specific methods for quantitative analysis of caspase-3 activities in cell apoptosis.

An Epidermal Growth Factor Receptor Intron 1 Polymorphism in Healthy Women in Poland

The frequency of CA allele combinations was assessed in healthy women from Poland and compared to previously published polymorphism data of individuals from Germany and a Caucasian reference group. There were close similarities between these three geographically and ethnically similar populations. By contrast, the distribution of these alleles in European and Asian (Japan) populations proved to be different. There might therefore be major ethnic differences in allelic frequencies of EGFR intron 1 polymorphism. Our results provide new data on EGFR microsatellite instability and may contribute to the understanding of EGFR gene expression regulation. The clinical relevance of these findings warrants further evaluation.

Epidemiological Analysis of Mycobacterium tuberculosis Strains Isolated from Patients of Small Communities Living in the South-East of Poland

The diversity of Mycobacterium tuberculosis clinical isolates, collected from a single hospital, was analyzed by ligation-mediated PCR techniques: FLiP and FLAP, and hybridization technique, IS6110-RFLP. The isolated strains were divided in terms of location (3 towns of Podkarpackie voivodeship differing in population size) and relationship (8 members of 4 families, each represented by 2 patients). Within each family identical DNA profiles, as well as drug resistance patterns were identified indicating a great chance of transmission of strains within the same family. Identical, or very similar patterns were also shared by strains isolated from unrelated patients living in a very small town (1 200 inhabitants) or hospitalized in the same place and time.

PCR melting profile as a tool for outbreak studies of Salmonella enterica in chickens

BACKGROUND

Salmonellosis is of great economic concern in all phases of the poultry industry, from production to marketing, leading to severe economic losses. Monitoring the source of the bacterial contamination has fundamental importance in the spreading of salmonellosis.

RESULTS

We applied a ligation-mediated PCR method, PCR MP (PCR melting profile), to type S. enterica ssp. enterica ser. Enteritidis (56 strains) and 43 control strains classified to other serovars isolated from poultry. We demonstrated the PCR MP potential for salmonellosis spreading monitoring. Our rapid test presents higher discriminatory power (0.939 vs. 0.608) compared to current molecular subtyping tool such as pulsed-field gel electrophoresis (PFGE), which ineffectiveness underlies the high degree of clonality of S. Enteritidis.

CONCLUSIONS

PCR MP was found to be a highly discriminating, sensitive and specific method that could be a valuable molecular tool, particularly for analyzing epidemiological links of limited number of S. enterica ser. Enteritidis strains.

Epidemiological Analysis of Mycobacterium tuberculosis Strains Isolated from Patients of Small Communities Living in the South-East of Poland

The diversity of Mycobacterium tuberculosis clinical isolates, collected from a single hospital, was analyzed by ligation-mediated PCR techniques: FLiP and FLAP, and hybridization technique, IS6110-RFLP. The isolated strains were divided in terms of location (3 towns of Podkarpackie voivodeship differing in population size) and relationship (8 members of 4 families, each represented by 2 patients). Within each family identical DNA profiles, as well as drug resistance patterns were identified indicating a great chance of transmission of strains within the same family. Identical, or very similar patterns were also shared by strains isolated from unrelated patients living in a very small town (1 200 inhabitants) or hospitalized in the same place and time.

Are bilateral breast cancers and breast cancers coexisting with ovarian cancer different from solitary tumors? A pair-matched immunohistochemical analysis aimed at intrinsic tumor phenotype

Patients with bilateral breast cancer (BBC) and breast-ovarian cancer syndrome (BOCS) constitute populations potentially enriched for molecular defects involved in the pathomechanisms of these malignancies. The aim of our study was to compare tumor morphology and expression of estrogen and progesterone receptor, HER2, Ki67, cytokeratin 5/6, E-cadherin, vimentin and epidermal growth factor receptor in tissue microarrays from 199 tumors from BBC or BOCS patients and 199 age-matched solitary tumors. Compared to controls, BBC and BOCS considered jointly had lower incidence of DCIS, lower expression of PgR and HER2, and higher expression of Ki67 and vimentin. BOCS tumors were of higher grade, had lower expression of ER and PgR and higher expression of Ki67, CK5/6, vimentin and EGFR. BBC had less DCIS component, lower HER2 expression and higher Ki67 expression. Metachronous BBC (mBBC) had lower expression of ER, PgR and HER2, and higher expression of Ki67 and vimentin. Synchronous BBC (sBBC) had less DCIS component, higher expression of ER, and lower expression of CK5/6, EGFR and E-cadherin. BBC and breast cancers in BOCS differ in many aspects from solitary tumors. BBC are a heterogeneous group of tumors, differing between sBBC and mBBC. mBBC phenotype shares many features with BOCS tumors.

Abstract P6-06-30: Are synchronous and metachronous bilateral breast cancers different? An immunohistochemical analysis aimed at intrinsic tumor phenotype

Background: The biology and pathomechanism of bilateral breast cancers is not fully understood: the risk of developing second (metachronous) breast cancer is 4-6 times higher than that of first primary in general population, whereas for synchronous breast cancers the number of cases is about 100 times higher than could be expected by chance alone. We compared the morphological and immunohistochemical characteristics of primary synchronous (sBBC) vs. metachronous (mBBC) bilateral breast cancers), with special focus on intrinsic tumor phenotype.

Methods: Tumor morphology and expression of 8 immunohistochemical markers were assessed in tissue microarrays containing primary breast tumor cores from 113 mBBC and 61 sBBC. Analyzed markers included hormone receptors (estrogen receptor, progesterone receptor), HER2, Ki67, cytokeratin 5/6, E-cadherin, vimentin and epidermal growth factor receptor. Surrogate intrinsic phenotypes were determined according to St Gallen 2011 criteria.

Results: mBBChad higher incidence of ductal histology (p = 0.037), lower estrogen receptor expression (p = 0.047), and higher expression of cytokeratin 5/6 (p = 0.017) and of vimentin (p = 0.008); in multivariate analysis only vimentin retained the significance (p = 0.01). Ten (13%) and 11 (26%) of mBBCand sBBC, respectively, had luminal A phenotype, 39 (50%) and 15 (36%) were luminal B HER2-negative, 13 (17%) and 12 (28%) - luminal B HER2-positive, 3 (4%) and 2 (5%) - HER2-positive (not luminal), and 12 (16%) and 2 (5%) had triple negative phenotype (p = 0.07).

Characteristics of mBBC and sBBCFeaturemBBC (%)sBBC (%)p valueDuctal histology98 (87)47 (77)0.037Grade 346 (41)17 (28)0.09Extensive intraductal component26 (23)18 (29)0.42Strong ER expression73 (67)48 (81)0.047Strong PR expression55 (49)38 (63)0.07HER2 positivity (2+, 3+)51 (46)29 (50)0.6Ki76 ≤14%24 (22)21 (35)0.06Surrogate intrinsic phenotype   luminal A10 (13)11 (26) luminal B HER2-39 (50)15 (36) luminal B HER2+13 (17)12 (28)0.07triple negative12 (16)2 (5) HER2+ (non luminal)3 (4)2 (5) CK5/6 &gt;10%28 (26)6 (11)0.017Vimentin &gt;10%25 (23)4 (7)0.008E-cadherin (+)88 (83)49 (83)0.99EGFR (+)35 (32)11 (19)0.07

Conclusion: mBBC, compared to sBBC, are characterized by more aggressive phenotype, expressed by lower expression of estrogen receptor and stronger expression of cytokeratin /6 and vimentin; this does not, however, translate into substantial differences in the proportion of intrinsic tumor phenotypes.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-30.

IS6110-based differentiation of Mycobacterium tuberculosis strains

In this study, 62 Mycobacterium tuberculosis strains were characterized by fast ligation-mediated PCR (FLiP) and, previously performed, IS6110 restriction fragment length polymorphism (RFLP). FLiP proved a reproducible and specific method for differentiation between M. tuberculosis strains. The discriminatory power of FLiP was close to that of the reference IS6110 RFLP suggesting its usefulness in studying the genetic diversity of M. tuberculosis strains.

Application of FLiP method for differentiation of Mycobacterium tuberculosis strains in comparison to commonly used methods, spoligotyping and MIRU-VNTR typing

The current "gold standard" in molecular epidemiological studies of Mycobacterium tuberculosis is IS6110 RFLP based on IS6110 polymorphism. However PCR-based methods are becoming increasingly important. Recently, fast ligation-mediated PCR (FLiP), based on IS6110 polymorphism was proposed. In this study, the discriminatory power of FLIP, spoligotyping and MIRU-VNTR typing, in differentiation of M. tuberculosis isolates was compared. The discriminatory index (HGI) of spoligotyping, MIRU-VNTR analysis, and FLiP was 0.653, 0.837, and 0.917, respectively. This indicates that FLiP allows a high level of differentiation among M. tuberculosis strains and it might be a valuable alternative to the other typing methods.

Clinical evaluation of developed PCR-based method with hydrolysis probes for TOP2A copy number evaluation in breast cancer samples

OBJECTIVES

The objective of this study was to develop a new real time PCR-based method for quantitative detection of topoisomerase II alpha (TOP2A) aberrations and to evaluate its clinical utility in breast cancer.

DESIGN AND METHODS

The method applied dually labelled hydrolysis probes and Pfaffl quantification method. The study group consisted of 83 consecutive breast cancer patients.

RESULTS

In the examined tumour samples median TOP2A gene dosage was 1.08 (range 0.34-7.55). TOP2A amplifications were found in 12 tumours (14.5%), no deletion was detected. Statistically significant positive correlation of TOP2A gene dosage with nodal status, tumour grade, and HER2 protein status was found. TOP2A status also correlated with disease free survival.

CONCLUSIONS

The newly developed real time PCR assay showed to be fast and easy to perform. Determined by the method TOP2A gene dosage was shown to be a potent prognostic factor in breast cancer.

Genetic evaluation of relationship between mutations in rpoB and resistance of Mycobacterium tuberculosis to rifampin

Background

Rifampin is a first line antituberculosis drug active against bacilli in logarithmic and stationary phase, which interferes with RNA synthesis by binding to bacterial RNA polymerase. Tubercle bacilli achieve resistance to rifampin by accumulation of mutations in a short-81 bp region of the rpoB gene. Among many mutations identified in the rpoB gene, few were verified by molecular genetic methods as responsible for resistance to rifampin (RMP).

Results

In this study eight different mutations identified in an 81 bp section of a "hot spot" region of the rpoB gene of RMP resistant Mycobacterium tuberculosis clinical strains were evaluated in respect to drug resistance. It was found that: mutations in positions 526 (H/D), 516 (D/V) and 531 (S/L) result in high level resistance to rifampin; mutations in positions 516 (D/Y), 515 (M/I), 510 (Q/H) or a double mutation in codons 512 (S/I) and 516 (D/G) relate to low level of resistance. Gene rpoB carrying mutations in codon 513 (Q/L) introduced into an M. tuberculosis laboratory strain did not cause resistance to rifampin, however the same gene introduced into two different clinical strains did, with the level of resistance depending on the host strain.

Conclusion

Mutations in an 81 bp "hot spot" region of the rpoB of M. tuberculosis lead to different levels of resistance to rifampin. Some mutations in this "hot spot" region of rpoB require a specific genetic background for the host strain to develop resistance to rifampin. Therefore, the identification of such mutations in a clinical M. tuberculosis strain is not enough to classify the given strain as resistant to rifampin.

Gene copy numbers of HER family in breast cancer

AIM

The aim of the study was to analyze the occurrence of abnormal gene copy numbers of all HER oncogenes and to correlate these alterations to other clinicopathological variables in a consecutive series of 225 breast cancer patients.

METHODS

Gene copy number of HER oncogenes was analyzed with double differential polymerase chain reaction (ddPCR). Statistical analysis was performed with a set of nonparametric tests.

RESULTS

Sixty-five percent of the tumors contained abnormal gene copy number of at least one HER oncogene. Alterations of at least two oncogenes were found in 31% of cases. The correlations between average gene copy numbers (AGCNs) of particular HER oncogenes were much stronger in node positive compared to node-negative tumors. Deletions of EGFR were associated with the lack of steroid hormone receptors. The HER3 and HER4 amplifications were more common in well differentiated tumors.

CONCLUSIONS

Our results indicate a key role of HER heterodimers in tumor progression and confirm earlier data that HER2 is the preferred partner for other HER oncogenes in this process. Deletions of EGFR were associated with unfavorable characteristics, whereas HER3 and HER4 amplifications may be linked with less aggressive phenotypes.

(CA)n Microsatellite polymorphism of ERBB-1 in breast cancer

The aim of this study was to determine polymorphism of repeated sequences (CA)(n) in the ERBB-1 gene. The study group included 197 breast cancer patients and 180 healthy women. DNA was isolated from fresh-frozen tumour tissue and from peripheral blood. ERBB-1 (CA)(n) microsatellite polymorphism was examined by polymerase chain reaction (PCR). A polymorphic simple sequence repeat region of 9-23 CA repeats was detected in both groups. Homozygotes comprised 22% and 34% of breast cancer patients and controls, respectively (P=0.009). An allelic imbalance (AI), mostly in the shorter allele, was found in 27% of breast cancer patients. AI occurrence was associated with the lack of oestrogen receptors in tumour cells (P=0.05); otherwise, there were no correlations between histoclinical features and (CA)(n) microsatellite polymorphism of ERBB-1. It was concluded that an allelic imbalance is a common feature in breast cancer patients and may coincide with the lack of oestrogen receptors in tumour cells. The clinical relevance of ERBB-1 microsatellite polymorphism in breast cancer remains to be established.

The diverse signaling network of EGFR, HER2, HER3 and HER4 tyrosine kinase receptors and the consequences for therapeutic approaches

The HER family of receptor tyrosine kinase couples binding of extracellular growth factor ligands to intracellular signal transduction pathways, contributing in this fashion to the ability of the cell to respond correctly to its environment. The HER family and its ligands are critically involved in the carcinogenesis of the mammary gland. Abnormal function of the members of HER family resulting in receptor hyper-activation (due to gene amplification, protein overexpression or abnormal transcriptional regulation) has been linked with breast cancer prognosis. It is also extensively studied as the predictive factor and target for therapy. There are clinical indications supporting the concept that none of the receptors: EGFR, HER2, HER3 and HER4 can be considered as the stand-alone receptor in breast cancer development and clinical course of the disease. There is a growing body of evidence that cooperation between them contributes to more aggressive tumor phenotype and influences the response to therapy. This underlines the importance of quantification of all HER family members and indicates the urgent need for implementation of methods that can efficiently and reliably examine four HER receptors as a whole panel in breast cancer patients.

An epidermal growth factor receptor intron 1 polymorphism in healthy women in Poland

The frequency of CA allele combinations was assessed in healthy women from Poland and compared to previously published polymorphism data of individuals from Germany and a Caucasian reference group. There were close similarities between these three geographically and ethnically similar populations. By contrast, the distribution of these alleles in European and Asian (Japan) populations proved to be different. There might therefore be major ethnic differences in allelic frequencies of EGFR intron 1 polymorphism. Our results provide new data on EGFR microsatellite instability and may contribute to the understanding of EGFR gene expression regulation. The clinical relevance of these findings warrants further evaluation.

An epidermal growth factor receptor intron 1 polymorphism in healthy women in Poland

The frequency of CA allele combinations was assessed in healthy women from Poland and compared to previously published polymorphism data of individuals from Germany and a Caucasian reference group. There were close similarities between these three geographically and ethnically similar populations. By contrast, the distribution of these alleles in European and Asian (Japan) populations proved to be different. There might therefore be major ethnic differences in allelic frequencies of EGFR intron 1 polymorphism. Our results provide new data on EGFR microsatellite instability and may contribute to the understanding of EGFR gene expression regulation. The clinical relevance of these findings warrants further evaluation. (Int J Biol Markers 2005; 20: 184-8).

Modified direct-double-differential PCR for gene dosage quantification of HER2

HER2 amplification and/or overexpression in breast cancer are adverse prognostic factors and can predict the response to trastuzumab therapy. As assessment of HER2 status in breast cancer is of great importance for clinical decision-making, it is crucial to have reliable methods to quantify HER2. In the present project, we have developed a modification of the direct-double-differential PCR method (dddPCR) for gene dosage quantification of HER2 in breast cancer samples. The study was also undertaken to establish the potential application of the newly developed dddPCR method for HER2 testing in a diagnostic laboratory. The dddPCR validity for determining HER2 amplification in comparison to IHC-based HercepTest for the detection of protein levels was performed. Modified dddPCR was proven to be highly reproducible and reliable. A statistically significant correlation between protein expression and gene dosage of HER2 was found in the examined material. The obtained results indicate that dddPCR provides a fast and reliable diagnostic tool for HER2 quantification and may be considered as a supplementary method to verify equivocal results obtained with IHC-based HercepTest. Notably, dddPCR can be performed in every basic molecular biology laboratory, and is inexpensive and time-saving.

Posterior capsule opacification after phacoemulsification in patients with postoperative steroidal and nonsteroidal treatment

PURPOSE

To evaluate the effect of dexamethasone, diclofenac, and a placebo given for 3 weeks after phacoemulsification and intraocular lens (IOL) implantation on the formation of posterior capsule opacification (PCO).

SETTING

St. Erik's Eye Hospital, Stockholm, Sweden.

METHODS

In a 2-year prospective randomized double-blind study, a laser flare meter was used to measure aqueous flare intensity preoperatively and 3 days, 2 weeks, and 2 years after phacoemulsification and IOL implantation. Posterior capsule opacification was evaluated 2 years postoperatively using retroillumination images taken with a Scheimpflug camera. The Evaluation of Posterior Capsule Opacification system was used to score the areas of PCO density.

RESULTS

The median rate of PCO 2 years after phacoemulsification was 0.72 (range 0.32 to 1.57) in the dexamethasone group, 0.78 (range 0.19 to 2.14) in the diclofenac group, and 0.70 (range 0.35 to 1.70) in the placebo group. The differences were not statistically significant (P>.05; Kruskal-Wallis analysis of variance, multiple comparisons). The rate of neodymium:YAG laser posterior capsulotomy during the 2 years after surgery was not statistically different between groups (P>.05, chi-square test). There was no correlation (Spearman rank coefficient) between laser flare measurements and PCO formation in any group during the study (P>.05).

CONCLUSION

Topical instillation of diclofenac, dexamethasone, or a placebo in the immediate period after phacoemulsification and IOL implantation did not seem to influence the formation of PCO 2 years after cataract surgery.

Gene copy numbers of erbB oncogenes in human pheochromocytoma

ErbB-1, -2, -3 and -4 proteins are growth factor receptors, encoded by the family of respective erbB protooncogenes. These receptor-encoding proto-oncogenes frequently undergo amplification, and less frequently, a deletion, in several human neoplasms. The role of the ErbB family in human endocrine neoplasms, including pheochromocytoma (PHEO), was not extensively tested and not previously established. The expression/overexpression of erbB oncogenes in pheochromocytoma tissue was determined only in a few cases, and to the best of our knowledge, their mutations (amplification or deletion) were not examined in any series of PHEO cases. We, therefore, used a double differential polymerase chain reaction (ddPCR) for determination of the amplification/deletion profiles of erbB-1, -2, -3 and -4 genes in formalin-fixed, paraffin embedded (FFPE) specimens of human PHEOs. We examined the average gene copy number (AGCN) of the genes in 36 samples of pheochromocytomas (2 extra-adrenal and 34 adrenal tumors). We found the mean AGCNs of the oncogenes equal 1.18 for erbB-1 [amplification was found in 11/35 cases (31%) and deletion in 6/35 cases (17%)], 2.00 for erbB-2 [amplification was found in 8/34 cases (24%), no deletion was found], 1.36 for erbB-3 [amplification was found in 4/36 cases (11%) and deletion in 1/36 cases (3%)], and 1.22 for erbB-4 [amplification was found in 5/30 cases (17%) and deletion in 1/30 cases (3%)]. A mutation(s) of any erbB oncogene was found in 25/36 (69%) samples tested. Some abnormalities of the erbB oncogenes showed interesting correlations with one another and with clinical features of the tumors. The frequent occurrence of amplifications and deletions of the erbB oncogenes in human pheochromocytoma implies the importance of the gene family in the development of these tumors.

p53 Gene status in relation to ex vivo chemosensitivity of non-small cell lung cancer

PURPOSE

About 40% of non-small cell lung cancer (NSCLC) patients are candidates for systemic chemotherapy, despite the fact that at diagnosis most NSCLC are usually chemoresistant both in vivo and ex vivo. It is important to develop sufficient methods of prediction of the response to chemotherapy and to find molecular markers that may prognose this response. Therefore, a study on the relationship of p53gene status to the ex vivo chemosensitivity of primary human NSCLC was performed.

METHODS

Three drug combinations (carboplatin/etoposide, cyclophosphamide/etoposide/epirubicin, and paclitaxel/carboplatin) were tested in a modified ATP cell viability assay. A group of 28 cases of primary human NSCLC was assessed.

RESULTS

Ex vivo chemosensitivity testing showed that tumors with p53 mutations were significantly more resistant to the cyclophosphamide/etoposide/epirubicin regimen than with normal p53 gene ( P = 0.012). However, no correlation was observed for two other treatment regimens.

CONCLUSION

Mutations in the p53gene can lead to enhanced chemoresistance, confirming the hypothesis that the p53 gene may serve as a marker of tumor response to treatment in NSCLC. However, the data also illustrate that some additional factors might contribute to drug resistance of the examined tumors.

Contact-activated migration of melanoma B16 and sarcoma XC cells

During migration, tumour cells interact with neighbouring neoplastic and normal host cells, and such interaction may influence their motile activity. We investigated the effect of homotypic collisions on the motile activity of two tumour cell lines, mouse melanoma B16 and rat sarcoma XC, and nontransformed human skin fibroblasts. It was found that the tumour cells show only limited motile activity when moving as single cells without contact with neighbours. At a higher density of the culture (and also at a greater number of cell to cell contacts) the activation of motility of investigated tumour cells was observed. On the other hand, the normal human skin fibroblasts showed a typical reaction of density-dependent inhibition of motility. The motile activity of tumour cells was not affected by conditioned media and was visibly dependent on a direct physical contact among colliding cells. The activation of cell movement was observed about 40-50 min after the initial contact between tumour cells. Contact-activated migration of neoplastic cells was inhibited by 50 microM verapamil (a selective voltage-gated calcium channel inhibitor) and 10 microM gadolinium chloride (a nonspecific blocker of mechanosensitive ion channels) but not by pertussis toxin. The observation that homotypic collisions among tumour cells strongly increase their motile activity suggests that contact-activated migration may play a significant role in tumour invasion and metastasis.

The suitability of DNA extracted from formalin-fixed, paraffin-embedded tissues for double differential polymerase chain reaction analysis

Formalin-fixed, paraffin-embedded (FFPE) tissues are one of the popular sources of diagnostic materials, the easiest to store and transport. They are often used as the source of nucleic acids for retrospective molecular analyses based on DNA amplification by polymerase chain reaction (PCR). However, it is known that nucleic acids from paraffin-embedded tissues are much worse templates than those recovered from fresh tissues. It is exceptionally important in a quantitative analysis, including double differential PCR (ddPCR). Therefore, a pilot study comparing quantity and quality of DNA extracted with various paraffin removal and DNA isolation procedures from FFPE tissues was conducted. Furthermore, the suitability of DNA isolated with optimized procedure for the assessment of erbB-2 average gene copy number (AGCN) was checked. Specimens for comparison of extraction and isolation procedures were generated from the same human normal thyroid tissue embedded in paraffin to eliminate variabilities in tissue processing and sample size. Three procedures of paraffin removal and three procedures of DNA extraction from deparaffinized tissue were compared. Only one procedure provided DNA, which was efficiently amplified in ddPCR. The material obtained with this optimized procedure was used to check the precision of ddPCR by evaluation of AGCN of erbB-2 oncogene. Low variability of obtained results close to expected AGCN value (AGCN=1) indicates high reproducibility of the method, as well as its high accuracy, if the normal value of erbB-2 AGCN in the examined tissue is assumed.

The effect of phenylephrine on pain and flare intensity in eyes with uveitis

PURPOSE

To investigate the influence of protein concentration in the anterior chamber, measured by laser flare meter, on pain sensation after phenylephrine instillation in patients with iridocyclitis.

METHODS

Twenty-five consecutive patients with iridocyclitis were included. Patients with cataract, exfoliation syndrome, diabetes mellitus, glaucoma or any other previous ocular diseases or ocular surgery were excluded. Patients were divided into two groups: Group 1--without fibrinoid reaction (FR) in the anterior chamber (18 patients), and Group 2--with FR (7 patients). Protein concentration in the anterior chamber was measured with laser flare meter (FC 500, Kowa Co., Japan). Pupil size was measured by Alcon Tilo Scale, and pain sensation was estimated by Visual Analogue Scale (VAS, Kabi Pharmacia). All measurements were done before and 1 hour after topical instillation of 10% phenylephrine hydrochloride into the subconjunctival sac of the inflamed eyes.

RESULTS

Eyes with iridocyclitis and fibrinoid reaction (FR) have a higher flare intensity compared to those without FR (p<0.05). Pupil size was significantly increased after phenylephrine instillation in both study groups (Wilcoxon test, p<0.05). The VAS pain and flare intensity were significantly decreased in group without FR after phenylephrine instillation (Group 1) compared to values before treatment (Wilcoxon test, p<0.05). In eyes with FR (Group 2), no significant influence of phenylephrine instillation was found on VAS pain and flare intensity.

CONCLUSIONS

After phenylephrine instillation, flare intensity and pain were significantly decreased only in eyes with iridocyclitis and without FR. The decreasing level of flare intensity, and paralysis of the pupil after phenylephrine instillation seem to alleviate pain in those eyes.

Visual outcome after phacoemulsification and IOL implantation in diabetic patients

AIMS

To follow visual acuity (VA) and progression of diabetic retinopathy (DR) after phacoemulsification in diabetic patients with different stages of DR and controls.

METHODS

This prospective study included 27 diabetic patients with no or mild to moderate non-proliferative DR; 25 patients with moderate to severe non-proliferative, or proliferative DR; and 22 non-diabetic controls. All patients underwent uncomplicated, phacoemulsification surgery, with implantation of a heparin-surface modified (HSM) poly(methylmethacrylate) (PMMA) intraocular lens (IOL) into the capsular bag. Colour fundus photographs and fluorescein angiograms (FA) were taken at 1 week (baseline), 3 months, and 1 year postoperatively to determine stability or progression of DR.

RESULTS

The VA of 46 diabetic eyes (88%), was improved 1 year after surgery and only six eyes (12%) were unchanged or worse. 41 diabetic eyes (79%) achieved a VA of 0.5 or better and 11 eyes (21%) had a final VA lower than 0.5. Significantly lower final corrected VA was found 1 year after surgery in eyes with advanced DR (median 0.5; range 0.1-1.0) compared with controls (1.0; 0.1-1.0) and eyes with no or mild to moderate DR (1.0; 0.1-1.0). Eyes with mild to moderate DR and clinically significant macular oedema (CSMO) 1 week postoperatively had a lower final VA than those without CSMO. Angiographic cystoid macular oedema (CMO) was detected with FA in 15% of all diabetic eyes 1 week postoperatively. 41 eyes (79%) showed no change or improvement of the retinal status 1 year after cataract surgery. Progression was found in 11 eyes (21%), mainly in eyes with mild to moderate DR and moderate to severe DR. Eyes with an indication for laser photocoagulation at baseline showed a significantly higher rate of progression of DR after surgery than those without indication for laser treatment.

CONCLUSION

The final visual outcome was improved in the majority of diabetic eyes. Eyes with CSMO at the time of surgery had the worst prognosis regarding postoperative VA.

Aqueous flare intensity in relation to different stages of diabetic retinopathy

PURPOSE

To compare laser flare intensity in patients with diabetes mellitus (DM) type I and type II to different stages of diabetic retinopathy (DR) and controls.

METHODS

This study comprised 88 consecutive patients with DM type I and 40 controls in the same age range, divided into two age groups: 20-34 years and 35-50 years; 108 consecutive patients with DM type II and 32 controls were also divided into two age groups: 45-59 years and 60-75 years. Patients with glaucoma, exfoliation syndrome, media opacities, uveitis, within 96 hours after laser photocoagulation, treatment with topical and systemic drugs which can affect aqueous protein concentration, were excluded. One eye was randomly selected from each diabetic patient and control. Flare intensity was measured with a laser flare meter without mydriatic drops, and was then correlated with the stages of DR within each age group.

RESULTS

Eyes with advanced DR, such as moderate-severe, severe non-proliferative DR and proliferative DR (PDR), had significantly higher flare intensity than controls and eyes without retinopathy in all age groups (p<0.05). Flare intensity values were similar for controls and eyes with mild-moderate DR in all age groups except the older patients with DM type II, particularly those with clinically significant macular edema (CSME) (p<0.05). Eyes with regressed proliferative DR and no indication for laser photocoagulation had significantly lower flare values than eyes with an indication for therapy (p<0.05). Eyes with iris rubeosis (IR) had significantly higher flare than those without IR (p<0.05). Flare values were significantly correlated with the duration of diabetes in DM types I and II (p<0.05).

CONCLUSIONS

Flare intensity was increased in eyes with mild-moderate DR with CSME, and in eyes with advanced and severe stages of DR. Aqueous flare was related to the duration of diabetes.

X-ray microanalytical and morphological observations of aqueous humor from cataract human eyes with and without diabetes mellitus

This study was conducted to determine the elemental composition of the aqueous humor in cataract human eyes, with and without diabetes mellitus. The aqueous humor was obtained during cataract surgery from 11 patients with diabetes mellitus and 11 controls. Droplets of aqueous humor, after air-drying on carbon plates, were analyzed by X-ray microanalysis. Before surgery, the protein concentration in the anterior chamber was measured with a laser flare meter. Flare intensity was significantly higher in eyes with diabetes mellitus than in controls (p < 0.05). The X-ray microanalytical results showed that the relative sulfur content in the aqueous humor was significantly higher in the diabetic eyes than in the controls (p < 0.05). The content of elements representing the mobile ions in the aqueous humor, i.e., Na, Cl, K, and Ca was similar in both studied groups. We conclude from these data that the high sulfur content in aqueous humor of diabetic eyes may be related to a higher level of proteins found in the humor in these eyes.

Posterior capsule opacification after phacoemulsification in patients with diabetes mellitus

PURPOSE

To compare posterior capsule opacification (PCO) after phacoemulsification and implantation of heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) in the capsular bag in patients with diabetes mellitus with that in a control group.

SETTING

St. Erik's Eye Hospital, Stockholm, Sweden.

METHODS

This prospective study comprised 26 patients with diabetes mellitus and 26 control patients without diabetes. Those with glaucoma, exfoliation syndrome, uveitis, and pupil size smaller than 6.0 mm after dilation were excluded. All patients received the same standardized phacoemulsification procedure with implantation of an HSM PMMA IOL in the capsular bag. Posterior capsule opacification was scored 1 and 2 years after surgery by evaluating retroillumination images taken with a Scheimpflug camera (Nidek Anterior Eye Segment Analysis System) after pupil dilation with phenylephrine 10% and cyclopentolate 1%. The PCO density behind the IOL optic was graded clinically from 0 to 4 (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe) and scored using the Evaluation of Posterior Capsule Opacification medical software developing system.

RESULTS

No differences in PCO were found between the diabetic and control groups 1 year after surgery. The total PCO score was significantly less in diabetic than in control eyes 2 years after surgery (P < .05, Mann-Whitney). In addition, progression of PCO from 1 year to 2 years after surgery was significantly less in diabetic groups with different stages of diabetic retinopathy than in the control group (P < or = .05, Kruskal-Wallis analysis of variance and multiple comparisons).

CONCLUSION

The rate of PCO after phacoemulsification was statistically significantly lower in patients with diabetes mellitus than in those without diabetes.

Posterior continuous curvilinear capsulorhexis and postoperative inflammation

PURPOSE

To evaluate the influence of posterior continuous curvilinear capsulorhexis (PCCC) on inflammation after phacoemulsification and implantation of a foldable silicone intraocular lens (IOL) in the capsular bag.

SETTING

St. Erik's Eye Hospital, Stockholm, Sweden.

METHODS

Fifty patients were enrolled in this prospective, randomized study. Eyes with diabetes mellitus, glaucoma, uveitis, exfoliation syndrome, other previous ocular diseases, or an axial length greater than 26.0 mm were excluded. One group comprised 25 eyes of 25 patients (median age 76 years) in which phacoemulsification and implantation of a silicone IOL in the capsular bag were performed. The other group consisted of 25 eyes of 25 patients (median age 77 years) who received the same surgical procedure in addition to PCCC. The aqueous protein concentration was measured using a laser flare meter (FC 500, Kowa Co.) preoperatively and 1 day, 1 week, and 1 and 3 months after surgery.

RESULTS

Surgical trauma significantly increased aqueous flare values 1 day, 1 week, and 1 month after surgery in both groups (P < .05). Three months postoperatively, flare values in both groups were not different from preoperative values. No difference between the 2 groups was found in flare intensity measurements or in best corrected visual acuity before and after uneventful surgery. The incidence of postoperative clinical cystoid macular edema was 8% (2 eyes) in the control group and 4% (1 eye) in the group with PCCC.

CONCLUSION

Postoperative flare intensity after phacoemulsification with PCCC and implantation of a foldable silicone IOL was not significantly different than postoperative flare measurements in a control group.

The effect of phenylephrine and pilocarpine on pupil size and aqueous flare intensity in patients with diabetes mellitus

PURPOSE

The aqueous flare intensity and pupillary size were studied before and after instillation of 10% phenylephrine and 4% pilocarpine in eyes with diabetes mellitus (DM).

METHODS

Twenty-three patients with DM type I were compared with 30 age-matched controls, and 25 patients with DM type II were compared with 30 age-matched controls. Patients with DM were divided into two groups: 1) with mild-moderate nonproliferative diabetic retinopathy (NPDR), and 2) with advanced diabetic retinopathy (DR) which includes moderate-severe, severe NPDR and proliferative DR. The aqueous flare intensity and the horizontal diameter of the pupil were measured before and 60 minutes after topical instillation of 10% phenylephrine and 60 min after topical administration of 4% pilocarpine.

RESULTS

Degree of induced mydriasis after phenylephrine instillation was not significantly different between diabetic groups and controls. Significantly less pronounced miosis was observed after stimulation of cholinergic receptors by pilocarpine in eyes with mild-moderate NPDR with DM type II and in eyes with advanced DR with DM type I and type II when compared to controls (p<0.05). Phenylephrine decreased flare intensity in all groups without a significant difference between groups. Pilocarpine instillation increased flare intensity in all groups as compared to flare intensity before any treatment. Also, a significantly smaller increase in flare intensity in eyes with advanced retinopathy in both DM type I and type II was found when compared to controls (p<0.05).

CONCLUSION

Pharmacological response to cholinergic stimulation on pupil size and flare intensity is weaker in advanced stages of DR.

Aqueous flare intensity after phacoemulsification in patients with diabetes mellitus

PURPOSE

To prospectively compare the postoperative blood-aqueous barrier breakdown induced by phacoemulsification and implantation of a heparin-surface-modified poly(methyl methacrylate) intraocular lens in the capsular bag in eyes with different stages of diabetic retinopathy (DR) and a control group.

SETTING

St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden.

METHODS

Aqueous flare intensity was measured preoperatively and 1 day, 1 week, and 3 months postoperatively in 21 nondiabetic control patients (Group 1), 20 diabetic patients with no or mild-moderate nonproliferative DR (Group 2), and 19 diabetic patients with advanced DR (moderate-severe, severe nonproliferative, and proliferative DR) who were divided into groups: without clinically significant macular edema (CSME), 7 eyes (Group 3), and with CSME, 12 eyes (Group 4).

RESULTS

Before surgery, flare intensity in Group 4 was significantly higher than in Groups 1 and 2 (P < .05). Surgical trauma increased flare values 1 day postoperatively in all groups. One week after surgery, Groups 1 and 4 had flare intensity significantly higher than preoperatively (P < .05). Recovery of flare occurred 3 months postoperatively in all groups except Group 2, in which it occurred 1 week after surgery. One day postoperatively, only Group 4 had significantly higher flare than Group 1 (P < .05). One week and 3 months after surgery, Group 4 had significantly higher flare intensity than Groups 1 and 2 (P < .05). The duration of phacoemulsification in Groups 2 and 4 was significantly longer than in Group 1 (P < .05). Operating time was significantly longer than in Group 1 only in Group 4 (P < .05).

CONCLUSION

Eyes with advanced stages of DR and with CSME had the highest flare intensity after cataract surgery.

Cataract surgery and pupil size in patients with diabetes mellitus

PURPOSE

Constriction of the pupil during phacoemulsification and intraocular lens (IOL) implantation in patients with diabetes mellitus was studied.

METHODS

Before surgery a combination of 0.75% cyclopentolate and 2.5% phenylephrine was applied topically to the eyes of 32 patients with diabetes mellitus and 25 age-matched controls. Epinephrine was mixed with buffered saline solution and used during the surgery. The surgical procedure included capsulorhexis, phacoemulsification in the posterior chamber and implantation into the capsular bag of a heparine surface-modified poly(methyl metacrylate) IOL with an optic diameter of 5.0 mm. The durations of phacoemulsification and the whole surgical procedure were recorded. Measurements of the horizontal pupillary diameter were taken before surgery, after phacoemulsification and at the end of the surgery.

RESULTS

There was no significant difference in pupil size between controls and the diabetic group before the operation. Surgically induced miosis after phacoemulsification and at the end of operation were significantly more pronounced in the diabetic group than in controls (p < 0.05) (p < 0.05). Phacoemulsification and the entire surgical procedure took significantly longer time when performed in the diabetic eyes (p < 0.05) (p < 0.05).

CONCLUSION

We conclude from these data that constriction of the pupil during cataract surgery is more pronounced in diabetic eyes as compared to controls.

[Lensectomy in treatment of traumatic cataracts]

Results of pars plana lensectomy (36 cases) and ab externo lensectomy (14 cases) were presented. Intra- and postoperative complications, and the advantages of these procedures in traumatic cataracts were discussed. It was established that both procedures improved the visual acuity in the majority of patients although pars plana lensectomy had slightly lower rate of complications.