1
|
Baiocchi GC, Vojdani A, Rosenberg AZ, Vojdani E, Halpert G, Ostrinski Y, Zyskind I, Filgueiras IS, Schimke LF, Marques AHC, Giil LM, Lavi YB, Silverberg JI, Zimmerman J, Hill DA, Thornton A, Kim M, De Vito R, Fonseca DLM, Plaça DR, Freire PP, Camara NOS, Calich VLG, Scheibenbogen C, Heidecke H, Lattin MT, Ochs HD, Riemekasten G, Amital H, Shoenfeld Y, Cabral-Marques O. Cross-sectional analysis reveals autoantibody signatures associated with COVID-19 severity. J Med Virol 2023; 95:e28538. [PMID: 36722456 DOI: 10.1002/jmv.28538] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with increased levels of autoantibodies targeting immunological proteins such as cytokines and chemokines. Reports further indicate that COVID-19 patients may develop a broad spectrum of autoimmune diseases due to reasons not fully understood. Even so, the landscape of autoantibodies induced by SARS-CoV-2 infection remains uncharted territory. To gain more insight, we carried out a comprehensive assessment of autoantibodies known to be linked to diverse autoimmune diseases observed in COVID-19 patients in a cohort of 231 individuals, of which 161 were COVID-19 patients (72 with mild, 61 moderate, and 28 with severe disease) and 70 were healthy controls. Dysregulated IgG and IgA autoantibody signatures, characterized mainly by elevated concentrations, occurred predominantly in patients with moderate or severe COVID-19 infection. Autoantibody levels often accompanied anti-SARS-CoV-2 antibody concentrations while stratifying COVID-19 severity as indicated by random forest and principal component analyses. Furthermore, while young versus elderly COVID-19 patients showed only slight differences in autoantibody levels, elderly patients with severe disease presented higher IgG autoantibody concentrations than young individuals with severe COVID-19. This work maps the intersection of COVID-19 and autoimmunity by demonstrating the dysregulation of multiple autoantibodies triggered during SARS-CoV-2 infection. Thus, this cross-sectional study suggests that SARS-CoV-2 infection induces autoantibody signatures associated with COVID-19 severity and several autoantibodies that can be used as biomarkers of COVID-19 severity, indicating autoantibodies as potential therapeutical targets for these patients.
Collapse
Affiliation(s)
- Gabriela C Baiocchi
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Aristo Vojdani
- Immunosciences Laboratory, Inc., Department of Immunology, Los Angeles, California, USA.,Cyrex Laboratories, Phoenix, Arizona, USA
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Gilad Halpert
- Ariel University, Ariel, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Saint Petersburg State University Russia, St Petersburg, Russia
| | - Yuri Ostrinski
- Ariel University, Ariel, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Saint Petersburg State University Russia, St Petersburg, Russia
| | - Israel Zyskind
- Department of Pediatrics, NYU Langone Medical Center, New York, New York, USA.,Maimonides Medical Center, Brooklyn, New York, USA
| | - Igor S Filgueiras
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lena F Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Alexandre H C Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lasse M Giil
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Yael B Lavi
- Department of Chemistry Ben Gurion University Beer-Sheva, Beer-Sheva, Israel
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, USA
| | | | | | | | - Myungjin Kim
- Data Science Initiative at Brown University, Providence, Rhode Island, USA
| | - Roberta De Vito
- Department of Biostatistics and the Data Science Initiative at Brown University, Providence, Rhode Island, USA
| | - Dennyson L M Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Desireé R Plaça
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, São Paulo, Brazil
| | - Paula P Freire
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Niels O S Camara
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Vera L G Calich
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Carmen Scheibenbogen
- Institute for Medical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Harald Heidecke
- CellTrend Gesellschaft mit beschränkter Haftung (GmbH), Luckenwalde, Germany
| | - Miriam T Lattin
- Department of Biology, Yeshiva University, Manhatten, New York, USA
| | - Hans D Ochs
- Department of Pediatrics, University of Washington School of Medicine, and Seattle Children's Research Institute, Seattle, Washington, USA
| | - Gabriela Riemekasten
- Department of Rheumatology, University Medical Center Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Howard Amital
- Ariel University, Ariel, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Saint Petersburg State University Russia, St Petersburg, Russia
| | - Otavio Cabral-Marques
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of Sao Paulo (USP), Sao Paulo, Brazil.,Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, São Paulo, Brazil.,Department of Pharmacy and Postgraduate Program of Health and Science, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine, Baltimore, USA.,Laboratory of Medical Investigation 29, University of São Paulo School of Medicine, São Paulo, Brazil
| |
Collapse
|
2
|
Iorgulescu JB, Ferris S, Agarwal A, Casavilca Zambrano S, Hill DA, Schmidt R, Perry A. Non-meningothelial meningeal tumours with meningioangiomatosis-like pattern of spread. Neuropathol Appl Neurobiol 2018; 44:743-746. [PMID: 29495087 DOI: 10.1111/nan.12481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/22/2018] [Indexed: 01/14/2023]
Affiliation(s)
- J B Iorgulescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S Ferris
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - A Agarwal
- Department of Pathology, Mercy Hospital, St. Louis, MO, USA
| | - S Casavilca Zambrano
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - D A Hill
- Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - R Schmidt
- Division of Neuropathology, Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA
| | - A Perry
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
3
|
Abstract
The first eight to ten TEmnp resonances have been identified in one large (6.1 X 7.3 X 13.0 m) and one small (1.0 X 0.6 X 2.0 m) TEM cell. The resonant frequencies fit a new equivalent coaxial box model with the effective length of the box depending on the mode. Weakly propagating TEmn modes were also detected at frequencies above their respective first-resonance frequencies. A biological body or metal box at the center of the test zone interacts strongly with the TE10p and TE11p resonances, but not with the TE01p resonances. These interactions cause bandwidth limitations in the use of TEM cells for bioeffects dosimetry studies, EMC testing, and probe calibration work.
Collapse
|
4
|
Friend SC, Royce ME, Kang H, Lomo L, Barry M, Wiggins C, Prossnitz E, Hill DA. Abstract P1-09-05: Survival disparities: Quality of care apparently not the answer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: In New Mexico (NM), Hispanic women have a 1.6-fold increased risk of breast cancer-specific death compared to non-Hispanic white women. In previous studies, race/ethnic minority women have been less likely to receive recommended adjuvant treatments, including radiation in women undergoing breast conservation, and hormonal therapy.
Objective: To determine whether non-receipt of recommended therapies contributed to disparate survival.
Methods: We conducted a case-cohort study of breast-cancer-specific survival within a population-based cohort of first invasive breast cancer diagnosed in white females from 1997-2009 in six NM counties, identified through Surveillance Epidemiology End Results (SEER). We selected fifteen percent of all women diagnosed with breast cancer and all breast cancer deaths. After IRB approval, data were collected from comprehensive medical chart reviews, supplemented by SEER information. Receipt of standard of care, vs. not, was defined based on age, diagnosis year and tumor characteristics, according to changes in treatment guidelines. Women who had a reported contraindication or refused therapy were omitted from assessment of quality of care for that therapy. Cox proportional hazards models for case-cohort were conducted using weighted estimates, with calculation of robust variance and hazard ratios (HR) and 95% confidence intervals (CI), using an alpha level of .05. Analyses were restricted to women of age 70 or less who survived at least 12 months. The proportional hazards assumption was verified by Schoenfeld residuals. All analyses were adjusted for age.
Results: Comprehensive medical records reviews were completed for 91% of eligible women (674 cohort members, 519 breast cancer deaths; median follow up 7.8 years). All others were omitted from analysis. Of women eligible for guideline-based treatment, receipt of guideline-appropriate therapy did not differ by Hispanic ethnicity for any treatment, and Hispanic women were slightly more likely overall to receive appropriate therapy (difference not significant). Among guideline-eligible women, at least 91% received radiotherapy, 78% received chemotherapy, 82% received endocrine therapy, and 89% received anti-HER2 targeted agents. After adjustment for other treatment, lack of receipt of guideline-appropriate therapy was related to an increased risk of breast cancer death for endocrine (HR 1.76; 95% CI 1.09-2.84) and radiation therapy (HR 2.05; 95% CI 1.14-3.69). The few HER2-positive women not treated precluded further assessment. After accounting for endocrine and radiation therapy the survival disparity HR of 1.6 in Hispanic women was reduced to 1.57 suggesting only 2% of the disparity was due to differences in receipt of these treatments.
Conclusion: Limitations include likely undercounts of appropriate therapy, thus proportions cited are minimal estimates. Appropriate therapy includes only documented receipt as therapy completion could not always be assessed. Hispanic women have a disproportionately higher breast cancer mortality despite apparently receiving adjuvant therapies to a similar degree as non-Hispanic white women. Equalizing standard of care and attempting to reduce treatment disparities may not be sufficient to address the disproportionate mortality in Hispanic women.
Citation Format: Friend SC, Royce ME, Kang H, Lomo L, Barry M, Wiggins C, Prossnitz E, Hill DA. Survival disparities: Quality of care apparently not the answer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-05.
Collapse
Affiliation(s)
- SC Friend
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - ME Royce
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - H Kang
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - L Lomo
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - M Barry
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - C Wiggins
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - E Prossnitz
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| | - DA Hill
- Cancer Research and Treatment Center and School of Medicine, University of New Mexico, Albuquerque, NM; University of New Mexico, Albuquerque, NM
| |
Collapse
|
5
|
Cajaiba MM, Khanna G, Smith EA, Gellert L, Chi YY, Mullen EA, Hill DA, Geller JI, Dome JS, Perlman EJ. Pediatric cystic nephromas: distinctive features and frequent DICER1 mutations. Hum Pathol 2015; 48:81-7. [PMID: 26772403 DOI: 10.1016/j.humpath.2015.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/24/2015] [Indexed: 12/21/2022]
Abstract
Cystic nephromas (CNs) are uncommon benign renal neoplasms that present with a bimodal age distribution, affecting either infants/young children or adult females. Although differences between these age groups have been suggested, large studies of pediatric CN have not been conducted. As a result, the nomenclature and diagnostic criteria for these lesions remain controversial. In addition, the morphological overlap seen between CN and cystic partially differentiated nephroblastoma (CPDN) can result in diagnostic dilemmas. This study reviews the morphologic and radiographic features of 44 pediatric CN prospectively enrolled on a Children's Oncology Group protocol from 2007 to 2013. Although the typical multicystic architecture with thin septa described in adult CN was present in all of our pediatric cases, differences were also identified. We report distinctive features that add to the morphological spectrum of CN in children. Of the 44 cases, 16 had been previously analyzed and reported for DICER1 mutation, and either loss of function or missense mutations or both were identified in 15 of 16. In contrast, we analyzed 10 cases of adult CN, and all were negative for DICER1 mutations; similarly, 6 CPDNs previously analyzed and reported were negative for DICER1 mutations. Therefore, the clinical, morphological, and genetic differences between pediatric and adult CN, as well as between CN and CPDN, suggest that these 3 lesions represent distinct entities.
Collapse
Affiliation(s)
- Mariana M Cajaiba
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL 60611.
| | - Geetika Khanna
- Department of Radiology, Washington University School of Medicine, St Louis, MO 63110
| | - Ethan A Smith
- Departrment of Radiology, University of Michigan Health System, Ann Arbor, MI 48109
| | - Lan Gellert
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Yueh-Yun Chi
- Department of Biostatistics, University of Florida, Gainesville, FL 32611
| | - Elizabeth A Mullen
- Department of Pediatric Oncology, Children's Hospital Boston/Dana-Farber Cancer Institute, Boston, MA 02115
| | - Dana A Hill
- Department of Pathology, Children's National Medical Center, Washington, DC 20010
| | - James I Geller
- Division of Pediatric Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229
| | - Jeffrey S Dome
- Division of Pediatric Oncology, Children's National Medical Center, Washington, DC 20010
| | - Elizabeth J Perlman
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL 60611
| |
Collapse
|
6
|
Pugh TJ, Yu W, Yang J, Field AL, Ambrogio L, Carter SL, Cibulskis K, Giannikopoulos P, Kiezun A, Kim J, McKenna A, Nickerson E, Getz G, Hoffher S, Messinger YH, Dehner LP, Roberts CWM, Rodriguez-Galindo C, Williams GM, Rossi CT, Meyerson M, Hill DA. Exome sequencing of pleuropulmonary blastoma reveals frequent biallelic loss of TP53 and two hits in DICER1 resulting in retention of 5p-derived miRNA hairpin loop sequences. Oncogene 2014; 33:5295-302. [PMID: 24909177 PMCID: PMC4224628 DOI: 10.1038/onc.2014.150] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 04/13/2014] [Accepted: 04/14/2014] [Indexed: 01/21/2023]
Abstract
Pleuropulmonary blastoma is a rare childhood malignancy of lung mesenchymal cells that can remain dormant as epithelial cysts or progress to high-grade sarcoma. Predisposing germline loss-of-function DICER1 variants have been described. We sought to uncover additional contributors through whole exome sequencing of 15 tumor/normal pairs, followed by targeted resequencing, miRNA analysis and immunohistochemical analysis of additional tumors. In addition to frequent biallelic loss of TP53 and mutations of NRAS or BRAF in some cases, each case had compound disruption of DICER1: a germline (12 cases) or somatic (3 cases) loss-of-function variant plus a somatic missense mutation in the RNase IIIb domain. 5p-Derived microRNA (miRNA) transcripts retained abnormal precursor miRNA loop sequences normally removed by DICER1. This work both defines a genetic interaction landscape with DICER1 mutation and provides evidence for alteration in miRNA transcripts as a consequence of DICER1 disruption in cancer.
Collapse
Affiliation(s)
- T J Pugh
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - W Yu
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - J Yang
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - A L Field
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - L Ambrogio
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S L Carter
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - K Cibulskis
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - A Kiezun
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - J Kim
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - A McKenna
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - E Nickerson
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - G Getz
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S Hoffher
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - Y H Messinger
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - L P Dehner
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO, USA
| | - C W M Roberts
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
- Dana-Farber/Children's Cancer Center, Boston, MA, USA
| | - C Rodriguez-Galindo
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
- Dana-Farber/Children's Cancer Center, Boston, MA, USA
| | - G M Williams
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - C T Rossi
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
| | - M Meyerson
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - D A Hill
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| |
Collapse
|
7
|
Gerone PJ, Hill DA, Appell LH, Baron S. Inhibition of respiratory virus infections of mice with aerosols of synthetic double-stranded ribonucleic Acid. Infect Immun 2010; 3:323-7. [PMID: 16557972 PMCID: PMC416150 DOI: 10.1128/iai.3.2.323-327.1971] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aerosols of double-stranded complexes of polyinosinic and polycytidylic acids (poly I:C) were useful in protecting mice infected with aerosols of influenza (A(2)/Taiwan/64) and parainfluenza type 1 (Sendai) viruses. Administration of poly I:C as an aerosol offers an advantage, particularly in therapy, by eliminating the risk of pulmonary dissemination of viral infections due to intranasally instilled fluids. Treatment of mice with aerosols of poly I:C reduced the infection rate with influenza virus but did not inhibit virus multiplication in the lungs of most of those animals where infection became established. Sendai virus infection rates were undiminished in mice treated with poly I:C, but lung-virus titers were significantly suppressed as compared with those of untreated animals. The maximum poly I:C doses (40 mug) administered by aerosol produced no evidence of toxicity in the mice.
Collapse
Affiliation(s)
- P J Gerone
- Biological Sciences Laboratories, Fort Detrick, Frederick, Maryland 21701
| | | | | | | |
Collapse
|
8
|
Wilburn EE, Mahan DC, Hill DA, Shipp TE, Yang H. An evaluation of natural (RRR-alpha-tocopheryl acetate) and synthetic (all-rac-alpha-tocopheryl acetate) vitamin E fortification in the diet or drinking water of weanling pigs. J Anim Sci 2007; 86:584-91. [PMID: 18156353 DOI: 10.2527/jas.2007-0377] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Three experiments conducted with weanling pigs evaluated the effects of vitamin E added to the drinking water or diet on plasma and tissue alpha-tocopherol concentrations. When natural or synthetic vitamin E was used, it was added at an IU-equivalent basis, but natural vitamin E was 73.5% (mg basis) of the synthetic vitamin E. Experiment 1 used 18-d-old weanling pigs (n = 120) in a 3 x 2 factorial arrangement of treatments in a randomized complete block design with 4 replicates. The first factor evaluated the dietary levels of natural vitamin E (RRR-alpha-tocopheryl acetate) added at 0, 50, or 300 IU/kg, whereas the second factor was the natural vitamin E added to the drinking water at 0 or 100 IU/L. Pigs were bled at periodic intervals, and 1 pig per pen was killed at the end of the 21-d trial and tissues (liver, heart, lung, and loin) were collected for alpha-tocopherol analysis. When vitamin E was not added to the diet or water, plasma alpha-tocopherol declined over the 21-d period. Although there were some interactions (P < 0.01), tissue and plasma alpha-tocopherol concentrations increased linearly when vitamin E was added to the diet or water. Experiment 2 was a 3 x 2 factorial in a randomized complete block design with 4 replicates. A total of 96 pigs weaned at 18 d of age, with an initial BW of 6.2 kg, were fed a nonvitamin E fortified diet, but natural or synthetic (all-rac-alpha-tocopheryl acetate) vitamin E was added to their drinking water at 50, 100, or 150 IU/L. Pigs were bled at 0, 3, 7, 10, 14, and 21 d postweaning, with tissues (liver, lung, heart, and loin) collected for alpha-tocopherol analysis at d 21. The results indicated that plasma alpha-tocopherol concentrations increased (P < 0.01) as vitamin E increased, with greater tissue alpha-tocopherol concentrations (P < 0.01) when natural vitamin E was provided. Experiment 3 was conducted in 2 replicates, but pigs (n = 60) were not provided vitamin E in the diet or water for 7 d postweaning, and then natural or synthetic vitamin E was added to the drinking water as in Exp. 2 (50, 100, or 150 IU/L). Pigs were bled at 0, 2, 4, 6, 8, 10, and 24 h after being provided vitamin E to evaluate the absorption from each vitamin E source and level. Plasma alpha-tocopherol increased quadratically (P < 0.01) and plateaued at 8 to 10 h for each treatment group. These results indicate that adding vitamin E to the pig's water supply at weaning was more effective in increasing plasma alpha-tocopherol than when it was added to the diet during the initial 14 d postweaning, and that natural vitamin E was a superior source compared with synthetic vitamin E.
Collapse
Affiliation(s)
- E E Wilburn
- The Ohio State University, The Ohio Agricultural Research and Development Center, Columbus 43210-1095, USA
| | | | | | | | | |
Collapse
|
9
|
Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 2007; 99:461-73. [PMID: 17704089 DOI: 10.1093/bja/aem238] [Citation(s) in RCA: 168] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a frequent and often debilitating event. The lifetime incidence of this condition is estimated to be between 13% and 40%. Fortunately, the majority of cases resolve spontaneously with simple analgesia and physiotherapy. However, the condition has the potential to become chronic and intractable, with major socio-economic implications. This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica. A Medline search was performed to obtain the published literature on the sciatica, between 1966 and 2006. Hand searches of relevant journals were also performed. Epidemiological factors found to influence incidence of sciatica included increasing height, age, genetic predisposition, walking, jogging (if a previous history of sciatica), and particular physical occupations, including driving. The influence of herniated nucleus pulposus and the probable cytokine-mediated inflammatory response in lumbar and sacral nerve roots is discussed. An abnormal immune response and possible mechanical factors are also proposed as factors that may mediate pain. The ongoing issue of the role of epidural steroid injection in the treatment of this condition is also discussed, as well as potential hazards of this procedure and the direction that future research should take.
Collapse
Affiliation(s)
- M A Stafford
- Department of Anaesthesia, Ulster Hospital, Dundonald, Upper Newtownards Road, Belfast BT16 1RH, Ireland
| | | | | |
Collapse
|
10
|
Reese CT, Ntam C, Martin TV, Carrington S, Leotaub J, Cox L, Williams RJ, Hill DA. Internalization of near-infrared fluorescent dyes within isolated macrophage populations. Cell Mol Biol (Noisy-le-grand) 2007; 53:27-33. [PMID: 17531146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Accepted: 03/20/2006] [Indexed: 05/15/2023]
Abstract
The development and application of microsensor technology has enhanced the ability of scientists to further understand various biological activities, such as changes in the intracellular environment after injury or toxic exposure. NIR microsensor technology may be useful in detecting the cellular injuries or adverse changes during the early onset period, allowing for the administration of therapies to initiate recovery. The development and use of Infrared (IR) and near infrared (NIR) dyes as biological micro-sensors due to their advanced spectral characteristics may be helpful. Three of the more useful NIR dye characteristics include the ability to minimize background interference by extraneous biological matrices, the ability to exhibit optimal molar absorptivity and quantum yields, and the ability to maintain normal cellular activity. Thus, the current study was designed to investigate the ability of selected NIR micro-sensor dyes to undergo cellular internalization, demonstrate intracellular NIR fluorescent signaling, and maintain normal cellular activity. The results demonstrate that the selected NIR micro-sensor dyes undergo cellular internalization. The presence of the dyes within the cells did not affect cell viability. In addition, these dyes demonstrate changes in absorbance and fluorescence after the immune cells were challenged with a stimulant. Moreover, critical cellular functions, such as tumor necrosis factor release and superoxide production were not compromised by the internalization of the fluorescent dyes. These data suggest that selected NIR micro-sensor dyes can undergo intracellular internalization within isolated macrophages without adversely affecting various parameters of normal cellular activity.
Collapse
Affiliation(s)
- C T Reese
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD 21251, USA
| | | | | | | | | | | | | | | |
Collapse
|
11
|
|
12
|
Abstract
We compared the analgesic efficacy and safety of remifentanil and pethidine via patient controlled analgesia for women in established uncomplicated labour. Women received either remifentanil 40 microg with a 2-min lockout (n = 20) or pethidine 15 mg with a 10-min lockout (n = 19). Visual analogue scores for pain during the study and for overall pain were similar for both groups (mean (SD) 6.4 (1.5) cm for remifentanil and 6.9 (1.7) cm for pethidine). The area under the curve for visual analogue scores of satisfaction with analgesia was higher for remifentanil than for pethidine (p = 0.001). Maternal arterial oxygen saturation was similar in both groups. Neurologic and Adaptive Capacity Scores at 30 min were higher for remifentanil than for pethidine (median (interquartile range [range]) 36 (34.5-37 [32-39]) vs 34 (33-35 [30-35]), respectively; p = 0.003).
Collapse
Affiliation(s)
- J M Blair
- St. Helier Hospital, Epsom and St. Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK.
| | | | | | | | | |
Collapse
|
13
|
Abstract
Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 micro g.kg-1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg-1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 micro g.kg-1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 micro g.kg-1 were better than in those given remifentanil 1.0 micro g.kg-1 (p < 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 micro g.kg-1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 micro g.kg-1 and in the control group (p < 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 micro g.kg-1 (p < 0.001). In conclusion, remifentanil 2 micro g.kg-1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.
Collapse
Affiliation(s)
- J M Blair
- Department of Anaesthesia, St Helier Hospital, Epsom and St Helier NHS Trust, Wrythe Lane, Carshalton, Surrey UK.
| | | | | | | |
Collapse
|
14
|
Sigurdson AS, Doody MM, Rao RS, Freedman DM, Alexander BH, Hauptmann M, Mohan AK, Yoshinaga S, Hill DA, Tarone R, Mabuchi K, Ron E, Linet MS. #63 Cancer incidence in the u. s. radiologic technologists health study, 1983–1998. Ann Epidemiol 2002. [DOI: 10.1016/s1047-2797(02)00351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
15
|
Hill DA. Influence of linker histone H1 on chromatin remodeling. Biochem Cell Biol 2002; 79:317-24. [PMID: 11467745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Chromatin-remodeling complexes have been a central area of focus for research dealing with accessing cellular DNA sequestered in chromatin. Although the linker histone H1 plays a major role in promoting and maintaining higher-order chromatin structure, it has been noticeably absent from assays utilizing chromatin-remodeling enzymes. This review focuses on two ATP-dependent chromatin-remodeling complexes, Drosophila ISWI and mammalian SWI/SNF, that have been assayed using chromatin templates containing histone H1.
Collapse
Affiliation(s)
- D A Hill
- Department of Cell Biology, University of Massachusetts Medical School, Worcester 01655, USA.
| |
Collapse
|
16
|
Cook JR, Dehner LP, Collins MH, Ma Z, Morris SW, Coffin CM, Hill DA. Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study. Am J Surg Pathol 2001; 25:1364-71. [PMID: 11684952 DOI: 10.1097/00000478-200111000-00003] [Citation(s) in RCA: 422] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal neoplasm with a variable histologic appearance that may mimic other spindle cell processes, particularly nodular fasciitis, desmoid tumor, and in intra-abdominal locations, gastrointestinal stromal tumor. Recently, gene fusions involving ALK at chromosome 2p23 have been described in IMTs. The resultant ALK protein overexpression in the myofibroblastic component of these tumors is detectable by immunohistochemistry. We examined 73 IMTs, 20 cases of nodular fasciitis, 15 desmoid fibromatoses, and 15 gastrointestinal stromal tumors by immunohistochemistry using ALK-11, a rabbit polyclonal antibody that recognizes the C-terminus of the protein. ALK positivity was detected in 44 of 73 (60%) IMTs. All cases of nodular fasciitis, desmoid fibromatosis, and gastrointestinal stromal tumors were ALK negative (p < 0.001). These findings demonstrate that ALK positivity is common in IMTs, and immunohistochemistry using anti-ALK antibodies can be helpful in the differential diagnosis of these neoplasms. In addition, anti-ALK staining seems to correlate with those IMTs that have the typical tri-patterned histologic appearance and clinical presentation, providing additional support to the premise that IMT is a distinctive clinicopathologic entity within the broad category of inflammatory pseudotumors.
Collapse
Affiliation(s)
- J R Cook
- Lauren V. Ackerman Division of Surgical Pathology, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | | | | | | | | |
Collapse
|
17
|
Wyatt-Ashmead J, Kleinschmidt-DeMasters BK, Hill DA, Mierau GW, McGavran L, Thompson SJ, Foreman NK. Rhabdoid glioblastoma. Clin Neuropathol 2001; 20:248-55. [PMID: 11758780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Rhabdoid phenotypic change has been described in a number of different neoplasms from diverse organ sites. These tumors share common light and electron-microscopic features, display a polyphenotypic immunohistochemical profile and often show cytogenetic abnormalities of chromosome 22. In the central nervous system (CNS), most rhabdoid tumors occur in the posterior fossa of very young children and are associated with a primitive neuroectodermal tumor (PNET) component and are designated atypical teratoid/rhabdoid tumors. Infrequently, other rhabdoid tumors of the CNS have been described, including rhabdoid meningiomas and malignant rhabdoid tumors of uncertain histogenesis. Several examples of conventional gliomas displaying significant areas with rhabdoid morphology were also presented in an abstract by Kepes and Moral [1991], although never published in final manuscript form. We now detail the case of an 18-year-old male with an aggressive, supratentorial CNS rhabdoid tumor that was associated with an epithelioid glioblastoma and apparently arose from areas of low-grade glioma. The rhabdoid tumor component was present in the original tumor but became more predominant with each of 3 successive resections. No areas of PNET were identified. Electron microscopy and immunohistochemistry showed features classic for rhabdoid tumors and cytogenetic studies demonstrated multiple tumor clones with monosomy 22. This case documents progressive rhabdoid transformation of a glioma, expands the spectrum of CNS tumor types that can display a rhabdoid phenotype and highlights the diagnostic and therapeutic challenges with this type of tumor.
Collapse
Affiliation(s)
- J Wyatt-Ashmead
- Department of Pathology, The Children's Hospital, Denver, CO, USA
| | | | | | | | | | | | | |
Collapse
|
18
|
Abstract
BACKGROUND Approximately 5-10% of patients with rhabdomyosarcomas (RMS) are diagnosed during the first year of life, and their clinical characteristics have been well documented. However, because RMS rarely occurs during the neonatal period, little is known about neonatal RMS. METHODS Four patients with neonatal RMS were treated at St. Jude Children's Research Hospital between 1962 and 1999. The authors report the results of a review of these patients and of cases described in the literature. Clinical, radiologic, and pathologic features of these patients and their outcomes were evaluated. RESULTS One patient with embryonal RMS was treated successfully with a combination of systemic chemotherapy and local control measures. The other three patients had alveolar RMS. Two of them had multiple skin and subcutaneous metastatic nodules at the time of diagnosis and developed brain metastases early in their course. In one of these patients, the PAX3-FKHR fusion transcript was detected. Three other similar cases of neonatal alveolar RMS with metastases to the skin and brain have been reported in the literature. CONCLUSIONS A distinct syndrome of neonatal RMS is described. This syndrome is characterized by alveolar histology, multiple skin and subcutaneous metastases, and fatal outcome as the result of early brain metastasis.
Collapse
Affiliation(s)
- C Rodriguez-Galindo
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
We have investigated the efficacy and safety of remifentanil in a patient-controlled analgesia device for labour in 21 women. Remifentanil was available in increasing doses (bolus doses 0.25-1.0 microg x kg(-1)) with and without a background infusion (0.025-0.05 microg x kg(-1) x min(-1)). A lockout time of 2 min was used. Thirteen out of 21 (62%) women chose to continue using remifentanil up to and during delivery. Nineteen out of 21 (90%) achieved a reduction in pain score from baseline. Using a VAS of 0-10 cm the median maximum reduction in pain score was 3 cm (range 0-8 cm). There was a significant reduction (P<0.05) from baseline pain scores (median= 8 cm) to scores at bolus doses in the range 0.25-0.5 microg x kg(-1) (median=5 cm). There were no significant reductions in the fetal heart rate. Apgar scores and cord blood gas analyses remained within normal limits. We conclude that a remifentanil patient-controlled analgesia system (bolus doses 0.25-0.5 microg x kg(-1), without a background infusion) may safely provide worthwhile, although incomplete, analgesia for labour.
Collapse
Affiliation(s)
- J M Blair
- Department of Anaesthetics, The Ulster Hospital, Dundonald, Belfast BT16 0RH, UK
| | | | | |
Collapse
|
20
|
Bridge JA, Kanamori M, Ma Z, Pickering D, Hill DA, Lydiatt W, Lui MY, Colleoni GW, Antonescu CR, Ladanyi M, Morris SW. Fusion of the ALK gene to the clathrin heavy chain gene, CLTC, in inflammatory myofibroblastic tumor. Am J Pathol 2001; 159:411-5. [PMID: 11485898 PMCID: PMC1850566 DOI: 10.1016/s0002-9440(10)61711-7] [Citation(s) in RCA: 285] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare, but distinctive mesenchymal neoplasm composed of fascicles of bland myofibroblasts admixed with a prominent inflammatory component. Genetic studies of IMTs have demonstrated chromosomal abnormalities of 2p23 and rearrangement of the anaplastic lymphoma kinase (ALK) gene locus. In a subset of IMTs, the ALK C-terminal kinase domain is fused with a tropomyosin N-terminal coiled-coil domain. In the current study, fusion of ALK with the clathrin heavy chain (CTLC) gene localized to 17q23 was detected in two cases of IMT. One of these cases exhibited a 2;17 translocation in addition to other karyotypic anomalies [46,XX,t(2;17)(p23;q23),add(16)(q24)].
Collapse
Affiliation(s)
- J A Bridge
- Department of Pathology, Center for Human Molecular Genetics, 983135 University of Nebraska Medical Center, Omaha, NE 68198, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Advances in molecular genetic research in the past 2 decades have led to an increased understanding of the genetic events in the pathogenesis and progression of human malignancies, including those of childhood. A number of pediatric malignancies have served as models for the molecular genetic approach to patients with cancer. These have highlighted the utility of molecular analysis for a variety of purposes including diagnosis, risk stratification and treatment planning, understanding of syndromes associated with cancer and genetic screening, genetic counseling and prophylactic treatment including surgery. It is likely that there soon will be individualized treatment regimens based on the molecular biologic profile of a patient's tumor. In addition, molecular profiling will lead to new drug development designed to induce differentiation of tumor cells, block dysregulated growth pathways, or reactivate silenced apoptotic pathways. This review discusses the molecular genetic aspects of some of the more common pediatric tumors as well as tumors whose pathogenetic mechanisms are particularly instructive.
Collapse
Affiliation(s)
- A M Davidoff
- Department of Surgery, St Jude Children's Research Hospital, Memphis, TN 38105, USA
| | | |
Collapse
|
22
|
|
23
|
Abstract
BACKGROUND Although the pathologic features and imaging appearance of childhood primary ovarian neoplasms have been well described, little information is available about the malignancies that may secondarily involve the ovary. OBJECTIVE To determine the relationship between the imaging features and the histopathology of secondary ovarian neoplasms in children treated at our institution. MATERIALS AND METHODS We searched our institutional database for codes indicating metastatic ovarian disease. Of the 35 patients with such codes, 18 had pathologically proven secondary ovarian disease. From their medical records we recorded demographic data, presenting symptoms, and evidence of endocrine dysfunction. We reviewed the pre-oophorectomy imaging and the subsequent pathologic specimens. RESULTS One-third of the patients had bilateral pelvic masses; another third had large masses indistinguishable from the ovaries. Twelve (67%) had either ascites, peritoneal implants, matted bowel, adenopathy, pleural effusions, or some combination of these. Five (28%) had other metastatic disease. Primary tumors included colon adenocarcinoma (9), Burkitt's lymphoma (3), alveolar rhabdomyosarcoma (3), Wilms' tumor (1), neuroblastoma (1), and retinoblastoma (1). CONCLUSION Although rare, secondary ovarian tumors should be considered in the differential diagnosis of children with ovarian masses. Bilateral ovarian masses or large masses indistinguishable from the ovaries, particularly in the presence of other metastatic foci, may help distinguish primary from secondary ovarian malignancies.
Collapse
Affiliation(s)
- M B McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, TN 38105-2794, USA.
| | | | | | | |
Collapse
|
24
|
Eudey AA, Hill DA, Muroyama Y. Are Japanese macaques threatened by neuroscience research? Nat Neurosci 2001; 4:335. [PMID: 11276212 DOI: 10.1038/85954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
25
|
Abstract
Metastatic osteosarcoma most commonly affects the lungs and other bones. Hepatic metastasis at the time of diagnosis is extremely rare. A 14-year-old boy with synovial sarcoma of the left popliteal fossa was treated with surgical resection, radiotherapy for microscopic residual disease, and 1 year of chemotherapy (vincristine, cyclophosphamide, dactinomycin, and doxorubicin). Approximately 10 years after the initial diagnosis, a secondary osteosarcoma developed in the left proximal tibia. Computed tomography at presentation showed bilateral pulmonary metastases and large ossified nodules in the liver that demonstrated abnormal avidity on 99mTc MDP bone scan indicating hepatic metastasis. Despite chemotherapy (cisplatin, ifosfamide, high-dose methotrexate, and dacarbazine), the patient died of progressive disease 4 months after the diagnosis of the second cancer. Hepatic metastasis was found at the time of diagnosis of a secondary osteosarcoma and manifested as ossified nodules. The risk of radiation-induced osteosarcoma should always be considered in decisions about treatment for soft-tissue sarcoma.
Collapse
Affiliation(s)
- N C Daw
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, and the University of Tennessee, Memphis, College of Medicine, Memphis, Tennessee, USA.
| | | | | | | | | |
Collapse
|
26
|
Sarangarajan R, Hill DA, Humphrey PA, Hitchcock MG, Dehner LP, Pfeifer JD. Primitive neuroectodermal tumors of the biliary and gastrointestinal tracts: clinicopathologic and molecular diagnostic study of two cases. Pediatr Dev Pathol 2001; 4:185-91. [PMID: 11178636 DOI: 10.1007/s100240010141] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Primitive neuroectodermal tumor (PNET) is a prototypic malignant small round cell tumor of childhood that is characterized in most cases by t(11;22) resulting in an EWS-FLI1 gene fusion. Once thought to be uncommon, PNET now accounts for almost 20% of malignant soft tissue tumors in children. Increased recognition of PNET is partly due to advances in immunohistochemistry and molecular diagnostics, which have led to the identification of the tumor in non-classical sites. We report the clinical, histologic, immunohistochemical, and molecular findings of two visceral PNETs of the digestive system--one involving the small intestine and the other involving the hepatic duct. Histologically, each tumor was composed of malignant small cells growing in sheets, nests, and lobules; the tumor cells of both cases showed characteristic immunoreactivity for vimentin and O13 (CD99). Reverse transcription-polymerase chain reaction (RT-PCR) analysis for t(11;22) using nested primers was performed with RNA extracted from paraffin-embedded, formalin-fixed tissue and demonstrated an EWS exon 7 to FLI1 exon 5 fusion in both cases, confirmed by Southern blot hybridization and DNA sequence analysis. These results illustrate the expanded clinicopathologic profile of PNET, and demonstrate that visceral PNETs, despite their unusual sites of presentation, maintain the characteristic immunohistochemical and genetic features of PNETs at more conventional sites.
Collapse
MESH Headings
- Adolescent
- Bile Duct Neoplasms/chemistry
- Bile Duct Neoplasms/genetics
- Bile Duct Neoplasms/pathology
- Biomarkers, Tumor/analysis
- DNA Primers/chemistry
- DNA, Neoplasm/analysis
- Female
- Hepatic Duct, Common/pathology
- Humans
- Immunoenzyme Techniques
- Jejunal Neoplasms/chemistry
- Jejunal Neoplasms/genetics
- Jejunal Neoplasms/pathology
- Male
- Neoplasm Proteins/analysis
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Neuroectodermal Tumors, Primitive, Peripheral/chemistry
- Neuroectodermal Tumors, Primitive, Peripheral/genetics
- Neuroectodermal Tumors, Primitive, Peripheral/pathology
- RNA, Neoplasm/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Sequence Analysis, DNA
- Wilms Tumor/pathology
Collapse
Affiliation(s)
- R Sarangarajan
- Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO 63110-1093, USA
| | | | | | | | | | | |
Collapse
|
27
|
McIntyre PG, Hill DA, Appleyard K, Taylor A, Hutchinson S, Goldberg DJ. Prevalence of antibodies to hepatitis C virus, HIV and human T-cell leukaemia/lymphoma viruses in injecting drug users in Tayside, Scotland, 1993-7. Epidemiol Infect 2001; 126:97-101. [PMID: 11293687 PMCID: PMC2869678 DOI: 10.1017/s0950268801005040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The prevalence of blood-borne viruses in injecting drug users (IDUs) in Tayside, Scotland was determined by testing serum samples from IDUs who underwent attributable HIV antibody testing during 1993-7. The prevalence of antibodies to HIV was 29/802, (3.6%); to hepatitis C virus (HCV) 451/691, (65.3%); and to human T-cell leukaemia/lymphoma viruses type 1 and 2 (HTLV) 0/679, (0.0%). The prevalence of HIV and HCV antibodies were higher in subjects over the age of 25 (P = 0.03 and P = 0.001, respectively). During 1993-7 the prevalence of HCV fell only in younger female IDUs (P < 0.01). HIV prevalence has declined dramatically since 1985, when a rate of 40% was recorded in similar populations. Harm reduction measures have failed to control HCV the spread of infection among IDUs in Tayside, as indicated by the high proportion of antibody positive IDUs, particularly males under the age of 25. Future studies should address the nature and effective reduction of continuing risk taking among IDUs in Tayside.
Collapse
Affiliation(s)
- P G McIntyre
- Department of Medical Microbiology, Ninewells Hospital & Medical School, Dundee, UK
| | | | | | | | | | | |
Collapse
|
28
|
Bruch LA, Hill DA, Cai DX, Levy BK, Dehner LP, Perry A. A role for fluorescence in situ hybridization detection of chromosome 22q dosage in distinguishing atypical teratoid/rhabdoid tumors from medulloblastoma/central primitive neuroectodermal tumors. Hum Pathol 2001; 32:156-62. [PMID: 11230702 DOI: 10.1053/hupa.2001.21572] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
It has been postulated that infants with medulloblastomas/central primitive neuroectodermal tumors (MB/PNET) may fare worse than older patients because some of them harbor unrecognized atypical teratoid/rhabdoid tumors (AT/RT), rare intracranial neoplasms that are typically unresponsive to therapy and rapidly fatal. Although small primitive cells are common to both entities, chromosome 22q11.2 deletions are common only in AT/RTs. Using fluorescence in situ hybridization (FISH) on archival, paraffin-embedded biopsy tissue with commercially available probes to 22q11.2, the region associated with RTs, we studied 8 cases of AT/RT, 12 cases of MB/PNET, and 4 cases of primitive central nervous system (CNS) neoplasms, which were difficult to classify. 22q Deletions were identified in 6 of 8 (75%) conventional AT/RTs and 0 of 12 (0%) children with classic MB/PNET. Of the 4 originally "difficult to classify" cases, 3 had deletions of 22q. In light of the FISH results, review of the morphology and immunophenotype resulted in 3 tumors being reclassified as AT/RTs and 1 as a large cell MB. These 4 cases highlight the potential diagnostic use of FISH for selected cases of primitive CNS malignancies in children and substantiate the notion that misdiagnosed AT/RTs may, in part account for the worse prognosis associated with "MB/PNET" in children younger than 2 years of age.
Collapse
Affiliation(s)
- L A Bruch
- Department of Pathology (Neuropathology) and Anatomic Pathology, Washington University School of Medicine, St Louis, MO 63110, USA
| | | | | | | | | | | |
Collapse
|
29
|
Hill DA, Weiss NS, Beresford SA, Voigt LF, Daling JR, Stanford JL, Self S. Continuous combined hormone replacement therapy and risk of endometrial cancer. Am J Obstet Gynecol 2000; 183:1456-61. [PMID: 11120510 DOI: 10.1067/mob.2000.108081] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Postmenopausal women who receive sequential hormone replacement therapy with estrogen combined with progestogen for 10 to 24 d/mo for a prolonged period may have an elevated endometrial cancer risk relative to those who have never received hormone replacement therapy. We investigated whether daily use of estrogen and progestogen (continuous combined hormone replacement therapy) could diminish any excess endometrial cancer risk. STUDY DESIGN A population-based study in Washington State obtained interview data from 969 women aged 45 to 74 years with endometrial cancer diagnosed during 1985 through 1991 or 1994 through 1995 and from 1325 age-matched control subjects selected primarily by random digit dialing. Women who had received only continuous combined hormone replacement therapy were compared with women who had only received another hormone replacement therapy regimen or who had never received hormone replacement therapy. RESULTS The risk of endometrial cancer among users of continuous combined hormone replacement therapy (n = 9 case patients, n = 33 control subjects) relative to women who had never received hormone replacement therapy was 0.6 (95% confidence interval, 0.3-1.3); the risk relative to women who received hormone replacement that included progestogen for 10 to 24 d/mo was 0.4 (95% confidence interval, 0.2-1.1). Most continuous combined hormone replacement therapy use was short-term (<72 months) or recent (in the previous 24 months). CONCLUSION Women who had received continuous combined hormone replacement therapy for several years did not appear to be at any increased risk for endometrial cancer relative to women who had never received hormone replacement therapy and may in fact be at decreased risk for endometrial cancer.
Collapse
Affiliation(s)
- D A Hill
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
The recognition of recurrent genetic alterations in specific tumour types has provided the basis for the reclassification of certain soft tissue neoplasms, and molecular analysis of patient material has the potential to provide both diagnostic and prognostic information. In this review, we evaluate the role of molecular genetic testing as the prospective 'gold standard' for sarcoma diagnosis. Molecular genetic testing, as with every new method, promises to improve accuracy and to be more sensitive and less subjective, claims that have been made previously by histochemistry, electron microscopy and immunohistochemistry. Technical limitations in molecular assays, as well as more general specificity issues, decrease the clinical usefulness of molecular pathological testing significantly and suggest that, at present, molecular evaluation is best considered an ancillary technique that neither supersedes other ancillary techniques nor eclipses traditional pathological examination.
Collapse
Affiliation(s)
- J D Pfeifer
- Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | | |
Collapse
|
31
|
Abstract
Combined spinal-epidural (CSE) for analgesia in labour is widely used as a method of providing pain relief while minimising motor blockade. Aiming to further reduce the associated motor weakness, we investigated the use of alfentanil alone as the initial intrathecal injection in a double-blind study. Thirty women were randomly allocated to receive either alfentanil 0.25 mg with bupivacaine 2.5 mg intrathecally, or alfentanil 0.25 mg in the same volume. Onset of analgesia did not differ significantly between groups but duration was significantly longer in those receiving alfentanil-bupivacaine (mean 55 min vs. 40 min; p < 0.05). Quality of analgesia was satisfactory for all women, although the cumulative analgesia scores were significantly lower in the women receiving the alfentanil-bupivacaine mixture (p = 0.003). More women in the alfentanil-bupivacaine group developed both a sensory level (15/15 vs. 6/15; p < 0.01) and sympathetic block (12/15 vs. 4/15; p < 0.01). Sixty per cent of women receiving the alfentanil-bupivacaine mixture demonstrated an impaired ability to straight leg raise compared with none of the women in the alfentanil-saline group (p < 0.01). The incidence of adverse effects in mother and fetus was similar in both groups. We conclude that intrathecal alfentanil 0.25 mg alone as part of a CSE technique provides rapid analgesia of satisfactory quality without detectable motor blockade.
Collapse
Affiliation(s)
- D A Hughes
- Department of Anaesthetics, The Ulster Hospital, Dundonald, Belfast BT16 1RH, UK
| | | |
Collapse
|
32
|
Hill DA, Chez RA, Quinlan J, Fuentes A, LaCombe J. Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening. J Reprod Med 2000; 45:823-6. [PMID: 11077631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture. STUDY DESIGN We performed a two-year retrospective chart review to determine the incidence of uterine rupture in patients with a previous cesarean delivery undergoing cervical ripening or the induction of labor. RESULTS Uterine dehiscence occurred in 1 and uterine rupture occurred in 3 of 48 women with a prior cesarean delivery treated with 50 micrograms doses of intravaginal misoprostol for cervical ripening. Uterine rupture was found in 1 of 89 women who had an oxytocin infusion for induction of labor and none of the 24 patients who received intravaginal prostaglandin E2 placed for cervical ripening. CONCLUSION Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.
Collapse
Affiliation(s)
- D A Hill
- Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, Orlando, USA.
| | | | | | | | | |
Collapse
|
33
|
Abstract
The physical structure and the compact nature of the eukaryotic genome present a functional barrier for any cellular process that requires access to the DNA. The linker histone H1 is intrinsically involved in both the determination of and the stability of higher order chromatin structure. Because histone H1 plays a pivotal role in the structure of chromatin, we investigated the effect of histone H1 on the nucleosome remodeling activity of human SWI/SNF, an ATP-dependent chromatin remodeling complex. The results from both DNase I digestion and restriction endonuclease accessibility assays indicate that the presence of H1 partially inhibits the nucleosome remodeling activity of hSWI/SNF. Neither H1 bound to the nucleosome nor free H1 affected the ATPase activity of hSWI/SNF, suggesting that the observed inhibition of hSWI/SNF nucleosome remodeling activity depends on the structure formed by the addition of H1 to nucleosomes.
Collapse
Affiliation(s)
- D A Hill
- Department of Cell Biology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA
| | | |
Collapse
|
34
|
Hill DA, Pfeifer JD, Marley EF, Dehner LP, Humphrey PA, Zhu X, Swanson PE. WT1 staining reliably differentiates desmoplastic small round cell tumor from Ewing sarcoma/primitive neuroectodermal tumor. An immunohistochemical and molecular diagnostic study. Am J Clin Pathol 2000; 114:345-53. [PMID: 10989634 DOI: 10.1093/ajcp/114.3.345] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Differentiating desmoplastic small round cell tumor (DSRCT) from another similar small round cell tumor of childhood, the Ewing sarcoma/primitive neuroectodermal tumor (EWS/PNET), can be difficult because morphologic and immunohistochemical features overlap. We studied the predictive value of immunohistochemistry with an antibody to the C-terminal region of the Wilms tumor (WT1) protein for differentiating DSRCT from EWS/PNET in 24 malignant small round cell tumors that had been previously diagnosed as DSRCT or EWS/PNET by standard methods. We performed reverse transcriptase-polymerase chain reaction (RT-PCR) analysis in cases with available tissue as a confirmatory measure: 6 of 13 DSRCTs were informative by RT-PCR, and 6 of 6 showed an EWS-WT1 fusion; all 13 DSRCTs showed strong, definitive nuclear staining with the WT1 antibody. All 11 EWS/PNETs were WT1 antibody negative; 7 of 11 cases classified as EWS/PNET were informative by RT-PCR, and 7 of 7 showed an EWS-FLI-1 fusion. For cases in which the morphologic and immunohistochemical features are consistent with a diagnosis of DSRCT, WT1 antibody staining predicts the EWS-WT1 translocation with high sensitivity and specificity and is, therefore, useful for differentiating DSRCT from EWS/PNET when genetic information is unavailable.
Collapse
MESH Headings
- Abdominal Neoplasms/diagnosis
- Abdominal Neoplasms/genetics
- Abdominal Neoplasms/metabolism
- Adolescent
- Adult
- Biomarkers, Tumor/metabolism
- Blotting, Southern
- Child
- Child, Preschool
- DNA Primers/chemistry
- DNA, Neoplasm/analysis
- DNA-Binding Proteins/metabolism
- Diagnosis, Differential
- Female
- Fibromatosis, Aggressive/diagnosis
- Fibromatosis, Aggressive/genetics
- Fibromatosis, Aggressive/metabolism
- Humans
- Immunoenzyme Techniques
- Male
- Neuroectodermal Tumors, Primitive/diagnosis
- Neuroectodermal Tumors, Primitive/genetics
- Neuroectodermal Tumors, Primitive/metabolism
- Oncogene Proteins, Fusion/metabolism
- Parotid Neoplasms/diagnosis
- Parotid Neoplasms/genetics
- Parotid Neoplasms/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/metabolism
- Sequence Analysis, DNA
- Transcription Factors/metabolism
- WT1 Proteins
Collapse
Affiliation(s)
- D A Hill
- Laboratory of Surgical Pathology, Washington University Medical Center, St Louis, MO, USA
| | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
BACKGROUND/PURPOSE To better characterize childhood carcinoid tumors, the authors reviewed the clinical presentation, treatment, and outcomes of pediatric patients with these rare tumors. METHODS A retrospective review was conducted of medical records and pathologic materials of all children with carcinoid tumors treated at St Jude Children's Research Hospital between December 1977 and March 1999. RESULTS Eight patients (median age, 12.7 years) were identified; 2 were boys, and 7 were white. Primary tumor sites were the appendix (n = 5), small intestine (n = 1), bronchus (n = 1), and 1 unknown site. In 7 cases, carcinoid tumor was not suspected at the time the tumor was identified. Seven patients had localized disease; 5 remain disease-free after complete resection, and 2, whose carcinoid tumors were identified incidentally, died of metastatic mucinous adenocarcinoma of the colon. One patient who presented with symptoms of carcinoid syndrome had metastatic disease that responded poorly to cytotoxic chemotherapy and remains alive with active disease. CONCLUSIONS Although most pediatric carcinoid tumors arise in the appendix, these tumors also occur in other primary sites. Clinical awareness and early diagnosis are important factors in preventing morbidity and mortality. Outcomes are excellent for patients with localized disease that is completely resected, but those with metastatic disease fare poorly. New therapeutic strategies are needed for these patients.
Collapse
Affiliation(s)
- S L Spunt
- Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Abstract
The feeding behavior of the southern subspecies of Japanese macaque (Macaca fuscata yakui) was studied over a period of 18 months in warm temperate broad-leaved forest on the island of Yakushima, Japan. Focal animal data were collected for the eight adults in the troop. Over a full annual cycle, 35.0% of foraging on identified foods was on leaves and shoots, 30.2% on fleshy fruit, 13.2% on seeds, and 5.5% on flowers. Invertebrates and other animal matter accounted for 10.3% of foraging and fungi for 4.6%. There was marked seasonal variation in the use of different food categories, and seeds, leaves, fleshy fruit, and animal matter were each predominant at different times of year. There was also evidence of annual cyclicity in patterns of foraging on all major food types. The monkeys spent less time moving and ate a greater variety of foods when feeding on leaves than when feeding on fruit and seeds, or on insects. Time spent foraging was positively correlated with diversity of the diet, but there was no simple relationship between time spent foraging and the predominant food type. This suggests that a wide variety of foods takes longer to harvest and process, irrespective of the food type. The diet of the study troop was flexible and could not be assigned to a simple dietary category, such as frugivorous or folivorous. If these data are representative of the subspecies, the Yakushima macaque is much more of a dietary generalist than most primates for which there are adequate data.
Collapse
Affiliation(s)
- D A Hill
- School of Biological Sciences, University of Sussex, Brighton, United Kingdom.
| |
Collapse
|
37
|
Cook JR, Hill DA, Humphrey PA, Pfeifer JD, El-Mofty SK. Squamous cell carcinoma arising in recurrent respiratory papillomatosis with pulmonary involvement: emerging common pattern of clinical features and human papillomavirus serotype association. Mod Pathol 2000; 13:914-8. [PMID: 10955460 DOI: 10.1038/modpathol.3880164] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Squamous papillomas of the lung are an uncommon feature of recurrent respiratory papillomatosis, occurring in fewer than 1% of cases. We describe a 23-year-old patient with pulmonary papillomas who developed a fatal squamous cell carcinoma of the lung. PCR-based human papillomavirus (HPV) typing showed the presence of HPV 11 DNA in both benign papillomas and invasive carcinoma. A review of the literature reveals four reports of malignant transformation of juvenile-onset recurrent respiratory papillomatosis in which HPV typing was performed. Similar clinical features are noted in all of the reports; specifically, each case has arisen in a young adult man with a history of papillomatosis since childhood. In each of the cases, HPV 11 was identified in association with the squamous cell carcinoma. Although HPV 11 is uncommonly associated with the development of invasive carcinoma at other sites, these findings suggest that it is correlated with malignant transformation in the setting of juvenile-onset recurrent respiratory papillomatosis.
Collapse
Affiliation(s)
- J R Cook
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology, Washington University School of Medicine, St. Louis, Missouri, USA.
| | | | | | | | | |
Collapse
|
38
|
Yee SB, Kinser S, Hill DA, Barton CC, Hotchkiss JA, Harkema JR, Ganey PE, Roth RA. Synergistic hepatotoxicity from coexposure to bacterial endotoxin and the pyrrolizidine alkaloid monocrotaline. Toxicol Appl Pharmacol 2000; 166:173-85. [PMID: 10906281 DOI: 10.1006/taap.2000.8968] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Individuals are commonly exposed to bacterial endotoxin (lipopolysaccharide [LPS]) through gram-negative bacterial infection and from its translocation from the gastrointestinal lumen into the circulation. Inasmuch as noninjurious doses of LPS augment the hepatotoxicity of certain xenobiotic agents, exposure to small amounts of LPS may be an important determinant of susceptibility to chemical intoxication. Monocrotaline (MCT) is a pyrrolizidine alkaloid phytotoxin that at large doses produces centrilobular liver lesions in rats. In the present study, MCT was coadministered with LPS to determine whether LPS would enhance its hepatotoxicity. Doses of MCT (100 mg/kg, ip) and LPS (7.4 x 10(6) EU/kg, iv), which were nonhepatotoxic when administered separately, produced significant liver injury in male, Sprague-Dawley rats when given in combination. Within 18 h after MCT administration, this cotreatment resulted in enhanced plasma alanine aminotransferase and aspartate aminotransferase activities, two markers of liver injury. Histologically, overt hemorrhage and necrosis appeared between 12 and 18 h. The lesions were centrilobular and midzonal and exhibited characteristics similar to lesions associated with larger doses of MCT and LPS, respectively. In the presence of LPS, the threshold for MCT toxicity was reduced to 13-33% of the dose required for toxicity with MCT alone. A study in isolated, hepatic parenchymal cells revealed no interaction between MCT and LPS in producing cytotoxicity. In summary, coexposure of rats to noninjurious doses of MCT and LPS resulted in pronounced liver injury. Results in vitro suggest that the enhanced toxicity does not result from a direct interaction of MCT and LPS with hepatic parenchymal cells. These results provide additional evidence that exposure to small amounts of LPS may be a determinant of susceptibility to food-borne hepatotoxins.
Collapse
Affiliation(s)
- S B Yee
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan 48824, USA
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Blair JM, Hill DA, Bali IM, Fee JP. Tracheal intubating conditions after induction with sevoflurane 8% in children. A comparison with two intravenous techniques. Anaesthesia 2000; 55:774-8. [PMID: 10947692 DOI: 10.1046/j.1365-2044.2000.01470.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We studied tracheal intubating conditions in 120 healthy children, aged 3-12 years, in a blinded, randomised clinical trial. Children were randomly allocated to one of three groups: group PS, propofol 3 mg.kg-1 and succinylcholine 1 mg.kg-1 (n = 40); group PA, propofol 3 mg.kg-1 and alfentanil 10 microg.kg-1 (n = 40); group SF, sevoflurane 8% in 60% nitrous oxide in oxygen for 3 min (n = 40). Tracheal intubating conditions were graded according to ease of laryngoscopy, position of vocal cords, coughing, jaw relaxation and movement of limbs. Overall intubating conditions were acceptable in 39 of 40 children in the propofol/succinylcholine group, 21 of 40 children in the propofol/alfentanil group and 35 of 40 children in the sevoflurane group. Children receiving propofol and succinylcholine or sevoflurane had better intubating conditions overall than those given propofol and alfentanil (p < 0.01). In conclusion, anaesthetic induction and tracheal intubation using sevoflurane 8% for 3 min is a satisfactory alternative to propofol with succinylcholine in children.
Collapse
Affiliation(s)
- J M Blair
- The Ulster Hospital, Dundonald, Belfast, UK
| | | | | | | |
Collapse
|
40
|
Abstract
Extramedullary hematopoiesis (EMH) after fetal development is uncommon and is most often seen in patients who have hematologic disorders. EMH unassociated with hematologic disease is rare. After the recent observation of EMH in a myocardial infarct, we sought to determine the frequency and clinicopathologic setting of EMH in myocardial tissues submitted for pathologic examination. Hematoxylin and eosin (H&E)-stained sections from 805 consecutive myocardial samples (207 surgical specimens, 598 autopsy specimens) were examined retrospectively. The presence of immature erythroid or myeloid cell clusters in intramyocardial capillaries or stroma was considered sufficient for the diagnosis of EMH. Immunoperoxidase studies confirming the nature of the hematopoietic cell infiltrate were performed in selected cases. Foci of EMH (often multiple) were identified in 15 of 207 surgical hearts (7.2%) and in 22 of 598 autopsy hearts (3.7%). Patient ages (exclusive of premature infants) ranged from 2 weeks to 73 years (median, 13 years). Twenty-four of 37 (65%) EMH-positive cases were associated with infarcts in various stages of repair (accounting for 11 of 68 [16.2%] of all infarcts in surgical specimens and 13 of 86 [15.1%] of infarcts in autopsy specimens). Acute infarcts less than 72 hours old, excluding those with acute extension, were not associated with EMH. Viral myocarditis and myocardial hypertrophy with fibrosis accounted for primary diagnoses in the nonischemic, EMH-positive surgical cases, whereas seven of nine nonischemic, EMH-positive autopsy cases involved premature or term infants with no obvious myocardial disease. Another autopsy patient had sarcoidosis with myelophthisic involvement of her bone marrow and represented one of only two cases overall in which a hematopoietic disorder was coexistent or suspected. Myocardial EMH is relatively common after myocardial infarct but is rarely encountered in normal or nonischemic myocardium. Its presence in healing but not early acute stages of infarct suggests that EMH results from inflammation- or repair-associated trophic factors, not from ischemia itself.
Collapse
Affiliation(s)
- D A Hill
- The Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital, Washington University Medical Center, St. Louis, Missouri 63110, USA
| | | |
Collapse
|
41
|
Abstract
Bacterial endotoxin (lipopolysaccharide; LPS) given to animals in large doses results in pronounced, midzonal liver injury. Exposure to smaller, non-injurious doses of LPS augments the toxicity of certain hepatotoxicants. This study was conducted to delineate the development of injury in a rat model of augmentation of aflatoxin B(1) (AFB(1)) hepatotoxicity by LPS. At large doses (i.e., > 1 mg/kg, ip), AFB(1) administration resulted in pronounced injury to the periportal regions of the liver. Male, Sprague-Dawley rats (250-350 g) were treated with 1 mg AFB(1)/kg, ip or its vehicle (0.5% DMSO/saline) and 4 h later with either E. coli LPS (7.4 x 106 EU/kg, iv) or its saline vehicle. Liver injury was assessed 6, 12, 24, 48, 72, or 96 h after AFB(1) administration. Hepatic parenchymal cell injury was evaluated as increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in serum and from histologic examination of liver sections. Biliary tract alterations were evaluated as increased concentration of serum bile acids and activities of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), and 5'-nucleotidase (5'-ND) in serum. At all times and for all markers, injury in rats treated with either AFB(1) or LPS alone was absent or modest. In the AFB(1)/LPS cotreated group, hepatic parenchymal cell injury was pronounced by 24 h and had returned to control values by 72 h. The injury began in the periportal region and spread midzonally with time. Furthermore, changes in serum markers indicative of biliary tract alterations were evident by 12 h and had returned to control values by 72 h. Thus, the nature of the hepatic lesions suggested that LPS potentiated the effects of AFB(1) on both parenchymal and bile duct epithelial cells.
Collapse
Affiliation(s)
- C C Barton
- Department of Pharmacology and Toxicology, National Center for Food Safety and Toxicology and Institute for Environmental Toxicology, Michigan State University, East Lansing, Michigan 48824, USA
| | | | | | | | | | | |
Collapse
|
42
|
Abstract
Puerperal ovarian vein thrombophlebitis is an uncommon condition that usually develops in the immediate postpartum period. Computed tomography, magnetic resonance imaging, Doppler ultrasound, and exploratory laparotomy may be performed to diagnose it. A woman developed worsening abdominal pain 6 weeks postpartum. Laparoscopic intervention allowed treatment of late-onset, left-sided puerperal ovarian vein thrombophlebitis. The disorder may develop much later after delivery than expected and can be successfully treated laparoscopically.
Collapse
Affiliation(s)
- D A Hill
- Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, 500 East Rollins Avenue, Suite 201, Orlando, FL 32803, USA
| |
Collapse
|
43
|
|
44
|
Quinlan JD, Hill DA, Maxwell BD, Boone S, Hoover F, Lense JJ. The necessity of both anorectal and vaginal cultures for group B streptococcus screening during pregnancy. J Fam Pract 2000; 49:447-448. [PMID: 10836777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Group B streptococcus (GBS) sepsis affects approximately 2 of every 1000 newborns. In an effort to decrease the incidence of neonatal GBS infection, the Centers for Disease Control and Prevention have established guidelines for screening and treatment during pregnancy. One strategy includes obtaining both vaginal and anorectal GBS cultures, then treating patients whose cultures are positive. Many of our patients are reluctant to undergo anorectal cultures. We conducted a study to determine whether performing cultures of both the vagina and anorectum would change patient management. METHODS We obtained vaginal and anorectal GBS cultures from 222 consecutive patients at 35 to 37 weeks' gestation. RESULTS Fifty-four patients (24.3%) had positive GBS cultures. Of those women, 10 (18.5%) had negative vaginal but positive rectal cultures. Thus, nearly one fifth of the patients with GBS colonization would not have received intrapartum antibiotics if only vaginal cultures had been performed. CONCLUSIONS Health care providers caring for pregnant patients should consider obtaining both vaginal and anorectal cultures when screening for Group B streptococcus.
Collapse
Affiliation(s)
- J D Quinlan
- Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, Orlando 32803, USA
| | | | | | | | | | | |
Collapse
|
45
|
Muthuswami R, Mesner LD, Wang D, Hill DA, Imbalzano AN, Hockensmith JW. Phosphoaminoglycosides inhibit SWI2/SNF2 family DNA-dependent molecular motor domains. Biochemistry 2000; 39:4358-65. [PMID: 10757984 DOI: 10.1021/bi992503r] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Members of the SWI2/SNF2 family of proteins participate in an array of nucleic acid metabolic functions, including chromatin remodeling and transcription. The present studies identify a novel strategy to specifically inhibit the functional DNA-dependent adenosinetriphosphatase (ATPase) motor domain common to SWI2/SNF2 family members. We have identified preparations of phosphoaminoglycosides, which are natural products of aminoglycoside-resistant bacteria, as inhibitors of the in vitro activities of three SWI2/SNF2 family members. These compounds inhibit the ATPase activity of the active DNA-dependent ATPase A domain (ADAAD) by competing with respect to DNA and thus have no effect on DNA-independent ATPases or on RNA-dependent ATPases. Within the superfamily of DNA-dependent ATPases, these compounds are most potent toward SWI2/SNF2 family members and less potent toward other DNA-dependent ATPases. We demonstrate that it is feasible to target DNA-dependent ATPases of a particular type without affecting the function of other ATPases. As the SWI2/SNF2 proteins have been proposed to function in all aspects of DNA metabolism, this paper provides an archetype for development of DNA metabolic inhibitors.
Collapse
Affiliation(s)
- R Muthuswami
- Department of Biochemistry and Molecular Genetics 440, School of Medicine, University of Virginia, Charlottesville, Virginia 22908, USA
| | | | | | | | | | | |
Collapse
|
46
|
de La Serna IL, Carlson KA, Hill DA, Guidi CJ, Stephenson RO, Sif S, Kingston RE, Imbalzano AN. Mammalian SWI-SNF complexes contribute to activation of the hsp70 gene. Mol Cell Biol 2000; 20:2839-51. [PMID: 10733587 PMCID: PMC85505 DOI: 10.1128/mcb.20.8.2839-2851.2000] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
ATP-dependent chromatin-remodeling complexes are conserved among all eukaryotes and function by altering nucleosome structure to allow cellular regulatory factors access to the DNA. Mammalian SWI-SNF complexes contain either of two highly conserved ATPase subunits: BRG1 or BRM. To identify cellular genes that require mammalian SWI-SNF complexes for the activation of gene expression, we have generated cell lines that inducibly express mutant forms of the BRG1 or BRM ATPases that are unable to bind and hydrolyze ATP. The mutant subunits physically associate with at least two endogenous members of mammalian SWI-SNF complexes, suggesting that nonfunctional, dominant negative complexes may be formed. We determined that expression of the mutant BRG1 or BRM proteins impaired the ability of cells to activate the endogenous stress response gene hsp70 in response to arsenite, a metabolic inhibitor, or cadmium, a heavy metal. Activation of hsp70 by heat stress, however, was unaffected. Activation of the heme oxygenase 1 promoter by arsenite or cadmium and activation of the cadmium-inducible metallothionein promoter also were unaffected by the expression of mutant SWI-SNF components. Analysis of a subset of constitutively expressed genes revealed no or minimal effects on transcript levels. We propose that the requirement for mammalian SWI-SNF complexes in gene activation events will be specific to individual genes and signaling pathways.
Collapse
Affiliation(s)
- I L de La Serna
- Department of Cell Biology, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Abstract
Gliomatosis peritonei, the implantation of neuroglial tissue upon the peritoneal surfaces, is a rare event most often associated with solid or immature teratomas of the ovary in young girls. The authors report a case of a 10-month-old girl with a ventriculoperitoneal shunt (VPS) who presented with bilateral inguinal hernias. Herniorrhaphy was uneventful. Microscopic examination of the hernia sacs showed exuberant mesothelial hyperplasia containing multiple nests of differentiated glial tissue. Subsequent computed tomography and laparoscopy disclosed normal ovaries with no evidence of intraabdominal or pelvic abnormalities. Gliomatosis peritonei in this case was attributed to transport of glial tissue from the cerebrospinal fluid into the peritoneal cavity via the shunt. With the exclusion of an ovarian germ cell neoplasm and in the presence of a VPS, the clinical course with regard to the glial implants in these children is uneventful. If it is appreciated that gliomatosis peritonei may be a complication of a VPS, an extensive clinical evaluation generally is unnecessary.
Collapse
Affiliation(s)
- D A Hill
- Department of Surgery, St Louis Children's Hospital, Washington University Medical Center, MO 63110, USA
| | | | | | | |
Collapse
|
48
|
Abstract
OBJECTIVE In randomized trials a higher proportion of women prescribed continuous combined hormone replacement therapy complete the full course of treatment compared with those prescribed sequential therapy. We sought to determine adherence to hormone therapy in a less-selected population. STUDY DESIGN Women enrolled in a prepaid health plan participated in a telephone interview 12 to 15 months after newly initiating use of hormone replacement therapy. The interview elicited information on whether the women were still taking the hormones as first prescribed and reasons for switching or discontinuation. A computerized pharmacy database was used to determine initial doses, prescription renewal, and dates of switching or discontinuation. RESULTS The proportion continuing the originally prescribed hormone regimen at 1 year was higher among continuous combined therapy users (68.9%, 62/90) than among sequential therapy users (54.4%, 62/114). Women who initiated continuous combined therapy were less likely to have switched regimens (10.0%) than were sequential users (20.2%; relative risk, 0.5; 95% confidence interval, 0.2-1.0) but only somewhat less likely to have discontinued use (21.2% vs 25.4%; relative risk, 0.7; 95% confidence interval, 0.4-1.3). Examined as a whole, women prescribed continuous combined therapy were less likely than those prescribed sequential therapy to quit or switch during the first year (relative risk, 0.6; 95% confidence interval, 0.4-1.0). CONCLUSION Although adherence was higher among women prescribed continuous combined hormone replacement therapy than sequential therapy, the high level of nonadherence in both groups suggests room for improvement of menopausal therapies so that women find them acceptable for sustained use.
Collapse
Affiliation(s)
- D A Hill
- Department of Epidemiology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, USA
| | | | | |
Collapse
|
49
|
Abstract
We report on an uncommon entity, the so-called "chest wall chondromatous hamartoma" or "mesenchymal hamartoma of the chest wall" (MHCW), diagnosed by fine-needle aspiration (FNA) cytology in a 6-mo-old boy. Radiologic features were those of an aggressive lesion with rib expansion and destruction, that contrasted with aspirate smears showing bland cartilage and spindled mesenchymal elements. The clinicoradiographic features together with the FNA yield of mixed cellular elements aided in the correct diagnosis of MHCW.
Collapse
Affiliation(s)
- S A Nicholson
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital and St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri, USA
| | | | | | | | | | | |
Collapse
|
50
|
Dehner LP, Hill DA, Deschryver K. Pathology of the breast in children, adolescents, and young adults. Semin Diagn Pathol 1999; 16:235-47. [PMID: 10490200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The pathologic spectrum of breast disease in children and adolescents is broad and includes entities more commonly seen in older patients. In general, the vast majority of breast masses in young patients are benign with fibroadenomas, gynecomastia, and macromastia accounting for the majority of surgical specimens. Malignant tumors are more likely to be secondary or metastatic than primary. Rhabdomyosarcoma and hematolymphoid tumors comprise a majority of malignant diagnoses in children. Primary carcinomas and sarcomas are rare, especially if sarcomas arising in the setting of cystosarcoma phyllodes are excluded.
Collapse
Affiliation(s)
- L P Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St Louis Children's Hospital, Washington University Medical Center, MO 63141, USA
| | | | | |
Collapse
|