A comparative study on the detection of Mycobacterium leprae DNA in urine samples of leprosy patients using Rlep-PCR with other conventional samples

BACKGROUND

Mycobacterium leprae causes leprosy that is highly stigmatized and chronic infectious skin disease. Only some diagnostic tools are being used for the identification M. leprae in clinical samples, such as bacillary detection, and histopathological tests. These methods are invasive and often have low sensitivity. Currently, the PCR technique has been used as an effective tool fordetecting M. leprae DNA across different clinical samples. The current study aims to detect M. leprae DNA in urine samples of untreated and treated leprosy patients using the Rlep gene (129 bp) and compared the detection among Ridley-Jopling Classification.

METHODS

Clinical samples (Blood, Urine, and Slit Skin Smears (SSS)) were collected from leprosy and Non-leprosy patients. DNA extraction was performed using standard laboratory protocol and Conventional PCR was carried out for all samples using Rlep gene target and the amplicons of urine samples were sequenced by Sanger sequencing to confirm the Rlep gene target.

RESULTS

The M. leprae DNA was successfully detected in all clinical samples across all types of leprosy among all the study groups using RLEP-PCR. Rlep gene target was able to detect the presence of M. leprae DNA in 79.17% of urine, 58.33% of blood, and 50% of SSS samples of untreated Smear-Negative leprosy patients. The statistical significant difference (p = 0.004) was observed between BI Negative (Slit Skin Smear test) and RLEP PCR positivity in urine samples of untreated leprosy group.

CONCLUSION

The PCR positivity using Rlep gene target (129 bp) was highest in all clinical samples among the study groups, across all types of leprosy. Untreated tuberculoid and PNL leprosy patients showed the highest PCR positivity in urine samples, indicating its potential as a non-invasive diagnostic tool for leprosy and even for contact screening.

Mycobacterium leprae and host immune transcriptomic signatures for reactional states in leprosy

Background

Mycobacterium leprae transcriptomic and human host immune gene expression signatures that demonstrate a plausible association with type I (T1R) and type II reactions (T2R) aid in early diagnosis, prevention of nerve damage and consequent demyelinating neuropathy in leprosy. The aim of the study is to identify M. leprae and host-associated gene-expression signatures that are associated with reactional states in leprosy.

Methods

The differentially expressed genes from the whole transcriptome of M. leprae were determined using genome-wide hybridization arrays with RNA extracted from skin biopsies of 20 T1R, 20 T2R and 20 non reactional controls (NR). Additionally, human immune gene-expressions were profiled using RT2-PCR profiler arrays and real-time qPCRs.

Results

The RNA quality was optimal in 16 NR, 18 T1R and 19 T2R samples. Whole transcriptome expression array of these samples revealed significant upregulation of the genes that encode integral and intrinsic membrane proteins, hydrolases and oxidoreductases. In T1R lesional skin biopsy specimens, the top 10 significantly upregulated genes are ML2064, ML1271, ML1960, ML1220, ML2498, ML1996, ML2388, ML0429, ML2030 and ML0224 in comparison to NR. In T2R, genes ML2498, ML1526, ML0394, ML1960, ML2388, ML0429, ML0281, ML1847, ML1618 and ML1271 were significantly upregulated. We noted ML2664 was significantly upregulated in T1R and repressed in T2R. Conversely, we have not noted any genes upregulated in T2R and repressed in T1R. In both T1R and T2R, ML2388 was significantly upregulated. This gene encodes a probable membrane protein and epitope prediction using Bepipred-2.0 revealed a distinct B-cell epitope. Overexpression of ML2388 was noted consistently across the reaction samples. From the host immune gene expression profiles, genes for CXCL9, CXCL10, CXCL2, CD40LG, IL17A and CXCL11 were upregulated in T1R when compared to the NR. In T2R, CXCL10, CXCL11, CXCL9, CXCL2 and CD40LG were upregulated when compared to the NR group.

Conclusion

A gene set signature involving bacterial genes ML2388, ML2664, and host immune genes CXCL10 and IL-17A can be transcriptomic markers for reactional states in leprosy.

Silent persistent left superior vena cava right-to-left shunt as a unique cause of recurrent brain abscesses

We present a novel case of recurrent brain abscesses found to be the result of a silent congenital right-to-left extra-cardiac shunt, a persistent left superior vena cava (PLSVC) draining into the left atrium. The patient’s brain abscess was evacuated surgically, treated with antibiotics, and his shunt was subsequently repaired. The case suggests that attention should be paid to evaluation for shunt physiology allowing for bypass of the pulmonary circulation in those with recurrent brain abscesses.

Optimized Synthesis of New Thiosemicarbazide Derivatives with Tuberculostatic Activity

Original results are presented in the field of research that addresses the extension of the reaction of residue of acyl-thiosemicarbazide fixation on the structure of 5-nitrobenzimidazole by a sulphonic group. The aim of the study is the increase of new thiosemicarbazide derivatives’ applicative potential in the field of biochemistry, with a wide range of medical applications. The newly obtained compounds were characterized by using elemental analysis and spectral analysis (FT-IR and ¹H NMR). A study regarding the optimization of the chemical reactions was made. The performed in vitro biological tests confirmed the tuberculostatic activity of three newly obtained compounds against Mycobacterium tuberculosis.

Should we redifine Hypertensive response in stress test to better predict cardiovascular risk?

Funding Acknowledgements

Type of funding sources: None.

Introduction

Systolic blood pressure (SBP) rise during exercise is normal, but some patients present with hypertensive response to exercise (HRE). The clinical implication of such phenomenon is not fully elucidated, and treatment strategies are still uncertain.

Purpose

To evaluate the relationship between HRE and the development of major cardiovascular events (MACE) - death, acute coronary syndrome (ACS) and stroke.

Methods

Single-center retrospective study of consecutive patients submitted to exercise test (ET) from 2012 to 2015. Patient’s demographics, baseline clinical characteristics, vital signs during ET and MACE occurrence during follow-up were analysed. HRE was defined as a peak systolic blood pressure (PSBP) >210 mmHg in men and >190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure >90 mmHg or a rise of 10 mmHg.

Results

We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%) and dyslipidaemia (61%). During a mean follow-up of 60 ± 2 months, the incidence of MACE was 9.2% with ACS being the most frequent (4.2%), followed by mortality (3.8%) and stroke (2.1%). Patients with inconclusive ET had a fourfold higher risk of acute coronary events (OR 4.1, CI 95% 1.55-11.14, p = 0.005). Baseline SBP and PSBP were predictors of MACE occurrence (OR 1.022, CI 95% 1.004-1.04, p = 0.016, OR 1.031 CI 95% 1.012-1.051, p = 0.001, respectively) and were both associated with cardiovascular hospitalization (p = 0.006; p < 0.001, respectively). PSBP had moderate ability to predict hospitalization of cardiovascular (CV) cause (AUC 0.71, p < 0.001) with a cut-off of 193 mmHg (sensibility 91%, specify 40%) and had moderate ability to predict MACE (AUC 0.67, p < 0.001) with a cut-off of 198 mmHg (sensibility 78.6%, specify 46.1%). Regarding mortality, antihypertensive therapy prior to ET was protective (p = 0.042), with no difference between different classes of drugs.

Conclusion

Our data reveal a high rate of MACE occurrence between patients with HRE. The finding of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs. An increased risk of ACS between patients with an inconclusive ET should lead to consider then for further investigation. HRE should be considered as part of CV risk assessment and adjusted lower HRE cut-off values should be considered in order to better predict MACE occurrence, particularly in high risk patients.

Abstract Figure.

Peripheral tryptophan and serotonin and kynurenine pathways in major depression: A case-control study

Introduction

The tryptophan pathway along with its two branches of metabolism to serotonin and kynurenine seems to be affected in major depression. In depressed patients, peripheral levels of tryptophan, serotonin, kynurenine and their metabolite remain unclear.

Objectives

Therefore, peripheral tryptophan and metabolites of serotonin and kynurenine were investigated extensively in 173 patients suffering from a current major depressive episode (MDE) and compared to 214 healthy controls (HC).

Methods

Fasting plasma levels of 11 peripheral metabolites were quantified: tryptophan, serotonin pathway (serotonin, its precursor 5-hydroxy-tryptophan and its metabolite the 5-hydroxy-indole acetic acid), and kynurenine pathway (kynurenine and six of its metabolites including anthranilic acid, kynurenic acid, nicotinamide, picolinic acid, xanthurenic acid and 3-hydroxy-anthranilic acid).

Results

60 (34.7%) patients were antidepressant drug free. Tryptophan levels did not differ between MDE patients and HC. Serotonin and its precursor (5-hydroxy-tryptophan) levels were lower in MDE patients than HC. Whereas, its metabolite (5-hydroxy-indole acetic acid) levels were within the standard range. Kynurenine and four of its metabolites (kynurenic acid, nicotinamide, picolinic acid and xanthurenic acid) were lower in MDE patients.

Conclusions

This study uses the largest ever sample of MDE patients, with an extensive assessment of peripheral tryptophan metabolism in plasma. These findings provide new insights into the peripheral signature of MDE. The reasons for these changes should be further investigated. These results might suggest a better stratification of patients and different therapeutic strategies therapeutic strategies.

The Impact of the COVID-19 Pandemic on Gastrointestinal Endoscopy Activity in a Tertiary Care Center from Northeastern Romania

BACKGROUND

The outbreak of the coronavirus disease 2019 (COVID-19) has led to significant changes in endoscopy units worldwide, with potential impact on patients' welfare as well as on endoscopy training. We aimed to assess the real-life impact of COVID-19 on the endoscopy unit in a tertiary care center from Romania.

METHODS

A 6.5-month period during the COVID-19 pandemic was compared to a similar period from 2019.

RESULTS

A 6.2-fold decrease of endoscopic procedures was noted. Colonoscopies were reduced from 916 to 42, p < 0.001; flexible sigmoidoscopies from 189 to 14, p = 0.009; upper gastrointestinal (GI) endoscopies from 2269 to 401, p = 0.006; and ERCP from 234 to 125, p < 0.001. The percentage of emergency procedures increased (38.8% vs. 26.2%, p < 0.001), as well as the rate of endoscopies performed for upper GI bleeding (42.5% vs. 24.4%, respectively, p < 0.001). The detection of cancers was considerably reduced (57 compared to 249, p = 0.001). There were fewer complications and higher success rates (7.6% vs. 19.2%, p < 0.001, and 94.2% vs. 90.7%, respectively). Fellows participation was also reduced from 90% to 40.9% (p < 0.001).

CONCLUSIONS

The COVID-19 pandemic has significantly altered the workflow of the endoscopy unit, lowering the number of procedures performed and potentially compromising the early detection of cancers.

Solanum nigrum Unripe fruit fraction attenuates Adriamycin resistance by down-regulating multi-drug resistance protein (Mdr)-1 through Jak-STAT pathway

Background

Solanum nigrum, herbal plant that commonly grows in temperate climate zone, has been used as a traditional folk medicine whose ripen fruits were proven to exhibit anti-tumor properties. In traditional Chinese medicine, it has been used for centuries to cure inflammation, edema, mastitis and hepatic cancer and in the Ayurvedic system of traditional medicine in India, S. nigrum is applied against enteric diseases, ulcer, diarrhea and skin diseases. A methanolic glycosidic extract fraction of unripe fruit of S. nigrum (SNME) was investigated for its anticancer property and possible mechanism to surmount adriamycin resistance in NCI/ADR-RES cells.

Methods

The NCI/ADR-RES cells were treated with 7.8125, 15.625, 31.25, 62.5, 125 and 250 μg/ml of methanolic extract of S. nigrum (SNME) for 12, 24 and 48 h, to check the cell viability and proliferation. The cells were also exposed to adriamycin alone or in combination with SNME and the effects on cell growth were determined by MTT. Cell cycle analysis, Ethidium bromide and Acridine orange staining, Annexin-binding efficiency, nuclear condensation and DNA fragmentation of the apoptotic NCI/ADR-RES cells were also determined. To elucidate the relationship between SNME and multi drug resistance, we analyzed the expression levels of Mdr-1, JAK1, STAT3, and pSTAT3 in NCI/ADR-RES cells after treatment with SNME.

Results

Results from the cytotoxicity assay showed a direct correlation between the concentration of methanolic glycosidic extract fraction of S. nigrum (SNME) and the surviving cell population. Combination with Adriamycin, SNME exhibits a synergistic action on NCI/ADR-RES cells, giving the first line of evidence to overcoming Adriamycin resistance. The SNME mediated cell growth suppression was proven to be apoptotic, based on results obtained from DNA fragmentation, annexin V apoptosis assaay and PARP cleavage analysis. Looking into the molecular insight SNME surpasses the chemoresistance of NCI/ADR-RES cells by inhibiting the JAK-STAT3 signaling pathway through the down regulation of JAK1, STAT3, pSTAT3, and Mdr1 expression.

Conclusions

Collectively our findings suggest that unripe fruit of Solanum nigrum could possibly be used as a chemosensitizing agent against Adriamycin resistant cancers.

Banff Histopathological Consensus Criteria for Preimplantation Kidney Biopsies

The Banff working group on preimplantation biopsy was established to develop consensus criteria (best practice guidelines) for the interpretation of preimplantation kidney biopsies. Digitally scanned slides were used (i) to evaluate interobserver variability of histopathologic findings, comparing frozen sections with formalin-fixed, paraffin-embedded tissue of wedge and needle core biopsies, and (ii) to correlate consensus histopathologic findings with graft outcome in a cohort of biopsies from international medical centers. Intraclass correlations (ICCs) and univariable and multivariable statistical analyses were performed. Good to fair reproducibility was observed in semiquantitative scores for percentage of glomerulosclerosis, arterial intimal fibrosis and interstitial fibrosis on frozen wedge biopsies. Evaluation of frozen wedge and core biopsies was comparable for number of glomeruli, but needle biopsies showed worse ICCs for glomerulosclerosis, interstitial fibrosis and tubular atrophy. A consensus evaluation form is provided to help standardize the reporting of histopathologic lesions in donor biopsies. It should be recognized that histologic parameters may not correlate with graft outcome in studies based on organs deemed to be acceptable after careful clinical assessment. Significant limitations remain in the assessment of implantation biopsies.

First international collaborative study to evaluate rabies antibody detection method for use in monitoring the effectiveness of oral vaccination programmes in fox and raccoon dog in Europe

The most effective and sustainable method to control and eliminate rabies in wildlife is the oral rabies vaccination (ORV) of target species, namely foxes and raccoon dogs in Europe. According to WHO and OIE, the effectiveness of oral vaccination campaigns should be regularly assessed via disease surveillance and ORV antibody monitoring. Rabies antibodies are generally screened for in field animal cadavers, whose body fluids are often of poor quality. Therefore, the use of alternative methods such as the enzyme-linked immunosorbent assay (ELISA) has been proposed to improve reliability of serological results obtained on wildlife samples. We undertook an international collaborative study to determine if the commercial BioPro ELISA Rabies Ab kit is a reliable and reproducible tool for rabies serological testing. Our results reveal that the overall specificity evaluated on naive samples reached 96.7%, and the coefficients of concordance obtained for fox and raccoon dog samples were 97.2% and 97.5%, respectively. The overall agreement values obtained for the four marketed oral vaccines used in Europe were all equal to or greater than 95%. The coefficients of concordance obtained by laboratories ranged from 87.2% to 100%. The results of this collaborative study show good robustness and reproducibility of the BioPro ELISA Rabies Ab kit.

Abstract POSTER-CTRL-1205: Neurocognitive evaluation of a cognitive training intervention in ovarian and gynecologic cancer survivors

Purpose: Our prior work indicates that a group-based cognitive training intervention can improve memory and attention in cancer survivors. This study examined potential for training transfer on two cognitive tasks and corresponding changes in neural activation patterns as measured by fMRI prior to and following the cognitive training intervention.

Methods: Seven gynecologic cancer (ovarian, breast, uterine) survivors (mean age: 64 years, mean time since primary treatment: 7.2 years) underwent a 7-week cognitive rehabilitation intervention delivered in group format. Participants were evaluated with a comprehensive cognitive battery and two experimental cognitive tasks prior to and following treatment. A word pair task required participants to learn pairs of words and later indicate whether words had been seen before (Item condition) or whether words had been paired together at learning (Relational condition). A verbal working memory task required participants to learn a set of 3, 5, or 7 letters and confirm or deny the presence of a probe letter. Participants also underwent fMRI scanning during word pair and verbal working memory tasks prior to and following treatment.

Results: Participants showed significant improvement following intervention in accuracy in the Relational condition, in which strong associations between presented word pairs were required for successful performance, t(3)=5.21, p&lt; .05. By contrast, accuracy did not increase significantly in the Item condition following intervention, t(3)=.48, p=.66). There was also a significant improvement in accuracy for the intermediate load (5-item) condition of the verbal working memory task following intervention, t(3)=4.17, p&lt;.05. fMRI analyses revealed activation in a frontoparietal network during both the word pairs and verbal working memory tasks. Future analyses will investigate changes in recruitment of this network following intervention.

Conclusions: Cancer survivors show evidence of specific transfer of memory skills following a group-based cognitive training intervention as demonstrated by improvement on the word memory task- relational item. In addition, there was a trend toward improvement on a working memory task. Neuroimaging results suggest frontoparietal network involvement for the cognitive task as well as some indication of a more efficient neural response following training. These results suggest that cognitive training may have a beneficial impact on both behavioral measures of cognition as well as neural activation markers.

Citation Format: H. Gray, M. K. Askren Thomas, K. Anderson, D. David, A. Singh, K. Murphy, S. Willis, H. Mendoza, M.M. Cherrier. Neurocognitive evaluation of a cognitive training intervention in ovarian and gynecologic cancer survivors [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr POSTER-CTRL-1205.

Hematopoietic PBX-interacting protein (HPIP) is over expressed in breast infiltrative ductal carcinoma and regulates cell adhesion and migration through modulation of focal adhesion dynamics

The scaffolding protein, hematopoietic PBX-interacting protein (HPIP/PBXIP1), regulates cell migration necessary for cancer cell dissemination. However, the mechanism that governs this process remains unknown. We show here that HPIP expression is associated with stages of breast cancer where cell dissemination results in poor patient outcome. Our investigation finds a novel association of HPIP with focal adhesion kinase (FAK) regulating FA dynamics. Interestingly, this interaction that led to activation of FAK protein was mediated by the C-terminal domain of HPIP and not the typical integrin-binding motif. Further, short hairpin RNA-mediated knockdown of FAK expression significantly reduced HPIP-induced cell migration indicating participation of FAK pathway. Live-cell time-lapse imaging and biochemical analysis further established the role of HPIP in microtubule-induced FA disassembly. We also found that HPIP-mediated MAPK activation led to phosphorylation and subsequent activation of calpain2, and the activated calpain2 in turn proteolyses FA protein, talin. Interestingly, HPIP is also proteolysed by calpain2 in breast cancer cells. The proteolysis of HPIP and talin by calpain2, and the activation of calapin2 by HPIP-mediated MAPK phosphorylation, is a novel regulatory axis to modulate the cell migration signal. Together, we have determined HPIP as a novel activator of FAK and a new substrate of calpain2. These molecular interactions between HPIP and FAK, and HPIP and calpain2 regulate cell adhesion and migration through modulation of FA dynamics.

Smurf2 E3 ubiquitin ligase modulates proliferation and invasiveness of breast cancer cells in a CNKSR2 dependent manner

BACKGROUND

Smurf2 is a member of the HECT family of E3 ubiquitin ligases that play important roles in determining the competence of cells to respond to TGF- β/BMP signaling pathway. However, besides TGF-β/BMP pathway, Smurf2 regulates a repertoire of other signaling pathways ranging from planar cell polarity during embryonic development to cell proliferation, migration, differentiation and senescence. Expression of Smurf2 is found to be dysregulated in many cancers including breast cancer. The purpose of the present study is to examine the effect of Smurf2 knockdown on the tumorigenic potential of human breast cancer cells emphasizing more on proliferative signaling pathway.

METHODS

siRNAs targeting different regions of the Smurf2 mRNA were employed to knockdown the expression of Smurf2. The biological effects of synthetic siRNAs on human breast cancer cells were investigated by examining the cell proliferation, migration, invasion, focus formation, anchorage-independent growth, cell cycle arrest, and cell cycle and cell proliferation related protein expressions upon Smurf2 silencing.

RESULTS

Smurf2 silencing in human breast cancer cells resulted in a decreased focus formation potential and clonogenicity as well as in vitro cell migration/invasion capabilities. Moreover, knockdown of Smurf2 suppressed cell proliferation. Cell cycle analysis showed that the anti-proliferative effect of Smurf2 siRNA was mediated by arresting cells in the G0/G1 phase, which was caused by decreased expression of cyclin D1and cdk4, followed by upregulation p21 and p27. Furthermore, we demonstrated that silencing of Smurf2 downregulated the proliferation of breast cancer cells by modulating the PI3K- PTEN-AKT-FoxO3a pathway via the scaffold protein CNKSR2 which is involved in RAS-dependent signaling pathways. The present study provides the first evidence that silencing Smurf2 using synthetic siRNAs can regulate the tumorigenic properties of human breast cancer cells in a CNKSR2 dependent manner.

CONCLUSIONS

Our results therefore suggest a novel relation between Smurf2 and CNKSR2 thereby regulating AKT-dependent cell proliferation and invasion. Owing to the fact that PI3K-AKT signaling is hyperactivated in various human cancers and that Smurf2 also regulates cellular transformation, our results indicate that Smurf2 may serve as a potential molecule for targeted cancer therapy of certain tumour types including breast cancer.

Disseminated histoplasmosis: a comparative study of the clinical features and outcome among immunocompromised and immunocompetent patients

BACKGROUND

Disseminated histoplasmosis is a chronic granulomatous disease caused by the dimorphic fungus, Histoplasma capsulatum. Clinical presentation can vary from the acute pulmonary to the chronic disseminated form. In India, disseminated histoplasmosis often presents with pyrexia of unknown origin with a presentation similar to 'disseminated tuberculosis' involving the adrenal glands and bone marrow. Due to rarity of the disease, data are lacking regarding its clinical presentation and outcome among immunocompromised and immunocompetent patients.

METHODS

During January 2000 to December 2010, we identified 37 patients of disseminated histoplasmosis and attempted to characterize the differences between immuno- compromised and immunocompetent patients. Demographic characteristics, clinical presentation, risk factors, laboratory findings, diagnostic yield, treatment received and prognosis were noted and compared between the two groups.

RESULTS

Eleven of 37 patients with disseminated histo- plasmosis were immunocompromised and 26 were immuno- competent. Comparison of their clinical features showed a higher frequency of skin lesions in the immunocompromised compared to the immunocompetent group (54.5% v. 11.5%). Pancytopenia and anaemia were more common among the immunocompromised (81.8%) compared to the immunocompetent (46.2%) group. In the immuno- compromised patients, the diagnosis was made most often by bone marrow aspirate and culture (72.7%) compared to the immunocompromised group where the diagnosis was most often obtained by adrenal gland biopsy and fungal cultures (57.7%). The cure rate was significantly higher in the immunocompetent group (73% v. 45%).

CONCLUSION

The clinical presentation and outcome of patients with disseminated histoplasmosis differs among immunocompromised and immunocompetent patients.

Smurf E3 ubiquitin ligases at the cross roads of oncogenesis and tumor suppression

Smad ubiquitin regulatory factors (Smurfs) belong to the HECT- family of E3 ubiquitin ligases and comprise mainly of two members, Smurf1 and Smurf2. Initially, Smurfs have been implicated in determining the competence of cells to respond to TGF-β/BMP signaling pathway. Nevertheless, the intrinsic catalytic activity has extended the repertoire of Smurf substrates beyond the TGF-β/BMP super family expanding its realm further to epigenetic modifications of histones governing the chromatin landscape. Through regulation of a large number of proteins in multiple cellular compartments, Smurfs regulate diverse cellular processes, including cell-cycle progression, cell proliferation, differentiation, DNA damage response, maintenance of genomic stability, and metastasis. As the genomic ablation of Smurfs leads to global changes in histone modifications and predisposition to a wide spectrum of tumors, Smurfs are also considered to have a novel tumor suppressor function. This review focuses on regulation network and biological functions of Smurfs in connection with its role in cancer progression. By providing a portrait of their protein targets, we intend to link the substrate specificity of Smurfs with their contribution to tumorigenesis. Since the regulation and biological functions of Smurfs are quite complex, understanding the oncogenic potential of these E3 ubiquitin ligases may facilitate the development of mechanism-based drugs in cancer treatment.

Retinoic acid receptor β2 (RARβ2): nonivasive biomarker for distinguishing malignant versus benign prostate lesions from bodily fluids

Alterations in the methylation patterns of promoter CpG islands have been associated with the transcriptional inhibition of genes in many human cancers, including prostate cancer (PCa).

OBJECTIVES

The aim of our study was to evaluate the diagnostic value of aberrant promoter hypermethylation of retinoic acid receptor β2 (RARβ2) gene in serum DNA samples from patients with the diagnosis of PCa and benign prostatic hyperplasia (BPH), as a new epigenetic biomarker in distinguishing between malignant and non-malignant lesions.

MATERIALS AND METHODS

Aberrant promoter hypermethylation was investigated in genomic DNA isolated from the serum of 91 patients diagnosed with of PCa and 94 with BPH (control subjects). In order to evaluate the methylation status of the RARβ2 gene we used the quantitative methylation-specific PCR (QMSP) method.

RESULTS

Promoter hypermethylation of RARβ2 gene was detected in serum samples from 89 of 91 (92.86%) patients with PCa, and in 10 of the 94 (10.7%) patients with BPH.

CONCLUSIONS

RARβ2 represents a promising molecular biomarker which may be used in discriminating between malignant and benign prostatic diseases by noninvasive methods.

Prognostic significance of STAT3 and phosphorylated STAT3 in human soft tissue tumors - a clinicopathological analysis

Background

Signal transducer and activator of transcription 3 (STAT3) is a key signaling molecule and a central cytoplasmic transcription factor, implicated in the regulation of growth. Its aberrant activation has been demonstrated to correlate with many types of human malignancy. However, whether constitutive STAT3 signaling plays a key role in the survival and growth of soft-tissue tumors is still unclear and hence needs to be elucidated further. In our study we examined the expression levels of STAT3 and pSTAT3 in different grades of soft tissue tumors and correlated with its clinicopathological characteristics.

Methods

Expression levels of STAT3 and pSTAT3 in soft tissue tumors were studied using Immunohistochemistry, Western blotting and Reverse transcriptase- PCR and correlated with its clinicopathological characteristics using Chi squared or Fisher's exact test and by logistic regression analysis. Statistical analysis was done using Intercooled Stata software (Intercooled Stata 8.2 version).

Results

Of the 82 soft tissue tumor samples, fifty four (65.8%) showed immunoreactivity for STAT3 and twenty eight (34.1%) for pSTAT3. Expression of STAT3 and pSTAT3 was significantly associated with tumor grade (P < 0.001; P < 0.001), tumor location (P = 0.025; P = 0.027), plane of tumor (P = 0.011; P = 0.006), and tumor necrosis (P = 0.001; P = 0.002). Western blotting and RT-PCR analysis showed increased expression of STAT3 and p-STAT3 as grade of malignancy increased.

Conclusion

These findings suggest that constitutive activation of STAT3 is an important factor related to carcinogenesis of human soft tissue tumors and is significantly associated with its clinicopathological parameters which may possibly have potential diagnostic implications.

How can we meet the information needs of patients with early stage papillary thyroid cancer considering radioactive iodine remnant ablation?

In patients with early stage papillary thyroid carcinoma (PTC) who have had a thyroidectomy, the decision must be made to accept or reject radioactive iodine remnant ablation (RRA). Counselling patients about this decision can be challenging, given the medical evidence uncertainties and the complexity of related information. Although physicians are the primary source of medical information for patients considering RRA, some patients have a desire for supplemental information from sources such as the internet. Yet, thyroid cancer resources on the internet are of variable quality, and some may not be applicable to the individual case. We have developed a computerized educational tool [called a decision aid (DA)], directed to patients with early stage papillary thyroid cancer, and intended as an adjunct to physician counselling, to relay evidence-based medical information on disease prognosis and the choice to accept or reject RRA. DAs are tools used to inform patients about available treatment options and have been utilized in oncologic decision-making. We tested our web-based DA in fifty patients with early stage PTC and found that it improved medical knowledge. Furthermore, participants found the technical usability of the tool acceptable. We are currently conducting a randomized controlled trial comparing the use of the DA plus usual care to usual care alone to confirm the educational benefit of the website and examine its impact on the decision-making process. In the future, DAs may play an expanded role as an adjunct to physician counselling in the care of patients with thyroid cancer.

Disseminated pseudallescheriosis in a dog

A case of disseminated pseudallescheriasis in a German Shepherd bitch is presented. Bones (ilium, a rib and phalanges), joints (elbow and acetabulum) and the surrounding tissues were the principal organs affected. In addition, Pseudallescheria boydii was isolated, in lower numbers, from the eye, kidney, lymph nodes draining the affected regions and urine. The dog was euthanized. P. boydii was identified by morphologic characteristics and molecular techniques (beta tubulin sequence). In addition, an ITS nucleotide sequence analysis showed that this strain differed from another isolate identified as Scedosporium apiospermum that had caused a disseminated infection in another German Shepherd. The importance of the molecular characterization of fungi belonging to the Pseudallescheria/Scedosporium complex, isolated from animals is stressed in light of the ongoing attempts to recharacterize these fungi.

Evaluation of dental and maxillary development in patients with cleft lip alveolus

Our purpose was to determine in 20 unilateral cleft lip and alveolus subjects characteristics of the maxillary permanent teeth and maxillary arch development. Clinical and radiographic examinations have been carried out to identify congenitally missing teeth and sagittal skeletal patterns. Study cast assessment was undertaken to evaluate mesiodistal widths of individual teeth, intercanine and intermolar distances for the maxillary arch, as well as dental relationships. We observed that the congenital absence of the upper incisors was higher on the cleft side than on the non-cleft side. There was a statistically significant difference between the mesiodistal widths of cleft-side permanent upper lateral incisors, and their antimeres (p<0.05). Most of the patients presented a class II dental relationship on the affected side comparing to class I/class III Angle on the unaffected side. We concluded that patients with isolated cleft lip and alveolus present perturbations in dental and maxillary arch development, a more severe disruption being recorded on the cleft side.

Effects of percutaneous transluminal coronary angioplasty on cardiopulmonary responses during exercise

AIM

The aim of this study was to examine by means of percutaneous transluminal coronary angioplasty (PTCA) whether dilating blocked coronary arteries in patients with coronary heart disease will improve relevant attributes measured during cardiopulmonary exercise testing (CPET).

METHODS

Fourteen myocardial ischemia patients (13 male, 1 female; age range: 42-72 years), who were referred for cardiac catheterization, participated in the study. Eight patients underwent PTCA (experimental group) and 6 did not (control group). All subjects performed CPET about 2 weeks before and 3 weeks after cardiac catheterization.

RESULTS

The results of electrocardiogram (ECG) analysis reveal a very low predictive accuracy (36%) for identifying coronary heart disease and/or anatomical changes caused by the PTCA. However, selected CPET parameters in the experimental group only showed significant post-PTCA changes from baseline. Peak oxygen uptake (VO(2)) increased from 17.49 to 20.75 mL x kg(1) x min(1), ventilatory anaerobic threshold from 12.15 to 14.39 mL x kg(1) x min(1), peak oxygen pulse (O(2)pulse) from 11.76 to 13.27 mL x beat(1), and O(2)pulse slope from 7.05 to 9.25, slope category. No significant inter- or intra-group differences were found in peak exercise heart rate, respiratory exchange ratio, subjective rating of perceived exertion, or systolic and diastolic blood pressure.

CONCLUSIONS

This study suggests that selected CPET parameters seem to be highly sensitive to changes in cardiac function caused by the PTCA, significantly more than with conventional stress ECG. These findings merit further investigation.

Assessment of the efficacy of oral vaccination of livestock guardian dogs in the framework of oral rabies vaccination of wild canids in Israel

Since 1956, red foxes (Vulpes vulpes) and golden jackals (Canis aureus) have been the primary vectors maintaining wildlife rabies in Israel. Oral rabies vaccination of wild canids, initiated in 1998, resulted in near-elimination of the disease in wildlife by 2005. In 2005 and 2006, an outbreak of rabies was observed in stray dogs in the vaccinated area of the Golan Heights, with no cases in foxes or jackals. Epidemiological investigations showed that the infected dogs were from territories across the border. This was confirmed by molecular analysis, which showed that the virus was different from rabies isolates endemic to this area. The objective of this study was to determine bait acceptance and the feasibility of oral rabies vaccination in packs of livestock guardian dogs. Coated sachets and fishmeal polymer baits of Raboral V-RG (Merial, USA) were tested in five different test zones. Both formats were hand-fed to individual dogs and to dogs belonging to dog packs. Bait uptake and consumption were observed in each dog. The estimated efficacy of oral rabies vaccination was very low (a maximum of 28%). Vaccine delivery problems were observed in dogs belonging to packs, whereby dominant animals consumed multiple baits and in competitive situations baits were swallowed whole. The uncertainty of oral vaccination necessitated turning to other methods to control this outbreak: stray dogs were removed and herd dogs were vaccinated parenterally. This study showed that oral rabies vaccination of dogs in packs using baits designed for wildlife would not be effective. Possibly, different baits or steps to circumvent competition within the pack will make this approach feasible.

ACTIDOM--a microsystem based on MEMS for activity monitoring of the frail elderly in their daily life

A "ambulatory activity recorder" was developed, with 3 accelerometers and 3 magnetometers, to detect and qualify the elementary activities of a person, such as walking and transfers. The signal processing is explained, along with the preliminary results obtained on young and older healthy subjects. This work open the way to continuous and automatic monitoring of the level of mobility.

Rabies vaccination programme for red foxes (Vulpes vulpes) and golden jackals (Canis aureus) in Israel (1999-2004)

Since 1956, red foxes (Vulpes vulpes) and, to a lesser extent, golden jackals (Canis aureus), have been the primary vectors maintaining endemic wildlife rabies in Israel. Starting in the autumn of 1998, oral rabies vaccination campaigns have been conducted in Israel targeting these two wildlife species, with increasing yearly geographical extension. Significant data have been accumulated from an area of approximately 5,200 km2 in Northern Israel. In the spring of 2003 the project was extended to 14,000 km2 and in the autumn to 21,000 km2, covering almost all inhabited areas in Israel and the West Bank. A total of two million RABORAL V-RG (Merial) vaccine-filled baits were distributed bi-annually by plane or helicopter at 14-19 baits km2. Since the onset of oral vaccination activities in 1998, annual bait acceptance in the vaccination zones has been demonstrated by biomarker detection (with tetracycline) in 55 % (429/783) of bone samples of target animals submitted for diagnosis. In 1999 to 2004, vaccine contact and induction of immunity in animals collected from the vaccination zones were reflected by seroconversion in 66 of 284 animals (23 %). By the year 2004, rabies cases declined sharply in all progressively vaccinated areas.