Functional Comparison of Blood-Derived Human Neural Progenitor Cells

Induced pluripotent stem cell (iPSC)-derived neural progenitor cells (NPCs) are promising tools to model complex neurological or psychiatric diseases, including schizophrenia. Multiple studies have compared patient-derived and healthy control NPCs derived from iPSCs in order to investigate cellular phenotypes of this disease, although the establishment, stabilization, and directed differentiation of iPSC lines are rather expensive and time-demanding. However, interrupted reprogramming by omitting the stabilization of iPSCs may allow for the generation of a plastic stage of the cells and thus provide a shortcut to derive NPSCs directly from tissue samples. Here, we demonstrate a method to generate shortcut NPCs (sNPCs) from blood mononuclear cells and present a detailed comparison of these sNPCs with NPCs obtained from the same blood samples through stable iPSC clones and a subsequent neural differentiation (classical NPCs-cNPCs). Peripheral blood cells were obtained from a schizophrenia patient and his two healthy parents (a case-parent trio), while a further umbilical cord blood sample was obtained from the cord of a healthy new-born. The expression of stage-specific markers in sNPCs and cNPCs were compared both at the protein and RNA levels. We also performed functional tests to investigate Wnt and glutamate signaling and the oxidative stress, as these pathways have been suggested to play important roles in the pathophysiology of schizophrenia. We found similar responses in the two types of NPCs, suggesting that the shortcut procedure provides sNPCs, allowing an efficient screening of disease-related phenotypes.

[Differentiated thyroid carcinoma: prognostic factors]

Factors influencing prognosis and long term outcome of thyroid cancer have been described by several groups. It is, however, not clear how the moderate iodine deficiency in Hungary can influence the previously described prognostic factors by other means than shifting differentiated cancer incidence toward the follicular type. Data of 423 out of 472 patients who had been operated on for papillary (372) and follicular (100) thyroid cancer between 1971 and 1997 at our institution have been analyzed retrospectively. Histological specimens were re-evaluated and, if needed, revised. Survival curves were compared using the Kaplan-Meier method. The overall 5 and 10 year survival rates were 93% and 89% for papillary, and 92% and 80% for follicular carcinoma. As an independent factor extrathyroidal invasion (papillary p = 0.000, follicular p = 0.000), lymph node involvement (papillary p = 0.000, follicular 0.011), distant metastases (papillary p = 0.000, follicular p = 0.000), and age over 40 years (papillary p = 0.000, follicular p = 0.000) had negative influence on survival. Multifocality, gender, type of surgery (total or near-total thyroidectomy vs. less than near-total thyroidectomy), and lymphocytic infiltration did not influence survival. Iodine intake did not influence survival, however, the incidence of follicular cancer was higher in iodine deficient regions. When analyzing the papillary and follicular groups separately by Cox regression, extrathyroidal invasion (p = 0.008), lymph node metastasis (p = 0.004), distant metastasis (p = 0.000), and age over 40 years (p = 0.000) were significant predictors in the papillary group, while only tumor extrathyroidal invasion (p = 0.019), and distant metastases (p = 0.000) were significant negative factors in the follicular group.

[Complications of laparoscopic cholecystectomy]

Number of bile duct injuries is rising with the spreading of laparoscopic cholecystectomy. Authors analyse the complications in the last 8 years, especially the bile duct injuries. During this period 1657 laparoscopic cholecystectomies were performed. Complication occurred in 28 cases during the intra- and postoperative period (1.68%). Main bile duct injury was detected in 7 cases (0.42%), while leakage from a Luschka's duct appeared in 10 patients. Three bleeding complications, 2 injuries of the duodenum and in 3 cases severe intraabdominal infection was observed. Four patients died (0.24%).

[Change in the surgical treatment of benign adrenal gland tumors. Laparoscopic adrenalectomy]

Since 1995 fifty-two patient was operated on the Ist Department of the Surgery (DEOEC) due to uni- and bilateral tumor of the adrenal gland. Between May 1999, and December 2000 the authors performed 11 transperitoneal laparoscopic adrenalectomies (LA). Conversion due to bleeding in 3 cases and due to suspected malignancy in 1 case was necessary. This malignant lesion could have been resected during the open surgery after only the temporary dissection of the right renal vein. Complete resection was carried out in 9 cases. In 2 cases where a well circumscribed adenoma or teratoma was visualized, only enucleation was performed. The complication rate was low (1 ptx). Blood replacement was not necessary. The operation mean time was not any longer in LA compared to the open surgical approach. Preoperatively adrenaline (A), noradrenaline (NA), metadrenaline (metA), normetadrenaline (normetA) and vanillylmandelic acid (VMA) were measured in 24-h urine samples. Adrenal imagery consisted in all patients of abdominal computed tomography and in 4 patients adrenal magnetic resonance imaging but [131I] metaiodobenzylguanidine (MIBG) and octreotide scintigraphy were not performed.

CONCLUSION

In the authors experience laparoscopic adrenalectomy is absolutely superior to the open surgery for the benign diseases of the adrenal gland not bigger than 6 cm. A short, uncomplicated and painless postoperative period can be achieved for the patients, with the same efficacy and safety compared to the conventional surgery. Enucleation without the whole adrenal gland excision is also possible.

Surgically treated Hashimoto's thyroiditis

The primary way to treat Hashimoto's thyroiditis is conservative. However, it has a relatively high occurrence in operated patients, up to 13% in the literature. Indications for surgery are suspicion of malignancy, and/or trachea/esophagus compression. 2818 thyroid operations were performed at our department between 1986 and 1995. 279 patients suffered from thyroid cancer and 2539 had benign disease. Histology revealed Hashimoto's thyroiditis in 118 cases. Coexisting malignant thyroid tumor was found in 14 cases (11.8%): 9 papillary, 2 follicular, 1 anaplastic cancer, and 2 non-Hodgkin lymphoma. Postoperative recurrent laryngeal nerve paralysis occurred in 8 cases, of which 6 remained permanent. This relatively high incidence supports the importance to identify the laryngeal nerve during every operation for Hashimoto's thyroiditis. Four patients had temporary and one had permanent hypoparathyroidism. Coexistence of Hashimoto's thyroiditis and thyroid carcinoma, the increased risk for the development of non-Hodgkin's lymphoma in chronic lymphocytic thyroiditis and the need for thyroxin supplementation in many cases justify a careful, long-term follow-up of patients with Hashimoto's disease.

Special features of childhood and juvenile thyroid carcinomas

A retrospective analysis was conducted on 36 patients who underwent surgery for childhood or juvenile thyroid cancers and who were regularly followed up during the course of 30 years. The biological properties and late prognosis of these patients were assessed, and the clinical and morphological characteristics of the tumors were examined. The distribution of the DNA content in the tumor cells was compared with that in adult tumor cells, and the results of cytogenetic tests performed on mothers operated on for thyroid tumors and their children are also discussed.

[Value of thyroglobulin determination in the follow up treatment of patients with thyroid cancer]

Tg measurements were performed regularly in 96 thyroid carcinomas in order to evaluate metastases and local recurrencies. Elevated Tg level was detected in 11 patient. 7 of them were operated on because of local recurrencies and lymph node metastases. All patients that needed reoperation had elevated Tg level. During the follow up period no patient needed reoperation who had elevated Tg level or metastases detected by other diagnostic procedures. Summarising the results they found the Tg level measurements valuable in the follow up of patients with differentiated thyroid cancer. The Tg level measurements can supplement or sometimes replace 131J thyroid scanning.

Rapid cytological diagnosis during thyroid surgery

The authors report the results of the use of intra-operative cytological examinations of the thyroid gland. In their hands, the method has a 96.3% accuracy in 757 patients with thyroid disorder. Benign conditions and malignant tumours can be correctly diagnosed. False negative diagnosis can arise with well-differentiated follicular carcinoma and the differentiation of follicular adenoma may be difficult. Atypical adenomas may give a false positive diagnosis. The incorrect diagnosis of chronic lymphocytic thyroiditis is unlikely when sufficient attention is given to the whole clinical picture.

[Management of lung and bone metastases from thyroid cancers of differentiated structures]

During a period of thirty years (1959-1989) 374 patients underwent surgery for differentiated thyroid carcinoma at the 1st Department of Surgery of the University Medical School in Debrecen. Distant metastases were found in the lungs or bones in 36 patients (9.6%). In 20 patients the first clinical sign of the primary disease was the distant metastasis. The aspects of surgical treatment depended on whether the metastases were solitary or multiple, capable or uncapable of radioiodine uptake. Whereas the majority of pulmonary metastases respond well to 131I-treatment the therapy of bone metastases is multidisciplinary. The 5-year survival rate was 47%, the 10-year one 19%.

[Prognostic significance of nuclear DNA content in highly malignant thyroid tumors]

The nuclear DNA content of tumour cells is correlated with the clinical outcome of a wide range of malignant disorders, among them thyroid neoplasia. The authors performed DNA determinations by means of the Feulgen cytofluorimetric method and demonstrate the connection between ploidy and biological aggressivity in cases of highly malignant thyroid tumours. The nuclear DNA content was measured in fresh surgical specimens from 53 patients suffering from malignancy, 13 of which proved pathohistologically to be highly malignant: 8 were anaplastic giant cell carcinomas, 3 squamous cell carcinomas and 2 were malignant lymphomas. 4 of the 8 giant cell carcinomas contained co-existent well-differentiated areas, namely follicular carcinomas in 3 patients and a papillary carcinoma in the 4th patient. 11 of the patients died of cancer, 9 within the 1st year. A different DNA distribution was found in the two survivors over a 10-year follow-up period. One of them showed a diploid cell population and the other facultative polyploidy, as opposed to the aneuploid pattern found in the 11 deceased patients. Both patterns confirm the correlation with a favourable outcome.

[The role of bile in the development of colon cancer induced by 1,2-dimethyl hydrazine in rats]

Experimental operative models were created in order to investigate the role of the bile acids in the development of colon cancer in rats. These techniques changed the concentration of bile acids in different parts of the colon, and the daily fecal total bile acid levels. The relationship between these changes and the development of 1,2-dimethylhydrazin-induced colon cancer was studied. Significantly more tumors than in the control group were found if the daily total bile acid level and the concentration of bile acids in the left subsite of the large bowel was increased. Our results suggest that bile acids, as promoting factors, may play a role in the development of colon cancer in rats.

Effects of indomethacin and prostaglandins I2 and E2 on the tone of human isolated mesenteric arteries

The actions of indomethacin (IND), PGE2 and PGI2 were studied on the tone of isolated mesenteric arteries obtained from operated patients. The cyclooxygenase inhibitors IND (3 mumol/l) and suprofen (0.58 mumol/l) increased the resting tone and potentiated the contractile responses to electrical stimulation and noradrenaline. Low concentrations of PGE2 (0.7-5.6 X 10(-9) mol/l) decreased the baseline tone and reduced the stimulation-evoked contractions whereas higher concentrations (from 5.7 X 10(-8) mol/l) increased the tone of vessels. PGI2 (0.7-10.8 X 10(-9) mol/l) also relaxed IND-treated arteries but, in contrast to PGE2, it did not produce contraction even at a concentration of 10(-6) mol/l. Prostacyclin reduced the tone evoked and sustained by a high concentration of PGE2 or PGF2 alpha, the IC50 values being 46.2 or 7.9 X 10(-9) mol/l, respectively. The contractile responses to electrical stimulation and to noradrenaline were also inhibited by PGI2 (IC50 5.6 and 6.8 X 10(-9) mol/l, respectively). These results suggest that the smooth muscle cells of human mesenteric arteries are just as sensitive to IND, PGE2 and PGI2 as are those from laboratory animals. Our observations may be of clinical importance.

The Hellinger distance as used for the representation of serological ABO distances among earlier human populations

The Hellinger (arccos) distance is examined for the purpose of demonstrating to what extent it represents the differences among populations. When the Hellinger distance is employed to estimate gene frequencies, a result very similar to that of the maximum likelihood (Bernstein) method can be gained. It is pointed out that in palaeoserological examinations the Dobson/Ikin method usually mentioned as Fisher method is not equivalent to the Bernstein method.