Effect of nutritionally complete feed with different fatty acid profile on the fatty acid composition of common carp fillet

Hungarian pond fish production is based on grains, but in the last few years, new ideas and efforts have appeared to intensify carp production technology. The basic objective was to change grain-based feeding to nutritionally complete feeds, which ensure rapid growth and more efficient feed conversion rates. This study aimed to utilise empty ponds during the summer period for carp production. Thus, there is no need for fish producers to catch fish in large ponds at the operating water level to satisfy smaller market demands appearing during the summer.

The other aim was to compare the meat quality of fish raised on traditional and nutritionally complete feed until market size in the last year of production. Fatty acid profile and the levels of saturated, monounsaturated, and polyunsaturated fatty acids in fish fillets were specified, and their ratios were analysed. The result showed that nutritionally complete feed with different fatty acid composition affects the fatty acid composition of carp fillet during the rearing period. Quality of the fillet of carp fed with higher unsaturated fatty acid content became more favourable to the consumers due to health promoting effect of polyunsaturated fatty acids.

Age-dependent effects of short-term exposure of T-2 toxin or deoxynivalenol on lipid peroxidation and glutathione redox system in broiler chickens

Purpose of this study was to investigate the age-dependent, short-term effects of T-2 toxin (5.77 mg T-2 and 1.40 mg HT-2 toxin/kg feed) or deoxynivalenol (DON) (4.86 mg DON and 1.39 mg 15-acetyl-DON/kg feed) in one and three weeks old broiler chicken to observe the changes in parameters of lipid peroxidation, glutathione redox system, and expression of genes related to glutathione redox system in the first 24 h of mycotoxin exposure. Glutathione-redox system responsed to T-2 toxin exposure in both age groups for T-2 toxin in the first 8 h of exposure, while a reactivation was observed in the 3-week-old group after 20 h, although lipid peroxidation did not change significantly. DON did not alter these parameters, only at gene expression level. Gene expression of phospholipid hydroperoxide glutathione peroxidase (GPX4) showed minor, but significant, changes in both age- and mycotoxin exposure groups. Glutathione reductase (GSR) showed a dual response for the mycotoxin exposure, which was not consequent in either age groups, or treatments. Glutathione synthetase (GSS) showed a decreasing tendency in the younger animals while in the older group elevating tendency was observed as effect of both mycotoxins. Time, treatment and their combined effect also showed relation with the changes in the parameters.

Changes in the regulation and activity of glutathione redox system, and lipid peroxidation processes in short-term aflatoxin B1 exposure in liver of laying hens

The purpose of this study was to investigate the short-term (48 hr) effects of feeding aflatoxin contaminated diet (170.3 μg/kg AFB1) in 49-week-old laying hens. Liver samples were taken at 12-hr intervals. Feed intake, body weight, absolute and relative liver weight were the same in groups. However, there was no feed intake during both dark periods (between 12nd to 24th and 36th to 48th hours of the experiment); therefore, aflatoxin intake was also negligible. Markers of initial phase of lipid peroxidation, conjugated dienes and trienes did not change as effect of aflatoxin, but terminal marker, malondialdehyde content was significantly higher at 12 hr as effect of aflatoxin. No significant difference was found in reduced glutathione concentration and glutathione peroxidase activity between the groups. Expression of glutathione peroxidase 4 gene (GPX4) was significantly reduced due to aflatoxin treatment at 12 and 24 hr, but induced later, while glutathione reductase gene (GSR) expression was significantly lower at 24 hr and glutathione synthetase gene (GSS) in aflatoxin-treated group at 12 hr. The results suggest that aflatoxin induced oxygen-free radical formation, but it did not reach critical level during this short period of time to cause activation of the expression of glutathione system.

Short-term effects of T-2 toxin exposure on some lipid peroxide and glutathione redox parameters of broiler chickens

The purpose of this study was to investigate the short-term effects of T-2 toxin exposure (3.09 mg/kg feed) on lipid peroxidation and glutathione redox system of broiler chicken. A total of 54 Cobb 500 cockerels were randomly distributed to two experimental groups at 21 days of age. Samples (blood plasma, red blood cell, liver, kidney and spleen) were collected every 12 h during a 48-h period. The results showed that the initial phase of lipid peroxidation, as measured by conjugated dienes and trienes in the liver, was continuously, but not significantly higher in T-2 toxin-dosed birds than in control birds. The termination phase of lipid peroxidation, as measured by malondialdehyde, was significantly higher in liver and kidney as a result of T-2 toxin exposure at the end of the experimental period (48th hour). The glutathione redox system activated shortly after starting the T-2 toxin exposure, which is supported by the significantly higher concentration of reduced glutathione and glutathione peroxidase activity in blood plasma at 24 and 48 h, in liver at 12, 24 and 36 h, and in kidney and spleen at 24 h. These results suggest that T-2 toxin, or its metabolites, may be involved in the generation of reactive oxygen substances which causes an increase in lipid peroxidation, and consequently activates the glutathione redox system, namely synthesis of reduced glutathione and glutathione peroxidase.

Effect of garlic oil supplementation on the glutathione redox system of broiler chickens fed with T-2 toxin contaminated feed

The aim of present study was to investigate whether garlic essential oil with natural organosulfur compounds that possess free radical scavenging activity is able to alleviate the adverse effects of T-2 toxin. In a two-weeks feeding trial with 14-day old Cobb cockerels (n=15 per group) housed in batteries, twelve experimental treatments were applied. The basal diet was experimentally contaminated with T-2 toxin at concentrations of 0, 0.52, 1.05 or 2.05 mg/kg and at each contamination level garlic oil was added at a dosage rate of 0, 0.3 or 1.5 g/kg, respectively. The experimental diets were fed for 14 days. In the first week of the trial, production traits showed numerically lower body weights, a lower feed intake, and subsequently higher feed to gain ratios in the animals exposed to T-2 toxin-contaminated diets. This effect became non-significant in the second week. Garlic oil supplementation at the lower dose of 0.3 mg/kg resulted in a significantly lower body weight gain at the highest T-2 toxin contamination level. The malondialdehyde concentration did not show any dose-related changes. The level of reduced glutathione was significantly higher in blood plasma as a result of the lower (0.3 g/kg) garlic oil supplementation and as an effect of T-2 toxin challenge in red blood cell haemolysate. Glutathione peroxidase activity showed the same trend. The results showed that the lower (0.3 g/kg) but not the higher (1.5 g/kg) dose of garlic oil supplementation had desirable effects on the measured redox parameters, eliminating some of the adverse effects of feeding T-2 toxin contaminated diet.

Correlations between daily weight gain, lipid peroxidation and glutathione status of liver and kidney in different pig genotypes

Abstract. Four pig hybrids (Pannon, Hungahib-39, Középtiszai and Dalland) were fattened up to 100±2 kg body weight. Feed intake and body weight were measured and daily weight gain was calculated. Malondialdehyde (MDA) and reduced glutathione (GSH) content, and glutathione peroxidase (GPx) activity were measured in liver and kidney. Daily weight gain was significantly lower in Pannon and Hungahib-39 hybrids. Amount of MDA was significantly higher in the liver of the hybrids with higher daily weight gain, and similar tendency was found in kidney. GSH content of liver did not differ significantly among the hybrids. The kidney of the Középtiszai hybrid had significantly lower GSH concentration than the others. GPx activity was the lowest in liver and kidney of Középtiszai hybrid. There was no significant correlation between daily weight gain and MDA content in liver, but positive correlation was found in the kidney of Pannon and Hungahib-39 hybrids. Daily weight gain showed significant correlation with GSH content of liver of Középtiszai hybrid. Between daily weight gain and GPx activity negative correlations were found in all hybrids and tissues, but none of them was significant. GSH content showed negative significant correlation with MDA content of liver of Középtiszai and in kidney of Pannon hybrid. Correlation between GSH content and GPx activity was positive and significant in the liver and kidney of Pannon hybrid. The results showed that different daily weight gain of pig hybrids has effect on the lipid peroxide and glutathione status of liver and kidney.

Negative allometry of docosahexaenoic acid in the fowl lung and pulmonary surfactant phospholipids

In a recent study (Comp. Biochem. Physiol. B. (2010)155: 301-308) we reported that the fatty acids (FA) of the avian (7 species) total lung phospholipids (PL) (i.e. lung parenchyma and surfactant together) provide allometric properties. To test whether this allometric scaling also occurs in either of the above components, in six gallinaceous species, in a body weight range from 150 g (Japanese quail, Coturnix coturnix japonica) to 19 kg (turkey, Meleagris gallopavo) the PL FA composition (mol%) was determined in the pulmonary surfactant, in native and in thoroughly lavaged lungs (referred to as lung parenchyma). In all three components docosahexaenoic acid (DHA) showed significant and negative allometric scaling (B = -0.056, -0.17 and -0.1, respectively). Surfactant PLs provided further negative allometry for palmitic acid and the opposite was found for palmitoleate and arachidonate. In the lung parenchymal PLs increasing body weight was matched with shorter chain FAs (average FA chain length) and competing n6 and n3 end-product fatty acids (positive allometry for arachidonic acid and negative for DHA). Negative allometric scaling was found for the tissue malondialdehyde concentration in the native and lavaged lungs (B = -0.1582 and -0.1594, respectively). In these tissues strong correlation was found between the MDA concentration and DHA proportion (r = 0.439 and 0.679, respectively), denoting the role of DHA in shaping the allometric properties and influencing the extent of in vivo lipid peroxidation of membrane lipids in fowl lungs.

Detection of a rare CDKN2A intronic mutation in a Hungarian melanoma-prone family and its role in splicing regulation

BACKGROUND

The major locus for melanoma predisposition is the cell cycle regulatory CDKN2A gene on chromosome 9p21. However, the frequency of germline coding mutations of the CDKN2A gene is lower than expected in melanoma-prone families linked to chromosome 9p21.

OBJECTIVES

To investigate whether the rare IVS1+37 G/C intronic mutation of the CDKN2A gene, recently identified in a Hungarian melanoma-prone family, influences mRNA splicing regulation.

METHODS

CDKN2A minigenes containing the wild-type and the mutant intronic sequence were created and transfected into HeLa cells with the aim of studying the mRNA transcripts.

RESULTS

The results revealed the emergence of a differential splicing pattern from the wild-type and the mutant minigene, suggesting that this mutation may alter the splicing of CDKN2A primary mRNA and therefore might have a pathogenetic role in familial melanoma.

CONCLUSIONS

We believe that these results confirm the importance of the identification and characterization of CDKN2A intronic mutations with a view to improving our understanding of the pathogenesis, and explain why the frequency of germline coding mutations of the CDKN2A gene is lower than expected in melanoma-prone families linked to chromosome 9p21.

The insulin resistance Grb14 adaptor protein promotes thyroid cancer ret signaling and progression

The growth factor receptor-bound protein (Grb) 14 is an adapter molecule of the Grb7/10/14 family with characteristic BPS domains serving to avidly bind tyrosine kinases. Grb14 inhibits insulin receptor (IR) catalytic activity through interaction with the BPS domain and impedes peptide substrate binding. Members of this Grb family have also been shown to interact with other kinases through their SH2 domain. Here we examined the functional role of Grb14 in thyroid cancer using loss- and gain-of-function approaches. Stable knockdown of Grb14 in thyroid cancer cells facilitated insulin receptor signaling. In contrast, RET phosphorylation was diminished in concert with reduced activation of Akt and STAT3. Loss of Grb14 also resulted in diminished cell proliferation and invasion both in vitro and in mouse flank xenografts. In complementary studies, forced expression of Grb14 interrupted insulin receptor signaling but facilitated RET activation, STAT3, and Akt phosphorylation. Consistent with these findings Grb14 over-expression enhanced cell invasion and resulted in striking metastases in an orthotopic thyroid cancer mouse xenograft model. Primary human thyroid cancer microarrays revealed a positive correlation between Grb14 expression and invasive behavior. Our findings uncover a new role for Grb14 in finely tuning receptor signaling and modulating thyroid cancer progression.

Effect of dietary fatty acid pattern on growth, body fat composition and antioxidant parameters in broilers

The effects of dietary fat supplementation on performance, fatty acid (FA) composition of tissues and antioxidant defence system of broilers were studied. Male broilers were placed in 20 floor pens (60 broilers per pen). The broilers were fed by diets with added different energy sources: lard (L); sunflower oil (SFO); soybean oil (SBO); and linseed oil (LSO). The treatments did not modify significantly growth performance and feed intake of the broilers. There was no effect of dietary FA pattern on reduced glutathione level and glutathione peroxidase activity of plasma, erythrocyte and liver samples. However, higher PUFA content of the diet resulted in a significant increase in malondialdehyde level of erythrocytes and liver. The broilers fed LSO diet more effectively maintained their antioxidant status with enhanced plasma radical scavenger capacity. FA composition in tissues reflected the FA pattern of the diets, although proportion of FAs with four or more double bonds was metabolic specific. LSO diet increased the level of C18:3, C20:5 and C22:6 in tissue lipids in relation to L, SFO and SBO diets. Significantly increased plasma radical scavenging capacity in concert with the enhanced C20:5 and C22:6 proportion in liver and muscle during LSO feeding indicate metabolic changes to counteract the oxidative injury. This may be related to the compounds produced after different biochemical pathways of n-6 and n-3 FAs.

Effects of ochratoxin A on some production traits, lipid peroxide and glutathione redox status of weaned piglets

The effect of feeding ochratoxin A (OTA) contaminated diet (379.6 and 338.1 microg/kg in starter and grower diets) on production traits, lipid peroxidation and some parameters of the glutathione redox system were investigated in weaned piglets over a seven-week period. Feed intake and feed conversion ratio (FCR) did not differ significantly, but in the first phase (0-28 days) the daily weight gain was significantly lower in the piglets fed the OTA-contaminated diet. Lipid peroxidation, as measured by the amount of malondialdehyde, glutathione content and glutathione peroxidase activity, did not change significantly in the blood plasma and red blood cell haemolysate in the OTA-loaded group, while malondialdehyde content increased significantly in the liver and markedly but not significantly in the kidney of piglets fed OTA-contaminated feed. Glutathione content did not differ significantly in the studied organs of the two groups while glutathione peroxidase activity of the OTA-loaded animals was significantly lower both in the liver and in the kidney. The results suggest that the use of feed-stuffs contaminated with low levels of OTA for seven weeks did not cause marked differences in the production traits or in lipid peroxidation and amount or activity of the glutathione redox system in the blood plasma, red blood cells and kidney, while significant changes occurred in the liver homogenate.

Investigation of lipid peroxide and glutathione redox status of chicken concerning on high dietary selenium intake

This study was designed to investigate the effects of excess (24.5 mg Se/kg feed) inorganic and organic dietary selenium supplementation on 3-week-old broilers. The experiments lasted 4 days. Intensity of lipid peroxidation processes (malondialdehyde, MDA) and the amount (reduced glutathione, GSH) and activity (glutathione peroxidase activity, GSHPx) of gluathione redox system were measured in blood plasma, red blood cell hemolysate and liver. Voluntary feed intake in the selenium-treated groups reduced remarkably. Elevated GSH concentration and GSHPx activity were measured in plasma and liver of both selenium-treated groups compared to the untreated control and the 'pair-fed' controls. The lipid peroxidation processes in the liver showed higher intensity than the control due to both selenium treatment. The applied dose of selenite and selenomethionine does not inhibit, but even improves the activity of glutathione redox system in the liver during the early period of selenium exposure.

Effect of feeding T-2 toxin contaminated feed on the utilisation of vitamin E in chickens

The purpose of the present study was to investigate the effect of experimental T-2 toxin load (2.35 mg/kg of feed) and vitamin E supply in the drinking water (10.5 mg/bird/day) on vitamin E levels of the blood plasma and liver in broiler chickens in a 14-day experiment. It was found that T-2 toxin load did not influence vitamin E content of the blood plasma except at day 3 after the toxin load when a moderate increase was detected in plasma vitamin E. No significant changes were found in vitamin E content of the liver. The simultaneous use of high-dose vitamin E supplementation and T-2 toxin load caused a significantly higher plasma vitamin E content but the changes were less expressed in the group subjected to T-2 toxin load. Vitamin E supply also resulted in a marked and significant increase in vitamin E concentrations of the liver on days 3 and 7 even in the T-2 loaded group, but this concentration significantly decreased thereafter. The results show that T-2 contamination of the diet has an adverse effect on the utilisation of vitamin E in broiler chickens.

Effect of different dietary fat sources on production traits, lipid peroxide status and on the glutathione redox system in African catfish [Clarias gariepinus (Burchell)] fingerlings. Short communication

Lipids are used to provide the energy to cover the metabolic needs and to provide essential fatty acids, which are important for membrane function [12]. Fats may contain high level of long chain polyunsaturated fatty acids, which are prone to peroxidation [8] and will interact with the antioxidant defense system [1]. There is contradiction in the literature about whether the intake of fish oil enhance [7] or deplete [4] tissue antioxidant defenses and the glutathione redox system in different organisms. The aim of the present study was to examine the effects of different dietary oils on parameters of the lipid peroxide state and the glutathione redox system in C. gariepinus fingerlings.

Differential utilization of hepatic and myocardial fatty acids during forced molt of laying hens

Feed was totally withdrawn from laying hens (n = 30, Hy-Line Brown, 608 d of age, 2.04 +/- 0.07 kg of mean BW) to induce molting. Ten birds were slaughtered on d 0 and 12, and the hepatic and myocardial triacylglycerol (TAG) and phospholipid (PL) fatty acid composition, as well as the tissue malondialdehyde (MDA) and reduced glutathione (GSH) concentrations were determined. The liver TAG and PL contents decreased by 24.3 and 16.1%, respectively, whereas the myocardial TAG content increased by 12%, and the PL decreased by 22%. Liver TAG fraction has been found to selectively retain arachidonic and docosahexanoic acids. Hepatic PL fatty acids were markedly affected by fasting; these changes reflected an altered PL metabolism, primarily degradation. Liver TAG compensated for the absence of dietary fatty acids, because we found practically no qualitative alteration in myocardial TAG. The lipid peroxide status, as measured with MDA content was, accordingly, increased in the liver tissue only. In the myocardial PL fatty acids, preferred conservation of arachidonic acid was shown, and it was hypothesized that energy deprivation of cardiomyocytes strongly improved PL degradation in fasting laying hens and influenced PL homeostasis. Generally the physiological recovery from forced molting associated with fasting is complete; however, the use of total feed withdrawal methods should be reevaluated.

Effect of supplementation with methionine and different fat sources on the glutathione redox system of growing chickens

The effect of supplementary methionine and fats of different saturation levels on the glutathione redox system of growing broiler cockerels was studied. The diet of three groups of chicks was supplemented with corn germ oil, beef tallow and fish oil at the levels of 30 g/kg and 50 g/kg of feed, respectively. The diet of further three groups was supplemented with methionine (5 g/kg of feed) in addition to the different fat sources. Control chicks were fed with a compound feed without methionine and fat supplementation. Reduced glutathione (GSH) and glutathione disulphide (GSSG) content as well as glutathione peroxidase activity in the liver were determined and GSH/GSSG ratio was calculated at day old and then at one and three weeks of age. Our results indicate that supplementary methionine stimulates both the synthesis of the glutathione redox system and glutathione peroxidase activity in growing chickens in the first period of postnatal life, when the risk of lipid peroxidation is high due to feeding unsaturated fats in the diet.

Effect of excess selenium supplementation on the glutathione redox system in broiler chicken

Selenium, as part of selenocysteine, is the active centre of selenoenzymes. Excess amount of selenium generates oxygen free radicals and reacts with thiol compounds such as reduced glutathione, composing seleno-diglutathione. These reactions impair the amount and/or activity of the biological antioxidant defence system. In the present experiment the effects of two inorganic selenium sources (Na2SeO3, Na2SeO4) on lipid peroxidation and on the content and activity of some components of the antioxidant defence mechanism were studied in Ross 308 hybrid cockerels. In the tissues examined, the glutathione redox system was altered in different ways as an effect of excess selenium. The amount of glutathione and, consequently, glutathione peroxidase activity declined in the blood plasma and in the red blood cell haemolysate, while in the liver malondialdehyde concentration increased only at the end of the experimental period as a result of the boosted enzyme activity. The authors suppose that the cause of increased lipid peroxidation was the potential toxic effect of selenium accumulation above the actual demand.

Clinical and biochemical features of sporadic and hereditary phaeochromocytomas: an analysis of 41 cases investigated in a single endocrine centre

The aims of this study were to estimate the prevalence of phaeochromocytomas among adrenal tumours and to analyse the clinical and biochemical features of sporadic and hereditary tumours. Our series of 609 adrenal tumours evaluated between January 1995 and July 2003 was reviewed. Catecholamine content in phaeochromocytoma tissues was also determined and correlated with clinical behaviour and biochemical parameters of patients. Forty-one (6.7%) of the 609 patients had phaeochromocytomas, of which 28 were sporadic (25 benign and three malignant) and 13 (all benign) were associated with hereditary diseases (multiple endocrine neoplasia type 2A in seven cases from four unrelated families carrying mutations of the RET gene, von Hippel-Lindau disease in two unrelated cases with mutations of the VHL gene, and type 1 neurofibromatosis in four unrelated cases). Bilateral tumours were found in three patients with hereditary syndromes and in one sporadic case. Tumour diameter was slightly but not significantly greater in patients with hereditary than in those with sporadic tumours. Systolic but not diastolic blood pressure was significantly higher in patients with sporadic compared with those with hereditary tumours, but comparison of other clinical data and biochemical parameters indicated an absence of significant differences in the mean age, presenting symptoms, heart rate, or fasting serum glucose levels. Tissue catecholamine content measured in 8 sporadic and 5 hereditary phaeochromocytomas was highly variable and it failed to show significant differences between hereditary and sporadic tumours. These results indicate a high proportion of hereditary diseases among patients with phaeochromocytomas. Genetic and clinical testing for hereditary diseases may be of great help to offer an appropriate treatment, follow-up and family screening for these patients.

Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing's syndrome

The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and beta-crosslaps (beta-CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 19-70 yr). Serum OC and beta-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5+/-12 ng/ml, mean+/-SD) and between 08:00 and 09:00 h (17.7+/-9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5+/-7.0 and 28.3+/-12.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3+/-12.2 to 21.8+/-9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8+/-15.9 to 24.1+/-14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5+/-4.6 ng/ml) and in patients with adrenal incidentalomas (12.2+/-6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in beta-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.

Segregation of the V804L mutation and S836S polymorphism of exon 14 of the RET gene in an extended kindred with familial medullary thyroid cancer

In multiple endocrine neoplasia type 2A (MEN 2A) and familial medullary thyroid cancer (FMTC), the majority of germline mutations are restricted to specific positions in exons 10 and 11 of the RET gene. However, germline mutations may very occasionally occur in other exons, including exon 14 of the RET gene. Interestingly, an increased frequency of a rare germline sequence variant of the RET exon 14, S836S, has been detected in patients with sporadic medullary thyroid cancer (MTC), and this variant has been proposed to play a role in the genesis of MTC and, perhaps, FMTC. In this study we report the segregation of a germline V804L mutation and a germline sequence variant S836S in exon 14 of the RET gene in an extended Hungarian FMTC kindred comprising 80 individuals of four generations. Molecular analysis of the RET gene was performed by direct DNA sequencing in 23 family members, of whom 12 had the V804L mutation, three had the V804L mutation and S836S polymorphism in separate alleles, and six had the S836S polymorphism, all in heterozygous forms. Two of the family members had neither mutation nor polymorphism of the RET gene. Three of the family members who had the V804L mutation and one member who could not be tested for mutation were operated for non-metastatic MTC, while one member with MTC who had the V804L mutation refused surgery. In all patients affected with MTC, the disease developed relatively late in life and never caused death. None of the other family members carrying the V804L mutation and/or the S836S polymorphism had clinical or biochemical evidence of MTC. These observations suggest that the co-existence of the V804L mutation and S836S polymorphism in separate alleles does not seem to aggravate the relatively low-risk disease phenotype characteristic in most patients with codon 804 mutations of the RET exon 14.

Identification of acute intermittent porphyria carriers by molecular biologic methods

Acute intermittent porphyria (AIP) is an autosomal dominant disease caused by mutations of the gene coding for hydroxymethylbilane synthase. Acute attack of AIP is a potentially life-threatening condition precipitated by certain drugs, alcohol, fasting and stress. Biochemical diagnosis before the manifestation of the symptoms is problematic, and genetic screening is required to identify asymptotic carriers. The aim of this study was to establish a fast, reproducible and reliable genetic method to detect mutations causing AIP. Exon 10 of one healthy individual and 12 AIP patients was studied using a recently developed method, temporal temperature gradient electrophoresis (TTGE). Mutation of exon 10 was detected using TTGE in one patient, DNA sequence analysis confirmed the presence of a heterozygous point mutation causing substitution of the arginine in position 173 of the gene with glutamine. These results were also confirmed using restriction enzyme analysis, and this method and TTGE identified a child of this patient as an asymptotic carrier of AIP.

Proposal for improved staging criteria for carcinoma of the esophagus and cardia

OBJECTIVE

Current staging for carcinoma of the esophagus and cardia remains imprecise. In an effort to improve on presently accepted staging criteria, new and improved criteria were sought.

METHODS

A total of 408 specimens resected for carcinoma of the esophagus or cardia between January 1, 1970, and January 1, 1994, were available for analysis. Pathology reports were reviewed, and available histologic slides were examined microscopically. When necessary, paraffin blocks of excised specimens were recut for further pathologic evaluation. On the basis of these findings, tumors were staged according to the criteria of American Joint Committee on Cancer (AJCC). New criteria were established based on the WNM concept and staged accordingly. Survival rates based on these sets of criteria were calculated for each stage, and results were compared.

RESULTS

Because our previous studies had shown no advantage provided by the revised AJCC criteria compared with those originally proposed, we modified the WNM system by eliminating the subdivisions of Stage II, reducing the T categories by 1, T3 and T4 having shown no survival differences, and increasing the N categories by 1, depending on the number of nodes involved, e.g. NO = no positive nodes; N1 = 1-4 positive nodes, and N2-5 or more positive nodes. The resulting staging system and 5-year survival rates obtained thereby are as follows: Stage O (TO, is, 1 NO), 88.2%; Stage I (T1N1, T2NO), 50.3%; Stage II (T2N1, T3N0) 22.5%; Stage III (T3N1, any T N2), 10.7%; and Stage IV (M1) 0%.

CONCLUSIONS

A new staging scheme for carcinoma of the esophagus and cardia is proposed that provides better prognostic stratification of patients than existing ones.

Esophagogastrectomy for carcinoma of the esophagus and cardia: a comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria

OBJECTIVE

A review of findings and results after standard resection for carcinoma of the esophagus and cardia without neoadjuvant therapy was done to provide a basis for comparison with current reports of radical resection and neoadjuvant therapy.

METHODS

A 24-year experience on one surgical service with 454 operations for carcinoma of the esophagus and cardia was reviewed. A comparison of findings and results in three consecutive 8-year intervals was analyzed, and new staging criteria were developed and compared with those currently favored by the American Joint Committee on Cancer.

RESULTS

From January 1, 1970, to January 1, 1994, 454 patients with carcinoma of the esophagus or cardia underwent operation, of whom 408 (90%) had esophagogastrectomy with a 30-day mortality rate of 2.5% and an additional hospital mortality rate of 1.2%. Of the 121 complications (30.7%), 71 (18%) were major and 50 (12.7%) were minor. Cardiovascular complications predominated. The overall 5-year survival was 24.7%, with a 33.7% survival after complete resections in the most recent interval under study. Palliation of dysphagia was achieved in nearly 80% of patients who survived the operation. During the three intervals under review, resectability, mortality, and complication rates remained constant. The percentages of left thoracotomies and transhiatal resections increased, and there was a decrease in thoracoabdominal incisions. The percentages of patients with Barrett's esophagus and stage 0 and I tumors increased. The percentage of complete resections (R0) increased, whereas that for resections with residual microscopic tumor (R1) decreased, and there was no change in the percentage of patients with residual gross tumor after resection (R2). Modified WNM staging criteria are proposed that provide better prognostic stratification of the disease than those currently favored by The American Joint Committee on Cancer.

CONCLUSIONS

Standard esophagogastrectomy is applicable in 90% of patients with operable carcinoma of the esophagus or cardia, with consistently low mortality and morbidity rates and satisfactory palliation of dysphagia. The 5-year survival (24.7% overall) remains suboptimal, but the current figure for complete resections (33.7%) is encouraging. There is a need for revision of the current American Joint Committee on Cancer staging criteria.

Esophageal achalasia and adenocarcinoma in Barrett's esophagus: a report of two cases and a review of the literature

Two cases of a rare combination of conditions, achalasia and adenocarcinoma in Barrett's esophagus are reported. Cancer developed 26 years after the onset of gastroesophageal reflux in one and 30 years after esophagomyotomy in the other. Twenty-one cases of Barrett's esophagus and achalasia have now been reported; adenocarcinoma developed in six patients. Only one has survived more than five years after treatment. Long-term surveillance of patients with achalasia is recommended.

Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients

OBJECTIVE

To assess a bedside technique for diagnosing osteomyelitis.

DESIGN

We prospectively assessed infected pedal ulcers for detectable bone by probing with a sterile, blunt, stainless steel probe. We then examined the relationship between detection of bone and the presence or absence of osteomyelitis that was defined histopathologically and/or clinically.

SETTING

A tertiary care center.

PATIENTS

Seventy-five hospitalized diabetic patients with a total of 76 infected foot ulcers were studied.

RESULTS

Osteomyelitis was diagnosed in 50 instances (66%) and was excluded in 26 instances. Bone was detected by probing in 33 of 50 ulcers with contiguous osteomyelitis; in contrast, bone was probed in only four of 26 ulcers without contiguous osteomyelitis (P < .001). Bone detected on probing was visible in only three instances. Palpating bone on probing the pedal ulcer had a sensitivity of 66% for osteomyelitis, a specificity of 85%, a positive predictive value of 89%, and a negative predictive value of 56%.

CONCLUSIONS

Palpation of bone in the depths of infected pedal ulcers in patients with diabetes is strongly correlated with the presence of underlying osteomyelitis. If bone is palpated on probing, specialized roentgenographic and radionuclide tests to diagnose osteomyelitis are unnecessary. Probing for bone should be included in the initial assessment of all diabetic patients with infected pedal ulcers.

Staging of carcinoma of the esophagus and cardia: a comparison of different staging criteria

The third edition [1988] of the Manual for Staging of Cancer of the American Joint Committee on Cancer (AJCC) was developed to permit finer discrimination between stages than was true of the previous edition [1983]. This study was designed to determine whether or not this goal was achieved. Pathologic staging of the specimens removed from 265 patients with carcinoma of the esophagus or cardia undergoing esophagogastrectomy between 1970 and 1988 was performed according to criteria published in the second and third editions and their survival data compared. The new staging criteria of the AJCC provides no better discrimination of stages according to survival than was true of the earlier version, the 5-year survival of stage IIA patients being similar to that of stage I patients (37.5 +/- 6.7% vs. 50.8 +/- 17.7%), and the survival of stage IIB patients being similar to that of stage III patients (16.2 +/- 8.1% vs. 13.6 +/- 3.7%). However, depth of wall penetration and extent of lymph node involvement were reliable independent predictors of survival. We propose a modified version of the Skinner WNM staging plan that provides a modest increase in staging fragmentation.

Degenerative ("ancient") changes in benign cutaneous schwannoma. A light microscopic, histochemical and immunohistochemical study

We studied the degenerative "ancient" changes in 19 cases of benign cutaneous schwannoma (BCS). Using conventional and immunohistochemical stains, we found (a) degenerative changes in 15 of 19 BCS; (b) prominent vascular abnormalities in 11 of 15 BCS; and (c) cytologic atypia in 15 of 19 BCS, without mitotic figures. We concluded that (1) degenerative, i.e., "ancient" changes are common in BCS and are qualitatively similar to those described in cellular schwannoma; (2) vascular abnormalities may be related to these degenerative changes; (3) cytologic atypia is commonly associated with "ancient" changes in BCS, but BCS is less cellular and has few if any mitotic figures as opposed to cellular schwannomas; and (4) the changes in "ancient" schwannoma do not indicate a "cellular" schwannoma.

Osteolysis after silicone arthroplasty

A young woman with a silicone lunate prosthesis for avascular necrosis developed painful lytic lesions in the distal ulna and the triquetrum. At reoperation, abundant reactive synovitis was found extending into those bone lesions. Histologic examination of the curetting samples revealed granulation tissue with histiocytes and many multinucleated giant cells containing refractile particles consistent with silicone. The authors report a giant cell lesion of the bone that radiographically and microscopically mimicked a neoplasm.

[The Budapest agglomeration, 1980-1990]

"The study analyses the development of Budapest and [the] 6 towns and 37 communes forming its conurbation between 1980 and 1990." Consideration is given to the city's population dynamics; housing conditions, including availability of utilities, transportation, telecommunications, and retail stores; health conditions of the population; and educational opportunities for residents. (SUMMARY IN ENG AND RUS)

Malignant eccrine spiradenoma. A clinicopathologic study

Malignant eccrine spiradenomas (MES) are exceedingly rare and their immunohistochemical and ultrastructural features have not been fully characterized. We studied two cases, one of them immunohistochemically and electron microscopically. Patient 1 had a 25-year history of multiple exophytic tumors involving the scalp, the skin of the face, and the torso. Of the lesions removed, ten were spiradenomas, two with malignant changes, and three were cylindromas. The malignant areas showed loss of tubular and nesting patterns, lack of two cell populations, and contained anaplastic cells with high mitotic rate. The immunohistochemical findings were consistent with eccrine differentiation. Patient 2 had a cystlike mass of long duration in the right groin. Histologically, the mass consisted of nodules of benign eccrine spiradenomas adjacent to a ductal-cystic mass lined by anaplastic cells, but areas of squamous and glandular differentiation were also present.

CONCLUSIONS

(a) Case 1 is probably the first reported MES associated with multiple spiradenomas and cylindromas. (b) Cytodifferentiation in MES is variable, sometimes with almost complete loss of eccrine differentiation. (c) Identification of adjacent spiradenomas may be required for definite diagnosis of MES. (d) Clinical history of longstanding lesions with recent fast growth warrants tissue diagnosis.

Primary diagnosis of disseminated fungal disease by fine-needle aspiration of soft-tissue lesions

Two cases of disseminated fungal infections diagnosed by fine-needle aspiration of soft-tissue masses are presented. Both patients were initially treated on an outpatient basis for a presumed musculoskeletal disorder before the diagnostic biopsy was obtained. The first patient apparently contracted Coccidioides immitis infection while residing in Arizona, but the diagnosis was rendered on an aspirate of a buttock mass performed in Boston. The second patient, a non-insulin-dependent diabetic, was diagnosed with a cryptococcal abscess on an aspirate of a shoulder mass performed in the emergency room. The diagnosis of coccidioidomycosis was confirmed by culture and that of Cryptococcus by serology. Fungal infection was clinically unsuspected in both patients and the cytologic diagnosis facilitated rapid implementation of therapy.

Evaluation of diagnostic methods for Helicobacter pylori gastritis

The authors evaluated the use of direct Gram-stained smears, 1- and 24-hour urease broth tests, histologic examination, and culture to detect Helicobacter pylori in 100 gastric biopsy specimens from 97 patients with epigastric symptoms. Twenty-six patients had positive cultures and 27 had H. pylori identifiable in hematoxylin and eosin-stained sections. The gastric biopsy specimens from the 29 patients with culture and/or histologic findings positive for H. pylori showed active gastritis in 27 cases (93%), compared with 26 cases (37%) without H. pylori (P less than 0.0001). Chronic gastritis was present in 25 cases (86%) with H. pylori and 40 cases (56%) without H. pylori (P less than 0.01). Twenty patients had positive Gram-stained smears. Fifteen patients had positive 1-hour urease tests, and 3 had delayed positive 24-hour urease tests. There were no false-positive Gram's stain results, three false-positive 24-hour urease tests, two false-negative histologic results, and three false-negative cultures (one inadvertently incubated anaerobically). The sensitivities of the methods were as follows: 62% for the 24-hour urease test, 69% for direct Gram's stain, 90% for culture, and 93% for histologic examination. The authors conclude that the urease test used in this study has low sensitivity and limited specificity; that the direct Gram-stained smear is a useful, highly specific, rapid screening test; and that the lengthier methods of culture and histologic examination have comparably high sensitivity for the definitive diagnosis of H. pylori gastritis.

Evaluation of diagnostic methods for Helicobacter pylori gastritis

The authors evaluated the use of direct Gram-stained smears, 1- and 24-hour urease broth tests, histologic examination, and culture to detect Helicobacter pylori in 100 gastric biopsy specimens from 97 patients with epigastric symptoms. Twenty-six patients had positive cultures and 27 had H. pylori identifiable in hematoxylin and eosin-stained sections. The gastric biopsy specimens from the 29 patients with culture and/or histologic findings positive for H. pylori showed active gastritis in 27 cases (93%), compared with 26 cases (37%) without H. pylori (P less than 0.0001). Chronic gastritis was present in 25 cases (86%) with H. pylori and 40 cases (56%) without H. pylori (P less than 0.01). Twenty patients had positive Gram-stained smears. Fifteen patients had positive 1-hour urease tests, and 3 had delayed positive 24-hour urease tests. There were no false-positive Gram's stain results, three false-positive 24-hour urease tests, two false-negative histologic results, and three false-negative cultures (one inadvertently incubated anaerobically). The sensitivities of the methods were as follows: 62% for the 24-hour urease test, 69% for direct Gram's stain, 90% for culture, and 93% for histologic examination. The authors conclude that the urease test used in this study has low sensitivity and limited specificity; that the direct Gram-stained smear is a useful, highly specific, rapid screening test; and that the lengthier methods of culture and histologic examination have comparably high sensitivity for the definitive diagnosis of H. pylori gastritis.

Collagenous spherulosis in chondroid syringomas

We report a case of collagenous spherulosis (CS) incidentally found in a chondroid syringoma of the facial skin. The lesion was studied by routine light microscopy, special stains, immunohistochemical methods, x-ray spectrophotometry, and electron microscopy. Light microscopy revealed solitary and confluent eosinophilic globules with radiating fibrillary structures within and around the lumina of the tubuloglandular components of chondroid syringoma. The fibrillary structures stained strongly for collagen and reticulin and less intensely for acidic mucopolysaccharides. Immunohistochemically, the globules were focally positive only for collagen type IV. Electron microscopy revealed radiating collagen fibers surrounded by basal lamina-like material. No inorganic crystals were identified by x-ray spectrophotometry. We conclude that (a) CS is not specific to breast but also occurs in chondroid syringomas; (b) the term collagenous spherulosis is appropriate because collagen fibers were demonstrated histochemically and ultrastructurally in the spherules; (c) CS appears to be associated with tubular epithelial structures; (d) there was no immunohistochemical evidence of myoepithelial differentiation. The etiology and significance of CS remain obscure.

Pigmented neuroectodermal tumor of infancy. A light microscopic and immunohistochemical study

We studied two cases of pigmented neuroectodermal tumor of infancy (PNTI) by routine light microscopy and immunohistochemistry on formalin fixed, paraffin embedded tissues using antibodies to HMB-45 "melanoma associated" antigen, S-100 protein, neuron specific enolase (NSE), Leu-7 antigen, chromogranin, epithelial membrane antigen, collagen Type IV, alpha-fetoprotein and muscle-specific actin and to the intermediate filaments cytokeratin (CK), vimentin, desmin and neural filaments. We found that the large epithelioid cells, many of which contained melanin pigment, were strongly positive for CK and HMB-45, and less intensively positive for vimentin and NSE. The small neuroblast-like cells revealed only focal, weak NSE positivity. Both cell types were negative for S-100 protein and for the other antigens examined. Our results suggest that: (1) the large and small cell populations in PNTI have different immunophenotypes; (2) the expression of CK and HMB-45, together with the S-100 negativity, appears unique for the pigmented cells; and (3) this profile may be helpful in the exclusion of melanoma and peripheral neuroblastoma from the differential diagnosis.

Cancerization of eccrine sweat ducts in Bowen's disease as studied by light microscopy, DNA spectrophotometry and immunohistochemistry

This study assesses the incidence, histogenesis, and significance of eccrine sweat duct involvement in Bowen's disease (BD). In a review of 96 cases of BD, four showed eccrine duct involvement on hematoxylin and eosin-stained histologic sections. One case was analyzed for deoxyribonucleic acid (DNA) ploidy by using computerized image analysis on Feulgen-stained slides. Sections were also stained immunohistochemically, using antibodies to carcinoembryonic antigen (CEA), gross cystic disease fluid protein (GCDFP), and S-100 protein, and for cytokeratins (CAM 5.2, AE 1/3). Our results showed that, in BD, (a) the eccrine sweat ducts can be extensively involved by atypical cells, (b) the atypical eccrine duct cells had an aneuploid DNA pattern, and (c) the atypical eccrine duct cells were negative for CEA, GCDFP, and S-100 protein but were positive for cytokeratins. We conclude that (a) the frequency of eccrine duct involvement in BD is relatively low (approximately 4 to 9%), (b) the aneuploid DNA pattern makes a benign squamous metaplasia unlikely, (c) the immunohistochemical results exclude coincidental Paget's disease or carcinoma of eccrine sweat glands, (d) the involvement of eccrine sweat ducts may represent a direct extension of the neoplastic epidermal keratinocytes, and (e) this process may have practical implications in the recurrence of superficially treated cases of BD.

Treatment of latent rabbit and human papillomavirus infections with 9-(2-phosphonylmethoxy)ethylguanine (PMEG)

The acyclic nucleotide PMEG was studied for effectiveness against Shope papillomavirus (CRPV) infection of rabbits and human papillomavirus type 11 (HPV-11) infections of human foreskin xenografts in athymic mice. PMEG given in the latent period strongly suppressed the subsequent growth rates of Shope papillomas. PMEG starting in the latent period and continuing for the duration of the experiment, inhibited HPV-11 infections of human skin, including condyloma growth, and synthesis of viral DNA and capsid antigen. Drug toxicity paralleled the therapeutic effects in rabbits but there was much less toxicity in athymic mice.