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Biomedical subjects

B Johansson

Publications and source records attributed to B Johansson.

At least 199 records · Page 11Linked to original sources

Fluorescence in situ hybridization analyses of hematologic malignancies reveal frequent cytogenetically unrecognized 12p rearrangements.

Thirty-two hematologic malignancies--nine with cytogenetically identified 12p abnormalities and 23 with whole or partial losses of chromosome 12--were selected for fluorescence in situ hybridization (FISH) investigations of 12p. These analyses revealed structural 12p changes, such as translocations, deletions, insertions, inversions and amplification, in 20 cases. ETV6 rearrangements were detected in three acute leukemias. One acute undifferentiated leukemia had t(4;12)(q12;p13) as the sole anomaly. The second case, an acute myeloid leukemia (AML), displayed complex abnormalities involving, among others, chromosomes 9 and 12. The third case, also an AML, had an insertion of the distal part of ETV6 into chromosome arm 11q and into multiple ring chromosomes, which also contained chromosome 11 material, resulting in an amplification of a possible fusion gene. The fusion partners in these cases remain to be identified. Thirty-one additional breakpoints on 12p could be characterized in detail. The majority of these breaks were shown to result in interchromosomal rearrangements, possibly indicating the location of hitherto unrecognized genes of importance in the pathogenesis of hematologic malignancies. The FISH analyses disclosed terminal or interstitial 12p deletions in 18 cases. Seven myeloid malignancies showed deletions restricted to a region, including ETV6 and CDKN1B, which has been reported to be frequently lost in leukemias. In four cases, the deletions involved both these genes, whereas two AML displayed loss of CDKN1B but not ETV6, supporting previously reported findings indicating a region of deletion not including this gene. However, one myelodysplastic syndrome lacked one copy of ETV6 but not CDKN1B. Hence, we suggest a minimal region of deletion on 12p located between the ETV6 and CDKN1B genes.

Adult↗

Hematologic malignancies with t(4;11)(q21;q23)--a cytogenetic, morphologic, immunophenotypic and clinical study of 183 cases. European 11q23 Workshop participants.

A total of 183 hematologic malignancies with t(4;11)(q21;q23), including five variant translocations, were collected by the Workshop. Clinical, morphologic and immunophenotypic features were compiled, and karyotypes with variant t(4;11) or secondary chromosomal aberrations were reviewed. All cases were acute leukemias (AL): 173 acute lymphoblastic leukemias (ALL), six acute myeloid leukemias (AML), three unclassifiable AL, and one biphenotypic AL. Ten patients had treatment-associated AL. Females were overrepresented (104 vs 79) and the age distribution was clearly nonrandom; 34% of the cases occurred in infants below the age of 12 months. The remaining AL were evenly distributed among the other age groups, with the oldest patient being 79 years old. An increased white blood cell count (WBC) was reported in more than 90% of the cases, with hyperleukocytosis (> or =100 x 10(9)/l) in 64%. Additional chromosomal changes were detected in 55 (30%) cases, most often gain of the X chromosome, i(7)(q10), and trisomy 8, with frequent breakpoints in 1p36, 1q21, 7q10, 11p15, 12p13, 17p11, and 17p10. All recurrent secondary changes resulted in genomic imbalances, in particular gains of 1q, 7q, 8, and X and losses of 7p and 17p. Event-free and overall survival (EFS and OS) could be ascertained in 170 and 171 patients, respectively. Kaplan-Meier estimates of EFS and OS showed no differences with regard to gender, WBC, or presence of secondary chromosomal abnormalities, and there was no increase of EFS or OS among the 55 cases that had undergone bone marrow transplantation. However, age had an important prognostic impact, with significantly (P < 0.0001) longer EFS and OS in children 2-9 years old than among infants and younger children, patients aged between 10 and 39 years and older adults.

Acute Disease↗

Ten novel 11q23 chromosomal partner sites. European 11q23 Workshop participants.

The MLL gene located at 11q23 has been described as a 'promiscuous' gene due its involvement with a large number of genetic partners. The EU Concerted Action Workshop on 11q23 provided 550 cases for study of which 82 showed abnormalities which did not involve the established translocations or deletion of 11q23. In these 'other' cases, which included inversions and duplications, 11q23 was found to be involved with 25 chromosome partners of which 10 had not been previously reported. These were 1q31, 4p11, 6q13, 8q21, 10q22, 10q25, 11q11, 11q21, 13q34 and 18q23. This study demonstrated the value of the Workshop, in confirming the diversity of chromosomal partner sites involved with 11q23 and in the identification of new partners.

Acute Disease↗

Derivative chromosomes of 11q23-translocations in hematologic malignancies. European 11q23 Workshop participants.

Cytogenetic and molecular analyses of 11q23/MLL positive hematologic malignancies show that der(11) encodes the critical 5'MLL/3'partner gene transcript. The role of der(non-11) bearing the 5'partner/3'MLL fusion is less certain. The cytogenetic evidence for der(11) as the critical partner was investigated. Among 1680 cases (550 workshop and 1130 published) 31 cases displayed a three-way (29 cases) or four-way (two cases) translocation and 26 had only one of the derivatives. The critical junction created by t(11;n)(q23;n) was seen in all six cases of t(1;11)(q21;q23), in both cases of t(6;11)(q27;q23), in all six cases of t(11;19)(q23;p13), in nine of 11 cases with t(4;11)(q21;q23) and in 17 of 20 cases with t(9;11)(p21-22;q23). These findings support the evidence for der(11) encoding the critical leukemogenic fusion transcript. In contrast, additional change involving duplication of one of the derivatives resulted in duplication only of the non-critical der(non-11) as follows: +der(4)t(4;11)(q21;q23) [9/553], +der(6)t(6;11)(q27;q23) [3/61], +der(9)t(9;11)(p21-22;q23) [5/291] and +der(19)t(11;19)(q23;p13) [6/164]. A literature search of other neoplastic disorders showed that either derivative may be duplicated. Duplication of the non-critical derivative is the norm in AML patients with t(8;21)(q22;q22) or t(15;17)(q22;q12-21). We suggest that the genomic imbalance, rather than over-expression of the noncritical 5'partner/3'MLL, is likely to be the important outcome.

Chromosome Aberrations↗

Myelodysplastic syndromes associated with 11q23 abnormalities. European 11q23 Workshop participants.

Most hematological neoplasms associated with 11q23 chromosomal rearrangement have been cases of acute lymphoblastic or acute myeloid leukemia. Although cases of myelodysplastic syndrome (MDS) are a minority, these syndromes should also be recognized as part of the spectrum of hematological disorders associated with 11q23 rearrangement. In this series of 550 patients with such rearrangement there were 28 (5.1%) who presented with MDS. A further five patients had a history of MDS but had evolved to AML by the time cytogenetic analysis was first undertaken. There were thus a total of 33 patients (6.0%) with an 11q23 abnormality whose initial presentation was as MDS. Of these 33 patients, a quarter (seven patients) were cases of secondary (therapy-related) MDS. Complex karyotypes and other poor prognosis chromosomal abnormalities such as -7 and 7q- were common and were not confined to secondary cases. The likelihood of presentation as MDS differed between different cytogenetic categories. The 28 patients in whom cytogenetic analysis was performed at presentation as MDS showed a wide age distribution, from 1 to 82 years; there were four children, two of 1 year of age. All FAB types of MDS were represented. Median survival was only 19.1 months. Leukemic transformation occurred in five patients including one case of transformation to a biphenotypic M5a/T-lineage acute leukemia.

Adolescent↗

Molecular characterization of jumping translocations reveals spatial and temporal breakpoint heterogeneity.

Jumping translocations (JT) are characterized by the relocalization of the same part of a donor to several recipient chromosomes. Although JT occasionally are constitutional, most are associated with hematologic malignancies. In such cases, JT usually arise during disease progression and are associated with poor prognosis. Despite its clinical importance, this cytogenetic phenomenon has not been characterized at the molecular level. We have analyzed JT in a juvenile chronic myelomonocytic leukemia that subsequently transformed to an acute myeloid leukemia. Detailed fluorescence in situ hybridization (FISH) analyses showed that the cytogenetically identical donor breakpoint at 3q21 was highly heterogeneous. In fact, more than 10 distinct breakpoints, four of which mapped within YACs, were identified. Analyses of samples during disease progression showed that the breakpoint complexity decreased, indicating clonal selection. Hence, the 3q21 breakpoints displayed a spatial as well as a temporal heterogeneity, revealing that JT are highly unstable, showing great variation in the size of donor segment. The breaks at the recipient chromosomes were mapped within the subtelomeric regions. The general telomere length was not affected and an underlying replication error resulting in microsatellite instability was excluded. We conclude that the emergence of JT is unlikely to cause fusion genes or to affect the expression of genes located in the breakpoint regions. The identification of YACs spanning the breakpoints, ie, YACs 913c7, 937g5, 948c2 and 955g1, may facilitate the isolation of DNA sequences leading to a genetic instability associated with the origin of multiple translocations.

Child, Preschool↗

Acid-induced duodenal mucosal nitric oxide output parallels bicarbonate secretion in the anaesthetized pig.

We recently showed the involvement of the L-arginine/nitric oxide (NO) pathway in acid-induced duodenal mucosal bicarbonate secretion in rats. The aim of the present study was to confirm this observation in pigs by direct measurements of NO production. Experiments were performed on 16 anaesthetized pigs of both sexes treated with guanethidine (6 mg kg-1, intravenously). A duodenal segment, devoid of pancreaticobiliary influxes, was perfused with saline and the duodenal mucosal bicarbonate secretion was calculated from continuous measurements of pH and PCO2. The perfusate contents of NO and its oxidative product nitrite were determined by chemiluminescence, after reduction of nitrite to NO. Luminal acidification with 30 mM hydrochloric acid increased the output of bicarbonate as well as NO to the perfusate, by 195 +/- 45% and 106 +/- 10%, respectively. These responses to acid were markedly inhibited by adding the NO synthase inhibitor NG-monomethyl-L-arginine (L-NMMA, 0.3 mM) to the perfusate. The inhibitory effect of L-NMMA could be reversed by administration of L-arginine (3 mM). The study presents simultaneous measurements of bicarbonate and NO outputs to a duodenal luminal perfusate. The results strongly support the view that the L-arginine/NO pathway is involved in the acid-induced duodenal mucosal bicarbonate secretory response.

Anesthetics, Combined↗

Low detection rate of HPV in oral and laryngeal carcinomas.

The presence of human papillomaviruses (HPVs) in 38 oral and 16 laryngeal lesions (verrucous hyperplasia, carcinoma in situ and carcinomas) was investigated using the polymerase chain reaction (PCR) technique. All biopsies were fresh frozen and a set of consensus and type-specific primers was used for PCR detection and HPV typing. In oral biopsies a low proportion of HPV-positive cases was found, despite the sensitive techniques. Only one case out of 38, a carcinoma in situ was positive (2.6%). It is thought that this finding reflects a minimal presence of HPV in the oral lesions, but a transient role of virus in the induction of carcinomas cannot be ruled out. Differences in relation to other studies may be geographical and/or methodological. In laryngeal carcinomas (and dysplasias), 3 out of 16 cases were HPV positive. This frequency (19%) concurs with most other studies.

Adult↗

Gastro-oesophageal reflux symptoms--clinical findings and effect of ranitidine treatment.

BACKGROUND: This study was performed to study the demography, effect of treatment with ranitidine and relapse pattern in patients with reflux symptoms. METHODS: Patients with reflux symptoms were examined by endoscopy and included in a double-blind, comparative trial of placebo and ranitidine 150 mg b.i.d. for two weeks. At two weeks satisfied patients continued the same treatment. Non-satisfied patients were randomised to ranitidine 150 mg b.i.d. or q.i.d for another two weeks. After four weeks medication was stopped and satisfied patients were followed for 24 weeks. No further endoscopy was performed. RESULTS: Four hundred and twenty-seven patients were randomised. At two weeks there was no significant difference between placebo and ranitidine, regarding the proportion of patients with complete relief from symptoms or satisfied with treatment. Ranitidine was superior to placebo in improving symptoms at two weeks. Ranitidine, 150 mg q.i.d. offered no additional advantage in weeks three to four over prolonging treatment with 150 mg b.i.d. after the first two weeks. Patients with oesophagitis at inclusion relapsed more than those with symptoms only, 67% compared with 52%, (p = 0.013). CONCLUSIONS: The effect of ranitidine was marginal compared to placebo. The relapse rate was high after treatment stopped.

Adolescent↗

Laparoscopic surgery for morbid obesity.

Morbid obesity, defined as a body mass index (BMI), i.e. weight (kg)/height (m2) over 36 for males and 38 for females, is a common condition and a threat for health, life and individual well being. Hitherto, surgery is the only effective treatment for weight reduction. Surgical methods can be malabsorptive, reducing the patients ability to absorb nutrients, or restrictive, reducing the capacity of food intake. Exclusively malabsorptive methods have been abandoned due to severe side effects. Restrictive methods, gastroplasties, reduces the compliance capacity of the stomach. Two types are performed laparoscopically, the vertical banded gastroplasty and the adjustable gastric banding. The proximal gastric by pass is also performed laparoscopically and is a combination of a restrictive proximal gastroplasty and a malabsorptive Roux-en-Y gastro-jejunal anastomosis. With laparoscopic adjustable gastric banding mean BMI was reduced from 41 kg/m2 to 33 kg/m2 (n = 43) after one year. Two years after surgery mean BMI was 30 kg/m2 (n = 16). The different operative techniques are further discussed in this paper.

Adult↗

Detecting gastrointestinal hypoperfusion during cardiac tamponade in pigs: a role for nitric oxide tonometry?

OBJECTIVE: To evaluate different techniques and regional approaches for detecting critical reductions in gastrointestinal (GI) perfusion. DESIGN: Laboratory, animal, controlled study. SETTING: University animal research laboratory. SUBJECTS: Thirteen anesthetized, ventilated, juvenile domestic pigs. INTERVENTIONS: Dextran was infused into the pericardial sac to achieve cardiac tamponade that reduced cardiac output to 25% of baseline value. Hemodynamics were invasively monitored, and blood gases were sampled in the systemic and portal circulations. Tonometers were placed in the corpus of the stomach and in the jejunum, 50 cm aboral to the ligament of Treitz. MEASUREMENTS AND MAIN RESULTS: We measured cardiac output, portal venous blood flow, mesenteric oxygen delivery and consumption, systemic and portal venous blood gases and acid-base balance, stomach and jejunal transepithelial potential difference, stomach and jejunal intramucosal pH, arterial plasma concentrations of asymmetric dimethylarginine, and jejunal, intraluminal nitric oxide. One hour of cardiac tamponade decreased mesenteric oxygen delivery and consumption in a linear fashion and resulted in mesenteric acidosis, as evidenced by decreases in pH, standard bicarbonate, oxygen saturation, and PO2 and increases in PCO2. The potential difference in the jejunum decreased earlier than in the stomach, whereas stomach intramucosal pH decreased before jejunal intramucosal pH. Intraluminal nitric oxide in the jejunum was markedly reduced soon after cardiac tamponade. This reduction was accompanied by an increase in arterial plasma concentrations of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine. Investigated variables were unchanged in control animals. CONCLUSIONS: Both intramucosal pH and potential difference measurements may be used to detect critical reduction in GI perfusion. Regional and temporal differences may reduce the accuracy of these methods. Jejunal tonometry can yield an early nitric oxide measurement that indicates mesenteric low-flow conditions. Jejunal tonometry also yields quantitative information about this modulator of hemodynamic and mucosal barrier function, information that is relevant to GI failure during shock.

Acid-Base Equilibrium↗

Disruption of the E1 and E2 reading frames of HPV 16 in cervical carcinoma is associated with poor prognosis.

The E1 and E2 reading frames of 158 cervical carcinoma samples containing human papillomavirus (HPV) 16 were mapped using polymerase chain reaction (PCR). The reading frames were amplified using primers spanning the entire genes. Of the analyzed samples, 23% showed no amplification with the E1 primers and 29% showed no amplification with the E2 primers. There was an overlap, but not complete identity, between the E1- and E2-disrupted groups. All E1- and E2-negative samples were further analyzed with primers spanning subsections of the E1 and E2 reading frames, which together covered the entire genes. Of the 35 samples negative for E1, 11 were positive in specific amplification of the 3' end of the E1 gene. Several different subsections of E2 could be amplified from most samples negative for the entire gene (37/46). Five classes of patterns were found, in which either all subsections of the E2 gene or subsections in the 5', middle, or 3' end were disrupted. Although a variable pattern of disruption/deletion in the E1-E2 area of the HPV 16 genome was found in cervical carcinoma, the 5' end disruption was the most common one in both E1 and E2. Patients with carcinomas showing disruptions in E1/E2 had a poorer survival than those without such changes, and E1 disruptions were the most important prognostically.

DNA, Viral↗

Characterization of three co-circulating genotypes of the small hydrophobic protein gene of mumps virus.

Eighteen virus isolates and 22 serum samples collected between 1971 and 1997 from patients with mumps were genotyped by PCR with specific primer pairs for the A, C and D genotypes of the small hydrophobic (SH) protein gene. All serum samples were subjected to nucleotide sequence analysis of the gene, and the deduced 57-amino-acid sequences were aligned with previously published sequences from the USA, Canada, Portugal, the UK, France, Germany, Switzerland, Denmark, Sweden, Russia, China and Japan. The existence of six genotypes of the SH protein gene, named A to F, was confirmed. In the Stockholm area, co-circulation of genotypes A, C and D at different times was found. There was a striking difference in genotype between the virus isolates and the serum samples. The 18 virus isolates represented genotypes C and D, whereas the 22 serum samples contained genotype A. In most cases, the amino acid sequences of the 22 genotype A specimens were identical to the previously described SBL-1 strain of genotype A. Genotypes C and D were always associated with meningitis, and in some cases parotitis, whereas infection with genotype A most often resulted in parotitis and seldom in meningitis.

Amino Acid Sequence↗

Liquid ionization chambers for absorbed dose measurements in water at low dose rates and intermediate photon energies.

Two new liquid ionization chamber (LIC) designs, consisting of cylindrical and plane-parallel configurations, are presented. They are designed to be suitable for high-precision measurements of absorbed dose-to-water at dose rates and photon energies typical for LDR intermediate photon energy brachytherapy sources. The chambers have a sensitive liquid layer thickness of 1 mm and sensitive volumes of 7 mm3 (plane-parallel) and 20 mm3 (cylindrical). The liquids used as sensitive media in the chambers are either isooctane (C8H18), tetramethylsilane (Si(CH3)4) or mixtures of these two liquids in the approximate proportions 2 to 1. A chamber filled with such a liquid mixture and with a polarizing voltage of 300 V, provides a volume sensitivity of about 10(-9)C Gy(-1) mm(-3) for absorbed dose measurements in water in an x-ray radiation field with an effective photon energy of 120 keV. In the interval 30 to 140 keV, the relative change in sensitivity is less than +/- 2.5%. The leakage current of the chambers is low and stable, which implies that absorbed dose measurements can be done with good reproducibility at dose-rates as low as 50 microGy min-1 (sigma < 3%). The long-term calibration stability was tested for a set of five chambers over a period of more than 1 year. No systematic change in their sensitivity could be observed. The general recombination at a polarizing voltage of 300 V is less than 2% for dose-rates up to about 100 mGy min-1. The temperature dependence at room temperature is 0.5% per degree C. The response is almost independent of the direction of the radiation for the plane-parallel LIC.

Biophysical Phenomena↗

Cytogenetic and fluorescence in situ hybridization analyses of chromosome 19 aberrations in pancreatic carcinomas: frequent loss of 19p13.3 and gain of 19q13.1-13.2.

Cytogenetic investigation of nine pancreatic carcinomas revealed structural rearrangements of chromosome 19 in eight cases, resulting in a high frequency of 19p losses and 19q gains. To characterize these imbalances further, we performed fluorescence in situ hybridization (FISH) analysis with 12 mapped and evenly distributed cosmids. The FISH study not only verified the cytogenetic findings but also disclosed additional chromosome 19 aberrations not detected by chromosome banding analysis. Seven carcinomas displayed 19p losses, always including 19p13.3, either through partial- or whole-arm deletions. Six cases showed gain of 19q, usually as one to two copies above the ploidy level. In one case, a high level of amplification in 19q13.1 was seen. The commonly overrepresented segment was 19q13.1-13.2. These results suggest that genes of importance in the development of pancreatic carcinomas are located in 19p13.3 and 19q13.1-13.2.

Aged↗