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Biomedical subjects

C Kuhnen

Publications and source records attributed to C Kuhnen.

48 records · Page 3Linked to original sources

MDM2 amplification and loss of heterozygosity at Rb and p53 genes: no simultaneous alterations in the oncogenesis of liposarcomas.

PURPOSE: The present study aimed to investigate the status of alterations of the MDM2, Rb and p53 genes in a series of 45 liposarcomas. Furthermore, the possible correlation with histological and clinical parameters was studied. METHODS: MDM2 amplification was examined by non-radioactive Southern blot hybridization with a human MDM2 cDNA probe. Mutations in the p53 gene were screened by polymerase chain reaction/single-strand conformation polymorphism analysis and direct sequencing. To study loss of heterozygosity (LOH) at the tumor-suppressor genes Rb and p53, we used four polymorphic intragenic Rb markers (introns 1, 17, 20, and 25) and two p53 markers (intron 1 and exon 4). RESULTS: MDM2 amplification was found in 19 of 45 liposarcomas (42.2%). The frequency of LOH in Rb and p53 was nearly identical (22%). In 4 of 9 tumors (44.4%) with LOH, allelic loss was a concurrent event in both genes. Of 45 liposarcomas, 6 (13.3%) showed p53 mutations. Overall, alterations of the p53/MDM2/Rb pathway occurred in 30 of 45 liposarcomas (66.6%). In contrast to myxoid and pleomorphic variants, well-differentiated liposarcomas were characterized by a high frequency of MDM2 amplification, a lack of LOH of Rb and p53, and p53 mutations. CONCLUSIONS: Obviously MDM2 amplification and LOH at the Rh and p53 genes do not occur simultaneously in the oncogenesis of liposarcomas, as is the case for MDM2 amplification and p53 gene mutations (with one exception). We suggest that well-differentiated, myxoid and pleomorphic liposarcomas are characterized by a different pattern of molecular alterations.

Adult↗

[Intracellular distribution of beta-catenin in soft tissue tumors].

AIMS: beta-Catenin originally known as an intracellular mediator of epithelial cell-to-cell adhesion is also involved in signal transduction processes. Since its important function in colorectal carcinogenesis has recently been recognized, the aim of our study was to investigate whether a similar intracellular distribution of beta-catenin can be detected in sarcomas and sarcoma-like lesions. METHODS: 45 soft tissue tumors were examined by immunohistochemistry. RESULTS: Different types of beta-catenin-distribution were observed: A more continuous localization at the cell membrane was evident especially in epithelioid-like sarcomas. In contrast only focal staining of cell membranes could be found in different tumors as well. Further on increased cytoplasmatic beta-catenin levels were detected in various types of tumors. CONCLUSIONS: The localization of beta-catenin at the cell membrane serves as a hint for a function of beta-catenin in cell adhesion of mesenchymal tumors apart from epithelial tissues. A nuclear and intracellular accumulation of beta-catenin has been observed in progression of colorectal tumors. The findings of increased levels of beta-catenin in soft tissue tumors may indicate a similar important function in the pathogenesis of these neoplasias.

Cell Adhesion↗

[Heart rupture after mitral valve replacement. Pathologic-anatomic findings].

The rupture of the free left ventricular wall is considered a serious complication following mitral valve replacement. We report about 3 cases characterized by similar pathologic-anatomical findings within the region of the left ventricle after mitral valve replacement. Following resection of the original and pathologically altered mitral valve and implantation of a prosthesis, rupture of the left ventricular wall occurred in short time intervals ranging from 1 to 12 h postoperatively. All cases represented a transverse midventricular disruption located between the mitral valve anulus and the resected papillary muscles. The histologic findings included necrotic, damaged myocardial structures with considerable bleeding to the interstitium. Inflammatory infiltration could be detected within the myocardial defects. Abnormal pathologic findings of the coronary arteries or intraoperative lesions could be excluded by thorough autoptic studies. Because of central localization of the ventricular disruption between the mitral valve anulus and the papillary muscles a direct traumatic myocardial injury caused by mitral valve orotheses is to be excluded. When taking into account several reports from literature in combination with our described findings, in autopsy, a loss of contractile integrity of the left ventricle following resection of mitral valve apparatus, especially the chordae tendinaea, should be considered as primary cause for this type of ventricular rupture. This destabilization will lead to a regionally stressec myocardial "stretching" which finally results in rupture of the left ventricular free wall. The described pathogenetic concept seemingly represents the decisive mechanism of this transverse midventricular disruption in all 3 cases. To prevent such post-operative complications, only very limited resection of the mitral valve apparatus should be performed to maintain parts of the chordae tendineae.

Aged↗

Expression of type IV collagenase correlates with the expression of vascular endothelial growth factor in primary non-small cell lung cancer.

Tumor growth and metastasis are angiogenesis-dependent processes initiated and regulated by a number of cytokines. Vascular endothelial growth factor (VEGF) is a potent angiogenic protein with a selective mitogenic effect on vascular endothelial cells, known to be involved in physiological (embryogenesis) and pathophysiological (rheumatoid arthritis, tumor) angiogenesis. An increased expression of matrix metalloproteinase type IV collagenase has been reported in invading endothelial cells in vitro and in malignant cells, degrading structures of the basement membranes in various human malignancies. In the present study we investigated the expression of the genes for type IV collagenase and vascular endothelial growth factor (VEGF) in 40 cases of primary non-small-cell lung cancer (NSCLC). Specimens were immunostained by an antibody directed against VEGF and mRNA transcripts of VEGF and type IV collagenase were localized by non-radioactive in situ hybridization. VEGF mRNA was detected in 33 neoplasms, while in 23 cases transcripts of the type IV collagenase gene were visualized by digoxigenin-labeled cDNA probes. Transcripts of both mRNAs were detected in malignant cells. Furthermore, anti-VEGF immunostaining was present in newly formed microvessels close to the atypical cells, and mRNA of type IV collagenase was present in stromal cells adjacent to the tumor. A statistically significant correlation was found between the expression of type IV collagenase and VEGF (P = 0.0061). These data suggest a double role for type IV collagenase in the metastatic process of NSCLC: (1) facilitating the invasion of tumor cells by the proteolytic cleavage of the basement membrane and (2) similarly supporting the endothelial cell invasion essential for tumor angiogenesis. Furthermore, our findings sustain the hypothesis that metastatic spread and angiogenesis are associated with a clonal expansion of highly angiogenic and invasive tumor cell clones.

Carcinoma, Non-Small-Cell Lung↗

[Malignant lymphoma and colon carcinoma 3 years after heart transplantation and immunosuppression].

Three years after heart transplantation and immunosuppressive therapy, a 66-year-old man suffered from dyspnea and showed symptoms mainly due to right heart failure. Malignant tumor cells were discovered within extensive pleural effusion. Computed tomography revealed two lesions of the liver suspicious of metastases, and recurrent blood in the stools was evident. The patient deteriorated rapidly and died 3 weeks after admission. Autopsy findings included an adenocarcinoma of the cecum (grade II) with metastases to the liver. High-grade immunoblastic non-Hodgkin's lymphoma of plasmoblastic differentiation was diagnosed, located within the mediastinal soft tissues and infiltrating the peri- and myocardium. Mesenteric lymph nodes were enlarged with histological verification of malignant lymphoma. The lymphatic tumor masses had caused considerable compression of the heart and vessels, leading to the signs of cardiac failure. The development of metastasizing colonic carcinoma and high-grade immunoblastic non-Hodgkin's lymphoma 3 years after heart transplantation and immunosuppressive therapy must be considered an unusual combination. Malignent lymphomas following heart transplantation have been described several times.

Adenocarcinoma↗

[Pulmonary lymphangioleiomyomatosis in tuberous sclerosis].

Pulmonary lymphangioleiomyomatosis was diagnosed in a 26-year-old woman with recurrent pneumothorax by histological evaluation of a lung biopsy obtained during video-thoracoscopy. A tumour of the right kidney had been removed 2 years previously; the histological picture was that of an angiomyolipoma. Immunohistochemical staining for anti-smooth muscle actin gave a strongly positive reaction in the tissue of the renal angiomyolipoma and in the pathologic lung tissue. Additional investigations showed an asymptomatic intracerebral tumour 5 cm in diameter in the left frontal lobe (brain scan). This multilocal renal, pulmonary and cerebral manifestation of benign mesenchymal proliferating tumours supports the classification of this case in the tuberous sclerosis complex.

Adult↗

Initial experience with 99m Tc-hexamethyl-propylene amine oxime (HM-PAO) single photon emission computed tomography (SPECT) in patients with focal epilepsy.

Brain single photon emission computed tomography (SPECT) was performed in 16 patients with focal epilepsy, as well as EEG, using 99m Tc-HM-PAO SPECT and a rotating gamma camera system. Pathological Tc-HM-PAO SPECT findings were registered in 75%. CT was positive in 25%. MRI was positive in 76%. The results of Tc-HM-PAO SPECT findings were compared with those of CT and MRI. 61% of the MRI findings correlated with the pathological SPECT findings with respect to the side of the hemisphere, and in 75% of the patients the focal EEG abnormality and the pathological Tc-HM-PAO-SPECT findings were localized in the same hemisphere.

Adolescent↗

Effect of valproic acid treatment on spike-wave discharge patterns during sleep and wakefulness.

7 patients suffering from absences were recorded before antiepileptic treatment, in the early phase of valproate monotherapy and after having reached steady state. Recordings made with the Oxford-Medilog 4-channel cassette recorder were analyzed visually as well as by a computerized s-w pattern recognition approach, the latter facilitating quantification of pattern characteristics (number, amplitudes and duration of spikes and waves). Measurements were made separately for epochs of wakefulness and sleep. Compared to the premedication phase the amount of s-w discharges in 24 h showed an average reduction of more than 90%. For the majority of the patients, 24-hour discharge profiles showed a maximum in the early morning. Duration and amplitude of both spike and wave elements was higher during sleep. For the waking state, the ratio wave amplitude/spike amplitude was found to be increased under medication.

Adolescent↗

Absolute beta-catenin concentrations in Wnt pathway-stimulated and non-stimulated cells.

The intracellular level of the proto-oncoprotein beta-catenin is a parameter for the activity of the Wnt pathway, which has been linked to carcinogenesis. The paper introduces a novel sandwich-based ELISA for the determination of the beta-catenin concentration in lysates from cells or tissues. The advantages of the method were proven by determining beta-catenin levels in cell lines and in cells after activation of the Wnt pathway. Analysis revealed high beta-catenin concentrations in the cell lines HeLa, KB, HT1080, MCF-7, U-87 and U-373, which had not been described before. Beta-catenin concentrations were compared in HEK293 and C57MG cells after activation of the Wnt pathway. The beta-catenin concentrations increased by different factors depending on whether the Wnt pathway was activated by incubation with LiCl or with Wnt-3a-conditioned medium. This finding indicated that the beta-catenin level depends on the way and level of Wnt pathway activation. The quantitative analysis of beta-catenin in colorectal tumours revealed high beta-catenin levels in tumours with truncating mutations in the APC gene.

Cell Line↗

Clinical monitoring during carbamazepine slow-release, once-daily monotherapy.

Forty-eight patients with complex partial and/or tonic-clonic seizures were treated with an 8 p.m. single dose of carbamazepine slow release (CBZ-SR) monotherapy. The steady-state serum level profiles of carbamazepine (CBZ) and its metabolites CBZ-10,11-epoxide (CBZE) and 10,11-dihydro-CBZ-10,11-diole (CBZD) during 24 h in 21 of 48 patients treated with daily single doses of 8.4 (+/- 2.4) mg/kg body weight CBZ-SR were determined by a high-performance liquid chromatography procedure. The 8 a.m. CBZ levels correlated very well with the mean CBZ levels of the 24-h profile. Unlike CBZD, the individual 24-h mean CBZE levels also correlated well with the respective CBZ levels (CBZE = 14.2% +/- 2.9 of CBZ). Increasing CBZ-SR doses does not result in a proportional increase of CBZ levels. Clinical efficacy of changing from CBZ standard tablets under mono- or combination therapy or from therapy with other antiepileptic drugs to once-daily evening CBZ-SR monotherapy or commencement CBZ-SR therapy in previously untreated patients was monitored in 35 of 48 patients for a period of 8 months to 2 years. Complete seizure control was observed in 51% of patients and more than 75% reduction of seizure frequency in 14%. Eight of 11 previously untreated patients became seizure free. With change from CBZ monotherapy to CBZ-SR single-dose therapy, five of six patients became seizure free. Changing from other therapeutic regimens to CBZ-SR once-daily evening monotherapy was less successful.

Adolescent↗