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Biomedical subjects

J Isola

Publications and source records attributed to J Isola.

At least 109 records · Page 6Linked to original sources

A regression model for identifying patients at high risk of hypotension, bradycardia and nausea during spinal anesthesia.

We analyzed the predictive value of a number of demographic and anesthesiological variables with respect to the three most common complications during spinal anesthesia: hypotension, bradycardia, and nausea. A stepwise logistic regression model was created, using data from a prospective study of 1752 patients to combine the predictive value of all entry variables. The highest risk factors for hypotension were: age greater than or equal to 50, a sensory level above Th6, receiving bupivacaine as a local anesthetic, body mass index greater than or equal to 30, and receiving opiate as a premedication. An anesthetic level above Th6 and age below 50 were primarily associated with bradycardia. Females and those with a high sensory level or receiving opiate as a premedication were at significant risk of nausea. The model was also reliably predictive for a separate group of 200 consecutive spinal anesthesia patients. Thus, the risk model may be clinically useful in identifying high-risk patients requiring additional attention.

Anesthesia, Spinal↗

Colocalization of peptide and glucocorticoid receptor immunoreactivities in rat central amygdaloid nucleus.

The central amygdaloid nucleus (ACe) is part of the amygdaloid complex that participates in adrenocorticotrophin secretion, stress-related reactions and behavioral functions. The ACe contains numerous glucocorticoid receptor (GR)-immunoreactive (IR) neurons, and in addition it has been shown to contain several neuropeptide-IR somata and nerve terminals. In order to study the relationship between the GR- and neuropeptide-IR structures we mapped the distribution of GR-like immunoreactivity (LI) in amygdaloid complex and colocalized the neuropeptide- and GR-LIs in the ACe. In the amygdaloid complex the central, medial and cortical nuclei contained a high number of GR-IR neurons, whereas a moderate number of GR-IR neurons were observed in the basolateral and basomedial nuclei. Only a few GR-IR neurons were seen in the lateral nucleus. In the ACe, the majority of corticotrophin-releasing factor (CRF)-, met-enkephalin (met-ENK)-, neurotensin (NT)- and somatostatin (SOM)-IR neurons contained also GR-IR. About half of the substance P (SP)-IR neurons were seen to contain GR-IR, whereas only some of the few vasoactive intestinal polypeptide and cholecystokinin-IR neurons showed GR-LI. Nerve terminals containing calcitonin gene-related peptide and the above mentioned peptides were seen in close contact with the GR-IR neurons. These results suggest that the glucocorticoids may modulate directly the neurotransmitter synthesis of the CRF-, met-ENK, NT-, SOM- and SP-IR cells in the ACe.

Amygdala↗

Ultrastructure and collagen composition of the myo-fascial junction in rat calf muscles.

The collagen composition and ultrastructural organization of the myo-fascial junction was studied using immunohistochemical techniques and electron microscopy. At the myo-fascial junction, a small amount of type-III collagen was found; however, the major collagen component was the type-I collagen. On the longitudinal sites of muscle cells, there were deep recesses and, within these, finger-like structures containing sarcomeres. In these recesses and in the finger-like structures of the myo-fascial junction, the sarcolemma was thickened (three times) in a similar way to the basal lamina at the myotendinous junction. Thin collagen fibers were closely associated with the thickened sarcolemma of the finger-like structures.

Animals↗

Prognostic significance of HER-2 oncoprotein expression in breast cancer: a 30-year follow-up.

PURPOSE: To study retrospectively the long-term prognostic significance of HER-2 oncoprotein expression in breast cancer (BC). PATIENTS AND METHODS: Two hundred nine consecutive female patients with invasive operable BC from a defined urban population were observed for a median of 30 years. Tissue expression of HER-2 oncoprotein was demonstrated by using an immunoperoxidase procedure. RESULTS: Fifty-five (26%) patients had cancer and a positive HER-2 oncoprotein stain reaction. They had significantly worse 10- and 25-year survival rates than those patients who had a negative stain reaction in their cancer (31% v 48% and 31% v 39%, respectively; P = .004). HER-2 expression was also associated with a poorer survival among patients who had axillary nodal metastases (P = .003; n = 104), but not among those patients who did not have metastases. HER-2 expression was related to the ductal histologic type, poor histologic grade, and high mitotic count, but not to tumor size, axillary nodal status, DNA ploidy, or S-phase fraction (SPF). In a multivariate analysis among patients with nodal metastases, HER-2 expression was an independent prognostic factor (P = .04) that predicted poor survival. However, if the entire series was entered onto the analysis, it did not emerge as an independent factor. CONCLUSIONS: HER-2 oncoprotein expression has long-term prognostic significance for predicting poor survival in BC, and it has an independent prognostic value among patients who presented with axillary nodal metastases. This result is contradictory to the argument that HER-2 expression is only a marker for drug resistance because the patients were not given adjuvant drug therapy.

Adult↗

Expression of epidermal growth factor receptor and ERBB2 (HER-2/Neu) oncoprotein in prostatic carcinomas.

Expression of epidermal growth factor receptor (EGFR) and ERBB2 oncoprotein were studied in paraffin-embedded normal (n = 2), hyperplastic (n = 17), and malignant (n = 147) prostatic tissues by immunohistochemistry. Strong immunoreactivity was detected in the epithelial cells of all normal and hyperplastic prostates with a new EGFR antibody (Mab31G7). In prostatic carcinomas, the EGFR immunoreactivity was variable with 47% showing uniform, 39% partial, and 14% no staining. Tumors with partial or uniform EGFR immunoreactivity were locally more advanced and of higher histological grade than the EGFR-negative tumors. EGFR-positive tumors also had two to three times higher S-phase fraction, suggesting that EGFR expression conferred proliferative advantage. Patients who had either partially or uniformly EGFR-positive carcinomas had a worse 10-yr progression-free (p = 0.05), overall (p = 0.03), and prostatic carcinoma-specific (p = 0.007) survival than those with EGFR-negative carcinomas. However, according to a multivariate analysis, EGFR did not have independent prognostic value. None of the normal, hyperplastic, or malignant prostate tissues showed clearly positive ERBB2 immunoreactivity with MAb1 antibody.

Carcinoma↗

Improved prognostic impact of S-phase values from paraffin-embedded breast and prostate carcinomas after correcting for nuclear slicing.

Nuclear debris may significantly interfere with the analysis of S-phase fraction (SPF) from paraffin-embedded tumors. We used a background subtraction algorithm to compensate for the effects of slicing of tumor cell nuclei during preparation of paraffin-embedded specimens. DNA histograms were analyzed from 88 node-negative breast and from 78 prostatic carcinomas. Median SPFs corrected for nuclear slicing were lower than uncorrected ones in both breast cancer (7.6% vs. 5.7%) and prostate cancer (6.7% vs. 4.2%). The median SPF value in each group was used as a cut-off point in survival studies. As compared with the uncorrected SPFs, corrected SPF levels resulted in a more significant survival difference between breast cancer patients with above and below median SPF (p = 0.0014 vs. p = 0.014) and in a higher relative risk (RR) of death (4.5 vs. 3.1). The same was true for prostate cancer survival (p less than 0.0001 vs. p = 0.002) and RR (5.3 vs. 3.1). Compared with the exponential background subtraction method, the sliced nuclei correction was more reproducible and could be applied in all evaluable histograms without the risk of overcompensation. In conclusion, our results support the use of background correction with the sliced nuclei model in DNA flow cytometric studies of archival tissues.

Breast Neoplasms↗

Macromolecular composition of the myotendinous junction.

The macromolecular composition of the myotendinous junction of the rat Achilles tendon was investigated. Heparan sulphate, chondroitin sulphate, and/or dermatan sulphate could be detected in the terminal processes of the muscle cells, but neither heparin nor keratan sulphate was present. The presence of hyaluronic acid was also questionable. High concentrations of sulphate containing glycosaminoglycans could be demonstrated both in the sarcolemma membranes and extracellular region. The main collagenous component in the myotendinous junction was type I collagen. Also small amounts of type III collagen was found at the myotendinous interface. In addition, high concentrations of fibronectin was present on the muscle cell surfaces of the junction. These results showed that myotendinous junction is histochemically and immunohistochemically a highly specified area rich in various polysaccharides. The high concentration of the polysaccharides in the myotendinous interface may increase the adhesive force between the muscle cell membrane and tendineal collagen fibrils and, by this way, it may be important in improving the elastic buffer capacity of the junction against loading.

Animals↗

Morphology and histochemistry of the myotendineal junction of the rat calf muscles. Histochemical, immunohistochemical and electron-microscopic study.

The macromolecular composition and morphometry of the myotendineal junction (MTJ) of slow-twitch (type 1) and fast-twitch (type 2) muscle fibers were studied in gastrocnemius-soleus-Achilles unit of the rat. Proteoglycans and glycosaminoglycans, type III collagen, fibronectin and laminin could be detected at the myotendineal junction. Due to the membrane folding finger-like processes were seen at the MTJ. The processes of type 1 fibers were greater in size. However, due to the subdivisions the processes of type 2 muscle fibers had a significantly greater surface length per muscle cell diameter than type 1 fibers. The myotendineal endings of both fiber types had a characteristic basal lamina, which was about three times thicker than in the longitudinal site of the same muscle cells. The basal lamina of type 1 fibers at the MTJ was significantly thicker than that of type 2 fibers.

Achilles Tendon↗

Simultaneous localization of calcitonin gene-related peptide and neurotensin in rat central amygdaloid nucleus.

The distribution of calcitonin gene-related peptide (CGRP) and neurotensin (NT)-like immunoreactivities (LI) was studied in rat central amygdaloid nucleus (ACe) with immunocytochemical double staining. A dense network of CGRP- and NT-immunoreactive (IR) nerve fibers and some NT-positive neurons were found in the lateral and lateral capsular subnuclei. Light microscopically CGRP-immunoreactive nerve endings were in close contact to most of the NT-immunoreactive neurons. Under the electron microscope CGRP-positive terminals formed symmetric axo-somatic synapses with part of the NT-IR neurons. These results indicate that the NT- and CGRP-containing neuronal systems are in contact with each other in the ACe. Both peptides have marked effects on the circulatory system when administered intracerebrally. Thus the NT-IR neuronal system receiving synaptic input from CGRP-IR nerve terminals may mediate the cardiovascular effects of these two peptides.

Amygdala↗

Steroid receptors and Ki-67 reactivity in ovarian cancer and in normal ovary: correlation with DNA flow cytometry, biochemical receptor assay, and patient survival.

Steroid hormone receptors and reactivity for Ki-67 proliferation antigen were studied immunohistochemically in non-neoplastic post-menopausal human ovary and in 29 ovarian cancers. In the normal ovary, oestrogen (OR) and progesterone receptors (PR) were found in the surface epithelium and PR also in the ovarian stroma. Of the ovarian carcinomas 38 per cent (11/29) contained OR and 69 per cent (20/29) PR. Oestrogen receptor expression was confined to malignant cells, whereas PR was present occasionally also in the tumour stroma. In most cases, ORs and PRs were found only in a small population of cancer cells. The growth fractions assessed by the percentage of Ki-67-positive cells ranged from 1 to 59 per cent (mean 19.7 per cent) with a significant correlation (r = 0.74, P less than 0.0001) to S-phase values (mean 12.9 per cent, range 1.2-25.9 per cent) determined by DNA flow cytometry. High Ki-67 (greater than or equal to 15 per cent) and S-phase levels (greater than or equal to 7.5 per cent) correlated with advanced disease stage and patient survival but not with OR or PR status, suggesting that hormone-receptor pathways and proliferative activity are not related in ovarian cancer. Positive OR status, however, identified patients with a better prognosis (P = 0.02), suggesting a correlation with tumour differentiation. The independent prognostic value of oestrogen receptor status and Ki-67 remains to be determined, but the prognostic impact of Ki-67 was comparable to that of S-phase values.

Adult↗

Immunoelectron-microscopic localization of a proliferation-associated antigen Ki-67 in MCF-7 cells.

Immunocytochemistry using the monoclonal antibody Ki-67 is a commonly used method to assess proliferative activity of malignant tumours, Ki-67 reacts with proliferating cells with an antigen, whose structure, function and exact locations are unknown. We studied the subcellular location of Ki-67 in MCF-7 cells using immunoelectron microscopy. In the interphase cells, Ki-67 immunoreactivity was localized in the nucleolus, mainly in the nucleolar cortex. In particular, areas of the granular component of the nucleolus were strongly stained. Weak spot-like nucleoplasmic immunostaining was also seen outside the nucleolus. During prophase Ki-67 antigen was localized on the surfaces of the condensed chromatin and during metaphase on the surface of the chromosomes. After cell division and prior to formation of new nucleoli, Ki-67 immunoreactivity was located in the nucleoplasm. Quantification of Ki-67 immunofluorescence signal by flow cytometry revealed highest Ki-67 levels in mitotic cells. The location of Ki-67 is very similar to certain recently described proteins of nucleolar preribosomes suggesting that Ki-67 may also be a component of the preribosomes.

Antibodies, Monoclonal↗

Discordant results between radioligand and immunohistochemical assays for steroid receptors in breast carcinoma.

Surgical biopsy specimens of 179 breast carcinoma were studied by steroid-binding and immunohistochemical assays or oestrogen and progesterone receptors (ER, PR) in order to explore reasons for discordant results between the two assay types. Receptor statuses in 18% of ER assays and 30% of PR assays were in disagreement. Immunohistochemistry-positive steroid-binding-negative status predominated among the discordant ER assays, while the discordant PR assays displayed the opposite situation. In discordant assays receptor concentration was significantly more often close to the cut-off (10-50 fmol mg-1) than in the concordant ones. Low binding affinity (high Kd) was also significantly associated with disagreeing assay results. These observations clearly indicate that immunohistochemical ER and PR assays measure high-affinity binding components (i.e. type I receptors) in steroid-binding assays. ER but not PR assays in premenopausal women disagreed more often than those in post-menopausal women. Such factors as histological type, specimen size in steroid-binding assay, grade of malignancy and tumour necrosis were statistically unrelated to agreement or disagreement of receptor assays.

Adult↗

Immunohistochemical versus biochemical estrogen-receptor and progesterone-receptor analysis: correlation with histological parameters.

Human breast carcinomas were evaluated for estrogen and progesterone receptors by immunohistochemistry using monoclonal anti-receptor antibodies (n = 267) and by cytosol steroid-binding assays (n = 212). The estrogen and progesterone receptor contents of the tumors correlated with histological features of differentiation, such as histological and nuclear grade, and with the amount of tumor necrosis and lymphoid infiltration. The correlation of immunohistochemically determined steroid receptor values with histological characteristics was somewhat better than that of biochemically assessed concentrations.

Breast Neoplasms↗

Incidence of atherosclerosis in the internal mammary artery.

The long-term patency of the internal mammary artery (IMA) graft is better than that of the saphenous vein graft in coronary bypass procedures. The better patency is thought to be due in part to a relatively low incidence of atherosclerosis in the IMA. In the present study, the incidence of atherosclerosis in the IMA was evaluated in a consecutive Finnish autopsy series of 160 patients. Forty-five patients (28%) had marked occlusion in some coronary arteries as well as a history of angina pectoris. Only 5 (3.1%) of the 160 patients had notable stenosis in the IMA. Three of these 5 patients did not have coronary heart disease. Macroscopic or microscopic signs of atherosclerosis were found in 12.4% of 314 IMAs. We conclude that the low incidence of atherosclerosis in the IMAs in our study is due to their good resistance to the sclerotic process, although the incidence of ischemic heart diseases in Finland is among the highest in the world.

Arteriosclerosis↗

Development of progestin-specific response in the chicken oviduct.

Avidin is a host acute defense protein induced by progestins and by inflammation caused by injurious factors such as microbes, viruses, toxic factors or tissue trauma. In the reproductive tract of egg-laying vertebrates avidin has evolved into a progestin-dependent secretory protein involved in anti-microbial action through its biotin avidity. For "progestin-dependent avidin" production, cellular differentiation by estrogen is necessary. In contrast, the expression of "progestin-independent or inflammation-induced avidin" does not require differentiation. Many cell types such as macrophages, heterophils and fibroblasts can produce avidin after non-specific cellular injuries. The wide distribution of avidin in avian, reptilian and amphibian species could be explained on the basis of its vital functions such as antimicrobial or antifungal, metabolic and immunomodulatory actions. The ontogeny of the progestin-dependent avidin synthesis is a complex event involving oviductal differentiation by steroid hormones leading to a specific gene expression. The first phase in oviductal differentiation by estrogens is characterized by a new chromatin organization and by an infiltration of progesterone receptor (PR)-containing mesenchymal cells into the subepithelial mucosa leading to epithelial cell differentiation ("mesenchymal and epithelial cell interaction"). The second phase in the differentiation of progestin-induced response is dependent on the presence of PR in the secretory cells. Two kinds of PR expression occur in the oviduct. The first is a "constitutive PR" and is found in the epithelial, submucosal and peritoneal cells of the immature chick oviduct without steroid treatment, and the second is an "inducible PR" found especially in the mucosal mesenchymal and smooth muscle cells. Avidin production requires PR in the target cells, but not all PR-containing cells can produce avidin. Therefore, in addition to PR, other transcription factors are needed to define the target cell specificity of the response to progestins. Earlier biochemical studies suggested that cytosolic and/or nuclear unoccupied PR was complexed as an 8 S form with the heat shock protein 90 (hsp90). Our immunohistochemical results, however, indicate that PR in vivo is not bound to hsp90, which is located entirely in the cytoplasm, whereas PR is an entirely nuclear protein in both ligand-occupied and unoccupied forms. Therefore, we assume that PR is a monomeric (4S) or homodimeric (5S) (chromatin?) protein associated to DNA. Ligand binding to PR appears to lead to a conformational change, dimer formation, tighter binding to PRE (progesterone responsive element) and to transcription factors, phosphorylation and proteolysis of PR as well as a chromatin change.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Oestrogen receptor content and cancer cell/stroma ratio in mammary carcinoma.

In a study of 86 human breast cancers the volume fraction of the neoplastic epithelium was estimated semiquantitatively and a significant association was found between the oestrogen receptor (ER) content and volume fraction of cancer cells of tumours (p less than 0.00001). Tumours with very low cellularity could thus be falsely ER negative. When quantitative ER concentration is used to predict the response of tumours to hormonal therapy the cellularity of tumours should be taken in consideration. The cellularity was not related to ER positivity. Although a correlation was seen between the contents of oestrogen and progesterone (PR) receptors, no correlation between PR content and volume fraction of the neoplastic epithelium was observed.

Breast Neoplasms↗