Esophageal cancer surgical practice guidelines. Esophageal Cancer Practice Guideline Committee.
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Carcinoma↗
Biomedical subjects
J Roth
Publications and source records attributed to J Roth.
The efficacy and tolerability of candesartan cilexetil in an elderly hypertensive population.
This study was performed to evaluate the antihypertensive efficacy and tolerability of candesartan cilexetil 8-16 mg once-daily in comparison with placebo in elderly hypertensive patients. Forty-one hospital and general practice centres in the Netherlands and in the United Kingdom enrolled 350 patients over 65 years of age with essential hypertension (WHO grades I or II). Patients with supine diastolic BP in the range 95-114 mm Hg after 4- to 8-week placebo run-in period (n = 193) were randomised to double-blind therapy with candesartan cilexetil or placebo. The initial dose of candesartan cilexetil 8 mg or placebo was doubled after 6 weeks if supine diastolic blood pressure (BP) exceeded 90 mm Hg. Mean (95% confidence interval) placebo-corrected reduction in supine diastolic BP after 12 weeks' treatment with candesartan cilexetil was 7.5 mm Hg (3.6-11.4; P < 0.001); the corresponding reduction in supine systolic BP was 13.6 mm Hg (6.9-20.2; P < 0.001). Placebo-corrected mean reduction in supine diastolic BP 2 and 4 h after the first dose of candesartan cilexetil were 2.2 mm Hg (-1.3 to +5.8; P = 0.219) and 4.0 mm Hg (-0.4 to +7.6; P = 0.027), respectively. Candesartan cilexetil had almost no influence on heart rate and did not affect the normal orthostatic changes in BP. Adverse events were equally common in the two treatment groups. Candesartan cilexetil 8-16 mg once-daily is an effective antihypertensive agent in elderly patients. The onset of action is smooth with no exaggerated response after the first dose and there is no postural hypotension. Candesartan cilexetil is very well tolerated in elderly hypertensives.
Aged↗
Beta 3-adrenoceptor gene variant in obesity and insulin resistance.
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Arginine↗
A synthetic peptide derived from a COOH-terminal domain of the insulin receptor specifically enhances insulin receptor signaling.
The role of the insulin receptor COOH-terminal domain in the regulation of insulin signal transduction was explored with a variety of synthetic peptides. One of the peptides, termed peptide HC, whose structure corresponds to residues 1293-1307 of the insulin proreceptor sequence, enhanced insulin-stimulated autophosphorylation of the insulin receptor in cell-free systems and in semipermeabilized Chinese hamster ovary (CHO) cells that had been transfected with an expression plasmid encoding the human insulin receptor (CHO/HIRc) at concentrations where there was no detectable effect on basal autophosphorylation levels or on receptor dephosphorylation. A lipophilic analogue of peptide HC, stearyl peptide HC, added to intact CHO/HIRc cells enhanced significantly insulin-stimulated insulin receptor autophosphorylation while having no effect on ligand-stimulated receptor phosphorylation in CHO cells overexpressing either the IGF-1 receptor or epidermal growth factor receptor. Addition of stearyl peptide HC to CHO/HIRc cells resulted in a 2.4 +/- 0.3-fold increase in the amount of insulin-stimulated phosphatidylinositol 3-kinase detected in anti-IRS-1 immunoprecipitates and a 2.1 +/- 0.6-fold increase in the levels of tyrosine phosphorylation of mitogen-activated protein kinase in response to insulin. Finally, a derivative of peptide HC coupled to a biotin moiety was prepared and showed to bind with the beta-subunit of the wild-type insulin receptor and a truncated receptor that lacks 43 amino acids from its carboxyl terminus. However, there was little binding, if any, of the peptide with the IGF-1 receptors or the epidermal growth factor receptors. Taken together, our data demonstrate that a pentadecapeptide related to the carboxyl terminus of the insulin receptor binds to the insulin receptor beta-subunit and that this interaction may contribute to the increased receptor's intrinsic activity and signal transduction.
Animals↗
Poly (alpha 2,8-deaminoneuraminic acid) is expressed in lung on a single 150-kDa glycoprotein and is an oncodevelopmental antigen.
Homopolymers of alpha 2,8-linked N-acetylneuraminic acid [poly(alpha 2,8-Neu5Ac)] of the neural cell adhesion molecule NCAM have been shown to be temporally expressed during lung development and represent a marker for small cell lung carcinoma. We report the presence of a further polysialic acid in lung that consists of oligo/polymers of alpha 2,8-linked deaminoneuraminic acid residues [poly (alpha 2,8-KDN)], as detected with a monoclonal antibody in conjunction with a specific sialidase. Although the various cell types forming the bronchi, alveolar septs, and blood vessels were positive for poly (alpha 2,8-KDN) by immunohistochemistry, this polysialic acid was found on a single 150-kDa glycoprotein by immunoblot analysis. The poly(alpha 2,8-KDN)-bearing glycoprotein was not related to an NCAM protein based on immunochemical criteria. The expression of the poly (alpha 2,8-KDN) was developmentally regulated as evidenced by its gradual disappearance in the rat lung parenchyma commencing 1 week after birth. In adult lung the blood vessel endothelia and the smooth muscle fibers of both blood vessels and bronchi were positive but not the bronchial and alveolar epithelium. The poly (alpha 2,8-KDN)-bearing 150-kDa glycoprotein became reexpressed in various histological types of lung carcinomas and cell lines derived from them and represents a new oncodevelopmental antigen in lung.
Animals↗
Lack of tolerance development to tumor necrosis factor alpha inside the central nervous system.
Tumor necrosis factor alpha (TNF alpha) was repeatedly microinfused into the lateral ventricle of guinea pig brains at a dose of 200 ng, 4 times within 150 min, at intervals of 3 days. In comparison to guinea pigs infused with solvent according to the same time schedule. the animals responded to TNF alpha with pronounced fevers. The quantity of the fever response was the same after each of the 4 microinfusions of TNF alpha. Three days after the last infusion of TNF alpha or solvent all animals received an intramuscular injection of bacterial lipopolysaccharide (LPS). The fever in response to LPS was the same in both groups. Thus, the reported development of tolerance to repeated systemic administration of TNF alpha 1-3 does not develop inside the blood-brain barrier. Also, the febrile response to LPS is not influenced by repeated central pre-treatment with TNF alpha, whereas repeated peripheral treatment does have an effect.
Animals↗
[Basis of radiation protection].
After an introduction, three selected contributions to the 10th Course on Radiation Protection held at the University Hospital of Basel are presented. The principles of radiation protection and new Swiss legislation are discussed as the basis for radiological protection. Ways are proposed of reducing radiation exposure while optimizing the X-ray picture with a minimum dose to patient and personnel. Radiation effects from low doses. From the beginning, life on this planet has been exposed to ionizing radiation from natural sources. For about one century additional irradiation has reached us from man-made sources as well. In Switzerland the overall annual radiation exposure from ambient and man-made sources amounts to about 4 mSv. The terrestrial and cosmic radiation and natural radionuclids in the body cause about 1.17 mSv (29%). As much as 1.6 mSv (40%) results from exposure to radon and its progenies, primarily inside homes. Medical applications contribute approximately 1 mSv (26%) to the annual radiation exposure and releases from atomic weapons, nuclear facilities and miscellaneous industrial operations yield less than 0.12 mSv (< 5%) to the annual dose. Observations of detrimental radiation effects from intermediate to high doses are challenged by observations of biopositive adaptive responses and hormesis following low dose exposure. The important question, whether cellular adaptive response or hormesis could cause beneficial effects to the human organism that would outweigh the detrimental effects attributed to low radiation doses, remains to be resolved. Whether radiation exerts a detrimental, inhibitory, modifying or even beneficial effect is likely to result from identical molecular lesions but to depend upon their quantity, localization and time scale of initiation, as well as the specific responsiveness of the cellular systems involved. For matters of radiation protection the bionegative radiation effects are classified as deterministic effects or stochastic effects respectively. The various histopathological reactions of tissues and organs following localized tissue irradiation, and the radiation syndromes following total body irradiation, constitute the deterministic effects. There will be a threshold below which deterministic effects do not appear and spontaneous incidences are not known. For low dose risk considerations deterministic effects are of no significance. Genetic effects and carcinogenesis are said to be stochastic effects. Characteristically the probability of stochastic effects increases with dose but the severity of the effects is independent of the dose. The shape of the dose-response relationship at intermediate to high dose levels is linear-quadratic. For exposure to low doses the response becomes linear, as is to be expected for a linear-quadratic function at low dose. No threshold is assumed for stochastic effects. The estimate of probability of fatal cancer by the ICRP is 4 x 10(-2) per Sv for the working population and 5 x 10(-2) per Sv for the total population. Their estimate of probability of serious hereditary disorders within the first two generations is 1 x 10(-2) per Sv. The highest probability coefficient is attributed to mental retardation following exposure in utero. Within the sensitive period at 8-15 weeks of gestation, a risk probability of 40 x 10(-2) per Sv is assumed but a threshold at 0.1 Sv is not excluded. Conclusions drawn from experiments, clinical observations and epidemiological studies following intermediate to high radiation exposures attribute a mutagenic and carcinogenic competence to all radiation doses. Microdosimetric considerations support this assumption. This conclusion cannot be confirmed experimentally nor by epidemiological studies of populations living under different conditions from natural sources of radiation. Nevertheless, a change in the present restrictive radiation protection policy does not yet appear appropriate.
Diagnostic Imaging↗
CD44 standard and variant isoform expression in human epidermal skin tumors is not correlated with tumor aggressiveness but down-regulated during proliferation and tumor de-differentiation.
CD44 isoforms have been reported to be involved in tumor invasion and metastasis formation. Normal human skin expresses high levels of CD44 isoforms, but little is known about their expression in epidermal skin tumors. Expression of CD44 standard (CD44s) and variant exon (CD44v3, -v4, -v5, -v6, -v9)-encoded gene products has been studied in 74 benign, semi-malignant and malignant human epithelial skin tumors using a panel of well-characterized, variant exon-specific monoclonal antibodies (MAbs). Sensitivity and resolution of the immunohistochemical staining in paraffin sections was substantially improved by using microwave-based antigen retrieval and an optimized streptavidin-biotin-peroxidase technique. Immunostaining was evaluated semi-quantitatively and correlated with tumor type and degree of histological differentiation by non-parametric statistical tests. Furthermore, the relationship between CD44 expression and cellular proliferation rate as defined by the Ki-67 antigen was analyzed in basal cell carcinomas. We found a significant correlation between tumor type and CD44 isoform expression. Basal cell carcinomas exhibited the weakest staining and keratoacanthomas the strongest. Squamous cell carcinomas ranged in between, with a tendency to down-regulate CD44 expression upon de-differentiation. In basal cell carcinomas, an inverse relationship between CD44 expression and proliferation rate was directly demonstrated at the cellular level using double immunolabelling. Our data indicate that qualitative and quantitative changes in CD44 splicevariant expression in human skin tumors do not correlate with invasive and metastatic potential but are rather related to the degree of tumor differentiation.
Animals↗
p53 as a target for cancer vaccines: recombinant canarypox virus vectors expressing p53 protect mice against lethal tumor cell challenge.
The p53 protein is an attractive target for immunotherapy, because mutations in the p53 gene are the most common genetic alterations found in human tumors. These mutations result in high levels of p53 protein in the tumor cell, whereas the expression level of wild-type p53 in nonmalignant tissue is usually much lower. Several canarypox virus recombinants expressing human or murine p53 in wild-type or mutant form were constructed. Immunization with these viruses protected BALB/c mice from a challenge with an isogenic and highly tumorigenic mouse fibroblast tumor cell line expressing high levels of mutant p53. The tumor protection was equally effective regardless of whether wild-type or mutant p53 was used for the immunization, indicating that the immunologic response was not dependent on any particular p53 mutation and that immunization with this live virus vaccine works effectively against mutant p53 protein expressed in a tumor cell. In tumors escaping immunologic rejection, the expression of the p53 protein was commonly down-regulated.
Amino Acid Sequence↗
[The CT image of atrophy of the head of the caudate nucleus in Huntington's chorea].
BACKGROUND: The aim of the study was to measure, using computed tomography (CT), the head of caudate nucleus in Huntington's disease (HD) and in controls in order to verify, whether differences in results have a diagnostic value. METHODS AND RESULTS: We measured using CT (orbitomeatal line, 5 mm slices), the head of caudate nucleus are a (HCNA), bifrontal distance (BFD: maximum distance between frontal horns of lateral ventricles), bicaudate distance (BCD: minimum distance between heads of caudate nuclei) and calculated an index (BCD/BFD) in 12 HD patients (mean age 44.6 yrs (SD: 8.8), mean duration of HD 3.6 yrs (2.5), and in 18 age matched healthy controls. We found in HD patients mean HCNA 0.40 cm2 (SD: 0.12) (min. 0.14 cm2, max. 0.55 cm2), in controls 1.20 (0.1) (1.06, 1.45). Mean BFD in HD patients was 3.99 cm (0.37), (3.31, 4.48) and in controls 3.55 (0.45) (2.84, 4.76). Mean BCD in HD patients was 2.74 cm (0.44) (2.06, 3.44) and in controls 1.55 (0.50) (0.79, 2.70) and mean BCD/BFD index in HD patients 0.68 (0.06) (0.59,0.77), and in controls 0.43 (0.10) (0.25, 0.59). The group statistics revealed the significant difference between HD patients and controls: HCNA (p < 0.0001), BFD (p < 0.01), BCD (p < 0.0001) and BCD/BFD index (p < 0.0001). When dealing with individual values, only HCNA shows no overlapping of values between HD patients and controls. CONCLUSIONS: CT linear measurement of HCNA is a simple and specific tool for the diagnosis of HD.
Adult↗
Occurrence of poly(alpha2,8-deaminoneuraminic acid) in mammalian tissues: widespread and developmentally regulated but highly selective expression on glycoproteins.
In tissues of higher organisms homopolymers of alpha2,8-linked N-acetylneuraminic acid can be found as a posttranslational modification on selected proteins. We report here the discovery of homopolymers of alpha2,8-linked deaminoneuraminic acid [poly(alpha2,8-KDN)] in various tissues derived from all three germ layers in vertebrates including mammals. The monoclonal antibody kdn8kdn in conjunction with a bacterial KDNase permitted the detection of poly(alpha2,8-KDN) by immunohistochemistry and immunoblotting. Further evidence for the existence of poly(alpha2,8-KDN) was obtained by gas/liquid chromatography. The poly(alpha2,8-KDN) glycan was detectable in all tissues studied with the exception of mucus-producing cells present in various organs, the extracellular matrix, and basement membranes. However, in certain organs such as muscle, kidney, lung, and brain its expression was developmentally regulated. Despite its widespread tissue distribution, the poly(alpha2,8-KDN) glycan was detected on a single 150-kDa glycoprotein except for a single >350-kDa glycoprotein in kidney, which makes it most distinctive among polysialic acids. The ubiquitous yet selective expression may be indicative of a general function of the poly(alpha2,8-KDN)-bearing glycoproteins.
Animals↗
Phosphorylation of MRP14, an S100 protein expressed during monocytic differentiation, modulates Ca(2+)-dependent translocation from cytoplasm to membranes and cytoskeleton.
MRP8 and MRP14 are two Ca(2+)-binding proteins expressed in myelomonocytic cells. Complexes of MRP8 and MRP14 colocalize with membranes and intermediate filaments in a Ca(2+)-dependent manner. MRP14, unlike MRP8, exists in two isoforms, the smaller of which (MRP14') has been shown to lack the first four amino acids; both MRP14 and MRP14' are also present as phosphorylated forms. As shown in the present work by metabolic labeling of monocytes with [35S]methionine, MRP14 and MRP14' are translated simultaneously. By PCR analysis we found no evidence for the presence of different mRNA species. Since MRP14 is encoded by a single copy gene, our data indicate that MRP14' formation is due to alternative translation of a single mRNA species. Two-dimensional electrophoresis of [32P]orthophosphate-labeled monocyte proteins followed by Western blotting and autoradiography revealed that the two phosphorylated MRP14 isoforms incorporated the bulk of the radioactivity found in monocytic proteins. Using differential centrifugation we demonstrated the presence of distinct isoform patterns in different subcellular locations. Further, in response to elevated Ca2+ concentrations we observed a preferential translocation of phosphorylated MRP14 isoforms from the cytosol toward membranes and the cytoskeleton. This might be caused by altered calcium binding, and indeed, using isoelectric focusing and 45Ca2+ overlay the MRP14 band containing phosphorylated MRP14 revealed increased Ca2+ binding compared with bands containing other MRP14 isoforms. This represents the first evidence for functional differences in phosphorylated MRP14 isoforms compared with nonphosphorylated MRP14 isoforms. These functional differences suggest that MRP14 represents the regulatory subunit of MRP8/MRP14 complexes.
Antigens, Differentiation↗
E-selectin expression in experimental models of inflammation in mice.
E-selectin (CD62E, formerly termed ELAM-1) is a cytokine-inducible adhesion molecule which mediates the binding of neutrophils, monocytes, and skin homing T-cells. The murine homologue of E-selectin has been cloned. A monoclonal antibody (21KC10) was used here to study immunohistochemically the expression and regulation of murine E-selectin in vitro and in vivo. As described for the human system, there was no staining of normal endothelium in skin and other tissues. LPS and tumour necrosis factor-alpha (TNF-alpha), but not interleukin-4 (IL-4) or interferon-gamma (IFN-gamma), induced a transient expression of E-selectin, both when injected in vivo and when added to endothelial cell lines in vitro. To analyse temporal expression of E-selectin under pathophysiological conditions in vivo, we chose two murine models of inflammation: allergic (ACD) and irritant contact dermatitis (ICD). Expression of E-selectin was found to be induced on vascular endothelium of post-capillary venules in both ACD and ICD. In ICD, maximal staining of endothelial cells occurred earlier than in ACD. Expression of E-selectin during ICD and ACD was then compared between strains of mice which differ with regard to the intensity of their inflammatory reaction. BALB/c mice, which in contrast to C57BI/6 mice show a denser infiltrate and prolonged influx of granulocyte and monocytes, revealed a more pronounced and more prolonged expression of E-selectin than C57BI/6 mice. This held true for both ACD and ICD, and in each case, peak expression of E-selectin was associated with the highest density of the leukocytic infiltrate. This study thus reveals regulatory mechanisms involved in the expression of murine E-selectin in vivo and in vitro. It also demonstrates a correlation between endothelial expression of E-selectin and the genetically determined intensity of the inflammatory response.
Animals↗
Identification of a novel surface molecule, RM3/1, that contributes to the adhesion of glucocorticoid-induced human monocytes to endothelial cells.
The functions of different populations of peripheral blood monocytes in the course of an inflammatory reaction are presently not fully understood. In particular, the mechanisms for their specific recruitment to an inflammatory site are not yet known. We investigated a dexamethasone (Dex)-inducible monocyte subtype and its adhesion to either unstimulated or lipopolysaccharide (LPS)- or interferon (IFN)-gamma-stimulated human umbilical vein endothelial cells (HUVEC). The Dex-induced monocytes were characterized by the expression of the surface glycoprotein RM3/1. It was found that pretreatment of monocytes with Dex increased their adhesion to unstimulated and stimulated HUVEC. This increase in adhesion was paralleled by the expression of the RM3/1 surface molecule. Treatment with cyclosporin A (CsA) caused a down-regulation of the RM3/1 density per cell by 67% and also decreased adhesion to HUVEC. In contrast, the expression of other adhesion molecules remained unaffected by Dex or CsA treatment. Treatment of Dex-induced monocytes with antibodies against RM3/1, CD11a, CD11b, CD11c, CD14 and CD18 resulted in suppression of adhesion to stimulated HUVEC by 46%, 18%, 17%, 12%, 25% and 15%, respectively. Antibodies to the known adhesion molecules on endothelial cells (vascular cell adhesion molecule-1, E-selectin) did not block adhesion of Dex-induced monocytes. However, the combination of antibodies to RM3/1 and CD14 inhibited adhesion to LPS-stimulated HUVEC by 74%. These effects were also seen on IFN-gamma-stimulated HUVEC, where adhesion of Dex-induced monocytes was blocked with antibodies to RM3/1 + CD14 by 63%. From this, it is concluded that the RM3/1-molecule is a novel surface molecule that contributes to the adhesion of cortisone-induced monocytes to LPS or cytokine-stimulated endothelial cells.
Antigens, CD↗
Can malignancy in insulinoma be predicted by the expression patterns of beta 1,6 branching of asparagine-linked oligosaccharides and polysialic acid of the neural cell adhesion molecule?
We analysed the value of the expression of beta 1,6 branching of asparagine-linked oligosaccharide chains and polysialic acid of the neural cell adhesion molecule (NCAM) in predicting malignant behaviour in human insulinomas, as these glycoconjugates have been associated with invasive growth and metastatic potential. Fifty-three insulinomas from patients with well-documented clinical and follow-up data were investigated. Lectin histochemical staining for beta 1,6 branches revealed that 11 (74%) of the 15 malignant insulinomas stained more strongly than normal beta cells. However, in as many as 23 (63.1%) of the 38 benign insulinomas with a disease-free follow up for 4-18 years (average 8 years), a staining intensity equivalent to that of malignant tumours was found. Two (13%) of the malignant insulinomas and 1 of the 4 liver metastases studied were unstained. None of the 53 insulinomas (and the rat RIN insulinoma) re-expressed polysialic acid as demonstrated by immunohistochemistry and Western blotting with the monoclonal antibody 735. Therefore, histochemical staining for beta 1,6 branches and immunohistochemistry for polysialic acid are unlikely to be of value as prognostic indicators for patients with insulinomas.
Adult↗
The silver anniversary of gold: 25 years of the colloidal gold marker system for immunocytochemistry and histochemistry.
Since 1971, when W.P. Faulk and G.M. Taylor published "An immunocolloid method for the electron microscope", colloidal gold has become a very widely used marker in microscopy. It has been used to detect a huge range of cellular and extracellular constituents by in situ hybridization, immunogold, lectin-gold, and enzyme-gold labeling. Besides its use in light microscopic immunogold and lectin-gold silver staining, colloidal gold remains the label of choice for transmission electron microscopy studying thin sections, freeze-etch, and surface replicas, as well as for scanning electron microscopy. The year 1996 is the 25th anniversary of the introduction of colloidal gold as a marker in immunoelectron microscopy and this overview outlines some of the major milestones in the development of the colloidal gold marker system.
Animals↗
Protein glycosylation in the endoplasmic reticulum and the Golgi apparatus and cell type-specificity of cell surface glycoconjugate expression: analysis by the protein A-gold and lectin-gold techniques.
High resolution immunolabeling applying the protein A-gold technique and carbohydrate cytochemistry using lectin-gold labeling on Lowicryl K4M and thawed-frozen thin sections are most useful approaches for the detection of protein antigens and lectin binding sites in intracellular organelles and the plasma membrane. They provided the basis for modern electron microscopic studies on protein glycosylation reactions and the identification of their subcellular localization as reviewed here. These studies have demonstrated organelle subcompartments and the cell type-specific compartmentation of endoplasmic reticulum and Golgi apparatus-associated glycosylation reactions. The other subject reviewed in this paper is cell surface glycoconjugates, as they are expressed in relation to specific cell types present in various organs and during cellular differentiation processes.
Animals↗