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Synergistic activities of multiple phosphotyrosine residues mediate full signaling from the Drosophila Torso receptor tyrosine kinase.

Here, we identify four tyrosine residues (Y644, Y698, Y767, and Y772) that become phosphorylated after activation of the Torso (Tor) receptor tyrosine kinase. Previously, we characterized phosphotyrosine sites (P-Y630 and P-Y918). Of the six P-Y sites identified, three (Y630, Y644, and Y698) are located in the kinase domain insert region, one (Y918) is located in the C-terminal tail region, and two (Y767 and Y772) are located in the activation loop of the kinase domain. To investigate the function of each P-Y residue in Tor signaling, we have generated transgenic Drosophila embryos expressing mutant Tor receptors containing either single or multiple tyrosine to phenylalanine substitutions. Single P-Y mutations were found to have either positive, negative, or no effect on the signaling activity of the receptor. Elimination of all P-Y sites within the kinase insert region resulted in the complete loss of receptor function, indicating that some combination of these sites is necessary for Tor signaling. Mutation of the C-terminal P-Y918 site revealed that this site is responsible for negative signaling or down-regulation of receptor activity. Mutation of the P-Y sites in the kinase domain activation loop demonstrated that these sites are essential for enzymatic activity. Our analysis provides a detailed in vivo example of the extent of cooperativity between P-Y residues in transducing the signal received by a receptor tyrosine kinase and in vivo data demonstrating the function of P-Y residues in the activation loop of the kinase domain.

Animals↗

Myofascial origins of low back pain. 2. Torso muscles.

Trigger points (TPs) in muscles of the lower torso associated with the spine are an important cause of low back pain. The quadratus lumborum is the muscle most commonly involved, but TPs located there are often overlooked because of inadequate physical examination techniques. TPs in the lower rectus abdominis refer pain horizontally across the low back, and those in the iliopsoas refer pain in a vertical pattern, parallel to the lumbosacral spine. The pain pattern of TPs in the serratus posterior inferior is noted in the region of the muscle itself.

Back↗

Differences in the sensations of warmth on the anterior torso of normal and spinal-cord transected individuals.

The threshold to warming was measured at 10 sites on the anterior torso between the umbilicus and the clavicle of normal and spinal-cord transected individuals. In normal individuals, thresholds were higher on the thorax than on the abdomen. Men had higher and more variable thresholds than women. Magnitude estimations of supra-threshold stimuli showed that men offer verbal estimates of warmth that are about half of the size of the estimates given by women to the same stimuli. The psychometric function shows that in women, the sensation of warmth grows more rapidly than in men after starting from a higher initial value. After spinal-cord injury, thresholds for detection of warming were elevated. This effect was most noticeable within 8 cm of the anesthetic zone, but farther away, thresholds were still elevated but uniform as a function of distance, being about 30% higher than in normal individuals. After spinal-cord injury, the psychometric functions show that small stimuli elicit relatively large sensations and that these sensations grow more slowly with increasing skin temperatures than for normal individuals. Thus, for small warm stimuli spinal-cord-injured patients (both men and women) have a response similar to normal women but the slope of the psychometric function is flat, being similar to the slope observed for normal men.

Adult↗

Reconstruction of laser-scanned 3D torso topography and stereoradiographical spine and rib-cage geometry in scoliosis.

Assessments of scoliosis are routinely done by means of clinical examination and full spinal x-rays. Multiple exposure to ionization radiation, however, can be hazardous to the child and is costly. Here, we explain the use of a noninvasive imaging technique, based on laser optical scanning, for quantifying the three-dimensional (3D) trunk surface topography that can be used to estimate parameters of 3D deformity of the spine. The laser optical scanning system consisted of four BIRIS laser cameras mounted on a ring moving along a vertical axis, producing a topographical mapping of the entire torso. In conjunction with the laser scans, an accurate 3D reconstruction of the spine and rib cage were developed from the digitized x-ray images. Results from 14 scoliotic patients are reported. The digitized surfaces provided the foundation data to start studying concordance of trunk surface asymmetry and spinal shape in idiopathic scoliosis.

Calibration↗

Effects of tissue conductivity variations on the cardiac magnetic fields simulated with a realistic heart-torso model.

Cardiac magnetic fields with varying tissue conductivities are simulated. A high-resolution finite-element torso model composed of 19 tissue types and with a voxel resolution of 1.5 mm x 1.5 mm x 3 mm is used. It has a detailed description of tissue geometries and therefore is well suited for analysing the effects of tissue conductivities on the cardiac magnetic fields. The computed results show the greatest sensitivity of the magnetic fields to the changes in the conductivity of blood and myocardium, and less significant sensitivity to the conductivity of the lungs, muscle, fat and other tissues. These results are relevant to future modelling of magnetocardiograms and solving the inverse problem. They also emphasize the importance of careful modelling of the blood and heart regions, and suggest that less attention needs to be directed to bone or fat tissue.

Biophysical Phenomena↗

Radiation therapy and conservative surgery for soft tissue sarcomas of the extremities, torso and head and neck.

Between May 1985 and July 1990, 45 patients (pts.) with primary (39) or recurrent (6) soft tissue sarcomas of the extremities (82%), torso (11%) and head and neck (7%) were treated with radiation therapy and conservative surgery. Seven pts. not amenable to conservative surgery underwent preoperative radiation therapy whereas 38 pts. underwent local excision and post-operative radiation therapy. Out of the 38 pts. managed by postoperative radiation, 24 (63%) showed negative surgical margins and 14 (37%) positive margins, their tumor being adjacent to vital structures. Preoperative radiation allowed conservative surgery in all 7 pts. with initially inoperable tumor; surgical margins were negative in 5 and positive in 2 pts. Twenty-six pts. (58%) had tumor greater than or equal to 5 cm (5-24) and 19 (42%) less than 5 cm (2.5-4.5) in diameter. High grade tumors (G2-G3) were reported in 41 pts. (90%). In pts. treated postoperatively the radiation dose was 64-66 Gy/32-33 fractions and the pts. treated preoperatively received a dose of 50 Gy/25 fractions. Median follow-up was 33 months and all pts. had a minimum follow-up of 12 months (12-72). Three pts. (6.5%) had local failure and 9 (20%) developed distant metastases with local tumor control. All distant metastases occurred in AJC stage IIIB, 9/18 (50%), with an increased frequency by tumor size. Overall local control and disease free survival rates at 5 years (product-limit method) were 93% and 73%, respectively. An evident decrease in disease-free survival rate (33%) was noted for stage IIIB pts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Characterization of maternal and zygotic D-raf proteins: dominant negative effects on Torso signal transduction.

The maternal D-raf serine/threonine kinase acts downstream of Torso (Tor) for specification of cell fates at the embryonic termini. D-raf activity is also required in other signal transduction pathways and consistent with its pleiotropic role, we find accumulation of a 90-kD D-raf protein throughout embryonic development. We also characterize the accumulation of maternal D-raf proteins in 0-2-hr embryos derived from females with germ cells lacking D-raf activity. Accumulation of a 90-kD or truncated mutant D-raf protein is observed for some of these embryos, while others lack the maternal D-raf protein. Then to determine whether rescue of the Tor pathway is influenced by pools of nonfunctional maternal D raf. wild-type D-raf mRNA was injected into embryos that inherit maternal stores of inactive 90-kD of truncated D-raf protein. For embryos lacking the maternal D-raf protein, a high level of terminal rescue is obtained. In contrast, rescue is reduced or not observed for embryos that accumulate mutant maternal D-raf proteins. These findings suggest that mutant forms of D-raf may deplete the embryo of a positive activator and/or form inactive protein complexes that affect rescue of the Tor pathway.

Animals↗

Drosophila gain-of-function mutant RTK torso triggers ectopic Dpp and STAT signaling.

Overactivation of receptor tyrosine kinases (RTKs) has been linked to tumorigenesis. To understand how a hyperactivated RTK functions differently from wild-type RTK, we conducted a genome-wide systematic survey for genes that are required for signaling by a gain-of-function mutant Drosophila RTK Torso (Tor). We screened chromosomal deficiencies for suppression of a gain-of-function mutation tor (tor(GOF)), which led to the identification of 26 genomic regions that, when in half dosage, suppressed the defects caused by tor(GOF). Testing of candidate genes in these regions revealed many genes known to be involved in Tor signaling (such as those encoding the Ras-MAPK cassette, adaptor and structural molecules of RTK signaling, and downstream target genes of Tor), confirming the specificity of this genetic screen. Importantly, this screen also identified components of the TGFbeta (Dpp) and JAK/STAT pathways as being required for Tor(GOF) signaling. Specifically, we found that reducing the dosage of thickveins (tkv), Mothers against dpp (Mad), or STAT92E (aka marelle), respectively, suppressed tor(GOF) phenotypes. Furthermore, we demonstrate that in tor(GOF) embryos, dpp is ectopically expressed and thus may contribute to the patterning defects. These results demonstrate an essential requirement of noncanonical signaling pathways for a persistently activated RTK to cause pathological defects in an organism.

Animals↗

Comparison of the 1st, 2nd and 3rd generation Lawrence Livermore National Laboratory Torso phantoms.

The Lawrence Livermore National Laboratory (LLNL) Torso phantom, which is the de facto standard for lung counter calibration for low energy photon emitters, has undergone a number of revisions since its development. The first generation used real human bone: the second generation used synthetic bone and had a major design change; the third generation had more subtle material and mould changes. This work has compared a first generation, two second generation, and two third generation LLNL phantoms to see if there are any differences between the phantoms. The comparison of five LLNL phantoms using the same counting regions has shown that the second and third generation phantoms are essentially equivalent at low photon energies, but the first generation phantom shows an increased counting efficiency at low photon energies due to a design flaw. It is also apparent that these phantoms have maintained their performance characteristics over an extended period of time.

Absorptiometry, Photon↗

Epidermoid cyst with sweat ducts on the torso.

We report a case of an epidermoid cyst arising on the upper chest that had a remarkable histologic pattern composed of structures resembling eccrine ducts in the horny layer and an acrosyringium. The expression of carcinoembryonic antigen (CEA) was also demonstrated immunohistochemically within these ductal structures. Eccrine ducts have been reported recently, in epidermoid cysts located in the palmoplantar region. The cyst described here suggests that epidermoid cysts derived from eccrine ducts may also appear on the torso.

Carcinoembryonic Antigen↗

Lower torso ischemia-induced lung injury is leukocyte dependent.

Lower torso ischemia leads on reperfusion to sequestration of polymorphonuclear leukocytes (PMN) in the lungs and increased permeability. This study tests the role of circulating leukocytes (WBC) in mediating this lung injury. Anesthetized sheep prepared with chronic lung lymph fistulae underwent 2 hours of bilateral hind limb tourniquet ischemia. In untreated controls (n = 7), 1 minute after reperfusion there were transient increases in mean pulmonary arterial pressure (MPAP) from 13 to 38 mmHg (p less than 0.05) and pulmonary microvascular pressure (Pmv) from 7 to 18 mmHg (p less than 0.05), changes temporally related to a rise in plasma thromboxane (Tx) B2 levels from 211 to 735 pg/ml (p less than 0.05). Lung lymph TxB2 levels rose from 400 to 1005 pg/ml at 30 minutes (p less than 0.05), and remained elevated longer than plasma levels. Lung lymph flow (QL) rose from 4.3 to 8.3 ml/30 minutes (p less than 0.05) after 30 minutes of reperfusion and remained elevated for 2 hours. The lymph/plasma (L/P) protein ratio was unchanged from 0.6, while the lymph protein clearance increased from 2.6 to 4.6 ml/30 minutes (p less than 0.05), suggesting increased microvascular permeability. WBC counts decreased within the first hour of reperfusion from 6853 to 3796/mm3 (p less than 0.05), and lung histology after 2 hours showed proteinaceous exudates and leukosequestration of 62 PMN/10 high-powered fields (HPF), higher than the 22 PMN/10 HPF (p less than 0.05) in sham animals (n = 3). Recruitment of the pulmonary vasculature by left atrial balloon inflation (n = 3) resulted in a rise in MPAP to 20 mmHg. After 3 hours of balloon inflation, QL stabilized at 9.8 ml/15 minutes, and a pressure-independent L/P protein ratio of 0.3 was achieved. During reperfusion, QL increased further to 11.2 ml/15 minutes, the L/P ratio rose to 0.56 and the calculated osmotic reflection coefficient decreased from 0.70 to 0.44, documenting an increase in lung microvascular permeability. In contrast to these untreated ischemic controls, sheep (n = 7) rendered leukopenic with hydroxyurea or nitrogen mustard and having a total WBC count of 760/mm3 and PMN count of 150/mm3 did not manifest reperfusion-induced increases in MPAP, Pmv, QL, lymph protein clearance, or lung lymph. TxB2 level (p less than 0.05). Plasma TxB2 levels rose slightly at 30 minutes from 199 to 288 pg/ml (p less than 0.05). Lung histology was normal. These data indicate that WBC mediate the ischemia-induced increase in pulmonary microvascular permeability.

Animals↗

Blockade of complement activation prevents local and pulmonary albumin leak after lower torso ischemia-reperfusion.

Lower torso ischemia and reperfusion leads to both local and remote tissue injuries. The purpose of this study was to assess the role of complement in mediating the local and remote microvascular permeability after bilateral hind limb tourniquet ischemia. Four hours of ischemia and 4 hours of reperfusion produced an increased skeletal muscle permeability index (muscle/blood 125I albumin ratio) of 2.90 +/- 0.35 compared with the index in nonischemic muscle of 0.25 +/- 0.02 (p < 0.01). Muscle wet-to-dry-weight ratio increased from 3.93 +/- 0.04 in sham to 5.55 +/- 0.09 in ischemic muscle (p < 0.0001). Lung permeability rose at 4 hours as indicated by the increased bronchoalveolar lavage (BAL)/blood 125I albumin ratio 4.36 +/- 0.41 x 10(-3) versus sham 2.64 +/- 0.28 x 10(-3) (p < 0.05) and neutrophil sequestration 0.28 +/- 0.02 U/g myeloperoxidase (MPO) versus sham 0.14 +/- 0.02 U/g (p < 0.001). Serum lytic activity of the classical but not the alternate complement pathway was reduced. The soluble complement receptor (sCR1) was used to inhibit complement activity and attenuated the increase in the permeability index after reperfusion in ischemic muscle 1.11 +/- 0.08 (p < 0.01) and reduced the lung BAL/blood 125I albumin ratio to sham levels 2.46 +/- 0.39 x 10(-3) (p < 0.05) at 6 mg/animal, without reducing the lung neutrophil sequestration, 0.24 +/- 0.02 U/g. The authors conclude that complement activation occurred during tourniquet ischemia and mediated permeability changes in the ischemic muscle and the lungs during reperfusion.

Albumins↗

Comparison of the LLNL and JAERI torso phantoms using Ge detectors and phoswich detectors.

The Human Monitoring Laboratory has compared the LLNL and JAERI torso phantoms using its germanium detector lung counting system by measuring the counting efficiencies for radioactive materials in the phantoms at photon energies of 17.7 keV, 59.5 keV, 121.8 keV, and 344 keV to assess the similarity (or differences) in performance characteristics. The counting efficiencies obtained from the two phantoms were compared by converting the Chest Wall Thickness data and Adipose Mass Fractions of the phantoms to Muscle Equivalent Chest Wall Thicknesses. The counting efficiencies for the two phantoms were found to be within a factor of 1.44 of each other at 17.7 keV, 1.30 at 59.5 keV, 1.25 at 121.8 keV, and 1.17 at 344 keV when using a four detector array (JAERI efficiency divided by LLNL efficiency). However, individual detector responses show that the counting efficiencies from the two phantoms differ considerably in the region of the heart (up to a factor of 6 at 17 keV). Other areas above the lungs give counting efficiencies that are similar to each other. A routine intercomparison exercise with Cameco Corporation has shown that the counting efficiencies derived from the LLNL and JAERI phantoms were found to be within a factor of 1.18 (JAERI/LLNL) when a natural uranium lung set was used to calibrate a lung counter consisting of phoswich detectors. This work has also shown that over the energy range 63 keV-185 keV the LLNL phantom can be used to calibrate phoswich detector systems that are positioned on the back of the subject.

Germanium↗

A joint HML-KAERI project--comparison of the LLNL and JAERI torso phantoms using four 50 mm Ge detectors.

The Health Physics Department of the Korea Atomic Energy Research Institute and the Human Monitoring Laboratory have collaborated to compare the LLNL and JAERI torso phantoms. The counting efficiencies of the phantoms at 17.7 keV, 59.5 keV, 121.8 keV, and 344 keV were measured with KAERI's germanium lung counting system. The data were made comparable by converting the chest wall thicknesses and adipose mass fractions of the phantoms to muscle equivalent chest wall thicknesses. The counting efficiencies of the two phantoms are within 12% to 17% of each other at 17.7 keV, 15% to 22% at 59.5 keV, 10% to 15% at 121.8 keV, and 7% to 10% at 344 keV. This joint study has shown that the LLNL and JAERI phantom are essentially equivalent for the purposes of calibrating a lung counting system that consists of two ACTII germanium detectors.

Germanium↗

Lung counting: a function to fit counting efficiency of a lung counting germanium detector array to muscle-equivalent-chest-wall-thickness and photon energy using a realistic torso phantom.

A function has been developed that will fit counting efficiency to chest wall thickness, adipose content of the chest wall, and photon energy. The adipose content of the chest wall is removed as a variable by use of the derived quantity: muscle equivalent chest wall thickness. The function has been tested on experimental data sets obtained from the LLNL and JAERI torso phantoms using a variety of germanium detector lung counting systems. The function is applicable over the range of existing phantoms and the range of equipment types tested. Subtle differences between the detector systems are shown by differences in the fit parameters. This analysis could be a useful addition to lung counting analysis software. The LLNL and JAERI phantoms have very similar counting characteristics as evidenced by the similarity of the function parameters when measured using a single detector system.

Calibration↗

Supplemental emergent chest computed tomography in the management of blunt torso trauma.

The efficacy of conventional chest X-ray (CXR) in comparison to chest computed tomography (CCT) in acutely injured blunt trauma patients was examined. Over a 21-month period, 50 patients underwent CXR and CCT according to a standard protocol, and their films and records were reviewed retrospectively. Hemo- and/or pneumothorax (HPTX) was noted in 12 patients (five by CXR, 12 by CCT). Pulmonary contusion (PC) was identified in ten patients (four by CXR, ten by CCT). Three additional false positive PC were diagnosed by CXR. Therapy changes based upon CCT findings occurred in seven of seven HPTX and five of six PC. The two imaging techniques were complementary in detecting fractures. Atelectasis was a common CCT finding (58% incidence). Chest X-ray is less sensitive than chest computed tomography in the detection of HPTX (42% vs. 100%) and PC (40% vs. 100%). Emergent chest computed tomography is recommended in stable patients with: 1) blunt high-energy torso trauma, 2) "cross-body" injury pattern, and/or 3) a mechanism of injury suggestive of chest trauma.

Adult↗

Determining anatomic injury with computed tomography in selected torso gunshot wounds.

BACKGROUND: Changes in the management of torso gunshot wounds (TGSWs) have evolved in recent years as a result of differences between military and civilian injuries and increasing interest in avoiding nontherapeutic invasive procedures. The objective of this study was to establish the utility and accuracy of computed tomography (CT) in the evaluation of selected patients with TGSWs. METHODS: Retrospective review for a 6-year period of patients who sustained TGSWs and underwent CT solely for the purpose of trajectory determination. Patients had complete physical examinations and plain radiographic evaluations by a dedicated group of in-house trauma surgeons. When trajectory was indeterminate after evaluation, CT was performed. In some cases, CT was used when trajectory was determined to be intracavitary but organ injury was believed to be unlikely or amenable to nonoperative management. RESULTS: Fifty TGSW patients underwent 52 computed tomographic scans. Abdominal/pelvic CT was performed in 37 patients, and thoracic CT was performed in 15 patients. All patients were stable and none sustained complications attributable to CT or delay in therapy. Twenty of 37 abdominal/pelvic computed tomographic scans excluded transabdominal or pelvic trajectory. Seventeen of 37 scans proved transabdominal or pelvic trajectory; nine laparotomies were performed, and eight patients were observed. Nine of 15 thoracic computed tomographic scans excluded transmediastinal trajectory. Six of 15 scans suggested vascular proximity and prompted further workup, which was positive in two cases. CONCLUSION: CT of selected TGSW patients is safe and may reduce the incidence of invasive diagnostic procedures. A prospective evaluation of CT for TGSW patients is warranted.

Abdominal Injuries↗

Nitroprusside in resuscitation of major torso trauma.

OBJECTIVE: Patients with thoracic aortic injury (TAI) usually have sustained other major trauma, and may require aggressive shock resuscitation. In the 24 hours after aortic repair and during resuscitation, our cardiothoracic surgeons request intravenous nitroprusside to maintain mean arterial pressure (MAP) less than 90 mm Hg to minimize bleeding at the repair. We compared the resuscitation response of patients who sustained major torso trauma (MTT) and TAI with that of patients who had MTT with no TAI to determine whether nitroprusside can effectively control MAP during resuscitation and whether use of nitroprusside, because of its peripheral vasodilatory effects, is associated with a favorable resuscitation response. METHODS: During the 9-month study period, 11 patients who sustained TAI and 38 patients who sustained MTT with no TAI met multiple organ failure risk/shock criteria and were resuscitated by a standardized protocol emphasizing volume loading and hemoglobin replacement to maintain systemic oxygen delivery index (DO2I) > or = 600 mL O2/min-m2 for the first 24 intensive care unit hours. For TAI patients, postoperative management included intravenous nitroprusside infusion titrated by the bedside nurse to maintain mean arterial pressure (MAP) less than 90 mm Hg during the same 24 hours. Data were obtained prospectively during resuscitation. Retrospectively, the resuscitation response of TAI and non-TAI patients was compared. RESULTS: For the TAI group, nitroprusside effectively controlled MAP (range, 77-87 mm Hg); for the non-TAI group, mean MAP exceeded 95 mm Hg within 5 hours. During the first 8 hours, MAP, pulmonary capillary wedge pressure, and systemic vascular resistance index were less, and DO2I was greater for the TAI than for the non-TAI group. The resuscitation goal of DO2I > or = 600 mL O2/ min-m2 was attained at 4 hours for the TAI group, and was attained at 12 hours for the non-TAI group. No revisions of aortic repairs were required during or as a result of resuscitation. CONCLUSION: During aggressive shock resuscitation, control of MAP using nitroprusside is feasible and is associated with a favorable resuscitation response. Nitroprusside may be a useful adjunct during shock resuscitation of MTT as a vasoactive agent that promotes peripheral tissue perfusion.

Adult↗