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PubMed2002

Hypermethylation of the hMLH1 gene promoter in solitary and multiple gastric cancers with microsatellite instability.

Human cancers with a high frequency microsatellite instability phenotype develop due to defects in DNA mismatch repair genes. Silencing of a DNA mismatch repair gene, hMLH1 gene, by promoter hypermethylation is a frequent cause of the microsatellite instability-H phenotype. Using methylation specific PCR we investigated the methylation status of the hMLH1 gene promoter in 17 solitary gastric cancers (12 microsatellite instability-H and five microsatellite stable tumours from 17 patients), and 13 multiple gastric cancers (eight microsatellite instability-H, one low frequency microsatellite instability-L and four microsatellite stable tumours from five patients) and also examined non-cancerous gastric mucosa both adjacent to and distant from each tumour. Expression of hMLH1 protein was evaluated by immunohistochemistry. All microsatellite instability-H tumours (20 out of 20) had evidence of methylation of hMLH1 promoter, whereas only one out of 10 microsatellite instability-L and microsatellite stable tumours did (P<0.0000005), and the methylation status correlated with hMLH1 protein expression (P<0.000003). Furthermore, methylation of the hMLH1 promoter was detected in 50% (6 out of 12) and 63% (5 out of 8) of non-cancerous gastric mucosa samples adjacent to, and in 33% (4 out of 12) and 40% (2 out of 5) of those obtained from distant portion of, solitary and multiple cancers with microsatellite instability-H. Thus both solitary and multiple gastric cancers with microsatellite instability-H have evidence of similar high levels of hMLH1 promoter hypermethylation in the surrounding non-cancerous tissue. Hypermethylation of the hMLH1 promoter occurs in non-cancerous gastric mucosa of microsatellite instability-H tumours and may increase the risk of subsequent neoplasia.

Adaptor Proteins, Signal Transducing↗
PubMed1999

Heterogeneity studies identify a subset of sporadic colorectal cancers without evidence for chromosomal or microsatellite instability.

Two apparently independent mechanisms of instability are recognized in colorectal cancer, microsatellite instability and chromosomal instability. Evidence from colorectal cancer cell lines indicates the presence of either, or both, types of instability in the vast majority. Here, we sought to determine the prevalence of such instability in primary sporadic colorectal cancers. Microsatellite instability was established by demonstration of ovel clonal, nongerm-line alleles in at least two of four tested loci. Chromosomal abnormalities were identified by comparative genomic hybridization (CGH) and flow cytometric analysis of nuclear DNA content. Tumours harbouring chromosomal instability were distinguished from those with stable but aneuploid karyotypes by comparing chromosomal defects at multiple sites throughout each cancer. This analysis allowed assessment of both the number of chromosomal abnormalities and their heterogeneity throughout the tumour. The results confirm that microsatellite instability is consistently associated with multiple, repeated changes in microsatellites throughout the growth of the affected colorectal carcinomas. There were also several carcinomas in which major structural or numerical abnormalities in chromosomes had clearly continued to arise during tumour growth. However, a substantial subset of tumours showed neither microsatellite instability nor multiple, major chromosomal abnormalities. We suggest that the development of a proportion of colorectal cancers proceeds via a different pathway of carcinogenesis not associated with either of the currently recognized forms of genomic instability.

Aged↗
PubMed2002

High-frequency microsatellite instability is associated with defective DNA mismatch repair in human melanoma.

Hereditary nonpolyposis colorectal cancers and a steadily increasing number of sporadic tumors display microsatellite instability. In colorectal tumors, high-frequency microsatellite instability is strictly associated with inactivation of the DNA mismatch repair genes hMSH2, hMLH1, or hPMS2, whereas mutations in the mismatch repair gene hMSH6 have been identified in a subset of tumors with low-frequency microsatellite instability. In addition to epithelial tumors of the colon, endometrium, and ovary, microsatellite instability has been reported to occur also in sporadic melanoma. The relationship between microsatellite instability and mismatch repair in melanoma cells, however, has not been investigated so far. In this study, we analyzed microsatellite instability, mismatch repair activity, and expression of the hMSH2, hMSH6, hMLH1, and hPMS2 proteins in five melanoma cell lines and in tumor specimens from which the cells were derived. Four cell lines displayed normal levels of mismatch repair activity and expressed all the mismatch repair proteins. The extracts of the fifth cell line lacked the hMLH1 and hPMS2 proteins, and were correspondingly deficient in the repair of DNA mismatches. This line displayed high-frequency microsatellite instability, whereas the four mismatch-repair-proficient cell lines displayed either no or low-frequency microsatellite instability. These findings could be confirmed in the tumor specimens, in that only the tumor that did not express hMLH1 and hPMS2 displayed high-frequency microsatellite instability. Our data are consistent with the hypothesis that in melanoma, similarly to epithelial tumors, only the high-frequency microsatellite instability phenotype is strictly dependent on a defective mismatch repair system. Further studies on a large series of tumor specimens are required to establish the frequency of mismatch repair loss in human melanoma.

Base Pair Mismatch↗
PubMed1997

Microsatellite instability and other molecular abnormalities in childhood acute lymphoblastic leukaemia.

Microsatellite instability (MSI) has been considered to represent the defect of DNA mismatch repair systems and has been implicated in the tumourigenesis of several human malignancies. To investigate the possible presence of microsatellite instability in childhood acute lymphoblastic leukaemia (ALL), we examined 48 primary ALL samples. Instability was determined at 85 different microsatellite loci localized to 12 different chromosome arms. Microsatellite instability was detected in five (10%) samples. Interestingly, the instability was found at chromosomal regions associated with frequent alterations. Two samples had instability at the microsatellite marker within the TEL gene on chromosome arm 12p. Two other samples had instability at a microsatellite marker close to CDKN2/p16 on 9p; one of these samples had a homozygous deletion at 9p21. The fifth sample had instability at the microsatellite marker on 6q, which we have found is a frequent region of loss of heterozygosity in childhood ALL. Taken together, instability was rare in childhood ALL, but was localized to the three most frequently deleted chromosome regions in childhood ALL, suggesting that localized microsatellite instability may identify a fragile chromosomal region which could result in alteration of surrounding target genes and lead to leukaemia.

Blotting, Southern↗
PubMed1995

Traumatic instability of the lumbar spine. A dynamic in vitro study of flexion-distraction injury.

STUDY DESIGN: This in vitro study determined the effect on the lumbar spine of a dynamic flexion-distraction loading simulating a lap seatbelt injury. The proportion by which the forces and the moments contributed to the injury of the lumbar spinal segment in such a situation was analyzed. The remaining stability of the injured lumbar motion segment was determined together with the threshold for lumbar spine instability in such an injury. OBJECTIVES: Based on the experimental results in this study, radiographic guidelines for instability criteria in lumbar and thoracolumbar dislocations in the sagittal plane without concomitant compression fracture of the middle column were proposed. SUMMARY OF BACKGROUND DATA: A number of check-lists and guidelines were suggested for the diagnosis of spinal instability after trauma, but no conclusive system was established. Those systems were mostly based on experiments performed on spinal segments after sequential ablation of ligaments and facet joints followed by static, unidirectional physiologic loading. We believed that there was a need for more profound knowledge of spinal injury and for instability criteria of lumbar spinal injuries based on more realistic experimental data simulating the clinical situation. In our injury model, we decided to study the biomechanic outcome of a flexion-distraction injury similar to seatbelt type injury seen in frontal motor vehicle collisions. METHODS: Twenty lumbar functional spinal units were first loaded statically with a physiologic flexion-shear load to determine angulations and displacements under noninjurous conditions. Dynamic flexion-shear loading to injury with two different load pulses was then applied. Static physiologic load was then again applied to determine any permanent residual deformation. RESULTS: The viscoelastic effect of loading rate on translatory and angular displacements and the values for translatory and angulation displacements at first sign of injury (yield) and at failure were determined. CONCLUSIONS: Radiographic guidelines for instability criteria in lumbar and thoracolumbar fracture-dislocations without concomitant posterior vertebral body compression are proposed: 1. Instability exists if there is a kyphosis of the lumbar motion segment > or = 12 degrees (impending instability) or > or = 19 degrees (total instability) on lateral radiographs. 2. Relative increase in interspinous process distance > or = 20 mm (impending instability), > or = 33 mm (total instability) on anteroposterior radiographs.

Accidents, Traffic↗
PubMed2003

Tissue microarray immunohistochemical expression analysis of mismatch repair (hMLH1 and hMSH2 genes) in endometrial carcinoma and atypical endometrial hyperplasia: relationship with microsatellite instability.

Alterations in the mismatch repair genes (hMLH1 and hMSH2) play an important role in the development of microsatellite instability in sporadic endometrial cancer. Tissue microarray technology allows molecular profiling of tumor samples at the DNA, RNA, and protein levels. We analyzed hMLH1 and hMSH2 expression by immunohistochemistry in a group of atypical endometrial hyperplasias (n = 10), endometrioid endometrial carcinomas (n = 58), and nonendometrioid endometrial carcinomas (n = 27) on tissue microarray. The results were correlated with microsatellite instability status as evaluated by BAT-25 and BAT-26. Overall, 29.4% of lesions showed microsatellite instability. Loss of nuclear hMLH1 and hMSH2 protein expression was seen in 22.3% and 6.5% of cases, respectively. Immunohistochemistry for hMLH1 and hMSH2 showed lack of protein expression in 64% and 16.6% of microsatellite instability-positive endometrial lesions, respectively. Taken together, hMLH1 or hMSH2 protein expression was absent in 18 of 24 microsatellite instability-positive cases (75% sensitivity). A high level of concordance was found between immunohistochemistry for hMLH1 and hMSH2 and microsatellite instability status evaluated by BAT-25 and BAT-26 (kappa value of 0.7). Of the 57 cases found to be microsatellite instability negative, 53 showed normal expression of both proteins (93% specificity). The observed predictive value of absence of expression of hMLH1 for predicting microsatellite instability-positive status was 82%. The predictive value of normal expression of both proteins for predicting microsatellite instability-negative status was 90%. These results are consistent with those previously reported in whole tissue sections. Therefore, immunohistochemical analysis of hMLH1 and hMSH2 expression on tissue microarray provides an accurate technique for screening for tumors with microsatellite instability. Tissue microarrays represent an ideal approach for comparing different diagnostic or predictive markers with one another in consecutive tissue microarray sections.

Adaptor Proteins, Signal Transducing↗
PubMed1998

Analysis of the frequency of microsatellite instability and p53 gene mutation in splenic marginal zone and MALT lymphomas.

AIMS: Studies of the genetic characteristics of splenic marginal zone lymphoma (SMZL) have failed to identify genetic changes specific to this tumour. Microsatellite instability is a type of genomic instability associated with different types of human cancer. Although microsatellite instability is rare in B cell non-Hodgkin's lymphomas, it has been found in some specific subsets, such as marginal zone lymphomas arising in mucosa associated lymphoid tissue (MALT), where an association with p53 mutation has been described. Because it has been proposed that SMZL and MALT are close in histogenetic terms, this study investigated the comparative frequency of microsatellite instability and p53 mutation in patients with SMZL and MALT lymphomas. METHODS: Microsatellite instability was investigated using seven microsatellite marker loci in 14 patients with SMZL and 20 patients with MALT lymphomas. In an attempt to clarify the role of p53 gene mutation in the pathogenesis of SMZL, exons 5-8 were also investigated by polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) and direct sequencing in a total of 20 patients with SMZL and 22 patients with MALT lymphomas. RESULTS: Microsatellite instability was not detected in patients with SMZL, although five of 20 patients with MALT lymphomas had microsatellite instability. The frequency of p53 mutation was low in both series (two of 20 patients with SMZL and one of 22 patients with MALT lymphomas). No significant association was found between p53 mutation and microsatellite instability. CONCLUSIONS: These results indicate that microsatellite instability is not associated with the molecular pathogenesis of SMZL, confirming the relatively increased frequency of microsatellite instability in MALT lymphomas, and perhaps suggesting that MALT and SMZL have different mechanisms of tumorigenesis.

Genes, p53↗
PubMed2002

Temperature effects on capillary instabilities in a thin nematic liquid crystalline fiber embedded in a viscous matrix.

Linear stability analysis of capillary instabilities in a thin nematic liquid crystalline cylindrical fiber embedded in an immiscible viscous matrix is performed by formulating and solving the governing nemato-capillary equations, that include the effect of temperature on the nematic ordering as well as the effect of the nematic orientation. A representative axial nematic orientation texture with the planar easy axis at the fiber surface is studied. The surface disturbance is expressed in normal modes, which include the azimuthal wave number m to take into account non-axisymmetric modes. Capillary instabilities in nematic fibers reflect the anisotropic nature of liquid crystals, such as the ordering and orientation contributions to the surface elasticity and surface normal and bending stresses. Surface gradients of normal and bending stresses provide additional anisotropic contributions to the capillary pressure that may renormalize the classical displacement and curvature forces that exist in any fluid fiber. The exact nature (stabilizing and destabilizing) and magnitude of the renormalization of the displacement and curvature forces depend on the nematic ordering and orientation, i.e. the anisotropic contribution to the surface energy, and accordingly capillary instabilities may be axisymmetric or non-axisymmetric. In addition, when the interface curvature effects are accounted for as contributions of the work of interfacial bending and torsion to the total energy of the system, the higher-order bending moment contribution to the surface stress tensor is critical in stabilizing the fiber instabilities. For the planar easy axis, the nematic ordering contribution to the surface energy, which renormalizes the effect of the fiber shape, plays a crucial role to determine the instability mechanisms. Moreover, the unstable modes, which are most likely observed, can be driven by the dependence of surface energy on the surface area. Low-ordering fibers display the classical axisymmetric mode, since the surface energy decreases by decreasing the surface area. Decreasing temperature gives rise to the encounter with a local maximum or to monotonic increase of the characteristic length of the axisymmetric mode. Meanwhile, in the presence of high surface ordering, non-axisymmetric finite wavelength instabilities emerge, with higher modes growing faster since the surface energy decreases by increasing the surface area. As temperature decreases, the pitches of the chiral microstructures become smaller. However, this non-axisymmetric instability mechanism can be regulated by taking account of the surface bending moment, which contains higher order variations in the interface curvatures. More and more non-axisymmetric modes emerge as temperature decreases, but, at constant temperature, only a finite number of non-axisymmetric modes are unstable and a single fastest growing mode emerges with lower and higher unstable modes growing slower. For nematic fibers, the classical fiber-to-droplet transformation is one of several possible instability pathways, while others include chiral microstructures. The capillary instabilities' growth rate of a thin nematic fiber in a viscous matrix is suppressed by increasing either the fiber or matrix viscosity, but the estimated droplet sizes after fiber breakup in axisymmetric instabilities decrease with increasing the matrix viscosity.

Journal Article↗
PubMed2003

Detection of cancer clones in human gastric adenoma by increased DNA-instability and other biomarkers.

An immunohistochemical differential staining of cancerous cells with anti-cytidine antibody after denaturation of nuclear DNA by acid hydrolysis with 2N HCl at 30 degree C for 20 min (DNA-instability test) has been used as a marker of malignancy. The test was applied to bioptic tissues of human gastric polyp assessed histopathologically as foveolar hyperplastic polyp (13 cases), mild (58 cases), moderate (86 cases), and severe (20 cases) dysplasia, and adenocarcinomas (14 cases). The serial sections of the same tissues were also subjected to immunohistochemical staining for Ki67, p53, DNA-fragmentation factor (DFF45), and basic fibroblast growth factor (bFGF). The DNA-instability test was positive in 14 (100%) adenocarcinoma cases, 20 (100%) severe dysplasia cases, 52 (60.5%) moderate dysplasia cases, and 12 (20.7%) mild dysplasia cases, indicating malignancy. All foveolar hyperplastic polyps were negative to the DNA-instability testing. Furthermore, the percentage of glands positive in the DNA-instability test steadily increased in going from mild (10%), to moderate (40%), to severe (100%) dysplasia, and adenocarcinoma (100%). All other biological markers tested in the present study showed significantly higher values in the adenoma glands, being positive to DNA-instability testing, irrespective of the dysplasia grade, as compared to those in the adenoma glands that were negative to DNA-instability testing. Furthermore, the former values were comparable to those in adenocarcinoma. These results indicate that cancer cell clones are already present at the adenoma stages showing a positive DNA-instability test, enhanced proliferative activity, p53 mutation, induction of DFF45 and bFGF. These factors allow cancer cell proliferation, producing heterogeneous subclones due to DNA-instability, enhancing their survival by escaping apoptosis, and providing abundant nutrients during the early-stage progression of gastric cancer. Based on these findings, we herein propose the concept of "procancer" (as opposed to "pre-cancer") as being a unique stage during the course of carcinogenesis and cancer progression. We designate the term to cancer clones at the very early stages of malignant progression that do not show distinguishable morphological atypia but do show positive DNA-instability testing and positive staining for various biomarkers such as Ki67, p53, DFF45, and bFGF. We also define the abnormal positive staining of these biomarkers, including the DNA-instability test as "functional atypia", compared to the ordinary morphological atypia.

Adenocarcinoma↗
PubMed2001

Bethesda guidelines: relation to microsatellite instability and MLH1 promoter methylation in patients with colorectal cancer.

BACKGROUND: Microsatellite instability is a hallmark of mismatch repair deficiency in hereditary nonpolyposis colorectal cancer and results from mutations in the mismatch repair genes MLH1 or MSH2 or from gene inactivation associated with DNA methylation. The Bethesda guidelines were established to identify patients with colorectal cancer who should be tested for microsatellite instability. OBJECTIVE: To assess the Bethesda guidelines for detection of microsatellite instability and to determine the role of MLH1 promoter methylation in colorectal cancer. DESIGN: Prospective cohort study. SETTING: Tertiary care referral center in Frankfurt, Germany. PATIENTS: 125 consecutive patients with colorectal cancer. MEASUREMENTS: Patients were assessed according to the Bethesda guidelines, and tumor specimens were analyzed for microsatellite instability. Patients with microsatellite instability were tested for MLH1 promoter methylation and MLH1 and MSH2 germline mutations. RESULTS: Microsatellite instability was detected in 17 of 58 patients who fulfilled and 5 of 67 patients who did not fulfill criteria of the Bethesda guidelines. In 11 of 17 patients with microsatellite instability who fulfilled Bethesda guidelines, an MLH1 (n = 3), MSH2 (n = 7), or combined MLH1 and MSH2 (n = 1) mutation was found. Among the patients with microsatellite instability who did not fulfill Bethesda guidelines, no mutations were observed; MLH1 promoter methylation was observed in 6 of 11 patients with an MLH1 or MSH2 mutation and 5 of 11 patients without an MLH1 or MSH2 mutation. CONCLUSIONS: The Bethesda guidelines are useful for selecting patients for microsatellite instability testing. MLH1 and MSH2 testing should be recommended in all patients with colorectal cancer and microsatellite instability who fulfill at least one Bethesda criterion. MLH1 promoter methylation may accompany rather than initiate carcinogenesis in patients with colorectal cancer who have mismatch repair gene defects.

Adaptor Proteins, Signal Transducing↗
PubMed2003

Widespread bimodal intrachromosomal genomic instability in sporadic breast cancers associated with 13q allelic imbalance.

Genomic instability is thought to underlie tumor progression in solid tumors, such as breast cancer. Although evidence that the hereditary breast cancer genes, BRCA1 and BRCA2, are involved in DNA repair suggests that genomic instability plays an important role in hereditary breast tumorigenesis, genomic instability remains poorly characterized in sporadic breast cancers. Using a DNA fingerprinting technique, inter-(simple sequence repeat) PCR (inter-SSR PCR), the degree of genomic instability was quantified in 47 sporadic breast cancers compared with matched adjacent normal breast tissues. Almost all sporadic breast cancers show significant genomic instability by inter-SSR PCR. The distribution of this instability is bimodal; 57% of the tumors show fewer changes, whereas 43% show striking genomic alterations. Further analysis of two inter-SSR PCR tumor-normal differences revealed a genomic amplification and probable deletion. Thus, inter-SSR PCR can detect chromosomal breakage-related genomic alterations in most sporadic breast cancers. Genomic instability as detected by inter-SSR PCR is not correlated with aneuploidy, suggesting that this technique preferentially detects intrachromosomal alterations. Chromosomal instability in breast cancer can therefore be subdivided into at least two groups: (a) intrachromosomal and (b) gross chromosomal. Allelic imbalance at markers at the 13q13 and retinoblastoma loci (13q) and not at 17q loci was significantly associated with high levels of intrachromosomal instability, suggesting genes at 13q13 and retinoblastoma loci are either selectively targeted or involved in the genesis of genomic instability in sporadic breast cancers.

Adult↗
PubMed2002

Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability.

OBJECTIVE: To describe the functional anatomy of the ankle complex as it relates to lateral ankle instability and to describe the pathomechanics and pathophysiology of acute lateral ankle sprains and chronic ankle instability. DATA SOURCES: I searched MEDLINE (1985-2001) and CINAHL (1982-2001) using the key words ankle sprain and ankle instability. DATA SYNTHESIS: Lateral ankle sprains are among the most common injuries incurred during sports participation. The ankle functions as a complex with contributions from the talocrural, subtalar, and inferior tibiofibular joints. Each of these joints must be considered in the pathomechanics and pathophysiology of lateral ankle sprains and chronic ankle instability. Lateral ankle sprains typically occur when the rearfoot undergoes excessive supination on an externally rotated lower leg. Recurrent ankle sprain is extremely common; in fact, the most common predisposition to suffering a sprain is the history of having suffered a previous ankle sprain. Chronic ankle instability may be due to mechanical instability, functional instability, or most likely, a combination of these 2 phenomena. Mechanical instability may be due to specific insufficiencies such as pathologic laxity, arthrokinematic changes, synovial irritation, or degenerative changes. Functional instability is caused by insufficiencies in proprioception and neuromuscular control. CONCLUSIONS/RECOMMENDATIONS: Lateral ankle sprains are often inadequately treated, resulting in frequent recurrence of ankle sprains. Appreciation of the complex anatomy and mechanics of the ankle joint and the pathomechanics and pathophysiology related to acute and chronic ankle instability is integral to the process of effectively evaluating and treating ankle injuries.

Journal Article↗
PubMed2002

Proprioception and Muscle Strength in Subjects With a History of Ankle Sprains and Chronic Instability.

OBJECTIVE: To examine if patients with chronic ankle instability or a history of ankle sprains without chronic instability have worse proprioception or less invertor and evertor muscle strength. DESIGN AND SETTING: We assessed proprioception and muscle strength on the Biodex isokinetic dynamometer in the laboratory of the Department of Sports Medicine, University Hospital Ghent. SUBJECTS: Subjects included 87 physical education students (44 men, 43 women, age = 18.33 +/- 1.25 years, mass = 66.09 +/- 8.11 kg, height = 174.11 +/- 8.57 cm) at the University of Ghent in Belgium. Their ankles were divided into 4 groups: a symptom-free control group, subjects with chronic ankle instability, subjects who had sustained an ankle sprain in the last 2 years without instability, and subjects who sustained an ankle sprain 3 to 5 years earlier without instability. MEASUREMENTS: Active and passive joint-position sense was assessed at the ankle, and isokinetic peak torque was determined for concentric and eccentric eversion and inversion movements at the ankle. RESULTS: Statistical analysis indicated significantly less accurate active position sense for the instability group compared with the control group at a position close to maximal inversion. The instability group also showed a significantly lower relative eversion muscle strength (% body weight). No significant differences were observed between the control group and the groups with past sprains without instability. CONCLUSIONS: We suggest that the possible cause of chronic ankle instability is a combination of diminished proprioception and evertor muscle weakness. Therefore, we emphasize proprioception and strength training in the rehabilitation program for ankle instability.

Journal Article↗
PubMed1980

Post-traumatic carpal instability.

A classification of the subtle patterns of carpal instability, exclusive of major carpal fractures, dislocations and fracture dislocations is proposed. This classification is based on a modification of Navarro's concept of the carpus; it is composed of 3 vertical longitudinal columns: lateral (scaphoid); central (lunate and distal carpal row); medial (triquetrum). Carpal dissociations may occur between the lateral and central columns (lateral instability), within the central column (central instability), between the central column and the triquetrum (medial instability), and between the entire carpus and the distal radioulnar articular surface (proximal instability). Lateral carpal instabilities are further subdivided according to the different components of the central column that articulate with the scaphoid. Therefore, 3 main lateral patterns may be identified: scaphoid-trapezium-trapezoid subluxation; scaphoid-capitate diastasis; scaphoid-lunate dissociation. An example of central instability is presented to illustrate this particular type of carpal dissociation. Medial, or lunate-triquetrum instability, is believed responsible for the volar-flexed intercalated segment instability pattern, in which the lunate collapses into a volar-flexed position and there is longitudinal "crumpling" of the radiocarpal link. Proximal carpal or radiocarpal instability may occur in an ulnar (ulnar translocation), dorsal (dorsal subluxation), or volar direction (volar subluxation). It is usually associated with loss of the anatomic alignment of the distal radius.

Adult↗
PubMed1995

Presence and instability of repetitive elements in sequences the altered expression of which characterizes risk for colonic cancer.

50C10 and 52H10 are two DNA clones previously reported by us to be overexpressed in human colonic mucosa at high risk for development of colonic tumors. This report presents sequencing data that reveal that these clones contain repetitive Alu elements. Each Alu sequence is associated with a 3'-oligoadenylate [oligo(A)] sequence, which is demonstrated to exhibit instability in human colonic tumors. The oligo(A) sequences only decrease in length, unlike microsatellites, which can either increase or decrease. Rigorous quantitative analysis of the length of the oligo(A) sequence in colonic tumors demonstrates that the standard deviation of the length of the sequence in tumors is a function of the mean length; i.e., as the oligo(A) sequence becomes progressively shorter, the variance increases. Both measurements, therefore, provide a quantitative index of the extent of instability in a tissue. Comparison of instability at the oligo(A) loci defined by 50C10 and 52H10 to instability at a CA microsatellite upstream of the apoD gene, and comparison of an oligo(A) and a CA microsatellite both in the 3' untranslated region of the cyclin D1 mRNA demonstrate that instability in a tumor, when present, is more prominent for the oligo(A) sequences than for the microsatellite (P < 0.0001). This suggests either that the mechanisms that generate oligo(A) instability are more penetrant than those that generate microsatellite instability, or that the instability at oligo(A) sequences takes place earlier in the development of the tumor and is selected for, thus becoming more prominent. These features of oligo(A) instability suggest that they may be uniquely useful in detecting and quantifying instability in tissues. Further, the presence of repetitive sequence elements in loci overexpressed in colonic mucosa at risk may be related to an extensive literature that demonstrates that a variety of repetitive sequences accumulate in the cellular RNA population during carcinogenesis and in tumors. Such RNA sequences could play a mechanistic role in tumor development.

Amino Acid Sequence↗
PubMed1993

Congenital genetic instability in colorectal carcinomas.

INTRODUCTION: Oncogenic evolution is probably based on a progressive selection of clonal subpopulations from within a single clone. This selection is supposed to be based on enhanced genetic instability in the genome. In the vast majority of patients this increased lability is supposed to be the result of acquired alterations, and once established, it may contribute to the continuing, genetic instability within the neoplastic cells. It has been postulated, that inborn chromosomal instability is not limited to a few rare syndromes. Indeed, one of the common colorectal cancer (CRC) syndromes, familial adenomatous polyposis (FAP), is supposed to be a chromosomal instability syndrome. Also the hereditary nonpolyposis colorectal cancer syndrome (Lynch Syndrome (LS)) has shown genomic instability. Knudson (1971, 1985) has shown, that the same gene can be involved in both the hereditary form of a cancer and in the sporadic form of the same cancer. Due to the existence of such hereditary chromosomal instability syndromes, inherited genetic instability may be of some importance in the evolution of sporadic colorectal cancers. METHODS: In vitro research on dermal fibroblasts is based on the theory, that all studied cells of an individual carry the same genetic material, irrespective of their in vivo expression. Increased in vitro tetraploidy (IVT+) in skin fibroblast cultures is supposed to be a germinally transmitted expression of genomic instability, with special reference to LS. At the same time the chromosomal aberrations, which occur in neoplasms, can be measured by flow cytometric DNA analysis. The DNA content, thus measured, is supposed to be an expression of somatic acquired genetic instability. Finally, since occult mandibular osteomas have been shown to be associated with FAP, we have investigated a substantial part of our patients with this phenotypical marker. AIM OF STUDY: In CRC the adenoma-carcinoma sequence is widely accepted, and the purpose of our investigation was to find a correlation, if any, between: Changes in adenoma flow cytometric DNA content and histological grade and type of adenomas. Changes in dermal fibroblast IVT+ from adenoma patients and histological grade and type of adenomas. Changes in dermal fibroblast IVT+ and flow cytometrical DNA content in adenomas and carcinomas from the same patients. Furthermore, we wanted to investigate if: The occurrence of IVT+ in skin fibroblasts among patients with CRC was different from that of IVT+ among patients without colorectal neoplasies. The occurrence of IVT+ in skin fibroblasts among patients with CRC was associated with the occurrence of occult mandibular osteomas in the same patients. The occurrence of dermal fibroblast IVT+ conveyed any prognostic significance in CRC patients. RESULTS AND CONCLUSIONS: 1) A significant correlation was found between both the occurrence of skin fibroblast IVT+ and adenoma DNA aneuploidy in relation to the degree of dysplasia and histological type of adenomas. This signifies, that inborn and acquired genetic instability is correlated to the adenoma-carcinoma sequence. IVT+ was found to be correlated to the progression of adenomas to carcinomas and not to the development of adenomas. 2) A direct correlation between IVT+ and adenoma DNA aneuploidy could not be demonstrated. However, among those patients with diploid adenomas and IVT+ 57% showed villous adenomas. Among those patients with diploid adenomas and IVT- only 14% had villous adenomas. This further substantiates the correlation of IVT+ to the adenoma-carcinoma sequence. IVT+ was highly associated with DNA aneuploidy in carcinomas, and since IVT+ was found to be significantly associated with CRC's with a DNA index > or = 1.5, it is suggested that IVT+ mainly is correlated to the early steps in tumor progression. 3) IVT+ was found in 34% of sporadic CRC, and tumor DNA aneuploidy was demonstrated in 73%...

Adenoma↗
PubMed1997

Transforming growth factor-beta receptor type 2 mutations and microsatellite instability in sporadic colorectal adenomas and carcinomas.

Frame-shift mutations in a run of 10 adenines (A10) of the transforming growth factor-beta receptor type 2 gene (TGF-beta RII) are commonly seen in inherited and sporadic colonic cancers that exhibit microsatellite instability. A10 mutations and instability also are commonly seen in hereditary nonpolyposis colon cancer-associated adenomas. However, instability is quite rare in sporadic adenomas, and the timing of acquisition of A10 mutations with respect to the sporadic adenoma-carcinoma sequence has not been reported. We evaluated 100 sporadic colorectal cancers and 164 sporadic adenomas for microsatellite instability with a set of 10 tetranucleotide polymerase chain reaction primer sets and for A10 frame-shift mutations. A10 mutations were significantly associated with microsatellite instability in colorectal cancers, being seen in 9 of 11 cancers with 50% or greater instability and in 0 of 89 tumors with less than 50% instability (P < 0.0001). A10 mutations were not detected in any adenomas, only three of which (1.8%) exhibited significant (30% or greater) instability. We conclude that both TGF-beta RII frame-shift mutations and microsatellite instability occur at a relatively late stage of sporadic colorectal tumorigenesis. A10 frame-shift mutations appear to be restricted to sporadic colorectal cancers with extensive microsatellite instability.

Adenoma↗
PubMed1998

The nucleus is the target for radiation-induced chromosomal instability.

We have previously described chromosomal instability in cells of a human-hamster hybrid cell line after exposure to X rays. Chromosomal instability in these cells is characterized by the appearance of novel chromosomal rearrangements multiple generations after exposure to ionizing radiation. To identify the cellular target(s) for radiation-induced chromosomal instability, cells were treated with 125I-labeled compounds and frozen. Radioactive decays from 125I cause damage to the cell primarily at the site of their decay, and freezing the cells allows damage to accumulate in the absence of other cellular processes. We found that the decay of 125I-iododeoxyuridine, which is incorporated into the DNA, caused chromosomal instability. While cell killing and first-division chromosomal rearrangements increased with increasing numbers of 125I decays, the frequency of chromosomal instability was independent of dose. Chromosomal instability could also be induced from incorporation of 125I-iododeoxyuridine without freezing the cells for accumulation of decays. This indicates that DNA double-strand breaks in frozen cells resulting from 125I decays failed to lead to instability. Incorporation of an 125I-labeled protein (125I-succinyl-concanavalin A), which was internalized into the cell and/or bound to the plasma membrane, neither caused chromosomal instability nor potentiated chromosomal instability induced by 125I-iododeoxyuridine. These results show that the target for radiation-induced chromosomal instability in these cells is the nucleus.

Animals↗