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Evaluation of the predictive value of Her-2/neu gene expression on osteosarcoma therapy in laser-microdissected paraffin-embedded tissue.

Histologic response to chemotherapy is currently the strongest prognostic factor in high-grade osteosarcoma, but it can only be assessed after several weeks of therapy. Thus, detection of chemosensitivity at the time of diagnosis would be of great clinical importance. The expression of the proto-oncogene Her-2/neu has been shown to be of predictive value in breast cancer and has also been considered as prognostic marker for osteosarcomas, but reports of mainly immunohistochemical studies are controversial. Therefore, the aim of this study was to investigate Her-2/neu gene expression in laser-microdissected osteosarcoma cells. Laser microdissection enables the precise isolation of morphological defined cells from archival tissue specimens and is in combination with the highly sensitive real-time RT-PCR technique a valuable tool for cell-specific analysis of gene expression. Through optimization of current protocols, we could show that this technique can be successfully applied on formalin-fixed, paraffin-embedded and decalcified osteosarcoma tissue with high sensitivity and reproducibility. In all 17 osteosarcoma biopsies analyzed, we could detect Her-2/neu gene expression. Expression correlated significantly with the response to preoperative chemotherapy, which was assessed histologically according to the six-grade scale of Salzer-Kuntschik. Risk assessment on the basis of increased Her-2/neu gene expression matched the histologic findings in 16 out of 17 cases (94%). These data demonstrate the reliability of laser microdissection in the analysis of gene expression and suggest a possible role of Her-2/neu as prognostic marker for therapy outcome in osteosarcomas.

Antineoplastic Agents↗

Abnormal expression of cell cycle regulatory proteins in ductal and lobular carcinomas of the breast.

In a previous study, we demonstrated that the G1 cell cycle checkpoint in carcinomas of the breast is frequently abrogated by loss of p16, the product of the CDKN2/INK4A gene, and, to a lesser extent, by loss of pRB, the product of the retinoblastoma gene. The purpose of the present study was to determine whether other mechanisms of cell cycle deregulation exist in breast cancers which have retained RB and p16 function. Paraffin sections of 81 invasive breast carcinomas (49 ductal, 26 lobular, 6 mixed) were reacted with monoclonal antibodies against cyclin D1 and p53, using optimized immunohistochemical staining protocols. The staining results were correlated with the expression of p16 and pRB, and with a variety of pathological parameters and DNA ploidy. Twenty-five tumors (31%) accumulated (presumably mutant) p53 and 28 (35%) overexpressed cyclin D1; 7 carcinomas (not including any pure lobular cancers) abnormally expressed both proteins. p53 accumulation correlated with nuclear, mitotic, and overall grade, but not with tumor size, lymph node involvement, or DNA ploidy. Overexpression of cyclin D1 was not associated with any of the patho-biological variables. There was an inverse correlation between loss of p16 and high levels of p53, but not cyclin D1. The G1 cell cycle checkpoint, which is controlled by RB, cyclin D1, and p16, was abrogated in 65% of carcinomas, and only p53 was abnormal in an additional 17%. The number of abnormally expressed genes correlated with mitotic activity and overall tumor grade, but not with tumor histology, size, or nodal status, suggesting that cell cycle deregulation is an early event in breast tumorigenesis. Only 18% of the carcinomas showed a normal level of expression of the four genes tested, and p16 appeared to be the most common target of cell cycle deregulation. These data point to the importance of cell cycle regulatory protein abnormalities in human breast cancer.

Breast Neoplasms↗

High efficiency transformation of intact yeast cells by electric field pulses.

We have developed an efficient method that electrically introduces DNA into intact yeast cells. Saccharomyces cerevisiae was used as a model in order to optimize the transformation protocol. Transformation efficiencies of 10(7) transformants/micrograms of plasmid DNA were obtained with a square wave electric pulse of 2.7 kV/cm during 15 milliseconds. The technique is simple and rapid. Even small quantities of DNA (100 pg) can be used to transform 10(8) cells. Important parameters are the pulse field strength and duration. Pretreatment of the yeast cells in the early phase of exponential growth with dithiothreitol increases transformation efficiency. The method has been successfully applied to various strains of S. cerevisiae as well as to other types of yeast.

Cell Survival↗

Mapping DNA-protein interactions in large genomes by sequence tag analysis of genomic enrichment.

Identifying the chromosomal targets of transcription factors is important for reconstructing the transcriptional regulatory networks underlying global gene expression programs. We have developed an unbiased genomic method called sequence tag analysis of genomic enrichment (STAGE) to identify the direct binding targets of transcription factors in vivo. STAGE is based on high-throughput sequencing of concatemerized tags derived from target DNA enriched by chromatin immunoprecipitation. We first used STAGE in yeast to confirm that RNA polymerase III genes are the most prominent targets of the TATA-box binding protein. We optimized the STAGE protocol and developed analysis methods to allow the identification of transcription factor targets in human cells. We used STAGE to identify several previously unknown binding targets of human transcription factor E2F4 that we independently validated by promoter-specific PCR and microarray hybridization. STAGE provides a means of identifying the chromosomal targets of DNA-associated proteins in any sequenced genome.

Cells, Cultured↗

A membrane antibody receptor for noninvasive imaging of gene expression.

Monitoring gene expression is important to optimize gene therapy protocols and ensure that the proper tissue distribution is achieved in clinical practice. We developed a noninvasive imaging system based on the expression of artificial antibody receptors to trap hapten-labeled imaging probes. Functional membrane-bound anti-dansyl antibodies (DNS receptor) were stably expressed on melanoma cells in vitro and in vivo. A bivalent (DNS)2-diethylenetriaminepentaacetic 111Indium probe specifically bound to cells that expressed DNS receptors but not control scFv receptors. Importantly, the 111In probe preferentially localized to DNS receptors but not control receptors on tumors in mice as assessed by gamma camera imaging. By 48 h after intravenous injection, the uptake of the probe in tumors expressing DNS receptors was 72 times greater than the amount of probe in the blood. This targeting strategy may allow noninvasive assessment of the location, extent and persistence of gene expression in living animals and in the clinic.

Animals↗

Accelerated micro-sequential injection in lab-on-valve format, applied to enzymatic assays.

The assay cycle of sequential injection (SI) analysis has been greatly accelerated by simultaneously processing two sample injections within the same manifold. This is achieved through micro-miniaturization of the SI system using the lab-on-valve format (LOV), and by optimizing the assay protocol for stopped-flow reaction rate measurements. The approach has been tested on enzymatic assays of glucose and ethanol, but it is, in principle, applicable to all SI reagent-based assays. The average assay time for a single run has been shortened from 200 s to approximately 30 s. Assays were carried out at 22 degree C and 37 degree C using commercially available reagent kits. For glucose, at 22 degree C, the calibration had a linear response (r(2)= 0.9999) for the concentration range of 100-1000 ppm. At 37 degree C, the calibration was linear (r(2)= 0.9996) for 100-600 ppm glucose, but was a second order polynomial curve (r(2)= 0.9996) for 100-1000 ppm. For ethanol, at both 22 degree C and 37 degree C, the calibrations were linear for the concentration range of 50-250 ppm. The r(2) at two temperatures was 0.9994 and 0.9995, respectively. For both the glucose and ethanol assays, the relative standard deviations were below 3%. Factors affecting sampling frequency are discussed. In this work, sequential injection is shown, for the first time, to achieve sampling frequency comparable to flow injection (FI), while retaining the advantages of small reagent consumption (typically microlitres per assay), minimized waste production, full automation of assay protocols, and zero carryover.

Journal Article↗

Low dose insemination in the sow--a review.

Artificial insemination (AI) in pigs has been established for about four decades but ejaculates are still used insufficiently. Higher demand of semen for AI and new techniques that involve low sperm concentration require the optimization of insemination protocols. Based on the knowledge of the physiology of sperm transportation and events in the female genital tract prior to fertilization, new strategies are under development to minimize sperm losses. One goal is to deposit the semen into the uterine horn rather than into the proximal cervix. It was shown that the minimal number of spermatozoa necessary for surgical AI at the utero-tubal junction (UTJ) were at least 1 x 10(6) diluted in 0.5 ml of a special extender. Artificial insemination into the distal part of the uterine horn required about 1 x 10(7) million sperm in 20 ml of extender. Meanwhile, first insemination devices for non-surgical intra-uterine AI are commercially available. Using similar sperm concentrations as for surgical AI, non-surgical uterine insemination did not differ significantly from control inseminations in terms of pregnancy rate and litter size. With respect to the fertilizing capacities of their ejaculates, boars have to be selected more strictly for sperm quality parameters as most of the compensatory effects of sperm cells disappear in maximally extended semen samples.

Animals↗

Influence of the bridging effect by sequential laser application on tissue ablation in an ex vivo model, taking organ perfusion into account.

OBJECTIVE: To improve the efficacy of interstitial laser coagulation of tissue by causing a 'bridging' effect, using a sequential multiple-probe procedure on an ex vivo kidney model, as only a limited area of tissue is destroyed with a single probe and the coagulation takes longer when multiple punctures are used. MATERIALS AND METHODS: A laser beam was generated using a Nd:YAG laser and applied to kidney tissue by a diffuser tip (quartz glass cap 2 x 19 mm). For sequential laser application (SLA), three probes were placed through punctures into kidney tissue, at 5 or 10 mm apart. The laser energy was applied in different time-energy combinations through the three probes. The effect of SLA was compared with that from one probe delivering the optimal PowerMode 180 protocol (Dornier, Germering, Germany), which represents the standard energy protocol for the clinical treatment of parenchymal organs using this laser device. An isolated porcine kidney was chosen for laser coagulation under different conditions of perfusion. The ablative efficacy was defined as the volume of necrosis per minute. RESULTS: Applying various time-energy combinations to isolated unperfused porcine kidney caused extensive tissue ablation (5.6 mL). In trials with saline and blood perfusion for improved cooling, the necrotic volume was 2.5 and 3.9 mL, respectively (with no carbonization, 3.2 mL). Compared with a single-probe procedure, the ablation efficacy was 10 times better with SLA coagulation. This improvement was initiated by the bridging effect: coagulation in neighbouring areas affects perfusion and convection to an extent that induces the formation of bridges of necrosis between the probes. CONCLUSION: Tissue ablation is markedly improved by interstitial laser coagulation using a sequential multiple-probe technique.

Animals↗

Characterization of the human quadriceps muscle in active elders.

OBJECTIVE: To compare muscle activation deficits and muscle physiology in older versus younger adults. DESIGN: A maximal volitional isometric contraction of the quadriceps muscle with burst-superimposition was used to assess strength and activation. In addition, force-frequency testing during fresh, fatigue, and recovery conditions and electrically elicited fatigue testing were performed. SETTING: Muscle performance laboratory. PATIENTS: Healthy, active young (age range, 20-28 yr) and older (age range, 66-83 yr) subjects. MAIN OUTCOME MEASURES: Torque production, activation of the quadriceps, F50 values from the force-frequency relationships (frequency at which 50% of the maximum normalized force is produced), and the average amount of fatigue. RESULTS: Older subjects were weaker (574.4 +/- 156 N) than younger subjects (900.9 +/- 295 N) and had significantly greater deficits in central activation in the quadriceps muscles (elderly = 95.5% activation; younger = 98.1% activation). The force-frequency curves for the elderly were to the left of the younger subjects for all 3 testing conditions. Aged muscles fatigued to the same extent as younger muscle (young = 49.8% +/- 2.6%, elderly = 51.1% +/- 2.8%). CONCLUSIONS: These results can be used to modify high-intensity strength training protocols designed to optimize sustainable strength gains in the elderly during rehabilitation.

Adult↗

Vitamin D therapy in patients with chronic renal disease: the role of the renal dietitian.

Chronic renal failure causes decreased vitamin D production, which profoundly alters parathyroid hormone (PTH) metabolism, and calcium and phosphorus balance. Correcting this deficiency is an important strategy in managing secondary hyperparathyroidism (SHPT) and helping to restore mineral balance. However, hypercalcemia and hyperphosphatemia are common side effects that hamper vitamin D hormone therapy by increasing dietary calcium and phosphorus absorption. This limitation has led to the development of D-hormone analogs that retain the ability to suppress PTH levels without causing drastic changes in calcium and phosphorus metabolism. These analogs have the potential to advance the management of SHPT. Renal dietitians can play a leading role in ensuring successful management of SHPT by participating in early patient intervention for abnormal mineral and vitamin D metabolism, by encouraging long-term phosphorus control, and by updating and implementing clinical protocols that promote optimal hormone levels (D and PTH), mineral levels (phosphorus and calcium), and nutritional factors.

Dietetics↗

The potential role of bone marrow transplantation in augmenting donor-derived immunity to hepatitis B after rat liver transplantation.

Adoptive transfer of immunity to hepatitis B virus (HBV) is not provoked solely by bone marrow, but also by liver transplantation, although transiently. In the current study, simultaneous bone marrow transplantation, which possibly can increase the number of antibody-secreting cells, was performed to augment the efficacy of transferring HBV immunity. Stimulation of donor-derived immune cells by postoperative vaccination was used to investigate whether a secondary immune response can be induced in recipients. Orthotopic liver transplantation (n = 28), performed in three rat strain combinations representing different genetic constellations, was compared with bone marrow-augmented liver transplantation (n = 21). Donors had been vaccinated twice with recombinant hepatitis B surface antigen (HBsAg). Recipients surviving more than 10 weeks received a boost vaccination. All animals were monitored weekly for the presence of antibodies to HBsAg (anti-HBs). Effective anti-HBs titers were measured in 82% of liver recipients (23 of 28 recipients) and lasted from 2 to 9 weeks. Ninety percent of bone marrow-augmented liver recipients (19 of 21 recipients) seroconverted, with anti-HBs persisting from 2 to 12 weeks. A greater seroconversion rate, prolonged titer duration, and different pattern of titer development were observed in bone marrow-augmented liver recipients, although statistical significance could not be obtained because of the small numbers of comparable animals. Posttransplantation vaccination in recipients of combined grafts did not arouse a typical secondary antibody response, but showed a tendency toward an earlier and stronger response to vaccine in comparison to recipients without immune transfer. Simultaneous bone marrow transplantation showed an augmenting, but limited, effect on humoral immune transfer. Therefore, other potentially promising cellular strategies, such as transfer of in vivo and ex vivo stimulated antigen-specific cells should be pursued further. Improvement of the effect of postoperative vaccination possibly can be achieved by optimizing the immunization protocol.

Animals↗

[Multislice spiral CT (MSCT) in pediatric radiology: dose reduction for chest and abdomen examinations].

The advent of multislice spiral CT (MSCT) technique has led to new aspects of dose reduction, especially for the dedicated use of MSCT in children. Optimizing pediatric MSCT protocols according to the clinical problem allows reduction of radiation exposure to a minimum without loss of diagnostic quality. The different parameters that influence the degree of dose reduction, like tube current-time product (mAs), tube voltage (kV), collimation and pitch, are discussed in context with previously published data and our own experience in nearly 200 pediatric CT examinations. In our department, the effective mAs is calculated for a pediatric chest MSCT by multiplication of the body weight in kilogram with a factor of 1 to 1.5 and for a pediatric abdominal MSCT by multiplication with a factor of 2 to 2.5. To calculate the equivalent effective dose for a contrast media-enhanced 80 kV protocol, the effective mAs of the 120 kV protocol can be multiplied by 2.7. A factor less than 2.7 means further dose reduction. Compared to the radiation exposure with a standard adult protocol, the effective dose in a pediatric thoracic MSCT could be reduced by up to 92 % in neonates, 89 % in toddlers and 80 % in school children. In abdominal MSCT, the effective dose could be reduced by up to 90 % in neonates, 89 % in toddlers and 83 % in school children. Using an adequate MSCT technique in children by adjusting the CT scanning parameters to the clinical question and body weight of the examined child enables a significant reduction of radiation exposure in comparison to standard MSCT protocols.

Body Weight↗

[Multislice CT of the pelvis: dose reduction with regard to image quality].

PURPOSE: To optimize the examination protocols of multislice CT (MSCT) of the pelvis for dose reduction with regard to image quality. MATERIALS AND METHODS: MSCT of the pelvis was performed on 5 cadaver specimens with stepwise reduction of the tube current at 140 kV (250, 200, 150, 100, 75, 50, 35, 25 mAs) and 120 kV (50, 27 mAs). The remaining scan parameters like collimation (4 x 1 mm) and table speed of 4 mm per rotation remained unchanged. Axial sections and coronal reconstructions were used to evaluate cortex, trabecular structures, subjective image quality, image noise and detail detectability (pelvis and SI joint), with evaluation performed independently by four blinded experienced radiologists on a 5-point scale. Kappa coefficient, accuracy of the observers to sort the films with regard to dose reduction and mean scores of image evaluation were determined for statistical analysis. RESULTS: The deterioration of the image quality was most pronounced for all criteria between 75 mAs and 50 mAs at 140 kV. Good results with adequate image quality were obtained for detail detectability at 50 mAs and 140 kV (effective dose [E]: 3.3 mSv) and for the remaining four criteria at 75 mAs (E: 4.9 mSv). There was a moderate agreement between the four observers (kappa coefficient: 0.27). All observers were excellent in arranging the images according to the increasing dose reduction. CONCLUSIONS: Image quality of MSCT of the pelvis appears to be acceptable at 75 mAs and 140 kV with the dose reduced to 46% of the average value of the nation-wide survey of the German Roentgen Society in 1999 for this type of examination.

Acetabulum↗

[Hydration for the prevention of contrast medium-induced nephropathy: an update].

Contrast medium-induced nephropathy (CIN) continues to be one of the most common causes of hospital-acquired acute renal failure. Since most of the clinical studies on the prophylactic use of different drugs to prevent CIN produced disappointing results, hydration remains the mainstay of prophylaxis. A number of recent prospective randomized trials provided further evidence of the effectiveness of hydration and relevant information regarding the optimization of hydration protocols. It was shown that a bolus hydration solely during examination is not sufficient to prevent CIN. In addition, isotonic 0.9 % saline was superior to the commonly used half-isotonic 0.45 % saline in another trial. An outpatient hydration protocol including oral hydration before the examination followed by forced intravenous hydration over 6 hrs. beginning 30 to 60 min. prior to examination seems to be comparable to the usual hydration over 24 hrs. Another hydration protocol, which could also be very attractive especially for outpatients, included the infusion of sodium bicarbonate. In a recent trial, hydration with sodium bicarbonate, given as a bolus for 1 hr. prior to examination followed by an infusion for 6 hrs. after examination, was more effective than hydration with sodium chloride for the prophylaxis of CIN. However, there is still a lack of large-scale, multi-center trials comparing different hydration protocols and investigating their influence on clinically relevant endpoints such as mortality or the need for dialysis.

Acute Kidney Injury↗

High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants.

BACKGROUND: The efficacy and safety of early high-frequency oscillatory ventilation as compared with conventional synchronized intermittent mandatory ventilation for the treatment of infants with very low birth weight have not been established. METHODS: We conducted a randomized, multicenter clinical trial to determine whether infants treated with early high-frequency oscillatory ventilation were more likely than infants treated with synchronized intermittent mandatory ventilation to be alive without requiring supplemental oxygen at 36 weeks of postmenstrual age. Eligible infants weighed 601 to 1200 g at birth, were less than four hours of age, had received one dose of surfactant, and required ventilation with a mean airway pressure of at least 6 cm of water and a fraction of inspired oxygen of at least 0.25. Infants were stratified according to birth weight and exposure to prenatal corticosteroids and then randomly assigned to high-frequency oscillatory ventilation or synchronized intermittent mandatory ventilation. Ventilation was managed according to protocols designed to optimize lung inflation and blood gas values. RESULTS: Five hundred infants were enrolled in the study. Infants randomly assigned to high-frequency oscillatory ventilation were successfully extubated earlier than infants assigned to synchronized intermittent mandatory ventilation (P<0.001). Of infants assigned to high-frequency oscillatory ventilation, 56 percent were alive without a need for supplemental oxygen at 36 weeks of postmenstrual age, as compared with 47 percent of those receiving synchronized intermittent mandatory ventilation (P=0.046). There was no difference between the groups in the risk of intracranial hemorrhage, cystic periventricular leukomalacia, or other complications. CONCLUSIONS: There was a small but significant benefit of high-frequency oscillatory ventilation in terms of the pulmonary outcome for very-low-birth-weight infants without an increase in the occurrence of other complications of premature birth.

Age Factors↗

Identification of genes differentially expressed by nerve growth factor- and neurotrophin-3-dependent sensory neurons.

The neurotrophins nerve growth factor (NGF) and neurotrophin-3 (NT3) support the survival of subpopulations of primary sensory neurons with defined and distinct physiological characteristics. Only a few genes have been identified as being differentially expressed in these subpopulations, and not much is known about the nature of the molecules involved in the processing of sensory information in NGF-dependent nociceptive neurons or NT3-dependent proprioceptive neurons. We devised a simple dorsal root ganglion (DRG) explant culture system, allowing the selection of neuronal populations preferentially responsive to NGF or NT3. The reliability of this assay was first monitored by the differential expression of the NGF and NT3 receptors trkA and trkC, as well as that of neuropeptides and calcium-binding proteins. We then identified four differentially expressed sodium channels, two enriched in the NGF population and two others in the NT3 population. Finally, using an optimized RNA fingerprinting protocol, we identified 20 additional genes, all differentially expressed in DRG explants cultured with NGF or NT3. This approach thus allows the identification of large number of genes expressed in subpopulations of primary sensory neurons and opens the possibility of studying the molecular mechanisms of nociception and proprioception.

Amino Acid Sequence↗

Novel pyridinium surfactants for efficient, nontoxic in vitro gene delivery.

Novel, double-chained pyridinium compounds have been developed that display highly efficient DNA transfection properties. The transfection efficiency of several of these compounds is enhanced by an order of magnitude, when compared with the transfection efficiency accomplished with the widely used cationic lipid system, lipofectin. Most importantly, the pyridinium compounds were found to be essentially nontoxic toward cells. Using various reporter genes, such as beta-galactosidase and pNEO (a gene construct that renders cells resistent to antibiotic derivatives of neomycin like G418), we demonstrate that the enhanced efficiency relates to the fact that a relative higher number of cells in the population is transfected (approximately 50% in the case of COS cells) by the pyridinium derivatives, whereas the delivery of DNA per cell is also enhanced. Furthermore, application of the pyridinium derivatives shows little cellular preference in their ability to transfect cells. By systematically modifying the structure of the pyridinium amphiphile, i.e., by changing either the headgroup structure or the alkyl chains, some insight was obtained that may lead to unraveling the mechanism of amphiphile-mediated transfection, and thus to protocols that further optimize the carrier properties of the amphiphile. Our results reveal that unsaturated alkyl chains enhance the transfection properties of the pyridinium-based amphiphiles. Preliminary experiments suggest that the structure-dependent improvement of transfection efficiency, when comparing pyridinium derivatives with lipofectin, likely relates to the mechanism of delivery rather than the packaging of the amphiphile/DNA complex.

Animals↗

Integrated proteomics and genomics strategies bring new insight into Candida albicans response upon macrophage interaction.

The interaction of Candida albicans with macrophages is considered a crucial step in the development of an adequate immune response in systemic candidiasis. An in vitro model of phagocytosis that includes a differential staining procedure to discriminate between internalized and non-internalized yeast was developed. Upon optimization of a protocol to obtain an enriched population of ingested yeasts, a thorough genomics and proteomics analysis was carried out on these cells. Both proteins and mRNA were obtained from the same sample and analyzed in parallel. The combination of two-dimensional PAGE with MS revealed a total of 132 differentially expressed yeast protein species upon macrophage interaction. Among these species, 67 unique proteins were identified. This is the first time that a proteomics approach has been used to study C. albicans-macrophage interaction. We provide evidence of a rapid protein response of the fungus to adapt to the new environment inside the phagosome by changing the expression of proteins belonging to different pathways. The clear down-regulation of the carbon-compound metabolism, plus the up-regulation of lipid, fatty acid, glyoxylate, and tricarboxylic acid cycles, indicates that yeast shifts to a starvation mode. There is an important activation of the degradation and detoxification protein machinery. The complementary genomics approach led to the detection of specific pathways related to the virulence of Candida. Network analyses allowed us to generate a hypothetical model of Candida cell death after macrophage interaction, highlighting the interconnection between actin cytoskeleton, mitochondria, and autophagy in the regulation of apoptosis. In conclusion, the combination of genomics, proteomics, and network analyses is a powerful strategy to better understand the complex host-pathogen interactions.

Animals↗