Down-regulation of epidermal growth factor receptor by selective expansion of a 5'-end regulatory dinucleotide repeat in colon cancer with microsatellite instability

PURPOSE

The epidermal growth factor receptor (EGFR) is overexpressed in several tumor types, and its expression is influenced by the length of a 5'-end microsatellite repeat (CA)n: the longer the repeat, the lower the expression. Dinucleotide repeats accumulate insertion/deletion types of mutations in tumors with microsatellite instability. We designed this study to estimate the occurrence of these mutations in EGFR(CA)n and their relevance in carcinogenesis of microsatellite instability-positive colon and gastric tumors.

EXPERIMENTAL DESIGN

We analyzed the frequency of EGFR(CA)n mutations in vivo in 55 colorectal and 14 gastric microsatellite instability-positive cancers, and in vitro in single-cell clone cultures of microsatellite instability-positive colon tumor cell line LS174. Single-cell clone cultures with different repeat lengths were analyzed by fluorescent-activated cell sorter for EGFR cell-surface expression. A correlation analysis was done between EGFR(CA)n mutations and mutations in KRAS, BRAF, and p53.

RESULTS

Unlike single-cell clone cultures, which exhibited higher rate of deletions compared with insertions, most of EGFR(CA)n mutations in colon and gastric tumors were insertions. Longer EGFR(CA)n correlated with lower EGFR cell-surface expression in single-cell clone cultures. In colon cancers, the elongation of the repeat was associated negatively with mutations in KRAS and BRAF, but not in p53.

CONCLUSIONS

The EGFR(CA)n elongation observed in tumors cannot be explained by an intrinsic property of this repeat favoring insertions versus deletions. Instead, a selection for repeat elongation occurs in microsatellite instability-positive tumors, leading to EGFR down-regulation. These findings suggest that in microsatellite instability-positive tumors current therapies targeting EGFR overexpression may have either no effect or an opposite to the expected effect.

Comparing methods of determining addition in presbyopes

BACKGROUND

The use of plus lenses to compensate for the reduction in the range of accommodation associated with presbyopia, brings the near point of accommodation to a comfortable distance for near visual tasks. Our aim was to compare the tentative near addition determined using the most common procedures with the final addition prescribed in presbyopic patients.

METHODS

Sixty-nine healthy subjects with a mean age of 51.0 years (range 40 to 60 years) were studied. Tentative near additions were determined using seven different techniques: dynamic retinoscopy, amplitude of accommodation (AA), age-expected addition, binocular fused cross-cylinder with and without myopisation, near duochrome, and balance of negative and positive relative accommodation. The power of the addition was then refined to arrive at the final addition.

RESULTS

The mean tentative near additions were higher than the final addition for every procedure except for the fused cross-cylinder without initial myopisation and age-expected addition methods. These biases were small in clinical terms (less than 0.25 D) with the exception of the AA procedure (0.34 D). The intervals between the 95% limits of agreement differed substantially and were always higher than +/-0.50 D.

CONCLUSIONS

All the techniques used displayed similar behaviour and provided a tentative addition close to the final addition. Due to the wide agreement intervals observed, the likelihood of error is high and supports the idea that any tentative addition has to be adjusted according to the particular needs of each patient. Among the methods examined here, we would recommend the age-expected procedure, as this technique produced results that correlated best with the final addition.

An alloantibody to a high-prevalence MNS antigen in a person with a GP.JL/Mk phenotype

The low-prevalence MNS blood group antigenTSEN is located at the junction of glycophorin A (GPA) to glycophorin B (GPB) in several hybrid glycophorin molecules. Extremely rare people have RBCs with a double dose of the TSEN antigen and have made an antibody to a high-prevalence MNS antigen. We report the first patient who is heterozygous for GYP.JL and Mk. During prenatal tests,an alloantibody to a high-prevalence antigen was detected in the serum of a 21-year-old Hispanic woman. The antibody detected an antigen resistant to treatment by papain, trypsin, alpha-chymotrypsin, or DTT. The antibody was strongly reactive by the IAT with all RBCs tested except those having the MkMk, GP.Hil/GP.Hil, or GP.JL/GP.JL phenotypes. The patient's RBCs typed M+N-S+/-s-U+, En(a+/-), Hut-, Mi(a-), Mur-, Vw-, Wr(a-b-), and were TSEN+, MINY+. Reactivity with Glycine soja suggested that her RBCs had a decreased level of sialic acid. Immunoblotting showed the presence of monomer and dimer forms of a GP(A-B) hybrid and an absence of GPA and GPB. Sequencing of DNA and PCR-RFLP using the restriction enzyme RsaI confirmed the presence of a hybrid GYP(AB). The patient's antibody was determined to be anti-EnaFR. She is the first person reported with the GP.JL phenotype associated with a deletion of GYPA and GYPB in trans to GYP.JL.

The relation of entrapment, shame and guilt to depression, in carers of people with dementia

There is increasing research exploring depression in carers of people with dementia. This study explored the relation of entrapment, shame and guilt to depression in a group of 70 carers of those with dementia. As in other studies the experience of entrapment in the role was highly related to depression. Moreover, experiences of shame relating to self-criticism, other people's expectations and the fear of their criticism were significantly related to depression, entrapment and guilt. Guilt however, as focused on the fears of harming others, letting others down and sense of responsibility, was not associated with depression or entrapment. Depression in carers may relate in part to feeling trapped in a role but also being vulnerable to criticism and feelings of inadequacy in that role. In this study, degree of behavioural disturbance/dependence was not found to be significantly associated with any of the research variables.

Right spatial neglect after left hemisphere stroke: qualitative and quantitative study

OBJECTIVES

Comparatively little research has been conducted on right neglect after left brain damage. The authors sought to assess contralateral neglect in subacute left hemisphere stroke patients using a comprehensive test battery validated in a large control group after right hemisphere stroke.

METHODS

Seventy-eight left hemisphere stroke patients were assessed. The test battery included a preliminary assessment of anosognosia and visual extinction, a clinical assessment of gaze orientation and personal neglect, and paper-and-pencil tests of spatial neglect in the peripersonal space. Only nonverbal tests were used.

RESULTS

Drawing and cancellation tasks revealed neglect in 10 to 13% of patients. The combined battery was more sensitive than any single test alone. A total of 43.5% of patients showed some degree of neglect on at least one measure. Anatomic analyses showed that neglect was more common and severe when the posterior association cortex was damaged.

CONCLUSIONS

The frequency of occurrence of right neglect was, as expected, much lower than that reported in a study using the same assessment battery in right brain damage stroke patients. Nevertheless, neglect was found in a substantial proportion of patients at a subacute stage, suggesting that it should be considered in the rehabilitation planning of left brain damage stroke patients.

Bacterial contamination of Mediterranean coastal seawater as affected by riverine inputs: simulation approach applied to a shellfish breeding area (Thau lagoon, France)

Consequences of short-term changes in thermotolerant coliform loads on their spatio-temporal distribution in a Mediterranean lagoon with large-scale mollusk farming (Thau lagoon, France) were explored using a simulation approach. Simulations were based on bacterial transport and survival coupled models forced by the input of bacterial loads from the two main rivers (Vène and Pallas) that flow into the lagoon. Different flow types (reference, sudden and constant), bringing the same bacterial load, were considered and subsequent spatial and temporal bacterial contamination of lagoon surface water and shellfish was estimated. Simulation results showed that as long as loads were high, hydrodynamical processes governed the distribution of bacterial abundance in receiving areas. As soon as loads decreased or when time supply increased, biological die-off processes became dominant. Bacterial contamination of shellfish induced by the different flow types appeared to depend on the receiving area. In the case of Pallas River area, a sudden input of bacteria led to a high bacterial contamination of shellfish but only during a short period ( approximately 1 day). A constant input of the same amount of bacteria induced a lower but significant contamination during all the simulation period (10 days). On the contrary, bacterial inputs from the Vène River led to shellfish contamination only when bacteria were delivered through a flood event. Exposure time of bacteria to adverse environmental conditions appeared to be the main explanation to the above-mentioned differences. Consequences of our results in terms of environmental management strategy were discussed.

Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke

OBJECTIVES

The lack of agreement regarding assessment methods is responsible for the variability in the reported rate of occurrence of spatial neglect after stroke. The aim of this study was to assess the sensitivity of different tests of neglect after right hemisphere stroke.

METHODS

Two hundred and six subacute right hemisphere stroke patients were given a test battery including a preliminary assessment of anosognosia and of visual extinction, a clinical assessment of gaze orientation and of personal neglect, and paper and pencil tests of spatial neglect in the peripersonal space. Patients were compared with a previously reported control group. A subgroup of patients (n=69) received a behavioural assessment of neglect in daily life situations.

RESULTS

The most sensitive paper and pencil measure was the starting point in the cancellation task. The whole battery was more sensitive than any single test alone. About 85% of patients presented some degree of neglect on at least one measure. An important finding was that behavioural assessment of neglect in daily life was more sensitive than any other single measure of neglect. Behavioural neglect was considered as moderate to severe in 36% of cases. A factorial analysis revealed that paper and pencil tests were related to two underlying factors. Dissociations were found between extrapersonal neglect, personal neglect, anosognosia, and extinction. Anatomical analyses showed that neglect was more common and severe when the posterior association cortex was damaged.

CONCLUSIONS

The automatic rightward orientation bias is the most sensitive clinical measure of neglect. Behavioural assessment is more sensitive than any single paper and pencil test. The results also support the assumption that neglect is a heterogeneous disorder.

Gorgonians mass mortality during the 1999 late summer in French Mediterranean coastal waters: the bacterial hypothesis

Mass mortality by tissue necrosis of several species of gorgons was observed during the 1999 late summer on the Liguro-Provençal Mediterranean coasts. We have investigated the occurrence of vibrios on necrosis affected gorgonians Paramuricea clauata and Eunicella cavolinii, and their ability to induce tissue necrosis. Among the 11 strains tested, only 5, belonging to species Vibrio splendidus, V. pelagius and V. campbellii, were able to induce tissue necrosis in a few days. Temperature experiments carried out at 11 degrees C, 18 degrees C and 23 degrees C showed that necrotic disease may occur only at the higher temperature tested. Statistical analysis suggested that, for these thermical conditions, marine Vibrio strains can significantly speed up the necrotic crisis.

[Presenting a battery for assessing spatial neglect. Norms and effects of age, educational level, sex, hand and laterality]

The aim of this study was to build up a battery for assessing spatial neglect, then to analyse the norms and potential effects of age, education level, sex, hand used, and laterality. It was also to contribute evaluating the pseudoneglect phenomenon described by Heilman, which consists in a tendency of normal subjects to neglect the right peripersonal space. Tasks selected were presented to important groups of normal subjects, most often larger than 450. The battery comprised of a bell cancellation test, scene copy, clock drawing, two line bisection tasks, identification of overlapping figures, text reading, writing task, and the representational task of the France map. For each of them, different variables were selected, especially investigating the difference between performance in the right and the left hemispaces. This study allowed defining the threshold values (percentiles 5 and 95) for deciding of the pathological character of a patient performance. It also showed that the pseudoneglect phenomenon is more obvious in some tasks such as line bisection, and probably also in the representational task of the France map and writing. His importance and at times his side were influenced by the factors we studied, with between tasks differences, but also by the nature of the task to be performed, and especially his verbal component.

Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus

All patients positive for methicillin-resistant Staphylococcus aureus (MRSA) at the University Hospitals of Geneva, Switzerland, between 1989 and 1997 (N = 1771) were included in a cohort study to evaluate the consequences of delayed containment of a hospital-wide outbreak occurring during a 4-year absence of MRSA control measures. The effects of efforts to control both the MRSA reservoir and the number of bacteraemic patients were assessed. Intensive infection control measures were initiated in 1993 and included patient screening, on-site surveillance, contact isolation, a computerized alert system, and hospital-wide promotion of hand hygiene. An increase in the rate of new MRSA-infected or -colonized patients was observed between 1989 and 1994 (from 0.05 to 0.60 cases per 100 admissions), which subsequently decreased to 0.24 cases in 1997 (P<0.001). However, the proportion of laboratory-documented methicillin-resistant isolates among all S. aureus showed little variation in the years from 1993 onwards (range, 19-24%), reflecting the result of an increase in the number of screening cultures. The annual number of patients with MRSA bacteraemia strongly correlated with the hospital-wide prevalence of MRSA patients (R(2)= 0.60; P = 0.01) and the rate of new MRSA patients (R(2)= 0.97; P<0.001). Consequently, the attack rate of nosocomial MRSA bacteraemia served as an excellent marker for the MRSA patient reservoir. In conclusion, despite delayed implementation, infection control measures had a substantial impact on both the reservoir of MRSA patients and the attack rate of MRSA bacteraemia.

Molecular phylogeny of European muroid rodents based on complete cytochrome b sequences

Phylogenetic relationships among 18 species of mainly European muroid rodents that belong to three subfamilies were estimated using complete sequences of the mitochondrial cytochrome b gene. The inferred monophyly of the subfamilies Murinae (mice and rats) and Arvicolinae (voles, lemmings, and muskrats) is in agreement with previous studies. Within the Murinae, the morphology-based division of the genus Apodemus into three subgenera is supported by these DNA sequence data. The relationships among the different genera of the Murinae were generally poorly resolved, and the relationships of Micromys and Acomys to the other murine genera remained unresolved. Within the subfamily Arvicolinae, the relations of the genera Arvicola, Clethrionomys, and Microtus remained tentative with our data. However, within the Microtus group, there is a good molecular support for the phylogenetic relationships. These findings suggest that the origin of the different murine and arvicoline lineages was rapid, indicating an adaptive radiation with fast speciation.

Dual task performance after severe diffuse traumatic brain injury or vascular prefrontal damage

The ability to perform two tasks simultaneously is a key function of the central executive of working memory (Baddeley, 1986). This study addressed dual-task performance after diffuse very severe traumatic brain injury (TBI) (mean coma duration = 21 days, mean post-traumatic amnesia = 70 days) or prefrontal damage due to a ruptured aneurysm of the anterior communicating artery (AACA). Mean time since injury was 8 and 16 months in the TBI and the AACA group respectively. A simple visual reaction time and random number generation were used as single and dual tasks. Randomization was self-paced, to control for individual differences in speed. Both patient groups had greater reaction time decrements than controls under the dual-task condition, suggesting a divided attention deficit. In addition, patients with AACA performed significantly poorer in random generation. These results suggest that patients with AACA and with severe TBI suffer from an impairment of the central executive system.

CB1 cannabinoid receptor antagonist-induced opiate withdrawal in morphine-dependent rats

Recent reports have provided evidence of a link between the endogenous brain cannabinoid system and the endogenous central opioid systems. Here we report that the selective CB1 receptor antagonist SR 141716A induced behavioral and endocrine alterations associated with opiate withdrawal in morphine-dependent animals in a dose-dependent manner and that naloxone induced an opiate withdrawal syndrome in animals made cannabinoid-dependent by repeated administration of the potent cannabinoid agonist HU-210. Additionally CB1 and mu-opioid receptor mRNAs were co-localized in brain areas relevant for opiate withdrawal such as the nucleus accumbens, septum, dorsal striatum, the central amygdaloid nucleus and the habenular complex. These results suggest that CB1 cannabinoid receptors may play a role in the neuroadaptive processes associated with opiate dependence, and they lend further support for the hypothesis of a potential role of cannabinoid receptors in the neurobiological changes that culminate in drug addiction.

Pathology of skin diseases in crocodiles

OBJECTIVE

To establish which skin diseases occur in crocodiles, particularly those on farms, to indicate the relative frequency of each particular disease and to provide information on pathogenesis, especially in regard to lesions with two or more pathogens present.

DESIGN

A gross and microscopic retrospective (period of 1989 to 1995) and current (1996 to 1997) examination of skin lesions in crocodiles in Queensland and the Northern Territory.

RESULT

Skin lesions were obtained from crocodiles on nine farms, from a group of experimental animals and from one adult found dead in the wild. A total of 203 lesions from 180, mostly young, crocodiles was examined; 119 lesions were from retrospectively examined cases and 84 were recent. The relative frequencies of four presumed primary pathogens in lesions were Dermatophilus sp 28.1%, fungi 14.8%, poxvirus 3.4% and probable Mycobacterium sp 2.5%. In addition, other bacteria of unknown significance were present in many lesions, and there was one case of presumed Paratrichosoma crocodilus infection. In 32.5% of lesions, multiple pathogens were identified.

CONCLUSION

Dermatophilosis is the most common and probably the most important skin disease of crocodiles in Australia, but it is frequently complicated by concurrent infection with fungi or other microorganisms.

Scanning Interferometric Apertureless Microscopy: Optical Imaging at 10 Angstrom Resolution

Interferometric near-field optical microscopy achieving a resolution of 10 angstroms is demonstrated. The scattered electric field variation caused by a vibrating probe tip in close proximity to a sample surface is measured by encoding it as a modulation in the optical phase of one arm of an interferometer. Unlike in regular near-field optical microscopes, where the contrast results from a weak source (or aperture) dipole interacting with the polarizability of the sample, the present form of imaging relies on a fundamentally different contrast mechanism: sensing the dipole-dipole coupling of two externally driven dipoles (the tip and sample dipoles) as their spacing is modulated.

CD28 costimulation up-regulates long-term IL-2R beta expression in human T cells through combined transcriptional and post-transcriptional regulation

Costimulatory molecules such as CD28 are required for induction of T cell clonal expansion and for prevention of T cell unresponsiveness. In combination with either CD3 or CD2 triggering, CD28 was shown to enhance T cell proliferation, cytolytic activity, production of cytokines and especially of IL-2, and expression of the IL-2R alpha-chain (IL-2R alpha). We and others have demonstrated that the costimulatory effect of CD28 on both IL-2 and IL-2R alpha expression results from a coordinated transcriptional activation of their genes and transcript stabilization. We show here that the CD28 stimulation, together with CD2, leads to a prolonged up-regulation of the constitutive expression of the IL-2R beta-chain in human peripheral T cells. As for IL-2R alpha, the increase in IL-2R beta gene expression seems to result from both transcriptional activation and transcript stabilization. In addition, IL-2 differentially regulates its own receptors, as only expression of IL-2R alpha, but not of IL-2R beta, is largely inhibited, at both the mRNA and protein levels, by blocking IL-2R mAbs. We propose that the long lasting T cell proliferation mediated by the CD2 and CD28 costimulation is mainly the consequence of the high and prolonged expression of both the IL-2R alpha- and beta-chains.

CD28 costimulation up-regulates long-term IL-2R beta expression in human T cells through combined transcriptional and post-transcriptional regulation

Costimulatory molecules such as CD28 are required for induction of T cell clonal expansion and for prevention of T cell unresponsiveness. In combination with either CD3 or CD2 triggering, CD28 was shown to enhance T cell proliferation, cytolytic activity, production of cytokines and especially of IL-2, and expression of the IL-2R alpha-chain (IL-2R alpha). We and others have demonstrated that the costimulatory effect of CD28 on both IL-2 and IL-2R alpha expression results from a coordinated transcriptional activation of their genes and transcript stabilization. We show here that the CD28 stimulation, together with CD2, leads to a prolonged up-regulation of the constitutive expression of the IL-2R beta-chain in human peripheral T cells. As for IL-2R alpha, the increase in IL-2R beta gene expression seems to result from both transcriptional activation and transcript stabilization. In addition, IL-2 differentially regulates its own receptors, as only expression of IL-2R alpha, but not of IL-2R beta, is largely inhibited, at both the mRNA and protein levels, by blocking IL-2R mAbs. We propose that the long lasting T cell proliferation mediated by the CD2 and CD28 costimulation is mainly the consequence of the high and prolonged expression of both the IL-2R alpha- and beta-chains.