Annexin A2 in renal cell carcinoma: expression, function, and prognostic significance

OBJECTIVE

Renal cell carcinoma (RCC) is the most lethal genitourinary cancer and intrinsically resistant to chemotherapy, radiotherapy, and hormone therapy. Annexin A2 (Anxa2) is a calcium-dependent phospholipid-binding protein found on various cell types that plays multiple roles in regulating cellular functions. In RCC, Anxa2 expression was correlated with tumor differentiation, clinical outcomes, and the metastatic potential; however, the underlying mechanisms remain obscure. This study investigated the role of Anxa2 in regulating tumorigenesis of RCC.

MATERIALS AND METHODS

Commercial RCC tissue microarray arrays and a kidney cancer quantitative polymerase chain reaction array were used to examine Anxa2 by immunohistochemistry and real-time polymerase chain reaction analysis. Short hairpin (sh)RNA-based lentiviral system technology was used to evaluate the effects of manipulating Anxa2 expression on multiple malignant features of 2 RCC cell lines, A498 and 786-O, and its mechanisms.

RESULTS

(1) The Anxa2 expression level was generally elevated to varying degrees in RCC tissues. In adjacent noncancerous tissues, Anxa2 was mainly expressed in glomeruli and slightly expressed in the cytoplasm of proximal tubules. (2) An increased Anxa2 expression level was found in tissues of clear cell RCC, papillary RCC, and chromophobe RCC, and it was prominently expressed in cancer cell membranes. In addition, the Anxa2 expression level was correlated with poor prognosis. (3) Silencing Anxa2 expression suppressed the abilities of cell migration and invasion, but cell proliferation was less affected. (4) Diminished Anxa2 expression caused alterations in the cell polarity, disrupted the formation of actin filaments, and reduced CXCR4 expression. (5) Inhibition of the Rho/Rock axis restored silencing of Anxa2-mediated suppression of cell motility.

CONCLUSIONS

Overall, our study points out the regulatory function of Anxa2 in RCC cell motility and provides a molecular-based mechanism of Anxa2 positivity in the progression of RCC.

A dual-substrate steady-state model for biological hydrogen production in an anaerobic hydrogen fermentation process

Biological hydrogen production from anaerobic waste fermentation possesses potential benefits in simultaneously reducing organic wastes and generating sustainable energy sources. Three kinetic-based steady-state models for anaerobic fermentation of multiple substrates, including glucose and peptone, were evaluated. Experimental results obtained from a continuous stirred tank reactor (CSTR) were primarily used for model evaluation. The dual-substrate steady-state model developed and the associated kinetic parameters estimated in this study successfully described the anaerobic growth of hydrogen-producing bacteria. The model was able to capture the general trends of consumption of substrates and accumulation of products, including formate, acetate, butyrate, and hydrogen, at dilution rates (D) between 0.06 and 0.69/h. According to the model, the adverse effects of endogeneous and peptone metabolism on net hydrogen production can be minimized by increasing D. For the operational conditions of D > 0.69/h, however, substantial washout of hydrogen-producing bacteria from the CSTR was observed, and it resulted in a rapid drop in hydrogen production rate as well.

Probing C–H⋯X hydrogen bonds in amide-functionalized imidazolium salts under high pressure

We have probed under high pressure the C-H hydrogen bonds formed by N,N(')-disubstituted imidazolium ions having PF(6) (-) and Br(-) counterions. High-pressure infrared spectral profiles, x-ray crystallographic analysis, and ab initio calculations allow us to make a vibrational assignment of these compounds. The appearance of a signal for the free-NH unit (or weakly bonded N-H...F unit) in the infrared spectrum of the PF(6) (-) salt indicates that conventional N-H...O and N-H...N hydrogen bonds do not fully dominate the packing. It is likely that the charge-enhanced C(2)-H...F interactions, combined with other weak hydrogen bonds, disturb the formation of N-H hydrogen bonds in the PF(6) (-) salt. This finding is consistent with the pressure-dependent results, which reveal that the C(2)-H...F interaction is enhanced upon increasing the pressure. In contrast to the PF(6) (-) salt, the imidazolium C-H bonds of the Br(-) salt have low sensitivity to high pressure. This finding suggests that the hydrogen bonding patterns are determined by the relative hydrogen bond acceptor strengths of the Br(-) and PF(6) (-) ions.

Paraneoplastic pemphigus in association with a retroperitoneal Castleman's disease presenting with a lichen planus pemphigoides-like eruption. A case report and review of literature

A 50-year-old man presented with severe mucosal erosions of the lips, oral cavity and perianal area, a lichen planus-like eruption on the trunk and extremities and scaly plaques of the palms and soles. The clinical impression was of Stevens--Johnson syndrome, or paraneoplastic pemphigus (PNP). Histopathology revealed vacuolar interface and lichenoid dermatitis with dyskeratosis and suprabasal acantholytic vesiculation. Direct immunofluorescence showed deposition of IgG in the intercellular space and linear deposition of C3 along the basal membrane zone. Indirect immunofluorescence revealed circulating IgG with intercellular staining of the epithelium of rat urinary bladder. Western blotting demonstrated bands of 250- and 230-kDa antigens. The clinical, histological and immunological features were consistent with the lichen planus pemphigoides variant of PNP. A retroperitoneal hyaline-vascular Castleman's disease was detected and excised. The skin lesions worsened initially after tumour resection but improved gradually, leaving extensive melanosis after cyclosporin and mycophenolate mofetil treatment.

Value of bronchoalveolar lavage combined with transbronchial lung biopsy in the diagnosis of peripheral lung cancer

BACKGROUND

Bronchoalveolar lavage (BAL) is a safe and established procedure to evaluate interstitial lung diseases and pulmonary tuberculosis. The diagnostic rate of peripheral lung cancer invisible through bronchoscopy applied by transbronchial lung biopsy (TBLB) is still low. The study was designed to evaluate whether BAL combined with TBLB might improve the positive value in the diagnosis of peripheral lung cancer.

METHODS

Thirty-seven of 72 patients who presented with peripheral lung lesions in chest radiography were proven to have a malignancy according to the final reports of cytology, histology, and clinical evidence. Each patient received BAL with or without TBLB. The patterns of chest radiography of the malignancies included 33 of infiltrative type and 4 of massive or nodular type.

RESULTS

BAL alone revealed positive malignant cells in 18 of 37 cases (sensitivity 48.6%), and the diagnostic value significantly increased to 73.0% (p < 0.05) with BAL + TBLB. In the infiltrative type of lung cancer, the diagnostic rate of BAL + TBLB (78.8%) was significantly improved compared to that of BAL alone (51.5%, p < 0.05). There was no difference of diagnostic value in those with nodular type. BAL + TBLB can achieve a very high diagnostic rate (100%) in cases of metastatic malignancy (n = 4). Only 2 patients developed bleeding post BAL + TBLB, and it was easily controlled by epinephrine spraying. One patient developed self-limited hemoptysis.

CONCLUSION

BAL + TBLB is a safe and valuable procedure to achieve a high sensitivity rate in the diagnosis of peripheral lung cancer, especially of the infiltrative type.

The value of transbronchial lung biopsy in the diagnosis of peripheral lung tumors according to cell type

BACKGROUND

Transbronchial lung biopsy (TBLB) is a useful diagnostic tool for peripheral lung tumors. However, the success rate is variable. Our study was designed to investigate the value of TBLB without fluoroscopic guidance in the diagnosis of variable cell types of peripheral lung cancers.

METHODS

A retrospective study was conducted to investigate a total of 597 patients who had undergone fiberoptic bronchoscopy for lung mass on chest X-ray in Chang Gung Memorial Hospital from January 1996 to December 1998. The lung masses were proven to be malignant by cytology and histology.

RESULTS

Of 358 patients (60.0%) proven with malignancy, 107 patients presented with peripheral lung cancer (17.9%), including 59 with adenocarcinoma, 26 with squamous cell carcinoma, 11 with poorly differentiated carcinoma, 3 with small cell carcinoma, and 8 with metastatic cancers. The diagnostic rate of peripheral lung cancer by TBLB reached 54.2%. The sensitivity rates of detection of non-small cell type by TBLB were adenocarcinoma, 50.9%; squamous cell carcinoma, 61.5%; and poorly differentiated carcinoma, 72.7%, while that of small cell carcinoma was 100%. In contrast, the sensitivity rate of TBLB for metastatic cancers was lower (12.5%) than for primary lung cancers. Repeated TBLB of peripheral lung cancers increased the diagnostic rate from 49.5% to 54.2%.

CONCLUSION

TBLB is an effective bronchoscopic sampling technique in the diagnosis of peripheral lung tumors without additional risk. The use of TBLB in the clinical routine should be encouraged.

Successful birth after intracytoplasmic sperm injection for severe male factor infertility in a woman with poor response to controlled ovarian hyperstimulation

Poor responders to controlled ovarian hyperstimulation (COH) present a clinical challenge for in vitro fertilization (IVF) and embryo transfer. The failure of IVF for the treatment of severe male-factor infertility can now be overcome by intracytoplasmic sperm injection (ICSI). The infertile couple documented in this case report came to our hospital because of bilateral tubal occlusion and severe oligoasthenospermia. After three poor-response cycles to COH, one mature oocyte was retrieved and was fertilized using ICSI. Normal fertilization ensued and one good-quality, eight-celled embryo was transferred into the woman's uterus. A single gestation was confirmed by ultrasound seven weeks after transfer. Amniocentesis was performed at 16 weeks and demonstrated a normal male fetus with a karyotype of 46,XY. The patient had a spontaneous, normal, vaginal delivery of a 2,650 g healthy male infant.

Effects of 17beta-estradiol on tachycardia-induced changes of atrial refractoriness and cisapride-induced ventricular arrhythmia

INTRODUCTION

Gender difference is known to be associated with the occurrence of arrhythmia. However, the effects of female sex hormone on atrial electrophysiology, and on the occurrence of torsades de pointes (TdP) induced by cisapride have been unclear.

METHODS AND RESULTS

Two experiments were included in this study. In experiment 1, effective refractory periods (ERPs) from five epicardial atrial sites were measured before and after rapid atrial pacing at 800 beats/min for 30 minutes in dogs with pretreatment of verapamil (n = 10), 17beta-estradiol (n = 10), or without pretreatment (n = 10, control group). In experiment 2, limb-lead ECG and monophasic action potentials in the left and right ventricles were recorded before and after each dose of cisapride (2 to 6 mg/kg) during different ventricular rates in dogs with (n = 9) and without (n = 14) concomitant administration of 17beta-estradiol (0.3 microg/kg). After 17beta-estradiol administration, there were greater atrial ERPs in the study dogs than in the control group. The atrial ERPs were shortened significantly after rapid atrial pacing, but the degree was greater in the control group than in the dogs pretreated with verapamil or 17beta-estradiol. Moreover, the recovery of atrial ERPs was faster in dogs pretreated with verapamil or 17beta-estradiol than in the control group. In experiment 2, cisapride prolonged the QT interval and biventricular APD90 and induced early afterdepolarizations (EADs) in a dose-dependent manner. However, dogs receiving cisapride combined with 17beta-estradiol had a greater increase of ventricular repolarization and a higher incidence of EADs than those receiving cisapride only. Moreover, dogs receiving cisapride combined with 17beta-estradiol (3/9, 33%) had a greater incidence of TdP than those receiving cisapride only (0/14, 0%, P < 0.05).

CONCLUSIONS

17beta-estradiol has a significant effect on atrial electrophysiology, which may be related to the prevention of atrial fibrillation. However, the high incidence of TdP in dogs receiving cisapride combined with 17beta-estradiol suggests that the female sex hormone is an important risk factor of cisapride-induced proarrhythmia.

Button batteries as foreign bodies in the nasal cavities

Two cases of foreign bodies (button batteries) in the nasal cavities were reported. The first patient was a 6-year-old girl who put a button battery into her left nostril and ulceration of the septum and inferior turbinate was found. The other patient was a 3-year-old boy, the alkaline battery caused neither septal perforation nor stenosis of the nasal meatus. All button batteries as foreign bodies in the nasal cavities should be removed immediately to prevent severe local tissue damage, resulting in late sequels, such as septal perforation or stenosis of the nasal meatus.