Making Graphene Nanoribbons Photoluminescent

We demonstrate the alignment-preserving transfer of parallel graphene nanoribbons (GNRs) onto insulating substrates. The photophysics of such samples is characterized by polarized Raman and photoluminescence (PL) spectroscopies. The Raman scattered light and the PL are polarized along the GNR axis. The Raman cross section as a function of excitation energy has distinct excitonic peaks associated with transitions between the one-dimensional parabolic subbands. We find that the PL of GNRs is intrinsically low but can be strongly enhanced by blue laser irradiation in ambient conditions or hydrogenation in ultrahigh vacuum. These functionalization routes cause the formation of sp³ defects in GNRs. We demonstrate the laser writing of luminescent patterns in GNR films for maskless lithography by the controlled generation of defects. Our findings set the stage for further exploration of the optical properties of GNRs on insulating substrates and in device geometries.

Aggressive Metaplastic Carcinoma of the Breast with Osteoclastic Giant Cells

Metaplastic carcinoma of the breast is an uncommon type of malignancy that is aggressive but can mimic other benign breast neoplastic processes on imaging. We present a case of a young female patient who presented with a rapidly progressing metaplastic carcinoma with osteoclastic giant cells subtype. There have been only very rare published reports of this pathologic subtype of metaplastic carcinoma containing osteoclastic giant cells.

Abstract P3-02-02: Impact of breast density notification laws on radiology practices: A survey of 110 radiology facilities

Purpose: Breast Density Notification laws, passed in 15 states as of April 2014, mandate that breast density information be given to patients often without guidance on modalities, patient selection or funding for supplemental screening. The purpose of this study is to assess the impact of breast density notification laws on radiology practices, specifically regarding breast cancer risk assessment and supplemental screening studies.

Methods:

We performed an anonymous 20-question web-based survey to Society of Breast Imaging radiologists using a Qualtrics Survey Tool between 8/2013-3/2014, with questions on radiology practices, breast cancer risk assessment, breast density measurement, supplemental screening tests, and support for referring physicians and patients. We compared survey results between groups using Fisher’s exact test.

Results:

121 radiologists from 110 facilities (48 academic, 43 large private hospital, 15 small private hospital and 4 other) representing 34 USA states and 1 Canadian site responded. 49% of facilities (54/110) were in states with an enacted breast density notification law. 37% of facilities (40/109) performed risk assessment, 26% (28/109) did not perform risk assessment, and 38% (41/109) did not but reported family history/other risk factors, with no significant difference in performing risk assessment between facilities with or without an enacted law (p-value 0.71). Of the 37 facilities performing risk assessment, 60% used the Gail model, 22% used the Tyrer-Cuzick model and 11% used the modified Gail model (multiple answers allowed [m.a.a.]). Of the 15 facilities performing risk assessment, 40% answered "yes" when asked whether performing risk assessment is a new task because of the density law. Breast density was estimated by only visual assessment in 98% of facilities (103/105), and by computer-based determination with or without visual assessment in 2% (2/105). Supplemental screening studies offered included magnetic resonance imaging (MRI) (88%, 92/105), handheld whole breast ultrasound (HHWBUS) (48%, 50/105), tomosynthesis (39%, 41/105), and automated WBUS (8%, 8/105) (m.a.a.). There was no significant difference in supplemental screening studies offered between facilities with or without an enacted law (p-value 0.26). In anticipation of the law, facilities implemented HHWBUS (33%, 16/48), tomosynthesis (6%, 3/48), automated WBUS (6%, 3/48) or none (60%, 29/48) (m.a.a.). Facilities with the enacted law prepared for the law with referring physician discussions (69%, 34/49), website (49%, 24/49), educational talks for referring physicians (43%, 21/49) or patients (31%, 15/49) (m.a.a.).

Conclusion:

Our survey showed variations in available supplemental screening modalities and policy implementation at each facility. There was no significant difference in performing risk assessment and supplemental screening studies between facilities with or without an enacted breast density notification law.

Citation Format: Lina Nayak, Kanae K Miyake, Yueyi Irene Liu, William R Thomas, Edward A Sickles, Bonnie N Joe, Karen Lindfors, R J Brenner, Stephen Feig, Lawrence W Bassett, Jessica W Leung, Haydee Ojeda-Fournier, Jonathan Hargreaves, Elissa Price, Jafi A Lipson, Allison W Kurian, Elyse Love, Donna D Walgenbach, Lauren Ryan, Meg Durbin, Bruce L Daniel, Linda Garcia, Debra M Ikeda. Impact of breast density notification laws on radiology practices: A survey of 110 radiology facilities [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-02-02.

Breast cancer mimic: cutaneous B-cell lymphoma presenting as an isolated breast mass

BACKGROUND

Primary cutaneous B-cell lymphoma typically localizes to the skin, and dissemination to internal organs is rare. Lymphomatous involvement of the breasts is also rare. We describe the clinical and radiological findings of an unusual case of primary cutaneous B-cell lymphoma presenting as an isolated breast mass without associated skin changes.

CASE PRESENTATION

The patient was a 55-year-old Caucasian female who initially presented with cutaneous B-cell lymphoma around her eyes and forehead with recurrence involving the skin between her breasts. Three years after terminating treatment due to a lack of symptoms, she presented for an annual screening mammogram that found a new mass in her upper inner right breast without imaging signs of cutaneous extension. On physical examination, there were no corresponding skin findings. Due to the suspicious imaging features of the mass that caused concern for primary breast malignancy, she underwent a core biopsy which revealed cutaneous B-cell lymphoma.

CONCLUSION

When evaluating patients with a systemic disease who present with findings atypical for that process, it is important to still consider the systemic disease as a potential etiology, particularly with lymphoma given its reputation as a great mimicker.

Consequences of false-positive screening mammograms

IMPORTANCE

False-positive mammograms, a common occurrence in breast cancer screening programs, represent a potential screening harm that is currently being evaluated by the US Preventive Services Task Force.

OBJECTIVE

To measure the effect of false-positive mammograms on quality of life by measuring personal anxiety, health utility, and attitudes toward future screening.

DESIGN, SETTING, AND PARTICIPANTS

The Digital Mammographic Imaging Screening Trial (DMIST) quality-of-life substudy telephone survey was performed shortly after screening and 1 year later at 22 DMIST sites and included randomly selected DMIST participants with positive and negative mammograms.

EXPOSURE

Mammogram requiring follow-up testing or referral without a cancer diagnosis.

MAIN OUTCOMES AND MEASURES

The 6-question short form of the Spielberger State-Trait Anxiety Inventory state scale (STAI-6) and the EuroQol EQ-5D instrument with US scoring. Attitudes toward future screening as measured by women's self-report of future intention to undergo mammographic screening and willingness to travel and stay overnight to undergo a hypothetical new type of mammography that would identify as many cancers with half the false-positive results.

RESULTS

Among 1450 eligible women invited to participate, 1226 (84.6%) were enrolled, with follow-up interviews obtained in 1028 (83.8%). Anxiety was significantly higher for women with false-positive mammograms (STAI-6, 35.2 vs 32.7), but health utility scores did not differ and there were no significant differences between groups at 1 year. Future screening intentions differed by group (25.7% vs 14.2% more likely in false-positive vs negative groups); willingness to travel and stay overnight did not (9.9% vs 10.5% in false-positive vs negative groups). Future screening intention was significantly increased among women with false-positive mammograms (odds ratio, 2.12; 95% CI, 1.54-2.93), younger age (2.78; 1.5-5.0), and poorer health (1.63; 1.09-2.43). Women's anticipated high-level anxiety regarding future false-positive mammograms was associated with willingness to travel overnight (odds ratio, 1.94; 95% CI, 1.28-2.95).

CONCLUSIONS AND RELEVANCE

False-positive mammograms were associated with increased short-term anxiety but not long-term anxiety, and there was no measurable health utility decrement. False-positive mammograms increased women's intention to undergo future breast cancer screening and did not increase their stated willingness to travel to avoid a false-positive result. Our finding of time-limited harm after false-positive screening mammograms is relevant for clinicians who counsel women on mammographic screening and for screening guideline development groups.

Abstract P2-01-01: Impact of California breast density notification law SB 1538 on California women and their health care providers

Purpose: To describe the impact of California Breast Density Notification law (SB 1538) on policy development, policy implementation and supplemental screening strategies within California medical facilities. SB 1538 mandates that breast density information be given to patients but provides no funding for supplemental screening, no guidance on how to triage women for supplemental screening nor which imaging modalities to use.

Methods:

As a result of the law, the California Breast Density Information Group (CBDIG) formed from academic and private practice radiologists and risk assessment experts, reviewing scientific literature and nationally recognized guidelines to provide evidence-based recommendations regarding supplemental screening in women with dense breast tissue. A survey was sent to 6 academic and 3 large private practices in California to record their experience in implementing the law.

Results: CBDIG created a public, institution-neutral, evidence-based website, “breastdensity.info”, that includes information and recommendations regarding supplemental breast screening, with triage for supplemental MRI or US based on breast cancer risk assessment using genetic or family history risk models. CBDIG facilities worked with referring health care providers to inform them of the new law, educated their staff and technologists on implementing policy, and developed notification strategies to comply with legislation.

The survey showed that all 9 facilities recommended supplemental screening based on family history models or genetic testing. 3/9 calculated breast cancer risk in the breast imaging clinic, and 2/9 emailed a risk survey to the patient. 3/9 reported risk in the radiology report, and 1/9 reported risk only if the patient was high risk. Risk assessments were performed by technologists and risk assessment health practitioners. 8/9 facilities estimated breast density by visual methods, and 1/9 by computer. All facilities performed screening breast MRI, 4/9 performed handheld screening US, and 2/9 tomosynthesis. 1/9 obtained tomosynthesis in anticipation of the law, 2/9 are trying to obtain automated whole breast US, and 3/9 are trying to obtain tomosynthesis. Facilities expressed concerns about additional false-positive biopsies produced by supplemental screenings, out-of-pocket expenses for women, and disparities (low income) in notified populations.

Conclusion: SB 1538 resulted in the formation of the CBDIG and the website, “breastdensity.info”. Our survey showed variations in imaging modalities available and policy implementation at each facility. Given that several states currently have breast density laws or have laws that will become effective in the near future, it is important for breast imagers and clinicians to be informed of the current literature, realize the variation in equipment and policies at various facilities, and develop recommendation strategies to guide patients seeking supplemental screening. We plan to follow up this survey with a larger survey of the Society of Breast Imagers at a later date.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-01-01.

A novel extracellular role for tissue transglutaminase in matrix-bound VEGF-mediated angiogenesis

The importance of tissue transglutaminase (TG2) in angiogenesis is unclear and contradictory. Here we show that inhibition of extracellular TG2 protein crosslinking or downregulation of TG2 expression leads to inhibition of angiogenesis in cell culture, the aorta ring assay and in vivo models. In a human umbilical vein endothelial cell (HUVEC) co-culture model, inhibition of extracellular TG2 activity can halt the progression of angiogenesis, even when introduced after tubule formation has commenced and after addition of excess vascular endothelial growth factor (VEGF). In both cases, this leads to a significant reduction in tubule branching. Knockdown of TG2 by short hairpin (shRNA) results in inhibition of HUVEC migration and tubule formation, which can be restored by add back of wt TG2, but not by the transamidation-defective but GTP-binding mutant W241A. TG2 inhibition results in inhibition of fibronectin deposition in HUVEC monocultures with a parallel reduction in matrix-bound VEGFA, leading to a reduction in phosphorylated VEGF receptor 2 (VEGFR2) at Tyr¹²¹⁴ and its downstream effectors Akt and ERK1/2, and importantly its association with β1 integrin. We propose a mechanism for the involvement of matrix-bound VEGFA in angiogenesis that is dependent on extracellular TG2-related activity.

Association study of FUT2 (rs601338) with celiac disease and inflammatory bowel disease in the Finnish population

Homozygosity for a nonsense mutation in the fucosyltransferase 2 (FUT2) gene (rs601338G>A) leads to the absence of ABH blood groups (FUT2 non-secretor status) in body fluids. As the secretor status has been shown to be a major determinant for the gut microbial spectrum, assumed to be important in the gut immune homeostasis, we studied the association of rs601338-FUT2 with celiac disease (CelD) and inflammatory bowel disease (IBD) in the Finnish population. Rs601338 was genotyped in CelD (n = 909), dermatitis herpetiformis (DH) (n = 116), ulcerative colitis (UC) (n = 496) and Crohn's disease (CD) (n = 280) patients and healthy controls (n = 2738). CelD showed significant genotypic [P = 0.0074, odds ratio (OR): 1.28] and recessive (P = 0.015, OR: 1.28) association with the rs601338-AA genotype. This was also found in the combined CelD+DH dataset (genotype association: P = 0.0060, OR: 1.28; recessive association: P < 0.011, OR: 1.28). The A allele of rs601338 showed nominal association with dominant protection from UC (P = 0.044, OR: 0.82) and UC+CD (P = 0.035, OR: 0.84). The frequency of non-secretors (rs601338-GG) in controls, CelD, DH, UC and CD datasets was 14.7%, 18%, 18.1%, 14.3% and 16.1%, respectively. No association was evident in the DH or CD datasets alone. In conclusion, FUT2 non-secretor status is associated with CelD susceptibility and FUT2 secretor status may also play a role in IBD in the Finnish population.

TU-E-217BCD-03: Characterization of Anatomical Noise in Mammography, Tomosynthesis and Breast CT

PURPOSE

The role of breast density in cancer detection has been well characterized, and newer modalities such as breast tomosynthesis and breast CT (bCT) were developed to improve cancer detection in the dense breast by reducing anatomical complexity. Anatomical noise was characterized on a small cohort of patient images and compared across digital mammography, tomosynthesis, and bCT images.

METHODS AND MATERIALS

An IRB-approved and HIPPA-compliant clinical study was performed on women undergoing breast biopsy, and mammography, tomosynthesis, and bCT were performed on both breasts immediately prior to biopsy. A total of 23 women participated in this study, and the unaffected breast (no lesion) was evaluated. A total of 1000 regions of interest were sampled on each image data set, and the 2D noise power spectrum (NPS) was evaluated. This was radially averaged to produce a 1D NPS, and the NPS was fit to a power law: ln{NPS(f)} = alpha+betaxln(f), over an anatomically-relevant range of spatial frequencies. The slope, beta, was averaged across patients and compared between modalities and projections.

RESULTS

The value of beta was determined for bCT data sets, and they were 1.75 (0.424), 1.83 (0.352), and 1.79 (0.397), for the coronal, sagittal and axial views, respectively. For tomosynthesis, beta was 3.06 (0.361) and 3.10 (0.315) for the CC and MLO views, respectively. For mammography, these values were 3.17 (0.226) and 3.30 (0.236), for the CC and MLO views, respectively. The values of beta for breast CT were significantly different than those for tomosynthesis and mammography (p<0.001, all 12 comparisons).

CONCLUSIONS

The results of this investigation demonstrate that the anatomical complexity of the breast, as characterized by the parameter beta, is statistically similar between mammography and tomosynthesis, a somewhat surprising finding. The breast CT image data, however, demonstrate a statistically-significant reduction in beta across all projections. Funded in part by Hologic Corporation and by a grant from the National Institute of Biomedical Imaging and Bioengineering, EB002138.

Extracellular transglutaminase 2 has a role in cell adhesion, whereas intracellular transglutaminase 2 is involved in regulation of endothelial cell proliferation and apoptosis

OBJECTIVE

Transglutaminase 2 (TG2) is a multifunctional protein with an important role in vascular biology, where it is involved in cell-matrix interaction, cell attachment and cell population expansion. In efforts to elucidate the role of TG2 in endothelial cell biology, in this study, we measured several endothelial cell characteristics in cells where TG2 was specifically knocked down by RNAi.

MATERIALS AND METHODS

The effect of small interfering RNA (siRNA)-TG2 on human umbilical vein endothelial cells was studied. Adhesion and cell viability were assessed by chemical reduction of MTT, and cell proliferation was analysed by flow cytometry. Apoptosis was evaluated by annexin V/PI dual staining and protein expression level was assayed by western blotting.

RESULTS

We found that siRNA-TG2 reduced endothelial cell number, lead to cell adhesion deficiency, cell cycle arrest in G₁ phase and induction of apoptosis. Our results show that exogenously added TG2 could reverse loss of adhesion but did not overcome the defect in cell proliferation, nor could it inhibit siRNA-TG2-induced apoptosis.

CONCLUSION

We conclude that TG2 loss in endothelial cells causes reduction in cell number as a result of cell cycle arrest, flaws in adhesion and induction of apoptosis. Our results imply that reduction in cell number and increased apoptosis in response to TG2 silencing is independent of the cell adhesion process. Altogether, our findings underline the significance of TG2 in endothelial cell cycle progression and cell survival, in vitro.

Epithelial transport and deamidation of gliadin peptides: a role for coeliac disease patient immunoglobulin A

In coeliac disease, the intake of dietary gluten induces small-bowel mucosal damage and the production of immunoglobulin (Ig)A class autoantibodies against transglutaminase 2 (TG2). We examined the effect of coeliac patient IgA on the apical-to-basal passage of gluten-derived gliadin peptides p31-43 and p57-68 in intestinal epithelial cells. We demonstrate that coeliac IgA enhances the passage of gliadin peptides, which could be abolished by inhibition of TG2 enzymatic activity. Moreover, we also found that both the apical and the basal cell culture media containing the immunogenic gliadin peptides were able to induce the proliferation of deamidation-dependent coeliac patient-derived T cells even in the absence of exogenous TG2. Our results suggest that coeliac patient IgA could play a role in the transepithelial passage of gliadin peptides, a process during which they might be deamidated.

Degradation of coeliac disease-inducing rye secalin by germinating cereal enzymes: diminishing toxic effects in intestinal epithelial cells

Currently the only treatment for coeliac disease is a lifelong gluten-free diet excluding food products containing wheat, rye and barley. There is, however, only scarce evidence as to harmful effects of rye in coeliac disease. To confirm the assumption that rye should be excluded from the coeliac patient's diet, we now sought to establish whether rye secalin activates toxic reactions in vitro in intestinal epithelial cell models as extensively as wheat gliadin. Further, we investigated the efficacy of germinating cereal enzymes from oat, wheat and barley to hydrolyse secalin into short fragments and whether secalin-induced harmful effects can be reduced by such pretreatment. In the current study, secalin elicited toxic reactions in intestinal Caco-2 epithelial cells similarly to gliadin: it induced epithelial cell layer permeability, tight junctional protein occludin and ZO-1 distortion and actin reorganization. In high-performance liquid chromatography and mass spectroscopy (HPLC-MS), germinating barley enzymes provided the most efficient degradation of secalin and gliadin peptides and was thus selected for further in vitro analysis. After germinating barley enzyme pretreatment, all toxic reactions induced by secalin were ameliorated. We conclude that germinating enzymes from barley are particularly efficient in the degradation of rye secalin. In future, these enzymes might be utilized as a novel medical treatment for coeliac disease or in food processing in order to develop high-quality coeliac-safe food products.

Neuropeptide S receptor 1 expression in the intestine and skin--putative role in peptide hormone secretion

Neuropeptide S receptor 1 (NPSR1) was recently found to be genetically associated with inflammatory bowel disease in addition to asthma and related traits. Epithelia of several organs express NPSR1 isoforms A and B, including the intestine and the skin, and NPSR1 appears to be upregulated in inflammation. In this study, we used cell lines and tissue samples to characterize the expression of NPSR1 and its ligand neuropeptide S (NPS) in inflammation. We used polyclonal and monoclonal antibodies to investigate the expression of NPS and NPSR1 in intestinal diseases, such as celiac disease and food allergy, and in cutaneous inflammatory disorders. We found that NPSR1-A was expressed by the enteroendocrine cells of the gut. Overall, the expression pattern of NPS was similar to its receptor suggesting an autocrine mechanism. In an NPSR1-A overexpressing cell model, stimulation with NPS resulted in a dose-dependent upregulation of glycoprotein hormone, alpha polypeptide (CGA), tachykinin 1 (TAC1), neurotensin (NTS) and galanin (GAL) encoding peptide hormones secreted by enteroendocrine cells. Because NPSR1 was also expressed in macrophages, neutrophils, and intraepithelial lymphocytes, we demonstrated that stimulation with the pro-inflammatory cytokines tumour necrosis factor alpha and interferon gamma increased NPSR1 expression in the THP-1 monocytic cells. In conclusion, similar to other neuropeptides and their receptors, NPSR1 signalling might play a dual role along the gut-brain axis. The NPS/NPSR1 pathway may participate in the regulation of the peptide hormone production in enteroendocrine cells of the small intestine.

Dependence of resonant light transmission properties of a subwavelength slit on structural parameters

We perform a systematic study of the resonant transmission of visible and near-infrared (NIR) light through a single subwavelength slit in a gold film when the parameters defining the structure are varied. We further examine the optical properties of a related nanostructure, a cross with subwavelength sized features. Focused ion beam (FIB) milling was used to fabricate nanoslits and crosses with linewidths ranging from 26 nm to 85 nm. The dimensions of the structure are found to affect strongly the transmittance spectrum. For example, as the slit becomes narrower the resonance is observed to both sharpen and shift significantly. Our observations are in good agreement with our earlier numerical calculations on the optical properties of nanoslits.

Live probiotic Bifidobacterium lactis bacteria inhibit the toxic effects induced by wheat gliadin in epithelial cell culture

Wheat gliadin induces severe intestinal symptoms and small-bowel mucosal damage in coeliac disease patients. At present, the only effective treatment for the disease is a strict life-long gluten-free diet. In this study we investigated whether probiotics Lactobacillus fermentum or Bifidobacterium lactis can inhibit the toxic effects of gliadin in intestinal cell culture conditions. The ability of live probiotics to inhibit peptic-tryptic digested gliadin-induced damage to human colon cells Caco-2 was evaluated by measuring epithelial permeability by transepithelial resistance, actin cytoskeleton arrangements by the extent of membrane ruffling and expression of tight junctional protein ZO-1. B. lactis inhibited the gliadin-induced increase dose-dependently in epithelial permeability, higher concentrations completely abolishing the gliadin-induced decrease in transepithelial resistance. The same bacterial strain also inhibited the formation of membrane ruffles in Caco-2 cells induced by gliadin administration. Furthermore, it also protected the tight junctions of Caco-2 cells against the effects of gliadin, as evinced by the pattern of ZO-1 expression. We conclude thus that live B. lactis bacteria can counteract directly the harmful effects exerted by coeliac-toxic gliadin and would clearly warrant further studies of its potential as a novel dietary supplement in the treatment of coeliac disease.

Coeliac disease-specific autoantibodies targeted against transglutaminase 2 disturb angiogenesis

Coeliac disease is characterized by immunoglobulin-A (IgA)-class autoantibodies targeted against transglutaminase 2 (TG2), a multi-functional protein also with a role in angiogenesis. These antibodies are present in patient serum but are also found bound to TG2 below the epithelial basement membrane and around capillaries in the small intestinal mucosa. Based on these facts and the information that the mucosal vasculature of coeliac patients on a gluten-containing diet is disorganized, we studied whether the coeliac disease-specific autoantibodies targeted against TG2 would disturb angiogenesis. The effects of coeliac disease-specific autoantibodies on in vitro angiogenesis were studied in angiogenic cell cultures. The binding of the antibodies to cells, endothelial sprouting, migration of both endothelial and vascular mesenchymal cells, the integrity of the actin cytoskeleton in both cell types and the differentiation of vascular mesenchymal cells were recorded. In vitro, IgA derived from coeliac disease patients on a gluten-containing diet binds to surface TG2 on endothelial and vascular mesenchymal cells and this binding can be inhibited by the removal of TG2. In addition, coeliac disease-specific autoantibodies targeting TG2 disturb several steps of angiogenesis: endothelial sprouting and the migration of both endothelial and vascular mesenchymal cells. Furthermore, the autoantibodies cause disorganization of the actin cytoskeleton in both capillary cell types that account most probably for the defective cellular migration. We conclude that coeliac disease-specific autoantibodies recognizing TG2 inhibit angiogenesis in vitro. This disturbance of the angiogenic process could lead in vivo to the disruption of the mucosal vasculature seen in coeliac disease patients on a gluten-containing diet.

Dipole-dipole interaction between molecules mediated by a chain of silver nanoparticles

We study the dipole-dipole coupling between two fluorescent molecules in the presence of a chain of metallic nanoparticles. We analyze the spectral behavior of the coupling strength and its dependence on the molecular orientation. Our results show that for certain resonant wavelengths the coupling strength between the molecules is greatly enhanced and is strongly polarization sensitive. We also demonstrate how metallic nanoparticles can be utilized in implementing a polarization-sensitive coupler.

Persistent small bowel mucosal villous atrophy without symptoms in coeliac disease

BACKGROUND

Refractory sprue with malabsorption carries a risk of lymphoma.

AIM

To examine whether a good clinical but poor histological response during a strict gluten-free diet predicts a poor outcome.

METHODS

The study involved all coeliac patients who showed no histological recovery within 2 years on a strict gluten-free diet. Small intestinal biopsy and bone mineral density were investigated in 2001 and clinical features were followed up until 2005. The results were compared to those in 18 coeliac patients with a good histological recovery.

RESULTS

Thirteen coeliac patients had persistent small intestinal villous atrophy despite maintaining gluten-free diet. All had demonstrated a good clinical response. Osteoporosis was found in 58% and 22% of the non-responders and responders, respectively (P = 0.04). In 2005, two of the non-responders had developed symptomatic refractory sprue, one died of lymphoma and one of carcinoid tumour, and one gastric adenocarcinoma was operated. None of the 18 controls had developed refractory sprue or malignancy. The frequency of histological non-responsive disease was 1.9%.

CONCLUSIONS

Persistent villous atrophy in adult coeliac disease, even in the absence of symptoms, carries a risk of subsequent severe complications. The follow-up biopsy is important in detecting these individuals.

Persistent small bowel mucosal villous atrophy without symptoms in coeliac disease

BACKGROUND

Refractory sprue with malabsorption carries a risk of lymphoma.

AIM

To examine whether a good clinical but poor histological response during a strict gluten-free diet predicts a poor outcome.

METHODS

The study involved all coeliac patients who showed no histological recovery within 2 years on a strict gluten-free diet. Small intestinal biopsy and bone mineral density were investigated in 2001 and clinical features were followed up until 2005. The results were compared to those in 18 coeliac patients with a good histological recovery.

RESULTS

Thirteen coeliac patients had persistent small intestinal villous atrophy despite maintaining gluten-free diet. All had demonstrated a good clinical response. Osteoporosis was found in 58% and 22% of the non-responders and responders, respectively (P = 0.04). In 2005, two of the non-responders had developed symptomatic refractory sprue, one died of lymphoma and one of carcinoid tumour, and one gastric adenocarcinoma was operated. None of the 18 controls had developed refractory sprue or malignancy. The frequency of histological non-responsive disease was 1.9%.

CONCLUSIONS

Persistent villous atrophy in adult coeliac disease, even in the absence of symptoms, carries a risk of subsequent severe complications. The follow-up biopsy is important in detecting these individuals.

SAP30L interacts with members of the Sin3A corepressor complex and targets Sin3A to the nucleolus

Histone acetylation plays a key role in the regulation of gene expression. The chromatin structure and accessibility of genes to transcription factors is regulated by enzymes that acetylate and deacetylate histones. The Sin3A corepressor complex recruits histone deacetylases and in many cases represses transcription. Here, we report that SAP30L, a close homolog of Sin3-associated protein 30 (SAP30), interacts with several components of the Sin3A corepressor complex. We show that it binds to the PAH3/HID (Paired Amphipathic Helix 3/Histone deacetylase Interacting Domain) region of mouse Sin3A with residues 120-140 in the C-terminal part of the protein. We provide evidence that SAP30L induces transcriptional repression, possibly via recruitment of Sin3A and histone deacetylases. Finally, we characterize a functional nucleolar localization signal in SAP30L and show that SAP30L and SAP30 are able to target Sin3A to the nucleolus.

Detection and spectroscopy of gold nanoparticles using supercontinuum white light confocal microscopy

We combine confocal microscopy using supercontinuum laser illumination and an interferometric detection technique to identify single nanoparticles of diameter below 10 nm. Spectral analysis of the signal allows us to record the plasmon resonance of a single nanoparticle. Our results hold great promise for fundamental studies of the optical properties of single metal clusters and for their use in biophysical applications.

Spectral analysis of resonant transmission of light through a single sub-wavelength slit

We analyze the spectral properties of resonant transmission of light through a sub-wavelength slit in a metal film. We show that the enhanced transmission can be understood in terms of interfering surface-wave-like modes propagating in the slit. We characterize the effect of geometrical and material properties of the slit on the transmission spectrum. Furthermore, we show that the wavelength of the transmission resonance strongly depends on the surrounding medium. This effect may be utilized in sensors, imaging, and the detection of, e.g. biomolecules.

Blisters in the small intestinal mucosa of coeliac patients contain T cells positive for cyclooxygenase 2

BACKGROUND AND AIMS

Coeliac disease is characterised by atrophy of the villi and hyperplasia of the crypts in the mucosa of the small intestine. It is caused by an environmental trigger, cereal gluten, which induces infiltration of the mucosa by inflammatory cells. We hypothesised that these inflammatory cells express cyclooxygenase 2 (COX-2), an enzyme that contributes to the synthesis of pro and anti-inflammatory prostaglandins and is known to be expressed at sites of inflammation in the stomach and colon. We have investigated expression of COX-2 in the coeliac disease affected small intestinal mucosa where it may be an indicator of either disease induction or mucosal restoration processes.

PATIENTS AND METHODS

Small intestinal biopsy samples from 15 coeliac patients and 15 non-coeliac individuals were stained immunohistochemically for COX-2. Samples from 10 of the patients were also stained after these patients had been on a gluten free diet for 6-24 months. Various cell type marker antigens were used for immunohistochemical identification of the type of cell that expressed COX-2. To further verify colocalisation of the cell type marker and COX-2, double immunoperoxidase and immunofluorescence methods were employed. Immunoelectron microscopy was used to investigate the subcellular location of COX-2.

RESULTS

In all samples taken from coeliac patients, clusters of cells with strong immunoreactivity for COX-2 were found in those areas of the lamina propria where the epithelium seemed to blister or was totally detached from the basement membrane. These clusters were reduced in number or totally absent in samples taken after a gluten free diet. No such clusters were seen in any control samples. The density of COX-2 positive cells lining the differentiated epithelium decreased significantly from 13.5 (5.1) cells/10(5) microm(2) (mean (SD)) in the untreated patient samples to 6.5 (2.0) cells/10(5) microm(2) after a gluten free diet (p<0.001), and was 3.3 (1.9) cells/10(5) microm(2) in control samples (p<0.001 compared with untreated or diet treated coeliac samples). Staining for COX-2 was localised to CD3+ T cells and CD68+ macrophages in the mucosal lesions but not all of these cells were positive for COX-2. Immunoelectron microscopy revealed that the ultrastructure of the COX-2 positive cells resembled that of lymphocytes, and the immunoreaction was localised to the rough endoplasmic reticulum and the nuclear envelope.

CONCLUSIONS

Our results show that in coeliac disease, blistering of small intestinal epithelial cells is associated with accumulation of COX-2 positive T cells, and the number of these cells decreases after a gluten free diet. These observations suggest that COX-2 mediated prostanoid synthesis contributes to healing of the coeliac mucosa and may be involved in maintenance of intestinal integrity.

Differentially expressed CC3/TIP30 and rab11 along in vivo and in vitro intestinal epithelial cell crypt-villus axis

We have previously shown that transforming growth factor-beta1 (TGF-beta1) is involved in the fibroblast-induced organization and differentiation of transformed phenotypically crypt-like T84 intestinal epithelial cells into absorptive enterocyte-like cells, when cultured within a three-dimensional collagen gel. We have used differential display polymerase chain reaction to find genes that are either up- or downregulated by TGF-beta in the T84 cells cultured in three-dimensional collagen gel and then studied how these in vitro differentially expressed genes are expressed in vivo in the small intestinal crypt-villus axis. We found that the TGF-beta1-treated T84 cells, like the villus tip enterocytes, expressed increased levels of CC3/TIP30 when compared to the undifferentiated cells. Furthermore, the expression of rab11 showed the opposite pattern, being higher in the undifferentiated cells both in vivo and in vitro. We conclude that the three-dimensional cell culture model where TGF-beta induces organization and differentiation of secretory T84 epithelial cells makes it possible to find up- and downregulated transcripts that also play a role in the human small intestinal crypt-villus axis.

Identification of novel transcription factor-like gene from human intestinal cells

Intestinal crypt epithelial T84 cells form luminal structures and differentiate to intestinal enterocyte-like cells in response to IMR-90 fibroblast-secreted transforming growth factor-beta when grown within three-dimensional collagen gel. In search of TGF-beta regulated genes involved in this differentiation process, we isolated a TGF-beta downregulated cDNA, human homologue of rat apoptosis antagonising transcription factor that codes for a 560-amino-acid protein. Human AATF-mRNA was expressed at high levels in human brain, heart, thymus, kidney, and placenta while in skeletal muscle and colon the expression was lower. The gene was mapped to chromosome 17q11.2-q12.

Results of treatment of stage IA and IIA Hodgkin's disease

This study analyzed the 5 year actuarial survival and disease-free survival of 122 patients with Stage IA and IIA Hodgkin's disease, (108 patients laparotomy staged) treated with mantle and paraaortic irradiation from 1975 to 1981. Prognostic subgroups and patterns of treatment failure were investigated. The 5 year actuarial survival and disease-free survival was 91% and 75% respectively for the entire group. For Stage IA patients, the 5 year survival and disease-free survival was 92% and 86% respectively, whereas for those in Stage IIA the respective figures were 86% and 65%. Individuals with greater than four sites of involvement at initial presentation; extensive mediastinal adenopathy; hilar or extramediastinal extension to lung, pleura or pericardium, had a poorer 5 year actuarial disease-free survival (43%-60%) than those without these factors (70%-85%). Of the 122 patients, there were 26 relapses: nine infield failures; two concurrent infield and systemic failures; nine marginal recurrences, and three relapses occurring systemically and three in nodal groups not irradiated. Following relapse, 17 patients were salvaged with chemotherapy. Two patients are alive with disease and seven patients died of Hodgkin's disease. Patients with less extensive mediastinal adenopathy and supradiaphragmatic nonmediastinal presentations can be satisfactorily treated with mantle and paraaortic irradiation, whereas patients with extensive mediastinal adenopathy receive six cycles of multiagent chemotherapy before irradiation.

Results of treatment of stage 3A Hodgkin's disease

From 1975 to 1981, 38 patients with Stage 3A Hodgkin's disease (35 patients pathologically staged) underwent mantle and para-aortic irradiation, and in 36 patients this was preceded or followed by at least six cycles of multiagent chemotherapy. Both the 5-year actuarial survival and disease-free survival for all 38 patients were 83%. There have been six treatment failures: two patients have relapsed within irradiated nodal groups, one patient in apical pericardial lymph nodes as a marginal recurrence, one patient concurrently infield and in unirradiated nodal groups, and two patients systemically (concurrently in unirradiated nodal groups). Of these six relapses, three patients have died of Hodgkin's disease, one patient has been salvaged, and two patients currently are under treatment for salvage. One patient has developed acute nonlymphocytic leukemia and died of this disease. Extensive disease, as estimated by the number of sites of involvement at presentation, degree of splenic involvement, extent of intra-abdominal disease or mediastinal involvement, did not reveal statistically significant prognostic subgroups for relapse. It is currently recommended that patients with Stage 3A Hodgkin's disease receive six cycles of multiagent chemotherapy and mantle and para-aortic irradiation.

Spring hookwire breast lesion localizer: use with rigid-compression mammographic systems

Modifications have been made in the spring hookwire system to facilitate accurate three-dimensional placement and to aid surgeons in gauging the location of the hook with respect to a breast lesion. Difficulties in placement of the needle created by rigid compression systems can be overcome by using a combination of a fenestrated compression plate and a spot-compression device.