Impact of in-hospital medical management for COVID-19 pandemic on door-to-balloon time in patients with ST-elevation myocardial infarction

Background

Delayed door-to-balloon (DTB) time and deterioration of in-hospital mortality during the coronavirus disease 2019 (COVID-19) pandemic have been reported. Little is known about the impact of changes in in-hospital medical management before primary percutaneous coronary intervention (PCI) for COVID-19 such as screening test (antigen or polymerase chain reaction (PCR) tests, chest CT for excluding the pneumoniae) and primary PCI under full personal protective equipment (PPE) on DTB time and in-hospital mortality.

Purpose

The purpose of this study was to evaluate the impact of in-hospital medical management for COVID-19 on DTB time and in-hospital mortality during COVID-19 pandemic period.

Methods

We compared DTB time and in-hospital mortality of 502 ST-elevation myocardial infarction (STEMI) patients during COVID-19 pandemic (February 2020 and January 2021) with 2035 STEMI patients before pandemic (February 2016 and January 2020) using date from Mie ACS registry, a retrospective and multicenter registry.

Results

The COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was performed on 173/502 (34.5%) patients (antigen or PCR tests; 39 (7.8%), chest CT; 156 (31.3%), full PPE; 11 (2.2%)). These patients had lower rate of achievement of DTB time ≤90 min compared with others (Figure 1A). Moreover, In-hospital management of COVID-19 screening tests and/or primary PCI under full PPE was an independent factor of DTB time>90 min with odds ratio of 1.94 (95% confidential interval: 1.37–2.76, p<0.001). In addition, in-hospital mortality of those patients was higher compared with others (Figure 1B).

Conclusion

In-hospital medical management for COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was the independent factor of DTB time>90 min. This study reinforces the need to focus efforts on shortening DTB time, while controlling the epidemic of infection.

Funding Acknowledgement

Type of funding sources: None.

The role of endothelin B receptor in bone modelling during orthodontic tooth movement: a study on ETB knockout rats

The endothelin system has an important role in bone modelling during orthodontic tooth movement (OTM); however, little is known about the involvement of endothelin B receptors (ET_B) in this process. The aim of this study was to evaluate the role of ET_B in bone modelling during OTM using ET_B knockout rats (ET_B-KO). Thirty-two male rats were divided into 4 groups (n = 8 per group): the ET_B-KO appliance group, ET_B-KO control group, wild type (ET_B-WT) appliance group, and ET_B-WT control group. The appliance consisted of a super-elastic closed-coil spring placed between the first and second left maxillary molar and the incisors. Tooth movement was measured on days 0 and 35, and maxillary alveolar bone volume, osteoblast, and osteoclast volume were determined histomorphometrically on day 35 of OTM. Next, we determined the serum endothelin 1 (ET-1) level and gene expression levels of the osteoclast activity marker cathepsin K and osteoblast activity markers osteocalcin and dentin matrix acidic phosphoprotein 1 (DMP1) on day 35. The ET_B-KO appliance group showed significantly lower osteoblast activity, diminished alveolar bone volume and less OTM than the ET_B-WT appliance group. Our results showed that ET_B is involved in bone modelling in the late stage of OTM.

Direct Observation of Long-Chain Branches in a Low-Density Polyethylene

Low-density polyethylene (LDPE) has short-chain branch (SCB) and long-chain branch (LCB). In particular, the influence of the structure of LCBs on polymer properties is remarkable; however, it has been difficult to precisely analyze LCB structures. In this study, we measured the chain length of LCBs and the distance between branch points of LDPE by atomic force microscopy. Consequently, three LCBs were confirmed in a main chain of 162 nm, and their length were measured as 10, 31, and 18 nm. The positions of the LCBs were 33, 70, and 78 nm from the main-chain end.

[A CASE REPORT OF FUNGUS BALL FOUND DURING TRANSURETHRAL URETEROLITHOTOMY]

Herein we report the confirmation of fungus balls (circular collections of C.tropicalis) during a transurethral ureterolithotomy, which is as far as we know the first reported instance. A-61-year old man was referred to the urology department with bilateral ureteral calculi. Initially a transurethral ureterolithotomy was attempted but residual stones existed. During the second operation, we found numerous white fluffy material in the renal pelvis. Because of them, we were unable to have a clear field of vision to complete operation. During the third operation, we found the fungus balls again and cultured them. Cultures yielded C.tropicalis.

Depth profiling of APTES self-assembled monolayers using surface-enhanced confocal Raman microspectroscopy

The internal structure of self-assembled monolayers (SAMs) such as 3-aminopropyltriethoxysilane (APTES) fabricated on a glass substrate is difficult to characterize and analyze at nanometer level. In this study, we employed surface-enhanced Raman spectroscopy (SERS) to study the internal molecular structure of APTES SAMs. The sample APTES SAMs were deposited with Ag nanoparticles to enhance the Raman signal and to obtain subtler structure information, which were supported by density functional theory calculations. In addition, in order to carry out high-resolution analysis, especially for vertical direction, a fine piezo electric positioner was used to control the depth scanning with a step of 0.1nm. We measured and distinguished the vertical Raman intensity variations of specific groups in APTES, such as Ag/NH₂, CH₂, and SiO, with high resolution. The interfacial bond at the two interfaces of Ag-APTES and APTES-SiO₂ was identified. Moreover, APTES molecule orientation was demonstrated to be inhomogeneous from frequency shift.

[Case of a Plasmacytoid Urothelial Carcinoma Identified Due to the Hardening of the Abdominal Wall]

The patient was a 75 year-old male. Noticing areas of hardening in the lower abdomen, and consequently feelings of systemic fatigue and difficulty in walking, the patient visited a clinic and was diagnosed with kidney failure prior to the visit to our clinic. Computed tomography and magnetic resonance imaging showed thickness of the rectus abdominis muscle and the bladder wall, and bilateral hydronephrosis was also identified. As no explicit tumor was identified in the bladder, the patient underwent biopsies of the abdominal wall and bladder membrane mucous, and was diagnosed with a plasmacytoid urothelial carcinoma primarily developed in the bladder. The patient displayed a poor general state of health and died five months after the diagnosis. It is known that plasmacytoid urothelial carcinomas progress rapidly and the prognosis is poorer than for the micropapillary variant. It is important to obtain a tissue specimen in the early stage of this disease because there are cases in which no explicit tumor can be identified. Furthermore, the value of carbohydrate antigen (CA) 19-9 of the patient was much higher than would be expected as normal at the first visit. It kept rising during the follow-up and was useful as a marker to indicate the progress of the disease.

Pro-Tumorigenic Phosphorylation of p120 Catenin in Renal and Breast Cancer

Altered protein expression and phosphorylation are common events during malignant transformation. These perturbations have been widely explored in the context of E-cadherin cell-cell adhesion complexes, which are central in the maintenance of the normal epithelial phenotype. A major component of these complexes is p120 catenin (p120), which binds and stabilizes E-cadherin to promote its adhesive and tumor suppressing function. However, p120 is also an essential mediator of pro-tumorigenic signals driven by oncogenes, such as Src, and can be phosphorylated at multiple sites. Although alterations in p120 expression have been extensively studied by immunohistochemistry (IHC) in the context of tumor progression, little is known about the status and role of p120 phosphorylation in cancer. Here we show that tyrosine and threonine phosphorylation of p120 in two sites, Y228 and T916, is elevated in renal and breast tumor tissue samples. We also show that tyrosine phosphorylation of p120 at its N-terminus, including at the Y228 site is required for its pro-tumorigenic potential. In contrast, phosphorylation of p120 at T916 does not affect this p120 function. However, phosphorylation of p120 at T916 interferes with epitope recognition of the most commonly used p120 antibody, namely pp120. As a result, this antibody selectively underrepresents p120 levels in tumor tissues, where p120 is phosphorylated. Overall, our data support a role of p120 phosphorylation as a marker and mediator of tumor transformation. Importantly, they also argue that the level and localization of p120 in human cancer tissues immunostained with pp120 needs to be re-evaluated.

Nomogram for overall survival of Japanese patients with bone-metastatic prostate cancer

Background

We analyzed the relationship between prostate cancer outcomes and pretreatment clinical factors and developed a prognostic nomogram of overall survival (OS) of patients with bone metastasis.

Methods

From 1993 to 2011, 463 consecutive patients were treated for bone-metastatic prostate cancer. Data sets from 361 patients were used to develop a nomogram (training data), and data sets of 102 patients were used for validation of the nomogram (validation data). Using the external validation data set, the nomogram was assessed for discriminatory ability, and the predictions were assessed for calibration accuracy by plotting actual survival against predicted risk.

Results

Of the 361 patients in the training data set, 205 (56.8%) patients died, 169 (46.8%) deaths of which were due to prostate cancer. The median follow-up period was 55.2 months. In the multivariate analysis, patient age, serum prostate-specific antigen level, clinical T stage, extent of disease on bone scan, and biopsy Gleason sum were independent prognostic factors. We developed a prognostic model comprising these five factors for patients with bone-metastatic prostate cancer. This nomogram can be used to estimate 1-, 3-, and 5-year survival probability. External validation of this model using 102 validation data sets showed reasonable accuracy (concordance index, 0.719).

Conclusion

Our pretreatment prognostic nomogram might be useful for Japanese patients with bone-metastatic prostate cancer.

Uremic serum contains humoral factor(s) larger than fifty kilodaltons which suppresses endothelin production in cultured endothelial cells

Direct effects of human uremic serum on the production of endothelin-1 in cultured porcine endothelial cells were examined in this study. Uremic serum decreased the level of monomeric endothelin-1 secreted into the culture medium by endothelial cells. This effect occurred at a transcriptional step because uremic serum decreased the endothelin-1 mRNA level in those cells. For the partial characterization of this inhibitory activity, uremic serum was fractionated with a centricut column. Uremic serum contains humoral factor(s) larger than 50 kD which suppress the endothelin-1 mRNA level in cultured endothelial cells.

[Renal arteriovenous fistula (AVF) following nephrectomy : a case of arterial embolization treatment]

The patient was a 78-year-old female. At the age of 76, the patient had undergone computed tomographic scanning for left lower abdominal pain. A retroperitoneal mass was detected on the right side of the abdomen. The patient had been subject to right nephrectomy due to renal calculus at the age of 33. With Doppler echocardiography and magnetic resonance imaging (MRI), based on the nephrectomy the patient was diagnosed with a renal arteriovenous fistula developed in the right renal bed. Following the wishes of the patient a follow-up examination was conducted. Because of poor heart condition and renal dysfunction, percutaneous arterial embolization was performed. After the embolization, the heart condition and renal dysfunction indicators improved and the blood flow in the arteriovenous fistula disappeared. Cases of renal arteriovenous fistulae after nephrectomy are rare, with only 90 reported worldwide, and percutaneous arterial embolization has been used as the first choice of treatment in recent years.

[Effect of prophylactic intravesical instillation of pirarubicin to prevent recurrent bladder tumors following nephroureterectomy for upper urinary tract cancer]

We retrospectively evaluated 23 patients who had been administered pirarubicin by intravesical instillation once weekly for 5 weeks, after undergoing surgery for upper urinary tract cancer between May 2003 and October 2008. We compared their clinical records with those of 19 patients with upper urinary tract cancer subjected to nephroureterectomy between 1998 and 2008, and who did not receive intravesical instillation of pirarubicin. This prophylactic therapy was well tolerated and contributed to reduce the rate of bladder recurrence. The non-recurrence rate at 2 years was 87.0% in the instillation group and 68.4% in the non-instillation group (P＝0.0025). The overall analysis of the study population did not reveal any statistically significant risk factors of bladder recurrence.

[A case report of eosinophilic funiculitis difficult to distinguish from incarceration of inguinal hernia]

A 45-year-old man visited our emergency room with left inguinal pain, mass and high-grade fever. Emergency surgery was performed with a primary diagnosis of left inguinal hernia. Although there was no hernia, there was a mass involving the spermatic cord in the left inguinal canal. We performed high orchiectomy because of the possibility of malignancy. Pathological findings showed eosinophilic infiltration in the mass lesion. An allergic inflammation was suspected to have occurred in the spermatic cord. His postoperative course was good.

Animals lacking endothelin-converting enzyme-2 are deficient in learning and memory

Endothelin-converting enzyme (ECE)-2 is a metalloprotease that possesses many properties consistent with it being a neuropeptide-processing enzyme. This protease is found primarily in neural tissues, with high levels of expression in midbrain, cerebellum, hypothalamus, frontal cortex and spinal cord and moderate levels in hippocampus and striatum. To evaluate its role in neural function, mice have been generated lacking this enzyme. Physical appearance, autonomic reflexes, motor co-ordination, balance, locomotor activity and spontaneous emotional responses appear normal in these knockout (KO) mice. However, these mutants display deficits in learning and memory as evidenced by marked impairment in the Morris water maze. Knockout mice are also deficient in object recognition memory where they show delays in discerning changes in object location and in recognizing the introduction of a novel object. In this study, perseveration appears to interfere with learning and memory. Finally, mutants are impaired in social transmission of food preference where they show poor short-term memory and perturbations in long-term memory; the latter can be ameliorated by reminder cues. As ECE-2 has been implicated in Alzheimer's disease, the deficits in learning and memory in the KO mice may provide unique insights into processes that may contribute to this disease and possible other disorders of cognition.

Narcoleptic orexin receptor knockout mice express enhanced cholinergic properties in laterodorsal tegmental neurons

Pharmacological studies of narcoleptic canines indicate that exaggerated pontine cholinergic transmission promotes cataplexy. As disruption of orexin (hypocretin) signaling is a primary defect in narcolepsy with cataplexy, we investigated whether markers of cholinergic synaptic transmission might be altered in mice constitutively lacking orexin receptors (double receptor knockout; DKO). mRNA for Choline acetyltransferase (ChAT), vesicular acetylcholine transporter (VAChT) and the high-affinity choline transporter (CHT1) but not acetylcholinesterase (AChE) was significantly higher in samples from DKO than wild-type (WT) mice. This was region-specific; levels were elevated in samples from the laterodorsal tegmental nucleus (LDT) and the fifth motor nucleus (Mo5) but not in whole brainstem samples. Consistent with region-specific changes, we were unable to detect significant differences in Western blots for ChAT and CHT1 in isolates from brainstem, thalamus and cortex or in ChAT enzymatic activity in the pons. However, using ChAT immunocytochemistry, we found that while the number of cholinergic neurons in the LDT and Mo5 were not different, the intensity of somatic ChAT immunostaining was significantly greater in the LDT, but not Mo5, from DKO than from WT mice. We also found that ChAT activity was significantly reduced in cortical samples from DKO compared with WT mice. Collectively, these findings suggest that the orexins can regulate neurotransmitter expression and that the constitutive absence of orexin signaling results in an up-regulation of the machinery necessary for cholinergic neurotransmission in a mesopontine population of neurons that have been associated with both normal rapid eye movement sleep and cataplexy.

The 19-amino acid insertion in the tumor-associated splice isoform Rac1b confers specific binding to p120 catenin

The Rac1b splice isoform contains a 19-amino acid insertion not found in Rac1; this insertion leads to decreased GTPase activity and reduced affinity for GDP, resulting in the intracellular predominance of GTP-bound Rac1b. Here, using co-precipitation and proteomic methods, we find that Rac1b does not bind to many common regulators of Rho family GTPases but that it does display enhanced binding to SmgGDS, RACK1, and p120 catenin (p120(ctn)), proteins involved in cell-cell adhesion, motility, and transcriptional regulation. We use molecular modeling and structure analysis approaches to determine that the interaction between Rac1b and p120(ctn) is dependent upon protein regions that are predicted to be unstructured in the absence of molecular complex formation, suggesting that the interaction between these two proteins involves coupled folding and binding. We also find that directed cell movement initiated by Rac1b is dependent upon p120. These results define a distinct binding functionality of Rac1b and provide insight into how the distinct phenotypic program activated by this protein may be implemented through molecular recognition of effectors distinct from those of Rac1.

Histamine-1 receptor is not required as a downstream effector of orexin-2 receptor in maintenance of basal sleep/wake states

AIM

The effect of orexin on wakefulness has been suggested to be largely mediated by activation of histaminergic neurones in the tuberomammillary nucleus (TMN) via orexin receptor-2 (OX(2)R). However, orexin receptors in other regions of the brain might also play important roles in maintenance of wakefulness. To dissect the role of the histaminergic system as a downstream mediator of the orexin system in the regulation of sleep/wake states without compensation by the orexin receptor-1 (OX(1)R) mediated pathways, we analysed the phenotype of Histamine-1 receptor (H(1)R) and OX(1)R double-deficient (H(1)R(-/-);OX(1)R(-/-)) mice. These mice lack OX(1)R-mediated pathways in addition to deficiency of H(1)R, which is thought to be the most important system in downstream of OX(2)R.

METHODS

We used H(1)R deficient (H(1)R(-/-)) mice, H(1)R(-/-);OX(1)R(-/-) mice, OX(1)R and OX(2)R double-deficient (OX(1)R(-/-);OX(2)R(-/-)) mice, and wild type controls. Rapid eye movement (REM) sleep, non-REM (NREM) sleep and awake states were determined by polygraphic electroencephalographic/electromyographic recording.

RESULTS

No abnormality in sleep/wake states was observed in H(1)R(-/-) mice, consistent with previous studies. H(1)R(-/-);OX(1)R(-/-) mice also showed a sleep/wake phenotype comparable to that of wild type mice, while OX(1)R(-/-); OX(2)R(-/-) mice showed severe fragmentation of sleep/wake states.

CONCLUSION

Our observations showed that regulation of the sleep/wake states is completely achieved by OX(2)R-expressing neurones without involving H(1)R-mediated pathways. The maintenance of basal physiological sleep/wake states is fully achieved without both H(1) and OX(1) receptors. Downstream pathways of OX(2)R other than the histaminergic system might play an important role in the maintenance of sleep/wake states.

[Chemotherapy with low-dose docetaxel and estramustine phosphate in patient with liver dysfunction due to liver metastases of hormone-refractory prostate cancer : a case report]

A 82-year-old man was referred to our hospital for treatment of hormone-refractory prostate cancer with liver metastases. The obstruction of intrahepatic bile ducts due to the rapid growth of liver metastases induced liver dysfunction. We administered 25 mg/m(2) docetaxel on day1 and 280 mg/body estramustine phosphate on day 1 to day 3, every 4 weeks. After two courses of this combined chemothrapy, the liver metastases were markedly reduced in size with the rapid improvement of liver function.

Non-Gaussian state generation from linear elements via feedback

We present a feedback scheme to produce quantum non-Gaussian states from linear optical elements. Instead of traditional additive control methods, we introduce a mutiplicative feedback control and apply it to the deterministic generation of quantum superposition states. The protocol of feedback control is based on quantum nondemolition measurement of a quadrature, multifeedback structure, and Lyapunov stability for feedback design.

[Mixed epithelial and stromal tumor of kidney: a case report]

Mixed epithelial and stromal tumor of kidney (MEST-K) is a rare benign renal tumor that was first described by Michal and Syrucek in 1998. Its frequency is 0.2-0.28% of all the renal tumors. Here, we report an additional case of MEST-K occurring in a 28-year-old woman. The patient visited a hospital with complaints of lumbago and fever caused by pyelonephritis. The computed tomography revealed hydronephrosis and a cystic tumor in the right kidney, and laparoscopic right nephrectomy was performed. The resected kidney contained a cystic lesion with a grayish-white mural nodule, in the lower portion. The entire lesion measured 5 cm in diameter, and the mural nodule 2.5 cm in diameter. Histologically, the cyst was lined with tall columnar and transitional epithelia. The mural nodule showed microcystic architectures lined with tall columnar and transitional epithelia, scattered in a compact stroma. Immunohistochemically, spindle cells in the stroma were positive for smooth muscle-specific actin, and estrogen and progesterone receptors (ER and PR). Based on these findings, the tumor was diagnosed as MEST-K. MEST-K was newly introduced to the WHO classification of renal tumors, with a pathogenesis related to long-term estrogen exposure, because of ER and PR expression in the stroma. It is important to consider the possibility of this tumor when encountering cases of cystic tumor in middle-aged and older women, and men with a previous history of estrogen administration.

[A case of adult-onset idiopathic hypogonadotropic hypogonadism presenting with infertility]

A 28-year-old man with adult-onset idiopathic male hypogonadotropic hypogonadism (MHH) is reported. He had been delivered normally and had normal puberty. He was referred to our hospital with a chief complaint of infertility. Serum levels of testosterone, luteinizing hormone, and follicle stimulating hormone (FSH) were low. Semen analysis demonstrated azoospermia. Pituitary hypofunction was suggested by gonadotropin releasing hormone (GnRH) loading test. Magnetic resonance images did not detect any abnormalities in the hypothalamic-pituitary region. After a diagnosis of adult-onset hypogonadotropic hypogonadism was established, the patient received human chorionic gonadotropin (hCG) and recombinant FSH treatment. After 5 months, his sperm count reached 6.9 x 10(6) per ml and his wife became pregnant. Adult-onset HH in most cases is caused by tumors and trauma. To our knowledge 17 cases of adult-onset idiopathic HH have been reported, and there were only 3 cases that were caused by pituitary dysfunction. This report showed that r-FSH and hCG therapy was effective in promoting fertility in a patient with adult-onset idiopathic MHH.

Synapses are regulated by the cytoplasmic tyrosine kinase Fer in a pathway mediated by p120catenin, Fer, SHP-2, and beta-catenin

Localization of presynaptic components to synaptic sites is critical for hippocampal synapse formation. Cell adhesion–regulated signaling is important for synaptic development and function, but little is known about differentiation of the presynaptic compartment. In this study, we describe a pathway that promotes presynaptic development involving p120catenin (p120ctn), the cytoplasmic tyrosine kinase Fer, the protein phosphatase SHP-2, and β-catenin. Presynaptic Fer depletion prevents localization of active zone constituents and synaptic vesicles and inhibits excitatory synapse formation and synaptic transmission. Depletion of p120ctn or SHP-2 similarly disrupts synaptic vesicle localization with active SHP-2, restoring synapse formation in the absence of Fer. Fer or SHP-2 depletion results in elevated tyrosine phosphorylation of β-catenin. β-Catenin overexpression restores normal synaptic vesicle localization in the absence of Fer or SHP-2. Our results indicate that a presynaptic signaling pathway through p120ctn, Fer, SHP-2, and β-catenin promotes excitatory synapse development and function.

Atypical retardation pattern in measurements of scanning laser polarimetry and its relating factors

PURPOSE

To assess the prevalence of atypical retardation pattern (ARP) in scanning laser polarimetry (SLP) with variable corneal compensation (VCC) and enhanced corneal compensation (ECC), and to evaluate the factors relating to typical scan score (TSS).

METHODS

Measurements of SLP-VCC, SLP-ECC, and the Humphrey field analyzer (HFA) were performed in 105 normal subjects and 82 open-angle glaucoma (OAG) patients. ARP was defined as an SLP image with TSS<80.

RESULTS

Prevalence of ARP with SLP-VCC was 13.3 and 14.6% in normal and OAG eyes, respectively, and that with SLP-ECC (2.9% and 1.2%) was lower than SLP-VCC (P<0.009). TSS with SLP-VCC was significantly correlated with age (partial correlation coefficient (PCC)=-0.22, P=0.003) and refractive error (PCC=0.26, P<0.001) after adjusting for each other. TSS with SLP-ECC was significantly correlated with neither age nor refractive error (PCC=-0.02, P=0.788; PCC=0.10, P=0.177, respectively). In OAG eyes, mean deviation (MD) of HFA was significantly correlated with TSS with SLP-VCC and SLP-ECC (PCC=0.35, P=0.001; PCC=0.23, P=0.039, respectively). In SLP-VCC, MD was significantly correlated with retinal nerve fibre layer (RNFL) thickness only after excluding eyes with ARP (P<0.001).

CONCLUSIONS

ARP in SLP-VCC measurements was found in more than 10% of normal or glaucomatous eyes, and TSS was significantly lower in older subjects, more myopic eyes, or eyes with more advanced glaucomatous damage. The presence of ARP disturbs the accuracy of RNFL thickness measurement by SLP-VCC. In SLP-ECC measurements, prevalence of ARP was considerably lower and TSS was not affected by age or refractive error, suggesting the advantages of ECC in clinical practices.

p120 catenin induces opposing effects on tumor cell growth depending on E-cadherin expression

p120 catenin regulates the activity of the Rho family guanosine triphosphatases (including RhoA and Rac1) in an adhesion-dependent manner. Through this action, p120 promotes a sessile cellular phenotype when associated with epithelial cadherin (E-cadherin) or a motile phenotype when associated with mesenchymal cadherins. In this study, we show that p120 also exerts significant and diametrically opposing effects on tumor cell growth depending on E-cadherin expression. Endogenous p120 acts to stabilize E-cadherin complexes and to actively promote the tumor-suppressive function of E-cadherin, potently inhibiting Ras activation. Upon E-cadherin loss during tumor progression, the negative regulation of Ras is relieved; under these conditions, endogenous p120 promotes transformed cell growth both in vitro and in vivo by activating a Rac1-mitogen-activated protein kinase signaling pathway normally activated by the adhesion of cells to the extracellular matrix. These data indicate that both E-cadherin and p120 are important regulators of tumor cell growth and imply roles for both proteins in chemoresistance and targeted therapeutics.

Abnormal response of melanin-concentrating hormone deficient mice to fasting: hyperactivity and rapid eye movement sleep suppression

Melanin-concentrating hormone (MCH) is a hypothalamic neuropeptide that has been implicated in energy homeostasis. Pharmacological studies with MCH and its receptor antagonists have suggested additional behavioral roles for the neuropeptide in the control of mood and vigilance states. These suggestions have been supported by a report of modified sleep in the MCH-1 receptor knockout mouse. Here we found that MCH knockout (MCH(-)(/)(-)) mice slept less during both the light and dark phases under baseline conditions. In response to fasting, MCH(-)(/)(-) mice exhibited marked hyperactivity, accelerated weight loss and an exaggerated decrease in rapid eye movement (REM) sleep. Following a 6-h period of sleep deprivation, however, the sleep rebound in MCH(-)(/)(-) mice was normal. Thus MCH(-)(/)(-) mice adapt poorly to fasting, and their loss of bodyweight under this condition is associated with behavioral hyperactivity and abnormal expression of REM sleep. These results support a role for MCH in vigilance state regulation in response to changes in energy homeostasis and may relate to a recent report of initial clinical trials with a novel MCH-1 receptor antagonist. When combined with caloric restriction, the treatment of healthy, obese subjects with this compound resulted in some subjects experiencing vivid dreams and sleep disturbances.