Gut peptides before and following Roux-En-Y gastric bypass: A systematic review and meta-analysis

A systematic search was conducted in Medline Ovid, Embase, Scopus, and Cochrane Central Register of Controlled Trials up until March 2021 following PRISMA guidelines. Studies included evaluated ghrelin, GLP-1, PYY or appetite sensation via visual analogue scales (VASs) before and after Roux-en-Y gastric bypass (RYGB) in adults. A multilevel model with random effects for study and follow-up time points nested in study was fit to the data. The model included kcal consumption as a covariate and time points as moderators. Among the 2559 articles identified, k = 47 were included, among which k = 19 evaluated ghrelin, k = 40 GLP-1, k = 22 PYY, and k = 8 appetite sensation. Our results indicate that fasting ghrelin levels are decreased 2 weeks post-RYGB (p = 0.005) but do not differ from baseline from 6 weeks to 1-year post-RYGB. Postprandial ghrelin and fasting GLP-1 levels were not different from pre-surgical values. Postprandial levels of GLP-1 increased significantly from 1 week (p < 0.001) to 2 years post-RYGB (p < 0.01) compared with pre-RYGB. Fasting PYY increased at 6 months (p = 0.034) and 1 year (p = 0.029) post-surgery; also, postprandial levels increased up to 1 year (p < 0.01). Insufficient data on appetite sensation were available to be meta-analyzed.

Physical activity motives, barriers, and preferences in people with obesity: A systematic review

Background

Although the benefits of physical activity (PA) are well known, physical inactivity is highly prevalent among people with obesity. The objective of this systematic review was to i) appraise knowledge on PA motives, barriers, and preferences in individuals with obesity, and ii) quantify the most frequently reported PA motives, barriers and preferences in this population.

Methods

Six databases (Pubmed, CINAHL, Psyarticle, SportDiscus, Web of science and Proquest) were searched by independent reviewers to identify relevant quantitative or qualitative articles reporting PA motives, barriers or preferences in adults with body mass index ≥ 30 kg/m² (last searched in June 2020). Risk of bias for each study was assessed by two independent reviewers with the Mixed Methods Appraisal Tool (MMAT).

Results

From 5,899 papers identified, a total of 27 studies, 14 quantitative, 10 qualitative and 3 mixed studies were included. About 30% of studies have a MMAT score below 50% (k = 8). The three most reported PA motives in people with obesity were weight management, energy/physical fitness, and social support. The three most common PA barriers were lack of self-discipline/motivation, pain or physical discomfort, and lack of time. Based on the only 4 studies available, walking seems to be the preferred mode of PA in people with obesity.

Conclusions

Weight management, lack of motivation and pain are key PA motives and barriers in people with obesity, and should be addressed in future interventions to facilitate PA initiation and maintenance. Further research is needed to investigate the PA preferences of people with obesity.

Double-Step Paradigm in Microgravity: Preservation of Sensorimotor Flexibility in Altered Gravitational Force Field

The way we can correct our ongoing movements to sudden and unforeseen perturbations is key to our ability to rapidly adjust our behavior to novel environmental demands. Referred to as sensorimotor flexibility, this ability can be assessed by the double-step paradigm in which participants must correct their ongoing arm movements to reach targets that unexpectedly change location (i.e., target jump). While this type of corrections has been demonstrated in normogravity in the extent of reasonable spatiotemporal constraints underpinning the target jumps, less is known about sensorimotor flexibility in altered gravitational force fields. We thus aimed to assess sensorimotor flexibility by comparing online arm pointing corrections observed during microgravity episodes of parabolic flights with normogravity standards. Seven participants were asked to point as fast and as accurately as possible toward one of two visual targets with their right index finger. The targets were aligned vertically in the mid-sagittal plane and were separated by 10 cm. In 20% of the trials, the initially illuminated lower target was switched off at movement onset while the upper target was concomitantly switched on prompting participants to change the trajectory of their ongoing movements. Results showed that, both in normogravity and microgravity, participants successfully performed the pointing task including when the target jumped unexpectedly (i.e., comparable success rate). Most importantly, no significant difference was found in target jump trials regarding arm kinematics between both gravitational environments, neither in terms of peak velocity, relative deceleration duration, peak acceleration or time to peak acceleration. Using inverse dynamics based on experimental and anthropometrical data, we demonstrated that the shoulder torques for accelerating and decelerating the vertical arm movements substantially differed between microgravity and normogravity. Our data therefore highlight the capacity of the central nervous system to perform very fast neuromuscular adjustments that are adapted to the gravitational constraints. We discuss our findings by considering the contribution of feedforward and feedback mechanisms in the online control of arm pointing movements.

Improving spatial updating accuracy in absence of external feedback

Updating the position of an earth-fixed target during whole-body rotation seems to rely on cognitive processes such as the utilization of external feedback. According to perceptual learning models, improvement in performance can also occur without external feedback. The aim of this study was to assess spatial updating improvement in the absence and in the presence of external feedback. While being rotated counterclockwise (CCW), participants had to predict when their body midline had crossed the position of a memorized target. Four experimental conditions were tested: (1) Pre-test: the target was presented 30° in the CCW direction from participant's midline. (2) Practice: the target was located 45° in the CCW direction from participant's midline. One group received external feedback about their spatial accuracy (Mackrous and Simoneau, 2014) while the other group did not. (3) Transfer T(30)CCW: the target was presented 30° in the CCW direction to evaluate whether improvement in performance, during practice, generalized to other target eccentricity. (4) Transfer T(30)CW: the target was presented 30° in the clockwise (CW) direction and participants were rotated CW. This transfer condition evaluated whether improvement in performance generalized to the untrained rotation direction. With practice, performance improved in the absence of external feedback (p=0.004). Nonetheless, larger improvement occurred when external feedback was provided (ps=0.002). During T(30)CCW, performance remained better for the feedback than the no-feedback group (p=0.005). However, no group difference was observed for the untrained direction (p=0.22). We demonstrated that spatial updating improved without external feedback but less than when external feedback was given. These observations are explained by a mixture of calibration processes and supervised vestibular learning.

Online control of anticipated postural adjustments in step initiation: evidence from behavioral and computational approaches

Anticipatory postural adjustments (APAs) prior to step execution are thought to be immutable once released. Here we challenge this assumption by testing whether APAs can be modified online if a body perturbation occurs during execution. Two directions of perturbation (resisting and assisting) relative to the body weight transfer were used during the execution of APAs. We found that APAs are modified online (increase in both ground pressure and muscle activity) to compensate for resisting perturbations. The outcomes of a biomechanical model confirmed that the early changes in the APAs resulted from an active control of the APAs and were not merely mechanical consequences of the perturbation. However, no modification of the initial feedforward command was observed for assisting perturbations. The motor command changes for the resisting perturbation may originate from the mismatch between passively originated forces and those actively specified by the central command when acting in the opposite direction. The absence of a mismatch in the assisting perturbation might explain why the central nervous system was not prompted to modify the APAs in this condition.

Obesity Adds Constraint on Balance Control and Movement Performance

We examined if a weight loss program improves the speed-accuracy tradeoff of goal-directed aiming movements of obese individuals. Ten obese subjects aimed at targets of different sizes from a seated and a standing posture. The kinematics of the aiming was recorded. All participants were evaluated before and after a weight loss program when weight reduction had stabilized. Before weight loss, movement times and duration of deceleration phases were longer when subjects were standing than when they were seated. These effects vanished after weight loss. Weight loss yielded an increased aiming speed when subjects aimed at targets from an upright posture and this effect was greater for the smaller target. This difference was not observed when seated. The results suggest that a more stable postural platform resulting from weight loss allows a better control of the upper-limb movement.

Reducing weight increases postural stability in obese and morbid obese men

OBJECTIVE

To investigate the effect of weight loss on balance control in obese and morbid obese men.

METHODS

In a longitudinal and clinical intervention study, postural stability was measured with a force platform before and after weight loss in men. Weight loss was obtained in obese men (mean body mass index (BMI)=33.0 kg/m(2)) by hypocaloric diet until resistance and in morbid obese men (mean BMI=50.5 kg/m(2)) by bariatric surgery. Morbid obese men were tested before surgery, and 3 and 12 months after surgery when they had lost 20 and nearly 50% of initial body weight, respectively. Normal weight individuals (mean BMI=22.7 kg/m(2)) were tested twice within a 6- to 12-month period to serve as control. Body fatness and fat distribution measures, and posturographic parameters of the center of foot pressure (CP) along the antero-posterior and medio-lateral axes for conditions with and without vision were performed in all subjects.

RESULTS

Weight loss averaged 12.3 kg after dieting and 71.3 kg after surgery. Body weight remained unchanged in the control group. After weight loss, nearly all measures of postural stability were improved with and without vision (i.e., CP speed and range in antero-posterior and medio-lateral axes). A strong linear relationship was observed between weight loss and improvement in balance control measured from CP speed (adjusted R (2)=0.65, P<0.001).

CONCLUSION

Weight loss improves balance control in obese men and the extent of the improvement is directly related to the amount of weight loss. This should decrease the habitual greater risk of falling observed in obese individuals.

Influence of obesity on accurate and rapid arm movement performed from a standing posture

INTRODUCTION

Obesity yields a decreased postural stability. The potentially negative impact of obesity on the control of upper limb movements, however, has not been documented. This study sought to examine if obesity imposes an additional balance control constraint limiting the speed and accuracy with which an upper limb goal-directed movement performed from an upright standing position can be executed.

METHOD

Eight healthy lean subjects (body mass index (BMI) between 20.9 and 25.0 kg/m(2)) and nine healthy obese subjects (BMI between 30.5 and 48.6 kg/m(2)) pointed to a target located in front of them from an upright standing posture. The task was to aim at the target as fast and as precisely as possible after an auditory signal. The difficulty of the task was varied by using different target sizes (0.5, 1.0, 2.5 and 5.0 cm width). Hand movement time (MT) and velocity profiles were measured to quantify the aiming. Centre of pressure and segmental kinematics were analysed to document postural stability.

RESULTS

When aiming, the forward centre of pressure (CP) displacement was greater for the obese group than for the normal BMI group (4.6 and 1.9 cm, respectively). For the obese group, a decrease in the target size was associated with an increase in backward CP displacement and CP peak speed whereas for the normal BMI group backward CP displacements and CP peak speed were about the same across all target sizes. Obese participants aimed at the target moving their whole body forward whereas the normal BMI subjects predominantly made an elbow extension and shoulder flexion. For both groups, MT increased with a decreasing target size. Compare to the normal BMI group, this effect was exacerbated for the obese group. For the two smallest targets, movements were on average 115 and 145 ms slower for the obese than for the normal BMI group suggesting that obesity added a balance constraint and limited the speed with which an accurate movement could be done.

SUMMARY

Obesity, because of its effects on the control of balance, also imposes constraints on goal-directed movements. From a clinical perspective, obese individuals might be less efficient and more at risk of injuries than normal weight individuals in a large number of work tasks and daily activities requiring upper limb movements performed from an upright standing position.

Effects of predictive mechanisms on head stability during forward trunk perturbation

While much is known about reflex and mechanical contributions to the control of head stability, little is known about predictive control. The goal of this experiment was to determine the contribution of predictive mechanisms to head stability in space, in the pitch plane, during forward trunk perturbations. Eleven standing healthy subjects had their trunk pulled forward by a load-pulley apparatus. The perturbation was either self-triggered or imposed (triggered by the experimenter). Subjects were exposed to two loads: 2% and 4% of their body weight. The contributions of torques acting on the head-neck system were inferred from head and trunk kinematics, neck muscle EMG, and the torques acting on the head, which were computed using inverse dynamics. The results showed that both the head and trunk moved less during the self-triggered than imposed condition during both loads for most of the participants. There was no evidence of predictive neck countertorque or increased neck muscle co-contraction during the self-triggered condition. These findings suggest that most of the subjects improved head stability in the self-triggered condition by reducing trunk motion and the associated interactive torque that perturbed the head.

Attentional demands for postural control: the effects of aging and sensory reintegration

The aim of this experiment was to examine if, with aging, the task of reintegrating sensory information perturbs balance and requires additional attentional demand. Young adults and the elderly were asked to maintain a stable upright posture while standing on a force platform. Visual and ankle proprioceptive information were removed or perturbed and suddenly reinserted. Subjects also had to respond vocally as quickly as possible to an unpredictable auditory stimulus presented before or following a sensory reintegration and in control conditions. Reaction times to the auditory stimuli were used as an index of the attentional demands necessary for calibrating the postural system. Reintegration of proprioception in absence of vision and under vision yielded a faster center of pressure velocity for both groups. This effect, however, was more important for the elderly than the young adults. An increased attentional demand was observed for both groups when proprioceptive information had to be reintegrated in absence of vision. Altogether, these results propose that, for the elderly persons, postural contexts requiring a reweighting of sensory inputs could lead to increased risk for loss of balance and falls if insufficient attentional resources are allocated to the postural task.

Increased risk for falling associated with obesity: mathematical modeling of postural control

Recent epidemiological studies report that obesity is positively related to fracture incidence. In the present experiment, a model of postural control was used to examine the impact of an abnormal distribution of body fat in the abdominal area upon postural stability. Obese and lightweight humanoids were destabilized by imposing a small initial angular speed from a neutral standing position. To avoid a loss of stability yielding a stepping reaction or a fall, an ankle torque is necessary to counteract the perturbation. Three torque parameters--ankle torque onset, time to peak torque, and muscular ankle torque--were entered in a program to simulate the intrinsic variability of the human postural control system. A loss of stability was detected when the center of pressure exceeded stability margins. The most striking observation is the nonlinear increase of torque needed to stabilize the humanoid when the motor response was characterized by delayed temporal parameters. The effect was more pronounced when an anterior position of the center of mass was included in the simulations. This suggests that, when submitted to daily postural stresses and perturbations, obese persons (particularly those with an abnormal distribution of body fat in the abdominal area) may be at higher risk of falling than lightweight individuals.

Chromosome 9 deletions and recurrence of superficial bladder cancer: identification of four regions of prognostic interest

In a previous study, loss of heterozygosity (LOH) of 28 chromosome 9 microsatellite markers was assessed on 139 Ta/T1 bladder tumors. LOH at one or more loci was detected in 67 tumors, 62 presenting subchromosomal deletions. One hundred and thirty-three of these patients have now been followed for up to 8 years. The purpose of the present study was to evaluate the potential biological significance of chromosome 9 deletions in superficial bladder tumors at initial diagnosis. High grade was associated with LOH (P=0.004). Large tumors carried more frequently 9p deletions (P=0.022). Female patients had more chromosome 9q LOH than male patients did (P=0.010). Chromosome 9 LOH at all loci was associated with an elevated risk of recurrence but four regions were associated with a particularly high risk of recurrence. Multivariate analysis taking into account grade, stage, size and number of tumors showed that tumors deleted in the regions 9ptr-p22, 9q22.3, 9q33, and 9q34 recurred significantly more rapidly than those without deletions (Recurrence rate ratio=2.32, 2.53, 2.52 and 2.43 respectively). Log-rank statistics comparing Kaplan-Meier survival curves for the same chromosomal regions confirmed the correlation (P=0.0002, 0.010, 0.002 and 0.009 respectively). Only four patients progressed to muscle-invasive disease. They all had extensive deletions on 9q but none had deletions at 9ptr-p22. This study suggests a link between chromosome 9 anomalies and recurrence of superficial bladder cancer.

Different populations of inositol 1,4,5-trisphosphate receptors expressed in the bovine adrenal cortex

The inositol 1,4,5-trisphosphate (InsP3) receptor forms a tetrameric channel responsible for the release of Ca2+ from intracellular stores. In the present study we showed that the experimental approach used to separate bound and free ligands may discriminate between two populations of InsP3 binding sites in bovine adrenal cortex microsomes. A large population of low affinity sites and a small population of high affinity sites were detected with centrifugation and filtration approaches, respectively. Both populations were found in the supernatant and the cytoskeleton fractions of Triton X-100 solubilized microsomes. After treatment of microsomes with thimerosal, an alkylating reagent known to increase InsP3 receptor affinity, the filtration and the centrifugation approaches yielded identical results. With selective anti-InsP3 receptor antibodies, we showed that types 1, 2 and 3 InsP3 receptors are present in intact microsomes and in the cytoskeleton fraction. Binding studies on immunoprecipitated receptors revealed that anti-type 1 antibody recognizes a large population of low affinity sites whereas anti-type 2 antibody recognizes a small population of high affinity sites. Our results indicate that the three types of InsP3 receptors are expressed at different levels in the bovine adrenal cortex. The presence of different types of InsP3 receptors with different ligand binding affinities and their association with the cytoskeleton offer a convenient way for the cell to simultaneously regulate its intracellular Ca2+ concentration and reorganize the spatial distribution of its Ca2+ stores.

Pointing to a target from an upright position in human: tuning of postural responses when there is target uncertainty

Human subjects performed, from a standing position, rapid hand pointings to visual targets located within or beyond the prehension space. To examine the interaction between posture and the goal-directed movement we introduced a visual double-step perturbation requiring a reprogramming of the hand movement. Trials directed towards the same spatial goal but differentiated only by the likeliness of a visual double-step were compared. The hand kinematics was not affected by the uncertainty of the visual perturbation; an increased trunk bending, however, was observed. This suggests that uncertainty constraints are integrated in a predictive manner for the optimal coordination of the hand and postural control systems.

P53 point mutations in initial superficial bladder cancer occur only in tumors from current or recent cigarette smokers

Sequencing of p53 exons 5-8 was carried out on 51 initial superficial bladder tumors selected on the basis of high grade and/or p53 overexpression (immunohistochemistry without antigen retrieval). Fourteen point mutations in 13 tumors and one 21 bp deletion in another tumor were identified. In addition, a germ-line mutation corresponding to a previously described polymorphism was detected in exon 6, in two tumors. Mostly G-->A transitions (10) were found. Only three occurred at CpG sites, suggesting a major role for exogenous carcinogens in bladder tumorigenesis. Immunostaining for p53 and MDM2, using antigen retrieval, was carried out on the same tumors. A correlation was found between the percentage of p53-positive cells and the presence of p53 mutations (P = 0.005). No correlation was found between overexpression of p53 and MDM2 in this selected cohort of mostly high grade tumors. The presence of p53 mutations was also analyzed as a function of the smoking habits of the patients. A significant association was found between the presence of p53 point mutations and the number of years of smoking (P = 0.043). All patients with tumors carrying missense or nonsense p53 mutations had smoked for >/=30 years and if former smokers, had stopped for </=5 years. However, no correlation was found between the presence of p53 point mutations and the number of cigarettes smoked. The deletion mutation was the only one present in a tumor from a non-smoker. The data suggest that duration of exposure to carcinogens is the most critical factor in p53 mutagenesis in bladder cancer.

Expression of functionally distinct variants of the beta(4)A integrin subunit in relation to the differentiation state in human intestinal cells

Integrins are important mediators of cell-laminin interactions. In the small intestinal epithelium, which consists of spatially separated proliferative and differentiated cell populations located, respectively, in the crypt and on the villus, laminins and laminin-binding integrins are differentially expressed along the crypt-villus axis. One exception to this is the integrin alpha(6)beta(4), which is thought to be ubiquitously expressed by intestinal cells. However, in this study, a re-evaluation of the beta(4) subunit expression with different antibodies revealed that two forms of beta(4) exist in the human intestinal epithelium. Furthermore, we show that differentiated enterocytes express a full-length 205-kDa beta(4)A subunit, whereas undifferentiated crypt cells express a novel beta(4)A subunit that does not contain the COOH-terminal segment of the cytoplasmic domain (beta(4)A(ctd-)). This new form was not found to arise from alternative beta(4) mRNA splicing. Moreover, we found that these two beta(4)A forms can associate into alpha(6)beta(4)A complexes; however, the beta(4)A(ctd-) integrin expressed by the undifferentiated crypt cells is not functional for adhesion to laminin-5. Hence, these studies identify a novel alpha(6)beta(4)A(ctd-) integrin expressed in undifferentiated intestinal crypt cells that is functionally distinct.

Role of the feedforward command and reafferent information in the coordination of a passing prehension task

The performances of a deafferented patient and five control subjects have been studied during a self-driven passing task in which one hand has to grasp an object transported by the other hand and in a unimanual reach-to-grasp task. The kinematics of the reach and grasp components and the scaling of the grip aperture recorded for the self-driven passing task were very similar in controls and the deafferented subject (GL). In contrast, for the unimanual task when vision was absent, GL's coordination between reaching and grasping was delayed in space and time compared with the control subjects. In addition, frequent reopening of the grip was observed in GL during the final closure phase of the unimanual prehension task. These results support the notion that afferent proprioceptive information resulting from the reaching movement - which seemed to be used to coordinate reaching and grasping commands in the unimanual task - is no longer necessary in the self-induced passing task. Finally, for the externally driven passing task, when the object was passively transported by the experimenter, the coordination was consistently modified in all subjects; grip aperture onset was delayed, thus asserting a specific contribution of the central command or feedforward mechanisms into the anticipation of the grasp onset observed in the self-driven passing task. The origin and nature of the information necessary for building up the feedforward mechanisms remains to be elucidated.

Low frequency of human papillomavirus infection in initial papillary bladder tumors

The involvement of human papillomavirus (HPV) in bladder cancer remains controversial. We previously reported detection of L1-HPV DNA in 39% of bladder cancers of mixed grade and stage. To clarify the possible etiologic role of HPV we studied, using the same technique, a more homogeneous group of initial low-stage tumors. We investigated a total of 187 newly diagnosed superficial papillary bladder tumors for the presence of L1-HPV DNA by the polymerase chain reaction method and hybridization with specific probes for HPV 6, 11, 16, 18, 33. HPV DNA was detected in 16 (8.5%) of the 187 specimens tested, although in a low copy number compared with SiHa cervical cancer cells used as control. HPV type 16 was observed in eight tumors while HPV type 6 and type 11 were each observed in three tumors. Two tumor specimens contained two types of HPV: one tumor hybridized with type 6 and 16 and the other with type 11 and 18. This low rate of HPV detection (8.5%) in initial tumors does not favor a prominent role for HPV in bladder carcinogenesis.

Aging and postural control: postural perturbations caused by changing the visual anchor

OBJECTIVE

To determine the effect of modifying the stable visual anchor on the postural stability of older individuals. The visual anchor was changed by opening doors similar to those found in an elevator cage. Lighting intensities inside and outside the cage were varied to create increasing or decreasing luminosity conditions. The effect of adding a cognitive load (counting backwards) was also tested.

DESIGN

A controlled laboratory study.

SETTING

Tests performed in a balance laboratory.

MEASUREMENTS

Sensory and clinical measurements to insure the integrity of the central and peripheral nervous system. Measures of balance were derived from the recordings of the center of foot pressure. These measures included range and speed of the center of foot pressure.

PARTICIPANTS

Eight older, community-dwelling subjects and nine young subjects participated. A sensorimotor evaluation was used to insure that all older individuals were free from any pathologies affecting postural stability. All participants had a low score (indicating high balance confidence) on the Falls Efficacy Scale and no history of falls.

RESULTS

Older individuals were affected by modification of the stable visual anchor induced by the opening of doors similar to that of an elevator cage. They showed greater ranges of the center of foot pressure (COP) and speed of the COP after than before the opening of the doors. Furthermore, the increased ranges and speed were two to three times greater than that observed for the young subjects. A lighting intensity considered as comfortable for reading inside the elevator affected the overall postural stability of the older participants negatively. Counting backwards also decreased their overall stability.

CONCLUSION

Changing the stable visual anchor, as when exiting an elevator cage, could be a significant risk factor for older persons. Moreover, when combined with a cognitive load or lower lighting intensity inside the elevator cage, the negative effects on the postural stability of older persons are exacerbated.

Four tumor suppressor loci on chromosome 9q in bladder cancer: evidence for two novel candidate regions at 9q22.3 and 9q31

The most common genetic alteration identified in transitional cell carcinoma (TCC) of the bladder is loss of heterozygosity (LOH) on chromosome 9. However, localization of tumor suppressor genes on 9q has been hampered by the low frequency of subchromosomal deletions. We have analysed 139 primary, initial low stage TCC of the bladder using a panel of 28 microsatellite markers spanning chromosome 9 at an average distance of 5 Mb, following a primer-extension preamplification (PEP) technique. Sixty-seven (48%) tumors showed LOH at one or more loci and partial deletions were detected in 62 (45%) tumors; apparent monosomy 9 was detected in only five (4%) tumors. Deletions were more frequent on 9q (44%) than on 9p (23%), the latter being mostly associated with 9q deletion, suggesting that alteration of genes on 9q may be an early event associated with superficial papillary tumors. Combined data from the cases with partial 9q deletions displayed four candidate regions for tumor suppressor loci, based on the frequency of deletion observed and tumors with unique deletions at these sites. In two tumors, the unique partial deletion comprised D9S12 at 9q22.3, a region encompassing loci for the Gorlin syndrome and multiple self-healing squamous epithelioma gene. In two other tumors, the single LOH was identified at the D9S172 locus at 9q31-32 where the dysautonia and Fukuyama-type congenital muscular dystrophy genes have been located. One tumor showed unique LOH at the GSN locus at 9q33, a region frequently deleted in other sporadic tumors while the fourth region of deletion was observed at 9q34 between ASS and ABL-1, in two tumors. This region is frequently deleted in tumors and encompasses the locus for the hereditary hemorrhagic telangiectasia gene. These findings suggest four target regions on 9q within which suppressor genes for TCC may reside.

Updating visual space during passive and voluntary head-in-space movements

The accuracy of our spatially oriented behaviors largely depends on the precision of monitoring the change in body position with respect to space during self-motion. We investigated observers' capacity to determine, before and after head rotations about the yaw axis, the position of a memorized earth-fixed visual target positioned 21 degrees laterally. The subjects (n=6) showed small errors (mean=-0.6 degrees) and little variability (mean=0.9 degrees) in determining the position of an extinguished visual-target position when the head (and gaze) remained in a straight-ahead position. This accuracy was preserved when subjects voluntary rotated the head by various magnitudes in the direction of the memorized visual target (head rotations ranged between 5 degrees and 60 degrees). However, when the chair on which the subjects were seated was unexpectedly rotated about the yaw axis in the direction of the target (chair rotations ranged between 6 degrees and 36 degrees ) during the head-on-trunk rotations, the performance was markedly decreased, both in terms of spatial precision (mean error=5.6 degrees ) and variability (mean=5.7 degrees). A control experiment showed that the prior knowledge of chair rotation occurrence had no effect on the perceived target position after head-trunk movements. Updating an earth-fixed target position during head-on-trunk rotations could be achieved through both cervical and vestibular signals processing, but, in the present experiment, the vestibular output was the only signal that had the potentiality to contribute to accurate coding of the target position after simultaneous head and trunk movements. Our results therefore suggest that the vestibular output is a noisy signal for the central nervous signal to update the visual space during head-in-space motion.

Generation, validation, and large scale production of adenoviral recombinants with large size inserts such as a 6.3 kb human dystrophin cDNA

Human, serotype 5 (Ad 5), replication-defective recombinant adenoviruses (AdVs) expressing a 6.3 kb partial dystrophin cDNA (Becker) under the control of either the CMV early or the RSV LTR promoter/enhancer in combination with various polyadenylation sequences (polyA), were developed for gene transfer studies aimed at Duchenne muscular dystrophy. Based on previous experience, a strategy for generation, screening and validation of AdVs with relatively large size gene expression cassette inserts was established. Here we focus on some aspects of stability and safety of such AdVs as gene therapeutic tools based on relevant molecular biological methods. Furthermore, the quality of our best AdV-minidystrophin construct was validated following its large scale production and purification as well as its delivery in mdx mice. These results are of interest for establishing other AdVs, where the combined length of a tissue specific promoter, the gene of interest and the polyA sequences reach the upper limit of the packaging capacity of first generation AdVs.

Dystrophin expression in muscles of mdx mice after adenovirus-mediated in vivo gene transfer

We have generated high-titer adenoviral recombinants (AVR) expressing a 6.3-kb partial dystrophin cDNA insert under the control of either the Rous sarcoma virus (RSV) or cytomegalovirus (CMV) promoter. These AVR preparations were free of both E1-containing AVR and AVR with a nonfunctional dystrophin expression cassette. With these optimal AVR preparations, we have obtained a high degree of short-term (10 days) expression of a truncated (approximately 200 kD) dystrophin in dystrophin-deficient mdx muscles injected in the neonatal period; a lesser degree of expression of dystrophin was found in muscles injected in the young adult age and in old animals. Microscopic indices of muscle damage revealed that the truncated dystrophin provided a significant protection of the transduced muscle fibers. However, by 60 days post-injection, a substantial reduction of the number of dystrophin-positive fibers was noted, even in the neonatally injected muscles, and near-total elimination of dystrophin-positive fibers occurred in muscles injected in the adult age. These effects appeared to be brought about by the activity of CD8+ cytotoxic lymphocytes directed against the transduced cells, leading to their eventual elimination. In severe combined immunodeficiency (SCID) mice, lacking both humoral and cellular immune competence, muscles transduced (either in the neonatal or adult age) by AVR containing a CMV-LacZ expression cassette maintained the early (10 day) transduction level up to 30 days post-injection. Systemic administration of AVR (i.e., into the left ventricle of the heart) led in 5 days to a high number of dystrophin-positive fibers in heart, diaphragm, and intercostal muscles but not in limb muscles.

Emergence of early region 1-containing replication-competent adenovirus in stocks of replication-defective adenovirus recombinants (delta E1 + delta E3) during multiple passages in 293 cells

Early region 1 (E1)-deleted human adenovirus (AV) recombinants have been shown to be powerful tools of gene transfer in vivo and in vitro and are considered for application in human gene therapy. We could detect increasing titers of E1-containing adenovirus in two independent E1 + E3-deleted recombinant AV stocks during multiple passages in 293 cells, most likely due to a recombinant event with the host cell genome. We show the deleterious effects of this E1-containing, mostly replication-competent AV subpopulation in vivo and compare different screening methods of AV stocks for its detection. These considerations are important for the safety of human gene therapy trials.

A differential efficiency of adenovirus-mediated in vivo gene transfer into skeletal muscle cells of different maturity

High titre (10(11)-10(12) pfu/ml) suspensions of autonomously replication-defective type 5 human adenovirus (AV) recombinants with different reporter gene inserts (CMV-Luciferase (Lux), CMV-beta-galactosidase (Lac Z), RSV-Lux and RSV-Lac Z) were injected into intact quadriceps muscles of 1-5 day old (Group 1) or 35-45 day old (Group 2) normal mice, as well as regenerating adult mouse muscles (Group 3) and 35 day old mdx muscles (Group 4). The expression of the reporter genes was quantitated 10 days and 2 months later. At 10 days postinjection all reporter gene expression was very high in the neonatally injected (Group 1) muscles. In Group 2 muscles the transduction was markedly less. In Group 3 muscles the gene expression was significantly better than in the Group 2 muscles. In adult mdx muscles (Group 4) where spontaneous regeneration is usually present, the results were similar to those in Group 3 animals. At 2 months post-injection in Group 1 animals, the RSV-Lux expression was even higher than at 10 days postinjection. The cell surface density of alpha v-integrin-containing molecules including the internalization receptor for AV in Groups 1, 2, 3 and 4 showed a positive correlation with AV transducibility. We conclude that adenovirus vector in high titre (10(10) pfu/ml or above) is capable of efficiently transducing only immature muscle cells but not mature muscle fibers in vivo and this appears to correlate with a higher surface density of the available AV internalization receptor in immature muscle cells and lower level in mature muscle fibers.(ABSTRACT TRUNCATED AT 250 WORDS)