Overcoming the coupled climate and biodiversity crises and their societal impacts

Earth's biodiversity and human societies face pollution, overconsumption of natural resources, urbanization, demographic shifts, social and economic inequalities, and habitat loss, many of which are exacerbated by climate change. Here, we review links among climate, biodiversity, and society and develop a roadmap toward sustainability. These include limiting warming to 1.5°C and effectively conserving and restoring functional ecosystems on 30 to 50% of land, freshwater, and ocean "scapes." We envision a mosaic of interconnected protected and shared spaces, including intensively used spaces, to strengthen self-sustaining biodiversity, the capacity of people and nature to adapt to and mitigate climate change, and nature's contributions to people. Fostering interlinked human, ecosystem, and planetary health for a livable future urgently requires bold implementation of transformative policy interventions through interconnected institutions, governance, and social systems from local to global levels.

Lung-Targeted Delivery of Dimethyl Fumarate Promotes the Reversal of Age-Dependent Established Lung Fibrosis

Idiopathic pulmonary fibrosis (IPF), a severe and deadly form of lung fibrosis, is widely regarded as a disease of aging. We previously demonstrated that aged mice with persistent lung fibrosis and IPF lung myofibroblasts exhibit deficient Nrf2-mediated antioxidant responses. Tecfidera is an orally administered FDA-approved drug for the treatment of multiple sclerosis, where the active pharmaceutical ingredient is dimethyl fumarate (DMF), an active Nrf2 activator. However, no studies have evaluated the efficacy of DMF for age-associated persistent lung fibrosis. Here, we demonstrate that in IPF lung fibroblasts, DMF treatment inhibited both TGF-β-mediated pro-fibrotic phenotypes and led to a reversal of established pro-fibrotic phenotypes. We also evaluated the pre-clinical efficacy of lung-targeted (inhaled) vs. systemic (oral) delivery of DMF in an aging murine model of bleomycin-induced persistent lung fibrosis. DMF or vehicle was administered daily to aged mice by oral gavage or intranasal delivery from 3-6 weeks post-injury when mice exhibited non-resolving lung fibrosis. In contrast to systemic (oral) delivery, only lung-targeted (inhaled) delivery of DMF restored lung Nrf2 expression levels, reduced lung oxidative stress, and promoted the resolution of age-dependent established fibrosis. This is the first study to demonstrate the efficacy of lung-targeted DMF delivery to promote the resolution of age-dependent established lung fibrosis.

Leveraging ageing models of pulmonary fibrosis: the efficacy of nintedanib in ageing

Nintedanib is one of two US Food and Drug Administration (FDA)-approved treatments for idiopathic pulmonary fibrosis (IPF). The clinical efficacy of nintedanib for inhibiting the progression of lung fibrosis is well-established [1]. However, although nintedanib is overwhelmingly prescribed to elderly patients, the impact of ageing on its efficacy is difficult to discern from clinical data due to the magnitude of confounding variables that exist among human subjects (genetics, gender, comorbidities, disease stage at the onset of treatment, etc.). A recent post hoc meta-analysis of five IPF clinical trials suggested that the effect of nintedanib in reducing the rate of forced vital capacity decline is consistent across patients with age (patients >75 versus patients <75 years of age) [2]. However, it is important to note that the average age of IPF diagnosis is 66 years and the average patient ages in these cohorts were 78 (>75) versus 64 (<75) years. Further, one could argue that patients in both cohorts represent the elderly population. This study highlights the complexity of evaluating the impact of ageing on efficacy in a clinical setting. To date, all pre-clinical efficacy studies with nintedanib have been performed in young animals. We therefore sought to determine whether ageing impacts the efficacy of nintedanib for inhibiting the development of lung fibrosis. Bleomycin-induced lung injury in young (2 month) and aged (18 month) mice was followed by treatment with nintedanib or vehicle from day 10–21 (figure 1a), using a previously described protocol [3]. We previously demonstrated in this injury model that the severity of lung fibrosis is identical in young and aged mice, in terms of the net increase in total lung collagen following injury [4]. Although some prior studies have reported seemingly contradictory results, indicating increased severity of fibrosis in aged mice [5, 6], this discrepancy could be attributed to increased baseline levels of collagen in aged mice and the methodology/analyses used for fibrosis assessment, as the net increase in collagen appear to be similar in both young and aged mice [5, 6]. In line with our previous findings, both young and aged vehicle-treated mice demonstrated similar levels of fibrosis severity and a similar decline in lung function at 3 weeks post-injury (figure 1b–d, g–h). Also consistent with numerous prior reports [7, 8], we found that in young mice, nintedanib demonstrated efficacy for inhibiting the development of fibrosis (figure 1b–g) and led to improved lung function (figure 1h). Interestingly, nintedanib also significantly inhibited the development of lung fibrosis in aged mice, to a similar extent as young cohorts (figure 1b–g). Although nintedanib treatment resulted in lung functional improvement to a similar extent in both young (49%) and aged (57%) mice (figure 1h), results did not reach statistical significance in aged mice. Of note, there is less than 47% power to detect mean differences between the aged-vehicle and aged-nintedanib groups given the observed effect and sample sizes of aged mice; the trending p-value of 0.06 is displayed to provide a better understanding of the results. No significant differences in survival rate were observed between nintedanib- versus vehicle-treated groups for both young (68% versus 72%, respectively) and aged mice (83% versus 76%, respectively) during this treatment period (day 10–21). Overall, these data indicate that ageing does not impact the efficacy of nintedanib in terms of its ability to inhibit the development of de novo lung fibrosis.

Although nintedanib is overwhelmingly prescribed to elderly patients, this is the first study to demonstrate that ageing does not impact the efficacy of nintedanib. This study sheds light on the utility of aged animal models in pulmonary fibrosis.https://bit.ly/3zA9RC5

Unconventional supercurrent phase in Ising superconductor Josephson junction with atomically thin magnetic insulator

In two-dimensional (2D) NbSe₂ crystal, which lacks inversion symmetry, strong spin-orbit coupling aligns the spins of Cooper pairs to the orbital valleys, forming Ising Cooper pairs (ICPs). The unusual spin texture of ICPs can be further modulated by introducing magnetic exchange. Here, we report unconventional supercurrent phase in van der Waals heterostructure Josephson junctions (JJs) that couples NbSe₂ ICPs across an atomically thin magnetic insulator (MI) Cr₂Ge₂Te₆. By constructing a superconducting quantum interference device (SQUID), we measure the phase of the transferred Cooper pairs in the MI JJ. We demonstrate a doubly degenerate nontrivial JJ phase (ϕ), formed by momentum-conserving tunneling of ICPs across magnetic domains in the barrier. The doubly degenerate ground states in MI JJs provide a two-level quantum system that can be utilized as a new dissipationless component for superconducting quantum devices. Our work boosts the study of various superconducting states with spin-orbit coupling, opening up an avenue to designing new superconducting phase-controlled quantum electronic devices.

Van der Waals structures provide a new platform to explore novel physics of superconductor/ferromagnet interfaces. Here, NbSe₂ Josephson junction with Cr₂Ge₂Te₆ enables non-trivial Josephson phase by spin-dependent interaction, boosting the study of superconducting states with spin-orbit coupling and phase-controlled quantum electronic device.

Efficient distribution of oral vaccines examined by infrared triggered camera for advancing the control of raccoon dog rabies in South Korea

The field distribution of the oral rabies vaccine is effective in controlling the spread of rabies. The present study aimed to investigate efficient distribution locations based on the environment, contact rate, and consumption by target wildlife species in South Korea. The target species (Korean raccoon dogs, domestic dogs, and feral cats) accounted for 945 contacts (52.2%), in total 1,808 contacts. There were 863 (47.8%) contacts by non-target species. Raccoon dogs, a main reservoir of rabies in South Korea, had the highest contact rate (34.1%) among all species. The contact rate by target species was highest at riparian sites and bushy mountainous vegetation, where raccoon dogs are abundant. There was remarkable contact by raccoon dogs in mountainous areas below 150 m with bushy vegetation. Our results indicate that these locations are efficient areas for vaccine distribution, especially targeting the raccoon dog. Vaccines were continuously contacted with intervals ranging from one hour to one day. Vaccines at 94.4% of the distribution points were completely consumed within two weeks. The mean consumption rate was 95.2 ± 1.93% during the overall study period. These findings suggest that the oral rabies vaccine attracts wildlife including domestic dogs and feral cats. Our results suggest that low sections of mountainous areas with bushy vegetation and/or neighboring riparian areas are rich in target wildlife species (especially raccoon dogs) and are efficient locations for vaccine distribution to control rabies in South Korea.

Impaired Myofibroblast Dedifferentiation Contributes to Nonresolving Fibrosis in Aging

Idiopathic pulmonary fibrosis (IPF) is a fatal age-associated disease with no cure. Although IPF is widely regarded as a disease of aging, the cellular mechanisms that contribute to this age-associated predilection remain elusive. In this study, we sought to evaluate the consequences of senescence on myofibroblast cell fate and fibrotic responses to lung injury in the context of aging. We demonstrated that nonsenescent lung myofibroblasts maintained the capacity for dedifferentiation, whereas senescent/IPF myofibroblasts exhibited an impaired capacity for dedifferentiation. We previously demonstrated that the transcription factor MyoD acts as a critical switch in the differentiation and dedifferentiation of myofibroblasts. Here, we demonstrate that decreased levels of MyoD preceded myofibroblast dedifferentiation and apoptosis susceptibility in nonsenescent cells, whereas MyoD expression remained elevated in senescent/IPF myofibroblasts, which failed to undergo dedifferentiation and demonstrated resistance to apoptosis. Genetic strategies to silence MyoD restored the susceptibility of IPF myofibroblasts to undergo apoptosis and led to a partial reversal of age-associated persistent fibrosis in vivo. The capacity for myofibroblast dedifferentiation and subsequent apoptosis may be critical for normal physiologic responses to tissue injury, whereas restricted dedifferentiation and apoptosis resistance in senescent cells may underlie the progressive nature of age-associated human fibrotic disorders. These studies support the concept that senescence may promote profibrotic effects via impaired myofibroblast dedifferentiation and apoptosis resistance, which contributes to myofibroblast accumulation and ultimately persistent fibrosis in aging.

Relationship between sociability toward humans and physiological stress in dogs

Sociability is an essential trait for dogs to successfully interact with humans. In this study, the relationship between sociability and physiological stress was examined. Additionally, whether differences exist between companion dogs (C group) and shelter dogs (S group) was examined. Overall, healthy 37 dogs (C group=21 and S group=16) were examined. After 5 min of walking, the dog and the owner (or the chief manager) rested freely in the experimental location for 5 min. The behavioral test with 6 categories was conducted to evaluate sociability over 4 min. The establishment of two groups (H group=dogs with high sociability; L group=dogs with low sociability) was supported by the statistical results of the behavioral tests. Saliva was collected before (P1) and after the test period (P2), and salivary cortisol levels were determined and statistically analyzed. The cortisol concentrations at P2 and the differences in concentrations between P1 and P2 (P2–P1) in the groups with high sociability were significantly lower than those in the groups with low sociability. These results may demonstrate that sociable dogs adapt more comfortably to strangers and unfamiliar situations. Meanwhile, there were significant differences in hormonal results between the C and S groups. For this reason, their sociability should be evaluated using behavioral and physiological assessments before re-adoption to ensure their successful adaptation.

Evaluation of effects of olfactory and auditory stimulation on separation anxiety by salivary cortisol measurement in dogs

Separation anxiety (SA) is a serious behavioral problem in dogs. In this study, salivary cortisol was studied to determine if the owner's odor or voice could reduce SA in dogs. Twenty-eight dogs with SA were divided into three groups: group 1 (control), group 2 (with owner's clothes during the separation period; SP) and group 3 (a recording of the owner's voice was played during SP). The dog's saliva was collected after the owner and their dog were in the experimental room for 5 min (PRE). The dog was then separated from the owner for 20 min and saliva collected four times at intervals of 5 min (SP1–4). Finally, the owner was allowed back into the room to calm the dog for 5 min, after which saliva was collected (POST). Evaluation of salivary cortisol concentrations by ELISA revealed that the ratios of SP1 concentration to PRE or POST concentrations were significantly higher in group 1 than in group 2 or 3. Additionally, the concentrations of SP1–PRE and SP1–POST among groups differed significantly. These findings indicate that the owner's odor or voice may be helpful to managing stress in dogs with SA.

Dysregulated Nox4 ubiquitination contributes to redox imbalance and age-related severity of acute lung injury

Acute respiratory distress syndrome (ARDS) is a devastating critical illness disproportionately affecting the elderly population, with both higher incidence and mortality. The integrity of the lung endothelial cell (EC) monolayer is critical for preservation of lung function. However, mechanisms mediating EC barrier regulation in the context of aging remain unclear. We assessed the severity of acute lung injury (ALI) in young (2 mo) and aged (18 mo) mice using a two-hit preclinical model. Compared with young cohorts, aged mice exhibited increased ALI severity, with greater vascular permeability characterized by elevated albumin influx and levels of bronchoalveolar lavage (BAL) cells (neutrophils) and protein. Aged/injured mice also demonstrated elevated levels of reactive oxygen species (ROS) in the BAL, which was associated with upregulation of the ROS-generating enzyme, Nox4. We evaluated the role of aging in human lung EC barrier regulation utilizing a cellular model of replicative senescence. Senescent EC populations were defined by increases in β-galactosidase activity and p16 levels. In response to lipopolysaccharide (LPS) challenge, senescent ECs demonstrate exacerbated permeability responses compared with control "young" ECs. LPS challenge led to a rapid induction of Nox4 expression in both control and senescent ECs, which was posttranslationally mediated via the proteasome/ubiquitin system. However, senescent ECs demonstrated deficient Nox4 ubiquitination, resulting in sustained expression of Nox4 and alterations in cellular redox homeostasis. Pharmacological inhibition of Nox4 in senescent ECs reduced LPS-induced alterations in permeability. These studies provide insight into the roles of Nox4/senescence in EC barrier responses and offer a mechanistic link to the increased incidence and mortality of ARDS associated with aging.

Rapid enlargement of endometrial stromal sarcoma after uterine fibroid embolization for presumed adenomyosis: a case report and literature review

Uterine sarcomas have rarely been diagnosed after uterine artery embolization. It remains unclear whether the diagnostic work-up is required prior to such embolization to prevent a missed diagnosis of sarcomas and a delay in providing definitive treatment. Because of the rarity and heterogeneity of endometrial stromal neoplasms, little is known about their epidemiology, pathogenesis, and molecular pathology. The authors report a case of low-grade endometrial stromal sarcoma (ESS) diagnosed after uterine fibroid embolization. Although they performed laparoscopic biopsy of the rapidly growing uterine mass, they could not detect the ESS. Although rare, ESS should be considered in the differential diagnosis of uterine fibroid enlargement. It is essential to assess the risk of malignancy by taking into account the patient's clinical symptoms, results of the physical exam, and imaging findings prior to uterine artery embolization. Pathologic diagnosis should include an adequate biopsy sample and the use of molecular genetic testing.

Selective repression of RET proto-oncogene in medullary thyroid carcinoma by a natural alkaloid berberine

Background

The gain-of-function mutation of the RET proto-oncogene, which encodes a receptor tyrosine kinase, is strongly associated with the development of several medullary thyroid carcinomas (MTCs). Thus, the RET protein has been explored as an excellent target for progressive and advanced MTC. In this study we have demonstrated a therapeutic strategy for MTC by suppressing the transcription of RET proto-oncogene though the stabilization of G-quadruplex structure formed on the promoter region of this gene using a natural product berberine.

Methods

Medullary thyroid carcinoma (MTC) TT cell line has been used to evaluate the effects of berberine on RET expression and its downstream signaling pathways. The specificity of berberine was demonstrated by using the papillary thyroid carcinoma TPC1 cell line, which lacks the G-quadruplex forming sequence on the RET promoter region due to chromosomal rearrangement.

Results

Berberine suppressed the RET expression by more than 90 % in MTC TT cells at a concentration of 2.5 μg/ml with minimal effect on the TPC1 cells. Canadine, which is a structural analogue of berberine, showed little interaction with RET G-quadruplex and also had no effect on RET expression in MTC TT cells. The down-regulation of RET with berberine further inhibited the cell proliferation through cell cycle arrest and activation of apoptosis in TT cells, which was confirmed by a 2-fold increase in the caspase-3 activity and the down-regulation of cell-cycle regulatory proteins.

Conclusion

Our data strongly suggest that the G-quadruplex forming region and the stabilization of this structure play a critical role in mediating the repressive effect of berberine on RET transcription.

Suppression of creep-regime dynamics in epitaxial ferroelectric BiFeO3 films

Switching dynamics of ferroelectric materials are governed by the response of domain walls to applied electric field. In epitaxial ferroelectric films, thermally-activated ‘creep’ motion plays a significant role in domain wall dynamics, and accordingly, detailed understanding of the system’s switching properties requires that this creep motion be taken into account. Despite this importance, few studies have investigated creep motion in ferroelectric films under ac-driven force. Here, we explore ac hysteretic dynamics in epitaxial BiFeO₃ thin films, through ferroelectric hysteresis measurements, and stroboscopic piezoresponse force microscopy. We reveal that identically-fabricated BiFeO₃ films on SrRuO₃ or La_0.67Sr_0.33MnO₃ bottom electrodes exhibit markedly different switching behaviour, with BiFeO₃/SrRuO₃ presenting essentially creep-free dynamics. This unprecedented result arises from the distinctive spatial inhomogeneities of the internal fields, these being influenced by the bottom electrode’s surface morphology. Our findings further highlight the importance of controlling interface and defect characteristics, to engineer ferroelectric devices with optimised performance.

Abstract 3208: Identification and characterization of a small molecule involved in the downregulation of RET transcription in MTC

The gain of function mutations in the RET proto-oncogene, which results in the constitutive activation of the mitogenic pathways, were found mainly in Medullary Thyroid Carcinoma (MTC). In our study, a new therapeutic strategy has been explored to repress the expression of the RET gene by targeting the transcriptional activation of this gene with small molecules. The transcriptional inhibitor of the RET gene was initially screened from the NCI chemical libraries using the cell-based luciferase reporter gene assay, which has a promoter sequence identical to the RET promoter. As a result of our screening effort, a small molecule, nonactin, has been identified as a potential lead compound, downregulating the transcriptional activity of the RET gene promoter. The effect of this molecule in the downregulation of the RET mRNA levels and the protein levels was confirmed by RT-PCR and western blotting respectively. We also observed that Egr1 expression is downergulated in a dose dependent manner by this small molecule, which is in correlation with the RET downregulation. The RET promoter has a highly conserved GC rich region, which acts as a binding site for Egr-1, which is involved in the transcription of many growth factor genes. Thus, we conclude that Egr1 would be one of important transcriptional factors involved in the activation of the RET and nonactin inhibits the expression of Egr1, which in turn downregulates the transcription of RET oncogene.

Citation Format: Vishnu Muthuraj Kumarasamy, Yoon-Joo Shin, Daekyu Sun. Identification and characterization of a small molecule involved in the downregulation of RET transcription in MTC. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3208. doi:10.1158/1538-7445.AM2014-3208

Abstract 745: Role of G-quadruplex structures in the human RET promoter region in the regulation of this gene

The medullary thyroid carcinoma (MTC) is a tumor type characterized by germline point mutations of the RET (REarranged during Transfection) proto-oncogene. Since these mutations are known to induce oncogenic activation of RET tyrosine kinase, various therapeutic strategies interfering with the oncogenic function of RET protein have been developed and tested for treating RET-associated cancers in several preclinical and clinical studies. Our previous study has demonstrated that the G-rich strand in the polypurine/polypyrimidine (pPu/pPy) region of the RET proximal promoter is capable of forming intramolecular G-quadruplex structures in vitro in the presence of K+, which can be further stabilized by a G-quadruplex interactive agents. Thus, the detailed mechanism by which G-quadruplex structures regulate RET transcription has been studied using mutation analysis and promoter reporter assays together with a detailed analysis of transcription factor binding to the RET promoter in vivo. To this end, we have explored the Flp-In cell system using homologous recombination, which allows integration of a single copy of a wild type or G-quadruplex-mutant RET promoter–luciferase construct into a specific genomic recombination locus (FRT site) in a host Flp-In the human embryonic kidney 293 (HEK293) cell line. Thus, differences in reporter expression levels from isolated isogenic cell clones can be ascribed more confidently to promoter-specific effects, rather than enhancer/silencer artifacts due to variations in integration sites. Using these isogenic cell lines, we are able to provide strong evidence for G-quadruplex-dependent transcriptional repression of the RET gene in vivo.

Citation Format: Daekyu Sun, Yoon-Joo Shin. Role of G-quadruplex structures in the human RET promoter region in the regulation of this gene. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 745. doi:10.1158/1538-7445.AM2013-745

Abstract A140: Development of high-throughput assay for new agents that inhibit the transcription of the HIF-1alpha gene

The hypoxic (low-oxygen) region is developed in most solid tumors as they grow and outstrip their blood supply. A critical mediator of this series of hypoxic responses is known as the transcription factor hypoxia-inducible factor 1 (HIF-1), which mediates increased expression of proteins that promote angiogenesis, anaerobic metabolism, and many other survival pathways. Therefore, HIF-1 alpha has been proposed as a particular target for therapeutic intervention of human cancer. Thus, there is need for extensive discovery of new types of more specific HIF-1 inhibitors, including small molecules that directly inhibit the transcription of the HIF-1 alpha gene. In our preliminary studies, we have demonstrated that the transcription of HIF-1 alpha gene is greatly dependent upon the presence of the pPu/pPy tract within its proximal promoter region. We further explored if it is feasible to identify small molecules that inhibit the transcription of the HIF-1 alpha gene by interfering with the assembly of the transcription machinery to the proximal promoter region of this gene. As a means of measuring promoter response to small molecules in cells, the luciferase reporter-based cell assays would be simple, straightforward, and very effective. Thus, this assay could also be used to identify transcriptional inhibitors of the HIF-1 alpha gene. To determine if luciferase reporter assay is amenable for high-throughput screening for novel inhibitors of the transcription of the HIF-1 alpha gene, we used the Flp-In system to generate genetically engineered Flp-In 293 cell lines stably expressing the firefly luciferase gene under the control of the HIF-1 alpha promoter as described in our preliminary studies. In our preliminary studies, we have also demonstrated that the transcription of HIF-1 alpha gene is greatly dependent upon the presence of the pPu/pPy tract within its proximal promoter region.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr A140.

Heterogeneous nuclear ribonucleoprotein K and nucleolin as transcriptional activators of the vascular endothelial growth factor promoter through interaction with secondary DNA structures

The human vascular endothelial growth factor (VEGF) promoter contains a polypurine/polypyrimidine (pPu/pPy) tract that is known to play a critical role in its transcriptional regulation. This pPu/pPy tract undergoes a conformational transition between B-DNA, single-stranded DNA, and atypical secondary DNA structures such as G-quadruplexes and i-motifs. We studied the interaction of the cytosine-rich (C-rich) and guanine-rich (G-rich) strands of this tract with transcription factors heterogeneous nuclear ribonucleoprotein (hnRNP) K and nucleolin, respectively, both in vitro and in vivo and their potential role in the transcriptional control of VEGF. Using chromatin immunoprecipitation (ChIP) assay for our in vivo studies and electrophoretic mobility shift assay (EMSA) for our in vitro studies, we demonstrated that both nucleolin and hnRNP K bind selectively to the G- and C-rich sequences, respectively, in the pPu/pPy tract of the VEGF promoter. The small interfering RNA (siRNA)-mediated silencing of either nucleolin or hnRNP K resulted in the down-regulation of basal VEGF gene, suggesting that they act as activators of VEGF transcription. Taken together, the identification of transcription factors that can recognize and bind to atypical DNA structures within the pPu/pPy tract will provide new insight into mechanisms of transcriptional regulation of the VEGF gene.

Evidence of the formation of G-quadruplex structures in the promoter region of the human vascular endothelial growth factor gene

The polypurine/polypyrimidine (pPu/pPy) tract of the human vascular endothelial growth factor (VEGF) gene is proposed to be structurally dynamic and to have potential to adopt non-B DNA structures. In the present study, we further provide evidence for the existence of the G-quadruplex structure within this tract both in vitro and in vivo using the dimethyl sulfate (DMS) footprinting technique and nucleolin as a structural probe specifically recognizing G-quadruplex structures. We observed that the overall reactivity of the guanine residues within this tract toward DMS was significantly reduced compared with other guanine residues of the flanking regions in both in vitro and in vivo footprinting experiments. We also demonstrated that nucleolin, which is known to bind to G-quadruplex structures, is able to bind specifically to the G-rich sequence of this region in negatively supercoiled DNA. Our chromatin immunoprecipitation analysis further revealed binding of nucleolin to the promoter region of the VEGF gene in vivo. Taken together, our results are in agreement with our hypothesis that secondary DNA structures, such as G-quadruplexes, can be formed in supercoiled duplex DNA and DNA in chromatin in vivo under physiological conditions similar to those formed in single-stranded DNA templates.

Thiol-dependent DNA cleavage by aminomethylated Beaucage's reagent

Aminomethylated Beaucage's reagent 1 was found to be more potent than 3H-1,2-benzodithiol-3-one 1,1-dioxide (Beaucage's reagent) in causing DNA cleavage. The current study demonstrated the importance of the amino functionality in enhancing DNA-cleaving activities, and such findings may facilitate development of novel sulfur-containing DNA-cleaving molecules in cancer therapy.

Abstract A203: Heterogeneous nuclear ribonucleoprotein K (hnRNP K) binds to the vascular endothelial growth factor (VEGF) promoter and plays a role in its transcriptional control

The vascular endothelial growth factor (VEGF) promoter is capable of forming secondary DNA structures, called G-quadruplex and i-motif, in its proximal promoter region (−85 to −50 from the transcription initiation site) that can mask transcription factor binding sites thereby inhibiting transcription. To understand this dynamic region and its implications in transcriptional control we studied protein-DNA interactions of this structurally versatile region, specifically those involving transcription factors. Our candidate transcription factor, heterogeneous nuclear ribonucleoprotein K (hnRNP K) is a single-stranded DNA binding protein able to binding to cytosine-rich sequences such as the VEGF polypurine/polypyrimidine tract. We found that the cytosine-rich 24-bp oligomer has the potential of forming an i-motif at pH 6.5 and formed a complex with hnRNP K as shown by CD spectra analysis and electrophoretic mobility shift assay (EMSA), respectively. The binding of hnRNP K to the VEGF promoter was confirmed through chromatin immunoprecipitation (ChIP) assay, and its effect on transcriptional control was demonstrated through RT/PCR of hnRNP K siRNA KO and overexpression assays. We also observed through EMSA/Footprint that the hnRNP K protein changes the oligo conformation from an i-motif structure to a more unstructured linear conformation. In summary, this work is the first to show that hnRNP K serves a role in the transcriptional control of VEGF and that a bromine solution left to react to the protein-complex can be used to footprint its binding motif.

Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A203.

Comprehensive clinical follow-up of late effects in childhood cancer survivors shows the need for early and well-timed intervention

BACKGROUND

Due to recent advances in treatment, nearly 80% of childhood cancer patients become long-term survivors. Studies on the late effects of survivors are under way worldwide. However, data on Asian survivors remain limited.

METHODS

Data on 241 survivors at the Long-term Follow-up Clinic in Severance Hospital, South Korea, were collected and late effects were confirmed by oncologists.

RESULTS

The median follow-up from diagnosis was 7.8 years. Late effects were identified in 59.8% of survivors and 23.2% had two or more late effects. Grade 3 or higher late effects were present in 10.8%. The most common late effects involved endocrine system (29.0%). Late effects were present in 95.7% of brain tumor survivors and 36.0% of Wilms' tumor survivors. Chemotherapy, hematopoietic stem-cell transplantation and radiotherapy were significant factors associated with the number and severity of late effects (P < 0.05). Brain tumor survivors had more severe late effects (P < 0.001), whereas Wilms' tumor survivors had fewer and milder late effects (P < 0.05).

CONCLUSION

The observation that over 50% of cancer survivors suffered from late effects during the short follow-up period and that a high frequency of endocrine late effects was present indicates the need for early and well-timed intervention of the survivors.

Circulating osteoprotegerin levels are elevated and correlated with antiphospholipid antibodies in patients with systemic lupus erythematosus

Patients with antiphospholipid syndrome (APS) have an increased risk for the development of thrombotic complications. Recent studies indicate that osteoprotegerin (OPG) acts as an important molecule in the development of vascular diseases. The aim of the present study was to examine the association between serum OPG levels and APS manifestations in patients with SLE. Seventy-nine patients with SLE and ninety-two healthy controls, matched for age and sex, were included in this study. Serum levels of OPG, monocyte chemoattractant protein(MCP)-1 and soluble E-selectin were determined by ELISA. At the time of serum sampling, various clinical and laboratory parameters were assessed. We found that serum levels of OPG were significantly higher in patients with SLE than in healthy controls (1236 ± 82 vs 967 ± 37 pg/mL, P = 0.003). Particularly, serum OPG levels were significantly higher in SLE patients with APS than those without (1615 ± 191 vs 1171 ± 91 pg/mL, P = 0.006). Serum OPG levels correlated with titres of IgG anti-cardiolipin antibody ( P = 0.026) and anti-β2-glycoprotein I antibody ( P < 0.001). Moreover, serum OPG also correlated with serum levels of sE-selectin ( P = 0.002), which is an endothelial cell activation marker, and MCP-1 ( P = 0.003), a well known chemokine implicated in thrombogenesis. Collectively, serum OPG levels were increased in SLE patients with APS and correlated with titres of antiphospholipid antibodies, suggesting that OPG might be linked to the development of APS.

Fabrication of transparent capacitive structure by self-assembled thin films

An approach to fabricating transparent electronic devices by using nanomaterial and nanofabrication is presented in this paper. A see-through capacitor is constructed from self-assembled silica nanoparticle layers that are stacked on the transparent substrate. The electrodes are made of indium tin oxide. Unlike the traditional processes used to fabricate such devices, the self-assembly approach enables one to synthesize the thin film layers at lower temperature and cost, and with a broader availability of nanomaterials. The vertical dimension of the self-assembled thin films can be precisely controlled, as well as the molecular order in the thin film layers. The shape of the capacitor is generated by planar micropatterning. The monitoring by quartz crystal demonstrates the steady growth of the silica nanoparticle multilayer. In addition, because the material synthesis and the device fabrication steps are separate, the fabrication is not affected by the harsh conditions required for the material synthesis. As a result, a clear pattern is allowed over a large area on the substrate. The prepared capacitive structure has an optical transparency higher than 92% over the visible spectrum. The capacitive impedance is measured at different frequencies and fit the theoretical results. As one of the fundamental components, this type of capacitive structure can serve in the transparent circuits, interactive media and sensors, as well as being applicable to other transparent devices.

Relationship between the change in overweight status from childhood to adolescence and metabolic syndrome phenotypes: a 9-year retrospective study

OBJECTIVE

To evaluate how the changes in overweight status from childhood to adolescence are related to metabolic syndrome phenotypes in adolescents.

SUBJECTS AND METHODS

A total 375 adolescents aged 16 years. The overweight status from childhood to adolescence (from 7 years of age to 16 years) was determined by body mass index (BMI, kg/m(2)) calculated from records of the School Physical Examination data. The change in body weight was classified into four groups: normal weight to normal weight (NW-NW); overweight to normal (OW-NW); normal to overweight (NW-OW); overweight to overweight (OW-OW). Metabolic syndrome phenotypes were examined from a cross-sectional survey.

RESULTS

The mean values of all phenotypes except for body fatness (BMI and waist) and the cluster score of phenotypes at 16 years of age were not different between the NW-NW group and the OW-NW group, nor between the NW-OW group and the OW-OW group. However, the score as well as the level of body fatness and blood glucose were significantly different between current overweight and normal adolescents regardless of overweight status during childhood (P<0.05).

CONCLUSION

There was a linear relationship between overweight status during childhood and metabolic syndrome phenotypes in adolescence but current overweight status (adolescence overweight) was more closely related to the adolescent risk of metabolic syndrome than childhood overweight status.

Clusterin induces differentiation of pancreatic duct cells into insulin-secreting cells

AIMS/HYPOTHESIS

We recently reported that expression of the gene encoding clusterin (Clu) is upregulated in the regenerating pancreas, particularly in tissues undergoing differentiation. This led us to propose that clusterin participates in the cytodifferentiation of pancreatic tissue, particularly the endocrine islet cells. The aim of this study was to investigate whether clusterin induces the differentiation of duct-lining cells into insulin-secreting cells.

METHODS

We isolated ductal tissue from rat pancreas and cultured it to develop epithelial cell explants for transfection of the Clu cDNA as well as for treatment of clusterin protein.

RESULTS

The number of newly differentiated insulin cells increased 6.9-fold upon Clu overexpression compared with controls. Ins1 mRNA and peptide levels were also increased. Furthermore, glucose-stimulated insulin secretion was observed in the differentiated insulin cells. These cells were immunoreactive for insulin and C-peptide, but negative for other islet hormones and for cytokeratin-20, which indicates a fully differentiated state. Insulin cell differentiation was also increased in a dose-dependent manner by treating duct cells in culture with clusterin, indicating a growth-factor-like action of clusterin in insulin cell differentiation.

CONCLUSIONS/INTERPRETATION

These results suggest that clusterin can be considered as a potential morphogenic factor that promotes differentiation of pancreatic beta cells.

Comparison of one-step RT-PCR and a nested PCR for the detection of canine distemper virus in clinical samples

OBJECTIVE

To develop a rapid and sensitive method for the detection of canine distemper virus (CDV) by nested PCR using clinical specimens.

DESIGN

A nested PCR was developed, compared to a one-step RT-PCR and validated.

PROCEDURE

Two sets of specific primers for a one-step RT-PCR and a nested PCR, targeting a 640 bp fragment and a 297 bp fragment, respectively, were selected from the highly conserved region of the nucleocapsid protein (NP) gene of CDV. The nested PCR and the one-step RT-PCR were used to amplify a part of the CDV NP gene of a CDV vaccinal strain and samples of urine, blood, nasal discharge and saliva from 29 dogs suspected of suffering CD.

RESULTS

Both the one-step RT-PCR and the nested PCR reacted with the CDV vaccinal strain, but not with canine parvovirus. The expected 640 bp fragment of the NP gene was detected in 11/22 (50.0%) blood, 10/20 (50.0%) urine, 5/25 (20.0%) saliva and 6/27 (22.2%) nasal swab samples by one-step RT-PCR, whereas the nested PCR amplified an expected 297 bp fragment of the NP gene in 18/22 (81.8%) blood, 15/20 (75.0%) urine, 14/25 (56%) saliva and 19/27 (70.3%) nasal swab samples.

CONCLUSION

The nested PCR detected CDV in blood, urine, nasal swab and saliva more frequently than did the one-step RT-PCR. Therefore, this assay should be a useful aid to antemortem diagnosis of CDV infections in dogs.

Rubella antibody loss rates in Korean children

We followed students in eight elementary schools for rubella antibody from 1993 to 1996 (602 pairs) and 1996-9 (588 pairs) in Gyeonggi Province, Korea. We tested rubella IgG and administered rubella vaccine to the children with the titres < 10 IU/ml. The loss rates of rubella IgG during the follow-up periods were 14.3 and 15.8%, respectively. Among vaccinated groups, the loss rate was 18.8%, which was significantly higher than 13.8% of the mixture of natural and vaccine-induced immunity groups. The group that had the lower preceding antibody titre had a higher loss rate of 24.8% compared to 7.2% for the group whose titre was 40 IU/ml or above. In a multivariate analysis, age and gender were not related to antibody loss rate. Under this higher rubella antibody loss rate, in order to prevent congenital rubella syndrome, the immunization for women at childbearing age appears necessary until rubella can be eliminated or controlled.

[Ambulatory surgery of otosclerosis: retrospective study of 102 cases]

A retrospective study of 102 selected patients operated for otosclerosis (34 outpatient surgery, 68 hospitalised), having all of them the inclusion criteria of the ambulatory surgery, treated as outpatient in a traditional health sector or hospitalised, depending on their own choice, has been lead. We analysed the results of the pure tone audiometric tests two to six months after surgery. No significative difference was found between the two groups on audiometric results as for the postoperative complications. On the other side, it seems that young patients are more interested by the one-day surgery. The failure of the ambulatory surgery could be explained by the vertigo or dizziness per- or postoperatively. Finally, the evaluation of the cost-benefit shows that the ambulatory surgery in a traditional health sector could lead a budgetary saving policy. A saving way that will grow in a specialized sector devoted to the ambulatory practice.

Antisense Bcl2 oligonucleotide in cisplatin-resistant bladder cancer cell lines

OBJECTIVE

To determine the change of expression of Bcl2 in cisplatin-resistant bladder cancer cell lines and the reversibility of chemoresistance to cisplatin with antisense oligonucleotide against Bcl2, as higher expression of Bcl2 is associated with drug resistance in many different cancer cell lines.

MATERIALS AND METHODS

In the cisplatin-resistant bladder tumour cell lines T24R1 and T24R2, the expression of Bcl2 was determined by reverse transcription-polymerase chain reaction and Western blot assay, and antisense oligonucleotide targeting of the Bcl2 coding sequence was administered with lipofectin.

RESULTS

The expression of Bcl2 mRNA and protein was greater in T24R1 and T24R2 cells than in the parent T24 cells. Short-term exposure to cisplatin up-regulated Bcl2 mRNA and protein expression in parent T24 cells. Treatment with antisense oligonucleotide down-regulated Bcl2 protein expression and significantly enhanced the cytotoxicity of cisplatin.

CONCLUSIONS

Up-regulation of Bcl2 protein expression might be one of the mechanisms of cisplatin resistance in bladder cancer cells, and antisense Bcl2 oligonucleotide may be helpful in chemotherapy for bladder cancer by reversing cisplatin resistance.

[Reliability of CT scan in the diagnosis of conductive hearing loss with normal tympanic membrane]

The goal of this study was to assess the reliability of CT-Scan in the cases of conductive hearing losses with normal tympanic membrane. A computed tomography of the temporal bone (CT-Scan) has been performed in a prospective manner in all patients who underwent surgery for a conductive hearing loss with a normal tympanic membrane in our department. Out of 474 cases, 437 cases (92.2%) presented with otosclerosis. In 25 cases a minor malformation (5.3%) was found at surgery, and in 12 cases (2.5%), another diagnosis was made. Sensitivity of CT-Scan was 91.3% in otosclerosis and 57% in minor malformations. In 8.7% of cases, a superficial and beginning surgical focus was put in evidence whereas CT-Scan was normal. Theses cases represent infra-radiological cases of otosclerosis. In case of radiological otosclerosis, fenestral otosclerosis was found in 83.5% of the cases. CT-Scan was found specific on the operated and deaf side, but in 11.3% of the cases, a radiologic focus did not have a clinical consequence on the controlateral side. A radiological focus is not systematically responsible for a hearing loss. Finally, CT-Scan remains a reliable, sensitive and specific exam in the diagnosis of cases of conductive hearing losses with normal tympanic membrane.

Therapeutic trial in the first three Asian cases of ethylmalonic encephalopathy: response to riboflavin

Three Korean girls with ethylmalonic encephalopathy, the first Asian cases, were identified. In all three cases, we observed slight improvement in motor functions, cognitive behaviours and chronic mucoid diarrhoea after treatment with riboflavin and/or coenzyme Q10 treatment. The precise pathogenesis of ethylmalonic encephalopathy has not been fully elucidated, but riboflavin treatment may be helpful.

Clusterin expression during regeneration of pancreatic islet cells in streptozotocin-induced diabetic rats

AIMS/HYPOTHESIS

Beta-cell regeneration has been reported after islet injury in an animal model for diabetes. Recently, we showed up-regulation of clusterin after islet injury and suggested that clusterin might be involved in cytoprotection and in the regeneration of islet cells. The aim of this study was to investigate the correlation of clusterin expression with islet regeneration and its effect on islet cell replication.

METHODS

Streptozotocin was administrated to rats to induce various types of diabetes. Islet regeneration and clusterin expression were examined after islet injuries. Clusterin cDNA was transfected to MIN6 cells and their proliferation activity was measured by a [3H]thymidine-incorporation assay.

RESULTS

A diabetogenic dose of streptozotocin injected in rats provoked an immediate degeneration of beta cells. In this model, islets showed increased clusterin expression with extensive proliferation of alpha cells but showed poor beta-cell replication. A subdiabetogenic dose of streptozotocin, however, led to the proliferation of beta cells with clusterin up-regulation. In streptozotocin-treated neonatal rats, up-regulation of clusterin was noted during beta-cell proliferation. In all experimental models, clusterin was expressed in alpha cells in close correlation with islet cell proliferation, higher transcription of insulin mRNA and MAPKs activation. Cell replication was increased by 31 % in the MIN6 cells transfected by the clusterin cDNA.

CONCLUSION/INTERPRETATION

Up-regulation of clusterin in alpha cells might induce beta-cell proliferation and thus restore their population after islet injury. We suggest that clusterin could be considered as a growth factor-like molecule stimulating islet-cell proliferation by paracrine action.

Correlations between computed tomography findings and family history in otosclerotic patients

BACKGROUND

Otosclerosis is a heritable disease affecting the otic capsule. Its genetics have been studied since the 19th century, but several issues remain controversial.

OBJECTIVE

The goals of this study were to assess the prevalence of sporadic and familial forms of otosclerosis in a population of otosclerotic patients and to compare the radiologic findings between both groups.

STUDY DESIGN AND SETTING

This retrospective study was conducted in a single institution.

PATIENTS

This study included 211 patients operated on for otosclerosis.

MAIN OUTCOME MEASURES

Clinical data, including pure tone audiograms, were available from patients' charts. A questionnaire assessing family history of otosclerosis and deafness was mailed to the otosclerotic patients. A relative was considered otosclerotic if surgery confirmed the disease. The family history was correlated with the computed tomography results. This examination was performed before surgery in all patients.

RESULTS

A family history of otosclerosis was found in 24.2% of the patients. The radiologic findings differed between patients with a sporadic form of otosclerosis and those with a familial form. The lesions were more often detectable, bilateral, and severe in the familial forms (p < 0.05).

CONCLUSION

These findings lead to the assumption that fenestral radiologic otosclerosis occurs more in sporadic forms, whereas more extensive lesions on computed tomography seem to indicate the familial forms. Hereditary forms demonstrated to be familial seem to lead to more severe disease. The search for a genome locus of otosclerosis may be enlightened by these findings.

New chiral crown ether stationary phase for the liquid chromatographic resolution of alpha-amino acid enantiomers

A new chiral stationary phase (CSP) for the liquid chromatographic separation of enantiomers was prepared by bonding a novel enantiopure (diphenyl-substituted 1,1'-binaphthyl) crown ether to 5 microm silica gel. The resulting CSP was applied to the separation of the enantiomers of various natural and unnatural alpha-amino acids. All alpha-amino acids tested were resolved very well on the new CSP, with the exception of proline, which does not contain a primary amino group. The resolution of alpha-amino acid enantiomers on this new CSP was found to be dependent on the type and amounts of organic and acidic modifiers, and on column temperature.

Sensorineural hearing loss and otosclerosis: a clinical and radiologic survey of 437 cases

The aim of this study was to determine if a relationship exists between bone level thresholds and the extension of otosclerotic foci within the otic capsule. The study consisted of a retrospective case review in a university hospital. We included patients who underwent surgery for otosclerosis in our department and who had a CT scan prior to surgery. We analyzed the data charts and CT scans of 437 cases (386 patients). On CT scan, we distinguished patients with fenestral otosclerosis and/or with a pericochlear focus. A pericochlear focus could be extended (Group 2) or not (Group 1) to the cochlear endosteum. Data for Groups 1 and 2 were compared with those for the control group of all patients for whom CT scan showed no cochlear focus (Group 3). Of the 437 CT scans, 399 were positive (91.3%). An anterior focus was reported in 305 cases (69.8%), a footplate thickening in 21 cases (4.8%) and both anomalies were encountered in 60 cases (13.7%). A pericochlear focus was reported in 53 examinations. This focus was extended to the endosteum in 14 cases (26.4% of the pericochlear foci). In Group 1, preoperative air conduction (AC) thresholds were significantly lower than in the control group (p < 0.05). The air--bone gap was also significantly larger in Group 1 (p < 0.05). Bone conduction (BC) thresholds were lower in Group 1 than in the control group but the difference was not significant. In Group 2, preoperative AC thresholds were significantly lower than in the control group (p < 0.05). BC thresholds were also lower in Group 2 than in the control group and the difference was significant (p < 0.05). As a result of this study, we assume that there may be a relationship between bone level thresholds and the radiological extension of otosclerosis within the otic capsule.

Effectiveness of conservative management of acoustic neuromas

OBJECTIVE

The goal of this study was to assess the effectiveness of the conservative management in patients with acoustic neuroma (vestibular schwannoma).

STUDY DESIGN

This retrospective study was performed in a university hospital.

PATIENTS

Patients were selected for this wait-and-see policy on the basis of age, general condition, audiometric results, tumor size, and patient preference. The study group included 97 patients, 87 of whom had at least two neuroradiologic examinations. The mean age of this population was 63 years (29 to 89 years). The mean length of follow-up of this population was 31 months. Eighty-seven of these patients had at least two radiologic examinations (magnetic resonance imaging or computed tomography). The mean interval between the initial and follow-up radiologic examinations was 15 months.

MAIN OUTCOME MEASURES

Tumor size was measured by use of two-dimensional data in all patients. The mean tumor size was 12 mm. The growth rate of the tumor was estimated by comparison of the results of the measurements from the initial and follow-up neuroradiologic examinations.

RESULTS

Of the 97 patients studied, 6 patients required surgery and 6 required radiotherapy. Sixty patients (62%) were still being treated conservatively at the end of the study period. Three patients of 28 who were classified as candidates for hearing preservation surgery lost their candidacy during the observation period. The mean annual tumor growth rate was 1.52 mm/year. The tumor was stable in size in 36% of patients, regressed in 11% of patients, or grew in 53% of patients. The growth patterns of the acoustic neuroma fell into five categories: continuous growth in 15% of patients, negative growth in 5%, growth followed by negative growth in 40%, negative growth followed by growth in 20%, and no variation of tumor size in 20%.

CONCLUSION

Conservative management of acoustic neuromas carries difficulties: long-term follow-up of the patients and unpredictability of the tumor growth pattern. A reliable and reproducible radiologic method for evaluating tumor size is of great importance.

Overexpression of protein kinase C delta represses expression of proliferin in NIH3T3 cells that regulates cell proliferation

Protein kinase C (PKC) delta is known to inhibit proliferation of many cell types. In this study we found that overexpression of PKCdelta reduced proliferation of NIH3T3 cells. To identify specific genes regulated by PKCdelta in regulation of cell proliferation, we used differential display-polymerase chain reaction in PKCdelta-overexpressing NIH3T3 cells and found that the expression of proliferin, a secreted protein known to stimulate cell proliferation, was significantly repressed. Transient transfection study indicated that the repression of proliferin expression was inversely proportional to the expression levels of PKCdelta. Addition of an anti-proliferin antibody to culture medium to neutralize the secreted proliferin decreased cell proliferation in a dose-dependent manner. Our results, therefore, suggest that overexpression of PKCdelta induces transcriptional repression of proliferin, thereby resulting in inhibition of cell proliferation.

Pure sensorineural hearing loss and otosclerosis. An imaging case report

Pure sensorineural hearing loss is not a rare finding in otological practice. Numerous aetiologies could be at the origin of such a deficit. However, otosclerosis is very rarely cited as a cause of pure sensorineural hearing loss. We present one such case of pure sensorineural hearing loss linked to otosclerosis in a 30-year old caucasian male and underline the high contribution of computed tomography to confirm such a diagnosis. Pure sensorineural hearing loss due to otosclerosis is a rare event and can be misdiagnosed. The clinical diagnosis of such a disease may be difficult. In these cases, CT-Scan is the exam of choice to confirm the diagnosis.

Retinoic acid and its geometrical isomers block both growth and fusion of L6 myoblasts by modulating the expression of protein kinase A

All-trans retinoic acid (RA) and its geometrical isomers, such as 9-cis RA, 13-cis RA, and 9,13-di-cis RA, strongly inhibited both growth and fusion of L6 myoblasts. However, illumination of white light diminished their inhibitory activity on membrane fusion with little effect on cell growth. During myogenic differentiation, the intracellular level of cAMP decreased whereas the total activity of protein kinase A as well as the protein level of its regulatory subunit Ialpha (RIalpha) and catalytic subunit (Calpha) increased. RAs raised the intracellular level of cAMP by over 3-fold, but decreased the total activity of protein kinase A. Like RAs, dibutyryl-cAMP inhibited myoblast fusion and reduced the expression of both RIalpha and Calpha subunits. These results suggest that RAs negatively modulate the differentiation of L6 myoblasts by increasing the intracellular level of cAMP, which may in turn down-regulate the expression of protein kinase A and hence its activity.

Benefits of cochlear implantation in elderly patients

Cochlear implantation in elderly patients is a questionable subject. The purpose of this study was to evaluate the procedure and its outcome, the postoperative course, and the audiologic and social benefits of cochlear implantation in this population. Twenty-seven patients older than 60 years were compared with a control group of 15 adult patients. This retrospective study analyzed data concerning the outcome of the procedure, postoperative course, postoperative orthophonic test results, and answers of a questionnaire assessing the changes in communication, perception, and social outcomes. The procedure was uneventful in both groups. Minor complications were not more frequent in elderly patients. Orthophonic test results were comparable in both groups. At 12 months, 83% of the elderly patients had an open-set speech discrimination score above 60%. The benefits of cochlear implantation in terms of the quality of life are not statistically different with younger patients. Cost-utility analysis might support these findings.

Analysis of the precore and core promoter DNA sequence in liver tissues from patients with hepatocellular carcinoma

To investigate the role of mutant hepatitis B virus (HBV) in the development of hepatocellular carcinoma (HCC), 20 patients with HCC were studied for precore and core promoter mutations in tumorous and nontumorous tissues. The precore and core promoter region was amplified and analyzed by direct sequencing. Among the 20 tumorous and nontumorous tissues, precore mutant HBV was found in 12 (60%) and 18 (90%), respectively. Of the 12 tumorous tissues with precore mutant, nine tissues had a single mutation (1896) and one tissue had another single mutation (1899). The remaining two tissues had a double mutation (1896 and 1899). A single mutation (1896) and a single mutation (1899) were found in 11 and two of the 18 nontumorous tissues with precore mutant, respectively. Among 20 tumorous and nontumorous tissues, HBV with a C to T mutation at nucleotide (nt) 1846 was detected in six and eight, respectively, and was associated with the virus carrying a mutation (1896 or 1899) except in two tumorous tissues. Mutations at nt 1762 and 1764 in core promoter were observed in 16 (80%) tumorous tissues and 18 (90%) nontumorous tissues. Mutations in the precore and core promoter region were found frequently in nontumorous tissue and in tumorous tissue (18/20 and 12/20 in precore region, 18/20 and 16/20 in core promoter respectively). The high prevalence of precore and core promoter mutations in liver tissue from patients with HCC suggests that these mutations may contribute to the development of HCC.

Comparison of Korean-American adoptees and biological children of their adoptive parents: a pilot study

This study compared a small group of Korean-American adoptees with their adoptive siblings who are biological children of the adoptive parents with respect to their psychosocial adjustment. Eighteen Korean-American adoptees were compared with nine biological children by a structured demographic, medical, clinical survey form and the Child Behavior Checklist-Parent Form (CBCL-P). The parents did not raise any more concerns about the adjustment of adopted children than their biological children. On the CBCL-P, the two groups did not differ significantly in competence T-scores, total behavioral problems, broad and T-scores and the total number of problem behaviors except for lower social competence in adopted children and a higher internalization score in biological children. In conclusion, the international adoptees, the Korean-American children have adjusted well during their early childhood after early adoption. Further studies employing a larger sample are warranted to better understand the international adoption practice.

Perfusion impairments in infantile autism on technetium-99m ethyl cysteinate dimer brain single-photon emission tomography: comparison with findings on magnetic resonance imaging

The neuro-anatomical substrate of autism has been the subject of detailed investigation. Because previous studies have not demonstrated consistent and specific neuro-imaging findings in autism and most such studies have been performed in adults and school-aged children, we performed a retrospective review in young children in search of common functional and anatomical abnormalities with brain single-photon emission tomography (SPET) using technetium-99m ethyl cysteinate dimer (ECD) and correlative magnetic resonance imaging (MRI). The patient population was composed of 23 children aged 28-92 months (mean: 54 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPET was performed after intravenous injection of 185-370 MBq of 99mTc-ECD using a brain-dedicated annular crystal gamma camera. MRI was performed in all patients, including T1, T2 axial and T1 sagittal sequences. SPET data were assessed visually. Twenty patients had abnormal SPET scans revealing focal areas of decreased perfusion. Decreased perfusion of the cerebellar hemisphere (20/23), thalami (19/23), basal ganglia (5/23) and posterior parietal (10/23) and temporal (7/23) areas were noted on brain SPET. By contrast all patients had normal MRI findings without evidence of abnormalities of the cerebellar vermis, cerebellar hemisphere, thalami, basal ganglia or parietotemporal cortex. In conclusion, extensive perfusion impairments involving the cerebellum, thalami and parietal cortex were found in this study. SPET may be more sensitive in reflecting the pathophysiology of autism than MRI. However, further studies are necessary to determine the significance of thalamic and parietal perfusion impairment in autism.

[Adenoid cystic carcinoma of the larynx. A case report and review of the literature]

Laryngeal adenoïd cystic carcinoma (ACC) is a rare disease due to the poor distribution of the accessory salivary glands in this area. The authors describe a case of ACC arising from the sus glottic area and underline the difficulty of such a diagnosis, which is in fact an histologic finding. The signs of discovery of a laryngeal ACC are not different from other tumors of the area, except pain frequently evoked in these tumors. Laryngeal ACC arises exceptionally before the age of 20 years and no risk factor is known. The most frequent localization is in the sub-glottic area, but sus glottic and glottic localizations have been reported. Evolution is marked by the onset of cervical lymph adenopathies and systemic metastasis most often located in the lung. The treatment comprises wide surgical exerisis followed by radiotherapy. Other reports seem to indicate that the pronostic of the laryngeal location of this disease is worse than in other areas of the head and neck.

Hearing restoration in posterior fossa tumors

OBJECTIVE

This study aimed to assess the results of hearing restoration with a cochlear or a brainstem implant in posterior fossa tumors.

PATIENTS

Six patients were selected. Two patients with an acoustic neuroma in the only-hearing ear (cases 1 and 2), one patient with a posterior fossa meningioma (case 3), one patient with bilateral facial neuroma (case 4), and two patients with bilateral acoustic neuroma (cases 5 and 6) participated.

INTERVENTION

In cases 1 and 2, the patients had a cochlear implant inserted on the only-hearing ear opposite the acoustic neuroma. In case 3, the patient presented with total deafness on the left side and a 10-mm meningioma on the right side. A cochlear implantation was performed after removal of the meningioma on the right side. In case 4, the patient was operated on on both sides with bilateral postoperative deafness. A cochlear implantation was performed on the better hearing ear. In cases 5 and 6, patients underwent an auditory brainstem implantation after the exeresis of the second tumor.

RESULTS

Promontory test results were positive for patients 1, 2, 3, and 4. After implantation, patients 1, 2, 3, and 4 scored 98%, 13%, 70%, and 30%, respectively, in open-set sentence recognition tests, whereas patients 5 and 6 scored 0% and 20%, respectively.

CONCLUSIONS

In case of nonfunctional cochlear nerve, in acoustic neuroma, either bilateral and in the only-hearing ear, promontory test should be performed. If positive results, a cochlear implantation should be performed, because successful results could be expected. Overall results of cochlear implantation on speech discrimination are better than those obtained with a brainstem implant.

Localization of hepatitis B virus DNA in hepatocellular carcinoma by polymerase chain reaction in situ hybridization

The polymerase chain reaction in situ hybridization (PCR-ISH) is a new technique that combines the sensitivity of PCR with the localizing ability of ISH. To investigate the expression pattern of hepatitis B virus (HBV) in the tissue of hepatocellular carcinoma (HCC), we detected HBV-DNA with PCR-ISH in paraffin-embedded tumor and corresponding non-tumor tissues from 11 HCC patients. HBV-DNA was detected in 4 of 11 tumor tissues and in 7 of 10 non-tumor tissues. In tumor tissues, positive signals were scattered in the tissue with occasional clustering, and were found mainly in the cytoplasm of HCC cells rather than in the nucleus. In non-tumor tissues, the number of positive signals was higher than in tumor tissues and they were found in regenerating nodules with differing patterns and intensities. When we compared the detection rate of PCR-ISH with nested PCR among 10 tissue samples, HBV-DNA was detected in 5 tissue samples by PCR-ISH, but the S gene was detected in 10, precore gene in 9 and X gene in 8 by nested PCR. The findings suggest that PCR-ISH is a sensitive technique for localizing HBV in tissue sections and that the low level of HBV replication persists in HCC cells.

[Conservation of residual hearing after cochlear implantation]

Indications for cochlear implantation have been expanded to include severely hearing impaired adults and may increase the number of patients presenting with preoperative residual hearing. Conservation of residual hearing may allow better performance with an implant. However, conventional thought is that implantation destroys auditory structures involved in residual hearing. This study was undertaken to assess if there are general or surgical factors intervening in the conservation of residual hearing in a sample of multichannel implant recipients. A retrospective study on 50 adult cochlear recipients with preoperative residual hearing has been undertaken. Sixteen of 50 implanted subjects (32%) were found to have conserved their residual hearing. Among them, seven patients have clinically non-significant changes of hearing. Age, side of implantation, gender and etiology did not influence the outcome of residual hearing. Round window ossification, ossification of the cochlea, length of insertion, approach and site of insertion (scala tympani vs.scala vestibuli) were not found to be statistically significant between the population having lost and the population having conserved residual hearing. This study emphasizes the need to undertake a larger multicenter longitudinal study to determine the existence of factors related to the conservation of residual hearing.

[Cochlear implants in the elderly]

The authors present a retrospective and multicenter study of 18 elderly patients aged above 60 years-old who underwent a cochlear implantation by comparing them with a population of adult patients. The purpose of this study is to evaluate the utility and benefits of cochlear implantation in the elderly by analyzing the clinical data and the results of a questionnaire assessing the use of the implant and the consequences of implantation on the quality of life. The results of this study indicate that the improvement of quality of life in the elderly is similar compared to a control group of adult patients.