The HER2 Signaling Network in Breast Cancer--Like a Spider in its Web

The human epidermal growth factor receptor 2 (HER2) is a major player in the survival and proliferation of tumour cells and is overexpressed in up to 30 % of breast cancer cases. A considerable amount of work has been undertaken to unravel the activity and function of HER2 to try and develop effective therapies that impede its action in HER2 positive breast tumours. Research has focused on exploring the HER2 activated phosphoinositide-3-kinase (PI3K)/AKT and rat sarcoma/mitogen-activated protein kinase (RAS/MAPK) pathways for therapies. Despite the advances, cases of drug resistance and recurrence of disease still remain a challenge to overcome. An important aspect for drug resistance is the complexity of the HER2 signaling network. This includes the crosstalk between HER2 and hormone receptors; its function as a transcription factor; the regulation of HER2 by protein-tyrosine phosphatases and a complex network of positive and negative feedback-loops. This review summarises the current knowledge of many different HER2 interactions to illustrate the complexity of the HER2 network from the transcription of HER2 to the effect of its downstream targets. Exploring the novel avenues of the HER2 signaling could yield a better understanding of treatment resistance and give rise to developing new and more effective therapies.

The standardized psychometric assessment of altered states of consciousness (ASCs) in humans

The APZ questionnaire was developed in order to explore hypotheses on ASCs. First -- in a series of 11 experiments using different induction methods on N = 393 healthy subjects -- the hypothesis was tested that ASCs have major dimensions in common irrespective of the mode of their induction. In the International Study on Altered States of Consciousness (ISASC) the external validity of the experimental results was assessed. The ISASC was carried out on a total of N = 1133 subjects in six countries. The main results of the experimental studies were corroborated in the field studies. The results can be summarized as follows: the common denominator of ASCs is described by three oblique dimensions, designated as "Oceanic Boundlessness (OSE)", "Dread of Ego Dissolution (AIA)" and "Visionary Restructuralization (VUS)". The reliability and validity of the scales are satisfactory. Tested versions of the APZ scales are available in English (UK, USA), German, Italian and Portuguese. Psychometrically as yet untested versions exist in Dutch, Finnish, French, Greek, Spanish and Russian. The APZ questionnaire has become the international standard for the assessment of ASCs, thus helping to integrate research. A psychometrically improved version exists in German (OAV questionnaire). The BETA questionnaire, which measures the dimensions "Vigilance Reduction (VIR)" and "Auditive Alteration (AVE)" is also available in German. These dimensions are most likely etiology-dependent.

[Health promotion and nutrition counseling for obese patients--a responsibility of medical care]

For prevention and therapy of overweight the joined effort of physicians and nutritional consultants is suggested to be the most effective approach. To develop a model of cooperation, the present situation of communication has been analyzed by questioning 57 overweight volunteers (by questionnaire), 34 physicians (both by questionnaire and interview), and 4 nutritional consultants (by interview). The physicians and the nutritional consultants feel the lack of communication and they express the wish to improve the cooperation. There is also a need for organizing structures of such collaboration, e.g. nutritional consultation either as part of the medical practice or as a special practice where the patient is to be referred to.

Sulfate concentrations in Norway spruce needles in relation to atmospheric SO(2): a comparison of trees from various forests in Germany with trees fumigated with SO(2) in growth chambers

Concentrations of inorganic sulfur, organic sulfur and water-soluble cations and anions were determined in needles of young Norway spruce trees (Picea abies L. (Karst.)) that had been fumigated in growth chambers for weeks or months with different concentrations of SO(2), SO(2) plus ozone, or SO(2) plus NO(2). Measurements were also made on needles from older trees growing in forests in various regions of Germany with different mean annual atmospheric SO(2) emissions. In the fumigated young trees, sulfate accumulation in the needles was a linear function of atmospheric SO(2) concentration. Little or no sulfur was incorporated into the organic sulfur fraction. The mean accumulation rate of sulfate in needles of fumigated trees was about 0.4 nmol g(dw) (-1) (nl l(-1))(-1) h(-1), which is very similar to the estimated rate of uptake of atmospheric SO(2) calculated from mean stomatal conductances (15 mmol m(-2) s(-1)) and the external SO(2) concentration (the calculated rate of uptake was 0.37 nmol g(dw) (-1) (nl l(-1))(-1) h(-1)). Concentrations of organic acids and other inorganic ions did not change much in response to SO(2) fumigation. In needles collected from trees in south and southeast Germany, large differences in sulfate concentrations were observed that probably reflect SO(2) emissions in the different regions. The highest foliar sulfate concentrations, and the highest annual increase in sulfate concentration with needle age were observed in material collected from the heavily polluted Erzgebirge (up to 12 micro mol g(dw) (-1) year(-1)), followed by material from the Fichtelgebirge (up to 6 micro mol g(dw) (-1) year(-1)). If it is assumed that this annual increase is the result of uptake of SO(2) from the atmosphere, mean annual atmospheric SO(2) concentrations can be calculated. The calculated values were somewhat below the measured values in the Fichtelgebirge and in the heavily polluted Erzgebirge. Norway spruce trees can cope with high concentrations of atmospheric SO(2), provided that they can neutralize the sulfuric acid formed from SO(2). It appears that, in the field, the acid load is decreased by H(+) translocation to the roots and subsequent H(+)/K(+) exchange. However, this may be a very slow process, because it was not observed in the short-term fumigation experiments.

Treatment of pharmacological priapism with phenylephrine

Pharmacological prolonged erections or priapism due to anesthesia were treated in 36 patients with intracorporeal injections of phenylephrine. Detumescence was obtained rapidly in every case and no marked side effect was reported. Considering the possible toxicity of other adrenergic agents, phenylephrine is strongly recommended in the treatment of priapism.

Delta-9-tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial

A double-blind study was performed comparing 5 mg delta-9-tetrahydrocannabinol (THC) p.o., 50 mg codeine p.o., and placebo in a patient with spasticity and pain due to spinal cord injury. The three conditions were applied 18 times each in a randomized and balanced order. Delta-9-THC and codeine both had an analgesic effect in comparison with placebo. Only delta-9-THC showed a significant beneficial effect on spasticity. In the dosage of THC used no altered consciousness occurred.

Giant leiomyoma of the kidney

A rare case of giant renal leiomyoma presenting as a suprarenal mass is reported. This type of tumor seldom gives rise to other clinical symptoms. The angiographic appearance has no characteristic features. The treatment of choice is nephrectomy since it is impossible to make a correct preoperative diagnosis.

[Consumption and ruminating behavior of sheep. 4. Experiments on young female sheep in different rearing intensities]

In the framework of two rearing experiments with female merino meat sheep, measurings of the consumption and ruminating behaviour were carried out. Animals raised with a lot of roughage ruminated longer both in their lamb and young sheep periods. An increased quota of roughage in the ration increased both the ruminating time and the number of chewing moves and cycles significantly for young sheep. The dry matter intake capacity of animals raised with high quotas of roughage was by 14 and 8% resp. higher in the lamb period and by 26 and 18% resp. higher in the young sheep period. Rations with 24% chopped and dried green fodder and 11 ... 14% resp. crude fibre brought about a period of more than 6 hours ruminating and a minimum of 22,000 ruminating movements per day for lambs. Young sheep raised with high quotas of roughage showed an increased ruminating activity in subsequent periods of sole feeding with roughage.

[The effect of pregnancy and lactation on digestive processes in sheep]

The average passage time, the rumen fluid volume and the digestibility of the organic matter were determined in addition to 3 individual feeding experiments with fertility oriented crossbreed ewes, which received pelleted straw-concentrate mixtures. The average passage time of the feed particles through the digestive tract is shorter in pregnant animals than in lactating ones. It is longest in non-pregnant sheep. High quotas of straw and coarse particles prolong the passage time, increasing feed intake and supplements of long straw shorten it. The volume of rumen fluid is lower in ewes fed ad libitum in the stage of late pregnancy and after lactation than during lactation. The rumen fluid volume is also lower in restrictively fed animals during the stage of late pregnancy than during lactation. In animals in the stage of late pregnancy it correlates negatively with the weight of the litter. On an average of all experiments at maintenance level the digestibility of the organic matter in ewes in the 4th month of pregnancy gravidity amounted to 56.6%, in the 2nd month of lactation to 59.8% and in wethers to 59.5% Due to an increase of energy intake from maintenance to 2. maintenance digestibility of the straw-concentrate mixture with 40% straw decreased by 5.5 units and of that with 60% straw by 17.8 units in the period before delivery. Pregnancy in the 4th month resulted in a digestion depression of between 3.0 and 5.8 units.

[Consumption and ruminating behavior in sheep. 5. Continuous registration and recording of consumption and rumination dependent jaw movements in sheep based on acceleration measurements]

A method of the registration of the feed intake and ruminating behaviour of sheep which uses piezoelectric converters was tested. The appliance-technological solution and the feasibility and routine measurings are described. It showed that measurings on the basis of acceleration registration produced similar results as the 'halter method with plate feelers' used so far and that disturbance of the test animals is reduced.

[Consumption and ruminating behavior in sheep. 3. Experiments on infertile female sheep of different breeds with reference to feed type and feeding duration]

Ewes of the breeds merino fattening sheep, Stavropol merino and fertility hybrid were studied as to their consumption and ruminating behaviour after receiving a pelleted straw-concentrate mixture, maize silage and wilted silaged grass. During the feeding periods of 2 X 45 min or 2 X 180 min/d unlimited rations were available to the animals. With 86 min/d the sheep used the short feeding period nearly completely for feed intake. In the longer feeding period the sheep consumed 18% more feed in 161 min/d, ate more slowly, however, and ruminated somewhat less. In comparison with the straw-concentrate mixture, the silage rations were ruminated for shorter periods and less effectively, the number of ruminating movements per day and cycle was reduced, the breaks between bites became longer. The wilted grass silage stimulated ruminating even less than chopped maize silage. There were significant differences between the breeds in the ruminating frequency, which affected the number of ruminating movements per day and cycle.

[Eating and ruminating behavior of sheep. 2. Experiments in pregnant and lactating ewes fed with a straw-concentrate mixture]

Fertility oriented ewes in the late stage of gestation and during the lactation period received 19 feeding regimes on the basis of straw-concentrate mixtures, which essentially differed in the feedstuff structure. The ewes fed ad libitum on average used between 5 and 6 hours per day feed intake in the 86 measuring periods. The average daily ruminating time ranged from 398 to 502 minutes. An increasing straw content resulted in significantly longer ruminating periods and a higher number of masticatory movements, additional quotas of long straw had non effect. But even the most unfavourable feeding variants (straw-concentrate mixtures with 40% straw meal treated with NaOH) elicited 21 100 ruminating masticatory movements in 5 hours of ruminating. There were no significant differences between the absolute consumption and ruminating activities in the late stage of gestation and the lactation period; with reference to feed and crude fibre intake the ruminating expenditure in the late stage of gestation was always significantly higher. Rations with a low structural effect resulted in a more unbalanced distribution of consumption and ruminating activities in the course of the day than well structured rations.

[Determination of the average duration of food in the digestive tract of sheep]

The average time the test feed remains in sheep was determined with ewes during three stages of the reproduction cycle. The feed was labelled with 51Cr2O3. Experiment conditions are described under which the experiments can be carried out within the permissible limits.

[Studies on rumen fermentation with special reference to the volatile fatty acid production rate in ewes during reproduction. 2. Production rate of volatile fatty acids and rumen volume]

Methods and results of the measuring of the rumen volume and the passage rate as well as the dependence of the production of volatile fatty acids on the parameters mentioned are described. The correlative relations between rumen volume on the one hand and feed passage on the other hand to the production quotas are investigated. Passage rates and rumen volumes were determined with the help of the isotope dilution method. In the course of reproduction rumen volumes of 7.81, 6.41, 8.91, 7.11 in experiment 1 and 5.41, 5.81, 9.51 and 4.71 in experiment 2 were measured in the sequence early stage of gestation, late stage of gestation, lactation and the period between pregnancies. The average total production of volatile fatty acids within 12 hours amounted to 475 mmol, 265 mmol, 313 mmol and 351 mmol in experiment 1 and 155 mmol, 175 mmol, 271 mmol and 144 mmol in experiment 2 in the same sequence. The average passage duration of the feed through the digestive tract of the ewes was 32.4 h in experiment 1 and 33.6 h in experiment 2. The relatively high feed intake of the ewes resulted in a short passage duration and could be a cause of the low production quotas of the volatile fatty acids.

Comparison of AMP system and comprehensive psychopathological rating scale with regard to contents

Using a sample of 170 patients the psychopathological contents of the AMP system and the Comprehensive Psychopathological Rating Scale (CPRS) were compared by canonical correlations. The nine primary AMP scales predict 86% of the variance of the three CPRS scales. 64% of the variance of the nine AMP scales is explained by the CPRS scales. The secondary scales are nearly equivalent. The univariate analysis showed that all AMP scales with the exception of the 'hostility syndrome' and the 'catatonic syndrome' correlate highly with one of the psychopathological CPRS scales.

[Feed intake of ewes in the perinatal period]

8 individual feeding experiments served the ascertainment of the consumption performance of ewes in the perinatal phase. In 6 experiments with a total of 176 fertility oriented ewes the daily intake of pelleted straw-concentrate mixtures between the 4th week ante partum and the 6th week post partum was determined. On average the ewes consumed 1701 g dry matter in the last phase of gestation and 2271 g DM during lactation per animal and day. Intense grinding and NaOH-treatment increased feed intake; high straw content, limited duration of feeding and NH3-treatment decreased it. A higher number of lambs had, in the last phase of gestation, a decreasing and during lactation an increasing effect on consumption. Maize silage in the last phase of gestation resulted in very low feed intake. In contra to this, rations of alfalfa hay and maize silage were consumed well during lactation. There were no significant differences due to species or age with regard to consumption performance.

[Rumen fermentation with special reference to volatile fatty acid production during reproduction. 1. Methods and results of volatile fatty acid levels and production rates in vitro]

The target of the investigations was to register part of the synthesis performance in the rumen of ewes during the complete reproduction cycle. With the help of in-vitro experiments with artificial rumen the concentration and production rates of volatile fatty acids in the rumen fluid were measured. From the experiments the measured data of fertility-accentuated crossbreeding (experiment 1) and crossbreeding (experiment 2) ewes were contrasted. The average concentrations of volatile fatty acids in ewes are 95.4 m mol/l in experiment 1 and 109.2 m mol/l in experiment 2 during the early stage gestation, 121.4 m mol/l in experiment 1 and 99.8 m mol/l in experiment 2 in the last stage stage of gestation, 129.6 m mol/l in experiment 1 and 112.8 m mol/l in experiment 2 during lactation and 106.6 m mol/l in experiment 1 and 112.9 m mol/l in experiment 2 during the dry period. The production rates of volatile fatty acids calculated form their concentration amount to 4.8 m mol/l X h in experiment 1 and 2.6 m mol/l X h in experiment 2 in the early stage of gestation, 3.5 m mol/l X h in experiment 1 and 3.1 m mol/l X h in experiment 2 in the last stage of gestation, 3.2 m mol/l X h in experiment 1 and 2.7 m mol/l X h in experiment 2 during lactation and 3.7 m mol/l X h in experiment 1 and 2.9 m mol/l X h in experiment 2 in the dry period. The correlation between the concentration and the production rate of volatile fatty acids is not significantly negative in either of the ewe experiments. The scattering of the individual values is wide so that the individual influence of the test animals as well as the influence of the in-vitro method used permit the conclusion that a significant statement on the influence of the genotype and the stage of reproduction on the production rates cannot be made.

Comparison of the AMP system and the CPRS with regard to interrater reliability

The interrater reliability of the AMP system and the Comprehensive Psychiatric Rating Scale (CPRS) was compared in a sample of 30 hospitalized schizophrenic or depressive patients. The CPRS proved to have on average a slightly higher reliability on both the level of items and primary scales. The reliability of the secondary scales was nearly identical.

[Scale construction of the German version of the Comprehensive Psychopathological Rating Scale (CPRS)]

170 hospitalised patients (96 schizophrenic, 71 depressive, and 3 manic) were examined during the German version of the CPRS. Based on factor analytical results four subscales ('manic syndrome', 'schizophrenic syndrome', 'depressive syndrome', and 'side-effects') and two second-order scales ('manic-depressive syndrome' and 'schizophrenic syndrome') were constructed. The first three subscales show a good reliability. The fourth subscale ('side-effects') has an insufficient internal consistency, mainly due to the small number of items (6). The two subscales 'schizophrenic syndrome' and 'depressive syndrome' and the two second-order scales can differentiate very well between schizophrenic and depressive syndromes. The validity of the first and fourth subscale could not be examined in this study.

[Interrater reliability of the German version of the Comprehensive Psychopathological Rating Scale (CPRS)]

The interrater reliability of the German version of the CPRS was examined in 30 patients (18 schizophrenic, 11 depressive and 1 manic). All patients were examined by the same two raters. The agreement of 55 out of 65 items was determined using the kappa coefficient. Kappa was calculated concerning symptom present/not present and differences less than or equal to 2/difference greater than 2.49 or 54 items show a moderate to excellent agreement. Items based on self-rating have a better interrater reliability than items based on the rating of the psychiatrists. The interrater reliability of the syndromes was calculated, using the rank correlation coefficient. The agreement concerning the 4 primary and the 2 second-order factors is high or excellent. The good results show the usefulness of the CPRS for the assessment of psychopathological findings.

[Comparison of psychiatrist's rating and self rating of schizoprenic patients (author's transl)]

40 acute schizophrenic in-patients were examined using a rating scale (AMP-system) and a self-report questionnaire (APZ) immediately after their admission and on average 7 weeks later. The aim of the study was to clarify the usefulness of self-report questionnaires in schizophrenic patients. There were four groups of subjects: 1. Patients, who filled in the questionnaire immediately after admission, 2. patients, who did not at this phase of their illness, 3. patients, who filled in the form 7 weeks later during remission and 4. patients, who did not. The main questions were: --Are their any differences in the psychopathology between testable and untestable patients immediately after admission resp. during remission 7 weeks later? --How do the psychiatrist's ratings and the self-ratings correlate in different phases of the illness? If was found that the degree of psychopathology correlated negatively in the acute state with the capacity to perform a self-rating. Seven weeks later during remission this correlation could not be found anymore. Motivational variables of staff and patients in influencing the testability are mentioned. It is also shown that there are selfreports and rating-scales. The correlations are different during the two phases of the illness.

[Psychological aspects of sleep deprivation. A controlled study on depressives and normals (author's transl)]

A study of total sleep deprivation for one night was performed on 12 patients with endogenic depression and 10 with neurotic depression, as well as a control group of 10 normals. The study was designed to answer the following questions: 1. Are the correlations between self-ratings and clinical assessments of sleep deprivation effects satisfactory? 2. Are sleep deprivation effects modified by the personality dimensions extraversion and neuroticism? 3. What effects do the interactions of rater and patient and their expectations have on therapeutic results? The findings confirmed the therapeutic effects of sleep deprivation in depressives. The correlations between self-ratings and clinical assessments were satisfactory. The therapeutic effects were not significantly influenced by psychiatrist-patient interactions or their expectations. The relevance of these results to explanations of sleep deprivation effects is discussed.

[Effects of N,N-dimethyltryptamine (DMT) on tests of psychoticism (author's transl)]

In a controlled study on 38 volunteers the effects of 250 micrograms/kg N,N-dimethyltryptamine (DMT) i.m. on objective and performance tests measuring psychoticism according to Eysenck were assessed. The hypothesis was tested that subjects treated with DMT (N = 26) differ from those receiving placebo (N = 12) in the same way as endogenous psychotics differ from normals. Confirmation was obtained in 7 out of 19 variables, most of which may be considered as tests of concentration. These results are similar to those of a previous study on the effects of (-) delta9-trans-Tetrahydrocannabinol.

[Comparison of altered states of consciousness induced by the hallucinogens (--)-delta9-trans-tetrahydrocannabinol (delta9-THC) and N,N-dimethyltryptamine (DMT) (author's transl)]

The study compares altered states of consciousness induced by the hallucinogens (--)delta9-trans-Tetrahydrocannabinol (delta9-THC) and N,N-Dimethyltryptamine (DMT) using two placebo control groups. A total of 24 subjects received 250 mug delta9-THC p.o./kg body weight and 26 subjects were treated with 250 mug DMT i.m./kg. Placebo was given to 24 subjects. The effects were assessed by a questionnaire administered following the experimental conditions. Questionnaire items were combined into the following eight scales according to their content and several cirteria of the theory of mental testing: visual hallucinations (illusions), auditory hallucinations (illusions), impairment of memory and attention, depersonalization syndrome, deprealization syndrome, changes of body image, euphoric state and anxious-depressive state. The two hallucinogen groups differed significantly from placebo on all eight scales. No difference, however, between delta9-THC and DMT was significant. On the scale "optical hallucinations (illusions)" a tendency that DMT might have stronger effects than delta9-THC was found. Methodological problems of comparing different hallucinogens are discussed.

[Altered states of consciousness induced by N,N-dimethyltryptamine (DMT)]

In a controlled study on 38 volunteers the effects of 250 mcg/kg N,N-Dimethyltryptamine (DMT) i.m. were assessed. 26 subjects received DMT and 12 placebo. The altered states of consciousness and the somatic changes were measured by several questionnaires administered after the experiment. In spite of the low dose as compared to previous studies significant differences to placebo were found in the following syndromes of altered states of consciousness: visual hallucinations rep. illusions, impairment of memory and attention, changes of body image, depersonalization syndrome, derealization syndrome, euphoric state, anxious-depressive state and delusion. The somatic side effects were mainly subjective respiratory troubles, dizziness and weakness.

[Effects of (--)delta-9-trans-tetrahydrocannabinol (delta-9-THC) on tests of psychoticism. A study of Eysenck's drug postulate on the effects of hallucinogens in relation to psychoticism (author's transl)]

In a double-blind study on 36 volunteers the effects of 250 mug/kg (--)delta-9-trans-tetrahydrocannabinol p.o. on objective and performance tests measuring psychoticism according to Eysenck were assessed. The hypothesis was tested that subjects treated with delta-9-THC differ from those receiving placebo in the same way as endogenous psychotics differ from normals. Confirmation was obtained in only 5 out of 19 variables. Four of these 5 variables may be considered as tests of concentration.