Prevalence of KRAS mutations in metastatic colorectal cancer: A retrospective observational study from India

BACKGROUND

One of the genetic alterations implicated in tumor progression in colorectal cancers (CRCs) are abnormalities in Kristen Rat Sarcoma (KRAS) gene. Evaluation of KRAS mutation status is an important prognostic factor and has predictive value in deciding first line therapy based on monoclonal antibodies such as Cetuximab and Panitumumab in metastatic CRCs.

MATERIALS AND METHODS

In this retrospective study, we analyzed 7 different somatic mutations in Exon 2 of KRAS gene in 299 unselected incidental CRC patients who visited the hospital for clinical management during the period 2009-2013. Most of the tumors were primarily originating from colon and rectum; nevertheless, there were a few from rectosigmoid, sigmoid, ceacum and anal canal in the study group. Genomic DNA extracted from paraffin embedded tumor tissues was screened for 7 point mutations located in Codons 12 and 13 of KRAS gene, using Scorpions amplified refractory mutation system real time polymerase chain reaction technology. Statistical analysis was performed to assess bivariate relationship between different variables that includes: mutation status, mutation type, tumor location, tumor morphology, age and sex.

RESULTS

Prevalence of mutation in Codons 12 and 13 was 42.8% in the study group. Well-differentiated tumors had significantly more mutation positivity than moderately and poorly differentiated tumors (P = 0.001). 92% of the mutations were from Codon 12 and 8% in Codon 13. Glycine to Arginine was relatively more common in rectosigmoid followed by ceacum, while Glycine to Alanine mutation was relatively more prevalent in sigmoid, followed by rectum and rectosigmoid.

CONCLUSION

The results suggest a prevalence of KRAS mutation at 42.8% in Indian population indicating that this testing is very crucial for targeted therapy management in metastatic CRC in India. Further analysis on mutation status of other homologues such as NRAS and downstream partner, v-raf murine sarcoma viral oncogene homolog B1, would add value to understanding the role of anti-epidermal growth factor receptor therapy in CRC management.

Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach

Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure.

Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. Rodriguez- Merchan criteria was used to grade the functional outcome.

Results: Of the 54 patients, 28 (58.85%) were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%).The mean (± SD) duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%). Four (7.40%) patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez – Merchan criteria showed that 37(68.51%) of the patients had good and 12 (22.22%) had excellent functional outcome.

Atenolol and amlodipine combination overdose managed with continuous venovenous hemodiafiltration: A case report

We present a patient of who ingested large dose of of atenolol and amlodipine and was treated successfully with continuous venovenous hemodiafiltration. Early recognition of indications for renal support and early initiation of the same is the key to successful management.

Characterization of Bacillus thuringiensis Cry1 class proteins in relation to their insecticidal action

Thirty nine Bt Cry1 subgroup protein sequences were retrieved from NCBI and analyzed for physicochemical properties, active site and relationship in relation to their variations in toxicity. Cry1 proteins were found to be hydrophilic and stable. SOSUI server predicted presence of two transmembrane regions in Ag and a single transmembrane region from Aa to Ae. EMBOSS PepWheel tool analysis of the transmembrane regions showed that there were 23 highly conserved residues towards the N terminal which are hydrophobic and more than half of the residues were neutrally charged. No signal peptide was detected which classifies the Cry1 group proteins as non-secretory proteins. Cry1 proteins have very high composition of neutral amino acids and might transform into negative charge after solubilization in alkaline environment (insect midgut). The negatively charged protein might misfold causing difficultly to digest and thereby be toxic to lepidopteran. Active sites of Cry1 proteins with more than 50% neutral amino acids showed wide insecticidal spectrum and further positive correlation (r = 0.7731) was observed between neutral amino acids and insect species affected (Y = -138.21 + 2.907X). Similarity of sequences was found between Cry1 proteins based on their high or low spectrum of insecticidal activity.

Analysis of aminoacids pattern in receptor tyrosine kinase using Boolean association rule

Cancers are characterized by unrestricted cell division and independency of growth factor and other external signal responsiveness. Eukaryotic parental cells of tumors, on the other hand, constitute tissues and other higher structures like organs and systems and are capable of performing various functions in a highly co-ordinated fashion. Hence, cancer cells may be considered as entities capable of incessant growth and cell division but lacking any evolutionarily advanced intracellular or intercellular regulation. Since receptor tyrosine kinases are highly altered and exist in deregulated/constitutively active forms in cancer cells - achieved through various epigenetic mechanisms - we hypothesize the functional RTKs in cancer cells to resemble their counterparts in more primitive species. Analysis of RTK sequences of various species and of cancer is, therefore, expected to prove this hypothesis. Association rule in data mining can reveal the hidden biological information. This study utilizes the Boolean association rule to mine the occurrence pattern of glycine, arginine and alanine in receptor tyrosine kinases (RTKs) of invertebrates, vertebrates and cancer related vertebrate RTKs based on protein sequence informations. The results reveal that vertebrate cancer RTKs resembles prokaryotes and invertebrate RTKs showing an increasing trend of glycine, alanine and decreasing trend in arginine composition. The aminoacid compositions of vertebrates: invertebrates: prokaryotes: vertebrate cancer with respect to Glycine (>=6.1) were 42.86: 50.0: 85.71: 100%, Alanine (>=6.2) were 10.72: 66.67: 85.71: 100%, whereas Arginine (>=5.9) were 21.43: 16.67: 14.29: 0%, respectively. In conclusion, results from this study supports our hypothesis that cancer cells may resemble lower organisms since functionally cancer cells are unresponsive to external signals and various regulatory mechanisms typically found in higher eukaryotes are largely absent.

Neovascularization in an arterio-venous loop-containing tissue engineering chamber: role of NADPH oxidase

Using an in vivo arterio-venous loop-containing tissue-engineering chamber, we have created a variety of vascularized tissue blocks, including functional myocardium. The viability of the transplanted cells is limited by the rate of neovascularization in the chamber. A Nox2-containing nicotinamide adenine dinucleotide phosphate (NADPH) oxidase is thought to have a critical role in ischaemic angiogenesis. In this study we investigated whether NADPH oxidase is involved in the neovascularization process in the tissue-engineering chamber. New blood vessels originating from the venous and the arterial ends of the loop could be identified after 3 days, and the vessel density (by lectin staining) peaked after 7 days and was maintained for at least 14 days. This was accompanied by granulation tissue formation and concomitant increase in the mRNA level of Nox4 NADPH oxidase. Although the total level of Nox2 mRNA in the chamber tissue decreased from day 3 to day 7, immunohistochemistry identified a strong expression of Nox2 in the endothelial cells of the new vessels. In human microvascular endothelial cells, the NADPH oxidase inhibitor apocynin reduced NADPH oxidase activity and inhibited the angiogenic responses in vitro. Local treatment with the NADPH oxidase inhibitors apocynin or gp91ds-tat peptide significantly suppressed the vessel growth in the chamber. In conclusion, NADPH oxidase-dependent redox signalling is important for neovascularization in this novel tissue-engineering chamber in vivo, and boosting this signalling might be a new approach to extending vascularization and tissue growth.

Influence of metham sodium on suppression of collar rot disease of peanut, in vitro antibiosis, siderophore production and root colonization by a fluorescent pseudomonad strain FPO4

A hydroxamate type siderophore producing fluorescent Pseudomonas strain, isolated from the rhizoplane of paddy root showing plant growth promoting activity, exhibited a decreased in vitro antibiosis, production of siderophore and suppression of collar rot in presence of metham sodium. Use of herbicide had a detrimental effect on the plant growth promoting activity of this organism. The multiple drug resistant mutant strain derived from this rhizobacteria colonized the roots, but the herbicide application had a negative effect on their population. HPLC analysis of the siderophore showed five peaks of which the peak number three confirmed the antifungal activity.

Antideuteron yield at the AGS and coalescence implications

We present Experiment 864's measurement of invariant antideuteron yields in 11.5A GeV/c Au+Pt collisions. The analysis includes 250x10(6) triggers representing 14x10(9) 10% central interactions sampled for events with high mass candidates. We find (1/2pip(t))d(2)N/dydp(t) = 3.5+/-1.5(stat)+0.9-0.5(syst)x10(-8) GeV-2 c(2) for 1.8<y<2.2, < p(t)> = 0.35 GeV/c ( y(c.m.) = 1.6) and 3.7+/-2.7(stat)+1.4-1.5(syst)x10(-8) GeV-2 c(2) for 1.4<y<1.8, < p(t)> = 0.26 GeV/c, and a coalescence parameter B2; of 4.1+/-2. 9(stat)+2.3-2.4(syst)x10(-3) GeV2 c(-3). Implications for coalescence and antimatter annihilation are discussed.

Poorly differentiated carcinoma of the lung presenting with Lambert--Eaton myasthenic syndrome

Lambert-Eaton myasthenic syndrome commonly seen in small-cell lung cancer represents an autoimmune reaction against antigens coexpressed by tumor and neurons. It is rarely seen with other histologic subtypes. Symptoms antedate the appearance of the neoplasm by weeks to years. Therapeutic options range from immunosuppression, plasmapheresis, pharmacologic facilitation of neuromuscular transmission, and definitive therapy of the primary tumor. This case report describes the rare association of Lambert-Eaton myasthenic syndrome with non-small-cell lung cancer.

Left ventricular mass index in patients of end stage renal disease (non-diabetic) on regular haemodialysis

Echocardiography in patients of end stage renal failure (non diabetic) on regular haemodialysis revealed increase in left ventricular mass index in comparison to healthy controls. Anaemia, chronic uraemic state and hypertension were the probable contributory factors.

Hepatic cysts in adult polycystic kidney disease

Of ninety two adult polycystic kidney patients 18.5% had liver cysts. Mostly they were multiple. Liver cysts were more common in men.

Crop improvement and disease suppression by a Bacillus spp. SR2 from pea nut rhizosphere

An antibiotic producing Bacillus strain SR2, isolated from pea nut rhizosphere, showed in vitro antibiosis against many known plant pathogens. Seed bacterization with this strain showed an enhancement in seed germination, shoot height, root length, fresh and dry weights in four crop plants. A multiple drug resistant strain, SR2+, used to monitor root colonization confirmed the root colonization by the organism. Seed bacterization, reduced the number of chick pea wilted plants in wilt-sick soil, making the organism a potential bio-control agent against chick pea wilt.

Fungicidal and insect controlling properties of Proteus strain RRLJ 16, isolated from tea, Camellia sinensis (L) O Kuntze, plantations

A strain of Proteus RRLJ 16, isolated from acid (pH 4.5-5.5) iron rich tea (Camellia sinensis) plantation soil, produced siderophores with single absorption peak at 370 nm when cultured in iron free medium. Extracted crude fraction of siderophores and live cultures showed in vitro antibiosis against five species of pathogenic fungi. When the strain was cultured in a normal bacteriological medium without iron stress, it produced an insect repellent compound. The culture filtrate sprayed (dilution of 1:100 in water) on tea plants infected with pink mites or green flies, the insect populations disappeared from the plants. Termite galleries sprayed similarly showed no termite activity after 24 hr of spraying. No reinfestation by insects was observed on treated plants for more than one year.

Plasma levels of luteinizing hormone in intact and castrated photosensitive blackheaded buntings (Emberiza melanocephala) exposed to stimulatory and nonstimulatory photoperiods

Experiments were performed to investigate the effects of castration and/or photostimulation on plasma luteinizing hormone (LH) in photosensitive blackhead buntings. Castration evoked a significant rise in plasma LH in birds held under 8 h light: 16 h darkness (8L:16D). On exposure to 18L:6D for 24 d, both the intact birds and the castrates exhibited a significant rise in plasma LH, although the change in LH levels in the castrates was approximately 8 times greater than in the intact birds. When control birds under 8L:16D which showed no change in plasma LH up to d 13 were transferred to a 36-h resonance cycle (8L:28D), plasma LH rose significantly within 4 cycles of the treatment. Furthermore, the intact buntings showed rapid increase and decrease in the plasma LH levels during a 16-wk exposure to long (16L:8D) but not to short (8L:16D) photoperiods. These results suggest that: i) the photoperiodic drive on LH secretion is inhibited by the testes; ii) the blackheaded bunting has a strong photoresponsive system; and iii) a circadian rhythm of photosensitivity is involved in the photoperiodic time measurement in this species.

Photoperiodic control of annual reproductive cycle in subtropical brahminy myna, Sturnus pagodarum

The aims of this investigation were to: (i) study the effect of the length of photoperiod on the timing of onset of gonadal recrudescence and postreproductive decline in photoresponsivity, and (ii) identify the mechanism(s) involved in the initiation of gonadal recrudescence in the subtropical brahminy myna (Sturnus pagodarum). Two series of experiments were performed using adult birds: (1) Groups of birds were subjected to 12L:12D, 14L:10D, and 16L:8D in January and to 12L:12D and 14L:10D in March. Those exposed to 12L and 14L in March were transferred to longer daylengths (16L:8D, 20L:4D) after 180 days. In the January birds, 14L and 16L induced testicular growth and regression earlier than 12L; also, 16L caused gonadal recrudescence earlier than 14L. The 14L photoperiod, however, induced gonadal development in March birds within 30 days, similar to that found in January birds under 16L:8D. The response of March birds to 12L:12D was, however, similar to those of January birds, except that the time of maximum testicular response and subsequent regression was advanced in the former group. It is concluded that the refractoriness to long day photostimulation is fully dissipated in March but not in January. (2) Groups of unstimulated and stimulated birds were exposed to "resonance" and "interrupted-night" light: dark cycles for 5 weeks. Resonance LD cycles of 12 (8L:4D)- and 36 (8L:28D)-hour induced day responses, while groups under 24 (8L:16D)- and 48 (8L:40D)-hr cycles behaved as if exposed to short days. In night-interruption experiments, a 1 hr light pulse given 12 and 16 hr, but not 20 hr, after dawn induced the long day response. These results suggest that in brahminy myna the time to the onset of gonadal recrudescence and subsequent regression (photorefractoriness) is dependent on the length of photophase as well as time of the year when exposed to stimulatory photoperiods, and that a light-sensitive rhythm with a period of about 24 hr is involved in the photoperiodic induction of gonadal recrudescence.

Photostimulation of blackheaded bunting: subjective interpretation of day and night depends upon both photophase contrast and light intensity

Blackheaded buntings were exposed to constant dim light (approximately 2 lux) for 77 days and subsequently to 12:12 illumination, consisting of either dim light:complete darkness (dl:dk) (2:0 lux) or bright light:dim light (bl:dl) (10, 35, and 90 lux:2, 10, and 35 lux, respectively, with 180 degrees bl:dl transitions) for 2-3 weeks each. Birds were unstimulated until day 100, under dim LL (dl:dl) and 12dl:12dk. Photostimulation with a significant increase (p less than 0.001) in average body weight and testis volume occurred on exposure to 12bl:12dl (10:2 lux); birds remained fat and testes were enlarged until the end (day 173) of the experiment. Locomotor activity also did not have a discernible pattern under the nongonadostimulatory photoregimes. Birds became active in the bright photophase (subjective day) of 12bl:12dl (10:2 lux) on day 5 (day 105 of the experiment), but beginning on day 113 more intense perch-hopping was initiated in the dim photophase (subjective night), indicating the appearance of nocturnal migratory restlessness in the caged birds. A 180 degrees transition in the bl:dl photophases at this time for 2 weeks resulted in complete shift in the timing of daytime and nighttime activity. This trend is maintained under all subsequent 12bl:12dl exposures. These results suggest that the light intensity required for photostimulation in the blackheaded bunting is absolute, and that the subjective interpretation of day and night depends upon the photophase contrast, as well.

Termination of photorefractoriness in the brahminy myna, Sturnus pagodarum: role of photoperiods and gonadal hormones

In brahminy myna a photosensitive species, long days caused full gonadal development followed by rapid regression, whereas short days inhibited these responses. Experiments were performed to investigate the effects of duration of photoperiod and gonadal hormones on the recovery of photosensitivity to long photoperiods in male birds. Groups of photorefractory birds were subjected to 8-, 9- or 11-hr daily photoperiods for 45 (6.5 weeks) or 63 (9 weeks) days and then transferred to 15 h daily photoperiods for 60 days to check for the regaining of photoresponsivity. A control group was held under 15L:9D throughout the period of study. Another experiment included three groups of photorefractory males, which were maintained on 9L:15D for 9 weeks and administered with, birth-1day-1 alternately for first 30 days olive oil or different doses (10 or 100 micrograms) of testosterone propionate (TP)/bird/day alternately for first 30 days, and then transferred to 15L:9D for another 30 days to test the recovery of photosensitivity. The results indicated that (i) a period of exposure to short daylengths is required to dissipate photorefractoriness, (ii) termination of photorefractoriness is dependent on the length and duration of photoperiods and (iii) TP inhibits the recovery of photosensitivity in a dose dependent manner.

Seasonal reproduction in subtropical brahminy myna, Sturnus pagodarum: role of photoperiod

Experiments were performed to study the extent of the involvement of photoperiod in the timing of seasonal reproduction in brahminy myna (Sturnus pagodarum). The reproductive cycle corresponds to annual variations in day length and there is a marked seasonal variation in the photogonadal response of birds, which is evident when birds are shifted from normal day length to long photoperiods (15L:9D) every month. This is supported by the results from constant long (15L:9D) and short (9L:15D) photoperiodic treatments. Whereas the reproductive cycle was abolished in short photoperiods, a 15L:9D photoperiod induced a single complete gonadal growth-involution cycle after which birds became photorefractory. Further, exposure of birds to 8L:16D during different phases of the reproductive cycle indicated that the effect of short photoperiods on advancement of photosensitivity depended on the reproductive status attained when shifting took place. These laboratory investigations clearly suggest that the annual photocycle affects the timing of the reproductive cycle of brahminy myna.

The development of photorefractoriness in termination of the breeding season in the tropical brahminy myna: role of photoperiod

Gonads of brahminy myna (Sturnus pagodarum) spontaneously regress in July/August when the daylength is still stimulatory. Experiments were conducted to investigate if photoperiod was involved in the timing of gonadal regression and if photorefractoriness terminated the breeding season in this species. The observations obtained in the present study clearly show that: i) increasing photoperiods of spring/summer programmed for eventual gonadal regression in the late summer; ii) the birds developed photorefractoriness to all stimulatory daylengths and consequently the breeding season could not be extended by providing more stimulatory photoperiods; and iii) exposure to short daylength treatment failed to overcome the onset of refractoriness in birds after they had attained full gonadal growth and development. These results suggest that refractoriness is a process used by the brahminy myna to terminate the breeding season, and that this species becomes totally photorefractory.

Extraction-spectrophotometric determination of hydrogen sulphide

A sensitive spectrophotometric method for the determination of trace amounts of hydrogen sulphide (H2S) after fixing in a modified zinc acetate-disodium ethylenediaminetetraacetate-sodium hydroxide solution is described. The fixed H2S is stable for 3 d. The reaction of iodate with H2S in the presence of acid and an excess of chloride leads to the formation of ICI which is stabilised as ICI2-. The species formed reacts with 2',7'-dichlorofluorescein to form 2',7'-dichloro-4',5'-diiodofluorescein which is extracted into a mixture of 15% isoamyl acetate in isoamyl alcohol. The colour system obeys Beer's law in the range 0-2.5 micrograms of H2S. The coefficient of variation is 4.5% for ten determinations of 2.0 micrograms of H2S. The effect of interfering gases on the determination is discussed. The method was applied to the determination of residual amounts of H2S present in a laboratory fume cupboard and the results obtained were compared with those given by the widely used Methylene Blue method. The method can be used to determine down to 0.3 micrograms of H2S.

Effect of testosterone on testes, body weight and plumage regeneration in photorefractory male redheaded bunting Emberiza bruniceps

Various doses of testosterone propionate (TP) were administered for 10 days to refractory male redheaded buntings exposed to 15L:9D in last week of June, shortly before the onset of molt, to determine the effect of exogenous male hormone on the testes, body weight and plumage regeneration in photorefractory birds. While 5-, 10-, or 25 micrograms of TP bird-1 day-1 did not affect the testes, body weight or feather regeneration, testicular growth was stimulated but body weight declined and plumage regeneration prevented in birds that received 150- or 250 micrograms of TP bird-1 day-1. In contrast, a 50 micrograms treatment, although unable to induce the growth of the testes, caused loss in body weight and feather regeneration. Also, a 25 micrograms dose of TP administered to photostimulated birds induced complete testicular atrophy. These results suggests that testosterone exerts dose-dependent effects on the testes, body weight and plumage regeneration in buntings. A positive correlation is found between the amount of hormone and the testes growth, while the increasing amount of hormone has negative effect on the body weight and regeneration of feathers.

High-frequency jet ventilation versus conventional ventilation after surfactant displacement in dogs

High-frequency jet ventilation (HFJV) was compared with conventional ventilation (CV) after surfactant displacement with diocytyl sodium sulfosuccinate (OT) via ultrasonic nebulization. After aerosol delivery, dogs were separated into 3 groups and followed for 2 h. Ventilator settings were not changed in group I (CV) and group II (HFJV) after OT delivery. In group III, drive pressure was increased to 40 psi. Adequacy of oxygenation varied directly with peak inspiratory pressure (PIP) rather than airway pressure (Paw) in both HFJV and CV. In all groups, immediately after OT administration PaO2 decreased and there was a slight increase in Paw; PIP was significantly elevated only in groups I and III. Two hours later, PaO2 had returned to baseline in groups I and III, but had not improved significantly in group II. Paw remained the same in all groups. These data demonstrate that in noncompliant lungs, oxygenation is not improved unless a high PIP is used to establish the critical opening pressures needed to rerecruit alveoli. In this noncompliant lung model, HFJV was not effective at low Paw values, and thus offered no apparent advantage over CV.

Synthesis of thyroglobulin in thyroid carcinoma patients after radioiodine therapy

Endogenously radioiodinated thyroglobulin (Tg) and the serum concentration of Tg have been measured in patients with metastatic thyroid carcinoma after therapeutic doses of radioiodine. Serial samples of blood were analyzed for both these parameters over a period of 10 to 22 days. The specific activity of Tg (cpm/ng) was calculated for each sample. Among the six patients studied, three showed constant specific activity. The specific activity of the other three fell, indicating the entering of newly synthesized Tg into the circulation. The respective amounts of Tg entering into the circulation in these three patients were 120, 852, and 20,935 ng/ml serum/day.