Telomerase reverse transcriptase (TERT) expression and proliferation in canine brain tumours

Telomerase is a ribonucleoprotein enzyme complex that synthesizes telomere DNA. It is detected in 85-90% of malignant tumours in humans, but not in most somatic cells. Because telomerase plays a critical role in cell immortality, it represents an important target for anticancer therapies. We have previously shown that the dog is a potentially useful model for evaluating telomerase-based therapeutics. In this present study we analysed 93 canine brain tumours for telomerase reverse transcriptase (TERT) expression by immunohistochemistry. TERT immunoreactivity was detected in 16 of 50 grade 1 (32%) and 29 of 43 grade 2 tumours (67.4%), demonstrating a statistically significant association with histological grade (P = 0.00012). A subset of 51 tumours was also assessed for MIB-1 expression. The MIB-1 labelling index (LI) was found to correlate significantly with tumour grade, with a mean MIB-1 LI of 1.5% for grade 1 tumours, as compared with a mean MIB-1 LI of 21.7% for grade 2 tumours (P << 0.001). The MIB-1 LI was also significantly associated with TERT expression in all brain tumours (P << 0.001). These data further support the dog as a model for the preclinical development of telomerase-based therapeutics in brain tumours.

Rapid simultaneous measurement of multiple cytokines using 100 microl sample volumes--association with neonatal sepsis

Early diagnosis of neonatal infection has proved problematic due to the inadequacy of currently available laboratory tests. Neonatal sepsis is associated with an increase in plasma-derived cytokine levels, but an increase of a single cytokine cannot identify neonatal sepsis specifically and multiple cytokine levels are required. The time constraints and relatively large volume of plasma required to measure multiple cytokines from newborn infants by conventional enzyme-linked immunosorbent assay (ELISA) techniques is prohibitive. We therefore applied cytometric bead array (CBA) technology for simultaneous measurement of multiple cytokines from a group of 18 term neonates with infection confirmed by culture and a control group. 'Normal' ranges were established for each cytokine from 1-7-, 8-14- and 15-21-day-old newborns. There was no significant change in the levels of cytokines from infants in different control age groups, suggesting that basal cytokine levels are unchanged in the first 3 weeks of life. In the patient groups, however, there was a significant difference in several cytokines between the different age groups. Interleukin (IL)-6, IL-10 and IL-12 were increased significantly in the 1-7-day-old patient group compared to either the 8-14 and 15-21 age group, suggesting that infection in utero is associated with increased levels of these cytokines compared to infection acquired following birth. When individual patient cytokine levels were compared to normal control reference ranges, two patients failed to show significant elevation of any cytokine tested. All other patients showed elevated levels of between one and nine cytokines tested (mean of 4.6). There was no correlation between elevated cytokine levels and types of infective organism or patient age. In conclusion, neonatal sepsis is associated with the elevation of multiple plasma cytokines. The use of CBA kits is a rapid, easy, low sample volume and sensitive method to measure multiple plasma cytokines.

T*1e and T*2e maps derived in vivo from the rat using longitudinally detected electron spin resonance phase imaging: application to abdominal oxygen mapping

A novel imaging modality is introduced which uses radiofrequency longitudinally detected electron spin resonance (RF-LODESR). It is capable of providing qualitative and semiquantitative information on a variety of parameters reflecting physiological function, the most significant being tissue oxygenation. Effective spin-lattice (T*1e) and spin-spin (T*2e) electronic relaxation time maps of the abdomen of living 200-g rats were generated after intravenous administration of a triarylmethyl free radical (TAM). These maps were used to evaluate oxygen distribution. Differences between the liver, kidneys, and bladder were noted. Conclusions were made regarding the distribution, perfusion, and excretion rate of the contrast medium. Ligature-induced anoxia in the kidney was also visualized. LODESR involves transverse ESR irradiation with a modulated excitation, and observing oscillations in the spin magnetization parallel to the main magnetic field. The T*1e and T*2e maps were calculated from a set of LODESR signal phase images collected at different detection frequencies. Each phase image also provides qualitative information on tissue oxygen levels without any further processing. This method presents an alternative to the conventional transverse ESR linewidth-based oximetry methods, particularly for animal whole-body imaging applications.

Clostridial antibody response from injection-site lesions in beef cattle, long-term response to single or multiple doses, and response in newborn beef calves

Experiments were conducted to compare clostridial antibody response of beef heifers that do and do not develop injection-site lesions, evaluate long-term antibody response of a single- and multiple-dose toxoid, and evaluate the ability of a clostridial toxoid to elicit an active antibody response in newborn calves. In Exp. 1, 37 weaned heifers were vaccinated (d 0) with a clostridial vaccine (Alpha-7, 2 mL, s.c.). Serum samples were collected on d 0, 28, 56, 84, and 112 to determine clostridial antibody titers. On d 28, heifers were visually inspected and palpated for injection-site lesions. The percentage of heifers that developed lesions was 64.9%. Lesioned heifers had elevated antibody titers for Clostridium chauvoei (CC) on d 28 (P < 0.08) and 84 (P < 0.07) compared with non-lesioned heifers. Clostridium sordellii (CS) and perfringens type D (CPD) antibody titers were greater in lesioned heifers than in non-lesioned heifers on d 28 and 56. In Exp. 2, long-term antibody response of Alpha-7 (A7) and Ultrabac 7 (UB7) was investigated in stocker heifers. The A7 heifers (n = 15) received one 2-mL vaccination (d 0), and the UB7 heifers (n = 15) received a 5-mL vaccination on d 0 and 28. Blood samples were collected on d 0, 28, 56, 84, 112, 140, and 180. Clostridium chauvoei, CPD, and Cl. novyi (CN) antibody titers from the A7 heifers were greater than those from the UB7 heifers on d 28. Due to the second UB7 injection, CC, CS, CN, and Cl. perfringens type C (CPC) antibody titers were greater in UB7 heifers than in A7 heifers on d 56. By d 112, titers were not different, and by d 140 all antibody titers were below detectable levels. In Exp. 3, 58 pregnant, mature, crossbred cows were vaccinated with A7 before calving. At birth, calves were carefully observed to ensure consumption of colostrum. Calves were blocked according to parturition date, and calves in each block were randomly allocated to receive A7 (s.c. at 3 +/- 3 d of age) or remain unvaccinated controls. Calves were bled at the time of vaccination (d 0) and on d 28, 56, 84, and 112. Antibody titers for CC, CPC, and CPD were elevated on d 0 and decreased throughout the experimental period (P < 0.01), but no titer differences (P > 0.10) were detected between treatment groups on any of the days sampled. These data indicated that antibody titers against clostridial diseases are enhanced when injection-site lesions develop. One injection of Alpha-7 seemed to provide the same length of protection as two injections of Ultrabac 7.

Electron spin relaxation time measurements using radiofrequency longitudinally detected ESR and application in oximetry

Longitudinally detected ESR (LODESR) involves transverse ESR irradiation with a modulated source and observing oscillations in the spin magnetization parallel to the main magnetic field. In this study, radiofrequency-LODESR was used for oximetry by measuring the relaxation times of the electron. T1e and T2e were measured by investigating LODESR signal magnitude as a function of detection frequency. We have also predicted theoretically and verified experimentally the LODESR signal phase dependence on detection frequency and relaxation times. These methods are valid even for inhomogeneous lines provided that T1e>>T2e. We have also developed a new method for measuring T1e, valid for inhomogeneous spectra, for all values of T1e and T2e, based on measuring the spectral area as a function of detection frequency. We have measured T1e and T2e for lithium phthalocyanine crystals, for the nitroxide TEMPOL, and for the single line agent Triarylmethyl (TAM). Furthermore, we have collected spectra from aqueous solutions of TEMPOL and TAM at different oxygen concentrations and confirmed that T1e values are reduced with increased oxygen concentration. We have also measured the spin-lattice electronic relaxation time for degassed aqueous solutions of the same agents at different agent concentrations. T1e decreases as a function of concentration for TAM while it remains independent of free radical concentration for TEMPOL, a major advantage for oxygen mapping. This method, combined with the ability of LODESR to provide images of exogenous free radicals in vivo, presents an attractive alternative to the conventional transverse ESR linewidth based oximetry methods.

Continuous-wave magnetic resonance imaging of short T(2) materials

There is growing interest in the use of magnetic resonance imaging (MRI) to examine solid materials where the restricted motion of the probed spins leads to broad lines and short T(2) values, rendering many interesting systems invisible to conventional 2DFT pulsed imaging methods. In EPR T(2) seldom exceeds 0.1 mus and continuous-wave methods are adopted for spectroscopy and imaging. In this paper we demonstrate the use of continuous-wave MRI to obtain 2-dimensional images of short T(2) samples. The prototype system can image samples up to 50 mm in diameter by 60 mm long and has been used to image polymers and water penetration in porous media. Typical acquisition times range between 10 and 40 min. Resolution of 1 to 2 mm has been achieved for samples with T(2) values ranging from 38 to 750 mus. There is the possibility of producing image contrast that is determined by the material properties of the sample.

Biological applications of spin pH probes

The determination of pH is one of the most important problems in the biochemistry of living organisms, since many of the vital processes of cells and cellular organelles depend on the local pH value. Amongst currently used experimental approaches for the measurement of pH, the application of spin pH probes in combination with EPR spectroscopy is a comparatively new and rapidly developing field. In this article we describe the background, advantages and limitations of the method of spin pH probes, and discuss its recent applications. Availability of a wide variety of pH-sensitive nitroxides with different ranges of pH-sensitivity, labeling group and lipophilicity facilitates their application to a variety of biological systems from subcellular organelles to complex organisms. The recent progress in low-field EPR-based imaging and spectroscopy-based techniques allows spin pH probes to be used for non-invasive in vivo pH measurement and pH-sensitive imaging.

Multimodality magnetic resonance systems for studying free radicals in vivo

The multimodality approach to in vivo detection of free radicals combines the relative benefits of three free radical detection modalities: conventional RF CW-ESR, LODESR and PEDRI. We have built apparatus capable of combining these modalities to allow sequential PEDRI and CW-ESR, sequential LODESR and proton NMR imaging and simultaneous LODESR and CW-ESR. These systems offer superior performance in terms of both the scope and quality of information over single-modality free radical detection systems.

Recent developments in combining LODESR imaging with proton NMR imaging

We have designed and constructed RF coil assemblies and the appropriate instrumentation for combining proton NMR imaging with LODESR imaging. This has enabled us to collect sequential images from the same sample using both methods. The coil assembly consists of a crossed ellipse coil for LODESR and proton NMR signal detection and a saddle coil for excitation of the ESR resonance. Images have been collected of phantoms containing copper sulphate and Tempol solutions. NMR images were collected (4.3 min) and within 30 s LODESR data collection started (collection time 2.5 min). Only the Tempol solutions are visible in the LODESR images.

Alloresponses to HLA-DP detected in the primary MLR: correlation with a single amino acid difference

The one-way mixed lymphocyte reaction (MLR-1) response was measured in both directions in 50 HLA-A, B, DR and DQ identical pairs and the role of DP studied in MLR stimulation. DR, DQ and DP typing was performed at the allele level by the polymerase chain reaction-sequence specific oligotyping (PCR-SSO) technique. The group consisted of 19 potential bone marrow transplant recipients and 34 matched unrelated donors. When more than one matched donor was available for a patient, donor/donor MLR-1 was also studied. DP identity was observed in 3 out of 50 pairs (6%), however due to homozygosity no incompatibility was present in the stimulating cells in 21 out of 100 cases (21%). There was a significant difference in the range of relative responses (RR) between zero DPB1 mismatches and one (p = 0.002) and two (p = 0.02) DPB1 mismatches: 52.4% of cases in the zero DPB1 mismatch group had RR < 1.0% compared with 31.6% and 27.3% in the one and two DPB1 mismatches. Stimulation by DPB1*0201 and 0301 gave the highest RR (12.9 +/- 22.5 and 17.5 +/- 17.0, respectively) while stimulation with DPB1*0401 and 0402 resulted in low levels of T cell response (1.3 +/- 8.2 and 0.6 +/- 11.5, respectively). When the responses were restricted to DPB1*0401 homozygotes to standardise for responder type similar results were obtained (DPB1*0201 v DPB1*0402 p = 0.008). The protein products of the DPB1*0201 and 0402 alleles differ by a single amino acid at position 69 (DPB1*0402--Lysine, DPB1*0201--glutamic acid). A further analysis was performed therefore scoring responders and stimulators as glutamic acid positive (E+) or negative (E-). There was a highly significant increase in the response to E+ stimulators compared with E- stimulators (p = 0.004). There was also a significant difference in the distribution of relative responses between the E+ stimulator group and the subgroups of E- responders/E- stimulators (p = 0.012) and E+ responders/E- stimulators (p = 0.009). However the amino acid difference at position 69 does not explain all responses due to DP in the MLR-1 as evidenced by the strong responses observed in cases where DPB1*0301 (lysine pos.) was the only difference on the stimulator cells. The results indicate that not all DP incompatibilities elicit a measurable T cell MLR response, but where a response does occur residue 69 in the first domain of DP appears to be pivotal. These results may have implications with respect to GVHD in bone marrow transplantation.

Clostridial vaccination efficacy on stimulating and maintaining an immune response in beef cows and calves

Experiments were conducted to determine the efficacy in stimulating and maintaining an immune response in the presence of maternal antibodies, compare the extent of the anamnestic responses to revaccination, and compare the maternal antibody response of 2- or 5-mL clostridial vaccination. In Exp. 1, 118 nursing calves were randomly assigned to receive a 2-mL (Alpha-7, A7) or a 5-mL clostridial vaccine (Ultrabac 7; UB7) at 50.4 +/- 15.30 (X +/- SD) d of age (d 0 = date of calving). Calves were revaccinated with the same treatment on d 170. Blood samples were collected from 10 calves of each treatment group on d 50, 170, and 191 to determine antitoxin units for Clostridium perfringens type C (PC) and D (PD) and agglutination titers for Cl. chauvoei (CC). The A7-treated calves tended (P < .10) to have higher PC units on d 170, an increased rate of change in PD units from d 170 to d 191 (P < .06), and a tendency (P < .10) for enhanced CC titers on d 191 compared with UB7-treated calves. In Exp. 2, 109 pregnant cows and 83 pregnant heifers were randomly assigned within a 2 x 2 x 2 factorial design. The main effects were dam age (cow or heifer), dam treatment (A7 or UB7), and calf treatment (A7 or UB7). Dams were vaccinated with A7 or UB7 d 124 prepartum (d -124) and d 53 after birth. At d 53.4 +/- 12.88, calves were vaccinated with A7 or UB7 (d 53). Calves were revaccinated with the same treatment on d 173. Blood samples were collected from 10 dams per treatment group on d -124, 53, and 173 and from their calves on d 53, 173, and 194. Cows had higher antitoxin levels for PC (P < .01) and PD (P < .05) than heifers. The A7-treated dams had higher (P < .01) PD units on d 53 and d 173 and CC on d 173 than did UB7-treated dams. Calves from A7-treated cows had higher (P < .03) PD units on d 53 than calves from UB7-treated cows. The A7-treated calves had higher titers for CC (P < .01) on d 173 than did UB7-treated calves, and this enhanced level seemed to continue to d 194 (P < .08). In conclusion, titers for clostridial diseases in 50- to 53-d-old calves can be enhanced if dams are vaccinated approximately 4 mo before calving, and 120 d between clostridial vaccinations seems to be too long for adequate protection.

The Fas antigen (CD95) on human lymphoid cells: epitope analysis with ten antibodies

The expression of CD95 antigen was examined on adult and cord blood lymphocytes using a highly sensitive immunofluorescence/flow cytometric procedure. CD95 was expressed by the majority of circulating blood T cells in adults, and by a smaller proportion of CD4+ and CD8+ T cells in cord blood. The majority of circulating B cells did not react with seven CD95 antibodies, but three antibodies did stain B cells. In tonsil sections, CD95 was expressed throughout the tissue but germinal centres showed generally stronger staining than the surrounding follicular mantle and interfollicular areas. This was confirmed by flow cytometry, which showed expression preferentially on B cells with a germinal centre phenotype. Because different antibodies stained different proportions of B cells, CD95 epitopes were examined by inhibition, additive binding and protease susceptibility studies using a panel of ten CD95 antibodies. B cells apparently reacting selectively with CD95 antibodies were sorted and CD95 mRNA was reverse transcribed to cDNA and analyzed, in order to confirm the presence of CD95 in cells which reacted selectively and to explore the possible existence of CD95 isoforms. The major cDNA band was identical in the two populations. Inhibition of N-glycosylation suggested that the epitopes detected differentially could not be accounted for by differential N-glycosylation.

Young Investigator Award presentation at the 13th Annual Meeting of the ESMRMB, September 1996, Prague. A proton-electron double-resonance imaging apparatus with simultaneous multiple electron paramagnetic resonance irradiation at 10 mT

The detection of free radicals in vivo is very important for the study of many physiologic and pathologic conditions. Free radicals have been implicated in a number of diseases such as ischemia, inflammation, kidney damage, and cancer. Proton-electron double-resonance imaging (PEDRI) allows the indirect detection of free radicals via the Overhauser effect. Nitroxide free radicals used for in vivo PEDRI studies present spectra with two or three lines, but most PEDRI experiments performed to date have used only single-line electron paramagnetic resonance (EPR) irradiation. There is theoretical evidence that simultaneous irradiation of multiple EPR transitions could increase the maximum achievable PEDRI enhancement. From the experimental point of view, this requires the combined use of a suitable multiple-frequency EPR source and a multiple-tuned EPR resonator. A novel radiofrequency (RF) triple-tuned loop-gap resonator for use in PEDRI has recently been developed, and dynamic nuclear polarization (DNP) data were reported. In the present study we describe a new PEDRI apparatus, equipped with a triple-tuned resonator, that is suitable for simultaneous double- or triple-EPR irradiation of nitroxide free radicals. In particular, the details of the EPR hardware used to generate the two or three EPR frequencies are given, and PEDRI images obtained with simultaneous multiple EPR irradiation are shown. Moreover, DNP experimental results showing the increase of the enhancement as a function of the EPR power for single and simultaneous double EPR irradiation are presented. The main goal of this apparatus is to improve the sensitivity and/or to reduce EPR irradiation power in a PEDRI experiment. This is likely to be particularly important in future biologic applications of PEDRI where the applied power must be optimized to reduce sample heating.

Vogt-Koyanagi-Harada syndrome in patients of Vietnamese ancestry

BACKGROUND

Vogt-Koyanagi-Harada syndrome (VKH), is an idiopathic, multisystem inflammatory disorder primarily involving the eye. HLA typing has shown a strong association between the HLA-DR4 antigen and people of Japanese, Han Chinese and Hispanic ancestry with VKH. This study reviewed the clinical features and HLA typing of Vietnamese patients with VKH.

PATIENTS AND METHODS

A retrospective review of four unrelated Vietnamese patients with VKH seen in private practice and hospital clinic. The American Uveitis Society (1978) criteria for VKH diagnosis were satisfied. Standard microcytotoxic assays for Class I antigens and HLA-DNA typing of Class II DR antigens (DRB1 genotyping) by the PCR-SSO method were performed.

RESULTS

The clinical features of VKH in Vietnamese were comparable to those seen in other Asian races. HLA-DR4 was present in three of the four VKH patients. Two of these patients also expressed the allele DRB1*0405.

DISCUSSION

The strong association between HLA-DR4 and the DRB1*0405 allele and VKH seen in Japanese people, may well also exist in Vietnamese people. The HLA association suggests an immunogenetic predisposition to VKH.

An immunogenetic analysis of the T-cell recognition of the major house dust mite allergen Der p 2: identification of high- and low-responder HLA-DQ alleles and localization of T-cell epitopes

Cellular reactivity to Der p 2, a major allergen of the house dust mite (HDM) Dermatophagoides pteronyssinus, was studied in a group of 41 symptomatic HDM sensitive patients, using fresh peripheral blood mononuclear cells (PBMC) and assays of proliferation. Sixty per cent of the patients responded to Der p2, with reactivities being greater in patients with asthma as one of their clinical manifestations and also in those who had skin-test reactivity to a number of allergens. HLA-DR and -DQ serotyping was undertaken in 39 of the patients and the magnitude of T-cell proliferative responses to Der p 2 were found to be positively associated with DQ7 and negatively associated with DQ2. T-cell determinants within the Der p 2 molecule were identified by assays using a series of overlapping peptides (15- to 19-mers) spanning the entire protein. Fifty-nine per cent of the 41 HDM-sensitive patients responded to one or more of the peptides. All of the peptides were antigenic for at least one of the individuals, indicating the heterogeneity of the human repertoire reactive with Der p 2. There was a substantial variability in the number and location of epitopes recognized by T cells from the different allergic patients, the mean number per patient being 2.3 +/- 1.3 (SD). The most frequently recognized peptide was that spanning residues 111-129, being stimulatory in 66.7%, the other peptides were each recognized by between 8 to 25% of individuals. There was no correlation between the epitope recognized and the presence of particular HLA-DQ antigens.

Combined coronary artery bypass grafting and abdominal aortic aneurysm repair

Fifteen patients of mean age 65 years underwent simultaneous coronary artery bypass grafting and abdominal aortic aneurysm repair between 1988 and 1992. Of these 13 had coexistent angina and two had symptomless coronary artery disease detected by preoperative dipyridamole thallium scanning or exercise stress testing. All patients had significant coronary artery disease on coronary angiography. Coronary artery bypass grafting was performed first, with a median number of grafts of 4, a median aortic cross-clamp time of 39 min and a median bypass time of 74 min. Abdominal aortic aneurysm repair followed with a median aortic clamp time of 66 min. Six straight and nine bifurcated grafts were inserted. The median total operating time was 395 min. All patients were managed postoperatively in the cardiothoracic intensive care unit with a median duration of 5 days. The median total hospitalization was 14 days. One patient died of non-cardiac causes; hence the mortality rate was 6.7%. The authors' experience suggests that combined coronary artery bypass grafting and abdominal aortic aneurysm repair is feasible in carefully selected patients.

Multiple non-melanoma skin cancer: evidence that different MHC genes are associated with different cancers

HLA DR frequencies of patients with multiple non-melanoma skin cancers were analysed. There were significant differences in the frequencies of HLA DR1, DR4 and DR7 between patients who only had basal cell carcinomas and patients who had both basal and squamous cell carcinomas. There were significant differences in the frequency of HLA DR53 between the two groups. This antigen is in linkage disequilibrium with HLA DR4 and DR7, and it is not possible to distinguish the primary susceptibility locus.

Prognostic significance of detection of monoclonality in remission marrow in acute lymphoblastic leukemia in childhood. Australian and New Zealand Children's Cancer Study Group

Techniques based on the polymerase chain reaction (PCR) to detect rearrangement of the immunoglobulin or T-cell receptor genes can detect residual disease in leukemia and hence have the potential to improve prognosis and treatment. Such techniques may involve either detection of monoclonality, which is simple and quick but has limited sensitivity, or specific detection of the leukaemic clone, which is complex and time-consuming but has high sensitivity. The PCR was used to detect monoclonal rearrangements of the immunoglobulin heavy chain and/or T-cell receptor gamma chain genes in archival marrow specimens from 185 children with acute lymphoblastic leukemia who achieved remission during two consecutive Australasian trials of treatment. A monoclonal rearrangement was detected at diagnosis in 152 (84%) patients and in these patients detection of the same rearrangement in the remission marrow at the end of induction therapy was highly significantly correlated with outcome. There were nine patients in whom polymerase chain reaction showed only the monoclonal rearrangement and eight (89%) relapsed; there were 26 patients in whom PCR showed the leukemic monoclonal rearrangement as well as polyclonal rearrangements from normal lymphocytes and 12 (46%) relapsed; and there were 117 patients in whom only polyclonal rearrangements could be detected and only 29 (25%) relapsed. In patients who relapsed, remissions were shorter in those patients in whom the leukemic rearrangements had been detected in the remission marrow. Treatment in the later trial was more intensive than in the earlier trial, the results were better and the PCR detected the leukemic rearrangement in the remission marrow in significantly fewer patients. We conclude that detection by PCR of the monoclonal gene rearrangement of the leukemic clone in remission marrow indicates that numerous leukemic cells have survived induction therapy and is a good predictor of relapse. However, due to limited sensitivity of the test, failure to detect the leukemic clone by PCR is not a sufficiently good predictor of ultimate cure.

HLA DR4 is associated with the development of multiple basal cell carcinomas and malignant melanoma

An association between HLA DR4 and the development of multiple basal cell carcinomas (BCC) and malignant melanoma (MM) was detected in southern Australia. There were highly significant differences in HLA DR frequencies between patients with multiple BCCs and MM and matched patients with multiple BCCs only. These findings suggest that hereditary factors associated with the HLA system influence what types of multiple skin cancers people develop.

Multiple basal cell carcinoma in tropical Australia

No association between HLA DR1 and the development of multiple basal cell carcinomas (BCC) was found among patients who had lived at least two-thirds of their lives in the tropics. The percentage of patients with multiple BCCs increased with age; this was different from what has been found in people living in the temperate zone of Australia.

HLA-DR1 is not a sign of poor prognosis for the development of multiple basal cell carcinomas

BACKGROUND

HLA-DR1 is associated with the development of multiple basal cell carcinomas (BCC). However, the association is weak.

OBJECTIVE

The purpose of our study was to determine whether HLA-DR1 is a marker for susceptibility to the development of many BCCs during a lifetime.

METHODS

Persons with multiple BCCs were placed into two groups: those with less than 10 and those with 20 or more. In addition, the HLA-DR1 frequencies were analyzed.

RESULTS

HLA-DR1 was associated with multiple BCCs in the group with less than 10 BCCs but not with the other group. These patients were significantly younger on average than those with 20 or more BCCs.

CONCLUSION

HLA-DR1 is associated with the development of multiple BCCs at an early age but it is not associated with development of large numbers of BCCs. The amount of UV light a person receives appears to be more important.

Skin cancers and HLA frequencies in renal transplant recipients

An association between HLA DR7 and the development of multiple non-melanoma skin cancer was detected in immunosuppressed patients in southern Australia. The relative risk was 2.6 which was lower than for immunocompetent patients with the same skin cancers. HLA frequencies of renal transplant recipients with multiple skin cancers were determined. The types HLA B27 and HLA Dr7 were found in significantly higher frequency, and there was no absence of HLA A11.

Age and multiple basal cell carcinomas in Australia

A survey of patients with skin cancer in southern Australia detected that the development of multiple BCCs is common. The incidence of multiple BCCs peaks during the sixth decade and reaches a plateau. Human leukocyte antigen (HLA) DR1 was associated with the development of multiple BCCs in people under the age of 55, but not in older people.

Multiple basal cell carcinomas and HLA frequencies in southern Australia

An association between HLA-DR1 and the development of multiple basal cell carcinomas was detected in southern Australia. A reduction in HLA-DR4 was found in patients with basal cell carcinoma compared with a local control group. The relative risk for HLA-DR1 was 2.1, which was lower than that for persons in farther countries from the equator.

Motor impersistence: a right-hemisphere syndrome

We studied motor impersistence with a standardized clinical test of sustained actions, both in patients with acute focal stroke lesions, who were matched for age and size of lesion, and normal controls. Patients with right-sided lesions had significantly more impersistence than did those with left-sided lesions. The most discriminating tests were eye-closure, mouth-opening, tongue-protrusion, and gaze to the left. Right central and frontal lesions seemed to be more responsible for motor impersistence than were posterior or left-sided lesions. Although motor impersistence is sometimes seen with diffuse cerebral disease, it is also a sign of right-hemisphere lesions; the phenomenon is probably related to mechanisms of directed attention that are necessary to sustain motor activity.