Impact of microsatellite status in early-onset colonic cancer

BACKGROUND

The molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status.

METHODS

Anonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated.

RESULTS

A total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively).

CONCLUSION

Patients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.

Microsatellite instability in young patients with rectal cancer: molecular findings and treatment response

In this study of 400 patients with early-onset rectal cancer, 12.5 per cent demonstrated microsatellite instability (MSI). MSI was associated with a reduced likelihood of nodal positivity, an increased rate of pathological complete response, and improved disease-specific survival.

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review

Importance

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.

Observations

Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.

Conclusions and Relevance

The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

High-performance flexible asymmetric supercapacitor based on rGO anode and WO3/WS2 core/shell nanowire cathode

Flexible smart electronics require their energy storage device to be flexible in nature. Developing high-performance flexible energy storage devices require direct integration of electrode active materials on current collectors to satisfy the high electronic/ionic conductivity and long-term durability requirements. Herein, we develop a flexible all-solid-state asymmetric supercapacitor comprised of reduced graphene oxide (rGO) and core/shell tungsten trioxide/tungsten disulfide (WO₃/WS₂) nanowire based electrodes. The electrodes synthesized via electrochemical deposition and chemical vapor deposition avoided the necessity to use non-conductive binders and offered excellent cyclic stability. The structural integrity provided by the rGO and WO₃/WS₂ electrodes facilitated excellent electrochemical stability with capacitance retention of 90% and 100% after 10 000 charge-discharge cycles, respectively. An all-solid-state device provides a voltage window of 1.5 V and more than 70% capacitance retention after 10 000 charge-discharge cycles. Providing 97% capacitance retention upon mechanical bending reveals its potential to be used as an energy storage devices in flexible electronics.

Wafer-Scale Two-Dimensional MoS2 Layers Integrated on Cellulose Substrates Toward Environmentally Friendly Transient Electronic Devices

We explored the feasibility of wafer-scale two-dimensional (2D) molybdenum disulfide (MoS₂) layers toward futuristic environmentally friendly electronics that adopt biodegradable substrates. Large-area (> a few cm²) 2D MoS₂ layers grown on silicon dioxide/silicon (SiO₂/Si) wafers were delaminated and integrated onto a variety of cellulose-based substrates of various components and shapes in a controlled manner; examples of the substrates include planar papers, cylindrical natural rubbers, and 2,2,6,6-tetramethylpiperidine-1-oxyl-oxidized cellulose nanofibers. The integrated 2D layers were confirmed to well preserve their intrinsic structural and chemical integrity even on such exotic substrates. Proof-of-concept devices employing large-area 2D MoS₂ layers/cellulose substrates were demonstrated for a variety of applications, including photodetectors, pressure sensors, and field-effect transistors. Furthermore, we demonstrated the complete "dissolution" of the integrated 2D MoS₂ layers in a buffer solution composed of baking soda and deionized water, confirming their environmentally friendly transient characteristics. Moreover, the approaches to delaminate and integrate them do not demand any chemicals except for water, and their original substrates can be recycled for subsequent growths, ensuring excellent chemical benignity and process sustainability.

Umbilical cord as human cell source for mitral valve tissue engineering - venous vs. arterial cells

Around 2% of the population in developed nations are affected by mitral valve disease and available valvular replacements are not designed for the atrioventricular position. Recently our group developed the first tissue-engineered heart valve (TEHV) specifically designed for the mitral position - the TexMi valve. The valve recapitulates the main components of the native valve, i.e. annulus, asymmetric leaflets and the crucial chordae tendineae. In the present study, we evaluated the human umbilical cord as a clinically applicable cell source for the TexMi valve. Valves produced with cells isolated from human umbilical cord veins (HUVs) and human umbilical cord arteries (HUAs) were conditioned for 21 days in custom-made bioreactors and evaluated in terms of extracellular matrix (ECM) composition and mechanical properties. In addition, static cell-laden fibrin discs were molded to investigate cell-mediated tissue contraction and differences in ECM production. HUA and HUV cells were able to deliver functional valves with a rich ECM composed mainly of collagen. Particularly noteworthy was the synthesis of elastin, which has been observed rarely in TEHV. The elastin synthesis was significantly higher in TexMi valves produced with HUV cells and therefore the HUV is considered to be the preferred cell source.

Diversity of cytosolic HSP70 Heat Shock Protein from decapods and their phylogenetic placement within Arthropoda

The 70kDa heat shock proteins (HSP70) are considered the most conserved members of the HSP family. These proteins are primordial to the cell, because of their implications in many cellular pathways (e. g., development, immunity) and also because they minimize the effects of multiple stresses (e. g., temperature, pollutants, salinity, radiations). In the cytosol, two ubiquitous HSP70s with either a constitutive (HSC70) or an inducible (HSP70) expression pattern are found in all metazoan species, encoded by 5 or 6 genes (Drosophila melanogaster or yeast and human respectively). The cytosolic HSP70 protein family is considered a major actor in environmental adaptation, and widely used in ecology as an important biomarker of environmental stress. Nevertheless, the diversity of cytosolic HSP70 remains unclear amongst the Athropoda phylum, especially within decapods. Using 122 new and 311 available sequences, we carried out analyses of the overall cytosolic HSP70 diversity in arthropods (with a focus on decapods) and inferred molecular phylogenies. Overall structural and phylogenetic analyses showed a surprisingly high diversity in cytosolic HSP70 and revealed the existence of several unrecognised groups. All crustacean HSP70 sequences present signature motifs and molecular weights characteristic of non-organellar HSP70, with multiple specific substitutions in the protein sequence. The cytosolic HSP70 family in arthropods appears to be constituted of at least three distinct groups (annotated as A, B and C), which comprise several subdivisions, including both constitutive and inducible forms. Group A is constituted by several classes of Arthropods, while group B and C seem to be specific to Malacostraca and Hexapoda/Chelicerata, respectively. The HSP70 organization appeared much more complex than previously suggested, and far beyond a simple differentiation according to their expression pattern (HSC70 versus HSP70). This study proposes a new classification of cytosolic HSP70 and an evolutionary model of the distinct forms amongst the Arthropoda phylum. The observed differences between HSP70 groups will probably have to be linked to distinct interactions with co-chaperones or other co-factors.

A Nucleosome Interaction Module Is Required for Normal Function of Arabidopsis thaliana BRAHMA

The BRAHMA (BRM) gene encodes the SNF2-type ATPase of the putative Arabidopsis thaliana SWI/SNF chromatin remodelling complex. This family of ATPases is characterized by the presence of a conserved catalytic domain and an arrangement of auxiliary domains, whose functions in the remodelling activity remains unclear. Here, we characterize, at the molecular and functional level, the carboxy-terminal part of Arabidopsis BRM. We have found three DNA-binding regions that bind various free DNA and nucleosomal probes with different specificity. One of these regions contains an AT-hook motif. The carboxy terminus also contains a bromodomain able to bind histones H3 and H4. We propose that this array of domains constitute a nucleosome interaction module that helps BRM to interact with its substrate. We also characterize an Arabidopsis mutant that expresses a BRM protein lacking the last 454 amino acid residues (BRM-DeltaC), encompassing the bromodomain and two of the three DNA-binding activities identified. This mutant displays an intermediate phenotype between those of the wild-type and a null allele mutant, suggesting that the nucleosome interaction module is required for the normal function of BRM but it is not essential for the remodelling activity of BRM-containing SWI/SNF complexes.

[The late follow-up evolution of myocardial infarct]

The aim of this paper was to study the long term evolution of patients (one to five years) after an acute myocardial infarction. Three hundred and twenty questionnaires were sent to patients admitted and diagnosed as acute myocardial infarction in the private sector of the Instituto Nacional de Cardiología "Ignacio Chávez". One hundred seventy five useful answers were obtained. Of these patients, coronariography was performed in 132 during the acute episode. In 57 CABG was performed. Most of them had three vessels or main left coronary artery occlusions. In the late long term evolution 68 patients had angor pectoris, 16 had unstable angina, more advanced lesions were found in 14 of them in a new angiographic study. In nine CABG was performed, three were treated with angioplasty, in two there was no indication for intervention. One had a new myocardial infarction and one died. Only four patients had a new myocardial infarction, two of them died, and another one had heart failure. In three of them a new angiographic study showed significant occlusion of the main left coronary artery. Eight patients died between the second and fourth year of evolution, in two it was a sudden death, two had a new myocardial infarction, three had heart failure and in one the cause of death was a stroke. Ten patients died during the first year of evolution the main cause was sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

[The hospital course of patients with acute myocardial infarction after discharge from the coronary unit]

The in-hospital clinical course of 100 patients discharged from the CCU with a Acute Myocardial Infarction (AMI) were studied at the Instituto Nacional de Cardiología "Ignacio Chávez" 86 were men and 14 women, the age in the majority was between 50 and 80 years. The diaphragmatic necrosis was predominant. 11 patients had angina pectoris after the infarction, five cardiac failure, 4 a new AMI and 5 died (5%). Coronary angiography was performed in 35 patients, and treadmill test at 63. The treadmill test results had a good correlation with the angiographic findings. Coronary bypass grafts surgery was performed in 18 patients, 17 had good evolution, without post surgery angina or cardiac failure. One died at the OR. 3 pts more had PTCA, two in the AD and one a circumflex incomplete dilatation. All 3 were discharged asymptomatic. Four patients had another AMI, two died with cardiogenic shock, and two good clinical course, including one who had AMI after had graft surgery. Five pts died. Two with another AMI, one at the OR and two had a sudden death. One of these had previous cardiac failure and PVC. It is concluded that: patients with a new AMI and cardiac failure have poor prognosis. The coronary graft surgery has great therapeutic value in pts with angina post AMI. The treadmill test has a good correlation with the coronary damage found at angiography.

[Myocardial revascularization. The evolution of 100 cases]

The postoperative course of 100 pts. that underwent aorto-coronary bypass surgery was studied at the Instituto Nacional de Cardiología "Ignacio Chávez": 84 were men and 16 women between 37 and 74 years. 56 had previous history of myocardial infarction, while in 16 of them occurred within 30 days of the surgical procedure. 88 had symptomatic angina and 8 were in cardiac failure. The coronariography showed trivascular lesions in 73% and 8 pts. had stenosis of the left main coronary artery. Two pts. had 5 coronary grafts, 4 had 17, 3 had 37, two 35 and one 9 pts. All anterior descending coronary arteries were grafted. 61 of them and the 8 main left damaged were grafted with internal mammary artery Afert surgery; 15 pts had AMI, 4 profuse bleeding, one cardiac failure and shock. CPK enzyme levels of 500 were found in the majority of the pts with AMI with 81.2 positive predictive value and negative of 97.6. Three pts died, two at the OR with cardiac failure one of them had ventricular rupture, and the last at the ICU also with cardiac failure. We emphasize that CPK values of 500 UI or more in the postoperative course may be diagnostic of AMI.

[Hospital course of acute myocardial infarction treated with or without anticoagulants]

Three hundred patients with acute myocardial infarction (AMI) were studied. Half of them received anticoagulant treatment with heparin and acenocoumarin (Group I) The other 150 patients did not have anticoagulant therapy (Group II) Both groups were similar in age, sex, prior history of diabetes, arterial hypertension or smoking habits. The incidence of persistent angina, arrhythmias, pulmonary embolism and re-infarction was not different for both groups. The mortality was slightly higher in group II. Of the patients who died, the autopsy demonstrated fresh thrombi in all cases of both groups; in addition, most of the patients of group II hemorrhage of the coronary artery wall was found.

[Acute myocardial infarct with cardiogenic shock]

Cardiogenic shock is the most severe complication of acute myocardial infarction (AMI). The Acute Myocardial Infarction (AMI) complicated with shock has the highest mortality. Between january 1980 and june 1983, 903 patients with AMI were admitted to the CCU of the Instituto Nacional de Cardiolog ía; in 38 of them (4.2%) shock ensued. Of the patients with shock, 52.6% died soon after arrival and 25% died soon after shock developed. Only 10 patients could be controlled with a Swan-Ganz catheter and could be treated according to the hemodynamic features. Nine of them were males, the majority older than 60. Three of the 10, had a previous myocardial infarction, 4 had angina 1 arterial hypertension, and 1 diabetes. The AMI was anterior in five patients, diaphragmatic and lateral in one, diaphragmatic with right ventricular extension in two, lateral in one and antero septal in the last one. The clinical manifestations of angina persisted in 6. The shock state appeared in most of the cases during the first 6 hours. The PWP was higher than 18 mm Hg in all the patients. The cardiac index was less than 2, the systemic blood pressure under 90 mmHg and the peripheral resistance was elevated in all the cases. They were treated with digitalis, Dopamine and Sodium Nitroprusiate . Nine of the 10 patients died; five had post mortem examination. The coronary arteries were occluded with a recent thrombi and the necrosis involved more than 40.0% of the ventricular mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Altitude and infant growth in Bolivia: a longitudinal study

The growth of 79 healthy, well-nourished lowland (400 M) and highland (3600 M) Bolivian infants was analyzed in a longitudinal study through the first postnatal year. Compared to low altitude infants, the high altitude infants were found, by analysis of covariance controlling for size at the previous exam, to be significantly shorter at birth, 1 and 6 months, while they were significantly lighter only at birth and 1 year. Recumbent length gain was slower in the high altitude infants in the early months of life, while weight gain did not differ between altitudes. The observed lower weights at high altitude throughout the first year appear to be due to a persistence of lower weights seen at birth and not to postnatal growth retardation. Significantly greater triceps and subscapular skinfold thickness measurements were found in the highland group, despite their smaller length and weight. The possible causes and implications of the greater fat accumulation in the highland infants are discussed.

[Electrophysiological studies in permanent atrial paralysis]

Permanent atrial paralysis is a very rare entity characterized by absence of electrical and mechanical activity of the atria which persists for months or years. We present a patient with congestive cardiomyopathy and chronic atrial paralysis. The phonomechanocardiographic study confirmed the absence of mechanical contraction of the atrium and did not show atrial electrical activity in the superficial electrocardiogram nor in the intracavitary tracing. In the electrophysiological study of the biopsy of the atrial myocardium an unexcitable tissue was found with an important diastolic despolarization of 30 mv. The histologic and ultrastructural studies showed nonspecific changes, with the replacement of the myocardial cells by fibrous tissue.

[Value of the electrocardiogram to predict the pattern of left ventricular contraction in ischemic cardiopathy]

A correlative electrocardiographic and ventriculographic study was performed in a series of 100 patients with clinical and electrocardiographic diagnosis of ischemic heart disease. The analysis was focused on the possibility of predicting ventricular contraction pattern (VCP) disturbances, through electrocardiographic signs of coronary insufficiency. Two main groups were separated on the basis of the presence of necrosis. There were 66 cases with necrosis, and 34 without it. The type of VCP was calssified in accordance with the criterion of Herman et al. in: asyneresis, akinesis and dyskininesis. The degree of coronary narrowing was arbitrarily evalued as less than 50%, between 50 and 75%, and over 75% of the lumen.