Prognostic value of p53 overexpression in head and neck carcinomas: a pilot study

OBJECTIVE: To correlate p53 overexpression in squamous cell carcinoma of the head and neck region with the outcome of treatment. STUDY DESIGN: Twenty-five biopsy-proven squamous cell carcinomas of the head and neck region, locally advanced and untreated, were studied. Before treatment, all patients underwent fine needle aspiration from primary and/or metastatic lesions. Smears were prepared from the aspirate for immunostaining, and p53 overexpression was measured semiquantitatively. All patients received a radical dosage of radiation equivalent to 60 Gy for 6 weeks in 30 fractions from a 6-MV linear accelerator. Local-regional disease control was studied, and the mean follow-up duration was one year. The pretreatment values of p53 overexpression were correlated with the outcome of treatment. RESULTS: Overexpression of p53 was found in 36% patients. At the end of 1 year, 6/9 patients showing overexpression were disease free as compared to 5/16 patients without overexpression. The difference was not significant (chi2 test, P>.05). CONCLUSION: Response to radiation therapy is not dependent on p53 overexpression in squamous cell carcinoma of the head and neck region. However, this was only a pilot study, and a large number of cases are needed to establish the prognostic value of p53 overexpression in locally advanced head and neck squamous cell carcinoma.     

Ginkgo biloba in dyslexia: a pilot study.

OBJECTIVES: The purpose of this study was to collect preliminary information on the possible efficacy and tolerability of EGb 761 standardized plant extract of Ginkgo biloba as a treatment of dyslexia in school-aged children. METHODS: Fifteen children (5-16 year old) with dyslexia participated in an open-label trial of EGb 761 given as a single morning dose of 80 mg. Standardized tests for dyslexia were administered at baseline and at the end of the study. RESULTS: All 15 children completed the trial. The score of the standardized tests for dyslexia decreased. On the list of words the score decreased from mean 4.33 (SD=2.37) at baseline to 2.66 (SD=1.58) at the end of the study (p<0.01), on the list of non-words from mean 3.39 (SD=1.5) at baseline to 2.26 (SD=0.92) at the end of the study (p<0.02) and on the reading piece from mean 3.52 (SD=2.11) to 2.13 (SD=1.25); at the end of the study (p<0.05). At the end of the study 9 children did not perform below the -2 SD on the list of words and 7 on reading text and so they no longer fulfilled the DSM-IV-TR criteria for dyslexia. A brief period of headache was reported by the parents of two children. CONCLUSION: These data suggest that EGb 761 standardized plant extract of Ginkgo biloba has acceptable acute tolerability at single doses up to 80 mg/day and is possibly efficacious in decreasing dyslexia difficulties. The need for a double-blind trial is discussed by the authors.     

Cytokeratins in normal lung and lung carcinomas. I. Adenocarcinomas, squamous cell carcinomas and cultured cell lines

The various epithelial cells of the lower respiratory tract and the carcinomas derived from them differ markedly in their differentiation characteristics. Using immunofluorescence microscopy and two-dimensional gel electrophoresis of cytoskeletal proteins from microdissected tissues we have considered whether cytokeratin polypeptides can serve as markers of cell differentiation in epithelia from various parts of the human and bovine lower respiratory tract. In addition , we have compared these protein patterns with those found in the two commonest types of human lung carcinoma and in several cultured lung carcinoma cell lines. By immunofluorescence microscopy, broad spectrum antibodies to cytokeratins stain all epithelial cells of the respiratory tract, including basal, ciliated, goblet, and alveolar cells as well as all tumor cells of adenocarcinomas and squamous cell carcinomas. However, in contrast, selective cytokeratin antibodies reveal cell type-related differences. Basal cells of the bronchial epithelium react with antibodies raised against a specific epidermal keratin polypeptide but not with antibodies derived from cytokeratins characteristic of simple epithelia. When examined by two-dimensional gel electrophoresis, the alveolar cells of human lung show cytokeratin polypeptides typical of simple epithelia (nos. 7, 8, 18 and 19) whereas the bronchial epithelium expresses, in addition, basic cytokeratins (no. 5, small amounts of no. 6) as well as the acidic polypeptides nos. 15 and 17. Bovine alveolar cells also differ from cells of the tracheal epithelium by the absence of a basic cytokeratin polypeptide. All adenocarcinomas of the lung reveal a "simple-epithelium-type" cytokeratin pattern (nos. 7, 8, 18 and 19). In contrast, squamous cell carcinomas of the lung contain an unusual complexity of cytokeratins. We have consistently found polypeptides nos. 5, 6, 8, 13, 17, 18 and 19 and, in some cases, variable amounts of cytokeratins nos. 4, 14 and 15. Several established cell lines derived from human lung carcinomas (SK-LU-1, Calu -1, SK-MES-1 and A-549) show a uniform pattern of cytokeratin polypeptides (nos. 7, 8, 18 and 19), similar to that found in adenocarcinomas. In addition, vimentin filaments are produced in all the cell lines examined, except for SK-LU-1.(ABSTRACT TRUNCATED AT 400 WORDS)     

AgNOR quantification in cells of normal oral mucosa exposed to smoking and alcohol. A cytopathologic study

OBJECTIVE: To evaluate cell proliferative activity by counting and measuring argyrophilic nucleolar organizer regions (AgNORs) per nucleus in cell smears from mucosa clinically exposed to smoking and alcohol. STUDY DESIGN: Group 1 (control) consisted 17 patients, group 2 (smoking) of 25 and group 3 (smoking and alcohol) of 18. Cell smears collected from the mucosa of the lower lip, border of the tongue and floor of the mouth underwent AgNOR staining. Mean number and mean area of AgNORs per nucleus were calculated for the first 50 cells in each smear. ANOVA and the Tukey test were used for statistical analyses at a 5% significance level. RESULTS: Statistical analyses revealed a greater mean number and larger mean area of AgNORs per nucleus in groups 2 (smoking) and 3 (smoking and alcohol). Samples from the border of the tongue had the lowest mean values for number and area of AgNORs per nucleus in comparison with samples from the lower lip and floor of the mouth in the 3 groups. CONCLUSION: Anatomic sites exposed to smoking or to smoking and alcohol had increased cellular proliferative activity.     

Transition metal abundances in microbial carbonate: a pilot study based on in situ LA-ICP-MS analysis

The ability to recognize the former existence of microbes as well as the biological origin of marine precipitates, such as putative microbialites, is crucial for understanding the development and history of early life on Earth. Increasingly, such rocks hold keys to understanding the geochemical evolution of the oceans and linked Earth systems. Vital trace elements previously have received relatively little attention as clues to the origin of carbonate rocks, and low abundance transition elements in particular, have been difficult to analyse in carbonate matrices for technical reasons. We have used laser ablation–inductively coupled plasma–mass spectroscopy for the in situ measurement of a broad suite of vital transition metals in Late Devonian reefal limestones that contain coeval microbialite (the calcimicrobe Renalcis), stromatoporoid sponge skeleton, early marine cement, and later diagenetic cement. Comparative experiments conducted in two different ion extraction modes determined theoretical detection limits for transition elements on NIST reference material SRM 612. Analyses of NIST glasses SRM 614 and 616 demonstrate accuracy relative to previously published data. On that basis we have identified significant enrichment of the vital elements V, Sn, Cu and Zn within the Renalcis. The stromatoporoid skeleton by contrast is enriched only in V. Earliest cements, which also may have been mediated to some degree by microbial biofilms on the basis of their morphology, show a much smaller degree of enrichment, and later cements show no enrichment, with the exception of Zn, which is concentrated in the latest cement. Fine particulate carbonate sediments (micrite) show variable metal enrichments that are attributable to varying contributions from detrital siliciclastic contamination. Renalcis was also enriched above the sponge and cements in regards to Mn, Cd, Co, and possibly Cr, but at less robust levels. Molybdenum and Sb were found not to be enriched in the Renalcis, and Ni, although clearly very low in concentration, could not be evaluated owing to its high detection limit. We additionally were able to identify specific zones of contamination in Renalcis encountered as the laser drilled deeper into the carbonate. Time resolved analysis allows exclusion of such contaminants from integration into the results. Successful application of the new technique will now allow us to assess metal uptake in ancient carbonates with implications for interpreting the biogenicity of putative microbialites.     

A pilot study with a therapeutic vaccine based on hydroxyapatite ceramic particles and self-antigens in cancer patients

We describe an approach to produce an autologous therapeutic antitumor vaccine using hydroxyapatite (HA) for vaccinating cancer patients. The novel approach involved (1) the purification of part of the self-tumor antigens/ adjuvants using column chromatography with HA, (2) the employ of HA as a medium to attract antigen-presenting cells (APCs) to the vaccination site, and (3) the use of HA as a vector to present in vivo the tumor antigens and adjuvants to the patient's APCs. The vaccine was prepared using and combining HA particles, with at least 3 heat shock proteins (gp96 was one of them possibly with chaperoned proteins/peptides as shown in the slot blots) and with proteins from the cell membrane system (including Hsp70, Hsp27, and membrane proteins). The timing of HA degradation was tested in rats; the HA particles administered under the skin attracted macrophages and were degraded into smaller particles, and they were totally phagocytized within 1 week. In patients (n = 20), the vaccine was then administered weekly and showed very low toxicity, causing minor and tolerable local inflammation (erythema, papule, or local pain); only 1 patient who received a larger dose presented hot flashes, and there were no systemic manifestations of toxicity or autoimmune diseases attributed to the vaccine. Our study suggests that this therapeutic vaccine has shown some efficacy producing a positive response in certain patients. Stable disease was noted in 25% of the patients (renal carcinoma, breast carcinoma, and astrocytoma), and a partial response was noted in 15% of the patients (breast carcinoma and astrocytoma). The most encouraging results were seen in patients with recurrent disease; 4 patients in these conditions (20%) are disease free following the vaccine administration. However, we do not want to overstate the clinical efficacy in this small number of patients. The therapeutic vaccine tested in our study is working by activating the T-cell response as was shown in the comparative histological and immunohistochemical study performed in the pre- and postvaccine biopsy taken from a patient with inflammatory breast carcinoma. However, we cannot ruled out that the vaccine could also be producing an antibody(ies)-mediated response. In conclusion, this therapeutic vaccine based on HA ceramic particles and self-antigens can be safely administered and is showing some encouraging clinical results in cancer patients.     

Fast and accurate phylogeny reconstruction algorithms based on the minimum-evolution principle.

The Minimum Evolution (ME) approach to phylogeny estimation has been shown to be statistically consistent when it is used in conjunction with ordinary least-squares (OLS) fitting of a metric to a tree structure. The traditional approach to using ME has been to start with the Neighbor Joining (NJ) topology for a given matrix and then do a topological search from that starting point. The first stage requires O(n(3)) time, where n is the number of taxa, while the current implementations of the second are in O(p n(3)) or more, where p is the number of swaps performed by the program. In this paper, we examine a greedy approach to minimum evolution which produces a starting topology in O(n(2)) time. Moreover, we provide an algorithm that searches for the best topology using nearest neighbor interchanges (NNIs), where the cost of doing p NNIs is O(n(2) + p n), i.e., O(n(2)) in practice because p is always much smaller than n. The Greedy Minimum Evolution (GME) algorithm, when used in combination with NNIs, produces trees which are fairly close to NJ trees in terms of topological accuracy. We also examine ME under a balanced weighting scheme, where sibling subtrees have equal weight, as opposed to the standard "unweighted" OLS, where all taxa have the same weight so that the weight of a subtree is equal to the number of its taxa. The balanced minimum evolution scheme (BME) runs slower than the OLS version, requiring O(n(2) x diam(T)) operations to build the starting tree and O(p n x diam(T)) to perform the NNIs, where diam(T) is the topological diameter of the output tree. In the usual Yule-Harding distribution on phylogenetic trees, the diameter expectation is in log(n), so our algorithms are in practice faster that NJ. Moreover, this BME scheme yields a very significant improvement over NJ and other distance-based algorithms, especially with large trees, in terms of topological accuracy.     

Enzyme-ultracytochemical study of adenylate and guanylate cyclases in normal and pathologic human nasal mucosa

The ultracytochemical localization of adenylate cyclase (AC) and guanylate cyclase B (GC-B) and C (GC-C) activity was studied after stimulation with pituitary adenylate cyclase activating peptide, C-type natriuretic peptide and guanylin, respectively, in normal human respiratory nasal mucosa and mucosa of nasal polyps. To demonstrate these enzymatic activities, we employed enzyme-ultracytochemical methods for electron microscopy. Both normal and pathologic nasal mucosa contained AC, GC-B and GC-C activity. In the upper portion of respiratory epithelium, the enzymes were detected on ciliary and microvillar membranes. In ciliary membranes, GC-B was the predominant form expressed. In goblet cells and in glands of the lamina propria, enzymatic activities were localized mainly on plasma membranes and on membranes lining secretory granules. The results did not reveal any evident differences between the enzymatic activities in normal and pathological nasal mucosa and suggest complementary activities for these enzymes and their stimulators in the regulation of mucociliary transport and glandular secretion.     

Mucin histochemistry of the anal canal epithelium. Studies of normal anal mucosa and mucosa adjacent to carcinoma

Summary The epithelial lining of the anal canal is of colo-rectal type in the upper part and squamous in the lower part, while the middle zone is called the anal transitional zone (ATZ). This zone is characterized by an epithelium which bears a resemblance to that of the anal glands and shows little mucus secretion. The histochemical properties of the mucins in the epithelium of 39 anal canals, resected for ano-rectal adenocarcinoma, basaloid carcinoma, squamous carcinoma and malignant melanoma were investigated. The study reveals that (1) the mucin composition of the ATZ epithelium corresponds to that of the anal glands, being characterized by a mixture of sulpho- and sialomucins with scarcity or absence ofO-acylated sialic acids; and (2) cases with carcinomas located near the dentate line show changes in the mucin composition of the adjoining anal canal epithelium, regardless of tumour type. In colo-rectal type mucosa, these mucins consist of increasing amounts of sialomucins with a predominance ofN-acyl derivatives, and in the anal could be detected in the ATZ epithelium. It is concluded that rectal and anal glands in the anal canal are exposed to stimuli which alter the normal process of glycoprotein synthesis and secretion. The changes seem to be secondary to tumour growth and independent of the histological type of tumour.     

Brazilian green propolis on Helicobacter pylori infection. a pilot clinical study

Recent in vitro studies suggest that propolis and some of its phenolic components are able to inhibit Helicobacter pylori growth. To date, there are no clinical studies. AIMS: To evaluate the effect of Brazilian green propolis on H. pylori-infected individuals. PATIENTS AND METHODS: Eighteen (11 females, 7 males, mean age 47 years) participants were included. Before treatment, all participants were submitted to gastroscopy, and H. pylori infection was confirmed by histology, urease test, and (13)C-urea breath test (UBT). Participants with UBT showing a delta over baseline (DOB) value higher than 4 per thousand were considered positive for H. pylori infection. Twenty drops from an alcoholic preparation of Brazilian green propolis were administered three times a day for 7 days. Clinical evaluation and UBT were performed at 1-3 days and at 40 days after the end of therapy to evaluate H. pylori suppression or eradication, respectively. RESULTS: All participants took all medication and completed the study. Eighty-three percent of the subjects did not succeed in suppressing or eradicating H. pylori. Two participants reached partial suppression after treatment, but became positive again at UBT performed 40 days after treatment. Another participant presented negative at UBT 40 days after treatment, not confirmed by a second UBT performed 100 days after treatment. CONCLUSIONS: Brazilian green propolis used in popular dose showed minimal effect on H. pylori infection. Larger studies with longer duration, larger dose, and different frequency of administration of propolis extract should be undertaken to define its role on H. pylori therapy.     

Histochemical characteristics of mucins in the small intestine. A comparative study of normal mucosa, benign epithelial tumours and carcinoma

Synopsis The histochemical properties of the mucins in seven benign epithelial tumours and 15 carcinomas distributed along the duodenum, jejunum and ileum were investigated and compared with normal controls. This study reveals that (a) goblet cells in normal small intestine contain neutral and sialomucins but no sulphated material; (b) the proportion of the different types of mucins in the goblet cells vary along the crypts and villi with an increasing amount of sialomucins towards the villus top; (c) mucin composition also changes from duodenum to ileum particularly in the proportions of sialic acid types and in the presence of traces of sulphomucins in the ileal mucosa close to the ileo-caecal valve, suggesting a gradual transition through the small intestine to the colon; (d) benign tumours show the same mucin pattern as normal mucosa; (e) the mucosa adjacent to carcinoma shows increasing amounts of sialomucins and sulphomucins; (f) carcinomas present a variety of mucin patterns, and thus the study of mucins seems to be of no value in differentiating tumours of the small intestine from those elsewhere in the gastrointestinal tract. A working hypothesis based on the Unitary Theory of the origin of the intestinal epithelial cells is proposed to explain the variations in glycoprotein synthesis with cell differentiation and carcinogenesis.     

Prescription information leaflets: a pilot study in general practice.

Leaflets containing information about medicines were issued to 56 patients prescribed penicillins and 43 patients prescribed non-steroidal anti-inflammatory drugs. The patients were interviewed between four and 10 days later and their responses compared with those of 65 patients prescribed penicillin and 33 prescribed nonsteroidal anti-inflammatory drugs who did not receive a leaflet. Patients who received a leaflet were more likely to be completely satisfied with their treatment and with the information they had been given. They were also more likely to know the name of their medicine and much more aware of potential unwanted effects. Although there was no evidence that knowledge increased the incidence of adverse effects, when these did occur they were more likely to be recognised as being due to the medicine. Further studies of other leaflets are warranted, including leaflets for drugs that are taken long term.     

Lectin binding patterns in normal, metaplastic, and neoplastic gastric mucosa.

We investigated lectin binding patterns on tissue specimens of normal and metaplastic gastric surface mucosae, gastric adenomas, and intestinal and diffuse-type gastric carcinomas. Compared with normal gastric mucosa, metaplastic mucosa exhibited an increase of ConA binding and decreases of WGA, PNA, UEA-1, and DBA binding in the cytoplasm, and decreases of ConA, PNA, and UEA-1 binding at the luminal surface. Intestinal carcinomas were similar to metaplastic gastric surface mucosa in ConA, WGA, and UEA-1 binding in the cytoplasm, while diffuse-type carcinomas were similar to normal gastric mucosa in WGA and UEA-1 binding in the cytoplasm. Adenomas were similar to intestinal carcinomas in ConA and UEA-1 binding in the cytoplasm, but were different from intestinal carcinomas in Con A and UEA-1 binding at the luminal surface. For UEA-1, normal and metaplastic gastric surface mucosae did not show a significant difference between the blood type A, AB, B group and the O group. Intestinal and diffuse carcinomas and adenomas also did not show such a difference between the blood groups. For DBA, normal gastric surface mucosa showed a significant difference between the blood type B, O group and the A, AB group. Normal gastric mucosa of the blood type A, AB group was frequently positive for DBA binding in the cytoplasm and at the luminal surface. Metaplastic mucosa did not show a significant difference between the blood groups. Intestinal and diffuse-type carcinomas and adenomas also did not show a difference between the blood groups. DBA binding in the cytoplasm of intestinal carcinomas and adenomas was more frequently positive than that of normal and metaplastic mucosae, except for normal gastric mucosa of the blood type A, AB group. Compared with diffuse-type carcinomas, intestinal carcinomas were accompanied by a significant increase of ConA binding and decreases of WGA and PNA binding in the cytoplasm.