Molecular characterization by array comparative genomic hybridization and DNA sequencing of 194 desmoid tumors

Desmoid tumors are fibroblastic/myofibroblastic proliferations. Previous studies reported that CTNNB1 mutations were detected in 84% and that mutations of the APC gene were found in several cases of sporadic desmoid tumors lacking CTNNB1 mutations. Forty tumors were analyzed by comparative genomic hybridization (CGH). Karyotype and fluorescence in situ hybridization revealed a nonrandom occurrence of trisomy 8 associated with an increased risk of recurrence. We report the first molecular characterization including a large series of patients. We performed array CGH on frozen samples of 194 tumors, and we screened for APC mutations in patients without CNNTB1 mutation. A high frequency of genomically normal tumors was observed. Four relevant and recurrent alterations (loss of 6q, loss of 5q, gain of 20q, and gain of Chromosome 8) were found in 40 out of 46 tumors with chromosomal changes. Gain of Chromosomes 8 and 20 was not associated with an increased risk of recurrence. Cases with loss of 5q had a minimal common region in 5q22.5 including the APC locus. Alterations of APC, including loss of the entire locus, and CTNNB1 mutation could explain the tumorigenesis in 89% of sporadic desmoids tumors and desmoids tumors occurring in the context of Gardner's syndrome. A better understanding of the pathogenetic pathways in the initiation and progression of desmoid tumors requires studies of 8q and 20q gains, as well as of 6q and 5q losses, and study of the Wnt/β‐catenin pathway. © 2010 Wiley‐Liss, Inc.     

Molecular characterization of a human monoclonal antibody that interacts with a sulfated tyrosine-containing epitope of the GPIb receptor and inhibits platelet functions

Modification of tyrosine residues in extracellular proteins by a sulfate moity plays an important role in many ligand/receptors interactions. In the present work, we describe a unique human monoclonal antibody, termed Y1-scFv, that is specific for a sulfated epitope in the platelat receptor GPIb. The Y1-scFv single chain antibody (scFv) competes with von Willebrand factor (vWF) for binding to human platelets and thus effectively inhibits platelet aggregation. Limited proteolysis of GPIb molecule, using the endoproteases, mocarhagin and cathepsin G, revealed that a seven amino-acid epitope, Tyr-276 to Glu-282, contains the recognition site for Y1-scFv. This GPIb region contains three sulfated tyrosine residues. Binding studies of Y1-scFv to cells and to synthetic peptides in vitro indicated that of the seven residues comprising the epitope only sulfo-Tyr-276 and adjacent Asp-277 are critical for the interaction. To identify the reciprocal sequences in the antibody that recognize the sulfated epitope, we introduced mutations within the complementary-determining region of the heavy chain (CDR3H) of Y1-scFv (MRAPVI). Arginine residue in the second position was critical for the binding. Moreover, a mutant, containing two sequential arginine residues, in the second and third positions of the CDR3H (MRRPVI), showed a nine-fold increased binding to GPIb. This antibody mutant also demonstrated a significant increase in inhibition of vWF-dependent platelet aggregation and adhesion under flow. In conclusion, this unique antibody and mutants, that recognize a sulfated epitope in GP1b receptor, efficiently inhibited platelet adhesion and aggregation, making it a candidate for a new anti-thrombotic agent.     

Loss of heterozygosity at loci from chromosome arm 22Q in human sporadic breast carcinomas

Forty-four breast carcinomas were studied for loss of heterozygosity (LOH) at 25 microsatellite markers distributed almost evenly along chromosome arm 22q. LOH at at least one marker were observed in 66% tumors, while 6 regions of consistent LOH were identified. The size of each region ranged between 3 and 6 cM, and the distance between each region was estimated to be 8 to 12 cM. Even if not all these regions contain a bona fide tumor-suppressor gene, it is possible that several loci from chromosome arm 22q may be involved in breast carcinogenesis. Int. J. Cancer 75:181–186, 1998. © 1998 Wiley-Liss, Inc.     

Endodontic failure caused by inadequate restorative procedures: review and treatment recommendations

A review of the literature was performed to determine whether prompt placement of coronal restorations, including sealing and placement of posts and cores, can positively influence the long-term prognosis of teeth after root canal therapy. Both hand and MEDLINE searches were employed to identify peer-reviewed articles on radicular apical integrity after coronal restorations, especially where root canal space was used for post and core fabrication. A total of 41 articles published between 1969 and 1999 (the majority from the 1990s) were reviewed. The literature suggests that the prognosis of root canal-treated teeth can be improved by sealing the canal and minimizing the leakage of oral fluids and bacteria into the periradicular areas as soon as possible after the completion of root canal therapy.     

Ewing's sarcoma metastatic to focal nodular hyperplasia of liver

A case is presented of a young woman discovered at thoracotomy to have Ewing's sarcoma of the left lower ribs with soft tissue extension to the diaphragm and thoracic wall. Laparotomy at the same operation showed a nodule of focal nodular hyperplasia of the liver with a focus of metastasis from the sarcoma within the area of hyperplasia. This is the first report of metastasis of any tumor to a hepatic lesion of this sort. Possible reasons for metastasis to this type of lesion are discussed.     

Deterministic chaos and noise in three in vitro hippocampal models of epilepsy

Recent reports have suggested that chaos control techniques may be useful for electrically manipulating epileptiform bursting behavior in neuronal ensembles. Because the dynamics of spontaneous in vitro bursting had not been well determined previously, analysis of this behavior in the rat hippocampus was performed. Epileptiform bursting was induced in transverse rat hippocampal slices using three experimental methods. Slices were bathed in artificial cerebrospinal fluid containing: (1) elevated potassium ([K⁺]_o=10.5 mM), (2) zero magnesium, or (3) the GABA_A-receptor antagonists bicuculline (20 M) and picrotoxin (250 M). The existence of chaos and determinism was assessed using two different analytical techniques: unstable periodic orbit (UPO) analysis and a new technique for estimating Lyapunov exponents. Significance of these results was assessed by comparing the calculations for each experiment with corresponding randomized surrogate data. UPOs of multiple periods were highly prevalent in experiments from all three epilepsy models: 73% of all experiments contained at least one statistically significant period-1 or period-2 orbit. However, the expansion rate analysis did not provide any evidence of determinism in the data. This suggests that the system may be globally stochastic but contains local pockets of determinism. Thus, manipulation of bursting behavior using chaos control algorithms may yet hold promise for reverting or preventing epileptic seizures. © 2001 Biomedical Engineering Society. PAC01: 8719Nn, 8719Xx, 0545Gg, 8717Nn, 8719La     

Diagnostic dilemmas and current therapy of Fallopian tube cancer.

Primary tubal cancer, unlike ovarian cancer, is not routinely suspected preoperatively, and thus diagnosis and therapy are delayed. We have recently encountered two cases in which primary Fallopian tube cancer masqueraded as other lesions. One presented as a pelvic inflammatory process, the second as cervical cancer. Primary Fallopian cancer should be suspected by the clinician, even if the presenting symptoms are atypical. Chemotherapy with taxol and cisplatin was instituted following debulking surgery.     

Disclosure to the family of breast/ovarian cancer genetic test results: Patient's willingness and associated factors

Informed probands are key actors for disclosing genetic information to their relatives when a mutation has been identified in the family. The objectives were to study women's attitudes towards the family disclosure of positive breast cancer genetic testing results and to determine the predictive factors of the diffusion patterns observed. A national multi‐center cross‐sectional survey was carried out at five French cancer genetic clinics during a 1‐year period. Self‐administered questionnaires were completed after the consultation by 84.5% (398/471) of women attending breast cancer genetic clinics for the first time. Among the 383 respondents who had at least one living first‐degree relative to inform, 8.6% would inform none, 33.2% would inform at least one of them, and 58.2% would inform all of them. The sibship would be the most frequently informed blood relatives, sisters in 86.9% and brothers in 79% compared with mother in 71.4%, children in 70.4%, and father in 64.9%. Women of the family would be more frequently informed than men (P < 0.05). After multivariate adjustment, age, the fact to be affected by cancer, the number of daughters, and the emotional disturbance due to cancer in a close relationship were the main determinants (P < 0.05) of the diffusion patterns observed. The first step of the relatives' attendance to genetic counseling and the proband's willingness to disclose breast cancer genetic tests results was high in this study and was clearly dependent on the women's personal and emotional characteristics. Am. J. Med. Genet. 94:13–18, 2000. © 2000 Wiley‐Liss, Inc.     

Identification and management of HNPCC syndrome (hereditary non polyposis colon cancer), hereditary predisposition to colorectal and endometrial adenocarcinomas

BACKGROUND: The HNPCC syndrome (hereditary non polyposis colon cancer) is an inherited condition defined by clinical and genealogical information, known as Amsterdam criteria. In about 70% of cases, HNPCC syndrome is caused by germline mutations in MMR genes, leading to microsatellite instability of tumor DNA (MSI phenotype). Patients affected by the disease are at high risk for colorectal and endometrial carcinomas, but also for small intestine, urothelial, ovary, stomach and biliary tract carcinomas. HNPCC syndrome is responsible for 5% of colorectal cancers. Identification and management of this disease are part of a multidisciplinary procedure. METHODS: 12 experts have been mandated by the French Health Ministry to analyze and synthesize their consensus position, and the resulting document has been reviewed by an additional group of 4 independent experts. MAIN RECOMMENDATIONS: The lack of sensitivity of Amsterdam criteria in recognizing patients carrying a MMR germline mutation led to an enlargement of these criteria for the recruitment of possible HNPCC patients, and to a 2-steps strategy, asking first for a tumor characterization according to MSI phenotype, especially in case of early-onset sporadic cases. The identification of germline MMR mutations has no major consequence on the cancer treatments, but influences markedly the long-term follow-up and the management of at-risk relatives. Gene carriers will enter a follow-up program regarding their colorectal and endometrial cancer risks, but other organs being at low lifetime risk, no specific surveillance will be proposed.