An Unusual Case of Congenitally Unguarded Tricuspid Valve Orifice Associated with Pulmonary Valve Atresia and Intact Ventricular Septum

We report on a premature neonate who presented with cyanosis soon after birth. She was found on echocardiography to have an unguarded tricuspid valve orifice associated with pulmonary valve atresia and an intact interventricular septum. Owing to the small‐sized pulmonary arteries, she was initially managed conservatively with prostaglandin infusion, and at one year of age underwent a successful bidirectional cavo‐pulmonary (Glenn) shunt operation. (ECHOCARDIOGRAPHY 2010;27:202‐204)     

ADAM28: A potential oncogene involved in asbestos‐related lung adenocarcinomas

Asbestos‐related lung cancer accounts for 4–12% of all lung cancers worldwide. Since putative mechanisms of carcinogenesis differ between asbestos and tobacco induced lung cancers, tumors induced by the two agents may be genetically distinct. To identify gene expression biomarkers associated with asbestos‐related lung tumorigenicity we performed gene expression array analysis on tumors of 36 patients with primary lung adenocarcinoma, comparing 12 patients with lung asbestos body counts above levels associated with urban dwelling (ARLC‐AC: asbestos‐related lung cancer‐adenocarcinoma) with 24 patients with no asbestos bodies (NARLC‐AC: non‐asbestos related lung cancer‐adenocarcinoma). Genes differentially expressed between ARLC‐AC and NARLC‐AC were identified on fold change and P value, and then prioritized using gene ontology. Candidates included ZNRF3, ADAM28, PPP1CA, IRF6, RAB3D, and PRDX1. Expression of these six genes was technically and biologically replicated by qRT‐PCR in the training set and biologically validated in three independent test sets. ADAM28, encoding a disintegrin and metalloproteinase domain protein that interacts with integrins, was consistently upregulated in ARLC across all four datasets. Further studies are being designed to investigate the possible role of this gene in asbestos lung tumorigenicity, its potential utility as a marker of asbestos related lung cancer for purposes of causal attribution, and its potential as a treatment target for lung cancers arising in asbestos exposed persons. © 2010 Wiley‐Liss, Inc.     

What factors determine patients’ preference for tumour necrosis factor inhibitors in ankylosing spondylitis?

Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement ‘My doctor gave me a choice and I made a decision based on my personal preference’. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy.     

Portrayal of depression and other mental illnesses in Australian nonfiction media

This study describes Australian media portrayal of mental illnesses, focusing on depression. A random sample of 1,123 items was selected for analysis from a pool of 13,389 nonfictional media items about mental illness collected between March 2000 and February 2001. Depression was portrayed more frequently than other mental illnesses. Items about depression, eating disorders, and substance use disorders most commonly described policies or programs, whereas items about schizophrenia most frequently portrayed individuals or symptoms and treatment. A minority of items about depression presented information about symptoms, causes, treatment, or prognosis. Although such information was generally accurate, a proportion of items conveyed misleading messages. There is therefore scope for increasing the level of accurate information provided about depression in the Australian media. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 283–297, 2005.     

Induction of an antigen specific humoral immune response by immunization with the aggregate‐free human TGFα‐P64k fusion protein

Transforming growth factor alpha (TGFα) is an important epidermal growth factor receptor (EGFR) ligand. Over‐expression of both molecules in epithelial tumors has been correlated with poor prognosis and disease progression. Due to the importance of TGFα in tumorigenesis, this molecule has great potential for cancer immunotherapy. We previously designed a TGFα‐based vaccine consisting of a fusion protein between human TGFα (hTGFα) and P64k protein from Neisseria meningitidis expressed in Escherichia coli. However, this protein was obtained highly aggregated, which hampered its introduction into clinical use. In this study, we demonstrate that this aggregation state is not a consequence of IMAC purification, but is formed after bacterial disruption. To obtain this protein as a monomer, we designed a procedure that included an unfolding/refolding step at the end of purification. We verified that hTGFα in the refolded fusion protein (hTGFα‐P64k‐r) is immunogenic in mice. The latter was capable of inducing a humoral immune response against hTGFα identical to that generated with the aggregated fusion protein, demonstrating that the aggregation level has no influence on hTGFα immunogenicity. We also showed that TGFα‐directed antibodies induced apoptosis in A431 cells. The present results also validated the potential use of this vaccine in cancer patients with tumors overexpressing TGFα. Drug Dev Res 69 2008. © 2008 Wiley‐Liss, Inc.