Queensland Lung Cancer Screening Study: rationale, design and methods.

BACKGROUND: Lung cancer is the leading cause of cancer-related mortality in Australia. Screening using low-dose computed tomography (LDCT) can reduce lung cancer mortality. The feasibility of screening in Australia is unknown. This paper describes the rationale, design and methods of the Queensland Lung Cancer Screening Study. AIMS: The aim of the study is to describe the methodology for a feasibility study of lung cancer screening by LDCT in Australia. METHODS: The Queensland Lung Cancer Screening Study is an ongoing, prospective observational study of screening by LDCT at a single tertiary institution. Healthy volunteers at high risk of lung cancer (age 60-74 years; smoking history ≥30 pack years, current or quit within 15 years; forced expiratory volume in 1s ≥50% predicted) are recruited from the general public through newspaper advertisement and press release. Participants receive a LDCT scan of the chest at baseline, year 1 and year 2 using a multidetector helical computed tomography scanner and are followed up for a total of 5 years. Feasibility of screening will be assessed by cancer detection rates, lung nodule prevalence, optimal management strategies for lung nodules, economic costs, healthcare utilisation and participant quality of life. CONCLUSIONS: Studying LDCT screening in the Australian setting will help us understand how differences in populations, background diseases and healthcare structures modulate screening effectiveness. This information, together with results from overseas randomised studies, will inform and facilitate local policymaking.

Foot-and-mouth disease virus exhibits an altered tropism in the presence of specific immunoglobulins, enabling productive infection and killing of dendritic cells.

Foot-and-mouth disease virus (FMDV) causes an acute vesicular disease of farm animals. The development of successful control strategies is limited by an incomplete understanding of the immune response to FMDV. Dendritic cells (DC) mediate the induction of immunity to pathogens, but their role in FMDV infection of cattle is uncharacterized. Bovine monocyte-derived DC (moDC) were exposed to integrin-binding and cell culture-adapted strains of FMDV in vitro. MoDC were not largely susceptible to infection by integrin-binding FMDV but were susceptible to culture-adapted virus. Binding specific antibodies to integrin-binding FMDV at neutralizing or subneutralizing IgG concentrations significantly enhanced infection via CD32 (FcγR). Monocytes also expressed CD32 but were nonsusceptible to FMDV immune complex (IC) infection, indicating a requirement for additional factors involved in cellular susceptibility. Infection of moDC by the FMDV IC was productive and associated with high levels of cell death. Infected moDC were unable to efficiently stimulate FMDV-specific CD4(+) memory T cells, but exposing moDC to IC containing inactivated FMDV resulted in significantly increased T cell stimulation. Thus, neutralized FMDV concurrently loses its ability to infect susceptible cells while gaining the capacity to infect immune cells. This represents a change in the tropism of FMDV that could occur after the onset of the antibody response. We propose that IC could dynamically influence the anti-FMDV immune response and that this may explain why the early immune response to FMDV has evolved toward T cell independence in vivo. Moreover, we propose that DC targeting could prove useful in the development of effective vaccines against FMDV.

Antibodies to prion protein inhibit human colon cancer cell growth.

A putative role for prion protein (PrP) in apoptosis has been implicated. This function was investigated to test whether antibodies to PrP could induce apoptosis and be utilised in the treatment of cancers. Various antibodies to PrP were screened in MTT proliferation assays with HCT 116 colon cancer cells. Antibodies were shown to have varying degrees of anti-proliferative activity, with 3F4 and 6D11 essentially inactive, compared to other highly active antibodies. Surprisingly, BAR221 and F89/160.1.5 antibodies were particularly potent and afforded >40% reduction in proliferation at 50 microg/ml. In combination therapy experiments, antibodies to PrP enhanced the effect of irinotecan, 5-FU, cisplatin and doxorubicin to varying degrees. Use of PrP antibody in vitro resulted in increased apoptosis as measured by reduced Bcl-2 expression. In different colon cancer cell lines, antibody effectiveness correlated with tumour aggressiveness. Remarkably, in an in vivo nude mouse bearing human HCT 116 xenografts, tumour growth was inhibited by treatment with PrP antibody. Forty-seven days after treatment, at 9 mg/kg antibody in combination with irinotecan, tumour sizes were approximately 33% smaller compared to animals receiving irinotecan alone. The data suggest a potential pharmacological application for PrP antibodies in combination chemotherapy.

Aggresomes resemble sites specialized for virus assembly.

The large cytoplasmic DNA viruses such as poxviruses, iridoviruses, and African swine fever virus (ASFV) assemble in discrete perinuclear foci called viral factories. Factories exclude host proteins, suggesting that they are novel subcellular structures induced by viruses. Novel perinuclear structures, called aggresomes are also formed by cells in response to misfolded protein (Johnston, J.A., C.L. Ward, and R.R. Kopito. 1998. J. Cell Biol. 143:1883--1898; García-Mata, R., Z. Bebök, E.J. Sorscher, and E.S. Sztul. 1999. J. Cell Biol. 146:1239--1254). In this study, we have investigated whether aggresomes and viral factories are related structures. Aggresomes were compared with viral factories produced by ASFV. Aggresomes and viral factories were located close to the microtubule organizing center and required an intact microtubular network for assembly. Both structures caused rearrangement of intermediate filaments and the collapse of vimentin into characteristic cages, and both recruited mitochondria and cellular chaperones. Given that ASFV factories resemble aggresomes, it is possible that a cellular response originally designed to reduce the toxicity of misfolded proteins is exploited by cytoplasmic DNA viruses to concentrate structural proteins at virus assembly sites.

Excited singlet absorption in 1,2-benzanthracene by the use of nanosecond laser photolysis and spectroscopy.

Using the technique of laser photolysis and spectroscopy, we have observed excited singlet state absorption bands in 1,2-benzanthracene at 560 and 520 nanometers. The bands decay in less than 50 nanoseconds and are replaced by the known absorption spectrum of the lowest triplet state.

Endobronchial ultrasound convex-probe transbronchial needle aspiration as the first diagnostic test in patients with pulmonary masses and associated hilar or mediastinal nodes.

BACKGROUND: In the diagnosis of patients with a lung mass and hilar or mediastinal lymph nodes (N1or N2) it may be that patients are unnecessarily having biopsies of the primary lung cancer when sampling of the nodes would give both a tissue diagnosis and staging. By comparing node station and size in patients having just one procedure (endobronchial ultrasound transbronchial needle aspiration [EBUS TBNA]) with those having extra procedures on the primary mass before EBUS TBNA, similarity of nodes in the two groups might suggest that the extra procedures were unnecessary. METHODS: A prospective case series of patients with coexistent lung mass and N1or N2 nodes compared results for EBUS TBNA in patients with no prior bronchoscopy (group A) with patients who had a bronchoscopy or transthoracic needle aspiration elsewhere directed at the primary mass (group B). RESULTS: Sixty-eight EBUS TBNA procedures were carried out in 67 patients with 23 patients in group A, and 45 in group B. Nodes sampled included stations 2, 3, 4, 7, 10, 11 and 12. Node size was approximately the same in both groups, 16.5 +/- 6 mm in group A and 16.9 +/- 6 mm in group B. For malignancy sensitivity by EBUS TBNA was 94% in group A and 95% in group B, with surgical sampling showing three TBNA false negatives. CONCLUSION: There was no difference between the two groups in node size or location. Diagnostic yield overall was high. With expanding use of EBUS TBNA, a new guideline for its initial application in such patients could reduce the overall number of procedures.

Vertical distribution, migration rates, and model comparison of actinium in a semi-arid environment.

Vertical soil characterization and migration of radionuclides were investigated at four radioactively contaminated sites on Kirtland Air Force Base (KAFB), New Mexico to determine the vertical downward migration of radionuclides in a semi-arid environment. The surface soils (0-15 cm) were intentionally contaminated with Brazilian sludge (containing (232)Thorium and other radionuclides) approximately 40 years ago, in order to simulate the conditions resulting from a nuclear weapons accident. Site grading consisted of manually raking or machine disking the sludge. The majority of the radioactivity was found in the top 15 cm of soil, with retention ranging from 69 to 88%. Two models, a compartment diffusion model and leach rate model, were evaluated to determine their capabilities and limitations in predicting radionuclide behavior. The migration rates of actinium were calculated with the diffusion compartment and the leach rate models for all sites, and ranged from 0.009 to 0.1 cm/yr increasing with depth. The migration rates calculated with the leach rate models were similar to those using the diffusion compartment model and did not increase with depth (0.045-0.076, 0.0 cm/yr). The research found that the physical and chemical properties governing transport processes of water and solutes in soil provide a valid radionuclide transport model. The evaluation also showed that the physical model has fewer limitations and may be more applicable to this environment.

Transient states in reaction centers containing reduced bacteriopheophytin.

Photosynthetic reaction centers isolated from Rhodopseudomonas sphaeroides strain R-26 were excited with non-saturating 7-ps, 600-nm flashes under various conditions, and the resulting absorbance changes were measured. If the quinone electron acceptor (Q) is in the oxidized state, flash excitation generates a transient state (PF), in which an electron has moved from the primary electron donor (P, a dimer of bacteriochlorophylls) to an acceptor complex involving a special bacteriopheophytin (H) and another bacteriochlorophyll (B). PF decays in 200 ps as an electron moves from H to Q and the acceptor complex are reduced photochemically before the excitation, the flash generates a different transient state of P with a high quantum yield. This state decays with a lifetime of 340 ps. There is no indication of electron transfer from P to B under these conditions, but this does not rule out the possibility that B is an intermediate electron carrier between P and H. Measurements of the yield of fluorescence from P under various conditions show that the 340 ps state is not the fluorescent excited singlet state of P. The transient state could be a triplet state, a charge-transfer state of P, or another excited singlet state that is not fluorescent.

Primary photochemical processes in isolated reaction centers of Rhodopseudomonas viridis.

Picosecond and nanosecond spectroscopic techniques have been used to study the primary electron transfer processes in reaction centers isolated from the photosynthetic bacterium Rhodopseudomonas viridis. Following flash excitation, the first excited singlet state (P*) of the bacteriochlorophyll complex (P) transfers an electron to an intermediate acceptor (I) in less than 20 ps. The radical pair state P+I-) subsequently transfers an electron to another acceptor (X) in about 230 ps. There is an additional step of unknown significance exhibiting 35 ps kinetics. P+ subsequently extracts an electron from a cytochrome, with a time constant of about 270 ns. At low redox potential (X reduced before the flash), the state P+I- (or PF) lives approx. 15 ns. It decays, in part, into a longer lived state (PR), which appears to be a triplet state. State PR decays with an exponential time of approx. 55 microseconds. After continuous illumination at low redox potential (I and X both reduced), excitation with an 8-ps flash produces absorption changes reflecting the formation of the first excited singlet state, P*. Most of P* then decays with a time constant of 20 ps. The spectra of the absorbance changes associated with the conversion of P to P* or P+ support the view that P involves two or more interacting bacteriochlorophylls. The absorbance changes associated with the reduction of I to I- suggest that I is a bacteriopheophytin interacting strongly with one or more bacteriochlorophylls in the reaction center.

Subpicosecond and picosecond studies of electron transfer intermediates in Rhodopseudomonas sphaeroides reaction centers.

The primary electron transfer processes in isolated reaction centers of Rhodopseudomonas sphaeroides have been investigated with subpicosecond and picosecond spectroscopic techniques. Spectra and kinetics of the absorbance changes following excitation with 0.7-ps 610-nm pulses, absorbed predominantly by bacteriochlorophyll (BChl), indicate that the radical pair state P+BPh-, in which an electron has been transferred from the BChl dimer (P) to a bacteriopheophytin (BPh), is formed with a time constant no greater than 4 ps. The initial absorbance changes also reveal an earlier state, which could be an excited singlet state, or a P+BChl- radical pair. The bleaching at 870 nm produced by 7 ps excitation at 530 nm (absorbed by BPh) or at 600 nm (absorbed predominantly by BChl) shows no resolvable delay with respect to standard compounds in solution, suggesting that the time for energy transfer from BPh to P is less than 7 ps. However, the bleaching in the BPh band at 545 nm following 7-ps 600-nm excitation, exhibits an 8- to 10-ps lag with respect to standard compounds. This finding is qualitatively similar to the 35-ps delay previously observed at 760 nm by Shuvalov at al. (Shuvalov, V.A., Klevanik, A.V., Sharkov, A.V., Matveetz, Y.A. and Kryukov, P.G. (1978) FEBS Lett. 91, 135-139) when 25-ps 880-nm excitation flashes were used. A delay in the bleaching approximately equal to the width of the excitation flash can be explained in terms of the opposing effects of bleaching due to the reduction of BPh, and absorbance increases due to short-lived excited states (probably of BChl) that turn over rapidly during the flash. The decay of the initial bleaching at 800 nm produced by 7-ps 530- or 600-nm excitation flashes shows a fast component with a 30-ps time constant, in addition to a slower component having the 200-ps kinetics expected for the decay of P+BPh-. the dependence on excitation intensity of the absorbance changes due to the 30-p]s component indicate that the quantum yield of the state responsible for this step is lower than that observed for the primary electron transfer reactions. This suggests that at least part of the transient bleaching at 800 nm is due to a secondary process, possibly caused by excitation with an excessive number of photons. If the 800-nm absorbing BChl (B) acts as an intermediate electron carrier in the primary photochemical reaction, electron transfer between B and the BPh must have a time constant no greater than 4 ps.

Post-synaptic 5-HT1A receptor involvement in yawning and penile erections induced by apomorphine, physostigmine and mCPP in rats.

Apomorphine and mCPP induced yawning associated with penile erections in rats, whereas physostigmine induced only yawns. Apomorphine-induced yawning and penile erections were antagonized by low doses of raclopride, whereas physostigmine-induced yawning and mCPP-induced effects were only partly inhibited at high doses of raclopride. Scopolamine as well as clozapine antagonized yawning and penile erections induced by apomorphine, mCPP and physostigmine. Similarly, the 5-HT1A agonists 8-OH-DPAT and S 14506 inhibited yawning and penile erections induced by apomorphine, mCPP and physostigmine, and at similar doses induced lower lip retraction and hyperreactivity to handling. The beta/5-HT1A antagonist tertatolol reversed the inhibitory effects of 8-OH-DPAT and S 14506 on drug-induced yawning and penile erections and increased apomorphine- and physostigmine-induced yawn frequency but not penile erection frequency. Like tertatolol, propranolol increased apomorphine- and physostigmine-induced yawn frequency, whereas ICI 118551 increased only physostigmine-induced yawning. 8-OH-DPAT- and S 14506-induced lower lip retraction and hyperreactivity to handling were also significantly antagonized by tertatolol. Finally, p-chlorophenylalanine pretreatment produced about 95% depletion in 5-HT in hypothalamus, hippocampus, striatum and frontal cortex and modified neither the responses of the inducing drugs nor the inhibitory effects of 8-OH-DPAT and S 14506 on drug-induced yawning and penile erections.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of ABA 8'-hydroxylase by (+)-S-, (-)-R- and 8'-8'-8'-trifluoro-S-abscisic acid in suspension cultures of potato and Arabidopsis.

Suspension cultures of potato and Arabidopsis were incubated with 50 microM of (+)-ABA and (-)-ABA for 3 hr. These pretreatments were found to increase the rate, by two- to seven-fold, of formation of [2H6] phaseic acid (PA) from [2H6] ABA, applied in a subsequent incubation. Pretreatment with trifluoro-ABA had a higher efficacy, increasing the rate of conversion 15-fold. Suspension cell cultures that had been dehydrated and then rehydrated in the presence of [2H6] ABA displayed a much lower enhancement of PA formation. We conclude that ABA induces its own oxidative catabolism in suspension cultures.

How good is the radial artery as a bypass graft?

The radial artery is being used with increasing frequency to replace the saphenous vein as a coronary artery bypass graft, on the basis of the belief that it will provide improved long-term patency. Innovative techniques in assessing the ulnar collateral circulation to the hand continue to evolve, giving comfort to the surgeon. Several centres have confirmed that the early results of surgery using the radial artery are similar to those using conventional grafts. Few late graft patency results or clinical data have been reported. Unresolved issues, such as the importance of pathological changes in the radial artery, the prevention of spasm, and the hypoperfusion syndrome, lurk in the background. The role of the radial artery continues to evolve.

The innervation of the cervical intervertebral discs.

Microdissection and histologic studies were undertaken to determine the innervation of the cervical intervertebral discs. The cervical sinuvertebral nerves were found to have an upward course in the vertebral canal, supplying the disc at their level of entry and the disc above. Branches of the vertebral nerve supplied the lateral aspects of the cervical discs. Histologic studies of discs obtained at operation showed the presence of nerve fibers as deeply as the outer third of the anulus fibrosus. These anatomic findings provide the hitherto missing substrate for primary disc pain and the pain of provocation discography.

Reliable, inexpensive microcomputer interface for the optical multichannel analyzer (OMA).

A microprocessor system and interface for the optical multichannel analyzer (OMA) is described. The interface hardware and software are very simple and easy to implement. The microcomputer is used in conjunction with the OMA in the 2-d (two-dimensional) mode as the data acquisition, analysis and storage system for a 8-ps-resolution transient absorption spectrometer. However, the microcomputer and interface hardware and software are of general use in any application where rapid transfer, processing and storage of spectroscopic information from the OMA are required.

Missed foreign body and nessitans empyema.

A recurrent empyema over a three-month period ultimately presented as an empyema necessitans (an empyema pointing through the skin) due to Fusobacterium varium. The recurrence of the empyema was due to an animal vertebra aspirated, during a bar-room altercation, into the right main bronchus, mimicking an endobronchial tumour.

A virally encoded chaperone specialized for folding of the major capsid protein of African swine fever virus.

It is generally believed that cellular chaperones facilitate the folding of virus capsid proteins, or that capsid proteins fold spontaneously. Here we show that p73, the major capsid protein of African swine fever virus (ASFV) failed to fold and aggregated when expressed alone in cells. This demonstrated that cellular chaperones were unable to aid the folding of p73 and suggested that ASFV may encode a chaperone. An 80-kDa protein encoded by ASFV, termed the capsid-associated protein (CAP) 80, bound to the newly synthesized capsid protein in infected cells. The 80-kDa protein was released following conformational maturation of p73 and dissociated before capsid assembly. Coexpression of the 80-kDa protein with p73 prevented aggregation and allowed the capsid protein to fold with kinetics identical to those seen in infected cells. CAP80 is, therefore, a virally encoded chaperone that facilitates capsid protein folding by masking domains exposed by the newly synthesized capsid protein, which are susceptible to aggregation, but cannot be accommodated by host chaperones. It is likely that these domains are ultimately buried when newly synthesized capsid proteins are added to the growing capsid shell.