Relationship between Chromosomal Aberrations and Gene Expressions in the p53 Pathway in Chronic Lymphocytic Leukemia.

Chronic lymphocytic leukemia (CLL) is a neoplasm characterized by excessive accumulation of B lymphocytes in the peripheral blood, bone marrow and lymph nodes. We assessed the expressions of 22 genes in the p53 pathway in 30 CLL patients and 15 healthy subjects by a RT2 Profiler PCR (polymerase chain reaction) Array technique and their relation to cytogenetic aberrations detected by fluorescent in situ hybridization (FISH). Our Student's t-test results indicated that ATM, ATR, BAX, CASP9, CDK4, CDKN2A, CHEK1, CHEK2, E2F3, MCL1, MDM2, MDM4, PCNA, RB1, P53 and BCL2 genes were statistically significant (p <0.001). For six genes (APAF1, CDKN1A, E2F1, GADD45A, PTEN and PTX3) were not statistically significant. The ATM, ATR, BAX, CASP9, CDK4, CDKN1A, CDKN2A, CHEK1, CHEK2, MDM2, MDM4, PCNA, RB1, P53, E2F1, GADD45A and BCL2 genes were found to be upregulated by the 2-ᐃᐃCt (relative fold change in gene expression) method. The highest up-regulation was detected in CDKN2A and BCL2 genes, 10.22- and 8.51-fold, respectively. On the other hand, the PTX3 gene with a fold regulation of 1.84 was found to the highest downregulation. Overall, the CDNK2A BCL2 and PTX3 genes are related to the mechanism of the disease in the p53 pathway and may be an important predictor of the prognosis of the disease. The BCL2 gene may be associated with increased risk of developing CLL. We suggest that the PTX3 gene may be considered as a marker associated with CLL disease. The CDKN2A gene expression seems to play a protective role in CLL.

Clinical features and molecular genetic analysis in a Turkish family with oral white sponge nevus.

BACKGROUND: Oral white sponge nevus (WSN) is a rare autosomal dominant benign condition, characterized by asymptomatic spongy white plaques. Mutations in Keratin 4 (KRT4) and 13 (KRT13) have been shown to cause WSN. Familial cases are uncommon due to irregular penetrance. Thus, the aim of the study was: a) to demonstrate the clinical and histopathological features of a three-generation Turkish family with oral WSN b) to determine whether KRT4 or KRT13 gene mutation was the molecular basis of WSN. MATERIAL AND METHODS: Out of twenty members of the family ten were available for assessment. Venous blood samples from six affected and five unaffected members and 48 healthy controls were obtained for genetic mutational analysis. Polymerase chain reaction was used to amplify all exons within KRT4 and KRT13 genes. These products were sequenced and the data was examined for mutations and polymorphisms. RESULTS: Varying presentation and severity of clinical features were observed. Analysis of the KRT13 gene revealed the sequence variant Y118D as the disease-causing mutation. One patient revealed several previously unreported polymorphisms including a novel mutation in exon 1 of the KRT13 gene and a heterozygous deletion in exon 1 of KRT4. This deletion in the KRT4 gene was found to be a common polymorphism reflecting a high allele frequency of 31.25% in the Turkish population. CONCLUSIONS: Oral WSN may manifest variable clinical features. The novel mutation found in the KRT13 gene is believed to add evidence for a mutational hotspot in the mucosal keratins. Molecular genetic analysis is required to establish correct diagnosis and appropriate genetic consultation.

The frequency of C609T polymorphism in the NQO1 gene and its relation to cytogenetic abnormalities in patients with myelodysplastic syndrome.

The aim of the present study is to evaluate the frequency of C609T polymorphism in the NQO1 (NAD(P)H) quinon oxydoreductase) gene and its relation to cytogenetic abnormalities in patients with Myelodysplastic Syndrome (MDS). The study group consisted of 80 patients MDS with 13 of them in the pediatric age group. The frequency of the NQO1 gene polymorphism was compared with a healthy control group involving 423 individuals. Cytogenetic abnormalities were detected in 43 patients (54%). In patients with MDS the overall frequency of the C609T polymorphism was not different than controls. Also, although the frequency of the C609T polymorphism was higher in patients with secondary MDS (sMDS) (OR: 1.893, 95% CI: 0.840-4.265, p=0.238) , 5/del(5q) (OR:1.298, 95% CI: 0.331-5.086,p=0.124), +21(OR:1.817, 95% CI:0.429-7698,p=0.124) and t(8;21) (OR:3.028, 95% CI: 0.604-15.172,p=0.137) groups, the difference did not reach statistical significiance. Our results do not support the view that the C609T polymorphism has a role in the pathogenesis of MDS. Also the frequency of the C609T allele did not seem to be associated with cytogenetic abnormalities.

Evaluation of micronuclear frequencies in both circulating lymphocytes and buccal epithelial cells of patients with oral lichen planus and oral lichenoid contact reactions.

OBJECTIVE: The aim of this study was to evaluate the frequency of micronuclei (MNs) in both circulating lymphocytes and buccal epithelial cells of patients with oral lichenoid contact reactions (OLCRs) or with oral lichen planus (OLP) and compare their MN scores with those of healthy controls (HCs). MATERIAL AND METHODS: The study group included 21 patients (mean age 51.3 ± 12.4; 6 males, 15 females) with OLCRs and 22 patients (mean age 47.6 ± 14.4; 4 males, 18 females) with OLP who were clinically diagnosed and histopathologically confirmed according to WHO diagnostic criteria (WHO Collaborating Centre for Oral Precancerous Lesions, 1978). All patients with OLCR demonstrated contact allergy to tested dental materials when evaluated by skin patch testing according to International Contact Dermatitis Research Group (ICDRG), while all OLP patients tested negative to patch testing. Seventeen individuals with no oral mucosal disorders (mean age 51.7 ± 11.3; 8 males, 9 females) were recruited to constitute the healthy control group. [Correction added on 30 May 2014, after first online publication: the term, 'mean age' has been added to the text in parenthesis throughout the Material and Methods section.] Clinical features including type of OLP, location, disease severity, presence of skin lesions, presence of systemic disease including any allergies and dental (periodontal) status were recorded. MN analyses were performed on peripheral blood lymphocytes and on smears of buccal epithelial cells of all three study groups. RESULTS: Most OLP and OLCR lesions were of reticular type (83%), and OLP lesions were distributed bilaterally on the buccal mucosa (90.5%). The medians of MN frequencies in buccal epithelial cells in OLP and OLCR groups were significantly higher when compared with HC group (P < 0.001). [Correction added on 30 May 2014, after first online publication: in the results, 2nd sentence, the word 'lymphocytes' has been removed.] There was no significant difference between OLP group (14.5 range 3-95) and OLCR group (16.0 range 3-93) in terms of median MN frequencies in buccal epithelial cells (P = 0.724) nor in peripheral lymphocytes between OLP group (2.0 range 0-7) and OLCR group (1.0 range 0-6) (P = 0.92). [Correction added on 30 May 2014, after first online publication: (P = 0.92) was wrongly placed after 'peripheral lymphocytes' and has now been shifted to the end of the last sentence.] CONCLUSIONS: Micronuclei scores do not distinguish OLP from OLCR when using buccal smears. OLP and OLCR both demonstrated significantly higher MN frequencies in buccal cells, compared with healthy controls. MN assessment in both buccal epithelial cells and circulating lymphocytes may serve as a potential biomarker tool for evaluating any cancer risk in OLP and OLCR. [Correction added on 30 May 2014, after first online publication: the first and second sentences in the conclusions have been slightly changed.].

Investigation of mutations in the synaptonemal complex protein 3 (SYCP3) gene among azoospermic infertile male patients in the Turkish population.

To investigate possible mutations and/or single nucleotide polymorphisms in the synaptonemal complex protein 3 (SYCP3) gene among nonobstructive azoospermic infertile males in a Turkish population, 75 nonobstructive azoospermic infertile male patients were included in the study. These patients were unrelated to each other and had 46,XY chromosome structure without Y microdeletion. In addition, 75 individuals whose fertility was proven by reproduction were enrolled in the study as controls. Nine exon deep intronic primers belonging to the SYCP3 gene were designed and amplified by PCR, and the nucleotide sequences were identified by DNA sequence analysis. DNA sequence analysis was used to detect mutations and/or single nucleotide polymorphisms in the SYCP3 gene. No mutations were detected in the 9 exons of SYCP3. A total of eleven variations, however, were detected: seven have been identified in the NCBI SNP database, whereas four have not. On the basis of the results, we agree with the idea that SYCP3 mutations are not associated with the genetic susceptibility for meiotic arrest in infertile male patients with nonobstructive azoospermia in the Turkish population and that further studies investigating the other components of the synaptonemal complex protein (SYCP1, SYCP2) should be conducted.

Micronuclear and sister chromatid exchange analyses in peripheral lymphocytes of patients with oral lichen planus--a pilot study.

OBJECTIVE: The purpose of this study was to determine the genetic instability of peripheral blood lymphocytes from patients diagnosed with oral lichen planus (OLP) by investigation of frequencies of micronuclei (MN) and sister chromatid exchange (SCE). MATERIALS AND METHODS: A total of 22 newly diagnosed and untreated patients with OLP of same severity scores and twenty healthy controls participated in this study. They were all non-smokers with no previous history or family history of cancer. The periodontal status, flow rate and buffering capacity of whole mouth saliva were recorded. SCE and MN analyses were performed on peripheral blood lymphocytes of OLP patients and healthy controls. RESULTS: The frequencies of MN (50.00 +/- 22.36) and SCE (6.89 +/- 1.48) in OLP patients were found to be significantly elevated compared with that in normal individuals (25.20 +/- 9.52 and 5.93 +/- 1.31; z = 3.946, P = 0.0001; z = 2.346, P = 0.019). There were no significant differences in the MN frequency and SCE between the two subgroups with reticular or erosive types of OLP. CONCLUSION: These pilot data indicate an increased genomic instability in peripheral blood lymphocytes of a cohort of Turkish patients diagnosed with oral lichen planus as compared with that of healthy individuals. As patients with OLP may have an increased or potential risk for oral malignancy, these assays could be used in translational research to monitor beneficial effects of interventions and long-term prognosis.

Initial maternal meiotic I error leading to the formation of a maternal i(2q) and a paternal i(2p) in a healthy male.

We report on the investigation of the parental origin and mode of formation of the two isochromosomes, i(2p) and i(2q), detected in a healthy adult male. Conventional cytogenetic analysis revealed the proband's lack of structurally normal chromosomes 2, these being replaced by an i(2p) and an i(2q). Investigation of the parental origin of the isochromosomes revealed a paternal origin of the i(2p) chromosome and a maternal origin of the i(2q) chromosome. Thus, the formation of both isochromosomes, or at least of the paternal i(2p), appears to have occurred postzygotically. Interestingly, whilst a paternal isodisomy was observed for the entire 2p, maternal heterodisomy was detected for two segments of 2q, separated by a segment showing isodisomy. The results are indicative of an initial error (non-disjunction or i(2q) formation) concerning the maternal chromosomes 2 during meiosis I, which likely favored the subsequent mitotic recombination event resulting in the presence of two isochromosomes. To the best of our knowledge this is the first case of an initial meiotic error, followed by postzygotic trisomy rescue through the formation of isochromosomes, resulting in a normal phenotype. A prenatal detection, by cytogenetic and molecular analysis, of such chromosome abnormality would have led to the incorrect conclusion of a most likely poor prognosis for the fetus.

Sister chromatid exchange frequency in B-cells stimulated by TPA in chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) is characterised by the clonal proliferation and accumulation of neoplastic B-lymphocytes. The median age of the patients is 65 years, and more men than women are affected. The overwhelming majority of CLLs are of B-cell origin. Chromosomal aberrations have been detected in more than 50% of the B-cells obtained from peripheral blood samples after appropriate stimulation with polyclonal B-cell mitogens. The analysis of sister chromatid exchange is a cytogenetic technique used to show DNA damage due to an exchange of DNA fragments between sister chromatids. In this study, lymphocytes from 22 patients with CLL-B (7 female, 15 male; mean age 64.09 +/- 7.56 years) were stimulated by a B-cell mitogen (TPA) and BrdU added at the 24 h of the culture. Metaphase chromosomes were stained with a fluorescence plus Giemsa technique after a standard harvest procedure. The frequency of sister chromatid exchange was found to be increased significantly P =.02) in patients with CLL-B (8.24 +/- 1.36 per metaphase) compared to controls (7.25 +/- 1.42 per metaphase). We conclude that the increased frequency of sister chromatid exchange in chronic lymphocytic leukemia after stimulation with a B-cell mitogen (TPA) may reflect DNA instability and defective DNA repair in these patients.

A case of chronic lymphocytic leukemia with a constitutional pericentric inversion of chromosome 1.

Chronic lymphocytic leukemia (CLL) has been reported to be associated with various chromosomal aberrations, the most common being trisomy 12 and structural rearrangements involving 13q, 11q, and 17p. We present a case of CLL with a constitutional pericentric inversion of chromosome 1.

47,XYY karyotype in acute myeloid leukemia.

A case of acute myelomonocytic leukemia (AMMoL; M4) with a 47,XYY karyotype is reported. This chromosome aneuploidy was found in both bone marrow cells and mitogen-stimulated lymphocytes. The contribution of XYY chromosomal constitution in the pathogenesis of AMMoL is controversial.

Brucellosis in a mother and her young infant: probable transmission by breast milk.

Brucellosis, although primarily a zoonotic infection, is also a threat for human health. Infection can be transmitted to humans through direct contact with infected animals, products of conception, or animal discharges, and through consumption of potentially infected milk, milk products, or meat. Human-to-human transmission is rare. There have been case reports of transmission via blood transfusion and bone marrow transplantation from infected donors. Sexual intercourse is a possible means of transmission. Neonatal infection can be acquired transplacentally or during delivery. This report describes a mother with brucellosis who probably transmitted the infection to her 3-month-old baby by breast milk.

Gingival fibromatosis combined with cherubism and psychomotor retardation: a rare syndrome.

Gingival fibromatosis is frequently an isolated condition, but rarely associated with some uncommon syndromes. This paper describes an 11-year-old patient with pronounced gingival enlargement, cherubic facial appearance, and psychomotor retardation and discusses the major aspects of the case. The most striking finding orally was the presence of grossly hyperplastic gingiva, which completely covered all teeth except the occlusal surfaces of some teeth. The swelling in the lower part of the face and the appearance of sclera beneath the iris suggest cherubism. The diagnosis was confirmed by the detection of giant cell regenerative granuloma and perivascular eosinophilic particles and osteoclasts after biopsy of the mandible. In this case, surgery was the only effective way to treat the patient. A full-mouth gingivectomy procedure was performed under general anesthesia in 2 stages. The case was followed for 12 months and no recurrence was seen. An appropriate oral hygiene regimen was established.

Vitamin E and ATPases: protection of ATPase activities by vitamin E supplementation in various tissues of hypercholesterolemic rats.

It has been shown that the lipid composition of plasma membrane can be modified in vivo by dietary fat. It has also been observed that an increase in the cholesterol content of plasma membranes results in decreased activities of ATPases. In the present study, we evaluated the changes in the activities of ATPases from erythrocytes, hepatocytes, and kidney cortex caused by cholesterol-rich diet in rats and subsequently examined the role of vitamin E administration on the cholesterol-induced effects in these tissues. Administration of hypercholesterolemic diet to the rats for 4.5 months, significantly decreased membrane Na(+)-K(+)-ATPase and Ca+2-ATPase activities in comparison to the controls in all tissues studied. Vitamin E supplementation to the hypercholesterolemic rats led to a recovery in membrane ATPase activities. In conclusion, vitamin E supplementation to the rats provided protection against hypercholesterolemic diet-induced impairment of membrane-bound ATPases.

The role of HLA antigens in chronic hepatitis B virus infection.

OBJECTIVE: To investigate the mechanism underlying the development of chronic hepatitis B virus infection (HBV) in Turkish population using HLA tissue typing. METHODS: The study group I consisted of 20 patients with HBV-related chronic liver disease (cirrhosis, chronic active hepatitis or chronic persistent hepatitis). The study group II included 30 HBV chronic carriers. The control group consisted of 50 healthy subjects with negative serologic markers for HBV. HLA typing was performed by Terasaki's microlymphocytotoxicity method. RESULTS: The frequencies of HLA-DR13 and DQ3 were significantly higher in the patients with HBV-related chronic liver disease compared to those of control group. The absence of HLA-A24 and CW1 was also significant in group I. The frequencies of HLA A2, B8, B13, CW3, DR13 were significantly higher in group II compared to the control group. There were increased frequencies of HLA- B8, B13, DR7, DR13, and DQ3 in both group I and group II. CONCLUSION: HLA-A24 AND Cw1 were associated with low risk for HBV-related chronic liver disease and HLA- B13, B8, DR7, DR13 and DQ3 were associated with high risk for chronic HBV infection in the Turkish population (JPMA 52:253;2002).

Case report: a surgical and prosthetic approach to combination syndrome presenting in a patient with craniofacial dysostosis (Crouzon syndrome).

A case of combined local surgical and prosthetic treatment in a patient with craniofacial dysostosis (Crouzon Syndrome) is described. The patient had atrophy and anterior fibrous replacement of the edentulous maxilla opposing natural mandibular anterior teeth and a lower removable partial denture. Initial prosthetic treatment alone was unsuccessful. The surgical management comprised augmentation of the maxilla with resorbable hydroxyapatite, in conjunction with a guided tissue regeneration technique and vestibuloplasty. This enabled conventional prosthetic management postoperatively to achieve an acceptable functional and aesthetic result.

Monitoring the genotoxic effects of radiosynovectomy with Re-186 in paediatric age group undergoing therapy for haemophilic synovitis.

PURPOSE: The aim of this study was to investigate the genotoxic effect on the peripheral blood lymphocytes potentially induced by Re-186 in paediatric age group undergoing radiosynovectomy for haemophilic synovitis, by using chromosomal aberration analysis (CA) and the micronuclei (MN) assay for detecting chromosomal aberrations, as well as the sister chromatid exchanges (SCE) technique for assessing DNA damage. METHODS: Cytogenetic analyses were evaluated in 20 boys (mean age: 13.8 +/- 2.7 years) before, and 2 and 90 days after radiosynovectomy from the peripheral lymphocytes of the patients. Joint retention and extra-articular spread of the radionuclides were evaluated by using quantitative gamma camera imaging. RESULTS: Imaging after radiosynovectomy revealed local lymph node visualization in 8 (40%) patients and hepatosplenic visualization in 3 (15%) patients due to extra-articular leakage of radioactive material. The mean frequency of chromosome aberrations (0.2 +/- 0.4/1000 cells) determined prior to the onset of therapy was not significantly increased in comparison with control values obtained 2 days (0.4 +/- 0.5/1000 cells) and 90 days (0.2 +/- 0.4/1000 cells) after therapy (P = 0.754 and P = 1.0). In the analysis of MN and SCE, when we compare the baseline levels, the mean MN and SCE frequencies were slightly higher in the control analyses performed 2 and 90 days after radiosynovectomy but there were no significant differences between baseline and control levels (chi(2) = 2.621, P = 0.270 and F = 0.573, P = 0.569, respectively). CONCLUSION: The major finding of this study with relatively small sample is that, radiosynovectomy with Re-186 does not seem to induce early genotoxic effects on the peripheral blood lymphocytes in paediatric age group.

A case of progressive pseudorheumatoid arthropathy of 'childhood' with the diagnosis delayed to the fifth decade.

Progressive pseudorheumatoid arthropathy of childhood (PPAC) is a rare single gene disorder which is frequently misdiagnosed as juvenile rheumatoid arthritis. It is characterised with arthralgia, joint contractures, bony swelling of metacarpophalangeal and interphalangeal joints and platyspondyly. Clinical and laboratory signs of joint inflammation such as synovitis, a high erythrocyte sedimentation rate and an elevated C-reactive protein level are usually absent. Although the disease begins early in life (usually between 3 and 8 years of age), the diagnosis may be delayed. In the present case report, we describe a male patient diagnosed with PPAC at the age of 46 years, although he had been exhibiting the typical radiological and clinical features of the disease since the age of 7 years.

Plasma antioxidants and type 2 diabetes mellitus.

Reports indicate that some complications of diabetes mellitus are associated with increased activity of free radicals and accumulation of lipid peroxidation products. The organism's susceptibility to free radical stress and peroxidative damage is related to the balance between the free radical load and the adequacy of antioxidant defenses. In the present study, the relationship between plasma oxidants and antioxidants in diabetes mellitus was investigated. Thirty patients with type-2 diabetes mellitus were examined as well as twenty healthy controls (matched for age and sex against the diabetic patients). The plasma insulin and C-peptide levels in the diabetic group were significantly lower (p < 0.001) than that of the control group. The mean plasma fructosamine, lipid peroxide, lipids and low-density lipoprotein cholesterol (LDL-C) levels were significantly high (p < 0.001) in the diabetic group compared to the control group. There were not any significant differences in the plasma high-density lipoprotein cholesterol (HDL-C) levels between the patients and the control group (p < 0.001). The type-2 diabetes mellitus patients exhibited higher activities of plasma superoxide dismutase (SOD) than control values, whereas plasma glutathione peroxidase (GPx) activities were significantly lower. Our results suggest that there seems to be an imbalance between plasma oxidant and antioxidant systems in patients with type-2 diabetes mellitus. The estimation of plasma antioxidant levels and their replenishment by exogenous agents when necessary may be useful in the prevention of the diabetic complications.