Functional analysis of different LMP1 proteins isolated from Epstein-Barr virus-positive carriers.

The Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis and is implicated in the development of several human malignancies. Latent membrane protein 1 (LMP1), an EBV protein with known oncogenic properties, may be important in the pathogenesis of EBV-associated tumors, particularly nasopharyngeal carcinoma (NPC) and Hodgkin's disease (HD). Several reports suggested that sequence variations in the LMP1 gene may define a more aggressive, geographically restricted EBV-genotype. Most mutations in the LMP1 gene described are located within the C-terminus of the protein. However, the effect of these mutations on the biological function of the protein remains widely unknown. Therefore, this study aimed in investigating whether mutations detected in LMP1 genes isolated from different EBV-positive carriers have an effect on the biological function of the protein. For this purpose the LMP1 genes were amplified by nested PCR from DNA out of bone marrow and peripheral blood lymphocytes and sequenced. Three functional assays were performed in order to evaluate the biological activity of the different isolates: activation of the transcription factors NF-kappaB and AP-1 as well as the anchorage independent growth of LMP1 transfected ratl cells in soft agar. The results suggested that whereas differences in the activation of NF-kappaB through the various LMP1 isolates correlated tightly with their different expression levels, the outgrowth of transfected cells in soft agar did not and the transcription factor NF-kappaB therefore appeared not to be the major effector for the transformation of the rodent cell line ratl by LMP1. The various LMP1-isolates also differed in their capacity in activating the transcription factor AP-1. We found no correlation between the transforming ability of the LMPI isolates and activation of AP-1 suggesting that other so far uncharacterized domains also influence the transforming ability of the protein.

The Brief Reasons for Living Inventory for Adolescents (BRFL-A).

This study modified and evaluated the psychometric properties of the Reasons for Living Inventory (RFL) in samples of adolescents. Internal consistency reliability, corrected item-total scale correlation, and exploratory factor analysis procedures were used with a mixed sample of 260 adolescents to identify 14 items for the brief version of the RFL (BRFL-A). Confirmatory factor analyses provided support for the five-factor oblique structure of the BRFL-A in a psychiatric inpatient sample with a range of suicidal behaviors. Reliabilities of the BRFL-A subscales were satisfactory. Four of the five subscales differentiated between suicidal and nonsuicidal adolescents. Significant correlations were found between three BRFL-A subscales and several suicide indices. Convergent-discriminant validity was examined by correlating the BRFL-A subscales with the Minnesota Multiphasic Personality Inventory-Adolescents (MMPI-A) Content Scales. Limitations of the study are discussed.

Consequences of elevated carbon dioxide and ozone for foliar chemical composition and dynamics in trembling aspen (Populus tremuloides) and paper birch (Betula papyrifera).

Atmospheric chemical composition affects foliar chemical composition, which in turn influences the dynamics of both herbivory and decomposition in ecosystems. We assessed the independent and interactive effects of CO2 and O3 fumigation on foliar chemistry of quaking aspen (Populus tremuloides) and paper birch (Betula papyrifera) at a Free-Air CO2 Enrichment (FACE) facility in northern Wisconsin. Leaf samples were collected at five time periods during a single growing season, and analyzed for nitrogen. starch and condensed tannin concentrations, nitrogen resorption efficiencies (NREs), and C:N ratios. Enriched CO2 reduced foliar nitrogen concentrations in aspen and birch; O3 only marginally reduced nitrogen concentrations. NREs were unaffected by pollution treatment in aspen, declined with 03 exposure in birch, and this decline was ameliorated by enriched CO2. C:N ratios of abscised leaves increased in response to enriched CO2 in both tree species. O3 did not significantly alter C:N ratios in aspen, although values tended to be higher in + CO2 + O3 leaves. For birch, O3 decreased C:N ratios under ambient CO2 and increased C:N ratios under elevated CO2. Thus, under the combined pollutants, the C:N ratios of both aspen and birch leaves were elevated above the averaged responses to the individual and independent trace gas treatments. Starch concentrations were largely unresponsive to CO2 and O3 treatments in aspen. but increased in response to elevated CO2 in birch. Levels of condensed tannins were negligibly affected by CO2 and O3 treatments in aspen, but increased in response to enriched CO2 in birch. Results from this work suggest that changes in foliar chemical composition elicited by enriched CO2 are likely to impact herbivory and decomposition, whereas the effects of O3 are likely to be minor, except in cases where they influence plant response to CO2.

The multi-attitude suicide tendency scale: further validation with adolescent psychiatric inpatients.

The present study was designed to examine the construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. This new scale has four subscales: attraction to life, repulsion by life, attraction to death, and repulsion by death. Confirmatory factor analysis of the scale items provided support for the fit of the 28-item, four-factor model. Results of logistic regression analyses revealed that high scores on the repulsion by life and the attraction to death subscales were useful in assessing the risk for suicide attempts. Results of the hierarchical regression analysis showed that high repulsion by life and low attraction to life subscale scores contributed to the prediction of scores on the suicide probability scale. We also examined gender differences on the four subscales and the psychological correlates of each subscale.

The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples.

Past suicidal behaviors including ideation and attempts have been identified as significant risk factors for subsequent suicidal behavior. However, inadequate attention has been given to the development or validation of measures of past suicidal behavior. The present study examined the reliability and validity of a brief self-report measure of past suicidal behavior, the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Participants included psychiatric inpatient adolescents, high school students, psychiatric inpatient adults, and undergraduates. Logistic regression analyses provided empirical support for the usefulness of the SBQ-R as a risk measure of suicide to differentiate between suicide-risk and nonsuicidal study participants. Receiver operating characteristic (ROC) analyses indicated that the most useful cutoff scores on the SBQ-R were 7 for nonsuicidal samples, and 8 for clinical samples. Both the single SBQ-R Item 1 and SBQ-R total scores are recommended for use in clinical and nonclinical settings.

[Cancer induction by urinary drainage or diversion through intestinal segments?]. / Karzinominduktion durch Harnab- oder -umleitung über Darmabschnitte?

Since the introduction of ureterosigmoidostomy 79 cases of adenocarcinomas of the sigmoid near the implantation site of the ureters were described. Clinical and experimental data indicate that the excretion of urine and faeces together leads to endogenous nitrosamine synthesis and thus induces carcinomas. Other factors--like carcinogens excreted with the urine or chronic irritation of the mucosa by urine--could also cause carcinomas in the urine diverting parts of the intestine. Based on our own cases and a study of the literature we investigated whether other forms of urinary diversion can induce tumors. So far 4 tumor cases in ileum conduits and 2 cases in colon conduits have been reported together with 2 tumors in bladder augmentation (ileocystoplasty). We found in our material 1 case of cancer in a rectum bladder, 1 in a colocystoplasty, and 2 after ureterosigmoidostomy. In ureter substitution plasty and following Kock- or Camey-technique no cases of tumor induction have been reported so far. From the presently available data it must be concluded that urinary diversion using intestine may cause tumor induction. With the interval between surgery and evidence of tumor being at least 20 years a sharp increase in morbidity must be expected for the years after 1990. This leads to the demand that all patients with urinary diversion using intestine must be regularly evaluated by radiological, endoscopic and bioptic controls. These oncological aspects should be considered for the appropriate choice of urinary diversion especially in children.

[Micturition disorder as a sequela of sacral autonomic diabetic neuropathy]. / Harnblasenentleerungsstörung als Folge einer sakralen autonomen diabetischen Neuropathie.

Diabetic neuropathy may manifest itself also in the autonomous nervous system and thus lead to a functional disorder of the urinary bladder. Urodynamic studies carried out in 11 diabetic patients with unclear bladder dysfunction allowed 2 forms of bladder anomalies to be identified: 1. detrusor hyperreflexia, 2. hyporeflexia and areflexia of the detrusor. Whereas hyperreflexia is clinically characterised by signs of motor urgency, hyporeflexia is mainly identifiable by residual urine formation and recurrent infections of the urinary tract. Therapy depends on the type of dysfunction and consists of physiotherapeutic measures, drug therapy and occasionally surgery.

[Nuclear medicine assessment of renal function in beagles before and after extracorporeal percutaneous lithotripsy with a piezoelectric instrument system]. / Nuklearmedizinische Nierenfunktionsprüfung an Beagle-Hunden vor und nach extrakorporaler perkutaner Lithotripsie mit einem piezoelektrischen Gerätesystem (EPL).

High energy sound pulses which are generated piezoelectrically can be used for extracorporal lithotripsy as an alternative to shock-waves. Since several years a lithotripter for renal concrements based on piezoelectrical oscillators has been developed at the Department for Urology in Homburg/Saar; W.Germany. The present paper describes animal experiments which have been carried out with Beagle-dogs in order to prove that the sound pulses used for lithotripsy do not affect renal function. This function is measured by methods of nuclear medicine (131J-Hippuran Clearance with a modified evaluation). In addition it is evaluated by 111In labelled leucocytes if inflammatory processes in the kidney are suspected. It could be demonstrated that no detremental effects on the kidneys can be detected even with the most sensitive methods of nuclear medicine.

[Therapy of the carcinoma of the prostate and case control (III) (Author's transl)]. / Therapie des Prostata-Carcinoms und Verlaufskontrole (III)

In a third information of our long-term study with now 304 cases we report on 54 cases with monotherapy-only orchiectomy, only hormones and combination of boths. With it the rectal palpable results have coincided significantly with the histological findings in all 3 therapeutic forms. As for the therapeutic result no difference is to be seen either histological or clinical after a 3 years' observation period. We cannot tell anything now about optimal methods of treatment with regard to the histological starting material. In all 3 therapeutic forms we observed regressions to stage O. The smallest plasma-testosteron concentration was found after orchiectomy, where no increase was recorded during the whole observation period.

[Disintegration of kidney calculi with a piezoelectric instrument system. Initial clinical experiences]. / Die Zertrümmerung von Nierensteinen mit einem piezoelektrischen Gerätesystem. Erste klinische Erfahrungen.

Since December 1985 extracorporeal piezoelectric renal lithotripsy has been tested in humans. Up to now 50 patients with renal calculi have been treated. The lithotriptor consists of a special mobile table with an opening in the surface to apply shock waves. Urinary calculi are located by integrated ultrasound location systems. As the piezoelectrically generated high-energy sound pulse does not cause pain, treatment is possible without anesthesia. Permanent ultrasonic control of the stones in the focus during lithotripsy allows effective application of shock waves. With this piezoelectric system the electrocardiogram does not have to be triggered. So far the results have been encouraging and following these tests clinical application is expected to be successful.

[Disintegration of kidney calculi by piezoelectrically generated high-energy sound waves. Physical principles and experimental studies]. / Die Zertrümmerung von Nierensteinen durch piezoelektrisch erzeugte Hochenergie-Schallpulse. Physikalische Grundlagen und experimentelle Untersuchungen.

The recently developed equipment for extracorporeal piezoelectric lithotripsy (EPL) represents an improvement concerning the shock-wave-induced disintegration of urinary calculi. While the usual spark gap transmitter needs a focusing reflector, the piezoelectric lithotriptor is based on a self-focusing spherical bowl transmitter. The stone is detected exclusively by ultrasound. For this purpose, an integrated sector scanner is used as well as the high-energy sound transmitter itself. With the piezoelectrically generated high-energy sound pulses we have succeeded in completely disintegrating implanted stones in the renal pelvis of dogs without injuring the morphology or function of the exposed kidneys.

The positive and negative suicide ideation inventory: development and validation.

We conducted two studies to develop and validate a brief self-report measure for assessing the frequency of positive and negative thoughts related to suicidal behavior. Items on this new measure, the Positive and Negative Suicide Ideation inventory, were generated by undergraduates. In Study 1, we administered a 20-item version of the inventory to 150 male and 300 female undergraduates and conducted an exploratory principal axis factor analysis with varimax rotation. Two factors, Positive Ideation and Negative Ideation, were retained. In Study 2, we conducted a confirmatory factor analysis to validate the fit of the one-factor and the oblique two-factor models to data from another sample of 84 men and 202 women. The oblique two-factor model provided an excellent fit to the sample data. We also examined preliminary evidence of concurrent and predictive validity. Over-all, these findings suggested that the inventory is a well-developed self-report measure for assessing the frequency of positive and negative thoughts related to suicidal behavior.

Development and psychometric properties of the Student Worry Questionnaire-30.

Described are the development and initial psychometric properties (Ns = 50 and 188) of a self-report measure, the Student Worry Questionnaire-30, for use with college undergraduates. Exploratory principal components analyses (Ns = 388, 350, and 396) with oblimin rotation indicated six domains of worrisome thinking, financial-related concerns, significant others' well-being, social adequacy concerns, academic concerns, and general anxiety symptoms. The total score and scale scores showed internal consistency of .80 to .94. Also, test-retest reliability analyses (.75 to .80) support consistency of responses over 4 wk. Strong evidence for convergent validity) was indicated. Confirmatory factor analysis confirmed the fit of the 6-factor oblique model. Limitations of the present studies, and directions for research are discussed.

Short and long latency response due to transition from bilateral to unilateral contraction.

The aim of this study was to investigate the effect of fast and slow relaxation of the knee extensor muscle of the dominant leg on torque-time curve of the unilaterally contracting contralateral muscle. Eight adult male subjects were recruited without bilateral deficit. In Task 1 subjects exerted bilateral and unilateral torque and bilateral index was calculated. In Task 2 subjects relaxed the right knee extensors as slow as possible while maximum activation of the contralateral muscle had to be maintained. In Task 3 the relaxation was as fast as possible. During slow relaxation the short latency response (dM1) was 6.6% torque reduction in the left leg. On the contrary fast muscle relaxation resulted in a 7.3% increase. During long latency response the torque increased in both tasks, but did not exceed the torque measured in Task 1. Significant correlation was found between the rate of torque reduction (RTR) and dM1 (r = 0.95, P < 0.001), time to peak (t1) and dM1 (r = 0.812, P < 0.01). The regression analysis indicated that RTR greater or less than -1.0 Nm/ms results in opposite short latency response. We concluded that the different tasks for two knee extensor muscles result in transient interhemispheric effects which are time and rate of torque reduction dependent.

[Secondary malignancies in urinary diversions]. / Sekundärmalignome in Harnableitungen.

In contrast to ureterosigmoidostomy no reliable clinical data exist for tumor risk in different forms of urinary diversion using isolated intestinal segments.In 44 German urological departments, operation frequencies, indications, patient age, and operation dates of the different forms of urinary diversion, operated between 1970 and 2007, could be registered. The secondary tumors up to 2009 were registered as well and related to the numbers of the different forms of urinary diversions resulting in tumor prevalences.In 17,758 urinary diversions 32 secondary tumors occurred. The tumor risk in ureterosigmoidostomy (22-fold) and cystoplasty (13-fold) is significantly higher than in other continent forms of urinary diversion such as neobladders or pouches (p<0.0001). The difference between ureterosigmoidostomy and cystoplasty is not significant, nor is the difference between ileocecal pouches (0.14%) and ileal neobladders (0.05%) (p=0.46). The tumor risk in ileocecal (1.26%) and colonic neobladders (1.43%) is significantly higher (p=0.0001) than in ileal neobladders (0.5%). Of the 16 tumors that occurred following ureterosigmoidostomy, 16 (94%) developed directly at the ureterocolonic borderline in contrast to only 50% following urinary diversions via isolated intestinal segments.From postoperative year 5 regular endoscopic controls of ureterosigmoidostomies, cystoplasties, and orthotopic (ileo-)colonic neobladders are necessary. In ileocecal pouches, regular endoscopy is necessary at least in the presence of symptoms or should be performed routinely at greater intervals. Following neobladders or conduits, only urethroscopies for urethral recurrence are necessary.

[Robotic-assisted laparoscopic radical cystectomy: evaluation of functional and oncological results]. / Cistectomía radical laparoscópica asistida por robot: evaluación de los resultados funcionales y oncológicos.

PURPOSE: radical cystectomy remains the most effective treatment for patients with localized, invasive bladder cancer and recurrent noninvasive disease. We report our experience with 84 consecutive cases of robotic assisted laparoscopic radical cystectomy with regard to perioperative results, pathological outcomes and surgical complications. MATERIALS AND METHODS: a total of 84 consecutive patients (70 male and 14 female) underwent robotic radical cystectomy and urinary diversion at our institution from January 2007 to August 2010 for clinically localized bladder cancer. Outcome measures evaluated included operative variables, hospital recovery, pathological outcomes and complication rate. RESULTS: mean age of this cohort was 65.5 years (range 28 to 82). Of the patients 62 underwent ileal conduit diversion, 22 received a neobladder. Mean operating room time for all patients was 261min. (range: 243-618min.) and mean surgical blood loss was 298ml (range: 50-2000ml). 29% of the cases were pT1 or less disease, 38% were pT2, 26% and 7% were pT3 and T4 disease respectively, 15% were node positive. Mean number of lymph nodes removed was 15 (range 1 to 33). In 2 cases (2.4%) there was a positive surgical margin. Mean days to flatus were 2.12, bowel movement 2.87 and discharge home 17.7 (range: 10-33). There were 45 postoperative complications with 11.9% having a major complication (Clavien grade 3 or higher). At a mean followup of 16.7 months 10 patients (11%) had disease recurrence and 2 died of disease. CONCLUSIONS: our experience with robotic radical cystectomy for the treatment of bladder cancer suggests that in proper hands this procedure provides acceptable surgical and pathological outcomes.

Cistectomía radical laparoscópica asistida por robot: evaluación de los resultados funcionales y oncológicos / Robotic-Assisted Laparoscopic Radical Cystectomy: Evaluation of Functional and Oncological Results

Objetivo: presentamos nuestra experiencia en cistectomía radical robótica informando sobre los resultados quirúrgicos, tanto desde el punto de vista oncológico como funcional. Material y método: entre enero de 2007 y agosto de 2010 fueron operados en nuestra institución un total de 84 pacientes (70 hombres y 14 mujeres) con diagnóstico histopatológico de cáncer de vejiga invasor no metastásico. Evaluamos variables quirúrgicas, el tiempo de recuperación intrahospitalario, los hallazgos patológicos y las complicaciones peri y postoperatorias. Resultados: la edad media de la población en estudio fue 65,6 años (rango: 28-82). En 62 pacientes se realizó derivación urinaria con ureteroileostomía tipo Wallace, los 22 pacientes restantes recibieron una neovejiga ileal tipo Studer. El tiempo promedio de cirugía fue de 261 minutos (rango: 243-618) y la pérdida promedio de sangre intraoperatoria fue de 298ml (rango 50-2.000). Un 29, 38, 26 y 7% presentaron estadios histopatológicos postoperatorios pT1, pT2, pT3 y pT4, respectivamente. El 15% de los pacientes operados presentó metástasis locales a nivel ganglionar. El número de ganglios linfáticos resecados por procedimiento quirúrgico fue de 14,47 (rango: 1-33). En dos casos (2,4%) se registraron márgenes quirúrgicos positivos. El tiempo promedio de aparición de flatos fue 2,12 días, evacuación intestinal postoperatoria 2,87 y alta médica 17,710-33. Un total de 45 pacientes presentaron complicaciones perioperatorias. De estos sólo un 11,9% tuvo complicaciones mayores (Clavien III o mayor) que necesitaron de un tratamiento más invasivo. El tiempo promedio de seguimiento fue de 16,7 meses. Durante ese período 10 pacientes (11%) presentaron recidiva del tumor vesical, de los cuales dos (2,38%) fallecieron. Conclusión: nuestra experiencia con cistectomía radical robótica en el tratamiento del cáncer de vejiga sugiere que en manos adecuadas este procedimiento proporciona resultados quirúrgicos y patológicos aceptables (AU)

Purpose: radical cystectomy remains the most effective treatment for patients with localized, invasive bladder cancer and recurrent noninvasive disease. We report our experience with 84 consecutive cases of robotic assisted laparoscopic radical cystectomy with regard to perioperative results, pathological outcomes and surgical complications. Materials and methods: a total of 84 consecutive patients (70 male and 14 female) underwent robotic radical cystectomy and urinary diversion at our institution from January 2007 to August 2010 for clinically localized bladder cancer. Outcome measures evaluated included operative variables, hospital recovery, pathological outcomes and complication rate. Results: mean age of this cohort was 65.5 years (range 28 to 82). Of the patients 62 underwent ileal conduit diversion, 22 received a neobladder. Mean operating room time for all patients was 261min. (range: 243-618min.) and mean surgical blood loss was 298ml (range: 50-2000ml). 29% of the cases were pT1 or less disease, 38% were pT2, 26% and 7% were pT3 and T4 disease respectively, 15% were node positive. Mean number of lymph nodes removed was 15 (range 1 to 33). In 2 cases (2.4%) there was a positive surgical margin. Mean days to flatus were 2.12, bowel movement 2.87 and discharge home 17.7 (range: 10-33). There were 45 postoperative complications with 11.9% having a major complication (Clavien grade 3 or higher). At a mean followup of 16.7 months 10 patients (11%) had disease recurrence and 2 died of disease. Conclusions: our experience with robotic radical cystectomy for the treatment of bladder cancer suggests that in proper hands this procedure provides acceptable surgical and pathological outcomes (AU)