Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified "Infarct-like Myocarditis".

PURPOSE: Cardiac magnetic resonance (CMR) has increasingly proved to be a valuable diagnostic tool for evaluating patients with suspected myocarditis. The objective of this study was to evaluate the diagnostic value of functional and morphological parameters including tissue characterization in patients with "infarct-like myocarditis". MATERIALS AND METHODS: 43 patients with clinically verified cases of "infarct-like myocarditis" (median time to MRI scanning after admission for acute symptoms 3 days) and 35 control patients matched by age and sex were included in this retrospective case control study. In this study we used a 1.5 T MRI scanner conducting steady-state-free-precession sequences, T2-weighted imaging, T1-weighted imaging before and after contrast administration and late gadolinium enhancement sequences. According to the recommendations for CMR diagnosis of myocarditis (Lake Louise consensus criteria), a scan was positive for acute myocarditis if 2 of 3 CMR criteria were present. RESULTS: 30 % of the patients with "infarct-like myocarditis" had a reduced left ventricular ejection fraction, 11 % had an increased LV end-diastolic volume index and 35 % had an increased LV mass index. The sensitivity of wall motion abnormalities was 63 % with a regional distribution in 49 %. In 47 % of cases regional wall motion abnormalities were present in the lateral left ventricular segments. Pericardial effusions were discovered in 65 % of cases with a circular appearance in 21 % and focal manifestation in 44 %. The diagnostic sensitivity, specificity, and accuracy of CMR in patients with "infarct-like myocarditis" were 67 %, 100 % and 82 %, respectively. The LGE alone was the most sensitive test parameter with 86 %, providing a specificity of 100 % and accuracy of 92 %. CONCLUSION: Our study results can be applied to the subgroup of patients with "infarct-like myocarditis", where we found that LGE alone was the most sensitive test parameter. In addition to tissue characterization, the functional and morphological analysis of patients with acute myocarditis provides a useful further diagnostic tool. KEY POINTS: •Infarct-like myocarditis can be diagnosed by CMR with high validity and reliability. •LGE allone performed best with a sensitivity of 86 %. •Functional and morphological CMR parameters in addition to tissue characterization are useful tool in the diagnosis of acute myocarditis.

Established and new mouse models reveal E2f1 and Cdk2 dependency of retinoblastoma, and expose effective strategies to block tumor initiation.

RB(+/-) individuals develop retinoblastoma and, subsequently, many other tumors. The Rb relatives p107 and p130 protect the tumor-resistant Rb(-/-) mouse retina. Determining the mechanism underlying this tumor suppressor function may expose novel strategies to block Rb pathway cancers. p107/p130 are best known as E2f inhibitors, but here we implicate E2f-independent Cdk2 inhibition as the critical p107 tumor suppressor function in vivo. Like p107 loss, deleting p27 or inactivating its Cdk inhibitor (CKI) function (p27(CK-)) cooperated with Rb loss to induce retinoblastoma. Genetically, p107 behaved like a CKI because inactivating Rb and one allele each of p27 and p107 was tumorigenic. Although Rb loss induced canonical E2f targets, unexpectedly p107 loss did not further induce these genes, but instead caused post-transcriptional Skp2 induction and Cdk2 activation. Strikingly, Cdk2 activity correlated with tumor penetrance across all the retinoblastoma models. Therefore, Rb restrains E2f, but p107 inhibits cross talk to Cdk. While removing either E2f2 or E2f3 genes had little effect, removing only one E2f1 allele blocked tumorigenesis. More importantly, exposing retinoblastoma-prone fetuses to small molecule inhibitors of E2f (HLM006474) or Cdk (R547) for merely 1 week dramatically inhibited subsequent tumorigenesis in adult mice. Protection was achieved without disrupting normal proliferation. Thus, exquisite sensitivity of the cell-of-origin to E2f and Cdk activity can be exploited to prevent Rb pathway-induced cancer in vivo without perturbing normal cell division. These data suggest that E2f inhibitors, never before tested in vivo, or CKIs, largely disappointing as therapeutics, may be effective preventive agents.

Intralines of quasi-conical intersections on torsion planes: methylamine as a case study.

Recently we reported on a novel feature associated with the intersection of the two lowest states (1)A' and (1)A'' of the methylamine (J. Chem. Phys. 2008, 128, 244302). We established the existence of a finite (closed) line of conical intersections (ci), namely, a finite seam, located in the HC-NHH symmetry plane, a line that is formed by moving a single hydrogen on that plane while locking the positions of the (six) other atoms. In the present article, this study is extended to the corresponding torsion planes formed by rotating the methyl group around the CN axis. The torsion planes, in contrast with the HC-NHH symmetry plane, do not satisfy the symmetry feature that enables the seam just mentioned. Nevertheless, the calculated nonadiabatic coupling terms (NACTs) resemble features similar to those encountered in the HC-NHH symmetry plane. Following a tedious numerical study supported by a theoretical model (Section III), it was verified that these NACTs may become similar to those on the symmetry plane, sometimes even to the level of almost no distinction, but lack one basic feature; namely, they are not singular and therefore do not form topological effects.

An intraline of conical intersections for methylamine.

In this article are considered the conical intersections (ci's) related to the N-H bond in the methylamine, CH(3)NH(2), molecule. The novel feature that was revealed is that the two lowest states 1A(') and 1A(") are coupled by a line of cis located in HC-NHH plane-a line that is formed by moving a single hydrogen on that plane while fixing the (six) other atoms. The validity of this line was proven first by studying the singularities of the (angular) nonadiabatic coupling terms and then by revealing the degeneracy points formed by the two interacting adiabatic potential energy surfaces (PESs). A theoretical analysis indicated that the line has to be a finite closed line. We also calculated the Berry phase for a contour that surrounds this line and found it to be 3.127 rad, namely, a value reasonably close to pi. The existence of such lines of cis-instead of isolated cis (as exhibited by other n-atomic (n>3) molecules such as HNCO or C(2)H(2))-may enhance significantly the transition rate from an upper adiabatic state to a lower one. There are also numerical advantages in such situations, that is, if such a line is properly placed in that plane (like in the present case) the wave-packet treatment of the nuclei can be carried out employing a single diabatic PES instead of having to consider two coupled PESs.

Usefulness of CDK5RAP3, CCNB2, and RAGE genes for the diagnosis of lung adenocarcinoma.

We used oligonucleotide microarrays with probe sets to 22,283 genes to analyze the gene expression profile of lung adenocarcinoma. Cancerous and noncancerous tissue samples were obtained from 23 patients with stage I or II lung cancer; 18 tissue pairs and 5 cancerous tissues. A list of 2065 genes that differentiate between cancerous and noncancerous tissues was generated using Winsorized paired t-tests. We analyzed CDK5RAP3 and CCNB2, which are involved in cell cycle progression, and RAGE. The first 2 of these 3 genes proved to be overexpressed in tumor tissue, whereas the RAGE gene was suppressed in tumor tissue. When CDK5RAP3 and CCNB2 were examined in individual patients we found that in cases where one of these genes was only slightly overexpressed the other was highly overexpressed. The combined expression of the 2 cell cycle genes was found to be statistically significant for differentiating between cancerous and noncancerous tissues. Inclusion of the data for the RAGE gene made the differentiation more powerful. The gene expression ratio gave a clear result: when CDK5RAP3 was expressed more than RAGE, the tissue was carcinomatous, and vice versa. We therefore conclude that these 3 genes may be used as a very reliable biomarker of lung adenocarcinoma.

[Diagnosis of appendicitis using harmonic ultrasound imaging]. / Sonografische Diagnostik der Appendizitis bei Kindern - Verbesserte Darstellung mittels Harmonic Imaging.

INTRODUCTION: Harmonic Imaging (HI) is a new Ultrasound (US) modality with high contrast and spatial resolution. Aim of this study was to compare fundamental imaging (FI) and HI in the diagnosis of appendicitis. PATIENTS AND METHODS: In 50 children (male : female, 25 : 25; mean age: 9.9 years) prior to an appendectomy US of the right lower quadrant was performed in both FI and HI (Tissue Harmonic Imaging - THI - Sonoline Elegra, Siemens, 7.5 MHz linear). The images were compared with respect to delineation of surrounding, contour, wall and content of the appendix. RESULTS: In 43 / 50 (86 %) patients diagnosis of appendicitis was confirmed histologically (sensitivity 98 %, specificity 94 %). In 37 / 43 patients the appendix was depicted using FI. With HI this number was 40 / 43. HI was significantly better in delineating the contour, wall, mucosa and content of the appendix (p < 0.01). HI also exceeded in demonstrating free fluid, mesenterial lymph nodes and surrounding echogenicity. CONCLUSION: HI of appendicitis provides images with significantly better quality than FI. When both imaging options are available harmonic imaging modality should be the preferred choice for scanning the appendix.

Expression of the ankyrin repeat domain 6 gene (Ankrd6) during mouse brain development.

The structure and developmental expression pattern of the ankyrin repeat domain 6 (Ankrd6) gene, initially named Diversin, were studied in the mouse. Ankrd6 is transcribed as a 5.8-kb mRNA composed of 15 exons that encodes a 712 amino acid protein with 6 ankyrin repeats. Ankrd6 is expressed prominently in the developing brain from E12 to maturity, suggesting a role during brain development. In embryos, expression is maximal in ventricular zones of neuronal proliferation and intermediate zones of neuronal migration and extends to postmigratory neuronal fields during the postnatal period. In the mature brain, the Ankrd6-related signal is highest in cortical layer II, granule cells of the dentate gyrus, olfactory granules and a subset of Purkinje cells in the vestibulocerebellum. Ankrd6 is related to the Drosophila gene Diego, which interacts with Flamingo in the regulation of planar cell polarity (Feiguin et al., 2001). However, the canvas of Ankrd6 expression does not match closely that of the three mouse Flamingo homologs, Celsr1-3 (Tissir et al., 2002). These data suggest that Ankrd6 may be involved in brain development in interaction with Celsr/Flamingo but also other signaling pathways.

Imaging transgene expression in live animals.

Monitoring the expression of therapeutic genes in targeted tissues in disease models is important to assessing the effectiveness of systems of gene therapy delivery. We applied a new light-detection cooled charged-coupled device (CCCD) camera for continuous in vivo assessment of commonly used gene therapy delivery systems (such as ex vivo manipulated cells, viral vectors, and naked DNA), without the need to kill animals. We examined a variety of criteria related to real-time monitoring of luciferase (luc) gene expression in tissues including bone, muscle, salivary glands, dermis, liver, peritoneum, testis, teeth, prostate, and bladder in living mice and rats. These criteria included determination of the efficiency of infection/transfection of various viral and nonviral delivery systems, promoter specificity, and visualization of luciferase activity, and of the ability of luciferin to reach various organs. The exposure time for detection of luc activity by the CCCD camera is relatively short (approximately 2 minutes) compared with the intensified CCD camera photon-counting method (approximately 15 minutes). Here we transduce a variety of vectors (such as viruses, transfected cells, and naked DNA) by various delivery methods, including electroporation, systemic injection of viruses, and tail-vein, high-velocity-high-volume administration of DNA plasmids. The location, intensity, and duration of luc expression in different organs were determined. The distribution of luciferin is most probably not a barrier for the detection of in vivo luciferase activity. We showed that the CCCD photon detection system is a simple, reproducible, and applicable method that enables the continuous monitoring of a gene delivery system in living animals.

Apical localization of wingless transcripts is required for wingless signaling.

Many developing and adult tissues are comprised of polarized epithelia. Proteins that are asymmetrically distributed in these cells are thought to be localized by protein trafficking. Here we show that the distribution and function of the signaling protein Wingless is predetermined by the subcellular localization of its mRNA. High-resolution in situ hybridization reveals apical transcript localization in the majority of tissues examined. This localization is mediated by two independently acting elements in the 3' UTR. Replacement of these elements with non- or basolaterally localizing elements yields proteins with altered intracellular and extracellular distributions and reduced signaling activities. This novel aspect of the wingless signaling pathway is conserved and may prove to be a mechanism used commonly for establishing epithelial cell polarity.

Evolution of cortical lamination: the reelin/Dab1 pathway.

The mammalian cortical plate is characterized by its radial organization and its inside-outside developmental gradient. Observations on reelin and Dab1-deficient mice show that reelin and Dab1 are both required to develop radial cortical organization and a normal maturation gradient. In the reptilian cortex, radial organization varies among species; it is the most rudimentary in turtles and the most elaborate in lizards, and can be described as intermediate in other species such as crocodilians and Sphenodon. On the other hand, the gradient of corticogenesis is directed from outside to inside in all reptiles studied, as well as in mice that are deficient in reelin, Dab1, as well as cyclin-dependent kinase 5 (Cdk5) and p35. All reptiles, even turtles, have reelin-expressing cells in the embryonic marginal zone. Mammals are characterized by a drastic increase in the number of reelin-positive cells (Cajal-Retzius cells) as well as by an amplification of reelin expression per cell. In lizards, the pattern of reelin expression is different, as reelin-expressing cells are also present below the cortical plate. In all mammalian and reptilian species, Dab1 is expressed in cortical plate cells. These data suggest that the reelin/Dab1 pathway was a driver of cortical evolution on the synapsid lineage and that similarities in radial cortical organization between squamates and mammals result from evolutionary convergence.