Absence of high-risk human papilloma virus in p16 positive inverted sinonasal papilloma.

OBJECTIVES: Sinonasal inverted papilloma (SIP) is a relatively rare disease, and its etiology is not understood. It is characterized by locally aggressive growth and a strong tendency to recur despite its benign histology. AIMS: The aim of this study was to identify the presence of human papilloma virus (HPV) and its surrogate marker p16 in SIP tissue samples from a regional cohort. MATERIAL AND METHODS: Subjects were identified from our regional center cohort of 88 SIP patients treated between 1984-2014. From these subjects, 54 were included in this study. Of these, 53 biopsies were analyzed with PCR, and 54 samples were immunohistochemically stained for p16. DNA was extracted from histopathologically verified SIP. Genotype screening for 13 high risk-, 5 oncogenic and 6 low risk HPV types was performed using the PapilloCheck® HPV-screening test. RESULTS: HPV analysis was successful for 38 of 53 samples. Of the 38 successfully analyzed samples, only 2 samples were positive for HPV 11. Notably, p16 was present in the epithelia in all samples, and in the papilloma lesions in 37 samples. CONCLUSION: Since only 2 out of 38 SIPs were positive for HPV (type 11), and at the same time p16 was positive in epithelia in all samples and in 37 of 38 papilloma lesions of the samples, it is concluded that p16 cannot be used as a surrogate marker for high-risk HPV-infection in SIP. We are currently planning a prospective, multicenter study in order to increase the study power and in order to be able to better evaluate the clinical implications of HPV-and p16 in SIP.

The histone deacetylase inhibitor trichostatin A reduces lysosomal pH and enhances cisplatin-induced apoptosis.

High activity of histone deacetylases (HDACs) has been documented in several types of cancer and may be associated with survival advantage. In a head and neck squamous cell carcinoma cell line, cisplatin-induced apoptosis was augmented by pretreatment with the HDAC inhibitor trichostatin A. Apoptosis was accompanied by lysosomal membrane permeabilization (LMP), as shown by immunoblotting of the lysosomal marker protease cathepsin B in extracted cytosol and by immunofluorescence. Moreover, LAMP-2 (lysosomal associated membrane protein-2) was translocated from lysosomal membranes and found in a digitonin extractable fraction together with cytosolic proteins and pretreatment with trichostatin A potentiated the release. Overall, protein level of LAMP-2 was decreased during cell death and, interestingly, inhibition of cysteine cathepsins, by the pan-cysteine cathepsin inhibitor zFA-FMK, prevented loss of LAMP-2. The importance of LAMP-2 for lysosomal membrane stability, was confirmed by showing that LAMP-2 knockout MEFs (mouse embryonic fibroblasts) were more sensitive to cisplatin as compared to the corresponding wildtype cells. Trichostatin A reduced lysosomal pH from 4.46 to 4.25 and cell death was prevented when lysosomal pH was increased by NH(4)Cl, or when inhibiting the activity of lysosomal proteases. We conclude that trichostatin A enhances cisplatin induced cell death by decreasing lysosomal pH, which augments cathepsin activity resulting in reduced LAMP-2 level, and might promote LMP.

Quantification of kinetic changes in protein tyrosine phosphorylation and cytosolic Ca²âº concentration in boar spermatozoa during cryopreservation.

Protein tyrosine phosphorylation in sperm is associated with capacitation in several mammalian species. Although tyrosine phosphorylated proteins have been demonstrated in cryopreserved sperm, indicating capacitation-like changes during cryopreservation, these changes have not yet been quantified objectively. We monitored tyrosine phosphorylation, intracellular calcium and sperm kinematics throughout the cryopreservation process, and studied the relationships among them in boar spermatozoa. Sperm kinetics changed significantly during cryopreservation: curvilinear velocity, average path velocity and straight line velocity all decreased significantly (P < 0.05). While the percentage of sperm with high intracellular calcium declined (P < 0.05), global phosphorylation increased significantly (P < 0.01). Specifically, cooling to 5 °C induced phosphorylation in the spermatozoa. After cooling, a 32-kDa protein not observed in fresh semen appeared and was consistently present throughout the cryopreservation process. While the level of expression of this phosphoprotein decreased after addition of the second extender, frozen-thawed spermatozoa showed an increased expression. The proportion of sperm cells with phosphorylation in the acrosomal area also increased significantly (P < 0.05) during cryopreservation, indicating that phosphorylation might be associated with capacitation-like changes. These results provide the first quantitative evidence of dynamic changes in the subpopulation of boar spermatozoa undergoing tyrosine phosphorylation during cryopreservation.

Generation of a dendritic cell-based vaccine in chronic lymphocytic leukaemia using CliniMACS platform for large-scale production.

We previously demonstrated that dendritic cells (DC) that have endocytosed apoptotic bodies of autologous leukemic cells (Apo-DC) can boost antileukemic T-cell responses. In this study, we report a description of the production procedure and product specification of the Apo-DC vaccine preparations for clinical use. Enriched populations of CD14+ monocytic precursors and CD19+ leukaemic cells were obtained using CliniMACS technology from a single leukapheresis product. Apoptotic bodies were obtained by irradiating (5 Gy) CD19+ selected B cells. DC were generated ex vivo by culturing monocytes with granulocyte macrophage colony-stimulating factor and interleukin-4. Following coculture with apoptotic bodies, DCs were matured with tumour necrosis factor-alpha. The mean percentage of CD14+ cells in the peripheral blood as well as in the leukapheresis product of the patients (n = 10) was approximately 2% (range, 0.8-3.3). Immunomagnetic selection using the CD14 reagent yielded a CD14+ population that was 91 +/- 2.2% (mean +/- SEM) pure. Immunomagnetic selection of CD19 expressing cells yielded a population that was 100 +/- 0.03% pure. Cell viability immediately after selection was 97% and 98% after 7 days of culture. The Apo-DC cellular vaccine product showed a mature phenotype, with a high rate of endocytosis (84%) of apoptotic leukemic B-cells. In conclusion, despite significant variability in the circulating monocyte frequency of the chronic lymphocytic leukaemia patients, our method permitted the production of a DC vaccine with high reproducibility and conforming with recommended quality standards.

Microbiological evaluation of a commercial transport system for urine samples.

The aim of this study was to evaluate a commercial tube prepared with boric acid, sodium formate and sorbitol (Hemogard Vacutainer tubes, Becton-Dickinson, HG tubes). Fourteen bacterial strains were incubated in urine in HG tubes and conventional tubes. During a 24-h period, most of the microorganisms grew readily in conventional tubes at room temperature, whereas the bacterial counts were comparatively unchanged when chilled or kept in HG tubes. The bacterial counts of Alcaligenes faecalis and lactobacilli decreased by two 10 logarithms in the HG tubes, at room temperature. Experiments were also performed with the addition of various antibiotics. Ciprofloxacin caused a decrease in E. coli counts regardless of type of tube used, while the HG tubes and the conventional tubes kept chilled conserved bacterial counts upon challenge with fosfomycin, trimethoprim or mecillinam. Bedside cultures from 154 outpatients were sampled and divided into three tubes. One conventional tube was sent to our laboratory by ordinary chilled transport. Another conventional tube and one HG tube were transported to the laboratory without chilling. Cultures were performed upon arrival at the laboratory and then 24, 48 and 72 h after primary sampling. Within 24 h of sampling, no significant differences in bacterial counts were observed between chilled conventional tubes and the HG tubes at room temperature. However, in the HG tubes a significant change in enterococcal counts was noted within 48 h.

Self-rated health. Comparisons between three different measures. Results from a population study.

BACKGROUND: Self-rating of health is among the most frequently assessed health perceptions in epidemiological research. The aim of this study was to compare different measures of global self-rated health (SRH) with respect to differences in age and sex groups and relations to hypothesized determinants. METHOD: Three single-question measures of SRH were included in a health questionnaire administered to 8200 randomly chosen men and women. Two SRH measures were non-comparative, one with seven (SRH-7) and one with five response options (SRH-5), while the third measure included a comparison with others of the same age (SRH-age). SRH-7 had specified response options only at the ends of the scale, while the other two measures gave specified statements for each option. Comparisons between the SRH assessments were studied with respect to response frequencies, frequency distributions, age and gender differences and differences in associations with hypothesized determinants. RESULTS: The differences between the SRH measures were in most cases marginal. Some diversities may, however, be worth considering: a high drop-out rate for the SRH-7 measure in the oldest age group; a trend that SRH-7 correlated most strongly with the independent variables; SRH-age showed improved health ratings with increasing age but a less skewed frequency distribution compared to the non-comparative measures. CONCLUSIONS: The results imply that non-comparative measures are more appropriate in longitudinal studies and that measures without specified response options might be less suitable for an older study group. The overall impression is, however, that the different measures represents parallel assessments of subjective health.

Gastric cancer and human leukocyte antigen: distinct DQ and DR alleles are associated with development of gastric cancer and infection by Helicobacter pylori.

DNA and sera from 130 cases of gastric cancer and 263 population-based controls were analyzed to study the association of HLA class II DR-DQ alleles with Helicobacter pylori (Hp) infection and the risk for gastric cancer. Presence of the DQA1*0102 allele was inversely and significantly associated with Hp seropositivity (P = 2 x 10(-5)), which is an independent replication of previous findings. However, this inverse relationship with Hp did not correspond with a reduced risk of gastric cancer. At the DRB1 locus, the *1601 allele was significantly associated with an increased gastric cancer risk with an odds ratio (95% confidence interval) of 8.7 (range, 2.7-28.0). The effect of *1601 was more pronounced among Hp-negative subjects, and the association was stronger with the diffuse, rather than with the intestinal, histological type of gastric cancer. Because none of the HLA alleles were associated with both Hp infection and gastric cancer, the HLA DR-DQ alleles are linked with gastric cancer risk through other mechanisms than an increased susceptibility to Hp infection.

Defective heparan sulfate biosynthesis and neonatal lethality in mice lacking N-deacetylase/N-sulfotransferase-1.

Heparan sulfate is a sulfated polysaccharide present on most cell surfaces and in the extracellular matrix. In vivo functions of heparan sulfate can be studied in mouse strains lacking enzymes involved in the biosynthesis of heparan sulfate. Glucosaminyl N-deacetylase/N-sulfotransferase (NDST) catalyzes the first modifying step in the biosynthesis of the polysaccharide. This bifunctional enzyme occurs in several isoforms. We here report that targeted gene disruption of NDST-1 in the mouse results in a structural alteration of heparan sulfate in most basement membranes as revealed by immunohistochemical staining of fetal tissue sections using antibodies raised against heparan sulfate. Biochemical analysis of heparan sulfate purified from fibroblast cultures, lung, and liver of NDST-1-deficient embryos demonstrated a dramatic reduction in N-sulfate content. Most NDST-1-deficient embryos survive until birth; however, they turn out to be cyanotic and die neonatally in a condition resembling respiratory distress syndrome. In addition, a minor proportion of NDST-1-deficient embryos die during the embryonic period. The cause of the embryonic lethality is still obscure, but incompletely penetrant defects of the skull and the eyes have been observed.

Overexpression of different isoforms of glucosaminyl N-deacetylase/N-sulfotransferase results in distinct heparan sulfate N-sulfation patterns.

Functional interactions of heparan sulfate (HS) with selected proteins depend on distinct saccharide sequences which are generated during biosynthesis of the polysaccharide. Glucosaminyl N-deacetylase/N-sulfotransferases (NDSTs) catalyze both the N-deacetylation and N-sulfation reactions that initiate the modification of the (GlcNAc-GlcA)(n) polysaccharide backbone. The N-acetyl/N-sulfate exchange is restricted to certain regions of the polysaccharide chains, and only these can be further modified by glucuronyl C5-epimerization and O-sulfation at various positions. To investigate whether NDST isoforms influenced differently the structure of HS, murine NDST-1 was overexpressed in human kidney 293 cells, and the structure of the HS produced was compared to HS from NDST-2 overexpressing cells [Cheung, W. F., Eriksson, I., Kusche-Gullberg M., Lindahl, U., and Kjellén, L. (1996) Biochemistry 35, 5250-5256]. The level of N-sulfation increased from 40% in control cells to 60% and 80%, respectively, in NDST-1 and NDST-2 transfected cells. Interestingly, the increase in N-sulfation was accompanied by an increased chain length, while no effect on IdoA content or O-sulfation was seen. The most extended N-sulfated domains were found in HS synthesized by NDST-2 transfected cells. Since both the N-deacetylase and the N-sulfotransferase activities were lower in these cells than in the NDST-1 overexpressing cells, we conclude that, in addition to the level of enzyme expression, the NDST isoform also is important in determining the N-sulfation pattern in HS.

Minimally invasive treatment of infection staghorn stones with shock wave lithotripsy and chemolysis.

We report the results in 118 patients with infection staghorn stones treated with an anaesthesia-free minimally invasive method that combined repeated shock-wave lithotripsy (SWL) sessions (unmodified Dornier HM3 lithotripter) and percutaneous chemolysis with Renacidin. The stone-free rate was 60%. In 27 consecutive patients with infection staghorn stones representative of patients with this stone type in the population, a stone-free rate of 77% was recorded. The latter figure is comparable with results reported for open surgery, percutaneous surgery and sandwich therapy, and superior to that recorded with SWL alone. During the study period, no patient referred to us with an infection staghorn stone was treated with percutaneous, ureteroscopic or open surgery, and all treatments were carried out without regional or general anaesthesia. The described treatment concept had a very low complication rate, but required a fairly long hospital stay, with a mean of 32 days (range: 5-82). The long period necessary for completing the treatment in the most complicated cases might render the procedure less attractive as a standard method, but it is nevertheless an excellent option in high-risk patients and in all those patients in whom other procedures are impossible.

Abnormal mast cells in mice deficient in a heparin-synthesizing enzyme.

Heparin is a sulphated polysaccharide, synthesized exclusively by connective-tissue-type mast cells and stored in the secretory granules in complex with histamine and various mast-cell proteases. Although heparin has long been used as an antithrombotic drug, endogenous heparin is not present in the blood, so it cannot have a physiological role in regulating blood coagulation. The biosynthesis of heparin involves a series of enzymatic reactions, including sulphation at various positions. The initial modification step, catalysed by the enzyme glucosaminyl N-deacetylase/N-sulphotransferase-2, NDST-2, is essential for the subsequent reactions. Here we report that mice carrying a targeted disruption of the gene encoding NDST-2 are unable to synthesize sulphated heparin. These NDST-2-deficient mice are viable and fertile but have fewer connective-tissue-type mast cells; these cells have an altered morphology and contain severely reduced amounts of histamine and mast-cell proteases. Our results indicate that one site of physiological action for heparin could be inside connective-tissue-type mast cells, where its absence results in severe defects in the secretory granules.

[3H]tiagabine binding to GABA uptake sites in human brain.

The binding of [3H]tiagabine ((RS-1-(4,4-(3-methyl-2-thienyl)-3-butenyl)-3-piperidine carboxylic acid) to homogenates of frozen post-mortem human brain has been characterized. Inhibition experiments with gamma-aminobutyric acid (GABA), GABA uptake inhibitors, ligands active at postsynaptic GABA receptors and receptors for other neurotransmitters, suggest that [3H]tiagabine binds with high affinity to GABA uptake sites. Inhibition and kinetic experiments suggests that 70%-80% of the binding is to a high affinity site. Saturation experiments showed that the binding was saturable. Bmax was 3.4 pmol/mg protein and Kd 16 nM in frontal cortex. The dissociation constants (Kd) measured in kinetic and equilibrium experiments were in the same range (16-56 nM). The regional distribution was studied in nine brain regions and the binding was heterogenous, with the highest binding in frontal cortex and parietal cortex and the lowest binding in nucleus caudatus and putamen. This is, to our knowledge, the first study on [3H]tiagabine binding in human tissue. It is concluded that [3H]tiagabine binding can be used as a specific marker for the GABA transporter GAT-1 in homogenates of human brain.

'Misplacement' of elderly people in the caring organisation: reasons and alternatives.

The degree of misplacement in the care organisation was studied in a repeated cross-sectional study (788 persons in 1993 and 1538 in 1988, 65 years and older) in Sundsvall, an industrial city in the middle of Sweden. The overall misplacements were 23% both in 1988 and 1993. Misplacements were most frequent in the homes for the aged (about 50%). At the nursing homes, misplacement decreased from 27 to 12% between 1988 and 1993, while it has increased in home care from 8 to 27%. Almost half of the misplacements in home care needed nursing home or psychogeriatric care. The main conclusion is that the care organisation is not working optimally. The number of misplacements reflects an exhausted care situation. The concept of misplacement is probably valuable, but its usefulness must be evaluated in further studies.

An experimental head restraint concept for primary prevention of head and neck injuries in frontal collisions.

The Experimental Head Restraint Concept (EHRC), a 'safety belt' for the head, is designed to reduce forces to the head and neck, in frontal car crashes. The EHRC was evaluated experimentally in frontal collision for a crash severity of 11 m/s, and numerically in frontal collision for a crash severity of 11 and 15 m/s. Experimental data obtained from a frontal barrier test (11 m/s) showed a 67% reduction of the HIC value from 411 (without EHRC) to 136 (with EHRC). The same level of reduction was also obtained for the higher speed in the numerical simulation. The moment in the neck was shown in experimental configuration to increase a few percent using the EHRC, but as presented in a numerical analysis, the moment was reduced by stiffening the EHRC. The EHRC clearly has a potential role in the search for primary prevention of neurotrauma injuries in frontal related car crashes. However, there is a strong need for more advanced injury criteria for the neck in order to optimize such complex safety systems.

Identification and expression in mouse of two heparan sulfate glucosaminyl N-deacetylase/N-sulfotransferase genes.

The biosynthesis of heparan sulfate/heparin is a complex process that requires the coordinate action of a number of different enzymes. In close connection with polymerization of the polysaccharide chain, the modification reactions are initiated by N-deacetylation followed by N-sulfation of N-acetylglucosamine units. These two reactions are carried out by a single protein. Proteins with such dual activities were first purified and cloned from rat liver and mouse mastocytoma. The mouse mastocytoma enzyme is encoded by an approximately 4-kilobase (kb) mRNA, whereas the rat liver transcript contains approximately 8 kb. In the present study, the primary structure of the enzyme encoded by the mouse 8-kb transcript is described. It is demonstrated that both the 4-and 8-kb transcripts have a wide tissue distribution and that they are encoded by separate genes. Characterization of the gene encoding the 4-kb transcript demonstrates that it spans a region of about 8 kb and that it contains at least 14 exons. The similarity of this gene and the previously characterized human gene for the 8-kb transcript is discussed.

High resolution genetic typing of the class II HLA-DRB1 locus using group-specific amplification and SSO-hybridisation in microplates.

The HLA-DRB1 locus is one of the most polymorphic HLA class II loci and rapid and accurate typing of this polymorphism is important both in bone-marrow transplantation, analysis of disease association and in forensic medicine. The allelic variation at DRB1 is characterized by combinations of a limited number of amino-acid motifs, reducing the resolution of a typing strategy based on a single PCR and subsequent analysis of polymorphic motifs. In the present paper we describe a strategy for typing of DRB1 based on eight allele-specific PCRs followed by sandwich hybridization to immobilized probes in a microplate format. The combined approach results in a rapid typing system with very high resolution. Using a rapid DNA extraction protocol, a complete HLA-DRB1 typing can be performed in less than a day.

Detection of serum interferon-alpha by dissociation-enhanced lanthanide fluoroimmunoassay. Studies of patients with acute viral and bacterial infections.

A sensitive dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA) was evaluated for ability to detect interferon-alpha (IFN-alpha) in serum of patients with acute infectious disease of less than one week's duration and a fever of > 38 degrees C. None of 36 patients with confirmed or probable bacterial disease was IFN-alpha positive. In contrast, 13/26 patients with viral infections had detectable levels of IFN-alpha in serum, all clearly positive (> or = 10 U/ml). The IFN-alpha positive serum samples were obtained early after onset of clinical disease, after a mean of 2.4 days. The IFN-alpha positive samples were obtained from 10 of the 12 patients with influenza or flu-like infection, and 3 of the 5 patients with varicella or herpes zoster. The IFN-alpha negative patients with viral disease (n = 9) included five patients with mononucleosis. The DELFIA should be useful in further studies of the value of IFN-alpha determinations in the identification of acute viral infections.

Mouse mastocytoma cells synthesize undersulfated heparin and chondroitin sulfate in the presence of brefeldin A.

In order to study the subcellular localization and organization of the enzymes involved in the glycosylation of the hybrid proteoglycan serglycin, mouse mastocytoma cells were metabolically labeled with [35S]sulfate or [3H]glucosamine in the absence or presence of brefeldin A. This drug is known to induce a disassembly of the proximal part of the Golgi complex, resulting in a redistribution of cis-, medial-, and trans-Golgi resident enzymes back to the endoplasmic reticulum, and to block the anterograde transport of proteins to the trans-Golgi network. Although the total incorporation of [3H]glucosamine into glycosaminoglycan chains was reduced to about 25% in brefeldin A-treated cells compared to control cells, both control cells and cells treated with brefeldin A synthesized heparin as well as chondroitin sulfate chains. Therefore, enzymes involved in the biosynthesis of both types of glycosaminoglycan chains seem to be present proximal to the trans-Golgi network in these cells. Chondroitin sulfate and heparin synthesized in cells exposed to brefeldin A were undersulfated, as demonstrated by ion-exchange chromatography, compositional analyses of disaccharides, as well as by a lower [35S]sulfate/[3H]glucosamine ratio compared to controls. In heparin biosynthesis, both N- and O-sulfation reactions were impaired, with a larger relative decrease in 2-O-sulfation than in 6-O-sulfation. Despite undersulfation, the heparin chains synthesized in the presence of brefeldin A were larger (30 kDa) than the heparin synthesized by control cells (20 kDa). The reduced [3H]glucosamine incorporation in brefeldin A-treated cells was partly due to decreased number of glycosaminoglycan chains synthesized, but also to the biosynthesis of chondroitin sulfate chains of smaller molecular size (8 versus 15 kDa in control cells). Brefeldin A had no effect on the glycosaminoglycan synthesis when used in a cell-free, microsomal fraction, indicating that brefeldin A does not interfere directly with the enzymes involved in the biosynthesis of glycosaminoglycans.

Idiotype-specific T lymphocytes in monoclonal gammopathies: evidence for the presence of CD4+ and CD8+ subsets.

Tumour-specific CD4+ T helper (Th) and CD8+ T cytotoxic (Tc) cells may participate in the control and eradication of tumour cells. In the present study, idiotype-specific stimulation of CD4+ and CD8+ blood T cells from patients with monoclonal gammopathy of undetermined significance and patients with untreated multiple myeloma stage I was examined. Activation was measured in the CD4+ and CD8+ subsets enriched by magnetic microbeads as the incorporation of 3H-thymidine and the secretion of interferon (IFN)-gamma, interleukin (IL)-2 and IL-4 by single cells using the enzyme-linked immunospot assay. Idiotype-specific T cells were found in four of seven patients. Stimulation was mainly confined to the CD4+ subset in three of the four responding patients. This type of response was major histocompatibility complex (MHC) class II restricted as it could be inhibited by monoclonal antibodies against MHC class II (HLA-DR), but not against class I (HLA-ABC) molecules. Idiotype-specific CD8+ T cells were also demonstrated in these patients although at a lower frequency. One patient showed a strong and dominating activation of CD8+ T cells which could be blocked by antibodies against HLA-ABC but not against HLA-DR. Idiotype-specific CD4+ or CD8+ T cells were mainly of the type-1 subsets as judged by their secretion of IFN-gamma and IL-2. Thus, this study provides evidence for the presence of idiotype-specific and MHC-restricted CD4+ and CD8+ T cells of the type-1 subsets in patients with monoclonal gammopathies. Such T cells with the potential to control the growth of tumour B cells may be a suitable target for immunotherapeutic interventions in patients.