Defective E-cadherin/catenin complexes in human cancer.

Cancer is caused by a series of genomic changes leading directly or indirectly to disturbance of growth, differentiation and tissue integrity. Genomic, transcriptional or posttranscriptional alterations of E-cadherin/catenin complexes that are implicated in various steps of cancer development comprise mutational inactivation, transcriptional downregulation of E-cadherin sometimes accompanied by upregulation of N-cadherin, proteolysis of E-cadherin and posttranslational stabilisation of beta-catenin and plakoglobin. The E-cadherin/catenin complex serves not only cell-cell adhesion but also transduces signals to the nucleus and to the cytoskeleton, either directly or through its connections with multiple other complexes. We review here the expression of E-cadherin/catenin in human cancers, emphasising methods of observation and prognostic interpretation of results. This is illustrated in thyroid lesions from the benign follicular adenoma to the extremely malignant anaplastic carcinoma. The eye is an organ largely neglected by students of cadherins and catenins. The implication of a variety of members of these molecular families in the embryonic development of the eye strongly suggests that disturbances of cadherin/catenin complexes are crucial also in the development of ocular tumours.

Aortic stenosis. Gender influence on left ventricular geometry and function in patients under 70 years of age.

OBJECTIVE: To verify if adaptive left ventricle (LV) characteristics are also present in individuals under 70 years of age with severe aortic stenosis (AS). METHODS: The study comprised 40 consecutive patients under 70 years of age with AS and no associated coronary artery disease, referred for valve surgery. Out of the 40 patients, 22 were men and 18 women, and the mean age was 49.8 +/- 14.3 years. Cardiac symptoms, presence of systemic hypertension (SH), functional class according to the New York Heart Association (NYHA), and valve lesion etiology were considered. LV cavity dimensions, ejection fraction (EF), fractional shortening (FS), mass (MS), and relative diastolic thickness (RDT) were examined by Doppler echocardiography. RESULTS: Fourteen (63.6%) men and 11 (61.6%) women were classified as NYHA class III/IV (p = 0.70). There was no difference in the frequency of angina, syncope or dyspnea between genders. The incidence of SH was greater in women than in men (10 versus 2, p = 0.0044). Women had a smaller LV end-diastolic diameter index (32.1 +/- 6.5 x 36.5 +/- 5.3 mm/m2, p = 0.027), LV end-systolic diameter index (19.9 +/- 5.9 x 26.5 +/- 6.4 mm/m2, p = 0.0022) and LV mass index (MS) (211.4 +/- 71.1 x 270.9 +/- 74.9 g/m2, p = 0.017) when compared with men. EF (66.2 +/- 13.4 x 52.0 +/- 14.6%, p = 0.0032), FS (37.6 +/- 10.7 x 27.9 +/- 9.6%, p = 0.0046) and RDT (0.58 +/- 0.22 x 0.44 +/- 0.09, p = 0.0095) were significantly greater in women than in men. CONCLUSION: It is the patient gender rather than age that influences left ventricular adaptive response to AS.

[Coronary artery dissection without acute myocardial infarction]. / Dissecção de Artéria coronária sem infarto agudo do miocárdio.

A 57 year-old-man with acute aortic dissection (DeBakey type I) who developed right coronary artery dissection without acute myocardial infarction. He was successful surgically treated and became asymptomatic.

[Silent myocardial ischemia. Experience with ambulatory electrocardiographic monitoring]. / Isquemia miocárdica silenciosa. Experiência com a moniorização eletrocardiográfica ambulatoriai.

A 24-hour recording of ambulatory EKG (Holter) was obtained in 159 patients with coronary disease: previous myocardial infarction (n = 76), myocardial revascularization (n = 66), severe obstruction during cine-coronarography (n = 13) or during coronary angioplasty (n = 4). Prophylactic anti-anginal drugs were maintained during the Holter and, despite the medication, transitory episodes of myocardial ischemia (MI) were recorded in 51 patients (32%), either with angina (AMI) or silent (SMI), isolated SMI was recorded in 44 patients (86%), 6 subjects had both SMI (16 episodes) and AMI (12 episodes) and one patient had only one episode of AMI. There was a total of 119 episodes of MI, 106 of SMI (89.1%) and 13 AMI (10.9%). The total duration of the episodes of SMI per patient varied from 1 min to 235 min and the IMS maximal duration was 221 min. In the six cases with both SMI and AMI, the total duration of SMI was 461 min and AMI was 306 min. The circadian distribution of the episodes of SMI was: from 12:00 to 18:00-31.4%, 18:00 to 24:00-27.6%, 0:00 to 6:00-7.7% and 6:00 to 12:00-33.3%. The SMI activity was recorded in 89 episodes-23.6% during sleep, 22.4% at rest, 46% during physical activity and 8% during other activities. The mean ST segment depression during SMI (n = 106) was of -2.25 mm and during AMI (n = 13) was of -3.25 mm.(ABSTRACT TRUNCATED AT 250 WORDS)