ABSTRACT
BACKGROUND: Sox11 is a transcription factor expressed in foetal and neoplastic brain tissue, including gliomas. It has been shown to suppress the tumourigenicity of glioma stem cells in vivo, thereby being hypothesised to function as a tumour suppressor. METHODS: We investigated the expression of Sox11 in 132 diffuse astrocytomas in relation to the regulator cell marker nestin, c-Met and IDH1-R132H, which have shown to be differentially expressed among the molecular subgroups of malignant gliomas, as well as to an inducer of astrocytic differentiation, that is, signal transducer and activator of transcription (p-STAT-3), clinicopathological features and survival. RESULTS: Sox11 immunoreactivity was identified in all tumours irrespective of grade, but being correlated with p-STAT-3. Three out of seven cases showed partial Sox11 promoter methylation. In >50% of our cases neoplastic cells coexpressed Sox11 and nestin, a finding further confirmed in primary glioblastoma cell cultures. Furthermore, nestin, c-Met and IDH1-R132H expression differed among grade categories. Cluster analysis identified four groups of patients according to c-Met, nestin and IDH1-R132H expression. The c-Met/nestin high-expressor group displayed a higher Sox11 expression. Sox11 expression was an indicator of favourable prognosis in glioblastomas, which remained in multivariate analysis and validated in an independent set of 72 cases. The c-Met/nestin high-expressor group was marginally with shorter survival in univariate analysis. CONCLUSIONS: We highlight the importance of Sox11 expression as a favourable prognosticator in glioblastomas. c-Met/nestin/IDH1-R132H expression phenotypes recapitulate the molecular subgroups of malignant glioma.
Subject(s)
Astrocytoma/genetics , Brain Neoplasms/genetics , Intermediate Filament Proteins/genetics , Isocitrate Dehydrogenase/genetics , Nerve Tissue Proteins/genetics , Proto-Oncogene Proteins c-met/genetics , SOXC Transcription Factors/genetics , Adult , Aged , Aged, 80 and over , Amino Acid Substitution , Arginine/genetics , Astrocytoma/diagnosis , Astrocytoma/metabolism , Astrocytoma/mortality , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Brain Neoplasms/diagnosis , Brain Neoplasms/metabolism , Brain Neoplasms/mortality , Cohort Studies , Female , Gene Expression Regulation, Neoplastic , Histidine/genetics , Humans , Intermediate Filament Proteins/metabolism , Isocitrate Dehydrogenase/metabolism , Male , Middle Aged , Nerve Tissue Proteins/metabolism , Nestin , Phenotype , Phosphorylation , Prognosis , Protein Kinases/metabolism , Proto-Oncogene Proteins c-met/metabolism , SOXC Transcription Factors/metabolism , STAT3 Transcription Factor/metabolism , Survival Analysis , Tumor Cells, Cultured , Young AdultABSTRACT
BACKGROUND: This study describes and evaluates the early results of a new surgical technique to reconstruct the right ventricular outflow tract and fit it with a new valve after the Ross procedure. METHODS AND RESULTS: Between March 1996 and November 1997, 20 patients underwent a Ross operation with a new approach consisting of a direct anastomosis between the remaining pulmonary artery trunk and the infundibulum and of the creation of a monocusp tailored from the anterior pulmonary artery wall as a means of reconstructing the valve. The 20 patients (12 males and 8 females) had a mean age of 27.4 years (range, 17 to 42 years). Ten of them had predominant aortic regurgitation, 8 had aortic stenosis, and 2 had mixed disease. There were no deaths during the follow-up period of up to 20 months, no early or late repeat operations, and no specific complications secondary to the surgical technique. During the follow-up, at the aortic autograft site, 19 patients had no or trivial regurgitation, and a mild regurgitation was found in only 1 patient. Across the pulmonary monocusp, color flow Doppler demonstrated no or trivial incompetence in 10 patients, mild incompetence in 7, and moderate incompetence in 3. No significant pressure gradient was shown. CONCLUSIONS: Our experience supports the use of this new surgical procedure and allows extension of the Ross operation to where there are no facilities for homografts. It may be an alternative for right ventricular outflow tract reconstruction with a homograft should the results be confirmed at long-term follow-up.
Subject(s)
Pulmonary Valve/surgery , Ventricular Outflow Obstruction/surgery , Adolescent , Adult , Aorta/surgery , Echocardiography, Doppler, Color , Female , Humans , Male , Medical Illustration , Postoperative Complications , Pulmonary Artery/transplantation , Pulmonary Valve/physiopathology , Transplantation, Autologous , Treatment OutcomeABSTRACT
The efficacy and safety of spiramycin were compared with those of penicillin V in the treatment of 55 patients with acute bacterial tonsillitis. The most frequently isolated pathogens were streptococci and about one-third were group A/beta haemolytic streptococci. There was one clinical failure in the patients treated with penicillin, and none with spiramycin. No side effects were reported in either of the treatment groups. Thus in this study, spiramycin proved to be equivalent to penicillin in the treatment of acute bacterial tonsillitis in adults.
