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3.
Klin Onkol ; 29 Suppl 4(Suppl 4): 72-77, 2016.
Article in Czech | MEDLINE | ID: mdl-27846724

ABSTRACT

BACKGROUND: Correct function of the immune system depends on close cooperation between stimulation and inhibition signals, which protect an organism from outside microorganisms and other agents, but also protects healthy tissues against possible self-destructing attacks of the immune system. However, the inhibitory mechanisms can be abused by cancer cells that evade immune responses and, in fact, they help develop cancer. Therefore, one of the characteristics of cancer cells is the ability to evade immune recognition. Immunotherapy is a treatment method that stimulates the immune system to fight cancer. The checkpoints of the immune system can be considered as effective and specific therapeutic targets. Programmed cell death signaling pathway (PD-1/PD-L1) is one of the most discussed inhibition pathways in recent years. Blockage of PD-1/PD-L1 interaction restores mechanisms of immune response and increases antitumor immune activity. Monoclonal antibodies blocking PD-1 receptor or its ligand PD-L1 have already shown clinical efficacy. However, it is important to carry out research to explore the mechanisms of PD-1/PD-L1 pathway to find new factors, which influence its activity and, of course, to illuminate the variability of this pathway which naturally originates in the diversity of the tumor milieu. Obtained results could be utilized to achieve maximal anticancer effect after inhibition of PD-1/PD-L1 signaling pathway useful in clinical practice. AIM: The aim of the article is to summarize current knowledge about PD-1/PD-L1 signaling pathway and to discuss its role in antitumor immune response.Key words: programmed cell death pathway - tumor escape - PD-1 - PD-L1 - CD274This work was supported by the project MEYS - NPS I - LO1413.The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 6. 2016Accepted: 4. 8. 2016.


Subject(s)
B7-H1 Antigen/metabolism , Neoplasms/immunology , Neoplasms/metabolism , Programmed Cell Death 1 Receptor/metabolism , Tumor Escape/immunology , B7-H1 Antigen/antagonists & inhibitors , Humans , Neoplasms/drug therapy , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Signal Transduction
4.
Rofo ; 188(8): 746-52, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27388996

ABSTRACT

PURPOSE: The aim of this study was to evaluate the technical feasibility and short-time patency rate of iliac side branch devices based on the authors' institution's experience. MATERIALS AND METHODS: Data of 17 patients (all men) with an aortoiliac aneurysm (median age 72.5 years) who underwent endovascular repair between October 2013 and June 2015 (20 months) at our institution was analyzed retrospectively. Primary endpoint was primary technical success, defined as adequate implantation of the iliac branch device with patency of the hypogastric side branch without the need of further re-interventions within 30 days. Mean follow-up was 8.2 ±â€Š5.4 months. RESULTS: Eighteen iliac side branch devices were implanted with a branch patency of 100 % and a primary technical success rate of 94.4 % (n = 17). Perioperative 30 days mortality was 0 %. The mean diameter of treated abdominal aorta and common iliac artery was 41 ±â€Š14 and 30 ±â€Š8 mm. In one case partial dislocation of the iliac side branch device occurred due to severe kinking of iliac arteries with development of an iliac endoleak type Ib that had to be treated in a second intervention. Three patients (15 %) showed an endoleak type II from the inferior mesenteric artery without the need of re-intervention. After three months one patient suffered from subtotal thrombotic occlusion of the bridging stent that was successfully resolved through intra-arterial fibrinolytic therapy and additional stent graft implantation. CONCLUSION: Summarized, implantation of iliac side branch devices is a feasible technique with favourable short-term results in patients with aortoiliac aneurysm. KEY POINTS: • Implantation of iliac side branch devices is a feasible technique.• Distinguish short-term results of side branch endografting in patients with aortoiliac aneurysm.• Carefully patient selection is necessary to avoid complications and re-interventions. Citation Format: • Maus V, Kurz P, Sommer CM et al. The Use of Iliac Side Branch Devices in Patients with Aortoiliac Aneurysm.. Fortschr Röntgenstr 2016; 188: 746 - 752.


Subject(s)
Aortic Aneurysm, Abdominal/diagnosis , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis , Graft Rejection/etiology , Iliac Aneurysm/diagnosis , Iliac Aneurysm/surgery , Aged , Aged, 80 and over , Feasibility Studies , Female , Graft Survival , Humans , Longitudinal Studies , Male , Middle Aged , Postoperative Complications , Prosthesis Design , Risk Factors , Survival Rate , Treatment Outcome , Vascular Patency
5.
Unfallchirurg ; 117(1): 72-4, 2014 Jan.
Article in German | MEDLINE | ID: mdl-23483252

ABSTRACT

The occurrence of aortic dissections after deceleration trauma is commonplace but aortic injuries after blunt trauma are extremely rare complications. We report a case of an acute aortic rupture accompanied by a type B dissection after a skiing accident with blunt thoracic trauma and renal contusion. The leading symptom was the onset of hematuria 12 h later. The computed tomography (CT) angiography permitted the exact diagnosis and the patient was transferred for acute thoracic endovascular aortic repair. This regimen resulted in the patient achieving a stable condition and potentially harmful complications could be avoided.


Subject(s)
Aortic Dissection/surgery , Aortic Rupture/surgery , Athletic Injuries/surgery , Multiple Trauma/surgery , Skiing/injuries , Wounds, Nonpenetrating/surgery , Accidents , Aged , Aortic Dissection/diagnosis , Aortic Rupture/diagnosis , Athletic Injuries/diagnosis , Humans , Male , Multiple Trauma/diagnosis , Treatment Outcome , Wounds, Nonpenetrating/diagnosis
7.
Oncogene ; 32(20): 2499-509, 2013 May 16.
Article in English | MEDLINE | ID: mdl-22945652

ABSTRACT

Clinical studies have defined the core 'genetic blueprint' of a cancer cell, but this information does not necessarily predict the cancer phenotype. Signalling hubs that mediate such phenotype have been identified largely using OMICS platforms that measure dynamic molecular changes within the cancer cell landscape. The pro-oncogenic protein anterior gradient 2 (AGR2) is a case in point; AGR2 has been shown using a range of expression platforms to be involved in asthma, inflammatory bowel disease, cell transformation, cancer drug resistance and metastatic growth. AGR2 protein is also highly overexpressed in a diverse range of human cancers and can be secreted and detected in extracellular fluids, thus representing a compelling pro-oncogenic signalling intermediate in human cancer. AGR2 belongs to the protein disulphide isomerase family with all the key features of an endoplasmic reticulum-resident protein-this gives clues into how it might function as an oncoprotein through the regulation of protein folding, maturation and secretion that can drive metastatic cell growth. In this review, we will describe the known aspects of AGR2 molecular biology, including gene structure and regulation, emerging protein interaction networks and how its subcellular localization mediates its biological functions. We will finally review the cases of AGR2 expression in human cancers, the pathophysiological consequences of AGR2 overexpression, its potential role as a tumour biomarker that predicts the response to therapy and how the AGR2 pathway might form the basis for drug discovery programmes aimed at targeting protein folding/maturation pathways that mediate secretion and metastasis.


Subject(s)
Endoplasmic Reticulum/metabolism , Gene Expression Regulation, Neoplastic , Neoplasms/genetics , Proteins/genetics , Proteins/metabolism , Amino Acid Motifs , Androgens/metabolism , Animals , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Carrier Proteins/genetics , Carrier Proteins/metabolism , Drug Resistance, Neoplasm , Estrogens/metabolism , Extracellular Fluid/metabolism , Female , Gene Expression Regulation, Developmental , Humans , Mucoproteins , Multigene Family , Neoplasm Proteins/genetics , Neoplasm Proteins/metabolism , Neoplasms/drug therapy , Neoplasms/metabolism , Neoplasms/physiopathology , Oncogene Proteins , Promoter Regions, Genetic , Protein Interaction Maps , Tamoxifen/pharmacology
8.
Vet J ; 196(3): 414-23, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23219486

ABSTRACT

Cancer stem cells were identified in a feline mammary carcinoma cell line by demonstrating expression of CD133 and utilising the tumour sphere assay. A population of cells was identified that had an invasive, mesenchymal phenotype, expressed markers of pluripotency and enhanced tumour formation in the NOD-SCID mouse and chick embryo models. This population of feline mammary carcinoma stem cells was resistant to chemotherapy and radiation, possibly due to aberrant activation of the ATM/p53 DNA damage pathway. Epithelial-mesenchymal transition was a feature of the invasive phenotype. These data demonstrate that cancer stem cells are a feature of mammary cancer in cats.


Subject(s)
Ataxia Telangiectasia Mutated Proteins/metabolism , Cat Diseases/pathology , Drug Resistance, Neoplasm , Mammary Neoplasms, Animal/pathology , Neoplastic Stem Cells/physiology , Tumor Suppressor Protein p53/metabolism , AC133 Antigen , Adenosine Deaminase/deficiency , Agammaglobulinemia , Animals , Antigens, CD/genetics , Antigens, CD/metabolism , Antineoplastic Agents/pharmacology , Ataxia Telangiectasia Mutated Proteins/genetics , Carcinoma/veterinary , Cats , DNA Damage , Female , Gene Expression Regulation, Neoplastic/physiology , Glycoproteins/genetics , Glycoproteins/metabolism , Mice , Neoplasms, Experimental , Neoplastic Stem Cells/drug effects , Neoplastic Stem Cells/pathology , Neoplastic Stem Cells/radiation effects , Peptides/genetics , Peptides/metabolism , Severe Combined Immunodeficiency , Tumor Suppressor Protein p53/genetics
9.
Oncogene ; 29(34): 4838-47, 2010 Aug 26.
Article in English | MEDLINE | ID: mdl-20531310

ABSTRACT

Transcriptomic screens in breast cancer cell lines have identified a protein named anterior gradient-2 (AGR2) as a potentially novel oncogene overexpressed in estrogen receptor (ER) positive tumours. As targeting the ER is responsible for major improvements in cure rates and prevention of breast cancers, we have evaluated the pro-oncogenic function of AGR2 in anti-hormone therapeutic responses. We show that AGR2 expression promotes cancer cell survival in clonogenic assays and increases cell proliferation and viability in a range of cancer cell lines. Chromatin immunoprecipitation and reporter assays indicate that AGR2 is transcriptionally activated by estrogen through ERalpha. However, we also found that AGR2 expression is elevated rather than inhibited in response to tamoxifen, thus identifying a novel mechanism to account for an agonistic effect of the drug on a specific pro-oncogenic pathway. Consistent with these data, clinical analysis indicates that AGR2 expression is related to treatment failure in ERalpha-positive breast cancers treated with tamoxifen. In contrast, AGR2 is one of the most highly suppressed genes in cancers of responding patients treated with the anti-hormonal drug letrozole. These data indicate that the AGR2 pathway represents a novel pro-oncogenic pathway for evaluation as anti-cancer drug developments, especially therapies that by-pass the agonist effects of tamoxifen.


Subject(s)
Antineoplastic Agents, Hormonal/pharmacology , Breast Neoplasms/drug therapy , Proteins/metabolism , Tamoxifen/pharmacology , Breast Neoplasms/genetics , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Cell Line, Tumor , Cell Survival/drug effects , Cell Survival/physiology , Female , Humans , Mucoproteins , Oncogene Proteins , Prognosis , Transfection
10.
J Gen Virol ; 89(Pt 1): 87-96, 2008 Jan.
Article in English | MEDLINE | ID: mdl-18089732

ABSTRACT

Here, we demonstrate that human herpesvirus 6B (HHV-6B) infection upregulates the tumour suppressor p53 and induces phosphorylation of p53 at Ser392. Interestingly, phosphorylation at the equivalent site has previously been shown to correlate with p53 tumour suppression in murine models. Although the signalling pathways leading to Ser392 phosphorylation are poorly understood, they seem to include casein kinase 2 (CK2), double-stranded RNA-activated protein kinase (PKR), p38 or cyclin-dependent kinase 9 (Cdk9). By using column chromatography and in vitro kinase assays, CK2 and p38, but not PKR or Cdk9, eluted in column fractions that phosphorylated p53 at Ser392. However, treatment of cells with neither the CK2 and Cdk9 inhibitor 5,6-dichloro-1-beta-d-ribofuranosylbenzimidazole (DRB) nor p38 kinase inhibitors reduced HHV-6B-induced Ser392 phosphorylation significantly. Knockdown of the CK2beta subunit or p38alpha by small interfering RNA had no effect on HHV-6B-induced phosphorylation of p53 at Ser392. Thus, HHV-6B induces p53 Ser392 phosphorylation by an atypical pathway independent of CK2 and p38 kinases, whereas mitogen-activated protein (MAP) kinase signalling pathways are involved in viral replication.


Subject(s)
Casein Kinase II/metabolism , Herpesvirus 6, Human/physiology , Tumor Suppressor Protein p53/metabolism , p38 Mitogen-Activated Protein Kinases/metabolism , Casein Kinase II/genetics , Cell Line , Epithelial Cells/physiology , Epithelial Cells/virology , Humans , Phosphorylation , RNA, Small Interfering/genetics , Serine/analysis , Tumor Suppressor Protein p53/chemistry , p38 Mitogen-Activated Protein Kinases/genetics , p38 Mitogen-Activated Protein Kinases/isolation & purification
11.
Oncogene ; 26(8): 1137-46, 2007 Feb 22.
Article in English | MEDLINE | ID: mdl-16924239

ABSTRACT

We have previously reported tumour-selective killing by the sigma (sigma) receptor ligand rimcazole. We now report that rimcazole elevates hypoxia inducible factor-1alpha (HIF-1alpha) protein levels under normoxic conditions in colorectal (HCT-116) and mammary carcinoma (MDA MB 231) cells but fails to induce HIF-1alpha in normal fibroblasts or mammary epithelial cells. Combining the sigma-1 agonist (+)-pentazocine with rimcazole substantially reduces the accumulation of HIF-1alpha, confirming that the effect is mediated at least partly by antagonism of sigma-1 sites. HIF-1alpha knockdown by RNA interference attenuates rimcazole-induced cell death in both cell types. Thus, the induction of HIF-1alpha by rimcazole contributes to tumour cell killing. In a comparison of HCT-116p53+/+ and HCT-116p53-/- cells, HIF-1alpha levels are consistently higher after rimcazole treatment in HCT-116p53+/+ cells. Furthermore, although rimcazole kills HCT-116p53-/- cells, it has a more potent apoptosis-inducing effect in HCT-116p53+/+ cells. This suggests that the presence of functional p53 protein may enhance death induction by rimcazole in part through greater induction of HIF-1alpha. p53 is not required, however, for the rimcazole-induced engagement of HIF-1alpha in proapoptotic mode as HIF-1alpha knockdown attenuates rimcazole-induced death to comparable extents in p53 mutant and wild-type cell systems. Knowledge of HIF-1alpha involvement may assist the re-profiling of rimcazole and other sigma ligands as cancer therapeutics.


Subject(s)
Apoptosis , Carbazoles/pharmacology , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Neoplasms/metabolism , Receptors, sigma/antagonists & inhibitors , Cell Line, Tumor , Epithelial Cells/metabolism , Fibroblasts/metabolism , Humans , Hypoxia-Inducible Factor 1, alpha Subunit/antagonists & inhibitors , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Pentazocine/pharmacology , RNA Interference , Receptors, sigma/agonists , Tumor Suppressor Protein p53/metabolism , Up-Regulation
12.
Eur J Cancer ; 42(9): 1283-92, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16679013

ABSTRACT

Epithelial keratinocyte regeneration has been exemplified as dependent on a population of cellular progenitors that have retained developmental pluripotency, a latent capacity for proliferation and differentiation with a prolonged lifespan. Recent evidence suggests that the cell populations that regulate the development of normal tissues, and which play vital roles in maintaining the overall homeostasis of the tissue, might be the key target population that is essential for malignant cancer development, thus giving rise to the notion of 'cancer stem cells'. This review examines the leading research into the relationship between adult stem cells in human skin marked by p63alphaDeltaN, their putative importance in cancer development, and how we might exploit our evolving knowledge of adult tissue stem cells to aid cancer treatments in the future. Furthermore, the review examines information regarding ataxia telangiectasia mutated (ATM) kinase and key regulatory events that take place on p53, only within putative keratinocyte stem cells that are transcriptionally regulated by p63alphaDeltaN.


Subject(s)
Epithelial Cells/cytology , Keratinocytes/pathology , Neoplastic Stem Cells/pathology , Stem Cells/cytology , Cell Proliferation , Epithelial Cells/metabolism , Humans , Keratinocytes/metabolism , Membrane Proteins/metabolism , Neoplastic Stem Cells/metabolism , Skin/cytology , Tumor Suppressor Protein p53/metabolism
13.
Br J Dermatol ; 153(5): 1001-10, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16225614

ABSTRACT

BACKGROUND: Phosphorylation of the tumour suppressor p53 by the CK2/FACT pathway plays a central role in suppressing ultraviolet (UV)-induced skin cancer in animal models. Although p53 protein stabilization is induced after solar-simulated irradiation of human skin in vivo, p53 phosphorylation has not been defined. OBJECTIVES: To investigate the effects of clinically effective treatments for skin diseases including psoralen + UVA (PUVA) and photodynamic therapy (PDT) on p53 phosphorylation to determine whether the tumour-suppressing p53 kinase pathways are activated upon use of these therapies. METHODS: We used antibodies to the ATM/ATR and CK2/FACT phosphorylation sites on p53. RESULTS: We found that p53 activation was induced selectively by PUVA treatment, while 8-oxo-7,8-dihydroguanine DNA damage was induced selectively by 5-aminolaevulinic acid (ALA)-PDT treatment. Importantly, PUVA treatment resulted in p53 kinase activation, as defined by p53 modification at AT (serine-15) and CK2/FACT (serine-392) sites within the proliferative compartment. CONCLUSIONS: These data demonstrate that PUVA provokes accumulation and phosphorylation of p53 by AT and CK2/FACT within critical proliferative focal points (as determined by p63 colocalization studies) where DNA damage may lead to tumorigenesis. PDT is mechanistically distinct in that there is a lower level of induction of p53 expression with no evidence of AT- or CK2/FACT-mediated phosphorylation. This suggests that the type of DNA damage created by the reactive oxygen species generated by ALA-PDT does not induce the p53 pathway classically required for the repair of DNA photoadducts induced by UV.


Subject(s)
PUVA Therapy , Photochemotherapy , Skin/drug effects , Tumor Suppressor Protein p53/metabolism , Aminolevulinic Acid/therapeutic use , Apoptosis/drug effects , Apoptosis/radiation effects , Cyclin-Dependent Kinase Inhibitor p21/metabolism , DNA Damage , Humans , Keratinocytes/drug effects , Keratinocytes/radiation effects , Oxidative Stress/drug effects , Oxidative Stress/radiation effects , Phosphorylation/drug effects , Phosphorylation/radiation effects , Skin/metabolism , Skin/radiation effects
14.
Br J Dermatol ; 152(5): 1001-8, 2005 May.
Article in English | MEDLINE | ID: mdl-15888160

ABSTRACT

BACKGROUND: High-dose ultraviolet (UV) A1 therapy (doses in the order of 130 J cm(-2)) is effective for atopic dermatitis and scleroderma. UVA1 has been shown to induce a dose-dependent increase in p53 expression in keratinocytes. OBJECTIVES: To examine the effect of UVA1 on the activation of p53 by phosphorylation, which has not yet been studied. METHODS: Five adult volunteers were exposed to dose series of UVA1 (10-100 J cm(-2)) and, for comparison, narrowband UVB (TL-01) (25-550 mJ cm(-2)) and solar-simulated radiation (SSR) (5.6-30 J cm(-2)) on photoprotected buttock skin and the minimal erythema dose (MED) for each was determined at 24 h. Separate sites on the buttock were subsequently irradiated with a 3-MED dose of UVA1, TL-01 and SSR. At 24 h, punch biopsies (4 mm) were taken from each irradiated site and from an adjacent unirradiated control site, and immunohistochemical staining for p53 (Do-1), activation of p53 (assessed by phosphorylation at serine 15 and serine 392) and p21 was performed. Cell staining was expressed as the mean number of cells stained per three high-power fields (HPFs) and as a percentage of 1000 cells. Sunburn cells (SBCs) were also counted per HPF. RESULTS: UVA1 produced negligible numbers of SBCs, relatively little p53 (Do-1) staining (mean +/- SD cell count per HPF 16 +/- 10), no p53 activation and very little evidence of p21 expression (mean +/- SD cell count per HPF 5.3 +/- 7), in contrast to TL-01 (mean +/- SD cell count per HPF of 11.83 +/- 2.1 SBCs, 146.3 +/- 38 for Do-1, 26.6 +/- 15 for serine 15, 14.9 +/- 12 for serine 392 and 77.9 +/- 30 for p21) or SSR irradiation (mean +/- SD cell count per HPF of 3.5 +/- 1.2 SBCs, 147.5 +/- 62 for Do-1, 54 +/- 50 for serine 15, 38.9 +/- 18 for serine 392 and 56.7 +/- 30 for p21). CONCLUSIONS: These data indicate that there are fundamental differences in the effects of UVA1 on p53 and its activation pathways compared with TL-01 and SSR, and may in part explain the differential effects of these phototherapies.


Subject(s)
Cell Cycle Proteins/radiation effects , Skin/radiation effects , Sunlight , Tumor Suppressor Protein p53/radiation effects , Ultraviolet Rays , Adult , Apoptosis/radiation effects , Cell Cycle Proteins/metabolism , Cyclin-Dependent Kinase Inhibitor p21 , Erythema/etiology , Humans , Middle Aged , Phosphorylation/radiation effects , Radiation Dosage , Radiation Injuries/etiology , Skin/metabolism , Skin/pathology , Tumor Suppressor Protein p53/metabolism
16.
Br J Cancer ; 88(8): 1281-4, 2003 Apr 22.
Article in English | MEDLINE | ID: mdl-12698197

ABSTRACT

In the treatment of breast cancer, combination chemotherapy is used to overcome drug resistance. Combining doxorubicin and vinorelbine in the treatment of patients with metastatic breast cancer has shown high response rates; even single-agent vinorelbine in patients previously exposed to anthracyclines results in significant remission. Alterations in protein kinase-mediated signal transduction and p53 mutations may play a role in drug resistance with cross-talk between signal transduction and p53 pathways. The aim of this study was to establish the effects of doxorubicin and vinorelbine, as single agents, in combination, and as sequential treatments, on signal transduction and p53 in the breast cancer cell lines MCF-7 and MDA-MB-468. In both cell lines, increased p38 activity was demonstrated following vinorelbine but not doxorubicin treatment, whether vinorelbine was given prior to or simultaneously with doxorubicin. Mitogen-activated protein kinase (MAPK) activity and p53 expression remained unchanged following vinorelbine treatment. Doxorubicin treatment resulted in increased p53 expression, without changes in MAPK or p38 activity. These findings suggest that the effect of doxorubicin and vinorelbine used in combination may be achieved at least in part through distinct mechanisms. This additivism, where doxorubicin acts via p53 expression and vinorelbine through p38 activation, may contribute to the high clinical response rate when the two drugs are used together in the treatment of breast cancer.


Subject(s)
Doxorubicin/pharmacology , Genes, p53/drug effects , Mitogen-Activated Protein Kinases/metabolism , Vinblastine/analogs & derivatives , Vinblastine/pharmacology , Breast Neoplasms , Cell Line, Tumor , Drug Interactions , Female , Humans , Mitogen-Activated Protein Kinases/drug effects , Tumor Suppressor Protein p53/drug effects , Tumor Suppressor Protein p53/genetics , Tumor Suppressor Protein p53/metabolism , Vinorelbine , p38 Mitogen-Activated Protein Kinases
17.
Chirurg ; 74(4): 315-23, 2003 Apr.
Article in German | MEDLINE | ID: mdl-12719873

ABSTRACT

UNLABELLED: There are only four therapeutic options in minimally invasive vascular surgery. Combined open and endoluminal vascular repair is used most often to minimize surgical trauma. This procedure carries the risk of unfavorable long-term results, which must be hazarded in most elderly and critically ill patients. These new therapeutic procedures require a new generation of vascular surgeons. Besides endovascular surgery there is a new and interesting use of laparoscopic aortic surgery, which competes with endovascular surgery. Also endoscopic vein harvesting for bypass surgery is an interesting procedure to minimize surgical trauma. Minimally invasive procedures for varicose vein disease must be considered fashionable surgery and not aimed at minimizing surgical trauma since cosmetic aspects play an important role. CONCLUSIONS: Minimally invasive surgery does not yet play a major part in vascular surgery. Only combined open and endoluminal vascular repair is on the advance in vascular departments. Because of the increases in the incidence of vascular diseases and the use of new expensive therapeutic procedures that drain health care resources on the one hand and because of the controversy involved in allocating patients to different vascular specialists on the other hand, there is a large amount of dynamite in vascular politics that gives us a thrill for the future!


Subject(s)
Angioplasty, Balloon , Aortic Diseases/surgery , Coronary Artery Bypass , Coronary Disease/surgery , Laparoscopy , Minimally Invasive Surgical Procedures , Stents , Aortic Diseases/diagnostic imaging , Blood Vessel Prosthesis Implantation , Combined Modality Therapy , Coronary Disease/diagnostic imaging , Humans , Postoperative Complications/etiology , Radiography , Tissue and Organ Harvesting , Veins/transplantation
18.
Eur Radiol ; 11(12): 2539-42, 2001.
Article in English | MEDLINE | ID: mdl-11734956

ABSTRACT

A case of acute rupture of an abdominal aortic aneurysm in a patient with Behçet's disease is reported. The patient was successfully treated by implantation of an endovascular stent graft. The preinterventional diagnostic procedures and the postinterventional follow-up are described and the benefit and risk vs open surgery is discussed.


Subject(s)
Aortic Aneurysm, Abdominal/therapy , Behcet Syndrome/therapy , Blood Vessel Prosthesis Implantation , Stents , Adult , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography , Behcet Syndrome/diagnostic imaging , Follow-Up Studies , Humans , Male , Prosthesis Design
19.
Br J Cancer ; 85(12): 1878-82, 2001 Dec 14.
Article in English | MEDLINE | ID: mdl-11747329

ABSTRACT

A new cancer gene, HIC-1 (Hypermethylated in Cancer) telomeric to p53 on chromosome 17p may be of clinical importance in sporadic breast cancer. Regional DNA hypermethylation of 17p13.3 resulting in suppression of gene expression has been shown to precede 17p structural changes in human carcinogenesis. In addition, loss of heterozygosity studies have suggested clinically significant involvement of a gene on 17p13.3 associated with poor prognosis in breast cancer. Using RT-PCR analysis, we demonstrate that the MCF7 (wild type p53) cell line expressed HIC-1 transcripts but the MDAMB231 (mutant p53) cell line did not, suggesting loss of HIC-1 expression and p53 malfunction may be synergistic events in sporadic breast cancer. HIC-1 expression was examined using RT-PCR on RNA extracted from 50 primary untreated, human breast cancers and was detected in only 7/50 (14%) cancers. All seven patients with HIC-1 expression were alive without disease recurrence after 8 years follow-up and 5/7 had detectable p53 wild type mRNA expression. This suggests that retained HIC-1 expression may offer a survival advantage. However the seven cancers had 17p13.3 loss of heterozygosity (LOH; four patients), a feature previously associated with poor prognosis, or were homozygous (three patients) suggesting there may be two genes at 17p13.3 involved in breast carcinogenesis. Using a demethylating drug 5-aza-2'-deoxycytidine (DeoxyC), HIC-1 expression was restored in the MDAMB231 cells, also suggesting restoration of HIC-1 function by reversing HIC-1 hypermethylation may offer a therapeutic avenue in breast cancer.


Subject(s)
Azacitidine/analogs & derivatives , Breast Neoplasms/genetics , Carcinoma/genetics , Neoplasm Proteins/physiology , Transcription Factors/physiology , Antimetabolites, Antineoplastic/pharmacology , Azacitidine/pharmacology , Breast Neoplasms/metabolism , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Carcinoma/metabolism , Carcinoma/mortality , Carcinoma/pathology , Chromosome Deletion , Chromosomes, Human, Pair 17/genetics , Cohort Studies , DNA Methylation/drug effects , Decitabine , Enzyme Inhibitors/pharmacology , Female , Follow-Up Studies , Gene Deletion , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Gene Silencing/drug effects , Genes, p53 , Humans , Kruppel-Like Transcription Factors , Loss of Heterozygosity , Neoplasm Proteins/biosynthesis , Neoplasm Proteins/genetics , Prognosis , Prospective Studies , RNA, Messenger/biosynthesis , RNA, Neoplasm/biosynthesis , Reverse Transcriptase Polymerase Chain Reaction , Survival Analysis , Transcription Factors/biosynthesis , Transcription Factors/genetics , Tumor Cells, Cultured/metabolism
20.
Br J Cancer ; 85(8): 1102-5, 2001 Oct 19.
Article in English | MEDLINE | ID: mdl-11710820

ABSTRACT

Fine needle aspiration (FNA) biopsy is the least invasive method of sampling breast cancer in vivo and provides material for breast cancer diagnosis. FNA has also been used to examine cellular markers to predict and monitor the effects of therapy. The aim of this study was to assess the accuracy of using FNA material compared with resected cancer for Western blotting studies of the p53 pathway, a key to tumour response to radiotherapy and chemotherapy. Paired samples of breast cancer FNAs collected pre-operatively and post-operatively were compared with tissue samples obtained at the time of surgical resection. Western blots were probed for p53 using the antibodies DO12 and DO1, and for levels of downstream proteins p21/WAF1 and p27. The protein extracted by FNA was sufficient for up to 5 Western blot studies. p53 expression and phosphorylation did not differ significantly pre- and post-operatively, indicating that intra-operative manipulation does not affect p53 expression or downstream activation in breast cancer. However, expression of p53, p21 and p27 varied between individual patients suggesting a range of p53 pathway activation in breast cancer. Immunohistochemistry confirmed that the cancer cells accounted for the protein expression detected on Western blots. FNA yields adequate protein for Western blotting studies and could be used as a method to monitor p53 activity in vivo before and during anti-cancer treatment possibly providing early evidence of tumour response to therapy.


Subject(s)
Breast Neoplasms/chemistry , Muscle Proteins , Tumor Suppressor Protein p53/analysis , Biopsy, Needle , Cyclin-Dependent Kinase Inhibitor p21 , Cyclins/analysis , Female , Humans , Immunohistochemistry , Microfilament Proteins/analysis
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