HER2/neu expression correlates with vascular endothelial growth factor-C and lymphangiogenesis in lymph node-positive breast cancer.

BACKGROUND: Vascular endothelial growth factor-C (VEGF-C) is the main inducer of lymphangiogenesis. VEGF-C overexpression is associated with lymphovascular tumor cell invasion, an increased rate of lymph node metastasis and adverse prognosis in various human cancers. However, little is known about the upstream inducers of VEGF-C expression. Recent studies have shown that human epidermal growth factor receptor 2 (HER2/neu) overexpression is associated with high VEGF-C levels in human breast cancer cells. In addition to blocking of HER2/neu, tyrosine kinase significantly decreased VEGF-C expression in vitro. PATIENTS AND METHODS: VEGF-C expression, lymphatic microvessel density (LMVD), lymphovascular invasion (LVI) and HER2/neu expression were evaluated with immunohistochemical/FISH methods in a collective of 150 lymph node-positive human breast cancers with long-term follow-up. RESULTS: Cases with 3+ HER2/neu protein expression showed a significantly stronger VEGF-C expression than all others cases (P = 0.006). In addition, we found a significant correlation between VEGF-C expression and LMVD (P = 0.012) and a strong positive association between LMVD and LVI (P < 0.001). CONCLUSION: Our data provide evidence for a clinically relevant association between HER2/neu and VEGF-C expression in human breast cancer. Inhibiting HER2/neu may reduce tumor progression by blocking VEGF-C-mediated tumor cell proliferation and lymphogenic metastasis.

Stability of lyophilized and reconstituted plasma/albumin-free recombinant human factor VIII (ADVATE rAHF-PFM).

Traditionally the serum protein albumin has been used to stabilize lyophilized recombinant factor VIII (rFVIII) products. Advanced rFVIII products have now been developed that employ other stabilizers. ADVATE antihaemophilic factor (recombinant), plasma/albumin-free method (rAHF-PFM) utilizes trehalose and mannitol as stabilizers in the lyophilized preparation. An extensive in vitro evaluation was conducted on the stability of rAHF-PFM as measured by retained activity over time. Both lyophilized and reconstituted rAHF-PFM were analysed, and the full range of available potencies were tested under varying temperature conditions. Lyophilized rAHF-PFM exhibited a high degree of stability under a range of conditions. The mean retained activity of 15 rAHF-PFM lots (ranging from low to maximal potency) at 5 degrees C for 30 months was 91.6% (95% CI, 88.9-94.3%) of initial potency. rAHF-PFM also remained highly stable after storage at room temperature for 18 months, with 82.0% (95% CI, 79.2-84.9%) of initial activity retained at 25 degrees C and 79.1% (95% CI, 76.2-81.9%) at 30 degrees C. All other parameters, including moisture, appearance, solubility, pH and aggregation remained within the established product specifications. The mean retained activity after 1 month of storage at 40 degrees C was 94.0% (95% CI, 92.4-95.6%). A high temperature excursion to 40 degrees C for 2 weeks did not compromise subsequent stability of the lyophilized powder either under refrigeration or at room temperature. Reconstituted samples from 11 rAHF-PFM lots retained an average of 92.0% (95% CI, 89.8-94.3%) activity after 24 h. The present study provides evidence of good stability at differing temperatures of an albumin-free formulated rFVIII product.

Continuous infusion of FVIII and FIX concentrates: in vitro analysis of clinically relevant parameters.

A high purity factor VIII/von Willebrand Factor (FVIII/vWF) concentrate (IMMUNATE [STIM plus]) (n = 6 batches), and a high purity factor IX (FIX) concentrate (IMMUNINE [STIM plus]) (n = 7 batches), were assessed in vitro for their applicability to continuous infusion. Parameters pertinent to continuous infusion were investigated and included stability, sterility and, in the case of FIX, the generation of potentially thrombogenic components. Four stationary or transportable mini infusion pumps, equipped with polyethylene, polypropylene or polyvinylchloride plastic components were used. The concentrates were reconstituted without extra filling volume and perfused at 12.5 mL h-1 and 1 mL h-1; sampling was carried out at the start of the experiment and for up to 48 h. The FVIII procoagulant activity (FVIII:C) was assayed by amidolytic, 1-stage and 2-stage assays; vWF was examined for ristocetin cofactor activity, antigen and multimers. The FIX coagulation activity (FIX:C) was determined by a 1-stage coagulation assay; thrombogenicity potential was assessed in vivo (Wessler stasis model in rabbits) and in vitro (FIXa and nonactivated thromboplastin time). Reconstituted concentrate incubated under the same conditions served as a control. Both concentrates remained sterile throughout the testing period. The perfused and control samples remained stable, retaining over 95% of activity for FVIII:C and over 90% for FIX:C for up to 48 h. Intermittent decrease of FVIII:C or FIX:C was not observed, suggesting no adsorption of FVIII or FIX onto plastic surfaces during either short or long-term exposure. No thrombogenic components were detected in the high purity FIX concentrate. Thus, under the in vitro conditions used, FVIII/vWF and FIX were found to be suitable for administration by continuous infusion.

Production and quality assurance of Lys-plasminogen steam treated.

A highly purified plasminogen concentrate, LYS-PLASMINOGEN Steam Treated, has been developed for thrombolytic therapy of arterial and venous occlusions in combination with fibrinolytic agents. In search of a highly efficient drug covering this indication, we decided to select the lys-form of plasminogen because of its higher affinity to fibrin in contrast to the glu-form. This property of lys-plasminogen also led us to expect an improved thrombolytic activity as opposed to other forms of the proenzyme. The intermediate product is manufactured from pooled human citrated plasma by ethanol fractionation after separation of coagulation factor proteins. Further processing includes specific transformation and purification steps. The final product is a freeze-dried preparation characterized by a high specific activity greater than or equal to 18.0 CU/mg protein and a content of lys-plasminogen of greater than or equal to 95%. To reduce the risk of viral infections, the plasma pool includes only plasma donations which are ALT tested and negative for HBsAg and anti-HIV. In addition the intermediate freeze-dried bulk powder is subjected to a virus inactivation procedure based on steam treatment for 10 hours under standardized product specific conditions without using special protein stabilizers. Physical parameters of steam treatment provide for a maximum virus killing effect without impairing the biological plasminogen activity or changing the molecular integrity of the product. In a preclinical test HIV was inactivated by 6 log 10 after 3 hours of steam treatment leaving a 7 hour safety margin for inactivation of more heat resistant viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Limitations of paternity testing calculations.

A total of 252 black and white trios (mother, child, and putative father) in which the alleged father was known not to be the biological father (BF) were generated from paternity studies. The likelihood of paternity (W) and the paternity index (P) were calculated on the basis of ABO, Rh, MNS, and HLA phenotyping. The results were then reviewed to evaluate the arbitrary limits proposed by a number of states in recent paternity legislation. Two hundred forty-four of 252 non-fathers (NFs) (96.8%) were excluded. Of the 152 white NFs, 147 (96.7%) were excluded; 97 of the 100 blacks (97%) were excluded. Eight NFs could not be excluded by the routinely performed tests. The W value for those eight trios ranged from 1.2 to 98.8 percent. Based on limits proposed in legislation, had the NFs actually been alleged fathers, as many as four of the eight of these men could have had the burden of proving that they were not the BFs.

Variability in hand surface representations in areas 3b and 1 in adult owl and squirrel monkeys.

Detailed microelectrode maps of the hand representation were derived in cortical areas 3b and 1 from a series of normal adult owl and squirrel monkeys. While overlap relationships were maintained, and all maps were internally topographic, many map features varied significantly when examined in detail. Variable features of the hand representations among different monkeys included a) the overall shapes and sizes of hand surface representations; b) the actual and proportional areas of representations of different skin surfaces and the cortical magnifications of representations of specific skin surfaces, which commonly varied severalfold in area 3b and manyfold in area 1; c) the topographic relationships among skin surface representations, with skin surfaces that were represented adjacently in some monkeys represented in locations many hundreds of microns apart in others; d) the internal orderliness of representations; e) the completeness of representations of the dorsal hand surfaces; and f) the skin surfaces represented along the borders of the hand representation. Owl monkey maps were, in general, internally more strictly topographic than squirrel monkey maps. In both species, area 3b was more strictly topographic and less variable than was area 1. The degree of individual variability revealed in these experiments is difficult to reconcile with the hypothesis that details of cortical maps are ontogenetically specified during a period in early life. Instead, we propose that differences in the details of cortical map structure are the consequence of individual differences in lifelong use of the hands. This conclusion is consistent with earlier studies of the consequences of peripheral nerve transection and digital amputation, which revealed that cortical maps are dynamically maintained and are alterable as a function of use or nerve injury in these monkeys (Merzenich et al., '83a,b, '84a; Merzenich, '86; Jenkins et al., '84; Jenkins and Merzenich, '87).

The development of eye alignment in normal and naturally microstrabismic kittens.

The development of interocular alignment was pupillographically measured from eye opening throughout the first half year of life in normal kittens and in kittens deriving from a naturally strabismic cat colony. Whereas the cyclorotatory component of age dependent changes did not differ between the two groups, the horizontal divergence of the optical axes was increased in the future esotropes during the whole observation period. Surprisingly the divergence angle of the optical axes was correlated with the convergence angle of the visual axes as determined during cortical receptive field analysis at 7-9 months of age. The authors suggest a theory that might explain the microstrabismic misalignment of the visual axes with an intraretinal defect.

A developmental study of retinal afferents and visual responses in the cat pretectum.

Neuronal responses in the pretectum (PT) were analyzed in 4-16 week old kittens after visual and electrical stimulation and compared with adult responses from a previous study. All three retinal fiber types projecting to the adult PT could be electrically activated in kittens from 4 weeks on. There was a dramatic reduction of response latencies to electric shocks to retinal afferents applied at the optic chiasm (OX) and optic tract (OT) in postsynaptic cells as a function of age, involving X-, Y-, and W-fibers. At four through six weeks postnatally the reduction in latency was found to be due to enhanced signal transmission at the axonal terminal region. Latency reduction continued after six weeks of life due to sharp increases in conduction velocity of the afferent fibers. Different steps in the maturation of visual response specifity were found for neurons of different functional types. Possible relationships are discussed between the development of neuronal responses of pretectal cells and the maturation of oculomotor behavior.

Functional and developmental analysis of a visual corticopretectal pathway in the cat: a neuroanatomical and electrophysiological study.

The sensory corticopretectal projection in the cat and in its postnatal development were investigated combining neuroanatomical and electrophysiological techniques. The anatomical pattern of fiber termination was studied in relation to age using the anterograde HRP tracing method. Large injections were made in areas 17 and 18 of one or both hemispheres in 1-13 week old kittens and cats. Terminal label in the ipsilateral pretectum was seen only after the fourth week of life. Electrical stimulation in the same cortical areas evoked postsynaptic orthodromic excitation in 9-18% of cells at 4 weeks increasing to about 60% in the adult. In cats, but not in kittens, successful stimulation depended on the retinotopic matching of stimulation and recording sites. In adult cats a high incidence of direction and velocity tuning and a high degree of binocularity were seen in cells driven by the cortex as opposed to cells not so driven. Cortex driven cells in cats and kittens received convergent retinal input mainly via direct W-fibers, whereas cells not driven from cortex shock mainly received delayed W-fiber input. In kittens visual responses lacked sensitivity for direction and high movement velocity of patterns until 6 weeks postnatally, whereas ocular dominance distribution was not age-dependent.

Somatosensory cortical map changes following digit amputation in adult monkeys.

The cortical representations of the hand in area 3b in adult owl monkeys were defined with use of microelectrode mapping techniques 2-8 months after surgical amputation of digit 3, or of both digits 2 and 3. Digital nerves were tied to prevent their regeneration within the amputation stump. Successive maps were derived in several monkeys to determine the nature of changes in map organization in the same individuals over time. In all monkeys studied, the representations of adjacent digits and palmar surfaces expanded topographically to occupy most or all of the cortical territories formerly representing the amputated digit(s). With the expansion of the representations of these surrounding skin surfaces (1) there were severalfold increases in their magnification and (2) roughly corresponding decreases in receptive field areas. Thus, with increases in magnification, surrounding skin surfaces were represented in correspondingly finer grain, implying that the rule relating receptive field overlap to separation in distance across the cortex (see Sur et al., '80) was dynamically maintained as receptive fields progressively decreased in size. These studies also revealed that: the discontinuities between the representations of the digits underwent significant translocations (usually by hundreds of microns) after amputation, and sharp new discontinuous boundaries formed where usually separated, expanded digital representations (e.g., of digits 1 and 4) approached each other in the reorganizing map, implying that these map discontinuities are normally dynamically maintained. Changes in receptive field sizes with expansion of representations of surrounding skin surfaces into the deprived cortical zone had a spatial distribution and time course similar to changes in sensory acuity on the stumps of human amputees. This suggests that experience-dependent map changes result in changes in sensory capabilities. The major topographic changes were limited to a cortical zone 500-700 micron on either side of the initial boundaries of the representation of the amputated digits. More distant regions did not appear to reorganize (i.e., were not occupied by inputs from surrounding skin surfaces) even many months after amputation. The representations of some skin surfaces moved in entirety to locations within the former territories of representation of amputated digits in every monkey studied. In man, no mislocation errors or perceptual distortions result from stimulation of surfaces surrounding a digital amputation.(ABSTRACT TRUNCATED AT 400 WORDS)

Shortage of binocular cells in area 17 of visual cortex in cats with congenital strabismus.

Twenty-nine pigmented offspring of an innately esotropic female cat exhibited varying deficits in the number of binocular cells recorded in area 17 of the visual cortex as compared to 12 normal cats. Misalignment of the two eyes in these cats was found in the awake as well as in the paralysed state. Pupillography combined with measurements of visual disparity yielded abnormal esotropia of up to 8.4 degrees under paralysis, which corresponds to an abnormal convergence of the freely moving eyes of up to 14 degrees (average 7.4 degrees). In the majority of animals cortical binocularity was found reduced by the two eyes controlling independent sets of separate units (U-shaped ocular dominance distribution) whereas in 7 cats the reduction was due to a partial loss of one eye's influence. The proportion of monocular units correlated with the degree of crossover of the visual axes (r = 0.73). Anatomical investigation of the retinofugal projections revealed normal appearance in three previously recorded cats in which more than 50% of cortical units had been monocularly driven. The small angles of esotropia and the "normal" appearance of eye position judged by the pupillary positions in the orbit of these cats, might suggest that we found an animal model for microstrabismus.

Projections from areas 17 and 18 of the visual cortex to the nucleus of the optic tract.

The corticofugal pathway to the nucleus of the optic tract (NOT) in the cat was studied with visual and electrical stimulation in two experimental series. In 10 experiments cells in the NOT were identified, and orthodromic responses evoked by single electric shocks applied through microelectrodes situated at different loci in areas 17 and 18. All but 2 units gave clear responses to shocks applied to either cortical electrode. The mean of response latencies was calculated to be 3.29 ms for area 17 stimulation and 3.04 ms for area 18 stimulation. In 8 further experiments the stimulation and recording sites were reversed; i.e. single shocks through microelectrodes in the NOT were used to elicit antidromic discharges in areas 17 and 18. A third microelectrode was placed in the superior colliculus (SC) at a position in retinotopic register with the units recorded at the NOT stimulation site. Out of 231 cortical units tested, 42 (17%) gave an antidromic response to NOT and/or SC shock. Seventeen units responded both to NOT and SC stimulation, 18 to NOT alone, and 7 to SC alone. The response latencies after NOT shock (mean 2.8 ms +/- 1.5 S.D.) did not differ significantly from those to SC shock (2.9 ms +/- 1.5 S.D.). All cortical cells activated antidromically from NOT and/or SC were located in layer V of areas 17 and 18. These units showed the following response characteristics: they responded well to conventional light bars as well as to large area random dot patterns; they were binocular and showed direction tuning; as compared to NOT cells they were more sharply tuned for stimulus velocity preferring faster movements. The present findings suggest a convergent projection to the NOT from the same type of cortical cells that project to the superior colliculus.

A quantitative analysis of the direction-specific response of Neurons in the cat's nucleus of the optic tract.

All cells in the nucleus of the optic tract (NOT) of the cat, that could be activated antidromically from the inferior olive, were shown to be direction-specific, as influenced by horizontal movements of an extensive visual stimulus. Cells in the left NOT were activated by leftward and inhibited by rightward movement, while those in the right NOT were activated by rightward and inhibited by leftward movement. Vertical movements did not modulate the spontaneous activity of the cells. The mean spontaneous discharge rate in 50 NOT cells was 30 spikes/s. This direction-specific response was maintained over a broad velocity range (Less Than 0.1 degrees - Greater Than 100 degrees/s). Velocities over 200 degrees/s could inhibit NOT cells regardless of stimulus direction. All cells in the NOT were driven by the contralateral eye, about half of them by the ipsilateral eye also. In addition, activation through the contralateral eye was stronger in most binocular units. Binocular cells preferred the same direction in the visual space through both eyes. An area approximately corresponding to the visual streak in the cat's retina projected most densely onto NOT cells. This included an extensive ipsilateral projection. No clear retinotopic order was seen. The most sensitive zone in the very large receptive fields (most diameters being Greater Than 20 degrees) was along the horizontal zero meridian of the visual field. The retinal input to NOT cells was mediated by W-fibers. The striking similarities between the input characteristics of NOT-cells and optokinetic nystagmus are discussed. The direction selectivity and ocular dominance of the NOT system as a whole can provide a possible explanation for the directional asymmetry in the cat's optokinetic nystagmus when only one eye is stimulated.

A comparison of visual responses in two pretectal nuclei and in the superior colliculus of the cat.

Single unit recordings from 220 units were obtained from the nuclei praetectalis anterior (NPA) and posterior (NPP) of 30 immobilized, anesthetized cats. Quantitative analysis of pretectal (PT) visual activity was mainly based on recordings from the NPP. For comparison, 160 collicular (CS) neurons were studied. A strong sensitivity for moving objects was evident in both samples. The following main types of PT activity were categorized: (A) slow movement, direction-selective units (21%); (B) slow movement, nondirection-selective units (19%); (C) units nonselective for stimulus velocity and direction (24%); (D) jerk movement selective, nondirection-selective units (36%). Latency measurements following single shocks to optic chiasm (OX) and tract (OT) showed mainly slow conducting fiber input to the PT and CS which can be divided into two different groups by conduction properties and synaptic delay: direct W-input and delayed W-input. Fast Y-fiber input of both types, direct and indirect, was recorded at both sites, PT and CS.

Continuous mapping of direction selectivity in the cat's visual cortex.

A new method is demonstrated for continuously mapping direction selectivity on complex cells in the cat's visual cortex. A large area random noise pattern which always covers the whole receptive field area is moved along a circular path. The average response histogram yields the cell's selectivity for stimulus direction directly and in much less time than the conventional methods.