Resection of residual retroperitoneal masses in testicular cancer: evaluation and improvement of selection criteria. The ReHiT study group. Re-analysis of histology in testicular cancer

Residual retroperitoneal masses may remain after chemotherapy for metastatic non-seminomatous testicular cancer, which harbour residual tumour or totally benign tissue (necrosis/fibrosis). These residual masses may be effectively removed by a surgical resection. We evaluated current selection criteria and tried to develop alternative criteria in a data set of 544 patients, who had retroperitoneal lymph node dissection of residual masses. Six resection policies were identified from the literature. Two alternative policies were developed with logistic regression analysis. Evaluation of the policies focused on the true-positive rate (resection in case of tumour), and the false-positive rate (resection in case of necrosis). It appeared that most current policies use the size of the residual mass (> or = 10 mm or > or = 20 mm) as the predominant selection criterion. This resulted in high true-positive rates (most > 90%), but false-positive rates between 37% and 87%. The alternative policies included five well-known predictors of necrosis in addition to residual mass size (primary tumour histology, prechemotherapy levels of the three tumour markers alphafetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) and mass shrinkage during chemotherapy). This strategy resulted in improved true- and false-positive rates, even when categories of the predictors were simplified for practical application. We conclude that a simple statistical model, based on a limited number of patient characteristics, provides better guidelines for patient selection than those currently used in clinical practice.     

Gangliosides minimize motor disabilities and histopathological changes in cortical lesioned and transplanted rats

The effect of bovine brain gangliosides was studied in rats lesioned by partial suction of the right somatosensory cortex and also in rats implanted with a piece of fetal brain tissue in this area. In both experiments a group of animals received 30 mg/kg i.p. of gangliosides daily for a period of 7 days after surgery. In lesioned rats, the untreated group showed a lower maintenance on a tight rope test at 7 as well as at 14 days, as compared with a sham-operated group (p < 0.05). In transplanted rats ganglioside treatment prevented the increase of the probability of falls from a horizontal bar at days 7 and 14 post-operations and the probability of slips on a vertical bar at day 7 (p < 0.05). Rats were killed at day 15 and brain coronal sections were obtained. Nuclear area and circularity were measured in a sample of cortical and grafted cells in a computer aid-image analyzer. Ganglioside protection on the normal size and shape of the nuclei in the ipsilateral cortex in lesioned as well as in transplanted rats (p < 0.01) was found. A higher nuclear area in ganglioside than in saline treated grafts was noted. Results suggest a protective action of the gangliosides against the lesion-induced motor dysfunction and secondary cortical cell degeneration.     

Ectopic expression of Hoxa-1 in the zebrafish alters the fate of the mandibular arch neural crest and phenocopies a retinoic acid-induced phenotype

Considerable evidence has demonstrated that retinoic acid influences the formation of the primary body axis in vertebrates and that this may occur through the regulation of Hox gene expression. In this study, we show that the phenotype induced by exogenous retinoic acid in the zebrafish can also be generated by the overexpression of Hoxa-1 following injection of synthetic RNA into the fertilised egg. The isolation, sequence and expression pattern of the zebrafish Hoxa-1 gene is described. We show that exogenously applied retinoic acid causes the ectopic accumulation of Hoxa-1 message during gastrulation in the hypoblast in the head region. Overexpression of Hoxa-1 following injection of RNA causes abnormal growth of the anterior hindbrain, duplication of Mauthner neurons in rhombomere (r) 2 and fate changes of r2 mesenchymal and neurogenic neural crest. These results are discussed in terms of the role of Hoxa-1 in controlling anterior hindbrain patterning and the relationship between expression of Hoxa-1 and retinoic acid.     

Outer surface lipoproteins of Borrelia burgdorferi activate vascular endothelium in vitro

Previously, we reported that activation of vascular endothelium by the Lyme disease pathogen Borrelia burgdorferi results in enhanced expression of endothelial cell adhesion molecules and promotion of the transendothelial migration of neutrophils in vitro. To investigate the role of spirochetal lipoproteins in this process, we assessed the ability of a synthetic lipohexapeptide corresponding to the N terminus of B. burgdorferi outer surface protein A (OspA) to activate human umbilical vein endothelial cells (HUVEC). Using a whole-cell enzyme-linked immunosorbent assay, we demonstrated that OspA lipopeptide activated endothelium in a dose-dependent fashion, as measured by upregulation of E-selectin. Near-maximal stimulation was achieved with 100 micromolar lipopeptide. In addition, the lipopeptide increased expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1). Similar results were obtained with 25 nM native OspA or lipidated recombinant OspA or OspB. Incubation of HUVEC with nonlipidated OspA peptide, nonlipidated recombinant OspA or OspB, or tripalmitoyl-S-glyceryl-cysteine had little or no effect on expression of these adhesion molecules. A mutant strain of B. burgdorferi that lacked OspA and OspB upregulated expression of E-selectin to the same degree as its wild-type counterpart, indicating that other spirochetal components also possess the ability to activate endothelium. Conditioned medium from HUVEC incubated with OspA lipopeptide or lipidated recombinant OspA induced chemotaxis of neutrophils in Boyden chamber assays, whereas the OspA preparations alone were devoid of chemotactic activity. When HUVEC grown on connective tissue substrates were treated with OspA lipopeptide, subsequently added neutrophils migrated across the endothelial monolayers. These results implicate the outer surface lipoproteins of B. burgdorferi as potential effector molecules in the promotion of a host inflammatory response.