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Biomedical subjects

J Koh

Publications and source records attributed to J Koh.

At least 19 recordsLinked to original sources
PubMed2006

Quality of life is predictive of survival in patients with unresectable hepatocellular carcinoma.

BACKGROUND: Patients with unresectable hepatocellular carcinoma (HCC) have a dismal prognosis. The objective of this study was to evaluate whether patient-reported baseline quality of life (QoL) measured by the EORTC QLQ-C30 instrument is predictive of survival for these patients. MATERIALS AND METHODS: Two hundred and thirty-three patients with unresectable HCC (mainly hepatitis B-associated) who were recruited into two separate randomized phase III clinical studies, based on palliative chemotherapy and palliative hormonal therapy, respectively, gave consent and received pretreatment QoL assessment. EORTC QLQ-C30 scores and clinical variables at the time of study entry were analyzed to identify factors that influenced survival by applying multivariate analysis. Independent prognostic factors for survival were studied by Cox regression analysis. RESULTS: Median survival of the 233 patients was 5.5 months (95% CI 4.2-6.5 months). Significant independent predictors of shorter survival were advanced Okuda staging (P = 0.0030; HR = 2.058), high baseline total bilirubin (P = 0.0008; HR = 1.013) and worse QoL score in the appetite score domain (P = 0.0028; HR for 10 point increase = 1.070). Patients who were entered into the chemotherapy trial (P = 0.0002; HR = 0.503), those who scored better in the physical functioning domain (P = 0.0034; HR for 10 point decrease = 0.911) and the role functioning domain (P = 0.0383; HR for 10 point decrease = 0.944) of the QoL questionnaire, were associated with longer survival. CONCLUSIONS: In the studied HCC population, patient-reported baseline QoL provides additional prognostic information that supplements traditional clinical factors, and is a new prognostic marker for survival for patients with unresectable HCC.

Adolescent↗
PubMed2006

[Successful removal of aberrant needles in the pericardium and lung].

A 28-year-old woman who had been diagnosed as schizophrenia was admitted to our hospital, complaining of chest pain. Her chest X-ray demonstrated 9 foreign bodies in the pericardium, lung and others. Her chest computed tomography (CT) confirmed needle-like shadows in the pericardium and lung. They were diagnosed as aberrant needles, and surgically removed. The intrapulmonary aberrant needle was removed with video-assisted thoracoscopic surgery. Aberrant needle in pericardium or lung should be removed surgically, because it is very dangerous. Intraoperative chest X-ray is always necessary before closing the wound to avoid leaving the residual fragments.

Adult↗
PubMed2003

Detailed computational study of p53 and p16: using evolutionary sequence analysis and disease-associated mutations to predict the functional consequences of allelic variants.

Deciding whether a missense allelic variant affects protein function is important in many contexts. We previously demonstrated that a detailed analysis of p53 intragenic conservation correlates with somatic mutation hotspots. Here we refine these evolutionary studies and expand them to the p16/Ink4a gene. We calculated that in order for 'absolute conservation' of a codon across multiple species to achieve P<0.05, the evolutionary substitution database must contain at least 3(M) variants, where M equals the number of codons in the gene. Codons in p53 were divided into high (73% of codons), intermediate (29% of codons), and low (0 codons) likelihood of being mutation hotspots. From a database of 263 somatic missense p16 mutations, we identified only four codons that are mutational hotspots at P<0.05 (8 mutations). However, data on function, structure, and disease association support the conclusion that 11 other codons with > or =5 somatic mutations also likely indicate functionally critical residues, even though P0.05. We calculated p16 evolution using amino acid substitution matrices and nucleotide substitution distances. We looked for evolutionary parameters at each codon that would predict whether missense mutations were disease associated or disrupted function. The current p16 evolutionary substitution database is too small to determine whether observations of 'absolute conservation' are statistically significant. Increasing the number of sequences from three to seven significantly improved the predictive value of evolutionary computations. The sensitivity and specificity for conservation scores in predicting disease association of p16 codons is 70-80%. Despite the small p16 sequence database, our calculations of high conservation correctly predicted loss of cell cycle arrest function in 75% of tested codons, and low conservation correctly predicted wild-type function in 80-90% of codons. These data validate our hypothesis that detailed evolutionary analyses help predict the consequences of missense amino-acid variants.

Amino Acid Sequence↗
PubMed2001

Influence of human p16(INK4) and p21(CIP1) on the in vitro activity of recombinant Plasmodium falciparum cyclin-dependent protein kinases.

The regulatory mechanisms of most cyclin dependent protein kinases (CDKs) are well understood and are highly conserved in eukaryotes. CDKs from the malaria parasite, Plasmodium falciparum, appear to be regulated in a similar manner with regard to cyclin binding and phosphorylation. In order to further understand their regulatory mechanisms, we examined two classes of cyclin dependent kinase inhibitors (CDIs) to inhibit a panel of plasmodial CDKs. We find that Pfmrk and PfPK5 are inhibited by heterologous p21(CIP1) with varying degrees of inhibition. In contrast, PfPK6, a kinase with sequence features characteristic of both a CDK and MAP kinase, is unaffected by this CDI. Furthermore, the CDK4/6 specific CDI, p16(INK4), fails to inhibit these plasmodial CDKs. Taken together, these results suggest that plasmodial CDKs may be regulated by the binding of inhibitory proteins in vivo.

Animals↗
PubMed2001

The COOH terminus of p18INK4C distinguishes function from p16INK4A.

The INK4 family of proteins consists of four members which can block progression from the G(1)-to-S phase of the cell cycle by inhibiting the activity of cyclin dependent kinases (cdks) 4 and 6. Although the gene encoding p16(INK4a) is commonly inactivated in human tumors, p18(INK4c) is rarely altered. We show here that overexpression of p18(INK4c) does not block cell cycle progression in a T-cell acute lymphocytic leukemia cell line (CEM) sensitive to p16(INK4a)-mediated G(1) arrest. A chimera consisting of the kinase-binding region of p16(INK4a) fused to the COOH terminus of p18(INK4c) is active in all known biochemical assays for INK4 function, but it does not arrest CEM cells. These data imply a novel level of p18(INK4c) regulation mediated through the COOH terminus and suggest that functional differences might underlie the distinct mutational profiles observed for p16(INK4a) and p18(INK4c) in tumors.

Amino Acid Sequence↗
PubMed2001

Research and teaching access to a large clinical picture archiving and communication system.

PURPOSE: To identify practical issues surrounding delivering digital images from picture archiving and communication systems (PACS) for research and teaching purposes. The complexity of Digital Imaging and Communications in Medicine (DICOM) access methods, security, patient confidentiality, PACS database integrity, portability, and scalability are discussed. A software prototype designed to resolve these issues is described. SYSTEM ARCHITECTURE: A six-component, three-tier, client server software application program supporting DICOM query/retrieve services was developed in the JAWA language. This software was interfaced to a large GE (Mt Prospect, IL) Medical Systems clinical PACS at Northwestern Memorial Hospital (NMH). CONCLUSION: Images can be delivered from a clinical PACS for research and teaching purposes. Concerns for security, patient confidentiality, integrity of the PACS database, and management of the transactions can be addressed. The described software is one such solution for achieving this goal.

Computer-Assisted Instruction↗
PubMed2001

An antibody to p16INK4A recognizes a modified form of galectin-3.

Galectin-3 is a carbohydrate binding protein involved in multiple processes including cell-cycle regulation and apoptosis. The ability of galectin-3 to protect cells from apoptosis is dependent upon a region of the protein known as a BH-1 domain for its homology to the anti-apoptotic protein Bcl-2. Here, we show that a monoclonal antibody (MAb) to the human tumor suppressor protein p16INK4A recognizes a post-translationally modified form of human galectin-3. The modified form is detectable in only a subset of cell types expressing galectin-3, indicating that the modification is cell-type-specific. Although there is little amino acid sequence homology between p16INK4a and galectin-3, we show by epitope mapping that the modification directly affects the structure of galectin-3's BH-1 domain. Elucidation of the nature of this modification might provide further insight into galectin-3 function.

Antigens, Differentiation↗
PubMed2000

Requirements for cell cycle arrest by p16INK4a.

Analysis of tumor-derived mutations has led to the suggestion that p16INK4a, cyclin D1, cdk4, and the retinoblastoma protein (pRB) are components of a regulatory pathway that is inactivated in most tumor cells. Cell cycle arrest induced by p16INK4a, an inhibitor of cyclin D-dependent kinases, requires pRB, and it has been proposed that this G1 arrest is mediated by pRB-E2F repressor complexes. By comparing the properties of primary mouse embryonic fibroblasts specifically lacking pRB-family members, we find that pRB is insufficient for a p16INK4a-induced arrest. In addition to pRB, a second function provided by either p107 or p130, two pRB-related proteins, is required for p16INK4a to block DNA synthesis. We infer that p16INK4a-induced arrest is not mediated exclusively by pRB, but depends on the nonredundant functions of at least two pRB-family members.

Animals↗
PubMed2000

p16(INK4a) expression begins early in human colon neoplasia and correlates inversely with markers of cell proliferation.

BACKGROUND & AIMS: p16(INK4a) is a cell cycle inhibitor and a major tumor-suppressor protein, but the regulation of p16(INK4a) is poorly understood and the physiologic settings in which it exerts its antiproliferative effects are unknown. A role for p16(INK4a) in intestinal neoplasia is suggested by the observation that the promoter region is methylated in a subset of human colon tumors. We examined the expression of the protein in specimens representing the full spectrum of neoplastic progression in the human colon and determined whether expressing cells showed evidence of cell cycle inhibition. METHODS: We studied p16(INK4a) expression by immunoprecipitation, immunoblotting, reverse-transcription polymerase chain reaction (RT-PCR), immunohistochemistry, and immunofluorescence in matched normal and neoplastic colonic tissue from 70 patients. RESULTS: p16(INK4a) expression was very low in normal mucosa, with staining observed in rare epithelial cells at the base of crypts. A distinctly higher expression was found in 4 of 7 aberrant crypt foci, 32 of 36 adenomas, 18 of 28 primary carcinomas, and 5 of 5 metastatic carcinomas. Within each neoplasm p16(INK4a) staining was heterogeneous, with higher expression commonly seen in areas bordering normal tissue. p16(INK4a) staining correlated inversely with that of Ki67, cyclin A, and the retinoblastoma protein, suggesting that cell cycle progression was inhibited. CONCLUSIONS: These results suggest that p16(INK4a) expression begins in the earliest detectable stages of neoplastic progression in the human colon and exerts a continuous, piecemeal constraint on tumor growth.

Blotting, Western↗
PubMed2000

Regulation of CDK7-carboxyl-terminal domain kinase activity by the tumor suppressor p16(INK4A) contributes to cell cycle regulation.

The eukaryotic cell cycle is regulated by cyclin-dependent kinases (CDKs). CDK4 and CDK6, which are activated by D-type cyclins during the G(1) phase of the cell cycle, are thought to be responsible for phosphorylation of the retinoblastoma gene product (pRb). The tumor suppressor p16(INK4A) inhibits phosphorylation of pRb by CDK4 and CDK6 and can thereby block cell cycle progression at the G(1)/S boundary. Phosphorylation of the carboxyl-terminal domain (CTD) of the large subunit of RNA polymerase II by general transcription factor TFIIH is believed to be an important regulatory event in transcription. TFIIH contains a CDK7 kinase subunit and phosphorylates the CTD. We have previously shown that p16(INK4A) inhibits phosphorylation of the CTD by TFIIH. Here we report that the ability of p16(INK4A) to inhibit CDK7-CTD kinase contributes to the capacity to induce cell cycle arrest. These results suggest that p16(INK4A) may regulate cell cycle progression by inhibiting not only CDK4-pRb kinase activity but also by modulating CDK7-CTD kinase activity. Regulation of CDK7-CTD kinase activity by p16(INK4A) thus may represent an alternative pathway for controlling cell cycle progression.

Amino Acid Sequence↗
PubMed2000

An association study between alcoholism and the serotonergic receptor genes.

BACKGROUND: Linkage and association studies of alcoholism using DNA makers have been conducted without conclusive results. The comorbidity of alcoholism with affective disorder indicates that dysfunction of the serotonergic system may play an important role in developing alcoholism. METHODS: We studied the genetic association between alcoholism and alleles of the HTR1A, HTR2A, and HTR2C genes. The subjects were 91 biologically unrelated alcoholics and 90 controls. Polymorphisms of these genes were determined by polymerase chain reaction restriction fragment length polymorphisms, and the data were analyzed by chi2 tests. RESULTS: We found no significant association between alcoholism and the HTR1A, HTR2A, and HTR2C genes. CONCLUSIONS: The study results suggest that these serotonergic receptor genes may not directly contribute to the etiology of alcoholism.

Adult↗
PubMed1999

Effects of nitroglycerin on fractal features of short-term heart rate and blood pressure variability.

PURPOSE: We investigated the effect of nitroglycerin(NTG) on fractal features of short-term heart rate variability (HRV) and blood pressure variability (BPV) using coarse-graining spectral analysis (CGSA). METHOD: Nine healthy young volunteers participated in this study. Five-minute recordings of electrocardiogram and blood pressure estimated by photoplethysmograph were made during stepwise NTG infusions of 0.2, 0.4, 0.8, and 1.6 microg.kg(-1).min(-1) under rate-controlled breathing at 0.25 Hz. CGSA broke down the total power of the time series into harmonic (low- and high-frequency) and nonharmonic (beta of 1/f(beta) and %fractal) components. RESULTS: A statistically significant difference from the control period was observed during the maximum dose of NTG infusion, with decrease in mean blood pressure, shortening of mean R-R interval, and increase in plasma norepinephrine and epinephrine. The beta in HRV increased significantly (0.89 +/- 0.06 vs. 1.27 +/- 0.13, P < 0.05). However, %fractal was not affected (47.9 +/- 6.7 vs. 50.1 +/- 4.0). Indicators of parasympathetic and sympathetic nervous system activity showed reduced and increased values, respectively. No change in BPV was observed for any measurement. CONCLUSION: The data suggest that NTG significantly affected fractal features, as well as harmonic components, of short-term HRV. NTG had no effect on BPV, suggesting a different mechanism for genesis of 1/f(beta) fluctuation in BPV and HRV.

Journal Article↗
PubMed1999

Immunohistochemical survey of p16INK4A expression in normal human adult and infant tissues.

p16INK4A is a cell cycle inhibitor that is commonly inactivated in human tumors and tumor cell lines. Despite its importance in human neoplasia, the normal pattern of p16 expression remains largely unknown. Therefore, we analyzed the immunohistochemical localization of p16 in all human organs and demonstrated that cellular p16 expression is highly selective. In adults, proliferative endometrium, breast ductal epithelium, squamous and tubal metaplastic epithelium of the uterine cervix, esophageal squamous epithelium, salivary glands, and antral gastric glands all strongly express the protein. p16 is also widely expressed in endocrine glands, including Langerhans cells in the pancreas and anterior pituicytes and Leydig and Sertoli cells in testis. Within each tissue, however, p16 expression does not correlate with cellular proliferation or maturation. In infants, p16 staining was limited to thymic Hassall's corpuscles, occasional thymic lymphocytes, and only rare pancreatic epithelial cells. Therefore, increased expression of p16 in adult tissues, as in mouse tissues, may reflect a role of p16 in cellular senescence. Restriction of p16 expression in infants to the thymus, the only organ committed to early senescence, is also consistent with such a role. Documentation of the pattern of p16 expression in normal tissues will contribute to our understanding of the normal function of this protein and to interpretation of potentially altered p16 expression in human tumors.

Adult↗
PubMed1998

Contributions of tidal lung inflation to human R-R interval and arterial pressure fluctuations.

We studied the effects of mechanical lung inflation on respiratory frequency R-R interval and arterial pressure fluctuations in nine healthy young adults undergoing elective orthopedic surgery. We conducted this research to define the contribution of pulmonary and thoracic stretch receptor input to respiratory sinus arrhythmia. We compared fast Fourier transform spectral power during three modes of ventilation: (1) spontaneous, frequency-controlled (0.25 Hz) breathing, (2) intermittent positive pressure ventilation (0.25 Hz, with a tidal volume of 8 ml/kg) and (3) high frequency jet ventilation (5.0 Hz, 2.5 kg/cm2), after sedation and vecuronium paralysis. Mean R-R intervals, arterial pressures and arterial blood gas levels were comparable during all three breathing conditions. Respiratory frequency systolic pressure spectral power was comparable during spontaneous breathing and conventional mechanical ventilation, but was significantly reduced during high frequency jet ventilation (P < 0.05). Respiratory frequency R-R interval spectral power (used as an index of respiratory sinus arrhythmia) declined dramatically with sedation and muscle paralysis (P < 0.05), but was greater during conventional mechanical, than high frequency jet ventilation (P < 0.05). These results suggest that although phasic inputs from pulmonary and thoracic stretch receptors make a statistically significant contribution to respiratory sinus arrhythmia, that contribution is small.

Adult↗
PubMed1998

Molecular genetic correlates of p16, cdk4, and pRb immunohistochemistry in glioblastomas.

The vast majority of glioblastomas have CDKN2A, CDK4, or RB gene alterations that perturb the p16-cdk4-pRb cell cycle regulatory cascade. To explore whether immunohistochemical methods provide an alternative means of assessing this pathway, we studied 25 glioblastomas using a combination of molecular genetic and immunohistochemical assays. Homozygous deletion of the CDKN2A gene was detected in 12 of 25 (48%) cases, CDK4 amplification in 4 of 25 (16%) tumors, and loss of heterozygosity at the RB gene in 8 of 22 (36%) informative cases. Five of 25 (20%) glioblastomas had diffuse p16 immunohistochemical positivity. Significantly, all of these had either CDK4 amplification or RB LOH, suggesting that p16 immunopositivity only occurs in those tumors with alterations of another component in the pathway. Nineteen (76%) cases were uniformly immunonegative for p16, and 12 (48%) had CDKN2A homozygous deletions, but the remaining 7 cases lacked CDKN2A deletions, mutations and promoter methylation. All glioblastomas stained diffusely for cdk4, irrespective of CDK4 gene amplification status. Extensive pRb staining was present in most cases that maintained both RB alleles, and absent in most cases with RB loss, but there were notable discrepancies. Thus, p16 and pRb immunohistochemistry cannot replace molecular genetic analysis of this critical regulatory cascade; instead, the combined results hint at complex regulation of this cell cycle checkpoint. From a practical point of view, although p16 immunonegativity does not necessarily indicate CDKN2A deletion, diffuse positive p16 immunostaining strongly suggests either CDK4 amplification or RB loss and excludes CDKN2A deletion.

Brain↗
PubMed1997

Association between early-onset alcoholism and the dopamine D2 receptor gene.

We examined the allelic association between the dopamine D2 receptor (DRD2) gene and alcoholism in 100 biologically unrelated Japanese alcoholics and 93 unrelated controls. Genomic DNA was prepared from peripheral white blood cells using the phenol-chloroform method. A 310-bp region surrounding the TaqA site at the DRD2 locus was amplified by polymerase chain reaction (PCR), and the PCR product was incubated with TaqI. The A1 allele remained intact while the A2 allele was cut. The frequency of the A1/A1 genotype and the frequency of the A1 allele were higher in early-onset alcoholics than in controls, P < 0.05 and P < 0.01, respectively. Moreover, the frequency of the A1/A1 genotype and the frequency of the A1 allele were higher in early-onset alcoholics with family histories of alcohol dependence than in controls, P < 0.01 and P < 0.01, respectively. The results indicate that the DRD2 gene is associated with susceptibility to early-onset alcoholism, and that each additional A1 allele shifts onset of alcoholism to an earlier age.

Adult↗
PubMed1997

Transforming growth factor beta stabilizes p15INK4B protein, increases p15INK4B-cdk4 complexes, and inhibits cyclin D1-cdk4 association in human mammary epithelial cells.

The effects of transforming growth factor beta (TGF-beta) were studied in closely related human mammary epithelial cells (HMEC), both finite-life-span 184 cells and immortal derivatives, 184A1S, and 184A1L5R, which differ in their cell cycle responses to TGF-beta but express type I and type II TGF-beta receptors and retain TGF-beta induction of extracellular matrix. The arrest-resistant phenotype was not due to loss of cyclin-dependent kinase (cdk) inhibitors. TGF-beta was shown to regulate p15INK4B expression at at least two levels: mRNA accumulation and protein stability. In TGF-beta-arrested HMEC, there was not only an increase in p15 mRNA but also a major increase in p5INK4B protein stability. As cdk4- and cdk6-associated p15INK4B increased during TGF-beta arrest of sensitive cells, there was a loss of cyclin D1, p21Cip1, and p27Kip1 from these kinase complexes, and cyclin E-cdk2-associated p27Kip1 increased. In HMEC, p15INK4B complexes did not contain detectable cyclin. p15INK4B from both sensitive and resistant cells could displace in vitro cyclin D1, p21Cip1, and p27Kip1 from cdk4 isolated from sensitive cells. Cyclin D1 could not be displaced from cdk4 in the resistant 184A1L5R cell lysates. Thus, in TGF-beta arrest, p15INK4B may displace already associated cyclin D1 from cdks and prevent new cyclin D1-cdk complexes from forming. Furthermore, p27Kip1 binding shifts from cdk4 to cyclin E-cdk2 during TGF-beta-mediated arrest. The importance of posttranslational regulation of p15INK4B by TGF-beta is underlined by the observation that in TGF-beta-resistant 184A1L5R, although the p15 transcript increased, p15INK4B protein was not stabilized and did not accumulate, and cyclin D1-cdk association and kinase activation were not inhibited.

Breast↗