Biomedical subjects

J L Messina

Publications and source records attributed to J L Messina.

At least 37 records · Page 2Linked to original sources

PubMed1997

Malignant melanoma: differential diagnosis of pigmented lesions.

The incidence of melanoma is rising globally despite increased awareness. Familiarity with the clinical signs and certain risk factors for melanoma can result in early recognition, and potentially influence outcome. Unfortunately, there are several other cutaneous tumors, both malignant and benign, that resemble melanoma, and may confuse and possibly delay the diagnosis. This paper discusses the clinical characteristics of melanoma and its most common pigmented simulators.

Dermatitis, Seborrheic↗

PubMed1996

Phase I/II trial for the treatment of cutaneous and subcutaneous tumors using electrochemotherapy.

BACKGROUND: Electroporation is a process that causes a transient increase in the permeability of cell membranes. It can be used to increase the intracellular concentration of chemotherapeutic agents in tumor cells (electrochemotherapy; ECT). A clinical study was initiated to determine if this mode of treatment would be effective against certain primary and metastatic cutaneous malignancies. A group of six patients, three with malignant melanoma, two with basal cell carcinoma, and one with metastatic adenocarcinoma, were enrolled in the study. the treatment was administered in a two-step process. METHODS: Each patient received a 10 unit/m2 dose of bleomycin administered intravenously at 1 to 1.5 units/minute. This was followed by eight 99 microsecond pulses at an amplitude of 1.3 kV/cm administered directly to the tumors 5 to 15 minutes after the bleomycin was completely infused. Pulses were administered after the injection of 1% lidocaine solution around the treatment site. RESULTS: Two of three melanoma patients had objective responses. In these two patients, five of six treated tumors decreased in size, and three completely responded. Untreated tumors displayed continued growth. Objective responses were observed in both basal cell carcinoma (BCC) patients. One patient had partial responses in both treated tumors. The other patient had one of four primary BCCs respond completely, and the remaining three respond partially. Patients with metastatic breast adenocarcinoma showed complete responses in both treated nodules after ECT. All patients tolerated the treatment well with no residual effects from the electric pulses. CONCLUSIONS: ECT was an effective local treatment in the majority of nodules treated. The results thus far are very encouraging and the study is being continued.

Adenocarcinoma↗

PubMed1996

Reflex sympathetic dystrophy with mutilating ulcerations suspicious of a factitial origin.

Reflex sympathetic dystrophy (RSD) is a poorly understood posttraumatic pain syndrome associated with dysfunction of the sympathetic nervous system. Pain is often out of proportion to the extent of injury. Progression of the disease may lead to dystrophic and atrophic changes resulting in total disability of an affected limb. Skin findings are highly variable and nonspecific and may rarely include bullae and ulcerations. We describe a mutilating case of RSD with unusual and severely disfiguring ulcerations that necessitated amputation of the right arm. Shortly after the amputation, ulcerations began appearing on the left arm. We suspect a factitial component but have been unable to prove or disprove it. We propose that some ulcerations in patients with RSD may be factitial in origin.

Female↗

PubMed1996

A generalized cutaneous reaction induced by granulocyte colony-stimulating factor.

BACKGROUND: The increasing use of recombinant forms of granulocyte and granulocyte-macrophage colony-stimulating factors (GCSF and GMCSF) for neutropenic conditions has resulted in reports of a variety of cutaneous reactions. OBJECTIVE: We studied the clinical and histologic findings in three patients who underwent bone marrow transplantation and subsequently had a cutaneous eruption associated with the use of GCSF. METHODS: Biopsy specimens taken at the height of the eruption were studied histologically and immunohistochemically. RESULTS: The patients had indurated, well-demarcated, occasionally annular, erythematous desquamation after withdrawal of the medication. Distinctive histologic features consisted of mild epidermal spongiosis overlying a dermal infiltrate of enlarged, plump macrophages. Increased expression of the vascular adhesion molecules ELAM-1 and VCAM-1, as well as the histologic keratinocyte-produced ICAM-1, was noted. CONCLUSION: the clinical and histological findings of the cutaneous reaction to GCSF are characteristic and allow its distinction from other eruptions that occur in bone marrow transplant recipients.

Adult↗

PubMed1996

The use of intraoperative radiolymphoscintigraphy for sentinel node biopsy in patients with malignant melanoma.

BACKGROUND: Selective lymphadenectomy or "sentinel node" biopsy has been introduced recently by Morton and colleagues (Arch Surg 1992;127:392-9) to stage patients with intermediate and thick malignant melanomas. It has proven to be an effective way to identify nodal basins at risk for metastasis without the morbidity of a complete lymph node dissection. The majority of biopsies can be performed under local anesthesia with small incisions, but technical difficulties occasionally result in unsuccessful explorations. Identification of the sentinel node can be enhanced by a intraoperative radiolymphoscintigraphy, a technique introduced Alex and Krag (Surg Oncol 1993;137-43) that uses radiolabeled sulfur colloid and a hand-held gamma probe. OBJECTIVE: We used intraoperative radiolymphoscintigraphy in conjunction with 1% lymphazurin blue dye to define the sentinel node(s) in 148 patients with greater than 0.76 mm in thickness or Clark level IV melanomas. Sentinel lymph nodes were isolated, harvested, and examined using conventional histopathology, and immunohistochemistry for S-100 and HMB-45 antibodies. RESULTS: The overall success rate of sentinel lymph node localization was 97% using a combination of the two techniques. Twenty-one (14%) patients had micrometastasis, and 17 of these subsequently underwent complete lymph node dissection. A total of 220 of 275 (80%) sentinel nodes harvested were radioactive or "hot" compared with 165 of 275 (60%) with the blue dye alone. Four of the patients with micrometastasis had sentinel nodes positive by gamma probe, but negative by blue dye mapping techniques. CONCLUSION: Our results suggest that intraoperative radiolymphoscintigraphy using a hand-held gamma detecting probe improves the identification of sentinel lymph nodes during selective lymphadenectomy. This may reduce the number of "unsuccessful explorations" using the vital blue dye technique for lymphatic mapping, and appeal to a greater variety of surgeons, including dermatologic surgeons.

Biopsy↗

PubMed1995

The role of selective lymphadenectomy in the management of patients with malignant melanoma.

BACKGROUND: A novel surgical technique based on selective lymphadenectomy was used to stage 132 patients with intermediate and thick cutaneous malignant melanoma. Preoperative and intraoperative lymph node mapping techniques were used to ascertain regional lymph node basins at risk for metastasis, and to identify the first node(s) the afferent lymphatics encounter in the basin, defined as the "sentinel" node(s). It has been shown that the histology of the sentinel node reflects the histology of the rest of the nodal bain, and according to preliminary studies using this technique, the likelihood of bypassing the sentinel node(s) to "higher" level nodes is less than 2%. Epidemiologic studies indicate that the long-term survival of patients with melanomas of intermediate thickness or greater is significantly compromised if regional lymph nodes are involved. Yet, the utility of performing lymph node dissections for the purposes of staging only is controversial, not only because of the morbidity and expense of the procedure, but the lack of proven survival benefit. OBJECTIVE: In the present study, we performed preoperative and intraoperative lymphatic mapping, harvested clinically normal sentinel nodes, and examined them for micrometastasis by light microscopy. Both conventional stains and immunocytochemistry for S-100 protein and HMB-45 antibodies were performed, and only those patients with documented micrometastasis received complete lymph node dissections. RESULTS: The sentinel node(s) was identified in each of the patients. Micrometastatic disease was detected in 31 (23%) of the patients by selective lymphadenectomy, and the sentinel node(s) was the only node involved in 83% of the cases upon subsequent complete nodal dissection. CONCLUSION: Our preliminary results suggest that selective lymphadenectomy following lymphatic mapping is an effective procedure for staging melanoma patients with lesions of intermediate thickness or greater. Our results indicate that sentinel lymph nodes may be successfully identified and harvested in the majority of patients, and that they may be examined for the first evidence of micrometastasis without the need of a complete nodal dissection. Information as to whether micrometastases are present in the sentinel node would be valuable in staging patients, and identifying candidates for complete nodal dissections. We are participating in a National Cancer Institute-sponsored multicenter trial to ascertain whether this surgical approach can impact on the recurrence rate and survival of patients with stage 1 and 2 melanoma.

Adolescent↗

PubMed1995

One of three CCArGG box/serum response elements of the beta-actin gene is an insulin-responsive element.

The cytoskeletal actins are abundant proteins in mammalian nonmuscle cells. We have previously reported that physiological concentrations of insulin induced beta-actin transcription in rat H4 hepatoma cells. To define whether one or more of the three CCArGG box elements or other elements within the beta-actin gene promoter is an insulin response element, we transfected H4 cells with regions of the human beta-actin gene promoter fused to the chloramphenicol acetyltransferase gene. A 350-basepair DNA fragment was isolated that mediates both insulin and serum effects. This fragment contains at least two up-stream elements, a CCAAT box and a CCArGG box, and accounts for more than 70% of the basal activity of the beta-actin promoter in H4 cells. There was a small, but significant, stimulatory effect of insulin over maximal serum induction, suggesting a difference in their mechanisms of action. Mutation of the CCAAT box drastically reduced basal expression, with no effect on insulin induction. In contrast, a mutation of the CCArGG element reduced basal expression and completely abolished insulin inducibility. Electrophoretic mobility shift assays suggested that insulin regulated the activity, but not the binding, of a factor(s) that associates with the CCArGG box. These data demonstrate that in H4 cells, insulin induction of beta-actin gene expression was mediated at least in part through one of the three beta-actin CCArGG elements.

Actins↗

PubMed1994

Regulation of gamma-actin gene expression by insulin.

Insulin exerts rapid effects on cellular metabolism and can cause morphological changes by inducing rearrangements of cytoskeletal components. The regulation of specific cytoskeletal genes by insulin, however, has not been studied extensively. In the present work insulin was found to rapidly, but transiently, increase transcription of the cytoskeletal gamma-actin gene in rat H4IIE (H4) hepatoma cells. Insulin-induced transcription of the gamma-actin gene was evident within 5 min and was maximal by 15 min at 10-fold above control levels. The stimulation of transcription was transient, with a return towards basal levels by 120 min. Transcription of gamma-actin was increased at insulin concentrations as low as 1 x 10(-11) M and was maximal at 1 x 10(-9) to 1 x 10(-8) M. Transcription of several control genes (skeletal and cardiac alpha-actin and beta-tubulin) were unaltered by insulin administration. Messenger RNA (mRNA) levels for the gamma-actin gene increased, but to a lesser degree than transcription. Since the gamma-actin message is an abundant and stable mRNA, its levels would not be expected to change dramatically from a transient induction of transcription. Like insulin, phorbol esters transiently increased transcription of the gamma-actin gene. In addition, pretreatment of cells with phorbol esters for 24 h reduced the ability of insulin to induce gamma-actin transcription. These data support our hypothesis that insulin and phorbol esters share intracellular signalling pathways in the control of transcription of specific genes.

Actins↗

PubMed1994

Synergistic induction of gene 33 expression by retinoic acid and insulin.

The expression of gene 33 in rat liver and hepatoma cells is regulated by multiple hormones and other bioactive agents. Previous studies have demonstrated a 15-fold increase in gene 33 mRNA after 1 h of insulin treatment. We demonstrate in this report that retinoic acid (RA) also controls the expression of this gene. Gene 33 mRNA levels are rapidly elevated by RA, with maximal accumulation (19-fold over control) attained after just 1 h of RA treatment. The transcription rate of gene 33 was increased by RA to a maximum level 6-fold greater than control values. Studies with inhibitors of RNA synthesis demonstrated no increase in the stability of gene 33 mRNA in response to RA or insulin. In addition, a synergistic induction of both gene 33 mRNA levels and the transcription rate of gene 33 was observed when both RA and insulin were added together. In the presence of both hormones, the transcription rate was induced almost 20-fold in 30 min, followed by a 49-fold increase in mRNA levels after 1 h. Thus, gene 33 represents the first example of a gene whose transcription rate is elevated directly by both insulin and RA, and synergistically elevated by treatment with both hormones together.

Animals↗

PubMed1994

Evidence for diverse roles of protein kinase-C in the inhibition of gene expression by insulin: the tyrosine aminotransferase, albumin, and phosphoenolpyruvate carboxykinase genes.

We have previously shown that insulin is less effective in inducing expression of several genes in H4 hepatoma cells with reduced functional protein kinase-C (PKC) activity. However, other reports suggest that insulin regulation of gene transcription is not PKC dependent. Insulin and phorbol 12-myristate 13-acetate (PMA) rapidly inhibit transcription of the tyrosine aminotransferase and albumin genes. Prolonged PMA pretreatment, to desensitize cells to PMA, resulted in a loss of insulin ability to inhibit albumin transcription. Insulin was still able to inhibit tyrosine aminotransferase transcription, but less than in non-PMA-pretreated cells, and there was also a slight decrease in the ability of insulin to inhibit phosphoenolpyruvate carboxykinase transcription. We previously demonstrated decreased responsiveness of PMA-induced gene expression in insulin-desensitized cells. In the present work, using insulin-desensitized H4 cells (insulin pretreatment for 24 h), subsequent treatment with PMA did not alter phosphoenolpyruvate carboxykinase transcription rates, whereas PMA did inhibit tyrosine aminotransferase transcription rates to an extent similar to observed in nonpretreated cells. Unexpectedly, there was a significant increase in albumin transcription after PMA addition to insulin-pretreated cells. These findings support our hypothesis that the role of PKC in the regulation of gene expression by insulin varies for different insulin-regulated genes.

Animals↗

PubMed1994

Identification of beta-actin sequences necessary for induction by phorbol esters and calcium ionophores.

Transcription of the cytoskeletal beta-actin gene is rapidly induced by phorbol 12-myristate 13-acetate (PMA) and the calcium ionophore, A23187, in cultured H4IIE hepatoma (H4) cells. PMA directly activates protein kinase C (PKC) and activation of PKC is necessary for the cellular actions of PMA, including induction of beta-actin gene transcription. In the present study, we determined the DNA sequence requirements for induction of the beta-actin gene by PMA and A23187. Constructs containing progressive deletions of normal and mutated human beta-actin 5' sequences fused to the reporter gene, bacterial chloramphenicol acetyltransferase, were analysed in transient transfections of H4 cells. We delineated the PMA response DNA element of the human beta-actin gene to the proximal CCArGG box (-62 to -53) in the 5' flanking region. In contrast, A23187 did not induce expression of transfected gene constructs containing this CCArGG box. Additionally, we demonstrated that CCArGG boxes from two other PMA-induced genes in H4 cells, c-fos and gamma-actin, could confer PMA inducibility to a heterologous promoter. This CCArGG box specifically interacts with one or more proteins present in nuclear extracts of H4 cells. These results indicate that in cultured cells, PMA-dependent induction of the beta-actin gene is mediated through the proximal CCArGG box. This suggests that the CCArGG box is a target for PKC action and may be involved in the control of other PKC regulated genes.

Actins↗

PubMed1993

Role of cytosolic calcium in regulation of cytoskeletal gene expression by insulin.

Insulin and calcium ionophores rapidly stimulated transcription of the cytoskeletal beta- and gamma-actin genes in serum-deprived rat H4-II-E hepatoma cells. The calcium ionophore A23187 (1 microM) stimulated transcription of the beta-actin gene by 7.3-, 5.4-, and 2.6-fold and the gamma-actin gene by 5.9-, 5.6-, and 2.6-fold at 15, 30, and 60 min, respectively. Ionomycin (1 microM) similarly increased beta- and gamma-actin transcription. Insulin stimulated beta-actin transcription 11.4-fold and gamma-actin 8.4-fold at 30 min. alpha-Tubulin transcription was induced by both insulin and calcium ionophores but to a lesser degree. The effects of A23187 or ionomycin together with insulin for 30 min were no greater than those of insulin alone. Insulin alone, however, did not significantly increase measurable intracellular calcium concentrations in fura-2-loaded cells. When cytosolic calcium was chelated using quin2 acetoxymethyl ester, the ability of A23187 to increase beta- and gamma-actin transcription was completely abolished, whereas insulin's ability to stimulate actin transcription was only partially inhibited. This suggests that the regulation of gene transcription by insulin may include calcium-dependent pathways but strongly implies that calcium-independent pathways are also utilized.

Actins↗

PubMed1992

Vanadate and insulin stimulate gene 33 expression.

Vanadate and insulin stimulated gene 33 expression in rat H4 hepatoma cells. Vanadate (10(-3) M) maximally increased gene 33 transcription 4-fold at 15 min. The maximal insulin induction (3-4-fold) was observed using 5 x 10(-9) M insulin for 30 min. Both vanadate and insulin increased cytoplasmic mRNA levels in a dose-dependent manner, with maximal effects observed by 60 min. These effects on gene 33 mRNA accumulation were greater than those on transcription. Vanadate (10(-3) M) maximally stimulated gene 33 mRNA levels 10-12-fold. The vanadate and insulin effects were not synergistic. Thus, high concentrations of vanadate regulate gene 33 expression in an insulin-like manner and, like insulin, vanadate probably controls transcriptional as well as post-transcriptional events.

Animals↗

PubMed1992

Rapid regulation of albumin transcription by insulin and phorbol esters in rat hepatoma cells.

The short-term effects of insulin and phorbol esters on the regulation of the albumin gene in rat H4IIE (H4) hepatoma cells were investigated and compared to the expression of a gene known to be inhibited by these agents, phosphoenol pyruvate carboxykinase (PEPCK). Both insulin and phorbol esters inhibited transcription of the albumin gene in a rapid, dose-dependent manner. Within 15 min, albumin transcription was reduced by approx. 80%. The inhibitory effects of insulin were evident at concentrations of insulin as low as 5.10(-11)M, suggesting that these effects were mediated through insulin-specific pathways. The ability of both phorbol esters and insulin to inhibit albumin transcription suggests that the negative control of this gene is a stable feature in H4 cells. The effect of phorbol esters to mimic insulin action on the albumin gene, and on several other genes in this cell line, implies that a common pathway may be shared by both insulin and phorbol esters.

Albumins↗

PubMed1992

Role of protein kinase C in insulin's regulation of c-fos transcription.

One of insulin's actions is the induction of DNA synthesis and cell division, but little is known about the molecular mechanisms involved. Previous studies indicate that insulin stimulates cell division and regulates the expression of several genes in rat H4IIE (H4) hepatoma cells. One of these genes is the proto-oncogene c-fos, a cellular gene whose deregulation has been implicated in the process of cellular differentiation and division. We have shown that insulin induces transcription of the c-fos gene in H4 cells. In the present study, the phorbol ester, phorbol 12-myristate 13-acetate (PMA), stimulated c-fos transcription in a rapid and dose-dependent manner with an 800% increase in transcription following 15-30 min of addition. This increase in c-fos transcription was transitory, returning towards baseline transcription rates within 120 min. PMA stimulated the translocation of protein kinase C (PKC) from the cytoplasm to the membrane in H4 hepatoma cells, as evidenced by a 77% decrease in cytosolic PKC and a 29% increase in membrane PKC activity following 10 min of treatment. Insulin addition to H4 cells for 10 min also resulted in a 31% decrease in cytosolic PKC activity, suggesting a translocation response. When H4 cells were pretreated with PMA for 24 h, there was a decrease of 20-45% in both cytosolic and membrane PKC activity and a complete loss of PMA's induction of c-fos transcription. Thus, the cells were functionally desensitized to further PMA addition. When cells were pretreated with PMA for 24 h, the insulin-induced increase in transcription of c-fos was reduced by 50%. Western blot analysis indicated that the PKC-beta isozyme followed a translocation pattern almost identical with that of total PKC activity. These results suggest that a PMA-sensitive form of PKC is preferentially lost upon PMA pretreatment and that this PKC subtype may be necessary for insulin to fully induce c-fos gene expression.

Animals↗

PubMed1992

Short- and long-term effects of insulin on tyrosine aminotransferase gene expression.

In the present study the relationship between changes in tyrosine aminotransferase (TAT) enzyme activity, cytoplasmic mRNA levels, and gene transcription in response to both short- and long-term exposure to insulin was investigated. Insulin acutely inhibited transcription of the TAT gene by 50% in serum-deprived rat H4 hepatoma cells. Following this initial 50% decrease in transcription, there was a 2.5-fold induction in TAT activity that could not be accounted for by a concomitant increase in TAT mRNA levels. Insulin had no effect on the half-life of TAT mRNA. Insulin exposure for short periods of time also inhibited the glucocorticoid- and cAMP-induced transcription of the TAT gene. Like insulin, protein synthesis inhibitors acutely inhibited basal and glucocorticoid-induced TAT transcription. TAT activity gradually returned toward basal levels after 8 h of insulin treatment. A second insulin-induced increase in TAT activity (3.5-fold above basal levels) was observed by 24 h of insulin treatment. This second phase of insulin-induced TAT activity was associated with elevated levels of TAT transcription and TAT mRNA levels, and therefore, unlike the earlier stimulation, could be accounted for by changes in gene expression. Thus, the insulin-mediated regulation of the TAT gene in H4 cells is complex. Different transcriptional and post-transcriptional mechanisms are likely to be involved in the biphasic responses to insulin.

Animals↗

PubMed1992

Regulation of beta-actin gene transcription by insulin and phorbol esters.

Insulin and the phorbol ester, phorbol 12-myristate 13-acetate, induce beta-actin gene transcription in H4 cells. This occurred rapidly, with a maximum 15-fold stimulation following 15 min of insulin (5 x 10(-9) M) or phorbol ester (1 microgram/ml) exposure. The increase in beta-actin transcription was transitory, returning to baseline within 120 min. Pretreatment of cells with phorbol ester for 24 h, reducing functional protein kinase C activity, abolished the ability of phorbol esters to increase beta-actin transcription. When insulin was added to phorbol ester-pretreated cells the insulin-induced increase in beta-actin transcription was reduced by 40-60%. These findings support our hypothesis that a common regulatory signal is utilized by both insulin and phorbol esters for the complete induction of specific genes.

Actins↗

PubMed1992

Protein synthesis and insulin regulation of p33 and PEPCK gene expression.

Insulin stimulates transcription and cytoplasmic accumulation of a specific mRNA (termed p33), while inhibiting transcription and accumulation of phosphoenolpyruvate carboxykinase (PEPCK) mRNA in rat H4IIE (H4) hepatoma cells. The present work examines the role of protein synthesis in regulation of these genes by insulin and dexamethasone. Like insulin, cycloheximide and anisomycin, two protein synthesis inhibitors, induced p33 transcription and reduced PEPCK transcription. The combination of either protein synthesis inhibitor and insulin did not induce p33 transcription or inhibit PEPCK transcription beyond that observed with either protein synthesis inhibitor alone. Dexamethasone induced both p33 and PEPCK transcription. The combination of insulin and dexamethasone, or protein synthesis inhibitors and dexamethasone, abolished dexamethasone-induced PEPCK transcription. Thus, protein synthesis inhibitors regulate transcription of the p33 and the PEPCK genes in an insulin-like manner.

Animals↗