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Biomedical subjects

L Cosentino

Publications and source records attributed to L Cosentino.

At least 19 recordsLinked to original sources

Differential mutation of transgenic and endogenous loci in vivo.

Although chemicals usually induce very similar frequencies of mutations in transgenes and endogenous genes in vivo when given acutely, chronic exposure to N-ethyl-N-nitrosourea (ENU) produced a more complex pattern in which the endogenous locus was spared many mutations. Here, we demonstrate that the effect is neither ENU-specific nor locus-specific, and thus, may be important in the extrapolations of risk assessment and in understanding mutational mechanisms. During chronic mutagen exposure, mutations at the transgene accumulate linearly with time, i.e. in direct proportion to the dose received. In contrast, mutations at the endogenous gene are much less frequent than those of the transgene early in the exposure period and the accumulation is not linear with time, but rather accelerates as the exposure continues. Previous comparisons involved the endogenous Dlb-1 locus and the lacI transgene from the Big BlueMouse in the small intestine. These experiments involved the Dlb-1 locus and the lacZ transgene from the MutaMouse in the small intestine and the hprt locus and the lacZ transgene in splenocytes. Comparisons were made in both tissues after acute and chronic exposures to ENU, the original mutagen, and in the small intestine after exposures to benzo(a)pyrene. All comparisons showed that during chronic exposures mutations at the transgene accumulate linearly with the increasing duration of exposure, whereas induced mutations of the endogenous gene initially accumulate at a slower rate. Thus, the difference in mutational response observed during low chronic treatment is not unique to a particular transgene, endogenous gene, tissue, or mutagen used, but may be a general phenomenon of such genes.

Animals↗

ENU induces mutations in the heart of lacZ transgenic mice.

The use of transgenic mouse models as somatic mutation assays allows determination of mutation in all tissues of the mouse, including non-dividing tissues. In this regard, these models can be used to study the possibility that mutations can be induced in mitotically quiescent organs such as the heart. Mutations are generally thought to be associated with mitotic processes of DNA replication. Mutations, however, are also postulated to occur in the absence of mitosis as the result of DNA repair. In order to determine whether or not mutations could be induced in the heart, we analyzed the mutant frequency in the hearts of F(1) (Muta Mouse X SWR) mice that had been treated acutely with 250 mg/kg ENU and sampled at days 10, 35, and 70 post-treatment. A significant increase in mutant frequency at day 70 shows that mutations can be induced in the heart. Since the heart contains small numbers of non-muscle cells, additional mechanisms that could explain these results were also considered. The effect of ENU-induced cell proliferation or a sub-population of rapidly dividing cells is ruled out by C(14)-thymidine uptake studies which showed minimal proliferation. By the same token, the influence of ex vivo mutations (i.e., DNA adducts fixed as mutations during replication in the bacteria) is ruled out by the observed time course of mutations, as well as experimental evidence showing that such mutations are not detected in the lacZ assay.

Animals↗

Effect of exogenous melatonin on mood and sleep efficiency in emergency medicine residents working night shifts.

OBJECTIVE: To determine whether melatonin taken prior to attempted daytime sleep sessions will improve daytime sleep quality, nighttime sleepiness, and mood state in emergency medicine (EM) residents, changing from daytime to nighttime work schedules. METHODS: A prospective, randomized, double-blind crossover design was used in an urban emergency department. Emergency medicine residents who worked two strings of nights, of at least three nights' duration each, and separated by at least one week of days were eligible. Subjects were randomized to receive either melatonin 1 mg or placebo, 30 to 60 minutes prior to their daytime sleep session, for three consecutive days after each night shift. Crossover to the other agent occurred during their subsequent night shifts. Objective measures of quality of daytime sleep were obtained using the Actigraph 1000. This device measures sleep motion and correlates with sleep efficiency, total sleep time, time in bed, and sleep latency. The Profile of Mood States (POMS) and the Stanford Sleepiness Scale (SSS) were also used to quantify nighttime mood and sleepiness. RESULTS: Among the 19 volunteers studied, there was no difference in sleep efficiency (91.16% vs 90.98%, NS), sleep duration (379.6 min vs 342.7 min, NS), or sleep latency (7.59 min vs 6.80 min, NS), between melatonin and placebo, respectively. In addition, neither the POMS total mood disturbance (5.769 baseline vs 12.212 melatonin vs 5.585 placebo, NS) nor the SSS (1.8846 baseline vs 2.2571 melatonin vs 2.1282 placebo, NS) demonstrated a statistical difference in nighttime mood and sleepiness between melatonin and placebo. CONCLUSIONS: There are no beneficial effects of a 1-mg melatonin dose on sleep quality, alertness, or mood state during night shift work among EM residents.

Adult↗

A comparison of the effects of diverse mutagens at the lacZ transgene and Dlb-1 locus in vivo.

Transgenic assays permit the detection of mutations in any tissue, whereas endogenous mutations can be measured in very few. For this reason comparisons between these loci when both can be measured in the same cells are of considerable interest. Previous comparisons have been inconsistent: usually these loci have responded alike, however, in some cases the endogenous locus has been more sensitive and at other times the transgenic locus has been more sensitive. Here we report a comparison of the lacZ transgene of the MutaMouse and the endogenous Dlb-1 gene in the epithelium of the small intestine after acute exposure to seven mutagens. Benzo[a]pyrene, 5-bromo-2'-deoxyuridine, methyl methane sulphonate, ethyl methane sulphonate, N-ethyl-N-nitrosourea, mitomycin C and N-methyl-N-nitrosourea were all given by gavage to F1 (MutaMouse x SWR) mice. Mutations were quantified 2 weeks after the end of treatment. The data shows that all of the agents induced similar mutant frequencies at the Dlb-1 locus and at the lacZ transgene. The acute treatments generally produced only modest increases in mutant frequency at both loci. The higher background frequency observed at the lacZ transgene reduces the ability of the transgenic assay to detect the same absolute increase in mutant frequency.

Animals↗

The cII locus in the MutaMouse system.

Here, we report the first application and characterization of the cII locus as a mutational target for use with the Muta(trade mark)Mouse system for quantifying somatic mutations in vivo. This locus can be analyzed for mutations using positive selection and is identical in sequence to the cII in the Big Blue((R)) Mouse. The cII displays similar spontaneous (5.5 x 10(-5)) and induced mutation frequencies when compared to the lacZ gene in the small intestine of MutaMice treated with ENU (N-ethyl-N-nitrosourea). After acute treatment with 250 mg/kg ENU (ip) the mutant frequencies were 127 x 10(-5) at the cII and 147 x 10(-5) at the lacZ loci, reaching a maximal mutant frequency 10 days posttreatment and remaining constant thereafter. These data prove that this transgene is genetically neutral, conferring neither selective advantage nor disadvantage on the host cells. The cII dose response curve was linear (R(2) = 0.93) comparable to the lacZ after treatments with 0, 50, 150, or 250 mg/kg ENU. Use of the cII locus (0.3 kb) addresses the single most significant drawback associated with the MutaMouse system, namely the inability to obtain sequence spectra efficiently, due to the large size of the lacZ gene (3.0 kb). Moreover, a less obvious application, but nevertheless of considerable importance, is the easy identification of jackpot mutations, without sequencing. The cII, identical in both sequence and origin on the transgenic constructs used in producing the Big Blue and MutaMouse systems, provides the first transgenic locus common to the two widely used in vivo mutagenesis assays.

Animals↗

Effects of extended chronic exposures on endogenous and transgenic loci: implications for low-dose extrapolations.

Although transgenic and endogenous loci generally respond alike to acute mutagenic exposures, those loci that have been tested respond differently to daily or continuous exposures. During chronic exposures, the transgenes accumulate mutations linearly, whereas the endogenous loci are less mutable initially but later accumulate mutations at an accelerating rate. The result is a reverse dose rate effect in which the same total dose is more mutagenic for the endogenous locus when spread over a longer time. This makes extrapolations to still lower chronic exposures uncertain. Here we report extension of a chronic exposure to N-ethyl-N-nitrosourea (ENU) in drinking water to longer times and to lower doses. The F(1) of MutaMouse males x SWR that were used permit detection of mutations at both lacZ and Dlb-1. Both of these mutations were found to be genetically neutral over this period. Extension of the exposure from 30 to 90 days at 94 microg/ml/d showed a continuation of the curves found previously for 10 to 30 days, namely, linear for mutations of the lacZ transgene and concave upward for the Dlb-1 endogenous gene. A simple model for these data is presented. Of the extended exposures, only the highest dose produced a significant increase in Dlb-1 mutant frequency, an increase consistent with the model. The time (at 2.8 microg/ml/d), concentration (after 480 days exposure), and dose (concentration x duration of exposure) response curves were not significantly different from linearity. The data for the transgene are not as convincing, due to the high spontaneous mutant frequency, obscuring the induced response.

Animals↗

Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients.

BACKGROUND: Endoscopic sphincterotomy (ES) plays an important role in treatment of biliary stones; however, there remain some controversies concerning complications of ES, which in most cases seem not to be predictable. METHODS: The aim of this study was a retrospective analysis of complications in 546 consecutive patients (267 males, 279 females, average age 63.7 years) who underwent endoscopic retrograde cholangiography (ERCP) for biliary stones from 1988 to 1995. RESULTS: ES was performed in 535 patients (98%), and extraction of stones was successful in 493 (92%). In all, 29 complications (5.4%) were observed, including bleeding 13, cholangitis seven, cholecystitis four, pancreatitis three, retroduodenal perforation two; of these, four (14%) required an operation. Overall mortality was 0.3%. CONCLUSION: While a significant decrease of the incidence of complications was observed in the course of the study, due to constantly improving experience, no correlation between risk factors and complications was identified.

Adolescent↗

The relationships among stem cells, crypts, and villi in the small intestine of mice as determined by mutation tagging.

The number of stem cells that maintain a crypt of the small intestine is uncertain. Although the number of stem cells per crypt had been thought to be 10-20, current estimates indicate a much smaller number, possibly 1 stem cell per crypt. We report here that in SWR and C57BL/6 X SWR F1 mice, the results of mutation tagging are inconsistent with the existence of more than one stem cell per crypt. Mutations at the Dlb-1 locus mark the progeny of a single epithelial stem cell in the small intestine and reveal the size of the mutant clone. The epithelial cells are produced in the crypts and migrate up the villi to be sloughed off at the tip so that a mutant clone takes the form of a ribbon on the villus. Because the size of the mutant clones must be inversely proportional to the number of stem cells contributing to the villus, this provides a means of counting the stem cells (ethylnitrosourea was used to induce mutations in the intestine). In the duodenum the ribbons average 0.099 +/- 0.004 villus circumferences, indicating that there are 1/0.099 = 10.2 stem cells per villus. Because there are 10.5 +/- 0.67 crypts/villus, the estimate gives 10.2/10.5 = 0.97 +/- 0.1 stem cells/crypt. Because each crypt must have at least one stem cell, the vast majority can have only one stem cell and very few may have two or more.

Animals↗

A test for neutrality of mutations of the lacZ transgene.

Neutral mutations are stable alterations in DNA that are neither beneficial nor damaging to the cell. Once a mutation is fixed in the DNA, the mutant frequency should increase to its maximum and plateau thereafter, provided that enough expression time is given. Evidence has been obtained indicating neutrality for the endogenous Dlb-1 locus and for the lacl in the BigBlue transgenic system, and is reported here for lacZ in the Muta Mouse system. We have found that, after an acute dose of ethylnitrosourea (ENU, 250 mg/kg) the mutant frequency for both lacZ transgene and Dlb-1 remained constant between 10 and 70 days after mutagenesis in the small intestine, where cell turnover is rapid (approximately 7 days). The same concept should apply to other tissues.

Animals↗

Why do stem cells exist?

Self-renewing tissues have a differentiation hierarchy such that the stem cells are the only permanent residents of the tissue, and it is in these cells that most cancerous mutations arise. The progeny of the stem cells either remain stem cells or enter a transient proliferating cell population that differentiates to produce the functional cells of the tissue. The reason that this differentiation hierarchy exists has not been established. We show here that alternative hierarchies, in which there would be no stem cells, are feasible and biologically plausible. We show that current evidence from somatic mutation frequencies at both transgenic and endogenous loci implicates cell division in the origin of most somatic mutations. We suggest, therefore, that the existence of stem cells is an evolutionary consequence of a selective pressure to avoid cancer by reducing the number of somatic mutations. The stem cell hierarchy reduces the number of cell divisions of those cells that reside permanently in the tissue, which reduces the number of somatic mutations and thus minimizes the cancer rate. In the small intestine, the existence of stem cells reduces the mutant frequency in the stem cells by about one order of magnitude. Since two or more mutations are required to transform a cell, the protective effect may be 100-fold or more. Similar factors may be expected in other tissues.

Age Factors↗

ERCP in the era of laparoscopic biliary surgery. Experience with 407 patients.

BACKGROUND: The combined endoscopic and laparoscopic treatment of biliary stones is now highly debated, especially as regards possible complications compared to one-step laparoscopic treatment. METHODS: This study analyzes 407 cases (116 males, 291 females, average age 49 years, range 2-87) observed in the period from May 1991 to July 1994. All patients were evaluated preoperatively for the presence of biliary stones. Considering clinical presentation, blood analysis, ultrasonography, and medical history, 99 patients (24%) were selected for preoperative endoscopic retrograde cholangiopancreatography (ERCP). One patient refused preoperative ERCP. RESULTS: Thirty-nine patients (40%) were found to have biliary stones and were submitted to therapeutic endoscopic sphincterotomy (ES). Endoscopic clearance of the bile ducts was achieved in all patients, with one complication (pancreatitis). In performing laparoscopic cholecystectomy, no technical difficulties could be attributed to ERCP, nor were there any conversions in patients who had had preoperative ERCP. Average postoperative hospital stay was 2.5 days. During a follow-up period of from 2 to 39 months, we diagnosed three patients (0.7%) with symptomatic residual stones. They were submitted to successful ERCP and extraction of the stones. CONCLUSIONS: We conclude that ERCP offers an accurate preoperative selection of patients, allows for effective planning of treatment, and simplifies laparoscopic surgery.

Adolescent↗

The induction of dominant somatic mutations at the Dlb-1 locus.

In the small intestine of heterozygous mice (Dlb-1b/Dlb-1a), the Dlb-1b allele results in a stainable epithelium. The mutation or loss of the dominant Dlb-1b allele in a stem cell results in a non-staining ribbon of cells on a villus of the small intestine. To determine if dominant mutations resulting in the gain of staining--the induction of a Dlb-1b-like allele--could also be detected, we examined Dlb-1a homozygous mice (SWR) 2 weeks after a single treatment with 250 mg/kg ethylnitrosourea. Mutations to the dominant allele should appear as brown ribbons on unstained villi. Such ribbons were observed in the treated group but not in controls. The mutant frequency was low compared to the frequency of Dlb-1a-like mutations reported at the Dlb-1b allele in heterozygous mice.

Animals↗

HIV-1 isolates from children with or without AIDS have similar in vitro biologic properties.

OBJECTIVE: To compare biologic properties of HIV-1 isolates from children with and without AIDS as a measure of viral cytopathogenicity. PATIENTS AND PARTICIPANTS: Virus isolates from peripheral blood mononuclear cells of 13 perinatally infected children were compared for specific in vitro biologic properties. METHODS: Virus isolates were examined for biologic properties as measured by their ability to infect H9 cells and to induce syncytia in susceptible cells. RESULTS: Most of the pediatric HIV-1 isolates failed to infect CD4+ H9 cells and induce syncytia in susceptible cells, regardless of whether they were from children with or without AIDS. All of the isolates, however, grew well in mitogen-stimulated normal adult lymphocytes. These results are in contrast to those with HIV-1 isolates from adults, whose biologic properties were related to the stages of the disease. CONCLUSIONS: These results indicate that, unlike adult HIV-1 isolates, the biologic properties of pediatric isolates are not related to the stages of the disease. The rapid development of disease in children may therefore be due to factors other than intrinsic properties of HIV-1 strains present in children.

Acquired Immunodeficiency Syndrome↗

Familial Alzheimer's disease. Evidences for clinical and genetic heterogeneity.

We report the genealogical, clinical and molecular genetic findings of a new family with autosomal dominant early-onset Alzheimer's disease (FAD) discovered in Torino (Italy). Up to now, the pedigree comprises 1500 members, distributed in 8 generations. 22 patients affected with Alzheimer's disease have been identified. The clinical course of the disease was fairly uniform in all the patients. An high incidence of myoclonic jerks and epileptic seizures was found. Molecular genetic studies showed the presence of positive but nonsignificant lod scores between chromosome 21 anonymous DNA markers and the disease. The data obtained from the Torino family were computed together with those of additional 47 pedigrees, with both early-onset and late-onset Alzheimer's disease. A predisposing locus for the disease was found on the pericentromeric region of chromosome 21 only in early-onset FAD pedigrees.

Adult↗

Intraoperative diagnosis of nervous system lesions.

OBJECTIVE: To determine the accuracy of comparative cytologic and frozen section intraoperative diagnosis in neuropathology and the relevance of diagnostic accuracy during both craniotomic and stereotactic biopsies and to provide further data on rare and/or diagnostically controversial lesions. STUDY DESIGN: Both cytologic and frozen section preparations were employed in the intraoperative diagnosis of 85 consecutive central and peripheral nervous system lesions obtained from classical surgery (70 samples, 4 of which were intramedullary) and stereotactic biopsies (15 samples). RESULTS: Combining cytologic and frozen section details allowed a fair diagnosis in 81 cases (95.29%), confirmed on paraffin sections. In the remaining cases intraoperative misdiagnosis was due to technical-staining defects (1 case); absence of tumor differentiation, resolved only by ultrastructural examination (2 cases); and marked tumor heterogeneity, resolved by wide tissue sampling and immunohistochemistry (1 case). CONCLUSION: Besides providing a general description of cytologic and frozen section criteria useful in intraoperative diagnostic neuropathology and adding further details about some problematic and/or rare entities, our work confirmed: (1) the usefulness of comparative cytologic and frozen section examination in the intraoperative diagnosis of central nervous system lesions, (2) the relevance of the accuracy of intraoperative diagnosis during both craniotomy and stereotaxis, including intramedullary samples; and (3) the importance of fair "conduct" in intraoperative neuropathology, always comparatively considering morphologic and clinicoradiologic data.

Central Nervous System↗

Value of cytology as an adjunctive intraoperative diagnostic method. An audit of 2,250 consecutive cases.

OBJECTIVE: To evaluate the role of intraoperative cytology (IC) in the improvement of diagnostic accuracy obtained by frozen section (FS) alone. STUDY DESIGN: Comparison of 2,250 intraoperative cytologies performed along with frozen sections, with the final diagnoses achieved on paraffin sections. RESULTS: In 18 cases the diagnoses were deferred until the paraffin sections at the time of intraoperative consultation. The diagnostic accuracy in distinguishing benign from malignant lesions by combined intraoperative cytology and frozen section was 99.2%. The accuracy rate is significantly higher than that reported in large series based on frozen section preparations alone. Sensitivity and specificity were, respectively, 98.2% and 100%. The diagnostic accuracy of each technique alone was 94.9% for FS (sensitivity 89.9%, specificity 97.9%) and 96% for IC (sensitivity 94.9%, and specificity 96.8%). Although specific diagnoses were more frequently formulated on the bases of frozen section examination, FSs were not diagnostic in 113 case in which cytology allowed a specific diagnosis. CONCLUSION: Our results emphasize the increasingly important diagnostic role of intraoperative cytology as an adjunct to frozen section. The approach does have limitations.

Breast Neoplasms↗

Evaluation of the expression of tissue DF-3 and MCA and the corresponding serum values in patients with breast carcinoma.

Two specific monoclonal antibodies for breast tissue (DF3 and MCAb-12) and the corresponding tumor markers CA15-3 and MCA in serum have been evaluated in 50 patients with breast cancer and in 15 controls. The expression of these antigens in tissue was poorly correlated with the common prognostic parameters. Their presence in serum was associated with an altered distribution of the antigens in the cell. The expression of these antigens in tissue enables us to select patients for serological follow-up and to evaluate tumor differentiation from a functional point of view.

Antibodies, Monoclonal↗

[Otitis media in childhood: a critical review of the literature].

Infection of the middle ear is one of the most common childhood illnesses accounting for one-third of the pediatrics practice during the first five years of life. Therefore treatment and prevention of the otitis media are of considerable importance. A review of the literature of the otitis media during the pediatric age is reported. In fact in the last years a large amount of knowledge, sometimes referring discordant opinions, has been acquired. The Authors report epidemiology, anatomy, pathology, physiology, microbiology, classification, clinical data diagnosis and therapy of the otitis media. Common conditions of the middle ear (normal, acute otitis media, chronic otitis media, recurrent otitis media) are described. In particular acute otitis media, otitis media with effusion, perforation of the tympanic membrane, fluid level in the middle ear, severe retraction or bulging of the tympanic membrane are pointed out in color-photographs.

Acute Disease↗