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Biomedical subjects

R Whitaker

Publications and source records attributed to R Whitaker.

At least 19 recordsLinked to original sources

Regulation of invasion of epithelial ovarian cancer by transforming growth factor-beta.

OBJECTIVE: The metastatic process in epithelial ovarian cancer is thought to involve surface shedding and subsequent dissemination of ovarian cancer cells, facilitated by localized proteolysis at the interface between ovarian cancer cells and peritoneal surfaces. The factors regulating the metastatic process, however, are not well understood. Transforming growth factor-beta (TGF-beta) is a multifunctional peptide that elicits numerous cellular effects pertinent to the metastatic process. The purpose of this study was to evaluate the regulatory role of TGF-beta on metastasis in ovarian cancer. METHOD: We evaluated the effect of TGF-beta on the metastatic characteristics (adhesion, invasion, motility, proteolysis) of five ovarian cancer cell lines (DOV-13 and OVCA 420, 429, 432, and 433), two short-term primary ovarian cancer cell cultures (OVCA 10 and OVCA 208), and five normal ovarian surface epithelial (NOSE) cell cultures (OSE 133, 185, 186, 188, and 189). The effect of TGF-beta on invasion and proteolysis was quantified using a modified Boyden chamber invasion assay, zymography, a coupled colorimetric activity assay, and an HPLC-based quantitation of synthetic substrate cleavage. RESULTS: TGF-beta significantly increased invasion in five of seven ovarian cancer cell lines in amounts ranging from 2- to 20-fold. In contrast, TGF-beta significantly decreased invasion in two of five NOSE isolates by 50 to 80% and had no significant effect on invasion in three. TGF-beta treatment increased matrix metalloproteinase (MMP) expression in OVCA 420 and 433 and DOV-13, resulting in MMP-dependent collagen cleavage and invasive activity. Addition of the MMP inhibitor GI12947 neutralized the enhancing effect of TGF-beta on invasion. TGF-beta had no effect on ovarian cancer cell motility and only increased adhesion in DOV-13. CONCLUSIONS: These data suggest that TGF-beta may enhance the invasiveness of ovarian cancers through induction of MMP activity.

Basement Membrane↗

Spontaneous mammary carcinomas fail to induce an immune response in syngeneic FVBN202 neu transgenic mice.

FVBN202 mice, which are transgenic for the rat neu gene, spontaneously develop mammary carcinomas between 6 and 7 months of age. We investigated whether these spontaneous tumors (spontaneous breast carcinoma cells, SBCC) could elicit an immune response in naive 6- to 8-week-old FVBN202 transgenic and FVBN nontransgenic mice. After s.c. injection of SBCC, the recently activated T cells, which were identified by their reduced expression of CD62L (L-selectin), were isolated from the draining lymph nodes, expanded with anti-CD3 and IL-2, and their cytokine response to tumor cells in vitro was analyzed. Tumor-vaccine draining lymph node lymphocytes (TVDLN) from transgenic mice failed to make IFN-gamma in response to the tumor cells. However, TVDLN from the nontransgenic mice exhibited a tumor-specific IFN-gamma response against the SBCC. This indicates that the SBCC are immunogenic. The lack of response in transgenic mice could not be attributed to cytokine immune deviation or T-cell signaling defects. Although transgenic mice were tolerant to their own tumors, their immune competence was established by their ability to respond in an allogeneic mixed lymphocyte reaction, to reject an allogeneic breast carcinoma cell line, and to produce a tumor-specific IFN-gamma response against a syngeneic cancer cell line. This transgenic mouse model provides the opportunity to investigate the immune response against a primary tumor cell culture rather than cell lines or clones and should prove useful for developing immunotherapies that overcome tolerance to self-tumor antigens.

Animals↗

Prediction using partly conditional time-varying coefficients regression models.

Data collected longitudinally in time provide the opportunity to develop predictive models of future observations given current data for an individual. Such models may be of particular value in defining individuals at high risk and thereby in suggesting subgroups for targeting of prevention intervention research efforts. In this paper, we propose a method for estimating predictive functions. The method uses an extension of the marginal regression analysis methods of Liang and Zeger (1986, Biometrika 73, 13-22) and is implemented using simple estimating equations. A key feature of the models is that regression coefficients are modelled as smooth functions of the times both at and for prediction. Data from a study of obesity in childhood and early adulthood is used to demonstrate the methodology. Criteria for defining individuals to be at high risk can be defined on the basis of estimated predictive functions. We suggest methods for evaluating the diagnostic accuracy (sensitivity and specificity) of such rules using cross-validation. The method holds promise as a robust and technically easy way of evaluating information about future prognosis that may be gleaned from a patient's current and past clinical status.

Adolescent↗

Central nervous system and plasma lipid profiles associated with carteolol and timolol in postmenopausal black women.

PURPOSE: Among ocular hypotensive agents, intrinsic sympathomimetic activity (ISA) is unique to carteolol hydrochloride. This study was conducted to evaluate the central nervous system (CNS) and plasma lipid profiles associated with timolol maleate and carteolol hydrochloride in postmenopausal black women with primary open-angle glaucoma (POAG) or ocular hypertension. METHODS: One hundred subjects met the inclusion and exclusion criteria for this randomized, double-masked, multicenter, parallel-group study. After completion of informed consent and complete ophthalmic examination, eligible patients entered a washout period, during which no topical ophthalmic medications were used. Blood samples were obtained for hematology and blood chemistry evaluations. Vital signs, ocular symptoms, Symptom Checklist-90-R (SCL-90-R) evaluation, intraocular pressure (IOP) measurements, and slit-lamp examinations were performed before randomization to treatment with either topical carteolol hydrochloride 1.0% or topical timolol maleate 0.5%. Patients received active medications twice daily and were monitored at 4 weeks and 12 weeks. At the conclusion of treatment, vital signs, ocular symptoms, SCL-90-R evaluation, IOP, slit-lamp examinations, and blood samples were obtained. RESULTS: Compared with baseline, high-density lipoprotein (HDL) cholesterol was significantly decreased (worsened) in the timolol group but did not change significantly in the carteolol group. The between-group difference was statistically significant. Total cholesterol to HDL ratio significantly increased (worsened) in the timolol group compared with baseline but did not change in the carteolol group. The difference between groups was statistically significant. No significant differences were observed between groups in SCL-90-R results for either somatization or depression. CONCLUSIONS: These results suggest that topical carteolol hydrochloride may have a more favorable blood lipid profile than topical timolol maleate in postmenopausal black women with POAG or ocular hypertension. Carteolol and timolol appear to have similar CNS side effect profiles.

Adrenergic beta-Antagonists↗

Characterization and functional analysis of the cis-autoproteolysis active center of glycosylasparaginase.

Glycosylasparaginase is an N-terminal nucleophile hydrolase and is activated by intramolecular autoproteolytic processing. This cis-autoproteolysis possesses unique kinetics characterized by a reversible N-O acyl rearrangement step in the processing. Arg-180 and Asp-183, involved in binding of the substrate in the mature enzyme, are also involved in binding of free amino acids in the partially formed substrate pocket on certain mutant precursors. This binding site is sequestered in the wild-type precursor. Binding of free amino acids on mutant precursors can either inhibit or accelerate their processing, depending on the individual mutants and amino acids. The polypeptide sequence at the processing site, which is highly conserved, adopts a special conformation. Asp-151 is essential for maintaining this conformation, possibly by anchoring its side chain into the partially formed substrate pocket through interaction with Arg-180. The reactive nucleophile Thr-152 is activated not only by deprotonation by His-150 but also by interaction with Thr-170, suggesting a His-Thr-Thr active triad for the autoproteolysis.

ATP-Binding Cassette Transporters↗

Glaucoma: what the nurse practitioner should know.

Glaucoma is both an international and a national public-health issue. Worldwide, glaucoma is one of the leading causes of blindness. Although more than two million people in the United States have glaucoma, yet only half of them are aware that they have the disease. The diagnosis of glaucoma requires an extensive ocular examination. Glaucoma consists of a group of ocular diseases that result in optic disk cupping and visual field loss. Although glaucoma is a blinding disease, in most cases, blindness may be prevented through early detection and treatment. Glaucoma management is determined by the type of glaucoma one has.

Adrenergic alpha-Agonists↗

The efficacy and safety of diclofenac 0.1% versus prednisolone acetate 1% following trabeculectomy with adjunctive mitomycin-C.

BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of diclofenac 0.1% versus prednisolone acetate 1% following trabeculectomy with adjunctive mitomycin-C. PATIENTS AND METHODS: The authors prospectively randomized chronic open-angle glaucoma patients who underwent trabeculectomy with adjunctive mitomycin-C to receive postoperatively either diclofenac 0.1% or prednisolone acetate 1% 4 times daily, to be tapered as inflammation resolved. RESULTS: In the diclofenac group (n = 14), the preoperative intraocular pressure of 30.4 +/- 13.1 decreased to 12.4 +/- 6.5 mm Hg at 6 months postoperatively. In the prednisolone acetate group (n = 12), the preoperative intraocular pressure decreased from 29.1 +/- 10.4 to 12.8 +/- 4.2 mm Hg at 6 months postoperatively (P = .85). The average number of medicines used 6 months postoperatively was 0.50 +/- 0.8 in the diclofenac group and 0.24 +/- 0.6 in the prednisolone acetate group (P = .36). Adverse events were similar between groups (P = .51). One patient in the diclofenac group underwent reoperation at 1 month due to uncontrolled intraocular pressure. CONCLUSIONS: This study shows that following trabeculectomy with adjunctive mitomycin-C, a similar intraocular pressure result may be expected when either diclofenac or prednisolone acetate is prescribed postoperatively for intraocular inflammation.

Aged↗

Heregulin and agonistic anti-p185(c-erbB2) antibodies inhibit proliferation but increase invasiveness of breast cancer cells that overexpress p185(c-erbB2): increased invasiveness may contribute to poor prognosis.

Overexpression of p185(c-erbB2) (p185/NEU/HER2) by tumor cells is associated with a poor prognosis in many but not all studies of breast and ovarian cancer. The poor prognosis associated with overexpression of p185(c-erbB2) could result from an increased growth rate or increased invasive potential. The p185(c-erbB2) tyrosine kinase receptor can be activated with agonistic antibodies directed against p185(c-erbB2) or with the ligand heregulin through a combinatorial interaction with erbB3 or erbB4. Consequently, we have asked whether heregulin or agonistic antibodies increase anchorage-independent growth or invasiveness of the SKBr3 breast cancer cell line, which overexpresses p185(c-erbB2). Incubation of SKBr3 breast cancer cells with heregulin inhibited anchorage-independent growth while enhancing tyrosine phosphorylation of p185(c-erbB2). Heregulin treatment also increased adhesion of SKBr3 cells to plastic and increased invasiveness of tumor cells into Matrigel membranes while increasing expression of the CD44 (HCAM) and CD54 (ICAM-1) adhesion molecules. Tumor cell invasion of Matrigel membranes was partially blocked by either anti-CD44 or anti-CD54 antibodies, indicating a role for these adhesion molecules in the invasion process. Compatible with the increased invasiveness, heregulin increased expression of the matrix metalloproteinase 9. In contrast, the agonistic anti-p185(c-erbB2) antibody ID5 induced only a subset of the responses induced by heregulin. ID5 induced tyrosine phosphorylation of p185(c-erbB2), increased invasiveness, and increased expression of CD44. Despite the similarity of effects of ID5 and heregulin on some outcomes, the ID5 antibody failed to increase adhesion to plastic, expression of CD54, or production of matrix metalloproteinase 9. Thus, the ID5 agonistic anti-p185(c-erbB2) antibody mimics rather than antagonizes some but not all of the actions of heregulin. Moreover, the poor prognosis of breast and ovarian cancers that overexpress p185(c-erbB2) could relate in part to enhanced invasiveness rather than to increased proliferative capacity.

Antibodies, Neoplasm↗

Immunohistochemical visualization of fibrin in anterior chamber angle after YAG laser capsulotomy.

Hematoxylin and eosin staining of rabbit eyes after YAG laser anterior capsulotomy showed amorphous substances at the anterior chamber angle. The amorphous substances were identified as fibrin by immunohistochemical methods. This finding indicated that the obstruction of aqueous humor flow by fibrin could be responsible for the elevation of intraocular pressure following YAG laser anterior capsulotomy.

Animals↗

Differentiation of Listeria monocytogenes and Listeria innocua by 16S rRNA genes and intraspecies discrimination of Listeria monocytogenes strains by random amplified polymorphic DNA polymorphisms.

Differences in the 16S rRNA genes (16S rDNA) which can be used to discriminate Listeria monocytogenes from Listeria innocua have been detected. The 16S rDNA were amplified by polymerase chain reaction with a set of oligonucleotide primers which flank a 1.5-kb fragment. Sequence differences were observed in the V2 region of the 16S rDNA both between L. monocytogenes Scott A and L. innocua and between different L. monocytogenes serotypes. Although L. monocytogenes SLCC2371 had the same V2 region sequence as L. innocua, the two species were different within the V9 region at nucleotides 1259 and 1292, in agreement with previous studies (R.-F. Wang, W.-W. Cao, and M.G. Johnson, Appl. Environ. Microbiol. 57:3666-3670, 1991). Intraspecies discrimination of L. monocytogenes strains was achieved by using the patterns generated by random amplified polymorphic DNA primers. Although some distinction can be made within the L. monocytogenes species by their 16S rDNA sequence, a far greater discrimination within species could be made by generating random amplified polymorphic DNA patterns from chromosomal DNA. By using a number of 10-bp primers, unique patterns for each isolate which in all cases examined differentiate between various L. monocytogenes serotypes, even though they may have the same 16S rRNA sequences, could be generated.

Base Sequence↗

Clonal origin of epithelial ovarian carcinoma: analysis by loss of heterozygosity, p53 mutation, and X-chromosome inactivation.

BACKGROUND: It has been suggested that multiple sites of epithelial ovarian carcinoma on the peritoneal surface reflect polyclonal disease arising from multiple primary tumors in the peritoneal mesothelium, rather than monoclonal disease spread by metastases from one primary ovarian cancer. PURPOSE: The purpose of this study was to investigate whether ovarian cancer has a monoclonal or polyclonal origin. METHODS: DNA specimens were obtained from peripheral blood lymphocytes (normal DNA) and from multiple tumor deposits of 17 women with epithelial ovarian carcinoma: primary tumors, metastatic deposits, and ascites. The clonal origin of each tumor was determined by performing (a) analysis to detect loss of heterozygosity at five loci on chromosomes 5, 11, 13, and 17; (b) sequencing of exons 5-8 of the p53 gene; and (c) X-chromosome inactivation analysis of the phosphoglycerate kinase (PGK) gene. RESULTS: In 15 of the 17 cases analyzed, there was clear evidence of monoclonal origin. The probability that the genetic events documented in these 15 cases occurred as independent events in each tumor deposit ranged from 2.5 x 10(-1) to 3.7 x 10(-16). In two cases, the pattern of allelic deletion and p53 gene mutation was compatible with either a monoclonal origin or origin from two primary ovarian tumors. CONCLUSIONS: The results did not support the hypothesis that ovarian cancer is a multifocal, polyclonal disease. Instead, the data suggest that sporadic epithelial ovarian carcinoma has either a monoclonal or a dual primary origin. IMPLICATIONS: These findings have important implications for understanding of the natural history of ovarian cancer and for clinical strategies aimed at prevention and early detection. Further studies will be required to determine the clonal origin of familial hereditary ovarian cancer.

Alleles↗

Regulation of growth of normal ovarian epithelial cells and ovarian cancer cell lines by transforming growth factor-beta.

OBJECTIVE: The purpose of this study was to study the role of transforming growth factor-beta in regulation of proliferation of normal and malignant ovarian epithelial cells. STUDY DESIGN: We examined production of and responsiveness to transforming growth factor-beta in primary monolayer cultures of epithelial cells from five normal human ovaries and in five ovarian cancer cell lines. RESULTS: In normal ovarian epithelial cells, proliferation always was inhibited by transforming growth factor-beta (greater than 40%) (p less than 0.01). Among the cancer cell lines, proliferation of one was markedly inhibited (greater than 95%) (p less than 0.01), two were only modestly inhibited (15% to 20%) (p less than 0.05), and two were unaffected. In addition, we found that all of the normal ovarian epithelial cells and four of five ovarian cancer cell lines produce transforming growth factor-beta ribonucleic acid and protein. CONCLUSIONS: These data suggest that transforming growth factor-beta may act as an autocrine growth inhibitory factor for normal ovarian epithelium in vivo. Because most of the ovarian cancer cell lines are relatively resistant to the growth inhibitory effect of transforming growth factor-beta and because one cell line does not produce transforming growth factor-beta, it is possible that loss of the transforming growth factor-beta pathway may play a role in the development of some ovarian cancers.

Cell Division↗

The effect of interferon gamma on epidermal growth factor receptor expression in normal and malignant ovarian epithelial cells.

OBJECTIVE: We examined the effect of interferon gamma on proliferation and epidermal growth factor receptor expression in ovarian cancer cell lines and normal ovarian epithelial cells. STUDY DESIGN: The tritiated thymidine incorporation assay was used to assess the effect of interferon gamma on proliferation. Scatchard analysis of anti-epidermal growth factor receptor antibody binding, and Western blotting of immunoprecipitates was used to assess the effect of interferon gamma on epidermal growth factor receptor expression. RESULTS: Although interferon gamma elicited 30% to 40% decreases in proliferation, epidermal growth factor receptor expression was strikingly increased in all four ovarian cancer cell lines. Scatchard analysis indicated that this increase occurred primarily at the cell surface, but total cellular receptor levels also were increased. In contrast, interferon gamma treatment of normal ovarian epithelial cells affected neither proliferation nor epidermal growth factor receptor levels. CONCLUSION: Because the up-regulation of epidermal growth factor receptors by interferon gamma appears to be confined to malignant cells, interferon gamma may facilitate immunotherapy and imaging of ovarian cancers by means of immunoconjugates directed against the epidermal growth factor receptor.

Antibodies, Monoclonal↗

Ethics: issues of concern.

Awareness of the aforementioned issues (confidentiality and privacy, deception and debriefing, and publication of study results and data analysis) is a major step in preventing the violation of a patient's dignity as a human being during a research study. Also, with patients themselves in unison with patient advocates demanding "humane" care and voicing the patient's "right to know" about alternative procedures, we must not assume our study participants to be naive and blindly trusting of nursing. On the other hand the public perception of nursing as a profession of "care givers" and not "harm doers" is one that we should perpetuate in good faith.

Confidentiality↗

Cultural, ethnic, racial, and religious factors: implications for ophthalmic nursing practice and research.

In her book, 9226 Kercheval: The storefront that did not burn, Milio (1970) states ... the one who would change others must himself be changed (p.xi). Thus if ophthalmic nursing practice is to have a positive impact upon patient outcomes in the twenty-first century, our nursing interventions and the empirical research that validates and legitimizes these interventions must be predicated upon factors that view the patient holistically. In particular, the integration of orthodox or traditional ophthalmic procedures with the patient's perceptions of health, cultural norms, values, religious doctrines, etc. If compromises between the nurse and the patient are not negotiated, nursing services will be avoided and nursing interventions such as patient education will be ignored (Reinhardt & Quinn, 1977). Sensitivity to cultural, ethnic, racial and religious factors will enhance ophthalmic nursing practice by helping to unravel such issues as patient compliance, differential responses to pain (Davitz, Sameshima, & Davitz, 1976; 1972; Zborowski, 1969; 1952), the relevance for utilizing a variety of teaching strategies for patient education, and family and community influence in the prescribed care of the patient. Having had our philosophy of health care shaped by a middle-class white, and traditionally patriarchal, value and belief paradigm (Donnelly & Sutterly, 1985), we tend to unconsciously gravitate toward ethnocentric attitudes and stereotypic behaviors when caring for patients who hold health beliefs and values different from our own. However, as we become acquainted with and learn to appreciate the norms and values of differing populations, there will be a diminution in ethnocentric attitudes and stereotypic behavior.

Clinical Nursing Research↗

Overexpression of HER-2/neu is associated with poor survival in advanced epithelial ovarian cancer.

Previous studies have suggested that overexpression of HER-2/neu oncogene occurs in 15-40% of breast cancers and that overexpression is associated with poor prognosis. In the present report, we have used an immunohistochemical technique involving a monoclonal antibody specifically reactive with the external domain of HER-2/neu to study expression of HER-2/neu in frozen sections of normal ovary and advanced epithelial ovarian cancer. The intensity of staining for HER-2neu was always moderate or less (0-2+) in normal ovarian epithelium. Among 73 ovarian cancers, 50 (68%) had staining similar to that for normal ovarian epithelium (0-2+) while 23 (32%) stained heavily (3+). Survival of the 23 patients with high HER-2/neu expression (median, 15.7 months) was significantly worse (P = 0.001) than that of the 50 patients (median, 32.8 months) with normal HER-2/neu expression. In addition, patients whose tumors had high HER-2/neu expression were significantly less likely to have a complete response to primary therapy (P less than 0.05) or have a negative second-look laparotomy when serum CA 125 levels were normal preoperatively (P less than 0.05). These findings suggest that HER-2/neu deserves further evaluation as a prognostic marker in epithelial ovarian cancer.

Female↗

Gastric cancer in Gwynedd. Possible links with bracken.

One hundred and one histologically confirmed gastric cancer patients in Gwynedd, North Wales, were matched by sex, age and social class to two hospital inpatients without cancer. Seventy-seven of the gastric cancer cases were also matched, using the same criteria, to a patient with a confirmed cancer of a different site (excluding oesophagus). A questionnaire was used to determine bracken exposure and source of water in childhood. Residential and occupational histories were obtained and the consumption of buttermilk, a potential vector of the bracken carcinogens, was quantified. Comparison of the gastric cancer patients with the non-cancer controls indicated that exposure to bracken in childhood had an increased risk (RR = 2.34, P less than 0.001) compared to no exposure and that length of residence in Gwynedd was associated with increased risk (RR = 2.46 for durations of 61 years and over, P less than 0.01). Consumption of buttermilk in childhood and adulthood was attended by increased risk (RR = 1.61 and 1.86 respectively, the latter being statistically significant, P less than 0.05). Neither the residence effect nor consumption of buttermilk in adulthood remained significant when considered in a multivariate analysis with bracken exposure.

Adult↗