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A genome-wide survey reveals a diverse array of enhancers coordinate the Drosophila innate immune response.

To defend against microbes, animals regulate a complex immune response. The Drosophila innate immune system deploys a large transcriptional induction of signaling proteins, antimicrobial effectors, and other critical immune factors. This transcriptional response is encoded in enhancers, cis-regulatory sequences that modulate gene expression by binding transcription factors (TFs). While enhancers and transcription factor binding sites (TFBS) have been identified for several immune responsive genes in Drosophila, most enhancers that regulate immune-induced genes are unknown. By identifying enhancers, we can understand how their composition controls expression and contributes to infection outcome. We employed STARR-seq (Self Transcribing Active Regulatory-Region sequencing) in a hemocyte-like cell line to identify immune-specific enhancers across the D. melanogaster genome and performed ATAC-seq in hemocytes extracted from adult flies to assess the chromatin state of these enhancers before and after immune stimulus. We identified thousands of enhancers responsive to IMD stimulation, one of the two primary immune signaling pathways in Drosophila. As expected, immune enhancers are enriched for motifs of Relish, an NF-κB factor, and Kay/Jra, a bZip heterodimer pair, involved in the Imd and JNK pathways respectively, compared to enhancers active in unstimulated cells. However, when grouping enhancers by their target gene's expression timing or functional role or by the enhancers' chromatin accessibility pre- or post-stimulus, different groups of TFBS motifs are enriched, suggesting distinct regulatory logic for different parts of the immune response. Identification and characterization of the diverse array of enhancers that regulate the innate immune response expands our understanding of how animals fight infections.

Drosophila immunity↗

An intron enhancer recognized by splicing factors activates polyadenylation.

Alternative processing of the pre-messenger RNA encoding calcitonin/calcitonin gene-related peptide (CT/CGRP) involves alternative inclusion of a 3'-terminal exon (exon 4) embedded within a six exon primary transcript. Expression of CT/CGRP in transgenic mice indicates that inclusion of exon 4 occurs in a wide variety of tissues, suggesting that the factors responsible for exon 4 inclusion are widely distributed. Inclusion of exon 4 requires an enhancer sequence located within the intron downstream of the poly(A) site of exon 4. Here we show that the intron enhancer activated in vitro polyadenylation cleavage of precursor RNAs containing the CT/CGRP exon 4 poly(A) site or heterologous poly(A) sites. To our knowledge this is the first example of an intron-located enhancer that facilitates polyadenylation. Within the enhancer sequence is a 5' splice site sequence immediately preceded by a pyrimidine tract. This 5' splice site sequence was required for enhanced polyadenylation and was recognized by both U1 small nuclear ribonucleoproteins (snRNPs) and alternative splicing factor/splicing factor 2 (ASF/SF2). Enhancement of polyadenylation required U1 RNA, suggesting that the 5' splice site sequence within the enhancer mediates enhancement via interaction with factors normally associated with functional 5' splice sites. Mutation of the polypyrimidine track of the enhancer also inhibited in vitro polyadenylation cleavage. Oligonucleotide competitions and UV cross-linking indicated that the enhancer pyrimidine track binds the polypyrimidine tract binding protein (PTB), but not U2 snRNP auxiliary factor (U2AF), and that binding of PTB was required for maximal enhancer-mediated polyadenylation. These results suggest that the enhancer binds known splicing factors, and that binding of these factors activates polyadenylation cleavage. Furthermore, these results suggest that regulation of alternative processing of CT/CGRP could occur at the level of polyadenylation, rather than splicing.

Alternative Splicing↗

The role of specific enhancer-promoter interactions in the Drosophila Adh promoter switch.

The Drosophila melanogaster alcohol dehydrogenase (Adh) gene is transcribed from two promoters active at different developmental stages. In this paper we show that the promoters are differentially stimulated by two enhancers, the Adh larval enhancer and the Adh adult enhancer. In early larval stages, the larval enhancer stimulates transcription from the proximal promoter; in late larval stages, the two enhancers act synergistically to stimulate transcription from the distal promoter; and in adults, the adult enhancer stimulates transcription from the distal promoter. To determine the basis for these enhancer-promoter interactions, we examined the effect of each enhancer on three different promoters. We found that the adult enhancer is stage specific and stimulates transcription from all three promoters. In contrast, the larval enhancer is potentially active in all stages and stimulates transcription from only two of the three promoters. These observations suggest that normal temporal expression of Adh depends on the stage-specific activity of the adult enhancer and the differential response of the proximal and distal promoters to the larval enhancer.

Alcohol Dehydrogenase↗

Gadolinium-enhanced dynamic MRI of the fractured carpal scaphoid: preliminary results.

The aim of the present report was to evaluate the vascularity of fracture fragments of the fractured carpal scaphoid in the acute (< 4 weeks) and chronic (> 3 months) phases using a gadolinium-enhanced dynamic MRI sequence. Eight patients with acute scaphoid fractures, six patients with chronic scaphoid fractures, and three control patients without fractures were evaluated using a T1-weighted fast spoiled gradient recalled acquisition (fSPGR) sequence with gadolinium-DTPA enhancement (0.1 mmol/kg bodyweight). Signal intensity over time plots were obtained using region of interest measurements from both fracture fragments. Enhancement factors (EF) were then calculated from the plots. No enhancement of the scaphoid was seen in control subjects (EF: distal scaphoid pole 1.04 +/- 0.01, proximal pole 1.07 +/- 0.08). In acute fracture patients, enhancement of the distal pole was greater than that of the proximal in all cases but one in which the two poles enhanced in a similar fashion (EF: distal 1.99 +/- 0.77, proximal 1.43 +/- 0.99). In chronic fracture patients the enhancement pattern was reversed, as the proximal pole enhanced to a greater degree than the distal with the exception of one case where both poles enhanced equally (EF: distal 1.74 +/- 0.52, proximal 2.64 +/- 0.50). Using a two-tailed non-parametric Mann-Whitney U-test, the difference in enhancement of the proximal poles between the acute and chronic groups was found to be highly significant (P < 0.003). Dynamic contrast-enhanced (fSPGR) MRI demonstrates significant differences in the enhancement patterns of the scaphoid when chronic and acute fractures are compared.

Adult↗

Polyomavirus DNA replication in the pancreas and in a transformed pancreas cell line has distinct enhancer requirements.

The regulatory DNA (enhancer) of polyomavirus (Py) is a major determinant of tissue-specific DNA replication during acute infection of newborn mice. Previously, we reported that the combination of one of the two Py enhancers (A enhancer) and the repeated Moloney murine leukemia virus (Mo-MuLV) enhancer gave a chimeric Py genome (Py-MuLV) that replicates predominantly in the acinar cells of the pancreas, a tissue not permissive for wild-type PyA2 replication (R. Rochford, B. A. Campbell, and L. P. Villareal. Proc. Nat. Acad. Sci. USA 84:449-453,1987). In this report, we further examine the combined enhancer requirements for acinar cell-specific Py replication. We also compare enhancer requirements for Py replication in the acinar cells of the pancreas with those of a transformed acinar cell line (266-6 cells). The deletion of sequences within the A enhancer of Py-MuLV (nucleotides 5098 to 5132) results in a virus with 10-fold-reduced levels of pancreas-specific replication. The deletion, however, of one of the 72-bp repeated Mo-MuLV enhancer sequences from Py-MuLV results in a complete loss of pancreas-specific DNA replication. Thus, the Py A enhancer is required for efficient replication of Py in the pancreas without otherwise altering organ specificity, but both of the repeated copies of the Mo-MuLV enhancer are essential for pancreas-specific Py replication. In contrast to the enhancer requirements for in vivo pancreas replication, in transformed acinar cells (266-6), PyA2 wild-type replicated efficiently and the Py-MuLV recombinant replicated inefficiently. These data suggest that the cell-specific control of DNA replication is different between normal pancreas cells and their transformed cell line counterparts and that this difference is apparent in the enhancer requirement of cell-specific Py DNA replication.

Animals↗

Identification and functional characterization of the human T-cell receptor beta gene transcriptional enhancer: common nuclear proteins interact with the transcriptional regulatory elements of the T-cell receptor alpha and beta genes.

A transcriptional enhancer has been mapped to a region 5.5 kilobases 3' of the C beta 2 gene in the human T-cell receptor (TCR) beta-chain locus. Transient transfections allowed localization of enhancer activity to a 480-base-pair HincII-XbaI restriction enzyme fragment. The TCR beta enhancer was active on both the minimal simian virus 40 promoter and a TCR beta variable gene promoter in both TCR alpha/beta + and TCR gamma/delta + T cells. It displayed significantly less activity in Epstein-Barr virus-transformed B cells and K562 chronic myelogenous leukemia cells and no activity in HeLa fibroblasts. DNA sequence analysis revealed that the enhancer contains a consensus immunoglobulin kappa E2 motif, as well as an AP-1-binding site and a cyclic AMP response element. DNase I footprint analyses using Jurkat T-cell nuclear extracts allowed the identification of five nuclear protein-binding sites, T beta 1 to T beta 5, within the enhancer element. Deletion and in vitro mutagenesis studies demonstrated that the T beta 2- and T beta 3- and T beta 4-binding sites are each required for full transcriptional enhancer activity. In contrast, deletion of the T beta 1- and T beta 5-binding sites had essentially no effect on enhancer function. Electrophoretic mobility shift assays demonstrated that TCR alpha/beta + and TCR gamma/delta + T cells expressed T beta 2-, T beta 3-, and T beta 4-binding activities. In contrast, non-T-cell lines, in which the enhancer was inactive, each lacked expression of at least one of these binding activities. TCR alpha and beta gene expression may be regulated by a common set of T-cell nuclear proteins in that the T beta 2 element binding a set of cyclic AMP response element-binding proteins that are also bound by the T alpha 1 element of the human TCR alpha enhancer and the decamer element present in a large number of human and murine TCR beta promoters. Similarly, the T beta 5 TCR beta-enhancer element and the T alpha 2 TCR alpha-enhancer element bind at least one common T-cell nuclear protein. Taken together, these results suggest that TCR beta gene expression is regulated by the interaction of multiple T cell nuclear proteins with a transcriptional enhancer element located 3' of the C beta 2 gene and that some of these proteins may be involved in the coordinate regulation of TCR alpha and beta gene expression.

Base Sequence↗

Functional cooperation of lens-specific and nonspecific elements in the delta 1-crystallin enhancer.

The expression of the chicken delta 1-crystallin gene is primarily regulated by the action of a lens-specific enhancer 1 kilobase long and located in the third intron of the gene (S. Hayashi, K. Goto, T. S. Okada, and H. Kondoh, Genes Dev. 1:818-828, 1987). The 120-base-long core segment is required for the activity of the delta 1-crystallin enhancer but by itself shows no activity. We analyzed the action of the core and adjoining segments of the delta 1-crystallin enhancer by two different approaches: (i) multiplication of the segments to express any cryptic effect and (ii) competition among enhancers for nuclear factors involved in enhancer action. We found that (i) the core defines a strictly lens-specific element, (ii) an adjoining segment defines an element with a broad specificity with regard to cell type, (iii) these elements cooperate in cis within the delta 1-crystallin enhancer, (iv) the multimers of these elements complete with each other and with delta 1-crystallin and simian virus 40 enhancers in trans apparently without sequence specificity but in a fashion reflecting the strength of the enhancers, and (v) the enhancers in trans do not affect the expression of enhancer-free genes, thereby ruling out the possibility of competition for general transcription factors. The last two observations raise the possibility that the enhancer segments interacting with different sequence-specific factors also interact with one other component involved in enhancer action.

Animals↗

Focal hepatic lesions: detection and characterization with combination gadolinium- and superparamagnetic iron oxide-enhanced MR imaging.

PURPOSE: To compare gadolinium- and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for detection and characterization of focal hepatic lesions when different contrast agent administration sequences are used. MATERIALS AND METHODS: Unenhanced, dynamic gadolinium-enhanced, and SPIO-enhanced hepatic MR images were obtained in 134 patients. SPIO-enhanced MR imaging was performed immediately after gadolinium-enhanced dynamic MR imaging in 50 patients, 1 day after gadolinium-enhanced dynamic MR imaging in 40 patients, and before gadolinium-enhanced dynamic MR imaging in 44 patients. Two radiologists independently reviewed the gadolinium image set (unenhanced and gadolinium-enhanced dynamic MR images) and the SPIO image set (unenhanced and SPIO-enhanced MR images) in random order. Lesion detection sensitivity and lesion characterization accuracy were compared by analyzing the area under the receiver operating characteristic curve (Az). RESULTS: Overall lesion detection accuracy for pooled data was significantly higher with the SPIO set (Az = 0.903) than with the gadolinium set (Az = 0.857) (P <.05). When hypovascular lesions were excluded, the detection rate was similar with the two sets. When hepatocellular carcinomas were excluded, the detection rate was significantly higher with the SPIO set (P <.01). Readers were more accurate in differentiating benign from malignant lesions with the gadolinium set (Az = 0.915) than with the SPIO set (Az = 0.847) (P <.01). Detection accuracy tended to be better with the images obtained after the second contrast agent was used. CONCLUSION: Hypovascular lesion detection was better with SPIO-enhanced MR images than with gadolinium-enhanced MR images. Detection and characterization of hypervascular lesions were improved with gadolinium-enhanced MR images.

Adult↗

Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced MR imaging.

PURPOSE: To prospectively compare accuracy of dynamic contrast material-enhanced thin-section multi-detector row helical computed tomography (CT), high-spatial-resolution three-dimensional (3D) dynamic gadolinium-enhanced magnetic resonance (MR) imaging, and superparamagnetic iron oxide (SPIO)-enhanced MR imaging with optimized gradient-echo (GRE) sequence for depiction of hepatic lesions; surgery and histologic analysis were the reference standard. MATERIALS AND METHODS: Local ethics committee approval was granted, and written informed consent was obtained. Fifty-eight patients (45 men, 13 women; age range, 47-82 years) with hepatic metastases were imaged with multi-detector row CT (3.2-mm section thickness), 3D dynamic gadolinium-enhanced MR imaging (2.5-mm effective section thickness), and SPIO-enhanced MR by using an optimized T2-weighted GRE sequence. Images were reviewed independently by two blinded observers who identified and localized lesions with a four-point confidence scale. Accuracy of each technique was measured with alternative free-response receiver operating characteristic analysis. Results were correlated with findings at surgery with intraoperative ultrasonography or histopathologic examination. Statistical differences among techniques for each observer were measured. RESULTS: Accuracy values for each observer for all metastases (n = 215) and 1.0-cm or smaller metastases (n = 80), respectively, follow: For CT, those for reader 1 were 0.82 and 0.65; for reader 2, 0.81 and 0.68. For gadolinium-enhanced MR imaging, those for reader 1 were 0.92 and 0.79; for reader 2, 0.90 and 0.76. For SPIO-enhanced MR imaging, those for reader 1 were 0.92 and 0.83; for reader 2, 0.92 and 0.81. For all metastases for both observers, there was no significant difference between MR techniques, but both were significantly more accurate than CT (P < .01). For metastases 1.0 cm or smaller and one observer, there was no significant difference between MR techniques, but both were more accurate than CT (P < .01); for the other observer, SPIO-enhanced MR imaging was more accurate than gadolinium-enhanced MR imaging (P < .05) and CT (P < .02), but there was no significant difference between gadolinium-enhanced MR imaging and CT (P = .2). CONCLUSION: Accuracy for gadolinium-enhanced MR imaging and SPIO-enhanced MR imaging was similar. Both techniques were significantly more accurate than CT.

Aged↗

Perilesional enhancement of hepatic metastases: correlation between MR imaging and histopathologic findings-initial observations.

PURPOSE: To correlate perilesional enhancement on gadolinium-enhanced magnetic resonance (MR) images with histopathologic findings in patients with hepatic metastases. MATERIALS AND METHODS: In seven patients with histopathologically proved hepatic metastases, MR images obtained before and early and late after the administration of gadopentetate dimeglumine were retrospectively evaluated for perilesional enhancement. The thickness of hepatic parenchyma with intense perilesional enhancement was calculated. The thickness of the histologic tumor border (the zone separating the outermost border of the tumor nodule from the surrounding hepatic parenchyma) also was measured. RESULTS: In three patients, early gadolinium-enhanced images showed prominent perilesional enhancement, which correlated with a thick tumor border containing peritumoral desmoplastic reaction, peritumoral inflammation, and vascular proliferation at histopathologic examination. In one patient, mild perilesional enhancement was shown. At histopathologic examination, the lesion periphery showed moderate peritumoral changes. In the remaining three patients, no perilesional enhancement was observed, and at histopathologic examination there was a thin tumor border that contained minimal to mild perilesional changes. The thickness of hepatic parenchyma with intense perilesional enhancement on early gadolinium-enhanced images showed a strong positive correlation with tumor border thickness at histopathologic examination (r = 0.99). CONCLUSION: Intense perilesional enhancement of metastases on early gadolinium-enhanced MR images correlates with histopathologic hepatic parenchymal changes, which include peritumoral desmoplastic reaction, inflammatory cell infiltration, and vascular proliferation.

Adult↗

Identification of a decidua-specific enhancer on the human prolactin gene with two critical activator protein 1 (AP-1) binding sites.

Deletion analysis of the human PRL promoter in endometrial stromal cells decidualized in vitro revealed a 536-bp enhancer located between nucleotide (nt) -2,040 to -1,505 in the 5'-flanking region. The 536-bp enhancer fragment ligated into a thymidine kinase (TK) promoter-luciferase reporter plasmid conferred enhancer activity in decidual-type cells but not nondecidual cells. DNase I footprint analysis of decidualized endometrial stromal cells revealed three protected regions, FP1-FP3. Transfection of overlapping 100-bp fragments of the 536-bp enhancer indicated that FP1 and FP3 each conferred enhancer activity. Gel shift assays indicated that both FP1 and FP3 bind activator protein 1 (AP-1), and JunD and Fra-2 are components of the AP-1 complex in decidual fibroblasts. Mutation of the AP-1 binding site in either FP1 or FP3 decreased enhancer activity by approximately 50%, while mutation of both sites almost completely abolished activity. Coexpression of the 536-bp enhancer and A-fos, a dominant negative to AP-1, decreased enhancer activity by approximately 70%. Conversely, coexpression of Fra-2 in combination with JunD or c-Jun and p300 increased enhancer activity 6- to 10-fold. Introduction of JunD and Fra-2 into nondecidual cells is sufficient to confer enhancer activity. JunD and Fra-2 protein expression was markedly increased in secretory phase endometrium and decidua of early pregnancy (high PRL content) compared with proliferative phase endometrium (no PRL). These investigations indicate that the 5'-flanking region of the human PRL gene contains a decidua-specific enhancer between nt -2,040/-1,505 and AP-1 binding sites within this enhancer region are critical for activity.

Binding Sites↗

Dynamic MRI of solitary pulmonary nodules: comparison of enhancement patterns of malignant and benign small peripheral lung lesions.

OBJECTIVE: The purpose of this study was to compare the dynamic contrast-enhanced MRI enhancement characteristics of malignant and benign solitary pulmonary nodules. MATERIALS AND METHODS: The characteristics of 202 solitary pulmonary nodules (diameter, 1-3 cm; 144 cases of primary lung cancer, 31 cases of focal organizing pneumonia, 15 tuberculomas, 12 hamartomas) were reviewed retrospectively. In all cases dynamic MR images were obtained before and 1, 2, 3, 4, 5, 6, and 8 minutes after bolus injection of gadopentetate dimeglumine. Maximum enhancement ratio, time at maximum enhancement ratio, slope of time-enhancement ratio curves, and washout ratio were assessed. Statistical analyses were performed with the Kruskal-Wallis test with Bonferroni correction, chi-square test, and receiver operating characteristic curves. RESULTS: For 122 (85%) of 144 primary lung cancers, time at maximum enhancement ratio was 4 minutes or less. For all tuberculomas and hamartomas, time at maximum enhancement ratio was greater than 4 minutes or gradual enhancement occurred without a peak time (p < 0.0001). Lung cancers had different maximum enhancement ratios and slopes than benign lesions (all p < 0.005). With 110% or lower maximum enhancement ratio as a cutoff value, the positive predictive value for malignancy was 92%; sensitivity, 63%; and specificity, 74%. With 13.5%/min or greater slope as a cutoff value, sensitivity, specificity, positive predictive value, and negative predictive value for malignancy were 94%, 96%, 99%, and 74%, respectively. CONCLUSION: Dynamic contrast-enhanced MRI is helpful in differentiating benign from malignant solitary pulmonary nodules. Absence of significant enhancement is a strong predictor that a lesion is benign.

Adult↗

Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging.

OBJECTIVE: The purpose of our study was to compare how well gadolinium-enhanced and ferumoxide-enhanced MR imaging reveal malignant hepatic tumors. SUBJECTS AND METHODS: Both gadolinium-enhanced and ferumoxide-enhanced MR imaging were separately performed in 53 patients with a total of 87 malignant hepatic tumors (57 hepatocellular carcinomas, 28 metastases, two cholangiocarcinomas). Thirty-one of the 53 patients had hepatic cirrhosis. Images were reviewed by three independent off-site observers. Observer performance was evaluated by means of sensitivity, specificity, and receiver operating characteristic curve analyses. RESULTS: Gadolinium-enhanced MR imaging outperformed ferumoxide-enhanced MR imaging in sensitivity (81% versus 62%, p < 0.01) for malignant-tumor detection. Specificity was comparable (94%) between the two types of MR imaging. Area under receiver operating characteristic curve (A(z)) value was significantly higher with gadolinium-enhanced MR imaging than with ferumoxide-enhanced MR imaging in patients overall (A(z) = 0.896 versus 0.805, p < 0.001), in patients with cirrhosis (A(z) = 0.907 versus 0.807, p < 0.001), and in patients without cirrhosis (A(z) = 0.899 versus 0.834, p < 0.01). The superiority was enhanced in the subset of patients with cirrhosis. CONCLUSION: Gadolinium-enhanced MR imaging outperforms ferumoxide-enhanced MR imaging in revealing malignant hepatic tumors. Gadolinium-enhanced MR imaging is recommended, particularly for patients with cirrhosis.

Aged↗

Correlation of CT enhancement, tumor angiogenesis and pathologic grading of pancreatic carcinoma.

AIM: To study the correlation between pancreatic phase CT enhancement, intratumor microvessel density (MVD) and pathologic grading of pancreatic carcinoma and to evaluate the relationship between the degrees of CT enhancement and malignancy of pancreatic carcinoma. METHODS: Thirty four patients with pancreatic carcinoma underwent CT scanning before resection. The enhancement degrees and forms of tumor were observed in pancreatic phase. The operative sample was stained with HE and CD34 marked by immunohistochemistry. MVD and histopathological grades of pancreatic carcinoma were examined. CT enhancement of the tumor, MVD counting in hot spot areas of neoplastic parenchymal cells and pathological grades of pancreatic carcinoma were comparatively analyzed. RESULTS: Highly differentiated pancreatic adenocarcinoma was identified in 16 patients, moderately-differentiated tumor in 7 and poorly-differentiated in 11. Isodensity CT enhancement was demonstrated in 13 cases, slightly low density enhancement in 9, slightly low density enhancement with small cystic lesions in 9 and slightly low density enhancement with large cystic lesions in 3. The counting of MVD with CD34 marked by immunohistochemistry in hot spot areas of neoplastic parenchyma cells was small in 10 cases, medium in 16 and large in 8. The pathological grades correlated well with CT enhancement of the tumor (r=0.7857, P<0.001) and with MVD counting of tumor (r=0.3613, P<0.05). The CT enhancement of tumor correlated with MVD(r=0.6768, P<0.001). CONCLUSION: There is an obvious and significant correlation between CT enhancement, pathological grades and MVD number in the hot spot areas of tumor. The extent of CT enhancement is inversely proportional to the malignant degree of pancreatic carcinoma, and to the MVD number in the hot spot areas of neoplastic parenchyma. The MVD in the hot spot areas of neoplastic parenchyma cells can also reflect the prognosis of the patients, and is directly proportional to the malignant degree of pancreatic carcinoma.

Adult↗

MR imaging enhancement patterns as predictors of hemorrhagic transformation in acute ischemic stroke.

BACKGROUND AND PURPOSE: Early parenchymal gadolinium enhancement on T1-weighted MR images is predictive of hemorrhagic transformation (HT) in rodent focal ischemia models, but its value in humans is unknown. We sought to investigate gadolinium enhancement in acute ischemic stroke patients to determine their association with subsequent HT. METHODS: We retrospectively examined 22 patients with ischemic stroke who underwent MR imaging within 4.9 hours (+/-1.4) of symptom onset. Patients receiving intravenous tissue plasminogen activator (tPA) (n = 6) were included. Twenty-one patients underwent repeat MR studies at 48 hours, 13 underwent additional MR imaging at 1 week, and one underwent follow-up head CT at 24 hours. Initial images were analyzed for enhancement patterns (vascular, meningeal, parenchymal). Follow-up T2- and T2*-weighted images were evaluated for hemorrhage. RESULTS: In all patients, initial MR images showed vascular enhancement in the vascular territory of the stroke lesion: 19 with vascular enhancement alone and three with vascular and parenchymal enhancement. All three patients with both enhancement patterns had HT: two large and symptomatic, and one asymptomatic (petechial hemorrhage). They received tPA before MR imaging. None of the patients without early parenchymal enhancement developed symptomatic hemorrhage. Six (32%) patients with vascular enhancement alone had petechial hemorrhage at follow-up imaging. In this limited sample, initial mean volumes on diffusion-weighted images, National Institute of Health Stroke Scale scores, and intervals from stroke onset to imaging did not differ between patients with vascular and parenchymal enhancement versus those with vascular enhancement alone. CONCLUSION: Early parenchymal enhancement of stroke lesions may be a good predictor of subsequent symptomatic HT may help identify patients at risk, especially after thrombolytic therapy.

Aged↗

[The correlation study of CT enhancement, intratumoral microvessel density and pathological grades in pancreatic carcinoma].

OBJECTIVE: The purpose of this work was to study the correlation of pancreatic phase CT enhancement, intratumoral microvessel density (MVD) and histopathological grades in pancreatic carcinoma and to evaluate the relationship between CT enhancement degree and the malignancy degree of pancreatic carcinoma. METHODS: 34 patients with pancreatic carcinoma underwent CT scanning before resection. The enhancement degrees and forms of tumor were observed in pancreatic-phase. The operational sample was stained with HE and CD34 marked by immunohistochemistry. MVD and histopathological grades of pancreatic carcinoma were examined. CT enhancement of the tumor, MVD counting in hot spots areas of neoplastic parenchymal cells and pathological grades of pancreatic carcinoma were comparatively analyzed. RESULTS: Highly differentiated pancreatic adenocarcinoma was identified in 16 patients, moderately differentiated tumor in 7 and poorly differentiated tumor in 11. Isodensity CT enhancement was demonstrated in 13 cases, slight low density enhancement in 9, slight low density enhancement along with small cyst lesion in 9 and slight low density enhancement along with large cyst lesion in 3. The counting of MVD with CD34 marked by immunohistochemistry in hot spot areas of neoplastic parenchyma cells were small in 10 cases, medium in 16 and large in 8. The pathological grades correlated with CT enhancement of tumor (r = 0. 785 7, P < 0.001). The pathological grade correlated with MVD counting of tumor (r = 0.361 3, P < 0.05). The CT enhancement of tumor correlated with MVD (r = 0.676 8, P < 0.001). CONCLUSION: There was obvious and significant correlation between CT enhancement, pathological grades MVD numbers in the hot spot areas of tumor. The malignant degree of pancreatic carcinoma was inversely proportional to the extent of CT enhancement and inversely proportional to MVD numbers in the hot spot areas of tumor.

Adult↗

Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images.

BACKGROUND/AIMS: We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. METHODS: A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. RESULTS: After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. CONCLUSIONS: Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.

Adult↗

The role of insulin in activation of two enhancers in the mouse GLUT1 gene.

We identified two enhancer elements of the mouse GLUT1 gene responsive to serum, growth factor, and oncogenes; the first enhancer element (enhancer-1) is located 2.7 kilobases upstream of the cap site of the gene, and the second one (enhancer-2) is located in the second intron of the gene (Murakami, T., Nishiyama, T., Shirotani, T., Shinohara, Y., Kan, M., Ishii, K., Kanai, F., Nakazuru, S., and Ebina, Y. (1992) J. Biol. Chem. 267, 9300-9306). In the present work, we describe the role of insulin in activation of these two enhancers. NIH/3T3 HIR3.5 cells, which express a large number of insulin receptors, were stably transformed by hybrid genes containing the enhancer(s) and promoter of GLUT1 gene and the coding region of chloramphenicol acetyltransferase (CAT) gene as a reporter gene. In stable transformants of the reporter gene without the enhancers, the CAT mRNA was not induced by insulin; however, in clones containing the reporter gene with enhancer-1, the CAT mRNA was induced by insulin at 30 min and reached a maximum at 1 h. In clones transfected by the reporter gene with enhancer-2, the CAT mRNA was induced at 1 h and reached a maximum at 3 h. To determine the early response element to insulin in enhancer-1, transformants of hybrid reporter genes containing truncated or mutated enhancer-1 were examined. The homologous sequence with the serum response element in enhancer-1 is essential for an early response to insulin.

3T3 Cells↗