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Which breast carcinomas need HER-2/neu gene study after immunohistochemical analysis? Results of combined use of antibodies against different c-erbB2 protein domains.

AIMS: Evaluation of HER2 gene amplification in breast cancers is a compelling, routine procedure. The aim of this work was to evaluate which breast carcinomas would really benefit from HER-2/neu gene analysis. METHODS AND RESULTS: We studied 130 invasive breast carcinomas by immunohistochemistry (IHC) using CB11 and TAB250 MAbs directed against different domains of the c-erbB2 molecule. From this series, we selected 106 cases (32 G1, 36 G2, and 38 G3) in which HER-2/neu gene analysis, using chromogenic in-situ hybridization (CISH), was successful. IHC results were scored using the FDA approved system with three score values: 0/1+ (negative), 2+, 3+ (positive). In addition, we developed a double scoring system with six score values (0/1+ 2+ negative, 3+, 4+, 5+, 6+ positive) obtained by summating the individual scoring values obtained with each MAb. All double scoring negative cases were non-amplified (100% sensitivity), whereas all cases scored 6+ were amplified. Double scoring values and CISH results were then correlated with grade and histological type. G1 ductal carcinomas and carcinomas of lobular and of special histological type did not show HER-2/neu amplification even in the presence of protein over-expression. CONCLUSIONS: The combined results of IHC analysis (double scoring values) obtained using MAbs directed against different c-erbB2 domains correctly indicates the HER-2/neu gene status in 57.5% of cases. In addition, simple morphological features such as low grade and special histological type are good predictors of the non-amplification of the HER-2/neu gene in breast carcinoma.

Adenocarcinoma↗

Note: cyclohexenoesculetin-beta-D-glucoside: a new substrate for the detection of bacterial beta-D-glucosidase.

A new substrate for the detection of bacterial beta-D-glucosidase was evaluated as an alternative to aesculin. This substrate, 3,4-cyclohexenoesculetin-7-beta-D-glucoside, was compared with aesculin for the detection of beta-D-glucosidase in 150 enterococci, 40 streptococci, 12 Listeria sp. and 250 strains of Enterobacteriaceae. In the Gram-positive strains tested, aesculin hydrolysis correlated with hydrolysis of 3,4-cyclohexenoesculetin-7-beta-D-glucoside. In the Gram-negative strains the new substrate was hydrolysed by all aesculin-positive strains and also by four strains (10%) of Escherichia coli which gave a negative aesculin reaction. 3,4-Cyclohexenoesculetin-7-beta-D-glucoside was shown to be a reliable alternative to aesculin and was shown to have significant advantages over aesculin when incorporated into solid media. This was due to the non-diffusible end product produced by hydrolysis of 3,4-cyclohexenoesculetin-7-beta-D-glucoside in the presence of iron.

Bacteria↗

A chromogenic plating medium for isolating Escherichia coli O157:H7 from beef.

There was no significant difference (P > 0.05) in the percentages of Escherichia coli O157:H7 cells recovered on BCM O157:H7 (+) agar (69.7%) and MacConkey sorbitol agar containing 5-bromo-4-chloro-3-indoxyl-beta-D-glucuronic acid (MSA-BCIG) (76.8%) vs Tryptic soy agar. Three E. coli O157:H7 strains (ATCC 35150, 43890 and 43894) were separately inoculated into raw ground beef at low (mean 0.32 cfu g-1) and high (mean 3.12 cfu g-1) levels. Using the United States Department of Agriculture (USDA) m-EC + novobiocin enrichment broth, BCM O157:H7 (+) medium surpassed MSA-BCIG agar with overall percentage sensitivities for BCM O157:H7 (+) of 92.1 and 94.4 compared with 52.6 and 84.7 for MSA-BCIG at low and high levels, respectively. A comparison of BCM O157:H7 (+) and MSA-BCIG agars using naturally contaminated beef samples was made utilizing presumptively positive enrichment broths previously identified by rapid methods. The E. coli O157:H7 cells in these broths were concentrated with Dynabeads anti-E. coli O157 before inoculating the agars. The respective percentage sensitivity and specificity values were 90.0 and 78.5 for BCM O157:H7 (+) and 70.0 and 46.4 for MSA-BCIG. Thus, under identical pre-plating conditions, BCM O157:H7 (+) medium displayed a greater sensitivity than MSA-BCIG for detecting E. coli O157:H7 in artificially inoculated beef, and both greater sensitivity and specificity upon examining naturally contaminated beef samples.

Animals↗

Monitoring the microbial contamination of beef carcass tissue with a rapid chromogenic Limulus amoebocyte lysate endpoint assay.

A chromogenic Limulus amoebocyte lysate (LAL) endpoint assay was found to be an accurate and rapid means of gauging levels of beef carcass microbial contamination within 10 min. The assay demonstrated a high correlation with the total mesophilic bacterial and coliform surface populations from inoculated beef carcass surface tissues. This assay was tested on a set of actual beef carcass surface samples (n = 121) demonstrating the utility of the chromogenic LAL test as a means of monitoring carcass microbial contamination in a near real-time fashion. Classifying the chromogenic LAL results into four contamination groups was found to be a sound means of utilizing the resultant chromogenic LAL data for detecting carcasses with high levels of microbial contamination. For beef carcass testing, this assay can be used with no instrumentation other than the required 37 degrees C incubator and, as an option, a microplate reader.

Abattoirs↗

Quantitative determination of total coliforms and Escherichia coli in marine waters with chromogenic and fluorogenic media.

This study compared the performance of LMX(R) broth (LMX), Chromocult Coliform(R) agar (CC) and Chromocult Coliform agar plus cefsulodin (10 microg ml-1) (CC-CFS), with standard methods multiple tube fermentation (MTF), for the enumeration of total coliforms and Escherichia coli from marine recreational waters. LMX and CC are two media designed to concurrently detect total coliform (TC) bacteria and E. coli by the specific action of beta-galactosidase (total coliforms) and beta-glucuronidase (E. coli). Overall results for the TC test showed that LMX, CC and MTF recovered 2.63, 1.95 and 1.90 times as many TCs as CC-CFS, respectively. Data from the multiple range test showed significant differences (P < 0.05) between TC counts on CC-CFS and LMX. The traditional MTF was less sensitive for E. coli enumeration. However, there was no statistically significant differences between LMX, CC, CC-CFS and the MTF method for E. coli enumeration. Background interference was reduced on CC-CFS and the counts obtained reflected more accurately the number of TCs. Therefore, the contribution of beta-galactosidase positive, non coliform bacteria (Aeromonas spp. and Vibrio spp.) to TC counts should not be neglected.

Bacteriological Techniques↗

Improvement of the detection of Listeria monocytogenes by the application of ALOA, a diagnostic, chromogenic isolation medium.

A new selective agar medium, ALOA, for the selective and differential isolation of Listeria monocytogenes has been evaluated. All stressed cultures of L. monocytogenes serovars tested grew on the medium as bluish colonies surrounded by a distinctive opaque halo and gave a productivity ratio of at least 0.95. Non-pathogenic Listeria sp. produced bluish colonies without a halo as was also the case for some enterococci and bacilli. Special attention must be paid to some Bacillus cereus strains and L. ivanovii since their colony appearance can be misleading. Only some unidentified listeria-like bacteria gave false-positive results. ALOA detected 4. 3% more positives from naturally contaminated dairy and meat samples compared with the ISO procedure when used with GenprobeTM or VidasTM for confirmation of presumptive colonies; 13.9% false negatives were found compared with 38.9% using PALCAM/Oxford. ALOA was also clearly superior to Oxford and PALCAM when samples containing both L. monocytogenes and L. innocua were examined. The introduction of ALOA in standard isolation procedures as an additional medium would enhance the detection ratio and reduce the time and cost of analysis for L. monocytogenes.

Cheese↗

Evaluation of novel beta-ribosidase substrates for the differentiation of Gram-negative bacteria.

AIMS: To synthesize novel substrates for the detection of beta-ribosidase and assess their potential for the differentiation of Gram-negative bacteria. METHODS AND RESULTS: Two novel chromogenic substrates, 3',4'-dihydroxyflavone-4'-beta-D-ribofuranoside (DHF-riboside) and 5-bromo-4-chloro-3-indolyl-beta-D-ribofuranoside (X-riboside) were evaluated along with a known fluorogenic substrate, 4-methylumbelliferyl-beta-D-ribofuranoside (4MU-riboside). A total of 543 Gram-negative bacilli were cultured on media containing either DHF-riboside or X-riboside. Hydrolysis of DHF-riboside or X-riboside resulted in the formation of clearly distinguishable black or blue-green colonies, respectively. Hydrolysis of 4MU-riboside was evaluated in a liquid medium in microtiter trays and yielded blue fluorescence on hydrolysis which was measured using fluorimetry. beta-Ribosidase activity was widespread with 75% of strains, including 85.6% of Enterobacteriaceae, showing activity with at least one substrate. Genera that demonstrated beta-ribosidase activity included Aeromonas, Citrobacter, Enterobacter, Escherichia, Hafnia, Klebsiella, Morganella, Providencia, Pseudomonas, Salmonella and Shigella. In contrast, strains of Proteus spp., Acinetobacter spp., Yersinia enterocolitica, Vibrio cholerae and Vibrio parahaemolyticus generally failed to demonstrate beta-ribosidase activity. CONCLUSIONS: The novel substrates DHF-riboside and X-riboside are effective for the detection of beta-ribosidase in agar-based media and may be useful for the differentiation and identification of Gram-negative bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report describing the application and utility of chromogenic substrates for beta-ribosidase. These substrates could be applied in chromogenic media for differentiation of Gram-negative bacteria.

Bacterial Typing Techniques↗

Determination of heparin in aqueous solutions.

OBJECTIVE: To develop a volumetric method for assaying heparin in aqueous media. METHOD: Heparin is precipitated out with an aqueous solution of an organic amine by titration and the end-point is based on the measurement of the medium dielectric permittivity. We studied the titration of a 500 IU/ml heparin solution with a 0.08 M cetylpyridinium chloride solution at pH 6.8. Then, we assayed sulphate groups selectively at pH 2. The results were compared against a classical method of SO2 determination. The sensitivity and reproducibility of the volumetric method were evaluated at pH 6.8 and compared with the characteristics of a chromogenic method, usually used for the assay of heparin in biological fluids. RESULTS: A linear relationship between anticoagulant activity and sulphate and carboxyl group concentration was observed. The method was less sensitive but more reproducible than the chromogenic method. CONCLUSION: The proposed method can be used for aqueous solutions and is easy to carry out. It can be fully automated and applied to formulation studies.

Cetylpyridinium↗

Immunolocalization of vimentin and alpha-smooth muscle actin in dysfunctional human temporomandibular joint disc samples.

The expression of vimentin and alpha-smooth muscle (alpha-SM) actin was examined in 10 human temporomandibular joint (TMJ) disc samples, with internal derangement and in two control specimens, in order to evaluate the phenotypic characteristics of TMJ disc cells in relationship to histological findings. This was accomplished by means of monoclonal antibodies specific for vimentin and alpha-SM actin and immunocytochemical technique. The study, revealed that every disc cell constantly expressed vimentin. Scattered alpha-SM actin positive cells could be appreciated in normal TMJ discs and tissues with minor pathological findings. In TMJ discs with severe alterations, i.e. tears and clefts, almost fibroblast-like cells, fibrochondrocytes and chondrocyte-like cells were strongly immunolabelled by anti-alpha-SM actin antibody. According to these findings it can be assumed that vimentin is expressed by all disc cell populations and it appears not to be influenced by any disease condition of the disc; on the other hand the up-regulation alpha-SM actin immunolabelling seems to be correlated to histopathological findings of tears and clefts. Cells, with a contractile phenotype, close to such defects, could be involved in disc tissue contraction and repair. The plasticity of disc cell populations which evolve towards a different phenotype when subjected to action of macro- and micro-environmental factors is also supported.

Actins↗

Substrate complexes and domain organization of the Salmonella flagellar export chaperones FlgN and FliT.

The flagellar proteins FlgN and FliT have been proposed to act as substrate-specific export chaperones, facilitating incorporation of the enterobacterial hook-associated axial proteins (HAPs) FlgK/FlgL and FliD into the growing flagellum. In Salmonella typhimurium flgN and fliT mutants, the export of target HAPs was reduced, concomitant with loss of unincorporated flagellin into the surrounding medium. Gel filtration chromatography of wild-type S. typhimurium cell extracts identified stable pools of FlgN and FliT homodimers in the cytosol, but no chaperone-substrate complexes were evident. Nevertheless, stable unique complexes were assembled efficiently in vitro by co-incubation of FlgN and FliT with target HAPs purified from recombinant Escherichia coli. The sizes of the chaperone-substrate complexes indicated that, in each case, a chaperone homodimer binds to a substrate monomer. FlgN prevented in vitro aggregation of FlgK monomers, generating a soluble form of the HAP. Recombinant polypeptides spanning the potentially amphipathic C-terminal regions of FlgN or FliT could not complement in trans the chaperone deficiency of the respective flgN and fliT mutants, but efficient flagellar assembly was restored by homodimeric translational fusions of these domains to glutathione S-transferase, which bound FlgK and FlgL like the wild-type FlgN. These data provide further evidence for the substrate-specific chaperone function of FlgN and FliT and indicate that these chaperones comprise common N- and C-terminal domains mediating homodimerization and HAP substrate binding respectively. In support of this view, the flgN mutation was specifically complemented by a hybrid chaperone comprising the N-terminal half of FliT and the C-terminal half of FlgN.

Bacterial Proteins↗

The role of amoebocytes in endotoxin-mediated coagulation in the innate immunity of Achatina fulica snails.

Achatina amoebocyte lysate (AAL) derived from amoebocytes of Achatina fulica was activated by Gram-negative bacterial endotoxins in a time-dependent manner resulting in gel formation/coagulation. The activation and maximum proliferation of amoebocytes was observed 40 min after intramuscular injection (20 microg/snail) of endotoxin. Endotoxin-mediated proteolytic activity of AAL towards a serine-protease-specific chromogenic substrate was maximum at pH 8.0, 37 degrees C and within 15 min in a divalent-cation-dependent manner. The AAL activity induced by the endotoxin was directly dependent on the endotoxin concentration, showed a high specificity and saturated at higher endotoxin concentrations. An endotoxin-sensitive factor (ESF) was purified from AAL to apparent homogeneity by single-step affinity chromatography on a heparin-Sepharose 4B column. Native ESF of molecular weight 140 000 was composed of two identical subunits of molecular weight 70 000 attached through non-covalent association. A strong binding to endotoxin (Escherichia coli 055:B5) was exhibited by ESF with a 40-fold higher biological activity than AAL. The ESF was shown to have a unique Phe-Ile active site with regard to its alternate activation by alpha-chymotrypsin instead of endotoxin. The ESF was characterized as a serine protease type as evidenced by potent inhibition with specific inhibitors.

Animals↗

Thermal effects on an enzymatically latent conformation of coagulation factor VIIa.

Activation of the zymogen factor VII yields an enzyme form, factor VIIa, with only modest activity. The thermal effect on this low activity of factor VIIa and its enhancement by the cofactor tissue factor was investigated. Factor VIIa activity measured with a chromogenic peptide substrate is characterized by an unusual temperature dependency which indicates that the activated protease exists in an equilibrium between a latent (enzymatically inactive) and an active conformation. As shown by calorimetry and activity measurements the thermal effects on factor VIIa are fully reversible below the denaturation temperature of 58.1 degrees C. A model for factor VIIa has been proposed [Higashi, S., Nishimura, H., Aita, K. & Iwanaga, S. (1994) J. Biol. Chem. 269, 18891-18898] in which the protease is supposed to exist primarily as a latent enzyme form because of the poor incorporation into the protease structure of the N-terminal Ile153 released by proteolytic cleavage during activation of factor VII. Binding of tissue factor to factor VIIa is assumed to shift the equilibrium towards an active conformation in which the N-terminal Ile153 forms a salt bridge with Asp343. We corroborate the validity of this model by: (a) chemical modification of factor VIIa; this suggests that the thermal effect on the equilibrium between the active and inactive conformation is reflected in the relative accessibility of the active site and the N-terminal Ile153; (b) measurements of factor VIIa binding to tissue factor indicating that complex formation is favoured by stabilization of the active conformation; and (c) activity measurements of a cross-linked factor VIIa-tissue factor complex; this showed that cross-linking stabilized the active conformation of factor VIIa and essentially prevented its thermally-induced transformation into the inactive state.

Alkylation↗

Identification of chlamydospore-negative Candida albicans using CHROMagar Candida medium.

This study was undertaken to evaluate the utility of CHROMagar Candida medium for the identification of chlamydospore-negative Candida albicans. A total of 60 isolates including 45 chlamydospore-negative C. albicans, 10 chlamydospore-positive C. albicans (positive controls) and five non-C. albicans (negative controls) were investigated. On the basis of germ tube test, assimilation of trehalose (Tre), glucosamine (GlcN), N-acetyl glucosamine (GlcNAc), secretory aspartyl production and serotyping, the 45 chlamydospore-negative C. albicans isolates were assigned to the reported three groups. Eighteen isolates showing positive germ tube test, negative for the assimilation of Tre, GlcN/GlcNAc, strong producers of proteinase (2+) and assigned to serotype B belonged to group I. Whereas, the isolates in group II and group III showed common characteristics including assimilation of Tre, GlcN/GlcNAc, moderate production of proteinase (1+) and were serotype A, except for the fact that group II isolates were germ tube positive and group III isolates were negative. Using CHROMagar Candida medium, all the 45 chlamydospore-negative and 10 positive control isolates were accurately identified on the basis of characteristic green color at 37 degrees C for 48 h of incubation. On the other hand at an optimum incubation temperature of 37 degrees C none of the non-C. albicans (negative controls) showed characteristic green color thus yielding a 100% sensitivity and specificity. Isolates in group-I showed a slow growth rate and no visible growth was observed at 24 h, whereas, groups II, III and the control isolates showed visible growth at 24 h. Besides differences in growth rates, these isolates also varied in their characteristic colony color which gradually changed over a period of time. The results of this study clearly suggest that CHROMagar Candida medium is not only a simple, reliable and cost effective method for the identification of chlamydospore-negative atypical C. albicans, but can also be used to differentiate various groups of chlamydospore-negative C. albicans.

Adult↗

Chromogenic in situ hybridization analysis of HER-2/neu status in breast carcinoma: application in screening of patients for trastuzumab (Herceptin) therapy.

Evaluation of HER-2/neu status is important in the management of patients with breast carcinoma, especially in determining the possible application of trastuzumab, a humanized anti-HER-2/neu monoclonal antibody. Chromogenic in situ hybridization (CISH) detection of the HER-2/neu oncogene is a newly developed in situ hybridization method that utilizes a robust and unique-sequence DNA probe labeled with digoxygenin, and sequential incubations with antidigoxygenin fluorescein, antifluorescein peroxidase, and diaminobenzidine. In this study, we examined 20 archival specimens of human breast carcinoma using CISH, and we correlated findings with immunohistochemical findings for HER-2/neu. HER-2/neu immunohistochemistry was carried out with HercepTest, a standardized immunohistochemical examination system for HER-2/neu overexpression in surgical pathology specimens. CISH analysis could be done in 18 out of 20 cases examined. Gene copy signals for HER-2/neu were recognized as intranuclear brown dots in both neoplastic and non-neoplastic cells. Seven carcinomas showed an increased number or size of signals and were interpreted as being positive for HER-2/neu amplification. Eight cases were positive with the HercepTest. Seven out of eight carcinoma cases found to overexpress immunoreactive HER-2/neu also demonstrated HER-2/neu gene amplification following CISH analysis. There was a significant correlation between immunohistochemical and CISH analyses (P < 0.001). We found that CISH was a specific, sensitive and easily applicable method for the detection of HER-2/neu gene amplification, which may be used together with immunohistochemical examination for the evaluation of patients with breast carcinoma.

Adenocarcinoma↗

Comparison of three chromogenic agar plates for isolation and identification of urinary tract pathogens.

OBJECTIVE: To comparatively assess the performance of three chromogenic agar plates, CPS ID2, Chromogenic UTI, and USA, for the detection and enumeration of all urinary tract pathogens and the direct identification of Escherichia coli, Proteus mirabilis and Enterococcus spp. METHODS: Two hundred and forty-three urine specimens prospectively collected from hospitalized patients were randomly inoculated in parallel on the three media. RESULTS: Of the 243 urine specimens, 235 yielded positive cultures, of which 151 were pure cultures and 84 were mixed cultures. CPS ID2, Chromogenic UTI and USA agar gave detection rates of 99.1%, 97.1% and 96.6%, respectively. The main difference in non-detection between CPS ID2 agar and the two new media concerned Staphylococcus spp. strains. Based on the total number of strains detected (n = 348), the total identification rates of E. coli, P. mirabilis and Enterococcus spp. on CPS ID2 agar, Chromogenic UTI agar and USA agar were 60.3%, 61.2% and 59.2%, respectively. CONCLUSION: The detection rates and identification rates of the three media were very close and only minor differences were noted. The lower detection rates for Chromogenic UTI and USA were mainly due to their lesser ability to support growth of Staphylococcus spp.

Agar↗

Comparative evaluation of three chromogenic agars for detection and rapid identification of aerobic Gram-negative bacteria in the normal intestinal microflora.

OBJECTIVE: To compare three different chromogenic agars and MacConkey agar for the detection of aerobic Gram-negative bacteria in the normal intestinal microflora and to assess the accuracy of the chromogenic agars for the direct identification of Escherichia coli. METHODS: A total of 164 Gram-negative clinical isolates (E. coli, Proteus, Klebsiella, Enterobacter, Morganella and Pseudomonas species) and 30 stool specimens were inoculated in parallel on four media: Chromagar E. coli/Coliform, Chromogenic urinary tract infection UTI medium, CHROMagar Orientation and MacConkey agar. All colonies that differed by color and/or morphology were selected for further identification by VITEK 1 and/or API 20E from each medium. RESULTS: On E. coli/Coliform agar five out of 32 (16%) E. coli strains failed to produce the color as described by the manufacturer. No remarkable discrepancies were found for the other clinical isolates. There was no significant difference in detection rate (DR) of aerobic Gram-negative bacteria in stool specimens between the different chromogenic agars and MacConkey agar. The overall DR was about 84%, and varied from 100% for monomicrobial specimens to 33% for polymicrobial specimens. The positive predictive values (PPV) for the direct identification of E. coli on Chromagar E. coli/Coliform, Chromogenic UTI medium and CHROMagar Orientation were 1.00, 0.93 and 0.93, respectively. The negative predictive values (NPV) were 0.53, 0.68 and 0.69, respectively. CONCLUSION: Chromogenic UTI medium and CHROMagar Orientation are the preferred media because of the higher NPV. The high PPV of these agars allows accurate and rapid identification of E. coli.

Agar↗

Novel selective and non-selective optical detection of microorganisms.

A new instrument, capable of detecting metabolic changes due to microbiological activity, is described. Optical changes in growth media are monitored in a semi-fluid zone that separates the liquid medium containing the sample. Data demonstrate that common media can be utilized in conjunction with this rapid automated technology. Nutrient broth with the pH dye indicator. bromocresol purple was suitable for total counts. Selective media containing dyes were utilized to assess the presence or absence of specific groups of organisms. Biochemical reactions, such as lysine decarboxylase activity, were identified by the unique generated patterns, and specific enzymatic cleavage reactions with chromogenic substrates, such as 5-bromo-4 chloro-3 indolyl-beta-D-glucuronic acid (X-GLUC), were monitored.

Bacillus cereus↗

Alizarin-beta-D-galactoside: a new substrate for the detection of bacterial beta-galactosidase.

We describe the synthesis of a new substrate for the detection of bacterial beta-galactosidase. This substrate, alizarin-beta-D-galactoside, is readily hydrolysed to release alizarin which complexes with various metal ions to form brightly coloured chelates. A total of 367 strains of Gram-negative bacteria were examined for their ability to hydrolyse three chromogenic substrates: alizarin-beta-D-galactoside (Aliz-gal), cyclohexenoesculetin-beta-D-galactoside (CHE-gal) and 5-bromo-4-chloro-3-indolyl-beta-D-galactoside (X-gal). A total of 182 strains (49.6%) were found to hydrolyse at least one of the three substrates. All of these 182 strains (100%) hydrolysed Aliz-gal whereas only 170 (93.4%) and 173 (95.1%) hydrolysed CHE-gal and X-gal, respectively. We conclude that alizarin-beta-D-galactoside is a highly sensitive substrate for the demonstration of beta-galactosidase.

Anthraquinones↗