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P300 as a clinical assay: rationale, evaluation, and findings.

Use of the P300 event-related brain potential (ERP) as a clinical assay is reviewed and assessed by comparing its distribution qualities with normative biomedical testing data from published studies. The coefficient of variation statistic was calculated for P300 data and a variety of clinical testing data. P300 amplitude and latency variability was found to be highly comparable and sometimes superior to routinely employed biomedical assays. These results are discussed in terms of how to control inter-group ERP variability and the application of normative P300 data in clinical settings.

Acoustic Stimulation↗

High-dose intravenous vitamin C is not associated with an increase of pro-oxidative biomarkers.

OBJECTIVE: High-dose vitamin C therapy might mediate beneficial clinical effects by counteracting reactive oxygen species. However, concerns are raised whether this approach might provoke diametrical (ie pro-oxidative) effects. The objective was to determine ascorbyl free radical (AFR) concentrations and potential variables of pro-oxidative damage. DESIGN: Crossover study; six healthy males received daily infusions of 750 or 7500 mg vitamin C for six consecutive days. Fasting concentrations of vitamin C and AFR were determined daily. On day 1, concentrations of vitamin C and AFR were measured at 0.25, 0.5, 1, 2, 4 and 8 h post infusion. Plasma concentrations of thiobarbituric acid-reactive substances (TBARS), tocopherol and urine concentrations of 8-oxoguanosine were determined on days 1 and 6. RESULTS: Kinetic studies on day 1 showed that concentrations of vitamin C and AFR displayed parallel dose- and time-dependent kinetics and elimination was highly efficient. Vitamin C and AFR fasting concentrations on days 2-6 were slightly above the baseline, suggesting new, stable steady states. TBARS decreased in both groups, whereas tocopherol and 8-oxoguanosine concentrations remained unchanged. CONCLUSION: Kinetics of AFR largely depend on plasma vitamin C concentrations and AFR is eliminated efficiently. Our data do not support induction of pro-oxidative effects in healthy volunteers given intravenous high-dose vitamin C. SPONSORSHIP: Pascoe Pharmazeutische Präparate GmbH, Giessen, Germany.

Adult↗

Melan-A/Mart-1 expression in various melanocytic lesions and in non-melanocytic soft tissue tumours.

AIMS: The purpose of this study was to test different malignant non-melanocytic tumours with the commercially available antibody Melan-A to examine its diagnostic specificity and to compare the S100, Melan-A and HMB-45 reactivity in various melanocytic lesions. METHODS AND RESULTS: Seventy-three benign and malignant melanocytic lesions and 31 cases of non-melanocytic tumours, sarcomas, carcinomas and carcinoids, were selected. Immunohistochemical staining of paraffin sections, following a high temperature antigen unmasking technique, was performed. Melan-A stains junctional and dermal melanocytes in all benign melanocytic lesions with the exception of neuro-naevoid areas. The epithelioid and the spindle cells in malignant melanomas did not show considerable difference in their Melan-A reactivity. The predominantly spindle cell type mucosal melanomas contained more Melan-A-positive cells than HMB-45-positive cells and similar results were observed in metastatic malignant melanomas. In desmoplastic melanomas the positivity of Melan-A was not consistent. None of the sarcomas, carcinomas and carcinoids expressed Melan-A. Almost all soft tissue tumours, except for two malignant gastrointestinal stromal tumours, were unreactive for HMB-45. These two cases did not react with Melan-A antibody. CONCLUSIONS: Melan-A is a useful additional marker to differentiate non-melanocytic tumours from primary or metastatic melanoma. In melanocytic lesions the Melan-A staining pattern is similar to S100, but seems to be more specific. In desmoplastic melanomas, however, the variable Melan-A staining further necessitated detailed histological examination and the use of the S100 reaction.

Antigens, Neoplasm↗

Spatial variability of in situ microbial activity: biotracer tests.

Biotracer tests have been proposed as a means by which to characterize the in situ biodegradation potential for field-scale systems. In this study, field experiments were conducted at two sites to evaluate the utility of the biotracer method for characterizing the spatial variability of microbial activity. The first site is a mixed waste-contaminated surficial aquifer in Utah, and the second site is a chlorinated solvent-contaminated regional aquifer in Tucson, Arizona. Mass recovery of the biotracer decreased approximately linearly with increasing residence time for the Tucson site. Similar behavior was observed at the Utah site, except in the region adjacent to the injection zone, where percent recoveries were much lower than those predicted using a correlation determined using data collected downgradient of the injection zone. First-order biodegradation rate coefficients obtained from model calibration of the tracer data varied between 0.2 and 0.5/day for the Tucson site. For the Utah site, the values varied between 0.1 and 0.6/day downgradient of the injection wells, and between 0.7 and 2.6/day near the injection wells. Considering the large range over which biodegradation rate coefficients can vary, the rate coefficient exhibited relatively minimal spatial variability (factor of 2.5) for the Tucson site. Conversely, the spatial variability of the rate coefficient was an order of magnitude greater for the Utah site. These differences in variability are consistent with conditions associated with the respective sites. For example, the greater microbial activity observed in the vicinity of the injection wells for the Utah site is consistent with the biomass distribution determined from analysis of core samples, which shows larger bacterial cell densities for the region near the injection wells. These results illustrate the utility of biotracer tests for in situ characterization of microbial activity (e.g., biodegradation potential), including evaluation of potential spatial variability.

Biodegradation, Environmental↗

Single-cell measurements of polyamidoamine dendrimer binding.

The binding of fluorescein-labeled polyamidoamine dendritic polymers (dendrimers) to the surface of individual fibroblast cells has been quantitatively measured using confocal fluorescence microscopy. Because the binding of these polymers is not strong, significant fluorescence from polymers in solution complicates the measurement, even using confocal optics. To overcome this difficulty, we have developed a new method employing a cell-entrapped marker dye to determine the extracellular volume in each voxel. This allows for a correct subtraction of fluorescence due to polymers in solution. We have found that, as expected, the larger dendrimers bound more tightly than the smaller generations, which may partially account for their increased efficacy in DNA transfection applications. The binding varied significantly from cell to cell, and an analysis of the cell surface area showed that this variability was not caused simply by variations in cell size.

Animals↗

Differences in expression of cardiovascular risk factors among type 2 diabetes mellitus patients of different age.

Atherosclerotic coronary heart disease and other forms of cardiovascular disease (CVD) are the major cause of mortality in type II diabetes (T2DM) as well as a major contributor to morbidity and lifetime costs. The purpose of this article is the identification of the biochemical parameters in plasma, which may serve as predisposition factors to CVD in T2DM patients of different ages. The variability of hyperglycemia, dyslipidemia, and inflammation with age progression was also studied for comparison. Four different diabetic groups allocated on the basis of the subjects' age (Group A: 15-25 years old; Group B: 26-40 years old; Group C: 40-60 years old; Group D: 60-80 years old) and consisting of 10 patients each, in parallel with 10 healthy controls matched for age, sex, and ethnic origin were screened for glucose, insulin, lipid profile (total cholesterol, triglycerides, LDL, and HDL), and inflammatory mediators (CRP, IL-6, and TNF-alpha). Significant differences were observed among the expressions of biochemical markers among different age groups. Hyperglycemia showed no variability with age whereas dyslipidemia correlated positively with age progression, as well as obesity, low physical activity, and family history of heart disease or diabetes. Marked inflammation was prominent only in Groups C and D. This article indicates that different biochemical parameters may be used for the assessment of CVD risk in T2DM patients of variable age.

Adolescent↗

Assessment of CA 15.3, CEA and TPA concentrations during monitoring of breast cancer.

The variability of the tumor markers cancer antigen (CA) 15.3, carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) during steady state concentrations and the rate of increase during progression is described. One hundred and ninety-two patients were monitored during first-line chemotherapy for metastatic breast cancer and during follow-up. Blood specimens were sampled approximately every four weeks. Steady state concentrations were registered for 77 (CA 15.3), 96 (CEA), and 127 (TPA) patients with below cutoff level values and for 28 (CA 15.3), 25 (CEA), and 11 (TPA) patients with above cutoff level values. Clinical and marker progression was registered for 75 (CA 15.3), 62 (CEA), and 57 (TPA) patients. The coefficients of total variation of steady state concentrations (comprising the intra- and interassay analytical imprecision and the within subject biological variation) were higher below (14.9% CA 15.3, 15.4% CEA, 25.9% TPA) than above cutoffs (9.6% CA 15.3,6.0% CEA, 19.9% TPA). The variability was similar for CA 15.3 and CEA but higher for TPA. During progression the rates of increase in concentrations were similar for CA 15.3 (0.0257) and CEA (0.0214) and lower than for TPA (0.0346). Our data indicate that criteria for assessment of sequential tumor marker concentrations should consider the marker in question, the steady state variability, the cutoff value, and the rate of increase during disease progression.

Adult↗

Nerve cell markers in ossifying fibromyxoid tumour of soft parts.

Reported herein are two benign ossifying fibromyxoid tumors (OFMTs) of the soft tissues in axilla and terminal phalanx respectively. Both cases on immunohistochemistry (IHC) showed reactivity for vimentin, S-100 protein and glial fibrillary acidic protein (GFAP) antibodies. In addition, a focal/diffuse strong positivity for neurofilament (NF) and neuron specific enolase (NSE) was observed. Electron microscopy in one instance revealed abundant intermediate filaments, primitive cell junctions and a focally present external lamina. In the light of nerve cell differentiation of these tumors and the similarity of IHC profile and EM features of OFMT to a poorly differentiated malignant peripheral nerve sheath tumor (MPNST); it is suggested that OFMT is a variably differentiated PNST rather than a simple Schwannian neoplasm as is believed.

Adult↗

Psychophysiological stress in elite golfers during practice and competition.

This study examined self-reported state anxiety (cognitive anxiety, somatic anxiety and self-confidence) measured by the Competitive State Anxiety Inventory-2 (CSAI-2; Martens, Vealey, Bump, & Smith, 1990) and physiological responses (salivary cortisol concentration and heart rate) in elite golfers prior to, during and on completion of a tournament and practice round. The relationships between psychophysiological variables were investigated by comparing physiological and psychological responses during competition and practice to each other, and to performance. Performance was determined for each player as the difference between 18 hole score and handicap. Fifteen male Professional Golfing Association (PGA) trainees (aged 21-25 years) competed in a PGA sanctioned tournament and a practice round on the same, or similar golf course. Players completed the CSAI-2 and collected saliva for cortisol analysis on four occasions: prior to tee off, and after completing holes 6, 12 and 18. Cortisol concentration was corrected for circadian variations in cortisol secretion, using baseline cortisol measures. Within-subject analysis revealed elite golfers experienced elevated cortisol, heart rate, cognitive and somatic anxiety, and lower self-confidence during competition compared to practice. For both game conditions, the highest cortisol response was measured prior to the commencement of play, whilst state anxiety measures did not change significantly during the golf rounds. Univariate and multivariate analyses failed to reveal significant correlations between the psychophysiological variables and golf performance. In conclusion, competition and practice were clearly discriminated by the psychophysiological variables, but none of these predicted performance.

Adult↗

Immunological markers in HIV-infected pregnant women. The European Collaborative Study and the Swiss HIV Pregnancy Cohort.

OBJECTIVE: To examine immunological markers in HIV-infected pregnant women. DESIGN: Women enrolled in the European Collaborative Study and the Swiss HIV Pregnancy Cohort were followed throughout pregnancy according to similar clinical and immunological protocols. Information was recorded at various times during pregnancy and, in some centres, also 6 weeks and 6 months post-partum. METHOD: Locally-weighted linear regression analysis was used to investigate changes in markers of cellular and humoral immune function during pregnancy and immediately post-partum, taking into account the serial measurement data structure. Women who received zidovudine during pregnancy were excluded. RESULTS: Four hundred and thirty-eight women had two or more measurements during pregnancy or within 6 months of delivery. Twenty-four per cent (106) of the women reported injecting drugs during pregnancy. Mean CD4 and CD8 cell counts declined to a low level 6 months before delivery, increased gradually until delivery and rose sharply to a peak level 3 months post-partum. In contrast, CD4 and CD8 percentages were stable during pregnancy, and increased slightly thereafter. The same pattern was evident for transmitting women, those delivered by Cesarean section, and women who injected drugs during pregnancy, and there was no evidence for an association with immunosuppression. Total immunoglobulin (Ig) G levels declined gradually throughout pregnancy until delivery, and increased in the 6 month post-partum period. Total IgM and IgA levels remained stable throughout pregnancy. CONCLUSIONS: These findings suggest that pregnancy does not accelerate HIV progression, but in view of the intrinsic variability in serial CD4 counts, caution should be exercised when assessing changes in immunological markers in individual pregnant women.

Antibody Formation↗

Colorectal cancer: morphologic variables related with carcinoembryonic antigen serum elevation (CEA).

OBJECTIVE: The purpose of this study is to identify morphologic parameters of colorectal adenocarcinoma which may be of influence in the increase of preoperatory CEA serum levels. METHOD: This study includes 127 patients on whom colectomy was performed. Twenty-eight morphologic parameters were analyzed in each surgical specimen. Serum determinations were made by enzymatic immunoassay. A multivariate study (logistic regression analysis) was made. Independent risk factors for CEA serum elevation were Cytologic Atypia (odd ratio: 2.85) Infiltrative Growth Pattern (odd ratio: 2.91) and the presence of tumoral cell infiltration directly among adipocytes (odd ratio: 2.62). When clinical variables (age, sex, tumor location, perforation, occlusion, hepatic metastases and peritoneal carcinomatosis) were added the infiltrative growth pattern (odd ratio: 3.12) and cytologic atypia persisted as independent risk factors, together with the clinical variable Hepatic Metastases (odd ratio: 24.84). CONCLUSION: In our series the morphologic variables Infiltrative Growth Pattern and Cytologic Atypia are independently related with CEA serum increase and are not influenced by the variable Hepatic Metastases.

Adult↗

Multiplex bead array assays: performance evaluation and comparison of sensitivity to ELISA.

The measurement of soluble cytokines and other analytes in serum and plasma is becoming increasingly important in the study and management of many diseases. As a result, there is a growing demand for rapid, precise, and cost-effective measurement of such analytes in both clinical and research laboratories. Multiplex bead array assays provide quantitative measurement of large numbers of analytes using an automated 96-well plate format. Enzyme-linked immunosorbent assay (ELISAs) have long been the standard for quantitative analysis of cytokines and other biomarkers, but are not well suited for high throughput multiplex analyses. However, prior to replacement of ELISA assays with multiplex bead array assays, there is a need to know how comparable these two methods are for quantitative analyses. A number of published studies have compared these two methods and it is apparent that certain elements of these assays, such as the clones of monoclonal antibodies used for detection and reporting, are pivotal in obtaining similar results from both assays. By careful consideration of these variables, it should be possible to utilize multiplex bead array assays in lieu of ELISAs for studies requiring high throughput analysis of numerous analytes.

Antibodies, Monoclonal↗

Toxicological foundations of ecological risk assessment: biomarker development and interpretation based on laboratory and wildlife species.

Ecological risk assessments based on chemical residue analysis and species demographics tend to ignore the bioavailability and bioaccumulation of the chemicals of concern. This study describes the incorporation of mechanistically based biomarkers into an ecological risk assessment of a poly-cyclic aromatic hydrocarbon (PAH)-contaminated site. A combination of soil residue analysis, tissue residue analysis, biomarkers in one-site trapped animals and biomarkers in animals confined to enclosures was used. In particular, the use of captured deer mice (Peromyscus maniculatus) for these studies is compared to the use of laboratory-raised deer mice placed in enclosures. This study indicates that the higher degree of variability in the responses of wild deer mice make the use of enclosure studies advantageous. Positive control studies performed by dosing laboratory-raised deer mice with the same PAHs as found on the site were used to validate this approach. These studies indicate that immune suppression occurred at PAH concentrations an order of magnitude below those required for the induction of ethoxyresorufin-O-dealkylase activity.

Animals↗

Congenital heart defects and abnormal maternal biomarkers of methionine and homocysteine metabolism.

BACKGROUND: It is well established that folic acid prevents neural tube defects. Although the mechanisms remain unclear, multivitamins containing folic acid may also protect against other birth defects, including congenital heart defects. OBJECTIVE: Our goal was to establish a maternal metabolic risk profile for nonsyndromic congenital heart defects that would enhance current preventive strategies. DESIGN: Using a case-control design, we measured biomarkers of the folate-dependent methionine and homocysteine pathway among a population-based sample of women whose pregnancies were affected by congenital heart defects (224 case subjects) or unaffected by any birth defect (90 control subjects). Plasma concentrations of folic acid, homocysteine, methionine, S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), vitamin B-12, and adenosine were compared, with control for lifestyle and sociodemographic variables. RESULTS: After covariate adjustment, case subjects had higher mean concentrations of homocysteine (P < 0.001) and SAH (P < 0.001) and lower mean concentrations of methionine (P = 0.019) and SAM (P = 0.014) than did control subjects. Vitamin B-12, folic acid, and adenosine concentrations did not differ significantly between case and control subjects. Homocysteine, SAH, and methionine were identified as the most important biomarkers predictive of case or control status. CONCLUSIONS: The basis for the observed abnormal metabolic profile among women whose pregnancies were affected by congenital heart defects cannot be defined without further analysis of relevant genetic and environmental factors. Nevertheless, a metabolic profile that is predictive of congenital heart defect risk would help to refine current nutritional intervention strategies to reduce risk and may provide mechanistic clues for further experimental studies.

Adult↗

Differentiating lymphoblastic lymphoma and Ewing's sarcoma: lymphocyte markers and gene rearrangement.

We encountered a child with an intraosseous small round cell tumor that was negative for LCA, CD20 (L26), and CD3 and positive for vimentin, CD99 (MIC-2), and periodic acid-Schiff. The tumor exhibited rosette-like formations. This case was initially interpreted as Ewing's sarcoma (ES); however, additional studies revealed positivity for CD79a, CD43, and TdT expression, and an immunoglobulin heavy chain gene rearrangement (IgH-R) by polymerase chain reaction (PCR) established this to be a precursor B-lymphoblastic lymphoma. Because the differential diagnosis of ES and lymphoblastic lymphoma can be difficult and the differential diagnostic value of leukocyte antigens and immunoglobulin heavy chain gene rearrangement studies have not been fully evaluated, we conducted a more extensive investigation on 33 (21 soft tissue and 12 intraosseous) ES cases. Cases were retrieved from the files of the Department of Pathology at Georgetown University and from the Soft Tissue Registry of the Armed Forces Institute of Pathology. The cases were studied by light microscopy, immunohistochemistry, and PCR for IgH-R and T cell receptor gamma chain gene rearrangement (Tgamma-R). There were 17 females and 16 males; the mean age was 29.3 years. Locations included the extremities (n = 17) and trunk (n = 16). All cases fit the ES spectrum by light microscopy and immunohistochemistry, as previously determined, and were negative for lymphoid markers (LCA, CD3, CD20, CD43, CD79a, and TdT), CD10 and CD34. CD99 was positive in 31/33 and bcl-2 was weakly positive in 13/33 cases. All 21 cases studied for gene rearrangements by PCR were negative for IgH-R and Tgamma-R. Distinction of intraosseous lymphoblastic lymphoma from ES may be difficult because lymphomas may occasionally exhibit unexpected morphologic and immunophenotypic properties including LCA, CD3 and CD20 negativity and cytokeratin positivity. Additional analysis using CD79a, CD43, TdT, and PCR should be performed to avoid misdiagnosis. True ES is negative for lymphoid markers including CD79a, CD43, and TdT, as well as for IgH-R and Tgamma-R.

12E7 Antigen↗

Reaction of nitroso derivatives of dinitropyrenes with sulfhydryl groups of peptides and hemoglobin in vitro and in rats.

Diesel engine emissions have been classified as a potential human carcinogen and may cause a variety of other health effects. Human exposure to diesel engine emissions is highly variable within the population. Therefore, specific methods for the biomonitoring of human exposure to diesel engine emissions are required for exposure assessment within epidemiological studies. Haemoglobin adducts of dinitropyrenes may serve as biomarkers for human exposures to diesel engine emissions.To characterize structures of dinitropyrene reaction products with sulfhydryl groups, glutathione was used to trap electrophilic nitroso intermediates formed from dinitropyrenes and glutathione S-conjugates were identified and characterized by Qtrap techniques using (HPLC-MS/MS) high-performance liquid chromatography coupled to triple quadrupole mass spectrometry. Nitrosonitropyrene-derived sulfinamides, sulfenamides and glutathione thioethers bound to carbon atoms in the aromatic ring, presumably formed by a rearrangement of intermediate sulfenamide cations, were formed in low yields. In haemoglobin from rats orally administered dinitropyrenes, mild alkaline hydrolysis of haemoglobin released aminonitropyrenes, which were identified by HPLC-MS/MS. The results demonstrate that dinitropyrenes undergo nitroreduction in rats and that the intermediate nitrosonitropyrenes bind to heamoglobin. The haemoglobin adducts formed from dinitropyrenes seem, in contrast to previous studies, to be hydrolysable and thus represent sulfen- and sulfinamides derived from the intermediate nitrosonitropyrenes. The developed Qtrap methods to detect and characterize glutathione S-conjugates rapidly may have wide applications in attempts to characterize reactive intermediates formed in complex mixtures in low concentrations.

Air Pollutants↗

Relationship between subjective social status and measures of health in older Taiwanese persons.

OBJECTIVES: To compare the association between subjective ladder ranking and health measures with the association between objective indices and health measures in older Taiwanese men and women. DESIGN: Cross-sectional study. SETTING: A population-representative sample of elderly and nearly elderly men and women in Taiwan. PARTICIPANTS: The study included 991 participants from the Social Environment and Biomarkers of Aging Study in Taiwan. MEASUREMENTS: The information collected included demographic characteristics; subjective ladder score of SES; objective measures of SES, including education, income, and occupation; health behaviors; health-related variables such as self-rated health, basic activity of daily living difficulties, instrumental activity of daily living (IADL) difficulties, and physical activity difficulties; and depression score. RESULTS: Low ladder score was associated with poorer self-rated health and more reported IADL and physical activity difficulties, even after adjustment for objective measures of SES and other covariates. The multiply adjusted odds ratio for a one-quartile difference in ladder score and worse self-rated health was 1.19 (95% confidence interval=1.06-1.33). The associations between subjective ladder ranking and health status were generally stronger in those who had 6 years or less of education than in those who received more education. CONCLUSION: A simple subjective assessment of one's ranking on the social hierarchy was associated with self-rated health and physical functional status in an older ethnic Chinese population. The associations were independent of the effects of traditional objective measures of SES, such as education, income, and occupation.

Activities of Daily Living↗