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Substrate overlap and functional competition between human nucleotide excision repair and Escherichia coli photolyase and (a)BC excision nuclease.

Human cell free extract prepared by the method of Manley et al. (1980) carries out repair synthesis on UV-irradiated DNA. Removal of pyrimidine dimers by photoreactivation with DNA photolyase reduces repair synthesis by about 50%. With excess enzyme in the reaction mixture photolyase reduced the repair signal by the same amount even in the absence of photoreactivating light, presumably by binding to pyrimidine dimers and interfering with the binding of human damage recognition protein. Similarly, the UvrB subunit of Escherichia coli (A)BC excinuclease when loaded onto UV-irradiated or psoralen-adducted DNA inhibited repair synthesis by cell-free extract by 75-80%. The opposite was true also as HeLa cell free extract specifically inhibited the photorepair of a thymine dimer by DNA photolyase and its removal by (A)BC excinuclease. Cell-free extracts from xeroderma pigmentosum (XP) complementation groups A and C were equally effective in blocking the E. coli repair proteins, while extracts from complementation groups D and E were ineffective in blocking the E. coli enzyme. These results suggest that XP-D and XP-E cells are defective in the damage recognition subunit(s) of human excision nuclease.

Binding, Competitive↗

Double dissociations of memory and executive functions in working memory tasks following frontal lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in man.

Thirty-two neurosurgical patients with unilateral or bilateral frontal lobe excisions, 41 patients with unilateral temporal lobe lesions and 19 patients who had undergone unilateral amygdalo-hippocampectomy were compared with matched controls on a computerized test of spatial working memory. A significant deficit was observed in the frontal lobe group, even at the least challenging level of task difficulty and this impairment was found to relate to the inefficient use of a particular searching strategy shown to improve performance on this task. In contrast, deficits in the temporal lobe group and the amygdalo-hippocampectomy group were only observed at the most difficult level of the task and in neither group could the deficit be related to the inefficient use of any particular searching strategy. In a follow-up study, the three patient groups were compared on analogous computerized tests of visual and verbal working memory. No deficits were observed in the frontal lobe group. By comparison, both the temporal lobe patients and the amygdalo-hippocampectomy group were significantly impaired in the visual working memory condition but not in the verbal working memory condition. These deficits were clearly evident at all levels of task difficulty and were not related to any particular searching strategy. The data are discussed in terms of the relative contributions of "executive' and "mnemonic' mechanisms to the contrasting, material dependent deficits observed in the frontal and temporal lobe groups.

Adult↗

The modern abdominoperineal excision: the next challenge after total mesorectal excision.

OBJECTIVES: Examine the cause of local recurrence (LR) and patient survival (S) following abdominoperineal resection (APR) and anterior resection (AR) for rectal carcinoma and the effect of introduction of total mesorectal excision (TME) on APR. METHODS: A total of 608 patients underwent surgery for rectal cancer in Leeds from 1986 to 1997. CRM status and follow-up data of local recurrence and patient survival were available for 561 patients, of whom 190 underwent APR (32.4%) and 371 AR (63.3%). Also, a retrospective study of pathologic images of 93 specimens of rectal carcinoma. RESULTS: Patients undergoing APR had a higher LR and lower survival (LR, 22.3% versus 13.5%, P = 0.002; S, 52.3% versus 65.8%, P = 0.003) than AR. LR free rates were lower in the APR group and cancer specific survival was lowered (LR, 66% versus 77%, log rank P = 0.03; S, 48% versus 59%, log rank P = 0.02). Morphometry: total area of surgically removed tissue outside the muscularis propria was smaller in APR specimens (n = 27) than AR specimens (n = 66) (P < 0.0001). Linear dimensions of transverse slices of tissue containing tumor, median posterior, and lateral measurements were smaller (P < 0.05) in the APR than the AR group. APR specimens with histologically positive CRM (n = 11) had a smaller area of tissue outside the muscularis propria (P = 0.04) compared with the CRM-negative APR specimens (n = 16). Incidence of CRM involvement in the APR group (41%) was higher than in the AR group (12%) (P = 0.006) in the 1997 to 2000 cohort. Similar results (36% and 22%) were found in the 1986 to 1997 cohort (P = 0.002). CONCLUSIONS: Patients treated by APR have a higher rate of CRM involvement, a higher LR, and poorer prognosis than AR. The frequency of CRM involvement for APR has not diminished with TME. CRM involvement in the APR specimens is related to the removal of less tissue at the level of the tumor in an APR. Where possible, a more radical operation should be considered for all low rectal cancer tumors.

Adenocarcinoma↗

Assessment of excision margins following wide local excision for breast carcinoma using specimen scrape cytology and tumour bed biopsy.

Specimen scrape cytology (SSC) and tumour bed biopsy (TBB) were used to assess adequacy of wide local excision of breast cancer. Thirty-nine (49%) of 80 cases were SSC positive and 18 (23%) TBB positive. When the main specimen contained ductal carcinoma in situ (DCIS) 21 (66%) of 32 cases were SSC positive compared to 18 (38%) of 48 when DCIS was absent (chi 2 = 9.17, P < 0.01). TBB results were not affected by the presence of DCIS. These findings may reflect the multifocal nature of breast cancer and especially DCIS. It is postulated that positive specimen cytology could be a better indicator of inadequate local surgical treatment than involved tumour bed biopsies or positive margins judged by conventional histology.

Adenocarcinoma↗

Comparison of disk excision and combined disk excision and spinal fusion for lumbar disk ruptures.

In a series of private patients 77 per cent over-all satisfactory results were obtained from surgical disk excision performed without spinal fusion. Patients in whom spinal fusion combined with discectomy has been recommended by other authors are not much more satisfied than patients with discectomy alone without fusion (81% versus 74% satisfactory). Patients in whom the third party influence prevails were significantly more dissatisfied (only 59% satisfactory). Findings of a definite disk rupture at the time of surgery result in a higher incidence of satisfactory rating than those with degenerative changes or with normal findings.

Adolescent↗

Nucleotide excision repair 3' endonuclease XPG stimulates the activity of base excision repairenzyme thymine glycol DNA glycosylase.

An ionizing radiation-induced DNA lesion, thymine glycol, is removed from DNA by a thymine glycol DNA glycosylase with an apurinic/apyrimidinic (AP) lyase activity encoded by the Escherichia coli endonuclease III ( nth ) gene and its homolog in humans. Cells from Cockayne syndrome patients with mutations in the XPG gene show approximately 2-fold reduced global repair of thymine glycol. Hence, I decided to investigate the molecular mechanism of the effect of XPG protein observed in vivo on thymine glycol removal by studying the interactions of XPG protein and human endonuclease III (HsNTH) protein in vitro and the effect of XPG protein on the activity of HsNTH protein on a substrate containing thymine glycol. The XPG protein stimulates the binding of HsNTH protein to its substrate and increases its glycosylase/AP lyase activity by a factor of approximately 2 through direct interaction between the two proteins. These results provide in vitro evidence for a second function of XPG protein in DNA repair and a mechanistic basis for its stimulatory activity on HsNTH protein.

DNA↗

[Excision of colorectal cancers: what can be expected of lymph node excision?].

We report a series of 413 patients with colo-rectal adenocarcinoma. 328 had a curative resection and 277 of them had elective lymphadenectomy; 51 had no lymphadenectomy because of either age or poor general status. Operative morbidity and mortality were not increased by lymphadenectomy. Survival was related to the lymph node involvement: 70.6% 5 year survival in patients without lymph node metastases, 49.3% 5 year survival in patients with lymph node metastases (P less than 0.001). However lymphadenectomy did not affect the survival rate of the patients. We conclude that lymphadenectomy had no deleterious effect. However, its real benefit on long term survival must be evaluated in further prospective randomised studies.

Actuarial Analysis↗