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Background: In most patients with secundum atrial septal defects (ASD), transcatheter closure is the preferred treatment strategy, but whether device size affects clinical outcomes is unknown. We sought to study the efficacy and safety of large closure devices compared to the use of smaller devices. Methods: Using a single-center, prospective registry of adult patients undergoing transcatheter ASD closure, patients receiving a large closure device (waist diameter ≥25 mm, n = 41) were compared to patients receiving smaller devices (waist diameter ≤24 mm, n = 66). We analyzed pre-interventional clinical, hemodynamic and echocardiographic data, interventional success and complication rates, and 6-month clinical and echocardiographic outcomes. The primary efficacy outcome was successful ASD closure achieved by a single procedure and confirmed by lack of a significant residual shunt at 6 months. The primary safety outcome was a composite of device embolization, major bleeding, and new-onset atrial arrhythmia occurring within 6 months. Results: Transcatheter ASD closure using large devices was successful in 90 % compared to 97 % of patients receiving smaller devices as defined by the primary efficacy outcome (p = 0.20). The primary safety outcome occurred in 4 patients of the large and 6 patients of the small device group, resulting in an event-free rate of 90 and 91 %, respectively (p = 0.89). Similar significant symptomatic improvement was observed in both treatment groups after 6 months, indicated by a 50 % increase in the fraction of patients in NYHA class I (p < 0.0001 vs. baseline). Conclusions: Transcatheter closure in this cohort of patients with large or small ASD was effective with similar complication rates during short-term follow-up irrespective of the size of the implanted device. [ABSTRACT FROM AUTHOR]

We aimed to study the potential influence of the variability in the assessment of echocardiographically measured left ventricular ejection fraction (LVEF) on indications for the implantation of internal cardioverter defibrillator and/or cardiac resynchronization devices in heart failure patients. TIME-CHF was a multicenter trial comparing NT-BNP versus symptom-guided therapy in patients aged ≥60 years. Patients had their LVEF assessed at the recruiting centre using visual assessment, the area-length or biplane Simpson's method. Echocardiographic data were transferred to the study core-lab for re-assessment. Re-assessment in the core-lab was done with biplane Simpson's method, and included an appraisal of image quality. 413 patients had the LVEF analyzed at the recruiting centre and at the core lab. Image quality was optimal in 191 and suboptimal in 222. Overall, the correlation between LVEF at the recruiting centres and at the core-lab was good, independent of image quality (R² = 0.62). However, when a LVEF ≤30 % or ≥30 % was used as a cut-off, about 20 % of all patients would have been re-assigned to having either a LVEF above or below the cut-off, this proportion was not significantly influenced by image quality. We conclude that correlation between LVEF assessed by different centres based on the same ultrasound data is good, regardless of image quality. However, one fifth of patients would have been re-assigned to a different category when using the clinically important cut-off of 30 %. [ABSTRACT FROM AUTHOR]

In patients with carcinoid heart disease, a multidisciplinary approach to patient care is required because treatment of the systemic disease and management of cardiac involvement must be considered at the same time. Somatostatin analogue use is a therapeutic cornerstone, effective in symptomatic control of the endocrine syndrome. Chemotherapy is of limited efficacy in patients with carcinoid tumors. Hepatic resection of metastases is the preferred treatment option and has been shown to result in improved outcome. It should be considered if at least 90% of the metastases in the liver are removable. Hepatic artery embolization is usually applied if a patient is not eligible for surgical debulking. Development and progression of carcinoid heart disease complicate the carcinoid syndrome and contribute to poor prognosis. In patients with severe cardiac involvement and well-controlled systemic disease, valve replacement surgery is an effective treatment modality that can relieve intractable symptoms and contribute to improved outcome. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndromes (MDS) are clonal malignant stem cell disorders characterized by inefficient hematopoiesis. The role of the marrow microenvironment in the pathogenesis of the disease has been controversial and no study has been performed so far to characterize mesenchymal cells (MC) from MDS patients and to analyse their ability to support hematopoiesis. To this end, we have isolated and characterized MC at diagnostic marrow samples (n=12) and have purified their CD34+CD38-and CD34+CD38+counterparts (n=7) before using MC as a short- and long-term hematopoietic support. We show that MC can be readily isolated from MDS marrow and exhibit a major expansion potential as well as an intact osteoblastic differentiation ability. They do not harbor the abnormal marker identified by FISH in the hematopoietic cells and they stimulate the growth of autologous clonogenic cells. Conversely, highly purified stem cells and their cytokine-expanded progeny harbor the clonal marker with variable frequencies, and both normal and abnormal long-term culture-initiating cell-derived progeny can be effectively supported by autologous MC. Thus, we demonstrate that MDS marrow is an abundant source of MC appearing both cytogenetically and functionally noninvolved by the malignant process and able to support hematopoiesis, suggesting their possible usefulness in future cell therapy approaches.Oncogene (2005) 24, 2441-2448. doi:10.1038/sj.onc.1208405 Published online 7 February 2005 [ABSTRACT FROM AUTHOR]

To discriminate among the chromosomal abnormalities associated with the etiology of hepatocellular carcinoma (HCC), we performed a comparative genomic hybridization (CGH) analysis on 34 HCCs resected on non-cirrhotic livers from patients serologically negative for both hepatitis B (HBV) and C (HCV) viruses. The results were compared to those of a previous analysis of 50 HCCs selected on the basis of their positivity for HBV infection. The majority of the abnormalities found in the HBV positive cases (losses of chromosome arms 1p, 8p, 6q, 13q and 14q and gains of 1q, 8q, 6p and 17q) were similarly detected in the virus negative specimens. In contrast, a significant decrease (40% on average) was observed for losses at 4q, 16q and 17p in non-viral HCC samples, suggesting that these abnormalities are tightly associated with HBV infection. Thus, in addition to a common pathway towards malignancy, a subset of alterations may preferentially contribute to virus-induced carcinogenesis. In a parallel CGH study of 10 fibrolamellar carcinomas, a rare subtype of HCC, we found in six out of the seven informative cases, gains of chromosome arm 1q. This region, which is also preferentially amplified in non fibrolamellar tumors (58%), may contain an essential proto-oncogene commonly implicated in liver carcinogenesis. Oncogene (2000) 19, 3733–3738 [ABSTRACT FROM AUTHOR]

Molecular cytogenetic analysis of several sporadic papillary renal cell carcinomas and of their xenografts in immunodeficient mice had previously allowed us to delimit a minimal overrepresented region of chromosome 7 shared by all of them to band 7q31. We have refined the location of the overlapping region to the junction of the subbands 7q31.2 and 7q31.3 by reverse painting with two differently labelled probes prepared from the small chromosome 7 derivatives microdissected from the cells of two distinct tumours. This small region was shown to contain the MET proto-oncogene, present at three to four copies per cell as determined by Southern blot analysis. The increased copy number of the MET gene was found to be associated with its overexpression at the mRNA level. However, no change in MET copy number or expression level was observed in the cells from two xenografted tumours serially transplanted into immunodeficient mice, as compared to those from the corresponding initial tumours. Our results indicate that expression of the MET proto-oncogene above a critical threshold is required for the maintenance of the tumorigenic phenotype of at least some papillary renal cell carcinomas, but does not further increase during tumour progression. Oncogene (2000) 19, 754–761. [ABSTRACT FROM AUTHOR]

The formation of histamine from its precursor histidine is catalyzed by histidine decarboxylase (HDC), a pyridoxal phosphate (PLP)-dependent decarboxylase. The knowledge of sequence similarities between various rodent HDCs permitted us to prepare a rat brain HDC cDNA probe. After reverse transcription of rat brain polyA + mRNA, the HDC cDNA obtained was amplified by the polymerase chain reaction using two specific primers. The resulting 1019-bp DNA was cloned in the p-MAL vector. Its sequence corresponds to the published data on rat fetal liver HDC. This 1019-bp rat probe detected two BamHI sequences in man; these were assigned to chromosome 15 by somatic hybrid cell analysis. According to the well-known homology between human chromosome 15 and mouse chromosome 2, the result obtained is in agreement with the published localization of HDC on mouse chromosome 2. The mapping of the human HDC gene on chromosome 15 is an original contribution to the chromosomal assignment of related PLP-dependent decarboxylases. [ABSTRACT FROM AUTHOR]

PP14 protein (placental protein 14) is abundantly secreted by the human endometrium under the influence of progesterone. Human PP14 is homologous to β-lactoglobulin, the main component of equine, bovine, and ovine milk whey. A genomic PP14 probe (PP14G1) was used for the chromosome assignment of the PP14 gene. Somatic hybrid cells enabled PP14G1 to be assigned to chromosome 9. In situ hybridization further refined this assignment to 9q34. The localization of the PP14 gene in the region of the ABO locus is consistent with the linkage described in bovines between beta-lactoglobulin and the J blood group (homologous to the human ABO group). [ABSTRACT FROM AUTHOR]

The staining properties of AT-specific dyes Hoechst 33342 and DAPI as revealed by Hoechst 33342/mithramycin and mithramycin/DAPI bivariate human flow karyotype patterns are different for chromosomes rich in heterochromatin. The peak corresponding to chromosome Y of a given cell line is higher on the A/T axis with mithramycin/DAPI staining than with mithramycin/Hoechst. The chromosome 1 was found slightly more fluorescent in mithramycin/DAPI than in mithramycin/Hoechst as judged by the slight displacement of its area on the Hoechst-DAPI axis. The other peaks did not show major differences. On the same flow karyotypes, chromosomal rearrangements were detected. [ABSTRACT FROM AUTHOR]

Human cDNAs coding for the new protein ral that shares 50% homology with the ras proteins have been recently isolated. A 600-bp fragment carrying mainly the coding region was used to localize the ral gene by hybridization with sorted chromosomes and in situ hybridization. Direct molecular hybridization on sorted chromosomes using a single laser illumination allowed the assignment of the ral gene to a region of the flow karyotype containing chromosomes 7, 8 and X. With dual laser analysis ral was assigned to the fraction containing chromosome 7. In the 331 human metaphases hybridized with the H-labelled insert, the silver grain distribution showed a unique major signal on chromosome 7p15-22. [ABSTRACT FROM AUTHOR]

Cytogenetic studies of three Fanconi's anemia patients are reported, one of the patients having erythroleukemia, the other two preleukemia. Clonal abnormalities were present in all three cases. Partial chromosomal duplication uncommon in other leukemias was observed. Partial duplication of the long arm of chromosome 3 has been observed in the present case of erythroleukemia examined as well as in a previously reported one. [ABSTRACT FROM AUTHOR]

We describe here a new sequence variant occurring in the coding region of the neurofibromatosis (NF1) gene (exon 13). This exonic polymorphism can be directly investigated by simple restriction enzyme digestion of RT-PCR (reverse transcription-polymerase chain reaction) products, making it a powerful tool for examining allele-specific mRNA expression levels. [ABSTRACT FROM AUTHOR]

Pretreatment of chromosomal preparations improves the reproducibility of R-banding. The pretreatment consists of covering slides with protein film made by a mixing of foetal calf serum and methanol acetic acid fixative. This procedure allows other banding techniques (GTG, Ag NOR). [ABSTRACT FROM AUTHOR]

Oncogene (2003) 22, 1907. doi:10.1038/sj.onc.1206225 [ABSTRACT FROM AUTHOR]