Vaporized Perfluorocarbon Confers Protection against Acute Lung Injury by Inhibiting MMP-9 Expression without Protective Effects in other Organs

OBJECTIVE: Vaporized perfluorocarbon (PFC) is a treatment for lung injury; this study investigated its mode of action and potential protective effects on other organs, which are unclear. METHODS: Acute lung injury was induced by lung lavage with artificial seawater in 32 female New Zealand White rabbits. Animals received either conventional mechanical ventilation (CMV), positive end-expiratory pressure under CMV (PEEP), vaporized PFC ventilation, or positive end-expiratory pressure with vaporized PFC ventilation (PEEP + PFC). Histopathology of the lung, small intestine, liver and kidney were investigated. Matrix metalloproteinase (MMP)-9 mRNA levels in the lung were analysed. RESULTS: Pathological injury of the lung was significantly alleviated in the PEEP, PFC and PEEP + PFC groups compared with the CMV group. Tissue damage in the liver, kidney and small intestine was similar between all groups. MMP-9 mRNA levels in the PEEP, PFC and PEEP + PFC groups were significantly lower than those in the CMV group. CONCLUSIONS: Vaporized PFC ventilation can significantly alleviate lung injury but has no significant protective effect on other organs. Alleviation of lung injury may be associated with MMP-9 inhibition.

Derivation of severity index for rheumatoid arthritis and its association with healthcare outcomes

OBJECTIVES

To develop a claims-based severity index for rheumatoid arthritis (RA) using the Veterans Health Administration (VHA) database.

METHODS

Adult patients with at least two RA diagnoses 2 months apart were identified between 10/1/2008-09/30/2009. Patients were required to have at least 12 months continuous health plan enrollment before and after the index date (first RA diagnosis date) for an overall study period of 10/1/2007-09/30/2010. A severity index for rheumatoid arthritis (SIFRA, a proprietary algorithm of SIMR, Inc. [STATinMED Research]) was developed by calculating a weighted sum of 34 RA-related indicators assessed by an expert Delphi panel of six rheumatologists, including laboratory, clinical, and functional status, extra-articular manifestations, surgical history, and medications, during a 1-year pre-index period. Separate SIFRA versions were derived for patients with and without laboratory information. Correlations between SIFRA and previously validated claims-based indexes for RA severity (CIRAS), and other traditional comorbidity indexes were calculated during the pre-index period. The relationship between SIFRA and follow-up healthcare outcomes was also examined using histograms.

RESULTS

The Spearman's rank correlations between SIFRA and CIRAS were 0.525 for SIFRA without and 0.539 with laboratory data. The correlations between SIFRA and the Charlson Comorbidity Index (CCI) (0.1503 without, 0.1135 with laboratory data), Elixhauser Index (ELIX) (0.105 without, 0.079 with laboratory data), and Chronic Disease Score (CDS) (0.255 without, 0.239 with laboratory data) were low. Histograms showed that patients in the upper tercile of SIFRA incurred $9123 more all-cause and $1326 more RA-related healthcare costs during the 1-year post-index period than patients in the lower tercile. Using SIFRA in combination with CCI, CDS, or ELIX significantly increased the percentage of variation explained in outcomes measures.

LIMITATIONS

Patients in the VHA database may not represent typical RA patients since the database generally contains older, economically disadvantaged men with a high disease burden. Validity of the score is indirectly based on disease activity score 28 (DAS28), which measures disease activity rather than severity.

CONCLUSIONS

SIFRA was found to have moderate correlations with the previously validated CIRAS score, and demonstrated evidence of being a significant determinant of total and RA-related healthcare costs for RA patients. This study suggests that SIFRA could be an important methodological tool to control for severity in RA-related outcomes research. The algorithm can be applied to any claims dataset.

Interplay between charge stripes and sign reversals of Hall and Seebeck effects in stripe-ordered La(1.6-x)Nd0.4Sr(x)CuO4 superconductors

The Hall and Seebeck effects of the stripe-ordered superconductor La(1.6-x)Nd(0.4)Sr(x)CuO(4) single crystals (x = 0.10, 0.12 and 0.15) were investigated systematically. The sign change of Hall and Seebeck coefficients (R(H) and S) from positive to negative with decreasing temperature suggests the presence of electron pockets in the Fermi surface due to the stripe ordering. We successfully tune this behavior through an epitaxial strain induced by the mismatch between the thin film and the substrate. The negative R(H) disappears in the thinner film in which the static charge stripe is greatly suppressed by the strong epitaxial strain, and for a strain released thicker film the negative R(H) recovers. These results indicate the possibility of Fermi surface reconstruction caused by the static charge stripe order in the system.

Complementary deoxyribonucleic acid cloning of avian G0/G1 switch gene 2, and its expression and association with production traits in chicken

As a member of the G0/G1 switch genes, G0/G1 switch gene 2 (G0S2) is related to many regulatory processes in the human and mouse. For example, it interacts directly with adipose triglyceride lipase to active its triglyceride hydrolysis activities. In this study, G0S2 gene cDNA of the chicken (522 bp), zebra finch (420 bp), sparrow (417 bp), pigeon (417 bp), and Bengalese finch (416 bp) were cloned, and each of them was encoded as a protein of 99 amino acids. The expression of G0S2 mRNA was determined by real-time reverse-transcription PCR analysis in 20 tested tissues of 21- and 91-d-old chickens. The highest mRNA level was found in abdominal fat and subcutaneous fat in both stages. Considerable G0S2 mRNA was also observed in chicken heart and muscle tissues. Expression of the chicken G0S2 gene varied at different stages and sexes. The abundance of G0S2 mRNA on d 21 was far higher than that on d 91. The abundance in female chickens was higher than that in males at both stages. In the coding region, we found 4 SNP, among which only G197A led to a change in the amino acids (Arg66Gln); the rest were synonymous substitutions. Association analysis showed that both G102A and G255A were significantly associated with head width (P < 0.05) and were highly significantly associated with leg muscle color (P < 0.01). The G102A was significantly associated with shank diameter at 63 d (P < 0.05). The SNP G197A was significantly associated with shank diameter at 49 d; CP content of leg muscle; total weights of the heart, liver, gizzard, and glandular stomach; and small intestine length (P < 0.05). In conclusion, much higher G0S2 mRNA was detected in both male and female chickens at 21 d of age than at 91 d of age, and 3 SNP (G102A, G197, and G255A) were associated with chicken production traits.

Stromal expression of cathepsin K in squamous cell carcinoma

BACKGROUND

Cathepsin K (CTSK), a cysteine protease with strong collagenolytic and elastolytic properties involved in extracellular matrix turnover, may be produced by neoplastic cells as well as stromal macrophages and fibroblasts. Its expression is suggested as associated with increased invasive and metastatic potential.

OBJECTIVES

The aim of this study is to examine stromal expression of cathepsin K in skin tumors.

METHODS

A series of 13 normal skin and 109 skin tumours, including 51 benign and 58 malignant epidermal tumours were tested for CTSK and Ki-67 expression by immunohistochemical analysis.

RESULTS

Stromal CTSK expression and the tumoral Ki-67 labelling index were significantly higher in invasive squamous cell carcinoma (SCC) than in other epidermal tumours.

CONCLUSION

Cathepsin K-positive stromal fibroblasts may play a crucial role in SCC progression by promoting extracellular matrix degradation, thereby facilitating SCC growth and invasion into surrounding tissue and vasculature. CTSK inhibitors may be a potential novel therapeutic option to decrease SCC progression.

Pharmacokinetics of verapamil in diabetic rats induced by combination of high-fat diet and streptozotocin injection

The aim of this study was to investigate effects of type 2 diabetes on the pharmacokinetics of verapamil after intravenous administration. Diabetes mellitus (DM) rats were induced by combination of high-fat diet (HFD) and streptozotocin. Plasma concentrations of verapamil in DM rats, rats fed with HFD, and control (CON) rats were measured after intravenous administration of 1 mg/kg verapamil and corresponding pharmacokinetic parameters were estimated. Area under the plasma concentration in DM rats was significantly smaller than that in CON rats. In vitro microsomal study showed that intrinsic clearance of verapamil in DM rats was significantly higher than those in CON rats. Compared to CON rats, higher intrinsic clearance was also observed in HFD rats. Western blot results demonstrated higher levels of CYP3A2 in DM and HFD rats, which was in line to activity of CYP3A. All the results gave a conclusion that diabetes may enhance metabolism of verapamil in rat, and the enhancement may partly result from induction of CYP3A.

Human papillomavirus 16 or 18 infection and prostate cancer risk: a meta-analysis

OBJECTIVE

Whether the oncogenic human papillomavirus (HPV) infection, especially infection with the most common subtypes 16 or 18, is related to prostate carcinogenesis remains conflicting. A meta-analysis with updated data was performed to obtain a more precise estimate of the association between them.

METHODS

Eligible studies were retrieved via both computer searches and review of references. The relation of HPV-16 or HPV-18 infection to prostate cancer (PC) was quantified separately. Stratified analyses based on HPV detection methods and geographic regions were also performed. Estimates of OR with 95% CI were summarized using the fixed-effect or random-effect models as appropriate.

RESULTS

Twenty-five eligible studies were retrieved. All the 25 studies were assigned for exploring the relation of HPV-16 infection to PC, while 13 studies provided additional information on HPV-18 simultaneously. In the overall estimates, the pooled OR indicated no significant increase of PC risk related with either HPV-16 (OR 1.09; 95% CI 0.97-1.23; P(heterogeneity) = 0.135) or HPV-18 (OR 1.05; 95% CI 0.89-1.24; P(heterogeneity) = 0.314) infection. Further quantitative assay of stratified data could also not yield any significant result, except the stratified analysis on HPV-16 DNA detection, which revealed higher HPV-16 DNA prevalence in PC cases (OR 1.54; 95% CI 1.07-2.20; P(heterogeneity) = 0.130).

CONCLUSIONS

Even though the overall estimates did not provide a supportive evidence for the causal role of HPV in prostate carcinogenesis, higher HPV-16 DNA prevalence in PC cases from the stratified analysis still indicated a potential association between HPV infection and PC risk in our meta-analysis.

Impaired amyloid β-degrading enzymes in brain of streptozotocin-induced diabetic rats

Enzymes that degrade the amyloid β-peptide (Aβ) are important regulators of cerebral Aβ levels. High level of Aβ was found in the brain of diabetic patients and diabetic animals. Aim of the study was to investigate whether activities of Aβ-degrading enzymes neprilysin (NEP), endothelin-converting enzyme 1 (ECE-1) and insulin-degrading enzyme (IDE) were impaired in the brain of diabetic rats. Diabetes was induced in rats by ip administration of 65 mg/kg streptozotocin. The temporal cortex and hippocampus were obtained for activity and mRNA level assays of the three enzymes on the 35th day after induction. ECE-1 activity was significantly decreased both in the hippocampus and cortex of diabetic rats, while for IDE significantly lower activity occurred only in the cortex. NEP activity was slightly decreased in both brain regions. The hippocampus of diabetic rats showed significant decrease in mRNA levels of NEP and ECE-1 and moderate increase in IDE mRNA level. The cortex of diabetic rats showed slight decrease in mRNA levels of the three enzymes. The results indicated that the three Aβ-degrading enzymes were damaged to different extents in the brain of diabetic rats, and impairment of ECE-1 and IDE partly contributed to the elevated Aβ(1-40) levels in brain of diabetic rats.

Abstract P1-09-08: Survival, Health Care Cost and Utilization of Patients with Triple Negative Breast Cancer in a U.S. Managed Care Setting

Objectives: Triple negative breast cancer (TNBC), a subtype of breast cancer characterized by its unique molecular profile and aggressive clinical behavior, lacks satisfactory standard therapies. Little is known about survival and economic cost of patients with TNBC. This study was conducted to compare the survival, health care cost and utilization of patients with TNBC versus patients with breast cancer that is not triple negative.

Methods: Analyses were conducted using Impact Intelligence Oncology Management (IIOM) (2002-2009) linked with United Health administrative claims. Patients were followed from the time of initial breast cancer diagnosis until death, disenrollment or end of the observation period. Continuous enrollment was required during the observation period. Staging and estrogen and progesterone receptors (ER/PR) and HER2 status were obtained at time of initial diagnosis. Patients’ age, region, cancer stage, comorbid conditions, health care costs and utilization prior to the initial diagnosis were controlled for risk-adjusted comparison. Cox regression was used for survival analysis. Health care resource use during the follow-up after initial diagnosis, such as number of hospitalizations, emergency room (ER) visits, office visits, outpatient visits and oncologist visits, were modeled with negative binomial regression. Since variable length of follow-up is allowed in the study design, we used inverse probability weight adjusted generalized linear models to estimate risk-adjusted annual total health care costs. Using a similar approach, we compared adjusted inpatient, pharmacy, office, outpatient, emergency and other costs between both groups.

Results: The study included 450 patients with TNBC and 1,807 patients without TNBC. At time of diagnosis, TNBC patients were younger (54 vs. 57, P&lt;0.001) than patients with no TNBC. After controlling with baseline differences, overall mortality risk rate for TNBC patients were over two times higher (HR: 2.15, P&lt;0.002). Stratified Kaplan-Meier (KM) analysis showed that the best survival rates were for stage I-III non-TNBC patients, followed by stage IV non-TNBC patients and stage I-III TNBC patients. The highest death rates occurred for stage IV TNBC patients. Adjusted comparison showed that patients with TNBC had significantly more annual number of hospitalizations, hospitalization days and number of ER visits relative to non-TNBC patients (1.28 vs. 0.95 P&lt;0.001, 10.20 vs. 6.07 P&lt;0.001, 1.30 vs. 0.93, P&lt;0.003). Although similar in annual total health cost, total adjusted inpatient costs for TNBC patients were almost 50% higher ($9,581 vs. $6,506, P&lt;0.001).

Conclusions: The economic and clinical burden of patients with TNBC is significant versus patients with breast cancer that are not triple negative.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-09-08.

Abstract P1-09-07: Survival, Health Care Utilization and Cost after Recurrence among Patients with Triple Negative Breast Cancer in a U.S. Managed Care Setting

Background: Triple negative breast cancer (TNBC) is characterized by the lack of expression of the genes for estrogen receptor, progesterone receptor or human epidermal growth factor recepter-2 and therefore it has a shorter recurrence-free interval. We compared the survival rates, health care costs and utilization of breast cancer recurrent patients who have triple negative versus no triple negative breast cancer.

Methods: Analyses were conducted using Impact Intelligence Oncology Management (IIOM) (2002-2009) linked with United Health administrative claims. Patients were followed from the time of initial breast cancer diagnosis until death, disenrollment or end of the observation period. Continuous enrollment was required during the observation period. Staging and estrogen and progesterone receptors (ER/PR) and HER2 status were obtained at time of initial diagnosis. Patients’ age, region, cancer stage, and comorbid conditions were controlled for risk-adjusted comparison. A stratified log-rank test was used to determine the equality of survival functions. Cox regression was used for the risk-adjusted survival analysis. Health care resource use during the follow-up period after recurrence was modeled with negative binomial regression. Inverse probability weight adjusted generalized linear models were used to estimate risk-adjusted total health care costs.

Results: The study included 289 recurrent breast cancer patients, out of which 87 (30%) had triple negative breast cancer. At time of recurrence, TNBC patients had similar age, plan, region, and cancer stage distribution relative to non-TNBC patients. During follow-up, TNBC patients had significantly lower survival rate (log-rank test P&lt;0.001). After controlling for baseline differences, the overall mortality risk rates for TNBC recurrent patients were almost three times higher than non-TNBC recurrent patients (HR:2.84, p=0.056). The risk-adjusted annual number of hospitalizations was also higher for TNBC patients with a recurrent event (1.65 vs. 1.13, p=0.05). There were no differences in health care costs after recurrence between TNBC and non-TNBC patients.

Conclusion: Although similar in health care costs, triple negative breast cancer is associated with higher mortality and number of hospitalizations after the recurrence of breast cancer.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-09-07.

Associations of ATGL gene polymorphisms with chicken growth and fat traits

Adipose triglyceride lipase (ATGL) catalyses the initial step in triglyceride hydrolysis, so the ATGL gene is a candidate for growth and fat traits in chickens. Nine reported single-nucleotide polymorphisms (SNPs) located in 3 exons of the chicken ATGL gene were chosen for genotyping an F2 population. Only 5 SNPs were confirmed for polymorphisms and used for association analyses. The results show that c.531G>A (p.E177Syn) was not associated with any growth and fat traits (P > 0.05), but c.782G>A (p.S261N) was associated with body weight (BW) on days 14, 21, 35, 63, 70, 77, cingulated fat width and abdominal fat pad weight (P < 0.05), and significantly associated with BW on days 42, 49, and 56 (P < 0.01). Significant associations of c.903C>T (p.F301Syn) with BW on days 49 and 77 days and crude protein content of breast muscle (P < 0.05), and c.1164G>A (p.K388Syn) with BW on day 7 (P < 0.05) were also detected. Additionally, c.1069T>C (p.L357Syn) was associated with breast muscle colour (P < 0.05), and significantly associated with crude fat (ether extract) content of breast muscle (P < 0.01). Thus the missense SNP of c.782G>A (p.S261N) was significantly associated with the largest number of chicken growth and fat traits in this study.

Spin structure transition in La(1.6-x)Nd(0.4)Sr(x)CuO(4) superconductors

The field and temperature dependencies of the spin structures in the normal states of La(1.6-x)Nd(0.4)Sr(x)CuO(4) (x = 0.10, 0.12, and 0.15) single crystals have been studied by measuring the magnetoresistance and susceptibility. A negative magnetoresistance appears just below the spin-ordering temperature for the magnetic fields parallel to the CuO(2) plane, which can be attributed to the spin-flop transition of the special spin structure in the normal state of the system. The anisotropic variations of susceptibilities with temperature for all the three specimens can be described in the framework of the crystal-field theory. The well fitted broad peaks of the in-plane susceptibilities χ(ab) for the specimens suggest that the susceptibilities are dominated by Nd(3+), and thus the spin reorientation of Cu(2+) in the CuO(2) plane can not be observed from the study of the susceptibility.

Avidity of thyroglobulin antibody in sera from patients with Hashimoto's thyroiditis with different thyroid functional status

The mechanism of disease progression in Hashimoto's thyroiditis (HT) is still unclear. Thyroglobulin antibody (TgAb) is a diagnostic hallmark of HT. The aim of our study was to evaluate the avidity of TgAb in sera from HT patients with different thyroid functional status. Sera from 50 patients with newly diagnosed HT were collected and divided into three groups according to thyroid function: patients with hypothyroidism (H, n=18), subclinical hypothyroidism (sH, n=18) and euthyroidism (Eu, n=14). Titres and avidity of TgAb were determined by enzyme-linked immunosorbent assays (ELISAs). Avidity constant (aK) was determined as the reciprocal value of the thyroglobulin molar concentration in the liquid phase resulting in 50% inhibition of TgAb binding to thyroglobulin in solid-phase ELISAs. The titres and aK of TgAb were performed using log-transformation, and expressed as lgT and lgaK, respectively. Mean lgT of TgAb in sera was 4.19+/-0.60 in H, 3.77+/-0.63 in sH, and 3.29+/-0.64 in Eu, respectively. The median avidity of TgAb was 2.30x10(9) in H, 8.80x10(8) in sH, 2.00x10(7) in Eu, respectively. lgT and lgaK of TgAb were at significantly lower levels in Eu than in sH and H (P<0.05). Correlation was found between lgT and lgaK (r=0.594, P<0.05). lgaK was also related to TSH (r=0.308, P<0.05). Our study indicated that patients with high-avidity TgAb might be at high risk of developing subclinical, even to overt, hypothyroidism.