Radiofrequency ablation for liver metastasis from gastric cancer

AIMS

Several studies have reported the benefit of hepatic resection for metastatic tumor from gastric cancer. However, the value of treatment with radiofrequency ablation (RFA) has not been clearly defined.

METHODS

Between Jan 2002 and Dec 2007, 21 patients with primary gastric cancer were diagnosed with synchronous or metachronous liver metastases. All patients were treated with RFA, and the complication, survival, and recurrence rates were assessed.

RESULTS

The postoperative complication rate was 5% (1/21), with no mortality. The median actuarial survival time was 14 months. The 1-yr, 2-yr, 3-yr, and 5-yr survival rates after RFA were 70%, 11%, 5%, and 3%, respectively. With a median follow-up time of 19 months, local recurrence at the RFA site was 19% (4/21). Solitary metastasis had significantly longer survival than multiple lesions after RFA (22 vs 10 months, P = 0.004).

CONCLUSIONS

RFA provides a minimally invasive and safe modality of treatment patients with liver metastasis from gastric cancer. Patients with solitary liver lesion were considered appropriate candidates for RFA.

Association between body mass index and suicide, and suicide attempt among British adults: the health improvement network database

OBJECTIVE

To examine the associations between body mass index (BMI) and incidence rate (IR) of suicide attempt and suicide.

DESIGN AND METHODS

849,434 British adults were identified from The Health Improvement Network (THIN) database between January 2000 and October 2007. BMI was categorized into six levels: <18.5 (underweight), 18.5-24.9 (normal weight), 25.0-29.9 (overweight), 30.0-34.9, 35.0-39.9, and ≥40 (obese levels I-III).

RESULTS

We identified 3,111 suicide attempts by Read codes and 75 suicides with medical records. The overall IR of suicide attempt was 82.2 cases per 100,000 person-years. The IR decreased with BMI in men with depression (471.3-166.0 cases per 100,000 person-years, P for trend = 0.02) and in men without depression (241.5-58.0 cases per 100,000 person-years, P for trend < 0.0001). In women with depression, an L-shaped relationship was observed, that is, a higher rate in underweight group when compared with reference group (503.2 vs. 282.7 per 100,000 person-years) and no significant differences in others (231.8-195.5 cases per 100,000 person-years). In women without depression, the IR was U-shaped with BMI (125.2 in underweight, 68.6 in reference, and 48.5-79.9 cases in overweight and obese I-III groups per 100,000 person-years, P for trend < 0.0001). The above trends remained after adjustment for the covariates. Regarding suicide, the overall IR was 2.0 cases per 100,000 person-years, which tended to decrease with BMI (P = 0.14).

CONCLUSIONS

We concluded an inverse linear association between BMI and suicide attempt among men, an L-shaped association in nondepressive women, and a U-shaped association in depressive women were observed. The study also suggested an inverse linear tendency between BMI and suicide.

Comparative proteomic analysis of rice seedlings in response to inoculation with Bacillus cereus

Reports suggest that Bacillus spp. can be used to increase plant growth and resistance to disease, but the molecular mechanisms underlying the interaction between Bacillus spp. and plant is not completely understood. In the present study, to clarify these underlying mechanisms, the interaction between Bacillus cereus and rice was investigated using two-dimensional gel electrophoresis. Through comparative analysis, a total of 31 differentially expressed proteins were obtained upon B. cereus NMSL88 treatment, including 22 proteins that were up-regulated and nine that were down-regulated. These data indicated that certain proteins involved in plant growth and development were up-regulated, such as xyloglucan endotransglycosylase. Interestingly, proteins involved in defence were also up-regulated, including peroxidases, glutathione S-transferases and kinases. Thus, proteins associated with disease resistance characteristics were induced in the plants after exposure to B. cereus NMSL88. In addition, several proteins involved in protein and lipid metabolism showed significant changes in expression.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present study is the first report to reveal the molecular mechanisms involved in rice seedlings in response to inoculation with Bacillus cereus at the level of proteome. The results demonstrated that B. cereus NMSL88 can up-regulate the expression of proteins related to plant growth and defence, and lead to enhanced plant growth and disease resistance.

Abstract P4-03-12: diagnostic value and clinical significance of integrin αvβ3 in breast mass

Background: Integrins are cell adhesion molecules that widely exists in cell surface, it is a hetero-dimeric protein bound non-covalently by α, β subunit. It plays the role of mediation during interaction of the αvβ3 and the corresponding receptor in signal transduction pathway, integrin αvβ3 is much richer in the surface of neovascular endothelial cells and tumor cells, while poor in the blood vessels and normal tissues. Therefore, it plays an important role in a variety of malignant tumors of the occurrence, development and metastasis processes. We find tumors constituted with neovascularization earlier by marker of integrin αvβ3.

Materials & Methods: We give patients who consider as breast mass intravenous injection of99mTc-3PRGD2 as a tracer preoperatively by SPECT/CT imaging and treat with surgery within a week, then make pathological examination with tumor tissues removed by needle biopsy. Then we make a retrospective analysis and evaluation of patients scanned completely by qualitative and semi-quantitative methods. All patients have signed the informed consent form before the test, together with the recognition of the Ethics Committee.

Results: From December 2011 to May 2012, a total of 245 patients were scanned and operated with clear paraffin pathological diagnosis by intravenous injection of99mTc −3PRGD2. Among them, a total of 106 patients (167 developing lesions) were positive with radionuclide imaging results, 139 patients were negative. Diseases of 106 patients are divided into four series: breast cancer, inflammation mastitis, phyllodes tumor and partly with fibroadenoma. They have in common that there is a clear flow signal in and around lesions by color Doppler ultrasound.

Discussion: After study on 245 patients, we created a molecular imaging tool to show expression of integration αvβ3 in order to assess tumor angiogenesis. Integrin αvβ3 plays an important role in physiological and pathological processes of malignant tumor, such as inflammation, tumor angiogenesis, invasion and metastasis etc. Therefore, its high expression is easy to find in cancer, mastitis, most of the phyllodes tumor and part of fiber adenoma with peripheral lesions. For patients with clear imaging, we make comprehensive analysis based on their ultrasound, mammography, MRI or CT results, which can generally contributes to the early diagnosis of disease in clinical. The detection of sentinel lymph node should be avoided for the patients with axillary lymph node imaging, who are clearly diagnosed as breast carcinoma with axillary lymph node metastases. These peptides are not only tumor receptor-targeted imaging agents with potential clinical value, but also laid a solid foundation for further development of receptor-targeted radionuclide therapy to solid tumors. The method marked with high expression of integrin αvβ3 in the tumor vascular endothelial cells by99mTc-3PRGD2 and SPECT/CT imaging mode has a broad prospect in the early diagnosis of tumor, lesion detection and efficacy evaluation. In the future, we may also find the new imaging agent with more accuracy and specificity. We believe that there will be more and more breast cancer patients benefit from the technology development of ECT/CT examination.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-03-12.

A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology

BACKGROUND

The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.

METHOD

We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.

RESULTS

Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.

CONCLUSIONS

This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.

Protective effect of naringenin-7-O-glucoside against oxidative stress induced by doxorubicin in H9c2 cardiomyocytes

Doxorubicin (DOX) is one of the most effective chemotherapeutic agents, but cardiotoxicity limits its clinical use. Although the mechanisms are not entirely understood, reactive oxygen species (ROS) and cardiomyocyte apoptosis appear to be involved in DOX cardiotoxicity. Protection or alleviation of DOX cardiotoxicity can be achieved by administration of natural phenolic compounds via activating endogenous defense systems and antiapoptosis. Naringenin-7-O-glucoside (NARG), isolated from Dracocephalum rupestre Hance, could protect from cardiomyocyte apoptosis and induce endogenous antioxidant enzymes against DOX toxicity, but the effects on intracellular ROS generation and cell membrane stability were not demonstrated. In the present study, we investigated the effects of NARG on H9c2 cell morphology, viability, lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, glutathine peroxidase (GSH-Px) activity, intracellular Ca2+ concentration, and ROS generation. Compared with DOX alone treatment group, the morphological injury of the cells in groups treated by DOX plus NARG was alleviated, cell viability was increased, the amount of released LDH and CK was significantly decreased, the activity of GSH-Px was increased, the content of intracellular Ca2+ and ROS generation was lowered remarkably. These results suggest that NARG could prevent cardiomyocytes from DOX-induced toxicity by their property of stabilizing the cell membrane and reducing ROS generation.

Behavioral symptoms in community-dwelling elderly Nigerians with dementia, mild cognitive impairment, and normal cognition

BACKGROUND

Few studies have examined the neuropsychiatric status of patients with dementia and cognitive impairment in the developing world despite the fact that current demographic trends suggest an urgent need for such studies.

OBJECTIVE

To assess the level of neuropsychiatric symptoms in community-dwelling individuals with dementia, cognitive impairment no dementia and normal cognition.

METHODS

Subjects were from the Ibadan site of Indianapolis-Ibadan Dementia Project with stable diagnoses of normal cognition, cognitive impairment, no dementia/mild cognitive impairment (CIND/MCI), and dementia. Informants of subjects made ratings on the neuropsychiatric inventory and blessed dementia scale; subjects were tested with the mini mental state examination.

RESULTS

One hundred and eight subjects were included in the analytic sample, 21 were cognitively normal, 34 were demented, and 53 were CIND/MCI. The diagnostic groups did not differ in age, per cent female, or per cent with any formal education. The most frequent symptoms among subjects with CIND/MCI were depression (45.3%), apathy (37.7%), night time behavior (28.3%), appetite change (24.5%), irritability (22.6%), delusions (22.6%), anxiety (18.9%), and agitation (17.0%). Depression was significantly more frequent among the CIND/MCI and dementia (44.1%) groups compared with the normal cognition group (9.5%). Distress scores were highest for the dementia group, lowest for the normal cognition group, and intermediate for the CIND/MCI group.

CONCLUSION

Significant neuropsychiatric symptomatology and distress are present among cognitively impaired persons in this community-based study of older adults in this sub-Saharan African country. Programs to assist family members of cognitively impaired and demented persons should be created or adapted for use in developing countries.

Frequency-modulated continuous-wave lidar using I/Q modulator for simplified heterodyne detection

A frequency-modulated continuous-wave (FMCW) lidar is demonstrated with heterodyne detection. The lidar transmitter utilizes an electro-optic I/Q modulator for the first time to generate carrier-suppressed and frequency-shifted FM modulation. This eliminates the need for an acousto-optic frequency shifter commonly used in heterodyne lidar transmitters. It also allows the use of a much wider modulation bandwidth to improve the range resolution. The capability of complex optical field modulation of the I/Q modulator provides an additional degree of freedom compared with an intensity modulator, which will benefit future lidar applications.

SU-E-T-88: Evaluating Gantry Sag on Linear Accelerators and Introducing an MLC-Based Compensation Strategy

PURPOSE

Gantry sag is one of the well-known sources of mechanical imperfections that compromise the spatial accuracy of radiation dose delivery. This study aims to quantify the gantry sag on multiple linacs and to investigate a multiple leaf collimator (MLC)-base strategy to compensate for gantry sag.

METHODS

We used the Winston-Lutz method to measure the gantry sag on three Varian linacs. A ball-bearing phantom was imaged with a square radiation field during gantry rotation. The images were analyzed to derive the radiation isocenter and subsequently the gantry sag, that is, the superior-inferior wobble of the radiation field center from the radiation isocenter as a function of gantry angle. Compensation for gantry sag was attempted by offsetting the MLC leaves at 90-degree collimator angle. The amount of offset was the opposite of measured gantry sag, which was gantry angle-specific.

RESULTS

Gantry sag was reproducible within a six-month period. On the three linacs, the maximum gantry sag was found to vary from 0.7 mm to 1.0 mm, depending on the linac and the collimator angle. The radiation field center moved inferiorly, or away from the gantry, when the gantry was rotated from 0 to 180 degrees. Comparison of gantry sag at 0- and 90-degree collimator angles showed that the uncertainty in MLC leaf positions did not increase the gantry sag. Instead, gantry sag was caused primarily by nonideal gantry rotation. After the MLC compensation was applied, the maximum gantry sag was reduced to less than 0.2 mm.

CONCLUSIONS

The results indicated that gantry sag on a linac can be quantitatively measured with sub-millimeter precision, using a simple ball-bearing phantom and the electronic portal imaging device. Reduction of gantry sag is feasible by applying a gantry angle-specific correction to MLC leaf positions at 90 degree collimator angle.

Multiclass microarray data classification based on confidence evaluation

Microarray technology is becoming a powerful tool for clinical diagnosis, as it has potential to discover gene expression patterns that are characteristic for a particular disease. To date, this possibility has received much attention in the context of cancer research, especially in tumor classification. However, most published articles have concentrated on the development of binary classification methods while neglected ubiquitous multiclass problems. Unfortunately, only a few multiclass classification approaches have had poor predictive accuracy. In an effort to improve classification accuracy, we developed a novel multiclass microarray data classification method. First, we applied a "one versus rest-support vector machine" to classify the samples. Then the classification confidence of each testing sample was evaluated according to its distribution in feature space and some with poor confidence were extracted. Next, a novel strategy, which we named as "class priority estimation method based on centroid distance", was used to make decisions about categories for those poor confidence samples. This approach was tested on seven benchmark multiclass microarray datasets, with encouraging results, demonstrating effectiveness and feasibility.

Hypertension and incident dementia in community-dwelling elderly Yoruba Nigerians

OBJECTIVES

To investigate the relationship between hypertension and dementia incidence in community-dwelling elderly Yoruba (aged 70 years and above) because of sparse information on dementia and its risk factors in developing countries.

MATERIALS AND METHODS

Community-based, prospective study of consenting elderly Yoruba using two-stage design. Blood pressure was measured during the baseline evaluation at 2001 and hypertension was defined as BP ≥ 140/90 mmHg. Diagnosis of dementia and normal cognition was by consensus using standard criteria. Non-demented subjects from the 2001 evaluation wave were re-evaluated during the 2004 and 2007 waves for dementia. Logistic regression was used to examine the association of baseline hypertension and incident dementia, after adjusting for age, gender, education, and histories of stroke and smoking. P-values <0.05 were considered significant.

RESULTS

During the 6-year follow-up, 120 individuals developed dementia, while 1633 remained non-demented. The frequency of hypertension in the demented group was significantly higher than in the non-demented (70.0% vs 60.2%, P = 0.034). Baseline hypertension was a significant risk factor for dementia (OR = 1.52; 95% CI 1.01-2.30). Higher systolic, diastolic or pulse pressure was associated with increased risk (P < 0.05). Participants with diastolic BP ≥ 90 mmHg were at a significantly greater risk than those with readings below 70 mmHg (OR = 1.65; 95% CI 1.01-2.69).

CONCLUSIONS

Hypertension was associated with increased risk of dementia in elderly Yoruba and its appropriate treatment may lower the risk.

Frontotemporal dementia caregivers and researchers: partnering for brain donation

This study utilized a community-based, participatory research model between the Association for Frontotemporal Degeneration (AFTD) and the Education Core of the Indiana Alzheimer Disease Center. A total of 30 caregivers of persons with frontotemporal dementia (FTD) participated in 6 focus groups in 3 cities. The majority of participants were spouses of the person with FTD and had been providing care for an average of 6 years. Transcript analysis revealed 7 prominent themes: willingness to participate, when/how the issue of brain donation is raised, who initiates discussion about brain donation, who is involved in decisions about brain donation, motivation for participating in brain donation, lack of effective communication, and barriers to research participation. Caregivers demonstrated a strong desire to participate in research and contribute to advancing knowledge. The lack of effective communication between the clinicians and caregivers was a barrier to developing positive rapport, detrimentally impacting research participation.

Chloropicrin emissions after shank injection: two-dimensional analytical and numerical model simulations of different source methods and field measurements

Understanding the control mechanisms of fumigant movement in soil is a fundamental step for developing management strategies to reduce atmospheric emissions. Most soil fumigants including chloropicrin (CP) are applied by shank injection, and the application process often leaves vertical soil fractures that would potentially cause preferential fumigant movement and increased emissions. This potential transport pathway was evaluated by comparing cumulative emissions and soil air concentrations of CP from direct field measurements with those predicted using analytical and numerical models after assuming either point or rectangle sources for the injected CP. Results clearly showed that shank-injected CP, when treated as vertical rectangle sources, produced cumulative emission losses similar to the field measurements. Treating the shanked CP as point sources caused approximately 50% underprediction than the field measurements. The study also demonstrated that fumigant cumulative emissions can be predicted, with reasonable accuracy, using either analytical or numerical simulations.

Managing agricultural emissions to the atmosphere: state of the science, fate and mitigation, and identifying research gaps

The impact of agriculture on regional air quality creates significant challenges to sustainability of food supplies and to the quality of national resources. Agricultural emissions to the atmosphere can lead to many nuisances, such as smog, haze, or offensive odors. They can also create more serious effects on human or environmental health, such as those posed by pesticides and other toxic industrial pollutants. It is recognized that deterioration of the atmosphere is undesirable, but the short- and long-term impacts of specific agricultural activities on air quality are not well known or understood. These concerns led to the organization of the 2009 American Chemical Society Symposium titled . An outcome of this symposium is this special collection of 14 research papers focusing on various issues associated with production agriculture and its effect on air quality. Topics included emissions from animal feeding operations, odors, volatile organic compounds, pesticides, mitigation, modeling, and risk assessment. These papers provide new research insights, identify gaps in current knowledge, and recommend important future research directions. As the scientific community gains a better understanding of the relationships between anthropogenic activities and their effects on environmental systems, technological advances should enable a reduction in adverse consequences on the environment.

The paraventricular nucleus modulates thyroidal motilin release and rat gastric motility

Motilin, an important endocrine regulator of gastrointestinal motility, was once considered to be produced in the gastrointestinal tract and brain. In recent years, however, motilin has been found in the human thyroid, as well as in that of the guinea pig. The physiological function and central modulation of thyroidal motilin remain poorly understood. To determine the functional role of thyroidal motilin, we observed the concentration of motilin in the plasma and also gastric motility before and after thyroidectomy. Our studies show that both the concentration of plasma motilin and gastric motility were decreased after thyroidectomy. To explore modulation-related nuclei, a c-Fos immune response experiment was carried out. The PVN of the hypothalamus was the main area of reactivity after thyroidectomy. Subsequently, we studied the effects of electrical excitation and PVN lesions on gastric motility and the expression of motilin in the thyroid and plasma. Excitation of the PVN was shown to prompt gastric motility that was partly prevented by the motilin receptor antagonist, GM-109. The effects of PVN excitation on gastric contraction were significantly reduced in thyroidectomised rats. In addition, the expression of motilin in the thyroid was significantly increased after PVN excitation and decreased after PVN lesions. The changes in the concentration of motilin in plasma induced by PVN stimulation were positively correlated with changes of gastric motility. In our in vitro study, the motilin secreted from TT cells (a parafollicular cell line originating from human thyroid medullary carcinoma) gradually increased on day 6 of culture, and motilin and calcitonin (CT) were co-expressed in TT cells. These results demonstrate that motilin from the thyroid could be secreted into the peripheral plasma and affect gastric motility and that PVN was a central nucleus for modulating gastric motility and motilin expression in the thyroid.