Paratubal cancer found at the time of laparoscopic surgery for adnexal torsion: a case report and literature review

INTRODUCTION

Paratubal cysts are common incidental finding, but malignant paratubal cancers have rare occurrence and have not been sufficiently described and discussed in previous studies.

CASE REPORT

This report describes a case of a 70-year-old female who underwent emergent laparoscopy for adnexal torsion. A serous cystadenocarcinoma arising in a paratubal cyst and accompanied by tubal torsion was revealed by frozen section and successfully treated with laparoscopic cytoreductive surgery and adjuvant chemotherapy.

CONCLUSION

This report is the first case of paratubal cancer with bilateral tubal torsion which was diagnosed and treated with laparoscopic surgery, and the third report describing serous cystadenocarcinoma arising in a paratubal cyst. In the laparoscopic surgery for the paratubal cyst clinically presumed as accompanied with tubal torsion, surgeons should not ignore the possibility of malignancy in spite of the rare incidence of paratubal cancers and the preconception that adnexal malignancies are seldom accompanied by tubal torsion.

Identification of a specific haptoglobin C-terminal fragment in arthritic synovial fluid and its effect on interleukin-6 expression

Haptoglobin (Hp), a major acute-phase plasma protein, has been found in arthritic synovial fluid (SF). However, the function and structural modifications of Hp in arthritic SF are unknown. To investigate in vivo generation of modified Hp associated with inflammatory disease, we examined a new Hp isoform in SF from patients with rheumatoid arthritis (RA). Specific Hp fragments of 28 000 and 15 000 molecular weight were identified in SF of patients with RA, and the two polypeptides were presumed to be fragments of the Hp β-chain (43 000 MW) produced by cleavage with plasmin. The 15 000 MW fragment, which is a C-terminal region of Hp, was observed at higher frequency and levels in RA than in osteoarthritis. Plasmin activity was also higher in SF of RA patients. A recombinant 15 000 MW Hp fragment up-regulated interlukin-6 expression in monocytic cells. These findings indicate that the C-terminal Hp fragment is generated by plasmin in local inflammatory environments and acts as an inflammatory mediator. They further suggest that a specific Hp fragment might be applied as a novel biomarker for the diagnosis and prognosis of inflammatory diseases such as RA.

Antiproliferative effect of gold(I) compound auranofin through inhibition of STAT3 and telomerase activity in MDA-MB 231 human breast cancer cells

Signal transducer and activator of transcription 3 (STAT3) and telomerase are considered attractive targets for anticancer therapy. The in vitro anticancer activity of the gold(I) compound auranofin was investigated using MDA-MB 231 human breast cancer cells, in which STAT3 is constitutively active. In cell culture, auranofin inhibited growth in a dose-dependent manner, and N-acetyl-L-cysteine (NAC), a scavenger of reactive oxygen species (ROS), markedly blocked the effect of auranofin. Incorporation of 5-bromo-2'-deoxyuridine into DNA and anchorage-independent cell growth on soft agar were decreased by auranofin treatment. STAT3 phosphorylation and telomerase activity were also attenuated in cells exposed to auranofin, but NAC pretreatment restored STAT3 phosphorylation and telomerase activity in these cells. These findings indicate that auranofin exerts in vitro antitumor effects in MDA-MB 231 cells and its activity involves inhibition of STAT3 and telomerase. Thus, auranofin shows potential as a novel anticancer drug that targets STAT3 and telomerase.

Lipopolysaccharide-induced indoleamine 2,3-dioxygenase expression in the periodontal ligament

BACKGROUND AND OBJECTIVE

Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-oxidizing enzyme with immune-inhibitory effects. The aim of this study was to investigate the expression of IDO by lipopolysaccharide (LPS), a component of gram-negative bacteria, in human periodontal ligament (PDL) cells.

MATERIAL AND METHODS

Human PDL cells and gingival fibroblasts (GFs) were prepared from explants of human PDLs and from gingival tissues of clinically healthy donors, respectively. Real-time RT-PCR, western blotting and the IDO enzyme assay were performed to determine the expression of IDO following LPS treatment of cells. LPS was injected into mice tail veins to evaluate the effects of LPS in vivo in the maxillary first molar. Immunofluorescence staining and histological analysis were followed to localize IDO in mouse PDL.

RESULTS

The level of expression of IDO mRNA in primary human PDL cells after LPS treatment was increased in a dose-dependent manner, reaching a peak 8 h after LPS treatment. The expression and activities of IDO protein were significantly increased in comparison with those of the control. In addition, the increased production of kynurenine in culture medium was observed 72 h after LPS treatment. In the immunofluorescence findings, stronger immunoreactivities were shown in PDL than in gingival tissues in the maxillae. In accordance with the immunofluorescence findings, LPS treatment induced a strong up-regulation of IDO mRNA in human PDL cells, whereas human GFs showed only a weak response to LPS.

CONCLUSION

These results clearly show that IDO was induced by LPS in primary human PDL cells, suggesting that PDL might be involved in the regulation of oral inflammatory disease.

Effects of an aqueous-ethanolic extract of ginger on cytochrome P450 enzyme-mediated drug metabolism

Ginger has been extensively used as a herbal medicine for thousands of years in Asia; it has also been used as a seasoning agent in several foods and beverages worldwide. In this study, the effect of an aqueous-ethanolic extract of ginger on CYP450-mediated drug metabolism was investigated in vitro to elucidate the herb-drug interactions. A CYP450-specific substrates mixture was incubated with an aqueous-ethanolic extract of ginger in human liver microsomes fortified with an NADPH-generating system, and the metabolites generated from each of the CYP450-specific metabolic reactions were measured by liquid chromatography-tandem mass spectrometry. The ginger extracts were tested at concentrations of 0.05-5 microg/mL. The resulting data showed that the ginger extract inhibited CYP2C19-mediated drug metabolism in a concentration-dependent manner with an IC50 value of 3.8 microg/mL. When the ginger extract was pre-incubated and assessed, the inhibition pattern did not change, indicating that the inhibition of CYP2C19 was competitive rather than mechanism-based. The effects on other CYP isozyme activity were negligible at the concentrations tested. In conclusion, this inhibitory effect of ginger extract could affect the pharmacokinetics and lead to interactions with drugs that are metabolized by CYP2C19.

Human mesenchymal stromal cells are mechanosensitive to vibration stimuli

Low-magnitude high-frequency (LMHF) vibrations have the ability to stimulate bone formation and reduce bone loss. However, the anabolic mechanisms that are mediated by vibration in human bone cells at the cellular level remain unclear. We hypothesized that human mesenchymal stromal cells (hMSCs) display direct osteoblastic responses to LMHF vibration signals. Daily exposure to vibrations increased the proliferation of hMSCs, with the highest efficiency occurring at a peak acceleration of 0.3 g and vibrations at 30 to 40 Hz. Specifically, these conditions promoted osteoblast differentiation through an increase in alkaline phosphatase activity and in vitro matrix mineralization. The effect of vibration on the expression of osteogenesis-related factors differed depending on culture method. hMSCs that underwent vibration in a monolayer culture did not exhibit any changes in the expressions of these genes, while cells in three-dimensional culture showed increased expression of type I collagen, osteoprotegerin, or VEGF, and VEGF induction appeared in 2 different hMSC lines. These results are among the first to demonstrate a dose-response effect upon LMHF stimulation, thereby demonstrating that hMSCs are mechanosensitive to LMHF vibration signals such that they could facilitate the osteogenic process.

Automated segmentation of hippocampal subfields in drug-naïve patients with Alzheimer disease

BACKGROUND AND PURPOSE

Although a few automated hippocampal subfield segmentation methods have been developed, there is no study on the effects of the diagnosis of Alzheimer disease on the hippocampal subfield volume with in vivo MR imaging. The aim of this study was to investigate hippocampal subfield volume differences between drug-naïve subjects with AD and healthy elderly controls by using an automated hippocampal subfield segmentation technique.

MATERIALS AND METHODS

Thirty-one drug-naïve subjects with AD and 33 group-matched healthy control subjects underwent 3T MR imaging, and hippocampal subfield volume was measured and compared between the groups.

RESULTS

Subjects with AD had significantly smaller volumes of the presubiculum, subiculum, CA2-3, and CA4 DG compared with healthy subjects (uncorrected, P<.001). In addition, we found significant positive correlations between the presubiculum and the subicular volumes and the MMSE-K and the CERAD-K verbal delayed recall scores in the AD group.

CONCLUSIONS

We are unaware of previous imaging studies of automated hippocampal subfield segmentation in AD. These structural changes in the hippocampal presubiculum, subiculum, and CA2-3 might be at the core of underlying neurobiologic mechanisms of hippocampal dysfunction and their relevance to verbal delayed recall impairments in AD.

An active extract of Ulmus pumila inhibits adipogenesis through regulation of cell cycle progression in 3T3-L1 cells

Obesity and its associated metabolic disorders has become a major obstacle in improving the average life span. In this regard therapeutic approach using natural compounds are currently receiving much attention. Herbal compounds rich in triterpenes are well known to regulate glucose and lipid metabolism. Here, we have found that Ulmus pumila (UP) contained at least four different triterpenoids and inhibited adipogenesis of 3T3-L1 cells. The cell viability was dose dependently decreased by UP showing the increase of cell accumulation in G1 phase while reducing in S and G2/M phase of cell cycle. UP treatment also significantly decreased the GPDH activity and intracellular lipid accumulation. In addition, UP inhibited the mRNA levels of adipogenic transcription factors and lipogenic genes such as PPARγ, C/EBPα, SREBP1c and FAS while showing no effects on C/EBP-β and C/EBP-δ. Importantly enough, treatment of cells with UP suppressed the TNF-α induced activation of NF-κB signaling. Collectively, our results indicate that UP extract effectively attenuated adipogenesis by controlling cell cycle progression and down regulating adipogenic gene expression.

P1-01-07: ErbB-2 Peptide Vaccination Suppresses Spontaneous Tumorigenesis and Tumor Stem Cell Expansion in MMTV-PyVT Transgenic Mouse

Immunization targeting ErbB-2 could have considerable therapeutic potential by controlling growth and metastasis of highly aggressive tumor cells in the earlier preclinical and clinical studies. Just a few studies have examined preventive potential of ErbB-2 vaccines in preclinical studies. However, animal model systems used in the previous studies were tumor transplantation or neu-transgenic mouse, which were not relevant to human HER-2 positive breast tumorigenesis. In this study, active immunotherapy against tumor antigen ErbB-2/neu for primary prevention of breast cancer was tested using FVB/N-Tg (MMTV-PyVT) transgenic mice model. Mice were grouped to receive either ErbB-2 peptide vaccine, immune adjuvant only, tetanus toxoid, or PBS every 2 weeks for 3 times and monthly thereafter. The MMTV-PyVT transgenic mice in control groups (PBS, immune adjuvant only, or tetanus toxoid peptide) developed spontaneous mammary adenocarcinomas in 12 to 15 weeks, but vaccination against ErbB-2 strongly suppressed tumor formation by 30 weeks of observation. Further pathologic examination showed complete prevention of tumorigenesis was observed in ErbB-2 vaccinated mice, whereas the mice in control groups developed highly aggressive ErbB-2 overexpressing tumors similar to human breast cancer. The tumor protective effect of peptide vaccination was associated with induction of ErbB-2-specific humoral immune responses as well as T cell responses. Additionally, role of signal through ErbB-2 pathway and the relationship with stemness of cancer cells were determined by Aldefluor assay, mammosphere formation assay using Mouse mammary carcinoma (MMC) cells in vitro, and level of nestin expression determined by Western blot analysis. Further analysis of mammosphere formation capacity of MMC cells using immune sera showed that sera from ErbB2 vaccinated mice had a significant inhibitory effect on mammosphere formation in ErbB-2 overexpressing MMC cells. These results suggest that ErbB-2 targeting by cancer vaccination might be useful adjuvant to standard therapy, helping to prevent relapse in patients with ErbB-2-overexpressing tumors by suppressing stem/progenitor cell population.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-01-07.

Hypoxia-inducible factor-1alpha enhances haptoglobin gene expression by improving binding of STAT3 to the promoter

Haptoglobin (Hp) is known to play a role in angiogenesis as well as in anti-inflammation. STAT3 is a major transcription factor for expression of human Hp. We investigated whether hypoxia-inducible factor-1α (HIF-1α), a key mediator of angiogenesis, participates in Hp gene expression. HIF-1α overexpression by gene transfection or hypoxia augmented Hp transcription in HepG2 human hepatoma cells. Conversely, knockdown of HIF-1α by specific siRNA transfection diminished Hp expression, although the level of STAT3 phosphorylation remained unchanged. A luciferase reporter assay using mutant Hp promoters demonstrated that two adjacent DNA elements, a STAT3-binding element (SBE) and a cAMP-response element (CRE)-like site in human Hp promoter -120/-97, were required for HIF-1α-stimulated transactivation of the Hp gene. HIF-1α, STAT3, and p300/CBP were simultaneously bound to the SBE/CRE as a complex form. When HIF-1α was knocked down, STAT3 binding to the SBE in the Hp promoter was attenuated. Our findings suggest that HIF-1α assists STAT3 in strong binding to the proximal SBE in the Hp promoter. The CRE-like site located near the SBE may contribute to the formation of a stable complex of STAT3, HIF-1α, and p300/CBP, which leads to maximum transcription of the Hp gene.

Development of polymer lab-on-a-chip (LOC) for oxidation-reduction potential (ORP) measurement

Reverse osmosis (RO) desalination has been recognized as a promising method to solve the water shortage problem. Nevertheless, since it is energy intensive and has many problems associated with biofouling/fouling of RO membranes in RO plants, its commercial acceptance is still slow. Especially, as high levels of oxidizing agents negatively affect RO membrane efficiency and life span. So, there is a need to develop sensitive, selective, portable and rapid methods to determine oxidation-reduction potential (ORP) in feed solution. For developing a polymer ORP lab-on-a-chip (LOC), a microchannel patterned on a polymer substrate was successfully filled with 800 nm diameter silica beads using self-assembly bead packing technology. The measured ORPs using the three kinds of redox potential solutions were typically slightly lower than those of the nominal redox potential. But, all of the measurements should be deemed acceptable. The ORP LOC has also a much shorter response time than the conventional potentiometric sensor.

The effectiveness of an aquarobic exercise program for patients with osteoarthritis

Aquarobics, a combination of the words aqua and aerobics, is based on the idea that much more energy is consumed during exercise when resisting water rather than air. The aquarobic exercise program is composed of patient education and aquarobic exercise. The program was effective in enhancing self-efficacy, decreasing pain, and improving depression levels, body weight, and blood lipid levels in patients with osteoarthritis. Therefore, this program can be widely used in a community setting for the management of osteoarthritis.

Improved biocompatibility of hydroxyapatite thin film prepared by aerosol deposition

Technical development for an efficient coating of bioactive materials improves the characteristics of a fully functional implant. The aim of this study was to investigate the osteoinductive effect of a newly developed hydroxyapatite (HA)-coating technique using aerosol deposition without post-heat treatment [room temperature (RT) group] on the titanium (Ti) dental implant in vitro and in vivo, compared with that of HA coating with post-heat treatment (HT-400 group) or machined surface (control group). Cell proliferation or attachment on the HA-coated Ti surface was assessed using tetrazolium salt, WST-8 or scanning electron microscopy (SEM). Human osteoblasts (HOB) on RT group were well attached and grew alike in the control or HT-400 group. The alkaline phosphatase activity of HOB cultured on RT and HT-400 group was significantly higher than the control group (p < 0.05). Evaluation by SEM, TEM, and XRD demonstrated that aerosol deposition facilitated HA particles to form a dense and uniform HA layer in the RT group despite no post-heating. In a rabbit tibia model (n = 3), the ratios of bone implant contact and bone area in the RT group (49.88%, 86.05%) were greater than in the HT-400 group (38.82%, 77.34%) or the control (28.31%, 73.86%). The finding of this study showed that the HA coating using aerosol deposition without post-heat treatment has a good biocompatibility, and provide a promoting strategy to enhance osseointegration in the application of the dental implant.

Osteogenic responses of human mesenchymal stromal cells to static stretch

Molecular signals driving the regenerative process in distraction osteogenesis (DO) involve a complex system of cellular behavior triggered by mechanical strain. However, it remains unclear how mesenchymal stromal cells (MSCs) adapt to osteogenic demands during DO. We hypothesized that human MSCs (hMSCs) modulate early osteogenic metabolism during exposure to static stretch. The proliferation of hMSCs was increased by static stretch, which, in turn, suppressed TGF-β1-mediated decreases in cell proliferation. The amount of stretching force applied had little effect on osteoblast differentiation of hMSCs induced by dexamethasone treatment. However, this strain induced sustained production of nitric oxide and vascular endothelial growth factor (VEGF), which are critical factors in angiogenesis, from differentiated hMSCs. Mechanical stretch involved ERK and p38 mitogen-activated protein kinase pathways, the selective inhibitors of which decreased static-stretch-induced VEGF production. These findings provide evidence that hMSCs act to facilitate early osteogenic metabolism during exposure to static stretch.

Caudal epidural block in children: comparison of needle insertion parallel with caudal canal versus conventional two-step technique

This study compared the technique of inserting the needle for caudal epidural blockade in a single pass parallel to the caudal canal versus the conventional technique of approaching the caudal canal with the needle at a steeper angle. Seventy-five patients, aged 0 to 72 months, scheduled for urological surgery were prospectively enrolled in this study. Patients were randomly divided into two groups: a conventional method group (caudal block performed with conventional needle insertion, n=40) and a new method group (needle inserted into the skin at an angle of 200 and into the caudal space without redirection, n=35). Two anaesthetists (A, B) performed the caudal blocks. For anaesthetist A, the mean time required (standard deviation) to perform needle insertion in the conventional method group was 2.2 (0.8) minutes and in the new method group 1.1 (0.7) minutes (P = 0.03). For anaesthetist B the mean time (standard deviation) to perform needle insertion in the conventional method group was 2.1 (1.1) minutes and in the new method group 1.3 (0.8) minutes (P = 0.04). Successful block was considered as first pass placement of the needle in the caudal canal confirmed (after placement) by ultrasound imaging, and the absence of a bloody tap. Subcutaneous placement of the needle after the first attempt occurred in two cases in the conventional method group and three cases in the new method group. Bloody tap occurred in four cases, all in the conventional method group and none in the new method group. When required, the second pass was successful in all cases.

Preparation and characterization of stearic acid-pullulan nanoparticles

For a new anticancer drug carrier, we synthesized 4 compositions of amphiphilic stearic acidconjugated pullulan (SAP) and characterized them with FT-IR spectroscopy. Crystalline changes were verified by x-ray diffraction patterns before and after synthesis of the SAP conjugate. SAP nanoparticles were prepared by a diafiltration method, and the fluorescence spectroscopy using pyrene showed particle self-assembly in water. SAP nanoparticles were spherical in TEM photos, and particle size ranged between 200 approximately 500 nm in photon correlation spectroscopy. Release of all-trans-retinoic acid from the SAP nanoparticles was maintained over 5 weeks. For further study in vivo, we tested the cytotoxicity of SAP nanoparticles using an MTT assay, and cytotoxicity was augmented as the molar mass of stearic acid increased in human liver carcinoma HepG2 cells. Therefore, SAP nanoparticles might be a promising longterm delivery carrier for hydrophobic therapeutic molecules with the appropriate composition.

Enhancement of angiogenic and vasculogenic potential of endothelial progenitor cells by haptoglobin

Endothelial progenitor cells (EPCs) were transfected with the haptoglobin (Hp) gene to investigate the effect of Hp on cell function. Hp potentiated the gene expression of various pro-angiogenic factors in the EPCs. The Hp-modified EPCs also increased in vitro tube formation on Matrigel compared with control cells. In hindlimb ischaemia models, Hp-EPCs showed a greater ability for improving blood perfusion and recovery from ischaemic injury. These results indicate that Hp improves EPC function in neovasculogenesis, which suggests that ex vivo modification of EPCs with the Hp gene can be applied to the treatment of vascular damage.

Polymorphism of haptoglobin in patients with premature rupture of membrane

PURPOSE

To investigate whether allelic polymorphism of haptoglobin (Hp) is associated with premature rupture of membrane (PROM), the Hp phenotypes of pregnant women with PROM were analyzed.

PATIENTS AND METHODS

The Hp phenotypes of 221 pregnant Korean women (187 control and 34 PROM patients) were determined by benzidine/hydrogen peroxide staining, following native polyacrylamide gel electrophoresis of hemoglobin-mixed sera. The Hp allele frequencies were calculated from the data of Hp phenotypes, and overall association with PROM was evaluated using Pearson Chi-Square test.

RESULTS

The polymorphic distribution of the patients cohort who underwent a normal delivery (control group) was similar to that of healthy Koreans. In contrast, however, patients with PROM showed significantly higher occurrence of the Hp 1-1 phenotype than control group (23.5% vs 8.0%). Hp 2-2 phenotype was lower in PROM cohort (38.2%) than in the control group (48.7%). The Hp(1) allele frequency in PROM group was significantly higher than that in the control group (0.426 vs 0.297, p = 0.034) with odds ratio of 1.762 (95% CI: 1.038 - 2.991).

CONCLUSION

These findings suggest that pregnant Korean women who possess Hp(1) allele (expressed as Hp 1-1 phenotype) have higher incidence of PROM than women with Hp(2) allele (expressed as Hp 2-2 phenotype). This is the first study that evaluated the significance of Hp polymorphism with respect to the development of PROM.

Development of a portable analyzer with polymer lab-on-a-chip (LOC) for continuous sampling and monitoring of Pb(II)

A new portable analyzer with polymer lab-on-a-chip (LOC) has been designed, fabricated and fully characterized for continuous sampling and monitoring of lead (Pb(II)) in this work. As the working electrodes of the sensor, bismuth (Bi (III)) which allowed the advantage of being more environmentally friendly than traditional mercury drop electrodes was used, while maintaining similar sensitivity and other desirable characteristics. The size of a portable analyzer was 30 cmx23 cmx7 cm, and the weight was around 3 kg. The small size gives the advantage of being portable for field use while not sacrificing portability for accuracy of measurement. Furthermore, the autonomous system developed in coordination with the development of new polymer LOC integrated with electrochemical sensors can provide an innovative way to monitor surface waters in an efficient, cost-effective and sustainable manner.