Abstract P3-10-25: The Prognosis of Metaplastic Breast Cancer Patients Compare to Triple-Negative Breast Cancer Patients

Background: Metaplastic breeast cancer (MBC) is a rare, heterogenous cancer characterized by admixture of adenocarcinoma with metaplastic elements, low hormone receptor expression and poor outcome. This study was planned to assess the clinicopathological chacteristics and immunohistochemical findings of MBC compared to invasive ductal carcinoma (IDC) including the triple-negative subtype (TN-IDC). Material and Methods: We retrospectively reviewed the medical records of 47 MBC and 1,346 IDC patients. Two hundred eighteen TN-IDC patients were included in the 1,346 IDC patients. Between 2005 and 2009, these patients were undergone surgical treatment at the Samsung Medical Center. Patients were reviewed clinicopathologic factors, immunohistochemistry of biologic factors such as ER, PR, HER-2, p53, Ki67, cytokeratine (CK) 5/6, epidermal growth factor receptor (EGFR), and treatment modalities (type of operation, use of chemotherapy, radiotherapy and hormone therapy). Result: The MBC patients presented with a larger tumor size (>T1, 66.0% vs. 44.3.%, P = 0.008), lower lymph node involvement (N0, 73.3% vs. 55.6%, P = 0.03), higher histologic (HG) and nuclear grade (NG) (HG3, 70.0% vs. 41.5%, P = 0.001; NG3,82.6% vs. 46.9%, P < 0.001), fewer estrogen receptor (ER), progesterone receptor (PR) and HER2 positivity (ER+, 4.3% vs. 69.2%, P < 0.001; PR+, 6.4% vs. 63.5%, P < 0.001; HER2+, 0% vs. 27.6%, P < 0.001), higher p53, CK5/6 and EGFR expression (p53+, 63.8% vs.38.8%, P < 0.001; CK5/6+, 71.9% vs.21.5%, P < 0.001; EGFR+, 93.9% vs.21.6%, P <0.001) and more TN subtypes (93.6% vs. 16.2%, P < 0.001) compared to the IDC group. There was no significant difference in clinicopathological characteristics with MBC and TN-IDC except EGFR over expression (EGFR+, 93.9% vs.69.0%, P = 0.017). In follow-up duration (median 30 months, range 2-56 months), seven (14.9%) MBC patients and 98 (7.2%) IDC patients recurred. The 3-year disease-free survival (DFS) rate was 78.1% in the MBC group and 91.1% in IDC group (P <0.001). The 3-year DFS rate was not significantly difference between MBC group and TN-IDC group (78.1% vs. 84.9%, P = 0.114). However, in patients with lymph node metastasis who underwent adjuvant chemotherapy, the 3-year DFS rate was 44.4% in MBC group and 72.5% in TN-IDC group (P = 0.025).

Discussion: In our result, MBC show poorer clinical outcome than IDC. It is not shown significant difference between MBC and TN-IDC. However, MBC patients with nodal metastasis have poorer prognosis than TN-IDC patients with metastasis despite adjuvant chemotherapy.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-25.

Design and construction of a compact microwave proton source for a proton linac

A 100 MeV, 20 mA proton linear accelerator is being developed by the Proton Engineering Frontier Project at the Korea Atomic Energy Research Institute. 20 MeV acceleration system using radio frequency quadrupole and drift tube linac was already developed and has been tested. To operate this acceleration system with a long time, more reliable proton source is needed. A compact microwave proton source was proposed and has been designed and constructed as a prototype ion source for the 100 MeV proton linear accelerator. The design of microwave power injection system is based on the microwave proton injector at LANL and CEA. The wave power from a 2.45 GHz, 2 kW magnetron source is introduced into a compact plasma chamber with 7 cm diameter and 5 cm length through a standard tapered, double-ridged waveguide (WRD250) and a quartz window. The microwave power supply is installed on high voltage platform. Axial magnetic fields up to 1 kG can be provided with a water-cooled solenoid coil. A single-hole three electrode extraction system is designed for an extraction current up to 30 mA at a 50 kV extraction voltage. The design and initial operations of the proton source are presented.

Decreased phosphorylation of STAT-1, STAT-4 and cytokine release in MDR-TB patients with primary resistance

SETTING

We recently showed that treatment failure rate was higher among multidrug-resistant tuberculosis (MDR-TB) patients without a previous history of tuberculosis (TB) treatment, or so-called 'primary resistance'.

OBJECTIVE

To investigate the phosphorylation levels of signal transducers and activators of transcription-1 (STAT-1) and STAT-4 and the subsequent cytokine release as a possible cause of a poor prognosis in MDR-TB patients with primary resistance.

DESIGN

Ten patients with successfully treated pulmonary TB without resistance, 12 MDR-TB patients with acquired resistance and 10 MDR-TB patients with primary resistance were enrolled. After 24 h stimulation of peripheral blood mononuclear cells (PBMC) with interferon-gamma (IFN-gamma), interleukin-12 (IL-12), purified protein derivative (PPD), or lysate of Mycobacterium tuberculosis, flow cytometric analysis of intracellular pSTAT-1 and pSTAT-4 were performed and secretion of IFN-gamma, IL-12p40 and tumour necrosis factor-alpha (TNF-alpha) was measured in culture supernatant.

RESULTS

The mean fluorescent intensities of pSTAT-1 and pSTAT-4 in PBMC of MDR-TB patients with primary resistance decreased on stimulation of IFN-gamma, PPD or lysate of M. tuberculosis when compared with patients with acquired resistance. In addition, secretion of IFN-gamma, IL-12p40 and TNF-alpha in these patients decreased on various stimuli.

CONCLUSION

Decreased phosphorylation of STAT-1, STAT-4, and of subsequent cytokine release, might be associated with a poor prognosis in MDR-TB patients with primary resistance.

Characterization of time-related changes after experimental bile duct ligation

BACKGROUND

Although bile duct ligation (BDL) in mice is used to study cholestasis, a detailed description of this animal model is lacking. The aim of this study was to define specific phases of acute and chronic injury and repair in the different cellular compartments of the liver.

METHODS

C57BL/6 mice underwent BDL or sham laparotomy, and serum and liver tissue were analysed between 8 h and 6 weeks later.

RESULTS

Biliary infarcts and alanine aminotransferase levels revealed acute hepatocellular injury peaking at days 2-3, paralleled by enhanced transcription of pro-proliferative mediators and followed by a distinct peak of hepatocellular proliferation at day 5. Cholangiocellular proliferation occurred in large bile ducts on days 2-3 and in small bile ducts on day 5. Neutrophil infiltration occurred within 8 h, with neutrophils remaining the predominant immune cell type until day 3. Acute injury was followed by continuous tissue repair, lymphocyte and Kupffer cell infiltration, and accumulation of collagen during the second week. Thereafter, the number of alpha-smooth muscle actin-positive cells and the expression of transforming growth factor beta1, tissue inhibitor of metalloproteinases 1 and procollagen (I) decreased, and liver fibrosis stabilized.

CONCLUSION

BDL elicits dynamic changes in mouse liver. The chronological dissection and quantification of these events identified specific phases of acute and chronic cholestatic liver injury.

White matter abnormalities in drug-naïve patients with obsessive-compulsive disorder: a diffusion tensor study before and after citalopram treatment

OBJECTIVE

The aim was to investigate the white matter abnormalities of drug-naïve patients with obsessive-compulsive disorder (OCD) using diffusion tensor-imaging and the white matter changes in the patients after pharmacotherapy.

METHOD

Thirteen drug-naïve OCD patients and 13 age- and sex-matched healthy comparison subjects were examined using diffusion tensor-imaging and structural magnetic resonance imaging. Measurements were made in OCD patients before and after 12 weeks of citalopram treatment.

RESULTS

Compared with controls, the drug-naïve OCD patients showed significant increases in fractional anisotropy (FA) in the corpus callosum, the internal capsule and white matter in the area superolateral to the right caudate. The increases in FA were mostly no longer observed in patients after 12 weeks of treatment compared with controls.

CONCLUSION

Our findings suggest that white matter alterations are associated with the pathophysiology of OCD, and the abnormalities may be partly reversible with pharmacotherapy.

Characteristics of indicator microorganisms in paddy rice plots after reclaimed water irrigation

A study was performed to examine the effects of reclaimed-water irrigation on microorganism concentration in the ponded-water of paddy rice plots. Several treatments were used and each one was triplicated to evaluate the change of indicator microorganisms (total coliforms (TC), faecal coliforms (FC), and E. coli) concentrations in 2003 and 2004 growing seasons. Their concentrations increased significantly after irrigation, but decreased by approximately 45% in 24 h. It implies that agricultural activities such as ploughing and fertilising need to be practiced one or two days after irrigation, considering health risks. Treatments with UV-disinfected water irrigation, demonstrated significantly lower concentrations than others, including control plots where natural water was irrigated. The monitoring result from actual paddy rice fields and experimental paddy plots showed that concentrations of indicator microorganisms ranged from 10(2) to 10(5) MPN/100 mL. The field scale water reuse research project is in progress and national guidelines for reclaimed-water irrigation are under preparation in Korea. A comprehensive assessment of existing agricultural practices and a thorough monitoring in the fields as well as treatment plots are recommended to make national guidelines more representative.

Integrated modelling under uncertainty in watershed-level assessment and management

Uncertainty in water quality model predictions is inevitably high due to natural stochasticity, model uncertainty, and parameter uncertainty. An integrated modelling system (modified-BASINS) under uncertainty is described and demonstrated for use in receiving-water quality prediction and watershed management. A Monte Carlo simulation was used to investigate the effect of various uncertainty types on output prediction. Without pollution control measures in the watershed, the concentrations of total nitrogen (T-N) and total phosphorus (T-P) in the Hwaong Reservoir, considering three uncertainty types, would be less than about 4.4 and 0.23 mg L(-1), respectively, in 2012, with 90% confidence. The effects of two watershed management practices, wastewater treatment plants (WWTP) and constructed wetlands (WETLAND), were evaluated. The combined scenario (WWTP + WETLAND) was the most effective at improving reservoir water quality, bringing concentrations of T-N and T-P in the Hwaong Reservoir to less than 3.4 and 0.14 mg L(-1), 24 and 41% improvements, respectively, with 90% confidence. Overall, the Monte Carlo simulation in the integrated modelling system was practical for estimating uncertainty and reliable in water quality prediction. The approach described here may allow decisions to be made based on the probability and level of risk, and its application is recommended.

Acute-phase response alters the disposition kinetics of cefepime following intravenous administration to rabbits

The effect of experimentally induced fever on the pharmacokinetics of cefepime administered intravenously at a dose of 75 mg/kg bw was studied in six healthy rabbits. The study was conducted in two consecutive phases, separated by a washout period of 2 weeks. Infection was induced by the intravenous inoculation of 5 x 10(8) cfu of Escherichia coli 24 h before the pharmacokinetic investigation was carried out. Serial blood samples for cefepime concentration determination were obtained for 48 h following drug administration. The concentrations of cefepime in the plasma were determined by a quantitative microbiological assay using an agar-gel diffusion method employing Bacillus subtilis ATCC 6633 as the test organism, with a level of detectability of approximately 0.10 microg/ml. Cefepime plasma concentrations versus time were evaluated by non-compartmental methods using WinNonLin. Cefepime was well tolerated and no serious adverse events were observed. Rectal temperature increased 1 degree C 24 h post injection in infected animals. Highly significant differences in the blood plasma concentrations of cefepime were observed between febrile and healthy animals at all the sampling times. This could explain the greater area under the plasma level-time curve of the drug in febrile compared with healthy animals. The results from pharmacokinetic calculations showed that both the distribution volume at steady state (V (dss)) and body clearance (CL(tot)) were affected in febrile as compared to healthy animals. The mean values of V (dss) and CL(tot) of cefepime in healthy rabbits were 1.168 L/kg and 0.303 L/kg/h, respectively. As compared with healthy animals, the mean estimates of V (dss) (0.917 L/kg) and CL(tot) (0.205 L/kg per h) of cefepime were significantly lower, whereas t (1/2lambda), MRT and AUMC were significantly higher in febrile rabbits. It is concluded that, although experimental infection had an effect on the disposition kinetics of cefepime in healthy and febrile rabbits, this was not sufficiently pronounced to require alteration of the dosage during disease.

Low loss high mesa optical waveguides based on InGaAsP/InP heterostructures

Low loss high mesa optical waveguides were fabricated on InGaAsP/InP heterostructures by utilizing inductively-coupled-plasma reactive ion etching (ICP-RIE) and electron beam lithography technique. The fabrication process was optimized by measuring sidewall roughness of deep-etched waveguides. Atomic force microscope loaded with carbon nanotude was used to obtain three-dimensional image of the etched sidewall of waveguides. The obtained statistical information such as rms roughness and correlation length was used to theoretically calculate scattering loss of waveguides. Several waveguides with different number of sharp bends and the length were fabricated and their propagation losses were measured by modified Fabry-Perot method. The measured propagation losses were compared with theoretically calculated losses.

Concurrent chemoradiotherapy in patients with nasopharyngeal cancer: prognostic significance of low expression of bax

A randomized trial has demonstrated that concurrent chemoradiotherapy (CRT) is superior to radiotherapy (RT) alone in locally advanced nasopharyngeal cancer (NPC). Our study comprise 35 patients with locally advanced NPC (stage I: 1, II: 12, III: 7, IV: 15) with 1 cycle of induction chemotherapy (5-fluorouracil 1,000 mg/m(2)/day and cisplatin 20 mg/m(2)/day, days 1- 4) followed by concurrent CRT starting on day 22. Concurrent CRT consisted of RT (70 Gy/35 fractions for 7 weeks) with cisplatin 20 mg/m(2)/day for 4 days on weeks 1, 4, 7 of RT. Complete response (CR) was achieved in 33 patients (94%). Four-year progression-free survival (PFS) and overall survival (OS) of all patients were 57% and 65%, respectively. In analysis of prognostic factors, low expression of bax was the most significant independent predictor of poor prognosis in both PFS (p=0.002) and OS (p=0.008). In conclusion, the outcome of patients treated with this combined therapeutical modality appears to be comparable with that of Intergroup 0099 trial with high CR rate. Low expression of bax was significantly associated with poor PFS and OS.

Effects of high concentrations of energy sources and metabolites on suspension culture of Chinese hamster ovary cells producing tissue plasminogen activator

A high-concentration medium was developed for the high-density cultivation of Chinese hamster ovary (CHO) cells to produce tissue plasminogen activator (tPA). First, the effects of the concentrations of several medium components on the growth and metabolism of CHO cells were studied particularly in relation to the serum concentration, in order to develop a suitable concentrated medium. High concentrations of serum, glucose, lactate, and glutamine and a low ammonia concentration increased the specific growth rate and decreased the specific tPA production rate. Among these components, the effect of the serum concentration was the most significant. There was an inverse correlation between the specific rates of cell growth and tPA production. Using a medium containing glutamine at twice the concentration of the original medium (F-12) allowed the medium volume to be reduced to seven-ninths that of the original, without any reduction in tPA productivity. When the F-12 medium was supplemented five-fold with amino acids and vitamins, the total amount of tPA produced, specific rate of tPA production, and yield of tPA per unit volume of medium employed were respectively enhanced 1.7, 1.5, and 3.6 times. As a consequence, the frequency of medium exchange could be reduced. The results strongly indicate that the supplementation of nutrient amino acids and vitamins to a medium with a low concentration of serum are the most critical factors for cost-effective tPA production in high-density cell cultivation.

Enhancement of styrene removal by Pseudomonas sp. SR-5 in mixed culture with a benzoic acid-degrading bacterium in biofilter

The growth of a styrene-degrading bacterium, Pseudomonas sp. SR-5, was inhibited by benzoic acid (BA), one of the styrene degradation intermediates, in liquid culture. A benzoic acid-degrading microorganism, Raoultella sp. strain A, was isolated from a peat biofilter inoculated with a wastewater. The styrene removal efficiencies of the two laboratory-scale biofilters inoculated with only strain SR-5 and a mixed culture of strains SR-5 and A were compared using a mixed packing material of peat and ceramic (1:1) for 45 days. The biofilter with the mixed culture showed a higher removal efficiency than that with a single culture of SR-5. The maximum elimination capacities of the biofilters with the mixed culture and the single culture were 141 g m(-3)h(-1) and 106 g m(-3)h(-1), respectively. In the biofilter with the single culture, 136 g of benzoic acid (m3 of dry packing material)(-1) was accumulated at the end of the experiment. However, no accumulation of benzoic acid was observed in the biofilter with the mixed culture.

Peripheral glutamate receptors contribute to mechanical hyperalgesia in a neuropathic pain model of the rat

We hypothesized that glutamate (Glu) released from the peripheral terminals of primary afferents contributes to the generation of mechanical hyperalgesia following peripheral nerve injury. Nerve injury was performed on rats with a lumbar 5 spinal nerve lesion (L5 SNL), which was preceded by L5 dorsal rhizotomy (L5 DR) to avoid the potential central effects induced by L5 SNL through the L5 dorsal root. Mechanical hyperalgesia, as evidenced by a reduction in paw withdrawal threshold (PWT), was short-lasting (<6 days) after L5 DR, but persistent (>42 days) after L5 SNL preceded by L5 DR. When an intraplantar injection into the affected hind paw was given immediately before L5 SNL, non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist MK-801 (20 nmol), group-I metabotropic Glu (mGlu) receptor antagonist DL-amino-3-phosphonopropionic acid (DL-AP3; 70 nmol), and selective group-II mGlu receptor agonist 4-aminopyrrolidine-2,4-dicarboxylate (APDC; 20 nmol) delayed the onset of PWT reduction for 1-4 days. However, this onset was not affected by alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid/kainate receptor antagonist 2,3-dioxo-6-nitro-1,2,3,4,-tetrahydrobenzo[f]quinoxaline-7-sulfonamide (NBQX; 100 nmol). When the same injection was given after L5 SNL-induced mechanical hyperalgesia had been established, MK-801 reversed the PWT reduction for 30-75 min, whereas NBQX, DL-AP3, or APDC had no effect. These results suggest that the manipulation of the peripheral Glu receptors reduces neuropathic pain, by blocking NMDA and group-I mGlu receptors and by stimulating group-II mGlu receptor during the induction phase of neuropathic pain, but only by blocking the NMDA receptor during its maintenance phase.

Ion channels of Fasciola hepatica incorporated into planar lipid bilayers

Ion channels are important target sites of anthelmintics, but little is known about those in Fasciola hepatica. In this work, we applied a planar lipid bilayer technique to characterize the properties of single ion channels in F. hepatica. Under a 200/40 mM KCl gradient, a large conductance channel of 251 pS was observed in 18% of the membranes studied. The channel was selective to K(+) over Cl(-) with a permeability ratio of K(+) to Cl(-) (PK/PCl) of 4.9. Open state probability (Po) of the channel was less than 0.5 and dependent on voltage (-60 to approximately +40 mV) and Ca(2+) (approximately 100 microM). The other two types of single channels observed in 11 and 5% of membranes, respectively, were a K(+)-permeable channel of 80 pS (PK/PCl=4.6) and a Cl(-)-permeable channel of 64 pS (PK/PCl=0.058). Open state probability of both channels showed little voltage dependence. The results indicate that distinct single channels of 60 to approximately 251 pS are present in relative abundance and, in addition, that the planar lipid bilayer technique can be a useful tool for the study of single ion channels in F. hepatica.

Styrene degradation by Pseudomonas sp. SR-5 in biofilters with organic and inorganic packing materials

Pseudomonas sp. SR-5 was isolated as a styrene-degrading bacterium. In liquid culture containing 1% (v/v) styrene, more than 90% styrene was degraded in 53 h and the doubling time of SR-5 was 2 h. The removal of styrene gas was investigated in biofilters for 31 days using an organic packing material of peat and an inorganic packing material of ceramic inoculated with SR-5. The maximum-styrene-elimination capacities for peat and ceramic packing materials were 236 and 81 g m(-3) h(-1), respectively. The percentage of styrene converted to low molecular weight compounds including CO(2) in the peat and ceramic biofilters during a 10-day operation were estimated to be 90.4 and 36.7%, respectively. As the pressure drop in the peat bioflter at the end of experiment was significantly higher than that in ceramic biofilter, a biofilter using a mixture of peat and ceramic was tested. We determined that the maximum elimination capacity was 170 g m(-3) h(-1) and the production of low molecular weight compounds was 95% at a low pressure drop for this mixed packing material filter.

Motility restriction after resection of an extraocular muscle

Restriction of eye movement after surgery is an unusual but troublesome complication. A patient presented with a limitation of abduction after a 5 mm resection of medial rectus muscle and an 8 mm recession of lateral rectus muscle. Since the forced duction test was positive, restrictive factors were suggested to be implicated. A reparative operation was performed at the postoperative 9 month, and the forced duction test was negative after releasing the resected medial rectus muscle. The patient showed an improved abduction after recessing the resected muscle. Even after an uneventful surgery, resection of an extraocular muscle may cause restriction of ocular rotation caused by muscle scarring to the sclera or by an increased tightness of the muscle.

Idarubicin, cytarabine, and topotecan in patients with refractory or relapsed acute myelogenous leukemia and high-risk myelodysplastic syndrome

In an effort to develop more effective therapy for patients with refractory or relapsed acute myelogenous leukemia (AML) and high-risk myelodysplastic syndrome (MDS), we investigated the efficacy of a combination chemotherapy consisting of idarubicin, cytarabine, and topotecan. Twenty-seven patients were treated: four with primary refractory AML, nine with AML in first relapse, four with AML in second relapse, and 10 with MDS-RAEB/RAEBT. Patients received as salvage therapy a single course of idarubicin 12 mg/m(2) IV bolus on days 1-3, cytarabine 1 g/m(2) over two hours q 12 hr on days 1-5, and topotecan 1.25 mg/m(2) over 24 hr on days 1-5. Median age was 42 years (range 17-65 years). All patients were evaluable for response: 14 (51.9%) achieved complete remission, 10 with AML (59%) and four with MDS (40%), respectively. Thirteen AML patients (excluding four relapsed after autologous stem cell transplantation) were grouped into four categories to stratify the probability of achieving complete remission (CR): group 1, first CR duration > or = 2 years and receiving first salvage treatment (S1); group 2, first CR duration 1-2 years and receiving S1; group 3, first CR duration 0-1 years and receiving S1; and group 4, first CR duration 0-1 years and receiving S2, S3, or S4 after failing S1. The response rate of each group was as follows: group 1, one of two (50%); group 2, one of one (100%); group 3, four of four (100%); group 4, two of six (33.3%). The median remission duration and survival of patients with AML were six and 12 months, respectively. Median duration of survival in 10 MDS patients was 15 months, and all four MDS patients achieving a CR maintained continuous CR with a median follow-up of 11 months. Severe myelosuppression was observed in all patients, resulting in fever or documented infections in 89% of patients. Median time to recovery of neutrophils > or =0.5 x 10(9)/l was 22 days (11-34) and for platelets > 20 x 10(9)/l 35 days (11-58). Reversible grade 3-4 toxicities included diarrhea (two patients) and mucositis (seven patients). We conclude that combination chemotherapy with intermediate dose cytarabine, idarubicin, and topotecan has significant antileukemic activity and acceptable toxicity in salvage AML and high-risk MDS.

Protective effects of resveratrol on hydrogen peroxide-induced apoptosis in rat pheochromocytoma (PC12) cells

Oxidative stress has been considered as a major cause of cellular injuries in a variety of clinical abnormalities. One of the plausible ways to prevent the reactive oxygen species (ROS)-mediated cellular injury is dietary or pharmaceutical augmentation of endogenous antioxidant defense capacity. Resveratrol (3,5,4'-trihydroxy-trans-stilbene), one of the major antioxidative constituents found in the skin of grapes, has been considered to be responsible in part for the protective effects of red wine consumption against coronary heart disease ('French Pardox'). In this study, we have investigated the effects of resveratrol on hydrogen peroxide-induced oxidative stress and apoptotic death in cultured rat pheochromocytoma (PC12) cells. PC12 cells treated with hydrogen peroxide underwent apoptotic death as determined by characteristic morphological features, internucleosomal DNA fragmentation and positive in situ end-labeling by terminal transferase (TUNEL staining). Resveratrol pretreatment attenuated hydrogen peroxide-induced cytotoxicity, DNA fragmentation, and intracellular accumulation of ROS. Hydrogen peroxide transiently induced activation of NF-kappaB in PC12 cells, which was mitigated by resveratrol pretreatment. These results suggest that resveratrol has the potential to prevent oxidative stress-induced cell death.

AC133 antigen as a prognostic factor in acute leukemia

AC133 is a novel 5-transmembrane antigen present on a CD34((bright)) subset of human hematopoietic stem cells (HSCs) and it is also expressed on the subset of CD34 positive (CD34(+)) leukemias. But the clinical significance of AC133 expression on leukemic blasts is not yet known. We investigated the expression of AC133 antigen on blast cells of acute leukemia. Forty-one cases of acute leukemia were examined for expression of AC133, CD34, and other antigens using multicolor flow-cytometry. Samples were considered positive if at least 20% of the cells specifically stained with monoclonal antibodies (MoAbs) revealed a higher fluorescence intensity compared to cells of corresponding negative control samples (=20% cut-off level). 14/36 (38.9%) acute myelogenous leukemia (AML) samples and 6/20 (30%) acute lymphoblastic leukemia (ALL) samples were positive for AC133, the difference was not significant. All AC133 positive (AC133(+)) leukemias expressed CD34, whereas 13 of 33 CD34(+) leukemias were negative for AC133, and AC133(+)/CD34(-) leukemia was not found. Expression rates of CD31, CD62L, CD62E, CD105 and CD144 were significantly higher in AC133(+) leukemia compared to those of AC133(-) leukemia (P=0.045, P<0.001, P<0.001, P<0.001, P=0.003, respectively), but bcl-2, CXCR-1, CXCR4, VLA-4, CD106 expression rates were not significantly different between AC133(+) and AC133(-) leukemias. None of the clinical prognostic markers such as age, hemogram, lactate dehydrogenase, and chromosomal aberration were significantly different between AC133(+) and AC133(-) leukemias. CR rates of AC133(+) AML and AC133(-) AML were not significantly different, although there was a trend toward higher CR rates in AC133(-) AML (18/22[81.8%] AC133(-) AML versus 9/14[64.3%] AC133(+) AML), but the 1-year relapse rate of AC133(+) AML was significantly higher than that of AC133(-) AML (8/9 (88.9%) versus 7/19 (36.8%), P=0.016). Median disease-free survival (DFS) times of AC133(+) and AC133(-) AML were significantly different (11 and 18 months, respectively, P=0.006), although overall survival (OS) times were not significantly different (AC133(+) 15 months versus AC133(-) 20 months, respectively, P=0.06). Similar results regarding clinical outcomes were found when AC133(+)/CD34(+) and AC133(-)/CD34(+) were analyzed separately, but the difference did not attain statistical significance. In ALL, 9/11 (81.8%) AC133(-) and 2/4 (50%) AC133(+) cases achieved CR, but the difference was not significant. Four of 11 AC133(-) ALL (36.4%) and 2 of 3 AC133(+) ALL (66.7%) relapsed within 1 year. In survival analysis, median DFS time and OS time of the AC133(+) group were 7 and 18 months, respectively, and these were not significantly different from those of the AC133(-) group (median DFS 15, OS 22 months, respectively). Our results demonstrate that AC133 expression in AML blasts is associated with poor clinical outcomes in terms of higher early relapse and shorter disease-free survival, suggesting that the AC133 antigen might provide the prognostic stratification of acute leukemia. However, to verify the effect of AC133 expression on the therapeutic outcomes of adult acute leukemia, further study including more cases is needed.

Differential cell death induced by salsolinol with and without copper: possible role of reactive oxygen species

Salsolinol (SAL), a novel dopaminergic catechol tetrahydroisoquinoline neurotoxin, has been speculated to contribute to the etiology of Parkinson's disease and neuropathology of chronic alcoholism. Our previous studies have demonstrated that SAL induces strand scission in øX174 supercoiled DNA and oxidative base modification in calf thymus DNA in the presence of cupric ion. We now report that treatment of rat pheochromocytoma (PC12) cells with SAL causes reduced viability, which was exacerbated by Cu(2+). The copper chelator bathocuproinedisulfonic acid ameliorated cytotoxicity induced by SAL and Cu(2+). N-Acetyl-L-cysteine and reduced glutathione protected against SAL- plus Cu(2+)-mediated PC12 cell death. Cells exposed to SAL underwent apoptosis, as revealed by characteristic morphological and biochemical changes. SAL treatment resulted in increased levels of Bax with a concomitant decrease in expression of Bcl-x(L). Furthermore, SAL rapidly activated c-Jun N-terminal kinase, whereas the activity of extracellular signal-regulated protein kinase remained unchanged. Transfection with Bcl-x(L) or Bcl-2 led to protection against SAL-mediated PC12 cell death. Although SAL alone could cause apoptotic death in PC12 cells, cells treated with SAL together with Cu(2+) became necrotic. Cells exposed to both SAL and Cu(2+) exhibited higher levels of intracellular reactive oxygen species, malondialdehyde, and 8-oxo-7,8-dihydro-2'-deoxyguanosine than did those treated with SAL alone. These results suggest that copper accelerates redox cycling of SAL, leading to massive production of reactive oxygen species, which can divert the SAL-induced cell death to necrosis.

Evidence that the intracellular domain of FGF receptor 2IIIb affects contact of the ectodomain with two FGF7 ligands

Models of the oligomeric FGF signaling complex, including those derived from crystal structures, vary in stoichiometry and arrangement of the three subunits comprised of heparin/heparan sulfate chains, FGFR tyrosine kinase and activating FGF. Here, using covalent affinity crosslinking of radiolabeled FGF7 to binary complexes of FGFR2IIIb and heparin, we show that two molecules of FGF7 contact each FGFR2IIIb. This supports models that propose a dimeric complex of two units with stoichiometry 1 FGF:1 FGFR in which each FGF contacts both FGFR. The bivalent FGF7 contact was dependent on the full-length amino terminus of FGF7alpha and the intracellular domain of FGFR2IIIb extending through the juxtamembrane domain and the beta1 and beta2 strands of the kinase which is required for ATP binding. We propose that the differences in crosslinking report differences in relationships among subunits in the ectodomain of the complex that are affected by the amino terminus of FGF and the FGFR intracellular domain. From this, we suggest the corollary that conformational relationships among subunits in the ectodomain are transmitted to the intracellular and ATP binding domains during activation of the complex.

Mutations in fibroblast growth factor receptor 2 and fibroblast growth factor receptor 3 genes associated with human gastric and colorectal cancers

Autosomal dominant disorders of skeletal and cranial development have been linked to fibroblast growth factor receptor (FGFR) 2 and FGFR3. Here we report two identical mutations in FGFR2 that cause craniosynostosis syndromes, Crouzon, Apert, and Pfeiffer in gastric carcinoma. A missense mutation (Ser267Pro) in exon IIIa and a splice site mutation (940-2A-->G) in exon IIIc were detected in gastric cancer patients. Interestingly, these heterozygous somatic mutations are identical to the germinal activating mutations in FGFR2 reported previously in craniosynostosis syndromes. In addition, the two novel mutations of FGFR3 in colorectal carcinomas were identified. All identified mutations occurred at highly conserved sequences, not only in the FGFR family of molecules, but also throughout evolution and clustered in the immunoglobulin-like loop-III domain, highlighting the functional importance of this domain. Our results indicate that FGFR2 and FGFR3, in addition to their potential role in skeletal dysplasias, play an important role in tumorigenesis.

Transplantation of peripheral blood stem cells mobilized by intensified consolidation and granulocyte colony-stimulating factor in acute leukemia

The purpose of this study was to evaluate the feasibility and efficacy of autologous transplantation of peripheral blood stem cells (PBSC) mobilized with high-dose consolidation chemotherapy and granulocyte colony-stimulating factor in patients with acute myelogenous leukemia (AML). Twenty patients received myeloablative chemotherapy or chemo-radiotherapy including total body irradiation followed by the infusion of PBSC. PBSC were collected by large-volume leukaphereses. The mean number of mononuclear cells and CD34-positive cells infused were 7.2 x 10(8)/kg (range, 2.2-16.6), and 6.6 x 106/kg (range, 2.1-27.7), respectively. Engraftment failure was not seen in the enrolled patients. The median time to neutrophil (> or = 500/microL) and platelet recovery (> or = 50,000/microL) from the transplant was 12 days (range, 8-20) and 28 days (range, 10-600), respectively. The 2-year probability of disease-free survival (DFS) and relapse were 43% and 57% for patients with AML transplanted in first complete remission (CR1). The outcome of the patients transplanted in the advanced status was significantly worse than the patients transplanted in CR1 (P=0.04). Most relapses occurred within 1 year after transplantation. Fatal hepatic veno-occlusive disease was observed in one case. Other transplantation-related toxicities were mild. Our results demonstrated that autologous transplantation of high-dose consolidation chemotherapy-mobilized peripheral blood progenitor cells is feasible in the patients with AML in CR1. To further reduce the risk of leukemia relapse, much effort should be contributed to the field of ex vivo purging and post-transplant immunotherapy.