Abstract P4-03-08: Pathological analysis of intraductal papillary lesions in 3690 patients

Background:Papillary lesions of the breast (PL) account for 1 - 2% in breast tumors and 10% in benign tumors. Ductoscopy due to its high rate (60 times) amplification and visualization of lesions, which makes it possible to directly visualize the duct from the orifice of the duct well into the periphery. It could not only find abnormities which other tests could not provide, but also predict histological diagnosis.However, ductoscopy findings and pathological results are not always consistent. Ductoscopy examine is limited by many factors such as complicated anatomical structure of breast and ductal obstruction, so in some cases it may have missed diagnosis. Lesions could be missed due to extrusion and shedding during ductoscopy examine procedure and preparation of pathological section.

Methods:In this study, we retrospectively studied on 4170 papillary lesions diagnosed by ductoscopy in 3690 patients from April 23, 2008 to October 31st, 2012 and compared incidence of each disease. These cases were evaluated by final histopathology(42.2% solitary papillary lesion, 32.5% multiple papillomatosis, 13.0% premalignant or malignant lesions, 6.5% mammary duct or plasma cell mastitis, 5.7% epithelial hyperplasia). The sensitivity of ductoscopy for PL in this study was 87.8%, and specificity was 89.2%.

Results and Discussion:Spontaneous nipple discharge(SND) is the third third most common presenting symptom of breast disease accounting for 3∼8% of breast symptoms. But in our experience, not all of the intraductal lesions would have SND, especially in those cases which localized more distally. Besides, intraductal lesions in premalignant or malignant lesions cases would have more incidence to localize distally than their benign papilloma. Thus, if we only take ductoscopy on patients who suffer SND, we might have some missed diagnosis for those people who did not suffer SND including malignant lesions.At present, although ductoscopy is not routine examination for breast cancer screening, we consider that for people who share a high-risk of developping breast cancer, although she might not have SND, ductoscopy could be a selective screen tool.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-03-08.

Systemic administration of an antagomir designed to inhibit miR-92, a regulator of angiogenesis, failed to modulate skeletal anabolic response to mechanical loading

The goal of this study is to evaluate if promotion of angiogenesis by systemic treatment with an antagomir against miR-92a, a well established inhibitor of angiogenesis, will maximize the benefits of exercise on bone. Ten week old female C57BL6/J mice were subjected to two weeks of external load by four point bending. During the first week of mechanical loading (ML), mice were injected (2.7 mg/kg of bodyweight) with antagomir against miR-92 or control antagomir (3 alternate days via retro-orbital). No difference in tissues weights (heart, kidney, liver) were found in mice treated with miR-92 vs. control antagomir suggesting no side effects. Two weeks of ML increased tibia TV, BV/TV and density by 6-15 %, as expected, in the control antagomir treated mice. Similar increases in the above parameters (7-16 %) were also seen in mice treated miR-92 antagomir. Administration of miR-92 antagomir was effective in reducing levels of mir-92 in heart, liver and skeletal muscle and in contrast, expression levels of two other microRNA's miR-93 and miR-20a remain constant, thus suggesting specificity of the antagomir used. Surprisingly, we failed to detect significant changes in the expression levels of vascular genes (VEGF, CD31 and Tie2) in heart, liver or skeletal muscle. Based on these findings, we conclude that systemic administration of antagomir against miR-92 while reduced expression levels of miR-92 in the tissues; it did not significantly alter either angiogenic or osteogenic response, thus suggesting possible redundancy in miR-92 regulation of angiogenesis.

Effects of two in-office bleaching agents with different pH on the structure of human enamel: an in situ and in vitro study

This study evaluated the effects of two in-office bleaching agents (Beyond and Opalescence Boost) with different pH on the structure and mechanical properties of human enamel in vitro and in situ. One hundred and eight enamel slabs were obtained from freshly extracted premolars. The specimens were randomly distributed into nine groups (n=12), and the human saliva (HS) in the volunteers' oral cavities was used to simulate the in situ condition: Beyond + HS, Opalescence Boost (O-Boost) + HS, Control + HS, Beyond + artificial saliva (AS), O-Boost + AS, Control + AS, Beyond + distilled water (DW), O-Boost + DW, and Control + DW. The bleaching treatments were performed on the first and eighth day, and the total bleaching time was 90 minutes. Baseline and final surface roughness (RMS), surface morphology, microhardness, and fracture toughness (FT) were measured before the treatment and on the fifteenth day, respectively. Compared with control groups, surface alterations on enamel were found in the Beyond + AS and Beyond + DW groups under atomic force microscopy evaluation. Two-way analysis of variance and Tukey test revealed that the RMS showed significant intergroup differences for both storage condition and bleaching agent, whereas microhardness and FT revealed no significant alteration. The results indicated that in-office bleaching agents with low pH values could induce enamel morphology alterations under in vitro conditions. The presence of natural HS could eliminate the demineralization effect caused by low pH.

Optimization of an integrated sponge--granular activated carbon fluidized bed bioreactor as pretreatment to microfiltration in wastewater reuse

A specific integrated fluidized bed bioreactor (iFBBR) was optimized in terms of organic loading rate (OLR), hydraulic retention time (HRT) and frequency of new sustainable flocculant (NSBF) addition for primary treated sewage effluent (PTSE) treatment. It was observed that iFBBR achieved the best performance with the operating conditions of 4 times/day NSBF addition, HRT of 90 min and OLR of 8.64 kg COD/day m(3). The removal efficiencies were found to be more than 93% of dissolved organic carbon (DOC), 61% of total nitrogen (T-N) and 60% of total phosphorus (T-P). iFBBR as pretreatment of submerged microfiltration (SMF) is successful in increasing the critical flux and reducing the membrane fouling. NSBF-iFBBR-SMF hybrid system led to very high organic removal efficiency with an average DOC removal of 97% from synthetic PTSE.

Evaluation of an integrated sponge--granular activated carbon fluidized bed bioreactor for treating primary treated sewage effluent

An integrated fluidized bed bioreactor (iFBBR) was designed to incorporate an aerobic sponge FBBR (ASB-FBBR) into an anoxic granular activated carbon FBBR (GAC-FBBR). This iFBBR was operated with and without adding a new starch based flocculant (NSBF) to treat synthetic primary treated sewage effluent (PTSE). The NSBF contains starch based cationic flocculants and trace nutrients. The results indicate that the iFBBR with NSBF addition could remove more than 93% dissolved organic carbon (DOC), 61% total nitrogen (T-N) and 60% total phosphorus (T-P) at just a very short hydraulic retention time of 50 min. The optimum frequency of adding NSBF to the iFFBR is four times per day. As a pretreatment to microfiltration, the iFFBR could increase 5L/m(2)h of critical flux thus reducing the membrane fouling. In addition, better microbial activity was also observed with high DO consumption (>66%) and specific oxygen uptake rate (>35 mg O(2)/g VSS h).

CC chemokine ligand 21 enhances the immunogenicity of the breast cancer cell line MCF-7 upon assistance of TLR2

CC chemokine ligand 21 (CCL21) is a known attractant for CCR7-positive (CCR7+) cells, but its additional role in the immunogenicity of CCR7+ cells remains poorly understood. This study explored the effects of CCL21-CCR7 ligation on cancer immunogenicity and related antitumor immune response, in the presence and absence of mitomycin C (MMC) treatment. CCL21-CCR7 binding upregulated human leukocyte antigen class I-restricted tumor antigen presentation with increased expression of human leukocyte antigen class I and transporter associated with antigen processing-1. In addition, CCL21 restrained the tumor-derived immunosuppressive factors FasL and transforming growth factor-β. Consequently, CCL21 facilitated cancer-educated lymphocytes reaction in vitro. In the tumor-bearing mouse, CCL21 inhibited tumor growth and prolonged mouse survival via lymphocytes, especially in CCR7+ cancer cells. Furthermore, Toll-like receptor 2 activation of lymphocytes assisted the tumor-suppression functions of CCL21, in vitro and in vivo. This study implies that CCL21 improved the immunogenicity of the CCR7+ breast cancer cell line even with MMC treatment and triggered antitumor response by lymphocytes. These findings provide a new insight into the research and application of CCL21-associated antitumor response.

Effect of icariin on bone formation during distraction osteogenesis in the rabbit mandible

The aim of this study was to evaluate the effect of icariin on bone formation during mandibular distraction. 40 Rabbits were randomly divided into experimental and control groups. Mandibular distraction was performed 5 days after unilateral mandibular osteotomy using a custom-made external distractor at a rate of 0.5mm/12h for 10 days. From the first day of distraction, icariin (2.5mg/kg · day) was orally administered to the experimental group and placebo to the controls. 10 Rabbits were killed at the end of weeks 2 and 4 of the consolidation phase. The distracted hemimandible was harvested and newly formed bone was evaluated by soft radiography, histology and bone histomorphometry. Regenerated bone was evaluated for bone mineral density by dual-energy X-ray absorptiometry. The experimental group had fewer radiolucent areas on soft radiography. Bone mineral density of regenerated bone was higher in the experimental than in the control group at 2 and 4 weeks. At 4 weeks, the experimental group had greater volumes of new bone, higher trabecular number, and less trabecular separation than the controls. Oral administration of icariin could promote bone formation during mandibular distraction osteogenesis and might be a promising method for shortening the course of distraction osteogenesis.

Causes of blind and partial sight certifications in England and Wales: April 2007-March 2008

PURPOSE

The last complete report on causes of blindness in England and Wales was for the data collected during April 1999-March 2000. This study updates these figures, with data collected during April 2007-March 2008.

METHODS

In England and Wales, registration for blindness and partial sight is initiated with certification by a consultant ophthalmologist with the consent of the patient. The main cause of visual impairment was ascertained where possible for all certificates completed during April 2007-March 2008 and a proportional comparison with 1999-2000 figures was made.

RESULTS

We received 23,185 Certificates of Vision Impairment (CVIs), of which 9823 were for severe sight impairment (blindness) (SSI) and 12,607 were for sight impairment (partial sight) (SI). These totals were considerably lower than the numbers certified in the year ending 31 March 2000. In 16.6% of CVIs, there were multiple causes of visual impairment as compared with 3% of BD8s in 2000. Degeneration of the macula and posterior pole (mostly age-related macular degeneration (AMD)) contributed to vision impairment in 12,746 newly certified blind or partially sighted.

CONCLUSIONS

AMD is still by far the leading cause of certified visual loss in England and Wales. Proportional comparisons are hampered by the increasing use of multiple pathology as a main cause of visual impairment, which is believed to have arisen owing to the change in certificate used for data collection. These figures are not estimates of the total numbers newly blind in the UK because not all those entitled to certification are offered and or accept it, but they do nevertheless document the number of people who are deemed to be sufficiently sight impaired to warrant support and have been both offered and accepted it. This is usually the case when no further ophthalmic intervention is thought likely to be of benefit in terms of restoring or improving vision.

Microbial community in granules from a high-rate EGSB reactor

The spatial distribution, quantity and diversity of different microorganisms within anaerobic granular sludge from a lab-scale expanded granular sludge bed (EGSB) reactor operated at different organic loading rates were studied using florescent in situ hybridization (FISH), real time quantitative-polymerase chain reaction (RTQ-PCR) and denaturing gradient gel electrophoresis (DGGE) techniques. The results indicated that most Eubacteria were located in the outer layer of granule, while the Archaea which mainly were methanogens and more sensible to the environmental conditions were located in the inner layer of the granule. The quantity of Archaea was obviously less than that of Eubacteria in the granules, but increased with the increasing of organic loading rates of the reactor. As the organic loading rate of the reactor increased and the operating time elapsed, the Archaea community in the granules changed significantly. Seven typical DGGE bands were collected and sequenced, and found that the dominant species of Archaea in the granules operated in the last period were mainly Methanocorpusculum, Methanobacterium, Methanosaeta.

Rapid, accurate determination of multidrug resistance in M. tuberculosis isolates and sputum using a biochip system

OBJECTIVE

To develop and evaluate a rapid biochip system for the determination of multidrug-resistant tuberculosis (MDR-TB) in Mycobacterium tuberculosis isolates and clinical sputum samples.

DESIGN

We developed a total solution-based system, including a biochip kit, apparatus for sample preparation, hybridisation, washing and data acquisition, and dedicated software for automated diagnosis. The biochip simultaneously identifies M. tuberculosis and detects the most commonly found mutations in the rpoB, katG and inhA genes. The system was assessed with 330 mycobacterial isolates and 129 sputum samples for rifampicin (RMP), and with 205 isolates and 105 sputum samples for isoniazid (INH), and then compared to DNA sequencing and conventional drug susceptibility testing (DST).

RESULTS

The entire biochip assay took 6 h. The concordance rate between the biochip assay and the DNA sequencing results was 100%. Compared to conventional DST, the concordance rates were 91.8% for isolates and 94.6% for sputum samples for RMP resistance, and 70.2% for isolates and 78.1% for sputum samples for INH resistance.

CONCLUSION

The biochip system provides a simple, rapid, reliable and accurate clinical assay for the parallel detection of M. tuberculosis and prevalent MDR-TB in a 6 h procedure, using either culture isolates or sputum samples for diagnosis.

Adsorption and bioadsorption of granular activated carbon (GAC) for dissolved organic carbon (DOC) removal in wastewater

In this study, the performances of GAC adsorption and GAC bioadsorption in terms of dissolved organic carbon (DOC) removal were investigated with synthetic biologically treated sewage effluent (BTSE), synthetic primary treated sewage effluent (PTSE), real BTSE and real PTSE. The main aims of this study are to verify and compare the efficiency of DOC removal by GAC (adsorption) and acclimatized GAC (bioadsorption). The results indicated that the performance of bioadsorption was significantly better than that of adsorption in all cases, showing the practical use of biological granular activated carbon (BGAC) in filtration process. The most significance was observed at a real PTSE with a GAC dose of 5g/L, having 54% and 96% of DOC removal by adsorption and bioadsorption, respectively. In addition, it was found that GAC adsorption equilibrium was successfully predicted by a hybrid Langmuir-Freundlich model whilst integrated linear driving force approximation (LDFA)+hybrid isotherm model could describe well the adsorption kinetics. Both adsorption isotherm and kinetic coefficients determined by these models will be useful to model the adsorption/bioadsorption process in DOC removal of BGAC filtration system.

Programmed death-1 ligands-transfected dendritic cells loaded with glutamic acid decarboxylase 65 (GAD65) inhibit both the alloresponse and the GAD65-reactive lymphocyte response

Type 1 diabetes (T1D) is due to a loss of immune tolerance to islet antigens, such as glutamic acid decarboxylase 65 (GAD65), for which islet transplantation is a promising therapy. Therefore, the generation of tolerance aiming at both alloantigen and GAD65 will help therapeutic intervention greatly in T1D. In this study, we tested the effect of programmed death-1 ligands (PD-L1)-transfected dendritic cells (DC) loaded with GAD65 on the alloresponse and GAD65-reactive lymphocyte response. The DC2.4 cell line was transfected with PD-L1 and co-cultured with GAD65. BALB-c mice were primed, respectively, by intraperitoneal injection with GAD65, PD-L1-transfected- or non-transfected DC (PD-L1/DC or DC), and PD-L1-transfected- or non-transfected DC loaded with GAD65 (PD-L1/DC/GAD65 or DC/GAD65). Splenocytes of treated mice were isolated and restimulated in vitro with GAD65 or the various DC populations above being used as stimulators, respectively. In the mixed lymphocyte reaction, DC/GAD65 were able to stimulate both allogeneic and GAD65-reactive lymphocytes. However, PD-L1/DC/GAD65 were poorer than DC/GAD65 at activating the GAD65-reactive lymphocyte response. Further, although PD-L1/DC could inhibit the alloresponse, PD-L1/DC/GAD65 were more effective at down-regulating the GAD65-reactive lymphocyte response. More importantly, PD-L1/DC/GAD65-primed lymphocytes exhibited the weakest proliferation when again restimulated in vitro by PD-L1/DC/GAD65. Additionally, PD-L1/DC/GAD65 down-regulated interferon-gamma and up-regulated interleukin-10 production by activated lymphocytes. Therefore, combined stimulation in vivo and in vitro by PD-L1/DC/GAD65 could inhibit both the alloresponse and the GAD65-reactive lymphocyte response, which may contribute to controlling diabetes and islet transplant rejection.

Intraoperative complications of cataract surgery in the very old

AIM

To identify whether the risk of an intraoperative complication of phakoemulsification cataract surgery increases with age.

METHODS

1441 consecutive patients undergoing phakoemulsification cataract surgery were assessed preoperatively, and data on the occurrence of intraoperative complications were collected prospectively. Data were entered into a computerised database, and logistic regression was used to examine evidence of an association between age and the risk of an intraoperative complication. In addition, the rates of intraoperative complications were compared between patients > or =88 years and those <88 years, and between patients > or =96 years and those <96 years.

RESULTS

No significant association was found between age and the risk of an intraoperative complication. The authors found little evidence that patients > or =88 years were at a greater risk of an intraoperative complication than those <88 years, or that those > or =96 years are at increased risk; however, numbers were small.

CONCLUSIONS

These results suggest that age alone is not a major risk factor for any intraoperative complications occurring during phakoemulsification cataract surgery. This has implications not just for tailoring the risk of complications occurring to individual patients but also for meaningful comparisons between national complication rates and those of individual surgeons, and better selection of cases suitable for instruction.

Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma

BACKGROUND/AIMS

Although optometrists have become an accepted part of the team in many hospital glaucoma clinics, their decision making ability has not been assessed formally. This study aims to document the accuracy and safety of clinical work undertaken by optometrists in the hospital setting by investigating their management decisions on follow up of patients with glaucoma.

METHODS

Four optometrists and three medical clinicians examined 50 patients each. Clinical findings were recorded as usual in the hospital records but management decisions were documented separately on a specially designed data collection form. Subsequently, the patient records and clinical findings were reviewed retrospectively and independently by two consultant ophthalmologists, who were masked to the management decisions of the optometrists and medical clinicians. The consultants' management decisions were then compared with those made by the optometrists and medical clinicians. Percentage agreements were computed together with kappa (kappa), or weighted kappa, statistics where appropriate.

RESULTS

Agreement between consultants and optometrists was 55% (kappa = 0.33) for evaluation of visual field status, 79% (kappa = 0.67) for medical management, 72-98% for other aspects of patient management, and 78% (weighted kappa = 0.35) for scheduling of next clinic appointment. Very similar levels of agreement were found between consultants and medical clinicians.

CONCLUSION

Agreement between optometrists and consultants, in glaucoma clinical decision making, was at least as good as that between medical clinicians and consultants. Within an appropriate environment, optometrists can safely work as part of the hospital glaucoma team in outpatient clinics.

Blepharospasm and hemifacial spasm: a protocol for titration of botulinum toxin dose to the individual patient and for the management of refractory cases

PURPOSE

To evaluate a protocol for the treatment of facial dystonias.

METHOD

A retrospective noncomparative interventional case series of all patients who attended a specialised tertiary referral clinic between January 2000 and January 2003. At the start of treatment, patients were seen and treated at weekly intervals until their symptoms were controlled or they developed complications. The sum of the weekly doses was taken as the individual patient dose and then given at 3-4 monthly intervals as required for the individual patient. Refractory cases of spasm underwent orbicularis muscle reduction. Pretarsal spasm was treated with pretarsal botulinum toxin. If the spasm was relieved but the patient could not open their eyelids, a trial of ptosis props was undertaken and the toxin injections continued, before considering a brow suspension. If patients could not see because of a spastic Bell's phenomenon, they were given centrally acting systemic medication.

RESULTS

Of 182 new patients, 63 (35%) required two or more sets of injections to titrate their optimum dose of toxin. Symptoms improved in 169 patients (93%). Of a total 332 new patients and follow-up patients, 47 (14%) underwent surgery during their management, 36 protractor myectomy, and 13 brow suspension. Protractor myectomy improved symptoms in 23 (64%). Brow suspension improved symptoms in 12 patients (92%).

CONCLUSIONS

The dose of botulinum toxin can be titrated to the individual patient, and the refractory cases managed satisfactorily if a logical protocol is followed.

Assessment of the reproducibility and repeatability of a method of grading macular subretinal fluid using optical coherence tomography

AIM

To devise a quantative method for the measurement of the extent of macular subretinal fluid using optical coherence tomography (OCT), and to assess the interobserver and intraobserver agreement for this grading system.

METHODS

Observational cohort series. Patients were a cohort who underwent retinal detachment surgery over an 18-month period. All patients had OCT scan at 6 weeks after surgery. The scans were graded by two independent observers experienced in OCT interpretation and each grader was masked to the others findings. Observer 1 then regraded the scans on a later day masked to his previous findings. The interobserver and intraobserver agreement was assessed using weighted Kappa (Kw) statistics.

RESULTS

In all, 116 patients were analysed. Both the intraobserver and interobserver agreement was very high, with Kw being 0.9631 and 0.9070, respectively.

CONCLUSIONS

The grading system for assessment of the extent of macular subretinal fluid using OCT appears to have very good reproducibility and repeatability. We propose that this grading system would be clinically useful when applied to pathologies visible on OCT scan of the macula.

Outcomes of macular hole surgery: implications for surgical management and clinical governance

PURPOSE

The optimal method and timing of the surgical treatment for idiopathic macular holes remains unknown. The aim of this retrospective study was to identify factors associated with anatomical and visual success in macular hole surgery.

METHODS

Case records of 55 patients undergoing macular hole surgery at three units in the 2-year period up to July 2002 were reviewed to identify factors associated with anatomical and visual success. The following potential prognosticators were evaluated: patient age, hole stage, hole latency prior to surgery, preoperative acuity, simultaneous phacoemulsification, and intraocular lens implantation, internal limiting membrane peeling with and/or without indocyanine green, and postoperative posturing.

RESULTS

The duration of preoperative symptoms, indocyanine green-assisted internal limiting membrane peeling, hole stage, and better preoperative visual acuity were associated with both anatomical success and regaining a postoperative visual acuity of 6/12 or better.

DISCUSSION

The closure rate in patients undergoing surgery within 1 year of onset was 94.0%, and in those waiting 1 year or more it was 47.4%. Clinical governance and quality issues should dictate that NHS macular hole surgery is available to all within 1 year of onset. This study showed no adverse effect of ICG dye retinal staining. The results support the use of a 'patient-friendly' approach of simultaneous cataract surgery with no prone postoperative posturing.

Cytomegalovirus infection in pregnancy

OBJECTIVES

To investigate the effects of intrauterine human cytomegalovirus (HCMV) infection on pregnancy outcomes and infant development.

METHODS

The study group consisted of the HCMV-IgM-positive offspring of 75 pregnant women, and a control group of the non-infected offspring of 73 pregnant women. Chorionic villi, amnionic fluid, and umbilical blood were obtained to detect HCMV-late mRNA with a reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The pregnancy outcomes were followed up. For all offspring, neurological development was evaluated with neurosonography, audiologic development with the brainstem auditory evoked potential (BAEP), and psychomotor development with the Beyley Scale of Infant Development (BSID).

RESULTS

In the study group the positive rate of late mRNA was 50% in the chorionic villi and 67.65% in the amnionic fluid and the umbilical blood; the incidence of abnormal pregnancy outcomes (abortion, preterm delivery, stillbirth, etc.) was much higher than in the control group (40% vs. 6.57%; chi(2)=24.06; P=0.001); the abnormal rate of neurosonography results at birth and 3 months after birth was higher in the study group than in the control group (P<0.05), as were BAEP values 4 months after birth (chi(2)=8.960; P=0.003). Scores for the Infant Mental Development Index (MDI) were apparently lower than in the control group. When congenitally infected children were tested at the age of 5.5-6.5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), their rate of mental retardation was still found to be approximately 20%.

CONCLUSIONS

Intrauterine HCMV infection is closely related to abnormal pregnancy outcomes, infant neurological damage, mental retardation, and hearing loss.

[Sequencing-based typing of HLA-DPB1 and DQB1 exon 2 in patients with type 1 diabetes mellitus]

OBJECTIVE

To investigate the correlation between type 1 diabetes mellitus susceptibility and HLA-DPB1 and DQB1 genes in Shandong Han population.

METHODS

HLA-DPB1 and DQB1 genes analysis were performed by sequencing-based typing in 52 type 1 diabetes mellitus patients and 38 normal controls.

RESULTS

The frequency of DPB1*2201 in diabetics was significantly higher than that in controls(26.92% vs 5.26%, P<0.01), but the frequency of DPB1*0402 in diabetics was significantly lower than that in controls(11.54% vs 34.21%, P<0.01). The frequencies of DQB1*0201, *0303 and *0604 in diabetics were higher than those in controls (24.04% vs 10.53%, P< 0.01; 22.12% vs 6.58%, P<0.05; 19.23% vs 7.89%, P<0.05), while the frequency of DQB1*0301 in diabetics was significantly lower than that in controls (4.81% vs 25.00%, P<0.01).

CONCLUSION

DPB1*2201, DQB1*0201, *0303 and *0604 may be susceptible alleles, and DPB1*0402 and DQB1*0301 may be protective alleles in patients with type 1 diabetes mellitus.

Role of CACC-box in the regulation of ovine follicle-stimulating hormone receptor expression

Tissue-specific and stage-specific expression of follicle-stimulating hormone receptor (FSH-R) in granulosa and Sertoli cells is required for normal development of ovarian follicles and germ cells. However, little is known of the transcription factors that regulate the FSH-R gene and its promoter. Using an ovine FSH-R promoter as a model system, we have identified a second DNase I footprinting 2 (FP2) region from -46 to -67 of the strongest ovine FSH-R promoter (-200 to +163) relative to the transcription start site. Electrophoretic mobility shift assay with a 22-base pair DNA probe (-46 to -67) and nuclear extracts from Sertoli (15P1) and granulosa (JC-410) cell lines demonstrated a sequence-specific DNA-protein complex. Further Southwestern and UV cross-linking analyses detected three predominant proteins of molecular weights 87, 60, and 50 kDa present in both Sertoli and granulosa cells bound to a 32P-labeled DNA probe as a complex. Gel competition experiments with DNA probes containing known Krupple-like factor binding sites revealed that the testis-specific zinc finger protein, ZNF202-like factor, Ras-responsive element binding protein-like factor, or both, may be among the potential candidate regulators. Mutation within the CACC box of the promoter abolished Krupple-like factor binding and significantly diminished promoter activity in both gonadal cells. These data suggest that Krupple-like transcription factors may play a role in the regulation of ovine FSH-R expression.

[Identification of red kojic from different habitats with clustering analysis by near-infrared diffuse reflectance spectrometry]

OBJECTIVE

To provide a new method for identifying Red kojic.

METHODS

Being controled with the Aspergillus terreus, near-infrared diffuse reflectance spectroscopy combining with clusering analysis was used in the identification of Red Kojic made by M. purpureus fermentation from 18 different habitats.

RESULTS

We can easily distinguish the Red Kojic from different habitats and the Aspergillus terreus. The results are consistent in some degree with that of morphologic study.

CONCLUSION

This method is a new, rapid, simple and low cost assay technique being able to be used in the quality control of Red Kojic.

Glycine betaine involvement in freezing tolerance and water stress in Arabidopsis thaliana

Levels of endogenous glycine betaine in the leaves were measured in response to cold acclimation, water stress and exogenous ABA application in Arabidopsis thaliana. The endogenous glycine betaine level in the leaves increased sharply during cold acclimation treatment as plants gained freezing tolerance. When glycine betaine (10 mM) was applied exogenously to the plants as a foliar spray, the freezing tolerance increased from -3.1 to -4.5 degrees C. In addition, when ABA (1 mM) was applied exogenously, the endogenous glycine betaine level and the freezing tolerance in the leaves increased. However, the increase in the leaf glycine betaine level induced by ABA was only about half of that by the cold acclimation treatment. Furthermore, when plants were subjected to water stress (leaf water potential of approximately -1.6 MPa), the endogenous leaf glycine betaine level increased by about 18-fold over that in the control plants. Water stress lead to significant increase in the freezing tolerance, which was slightly less than that induced by the cold acclimation treatment. The results suggest that glycine betaine is involved in the induction of freezing tolerance in response to cold acclimation, ABA, and water stress in Arabidopsis plants.

Characterization of regulatory elements of ovine follicle-stimulating hormone (FSH) receptor gene: the role of E-box in the regulation of ovine FSHreceptor expression

Expression and activation of follicle-stimulating hormone receptor (FSHR) in the granulosa and Sertoli cells are required for normal development of the ovarian follicles and germ cells. However, little is known regarding the mechanisms by which FSHR expression is regulated. We fused an ovine FSHR promoter to a luciferase gene to understand the promoter regulation in two gonadal cell lines. Deletion studies revealed that the strongest promoter was at -200 to +163 relative to the transcription start site. One of cis-elements protected from DNase I digestion was mapped to between +32 and +54 of the 174-base pair (bp) minimal promoter. Electrophoretic mobility shift assay with a 26-bp probe (+32 to +57) and nuclear extracts from Sertoli (15P1) and granulosa (JC-410) cell lines demonstrated a sequence-specific DNA-protein complex. Southwestern analysis detected a 43-kDa protein bound to the 26-bp probe. Gel supershift with upstream stimulatory factor 1 and 2 (USF-1/2) antibodies revealed that the DNA-protein complex contained these two transcription factors. Mutation within the E-box of the promoter abolished the sequence-specific binding and the minimal promoter activity but also greatly reduced the transcription of the proximal promoters by 49%-70%. These data suggest that the USF-1/2 binding to the promoter is required for the expression of the ovine FSHR in the gonadal cells.

Estrogen deficiency, obesity, and skeletal abnormalities in follicle-stimulating hormone receptor knockout (FORKO) female mice

Targeted disruption of the receptor for glycoprotein hormone, FSH (FSH-R) causes a gene dose-related endocrine and gametogenic abnormality in female mice. The resulting FSH-R knockout (FORKO) mutants have disordered estrous cycles, ovulatory defects, and atrophic uterus. The heterozygous animals that initially show reduced fertility undergo early reproductive senescence and stop breeding altogether. Lack of FSH-R signaling in females causes severe ovarian underdevelopment producing chronic estrogen deficiency. This was accompanied by increases in serum testosterone levels. Ovarian aromatase gene transcription and translation are unaltered in the mutants. Early loss of estrogen in the null mutants leads to obesity and skeletal abnormalities that intensify with age producing (kyphosis), a hunchback appearance. Both these changes also become apparent in older heterozygous mice coincident with early reproductive senescence. The expression of nuclear estrogen receptor(s) alpha and beta genes and the corresponding proteins in the ovary and uterus of FORKO mice appear to be intact. The loss of ovarian estrogen creates an imbalance in A and B forms of the progesterone receptor in the uterus of both heterozygotes and null mutants. Some of the changes we have documented here in FORKO mice are reminiscent of the ovarian dysfunction and other major symptoms that are usually associated with estrogen deficiency. In null mutants, estradiol-17beta administration promptly induced uterine growth and reversed the accumulation of adipose tissue indicating that estrogen receptors are functional. Thus, the phenotypes evident in these genetically altered FSH-R mutants may provide an experimental system to explore the effects of estrogenic compounds on different targets including the ovary in a nonsurgical setting.

[Study on the stability of N-alkyl-N'-(sodium p-aminobenzenesulfonate) thiourea]

In this work, the stability of 13 kinds derivative of thiourea were studied by the UV absorption spectra and IR spectra of thiourea compounds in acidic medium at pH = 4.00, neutrality medium at pH = 7.00, basic property medium at pH = 10.00, under the influence of diffeveut store time, oxygen and sun light. Their structures were discussed and the changing rules of stability were developed.

[Clinical and experimental study on antiviral activity of reduqing against human cytomegalovirus]

OBJECTIVE

To investigate the therapeutic efficacy of traditional Chinese medicine Reduqing (RDQ) against human cytomegalovirus (HCMV) in clinical and its antiviral activity in vitro.

METHODS

In clinical practice, HCMV antibody was detected to determine if the case was activity infected with HCMV. Fourteen patients were found and treated with RDQ. The drug was orally administered one dose, three times a day, for 18-30 days as one therapeutic course. And the efficacy was evaluated by ELISA, PCR and other methods. The in vitro inhibitory activity of RDQ against HCMV AD169 was carried out on human embryo lung fibroblasts (HEL) by cytopathic effect inhibition method. Ganciclovir (GCV) was used for positive control.

RESULTS

Fourteen pre- or during pregnant women with HCMV infection were treated with RDQ. After 18-30 days of treatment, all of them showed HCMV-IgM negative conversion, HCMV DNA negative conversion in 7/10 cases, and virus excretion by urine and cervix secretion was inhibited in 4/4 and 1/1 case. Five women gave birth to 5 normal newborns at term after treatment, among them 2 were asymptomatic virus carrier, the other 3 were uninfected. Experimental study in vitro showed that the maximal tolerance dosage (TD0) of RDQ was 20 micrograms/L, the minimal therapeutic concentration (MTC) was 5 micrograms/L, 50% inhibitory concentration (IC50) was 5 micrograms/L and the therapeutic index (TI) was 4. It suggested that RDQ had anti-HCMV activity in vitro and the effect increased with its concentration.

CONCLUSION

RDQ is a safe, valuable drug for inhibiting HCMV infection especially during pregnancy.

Chlorella virus PBCV-1 encodes a functional homospermidine synthase

Sequence analysis of the 330-kb genome of chlorella virus Paramecium bursaria chlorella virus 1 (PBCV-1) revealed an open reading frame, A237R, that encodes a protein with 34% amino acid identity to homospermidine synthase from Rhodopseudomonas viridis. Expression of the a237r gene product in Escherichia coli established that the recombinant enzyme catalyzes the NAD(+)-dependent formation of homospermidine from two molecules of putrescine. The a237r gene is expressed late in PBCV-1 infection. Both uninfected and PBCV-1-infected chlorella, as well as PBCV-1 virions, contain homospermidine, along with the more common polyamines putrescine, spermidine, and cadaverine. The total number of polyamine molecules per virion ( approximately 539) is too small to significantly neutralize the virus double-stranded DNA (>660,000 nucleotides). Consequently, the biological significance of the homospermidine synthase gene is unknown. However, the gene is widespread among the chlorella viruses. To our knowledge, this is the first report of a virus encoding an enzyme involved in polyamine biosynthesis.

Membrane topology and cell surface targeting of microsomal epoxide hydrolase. Evidence for multiple topological orientations

Microsomal epoxide hydrolase (mEH) is a bifunctional membrane protein that plays a central role in the metabolism of xenobiotics and in the hepatocyte uptake of bile acids. Numerous studies have established that this protein is expressed both in the endoplasmic reticulum and at the sinusoidal plasma membrane. Preliminary evidence has suggested that mEH is expressed in the endoplasmic reticulum (ER) membrane with two distinct topological orientations. To further characterize the membrane topology and targeting of this protein, an N-glycosylation site was engineered into mEH to serve as a topological probe for the elucidation of the cellular location of mEH domains. The cDNAs for mEH and this mEH derivative (mEHg) were then expressed in vitro and in COS-7 cells. Analysis of total expressed protein in these systems indicated that mEHg was largely unglycosylated, suggesting that expression in the ER was primarily of a type I orientation (Ccyt/Nexo). However, analysis, by biotin/avidin labeling procedures, of mEHg expressed at the surface of transfected COS-7 cells, showed it to be fully glycosylated, indicating that the topological form targeted to this site originally had a type II orientation (Cexo/Ncyt) in the ER. The surface expression of mEH was also confirmed by confocal fluorescence scanning microscopy. The sensitivity of mEH topology to the charge at the N-terminal domain was demonstrated by altering the net charge over a range of 0 to +3. The introduction of one positive charge led to a significant inversion in mEH topology based on glycosylation site analysis. A truncated form of mEH lacking the N-terminal hydrophobic transmembrane domain was also detected on the extracellular surface of transfected COS-7 cells, demonstrating the existence of at least one additional transmembrane segment. These results suggest that mEH may be integrated into the membrane with multiple transmembrane domains and is inserted into the ER membrane with two topological orientations, one of which is targeted to the plasma membrane where it mediates bile acid transport.

Upstream stimulatory factors mediate estrogen receptor activation of the cathepsin D promoter

Overexpression of cathepsin D (CD), a ubiquitous lysosomal protease, is closely associated with a poor clinical outcome for patients with breast cancer. Estrogen greatly induces transcription of the CD gene in estrogen receptor (ER)-positive breast cancer cells. In this report, we transiently introduced a human CD promoter/chloramphenicol acetyltransferase reporter gene into human MCF-7 breast cancer cells to study the mechanisms by which the ER activates the promoter. Using an in vivo Exonuclease III footprinting assay, we found that estrogen stimulation of MCF-7 cells induced loading of a transcription factor(s) to a portion of the promoter (-124 to -104) that is homologous to the adenovirus major late promoter element. Subsequent gel mobility shift assays with a 21-bp CD -124/-104 probe and nuclear extracts prepared from naive and estrogen-stimulated cells detected a single sequence-specific protein-DNA complex. Southwestern and UV cross-linking experiments detected two proteins of 44 kDa and 43 kDa that were specifically bound to the 21-bp fragment of the promoter. Gel super-shift assays with upstream stimulatory factor 1 (USF-1) and USF-2 antibodies demonstrated that USF-1 and USF-2 bound to the E box probe. Sequence specific binding was abolished by a 2-bp change shown previously to prevent the binding of USF to the E box. Incorporation of a mutant E box into the wild-type CD promoter/chloramphenicol acetyltransferase gene abolished USF binding and reduced the levels of both basal and estrogen-stimulated transcription. These results suggest that the ER targeting of USF-1 and USF-2 is a critical step in hormone activation of CD gene transcription in human breast cancer cells.

[Reoperation for recurrent carcinoma of the esophagus and cardia]

OBJECTIVE

To review the experience of reoperation for recurrent carcinoma of the esophagus and cardia.

METHOD

Between 1979 and 1996, 44 patients with recurrent esophageal and cardiac cancer after the first operation underwent reoperation. Among them, 21 had esophageal cancer and 23 cardiac cancer. 36 patients were male and 8 female, with age ranged from 42 to 68 years.

RESULT

The resectability rate was 77.2% (34/44) and the hospital mortality rate was 5.8%. Postoperative complications occurred in 7 patients with a morbidity of 20.5%. Pathologically, previous anastomotic relapse was seen in 26 patients, recurrent lesion of residual esophagus in 7, and recurrent cancerous residue at the esophageal bed in 1. 15 patients (44%) showed lymph node metastasis. Follow-up showed that 4 patients survived for 5 years, 4 for 3 years, and 3 for 2 years. 15 patients died within one year after reoperation.

CONCLUSION

The recurrence of esophageal and cardiac cancer after first operation is not a contraindication to reoperation, but careful preoperative assessment and patients' selection should become an integral part of the evaluation of these patients.

CpG methylation within the 5' regulatory region of the BRCA1 gene is tumor specific and includes a putative CREB binding site

Breast cancer is a genetic disease arising from a series of germ-line and/or somatic DNA changes in a variety of genes, including BRCA1 and BRCA2. DNA modifications have been shown to occur by a number of mechanisms that include DNA methylation. In some cases, the aberrant methylation of CpGs within 5' regulatory regions has led to suppression of gene activity. In this report we describe a variation in the pattern of DNA methylation within the regulatory region of the BRCA1 gene. We found no evidence of methylation at CpGs within the BRCA1 promoter in a variety of normal human tissues. However, screening of a series of randomly sampled breast carcinomas revealed the presence of CpG methylation adjacent to the BRCA1 transcription start site. One such methylated CpG occurs at a putative CREB (cAMP-responsive element binding) transcription factor binding site in the BRCA1 promoter. Gelshift assays with methylated and unmethylated BRCA1/CREB binding site oligonucleotides demonstrate that this site is sensitive to site-specific CpG methylation. These data suggest that aberrant DNA methylation at regulatory sequences in the BRCA1 locus may play a role in the transcriptional inactivation of the BRCA1 gene within subclones of breast tumors. This study represents the first evidence suggesting a role for DNA methylation in the transcriptional inactivation of the BRCA1 in human breast cancer.

Effects of different manipulations of acupuncture on electrical activity of stomach in humans

The author observed effects of 4 different acupuncture manipulations (lifting-thrusting, twisting-twirling, uniform reinforcing-reducing, and needling with sensation propagating along channels) on electrical activity of the stomach, using amplitude and frequency of human electrogastrogram (EGG) as the indexes. The experiment proved that both the twisting-twirling and the uniform reinforcing-reducing methods inhibited electrical activity of the stomach to reduce the frequency of EGG (P < 0.05), and at the same time the uniform reinforcing-reducing method decreased the amplitude (P < 0.001); while both the lifting-thrusting method and the manipulation for needling sensation propagating along channels excited electrical activity of the stomach to raise the amplitude of EGG (P < 0.01), and the lifting-thrusting method increased the frequency (P < 0.001). Accordingly, the lifting-thrusting method or the manipulation for needling sensation propagating along channels is suitable for chronic superficial gastritis, chronic atrophic gastritis, carcinoma of stomach with lower frequency and amplitude of EGG; whereas the uniform reinforcing-reducing or twisting-twirling method is good for patients with gastric and duodenal ulcer and hyperhydrochloria with higher frequence and amplitude of EGG.

Effects of dNTPs on the SCE frequency in plant root tip cells

The effects of deoxynucleoside triphosphate (dNTPs) on the frequency of sister-chromatid exchange (SCE) have been studied in plant root tip cells. Treatment with dATP caused a dose-dependent decrease in SCE frequency, while dGTP, caused a dose-dependent increase in SCE frequency both in Hordeum vulgare and in Vicia faba root tip cells. Treatment with dCTP and dTTP significantly increased SCE frequency in H. vulgare root tip cells, but significantly decreased SCE frequency in V. faba root tip cells. The SCE induced by treatment with dGTP could be totally reversed by treatment with an equal concentration of any of the other three dNTPs (dATP, dCTP and dTTP) both in H. vulgare and in V. faba. Treatment with a mixed equal concentration of dATP, dCTP, dGTP and dTTP did not alter the SCE frequency. These results suggest that dNTP pool imbalance is an SCE-affecting factor in plant cells.

Identification of a functional imperfect estrogen-responsive element in the 5'-promoter region of the human cathepsin D gene

17beta-Estradiol (E2) induces cathepsin D gene expression in MCF-7 human breast cancer cells. Previous studies have identified an Sp1-imperfect estrogen-responsive element (ERE) half-site [GGGCGG(N)23ACGGG] (-199 to -165) in the promoter region which forms an Sp1-estrogen receptor (ER) complex and confers E2 responsiveness on the corresponding Sp1-ERE-chloramphenicol acetyl transferase (CAT) construct. Further analysis of downstream regions of the promoter identified a CGCCC(N)3TGACC sequence (-119 to -107) which is homologous to the adenovirus major late promoter element (MLPE) and binds the ER to form a retarded band in a gel electrophoretic mobility shift assay. The corresponding promoter-CAT construct is also E2-inducible. The MLPE resembles an imperfect palindromic ERE containing imperfect (5') and perfect (3') ERE half-sites; analysis of oligonucleotides with mutations in these half-sites shows that only the perfect ERE half-site is required for binding the ER, whereas both sites are required for transactivation. In vivo exonuclease III footprinting showed that treatment with E2 also enhanced binding at the MLPE site. Identification of this second functional enhancer sequence in the 5'-promoter region of cathepsin D is consistent with the increasingly complex cell-specific regulation of hormone-responsive genes.