Prevalence and risk of fracture diagnoses in women across the adult life span: a national cross-sectional study

In a national sample of women veterans, the rate of lower limb fracture diagnosis was the highest across ages 18-74 years; rates of fracture diagnosis of other skeletal sites peaked in women aged 75+. Women with two or more primary care visits or mental healthcare visits had elevated odds of fracture diagnosis.

INTRODUCTION

We assessed the prevalence and healthcare utilization characteristics associated with a diagnosis of any fracture in women of all adult ages within the Veterans Health Administration.

METHODS

In 344,488 women during fiscal year 2012, logistic regression models for fracture diagnosis included age, race/ethnicity, residence, number of primary care visits, number of mental healthcare visits, and degree of service-connected disability.

RESULTS

Lower limb fracture diagnosis was most prevalent across ages 18-74 years and peaked in women aged 55-64 years. In women aged 75+, the prevalence rates of fracture diagnosis at the hip (102, 95 % CI = 88-115 per 10,000 women), upper limb (100, 95 % CI = 87-114 per 10,000 women), and lower limb (84, 95 % CI = 72-97 per 10,000 women) were the highest. Fractures at other skeletal sites peaked in those aged 75+ years. Black women had the lowest odds of a fracture diagnosis, followed by Asian/Pacific Islander and Hispanic women compared to non-Hispanic White (by 25-51 %, P < 0.05). Having two or more primary care visits or any mental health visit was each associated with an increased risk. Women with five or more primary care visits had a 3.36-fold (95 % CI = 3.02-3.75) greater odds than those with no such visit, and separately, women with five or more mental health visits had a 1.51-fold (95 % CI = 1.43-1.60) greater odds. Women with a fracture diagnosis had higher overall healthcare costs than those without (P < 0.001).

CONCLUSIONS

Prevalence of fracture diagnosis differed by age, race/ethnicity, and skeletal site of fracture. Fracture diagnosis may identify women veterans with greater overall healthcare needs.

Effects of dietary mixture of garlic (Allium sativum), coriander (Coriandrum sativum) and probiotics on immune responses and caecal counts in young laying hens

This study was conducted to evaluate the effects of a combined mixture of phytogenic extracts (garlic and coriander) and probiotics on growth performance and immune responses in laying hens based on the results of in vitro studies to screen for immunomodulatory potency of each ingredient. Several parameters of immunomodulatory potency were estimated using lamina propria leucocytes (LPLs) isolated from rat intestinal mucosa tissue. Results show that the combined mixture enhanced LPLs proliferation, increased LPL-mediated cytotoxicity against YAC-1 tumour cells, and decreased lipopolysaccharide (LPS)-induced cytokine production including tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in LPLs. For in vivo study, laying hens (n = 50/each diet group) were fed with control diet, a diet containing antibiotics (0.01% per kg feed) or the combined mixture (0.02% per kg feed) for 21 days. The dietary combined mixture improved egg production (p < 0.05) but not growth performance and carcass traits. Interestingly, the patterns of suppressing plasma IFN-γ productions during inflammation by LPS injection and decreasing caecal E. coli counts in the combined mixture group were comparable to those in the antibiotics group. Taken together, our results suggested that the 0.02% of combined mixture of phytogenic extracts and probiotics as ingredients has potential immunomodulatory effects in laying hens.

Effect of Intracranial Atherosclerotic Disease on Endovascular Treatment for Patients with Acute Vertebrobasilar Occlusion

BACKGROUND AND PURPOSE

Although intracranial atherosclerotic disease is often encountered during endovascular treatment for acute vertebrobasilar occlusions, its clinical implication is not well-known. We aimed to evaluate whether intracranial atherosclerotic disease influences the clinical outcomes following endovascular treatment of acute vertebrobasilar occlusive stroke.

MATERIALS AND METHODS

Fifty-one patients with acute vertebrobasilar occlusive stroke were included. The onset-to-groin puncture time was ≤12 hours, and aspiration- or stent-based thrombectomy was used as the primary treatment method. Following primary endovascular treatment, intracranial atherosclerotic disease (IAD group) was angiographically diagnosed when a fixed focal stenosis was observed at the occlusion site, whereas embolism (embolic group) was diagnosed if no stenosis was observed. Clinical and treatment variables were compared in both groups, and IAD was evaluated as a prognostic factor for clinical outcomes.

RESULTS

The baseline NIHSS score tended to be lower (14 versus 22, P = .097) in the IAD group (n = 19) than in the embolic group (n = 32). The procedural time was longer in the IAD group (96 versus 61 minutes, P = .002), despite similar rates of TICI 2b-3 (89.5% versus 87.5%, P = 1.000). The NIHSS score at 7 days was higher (21 versus 8, P = .060) and poor outcomes (mRS 4-6 at 3 months) were more frequent in the IAD group (73.7% versus 43.8%, P = .038). IAD (odds ratio, 5.469; 95% CI, 1.09-27.58; P = .040) was independently associated with poor outcomes.

CONCLUSIONS

An arterial occlusion related to IAD was associated with a longer procedural time and poorer clinical outcome. Further studies are warranted to elucidate the appropriate endovascular strategy.

Effects of age, replicative lifespan and growth rate of human nucleus pulposus cells on selecting age range for cell-based biological therapies for degenerative disc diseases

Autologous disc cell implantation, growth factors and gene therapy appear to be promising therapies for disc regeneration. Unfortunately, the replicative lifespan and growth kinetics of human nucleus pulposus (NP) cells related to host age are unclear. We investigated the potential relations among age, replicative lifespan and growth rate of NP cells, and determined the age range that is suitable for cell-based biological therapies for degenerative disc diseases. We used NP tissues classified by decade into five age groups: 30s, 40s, 50s, 60s and 70s. The mean cumulative population doubling level (PDL) and population doubling rate (PDR) of NP cells were assessed by decade. We also investigated correlations between cumulative PDL and age, and between PDR and age. The mean cumulative PDL and PDR decreased significantly in patients in their 60s. The mean cumulative PDL and PDR in the younger groups (30s, 40s and 50s) were significantly higher than those in the older groups (60s and 70s). There also were significant negative correlations between cumulative PDL and age, and between PDR and age. We found that the replicative lifespan and growth rate of human NP cells decreased with age. The replicative potential of NP cells decreased significantly in patients 60 years old and older. Young individuals less than 60 years old may be suitable candidates for NP cell-based biological therapies for treating degenerative disc diseases.

Papular angiolymphoid hyperplasia and lymphoplasmacytic plaque: a clinical and histological spectrum

Acral pseudolymphomatous angiokeratoma of children (APACHE) is a rare form of cutaneous pseudolymphoma characterized byangiomatous papules with a predilection for the acral regions of children. Classically, a dense dermal lymphocytic infiltrate composed of both T and B cells is seen in histological specimens, together with prominent vessels lined by plump endothelial cells. Increasing evidence suggests that this condition is neither necessarily acral, pseudolymphomatous, nor angiokeratomatous. It may not always be a pediatric disease. Therefore, the correctness of its nomenclature has been questioned. Herein, we report threecases whose clinical and histological features were consistent with the diagnosis of APACHE. To our knowledge, this is the first report of APACHE from Southeast Asia. We also discuss why we believe "APACHE" to be a misnomer and support "papular angiolymphoid hyperplasia" as a more accurate and encompassing term. In addition, we illustrate a case with significant overlapping features with lymphoplasmacytic plaque in children, suggesting that both entities may exist on a clinical andhistological spectrum.

Asthma and COPD overlap syndrome is associated with increased risk of hospitalisation

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is associated with poor prognosis and a high health care burden. The incidence of asthma and COPD overlap syndrome is increasing, and contributes to a high financial burden and poor prognosis.

OBJECTIVE

To investigate clinical features of the overlap syndrome among Asian patients and to analyse its impact on hospitalisation due to respiratory problems or death compared to COPD alone.

DESIGN

We performed a retrospective cohort analysis of 2933 COPD patients presenting at the Asan Medical Center from 1 January 2000 to 31 December 2009. Kaplan-Meier and Cox proportional hazard models were used to analyse the significance of clinical parameters, including age, sex, smoking history, body mass index (BMI), severity of airflow limitation, airway obstruction reversibility and overlap syndrome with hospitalisation due to respiratory problems or death.

RESULTS

Overlap syndrome patients were older, included smaller proportions of males and of smokers and had lower forced expiratory volume in 1 s (FEV1) (% predicted). Shorter hospitalisation-free and survival periods were noted among overlap syndrome patients. Overlap syndrome was significantly associated with risk of hospitalisation due to respiratory problems after adjusting for age, smoking history, BMI, FEV1 (% predicted) and changes in FEV1 (P < 0.001).

CONCLUSION

Asthma and COPD overlap syndrome is associated with a higher risk of hospitalisation due to respiratory problems than COPD alone.

Abstract P2-07-06: Periostin is associated with breast tumor progression and epithelial periostin expression is correlated with poor survival in patients with invasive breast carcinoma

Background: Invasion and metastasis are the direct causes of mortality in patients with breast cancer and require reciprocal interactions between cancer cells and the extracellular matrix (ECM). Periostin, a fasciclin-containing adhesive ECM glycoprotein, is frequently overexpressed in various types of human cancer, and its overexpression in cancer-associated stroma and/or cancer cells is usually associated with poor clinical outcomes. However, the expression of periostin in the successive steps of breast tumorigenesis and its association with outcome variables have not been well established in breast carcinoma. The purposes of the present study were to assess the role of periostin alteration in breast tumorigenesis and evaluate the putative prognostic value of periostin as a function of its compartmentalization.

Materials and Methods: Immunohistochemical staining with anti-periostin antibody was performed in a total of 300 patients (26 patients with normal breasts, 76 patients with ductal carcinoma in situ [DCIS], and 198 patients with invasive breast carcinoma [IBC]) using tissue microarray. Periostin immunoreactivity was assessed in both epithelial tissue and the surrounding stromal compartment. In addition, the mRNA and protein expression of periostin was analyzed in 10 paired normal/invasive cancer frozen specimens by quantitative real time-polymerase chain reaction and western blot analysis, respectively.

Results: Periostin mRNA and protein expression in cancer tissues was increased compared with that in adjacent normal tissues. Both epithelial and stromal periostin staining scores were significantly increased with disease progression in a stepwise manner to DCIS and IBC compared with those in normal breast tissues (P = 0.000 and 0.000, respectively). High epithelial and stromal periostin expression was observed in 109 of 189 (57.7%) and 158 of 189 (83.6%) cases of IBC, respectively. High epithelial periostin expression was more frequently observed in the distant metastatic relapse-positive group than in the distant metastatic relapse-negative group (41 [80.4%] of 51 cases versus 68 [49.3%] of 138 cases [P = 0.000]). Furthermore, high epithelial periostin expression was associated with reduced disease-free and overall survival on univariate and multivariate analyses.

Conclusion: Periostin might play an important role in the progression of breast tumor, and epithelial periostin expression may serve as a new parameter for prognostic prediction in patients with IBC. Further study of periostin expression and its potential as a target of therapy for IBC appears warranted.

Citation Format: Lee JS, Kim G-E, Park MH, Yoon JH. Periostin is associated with breast tumor progression and epithelial periostin expression is correlated with poor survival in patients with invasive breast carcinoma. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-07-06.

Failure to restore sagittal tibiotalar alignment in total ankle arthroplasty: Its relationship to the axis of the tibia and the positioning of the talar component

The purpose of this study was to evaluate the change in sagittal tibiotalar alignment after total ankle arthroplasty (TAA) for osteoarthritis and to investigate factors affecting the restoration of alignment. This retrospective study included 119 patients (120 ankles) who underwent three component TAA using the Hintegra prosthesis. A total of 63 ankles had anterior displacement of the talus before surgery (group A), 49 had alignment in the normal range (group B), and eight had posterior displacement of the talus (group C). Ankles in group A were further sub-divided into those in whom normal alignment was restored following TAA (41 ankles) and those with persistent displacement (22 ankles). Radiographic and clinical results were assessed. Pre-operatively, the alignment in group A was significantly more varus than that in group B, and the posterior slope of the tibial plafond was greater (p < 0.01 in both cases). The posterior slope of the tibial component was strongly associated with restoration of alignment: ankles in which the alignment was restored had significantly less posterior slope (p < 0.001). An anteriorly translated talus was restored to a normal position after TAA in most patients. We suggest that surgeons performing TAA using the Hintegra prosthesis should aim to insert the tibial component at close to 90° relative to the axis of the tibia, hence reducing posterior soft-tissue tension and allowing restoration of normal tibiotalar alignment following surgery.

Ultrasound-Guided Percutaneous Radiofrequency Lesioning When Treating Recalcitrant Plantar Fasciitis: Clinical Results

PURPOSE

We evaluated the effects of ultrasound (US)-guided percutaneous radiofrequency thermal lesioning (RTL) and the impact of obesity when treating patients with recalcitrant plantar fasciitis.

MATERIALS AND METHODS

30 consecutive patients were enrolled. The visual analog scale (VAS), American Orthopedic Foot-Ankle Society (AOFAS) Ankle-Hindfoot Score, and plantar fascia thickness measured using US were recorded at baseline and at follow-up 1, 3, 6, and 12 months after surgery under local anesthesia.

RESULTS

12 patients in the obese (BMI ≥ 30 kg/m(2)) group and 18 patients in the non-obese group. There were significant postoperative decreases in VAS scores and in fascial thickness, and an increase in the AOFAS scores (all p < 0.001). The obese group showed delayed pain and functional improvement within the first 3 months after the index procedure (p < 0.01). Significant pain reduction and functional improvement were apparent earlier (after 1 month, p < 0.001) in the non-obese group than in the obese group (after 3 months, p < 0.05). Fascia thickness was positively correlated with the VAS score and negatively correlated with the AOFAS score (both p < 0.001).

CONCLUSION

US should be regarded as a useful objective tool to guide RTL and to monitor the effectiveness of treatment. US-guided percutaneous RTL for recalcitrant PF is a minimally invasive treatment option that yields satisfactory results. Therefore, it should at least be considered before using more invasive procedures. Moreover, obesity leads to delayed improvement but does not affect overall outcome after 12 months. Plantar fascial thickness was correlated with VAS and AOFAS scores.

A Study of Piezoelectric Field Related Strain Difference in GaN-Based Blue Light-Emitting Diodes Grown on Silicon(111) and Sapphire Substrates

We investigate the strain difference in InGaN/GaN multiple quantum wells of blue light-emitting diode (LED) structures grown on silicon(1 11) and c-plane sapphire substrates by comparing the strength of piezo-electric fields in MQWs. The piezo-electric fields for two LED samples grown on silicon and sapphire substrates are measured by using the reverse-bias electro-reflectance (ER) spectroscopy. The flat-band voltage is obtained by measuring the applied reverse bias voltage that induces a phase inversion in the ER spectra, which is used to calculate the strength of piezo-electric fields. The piezo-electric field is determined to be 1.36 MV/cm for the LED on silicon substrate and 1.83 MV/cm for the LED on sapphire substrate. The ER measurement results indicate that the strain-induced piezo-electric field is greatly reduced in the LED grown on silicon substrates consistent with previous strain measurement results by micro-Raman spectroscopy and high-resolution transmission electron microscopy.

SATB2-associated syndrome presenting with Rett-like phenotypes

The SATB2-associated syndrome (SAS) was proposed recently, after the SATB2 gene was initially discovered to be associated with isolated cleft palate. This syndrome is characterized by intellectual disability with delayed speech development, facial dysmorphism, cleft or high-arched palate, and dentition problems. Here, we describe two novel SATB2 sequence variants in two unrelated patients presenting with Rett-like phenotypes. We performed trio-based whole-exome sequencing in a 17-month-old girl presenting with severe retardation and Rett-like phenotypes, which revealed a de novo missense variant in SATB2 (p.Glu396Gln). Moreover, targeted sequencing of the SATB2 gene was performed in a 2-year-old girl with severe psychomotor retardation, facial hypotonia, and cleft palate who also exhibited some features of Rett syndrome. A nonsense variant in SATB2 was identified in this patient (p.Arg459*). This study expanded the clinical and genetic spectrum of SAS. SATB2 variants should be considered in cases with psychomotor retardation alone or in any cases with Rett-like phenotypes, regardless of the typical features of SAS such as cleft palate.

Hybrid Percolation Transition in Cluster Merging Processes: Continuously Varying Exponents

Consider growing a network, in which every new connection is made between two disconnected nodes. At least one node is chosen randomly from a subset consisting of g fraction of the entire population in the smallest clusters. Here we show that this simple strategy for improving connection exhibits a more unusual phase transition, namely a hybrid percolation transition exhibiting the properties of both first-order and second-order phase transitions. The cluster size distribution of finite clusters at a transition point exhibits power-law behavior with a continuously varying exponent τ in the range 2<τ(g)≤2.5. This pattern reveals a necessary condition for a hybrid transition in cluster aggregation processes, which is comparable to the power-law behavior of the avalanche size distribution arising in models with link-deleting processes in interdependent networks.

Vertebral compression fractures may increase mortality in male patients with chronic obstructive pulmonary disease

BACKGROUND

Vertebral compression fracture (VCF) is frequent in chronic obstructive pulmonary disease (COPD) patients. However, little is known about whether VCF affects mortality in COPD patients.

OBJECTIVE

To investigate whether VCFs might increase death in COPD patients.

METHODS

In this retrospective cohort study, we enrolled 254 COPD patients with a recent history of hospitalisation due to respiratory problems. Patients were assessed for VCF using quantitative morphometric analyses of lateral chest radiographs; 211 patients received follow-up examinations for 2 years.

RESULTS

Of the 211 COPD patients analysed, 60 (28.4%) had VCF at enrolment. During the follow-up period, 33/60 (55.0%) patients with and 46/151 patients (30.5%) without VCF died (P = 0.003, log-rank test). Cox proportional hazard analysis revealed that VCF is an independent risk factor for death after adjusting for age, sex, body mass index, smoking, dyspnoea scale, forced expiratory volume in 1 sec (FEV1) and comorbidities (hazard ratio for VCF = 1.79, 95%CI 1.11-2.89, P = 0.02).

CONCLUSION

VCF might be an independent risk factor for death in male COPD patients.

Clinical Applications of Simultaneous PET/MR Imaging Using (R)-[11C]-Verapamil with Cyclosporin A: Preliminary Results on a Surrogate Marker of Drug-Resistant Epilepsy

BACKGROUND AND PURPOSE

The development of resistance to antiepileptic drugs is explained well by the transporter hypothesis, which suggests that drug resistance is caused by inadequate penetration of drugs into the brain barrier as a result of increased levels of efflux transporter such as p-glycoprotein. To evaluate the brain expression of p-glycoprotein in patients with drug-resistant epilepsy, including neocortical epilepsy, we developed a noninvsive quantitative analysis including asymmetry indices based on (R)-[(11)C]-verapamil PET/MR imaging with cyclosporin A, a p-glycoprotein inhibitor.

MATERIALS AND METHODS

Six patients with drug-resistant epilepsy, 5 patients with drug-sensitive epilepsy, and 8 healthy controls underwent dynamic (R)-[(11)C]-verapamil PET/MR imaging with an intravenous infusion of cyclosporin A. Asymmetry indices [(Right Region - Left Region)/(Right Region + Left Region) × 200%] of the standard uptake values in each of the paired lobes were calculated.

RESULTS

All patients with drug-resistant epilepsy had significantly different asymmetry from the healthy controls, whereas all patients with drug-sensitive epilepsy had asymmetry similar to that in healthy controls. In the temporal lobe, the asymmetry indices of patients with left temporal lobe drug-resistant epilepsy were more positive than those of healthy controls (healthy controls: 4.0413 ± 1.7452; patients: 7.2184 ± 1.8237; P = .048), and those of patients with right temporal drug-resistant epilepsy were more negative (patients: -1.6496 ± 3.4136; P = .044). In addition, specific regions that had significant asymmetry were different between the lateral and medial temporal lobe epilepsy groups. In the frontal lobe, the asymmetry index of patients with right frontal lobe drug-resistant epilepsy was more negative than that in healthy controls.

CONCLUSIONS

We confirmed that statistical parametric mapping analysis by using asymmetry indices of (R)-[(11)C]-verapamil PET/MR imaging with cyclosporin A could be used as a surrogate marker for drug-resistant epilepsy, and this approach might be helpful for localizing or lateralizing the epileptic zone.

Tevatron Combination of Single-Top-Quark Cross Sections and Determination of the Magnitude of the Cabibbo-Kobayashi-Maskawa Matrix Element V_{tb}

We present the final combination of CDF and D0 measurements of cross sections for single-top-quark production in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV. The data correspond to total integrated luminosities of up to 9.7 fb^{-1} per experiment. The t-channel cross section is measured to be σ_{t}=2.25_{-0.31}^{+0.29} pb. We also present the combinations of the two-dimensional measurements of the s- vs t-channel cross section. In addition, we give the combination of the s+t channel cross section measurement resulting in σ_{s+t}=3.30_{-0.40}^{+0.52} pb, without assuming the standard model value for the ratio σ_{s}/σ_{t}. The resulting value of the magnitude of the top-to-bottom quark coupling is |V_{tb}|=1.02_{-0.05}^{+0.06}, corresponding to |V_{tb}|>0.92 at the 95% C.L.

Sum-rule constraints on the surface state conductance of topological insulators

We report the Drude oscillator strength D and the magnitude of the bulk band gap E_{g} of the epitaxially grown, topological insulator (Bi,Sb)_{2}Te_{3}. The magnitude of E_{g}, in conjunction with the model independent f-sum rule, allows us to establish an upper bound for the magnitude of D expected in a typical Dirac-like system composed of linear bands. The experimentally observed D is found to be at or below this theoretical upper bound, demonstrating the effectiveness of alloying in eliminating bulk charge carriers. Moreover, direct comparison of the measured D to magnetoresistance measurements of the same sample supports assignment of the observed low-energy conduction to topological surface states.

Effects of Supplementing Brown Seaweed By-products in the Diet of Holstein Cows during Transition on Ruminal Fermentation, Growth Performance and Endocrine Responses

This study was conducted to examine the effects of supplementing brown seaweed by-products (BSB) in the diet of ruminants on ruminal fermentation characteristics, growth performance, endocrine response, and milk production in Holstein cows. In Experiment 1, the effects of different levels (0%, 2%, and 4% of basal diet as Control, 2% BSB, 4% BSB, respectively) of BSB were evaluated at 3, 6, 9, 12, and 24 h in vitro batch culture rumen fermentation. The pH tended to be higher for the higher level of BSB supplementation, with the pH at 12 h being significantly higher (p<0.05) than that of the control. The concentration of ammonia nitrogen was lower at 3, 9, 12, and 24 h incubation (p<0.05) compared with the control, and tended to be low at other incubation times. Volatile fatty acid concentration appeared to be minimally changed while lower values were observed with 4% BSB treatment at 24 h (p<0.05). In Experiment 2, effects of levels (0%, 2%, and 4%) of BSB on growth performance, endocrine responses and milk production were studied with Holstein dairy cows during transition. Dry matter intake, daily gain and feed efficiency were not affected by BSB supplementation. The concentration of plasma estrogen for the control, 2% BSB and 4% BSB after three months of pregnancy were 55.7, 94.1, and 72.3 pg/mL, respectively (p = 0.08). Although the differences of progesterone levels between BSB treatments and the control were minimal, the concentration in 4% BSB treatment increased to 157.7% compared with the initial level of the study. Triiodothyronine and thyroxine levels were also higher after both three months and eight months of pregnancy than the initial level at the beginning of the study. In addition, BSB treatments during one month after delivery did not affect daily milk yield and composition. In conclusion, the present results indicate that supplementation of BSB did not compromise ruminal fermentation, and animal performance at lower levels and hence may have potential to be used as a safe feed ingredient in dairy cows.

Search for Resonances Decaying to Top and Bottom Quarks with the CDF Experiment

We report on a search for charged massive resonances decaying to top (t) and bottom (b) quarks in the full data set of proton-antiproton collisions at a center-of-mass energy of √[s]=1.96  TeV collected by the CDF II detector at the Tevatron, corresponding to an integrated luminosity of 9.5  fb(-1). No significant excess above the standard model background prediction is observed. We set 95% Bayesian credibility mass-dependent upper limits on the heavy charged-particle production cross section times branching ratio to tb. Using a standard model extension with a W'→tb and left-right-symmetric couplings as a benchmark model, we constrain the W' mass and couplings in the 300-900  GeV/c(2) range. The limits presented here are the most stringent for a charged resonance with mass in the range 300-600  GeV/c(2) decaying to top and bottom quarks.

Ashkin-Teller model and diverse opinion phase transitions on multiplex networks

Multiplex networks (MNs) have become a platform of recent research in network sciences because networks in many real-world systems interact and function together. One of the main scientific issues in MNs is how the interdependence changes the emerging patterns or phase transitions. Until now, studies of such an issue have concentrated on cluster-breakdown phenomena, aiming to understand the resilience of the system under random failures of edges. These studies have revealed that various phase transition (PT) types emerge in MNs. However, such studies are rather limited to percolation-related problems, i.e., the limit q→1 of the q-state Potts model. Thus, a systematic study of opinion formation in social networks with the effect of interdependence between different social communities, which may be seen as the study of the emerging pattern of the Ising model on MNs, is needed. Here we study a well-known spin model called the Ashkin-Teller (AT) model in scale-free networks. The AT model can be regarded as a model for interacting systems between two species of Ising spins placed on respective layers in double-layer networks. Our study shows that, depending on the interlayer coupling strength and a network topology, unconventional PT patterns can also emerge in interaction-based phenomena: continuous, discontinuous, successive, and mixed-order PTs and a continuous PT not satisfying the scaling relation. The origins of such rich PT patterns are elucidated in the framework of Landau-Ginzburg theory.

The reliability and accuracy of measuring anteversion of the acetabular component on plain anteroposterior and lateral radiographs after total hip arthroplasty

There is no single standardised method of measuring the orientation of the acetabular component on plain radiographs after total hip arthroplasty. We assessed the reliability and accuracy of three methods of assessing anteversion of the acetabular component for 551 THAs using the PolyWare software and the methods of Liaw et al, and of Woo and Morrey. All measurements of the three methods had excellent intra- and inter-observer reliability. The values of the PolyWare software, which determines version of the acetabular component by edge detection were regarded as the reference standard. Although the PolyWare software and the method of Liaw et al were similarly precise, the method of Woo and Morrey was significantly less accurate (p < 0.001). The method of Liaw et al seemed to be more accurate than that of Woo and Morrey when compared with the measurements using the PolyWare software. If the qualified lateral radiograph was selected, anteversion measured using the method of Woo and Morrey was considered to be relatively reliable.

Comparison of Strain in GaN-Based Blue Light-Emitting Diode Grown on Silicon(111) and Sapphire Substrates

We compare the strain states and device performances of GaN-based blue light-emitting diodes (LEDs) grown on Si(111) and sapphire substrates. The strain characteristics are investigated using micro-Raman spectroscopy and high-resolution transmission electron microscopy. These analyses reveal that GaN layer grown on Si has a residual tensile strain in contrast to a compressive strain for GaN on sapphire, and quantum wells (QWs) on GaN/Si experience reduced lattice mismatch than those of GaN/sapphire. When external quantum efficiencies of LED on sapphire and Si substrates are compared, the LED on Si shows better efficiency droop characteristics and this is attributed to a decrease in piezo-electric field strength in InGaN/GaN layers owing to reduced lattice mismatch.

Tevatron constraints on models of the Higgs boson with exotic spin and parity using decays to bottom-antibottom quark pairs

Combined constraints from the CDF and D0 Collaborations on models of the Higgs boson with exotic spin J and parity P are presented and compared with results obtained assuming the standard model value JP=0+. Both collaborations analyzed approximately 10  fb(-) of proton-antiproton collisions with a center-of-mass energy of 1.96 TeV collected at the Fermilab Tevatron. Two models predicting exotic Higgs bosons with JP=0- and JP=2+ are tested. The kinematic properties of exotic Higgs boson production in association with a vector boson differ from those predicted for the standard model Higgs boson. Upper limits at the 95% credibility level on the production rates of the exotic Higgs bosons, expressed as fractions of the standard model Higgs boson production rate, are set at 0.36 for both the JP=0- hypothesis and the JP=2+ hypothesis. If the production rate times the branching ratio to a bottom-antibottom pair is the same as that predicted for the standard model Higgs boson, then the exotic bosons are excluded with significances of 5.0 standard deviations and 4.9 standard deviations for the JP=0- and JP=2+ hypotheses, respectively.

Disseminated intravascular coagulation in Korean hemorrhagic fever

To investigate the nature and role of coagulation and complement alterations in the pathogenesis of Korean hemorrhagic fever (KHF), the profiles from the early stages in 27 male patients were serially evaluated. Evidence of disseminated intravascular coagulation (DIC) was observed in 14 of the 27 patients (51.8%) sometime during the course of the disease. The earlier the coagulation tests were performed, the more frequently the evidence of DIC was found. The mean serum C3 concentration was significantly decreased during the early stages, while serum C4 concentrations revealed no significant variation. A significant decrease of the serum C3 concentration, however, was found only in the group with DIC. Korean hemorrhagic fever (KHF) is an acute, systemic disease characterized by fever, hemorrhagic manifestations, and renal failure. This disease has been known to occur from the Pacific Ocean to the Baltic Sea under various synonyms and toponyms including epidemic hemorrhagic fever, hemorrhagic nephrosonephritis and hemorrhagic fever with renal syndrome. Recent investigations demonstrated the identity of these conditions described from Korea, the Soviet Union, Japan, and China. Nephropathia epidemica of Scandinavia was also revealed to have a close serological relation to this disease, but with antigenic differences. The etiologic agent was identified in 1978 by Lee et al., who isolated a viral antigen from a field mouse, Apodemus agrarius coreae, which is the natural reservoir of this disease in Korea. The KHF or Hantaan virus has been propagated in cell cultures and observed electronmicroscopically. In thin sections, the virus was detected within the cytoplasmic granular matrices (viroplasms) of the infected cells. Virus particles were spherical and had an extremely electron-dense core. Negative-contrast staining showed that the virus had an icosahedral structure and annular surface capsomeres. The morphology and morphogenesis of the virus were similar to those of the orbiviruses. The characteristic pathologic findings observed in fatal cases of KHF are congestion and hemorrhage of the renal medulla, hemorrhage in the right atrial wall of the heart, and hemorrhage and necrosis in the anterior lobe of the pituitary gland. The microscopic characteristics of these lesions consist of hemorrhage, coagulation necrosis, and mononuclear cell infiltration. The clinical course of typical KHF may be divided into five phases, each designated for a characteristic physiologic aberration; febrile, hypotensive, oliguric, diuretic, and convalescent.(ABSTRACT TRUNCATED AT 400 WORDS)

Constraints on models of the Higgs boson with exotic spin and parity using decays to bottom-antibottom quarks in the full CDF data set

A search for particles with the same mass and couplings as those of the standard model Higgs boson but different spin and parity quantum numbers is presented. We test two specific alternative Higgs boson hypotheses: a pseudoscalar Higgs boson with spin-parity J^{P}=0^{-} and a gravitonlike Higgs boson with J^{P}=2^{+}, assuming for both a mass of 125  GeV/c^{2}. We search for these exotic states produced in association with a vector boson and decaying into a bottom-antibottom quark pair. The vector boson is reconstructed through its decay into an electron or muon pair, or an electron or muon and a neutrino, or it is inferred from an imbalance in total transverse momentum. We use expected kinematic differences between events containing exotic Higgs bosons and those containing standard model Higgs bosons. The data were collected by the CDF experiment at the Tevatron proton-antiproton collider, operating at a center-of-mass energy of sqrt[s]=1.96  TeV, and correspond to an integrated luminosity of 9.45  fb^{-1}. We exclude deviations from the predictions of the standard model with a Higgs boson of mass 125  GeV/c^{2} at the level of 5 standard deviations, assuming signal strengths for exotic boson production equal to the prediction for the standard model Higgs boson, and set upper limits of approximately 30% relative to the standard model rate on the possible rate of production of each exotic state.

Sublingual injection of microparticles containing glycolipid ligands for NKT cells and subunit vaccines induces antibody responses in oral cavity

Natural Killer T (NKT) cells are a unique type of innate immune cells which exert paradoxical roles in animal models through producing either Th1 or Th2 cytokines and activating dendritic cells. Alpha-galactosylceramide (αGalCer), a synthetic antigen for NKT cells, was found to be safe and immune stimulatory in cancer and hepatitis patients. We recently developed microparticle-formulated αGalCer, which is selectively presented by dendritic cells and macrophages, but not B cells, and thus can avoid the anergy of NKT cells. In this study, we have examined the immunogenicity of microparticles containing αGalCer and protein vaccine components through sublingual injection in mice. The results showed that sublingual injection of microparticles containing αGalCer and ovalbumin triggered IgG responses in serum (titer >1:100,000), which persisted for more than 3months. Microparticles containing ovalbumin alone also induced comparable level of IgG responses. However, immunoglobulin subclass analysis showed that sublingually injected microparticles containing αGalCer and ovalbumin induced 20 fold higher Th1 biased antibody (IgG2c) than microparticles containing OVA alone (1:20,000 as compared to 1:1000 titer). Sublingual injection of microparticles containing αGalCer and ovalbumin induced secretion of both IgG (titer >1:1000) and IgA (titer=1:80) in saliva secretion, while microparticles containing ovalbumin alone only induced secretion of IgG in saliva. Our results suggest that sublingual injection of microparticles and their subsequent trafficking to draining lymph nodes may induce adaptive immune responses in mucosal compartments. Ongoing studies are focused on the mechanism of antigen presentation and lymphocyte biology in the oral cavity, as well as the toxicity and efficacy of these candidate microparticles for future applications.

Post-infectious bronchiolitis obliterans in children: CT features that predict responsiveness to pulse methylprednisolone

OBJECTIVE

Intravenous pulse methylprednisolone therapy (IPMT) is an important treatment option for post-infectious obliterative bronchiolitis (OB), although it must be used carefully and only in selected patients because of its drawbacks. This study evaluated whether CT and clinical features of children with post-infectious OB can predict their responsiveness to IPMT.

METHODS

We searched the medical records for patients (less than 18 years of age) who were diagnosed with post-infectious OB between January 2000 and December 2011. 17 children who received IPMT were included in this study. All underwent chest CT before and after IPMT. The radiological features seen on pre-treatment CT were recorded. The air-trapping area percentages on pre- and post-treatment CT images were determined. The nine patients who exhibited decreased air trapping on post-treatment CT scans relative to pre-treatment scans were classed as responders. The patient ages and time from initial pneumonia to IPMT were recorded.

RESULTS

All responders and only four non-responders had thickened bronchial walls before treatment (p = 0.029). The two groups did not differ significantly in terms of bronchiolitis, bronchiectasis or the extent of air trapping, although the responders had a significantly shorter median interval between initial pneumonia and IPMT (4 vs 50 months; p = 0.005) and were significantly younger (median, 2.0 vs 7.5 years; p = 0.048).

CONCLUSION

Immediate IPMT may improve the degree of air trapping in children with post-infectious OB if they show a thickened bronchial wall on CT.

ADVANCES IN KNOWLEDGE

Children with post-infectious OB may respond favourably to IPMT when pre-treatment CT indicates bronchial-wall thickening.

Systematic review with meta-analysis: prompt endoscopy as the initial management strategy for uninvestigated dyspepsia in Asia

BACKGROUND

Prompt endoscopy should be considered as an initial strategy for uninvestigated dyspepsia in the background of high prevalence of Helicobacter pylori infection and malignancy. However, with changes of disease patterns and dyspepsia definition, the prevalence of organic lesions at endoscopy in dyspepsia patients and the predictive values of alarm features and age for in malignancy remain unclear in Asian population.

AIMS

To evaluate the appropriateness of prompt endoscopy as an initial dyspepsia management strategy, we investigated the organic lesion detection rates in Asian dyspepsia patients as well as the diagnostic accuracies of alarm features and age thresholds for malignancy.

METHODS

Literature was retrieved from MEDLINE, PubMed, Embase, Cochrane Library and CINAHL Plus. The prevalence rates of organic lesions and young cancer patients among dyspeptic patients and the sensitivities, specificities, likelihood ratios and diagnostic odds ratio (DOR) of alarm features and ages were estimated. The summary receiver operating characteristic curve was constructed and the area under the curve (AUC) calculated. Subgroup, sensitivity and meta-regression analyses were performed.

RESULTS

Of the 18 included studies, 15 reported organic lesion detection rates, and six and five analysed the predictive values of alarm features and ages respectively. The overall malignancy detection rate was 1.3% (95% CI: 0.80-2.10). Among cancer patients, 17.8% (95% CI: 10.90-29.00) were younger than 45 years and 3.0% (95% CI: 2.50-3.50) were younger than 35 years. The diagnostic accuracy of alarm features for predicting malignancy was moderate (DOR: 4.87, 95% CI: 2.72-8.71; AUC = 0.74). The diagnostic accuracy at age >35 years (DOR: 9.41, 95% CI: 7.89-11.21; AUC = 0.82) was better than that at age >45 years (DOR: 3.50, 95% CI: 2.32-5.27; AUC = 0.70).

CONCLUSIONS

The malignancy detection rate and proportion of young cancer patients were high among Asian dyspepsia patients. Alarm features and age were of limited value for predicting malignancy, and prompt endoscopy should be considered as the initial strategy for dyspepsia in Asian populations. The optimal age threshold for endoscopy screening in Asia might be 35 years.

PCDHB14- and GABRB1-like nervous system developmental genes are altered during early neuronal differentiation of NCCIT cells treated with ethanol

Ethanol (EtOH) exposure during embryonic development causes dysfunction of the central nervous system (CNS). Here, we examined the effects of chronic EtOH on gene expression during early stages of neuronal differentiation. Human embryonic carcinoma (NCCIT) cells were differentiated into neuronal precursors/lineages in the presence or absence of EtOH and folic acid. Gene expression profiling and pathway analysis demonstrated that EtOH deregulates many genes and pathways that are involved in early brain development. EtOH exposure downregulated several important genes, such as PCDHB14, GABRB1, CTNND2, NAV3, RALDH1, and OPN5, which are involved in CNS development, synapse assembly, synaptic transmission, and neurotransmitter receptor activity. GeneGo pathway analysis revealed that the deregulated genes mapped to disease pathways that were relevant to fetal alcohol spectrum disorders (FASD, such as neurotic disorders, epilepsy, and alcohol-related disorders). In conclusion, these findings suggest that the impairment of the neurological system or suboptimal synapse formation resulting from EtOH exposure could underlie the neurodevelopmental disorders in individuals with FASD.

Measurement of the single top quark production cross section and |Vtb| in events with one charged lepton, large missing transverse energy, and jets at CDF

We report a measurement of single top quark production in proton-antiproton collisions at a center-of-mass energy of sqrt[s]=1.96  TeV using a data set corresponding to 7.5  fb(-1) of integrated luminosity collected by the Collider Detector at Fermilab. We select events consistent with the single top quark decay process t→Wb→ℓνb by requiring the presence of an electron or muon, a large imbalance of transverse momentum indicating the presence of a neutrino, and two or three jets including at least one originating from a bottom quark. An artificial neural network is used to discriminate the signal from backgrounds. We measure a single top quark production cross section of 3.04(-0.53)(+0.57)  pb and set a lower limit on the magnitude of the coupling between the top quark and bottom quark |Vtb|>0.78 at the 95% credibility level.

Measurements of direct CP-violating asymmetries in charmless decays of bottom baryons

We report final measurements of direct CP-violating asymmetries in charmless decays of neutral bottom hadrons to pairs of charged hadrons with the upgraded Collider Detector at the Fermilab Tevatron. Using the complete √s=1.96  TeV proton-antiproton collisions data set, corresponding to 9.3  fb⁻¹ of integrated luminosity, we measure A(Λ(b)⁰→pπ⁻)=+0.06±0.07(stat)±0.03(syst) and A(Λ(b)⁰→pK⁻)=-0.10±0.08(stat)±0.04(syst), compatible with no asymmetry. In addition we measure the CP-violating asymmetries in B(s)⁰→K⁻π⁺ and B⁰→K⁺π⁻ decays to be A(B(s)⁰→K⁻π⁺)=+0.22±0.07(stat)±0.02(syst) and A(B⁰→K⁺π⁻)=-0.083±0.013(stat)±0.004(syst), respectively, which are significantly different from zero and consistent with current world averages.

Forced arterial suction thrombectomy with the penumbra reperfusion catheter in acute basilar artery occlusion: a retrospective comparison study in 2 Korean university hospitals

BACKGROUND AND PURPOSE

A performance of forced arterial suction thrombectomy was not reported for the treatment of acute basilar artery occlusion. This study compared revascularization performance between intra-arterial fibrinolytic treatment and forced arterial suction thrombectomy with a Penumbra reperfusion catheter in patients with acute basilar artery occlusion.

MATERIALS AND METHODS

Fifty-seven patients with acute basilar artery occlusion were treated with intra-arterial fibrinolysis (n = 25) or forced arterial suction thrombectomy (n = 32). Baseline characteristics, successful revascularization rate, and clinical outcomes were compared between the groups.

RESULTS

Baseline characteristics, the frequency of patients receiving intravenous recombinant tissue plasminogen activator, and mean time interval between symptom onset and femoral puncture did not differ between groups. The forced arterial suction thrombectomy group had a shorter procedure duration (75.5 minutes versus 113.3 minutes, P = .016) and higher successful revascularization rate (88% versus 60%, P = .017) than the fibrinolysis group. Fair outcome, indicated by a modified Rankin Scale 0-3, at 3 months was achieved in 34% of patients undergoing forced arterial suction thrombectomy and 8% of patients undergoing fibrinolysis (P = .019), and the mortality rate was significantly higher in the fibrinolysis group (25% versus 68%, P = .001). Multiple logistic regression analysis identified the forced arterial suction thrombectomy method as an independent predictor of fair outcome with adjustment for age, sex, initial NIHSS score, and the use of intravenous recombinant tissue plasminogen activator (odds ratio, 7.768; 95% CI, 1.246-48.416; P = .028).

CONCLUSIONS

In acute basilar artery occlusion, forced arterial suction thrombectomy demonstrated a higher revascularization rate and improved clinical outcome compared with traditional intra-arterial fibrinolysis. Further clinical trials with the newer Penumbra catheter are warranted.

Ground-state energy of the q-state Potts model: The minimum modularity

A wide range of interacting systems can be described by complex networks. A common feature of such networks is that they consist of several communities or modules, the degree of which may quantified as the modularity. However, even a random uncorrelated network, which has no obvious modular structure, has a finite modularity due to the quenched disorder. For this reason, the modularity of a given network is meaningful only when it is compared with that of a randomized network with the same degree distribution. In this context, it is important to calculate the modularity of a random uncorrelated network with an arbitrary degree distribution. The modularity of a random network has been calculated [Reichardt and Bornholdt, Phys. Rev. E 76, 015102 (2007)PLEEE81539-375510.1103/PhysRevE.76.015102]; however, this was limited to the case whereby the network was assumed to have only two communities, and it is evident that the modularity should be calculated in general with q(≥2) communities. Here we calculate the modularity for q communities by evaluating the ground-state energy of the q-state Potts Hamiltonian, based on replica symmetric solutions assuming that the mean degree is large. We found that the modularity is proportional to 〈sqrt[k]〉/〈k〉 regardless of q and that only the coefficient depends on q. In particular, when the degree distribution follows a power law, the modularity is proportional to 〈k〉^{-1/2}. Our analytical results are confirmed by comparison with numerical simulations. Therefore, our results can be used as reference values for real-world networks.

Extraction of optical constants using multiple reflections in the terahertz emitter-sample hybrid structure

To extract optical constants of nontransmitted samples in the terahertz (THz) spectral region, we employ a THz emitter-sample hybrid structure where THz pulses are generated at the emitter surface and multiply reflected at the interface between the THz emitter and the sample. Since each THz electric field profile appears well separated in a time domain, we could obtain the amplitude and phase spectra for each pulse from the Fourier transform, and determine the optical constants of the sample numerically based on the Fresnel equations. We applied this technique for doped semiconductors, and found that obtained optical constants are in good agreement with the values determined by using other conventional THz techniques.

Search for bosonic superweakly interacting massive dark matter particles with the XMASS-I detector

Bosonic superweakly interacting massive particles (super-WIMPs) are a candidate for warm dark matter. With the absorption of such a boson by a xenon atom, these dark matter candidates would deposit an energy equivalent to their rest mass in the detector. This is the first direct detection experiment exploring the vector super-WIMPs in the mass range between 40 and 120 keV. With the use of 165.9 day of data, no significant excess above background was observed in the fiducial mass of 41 kg. The present limit for the vector super-WIMPs excludes the possibility that such particles constitute all of dark matter. The absence of a signal also provides the most stringent direct constraint on the coupling constant of pseudoscalar super-WIMPs to electrons. The unprecedented sensitivity was achieved exploiting the low background at a level 10(-4)  kg-1 keVee-1 day-1 in the detector.

Measurement of the inclusive leptonic asymmetry in top-quark pairs that decay to two charged leptons at CDF

We measure the inclusive forward-backward asymmetry of the charged-lepton pseudorapidities from top-quark pairs produced in proton-antiproton collisions and decaying to final states that contain two charged leptons (electrons or muons). The data are collected with the Collider Detector at Fermilab and correspond to an integrated luminosity of 9.1 fb(-1). We measure the leptonic forward-backward asymmetry, A(FB)(ℓ), to be 0.072 ± 0.060 and the leptonic pair forward-backward asymmetry, A(FB)(ℓℓ), to be 0.076 ± 0.082. The measured values can be compared with the standard model predictions of A(FB)(ℓ) = 0.038 ± 0.003 and A(FB)(ℓℓ) = 0.048 ± 0.004, respectively. Additionally, we combine the A(FB)(ℓ) result with a previous determination from a final state with a single lepton and hadronic jets and obtain A(FB)(ℓ) = 0.090(-0.026)(+0.028).

Evidence for s-channel single-top-quark production in events with one charged lepton and two jets at CDF

We report evidence for s-channel single-top-quark production in proton-antiproton collisions at center-of-mass energy sqrt[s] = 1.96 TeV using a data set that corresponds to an integrated luminosity of 9.4 fb(-1) collected by the Collider Detector at Fermilab. We select events consistent with the s-channel process including two jets and one leptonically decaying W boson. The observed significance is 3.8 standard deviations with respect to the background-only prediction. Assuming a top-quark mass of 172.5 GeV/c(2), we measure the s-channel cross section to be 1.41(-0.42)(+0.44) pb.

Search for s-channel single-top-quark production in events with missing energy plus jets in pp collisions at sqrt[s] = 1.96 TeV

The first search for single-top-quark production from the exchange of an s-channel virtual W boson using events with an imbalance in the total transverse energy, b-tagged jets, and no identified leptons is presented. Assuming the electroweak production of top quarks of mass 172.5 GeV/c(2) in the s channel, a cross section of 1.12(-0.57)(+0.61) (stat+syst) pb with a significance of 1.9 standard deviations is measured. This measurement is combined with the result obtained from events with an imbalance in total transverse momentum, b-tagged jets, and exactly one identified lepton, yielding a cross section of 1.36(-0.32)(+0.37) (stat+syst) pb, with a significance of 4.2 standard deviations.

Observation of s-channel production of single top quarks at the Tevatron

We report the first observation of single-top-quark production in the s channel through the combination of the CDF and D0 measurements of the cross section in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV. The data correspond to total integrated luminosities of up to 9.7 fb(-1) per experiment. The measured cross section is σ(s) = 1.29(-0.24)(+0.26) pb. The probability of observing a statistical fluctuation of the background to a cross section of the observed size or larger is 1.8 × 10(-10), corresponding to a significance of 6.3 standard deviations for the presence of an s-channel contribution to the production of single-top quarks.

Measurement of B(t→Wb)/B(t→Wq) in top-quark-pair decays using dilepton events and the full CDF Run II data set

We present a measurement of the ratio of the top-quark branching fractions R=B(t→Wb)/B(t→Wq), where q represents any quark flavor, in events with two charged leptons, imbalance in total transverse energy, and at least two jets. The measurement uses proton-antiproton collision data at center-of-mass energy 1.96 TeV, corresponding to an integrated luminosity of 8.7  fb^{-1} collected with the Collider Detector at Fermilab during Run II of the Tevatron. We measure R to be 0.87±0.07, and extract the magnitude of the top-bottom quark coupling to be |V_{tb}|=0.93±0.04, assuming three generations of quarks. Under these assumptions, a lower limit of |V_{tb}|>0.85(0.87) at 95% (90%) credibility level is set.

Staging accuracy of endoscopic ultrasound performed by nonexpert endosonographers in patients with resectable esophageal squamous cell carcinoma: is it possible?

The accuracy of endoscopic ultrasound (EUS) is operator-dependent. According to learning curve study, the accuracy of EUS T-staging for esophageal cancer has been reported to be greater in an investigator who had performed at least 100 EUS examinations. We determined comparative study regarding T-staging accuracy of EUS for esophageal squamous cell carcinoma between expert and nonexpert endoscopic ultrasonographers. We retrospectively identified 73 consecutive patients with esophageal squamous cell carcinoma who underwent EUS and endoscopic mucosal resection, endoscopic submucosal dissection, or surgery. EUS was performed by expert (Group 1) and nonexpert (Group 2) endoscopic ultrasonographers in multitertiary hospitals. Groups 1 and 2 were 37 and 36 patients during 2005-2011, respectively. Forty-two patients (57.5%) of the overall patients underwent surgical exploration. Correct endoscopic ultrasonographic T-staging of Group 1 was observed in 34 (91.9%) patients, while that of Group 2 was observed in 26 (72.2%) patients. And there was significant difference in correct endoscopic ultrasonographic T-staging between Group 1 and Group 2 (P = 0.035). The incorrect endoscopic ultrasonographic T-staging of Group 1 were three cases that were overstaging (8.1%), but in Group 2 there were seven overstaging (19.4%) and three understaging (8.3%). There was no significant difference in overstaging or understaging of incorrect endoscopic ultrasonographic T-staging between Group 1 and Group 2 (P = 0.528). This study first provides evidence that endoscopic ultrasonographic T-staging of nonexpert endoscopic ultrasonographers was inferior to be correct, compared with that of expert endoscopic ultrasonographers. EUS staging for esophageal cancer should be performed by expert endoscopic ultrasonographers to provide appropriate management strategy.

Rare bone diseases and their dental, oral, and craniofacial manifestations

Hereditary diseases affecting the skeleton are heterogeneous in etiology and severity. Though many of these conditions are individually rare, the total number of people affected is great. These disorders often include dental-oral-craniofacial (DOC) manifestations, but the combination of the rarity and lack of in-depth reporting often limit our understanding and ability to diagnose and treat affected individuals. In this review, we focus on dental, oral, and craniofacial manifestations of rare bone diseases. Discussed are defects in 4 key physiologic processes in bone/tooth formation that serve as models for the understanding of other diseases in the skeleton and DOC complex: progenitor cell differentiation (fibrous dysplasia), extracellular matrix production (osteogenesis imperfecta), mineralization (familial tumoral calcinosis/hyperostosis hyperphosphatemia syndrome, hypophosphatemic rickets, and hypophosphatasia), and bone resorption (Gorham-Stout disease). For each condition, we highlight causative mutations (when known), etiopathology in the skeleton and DOC complex, and treatments. By understanding how these 4 foci are subverted to cause disease, we aim to improve the identification of genetic, molecular, and/or biologic causes, diagnoses, and treatment of these and other rare bone conditions that may share underlying mechanisms of disease.

High-resolution impedance manometry facilitates assessment of pharyngeal residue and oropharyngeal dysphagic mechanisms

The utility of high-resolution impedance manometry (HRIM) for evaluating oropharyngeal dysphagia (OPD) has been investigated. These approaches are limited because of the sophisticated methodology. A method of transforming HRIM into a simple and useful diagnostic tool for evaluating OPD is needed. A videofluoroscopic swallowing study (VFSS) and HRIM were performed by independent blinded examiners in 26 consecutive healthy volunteers (12 men; median age, 56.5 years) and 10 OPD patients (five men; median age, 59.5 years). Upper esophageal sphincter (UES) relaxation parameters were measured using a standard HRIM protocol. Peristalsis and bolus transit of the pharyngoesophageal (PE) segment were assessed using an HRIM-modified protocol in which the catheter was pulled back 10 cm. PE bolus transits were evaluated with an impedance contour pattern (linear vs. stasis) method. A significant difference was observed between the manometric measures of healthy volunteers and OPD patients for only the duration of pharyngeal contraction (0.49 ± 0.19 vs. 0.76 ± 0.33 s, P = 0.04). The percentage agreement and kappa value for detecting pharyngeal residue between the VFSS and the impedance analysis were 100% and 1.00, respectively. HRIM allowed for comprehensive assessment of abnormal pharyngeal components that caused pharyngeal residue on VFSS in two patients; reduced base of the tongue versus weak pharyngeal contraction in one, and reduced relaxation of the UES versus reduced laryngeal elevation in the remaining patient. Our findings demonstrated that HRIM using a simple methodology (i.e., pull-back of the catheter) detected pharyngeal residue through a simple analysis of the impedance contour pattern (linear vs. stasis). Furthermore, HRIM facilitated a comprehensive assessment of OPD mechanisms and recognition of subtle abnormalities not yet visible to the naked eye on VFSS.

First search for exotic Z Boson decays into photons and neutral pions in hadron collisions

A search for forbidden and exotic Z boson decays in the diphoton mass spectrum is presented for the first time in hadron collisions, based on data corresponding to 10.0 fb(-1) of integrated luminosity from proton-antiproton collisions at √s = 1.96 TeV collected by the CDF experiment. No evidence of signal is observed, and 95% credibility level Bayesian upper limits are set on the branching ratios of decays of the Z boson to a photon and neutral pion (which is detected as a photon), a pair of photons, and a pair of neutral pions. The observed branching ratio limits are 2.01 × 10(-5) for Z → π(0)γ, 1.46 × 10(-5) for Z → γγ, and 1.52 × 10(-5) for Z → π(0)π(0). The Z → π(0)γ and Z → γγ limits improve the most stringent results from other experiments by factors of 2.6 and 3.6, respectively. The Z → π(0)π(0) branching ratio limit is the first experimental result on this decay.

Clinical characteristics predicting early clinical failure after 72 h of antibiotic treatment in women with community-onset acute pyelonephritis: a prospective multicentre study

In patients with community-onset acute pyelonephritis (CO-APN), assessing the risk factors for poor clinical response after 72 h of antibiotic treatment (early clinical failure) is important. The objectives of this study were to define those risk factors, and to assess whether early clinical failure influences mortality and treatment outcomes. We prospectively collected the clinical and microbiological data of women with CO-APN in South Korea from March 2010 to February 2012. The numbers of cases in the early clinical success and early clinical failure groups were 840 (79.1%) and 222 (20.9%), respectively. Final clinical failure and mortality were higher in the early clinical failure group than in the early clinical success group (14.9% vs 2.3%, p <0.001; 6.8% vs 0.1%, p 0.001, respectively). In a multiple logistic regression model, the risk factors for early clinical failure among the total 1062 patients were diabetes mellitus (OR 1.5; 95% CI 1.1-2.1), chronic liver diseases (OR 3.3; 95% CI 1.6-6.7), malignancy (OR 2.2; 95% CI 1.1-4.4), Pitt score ≥2 (OR 2.5; 95% CI 1.6-3.8), presence of azotaemia (OR 1.8; 95% CI 1.2-2.7), white blood cell count ≥20 000/mm(3) (OR 2.5; 95% CI 1.6-4.0), serum C-reactive protein level ≥20 mg/dL (OR 1.7; 95% CI 1.2-2.4), and history of antibiotic usage within the previous year (OR 1.5; 95% CI 1.1-2.2). Analysing the subgroup of 743 patients with CO-APN due to Enterobacteriaceae, fluoroquinolone resistance of the uropathogen was another factor associated with early clinical failure (OR 1.7; 95% CI 1.1-2.5). Simple variables of underlying diseases, previous antibiotic usage and initial laboratory test outcomes can be used to decide on the direction of treatment in CO-APN.

INCB018424 induces apoptotic cell death through the suppression of pJAK1 in human colon cancer cells

Janus kinase (JAK) is one of the main upstream activators of signal transducers and activators of transcription (STAT) that are constitutively activated in various malignancies and are associated with cell growth, survival, and carcinogenesis. Here, we investigated the role of JAKs in colorectal cancer in order to develop effective therapeutic targets for INCB018424, which is the first JAK1/2 inhibitor to be approved by FDA. After examining the basal expression levels of phospho-JAK1 and phospho-JAK2, we measured the effects of INCB018424 on the phosphorylation of JAK1/2 using western blot analysis. Cell viability was determined using the trypan blue exclusion assay. The cell death mechanism was identified by the activation of caspase 3 using western blot and annexin V staining. The basal levels of phospho-JAK1 and phospho-JAK2 were cancer cell type dependent. Colorectal cancer cell lines that phosphorylate both JAK1 and JAK2 include DLD-1 and RKO. INCB018424 inactivates both JAK1 and JAK2 in DLD-1 cells but inactivates only JAK1 in RKO cells. Cell death was proportional to the inactivation of JAK1 but not JAK2. INCB018424 causes caspase-dependent cell death, which is prevented by treatment with z-VAD. The inhibition of JAK1 phosphorylation seemed sufficient to allow INCB018424-mediated apoptosis. JAK1 is a key molecule that is involved in colon cancer cell survival and the inhibition of JAK1 by INCB01424 results in caspase-dependent apoptosis in colorectal cancer cells. The use of selective JAK1 inhibitors could be an attractive therapy against colorectal cancer, but further clinical investigations are needed to test this possibility.

Abstract P1-08-35: Androgen receptor expression and changes in serum dehydroepiandrosterone sulfate levels in locally advanced breast cancer patients who received neoadjuvant chemotherapy

Purpose: The associations between androgen receptor (AR) expression, serum dehydroepiandrosterone-sulfate (DHEA-S) level and response to neoadjuvant chemotherapy (NCT) were investigated in locally advanced breast cancer patients who received NCT.

Methods: Between May 2008 and April 2013, a total of 346 patients underwent NCT mainly based on anthracycline with or without taxane regimens. Biomarkers including AR were immunohistochemically determined using biopsy specimens before NCT and tumors with ≥ 1% nuclear staining were considered positive for AR. Changes in serum DHEA-S levels before and after NCT were examined by chemiluminescent immunoassay (Access DHEA-S, Beckman Coulter, Inc., Brea, CA) in 205 (59.2%) patients. Pathologic complete response (pCR) was defined as the absence of residual invasive carcinomas in the surgical specimens of breast and lymph nodes. Breast cancer subtypes were categorized by immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67.

Results: Mean age at diagnosis was 49.7 years (range, 26–76). Clinical tumor size was ≥ 2cm in 243 (70.2%) patients and 318 (91.9%) showed node-positive disease at initial presentation. AR-positive tumor was determined in 195 (56.4%) patients and 95 (27.5%) achieved pCR after NCT. AR-negative tumors were significantly associated with grade III, ER-negative, PR-negative, HER2-negative, high Ki-67 index, and triple-negative subtype tumors. By univariate logistic regression analysis, AR-negative tumor showed significantly higher odds ratio of 1.650 (95% CI, 1.026–2.654; p-value, 0.039) for achievement of pCR. Nevertheless, not AR status but breast cancer subtype, longer duration of NCT and use of targeted agents remained to be significant for pCR by multivariate model. In the analysis of subgroup by breast cancer subtypes, AR-negative tumor was associated with pCR in 75 patients with the low proliferative luminal A subtype, while AR-positive tumor achieved higher pCR in 59 patients with the HER2-positive luminal B subtype. In 205 patients available for serum DHEA-S levels, there was no difference in DHEA-S between pCR and non-pCR groups, although a trend of decrease in DHEA-S after NCT was noted among postmenopausal AR-positive or luminal A subtype women who achieved pCR.

Conclusions: AR expression might predict pCR in locally advanced breast cancer patients who undergo NCT, but this implication could be different according to breast cancer subtypes. Clinical significance of changes in serum DHEA-S levels during NCT remains to be elucidated.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-35.