Identification of insulin-like growth factor 2 mRNA-binding protein 3 as a radioresistance factor in squamous esophageal cancer cells

Identification of reliable markers of radiosensitivity and the key molecules that donate susceptibility to anticancer treatments to esophageal cancer cells would be highly desirable. We found that the mRNA expression of insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) was higher in radioresistant TE-5 and TE-9 cells than in radiosensitive TE-12 cloneA1 cells. Conversely, knocking down expression of IGF2BP3 mRNA in TE-5 and TE-9 cells using small interfering RNA significantly enhanced their radiosensitivity. Furthermore, patients with squamous cell esophageal cancers strongly expressing IGF2BP3 tended to respond poorly to chemoradiation. These data suggest that IGF2BP3 may be a key marker of radiosensitivity that diminishes the susceptibility of squamous cell esophageal cancer cells to radiotherapy. IGF2BP3 may, thus, be a useful target for improving radiotherapy for patients with esophageal squamous cell carcinoma.

On the zero-bias anomaly and Kondo physics in quantum point contacts near pinch-off

We investigate the linear and non-linear conductance of quantum point contacts (QPCs), in the region near pinch-off where Kondo physics has previously been connected to the appearance of the 0.7 feature. In studies of seven different QPCs, fabricated in the same high-mobility GaAs/AlGaAs heterojunction, the linear conductance is widely found to show the presence of the 0.7 feature. The differential conductance, on the other hand, does not generally exhibit the zero-bias anomaly (ZBA) that has been proposed to indicate the Kondo effect. Indeed, even in the small subset of QPCs found to exhibit such an anomaly, the linear conductance does not always follow the universal temperature-dependent scaling behavior expected for the Kondo effect. Taken collectively, our observations demonstrate that, unlike the 0.7 feature, the ZBA is not a generic feature of low-temperature QPC conduction. We furthermore conclude that the mere observation of the ZBA alone is insufficient evidence for concluding that Kondo physics is active. While we do not rule out the possibility that the Kondo effect may occur in QPCs, our results appear to indicate that its observation requires a very strict set of conditions to be satisfied. This should be contrasted with the case of the 0.7 feature, which has been apparent since the earliest experimental investigations of QPC transport.

Impact of boost irradiation on pelvic lymph node control in patients with cervical cancer

Radiation therapy (RT) for metastatic pelvic lymph nodes (PLNs) is not well established in cervical cancer. In this study the correlation between size of lymph nodes and control doses of RT was analyzed. Between January 2002 and December 2007, 245 patients with squamous cell carcinoma of the cervix treated with a combination of external beam irradiation with or without boost irradiation and high-dose rate brachytherapy were investigated. Size of lymph node was measured by computed tomography before RT and just after 50 Gy RT. Of the 245 patients, 78 had PLN metastases, and a total of 129 had enlarged PLNs diagnosed as metastases; 22 patients had PLN failure. The PLN control rate at 5 years was 79.5% for positive cases and 95.8% for negative cases. In cases with positive PLNs, 12 of 129 nodes (9.3%) developed recurrences. There was significant correlation between PLN control rate and size of PLN after 50 Gy (<10 mm: 96.7%, ≥ 10 mm: 75.7 % (P<0.001)). In addition, the recurrence in these poor-response nodes was significantly correlated with dose of RT. Nine of 16 nodes receiving ≤ 58 Gy had recurrence, but none of 21 nodes receiving > 58 Gy had recurrence (P = 0.0003). These results suggested that the response of lymph nodes after RT was a more significant predictive factor for recurrence than size of lymph node before RT, and poor-response lymph nodes might require boost irradiation at a total dose of > 58 Gy.

Role of aquaporin-5 in gallbladder carcinoma

BACKGROUND/PURPOSE

Aquaporins (AQPs) are important in controlling bile formation. However, the exact role in human gallbladder carcinogenesis has not yet been defined.

METHODS

AQP-5-expressing gallbladder carcinoma (GBC) cell lines (NOZ) were transfected with anti-AQP-5 small interfering RNA (siRNA). Growth, migration, invasion assay, and drug susceptibility tests were performed. Next, microRNA (miRNA) expression was analyzed by miRNA oligo chip (3D-Gene®). AQP-5 and AQP-5-related miRNA target gene expressions were also analyzed using tissue microarray (TMA) in 44 GBC samples.

RESULTS

Treatment with AQP-5 siRNA decreased cell proliferation, migration, and invasion. On the other hand, those cells increased IC50 of gemcitabine. By performing miRNA assays, miR-29b, -200a, and -21 were shown to be highly overexpressed in cells treated with AQP-5 siRNA NOZ. When focusing on miR-21, phosphatase and tensin homolog (PTEN) was found to be a target of miR-21. In the TMA, AQP-5/PTEN coexpression was significantly associated with the depth of invasion and MIB-1 index (p = 0.003, 0.010). Survival of patients with a high AQP-5/PTEN coexpression was longer than that of patients with a low coexpression (p = 0.003).

CONCLUSIONS

Our result suggested that miR-21 and PTEN may contribute to the role of AQP-5 in GBC. AQP-5 and PTEN cascades are favorable biomarkers of GBC.

Percutaneous transhepatic biliary drainage assisted by real-time virtual sonography: a retrospective study

Background

Real-time virtual sonography (RVS) is a diagnostic imaging support system that can synchronize with ultrasound images in conjunction with computed tomography or magnetic resonance images using magnetic navigation system. RVS has been applied in clinical practice to perform such procedures as radiofrequency ablation and biopsy; however, the application of RVS for percutaneous transhepatic biliary drainage (PTBD) is rare.

Methods

Between 2007 and 2012, RVS-assisted PTBD was performed for 30 patients (19 males and 11 females; age range, 41 to 89 years; mean age, 66.9 years) with obstructive jaundice. The targeted bile duct was determined using the RVS system before the procedure. The intervention was considered to be successful when the targeted bile duct was punctured and the drainage catheter was placed in the bile duct. Complications were evaluated according to the Society of Interventional Radiology Clinical Practice Guidelines.

Results

A total of 37 interventions were performed for 30 patients. The interventions were successful in 35 (95%) of 37 interventions. The targeted bile ducts were: B3 (n = 24), B5 (n = 7), B8 (n = 3), B6 (n = 1), and the anterior (n = 1) and posterior (n = 1) branches of the right bile duct. The mean targeted bile duct diameter was 4.9 mm (1.9 to 8.2 mm). PTBD was able to be accomplished in all patients because the non-targeted bile ducts were successfully punctured alternatively. No major complications were observed in relation to the interventional procedure.

Conclusions

RVS-assisted PTBD is a feasible and safe procedure. Accurate puncture of targeted bile ducts can be achieved using this method.

Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: a multi-country study

OBJECTIVE

To investigate the risk of adverse pregnancy outcomes and caesarean section among adolescents in low- and middle-income countries.

DESIGN

Secondary analysis using facility-based cross-sectional data from the World Health Organization (WHO) Global Survey on Maternal and Perinatal Health.

SETTING

Twenty-three countries in Africa, Latin America, and Asia.

POPULATION

Women admitted for delivery in 363 health facilities during 2-3 months between 2004 and 2008.

METHODS

We constructed multilevel logistic regression models to estimate the effect of young maternal age on risks of adverse pregnancy outcomes.

MAIN OUTCOME MEASURES

Risk of adverse pregnancy outcomes among young mothers.

RESULTS

A total of 78 646 nulliparous mothers aged ≤24 years and their singleton infants were included in the analysis. Compared with mothers aged 20-24 years, adolescents aged 16-19 years had a significantly lower risk of caesarean section (adjusted OR 0.75, 95% CI 0.71-0.79). When the analysis was restricted to caesarean section indicated for presumed cephalopelvic disproportion, the risk of caesarean section was significantly higher among mothers aged ≤15 years (aOR 1.27, 95% CI 1.07-1.49) than among those aged 20-24 years. Higher risks of low birthweight and preterm birth were found among adolescents aged 16-19 years (aOR 1.10, 95% CI 1.03-1.17; aOR 1.16, 95% CI 1.09-1.23, respectively) and ≤15 years (aOR 1.33, 95% CI 1.14-1.54; aOR 1.56, 95% CI 1.35-1.80, respectively).

CONCLUSIONS

Adolescent girls experiencing pregnancy at a very young age (i.e. <16 years) have an increased risk of adverse pregnancy outcomes.

Attributable causes of cancer in Japan in 2005--systematic assessment to estimate current burden of cancer attributable to known preventable risk factors in Japan

BACKGROUND

To contribute to evidence-based policy decision making for national cancer control, we conducted a systematic assessment to estimate the current burden of cancer attributable to known preventable risk factors in Japan in 2005.

METHODS

We first estimated the population attributable fractions (PAFs) of each cancer attributable to known risk factors from relative risks derived primarily from Japanese pooled analyses and large-scale cohort studies and the prevalence of exposure in the period around 1990. Using nationwide vital statistics records and incidence estimates, we then estimated the attributable cancer incidence and mortality in 2005.

RESULTS

In 2005, ≈ 55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest PAF (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%).

CONCLUSIONS

In Japan, tobacco smoking and infections are major causes of cancer. Further control of these factors will contribute to substantial reductions in cancer incidence and mortality in Japan.

Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report

Introduction

Conversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques.

Case presentation

We present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis.

Conclusion

A replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.

Neuromuscular transmission is not impaired in axonal Guillain--Barré syndrome

BACKGROUND

Previous studies have shown that anti-GQ1b antibodies induce massive neuromuscular blocking. If anti-GM1 and -GD1a antibodies have similar effects on the neuromuscular junction (NMJ) in human limb muscles, this may explain selective motor involvement in axonal Guillain--Barré syndrome (GBS).

METHODS

Axonal-stimulating single-fibre electromyography was performed in the extensor digitorum communis muscle of 23 patients with GBS, including 13 with the axonal form whose sera had a high titre of serum IgG anti-GM1 or -GD1a antibodies.

RESULTS

All patients with axonal or demyelinating GBS showed normal or near-normal jitter, and no blocking.

CONCLUSION

In both axonal and demyelinating GBS, neuromuscular transmission is not impaired. Our results failed to support the hypothesis that anti-GM1 or -GD1a antibody affects the NMJ. In GBS, impulse transmission is presumably impaired in the motor nerve terminal axons proximal to the NMJ.

Blood flow change quantification in cervical cancer before and during radiation therapy using perfusion CT

The purpose of this study was to quantify the changes of tumor blood flow (BF) in cervical cancer after radiation therapy by using perfusion computed tomography (CT), and to examine the difference between maximum slope (MS) and single-input one-compartment model (SOCM) methods. Fourteen consecutive patients who received definitive radiation therapy for cervical cancer from October 2009 to February 2010 were enrolled in this study. Blood flow (BF) analyses were performed using both MS and SOCM methods. Quantitative BF maps were created using Body Perfusion (Toshiba Medical Systems, Co. Tokyo, Japan). Perfusion color maps were successfully created by the two analytical methods. BF of the tumors was clearly higher than that of normal cervix, making it possible to distinguish tumor tissue from normal cervical tissue. BF of the tumors after 20 Gy of radiation therapy calculated by the MS method was significantly larger than that before treatment (126.9 vs. 72.2 ml/min/100 ml, median; p < 0.05). Although BF calculated by the MS and SOCM methods showed a positive linear correlation (p < 0.001, r = 0.981), BF calculated by the MS method was lower than that obtained by the SOCM method (103.7 vs. 115.1 ml/min/100 ml, p < 0.01). The change of tumor BF in cervical cancer before and after radiation therapy can be monitored by conducting blood flow analysis using perfusion CT. BF by the MS method was lower than that by the SOCM method, but the two analytical methods correlated well. Perfusion CT may have potential in noninvasive monitoring of vascular and oxygenation status and for guiding adaptive therapy.

Ultrasonographic detection of fasciculations markedly increases diagnostic sensitivity of ALS

OBJECTIVES

To study the utility of muscle ultrasound (US) for detection of fasciculations and its contribution to diagnosis in amyotrophic lateral sclerosis (ALS). Fasciculations are characteristic features of ALS, and US can detect them easily and reliably. New diagnostic criteria for ALS, the Awaji algorithm, reintroduced fasciculations as evidence of acute denervation equivalent to that of fibrillations and positive sharp waves.

METHODS

In 81 consecutive patients with sporadic ALS, we prospectively performed needle EMG and US in 6 muscles (tongue, biceps brachii, first dorsalis interosseous, paraspinalis, vastus lateralis, and tibialis anterior), and diagnostic category were determined by revised El Escorial criteria and Awaji criteria.

RESULTS

Fasciculations were much more frequently detected by US than by EMG in the tongue (60% vs 0%), biceps brachii (88% vs 60%), and tibialis anterior muscles (83% vs 45%). The proportion of the patients with definite or probable ALS was 48% by revised El Escorial criteria and 79% by Awaji criteria using US.

CONCLUSIONS

Muscle US is a practical and efficient tool to detect fasciculations, particularly in the tongue. A combination of US and EMG substantially increases the diagnostic sensitivity of ALS.

POEMS syndrome with Guillan-Barre syndrome-like acute onset: a case report and review of neurological progression in 30 cases

POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes) syndrome is a rare cause of demyelinating neuropathy with monoclonal plasma cell proliferation, and POEMS neuropathy is usually chronically progressive. Herein, the authors report a 34-year-old woman with POEMS syndrome presenting as acute polyneuropathy. Within 2 weeks of disease onset, she became unable to walk with electrodiagnostic features of demyelination and was initially diagnosed as having Guillan-Barré syndrome. Other systemic features (oedema and skin changes) developed later, and an elevated serum level of vascular endothelial growth factor led to the diagnosis of POEMS syndrome. She received high-dose chemotherapy with autologous peripheral blood stem cell transplantation, resulting in good recovery. The authors also reviewed patterns and speed of progression of neuropathy in the 30 patients with POEMS syndrome; 22 (73%) of them were unable to walk independently with the median period of 9.5 months from POEMS onset (range 0.5-51 months). Whereas the speed of neuropathy progression varies considerably among patients, some POEMS patients can show acute or subacute polyneuropathy. The early diagnosis and treatment could result in rapid improvement as shown in the present patient.

Concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin for stage III unresectable, non-small-cell lung cancer: clinical application of a protocol used in a previous phase II study

PURPOSE

To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC).

METHODS AND MATERIALS

Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m(2), and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy.

RESULTS

The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade ≥3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade ≥3 severity were observed in 2.6% and 1.7% of patients, respectively.

CONCLUSIONS

The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

Therapeutic strategy for the treatment of postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy of radiotherapy

We investigated the effectiveness of chemoradiotherapy for the treatment of lymph node recurrence and hematogenous metastasis after esophagectomy for esophageal squamous cell carcinoma. Between 2001 and 2006, 216 patients with thoracic esophageal squamous cell carcinoma had curative esophagectomy. Of those, 23 with lymph node recurrence received chemoradiotherapy (50.0-68.8 Gy). In addition, five patients had isolated recurrences in a distant organ and received chemoradiotherapy (50.0-60.0 Gy). We analyzed outcomes from the radiotherapy for recurrent esophageal cancer. The 1-, 2-, and 5-year survival rates after recurrence for the 23 patients whose lymph node recurrence was treated with chemoradiotherapy were 52, 31, and 24%, respectively, and the median survival time was 13 months. Among the five patients with recurrent tumors in a distant organ, chemoradiotherapy produced a complete response in two patients, a partial response in one patient, and stable disease in two patients, giving an effectiveness rate of 60% (complete response + partial response). Chemoradiotherapy has a beneficial prognostic effect in patients with lymph node recurrence of esophageal squamous cell carcinoma. Chemoradiotherapy for a metastatic tumor in a distant organ may be the treatment of choice in cases where systemic chemotherapy has proven ineffective.

New Phosphorus Oxygen Hole Center in Γ-Irradiated SiO2:P2O5 Optical Fiber

The formation of paramagnetic centers upon γ-irradiation was examined for the silica based waveguides doped with P2O5 by using ESR and optical absorption. The centers inherent in SiO2 glasses such as Si-E′ and OHC were found to be replaced with P-related centers such as phosphorus oxygen hole centers and phosphorus electron center by introducing a small amount of P2O5. New type of POHC was detected especially in the glass with [P2O5] of 1.3 mol % at 77K, which was assumed to be a precursor of the POHC stable at room temperature. The correlation between γ-induced loss-increase and the formation of these defects was examined.

Intracavitary combined with CT-guided interstitial brachytherapy for locally advanced uterine cervical cancer: introduction of the technique and a case presentation

We report a new technique of brachytherapy consisting of intracavitary combined with computed tomography (CT)-guided interstitial brachytherapy for locally advanced cervical cancer. A Fletcher-Suit applicator and trocar point needles were used for performing high-dose rate brachytherapy under in-room CT guidance. First, a tandem and ovoids were implanted into the patient's vagina and uterus by conventional brachytherapy method. Based on clinical examination and MRI/CT imaging, operating radiation oncologists decided the positions of insertion in the tumor and the depth of the needles from the upper surface of the ovoid. Insertion of the needle applicator was performed from the vaginal vault inside the ovoid within the tumor under CT guidance. In treatment planning, dwell positions and time adaptations within the tandem and ovoids were performed first for optimization based on the Manchester system, and then stepwise addition of dwell positions within the needle was continued. Finally, dwell positions and dwell weights were manually modified until dose-volume constraints were optimally matched. In our pilot case, the dose of D90 to high-risk clinical target volume was improved from 3.5 Gy to 6.1 Gy by using our hybrid method on the dose-volume histogram. D1cc of the rectum, bladder and sigmoid colon by our hybrid method was 4.8 Gy, 6.4 Gy and 3.5 Gy, respectively. This method consists of advanced image-guided brachytherapy that can be performed safely and accurately. This approach has the potential of increasing target coverage, treated volume, and total dose without increasing the dose to organs at risk.

The benefit of small bowel and pelvic bone sparing in excluding common iliac lymph node region from conventional radiation fields in patients with uterine cervical cancer: a dosimetric study

The purpose of this study was to compare dose reduction to the small bowel and sacral bone by two-field and four-field techniques when the common iliac lymph node region is excluded from the radiation field in external beam radiotherapy of uterine cervical cancer. Thirteen patients with cervical cancer were entered into the study. Conventional treatment plans based on bony landmarks were made with parallel-opposed two-field technique (C2F) and four-field box technique (C4F). Modified C2F (M2F) and C4F (M4F) plans of excluding the common iliac lymph node region from the conventional radiation fields were created in reference to the bifurcations of pelvic arteries in computed tomography images. For each patient, the dose volume histograms for the small bowel and sacral bone resulting from the C2F, C4F, M2F, and M4F plans were compared. The volumes were obtained at 10 levels of prescribed dose, at increments of 10%, from 5 Gy to 50 Gy. By sparing both small bowel and sacral bone, the M2F and M4F plans were significantly better than the C2F and C4F plans at any dose level (p < 0.05), respectively. In addition, the M4F plan was significantly better than the M2F plan in sparing both small bowel at 10-50% of the prescribed dose (p < 0.05) and sacral bone at 40-100% of the prescribed dose (p < 0.05). The present study suggests that modified treatment planning could be useful for selected patients for reducing small bowel complications and insufficiency fracture after radiotherapy.

Phagocytosis plays a dual role in activating dendritic cells; digestive production of active Toll-like receptor ligands and cooperation with Toll-like receptor signaling

Phagocytosis is an initial step in innate immunity, which is also stimulated by signals via Toll-like receptors (TLRs); however, the cooperation of phagocytosis with signals through TLRs to establish acquired immunity is unknown. We found that phagocytosis is an essential process to induce an immune reaction against an insoluble TLR ligand. Cell-wall skeleton prepared from Mycobacterium bovis BCG (BCG-CWS), an insoluble TLR2 ligand, activated and matured murine splenic dendritic cell (DC) line BC-1 as well as a soluble TLR2 ligand, Pam3CSK4. Surprisingly, BC-1 maturation with BCG-CWS was completely suppressed by inhibiting phagocytosis, while that with Pam3CSK4 was not affected. Moreover, BCGCWS induced intense delayed-type hypersensitivity (DTH) reactions against mitomycin C-inactivated Lewis lung carcinoma cells but Pam3CSK4 did not. These results suggested that the phagocytosis process enables the insoluble TLR2 ligand to activate DCs via TLR2 comparable to a soluble TLR2 ligand in vitro, and stimulating TLR2 alone is not sufficient to establish T cell-mediated immunity in vivo. It is therefore conceivable that the process of phagocytosis induces additional effects on TLR2-stimulated DCs to activate cellmediated immunity in vivo.