Abstract 1083A: An ex vivo 3D bone metastasis model for prostate cancer

Introduction: Bone is the preferred site for prostate cancer (PCa) metastases and there is virtually no cure once the tumor is established within this niche. The development of therapeutic strategies against metastatic PCa has been limited by the lack of an all-human preclinical model to: (1) study PCa-bone interactions under physiologically relevant three dimensional (3D) microenvironments, (2) understand how these interactions result in the development of drug resistance, and (3) explore paradigm-changing precision medicine concepts.

Methods: Conditionally reprogrammed primary PCa cells (CR-PCa, derived from a lymph node metastatic site) were integrated with our ex vivo human 3D bone tissue platform, as a transformative approach for modeling tumor behavior at the bone niche. The 3D bone tissue was engineered using primary osteoblastic (OSB) cells from human bone samples. These cells were biomimetically assembly with biphasic calcium phosphate microbeads (BCPm) in perfusion microfluidic culture devices. BCPm were used to replicate the 3D cellular network of OSTs in human bone. This 3D tissue model was successfully used to support the osteocytic differentiation of primary human OSB cells within the BCPm structure, while maintaining a single cell layer of osteoblasts on the surface of the 3D tissue resembling the bone endosteum.

Results: Integration of the 3D bone tissue with CR-PCa cells resulted in a compromised endosteal layer after only 4 days of coculture, with more apoptotic OSTs in the tissues with CR-PCa vs. no PCa cells controls (P<0.01). For functional analysis, we stained 5 μm sections of the 3D tissues for alkaline phosphatase (ALP, an OSB marker) and sclerostin, an osteocytic marker and major signaling molecule released by embedded OSTs that suppresses osteoblastogenesis. Quantification of immunofluorescence staining revealed that ALP was significantly increased (P<0.05), whereas sclerostin significantly decreased (P<0.01) with the introduction of CR-PCa cells. This OSB phenotype, induced by PCa-bone interactions ex vivo, is entirely consistent with the OSB prostate cancer-bone metastasis niche seen in patients with advanced disease.

Conclusions: Our model recapitulates: (1) an OSB monolayer closely resembling the endosteum at the bone/ bone marrow interface, (2) the complex microphysiological features and functions of 3D-networked OSTs, and (3) the interactions of primary PCa cells with osteoblasts and OSTs.

Citation Format: Jenny Zilberberg, Saba Choudhary, Eugenia Dziopa, Cirian Mannion, Yair Kissin, Erika Parasido, Christopher Albanese, Woo Lee. An ex vivo 3D bone metastasis model for prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1083A.

Influence of Glass Microsphere Filler on the Rheological Behavior of an Epoxy Resin

The rheological behavior of epoxy resin filled with glass hollow microspheres was studied using three types of microspheres with different particle size distributions. The shear-rate dependence on viscosity, as well as relative apparent viscosity, of the suspensions was investigated at different microsphere filler loadings. The change in relative viscosity with different types of microsphere loads was also investigated using the established semi empirical model to estimate the critical filler load. It was found that the critical filler load for all suspensions tested depends mostly on the filler size distribution, neither on the average filler size nor on the specific surface area of the filler.

Influence of human parathyroid hormone during orthodontic tooth movement and relapse in the osteoporotic rat model: A preliminary study

OBJECTIVE

To investigate the effects of parathyroid hormone (PTH) on tooth movement in ovariectomized (OVX) rats by comparing the tooth movement distance and relapse and by examining the alveolar bone microstructure.

MATERIALS AND METHODS

Thirty 8-week-old female rats were classified into 3 groups: sham-operated, OVX and ovariectomized rats injected with PTH (PTH). Eight weeks later, a closed-coil spring appliance was placed between the maxillary incisor and the first molar and then activated with 50 cN of force. During tooth movement, 30 μg/kg of PTH was administered 3 times per week in the PTH group. Tooth movement distances were measured weekly. Five rats in each group were killed after 3 weeks for microcomputerized tomographic analysis, and the remaining 5 rats in each group were killed at an additional 3 weeks after the removal of the appliance to measure relapsed distance.

RESULTS

The OVX group showed significantly greater tooth movement compared to those in the other 2 groups at 2 and 3 weeks (P < .05). The relapse distance and relapse percentage for the OVX group were higher; however, it did not differ significantly from the PTH group. On micro-CT analysis, bone volume/tissue volume ratio and bone mineral density in the PTH group were significantly greater than in the OVX group (P < .05).

CONCLUSIONS

Application of PTH did not promote tooth movement in OVX rat, however, did lead to decrease in relapse tendency. Therefore, the application of PTH during orthodontic treatment of patients with osteoporosis should be carefully considered.

Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs: consensus report

Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound in Medicine assembled a multi-Society Task Force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency-assessment tools were developed based on existing national and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were generated, the pass score was established at or close to 75% for each, and obtaining a set of five ultrasound images with pass score in each was deemed necessary for attaining each competency. Given the current lack of substantial data on competency assessment in ultrasound training, the Task Force expects that the criteria set forth in this document will evolve with time. The Task Force also encourages use of ultrasound simulation in residency training and expects that simulation will play a significant part in the curriculum and the competency-assessment process. Incorporating this training curriculum and the competency-assessment tools may promote consistency in training and competency assessment, thus enhancing the performance and diagnostic accuracy of ultrasound examination in obstetrics and gynecology. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Direct Probing of Polarization Charge at Nanoscale Level

Ferroelectric materials possess spontaneous polarization that can be used for multiple applications. Owing to a long-term development of reducing the sizes of devices, the preparation of ferroelectric materials and devices is entering the nanometer-scale regime. Accordingly, to evaluate the ferroelectricity, there is a need to investigate the polarization charge at the nanoscale. Nonetheless, it is generally accepted that the detection of polarization charges using a conventional conductive atomic force microscopy (CAFM) without a top electrode is not feasible because the nanometer-scale radius of an atomic force microscopy (AFM) tip yields a very low signal-to-noise ratio. However, the detection is unrelated to the radius of an AFM tip and, in fact, a matter of the switched area. In this work, the direct probing of the polarization charge at the nanoscale is demonstrated using the positive-up-negative-down method based on the conventional CAFM approach without additional corrections or circuits to reduce the parasitic capacitance. The polarization charge densities of 73.7 and 119.0 µC cm^-2 are successfully probed in ferroelectric nanocapacitors and thin films, respectively. The obtained results show the feasibility of the evaluation of polarization charge at the nanoscale and provide a new guideline for evaluating the ferroelectricity at the nanoscale.

Graphene-vertically aligned carbon nanotube hybrid on PDMS as stretchable electrodes

Stretchable electrodes are a critical component for flexible electronics such as displays, energy devices, and wearable sensors. Carbon nanotubes (CNTs) and graphene have been considered for flexible electrode applications, due to their mechanical strength, high carrier mobility, and excellent thermal conductivity. Vertically aligned carbon nanotubes (VACNTs) provide the possibility to serve as interconnects to graphene sheets as stretchable electrodes that could maintain high electrical conductivity under large tensile strain. In this work, a graphene oxide (GO)-VACNT hybrid on a PDMS substrate was demonstrated. Here, 50 μm long VACNTs were grown on a Si/SiO₂ wafer substrate via atmospheric pressure chemical vapor deposition. VACNTs were directly transferred by delamination from the Si/SiO₂ to a semi-cured PDMS substrate, ensuring strong adhesion between VACNTs and PDMS upon full curing of the PDMS. GO ink was then printed on the surface of the VACNT carpet and thermally reduced to reduced graphene oxide (rGO). The sheet resistance of the rGO-VACNT hybrid was measured under uniaxial tensile strains up to 300% applied to the substrate. Under applied strain, the rGO-VACNT hybrid maintained a sheet resistant of 386 ± 55 Ω/sq. Cyclic stretching of the rGO-VACNT hybrid was performed with up to 50 cycles at 100% maximum tensile strain, showing no increase in sheet resistance. These results demonstrate promising performance of the rGO-VACNT hybrid for flexible electronics applications.

Genomic Alterations and Outcomes with VEGF-Targeted Therapy in Patients with Clear Cell Renal Cell Carcinoma

Background: Mutations in VHL, PBRM1, SETD2, BAP1, and KDM5C are common in clear cell renal cell carcinoma (ccRCC), and presence of certain mutations has been associated with outcomes in patients with non-metastatic disease. Limited information is available regarding the correlation between genomic alterations and outcomes in patients with metastatic disease, including response to VEGF-targeted therapy.

Objective: To explore correlations between mutational profiles and cancer-specific outcomes, including response to standard VEGF-targeted agents, in patients with metastatic cc RCC.

Methods: A retrospective review of 105 patients with metastatic ccRCC who had received systemic therapy and had targeted next-generation sequencing of tumors was conducted. Genomic alterations were correlated to outcomes, including overall survival and time to treatment failure to VEGF-targeted therapy.

Results: The most frequent mutations were detected in VHL (83%), PBRM1 (51%), SETD2 (35%), BAP1 (24%), KDM5C (16%), and TERT (14%). Time to treatment failure with VEGF-targeted therapy differed significantly by PBRM1 mutation status (p = 0.01, median 12.0 months for MT versus 6.9 months for WT) and BAP1 mutation status (p = 0.01, median 6.4 months for MT versus 11.0 months for WT). Shorter overall survival was associated with TERT mutations (p = 0.03, median 29.6 months for MT versus 52.6 months for WT) or BAP1 mutations (p = 0.02, median 28.7 months for MT versus not reached for WT).

Conclusions: Genomic alterations in ccRCC tumors have prognostic implications in patients with metastatic disease. BAP1 and TERT promoter mutations may be present in higher frequency than previously thought, and based on this data, deserve further study for their association with poor prognosis.

Adherence and persistence of mirabegron and anticholinergic therapies in patients with overactive bladder: a real-world claims data analysis

BACKGROUND

Adherence and persistence rates of anticholinergic (ACH) therapies have been well described. To date, few studies describe these metrics for mirabegron in patients with overactive bladder.

METHODS

This retrospective analysis of MarketScan^® database assessed adherence and persistence of patients receiving either mirabegron or ACH. Study eligibility required an index date (first prescription filled) between July 2012 and June 2013 with 12 months of continuous enrolment preindex date and 12 months of follow-up. Adherence was defined as a proportion of days covered of ≥ 80% among patients with at least 2 fills of index medication. Persistence measures included treatment failure described as either treatment discontinuation (medication supply gap ≥ 30 days) or switching to a different medication. A medication supply gap of ≥ 45 days was used as a sensitivity analysis.

RESULTS

The mean age of mirabegron users (n = 4037) was 67 years and 43% were ACH naïve while the mean age of ACH users was 62 years (n = 67,943). Over the 12-month follow-up period, 44% of patients treated with mirabegron and 31% of patients treated with ACH were adherent to their indexed medications. Treatment failure was 81% for mirabegron and 88% for ACH. Most mirabegron treatment failures were because of treatment discontinuation (67%) versus switching to ACH therapy (14%). The ACH discontinuation rate was 84% and treatment switching rate was 4%. The mean (standard deviation) time to treatment failure was 143 (130) days for mirabegron and 69 (69) days for ACH. Adherence and persistence patterns were similar in the sensitivity analysis using a ≥ 45-day supply gap threshold.

CONCLUSIONS

This real-world study demonstrated low adherence and persistence to mirabegron similar to ACH therapies.

Role of Piezo Channels in Joint Health and Injury

Cartilage is an intrinsically mechanically sensitive tissue composed of chondrocytes as the only cell type. Chondrocyte mechanotransduction is not well understood, but recently we identified critical components of the mechanotransduction machinery demonstrating how mechanical stimulation of these cells can be converted into cellular calcium signals. Physiologic mechanical cues induce anabolic responses of (post-mitotic) chondrocytes via transient receptor potential vanilloid 4 ion channels, whereas injurious mechanical stress is transduced by Piezo1 jointly with Piezo2 ion channels. This chapter sheds light on the latter discovery and provides a rationale for follow-up questions, such as the nature of interaction between Piezo1 and Piezo2, and their tethering to the cytoskeleton. These recent insights can be leveraged toward translational medical progress to benefit diagnosis and treatment of osteoarthritis, representing a large and growing unmet medical need in the United States and large parts of the world.

Nanosculpting of complex oxides by massive ionic transfer

Scanning probe microscopy (SPM)-based approaches have been extensively studied as methods to control the structure and properties of materials on the nanoscale. In many cases, the SPM probe is physically utilized to control structure and properties. In addition to physical modulation, it has been reported that voltage can be effectively used to modulate electrochemical phenomena on the sample surface. These studies suggest that electrochemical modulation of the structure and properties is possible by applying a voltage. Herein, in order to demonstrate voltage induced modulation of surface structure, we explored surface nanosculpting by creating electrochemically induced pits on the surface of TiO₂ thin films through the application of voltage using the atomic force microscope tip. Using a unipolar negative voltage sweep, pits were successfully generated. Further, the electric potential distribution was simulated to unravel the relationship between the pit volume and the magnitude of the applied voltage. Finally, surface protrusion induced by positive voltage sweep was also observed to elucidate the complete process of electrochemically induced surface modulation. These results can offer fundamental information for understanding how surface structure can be modulated by electrochemical phenomena.

Compact ECEI system with in-vessel reflective optics for WEST

An electron cyclotron emission imaging (ECEI) diagnostic system for WEST (W Environment for Steady state Tokamak) is under development to study the MHD instabilities affected by tungsten impurities. The system will provide 2-D T_e fluctuation images (width × height = ∼18 cm × ∼ 34 cm at low field side and ∼13 cm × ∼ 39 cm at high field side) from a poloidal cross section with high spatial (≤1.7 cm) and temporal (≤2 μs) resolutions. While the key concept and electronic structure are similar to that of prior ECEI systems on other tokamak devices such as KSTAR, DIII-D, or ASDEX-U, part of the imaging optics have to be placed inside the vacuum vessel in order to resolve issues on limited installation space and longer beam path to the detector position. The in-vessel optics consisting of two large curvature-radius mirrors are expected to withstand the extreme heating on long-pulse operation scenario (∼1000 s). The out-vessel optical housing is constructed as compact as possible to remove easily from the installation site in case of necessity. Commissioning of the system is scheduled on the second experimental WEST campaign end of 2017.

Ion gyroscale fluctuation measurement with microwave imaging reflectometer on KSTAR

Ion gyroscale turbulent fluctuations with the poloidal wavenumber k_θ ∼ 3 cm^-1 have been measured in the core region of the neutral beam (NB) injected low confinement (L-mode) plasmas on Korea superconducting tokamak advanced research. The turbulence poloidal wavenumbers are deduced from the frequencies and poloidal rotation velocities in the laboratory frame, measured by the multichannel microwave imaging reflectometer. Linear and nonlinear gyrokinetic simulations also predict the unstable modes with the normalized wavenumber k_θρ_s ∼ 0.4, consistent with the measurement. Comparison of the measured frequencies with the intrinsic mode frequencies from the linear simulations indicates that the measured ones are primarily due to the E × B flow velocity in the NB-injected fast rotating plasmas.

New compact and efficient local oscillator optic system for the KSTAR electron cyclotron emission imaging system

Electron cyclotron emission imaging (ECEI) diagnostic on Korean Superconducting Tokamak Advanced Research utilizes quasi-optical heterodyne-detection method to measure 2D (vertical and radial) T_e fluctuations from two toroidally separated poloidal cross section of the plasma. A cylindrical lens local oscillator (LO) optics with optical path length (OPL) 2-2.5 m has been used in the current ECEI system to couple the LO source to the 24 vertically aligned array of ECE detectors. For efficient and compact LO optics employing the Powell lens is proposed so that the OPL of the LO source is significantly reduced from ∼2.0 m to 0.4 m with new optics. The coupling efficiency of the LO source is expected to be improved especially at the edge channels. Results from the optical simulation together with the laboratory test of the prototype optics will be discussed in this paper.

Penetrating foreign body in the masticator space with injury to the internal maxillary artery: a surgical challenge

INTRODUCTION Foreign bodies (FBs) in the masticator space (MS) are a unique problem because of the difficulty of accessing this deep compartment within the head and neck. In addition, MS contents include critical structures such as the internal maxillary artery (IMA) and mandibular nerve. CASE HISTORY A 39-year-old tradesman was involved in a construction accident whereby a metallic projectile from a machinery drill penetrated his left cheek. Computed tomography revealed a metallic object of dimension 1.9 ×1.2 cm within the MS, with concomitant fracture of left maxillary anterior and lateral walls. Surgery was indicated in view of constant pain and swelling. The FB was removed through the cheek laceration with the aid of an X-ray image intensifier. Persistent significant bleeding was observed within the wound cavity after FB removal that could not be arrested despite attempts at haemostasis with adrenaline packing and oxidised cellulose polymers. Urgent selective left external carotid angiography showed breach of a distal branch of the left internal maxillary artery with contrast extravasation. Embolisation of this branch was undertaken successfully with a liquid agent. CONCLUSIONS This is the first time a FB within the MS with injury to the internal maxillary artery has been described.