Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

BACKGROUND AND PURPOSE

Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard.

MATERIALS AND METHODS

This study included 16 patients in whom crossed cerebellar diaschisis was shown on SPECT and 10 control subjects in whom crossed cerebellar diaschisis was not shown on SPECT. During the qualitative analysis, asymmetric cerebellar perfusion on arterial spin-labeling was divided into 1 of the following 3 grades by 2 blinded observers: the affected cerebellum was isointense compared with the unaffected cerebellum (grade I), it was slightly hypointense (grade II), or it was markedly hypointense (grade III). In the quantitative analysis, asymmetry indices were calculated by using SPECT and arterial spin-labeling images. For statistical analysis, κ statistics, the interobserver correlation coefficient, the independent t test, Pearson correlation, and linear regression analysis were used.

RESULTS

Almost all the diagnoses of crossed cerebellar diaschisis on SPECT were noted on arterial spin-labeling in both qualitative and quantitative analyses with good interobserver agreement (κ = 0.961; interobserver correlation coefficient, 0.806). The mean asymmetry index of arterial spin-labeling (26.06 ± 9.00) was significantly larger than that for SPECT (15.28 ± 5.34; P < .001). There was a significant positive correlation between the asymmetry indices obtained for SPECT and those for arterial spin-labeling (r = 0.77 [95% CI, 0.443-0.916]; P < .001). The relationship of asymmetry indices between SPECT and arterial spin-labeling (x, y) was calculated as y = 6.2131 + 1.2986x (R(2) = 0.592; P < .001).

CONCLUSIONS

Arterial spin-labeling can be a noninvasive alternative to SPECT for evaluating crossed cerebellar diaschisis.

Clinical significance of multidetector coronary computed tomography angiography to evaluate the prevalence and severity of coronary artery disease in asymptomatic kidney transplantation recipients

BACKGROUND

Coronary artery disease (CAD) is one of the leading causes of mortality in kidney transplantation (KT) recipients. Noninvasive coronary angiography with the use of multidetector computerized tomography (MDCT) is feasible with high sensitivity and negative predictive value to evaluate CAD. However, few studies have been conducted to elucidate the applicability of MDCT in KT. This study was designed to evaluate the prevalence and severity of CAD with the use of MDCT angiography in asymptomatic KT recipients.

METHODS

From September 2011 to November 2013, MDCT angiography was performed on 90 renal transplant recipients who had no pre-transplantation CAD history and stabilized post-transplantation renal function for 6-18 months. According to the MDCT results, we divided our study population into 2 groups: The no-CAD group (n = 36; 40.0%) and the CAD group (n = 54; 60.0%). Severity of CAD was categorized as follows: mild CAD, 1 vessel obstructive, 2 vessels obstructive (or in the proximal left anterior descending), and 3 vessels obstructive (or left main).

RESULTS

Among the risk factors, pre-transplantation diabetes mellitus and lower levels of high-density lipoprotein, higher parathyroid hormone levels, higher coronary artery calcification scores, and rejection episodes were independent factors for CAD. Thirty-two (59.3%) of the CAD group had mild obstructive lesions and 22 (40.7%) had obstructive lesions in >1 vessel according to MDCT angiography.

CONCLUSIONS

MDCT angiography is a useful and noninvasive method for detecting CAD even in asymptomatic KT recipients.

First Report of Choanephora Rot Caused by Choanephora cucurbitarum on Hosta plantaginea in Korea

Hosta plantaginea (Lam.) Asch. is an herbaceous perennial plant with ornamental value. In August 2013, water-soaked spots and wet rot were found on flowers of H. plantaginea in a garden bedded out for landscaping in Hongcheon County, Korea. Symptoms initially appeared as water-soaked spots at the tips of flowers. Dark gray spots on flower petals often coalesced and led to rotting of flowers, with abundant sporulation. However, no symptoms were found on the leaves. Approximately 30% of the flowers were affected in the landscape bed. A fungal isolate was obtained by plating surface-disinfested diseased flower tissue on potato dextrose agar (PDA). Fungal colonies covering the plate (diam. 90 mm) in 48 h were white at first, with abundant aerial mycelia, but later turned pale yellow with abundant sporangiola. Sporangiophores bearing sporangiola were aseptate, hyaline, and usually arose from infected tissue. Sporangiola were ellipsoid to ovoid, indehiscent, brown to dark brown, pediculate, 7 to 12 μm wide and 9 to 20 μm high, and showed longitudinal striations at high magnification. Sporangia were few-spored to multispored, pale brown to brown, and 50 to 150 μm. Sporangiospores from sporangia were broadly ellipsoid, brown to pale brown, with hyaline polar appendages, 8 to 10 μm wide and 15 to 22 μm high. Zygospores were not observed. The morphological and cultural characteristics, especially based on shape and striation of sporangiola, were identical with those of Choanephora cucurbitarum (Berk. & Ravenel) Thaxt. (2,3). A representative specimen was deposited in the Korea University Herbarium (KUS-F27540). Genomic DNA was extracted using a DNeasy Plant Mini Kit (Qiagen Inc., Valencia, CA). The primers ITS1/ITS4 and NL1/LR3 were used to amplify the internal transcribed spacer (ITS) region of rDNA and the D1/D2 region of the large subunit (LSU), respectively (4). The PCR products were purified and directly sequenced. The resulting 594-bp ITS and 680-bp D1/D2 sequences were submitted to GenBank (Accession Nos. KM200034 and KM200035). A GenBank BLAST search of the fungal database showed that the sequences of ITS and D1/D2 regions matched those of C. cucurbitrarum (JN943006 and JN939195) with 100% similarity. A pathogenicity test was conducted by spraying three healthy potted plants (2 months old) with a sporangiola suspension (2 × 10⁴ conidia/ml). Another three potted plants of the same age were treated with sterile water and served as controls. The plants were kept in humid chambers for 2 days and placed in a greenhouse (28°C and 60 to 80% RH). After 4 to 5 days, water-soaked spots were evident on the flowers of inoculated plants. No symptoms were observed on control plants. A pathogenicity test was conducted twice with the same results, fulfilling Koch's postulates. C. cucurbitarum has a wide host range but has not been previously reported to cause disease on H. plantaginea (1). To our knowledge, this is the first report of C. cucurbitarum on H. plantaginea globally as well as in Korea. Choanephora rot of flowers is an issue under high-moisture conditions, so allowing for adequate airflow and a dry plant canopy should aid in disease suppression. References: (1) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab. Online publication, ARS, USDA, retrieved July 11, 2014. (2) P. M. Kirk. Mycol. Pap. 152:1, 1984. (3) A. Saroj et al. Plant Dis. 96:293, 2012. (4) G. Walther et al. Persoonia 30:11, 2013.

Characterization of novel microsatellite markers derived from Korean rose bitterling (Rhodeus uyekii) genomic library

Korean rose bitterling (Rhodeus uyekii) is a freshwater fish endemic to Korea. Natural populations of this species have experienced severe declines as a result of habitat fragmentation and water pollution. To conserve and restore R. uyekii, the genetic diversity of this species needs to be assessed at the population level. Eighteen novel polymorphic microsatellite loci for R. uyekii were developed using an enriched partial genomic library. Polymorphisms at these loci were studied in 150 individuals collected from three populations. The number of alleles at each locus ranged from 3 to 47 (mean = 17.1). Within the populations, the observed heterozygosity ranged from 0.032 to 1.000, expected heterozygosity from 0.082 to 0.967, and polymorphism information content from 0.078 to 0.950. Six loci showed significant deviation from Hardy-Weinberg equilibrium after Bonferroni's correction, and no significant linkage disequilibrium was detected between most locus pairs, except in three cases. These highly informative microsatellite markers should be useful for genetic population structure analyses of R. uyekii.

Relative adrenal insufficiency in chronic liver disease: its prevalence and effects on long-term mortality

BACKGROUND

The relationship between relative adrenal insufficiency (RAI) and chronic liver disease is unclear.

AIM

To determine the frequency with which RAI is observed in noncritically ill patients at various stages of chronic liver disease, and the correlation between RAI and disease severity and long-term mortality.

METHODS

In total, 71 non-critically ill patients with liver cirrhosis (n = 54) and chronic hepatitis (n = 17) were evaluated prospectively. A short stimulation test (SST) with 250 μg of corticotrophin was performed to detect RAI. RAI was defined as an increase in serum cortisol of <9 μg/dL in patients with a basal total cortisol of <35 μg/dL.

RESULTS

RAI was observed in only 13 (24.1%) of 54 patients with cirrhosis. Compared to those without RAI, cirrhotic patients with RAI had significantly higher Child-Turcotte-Pugh score (10.3 ± 1.7 vs. 7.1 ± 1.8, mean ± s.d., P < 0.001) and Model for End-Stage Liver Disease score (14.5 ± 6.6 vs. 9.4 ± 3.7, P = 0.017). The cortisol response to corticotropin was negatively correlated with the severity of cirrhosis (P < 0.05). In addition, the mortality rate was higher in cirrhotic patients with RAI (69.2%) than in those without RAI (4.9%; P < 0.001) during the follow-up period of 20.1 ± 13.5 months (range, 5.8-51.1 months). The cumulative 1-year survival rates in cirrhotic patients with and without RAI were 69.2% and 95.0%, respectively (P = 0.05), while the corresponding cumulative 3-year survival rates were 0% and 95.0% (P < 0.001).

CONCLUSIONS

Relative adrenal insufficiency is more commonly observed in those with severe cirrhosis, and is clearly associated with more advanced liver disease and a shortened long-term survival. This suggests that relative adrenal insufficiency is an independent prognostic factor in non-critically ill patients with cirrhosis.

First Report of Black Stem Caused by Botryosporium longibrachiatum on Statice in Korea

Perennial statice is widely cultivated worldwide. In Korea, hybrid statice (Limonium latifolium × bellidifolium) is grown as a commercial cut flower crop in polyethylene-film-covered greenhouses. In April 2013, hundreds of hybrid statice plants of the cvs. Yellow Cream and Pinky Cream were found symptomatic of a previously unknown disease, with 10 to 15% incidence in 10 greenhouses of 1,600 m² surveyed in Gochang County, Korea. Affected stems turned dark brown and were usually covered with a fungus resembling the hoar-frost fungus, Botryosporium longibrachiatum (3), especially in a cool and humid environment. Symptoms consisted of stem blackening, as is typical for burley tobacco (1) and sweet basil (2). According to the farmer of the hybrid statice, stems blackened in the winter and spring of January to April when the tunnels were mostly closed, thus reaching 100% relative humidity (RH) every night due to poor ventilation. The fungus had an elongate main axis with lateral fertile branches in acropetal succession. Conidiophores were simple, erect, macronematous, 32 to 79 μm in length, with a terminal cluster of three to five ampullae. Conidiogneous cells were polyblastic. Conidia were ellipsoidal, elliptical-fusiform, hyaline, 7.6 to 9.5 × 3.0 to 4.2 μm. Colonies on potato dextrose agar (PDA) were floccose, non-pigmented, and chalk-white in color. Morphological and cultural characteristics of the fungus were consistent with previous reports of B. longibrachiatum (Oudem.) Maire (2,3). A voucher specimen was deposited in the Korea University Herbarium (KUS). Isolate KUS-F27305 was submitted to the Korean Agricultural Culture Collection (Accession No. KACC47263). Fungal DNA was extracted from isolate KACC47263 with DNeasy Plant Mini Kits. The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 and sequenced. The resulting sequence of 604 bp was deposited in GenBank (Accession No. KF372591). A BLAST search in GenBank exhibited ≥99% nucleotide identity with the ITS sequence of B. longibrachiatum (JX666334) from sweet basil in Korea. To confirm pathogenicity, colonized mycelial agar blocks from isolate KACC47263 were transferred individually onto stem apices and leaves of five statice plants of the cv. Yellow Cream. Five control plants were treated similarly with non-colonized agar blocks. The plants were incubated in a humid chamber at 22 ± 2°C with a 12-h photoperiod for 48 h, and then maintained in 100% RH. After 3 to 4 days, necrotic lesions identical to those observed in the original greenhouses, started to develop on the stem and leaves of inoculated plants, leading to blackened stems covered with the hoar-frost fungus after 14 days. B. longibrachiatum was re-isolated from the lesions of inoculated plants, fulfilling Koch's postulates. No symptoms were observed on control plants. The pathogenicity test was repeated with the cv. Pinky Cream with identical results. To our knowledge, this is the first report of B. longibrachiatum infecting perennial statice globally as well as in Korea. We propose the name black stem of statice for this disease, analogous to the disease on basil (2). References: (1) T. R. Anderson and T. W. Welacky. Plant Dis. 67:1158, 1983. (2) J. H. Park et al. Plant Dis. 97:425, 2013. (3) C. V. Subramanian. Hyphomycetes. Indian Council of Agricultural Research, New Delhi, India, 1971.

Oncologic outcomes of laparoscopic nephroureterectomy for pT3 upper urinary tract urothelial carcinoma

AIM

We present the oncologic outcomes of laparoscopic nephroureterectomy management of pT3 upper urinary tract urothelial carcinoma.

METHODS

Between October 2003 and January 2011, 50 patients with pT3 upper urinary tract urothelial carcinoma which had pathologically confirmed underwent laparoscopic nephroureterectomy at our institution. Demographic data, perioperative results, pathological findings and oncologic outcomes were reviewed and analyzed retrospectively.

RESULTS

There were 36 patients (72%) of high grade lesion and 14 patients (28%) of low grade lesion. Lymphovascular invasion was observed in 16 patients (32%) and the surgical margin was positive in one patient. N stage was pN0 in 16 (32%), pN1 in 3 (6%), pN2 in 1 (2%) and pN3 in 1 (2%). The 5-year overall survival rate was 52.6% and the 5-year cancer-specific survival rate was 65.3%. Overall recurrence developed in 23 patients. There were 10 patients (20%) of urothelial recurrence which were all occurred in the bladder at the mean period of 13.6 months, and 7 patients of them were invasive bladder cancer. There were 16 patients (32%) of non-urothelial recurrence developed at the mean period of 9.69 months. On multivariate analyses lymphadenopathy and lymph node involvement of cancer (N+) were identified as independent predictive factors for the cancer-specific survival, and concomitant bladder tumor, grade and lymphovascular invasion were identified as independent predictive factors for the overall recurrence free survival.

CONCLUSION

Laparoscopic nephroureterectomy in patients with high stage upper urinary tract urothelial carcinoma appear comparable to those of open surgery in the regard of oncologic outcomes.

First Report of Leaf Spot Caused by Cercospora fukushiana on New Guinea Impatiens in Korea

New Guinea impatiens, Impatiens hawkeri W. Bull, is widely cultivated as a potted plant and garden plant. In July 2013, hundreds of young plants (cv. Fanfare) showing symptoms of leaf spot with approximately 50% incidence were found in polyethylene tunnels in Yongin City, Korea. Leaf spots were circular to oblong, reaching 6 mm or more in diameter. The spots were initially uniformly brown to reddish brown, turning gray with reddish brown margin. Diseased plants defoliated prematurely and were abandoned without marketing due to signs of discoloration and yellowing on leaves. A cercosporoid fungus was consistently observed in association with disease symptoms. Stromata were brown, small, and composed of a few swollen hyphal cells. Conidiophores were emerging through the cuticle, fasciculate (n = 2 to 20), olivaceous to brown, paler toward the apex, straight to mildly curved, geniculate, 30 to 260 μm long, 3.5 to 5 μm wide, 1- to 6-septate, and with conspicuous conidial scars. Conidia were hyaline and acicular. Smaller conidia were straight and longer conidia were mildly curved. Conidia were subacute to obtuse at the apex, truncate to obconically truncate at the base, 2- to 18-septate, 30 to 320 × 3.5 to 5.5 μm, and with thickened, darkened hila at the base. Morphological characteristics of the fungus were consistent with the previous reports of Cercospora fukushiana (Matsuura) W. Yamam. (1). Voucher specimens were housed in the Korea University herbarium (KUS). An isolate from KUS-F27438 was deposited in the Korean Agricultural Culture Collection (Accession No. KACC47640). Fungal DNA was extracted with DNeasy Plant Mini Kits (Qiagen Inc., Valencia, CA). The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 (4) and sequenced. The resulting sequence of 497 bp was deposited in GenBank (Accession No. KJ620981). This showed >99% similarity with sequence of C. fukushiana (EF600954) on I. balsamina from Korea. Isolate of KACC47640 was used in the pathogenicity tests. Hyphal suspensions were prepared by grinding 3-week-old colonies grown on PDA with distilled water using a mortar and pestle. Five plants were inoculated with hyphal suspensions and five plants were sprayed with sterile distilled water. The plants were covered with plastic bags to maintain a relative humidity of 100% for 24 h and then transferred to a 25 ± 2°C greenhouse with a 12-h photoperiod. Typical symptoms of necrotic spots appeared on the inoculated leaves 10 days after inoculation, and were identical to the symptoms observed in the field. C. fukushiana was re-isolated from symptomatic leaf tissues, confirming Koch's postulates. No symptoms were observed on water-inoculated control plants. Previously, leaf spots of Impatiens spp. associated with C. apii, C. balsaminae, and C. fukushiana have been reported (1,2,3). To our knowledge, this is the first report of C. fukushiana on I. hawkeri in Korea. Our observations in the nurseries of I. hawkeri suggest that low humidity with good ventilation as well as plant hygiene in greenhouses might be main strategies for preventing this disease. References: (1) C. Chupp. A Monograph of the Fungus Genus Cercospora. Ithaca, NY, 1953. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., online publication, ARS, USDA, retrieved March 25, 2014. (3) J. M. Soares et al. Plant Dis. 93:1214, 2009. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

First Report of Anthracnose Caused by Colletotrichum lupini on Yellow Lupin in Korea

Yellow lupin (Lupinus luteus L.) is native to the Mediterranean region of southern Europe. In Korea, yellow lupins are cultivated for ornamental purposes. In May 2013, hundreds of yellow lupins that were grown in pots for 7 weeks in polyethylene-film-covered greenhouses were observed severely damaged by a previously unknown disease with about 30% disease incidence in a flower farm in Yongin City, Korea. Voucher specimens were deposited in the Korea University Herbarium (KUS). Early symptoms on petioles and stems appeared as small, slightly sunken, water-soaked, and circular spots. Lesions increased in size (4 to 12 μm in diameter), became more depressed, with a darkened central portion. As the disease progressed, affected areas sometimes girdled the stem and killed the shoot. Leaves were partly blighted, but less damaged. The darkened areas contained blackish acervuli from which masses of pale salmon-colored conidia were released in moist weather. Acervuli were circular to ellipsoid, 80 to 400 μm in diameter. Acervular setae were not observed. Conidia (n = 30) were long obclavate to oblong-elliptical, aguttulate, hyaline, and 10 to 18 × 3.6 to 5.2 μm with a length/width ratio of 2.6 to 3.6. Appressoria were single or occasionally in small dense clusters, medium brown, elliptical to round in outline with a smooth to lobate margin, and 8 to 14 × 6 to 9 μm. These characters were consistent with the description of Colletotrichum lupini (Bondar) Damm, P.F. Cannon & Crous (1,3). An isolate was deposited in the Korean Agricultural Culture Collection (Accession No. KACC47254). Fungal DNA was extracted with DNeasy Plant Mini DNA Extraction Kits (Qiagen Inc., Valencia, CA). The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 and sequenced. The resulting 545-bp sequence was deposited in GenBank (Accession No. KJ447119). The sequence showed 100% identity with sequences of C. lupini (e.g., GenBank AJ301968, JN943480, JQ948162, and KF207599). To confirm pathogenicity, inoculum was prepared by harvesting conidia with sterile distilled water from 3-week-old cultures on potato dextrose agar. A conidial suspension (2 × 10⁵ conidia/ml) was sprayed until runoff onto the aerial parts of five healthy plants. Control plants were sprayed with sterile water. The plants were covered with plastic bags to maintain a relative humidity of 100% for 48 h and then transferred to a greenhouse. Typical symptoms of necrotic spots appeared on the inoculated leaves 6 days after inoculation, and were identical to the ones observed in the field. C. lupini was re-isolated from symptomatic leaf tissues. No symptoms were observed on control plants. The pathogenicity test was repeated twice. Anthracnose associated with C. lupini on lupins has been known from Europe (Germany, Ukraine, Austria, and Netherlands), North America (Canada and the United States), South America (Bolivia and Brazil), and Oceania (Australia and New Zealand) (2,4). To our knowledge, this is the first report of C. lupini on yellow lupins in Asia as well as in Korea. The presence of C. lupini on lupins in Asia can be considered as a potentially new and serious threat to this ornamental plant. References: (1) U. Damm et al. Stud. Mycol. 73:37, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, ARS, USDA, Retrieved February 17, 2014. (3) H. I. Nirenberg et al. Mycologia 94:307, 2002. (4) E. Rosskopf et al. Plant Dis. 98:161, 2014.

First Report of Powdery Mildew Caused by Podosphaera xanthii on Verbena brasiliensis in Korea

Verbena brasiliensis Vell., commonly known as Brazilian verbena, is native to South America and has been introduced into North America, coastal Europe, southern Africa, and Australasia. Though partly cultivated for garden use, it is invasive in riverine areas and also on roadsides, forest margins, pastures, and waste areas (4). In Korea, this plant was first reported in 1998 in Jeju Island and has become widely naturalized by replacing indigenous plants and disrupting native ecosystems in most of southern part of Korea (3). Since 2009, powdery mildew on Brazilian verbena has been consistently found in several locations of Busan City, Korea. Symptoms appeared as circular to irregular white patches, which subsequently showed abundant hyphal growth on both sides of the leaves and on stems. High disease severity caused poor growth of the plants, resulting in premature senescence and reduced flowering. Specimens (n = 5) were deposited in the Korea University Herbarium (KUS). Appressoria on the mycelium were nipple-shaped or nearly absent. Conidiophores were 140 to 190 × 11 to 12.5 μm and produced 2 to 7 immature conidia in chains with a crenate outline. Foot-cells in conidiophores were straight, cylindric, relatively short, 50 to 65 μm long, and constricted at the very base of branching point from the hypha. Conidia were hyaline, ellipsoid to ovate, measured 28 to 38 × 18.5 to 22 μm (length/width ratio of 1.2 to 1.8), and contained distinct fibrosin bodies. Germ tubes were produced from the lateral position of conidia. No chasmothecia were observed. These structures are typical of the powdery mildew Euoidium anamorph of the genus Podosphaera. The morphological characteristics and measurements were consistent with those of P. xanthii (Castagne) U. Braun & Shishkoff (1). To confirm the identity, the complete internal transcribed spacer (ITS) region of rDNA of the isolate KUS-F27220 was amplified with primers ITS1/ITS4, and sequenced. The resulting 477-bp sequence was deposited in GenBank (Accession No. KJ472787). A GenBank BLAST search of this sequence revealed 100% identity with Podosphaera sp. on V. bonariensis and V.× hybrida from Japan (AB462804 and AB040347). The Podosphaera sp. isolates listed above are now placed in P. xanthii (1). Pathogenicity was confirmed through inoculation by gently pressing a diseased leaf onto leaves of three healthy, potted 2-month-old Brazilian verbena plants. Three non-inoculated plants served as controls. Inoculated plants developed signs and symptoms after 6 days, whereas the control plants remained symptomless. The fungus present on the inoculated leaves was identical morphologically to that originally observed on diseased plants. Powdery mildew of Verbena spp. associated with Podosphaera sp. (including Sphaerotheca sp.) has been globally reported, but not on V. brasiliensis (1,2). To our knowledge, this is the first report of powdery mildew disease caused by P. xanthii on V. brasiliensis globally. Our field observations suggest that the powdery mildew could limit expansion of V. brasiliensis in Korea. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No.11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, ARS, USDA, Retrieved February 18, 2014. (3) C. G. Song and Y. H. Yang. The Naturalized Plants in Jeju Island. Nam-Jeju County, Jeju, Korea, 2005. (4) P. F. Yao. Kew Bull. 45:101, 1990.

Genetic Polymorphisms of the Bovine NOV Gene Are Significantly Associated with Carcass Traits in Korean Cattle

The objective of this study was to investigate single nucleotide polymorphisms (SNPs) in the bovine nephroblastoma overexpressed (NOV) gene and to evaluate whether these polymorphisms affect carcass traits in the Korean cattle population. We resequenced to detect SNPs from 24 unrelated individuals and identified 19 SNPs within the full 8.4-kb gene, including the 1.5-kb promoter region. Of these 19 SNPs, four were selected for genotyping based on linkage disequilibrium (LD). We genotyped 429 steers to assess the associations of these four SNPs with carcass traits. Statistical analysis revealed that g.7801T>C and g.8379A>C polymorphisms in the NOV gene were associated with carcass weight (p = 0.012 and 0.008, respectively), and the g.2005A>G polymorphism was associated with the back fat thickness (BF) trait (p = 0.0001). One haplotype of the four SNPs (GGTA) was significantly associated with BF (p = 0.0005). Our findings suggest that polymorphisms in the NOV gene may be among the important genetic factors affecting carcass yield in beef cattle.

First Report of Powdery Mildew Caused by Erysiphe buhrii on Gypsophila paniculata in Korea

Gypsophila paniculata L. (baby's breath, family Caryophyllaceae), native to Central and Eastern Europe, is commonly cultivated as a commercial cut flower crop in greenhouses in Korea. Since 2011, baby's breath cv. Cassiopeia has been observed affected by a powdery mildew with nearly 100% disease incidence at the stage of harvesting in Iksan City. Powdery mildew colonies first appeared as thin white patches on stems and both sides of the leaves. As disease progressed, plants were covered with dense masses of spores, followed by senescence and reduction of quality of cut flowers. A voucher specimen was deposited in the Korea University Herbarium (Accession KUS-F27313). Appressoria were well-developed, multilobed or moderately lobed, and single or opposite in pairs. Conidiophores were straight, 95 to 150 × 7 to 10 μm, and composed of 3 to 4 cells. Foot-cells were cylindric or slightly sinuous at the base and 37 to 53 μm long. Singly produced conidia were cylindrical to oblong-elliptical, 35 to 56 × 12.5 to 18 μm with a length/width ratio of 2.1 to 3.6, devoid of fibrosin bodies, and with angular/rectangular wrinkling of outer walls. Germ tubes were in the perihilar position on conidia, and ended with lobed appressoria. No chasmothecia were found. These structures are typical of the Pseudoidium anamorph of the genus Erysiphe. Specific measurements and host range were consistent with those of E. buhrii U. Braun (2). To confirm identification, the complete internal transcribed spacer (ITS) region of rDNA of isolate KUS-F27313 was amplified with primers ITS1/ITS4, and sequenced directly. The resulting 725-bp sequence was deposited in GenBank (KJ530705). A GenBank BLAST search of the Korean isolate showed 99% similarity with E. buhrii on Acanthophyllum sp. (Caryophyllaceae) from Iran (AB128924). Pathogenicity was confirmed through inoculation by gently dusting conidia onto leaves of five healthy, potted baby's breath cv. Cassiopeia. Five non-inoculated plants served as controls. Inoculated plants were isolated from non-inoculated plants in separate rooms in a greenhouse at 25 ± 2°C. Inoculated plants developed signs and symptoms after 7 days, whereas the control plants remained symptomless. The fungus present on the inoculated plants was identical morphologically to that originally observed on diseased plants. Pathogenicity test was repeated twice. The powdery mildew disease caused by E. buhrii on baby's breath has been recorded in the former Soviet Union (Armenia, Kazakhstan, Ukraine), Romania, Turkey, Iran, Mongolia, and Argentina (1,3). Also, a fungus occurring on baby's breath was recorded as Oidium sp. from Japan (4). To our knowledge, this is the first report of powdery mildew caused by E. buhrii on baby's breath in Korea. Powdery mildew infections pose a serious threat to production of this cut flower crop. References: (1) K. Amano. Host Range and Geographical Distribution of the Powdery Mildew Fungi. Japan Scientific Societies Press, Tokyo, 1986. (2) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, ARS, USDA, Retrieved February 18, 2014. (4) M. Satou et al. Ann. Phytopathol. Soc. Jpn. 62:541, 1996.

First Report of Powdery Mildew Caused by Golovinomyces artemisiae on Artemisia annua in Korea

Artemisia annua L., known as sweet wormwood or sweet annie, is native to temperate Asia, but is naturalized throughout the world. It produces artemisinin, a potent antimalarial drug that is also effective in treating other parasitic diseases (4). In August 2013, hundreds of plants showing typical symptoms of powdery mildew were found in Seoul (37°36'29.4″ N 127°02'38.3″ E), Korea. Powdery mildew colonies first appeared as thin white patches, which progressed to abundant hyphal growth on both sides of the leaves, stems, and inflorescence. As symptoms continued to develop, the leaves became distorted and turned purplish-gray. Severe infections caused leaf withering and premature senescence. The same symptoms were found on sweet wormwoods in Nonsan (36°09'55.3″ N 127°01'07.1″ E) and Chuncheon (37°52'27.4″ N 127°43'10.0″ E), Korea. Voucher specimens were deposited in the Korea University Herbarium (KUS). Appressoria on the mycelium were nipple-shaped or occasionally lobed. Conidiophores were cylindrical, measured 120 to 230 × 10 to 12.5 μm, and produced 2 to 4 immature conidia in chains with a sinuate outline, followed by 2 to 3 cells. Foot-cells of conidiophores were straight, cylindrical, and 54 to 100 μm long. Conidia were hyaline, ellipsoid to barrel-shaped, measured 30 to 40 × 15 to 20 μm (length/width ratio of 1.5 to 2.1), lacked distinct fibrosin bodies, and showed reticulate wrinkling of the outer walls. Germ tubes were produced on the perihilar position of conidia. Primary conidia were apically rounded, basally subtruncate, and generally smaller than the secondary conidia. No chasmothecia were observed. The structures described above were typical of the powdery mildew Euoidium anamorph of the genus Golovinomyces, and the fungus measurements were similar to those of G. artemisiae (Grev.) V.P. Heluta (3). The complete internal transcribed spacer (ITS) region of rDNA from KUS-F27763 was amplified with primers ITS1/ITS4 and sequenced. The resulting sequence of 624 bp was deposited in GenBank (Accession No. KJ136112). The obtained ITS sequence shared >99% similarity with G. artemisiae on A. princeps and A. montana from Japan (AB077659 and AB077649) and A. argyi from China (KF056818). Pathogenicity was confirmed through inoculation by gently dusting conidia onto leaves of five healthy potted plants. Five non-inoculated plants served as controls. Inoculated plants developed symptoms after 5 days, whereas the control plants remained symptomless. The fungus present on the inoculated plants was identical morphologically to that originally observed on diseased plants. Powdery mildews of A. annua caused by G. artemisiae have been reported in Japan, China, the Russian Far East, and Romania (1,2). To our knowledge, this is the first report of powdery mildew caused by G. artemisiae on A. annua in Korea. Since sweet wormwood production was only recently started on a commercial scale in Korea, powdery mildew infections pose a serious threat to the production of this plant, especially in organic farming where chemical control options are limited. References: (1) K. Amano. Host Range and Geographical Distribution of the Powdery Mildew Fungi. Japan Scientific Societies Press, Tokyo, 1986. (2) U. Braun. The Powdery Mildews (Erysiphales) of Europe. G. Fischer Verlag, Jena, 1995. (3) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No.11. CBS, Utrecht, 2012. (4) P. J. Weathers et al. Phytochem. Rev. 10:173, 2011.

First Report of Powdery Mildew Caused by Golovinomyces sonchicola on Ixeris chinensis in Korea

Ixeris chinensis (Thunb.) Nakai, known as Chinese ixeris, is distributed from Siberia to Japan, including Korea, Taiwan, and China. The whole plant has been used in folk medicine in Asia (4). In Korea, the plants of Chinese ixeris have been gathered and used as a wild root vegetable. During summer to autumn of 2011, Chinese ixeris leaves were found to be heavily infected with a powdery mildew in several locations of Korea. Symptoms first appeared as thin white colonies, which subsequently developed into abundant hyphal growth on both sides of the leaves, leading to drying of the leaves. The same symptoms on Chinese ixeris leaves were continuously observed in 2012 and 2013. Voucher specimens (n = 10) were deposited at Korea University Herbarium (KUS). Hyphal appressoria were moderately lobed or nipple-shaped. Conidiophores arose from the lateral part of the hyphae, measured 100 to 270 × 10 to 12.5 μm, and produced 2 to 6 immature conidia in chains with a sinuate outline. Basal parts of foot-cells in conidiophores were curved. Conidia were barrel-shaped to ellipsoid, measured 26 to 36 × 13 to 19 μm (length/width ratio = 1.7 to 2.4), lacked fibrosin bodies, and showed reticulate wrinkling of the outer walls. Primary conidia were ovate with conical-obtuse apex and subtruncate base. Germ tubes were produced on the perihilar position of conidia. Chasmothecia were not observed. The morphological characteristics were typical of the Euoidium type anamorph of the genus Golovinomyces, and the fungus measurements and structures were consistent with those of G. sonchicola U. Braun & R.T.A. Cook (1). To confirm the identification, internal transcribed spacer (ITS) region of rDNA sequences from a representative material (KUS-F26212) was amplified using primers ITS5/P3 and sequenced (3). The resulting 416-bp sequence was deposited in GenBank (Accession No. KF819857). A GenBank BLAST search revealed that the isolate showed >99% sequence similarity with those of G. cichoracearum from Sonchus spp. (e.g., AB453762, AF011296, JQ010848, etc.). G. sonchicola is currently confined to G. cichoracearum s. lat. on Sonchus spp., based on molecular sequence analyses (1). Pathogenicity was confirmed through inoculation by gently pressing a diseased leaf onto leaves of five healthy potted Chinese ixeris. Five non-inoculated plants served as controls. Inoculated plants developed symptoms after 6 days, whereas the controls remained symptomless. The fungus present on the inoculated plants was identical morphologically to that originally observed on diseased plants. Powdery mildew infections of I. chinensis associated with Golovinomyces have been known in China (2). To our knowledge, this is the first report of powdery mildew disease caused by G. sonchicola on I. chinensis in Korea. Farming of Chinese ixeris has recently started on a commercial scale in Korea. Though no statistical data are available, we postulate the cultivation area in Korea to be approximately 200 ha, mostly growing without chemical controls. Occurrence of powdery mildews poses a potential threat to safe production of this vegetable, especially in organic farming. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No.11. CBS, Utrecht, 2012. (2) F. L. Tai. Bull. Chinese Bot. Sci. 2:16, 1936. (3) S. Takamatsu et al. Mycol. Res. 113:117, 2009. (4) S. J. Zhang et al. J. Nat. Prod. 69:1425, 2006.

Spontaneous resolution of post-transplant localized cytomegalovirus lymphadenitis mimicking tumor recurrence

Compromised T-cell immunity persists for up to 1 year after autologous stem cell transplantation (ASCT), and patients treated with ASCT are more likely to develop atypical lymphoid hyperplasia that mimics tumor recurrence. Here, we present a case of cervical lymphadenitis due to cytomegalovirus (CMV) reactivation in a patient who had undergone ASCT for Burkitt lymphoma, which mimicked tumor recurrence on computed tomography and positron emission tomography-computed tomography 6 months after ASCT. This lesion was confined to the regional lymph nodes and was not accompanied by signs of systemic involvement, such as fever, splenomegaly, an elevated C-reactive protein level, or viremia. The localized CMV lymphadenitis resolved spontaneously without treatment after 6 months (12 months after ASCT) and the elevated CMV immunoglobulin-M titer normalized 6 months after resolution. Our experience with this case suggests that cautious follow-up without anti-CMV treatment should be considered in cases of post-ASCT localized CMV lymphadenitis without systemic involvement in patients with complete engraftment.

DCE and DSC MR perfusion imaging in the differentiation of recurrent tumour from treatment-related changes in patients with glioma

AIM

To retrospectively compare the utility of perfusion magnetic resonance imaging (MRI) in distinguishing treatment-related changes from recurrent disease in glioma patients.

MATERIALS AND METHODS

Thirty-one patients with histologically diagnosed gliomas and increased enhancement after or during concurrent (chemo-) radiation therapy were enrolled. They underwent dynamic contrast-enhanced (DCE) permeability MRI followed by dynamic susceptibility contrast (DSC) perfusion MRI. The vascular transfer constant (rK(trans)) and initial areas under the concentration curve (riAUC) were obtained from DCE MRI, and cerebral blood volume (rCBV) was obtained from DSC MRI. Patients were classified as having treatment-related changes or recurrent tumours based on clinicoradiological results or pathological results from surgery.

RESULTS

Nineteen patients were diagnosed as having recurrences and 12 patients as having treatment-related changes. The rK(trans), riAUC, and rCBV values in the recurrent group were significantly higher than the values in the group with treatment-related changes (p < 0.05). For all 31 patients, there was no significant difference between DSC MRI and DCE MRI for the differentiating power between recurrence and treatment-related changes (p = 0.7227). However, when including only the 24 patients with concordant values of rK(trans) and riAUC, DCE MRI showed a significant AUC value of 0.786 in the receiver operating characteristic (ROC) curve analysis (p = 0.003), whereas DSC MRI did not (AUC = 0.643, p = 0.229).

CONCLUSION

MRI perfusion images appear to show promise in distinguishing treatment-related changes from recurrent tumours. When both rK(trans) and riAUC show concordant values, DCE MRI seems to be more powerful than DSC MRI in the differentiation of recurrence from treatment-related changes.

First Report of Powdery Mildew Caused by Erysiphe cruciferarum on Indian Mustard (Brassica juncea) in Korea

Indian mustard (Brassica juncea (L.) Czern.) belongs in the Brassicaceae and is widely cultivated in Korea for the edible leaves. In May 2011, Indian mustard plants of cv. Cheong-Kyeoja, growing in polyethylene-film-covered greenhouses in Hwaseong, Korea, were observed to be affected by a powdery mildew. Symptoms appeared as circular to irregular white colonies, which subsequently showed abundant hyphal growth on both leaf surfaces. Severely infected plants were unmarketable due to leaf discoloration, and most were not harvested. Voucher specimens have been deposited in the Korea University Herbarium (KUS). Appressoria on the mycelium were well developed, lobed, solitary, or in opposite pairs. Conidiophores were cylindrical, 70 to 115 × 8 to 10 μm, and composed of 3 to 4 cells. Foot-cells of conidiophores were straight to substraight, cylindrical, and relatively short (20 to 30 μm long). Singly-produced conidia were oblong to cylindrical or oval, 27.5 to 50 × 14 to 17.5 μm with a length/width ratio of 1.8 to 3.6, with angular/rectangular wrinkling of outer walls, and lacked distinct fibrosin bodies. Germ tubes were produced in the perihilar position of conidia. No chasmothecia were found. These structures are typical of the powdery mildew Pseudoidium anamorph of the genus Erysiphe. The specific measurements and characteristics were consistent with previous records of Erysiphe cruciferarum Opiz ex L. Junell (1). To confirm the identification, the complete internal transcribed spacer (ITS) region of rDNA of KUS-F24819 was amplified with primers ITS5 and P3 (4), and sequenced directly. The resulting 462-bp sequence was deposited in GenBank (Accession No. KC862331). A GenBank BLAST search of the ITS sequence showed 100% identity (462/462 bp) with those of isolates of E. cruciferarum from B. oleracea var. acephala, B. rapa, and Arabidopsis thaliana (GU721075, EU140958, and FJ548627, respectively). Pathogenicity was confirmed through inoculation by gently dusting conidia onto leaves of five healthy, potted Indian mustard plants of the cv. Cheong-Kyeoja. Five non-inoculated plants served as a control treatment. Inoculated plants were isolated from non-inoculated plants in separate rooms in a greenhouse at 18 to 24°C. Inoculated plants developed symptoms after 7 days, whereas the control plants remained symptomless. The fungus present on the inoculated plants was identical morphologically to that originally observed on the diseased plants, fulfilling Koch's postulates. There are records of E. cruciferarum infecting B. juncea in Europe (Finland, Romania, Sweden, Switzerland), the former Soviet Union, Australia, South Africa, and Asia (India, Japan, and China) (2,3). To our knowledge, this is the first report of powdery mildew caused by E. cruciferarum on B. juncea in Korea. Occurrence of powdery mildew is a threat to quality and marketability of this crop, especially those grown in organic farming where chemical control options are limited. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, 2012. (2) D. F. Farr and A. Y. Rossman. Fungal Databases, Syst. Mycol. Microbiol. Lab., Online publication. USDA ARS. Retrieved 20 March 2013. (3) P. Kaur et al. Plant Dis. 92:650, 2008. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.

The role of thioredoxin 1 in the mycophenolic acid-induced apoptosis of insulin-producing cells

Mycophenolic acid (MPA) is one of many effective immunosuppressive drugs. However, MPA can induce cellular toxicity and impair cellular function in β-cells. To explore the effects of MPA and the relation between MPA and Trx-1, we used various methods, including an Illumina microarray, to identify the genes regulated during pancreatic β-cell death following MPA treatment. INS-1E cells (a pancreatic β-cell line) and isolated rat islets were treated with MPA for 12, 24, or 36 h, and subsequent microarray analysis showed that (Trx1) gene expression was significantly reduced by MPA. Further, Trx1 overexpression increased the cell viability, decreased the activations of c-jun N-terminal kinase (JNK) and caspase-3 by MPA, and attenuated ROS upregulation by MPA. Furthermore, siRNA knockdown of Trx1 increased MPA-induced cell death and the activations of p-JNK and caspase-3, and MPA significantly provoked the apoptosis of insulin-secreting cells via Trx1 downregulation. Our findings suggest that the prevention of Trx1 downregulation in response to MPA is critical for successful islet transplantation.

Residual pain due to soft-tissue impingement after uncomplicated total ankle replacement

We report the incidence and intensity of persistent pain in patients with an otherwise uncomplicated total ankle replacement (TAR). Arthroscopic debridement was performed in selected cases and the clinical outcome was analysed. Among 120 uncomplicated TARs, there was persistent pain with a mean visual analogue scale (VAS) of 2.7 (0 to 8). The intensity of pain decreased in 115 ankles (95.8%). Exercise or walking for more than 30 minutes was the most common aggravating factor (62 ankles, 68.1%). The character of the pain was most commonly described as dull (50 ankles, 54.9%) and located on the medial aspect of the joint (43 ankles, 47.3%). A total of seven ankles (5.8%) underwent subsequent arthroscopy. These patients had local symptoms and a VAS for pain ≥ 7 on exertion. Impingement with fibrosis and synovitis was confirmed. After debridement, the median VAS decreased from 7 to 3 and six patients were satisfied. The median VAS for pain and the American Orthopaedic Foot and Ankle Society score of the ankles after debridement was similar to that of the uncomplicated TARs (p = 0.496 and p = 0.066, respectively). Although TAR reduces the intensity of pain, residual pain is not infrequent even in otherwise uncomplicated TARs and soft-tissue impingement is the possible cause.

First Confirmed Report of Cercospora Blight of Asparagus Caused by Cercospora asparagi in Korea

In September 2011, hundreds of asparagus (Asparagus officinalis L.) showing symptoms of blight with nearly 100% incidence (percentage of plants affected) were found in polyethylene tunnels at an organic farm in Gangneung City of Korea. Lesions on needles and branches of the ferns were small, elliptic to subcircular, pale tan to brown with reddish brown borders, and became gray and cottony due to heavy sporulation under continuous high humidity. Infection caused premature defoliation and weakened plant vigor. The damage purportedly due to this disease has reappeared with confirmation of the causal agent made again in 2012. A cercosporoid fungus was consistently associated with disease symptoms. Stromata were well developed, consisting of brown cells, and were 10 to 30 μm wide. Conidiophores were fasciculate (n = 2 to 12), olivaceous brown, paler upwards, straight to mildly curved, not geniculate in shorter ones, or 1 to 2 times geniculate in longer ones, 40 to 260 μm long, 3.5 to 5.5 μm wide, and 1- to 6-septate. Conidia were hyaline, cylindric to acicular, straight in shorter ones, curved in longer ones, truncate to obconically truncate at the base with darkened hila, guttulate, 2- to 12-septate, and 40 to 220 × 3 to 5 μm. Morphological characteristics of the fungus were consistent with the previous reports of Cercospora asparagi Sacc. (1). Voucher specimens were housed at the Korea University herbarium (KUS). An isolate from KUS-F26046 was deposited in the Korean Agricultural Culture Collection (Accession No. KACC46400). The complete internal transcribed spacer (ITS) region of rDNA was amplified with the primers ITS1/ITS4 and sequenced. The resulting sequence of 497 bp was deposited in GenBank (Accession No. JX964995). This showed >99% similarity with sequences of many Cercospora species, indicating their close phylogenetic relationship. For pathogenicity tests, conidial suspensions (10⁵ conidia/ml) were prepared by culturing the fungus on V8 juice agar (2) for 3 weeks. Five plants were inoculated with conidial suspensions and five plants were sprayed with sterile distilled water. The plants were covered with plastic bags to maintain 100% RH for 24 h and then transferred to a greenhouse. Typical symptoms of necrotic lesions appeared on the inoculated plants 6 days after treatment, and were identical to the ones observed in the field. C. asparagi was reisolated from symptomatic tissues, confirming Koch's postulates. No symptoms were observed on control plants. The disease has been reported through the regions of the world where asparagus is grown (3). In Korea, the disease was recorded in 1928 by Japanese workers under Cercosporina asparagicola Speg. (regarded as synonymous with Cercospora asparagi) with brief notes (4). Though one sample of asparagus was sent to the author (KSH) for diagnosis in 2009 summer and determined to be infected with C. asparagi (unpublished data), there has been no additional finding of the disease in Korea for the last 82 years. To our knowledge, this is the first confirmed report of Cercospora blight of asparagus caused by C. asparagi in Korea. References: (1) C. Chupp. A Monograph of the Fungus Genus Cercospora. Ithaca, NY, 1953. (2) C. J. Cooperman and S. F. Jenkins. Phytopathology 76:617, 1986. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, ARS, USDA, Retrieved October 20, 2012. (4) K. Nakata and S. Takimoto. Bull. Agric. Exp. Stat. Korea 15:1, 1928.

Adjuvant chemotherapy for gastric cancer: a randomised phase 3 trial of mitomycin-C plus either short-term doxifluridine or long-term doxifluridine plus cisplatin after curative D2 gastrectomy (AMC0201)

BACKGROUND

This phase 3 study evaluated the efficacy of new adjuvant chemotherapy (MFP), which intensified the mitomycin-C (MMC) plus short-term doxifluridine (Mf) for gastric cancer.

PATIENTS AND METHODS

A total of 855 patients (424 in Mf, 431 in MFP) with pathological stage II-IV (M0) gastric cancer after D2 gastrectomy were randomly assigned to receive either Mf (MMC 20 mg m(-2), followed by oral doxifluridine 460-600 mg m(-2) per day for 3 months) or MFP (MMC 20 mg m(-2), followed by oral doxifluridine 460-600 mg m(-2) per day for 12 months with 6 monthly infusions of 60 mg m(-2) of cisplatin) chemotherapy.

RESULTS

With a median follow-up of 6.6 years, there was no difference between the two groups in recurrence-free survival (RFS) (5-year RFS 61.1% in Mf and 57.9% in MFP; hazard ratio 1.10 (95% CI 0.89-1.35); P=0.39) and overall survival (OS) (5-year OS 66.5% in Mf and 65.0% in MFP; hazard ratio 1.11 (95% CI 0.89-1.39); P=0.33).

CONCLUSION

Intensification of Mf adjuvant chemotherapy by prolonging the duration of oral fluoropyrimidine and adding cisplatin was safe but not effective to improve the survivals in curatively resected gastric cancer patients.

Suitability of endoscopic submucosal dissection for treatment of submucosal gastric cancers

BACKGROUND

Endoscopic submucosal dissection (ESD) is not considered appropriate for all submucosal cancers owing to the risk of lymph node metastasis and difficulty estimating the deep margin status. This study aimed to determine predictive factors for lymph node metastases in submucosal cancer and to explore in which patients ESD might be feasible.

METHODS

Details of patients who had curative gastrectomy for submucosal gastric cancer at Asan Medical Centre from 2007 to 2011 were reviewed retrospectively to determine the relationship between lymph node metastasis and clinicopathological characteristics, including age, sex, tumour location, size, gross appearance, depth of invasion, histological type/differentiation, presence of lymphovascular/perineural invasion, and immunohistochemical staining results for p53, human epidermal growth factor receptor (HER) 1 and HER2.

RESULTS

A total of 1773 patients were analysed. The presence of lymphovascular invasion was related most strongly to lymph node metastasis. Multivariable analysis revealed that depth of invasion, tumour size, differentiation, gross appearance and perineural invasion were also related. Metastatic lymph nodes were found in four of 105 patients who met the classical criteria for ESD; all showed a moderately differentiated histological appearance. No lymph node metastases were observed in well differentiated SM1 tumours of any size (infiltration into upper third of submucosa), or in well differentiated SM2 (infiltration into middle third of submucosa) tumours of 2 cm or less without lymphovascular invasion.

CONCLUSION

Patients with well differentiated SM1 cancer of any size and those with well differentiated SM2 cancer of 2 cm or less without lymphovascular invasion may be suitable candidates for ESD.

Abstract P4-03-11: SUVmax of FDG-PET/CT is Associated with Chemotherapy Response Assay Test Results and Prognostic Factors in Breast Cancer Patients

Backgrounds:18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) is widely used for cancer evaluation and there are several studies which suggested maximum standard uptake value (SUVmax) may reflect the cancer patients' prognosis. Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) is commonly used as a chemosensitivity assay modality for the treatment of various cancers in clinical settings and there have been several studies on its usefulness in breast cancer. We previously reported chemosensitivity (ATP-CRA) results might reflect patients' prognosis. So we supposed that SUVmax could reflect chemosenitivity (ATP-CRA) results of patients, so performed this study to analyze the relationship between PET/CT SUVmax and chemosenstivity (ATP-CRA) results of these drugs. Furthermore, we evaluated prognostic factors for breast cancer according to SUVmax.

Materials and Methods: 102 breast cancer patients, who underwent PET/CT and chemosensitive (ATP-CRA) test between December 2010 and April 2012, were enrolled in this study. We analyzed, retrospectively, the correlation between SUVmax of PET/CT and chemosenitivity (ATP-CRA) results of doxorubicin/paclitaxel. SUVmax according to prognostic factors were also assessed.

Results: Chemosensitivity (ATP-CRA) results of doxorubicin and paclitaxel have significant positive correlation with SUVmax. Their correlation coefficient were 0.236 (p = 0.020) and 0.216 (p = 0.030), respectively. Patients with larger tumor size, higher histologic and nuclear grade, estrogen receptor negative, progesterone receptor negative, HER2 positive, and Ki67 positive (≥14%) have higher mean SUVmax values (p &lt; 0.05). In molecular subgroup analysis, triple negative group showed higher mean SUVmax values than luminal A group (p &lt; 0.001).

Conclusion: Higher SUVmax values of PET/CT is correlated with better chemosensitive (ATP-CRA) results of doxorubicin and paclitaxel, and poor prognostic factors of breast cancer. However, examination of additional cases might be needed.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-03-11.

Optimization of microbial poly(3-hydroxybutyrate) recover using dispersions of sodium hypochlorite solution and chloroform

Optimization was carried out for the recovery of microbiol poly(3-hydroxybutyrate) (PHB) from Alcaligenes eutrophus. This process involved the use of a dispersion made of sodium hypochlorite solution and chloroform. The dispersion enabled us to take advantage of both differential digestion by hypochlorite and solvent extraction by chloroform. The PHB recovery (%) from cell powder was maximized using a 30% hypochlorite concentration, a 90-min treatment time, and a 1:1 (v/v) chloroform-to-aqueous-phase ratio. Under these optimal conditions, the recovery was about 91% and the purity of recovered PHB was higher than 97%. The number average molecular weight, M(n) of recovered PHB was about 300,000 and the weight average molecular weight M(w) was about 1,020,000, compared to the original M(n) of 530,000 and M(w) of 1,272,000. The moderate decrease in both M(n) and M(w) might be ascribed to the shielding effect of chloroform. In addition, the relatively small decrease in M(w) probably resulted from the loss of short PHB chains which might be water soluble. The crystallinity of recovered PHB was in the range of 60 to 65%although a slightly higher crystallinity was observed when the dispersion was used. (c) 1994 John Wiley & Sons, Inc.