Droplet splashing by a slingshot mechanism

When a drop impacts onto a liquid pool, it ejects a thin horizontal sheet of liquid, which emerges from the neck region connecting the two liquid masses. The leading section of this ejecta bends down to meet the pool liquid. When the sheet touches the pool, at an "elbow," it ruptures and sends off microdroplets by a slingshot mechanism, driven by surface tension. High-speed imaging of the splashing droplets suggests the liquid sheet is of submicron thickness, as thin as 300 nm. Experiments in partial vacuum show that air resistance plays the primary role in bending the sheet. We identify a parameter regime where this slingshot occurs and also present a simple model for the sheet evolution, capable of reproducing the overall shape.

Stick-slip substructure in rapid tape peeling

The peeling of adhesive tape is known to proceed with a stick-slip mechanism and produces a characteristic ripping sound. The peeling also produces light and when peeled in a vacuum, even X-rays have been observed, whose emissions are correlated with the slip events. Here we present direct imaging of the detachment zone when Scotch tape is peeled off at high speed from a solid surface, revealing a highly regular substructure, during the slip phase. The typical 4-mm-long slip region has a regular substructure of transverse 220 μm wide slip bands, which fracture sideways at speeds over 300 m/s. The fracture tip emits waves into the detached section of the tape at ∼ 100 m/s, which promotes the sound, so characteristic of this phenomenon.

Association of distinct clinical subsets with myositis-specific autoantibodies towards anti-155/140-kDa polypeptides, anti-140-kDa polypeptides, and anti-aminoacyl tRNA synthetases in Japanese patients with dermatomyositis: a single-centre, cross-sectional study

OBJECTIVE

To determine the association of distinct clinical subsets with myositis-specific autoantibodies (MSAs) towards anti-155/140-kDa polypeptides [anti-155/140 antibodies (Abs)], anti-140-kDa polypeptides (anti-140 Abs), and anti-aminoacyl tRNA synthetases (ARS Abs) in Japanese patients with dermatomyositis (DM).

METHODS

We compared the clinical features and short-term prognoses of 30 DM patients whose serological status included these MSAs. The MSAs were determined by immunoprecipitation.

RESULTS

Anti-155/140 Abs (n = 5), anti-140 Abs (n = 8), and anti-ARS Abs (n = 7) did not overlap each other. All of the anti-155/140 Ab-positive patients (n = 5) were complicated by malignancies, as were all of the anti-140 Ab-positive patients (n = 8), who showed rapidly progressive interstitial lung disease (ILD). The survival rate at 6 months from the diagnosis of DM was significantly lower in the anti-140 Ab-positive patients than in the other patients.

CONCLUSION

This is the first study to report, in a single cohort of DM patients, that distinct clinical subsets are distributed in an anti-155/140 Ab-positive group, an anti-140 Ab-positive group, or an anti-ARS Ab-positive group. Our data also confirm previous evidence that anti-155/140 Abs are involved in malignancies and that anti-140 Abs are involved in rapidly progressive ILD.

Autoantibody-mediated regulation of B cell responses by functional anti-CD22 autoantibodies in patients with systemic sclerosis

Studies have demonstrated that B cells play important roles in systemic sclerosis (SSc), especially through the CD19/CD22 autoimmune loop. CD22 is a B cell-specific inhibitory receptor that dampens B cell antigen receptor (BCR) signalling via tyrosine phosphorylation-dependent mechanism. In this study, we examined the presence and functional property of circulating autoantibodies reacting with CD22 in systemic sclerosis. Serum samples from 10 tight skin (TSK/+) mice and 50 SSc patients were assessed for anti-CD22 autoantibodies by enzyme-linked immunosorbent assays using recombinant mouse or human CD22. The association between anti-CD22 antibodies and clinical features was also investigated in SSc patients. Furthermore, the influence of SSc serum including anti-CD22 autoantibodies for CD22 tyrosine phosphorylation was examined by Western blotting using phosphotyrosine-specific antibodies reacting with four major tyrosine motifs of CD22 cytoplasmic domain. Anti-CD22 autoantibodies were positive in 80% of TSK/+ mice and in 22% of SSc patients. Patients positive for anti-CD22 antibodies showed significantly higher modified Rodnan skin thickness score compared with patients negative for anti-CD22 antibodies. Furthermore, anti-CD22 antibodies from patients' sera were capable of reducing phosphorylation of all four CD22 tyrosine motifs, while sera negative for anti-CD22 antibodies did not affect CD22 phosphorylation. Thus, a subset of SSc patients possessed autoantibodies reacting with a major inhibitory B cell response regulator, CD22. Because these antibodies can interfere CD22-mediated suppression onto B cell activation in vitro, SSc B cells produce functional autoantibodies that can enhance their own activation. This unique regulation may contribute to the autoimmune aspect of SSc.

Toward 100 Mega-frames per second: design of an ultimate ultra-high-speed image sensor

Our experience in the design of an ultra-high speed image sensor targeting the theoretical maximum frame rate is summarized. The imager is the backside illuminated in situ storage image sensor (BSI ISIS). It is confirmed that the critical factor limiting the highest frame rate is the signal electron transit time from the generation layer at the back side of each pixel to the input gate to the in situ storage area on the front side. The theoretical maximum frame rate is estimated at 100 Mega-frames per second (Mfps) by transient simulation study. The sensor has a spatial resolution of 140,800 pixels with 126 linear storage elements installed in each pixel. The very high sensitivity is ensured by application of backside illumination technology and cooling. The ultra-high frame rate is achieved by the in situ storage image sensor (ISIS) structure on the front side. In this paper, we summarize technologies developed to achieve the theoretical maximum frame rate, including: (1) a special p-well design by triple injections to generate a smooth electric field backside towards the collection gate on the front side, resulting in much shorter electron transit time; (2) design technique to reduce RC delay by employing an extra metal layer exclusively to electrodes responsible for ultra-high speed image capturing; (3) a CCD specific complementary on-chip inductance minimization technique with a couple of stacked differential bus lines.

The challenge of early systemic sclerosis for the EULAR Scleroderma Trial and Research group (EUSTAR) community. It is time to cut the Gordian knot and develop a prevention or rescue strategy

Early diagnosis of systemic sclerosis (SSc) may allow the start of treatment that could slow disease progression. For this reason early diagnosis of the disease is of pivotal importance. However, the lack of diagnostic criteria and valid predictors significantly limit patient evaluation and the use of potentially effective drugs in the earliest phase of SSc. Early SSc may be suspected on the basis of Raynaud's phenomenon, puffy fingers, autoantibodies and SSc capillaroscopic pattern. In practice, the aim is to have criteria for the diagnosis of very early SSc. The criteria that are proposed are obviously provisional and need to be validated: (a) initially through a Delphi technique; (b) thereafter perhaps using already available datasets; but (c) of critical importance, through prospective studies. Only after prospective studies can these potential criteria be considered validated. The consensus on criteria for the classification of very early SSc might be part of the evolving EULAR/ACR project of reclassification of SSc.

Skin disease: a cardinal feature of systemic sclerosis

Despite the heterogeneity of SSc, almost all patients have skin involvement. As such, skin manifestations are critical in the initial diagnosis of SSc and in the subsequent sub-classification into the different subsets of disease. The two principal subsets are lcSSc and dcSSc. The main difference between these two subsets is the speed of disease progression and the extent and severity of skin and visceral involvement; lcSSc has an insidious onset with skin involvement confined largely to the face and extremities. Whilst vascular manifestations of SSc such as pulmonary arterial hypertension are typically more common in lcSSc, patients in both subsets can develop ischaemic digital ulcers. In dcSSc, disease progression is very rapid, with skin thickening extending beyond the extremities and earlier, more widespread internal organ involvement. DcSSc is generally considered to be the more severe subset of the disease. Skin scores in SSc correlate inversely with survival and are considered a valuable marker of disease severity. Skin involvement is easily detectable and, using the modified Rodnan skin score, the degree of skin fibrosis can be quantified. As well as general management measures, a number of targeted therapies are commonly used for treatment of cutaneous manifestations of SSc. These include the intravenous prostanoid iloprost and the dual endothelin receptor antagonist bosentan, which is approved in Europe for the prevention of new digital ulcers.

Down-regulation of MDR1 by epigenetic alteration in human epithelial ovarian cancer cells

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Background: Ovarian cancer is one of the most lethal malignancies in women. Despite recent studies of many oncogenes and tumor-suppressor genes concerning about its progression, the details of ovarian cancer biology still remains to be unclear. P-glycoprotein (P-gp) encoded by the MDR1 gene is a membrane protein that can export many kinds of antineoplastic agents from cells, and overexpression of P-gp has been reported to be implicated in treatment failure in cancer. DNA methylation, a major epigenetic process, can affect every step in carcinogenesis as well as genetic alterations. The contribution of such epigenetic alteration to the expression of MDR1 remains largely unexplored in human ovarian cancer. Methods: In this study, we evaluated the DNA methylation status of the MDR1 gene by methylation-specific PCR. Then, the expression of MDR-1 mRNA and protein in primary epithelial ovarian cancer specimens were evaluated by real-time RT-PCR and immunohistochemistry using anti-mouse P-gp F4 monoclonal antibody, respectively. The correlation between these results and clinicopathological features was examined. Results: MDR1 was hypermethylated in 12 of 12 (100%) ovarian cancer cell lines, and 5 of 13 (38%) primary ovarian cancers by methylation-specific PCR analysis. MDR1 mRNA expression was subsequently found to be lost in ovarian cancer cell lines with methylation by both real-time RT-PCR and immunohistochemistry. Thus, MDR1expression was associated with the DNA methylation status of the MDR1 gene. Conclusions: In conclusion, MDR1 was frequently hypermethylated in human ovarian cancers. Our results suggest that epigenetic regulation might play a role in the expression of MDR1 and clinical treatment outcomes in human ovarian cancer.

No significant financial relationships to disclose.

Epigenetic alteration of BRCA1 in human ovarian tumors

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Background: The breast cancer susceptibility gene 1 (BRCA1) is mutated in half of hereditary breast cancers, and in about 80% of hereditary breast and ovarian cancers. Also, BRCA1 expression is decreased in sporadic breast cancers by other mechanisms, such as epigenetic alteration, suggesting its important role in sporadic breast cancers. The epigenetic alteration of BRCA1 and its contribution in sporadic ovarian tumors are not fully understood. Methods: We evaluated the DNA methylation status of the BRCA1 5’ CpG island by methylation-specific PCR in 12 human ovarian cancer cell lines and 39 primary epithelial ovarian tumor specimens. Cases included the following: malignant (n = 16), borderline (n = 8), and benign (n = 16) tumors. The correlation between these results and clinicopathological features was examined. Results: BRCA1 was hypermethylated in one of 12 (8%) ovarian cancer cell lines and 15 of 39 (38%) primary ovarian tumors. Relative to clinicopathological features, BRCA1 methylation was detected in 39% of malignant and borderline tumors and in 38% of benign tumors, suggesting the importance of BRCA1 pathway in both types of tumors. Some adjacent nontumorous tissues also showed aberrant methylation. Conclusions: BRCA1 was found to be frequently hypermethylated both in benign and malignant ovarian tumors. Our results suggest that epigenetic alteration of BRCA1 might play a role in the development of benign and malignant sporadic ovarian tumors.

No significant financial relationships to disclose.

Comparison of the outcome between cervical adenocarcinoma and squamous cell carcinoma patients with adjuvant radiotherapy after radical surgery: SGSG/TGCU Intergroup Surveillance

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Background: We conducted the present surveillance to clarify the significance of adjuvant radiotherapy and the cause of poor outcome of adenocarcinoma (AC). Methods: A total of 825 patients with FIGO stage Ib-IIb cervical cancer, who underwent type III radical hysterectomy in 10 institutes of SGSG/ TGCU Intergroup between April 1997 and March 2003, were enrolled in this study. There were 543 patients with squamous cell carcinoma (SCC) (261 in stage Ib1, 67 in Ib2, 83 in IIa, 132 in IIb) and 282 with AC (186 in stage Ib1, 39 in Ib2, 11 in IIa, 46 in IIb). Mean age of patients was 49.0 yrs (range: 19–84 yrs) in SCC and 46.6 yrs (range: 18–84) in AC. Two hundred and fifty-five patient with SCC and 69 with AC received adjuvant radiotherapy including CCRT. Results: The 5-year overall survival rate (OS) for patients with SCC and AC were 87.4% and 83.4%. The OS for stage I patients did not differ between SCC and AC. Stage II patients with AC showed significantly worse prognosis compared with SCC (54.5% vs. 87.4% in IIa, 63.3% vs. 78.8% in IIb). There was a significant difference in OS for patients receiving adjuvant treatment between SCC and AC (83.0% vs. 73.9%). Although the OS for stage I patients did not differ between SCC and AC, the OS for stage II patients with AC was significantly lower (86.9% vs. 50.0% in IIa, 75.5% vs. 61.1% in stage IIb). In patients with stage I, SCC showed significantly higher lymphnode involvement compared with AC (16.5% vs. 9.7% in Ib1, 46.3% vs. 20.1% in Ib2). The incidence of lymphnode involvement did not differ between SCC and AC in patients with stage II (36.4% vs.34.9% in IIa and 39.1% vs.45.5% in IIb). When patients had lymphnode involvement, the outcome of patients with AC showed significantly worse than those with SCC (46.4% vs. 72.3%). The local failure defined as recurrence in stump and pelvis was more frequent in patients with AC compared with SCC (24.6% vs.10.7%). Conclusions: Although the incidence of lymphnode involvement did not differ between AC and SCC, AC patients with lymphnode involvement showed significantly worse outcome. The present study indicates that lower sensitivity to radiotherapy might be an important cause for the poorer prognosis in AC.

No significant financial relationships to disclose.

EULAR recommendations for the treatment of systemic sclerosis: a report from the EULAR Scleroderma Trials and Research group (EUSTAR)

PURPOSE

The optimal treatment of systemic sclerosis (SSc) is a challenge because the pathogenesis of SSc is unclear and it is an uncommon and clinically heterogeneous disease affecting multiple organ systems. The aim of the European League Against Rheumatism (EULAR) Scleroderma Trials and Research group (EUSTAR) was to develop evidence-based, consensus-derived recommendations for the treatment of SSc.

METHODS

To obtain and maintain a high level of intrinsic quality and comparability of this approach, EULAR standard operating procedures were followed. The task force comprised 18 SSc experts from Europe, the USA and Japan, two SSc patients and three fellows for literature research. The preliminary set of research questions concerning SSc treatment was provided by 74 EUSTAR centres.

RESULTS

Based on discussion of the clinical research evidence from published literature, and combining this with current expert opinion and clinical experience, 14 recommendations for the treatment of SSc were formulated. The final set includes the following recommendations: three on SSc-related digital vasculopathy (Raynaud's phenomenon and ulcers); four on SSc-related pulmonary arterial hypertension; three on SSc-related gastrointestinal involvement; two on scleroderma renal crisis; one on SSc-related interstitial lung disease and one on skin involvement. Experts also formulated several questions for a future research agenda.

CONCLUSIONS

Evidence-based, consensus-derived recommendations are useful for rheumatologists to help guide treatment for patients with SSc. These recommendations may also help to define directions for future clinical research in SSc.

Association study of a polymorphism of the CTGF gene and susceptibility to systemic sclerosis in the Japanese population

OBJECTIVES

To validate the association of a single nucleotide polymorphism (SNP) of the connective tissue growth factor gene (CTGF) with susceptibility to systemic sclerosis (SSc) in the Japanese population.

METHODS

395 Japanese patients with SSc, 115 patients with rheumatoid arthritis and 269 healthy Japanese volunteers were enrolled in the study. An SNP (rs6918698) at -945 bp from the start codon in the promoter region of the CTGF gene was determined by allelic discrimination with the use of a specific TaqMan probe.

RESULTS

The G allele showed a significantly higher frequency in patients with SSc than in controls (p<0.001; odds ratio 1.5; 95% confidence interval 1.2 to 1.9). In particular, the clinical subsets of SSc showed a more significant association between the G allele and diffuse cutaneous SSc (p<0.001) and the presence of interstitial lung disease (p<0.001), the presence of anti-topoisomerase I antibody (p<0.001) and anti-U1RNP antibody (p = 0.010). Association analyses using the genotype of the SNP yielded results similar to those of analyses using the allele.

CONCLUSIONS

This study confirms the association between an SNP in the CTGF gene and susceptibility to SSc, especially in the presence of diffuse cutaneous SSc, interstitial lung disease and anti-topoisomerase I antibody. The results strongly suggest that this SNP may be a powerful indicator of severe skin and lung involvement in patients with SSc.

European League Against Rheumatism (EULAR) Scleroderma Trial and Research group (EUSTAR) recommendations for the treatment of systemic sclerosis: methods of elaboration and results of systematic literature research

Objective:

To describe methods and procedures used for the development of the European League Against Rheumatism (EULAR)/EULAR Scleroderma Trial and Research group (EUSTAR) recommendations for the treatment of systemic sclerosis. In particular, the results of a web-based Delphi exercise aimed at selection of research questions and evidence from systematic literature research, as parts of the development of these recommendations, are presented in detail.

Methods:

In agreement with the EULAR standard operating procedures a Task Force was created that consisted of the EUSTAR board members, 10 systemic sclerosis (SSc) experts invited from outside the EUSTAR board and representing Europe, the USA and Japan, a clinical epidemiologist, 2 patients with SSc and 3 fellows for literature research. All EUSTAR centres were invited to contribute to the development of recommendations through submission and preliminary selection of the research questions. The systematic literature research was performed using the Pubmed, Medline, EMBASE and Cochrane databases. Retrieved trials were evaluated according to the Jadad classification, and the level of evidence was graded from 1 to 4. Outcome data for efficacy and adverse events were abstracted and effect size, number needed to treat (NNT) and number needed to harm (NNH) were calculated when appropriate.

Results:

In all, 65 EUSTAR Centres provided 304 research questions concerning SSc treatment. These questions were aggregated, subdivided into 19 treatment categories and then subjected to preliminary selection by a web-based Delphi technique. The final set of 26 research questions was created by the Expert Committee based on the results of the Delphi exercise and the expert’s experience.

Conclusions:

This paper is a comprehensive summary of the methods we used to build recommendations for the drug treatment of systemic sclerosis, combining an evidence based approach and expert opinion.

Serum levels of heat shock protein 70, a biomarker of cellular stress, are elevated in patients with systemic sclerosis: association with fibrosis and vascular damage

OBJECTIVE

To determine the clinical significance of heat shock protein (Hsp) 70, a sensitive biomarker for monitoring cellular stress, in systemic sclerosis (SSc), we investigated the prevalence and clinical correlation of serum Hsp70 levels in SSc patients.

METHODS

Serum Hsp70 levels were examined in 48 patients with SSc by enzyme-linked immunosorbent assay.

RESULT

Serum Hsp70 levels were significantly elevated in SSc patients compared to normal controls (n=30), and were similar between patients with diffuse cutaneous SSc (n=26) and those with limited cutaneous SSc (n=22). Serum Hsp70 levels were elevated in 27% of total SSc patients with 30% of diffuse cutaneous SSc patients and 23% of limited cutaneous SSc patients. Hsp70 levels were significantly increased in SSc patients with pulmonary fibrosis or contracture of phalanges compared with those without pulmonary fibrosis or contracture of phalanges. Serum Hsp70 levels correlated positively with modified Rodnan total skin thickness score, renal vascular resistance, serum levels of monocyte chemotactic protein-1, C-reacting protein, and serum levels of 8-isoprostane.

CONCLUSION

Serum Hsp70 levels were increased in SSc patients and were associated with pulmonary fibrosis, skin sclerosis, renal vascular damage, oxidative stress, and inflammation. These results suggest that Hsp70 is a useful serological marker for evaluating cellular stresses and the disease severity in SSc.