Does D2 plus para-aortic nodal dissection surgery offer a better survival outcome compared to D2 surgery only for gastric cancer consistently? A definite result based on a hospital population of nearly two decades

BACKGROUND AND AIMS

Curative resection is the treatment of choice for gastric cancer. Although it has been concluded that D2 lymphadenectomy plus para-aortic nodal dissection does not improve survival rate in curable gastric cancer, it is unclear whether D2 plus para-aortic nodal dissection has a benefit in some groups of patients. We conducted a retrospective study in our hospital, in which we compared D2 with D2 plus para-aortic nodal dissection lymphadenectomy for gastric cancer in subgroups of each clinical characteristic in terms of long-term survival after surgery.

MATERIAL AND METHODS

We selected 1792 patients who had undergone the treatment with curative intent between 1990 and 2007, 1344 in the D2 group and 448 in the D2 plus para-aortic nodal dissection group. Each procedure was verified by pathological analyses. The primary end points were 5-year overall survival.

RESULTS AND CONCLUSIONS

Median follow-up periods were 50 months for patients assigned to D2 group and 54 months for patients assigned to D2 plus para-aortic nodal dissection group. Overall 5-year survival was not significantly higher in patients assigned to D2 plus para-aortic nodal dissection surgery compared to those assigned to D2 surgery (31.2% (95% confidence interval: 19.8%-42.6%) vs 26.6% (95% confidence interval: 20.3%-32.9%); log-rank p = 0.433). D2 plus para-aortic nodal dissection surgery should only be used for curable gastric cancer of T3-4 and N2 stage and should not be used for T1 disease and total gastrectomy.

A nosocomial outbreak of KPC-2-producing Klebsiella pneumoniae in a Chinese hospital: dissemination of ST11 and emergence of ST37, ST392 and ST395

In China, Klebsiella pneumoniae carbapenemase (KPC) -producing K. pneumoniae isolates have been identified. However, little is known about the spread and outbreak of KPC-producing enterobacterial pathogens. In this study, 48 non-duplicated KPC-producing isolates were analysed for genetic relatedness by pulsed-field gel electrophoresis (PFGE), antimicrobial susceptibility by E-test, and sequence type (ST) by multilocus sequence typing. S1-PFGE and Southern blot were used for plasmid profiling, and PCR and subsequent sequencing were performed to determine the effects of genetic background on the blaKPC gene. From December 2011 to June 2012, an outbreak of the KPC-2-producing K. pneumoniae was observed. The 48 isolates of K. pneumoniae are categorized into eight PFGE types (A1, A2, A3, A4, B, C, D and E). The predominant pathogens of the outbreak were strains with PFGE types A1, A2 and A3, which all belong to ST11. Furthermore, ST37, ST392 and ST395 KPC-2-producing K. pneumoniae isolates have also been sporadically identified. The blaKPC-2 -carrying plasmids vary in size from 30 to 220 kb. The genetic environments of the blaKPC-2 gene for most strains were consistent with the genetic structure of blaKPC-2 on the plasmid pKP048. In conclusion, the dissemination and outbreak of KPC-2-producing K. pneumoniae isolates in this study appeared to be clonal, and ST11 K. pneumoniae was the predominant clone attributed to the outbreak. This is the first study to report the emergence and spread of KPC-producing K. pneumoniae ST392 and ST395 worldwide. Our findings suggest that horizontal transfer of Tn3-based transposons might mediate the spread of blaKPC-2 gene between different K. pneumoniae clones in China.

P1-06-20: Response to Neo-Adjuvant Chemotherapy and Outcomes for I-SPY 1 Patients Stratified by the 70-Gene Prognosis Signature (MammaPrint) and Molecular Subtyping (BluePrint)

Background

Classification of breast cancers into molecular subtypes may be important for the proper selection of therapy for patients as tumors with seemingly similar biology can have strikingly different clinical outcomes. We analyzed response to neo-adjuvant chemotherapy as a function of molecular sub-types and show patient survival from the multi-center neo adjuvant trial, I-SPY I (CALGB 150007/150012; ACRIN 6657). Previous analyses had shown that breast cancer subtypes as identified by immunohistochemistry or molecular analyses, have distinct clinical outcome (Esserman, ASCO 2009). Here, we analyze how the 70-gene signature (MammaPrint) together with an 80-gene molecular subtyping profile (BluePrint=Basal-type, Luminal-type, ERBB2-type; de Snoo, ASCO, 2010 and manuscript under review) can sub-classify patients.

Materials: This study was carried out on genomics data of core needle biopsies from 149 out of 221 patients enrolled in the I-SPY I trial, a multi-center trial designed to identify predictive markers of pathological complete response (pCR) and disease-free survival (DFS) in women with locally advanced breast cancer (3 cm or greater). All women received neoadjuvant Doxorubicin & Cytoxan followed by paclitaxel chemotherapy. The 70-gene and the subtyping signatures, Basal, Luminal and ERBB2-type were determined on 44K Agilent arrays available through the I-SPY 1 data portal (Esserman, ASCO, 2009 and manuscript under review).

Results: The 70-gene signature classified 9% of patients (13/149) as Low Risk, of whom one patient was ERBB2-type, and the other 12 were Luminal-type. None of these patients experienced a pCR. The remaining 136 were classified as 70-gene High Risk (91%), of whom 47% were classified as Luminal-type with a pCR rate of 13%, 41% were Basal-type with a pCR rate of 34%, and 12% were ERBB2-type with a pCR rate of 56%.

Patients with BluePrint Basal-type tumors had a 5-year DFS of 61%; ERBB2-type had a 5-year DFS of 78%; 70-gene High Risk/Luminal-type had a 5-year DFS of 73% and 70-gene Low Risk/Luminal-type showed 5-year DFS of 100%.

The molecular subtype classification shows significant association to clinically assessed receptor status. However, clinically assessed HER2+ patients were distributed across all molecular subtypes, where ER+HER+ are predominantly classified as Luminal-type.

Conclusion: This study was performed with the I-SPY I dataset, which provides a platform to compare, contrast & combine marker signatures to tailor therapy. We show how combining BluePrint, with MammaPrint risk-classification can detect specific groups of patients who are at high risk of recurrence and who would have a higher likelihood to benefit from chemotherapy. Furthermore, MammaPrint Low Risk patients do not benefit from neo-adjuvant therapy, though have excellent survival rates, suggesting that the Low Risk Luminal-type patients could be managed conservatively.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-06-20.

High titer ethanol production from simultaneous enzymatic saccharification and fermentation of aspen at high solids: a comparison between SPORL and dilute acid pretreatments

Native aspen (Populus tremuloides) was pretreated using sulfuric acid and sodium bisulfite (SPORL) and dilute sulfuric acid alone (DA). Simultaneous enzymatic saccharification and fermentation (SSF) was conducted at 18% solids using commercial enzymes with cellulase loadings ranging from 6 to 15 FPU/g glucan and Saccharomyces cerevisiae Y5. Compared with DA pretreatment, the SPORL pretreatment reduced the energy required for wood chip size-reduction, and reduced mixing energy of the resultant substrate for solid liquefaction. Approximately 60% more ethanol was produced from the solid SPORL substrate (211 L/ton wood at 59 g/L with SSF efficiency of 76%) than from the solid DA substrate (133 L/ton wood at 35 g/L with SSF efficiency 47%) at a cellulase loading of 10 FPU/g glucan after 120 h. When the cellulase loading was increased to 15 FPU/g glucan on the DA substrate, the ethanol yield still remained lower than the SPORL substrate at 10 FPU/g glucan.

Comparisons of SPORL and dilute acid pretreatments for sugar and ethanol productions from aspen

This study reports comparative evaluations of sugar and ethanol production from a native aspen (Populus tremuloides) between sulfite pretreatment to overcome recalcitrance of lignocellulose (SPORL) and dilute acid (DA) pretreatments. All aqueous pretreatments were carried out in a laboratory wood pulping digester using wood chips at 170°C with a liquid to oven dry (od) wood ratio (L/W) of 3:1 at two levels of acid charge on wood of 0.56 and 1.11%. Sodium bisulfite charge on od wood was 0 for DA and 1.5 or 3.0% for SPORL. All substrates produced by both pretreatments (except DA with pretreatment duration of 0) had good enzymatic digestibility of over 80%. However, SPORL produced higher enzymatic digestibility than its corresponding DA pretreatment for all the experiments conducted. As a result, SPORL produced higher ethanol yield from simultaneous saccharification and fermentation of cellulosic substrate than its corresponding DA pretreatment. SPORL was more effective than its corresponding DA pretreatment in reducing energy consumption for postpretreatment wood chip size-reduction. SPORL, with lower energy input and higher sugar and ethanol yield, produced higher sugar and ethanol production energy efficiencies than the corresponding DA pretreatment.

Impact of sex, age, race, ethnicity and aspirin use on bleeding symptoms in healthy adults

BACKGROUND

Comparing a patient's bleeding symptoms with those of healthy individuals is an important component of the diagnosis of bleeding disorders, but little is known about whether bleeding symptoms in healthy individuals vary by sex, race, ethnicity, age, or aspirin use. OBJECTIVES, PATIENTS/METHODS: We developed a comprehensive, ontology-backed, Web-based questionnaire to collect bleeding histories from 500 healthy adults. The mean age was 43 years (range 19-86 years), 63% were female, 19% were Hispanic, 37% were African-American, 43% were Caucasian, 8% were Asian, and 4% were multiracial.

RESULTS

18 of the 36 symptoms captured occurred with < 5% frequency, and 26% of participants reported no bleeding symptoms (range 0-19 symptoms). Differences in sex, race, ethnicity, aspirin use and age accounted for only 6-13% of the variability in symptoms. Although men reported fewer symptoms than women (median 1 vs. 2, P < 0.01), there was no difference when sex-specific questions were excluded (median 1 for both men and women, P = 0.50). However, women reported more easy bruising (24% vs. 7%, P < 0.01) and venipuncture-related bruising (10% vs. 3%, P = 0.02). The number of symptoms did not vary by race or age, but epistaxis was reported more frequently by Caucasians than by African-Americans (29% vs. 18%, P = 0.02), and epistaxis frequency decreased with age (odds ratio 0.97 per year, P < 0.01). Paradoxically, infrequent aspirin users reported more bruising and heavy menses than frequent users (21% vs. 8%, P = 0.01, and 56% vs. 38%, P = 0.03, respectively).

CONCLUSIONS

Our findings provide a contemporaneous and comprehensive description of bleeding symptoms in a diverse group of healthy individuals. Our Web-based system is freely available to other investigators.

Robust cellulosic ethanol production from SPORL-pretreated lodgepole pine using an adapted strain Saccharomyces cerevisiae without detoxification

This study reports an ethanol yield of 270L/ton wood from lodgepole pine pretreated with sulfite pretreatment to overcome recalcitrance of lignocellulose (SPORL) using an adapted strain, Saccharomyces cerevisiae Y5, without detoxification. The enzymatic hydrolysate produced from pretreated cellulosic solids substrate was combined with pretreatment hydrolysate before fermentation. Detoxification of the pretreatment hydrolysate using overliming or XAD-4 resin before being combined with enzymatic hydrolysate improved ethanol productivity in the first 4h of fermentation and overall fermentation efficiency. However, detoxification did not improve final ethanol yield because of sugar losses. The Y5 strain showed excellent ethanol productivities of 2.0 and 0.8g/L/h averaged over a period of 4 and 24h, respectively, in the undetoxified run. The furan metabolization rates of the Y5 strain were significantly higher for the undetoxified run than those for the detoxidfied runs, suggesting it can tolerate even higher furan concentrations than those studied. Preliminary mass and energy balances were conducted. SPORL produced an excellent monomeric sugar recovery value of about 85% theoretical and a net energy output of 4.05GJ/ton wood with an ethanol energy production efficiency of 178% before distillation.

Co-expression of xylose reductase gene from Candida shehatae and endogenous xylitol dehydrogenase gene in Saccharomyces cerevisiae and the effect of metabolizing xylose to ethanol

The inability of Saccharomyces cerevisiae to utilize xylose is attributed to its inability to convert xylose to xylulose. Low xylose reductase (XR) and xylitol dehydrogenase (XDH) activities in S. cerevisiae are regarded as the reason of blocking the pathway from xylose to xylulose. We had found that Candida shehatae could also be another source for XR gene except Pichia stipitis in the previous study. In this study, we tried to investigate if the expressed XR from C. shehatae could work with the over-expressed endogenous XDH together to achieve the same goal of converting xylose to ethanol in S. cerevisiae. The XR gene (XYL1) from C. shehatae and endogenous XDH gene (XYL2) were both cloned and over-expressed in host S. cerevisiae cell. The specific enzyme activities of XR and XDH were measured and the result of fermentation revealed that the new combination of two enzymes from different sources other than P. stipitis could also coordinate and work with each other and confer xylose utilization ability to S. cerevisiae.

Integrated Genomic Profiling of Endocrine Therapy Response in Advanced Breast Cancer

PurposeIn hormone receptor positive breast cancer the response rates for endocrine treatment, i.e. tamoxifen (TAM) or aromatase inhibitors (AIs), are only 50 to 70% in the advanced disease setting. The overall aim of this retrospective study is to identify a molecular signature using integrated genomic profiling to improve prediction of endocrine treatment outcome in the advanced disease setting.ObjectivesA) To compare mRNA expression profiles of TAM- and AI-treated patients and to identify genes and pathways associated with treatment outcome.B) To discover miRNA and mRNA signatures predictive for AI response.Patients and MethodsFresh frozen Estrogen Receptor (ER)-positive primary breast cancer specimens from patients with advanced disease treated with first-line AIs (N=55) or TAM (N=109) were analyzed. Expression profiles of 670 miRNAs and 44K mRNAs were generated using multiplex qRT-PCR and microarrays. Profiles were related to clinical response and time to progression (TTP). Statistical and bio-informatic tools were applied to discover and combine markers into an integrated genomic predictive signature. The nearest centroid prediction method of BRB-ArrayTools (Version3.7.0) was used to assess the predictive value.ResultsThe quality controlled and informative expression profiles of 277 miRNAs and 14112 mRNAs in 50 AI-treated tumors and 10433 mRNAs in 101 TAM-treated tumors were included for further analysis in the discovery phase.Global testing of mRNAs linked to Biocarta pathways demonstrated the involvement of the interferon pathway in endocrine therapy response in both AI- and TAM-treated patients. Using BRB-ArrayTools survival analysis to find genes associated with TTP (P&lt;0.05), we identified 1002 mRNAs in AI-treated and 662 mRNAs in TAM-treated tumors to be significantly related with TTP.The overlap of 40 mRNAs between AI- and TAM-treatment was defined as a mRNA signature for endocrine treatment outcome. In TAM-treated patients this classifier has a 69% accuracy (63% sensitivity, 74% specificity), an odds ratio for clinical benefit of 4.69 (95% CI 1.99-11.05, P&lt;0.001) and a hazard ratio for TTP of 0.17 (95% CI 0.10-0.29, P&lt;0.001). In AI-treated patients, this 40mRNA signature has a performance of 78% accuracy (84% sensitivity, 62% specificity) and significantly predicts clinical benefit (odds ratio = 8.27, 95% CI 2.00-34.3, P=0.004) and TTP (hazard ratio = 0.07, 95% CI 0.02-0.22, P&lt;0.001).After statistical analysis a 16 miRNAs classifier for AI-treatment outcome was identified with a performance of 78% accuracy (89% sensitivity, 46% specificity). This classifier significantly predicts clinical benefit (Odds ratio = 7.07, 95% CI 1.57-31.9, P=0.011) and TTP (hazard ratio = 0.24, 95% CI 0.09-0.61, P=0.003).The genomic mRNA and miRNA signatures are currently integrated and validated in additional samples as well as “in silico” on tumors treated with neo-adjuvant AI (Miller et al, JCO 2009).ConclusionThis is the first study that combines miRNA and mRNA profiling in an attempt to define an integrated genomic signature for endocrine treatment outcome. Additional prospective multicenter studies are needed to confirm the predictive value of this signature.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3029.

Analysis of four sorts of clinical factors associated with radiation-induced lung injury in patients with NSCLC after 3D-CRT

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Background: There are different clinical factors associated with radiation-induced lung injury in patients with non-small cell lung cancer (NSCLC) after three-dimensional conformal radiation therapy (3D-CRT) that have been studied, whereas their value are not same. According to their source, the factors can be sorted to four types. Methods: 119 NSCLC patients treated with 3D-CRT during 2003–2005 were retrospectively reviewed. They were divided into two arms according to whether grade >2 radiation- induced lung injury named by RTOG 3.0 were observed. The clinical parameters related to radiation-induced lung injury were divided into four sorts: general state of health and systematic sickness (gender, age, KPS, COPD, heart disease, diabetes), tumor-related factors (location, stage, volume), radiotherapy-related factors (dose, fraction per day, target margin, dosimetric parameters), other treatment factors (chemotherapy timing and agents). Univariate and multivariate analyses of the relation between clinical parameters and radiation pneumonitis were performed. Results: Occurrence of grade >2 radiation-induced lung injury was observed in 17/119 patients. In univariate analyses, GTV (p=0.009), ipsilateral mean lung dose (MLD)(p=0.017), ipsilateral lung V20 (p=0.036)and total lung MLD (p=0.034) were associated with radiation-induced lung injury. In multivariate analysis, ipsilateral lung MLD was the only independent factor associated with radiation-induced lung injury (p=0.019). A significant correlation was also observed between the three volumetric parameters (p≤0.001). Conclusions: Ipsilateral lung MLD was the only independent factor associated with grade >2 radiation-induced lung injury in our study, so that it should be included as a dose constraint factor for 3D-CRT of NSCLC.

No significant financial relationships to disclose.

Daylength responses of various morphogenetic events after panicle initiation in late japonica rice (Oryza sativa L. ssp. japonica)

Plant morphogenesis is an intimate cooperation between environmental signals and a genetically-encoded developmental programme. Although all stages subsequent to floral induction may be influenced by daylength, the information available has come from diverse species during different morphogenetic events. This makes it difficult to investigate how photoperiodic signalling is integrated into various steps of the developmental programme. Here, we report that, in late japonica rice lines, morphogenetic events, including 12th leaf, axis of the main panicle, awn of the glum, anthers, elongation rate of internodes, and pollen fertility of the photoperiod-sensitive genic male-sterile (PGMS) rice, are significantly affected by daylength after panicle initiation. These data indicate that daylength affects many morphologic events, and that changes in morphology are mainly determined by the characteristics of the events themselves. These findings lay a foundation for future investigations into how potentially common photoperiodic signalling system(s) are integrated with diversified developmental events. In addition, we discussed the essential nature of PGMS rice.

Urinary levels of RANTES and M-CSF are predictors of lupus nephritis flare

OBJECTIVE

To explore a new predictor of renal flares after successful inductive treatment for diffuse proliferative glomerulonephritis(DPGN) in patients with lupus nephritis.

METHODS

A cohort of patents with SLE DPGN who were treated initially with prednisone and cyclophosphamide were studied. Those who responded to inductive treatment were followed up for the occurrence of renal flares. Urinary levels of RANTES, MCP-1 and M-CSF were measured by ELISA. Other clinical and laboratory data were collected. The predictors and outcome of renal flare were analyzed.

RESULTS

Seventy-three qualified patients with SLE DPGN were investigated. After a mean follow-up of 24.5 +/- 6.4 months, 22 patients experienced renal flares. The median time to relapse was 14.1 +/- 4.1 months. The patients experiencing renal flare showed higher urinary RANTES, MCP-1 and M-CSF. However, independent predictors of renal flares were increased urinary RANTES and M-CSF. Eight patents developed doubling of the serum creatinine (CRX2) level. The occurrence of renal flares was the only predictor of CRX2.

CONCLUSIONS

Persistently increased urinary levels of RANTES and M-CSF after initial remission are predictors of renal flare in patients with SLE DPGN. Our results indicate monitoring urinary pro-inflammatory factors may direct us in managing those patients.

Rapid eye movement sleep deprivation selectively impairs recall of fear extinction in hippocampus-independent tasks in rats

Previous studies have shown that rapid eye movement (REM) sleep deprivation (RSD) exerts a detrimental effect on some memory tasks. However, whether post-learning RSD impairs memory for fear extinction, an important model of inhibitory learning, remains to be elucidated. The present study examined the effects of post-extinction RSD from 0 to 6 h and 6 to 12 h on recall of fear extinction tested 24 h after extinction training. We found that RSD from 0 to 6 h significantly increased freezing when recall of extinction of cued fear was tested in the context in which rats received extinction training whereas RSD from 6 to 12 h had no effect (experiments 1 and 2, two hippocampus-independent memory tasks). RSD at either time point had no effect on freezing when recall of extinction of cued fear was tested in the context different from that in which extinction training occurred (experiment 3, a hippocampus-dependent memory task). Additionally, we observed no effect of RSD at either time point on freezing during recall test for extinction of contextual fear (experiment 4, a hippocampus-dependent memory task). These results suggest that the effects of post-extinction RSD on memory for fear extinction are complex. RSD impairs recall of fear extinction in hippocampus-independent tasks, but does not affect recall of fear extinction in hippocampus-dependent tasks. Our findings extend previous research on the effects of RSD on learning and memory and support the notion that REM sleep is involved in memory process of certain tasks.

Dynamic changes in orbitofrontal neuronal activity in rats during opiate administration and withdrawal

The orbitofrontal cortex is involved in the reinforcing effects of drugs of abuse. However, how the dynamic activity in OFC changes during opiate administration and withdrawal period has not been investigated. We first tested the effects of opiates and drug craving with the conditioned place preference paradigm, using manganese-enhanced magnetic resonance imaging and traditional electroencephalograph recording techniques in rats. T1-weighted 2D MRI (4.7 T) was used after unilateral injection of MnCl(2) (200 nL, 80 mM) into the right orbitofrontal cortex. The manganese-enhanced magnetic resonance imaging data suggested that the OFC activity decreased during the opiate administration period but recovered increasingly during the withdrawal period. Also, we found decreases and increases in gamma-band (20-100 Hz) activity during the opiate administration and withdrawal period, respectively. Our results showed that orbitofrontal cortex activity decreased during morphine administration and then went up progressively over several days during withdrawal. The time course of the recovery of orbitofrontal activity from inhibition during the withdrawal period may be related to the experience of drug craving.

Cognitive impairment in Parkinson's disease revealed by event-related potential N270

Disturbed cognitive function is a well-recognized feature of idiopathic Parkinson's disease (PD). The aim of this study was to find a susceptive index to reveal the minor cognitive impairment in PD patients. Thirty PD patients without clinical dementia and thirty-four age-matched normal controls performed a matching task while event-related potentials (ERPs) were recorded from their scalp. There were two kinds of stimulus pairs in this study: match condition, the second stimulus (S2) in a pair was identical to the first one (S1); conflict condition, S2 conflicted with S1 in the color attribute. Subjects were required to press a button in the match condition and another button in the conflict condition. A negative ERP component, N270, which was considered to reflect the conflict processing activity in human brain, was evoked by the S2 of the conflict condition. The patient group showed a delayed and smaller N270 than the control group. The prolongation of its peak latency was significant at P3 and P4 electrodes and the reduction of its mean amplitude was significant at P3 electrode. The amplitude of P300 elicited in the match condition was decreased in the patient group at P4 electrode but its latency did not differ from the control group. These results indicate that PD patients as a group showed cognitive decline even in the absence of clinical dementia. N270 is a sensitive index in revealing this minor cognitive impairment.

Stabilization of breast cancer xenograft tumour neovasculature by angiopoietin-1

Angiopoietin-1 is a promoter of physiological vasculogenesis and angiogenesis because it induces vascular branching and smooth muscle recruitment to newly formed blood vessels. However, angiopoietin-1 expression in tumours appears to be uncommon, and angiopoietin-1 overexpression in cancer cells has been reported to lead to inhibition of xenograft tumour growth. We report here that angiopoietin-1 overexpression resulted in stabilization of tumour edge-associated blood vessels, as it prevented vessel dilation and dissociation of smooth muscle cells from existing vessels. In addition, angiopoietin-1 stimulated an infiltration of mesenchymal cells into the tumours, such that the coverage of microvessels by pericytes increased markedly, and the cancer cells were separated into small masses by the host stroma. The rates of both cancer cell proliferation and apoptosis decreased significantly in the presence of angiopoietin-1. Tie2, the receptor for angiopoietin-1, was found to be present in vascular smooth muscle cells in culture in addition to endothelial cells. These findings suggest that a vascular stabilization effect of angiopoietin-1 accounts for the inhibition of tumour growth.

Modulation of endothelial cell growth arrest and apoptosis by vascular endothelial growth inhibitor

Vascular endothelial growth inhibitor (VEGI), a new member of the tumor necrosis factor family, is an endothelial cell-specific gene and a potent inhibitor of endothelial cell proliferation, angiogenesis, and tumor growth. We report here that VEGI mediates the following two activities in endothelial cells: early G(1) arrest in G(0)/G(1) cells responding to growth stimuli, and programmed death in proliferating cells. G(0)/G(1)-synchronized bovine aortic endothelial cells were treated with VEGI before and after the onset of the growth cycle. When the cells were stimulated with growth conditions but treated simultaneously with VEGI, a reversible, early-G(1) growth arrest occurred, evidenced by the lack of late G(1) markers such as hyperphosphorylation of the retinoblastoma gene product and upregulation of the c-myc gene. Additionally, VEGI treatment led to inhibition of the activities of cyclin-dependent kinases CDK2, CDK4, and CDK6. In contrast, VEGI treatment of cells that had entered the growth cycle resulted in apoptotic cell death, as evidenced by terminal deoxytransferase labeling of fragmented DNA, caspase 3 activation, and annexin V staining, all of which were lacking in nonproliferating cells treated with VEGI. Additionally, stress-signaling proteins p38 and JNK were not as fully activated by VEGI in quiescent as compared with proliferating populations. These findings suggest a dual role for VEGI, the maintenance of growth arrest and induction of apoptosis, in the modulation of the endothelial cell cycle.

[Clinical evaluation on second stage reconstruction for laryngostenosis after partial laryngectomy for laryngeal cancer patients]

OBJECTIVE

To present a new method of decannulation for laryngostenosis patients after partial laryngectomy and extended partial laryngectomy, and restoration of the essential functions of larynx and normal neck appearance.

METHODS

Nineteen cases of laryngostenosis after partial laryngectomy and extended partial laryngectomy were treated with second stage reconstruction. The patients had been treated by vertical laryngectomy (6/19) using extended vertical laryngectomy (11/19) and frontolateral laryngectomy (2/19). Among these patients, second stage reconstruction of larynx was performed by using rotary door myocutaneous flap (17/19). Stemohyoideus flap (1/19) and sternocleidomastoid flap (1/19).

RESULTS

Three and five year-survival rates were 91.7% (11/12) and 3/5, respectively. Over-all decannulation rate was 84.2% (16/19), but 94.1% (16/17) in patients with rotary door myocutaneous flap and 0% (0/2) in both patients with sternohyoideus flap and sternocleidomastoid flap. There were 3 decannulation failures (15.8%). All patients resumed acceptable voice, 94.7% (18/19) enjoyed satisfactory phonation, but 5.3% (1/19) showed severe hoarseness. All except 2 patients returned normal swallow function. The latter 2 patients experienced mild abnormal swallow during eating fluid food in early stage of surgery, but had normal swallow function after 1-2 weeks.

CONCLUSION

Functional laryngectomy is a radical operation in selected cases with advanced laryngeal cancer. The second stage reconstruction with bi-pedical rotary door myocutaneous flaps can help decannulation in patients who developed laryngostenosis after partial laryngectomy and extended partial laryngectomy, and restore the essential function of larynx and normal neck appearance.

MRI measurements of orbital tissues in dysthyroid ophthalmopathy

BACKGROUND

Muscle volume investigation by different imaging techniques has proven useful in the diagnosis and follow up of treatment in dysthyroid ophthalmopathy. However, no study on muscle volume measurement by magnetic resonance imaging (MRI) has been done in this disease.

METHODS

Six patients with monocular or asymmetric binocular dysthyroid ophthalmopathy and eight controls were examined with orbital MRI using a surface coil. In the muscle volume study, 2 mm coronal slices were used for measuring the six extraocular muscles (EOM), i.e., medial rectus (MR), lateral rectus (LR) superior rectus (SR), inferior rectus (IR), superior oblique (SO), and inferior oblique (IO) muscles, as well as the orbital fatty tissue (OFT). In the muscle thickness study, 3 mm transverse and sagittal images were used for measuring the four rectus muscles during fixation in different gaze positions in horizontal and vertical planes.

RESULTS

In dysthyroid ophthalmopathy, the muscle volume of the six external eye muscles was significantly larger than in controls, except for the IO. The IR and MR showed the largest increase in muscle volume. The correlation between muscle thickness and different degrees of eye deflections was linear for all four rectus muscles both in patients and controls, and no significant differences in the slopes of the regression lines were found. The volume of OFT was significantly larger in patients than in controls, and the change in volume was larger than that of muscle volume.

CONCLUSIONS

MRI technique makes it possible to observe and evaluate quantitatively the volume of all six extraocular muscles and the orbital fatty tissue in dysthyroid ophthalmopathy. It also makes it possible to evaluate changes in morphology during eye muscle contraction.

[Answers to queries on absence of "heart related to fire" theory in the western Han Dynasty]

This paper claims that all the materials, including the first chapter of Lu's Chun Qiu Shi Er Ji, the theory of Heart Related to Fire in Huai Nan Zi Di Xing Xun, and "Chi Di Zi kills Bai Di Zi" are all later interpolations and are, therefore, unconvincing. The author offers ten questions conflicting with the old sayings.

Determination of active component in silymarin by RP-LC and LC/MS

Silybin, isosilybin, silydianin and silycristin in silymarin were separated and quantitatively determined by RP-HPLC. Two diastereoisomers of silybin and isosilybin were respectively separated by RP-HPLC and confirmed by LC/MS. Chromatographic condition consisted of column: Shim-pack VP-ODS (150 x 4.6mm i.d. 5 microm) and Pre-column (10 x 4.6 mm i.d. 5 microm); mobile phase: methanol and solvent mixture (water: dioxane=9:1) by gradient; flow rate: 1.5ml/min; column temp.: 40 degrees C; detector wavelength: 288 nm; The recovery of 99.66% for silycristin, 99.48% for silydianin, 100.0% for silybin and 98.72% for isosilybin was respectively obtained.

[Preparation of green fluorescent protein retrovirus and its application in mediating gene transfer into retinal pigment epithelial cells]

OBJECTIVE

To determine whether human retinal pigment epithelial (RPE) cells can be infected by retrovirus and modified by retrovirus-mediated gene transfer.

METHODS

Recombination retroviral vector pLNCX-GFP (green fluorescent protein, GFP) was generated by inserting 780 bp GFP cDNA fragment into the MCS site of pLNCX. pLNCX-GFP was transfected into ecotropic packaging cell line PhiX-Eco and amphotropic packaging cell line PhiX-Ampho and PA317. Retroviral titer was tested by counting GFP expression of NIH3T3 cells. Then RPE cells were infected by using GFP retrovirus-containing supernatant.

RESULTS

GFP was expressed and retrovirus was produced upon pLNCX-GFP being transfected into packaging cell line. The GFP retrovirus was able to infect primary cultured human RPE cells and immortalized RPE cell line.

CONCLUSION

The retrovirus can introduce a foreign gene into RPE cells efficiently, thereby it can be used as an important tool to deliver gene into RPE for therapy of fundus diseases.

[Determination of trace cadmium in human hair, fingernail and toenail for ten years by flame atomic absorption spectrometry]

The human hair, fingernail and toenail were collected from one person quarterly for about ten years, respectively thirty-three, forty-one and thirty-nine shares. The contents of traces cadmium in hair, fingernail and toenail have been determined by flame atomic absorption spectrometry, and the results were satisfactory. From a changing curve in human hair, fingernail and toenail cadmium by age, we found that the range of cadmium contents in hair was 0.0100-0.4100 microgram.g-1, in fingernail 0.0295-0.5314 microgram.g-1, in tene-nail 0.0899-1.274 micrograms.g-1, respectively. In the changing curve there is a nonlinear characteristic.

Different processes are involved in human brain for shape and face comparisons

Fifteen subjects participated in a matching task of visual stimuli. Two sequentially presented stimuli in a pair were the same shape (shape match), different shapes (shape mismatch), same human face (face match) or different faces (face mismatch). All four kinds of stimulus pairs were of equal probability. The shape mismatch pairs elicited a negative event-related potential component N270 (Peak latency: 262.1+/-16.5 ms, P4) after the second stimulus onset, while the face mismatch evoked N270 with longer peak latency (301.2+/-19.8 ms, P4) and N450. There exists a specific system for mismatch processing of a complex stimulus (face) in the human brain.

[Transporting into the kidney of medications injected into the renal adipose capsules of rats]

OBJECTIVE

To study the possibility of transporting into the renal tissue of medications by intrarenal adipose capsule injection (IC).

METHODS

1. Methylene blue (MB) was injected into the renal adipose capsule of 18 male healthy SD rats, and normal saline was injected into the renal adipose capsule at the side as control. Both kidneys taken out 1 - 24 hours after the injection, frozen slices were made to observe the transport of MB. 2. Salvia miltiorrhizae (SM) was injected into both renal adipose capsule of 18 male healthy SD rats. 48 healthy male SD rats were randomly divided into two groups, Tetramethylpyrazine (20 mg) was injected into per renal adipose capsule of the rats in one group and 40 mg Tetramethylpyrazine (TP) was injected into the veins of the rats in another group. 64 SD rats were randomly divided into two groups, methylprednisolone sodium succinate (25 mg/kg) was injected into per renal adipose capsule of the rats in one group and 50 mg/kg methylprednisolone (MP) sodium succinate was injected into the veins of the rats in another group. At different time, both kidneys and blood samples of all the rats were taken out. The contents of the three medications inside renal tissue and its blood samples were individually detected by HPLC.

RESULTS

The peak values in the renal tissue of MB, SM, TP, MP were successively 6 h, 24 h (36 mg/g +/- 18 mg/g), 12 h (2 288 microgram/g +/- 236 microgram/g) and 1 h (120 microgram/g +/- 16 microgram/g) after IC. The medicine diffusing into the kidney can maintain longer time in IC group.

CONCLUSION

The renal adipose capsule can be acted as the place of medicine storing and releasing into the kidney. The medicine diffusing into the kidney can attain higher concentration and maintain longer time. IC is a feasible method of local renal ad ministration with much less side effects.

Enhancement of conflict processing activity in human brain under task relevant condition

To investigate the working mechanism of the conflict processing system, pairs of colored numbers were sequentially presented on a screen to subjects. They were asked to determine if the magnitude or the color of the two numbers was identical. Event-related potentials (ERPs) were recorded at the same time. A negative potential peaking at 270 ms (N270) after the onset of the second number (S2) was elicited when S2 conflicted with the first number (S1) in task-relevant and (or) irrelevant attribute conflicts. The mean amplitude of the N270 was more negative in task relevant conflict than in irrelevant conflict. Therefore, the conflict processing activity can be initiated independently of the task, but is enhanced in task relevant conflict.

Morphine Up-regulates expression of substance P and its receptor in human blood mononuclear phagocytes and lymphocytes

In vitro and in vivo studies have indicated that there is an important relationship between morphine and neuropeptide substance P (SP). We therefore investigated the interaction of morphine and cultured human immune cells on the expression of SP, a neuropeptide which we have recently demonstrated to be produced by human monocytes and lymphocytes. Morphine up-regulated SP production in human mononuclear phagocytes and lymphocytes at both the mRNA and the protein level. In addition, morphine induced SP receptor (NK-1R) expression in human lymphocytes. The specific morphine receptor antagonist (naltrexone) blocked morphine-induced SP expression in human mononuclear phagocytes, supporting the concept of authentic morphine receptor-mediated regulation. Since SP modulates neurogenic inflammation and immunologic events, these data suggest that morphine-induced SP expression in cells of the immune system may be of importance in the pathogenesis of immune-mediated diseases, including neuroimmunologic diseases and AIDS.

[A theoretical study on vibrational spectra of S7 rings]

The geometries of S7 rings with the chair-type and boat-type conformations have been optimized using SCF-HF and hybrid density functional methods. (B3LYP) with the split valence 3-21 + G(d) and 6-31 + G(d) basis sets. Vibrational spectra of S7 rings have been predicted by using the same two methods: B3LYP/6-31 + G(d) and HF/3-21 + G(d) over the geometries optimized above, respectively. The symmetries of normal vibrational modes have been assigned. We also make comparisons between the present predictions and the previous experimental data.

Human brain sub-systems for discrimination of visual shapes

To investigate whether stereo and plane visual shapes are processed in the same brain system, participants were instructed to discriminate whether two visual stimuli presented in sequence were identical and event-related potential (ERP) was recorded from their scalp. The first (S1) and the second stimuli (S2) were the same stereo shapes in condition 1, but were different in condition 3. They were the same plane shapes in condition 2, but different in condition 4. A negative component (N270) was recorded in condition 3 and 4, which showed the maximal amplitude in the right posterior scalp in condition 3 and in the anterior scalp in condition 4. A different cognition mechanism is involved in the processing of non-matched stereo and plane visual shapes.

[Effects of ultrasonography on evaluating the status of cervical lymphatic metastasis in patients with oral squamous cell carcinoma]

OBJECTIVE

To investigate effects of ultrasonography on evaluating the status of cervical lymphatic metastasis in patients with oral squamous cell carcinoma (OSCC).

METHODS

Nineteen OSCC patients with the diagnosis confirmed by biopsy of primary focus were included in this study. All the patients were hospitalized in the department of stomatology, Beijing Medical University during June, 1995 and June, 1996, among them there were 13 men and 6 women. The ages were ranged from 31 to 71 years old, with the average of 54.4 years old. The primary focus of 13 cases were in tongue, 3 cases in cheek, 2 cases in gum, and 1 case in the conjunction of gum, mouth floor and tongue respectively. All the patients were examined by ultrasonography prior to operation, and operated with the procedures of excision of primary focus and radical neck dissection. The length, width, Vmax and Vmin and Resistance Index (RI = (Vmax-Vmin)/Vmax) of blood flow of cervical lymphatic nodes were measured with acuson 128 xp/10 color Doppler flow imaging scanner with a 7.5 MHz probe. The total of 34 cervical lymphatic nodes were examined by the scanner. L/W ratios in all nodes, RI and Vmax in 16 nodes were obtained respectively. All results were divided into two groups, metastases and non-metastases groups based on the pathological findings for further statistic analysis. Student t test was employed in the study.

RESULTS

The average L/W ratios, the average Vmax and the average RI were 1.95 and 2.17, 0.24 and 0.14, and 0.80 and 0.56 in metastases and non-metastases groups respectively. There was a significant difference between RI in two groups, but no statistical differences were revealed in L/W ratios and Vmax, despite the great difference in the average Vmax in the two groups. When RI > or = 0.65 and Vmax > or = 0.20 m/s were regarded as the criterion for positive diagnosis, the accuracy rate, the sensibility and the specificity was 91.2%, 90%, and 91.7% respectively in making diagnosis of OSCC.

CONCLUSION

The status of cervical lymphatic metastases in OSCC patients could be evaluated accurately by the color Doppler flow imaging scanner, which might be helpful in making accurately diagnosis of OSCC, selecting the appropriate operation procedure of neck dissection leading to increased survival ratio and improved quality of life for the patients.