Dry age-related macular degeneration: recent progress of therapeutic approaches

Age-related macular degeneration (AMD) is a progressive retinal degenerative disease and a common cause of blindness. In AMD, there are two phenotypes; "atrophic (dry)" and "neovascular (wet)". The former is characterized by the geographic atrophy due to death of retinal pigment epithelium, and the latter is developed due to choroidal neovascularization. While wet AMD can be treated by the inhibition of vascular endothelial growth factor or photodynamic therapy, so far there are no available treatments for dry AMD. Fortunately, understanding of pathogenesis in dry AMD has significantly been progressed and many candidates for the treatment of dry AMD have been introduced in clinical trials as well as preclinical stages. In this article, the progress of therapeutic approaches for dry AMD is reviewed.

Adjunctive mood stabilizer and benzodiazepine use in older Asian patients with schizophrenia, 2001-2009

OBJECTIVE

This study surveyed the use of adjunctive mood stabilizers (MS) and benzodiazepines (BZD) in older Asian schizophrenia patients and examined their demographic and clinical correlates.

METHOD

Information on hospitalized schizophrenia patients aged 55 years or more were extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study. A total of 1,452 patients from 9 Asian countries and territories was included in the study. The patients' sociodemographic and clinical characteristics and the prescriptions of antipsychotics, MS and BZD were recorded using a standardized protocol and data collection procedure.

RESULTS

The frequency of MS prescription was 26.7% in the pooled sample, with 25.5% in 2001, 26.9% in 2004 and 27.7% in 2009. The corresponding figures for BZD were 20.7%, 20.2%, 18.4% and 23.1%, respectively. Multiple logistic regression analysis of the whole sample revealed that patients on MS were younger and more likely to be men and to have extrapyramidal side effects (EPS) and a longer duration of illness. Compared to patients in China, those in Japan were more likely to receive MS, while Korean patents were prescribed less MS. In contrast, there were no significant sociodemographic or clinical correlates of BZD use. Compared to patients in China, their Korean and Singaporean counterparts were more likely to be on BZD.

CONCLUSIONS

The use of MS and BZD is not uncommon in older Asian patients with schizophrenia. Given the paucity of empirical data on the efficacy of these agents in individuals with schizophrenia of any age and concerns about added side effects in older patients in particular, the rationale for the prescription of these agents in this population warrants further examination.

Impact of chronic kidney disease on the presence and severity of aortic stenosis in patients at high risk for coronary artery disease

OBJECTIVE

We evaluated the impact of chronic kidney disease (CKD) on the presence and severity of aortic stenosis (AS) in patients at high risk for coronary artery disease (CAD).

METHODS

One hundred and twenty consecutive patients who underwent invasive coronary angiography were enrolled. Aortic valve area (AVA) was calculated by the continuity equation using transthoracic echocardiography, and was normalized by body surface area (AVA index).

RESULTS

Among all 120 patients, 78% had CAD, 55% had CKD (stage 3: 81%; stage 4: 19%), and 34% had AS (AVA < 2.0 cm²). Patients with AS were older, more often female, and had a higher frequency of CKD than those without AS, but the prevalence of CAD and most other coexisting conventional risk factors was similar between patients with and without AS. Multivariate linear regression analysis indicated that only CKD and CAD were independent determinants of AVA index with standardized coefficients of -0.37 and -0.28, respectively. When patients were divided into 3 groups (group 1: absence of CKD and CAD, n = 16; group 2: presence of either CKD or CAD, n = 51; and group 3: presence of both CKD and CAD, n = 53), group 3 had the smallest AVA index (1.19 ± 0.30*# cm²/m², *p < 0.05 vs. group 1: 1.65 ± 0.32 cm²/m², and #p < 0.05 vs. group 2: 1.43 ± 0.29* cm²/m²) and the highest peak velocity across the aortic valve (1.53 ± 0.41*# m/sec; *p < 0.05 vs. group 1: 1.28 ± 0.29 m/sec, and #p < 0.05 vs. group 2: 1.35 ± 0.27 m/sec).

CONCLUSION

CKD, even pre-stage 5 CKD, has a more powerful impact on the presence and severity of AS than other conventional risk factors for atherosclerosis in patients at high risk for CAD.

Antipsychotic polypharmacy in inpatients with schizophrenia in Asia (2001-2009)

OBJECTIVE

This study aimed to identify trends in the use of antipsychotic polypharmacy (APP) and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009.

METHOD

A total of 6,761 schizophrenia inpatients in 9 Asian countries and territories were examined; 2,399 in 2001, 2,136 in 2004, and 2,226 in 2009. Patients’ socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure.

RESULTS

The proportion of APP prescription decreased from 46.8 % in 2001, to 38.3 % in 2004, and increased to 43.4 % in 2009, with wide intercountry variations at each survey. Multiple logistic regression analysis of the whole sample revealed that patients on APP were younger, had a higher dose of antipsychotics in chlorpromazine equivalents, and more severe positive and negative symptoms. They were also more likely to receive depot and fi rst-generation antipsychotic drugs.

CONCLUSIONS

The frequency of APP prescription varied between countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining APP use in Asia. To resolve the discrepancy between treatment recommendation and clinical practice, regular reviews of prescription patterns are needed.

Elasticity of smectic liquid crystals with focal conic domains

We study the elastic properties of thermotropic smectic liquid crystals with focal conic domains (FCDs). After the application of the controlled preshear at different temperatures, we independently measure the shear modulus G' and the FCD size L. We find out that these quantities are related by the scaling relation G' ≈ γ(eff)/L, where γ(eff) is the effective surface tension of the FCDs. The experimentally obtained value of γ(eff) shows the same scaling as the effective surface tension of the layered systems √(KB), where K and B are the bending modulus and the layer compression modulus, respectively. The similarity of this scaling relation to that of the surfactant onion phase suggests an universal rheological behavior of the layered systems with defects.

Clinical outcome in patients with metastatic colorectal cancer harboring KRAS p.G13D mutation treated with cetuximab

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Background: Metastatic colorectal cancer patients with KRAS codon 12 or 13 mutated tumors are presently excluded from treatment with cetuximab (Cmab). On the other hand, a few patients who have mutated KRAS status occasionally respond to Cmab. The tumors of those patients predominantly had codon 13 mutation, and all codon 13 responder have mutation of p.G13D. We now compared the efficacy of Cmab among patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type colorectal cancer.

Methods: The patients from 9 Japanese institutions were retrospectively collected and analyzed. All patients were refractory to fluoropyrimidine, oxaliplatin and irinotecan, and were treated with Cmab and irinotecan combination regimen. Response rate (RR), progression-free survival (PFS) and overall survival (OS) were calculated respectively according to KRAS status.

Results: Ninety four patients were treated with combination therapy. Among 94 cases, 7 cases were p.G13D-mutant KRAS, 23 cases were other mutant KRAS and 63 cases were wild-type KRAS. Baseline characteristics by each subset were well-balanced. While one partial response (PR) and 4 stable diseases (SD) cases were found in 7 p.G13D-mutated cases, no PR was found in other KRAS mutated cases. Median PFS of the patients with p.G13D-mutant, other KRAS mutant and KRAS wild-type were 4.5 months (95%CI 1.7-), 2.3 months (95%CI 1.9-4.3), 4.6 months (95%CI 3.5-6.5) respectively. And median OS of the patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type were 9.3months (95%CI 8.5- 11.8), 7.4 months (95%CI 4.5-9.4), 12.2 months (95%CI 8.7-19.8) respectively. Although statistical significance was not found between the two mutated groups, there are trends that the patients with p.G13D-mutant may have received better clinical benefits from Cmab than the patients with other KRAS mutant.

Conclusions: Cmab may have therapeutic benefit in the patients with KRAS p.G13D-mutant colorectal cancer although further evaluation is warranted.

No significant financial relationships to disclose.

The Roles of Angiotensin II in Stretched Periodontal Ligament Cells

The loading caused by occlusion and mastication plays an important role in maintaining periodontal ligament (PDL) tissues. We hypothesized that a loading magnitude would be involved in the production of biological factors that function in the maintenance of PDL tissues. Here, we identified up-regulated gene expressions of transforming growth factor-β1 (TGF-β1), alkaline phosphatase (ALP), and angiotensinogen in human PDL fibroblastic cells (HPLFs) that were exposed to 8% stretch loading. Immunolocalization of angiotensin I/II (Ang I/II), which was converted from angiotensinogen, was detected in rat PDL tissues. HPLFs that were stimulated by Ang II also increased their gene expressions of TGF-β1 and ALP. Furthermore, the antagonist for Ang II type 2 receptor, rather than for type 1, significantly inhibited gene expressions induced by the stretch loading. Analysis of these data suggests that Ang II mediates the loading signal in stretched HPLFs to induce expressions of TGF-β1 and ALP.

Adsorption of four perfluorinated acids on non ion exchange polymer sorbents

Perfluorinated compounds (PFCs) have attracted global concern due to their ubiquitous distribution and properties of persistence, bio accumulation and toxicity. The process of adsorption has been identified as an effective technique to remove PFCs in water. Different non ion-exchange polymeric adsorbents were tested with regard to their sorption kinetics and isotherms at low PFCs concentrations. Selected PFCs were perfluorobutanoic acid (PFBA), perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA) and perfluorodecanoic acid (PFDA) and the tested polymers were three types of Dowex optopores (V-493, V503, and L493), Amberlite XAD-4, and Filtrasorb 400 (Granular Activated Carbon-GAC). We observed the selective adsorption of PFCs on synthetic polymers. For PFDA, Amberlite XAD-4 gave the Freundlich adsorption constant of 2,965 (microg PFCs/g sorbent)(microg PFCs/L)(-n), which was higher than that of GAC (121.89 (microg PFCs/g sorbent) (microg PFCS/L)(-n)). In the case of PFBA, GAC showed better performance (13.36) (microg PFCs/g sorbent) microg PFCS/L)(-n) than synthetic polymers (0.62-5.23) (microg PFCs/g sorbent) (microg PFCS/L)(-n). Adsorption kinetics of all adsorbents were well described (R2 = 0.85-1) by pseudo-second order kinetic model. Sorption capacity was influenced by initial PFCs concentration for all adsorbents. GAC reached the equilibrium concentration within 4 hours, Amberlite XAD 4 reached it within 10 hours and other polymers took more than 70 hours.

Abstract P3-10-28: Breast Cancer Patients with Neoadjuvant Chemotherapy Have a Different Clinical Significance of the Ki-67 Expression before and after the Treatment

Background: Reliable predictive and prognostic markers for routine diagnostic purposes are needed for breast cancer patients treated with neoadjuvant chemotherapy (NAC). Ki-67 is a marker for proliferating cells and is overexpressed in many breast cancers. Aim of this analysis was to evaluate the potential role of Ki-67 as a biomarker for the breast cancer patients with NAC.

Patients and Methods: A retrospective search of a prospectively maintained clinical breast cancer database was performed to identify patients treated with NAC at the National Cancer Center Hospital East. The expression of Ki-67 was assessed using immunohistochemistry (MIB-1) in pretherapy core-needle biopsy and post-therapy surgical excision specimens. Levels of Ki-67 index (percentage of Ki-67 positive cancer nuclei) were dichotomized as high (over 10%) and low (less or equal 10%). Survival curve was calculated using Kaplan-Meier method. Log-Rank test was used to detect differences.

Results: Records were available for 296 patients who were received NAC (anthracycline and/or taxane based) between Nov 2001 and Nov 2009. High and low Ki-67 index in pre-therapy were 173 and 123 cases, respectively. 51 cases (17%) of all achieved a pathological complete response (pCR: no residual invasive disease in the breast). pCR rate (23%) in high Ki-67 was significantly different from that (9%) in low Ki-67. 5-year overall survival estimates were 69% and 75%, respectively. However, there was not difference between the groups in overall survival curve at a median follow-up time of 31 months. Of 245 cases with residual invasive, high and low Ki-67 index in post-therapy were 80 and 165 cases, respectively. 62 cases maintained high Ki-67 index before and after NAC, 94 cases maintained low Ki-67 index. There was significantly difference between high and low Ki-67 indexes of post-therapy in overall survival curve (P&lt;0.01), 5-year overall survival estimates were 51% and 81%, respectively. Moreover, there was not significant different between 51 cases with pCR and low Ki-67 index in overall survival curve.

Conclusions: Although Ki-67 index in pre-therapy is a useful predictor for the therapeutic response to NAC, high Ki-67 index in pre-therapy dose not imply that the patients have a worse prognosis. Ki-67 index in post-therapy is useful to predict outcomes for patients with residual invasive disease.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-28.

A comparative study of adsorption of perfluorooctane sulfonate (PFOS) onto granular activated carbon, ion-exchange polymers and non-ion-exchange polymers

Perfluorooctane sulfonate (PFOS) is the latest chemical categorized as persistent organic pollutants (POPs). PFOS appears in the environmental water and tap water in ng L(-1) level. The process of adsorption has been identified as an effective technique to eliminate PFOS in water. Three non-ion-exchange polymers (DowV493, DowL493 and AmbXAD4), two ion-exchange polymers (DowMarathonA and AmbIRA400) and one granular activated carbon (GAC) (Filtersorb400) were tested with regard to their sorption kinetics and isotherms at low PFOS concentrations (100-1000 ng L(-1) equilibrium concentrations). The sorption capacities at 1 microg L(-1) equilibrium concentration decreased in the following order: ion-exchange polymers>non-ion-exchange polymers > GAC, but at further low equilibrium concentration (100 ng L(-1)) non-ion-exchange polymers showed higher adsorption capacity than other adsorbents. In the case of sorption kinetics, GAC and ion-exchange polymers reached the equilibrium concentration within 4 h and AmbXAD4 within 10 h. DowV493 and DowL493 took more than 80 h to reach equilibrium concentration. AmbIRA400 was identified as the best filter material to eliminate PFOS at equilibrium concentration > 1000 ng L(-1). Considering both adsorption isotherms and adsorption kinetics, AmbXAD4 and DowMarathonA were recommended to eliminate PFOS at ng L(-1) equilibrium concentration.

Incremental sanitation improvement strategy: comparison of options for Hanoi, Vietnam

Urban sanitation issues should be tackled strategically, and may be addressed effectively when sewage development is pursued in conjunction with complementary sanitation measures. Five sanitation improvement scenarios employing sewage, night-soil collection-and-treatment (NSCT) system, and/or septic-tank improvement by annual dislodging were analyzed from the perspective of COD loads, total nitrogen loads, and cost under the conditions found in Hanoi, Vietnam. Compared to the development of sewage alone, the scenario of developing NSCT systems in a complementary manner with sewage development was estimated to be the most effective for a rapid decrease of both COD and total nitrogen loads. However, it may be difficult in some cases to replace ordinary water-flush toilet by the micro-flush toilet that are used in NSCT systems. In this case, the scenario employing septic-tank improvement in conjunction with sewage development may be effective for a rapid decrease of COD in locations where septic tanks are widely used under poor maintenance conditions and nitrogen pollution is not serious compared to COD. It was calculated that the two scenarios above would respectively require cost increases of 16 and 22% over the sewage development scenario.

Estimation of pollutant loads from urban roadway runoff

A simulation model consisting of a deposition process and a wash-off process was proposed to evaluate the pollutant loads from urban roadways, and was verified based on field survey data obtained over a 5-year period in the Lake Biwa watershed. The model parameters were determined by minimizing the total sum of squares of differences between the observed data and simulated ones. By applying this model to all roadways in the watershed, the calculated amounts of COD(Mn), organic carbon, nitrogen and phosphorus in particulate forms were 15.9, 15.7, 0.88 and 0.15 kg/(km(2) .d), respectively, and those in dissolved forms were 14.1, 12.5, 2.62 and 0.03 kg/(km(2) .d), respectively. From the results, the pollutant loads of COD(Mn), TN and TP obtained for the Lake Biwa watershed (total roadway area of 98.9 km(2)) were estimated to be 2,950, 350 and 18 kg/d, respectively.

Ground-state and single-particle energies of nuclei around 16O, 40Ca, and 56Ni from realistic nucleon-nucleon forces

We perform ab initio calculations for nuclei around 16O, 40Ca, and 56Ni using realistic nucleon-nucleon forces. In particular, 56Ni is computed as the heaviest nucleus in this kind of ab initio calculation. Ground-state and single-particle energies including three-body-cluster effects are obtained within the framework of the unitary-model-operator approach. It is shown that the CD-Bonn nucleon-nucleon potential gives quite good results close to the experimental values for all nuclei in the present work.

Magnetic resonance imaging findings of ovarian stromal hyperthecosis

Ovarian stromal hyperthecosis is characterized by diffuse distribution of luteinized stromal cells accompanied by varying degrees of stromal hyperplasia. We report a case of ovarian stromal hyperthecosis with particular regard to magnetic resonance (MR)-pathologic correlation. At initial MR imaging, the central areas of the bilateral ovarian masses showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, while the peripheries of the bilateral masses showed isointensity to myometrium on T1-weighted images and heterogeneous signal intensities on T2-weighted images. At 15 days after the initial MR imaging examination, a second MR imaging demonstrated shrinkage of the bilateral ovarian masses. Change in the peripheries to predominantly isointensity to myometrium on the T2-weighted images was also observed. The patient underwent bilateral oophorectomy. Microscopic examination revealed scattered nests of lutein cells on a background of densely proliferated ovarian stroma with minimal collagen production in both ovaries. Edema was occasionally seen in the outer portion but was marked in the central zone of the ovaries, particularly on the left. The final pathologic diagnosis was stromal hyperthecosis. With regard to MR-pathologic correlation, the MR findings in the peripheries of the bilateral masses (isointensity relative to myometrium on both T1- and T2-weighted imaging) showed the characteristics of stromal hyperthecosis.

Cerebellar lesions in multiple system atrophy: postmortem MR imaging-pathologic correlations

BACKGROUND AND PURPOSE

Cerebellar atrophy and white matter T2-hyperintensities have been characterized as cerebellar lesions of multiple system atrophy (MSA). The aim of the study was to correlate MR images with histologic findings in cerebellar lesions of MSA.

MATERIALS AND METHODS

Postmortem T2-weighted images using 1.5T were compared with histologic findings in 7 postmortem-proved cases with MSA. The MR imaging findings in the cerebellar cortices and deep white matter dentate nucleus regions were compared with their histologic findings in each case.

RESULTS

We detected 3 types of cerebellar changes: type 1, no apparent atrophy or signal-intensity changes; type 2, cerebellar atrophy and inhomogeneous (patchy and/or confluent) cerebellar white matter hyperintensities; and type 3, cerebellar atrophy and diffuse white matter hyperintensities. Hypointensities were seen in the dentate nucleus regions. Atrophy of the cerebellar white matter was more severe than that of cerebellar cortices, and this anatomy was well depicted on coronal images. Histologically, degeneration was more severe in the cerebellar white matter than in the cerebellar cortices. Hyperintensities in the cerebellar white matter showed loss of myelinated fibers and gliosis. Hypointensities in the dentate nucleus regions revealed diffuse ferritin deposition in preserved dentate nuclei and white matter both around and within the nuclei.

CONCLUSIONS

Hyperintensities in the cerebellar white matter reflect degenerated white matter associated with loss of myelinated fibers and gliosis, whereas hypointensities in the dentate nucleus regions reflect diffuse ferritin deposition in preserved dentate nuclei and white matter around and within the nuclei. Degeneration is more severe in the cerebellar white matter than in the cerebellar cortices.

Demonstration of cerebral venous variations in the region of the third ventricle on phase-sensitive imaging

BACKGROUND AND PURPOSE

Susceptibility-weighted (SW) MR imaging has enabled noninvasive visualization of the cerebral veins and has shed light on the nature of venous architecture. For successful surgery of the third ventricle, understanding of the anatomy of the subependymal veins of the lateral ventricle and their relationships to the foramen of Monro is required preoperatively. The purpose of this study was to evaluate the anatomic variations of the subependymal veins around the third ventricle by use of phase-sensitive imaging (PSI) on the basis of principles similar to those of SW MR imaging.

MATERIALS AND METHODS

Included in this study were 642 sides in 321 patients. The courses of the anterior septal vein (ASV), thalamostriate vein, and internal cerebral vein (ICV) were evaluated. We classified these into 4 types (IA, IB, IIA, IIB) on the basis of standard classic angiographic criteria. The classification is based on their relationship with the ASV-ICV junction and the presence of a venous angle or a false venous angle, according to the method in a previous study. Other venous variations were classified as type III.

RESULTS

A venous angle was formed in 519 (80.9%), whereas a false venous angle was formed in 123 (19.1%). The ASV-ICV junction was located at the venous angle (type IA) in 407 (63.4%) of 642 sides. In 235 sides (36.6%), the ASV-ICV junction was located posteriorly beyond the foramen of Monro (types IB, IIA, IIB, and III).

CONCLUSIONS

PSI is useful for understanding normal variations of the subependymal veins in the region of the third ventricle.

Association of pharmacokinetics and germ-line mutations in EGFR and ABC transporters with erlotinib toxicity in patients with non-small cell lung cancer (NSCLC)

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Background: Erlotinib demonstrates substantial inter-individual differences in response and the development of skin rash (grade≥2) was correlated with efficacy. Erlotinib interacts with its target EGFR and the efflux transporter ABCB1 and ABCG2. EGFR CA repeat is associated with incidence of skin rash. A 421C>A SNP in ABCG2 and 1236C>T, 2677 G>(T/A), and 3435C>T SNPs in ABCB1 are associated with reduced protein expression. The aim of this study was to evaluate the effects of these variants and pharmacokinetics of erlotinib on toxicity grade in Japanese patients treating single agent erlotinib. Methods: Twenty-two patients with NSCLC received erlotinib orally at 150 mg/day and plasma levels of erlotinib were measured on days 1(D1), 8(D8), and stable phase (>day 14) by high-performance liquid chromatography. DNA from plasma was screened for SNPs in the EGFR, ABCB1, and ABCG2 genes using direct nucleotide sequencing or TaqMan assay. Eligibility criteria included: performance status (PS) < 3, age < 75, stage IIIB-IV, and written informed consent. Results: The mean Cmax (±SD) of D1 and D8 were 1.8 ± 1.0 and 3.1 ± 1.4 μg/ml, respectively. Trough concentration (Cmin) at D1 and steady state were 0.9 and 1.7 μg/ml, respectively. Grade 1–2 skin rash or diarrhea occurred in 95% of patients. One patient (Cmax at D1, 3.0 μg/ml) developed interstitial lung disease after continuous treatment with erlotinib for 3 days. The area under curves and Cmax on D1 were correlated with the severity of skin rash (p=0.05 and 0.01), however, Cmin were not correlated. Patients with homozygous variant and heterozygous for ABCB1 1236C>T, 2677 G>(T/A), and 3435C>T genotype as compared to patients carrying the wild-type were associated with higher Cmin at steady state (2.4 vs 1.2 μg/ml, p=0.01). EGFR CA repeat and AGCG2 421C>A genotype were not associated with any pharmacokinetic parameters. All Patients (n=4) with homozygous variant for ABCB1 1236TT- 2677TT/TA/AA-3435TT developed grade≥2 skin rash or diarrhea. Conclusions: The present study suggests that ABCB1 gene polymorphism is associated with the variable toxicity and pharmacokinetics to erlotinib treatment.

No significant financial relationships to disclose.

Overexpression of EphA4 gene and reduced expression of EphB2 gene: Correlation with liver metastasis in colorectal cancer

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The Eph receptors, members of a large family of transmembrane receptor tyrosine kinases, play important roles in a variety of biologic functions. Recent studies have suggested that EphA4 and EphB2 participate in the growth and development of various carcinomas. This study examined the relations of EphA4 and EphB2 gene expression to clinicopathological factors, especially metastasis, in patients with colorectal cancer. We studied surgical specimens of cancer tissue and adjacent normal mucosa obtained from 205 patients with untreated colorectal cancer. The relative expression levels of EphA4 and EphB2 mRNA in the specimens were measured by quantitative real-time, reverse-transcription polymerase chain reaction. The relative expression level of EphA4 mRNA was higher in the presence than in the absence of liver metastasis, whereas the relative expression levels of EphB2 mRNA were similar. Analysis of the relations between clinicopathological features and gene expression showed that high expression of the EphA4 gene and low expression of the EphB2 gene correlated with liver metastasis. There was no correlation between EphA4 and EphB2 gene expression. Our results suggest that over-expression of the EphA4 gene and reduced expression of the EphB2 gene might promote liver metastasis in colorectal cancer. Over-expression of the EphA4 gene and reduced expression of the EphB2 gene may thus be a useful predictor of liver metastasis in patients with colorectal cancer.

No significant financial relationships to disclose.

Influence of a triblock copolymer on phase behavior and shear-induced topologies of a surfactant lamellar phase

The influence of a triblock copolymer, poly(ethylene oxide)20-b-poly(propylene oxide)70-b-poly(ethylene oxide)20 (Pluronic P123) on the phase behavior and on the shear-induced multilamellar vesicle (MLV, also called Onion) formation in the lyotropic lamellar phase of the nonionic surfactant C10E3 was investigated by means of rheology, small-angle neutron scattering (SANS), and microscopy. Added triblock copolymer shifted the Lalpha-L3 phase transition to lower temperatures. In the presence of triblock copolymer, MLV structure was not stable and easily transformed back into the lamellar phase with increasing polymer concentration and temperature. In the study of the shear-induced MLV formation, we found an increase of the critical shear rate for the onset of the shear-thickening, which also indicates the instability of MLV in the presence of the triblock copolymer. No MLV formation was observed at high polymer concentration. Suppression of the shear-induced MLV formation might be attributed to the enhancement of the effective surface tension originating from the excluded volume effect between polymers adsorbed onto the membranes.

Pharmacokinetics of bevacizumab after topical, subconjunctival, and intravitreal administration in rabbits

PURPOSE

To investigate the pharmacokinetics of bevacizumab in rabbits for three different routes of administrations: intravitreal injection, subconjunctival injection, and eye drops.

METHODS

Pigmented rabbits received bevacizumab in one eye by topical eye drops (1.25 mg/0.05 mL six times daily for the first 7 days), single subconjunctival injection (1.25 mg/0.05 mL), or single intravitreal injection (1.25 mg/0.05 mL). Bevacizumab concentrations in plasma and ocular tissues in the treated and fellow eyes were determined by sandwich enzyme-linked immunosorbent assay at 1, 2, 4, and 12 weeks after administration.

RESULTS

After intravitreal injection in the treated eye, the mean maximum concentrations (C(max)) of bevacizumab in the iris/ciliary body and retina/choroid were 109,192.6, and 93,990.0 ng/g, respectively, whereas after subconjunctival injection, the C(max) was 1418.7 and 295.8 ng/g, respectively. In the fellow eyes, when the drug was administered by intravitreal injection, the C(max) was 753.6 ng/g in the iris/ciliary body and 224.2 ng/g in the retina/choroid and by subconjunctival injection was 1192.9 and 187.0 ng/g, respectively. With eye drops, only a small level of bevacizumab was detected in the iris/ciliary body and retina/choroid. Systemic exposure to bevacizumab was at the same level when administered by intravitreal or subconjunctival injection.

CONCLUSIONS

Intravitreal injection of bevacizumab was the most effective route of administration for intraocular tissue. Also, bevacizumab injected subconjunctivally was transported into the intraocular tissues of the treated eyes at an effective level. Both intravitreal and subconjunctival injections of bevacizumab resulted in high plasma concentrations. Bevacizumab was distributed into the intraocular tissues in fellow eyes via the systemic circulation. This treatment may be effective for blocking vascular endothelial growth factor activity.

Involvement of REG Ialpha protein in the regeneration of ductal epithelial cells in the minor salivary glands of patients with Sjögren's syndrome

The regenerating gene (Reg) was originally isolated from regenerating rat pancreatic islets and revealed recently to constitute a multi-gene family in humans. REG Ialpha protein is known to be overexpressed not only in various human inflammatory diseases but also in various experimental models of inflammation in animal tissues. However, its involvement in pathophysiology of the minor salivary gland (MSG) is not clear. We investigated REG Ialpha expression in the MSG of patients with primary Sjögren's syndrome (SS) and assessed its role in ductal epithelial cell proliferation in such tissues. Lip biopsy specimens were obtained from 40 patients with primary SS and examined using immunohistochemistry for REG Ialpha protein, Ki67 and single-strand DNA (ssDNA). The relationships among clinicopathological factors and expression of REG Ialpha protein, Ki67 and ssDNA in the MSG were then analysed. REG Ialpha protein was expressed rarely in ductal epithelial cells of the normal MSG but was apparently overexpressed in those of patients with SS. The labelling indices for both Ki67 and ssDNA in the ductal cells of the MSGs were significantly higher in SS patients than in controls. Moreover, these labelling indices were significantly higher in REG Ialpha-positive than in negative SS patients. REG Ialpha protein may play a role in the regeneration of ductal epithelial cells in the MSGs of patients with SS.

Effect of Fusarium verticillioides extract on specific antibody production against Paracoccidioides brasiliensis

The aim of this study was to evaluate the effect of partially purified Fusarium verticillioides fumonisins (FB) on the specific humoral response in mice infected with Paracoccidioides brasiliensis (Pb), the agent of paracoccidioidomycosis (PCM). Four groups of male Swiss mice were used (total 44 mice): infected (Pb), treated (FB), infected and treated (Pb/FB) and uninfected and untreated (PBS). Groups Pb and Pb/FB were inoculated i.v. with 1x105 Pb yeast cells (strain Pb18) and, after 28 days, groups FB and Pb/FB were inoculated (s.c.) with partially purified FB from F. verticillioides (5x2.25 mg FB/kg body weight). After 7 days, the plasma levels of total IgG and anti-gp43 IgG (specific antibody) were analysed by immunoenzyme assay (ELISA). The total IgG level was higher in groups Pb, FB and Pb/FB than in PBS (P<0.05) and the anti-gp43 IgG level was raised in groups Pb and Pb/FB, but a significant result was obtained only in Pb/FB, relative to the other groups (P<0.05). In conclusion, FB or other components of F. verticillioides extracts significantly increase the specific antibody response in male Swiss mice infected with Pb.