Is the 7/2(1)- isomer state of 43S spherical?

We report on the spectroscopic quadrupole moment measurement of the 7/2(1)(-) isomeric state in (16)(43)S(27) [E*=320.5(5) keV, T(1/2)=415(3) ns], using the time dependent perturbed angular distribution technique at the RIKEN RIBF facility. Our value, |Q(s)|=23(3) efm(2), is larger than that expected for a single-particle state. Shell model calculations using the modern SDPF-U interaction for this mass region reproduce remarkably well the measured |Q(s)|, and show that non-negligible correlations drive the isomeric state away from a purely spherical shape.

Efficacy of diffusion-weighted imaging for the differentiation between lymphomas and carcinomas of the nasopharynx and oropharynx: correlations of apparent diffusion coefficients and histologic features

BACKGROUND AND PURPOSE

ADCs may help distinguish benign from malignant head and neck diseases. We sought to evaluate the effectiveness of ADC for differentiating between carcinomas and lymphomas of the nasopharynx and oropharynx.

MATERIALS AND METHODS

We retrospectively compared the ADCs between 24 histologically proved lymphomas and 32 carcinomas, including 8 NPCs and 7 lymphomas of the nasopharynx, and 24 SCCs and 17 lymphomas of the oropharynx. ADCs were determined on tumor-by-tumor (overall ADCs) and pixel-by-pixel (ADC mapping) bases by using 2 b-values (500 and 1000 s/mm(2)).

RESULTS

Lymphomas and oropharyngeal SCCs had unique histologic features in terms of keratinization, cell attenuation, stromal areas, and necrosis and had distinctive ADCs (0.503 ± 0.099 × 10(-3) mm(2)/s for lymphomas and 0.842 ± 0.164 × 10(-3) mm(2)/s for SCCs). However, NPCs and lymphomas were similar in terms of these histologic features, exhibiting comparable ADCs (0.567 ± 0.057 × 10(-3) mm(2)/s for NPCs and 0.528 ± 0.094 × 10(-3) mm(2)/s for lymphomas). Poorly and moderately differentiated SCCs with homogeneous T2 signals were indistinguishable from lymphomas on conventional MR images; however, ADCs of these SCC subtypes were significantly larger than those of lymphomas. ADC mapping profiles with respect to percentage of tumor areas of extremely low, intermediate, and high ADC levels were well-correlated with the histologic features of lymphomas, NPCs, and different types of SCCs.

CONCLUSIONS

The effectiveness of ADC-based differentiation between lymphomas and carcinomas of the nasopharynx and oropharynx depends on their histologic characteristics.

Association of IL28B gene polymorphism with development of hepatocellular carcinoma in Japanese patients with chronic hepatitis C virus infection

IL28B single nucleotide polymorphisms (SNPs) are associated with spontaneous and treatment-induced elimination of hepatitis C virus (HCV). To assess whether the IL28B rs8099917 SNP also affects the progression of chronic HCV infection, we genotyped 511 Japanese HCV patients, including 69 with hepatocellular carcinoma (HCC). The T/T genotype of rs8099917 was not associated with the development of HCC (p = 0.623), although stepwise logistic regression analysis showed that liver cirrhosis, age greater than 68 years, and serum albumin <4.2 mg/dl were associated with HCC onset. It appears that the IL28B SNP does not directly influence hepatocarcinogenesis in chronic HCV infection.

P5-13-23: Individualized Treatment Strategies for HER2−Negative Breast Cancer Subtypes

Background Human epidermal growth factor receptor (HER2)-negative breast cancers are more heterogeneous than HER2−positive cancers, and tailored treatment is therefore required for luminal A and triple-negative breast cancer subtypes (LABC and TNBC). We therefore examined predictive factors for the efficacy of standard chemotherapy in LABC and TNBC subtypes.

Methods A total of 109 LABC and 61 TNBC patients were treated with standard neoadjuvant chemotherapy (NAC) consisting of an anthracycline and/or taxane. The pathological treatment response and prognosis were examined for each subtype. Expression levels of the following factors were examined in association with quasi-pathological complete response (QpCR): estrogen- and progesterone-receptor (ER and PgR) status, HER2, nuclear grade, MIB-1, p53, topoisomerase IIα (topoIIα), cytokeratin (CK) 5/6 and epidermal growth factor (EGFR).

Results QpCR rates in LABC and TNBC were 9.1% (10/109) and 54.1% (33/61), respectively. In LABC, the expression of PgR tended to be inversely associated with pathological response (p=0.087), while in TNBC, increased expression of topoIIa (p=0.006) and MIB-1 (p=0.018) were identified as predictors of QpCR. TopoIIα expression was also significantly associated with pathological response in multivariate analysis (p=0.014). The QpCR rate was higher in TNBC lacking CK5/6 and/or EGFR expression, defined as non-basal subtype (p=0.053).

Conclusions Low expression of PgR may be a possible predictor of the efficacy of chemotherapy in LABC, while a high level of proliferative activity, indicated by topoIIa and MIB-1, is associated with chemosensitivity in TNBC. Further subclassification into basaland non basal-subtypes may also be helpful for the development of individualized treatments.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-13-23.

Multiparametric MR imaging of sinonasal diseases: time-signal intensity curve- and apparent diffusion coefficient-based differentiation between benign and malignant lesions

BACKGROUND AND PURPOSE

The sinonasal region is a platform for a broad spectrum of benign and malignant diseases, and image-based differentiation between benign and malignant diseases in this area is often difficult. Here, we evaluated multiparametric MR imaging with combined use of TICs and ADCs for the differentiation between benign and malignant sinonasal tumors and tumorlike diseases.

MATERIALS AND METHODS

TICs obtained from dynamic contrast-enhanced MR imaging and ADCs were analyzed on a lesion-by-lesion (overall TIC and ADC) and pixel-by-pixel (TIC and ADC mapping) basis in patients with benign (n = 21) or malignant (n = 23) sinonasal tumors and tumorlike diseases. The TICs were semiautomatically classified into 5 distinctive patterns (flat, slow uptake, rapid uptake with low washout ratio, rapid uptake with high washout ratio, and miscellaneous). ADCs were determined by using b-values of 500 and 1000 s/mm(2).

RESULTS

Malignant sinonasal tumors had small (<25%) areas of the type 1 flat TIC profile as determined by pixel-by-pixel TIC analysis and large (≥50%) areas of low or extremely low ADCs (≤1.2 × 10(-3) mm(2/)s) as determined by ADC mapping. Consequently, stepwise classification on the basis of TICs and ADCs successfully (at 100% accuracy) discriminated malignant from benign sinonasal diseases in the present patient cohort.

CONCLUSIONS

Multiparametric MR imaging by using TICs and ADCs may help differentiate benign and malignant sinonasal diseases.

Enhanced silicon oxidation on titanium-covered Si(001)

We report on a core level photoemission study of the formation of an ultrathin SiO(x) layer grown at the interface of a titanium-covered Si(001) surface. Oxygen exposure at room temperature induces a large chemical shift of the Si 2p state, predominantly assigned to Si(4+). The results indicate that a SiO(2 - δ) layer, close to the stoichiometry of SiO(2), is formed below the TiO(x) film. The thickness of the SiO(2 - δ) layer is estimated to be ∼ 0.9 nm, corresponding to three to four oxide layers. Further chemical shift caused by annealing is attributed to the formation of titanium silicate (TiSi(x)O(y)).

cTAGE5 mediates collagen secretion through interaction with TANGO1 at endoplasmic reticulum exit sites

The mechanism of collagen secretion is not completely understood. It is found that cTAGE5 binds to TANGO1, and it is suggested that collagen VII export from the ER is driven by a cTAGE5/TANGO1 complex.

Cutaneous T-cell lymphoma-–associated antigen 5 (cTAGE5), an originally identified tumor antigen, is overexpressed in various cancer cell lines. The cDNA encodes an integral membrane protein containing two coiled-coil motifs and a proline-rich domain. We show that cTAGE5 specifically localizes to the endoplasmic reticulum (ER) exit sites. In addition, cTAGE5 forms a complex with TANGO1 (MIA3), a previously characterized cargo receptor for collagen VII, by the interaction of their coiled-coil motifs. Of interest, cTAGE5, as well as TANGO1, is capable of interacting with the inner-layer coatomer of COPII Sec23/24 complex through their C-terminal proline-rich domains and required for collagen VII secretion. We propose that cTAGE5 acts as a coreceptor of TANGO1 for collagen VII export from the ER.

Evaluation of arterial stiffness after successful renal transplantation using brachial-ankle pulse wave velocity

BACKGROUND

Cardiovascular disease remains a main cause of mortality in renal transplant recipients. Determination of aortic stiffness with pulse wave velocity (PWV) is considered a strong predictor of cardiovascular risk. We investigated arterial stiffness with brachial-ankle pulse wave velocity (baPWV) after successful renal transplantation.

METHODS

We studied 197 patients (mean age = 53.2 ± 10.8 years) who underwent successful renal transplantation. baPWV was evaluated with a noninvasive automatic Omron Colin device. During follow-up (mean = 183.8 ± 108.9 months), we investigated parameters of sex, age, body mass index, duration before (dialysis) and after transplantation, and cardiovascular risk factors (hypertension and diabetes). In all subjects, fasting concentrations of serum creatinine, non-(HDL) high-density lipoprotein-cholesterol (total cholesterol minus HDL-cholesterol), low-density lipoprotein-cholesterol, and triglyceride were also compared with those at enrollment.

RESULTS

Mean baPWV levels were 1519 ± 329 cm/s in our renal transplant recipients. baPWV increased independent of age, duration of dialysis before transplantation, and cardiovascular risk factors. Serum creatinine and dilation did not show any significant correlations to baPWV.

CONCLUSION

In renal transplant recipients, baPWV may be more influenced by past clinical history before transplantation than by current condition. Noninvasive assessment of arterial stiffness with baPWV may be a useful and convenient indicator of cardiovascular disease after renal transplantation.

High Quality a-SiO:H Films and Their Application to a-Si Solar Cells

Hydrogenated amorphous silicon oxide (a-SiO:H) films were prepared by rf glow discharge decomposition of SiH4, CO2 and H2 gas mixture. These films showed better properties than a-SiC:H films. By applying the a-SiO:H to the p-layer, we attained an efficiency of 12.5% for 1cm2 single junction solar cells and a total-area efficiency of 10.1% for 30cm × 40cm tandem submodules.

Flexible a-Si Solar Cells with Plastic Film Substrate

An amorphous silicon solar cell deposited on plastic film substrate has been studied. The solar cell has a new monolithic series-connected structure called SCAF, and will be fabricated by a newly developed fabrication process based on “Stepping Roll” film deposition system.

The process was compared with the conventional glass solar cell process. Preliminary results for small and large area SCAF solar cells were presented and discussed.

Fracture Behavior of Micro-Sized Ni-P Amorphous Alloy Specimens

Fracture behavior of micro-sized Ni-P Amorphous alloy specimens has been investigated using a newly developed mechanical testing machine. Specimens with dimensions of 10 × 12 × 50 μm were prepared by focused ion beam machining. Two types of specimens with different crack geometries were prepared. One specimen has a notch with root radius is 0.25 μtm and the other has a fatigue pre-crack. The shapes of the loaddisplacement curves are different for each type of specimen. The fracture strength of the specimens with a notch is higher than that with a fatigue pre-crack and the fracture surfaces of the specimens are also different for each type of specimen. This may be due to the difference in stress concentration at the crack (notch) tip, and indicates that even a notch with a root radius of 0.25 μm is not able to be regarded as a crack for micro-sized specimens. Therefore, the introduction of a fatigue pre-crack is essential for the evaluation of fracture toughness for such micro-sized specimens.

A case of pyogenic liver abscess infected with Fusobacterium necrophorum depicted by microscopy and confirmed by tissue culture

A 40-year-old man was admitted with a continuous high grade fever accompanying a relatively large solitary liver abscess with septations. A puncture of the abscess revealed gram-negative rods that could be identified histologically as Fusobacterium necrophorum, which was later confirmed by tissue culture. The patient was switched to meropenem and penicillin, and cured of the infection. Fusobacterium necrophorum is a rare bacterium causing potentially fatal liver abscesses in humans. Clinicians should bear Fusobacterium necrophorum in mind when treating patients with an enlarged solitary liver abscess.

[Thoracic aortic rupture resulting from methicillin-resistant Staphylococcus aureus infection: report of a case]

We report a successful surgical treatment of an aortic arch rupture caused by methicillin-resistant Staphylococcus aureus (MRSA) infection in a 72 years old man who had back pain and hemoptysis as symptoms. Computed tomography showed enlargement of the aortic arch within just 4 days. We diagnosed the state of impending rupture of inflammatory aneurysm and performed emergent operation. The upper lobe of the left lung adhered firmly to the site of rupture and sealed as the barrier to prevent bleeding. The aorta was replaced with a dacron graft in situ after entire resection of infected tissue and sufficient irrigation of the pleural cavity. The patient was treated with vancomycin and minocyclin for MRSA infection. The postoperative course of the patient was uneventful. This suggests that an early operation and a proper use of antibiotics lead to a successful clinical result in patient with infectious aortic rupture.

[Use of multidetector-row computed tomography in a patient with completely obstructed left anterior descending artery]

Multidetector-row computed tomography (MDCT) is a useful diagnostic procedure prior to coronary artery bypass grafting (CABG) as it visualizes the coronary artery less invasively, with higher negative predictive value and lower cost compared with standard coronary angiography (CAG). We recently experienced a case in which the left anterior descending artery (LAD) occlusion prevented CAG evaluation of peripheral vascular status and percutaneous coronary intervention (PCI) or CABG could not be indicated by CAG, whereas MDCT demonstrated a patency of the peripheral LAD. An off-pump coronary artery bypass surgery was performed based on the MDCT findings, and the intraoperative findings were essentially consistent with the MDCT findings. Our experience in this case suggests that the indication for CABG may be accurately judged by using high-resolution MDCT in cases in which CABG graftability may not be judged by CAG.

Climacteric-Like Disorders in Prostate Cancer Patients Treated With LHRH Agonists

We assessed long-term side effects with characteristics of female climacteric disorders in prostate cancer patients treated with luteinizing hormone-releasing hormone (LHRH) agonists. Such side effects are not considered to be serious, though they can significantly affect patient quality of life. Sixty-four prostate cancer patients treated with LHRH agonists and 30 benign prostatic hyperplasia patients, as a control group, were surveyed by questionnaire. The median age of the cancer patients was 74.9 years old, ranging from 60 to 94 years, and the median LHRH agonist dosing period was 16.5 months, ranging from 1 to 64 months. The results of the questionnaires were compared between the patients and the controls, as well as between different variables. Sixty (93.8%) of 64 patients claimed symptoms similar to female climacteric disorders. Further, more than 50% of the symptoms included in the questionnaire were reported by 14 (21.9%) of the patients. Symptoms reported by the patients were more severe than those by the controls. Hot flashes, sleep disturbance, and fatigue recorded high scores in the patient questionnaires as compared with those of the controls. In addition, as the term of LHRH agonist use increased, complaints of sweating or coldness in hands and feet increased. Patients without bone metastasis frequently experienced heaviness in the head and headaches compared to those with bone metastasis. The results of our questionnaire-based outcome study showed that side effects similar to female climacteric disorders in prostate cancer patients treated with LHRH agonists were more severe than in the control group, which could be detrimental to quality of life and general well-being.

Broadband and high power terahertz pulse generation beyond excitation bandwidth limitation via chi2 cascaded processes in LiNbO3

We proposed a novel THz generation technique beyond the limitation of the input optical pulse width, based on phase modulation via cascaded chi((2)) process. When intense THz electric field generated by optical rectification lies in electro-optic (EO) crystal, emitted THz field gives phase modulation to the optical excitation pulse. The phase modulation causes excitation pulse narrowing and consequently gives rise to the enhancement of conversion efficiency and THz wave bandwidth broadening. We experimentally realize this generation technique with high chi((2)) EO crystal LiNbO(3) and with subpicosecond pulse from Yb-doped fiber laser. It opens new concept of THz technologies.

Phase I study of sunitinib (SU) in combination with pemetrexed (Pem) in patients (pts) with advanced solid tumors (ST)

e14630

Background: SU is an oral, multitargeted tyrosine kinase inhibitor of VEGFRs, PDGFRs, KIT, RET, FLT3, and CSR-1, and shows antitumor activities in several types of solid malignancies. Non-small-cell lung cancer (NSCLC) xenograft data indicate SU enhanced the antitumor activity of Pem. This phase I study was designed to evaluate the safety, tolerability, and pharmacokinetics (PK) of combination therapy with the oral SU and Pem for Japanese patients with advanced ST. Methods: Pts with ST refractory to standard therapy were randomly assigned to receive either oral SU 50 mg/day for 2 weeks followed by 1 week rest (Schedule 2/1, S-2/1) or SU 37.5 mg continuous daily dose (CDD). Fixed-dose Pem (500mg/m2 IV) was administered on day1 every 21 days. A standard “3+3” design was employed in both treatment schedules and treatment continued until tumor progression or dose-limiting toxicity (DLT) was observed. Results: A total of 12 pts (med. age 63 years, range 49–69; 10 Male/ 2 Female) have been enrolled (6 pts in the S-2/1 arm and 6 pts in the CDD arm). The most common cancer is NSCLC (9 pts, 75%). All patients completed their first cycle for DLT evaluation, and no DLTs were observed in either treatment arm. The most common toxicities were fatigue (n=8), anorexia (n=6), and thrombocytopenia (n=12). Treatment-related ≥ grade 3 adverse events (AEs) included fatigue (n=1), hypertension (n=1), neutropenia (n=4), leucopenia (n=3), thrombocytopenia (n=2), lymphopenia (n=2), and increased ALT (n=1). Three pts (S-2/1: 2, CDD: 1) required dose reduction of SU due to G3 toxicities. All toxicities were clinically manageable and reversible. One pt with NSCLC had a documented PR with cavity formation inside the tumor. Conclusions: SU 37.5 mg/day (CDD schedule) plus Pem 500mg/m2 every 21 days, and SU 50 mg/day (S-2/1 schedule) plus Pem 500mg/m2 every 21 days were well tolerated and associated with encouraging antitumor activity.

[Table: see text]

Diffusion-weighted MR imaging of ameloblastomas and keratocystic odontogenic tumors: differentiation by apparent diffusion coefficients of cystic lesions

BACKGROUND AND PURPOSE

Ameloblastomas and keratocystic odontogenic tumors are major aggressive odontogenic tumors in the maxillomandibular regions, but the differentiation between these 2 tumors is frequently ineffective based on only conventional CT and MR imaging findings. Here, we evaluated diffusion-weighted MR imaging for the differentiation of these 2 odontogenic tumors.

MATERIALS AND METHODS

We prospectively studied 9 patients with ameloblastoma and 7 patients with keratocystic odontogenic tumor using diffusion-weighted MR imaging. Apparent diffusion coefficients (ADCs) of the nonenhancing and solid lesions in these tumors were determined with use of 2 b factors (500 and 1000).

RESULTS

Two types of nonenhancing lesions were identified; one with high signal intensity on fat-suppressed T2-weighted images (type A) and the other with low or intermediate intensity (type B). The type A nonenhancing lesions were observed in all the ameloblastomas, but they were evident in only 2 keratocystic odontogenic tumors. It is interesting to note that the ADCs of the nonenhancing lesions in the ameloblastomas were significantly higher than those of the nonenhancing lesions in the keratocystic odontogenic tumors (2.48 +/- 0.20 x 10(-3) mm(2)/s vs 1.13 +/- 0.56 x 10(-3) mm(2)/s; P < .001). The ADCs of the solid lesions in the ameloblastomas (1.39 +/- 0.15 x 10(-3) mm(2)/s) were significantly lower than those of the nonenhancing lesions in the ameloblastomas and were similar to those of the nonenhancing lesions in the keratocystic odontogenic tumors.

CONCLUSION

ADC determination may be used as an adjunct tool for differentiation between ameloblastomas and keratocystic odontogenic tumors.

Correlating purity by microdissection with gene expression in gastric cancer tissue

Microdissection is a feasible tool for the purification of target cells from heterogeneous tissue components. However, the extent to which cells need to be purified by microdissection for use in gene expression analysis has not been determined. In the present study, we obtained diffuse-type gastric cancer tissues at varying purities, and evaluated the corresponding expression of a cancer-specific gene, KRT19, by quantitative real-time PCR. The relationship between the degree of purity and gene expression was confirmed by using 60-mer oligonucleotide microarray analysis. Cancer-specific gene expression was stable in tissues of 10-50% purity, but at 60% or greater purity the slope of the graph was much steeper, indicating a correlation between tissue purity and increased gene expression. Tissues of 70% purity for cancer cells, acquired by microdissection, were therefore deemed to be of sufficient quality to distinguish between gene expression profiles from microdissected and non-microdissected specimens.

Hepatocyte growth factor and interleukin-6 in combination with prostate volume are possible prostate cancer tumor markers in patients with gray-zone PSA levels

The aim was to assess whether hepatocyte growth factor (HGF) and interleukin (IL)-6 in combination with prostate volume are able to accurately detect prostate cancer in patients with gray-zone prostate-specific antigen (PSA) levels. A total of 159 patients with PSA levels of <10 ng ml(-1) were enrolled. Forty-two (35.3%) were diagnosed with prostate cancer, whereas 117 (64.7%) had no cancer and were used as benign group. HGF and IL-6 density (HGFD and IL-6D, respectively) values were calculated by dividing serum HGF and IL-6 levels with prostate volume. Median IL-6 (2.3 pg ml(-1)) levels for the prostate cancer group were significantly higher than those for the benign group before adjustment for age (1.7 pg ml(-1)) (P=0.0098). After age adjustments, median IL-6 (2.17 pg ml(-1)), HGFD (0.00972 ng ml(-1) cm(-3)), and IL-6D (0.0848 pg ml(-1) cm(-3)) values for the prostate cancer group were significantly higher than those for the benign group (IL-6, 1.78 pg ml(-1); HGFD, 0.00732 ng/ml/cc; and IL-6D, 0.049 pg/ml/cc; P=0.0416, 0.007 and 0.0005, respectively). In receiver operating characteristic analyses, the areas under the curves for HGFD (0.64) and IL-6D (0.68) were significantly greater than those for HGF (0.52) and IL-6 (0.61) (P=0.0006 and 0.019, respectively). With an HGFD cutoff value of 0.00392 ng ml(-1) cm(-3) (sensitivity=100%, specificity=11%), 11.1% of the benign group were able to avoid unnecessary biopsies without missing prostate cancer. HGF and IL-6 levels in combination with prostate volume were shown to be useful parameters for prostate cancer screening in patients with gray-zone PSA levels.

Transcription-reverse transcription concerted reaction and minimal residual disease in axillary sentinel nodes of breast cancer

AIMS

To investigate the use of transcription-reverse transcription concerted reaction (TRC) to detect axillary lymph node metastases.

METHODS

Metastases in 423 lymph nodes obtained from 50 breast cancer patients were investigated by routine pathological hematoxylin and eosin (H and E) staining and quantitative analysis of carcinoembryonic antigen (CEA) mRNA by TRC. Enhanced pathological studies, serial sectioning and immunohistochemistry were conducted for cases which were negative by routine pathology, but positive by TRC.

RESULTS

Pathological examination identified metastatic disease in 67 lymph nodes. TRC CEA mRNA results were concordant with 89.8% of these cases at a threshold of 100 copies. TRC identified 30 false negative nodes, which was reduced to 15 by excluding node biopsies yielding less than 40 microg total RNA. Twelve nodes were histologically negative for cancer, but positive according to TRC. Serial sectioning and immunohistochemical analysis of these nodes revealed macrometastatic lesions in three, micrometastasis in one, and isolated tumor cells in two.

CONCLUSION

TRC for the detection of CEA mRNA may complement routine pathological examination by sentinel lymph node biopsy (SNB) in early breast cancer. We have started an enhanced pathological examination with serial sectioning on all excised sentinel nodes to set the best threshold for the TRC method.

Skewed T cell receptor repertoire of Vdelta1(+) gammadelta T lymphocytes after human allogeneic haematopoietic stem cell transplantation and the potential role for Epstein-Barr virus-infected B cells in clonal restriction

The proliferation of Vdelta1(+) gammadelta T lymphocytes has been described in various infections including human immunodeficiency virus (HIV), cytomegalovirus (CMV) and malaria. However, the antigen specificity and functions of the human Vdelta1(+) T cells remain obscure. We sought to explore the biological role for this T cell subset by investigating the reconstitution of T cell receptor (TCR) repertoires of Vdelta1(+) gammadelta T lymphocytes after human allogeneic haematopoietic stem cell transplantation (HSCT). We observed skewed TCR repertoires of the Vdelta1(+) T cells in 27 of 44 post-transplant patients. Only one patient developed EBV-associated post-transplant lymphoproliferative disorder in the present patient cohort. The -WGI- amino acid motif was observed in CDR3 of clonally expanded Vdelta1(+) T cells in half the patients. A skew was also detected in certain healthy donors, and the Vdelta1(+) T cell clone derived from the donor mature T cell pool persisted in the recipient's blood even 10 years after transplant. This T cell clone expanded in vitro against stimulation with autologous EBV-lymphoblastoid cell lines (LCL), and the Vdelta1(+) T cell line expanded in vitro from the same patient showed cytotoxicity against autologous EBV-LCL. EBV-infected cells could also induce in vitro oligoclonal expansions of autologous Vdelta1(+) T cells from healthy EBV-seropositive individuals. These results suggest that human Vdelta1(+) T cells have a TCR repertoire against EBV-infected B cells and may play a role in protecting recipients of allogeneic HSCT from EBV-associated disease.

Kidney transplantation in patients receiving dialysis treatment for more than 10 years

In the present single center study, we analyzed 277 kidney transplant patients (procedures performed between February 1984 and February 2006) to determine the impact of long-term dialysis on kidney transplant outcomes. Forty-four had been treated prior to renal transplantation with dialysis for more than 10 years (range, 10.0-32.5 years, average, 16.6 years; Group I), while the remaining 233 recipients showed an average end-stage renal disease period of 2.8 years (range, 0-9.8 years; Group II). There were no significant differences in patient survivals between the 2 groups: 97.3% vs 97.4% at 1 year; 85.7% vs 92.4% at 5 years; 85.7% vs 90.7% at 10 years (P = .2347). Five Group I patients died: 2 from infections, 2 from liver dysfunction, and 1 from cerebral bleeding. These causes of death were similar to those among Group II patients. Graft survival was not significantly different between the 2 groups: 95% vs 88.8% at 1 year; 75.5% vs 76.5% at 5 years; 75.5% vs 65.5% at 10 years (P = .6264). Our results suggested that dialysis treatment for more than 10 years did not have negative effects on posttransplantation patient and graft survival.

Retrospective Study of the Effects of Cyclosporine in Comparison With Azathioprine on Renal Transplant Recipients Infected With Hepatitis C Virus

A recent report noted that cyclosporine (CsA) inhibits replication of the hepatitis C virus (HCV) in vitro. Thus, CsA may be a superior immunosuppressant for renal transplant recipients infected with HCV. In the present retrospective study, we assessed whether CsA reduced the clinical impact of HCV infection among those patients. A total of 405 renal transplants were performed between 1973 and 2005, of whom we studied 189 who received CsA-based immunosuppression (CsA group) vs 108 who received an azathioprine-based regimen (AZA group). There were 44 HCVAb carriers and 145 noncarriers in the CsA group, and 41 carriers and 67 noncarriers in the AZA group. Our results showed that patient survival rate was significantly worse among HCVAb carriers than among noncarriers, as the overall survival rates were 82.9% and 90.9%, respectively, after 10 years and 71.5% and 85.7%, respectively, after 20 years (P = .0003). Patient survival rates were also significantly worse in HCVAb carriers than in noncarriers in both groups, which were 83.2% and 95.0%, respectively, after 10 years, and 74.7% and 88.8%, respectively, after 20 years (P = .0147) in the CsA group, and 82.9% and 83.6%, respectively, after 10 years and 70.7% and 80.6%, respectively, after 20 years (P = .0171) in the AZA group. Conversely, no significant difference was seen in patient survival rate for HCVAb carriers between the two groups (83.2% vs 82.9% at 10 years, and 74.7% vs 70.7% at 20 years, P = .8195). Our results confirmed that HCV infection has a negative impact on the long-term survival of renal transplant patients who receive either a CsA-based or an AZA-based regimen, suggesting that CsA does not have a positive impact on HCV carriers.

Colonic J-pouch decreases bowel frequency by improving the evacuation ratio

BACKGROUND/AIMS

To compare the functional outcome of ultra-low anterior resection for rectal cancer with colonic J-pouch reconstruction with that of straight reconstruction.

METHODOLOGY

Twenty-three patients who underwent ultra-low anterior resection with or without J-pouch reconstruction underwent bowel transit study, videodefecography, and answered a questionnaire survey 4 months and 1 year after surgery. Eleven healthy subjects underwent similar testing as controls.

RESULTS

Patients with a J-pouch had less frequent stools than patients with straight reconstruction 4 months after surgery (p<0.05), but the two groups were similar at 1 year. Bowel transit time was similar at both study points. The evacuation ratio was higher after J-pouch than straight reconstruction 4 months after surgery (p<0.05). However, the ratio improved in the straight group, and no difference existed at 1 year. Colonic contraction was seen only near the anastomosis 4 months after surgery, but the contraction proximal to the anastomosis improved over the next 8 months.

CONCLUSIONS

J-pouch reconstruction facilitates evacuation by improving the evacuation ratio. Although straight anastomosis caused excessive stool frequency 4 months after surgery, colonic function continued to improve and was comparable with J-pouch and straight reconstruction 1 year after surgery because the contraction ratio proximal to the anastomosis improved.

Blue-dye technique complements four-node sampling for early breast cancer

AIMS

To examine four-node axillary sampling assisted by a blue dye (4NAS/dye) technique as a sentinel node biopsy (SNB) for breast cancer.

METHODS

Lymphatic mapping was performed by injection of patent blue for 33 consecutive cases with breast cancer. Axillary sampling was performed until four nodes were obtained. This was followed by back-up axillary lymph node dissection to examine the feasibility of 4NAS/dye. The same study with 30 cases was conducted at an independent hospital to confirm the feasibility of this method. This method was then applied to 101 consecutive clinically node-negative patients to avoid axillary-node dissection, with intraoperative diagnosis made by frozen section examination.

RESULTS

The median numbers of blue-stained nodes and nodes excised by 4NAS/dye were 1.7 and 3.4, respectively. The identification rate of sentinel lymph nodes (SNs) was 81.8% using the dye alone and 97.0% when the combination was used. Pathological examination revealed that the nodal status was correctly predicted by the dye alone in 62.5% of cases with metastasis, whereas in 100% by 4NAS/dye. The dye alone was not sufficient to identify SNs, especially in cases with prior excisional biopsy. The identification rate of SNs and the accuracy rate in another feasibility study were 100% and 92.5% in 30 consecutive cases, respectively. 4NAS/dye successfully detected SNs in 100 of 101 cases of the subsequent observational study with an acceptable post-operative axillary morbidity and thus succeeded as an SNB.

CONCLUSIONS

The 4NAS/dye method is reliable for the detection of SNs. This method could be applied to observational studies without radio-isotope.

Effect of formalin on extraction of mRNA from a formalin-fixed sample: a basic investigation

BACKGROUND

The validity of molecular studies using RNA extracted from decades-old formalin-fixed and embedded tissue blocks is well documented. Formalin-fixed samples are, however, known to be poor materials for molecular biological applications. The aim of this study was to investigate the effect of formalin as a preservation agent on RNA quality and relevant molecular applications.

METHODS

The quantity and quality of RNA from liver tissues are modified by the fixation time. Rat liver tissues were harvested and fixed for 4, 8, 12, and 24 h in 10% buffer formalin, and only 9% of RNA could be extracted from the formalin-fixed tissue stored for 4 h.

RESULTS

Agarose gel electrophoresis did not show the characteristic pattern of RNA with 18S and 28S in all lanes. Based on the results, it is thought that the RNA was damaged owing to one or more of the following reasons: 1) formalin directly degrades RNA, 2) formalin inactivates RNase, and/or 3) formalin destroys the reagent for extraction of RNA. In this study, it was shown by electrophoresis that very little RNA was extracted by Trizol with 1% formalin.

CONCLUSIONS

Formalin has direct and indirect ill effects on RNA during the extraction process.

Clinical significance of serum CEA protein and CEA mRNA after resection of colorectal liver metastases

BACKGROUND

It is difficult to predict the recurrence of colorectal liver metastasis after curative hepatectomy. We investigated the relationship between subsequent metastasis and both CEA protein and CEA mRNA (TaqMan PCR) diachronic levels.

PATIENTS AND METHODS

The subjects were 30 patients with colorectal liver metastases. Serum CEA protein and CEA mRNA assays were performed every month after hepatectomy.

RESULTS

Metastasis recurred in 21 of the 30 patients. The CEA mRNA assay showed 26 cases with high (H) levels and 4 with low (L). Among the 15 patients whose protein levels were not elevated (NE group), 6 had recurrence; all 6 belonged to the mRNA H group. None of the 4 patients in the mRNA L group had recurrence. In the protein-elevated (E) group (DFI > 6 months) (n = 7), mRNA was elevated in 5 cases (71.4%) 6 months before recurrence, whereas protein was elevated in 1 case. The sensitivity, specificity and accuracy of CEA protein/mRNA for identifying recurrence were 71.4/100, 100/44.4, and 80/83.3%, respectively.

CONCLUSION

CEA mRNA is more sensitive than CEA protein in detecting recurrence. CEA mRNA may be useful for identifying high-risk groups or detecting recurrence at an early stage, when the CEA protein level is still low.

Gene expression profile analysis of regenerating liver after portal vein ligation in rats by a cDNA microarray system

AIMS

We assessed changes in gene expression of hypertrophied liver after portal vein ligation (PL) in a test group of rats compared to a control group, which had the same size liver but no PL.

METHODS

The portal veins of the left and median lobes in the test group were ligated in an initial operation. Four days after the PL, the liver volume of the posterior caudate lobe (5%) increased two-fold and comprised 10% of the liver. A 90% hepatectomy was then performed, leaving only the hypertrophied posterior caudate lobe, and leaving the normal anterior and posterior caudate lobes (10%) in the control (sham) group. A comparison of the expression profiles between two groups was performed using cDNA microarrays and the hepatic ATP level was measured.

RESULTS

The survival rate for the PL group was significantly higher than for the sham group at 4 days after the hepatectomy (56.3% and 26.7%, P < 0.05). Gene expression of cyclin D1, proliferating cell nuclear antigen, cyclin A and B was upregulated, and the cyclin-dependent kinase inhibitor was downregulated. Increases were observed in: (i) pyruvate dehydrogenase, the tricarboxylic acid cycle cycle regulator, (ii) acyl-CoA dehydrogenase, the oxidation regulator, and (iii) cytochrome oxidases, the oxidative phosphorylation regulator. Hepatic ATP concentration after hepatectomy was better maintained in the PL group than in the sham group (0.48 +/- 0.01 micromol/ml vs. 0.33 +/- 0.01 micromol/ml, P < 0.05).

CONCLUSION

The regenerating liver increased tolerance for extended hepatectomy compared to normal liver. It is believed that this is because the induced rapid regeneration of the remaining liver after hepatectomy increases ATP metabolism.

The prototype of sex chromosomes found in Korean populations of Rana rugosa

The seventh largest chromosome in Japanese populations of the frog Rana rugosa morphologically evolved as a sex chromosome. The sex chromosome is XX/XY type in one geographic form and ZZ/ZW type in another. In contrast, the seventh chromosomes are still homomorphic between the sexes in the other two geographic forms: they are more subtelocentric in the Kanto form and subtelocentric in the western Japanese form. To identify a prototype of the sex chromosomes, we extended our investigation in this study to the Korean form, which is supposed to be close to the phylogenetic origin of this species. The karyotype, a sex-linked gene sequence, and mechanisms of sex determination and gonadal differentiation were all examined. In addition, phylogenetic analyses were performed based on mitochondrial gene sequences and the results of crossings between the Korean and Japanese forms. As a consequence, the more subtelocentric seventh chromosome, shared by the Korean and Japanese Kanto forms, was concluded to be the prototype of the sex chromosomes. Starting at the prototype, a whole process of morphological sex chromosome evolution was reconstructed.