Polymorphisms in the CASPASE Genes and Survival in Patients With Early-Stage Non–Small-Cell Lung Cancer

Purpose

This study was conducted to determine the impact of potentially functional polymorphisms in the CASPASE (CASP) genes on the survival of early-stage non–small-cell lung cancer (NSCLC) patients.

Patients and Methods

Four hundred eleven consecutive patients with surgically resected NSCLC were enrolled. Nine potentially functional polymorphisms in the CASP3, CASP7, CASP8, CASP9, and CASP10 genes were investigated. The genotype and haplotype associations with overall survival (OS) and disease-free survival (DFS) were analyzed.

Results

Patients with the rs2227310 GG genotype had a significantly decreased OS and DFS compared with patients with the CC + CG genotype (adjusted hazard ratio [aHR] for OS, 1.67; 95% CI, 1.19 to 2.35; P = .003; aHR for DFS, 1.62; 95% CI, 1.19 to 2.22; P = .002). The rs4645981C>T genotype also had a significant effect on OS and DFS (under a recessive model; aHR for OS, 2.00; 95% CI, 1.04 to 3.85; P = .04; aHR for DFS, 2.76; 95% CI, 1.58 to 4.80; P = .0003). When the rs2227310 and rs4645981 genotypes were combined, patients with one or two bad genotypes had worse OS and DFS compared with those who had zero bad genotypes (aHR for OS, 1.75; 95% CI, 1.25 to 2.45; P = .001; aHR for DFS, 1.66; 95% CI, 1.23 to 2.26; P = .001).

Conclusion

The CASP7 rs2227310 and CASP9 rs4645981 polymorphisms may affect survival in early-stage NSCLC. The analysis of these polymorphisms can help identify patients at high risk for a poor disease outcome.

Prediction of bacterial proteins carrying a nuclear localization signal and nuclear targeting of HsdM from Klebsiella pneumoniae

Nuclear targeting of bacterial proteins is an emerging pathogenic mechanism whereby bacterial proteins can interact with nuclear molecules and alter the physiology of host cells. The fully sequenced bacterial genome can predict proteins that target the nuclei of host cells based on the presence of nuclear localization signal (NLS). In the present study, we predicted bacterial proteins with the NLS sequences from Klebsiella pneumoniae by bioinformatic analysis, and 13 proteins were identified as carrying putative NLS sequences. Among them, HsdM, a subunit of KpnAl that is a type I restriction-modification system found in K. pneumoniae, was selected for the experimental proof of nuclear targeting in host cells. HsdM carried the NLS sequences, (7)KKAKAKK(13), in the N-terminus. A transient expression of HsdM-EGFP in COS-1 cells exhibited exclusively a nuclear localization of the fusion proteins, whereas the fusion proteins of HsdM with substitutions in residues lysine to alanine in the NLS sequences, (7)AAAKAAA(13), were localized in the cytoplasm. HsdM was co-localized with importin o in the nuclei of host cells. Recombinant HsdM alone methylated the eukaryotic DNA in vitro assay. Although HsdM tested in this study has not been considered to be a virulence factor, the prediction of NLS motifs from the full sequenced genome of bacteria extends our knowledge of functional genomics to understand subcellular targeting of bacterial proteins.

Results of primary ossiculoplasty in ears with an intact stapes superstructure and malleus handle: inflammation in the middle ear at the time of surgery does not affect hearing outcomes

OBJECTIVE

To determine whether any factors are predictive of success or failure in primary ossiculoplasty employing autologous bone in Austin-Kartush Group A (stapes and malleus handle present) ears.

STUDY DESIGN

Retrospective review of a single-surgeon case series.

SETTING

Two District General Hospitals in the United Kingdom.

PATIENTS

Of 135 patients undergoing primary repair, 116 had sufficient data for analysis (mean follow-up 33 months).

MAIN OUTCOMES MEASURED

Postoperative air-bone gaps (pABG) in patients with differing qualities of middle-ear mucosa (active versus inactive), differing pathologies (mucosal versus squamous) and differing surgical procedures [canal-wall up (CWU) versus canal-wall down (CWD)].

SECONDARY OUTCOME MEASURE

'Belfast Rule of Thumb' (operated ear hearing brought to 30 dB or better or to within 15 dB of contralateral ear).

RESULTS

Postoperative ABGs were closed within 10 dB in 37%, 20 dB in 74% at latest follow-up. The only significant factors predicting hearing outcomes were the status of the canal wall (CWU = 14.1 dB, CWD = 24.7 dB: significant, P = 0.00) and whether surgery was primary or revision. Mean ABG was 14.7 for inactive middle ear mucosa, 17.2 for active middle ear mucosa (not significant, P = 0.25). Excluding CWD procedures from the analysis improved outcomes to 80% (within 20 dB) and 41% (within 10 dB) overall, and the mean for active and inactive ears to 14.2 and 14.0 dB respectively. Postoperatively, 82% of patients fulfilled the 'Belfast Rule of Thumb'.

CONCLUSION

The most significant prognostic factor affecting hearing outcomes - status of the canal wall - is independent of staging. The factor most associated with staging - the status of the middle ear mucosa - is only weakly associated with a successful functional outcome.

Substrate effect on aperture resonances in a thin metal film

We present a simple theoretical model to study the effect of a substrate on the resonance of an aperture in a thin metal film. The transmitted energy through an aperture is shown to be governed by the coupling of aperture waveguide mode to the incoming and the outgoing electromagnetic waves into the substrate region. Aperture resonance in the energy transmission thus depends critically on the refractive index of a substrate. We explain the substrate effect on aperture resonance in terms of destructive interference among evanescent modes or impedance mismatch. Our model shows an excellent agreement with a rigorous FDTD calculation and is consistent with previous experimental observations.

Terahertz near-field vectorial imaging of subwavelength apertures and aperture arrays

We present measurements of the complete terahertz (THz) electric near-field distribution, E(x), E(y) and E(z), in both the time- and frequency-domains, for subwavelength apertures and subsections of subwavelength aperture arrays. Measuring the individual components of the THz near-field with subwavelength spatial resolution, as they emerge from these structures, illustrates how the field interacts with the apertures. We observe the small but measurable y- and z-components of the electric field for both single apertures and arrays. Resonant contributions, attributed to Bloch modes, are detected and we observe the presence of a longitudinal field component, E(z), within the different array apertures, which can be attributed to a diffractive effect. These measurements illustrate in detail the individual THz field components emerging from subwavelength apertures and provide a direct measure of two important mechanisms that contribute to the net transmission of light through arrays.

Terahertz near-field enhancement in narrow rectangular apertures on metal film

We report huge field accumulations in rectangular aperture arrays on thin metal film by using shape resonance in THz frequency region. A huge far-field transmission enhancement is observed in samples of various widths ranging from 10 mum to 1.8 mum which correspond to only an order of lambda/100. Theoretical calculations based on vector diffraction theory indicates 230 times near-field enhancement in case of the 1.8 mum wide rectangular aperture. Transmission measurement through the single rectangular aperture shows that the shape resonance, not the periodicity, is mainly responsible for the transmission enhancement and the corresponding field enhancement.

Circulating interleukin 17 is increased in the acute stage of Kawasaki disease

OBJECTIVES

During the acute phase, patients with Kawasaki disease (KD), an acute systemic vasculitis, demonstrate a drastic increase in serum interleukin-6 (IL-6), which parallels the duration of the fever. Recently, IL-17 has been reported to induce IL-6 production. The aim of this study was to elucidate the involvement of IL-17 in the pathogenesis of KD.

METHODS

Serum samples were obtained from patients with KD (n=30) and normal controls (n=20), and the concentrations of IL-17 and IL-6 measured using enzyme-linked immunosorbent assay (ELISA).

RESULTS

Compared with the normal controls (2.08 +/- 2.14 pg/mL), serum IL-17 was markedly elevated in patients with acute KD (25.47 +/- 5.05 pg/mL): levels gradually decreased in the subacute phase (5.94 +/- 2.83 pg/mL). In the acute phase, levels of IL-6 were 83.52 +/- 19.12 pg/L, which correlated well with the serum levels of IL-17.

CONCLUSION

These results suggest that IL-17 may be involved in the development of, or the effects of inflammation in KD.

Epibulbar complex choristoma and hemimegalencephaly in linear sebaceous naevus syndrome

Epidermal naevus syndrome is a group of congenital syndromes comprising epidermal naevi associated with a variety of developmental abnormalities of the ocular, nervous, skeletal, cardiovascular and urogenital systems. We describe a case of an 8-month-old boy with a brown alopecic plaque on his face and scalp and a vascularized epibulbar mass involving the entire cornea, which had been present since birth. Histopathological examination identified sebaceous naevus in combination with complex choristoma. Magnetic resonance imaging of the brain showed hemimegalencephaly.

Bragg reflection of terahertz waves in plasmonic crystals

We present experimental and theoretical studies on terahertz surface plasmon (TSP) propagation on slit and rectangular aperture arrays in an aluminum sheet. Terahertz waves are coupled onto the plasmonic structures via a parallel plate waveguide. Long-lasting oscillations are observed in the temporal pulse shape after propagating through the periodic structure, whose Fourier transformation into the frequency domain results in Bragg-resonance spectral features. We show that the interference between the incident wave and the radiation reflected from both the aperture array and the waveguide block is responsible for this Bragg-resonance behavior. The reflection coefficient for a single slit is deduced to be 0.017 +/- 0.002.

Combined use of QuantiFERON-TB Gold assay and chest computed tomography in a tuberculosis outbreak

OBJECTIVE

To evaluate the value of the QuantiFERON-TB Gold (QFT-G) assay and chest computed tomography (CT), in addition to the conventional use of the tuberculin skin test (TST) and chest radiography (CXR), in a contact investigation of a tuberculosis (TB) outbreak.

DESIGN

In a contact investigation of a TB outbreak in a high school, TST and CXR were performed on all 1044 employees and students. QFT-G was performed on TST-positive subjects, and CT on QFT-G-positive subjects and students with TST > or =20 mm.

RESULTS

TST was positive in 388 subjects (37.2%), while QFT-G was positive in 7.6% (30/394). CXR showed abnormal findings suggestive of TB in 10 (1.0%) subjects, all of whom were TST-positive and six of whom were QFT-G-positive. Findings suggestive of active TB were noted in 17 (32.7%) of 52 subjects by CT. Collectively, among 21 (1.1%) TB patients, all were TST-positive, 12 (57.1%) were QFT-G-positive and active TB was diagnosed by CT, and not by CXR, in 11 subjects.

CONCLUSION

Compared to the conventional approach, the additional use of QFT-G in TST-positive subjects and chest CT in subgroups with a high probability of infection was found to be more effective in the differentiation between active TB, latent TB and non-infected subjects in a contact investigation.

Epigenetic inactivation of checkpoint kinase 2 gene in non-small cell lung cancer and its relationship with clinicopathological features

Lung cancer is the leading cause of cancer deaths worldwide and is usually associated with late diagnosis and poor prognosis. Tumor-acquired methylation of the promoter CpG islands (CGIs) is an important mechanism for silencing tumor suppressor genes. The checkpoint kinase 2 (CHK2) is a tumor suppressor that plays a crucial role in regulating cell-cycle checkpoints and apoptosis following DNA damage. The methylation statuses of two CGIs, distal and proximal, of human CHK2 gene were determined in non-small cell lung cancers (NSCLCs) using a nested methylation-specific PCR and bisulfite sequencing. The methylation of distal CHK2 CGI was found in 39 (28.1%) of the 139 NSCLCs. Its frequency was significantly more frequent in squamous cell carcinomas than in adenocarcinomas (40.0% vs 19.0%, p=0.006) and was also higher in ever-smokers than in never-smokers with a borderline significance (31.7% vs 17.1%, p=0.071). RT-PCR analysis showed that the distal CGI methylation correlated with CHK2 mRNA expression. However, the methylation of the proximal CHK2 CGI is not specific to tumors and not related to gene expression. These results suggest that the down-regulation of CHK2 gene via distal CGI methylation may play a role in the pathogenesis of NSCLC, particularly squamous cell carcinoma. However, further studies with large numbers of patients are needed to confirm our findings.

Dramatic effect of single-base mutation on the conformational dynamics of human telomeric G-quadruplex

Guanine-rich DNA sequences can form G-quadruplexes. These four-stranded structures are known to form in several genomic regions and to influence certain biological activities. Sometimes, the instability of G-quadruplexes causes the abnormal biological processes. Mutation is a culprit for the destabilization of G-quadruplexes, but the details of mutated G-quadruplexes are poorly understood. In this article, we investigated the conformational dynamics of single-base mutated human telomeric G-quadruplexes in the presence of K(+) with single-molecule FRET spectroscopy. We observed that the replacement of single guanine by thymine in a G-track induces various folded structures, i.e. structural polymorphism. Moreover, direct observation of their dynamics revealed that a single-base mutation causes fast unfolding of folded states under physiological conditions. Furthermore, we found that the degree of destabilization varies according to mutation positions. When the central guanine of a G-track is replaced, the G-quadruplexes unfold quickly at any K(+) concentrations and temperature. Meanwhile, outer-quartet mutated G-quadruplexes have heterogeneous dynamics at intermediate K(+) concentrations and longstanding folded states at high K(+) concentrations. Several factors such as base-stacking interaction and K(+) coordination are responsible for the different dynamics according to the mutation position.

Local capacitor model for plasmonic electric field enhancement

We present a local capacitor model that enables a simple yet quantitatively accurate description of lightning rod effect in nanoplasmonics. A notion of lambda-zone capacitance is proposed and applied to predict the strongly induced electric field by a light source near nanoscale metal edges such as metal tip or metal gap. The enhancement factor, calculated from the local capacitor model, shows excellent agreement with more rigorous results. The lambda-zone capacitor allows a blockwise treatment of nano-optical devices and constitutes a basic element of optical nanocircuits.

3-dimensional local field polarization vector mapping of a focused radially polarized beam using gold nanoparticle functionalized tips

We have measured local electric field polarization vectors in 3-dimensional space on the nanoscale. A radial polarized light is generated by using a radial polarization converter and focused by an objective lens. Gold nanoparticle functionalized tips are used to scatter the focused field into the far-field region. Two different methods, rotational analyzer ellipsometry and Stokes parameters, are used in determining the polarization state of the scattered light. Two methods give consistent results with each other. Three dimensional local polarization vectors could be reconstructed by applying back transformation of the fully characterized polarizability tensor of the tip.

Establishing a surveillance network for severe lower respiratory tract infections in Korean infants and young children

To reduce morbidity and mortality through integrated case management, a pilot study to detect respiratory viruses in patients with acute lower respiratory infections (ALRIs) was designed as part of a nationwide surveillance for this disease in Korea. The study population consisted of hospitalized patients under the age of 5 years with bronchiolitis, pneumonia, croup, or acute respiratory distress syndrome. A prospective 6-month study was performed. Two hundred and ninety-seven nasopharyngeal secretions were collected and multiplex reverse transcriptase polymerase chain reactions (RT-PCR)/polymerase chain reactions (PCR) were performed to detect respiratory viruses. If there were any positive RT-PCR/PCR results, viral cultures were proceeded for confirmation. Respiratory viruses were identified in 49.6% of 296 patients. The detection rates were as follows: respiratory syncytial virus (RSV) was the most commonly detected in 52.7% (87/165), human metapneumovirus (hMPV) in 15.8%, human corona virus (hCoV) in 5.5%, adenovirus in 9.7%, human bocavirus (hBoV) in 5.5%, parainfluenza virus (PIV) in 3.6%, rhinovirus (RV) in 4.2%, and the influenza virus in 3% of the patients with ALRIs. The consistent rate of positive results between RT-PCR and viral culture was 92% (105/114). Using our methods to detect viral causes seemed to be acceptable for the national surveillance of severe acute respiratory infections in infants and children.

Spatiotemporal regulation of fibroblast growth factor signal blocking for endoderm formation in Xenopus laevis

We have previously shown that the inhibition of fibroblast growth factor (FGF) signaling induced endodermal gene expression in the animal cap and caused the expansion of the endodermal mass in Xenopus embryos. However, we still do not know whether or not the alteration of FGF signaling controls embryonic cell fate, or when FGF signal blocking is required for endoderm formation in Xenopus. Here, we show that FGF signal blocking in embryonic cells causes their descendants to move into the endodermal region and to express endodermal genes. It is also interesting that blocking FGF signaling between fertilization and embryonic stage 10.5 promotes endoderm formation, but persistent FGF signaling blocking after stage 10.5 restricts endoderm formation and differentiation.

Aberrant methylation of ADAMTS1 in non-small cell lung cancer

ADAMTS1 (a disintegrin and metalloproteinase with thrombospondin type 1 motifs) is an extracellular matrix metalloproteinase with protease activity and antiangiogenic activity. It has been suggested that ADAMTS1 plays an important role in tumor growth and metastasis. In this study, we examined ADAMTS1 expression in non-small cell lung cancer (NSCLC), and we also evaluated whether the loss of ADAMTS1 expression is due to aberrant methylation of the gene. In addition, we examined the relationship between ADAMTS1 methylation and clinicopathologic features in NSCLC patients. ADAMTS1 expression was examined using reverse-transcription polymerase chain reaction (PCR), and the methylation status of the gene was evaluated by methylation-specific PCR in NSCLC cell lines (n=10) and primary NSCLC tumors (n=98). Down-regulation of ADAMTS1 was observed in 30% (3/10) of the NSCLC cell lines, and this down-regulation was found to be concordant with aberrant methylation of the gene. Furthermore, ADAMTS1 expression was restored after treatment with the demethylating agent, 5-Aza-2'-deoxycytidine, in cell lines that lacked ADAMTS1 expression. Aberrant methylation of the gene was observed in 31.6% (31 of 98) of the NSCLC tumors, while it was found in only 7.1% (7/98) of the corresponding nonmalignant tissues. Methylation in NSCLC tumors was not correlated with the clinicopathologic features of the patients, such as age, gender, and histology and pathologic staging of the tumor. Taken together, these results suggest that aberrant methylation of ADAMTS1 frequently occurs in NSCLCs and that it may play a role in the pathogenesis of NSCLC.

Near field imaging of terahertz focusing onto rectangular apertures

We performed terahertz near-field experiments on single rectangular holes with various lengths grown on an electro-optic crystal substrate with lambda/100 resolution. We find that the near-field amplitude becomes proportionally larger as the rectangle becomes narrower, strongly suggesting that a constant energy passes through even for a very narrow slit. The occurrence of a large field enhancement at the fundamental localized resonance is discussed confirming the funneling of energy at the near-field.

Polymorphisms in the Caspase7 gene and the risk of lung cancer

BACKGROUND

Caspase7 (CASP7) is an executioner CASP that conducted a coordinated program of proteolysis that results in the destruction of critical cell structures, and it plays an important role in the development and progression of cancer. The purpose of this study is to comprehensively evaluate potential functional polymorphisms in the CASP7 gene in relation to the risk of lung cancer.

METHODS

We first captured seven single nucleotide polymorphisms (SNPs) in the regulating region, exons and exon-intron boundaries of the CASP7 gene using public database and then determined their frequencies in 27 healthy Korean individuals. Next, we examined four SNPs (rs12415607g.C>A; rs11593766g.T>G; rs2227310g.C>G; and rs10787498g.T>C) in a case-control study that consisted of 720 lung cancer patients and 720 healthy controls.

RESULTS

Of the four SNPs studied in the case-control study, only the distribution of the rs2227310g.C>G genotypes differed significantly between the cases and controls (P=0.03). The rs2227310 GG genotype was associated with a significantly increased risk of lung cancer when compared with the rs2227310 CC genotype [adjusted odds ratio (OR)=1.42, 95% confidence interval (CI)=1.05-1.93, P=0.02] and with the combined rs2227310 CC and CG genotype (adjusted OR=1.38, 95% CI=1.05-1.81, P=0.02). Consistent with the results of genotyping analysis, the ATGT haplotype (rs12415607A/rs11593766T/rs2227310G/rs10787498T) was associated with a significantly increased risk of lung cancer when compared to other haplotypes (adjusted OR=1.21, 95% CI=1.04-1.42, P=0.02).

CONCLUSION

These results suggest that the CASP7 polymorphisms contribute to the genetic susceptibility to lung cancer.

Clinical course and lung function change of idiopathic nonspecific interstitial pneumonia

Most studies of idiopathic nonspecific interstitial pneumonia (NSIP) have primarily studied mortality. In order to clarify the detailed outcome and prognostic markers in idiopathic NSIP, the clinical course with initial radiological and clinical features was analysed. The clinical course of 83 patients who were classified with idiopathic NSIP (72 fibrotic, 11 cellular; 27 males and 56 females; mean+/-sd age 54.4+/-10.1 yrs) was retrospectively analysed. In fibrotic NSIP, 16 (22%) patients died of NSIP-related causes with a median (range) follow-up of 53 (0.3-181) months. Despite the favourable survival (5-yr 74%), patients with fibrotic NSIP were frequently hospitalised with recurrence rate of 36%. Reduced forced vital capacity at 12 months was a predictor of mortality. On follow-up, lung function was improved or stable in approximately 80% of the patients. The extent of consolidation and ground-glass opacity on initial high-resolution computed tomography correlated significantly with serial changes of lung function, and the presence of honeycombing was a predictor of poor prognosis. During follow-up, eight (10%) patients developed collagen vascular disease. In conclusion, the overall prognosis of fibrotic nonspecific interstitial pneumonia was good; however, there were significant recurrences despite initial improvement and a subset of the patients did not respond to therapy. Some patients developed collagen vascular diseases at a later date.

Role of human cytochrome P450 3A4 in the metabolism of DA–8159, a new erectogenic

The purpose of this paper was to characterize cytochrome P450 (CYP) enzymes involved in N-dealkylation of a new oral erectogenic, DA-8159 to DA-8164, a major circulating active metabolite, in human liver microsomes and to investigate the inhibitory potential of DA-8159 on CYP enzymes. CYP3A4 was identified as the major enzyme responsible for DA-8159 N-dealkylation to DA-8164 based on correlation analysis and specific CYP inhibitor and antibody-mediated inhibition study in human liver microsomes, and DA-8159 metabolism in cDNA expressed CYP enzymes. There is the possibility of drug-drug interactions when prescribing DA-8159 concomitantly with known inhibitors or inducers of CYP3A4. DA-8159 was found to be only a very weak inhibitor of eight major CYPs (1A2, 2A6, 2C8, 2C9, 2C19, 2D6, 2E1 and 3A4), the largest inhibition occurring against CYP2D6 (IC5o 67.7 microM) in human liver microsomes. Drug-drug interactions would not be predicted on the basis of DA-8159 inhibiting the metabolism of coadministered drugs.

Coherent exciton-surface-plasmon-polariton interaction in hybrid metal-semiconductor nanostructures

We report measurements of a coherent coupling between surface plasmon polaritons (SPP) and quantum well excitons in a hybrid metal-semiconductor nanostructure. The hybrid structure is designed to optimize the radiative exciton-SPP interaction which is probed by low-temperature, angle-resolved, far-field reflectivity spectroscopy. As a result of the coupling, a significant shift of approximately 7 meV and an increase in broadening by approximately 4 meV of the quantum well exciton resonance are observed. The experiments are corroborated by a phenomenological coupled-oscillator model predicting coupling strengths as large as 50 meV in structures with optimized detunings between the coupled exciton and SPP resonances. Such a strong interaction can, e.g., be used to enhance the luminescence yield of semiconductor quantum structures or to amplify SPP waves.

Femtosecond phase control of spatial localization of the optical near-field in a metal nanoslit array

We demonstrate spatial control of optical near-fields by femtosecond phase shaping in one-dimensional plasmonic structures. The near-field images display striking temporal-phase dependence, switching between double- and single-peak images within one lattice constant. The change of the near-field distribution is studied in the time and spectral domain. The spectral composition change observed by varying the time delay between two phase-locked femtosecond pulses explains the spatial control of the near-field images. Modal expansion calculations of linear light transmission using the surface impedance boundary condition are in excellent agreement with experiments.

Enhanced surface-excitonic emission in ZnO/Al(2)O(3) core-shell nanowires

We report the influence of an Al(2)O(3) shell on the photoluminescence emission of ZnO nanowires. At room temperature, the spectrum of the core-shell nanowires shows a strong reduction of the relative intensity of the green defect emission with respect to the near-band-edge emission. At 5 K an increase of the relative intensity of the surface exciton band with respect to the donor-bound exciton emission is observed. Annealing the core-shell nanowires at 500 °C does not increase the green defect luminescence at 5 K. We propose a model explaining the spectral changes.

Pulmonary tuberculosis with acute respiratory failure

The aim of the present study was to evaluate the clinical characteristics, prognoses and predictors of mortality of patients with pulmonary tuberculosis (TB) with acute respiratory failure (ARF), and to investigate the adjunctive use of corticosteroids in such cases. TB patients with ARF requiring mechanical ventilation (n = 90) were enrolled retrospectively during 1989-2006. The patients were divided into two groups: tuberculous pneumonia (TBP; n = 66), and miliary TB (MTB; n = 24). The TBP patients were older than the MTB patients (mean age 68.0 versus 54.5 yrs), and the mean+/-SD interval from hospital admission to start of anti-TB treatment was longer for the TBP than for the MTB group (5.0+/-7.0 versus 2.8+/-2.5 days). However, there was no difference in in-hospital mortality rate between the two groups (68.2 versus 58.3%). In the TBP patients, multivariate analysis showed that advanced age and shock unrelated to sepsis were associated with poor outcomes. Even though corticosteroid use was a predictor of survival in TBP patients, it was difficult to conclusively determine the efficacy of corticosteroids in TBP with ARF because of the retrospective study design. The present study reveals the need for randomised controlled trials to clarify the role of corticosteroids as adjunctive therapy in the management of tuberculous pneumonia with acute respiratory failure.

Surface plasmon polariton detection discriminating the polarization reversal image dipole effects

Image dipole effects are highly dependent on the polarization direction, constructive (destructive) interference between real and image dipoles for the vertically (horizontally) aligned one in the vicinity of metal surfaces, respectively. This polarization-reversal of the image dipole effects is quantitatively investigated by using a gold nanoparticle functionalized tip as a local dipolar scatterer and a propagating surface plasmon polariton as an excitation source of dipoles. The polarization-resolved detection technique is applied to separate the radiations of the vertical and the horizontal dipoles from each other. In our study, the image dipole effects on the far-field detected signals are fully explained by the Fabry-Perot like interference between the radiations from the real and the image dipoles, and by considering the finite size effects of the gold nanoparticle.

Advanced terahertz electric near-field measurements at sub-wavelength diameter metallic apertures

Using terahertz-light excitation, we have measured with sub-wavelength spatial, and sub-cycle temporal resolution the time- and frequency-dependent electric-field and surface-charge density in the vicinity of small metallic holes. In addition to a singularity like concentration of the electric field near the hole edges, we observe, that holes can act as differential operators whose near-field output is the time-derivative of the incident electric field. Our results confirm the well-known predictions made by Bouwkamp, Philips Res. Rep. 5, 321-332 (1950), and reveal, with unprecedented detail, what physically happens when light passes through a small hole.

Elevated anti-alpha-enolase antibody levels in Kawasaki disease

OBJECTIVE

By functioning as a heat-shock protein (HSP), alpha-enolase has an important role in the pathophysiology of multivariant vasculitis. Kawasaki disease (KD) is a type of vasculitis occurring primarily in children. The role of alpha-enolase in KD was assessed by measuring anti-alpha-enolase antibody (Ab) titres in patients with KD and the usefulness of anti-alpha-enolase Ab as a diagnostic tool in atypical KD patients was evaluated.

METHODS

Anti-alpha-enolase Ab titres were measured by using an enzyme-linked immunosorbent assay (ELISA) in seven normal control patients, nine febrile control patients and 14 KD patients (10 typical KD, four atypical KD). A standard deviation (SD) of 3 above the mean of the normal control group was considered to be positive reactivity. Western blotting using recombinant human alpha-enolase was performed in four KD patients and three normal controls.

RESULTS

With the positive reactivity limited to +3 SD over the mean (>0.6), 10 out of 14 patients (71%) were positive at the acute onset and 12 out of 14 patients (85.7%) were positive before discharge. In total, 12 out of 14 patients (85.7%) were positive either at acute onset or before discharge. All four atypical KD patients showed positive reactivity. Specific positive bands against recombinant human alpha-enolase were detected by western blotting in all four KD patients, but no reactivity was seen in three patients with normal controls.

CONCLUSION

This is the first study to demonstrate that autoantibodies against the alpha-enolase are present in the sera of KD patients. We suggest that anti-alpha-enolase Ab should be a good candidate for a diagnostic tool in atypical KD.

Incidence of tuberculosis among health care workers at a private university hospital in South Korea

SETTING

A private university hospital in South Korea.

OBJECTIVE

To investigate the incidence of tuberculosis (TB) among health care workers (HCWs) employed at a university hospital in South Korea.

DESIGN

The occurrence of TB cases among HCWs over a 6-year period (2001-2006) was reviewed. The prevalence of TB was compared with that of the general population using a prevalence ratio (PR) adjusted by age and sex.

RESULTS

The study involved 8433 people. TB developed in 61 HCWs (0.72%). The prevalence ratio among all HCWs was 1.05 (95%CI 0.80-1.35). In occupational subgroups, the PRs for doctors, nurses and employees in other departments were respectively 0.58 (95%CI 0.30-1.01), 1.81 (95%CI 1.21-2.59) and 0.95 (95% CI 0.58-1.46). For nurses working in TB-related departments, the relative risk of developing TB was 3.4 times higher (95%CI 1.52-8.25) than for employees in other departments (P=0.005). The PR for nurses working in TB-related department was 5.1 (95%CI 3.23-8.42).

CONCLUSION

Among HCWs, nurses working in TB-related departments were at increased risk of developing TB. This suggests that some TB develops via in-hospital infection.

Structural diversity and extreme stability of unimolecular Oxytricha nova telomeric G-quadruplex

Oxytricha nova telomeric DNA contains guanine-rich short-tandem repeat sequences (GGGGTTTT) n and terminates as a single strand at the 3'-end. This single-stranded overhang forms a novel DNA structure, namely, G-quadruplex, comprising four quartets. In this study, we investigated the structures and dynamics of unimolecular Oxytricha nova ( O. nova) telomeric G-quadruplexes by performing single molecule fluorescence resonance energy transfer (FRET) spectroscopy and bulk circular dichroism (CD) measurements. We observed that unimolecular O. nova G-quadruplexes exhibit structural polymorphism according to monovalent cations. In the presence of Na (+), only antiparallel conformation is detected, which was demonstrated in previous studies; however, in the presence of K (+), they fold into two different conformations, a parallel conformation and an antiparallel one different from that induced by Na (+). Furthermore, these G-quadruplexes show extremely high stability in their dynamics when compared with human G-quadruplexes. While human telomeric G-quadruplexes that possess three quartets display fast dynamic behavior (<100 s) at low K (+) concentrations or high temperatures, O. nova G-quadruplexes maintain their conformational state for a long time (>1000 s), even at the lowest K (+) concentration and the highest temperature investigated. This high stability is primarily due to an extra quartet that results in additional cation coordination. In addition to cation coordination, we propose that other factors such as base stacking and the size of the thymine loop may contribute to the stability of O. nova G-quadruplexes; this is based on the fact that the O. nova G-quadruplexes were observed to be more stable than the human ones in the presence of Li (+), which is known to greatly destabilize G-quadruplexes because of imprecise coordination. This extreme stability of four-quartet G-quadruplexes enables telomere protection even in the absence of protective proteins or in the case of abrupt environmental changes, although only a single G-quadruplex structure can be derived from the short single-stranded overhang.

Identification of polymorphisms in the XIAP gene and analysis of association with lung cancer risk in a Korean population

The X-linked inhibitor of apoptosis protein (XIAP) is a potent mammalian IAP, and has been shown to play an important role in development and progression of cancer. Polymorphisms in the XIAP gene may influence XIAP production or activity, thereby modulating susceptibility to lung cancer. To test this hypothesis, we first screened for polymorphisms in the XIAP gene by direct sequencing of genomic DNA samples from 27 healthy Korean women and then performed a case-control study to evaluate the association between the polymorphisms and the risk of lung cancer. The XIAP genotypes were determined by polymerase chain reaction amplification and melting curve analysis in 582 lung cancer patients and in 582 healthy control subjects who were frequency-matched for age and sex. We identified 12 single nucleotide polymorphisms (SNPs), one novel SNP [30051C>G (A321G) in exon 3] and the following 11 known SNPs: 192G>C (rs5956578), 262C>T (rs28382699), 318C>T (rs5958318), and 374C>T (rs12687176) in the putative promoter; 26615A>G (rs2355676) in intron 1; 41725A>G (rs5958338) in intron 5; 42009A>C (Q423P, rs5956583) in exon 6; 48162T>C (rs17334739) and 48228C>T (rs28382739) in intron 6; and 48542A>G (rs28382740) and 49333G>T (rs28382742) in 3'-UTR. Four of these 12 SNPs were selected for large-scale genotyping based on their frequencies and haplotype tagging status: 262C>T, 318C>T, 374C>T, and 42009A>C. The four XIAP polymorphisms and their haplotypes exhibited no apparent relationship with the risk of lung cancer. In addition, we observed no evidence of effect modification by age, sex, smoking history, or tumor histology. These results suggest that XIAP polymorphisms do not significantly affect susceptibility to lung cancer in Koreans.

Hypermethylation of the Ras association domain family 1A (RASSF1A) gene in gallbladder cancer

The tumor suppressor gene Ras association domain family 1A (RASSF1A) is highly methylated in a wide range of human sporadic tumors. The current study investigated the hypermethylation of RASSF1A, the expression of RASSF1A protein, and the correlation between these and the clinicopathological features of gallbladder (GB) cancer in Korean patients. Formalin-fixed, paraffin-embedded tumors and non-neoplastic GB tissues (22 carcinomas, 8 adenomas, 26 normal epithelia) were collected from patients who had undergone surgical resection. The methylation status of two regions of the RASSF1A CpG island was determined by methylation-specific PCR (MSP), and the expression of RASSF1A protein was examined by immunohistochemistry using tissue microarrays. The K-RAS mutation was analyzed by direct sequencing. Methylation of the RASSF1A promoter (region 1) was detected in 22.7% (5/22) of carcinomas, 12.5% (1/8) of adenomas, and 0% (0/26) of normal gallbladder epithelia (P = 0.025). Methylation of the first exon (region 2) was found in 36.4% (8/22) of carcinomas, 25.0% (2/8) of adenomas, and 8.0% (2/26) of normal gallbladder epithelia (P = 0.038). K-RAS mutations were present in 4.5% (1/22) of carcinomas and 25% (2/8) of adenomas. RASSF1A methylaton was not associated with clinicopathological factors or K-ras mutation. Reduction or loss of RASSF1A expression was observed in most methylated adenocarcinomas. Three RASSF1A-expressing human biliary tract cancer cell lines examined contained unmethylated promoters and exons 1. These results suggest that downregulation of RASSF1A expression by DNA hypermethylation may be involved in GB carcinogenesis.

The emerging role of pituitary tumour transforming gene (PTTG) in endocrine tumourigenesis

It is now 10 years since PTTG was first cloned and isolated. Perhaps the major story of the intervening decade of work performed by numerous groups around the world is the sheer multifunctionality ascribed to this gene. PTTG has been implicated in mechanisms of gene transactivation, cell transformation, angiogenesis, metabolism, apoptosis, DNA repair, genetic instability and mitotic control, both in endocrine and non-endocrine settings. In the current review, we cast a critical eye over a decade of PTTG research within the field of endocrine neoplasia.

Vector field mapping of local polarization using gold nanoparticle functionalized tips: independence of the tip shape

We have measured local electric field vectors of local polarizaton on the nanoscale using gold nanoparticle functionalized tips as local field scatterers. In our experiments, the local field induces a dipole-moment in the gold nanoparticle functionalized tip, which then radiates into the far-field, transferring the full information about the local electric field from the near into the far field. The polarization characteristics of the scattered fields are analyzed using a conventional ellipsometry method. The tip dependent scattering function- the polarizability tensor- is fully determined by far field scattering measurements. Once the polarizability tensor for each tip is correctly accounted for in the data analysis, our results show that the finally determined local field polarization vectors are essentially independent of the tip shape.

Separase, securin and Rad21 in neural cell growth

The key mitotic regulator securin is expressed at low levels in fetal brain compared with adult, and modulates the proliferation of human embryonic neuronal N-Tera2 (NT2) cells. We now examine the function and expression of securin's interacting partner separase, along with Rad21, the functional component of cohesin, which is cleaved by separase following interaction with securin. In contrast to securin, the cleaved forms of separase and Rad21 were highly expressed in human fetal cerebral cortex compared with adult. In a murine model of absent securin expression - the PTTG knock-out mouse - separase and Rad21 were over-expressed in multiple brain regions. In addition, cDNA array analysis of other key mitotic regulators additionally identified cyclin C and sestrin 2 to be induced in the brains of securin-null mice compared with wild type. Further, Rad21 mRNA expression was highly correlated with that of securin, separase, cyclin C and sestrin 2 in fetal brains. In embryonic neuronal NT2 cells, siRNA repression of separase failed to significantly alter cell turnover, whereas repression of securin expression resulted in increased levels of the activated forms of Rad21 and separase, and promoted cell proliferation. Our data suggest that the co-ordinated expression of separase, securin and Rad21 is fundamental for the developing brain.

Thyroid cancer: are molecular studies making any difference?

'Translational research' encompasses all activities that apply basic scientific research findings to clinical practice. Although it has taken almost 20 years since the first scientific discoveries, the approval of new 'drugs' such as Herceptin and Avastin represents a successful example. There has also been successful translation of science into the clinic in the field of otolaryngology. In the last decade, we have seen major developments in molecular biology and genetics. Two notable achievements have been the completion of the human genome project and the parallel advances in high-throughput molecular genomic and proteomic technologies. Linked with these events has been the enormous accumulation of new data which offers the promise of important future clinical applications. This review aims to discuss these major scientific developments, to demonstrate successes in thyroid translational research, and to summarise more recent research findings in thyroid disease which provide hope for the development of future clinical tools.

Terahertz electromagnetic wave transmission through random arrays of single rectangular holes and slits in thin metallic sheets

We report on the observation of terahertz transparency in random arrays of the single rectangular holes and slits with the areal coverage of only 12%. The terahertz transparency occurs at the fundamental shape resonance of the rectangular holes and confirms the theoretical predictions of earlier works of García-Vidal et al. [Phys. Rev. Lett. 95, 103901 (2005)] on single rectangular holes and of Ruan and Qiu [Phys. Rev. Lett. 96, 233901 (2006)] on random arrays of holes.

Fourier-transform terahertz near-field imaging of one-dimensional slit arrays: mapping of electric-field-, magnetic-field-, and Poynting vectors

We present 2D measurements of the full THz electric field behind a sample consisting of multiple slits in a metal foil. Our measurements, which have a sub-wavelength spatial, and a sub-period temporal resolution, reveal electric field lines, electric field vortices and saddle points. From our measurements we are able to reconstruct the magnetic field and, finally, the position and time-dependent Poynting vector which shows the flow of energy behind the sample. Our results show that it is possible to study the flow of light near sub-wavelength plasmonic structures such as slit-arrays and, by implication, other metamaterial samples.

Dental otalgia

BACKGROUND

Secondary or referred otalgia can represent a diagnostic challenge to the otolaryngologist. Collectively, dental disorders are the most common causes of secondary otalgia presenting to the ENT clinic, and may account for up to 50 per cent of referred otalgia. Temporomandibular joint dysfunction syndrome represents the most common dental cause of referred otalgia. Decay and pulpal inflammation of posterior teeth can also frequently present as otalgia. The common embryological developmental origin of both oral and dental structures and the ear is responsible for their overlapping sensory nerve supplies, and this explains referred otalgia secondary to dental and temporomandibular joint disorders. These disorders can be easily overlooked, resulting in unnecessary and costly investigations.

AIMS

This review aims to give a succinct overview of common dental causes of otalgia, and to provide ENT clinicians with guidelines for performing a rapid and simple dental and temporomandibular joint examination, which will reliably diagnose or exclude dental otalgia.

Increased serum levels of macrophage migration inhibitory factor in patients with Kawasaki disease

OBJECTIVE

To determine whether serum levels of macrophage migration inhibitory factor (MIF) increase in patients with Kawasaki disease (KD) and also correlate with other inflammatory indices.

METHODS

Serum samples from 10 patients with KD, 15 normal healthy subjects, and seven febrile control subjects were assayed for MIF by enzyme-linked immunosorbent assay (ELISA).

RESULTS

There was a significant increase in the serum levels of MIF in the acute stage of KD [113.06 (range 20.6-157.36) ng/mL] compared with those in the subacute stage [28.11 (8.57-143.48) ng/mL, p<0.01], normal controls [12.95 (8.40-18.67) ng/mL, p<0.001], and febrile controls [36.58 (21.31-59.67) ng/mL, p = 0.01]. The increase in MIF correlated with an increase in interleukin-6 (IL-6) (r = 0.52, p = 0.047).

CONCLUSION

MIF may be a useful marker in the acute stage of KD and may provide important clues to the pathogenesis of this disease.

Pad - a new self-collection device for human papillomavirus

This study was designed to determine the accuracy and agreement of a self-collection method using pad for human papillomavirus (HPV) DNA. One hundred and thirty-four patients at university hospitals voluntarily participated in the accuracy study, and 314 volunteers participated in the agreement study at local clinics. DNA was extracted and amplified using HPV L1 consensus primers designed for the direct sequencing. In the accuracy study, all samples were probed via histological examinations. With regard to the detection of squamous intraepithelial lesion (SIL), self-collection pad sampling displays sensitivity, of 76.9%, and specificity, of 93.3%. Three hundred and fourteen self-collection pad samples and the concurrent physicians' samples showed a 97.8% agreement, with a Kappa value of 0.9200. A new self-collection pad for the detection of HPV DNA appears to constitute an easy, rapid, and convenient alternative method for the cervical cancer screening of many women with the virtue of being incredible readily accessible.

Effective medium description of plasmonic metamaterials

We demonstrate that the electromagnetic properties of a plasmonic metamaterial, composed of a perfectly conducting metal film perforated with an array of holes, can be effectively described by a structureless, three layer film. The enhanced transmission, first observed by Ebbessen, is identified with resonant tunneling in the equivalent three layer system and perfect transmission is shown to be possible below the critical thickness of a metamaterial. The nature of modes mediating perfect transmission is clarified.

Combined effects of p73 and MDM2 polymorphisms on the risk of lung cancer

p73, a structural and functional homologue of p53, plays an important role in modulating cell-cycle control and apoptosis. MDM2 represses the transcriptional activity of p73 and thus attenuates its activity. Based on the interaction between p73 and MDM2 in cell-cycle control and apoptosis, we investigated the association between p73 G4C14-to-A4T14 and MDM2 309T > G polymorphisms, alone and in combination, on the risk of lung cancer in a Korean population. The p73 and MDM2 genotypes were determined in 582 lung cancer patients and in 582 healthy control subjects who were frequency-matched for age and gender. The p73 AT/AT and MDM2 309 GG genotypes were associated with a nonsignificant increased risk of lung cancer (adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI] = 0.83-2.24; and adjusted OR = 1.29, 95% CI = 0.92-1.80, respectively), compared with their wild-type genotypes, respectively. When the p73 and MDM2 polymorphisms were combined, the risk of lung cancer increased in a dose-dependent manner as the number of variant alleles increased (Ptrend = 0.01). Subjects with three or four variant alleles were at a significantly increased risk of lung cancer (adjusted OR = 1.74, 95% CI = 1.11-2.74, P = 0.02) compared to subjects with zero variant allele. These results suggest an additive effect of the p73 and MDM2 variant alleles on an increased risk of lung cancer.

Impact of short-term exposure to fluoroquinolones on ofloxacin resistance in HIV-negative patients with tuberculosis

SETTING

Seoul, Korea, a country with an intermediate tuberculosis (TB) burden and low prevalence of human immunodeficiency virus (HIV) infection.

OBJECTIVES

To determine the frequency of ofloxacin (OFX) resistance in Mycobacterium tuberculosis, and to assess whether short-term use of fluoroquinolones (FQNs) induces ofloxacin-resistant M. tuberculosis.

DESIGN

The subject cohort consisted of 2788 patients with culture-confirmed TB with drug susceptibility testing data; only four were HIV-positive. The patients were divided into two groups: those who were or were not recently exposed to FQNs.

RESULTS

Of the 2788 isolates, the rates of OFX resistance were 1.1% and 8.5% in initially treated and retreated patients, respectively (P < 0.05). Of the 94 OFX-resistant isolates, 83 (88.3%) were multidrug-resistant (MDR). There was no difference in rates of OFX resistance throughout the study period, or between the FQN-exposed (1/39, 2.6%) and control groups (93/2749, 3.4%). The median duration of FQN treatment was 7 days (range 1-47 days). One OFX-resistant isolate in the FQN-exposed group was MDR.

CONCLUSION

The rate of OFX-resistant M. tuberculosis was low and stationary throughout the study period in Korea. Most OFX resistance was accompanied by MDR, and the frequency of OFX-resistant M. tuberculosis was low in subjects taking short-term FQNs.