Brimonidine promotes axon growth after optic nerve injury through Erk phosphorylation

It is well known that axons of the adult mammalian central nervous system have a very limited ability to regenerate after injury. Therefore, the neurodegenerative process of glaucoma results in irreversible functional deficits, such as blindness. Brimonidine (BMD) is an alpha2-adrenergic receptor agonist that is used commonly to lower intraocular pressure in glaucoma. Although it has been suggested that BMD has neuroprotective effects, the underlying mechanism remains unknown. In this study, we explored the molecular mechanism underlying the neuroprotective effect of BMD in an optic nerve injury (ONI) model. BMD treatment promoted optic nerve regeneration by inducing Erk1/2 phosphorylation after ONI. In addition, an Erk1/2 antagonist suppressed BMD-mediated axonal regeneration. A gene expression analysis revealed that the expression of the neurotrophin receptor gene p75 was increased and that the expression of the tropomyosin receptor kinase B (TrkB) gene was decreased after ONI. BMD treatment abrogated the changes in the expression of these genes. These results indicate that BMD promotes optic nerve regeneration via the activation of Erk1/2.

The optimal timing for preparation of recipient superficial femoral veins to minimize intraoperative blood loss in living donor liver transplantation

AIMS

Intraoperative blood loss (IBL) usually predominates during the dissection of the native liver. A right-lobe living donor liver transplantation (LDLT) sometimes requires an additional procedure to obtain an autologous vein from the recipient for the vascular reconstruction. These procedure can sometime contribute to progressive coagulopathy causing unexpected bleeding. Therefore, we analyzed our cases to determine the optimal timing for vascular preparation from the patient in terms of IBL.

METHODS

Among 67 patients included in the study, 30 did not require an additional procedure to obtain the venous graft (group A), and 37 LDLT employed a superficial femoral vein (SFV). Of these, 13 had undergone removal of SFV after the hilar dissection and liver mobilization from retrohepatic area while preserving the inferior vena cava (group B), and 24 removal of the SFV immediately after hilar dissection without liver mobilization from the retrohepatic space (group C).

RESULTS

A significant difference existed only in the scores of the Model for End-stage Liver Disease. Although the median IBL for group C was similar to that for group A, the median IBL for group B was significantly higher than that for other 2 groups. The median duration from skin incision to graft implantation for group B was significantly longer than that for groups A and group C, because of the additional hemostatic procedures in the retrohepatic space including the leg site.

CONCLUSIONS

The timing for removal of SFV in LDLT patients affects IBL associated with consumptive coagulopathy and prolongs operative time. Based on our experience, we concluded that SFV preparation should be performed before liver mobilization from the retrohepatic area to minimize IBL.

Leisure-time physical activity is a significant predictor of stroke and total mortality in Japanese patients with type 2 diabetes: analysis from the Japan Diabetes Complications Study (JDCS)

AIMS/HYPOTHESIS

Our aim was to clarify the association between leisure-time physical activity (LTPA) and cardiovascular events and total mortality in a nationwide cohort of Japanese diabetic patients.

METHODS

Eligible patients (1,702) with type 2 diabetes (mean age, 58.5 years; 47% women) from 59 institutes were followed for a median of 8.05 years. A comprehensive lifestyle survey including LTPA and occupation was performed using standardised questionnaires. Outcome was occurrence of coronary heart disease (CHD), stroke and total mortality. The adjusted HR and 95% CI were calculated by Cox regression analysis.

RESULTS

A significant reduction in HR in patients in the top (≥ 15.4 metabolic equivalents [MET] h/week) vs the bottom tertile (≤ 3.7 MET h/week) of LTPA, adjusted by age, sex and diabetes duration, was observed in stroke (HR 0.55, 95% CI 0.32, 0.94) and total mortality (HR 0.49, 95% CI 0.26, 0.91) but not in CHD (HR 0.77, 95% CI 0.48, 1.25). The HR for stroke became borderline significant or nonsignificant after adjustment for lifestyle or clinical variables including diet or serum lipids. The significantly reduced total mortality by LTPA was independent of these variables and seemed not to be, at least mainly, attributed to reduced cardiovascular disease.

CONCLUSIONS/INTERPRETATION

In Japanese persons with type 2 diabetes, LTPA of 15.4 MET h/week or more was associated with a significantly lower risk of stroke partly through ameliorating combinations of cardiovascular risk factors. It was also associated with significantly reduced total mortality but independently of cardiovascular risk factors or events. These findings, implying differences from Western diabetic populations, should be considered in the clinical management of East Asians with diabetes.

Abstract P2-05-07: Comparison of hormone receptor and HER-2 expression in primary breast cancers and sentinel lymph node metastases

Background: Recently, it is a hot topic that the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor type 2 (HER2) may differ between the primary tumors and the paired recurrent metastatic tumors. On the other hand, the concordance of the ER, PR, and HER2 status between the primary tumor and ipsilateral axillary lymph node metastases is reported to be high in previous study. However, in these reports, the majority of lymph nodes metastases examined are macrometastases obtained from axillary lymph node dissection. The aim of the present study is to compare the ER, PR, and HER2 status of the primary breast tumors with that of sentinel lymph node micrometastases and macrometastases.

Methods: A total of 770 breast cancer patients underwent sentinel lymph node biopsy between 2006 and 2010 at our hospital. Among them, 87 patients who had only one node positive were eligible for our study. ER, PR, and HER2 status were determined by immunohistochemistry (IHC) and/or FISH.

Result: We analyzed 76 patients with 50(66%) patients with macrometastasesn and 26 (34%) micrometastases, except 11 cases those were indeterminate for IHC. ER status of primary tumor and the paired metastatic lymph node were almost full concordance except one case, in which ER was negative in primary tumor but ER was positive in lymph node. Discordance for PR was 15.8% (n = 12). Among these, six patients had PR-positive on primary and PR-negative in lymph node while six patients had PR-negative in primary and PR-positive in lymph node. Discordance for HER2 between primary tumor and metastatic lymph node was 5.3% (n = 4). Among these, three had negative in primaries and positive in lymph nodes while one had positive in primary and negative in lymph node. A discordance between primary and lymph node in HER2, ER, or PR status was observed in 14 of 67 (18.4%) cases.

Conclusions: The concordance in HER2, ER, and PR was high between the primary tumor and sentinel lymph nodes. However some cases had discordance of receptor status and these result may cause of discordance for distant metastases or poor prognosis.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-05-07.

Abstract P3-06-29: Change of circulating tumor cells before and after neoadjuvant chemotherapy in patients with primary breast cancer

Background: Circulating tumor cells (CTCs) in peripheral blood may represent the possible presence of early tumor dissemination. However, relatively few studies were designed to investigate the change of CTC status by adjuvant chemotherapy in operable breast cancer patients.

Patients and methods: Peripheral blood (7.5ml) was collected from 95 patients with stage II/III breast cancer before neoadjuvant chemotherapy (NAC). NAC consisted of anthracycline and paclitaxel chemotherapy and additional trastuzumab treatment for patients with HER2-positive tumors.

Results: The average age of patients was 52.6 year old (median 52.0). One or more CTCs were detected in 18 (18.9%) of 95 patients. CTCs were detected in 6 (12.0%) of 50 patients with clinical stage II disease and 12 (26.7%) of 45 patients with clinical stage III disease. According to tumor subtypes, CTCs were detected in 5 (17.9%) of 28 patients with hormone receptor (HR)-positive and HER2-negative tumors (L subtype), 3 (12.5%) of 24 patients with HR-positive and HER2-positive tumors (L-H subtype), 4 (22.2%) of 18 patients with HR-negative and HER2-positive tumors (H subtype), and 6 (24.0%) of 25 patients with HR-negative and HER2-negative tumors (TN subtype). After NAC, 17 (94.4%) of 18 patients who were CTC-positive before chemotherapy changed into negative status. 30 (31.6%) of 95 patients had a pathologic complete response (pCR) after NAC. There was no correlation between CTC status before NAC and pathological response. At the median follow up of 27 months, distant metastasis was observed in 9 patients (9.5%). Patients with clinical stage III, TN subtype, or non-pCR had a significantly worse disease-free survival (DFS). However, CTC status before NAC was not a significant prognostic factor.

Conclusion: NAC has a significant impact on CTC status irrespective of tumor subtypes. CTC status before NAC was not a significant prognostic factor in this study. The reason of which may be that most of patients showing positive for CTCs before NAC have changed into negative after NAC.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-29.

Isolation of highly purified rat cerebral lysosomes using percoll gradients with a variety of calcium concentrations

We were able to isolate a lysosomal fraction from rat brain which had a higher degree of purity than in previous studies with good recovery. This has been made possible by using percoll gradients following the swelling of mitochondria in the presence of calcium which would eliminate contamination from small amounts of mitochondria. By using percoll density gradient centrifugation after the swelling of mitochondria in the presence of calcium, cerebral lysosomes were purified 312-fold with the recovery of approximately 22 %, which is the highest reported for any cerebral lysosomal preparation. The most effective procedure for the separation was achieved by using 1.25 mM calcium incubation with post nuclear fraction. As brain lysosomes may play a major role not only in degrading macromolecules but also in their transport to the deposition site, obtaining purified rat cerebral lysosomes represents an important step in the study of the generation of macromolecules which accumulate in the brain.

Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomized prospective phase II clinical trial

BACKGROUND AND STUDY AIMS

Endoscopic submucosal dissection (ESD) has become a standard treatment. However, the treatment time tends to be relatively long and insufflation and manipulation of the endoscope can increase pain and discomfort. We aimed to find an optimal method for sedation during ESD.

PATIENTS AND METHODS

Patients scheduled to undergo ESD for early gastric cancer or adenoma were randomly assigned to sedation with midazolam or propofol, and consciousness level was evaluated by bispectral index (BIS) monitoring. Primary end points of effectiveness (three parameters) and secondary end points of safety during ESD and after return to the ward were compared between the groups. Study registration was in the UMIN Clinical Trial Registry (UMIN 000001497), and the institutional trial number was KDOG 0801.

RESULTS

From June 2008 through June 2009, we enrolled 178 patients (90 midazolam, 88 propofol). Regarding safety after ESD, recovery was significantly better in the propofol group immediately after and at 1 hour and 2 hours after return to the ward (P < 0.001). The number of patients who required a continuous supply of oxygen 2 hours after returning to the ward was significantly lower in the propofol group (midazolam 18; propofol 6; P = 0.010). Though propofol seemed to be better for effectiveness and safety, there were no statistically significant differences for all three primary end points and the safety parameters (hypotension, hypoxia, bradycardia).

CONCLUSIONS

Propofol with BIS monitoring improved recovery of patients after ESD, though this study was underpowered to prove the effectiveness and safety of propofol.

Availability of Self-Recorded Axillary Temperature for Assessment of Thermic Effects of Food: Relationship between HDL-Cholesterol Level and Postprandial Thermoregulation in Type 2 Diabetic Patients

The present study was performed to develop a simple procedure for assessment of body temperature and to determine whether postprandial thermoregulation is related to metabolic regulation in diabetic patients.

We examined 101 male and female subjects with diabetes. Axillary temperature was measured prior to and after all meals (3 meals per day) and self-recorded for 1 week. The averages were calculated. Positive postprandial thermoregulation (PPT) was defined as a pattern in which each of 3 average postprandial temperatures was higher than the corresponding 3 preprandial temperatures. Negative postprandial thermoregulation (NPT) was defined as the pattern except for PPT.

A significant increase in postprandial temperature was observed. With the exception of high-density lipoprotein (HDL)-cholesterol levels, there were no relationships between the categorized postprandial thermoregulation and other factors, including age, sex, body mass index, thyroid function, HbA1c, diabetic complications, lipid metabolism, and calorie intake. Logistic analysis indicated an independent positive relation between HDL-cholesterol and PPT.

A simple method for measurement of body temperature indicated that HDL-cholesterol level was predominantly associated with thermic effects of food in diabetic patients, while other metabolic factors showed no such relations. HDL-cholesterol may affect the postprandial regulation of body temperature in diabetic patients.

Time-dependent effects of low-frequency repetitive transcranial magnetic stimulation of the supramarginal gyrus

In this paper, we report our studies of the effects of stimulating the bilateral supramarginal gyrus (SMG) with low-frequency transcranial magnetic stimulation (rTMS) or short-term rTMS on brain excitability in humans. We analyzed the effects of various durations of stimulation on P300 latencies of the event-related potential (ERP). Magnetic pulses were delivered using a figure-eight flat coil. The intensity of rTMS was set to 80 % of the subject's motor threshold. In each round of rTMS, 100 magnetic pulses were applied over the scalp at frequencies of 1.00, 0.75, and 0.50 Hz. ERPs were measured prior to magnetic stimulation as a control. The effects of magnetic stimulation were then determined by measuring its effects on P300 latencies elicited by an odd-ball task. These latencies were measured before and 0, 5, 10, and 15 min after the magnetic stimulation. 1.00 Hz low-frequency rTMS of the left SMG decreased P300 latencies for approximately 10 min. In contrast, 0.50 Hz rTMS of the left SMG resulted in delayed P300 latencies for approximately 15 min. We furthermore found that 0.75 Hz rTMS of the left SMG and 1.00, 0.75 and 0.5 Hz rTMS of the right SMG did not affect P300 latencies. These results suggest that the duration of the effects of rTMS depend on the frequency of stimulation.

Wnt5a: its signalling, functions and implication in diseases

Wnt5a is a representative ligand that activates the β-catenin-independent pathways. Because the β-catenin-independent pathway includes multiple signalling cascades in addition to the planar cell polarity and Ca(2+) pathway, Wnt5a regulates a variety of cellular functions, such as proliferation, differentiation, migration, adhesion and polarity. Consistent with the multiple functions of Wnt5a signalling, Wnt5a knockout mice show various phenotypes, including an inability to extend the embryonic anterior-posterior and proximal-distal axes in outgrowth tissues. Thus, many important roles of Wnt5a in developmental processes have been demonstrated. Moreover, recent reports suggest that the postnatal abnormalities in the Wnt5a signalling are involved in various diseases, such as cancer, inflammatory diseases and metabolic disorders. Therefore, Wnt5a and its signalling pathways could be important targets for the diagnosis and therapy for human diseases.

The Enhancing Effect of -Cyclodextrin Inclusion on -Tocotrienol-dependent Negative Growth Control of Mesothelioma Cells in a Xenograft Model

Background: Malignant mesothelioma is an aggressive cancer with no effective treatment options. Of phytochemicals, tocotrienol (T3), a member of vitamin E, is one of the most potent anti-mesothelioma agents, but the effectiveness in vivo is quite limited, due to its low bioavailability. In this study, we investigated if the oral treatment of -T3 inclusion with -cyclodextrin (CD) could improve the bioavailability and anticancer activity of the T3.Findings: Using nude mice bearing MSTO-211H cells (a human malignant mesothelioma cell line), the effect of -T3 inclusion with -CD on -T3 level in tumor tissues, tumor growth, and its related mRNA levels were examined. The difference of tumor growth between the two groups had no statistical significance, but the latter showed a lower tendency compared with the former. In linked with this observation, the level of vascular endothelial growth factor mRNA required for in vivo tumor growth in -T3 inclusion with -CD group was lower than that in -T3 group, on the contrary, the level of -T3 level showed an opposite tendency.Conclusion: Our study demonstrated that the bioavailability of -T3 was improved by an oral administration of a novel -T3 inclusion complex with CD. Furthermore, the improvement of the bioavailability contributed to the increase of anticancer activity of -T3 in vivo.Key words: Anti-cancer agent, bioavailability, cyclodextrin, mesothelioma, tocotrienol.

Aerodynamics of a bio-inspired flexible flapping-wing micro air vehicle

MAVs (micro air vehicles) with a maximal dimension of 15 cm and nominal flight speeds of around 10 m s⁻¹, operate in a Reynolds number regime of 10⁵ or lower, in which most natural flyers including insects, bats and birds fly. Furthermore, due to their light weight and low flight speed, the MAVs' flight characteristics are substantially affected by environmental factors such as wind gust. Like natural flyers, the wing structures of MAVs are often flexible and tend to deform during flight. Consequently, the aero/fluid and structural dynamics of these flyers are closely linked to each other, making the entire flight vehicle difficult to analyze. We have recently developed a hummingbird-inspired, flapping flexible wing MAV with a weight of 2.4-3.0 g and a wingspan of 10-12 cm. In this study, we carry out an integrated study of the flexible wing aerodynamics of this flapping MAV by combining an in-house computational fluid dynamic (CFD) method and wind tunnel experiments. A CFD model that has a realistic wing planform and can mimic realistic flexible wing kinematics is established, which provides a quantitative prediction of unsteady aerodynamics of the four-winged MAV in terms of vortex and wake structures and their relationship with aerodynamic force generation. Wind tunnel experiments further confirm the effectiveness of the clap and fling mechanism employed in this bio-inspired MAV as well as the importance of the wing flexibility in designing small flapping-wing MAVs.

Lower plasma arginine in enteral tube-fed patients with pressure ulcer and improved pressure ulcer healing after arginine supplementation by Arginaid Water

OBJECTIVES

To determine the presence or extent of arginine deficiency in pressure ulcer (PU) patients on percutaneous endoscopic gastrostomy (PEG) feeding and to examine the effects of arginine supplementation on PU healing.

DESIGN

All eligible PEG patients, with and without PU, were cross-sectionally assessed for plasma arginine. Three-month supplementation with arginine-enriched water (Arginaid Water) was performed on a subset of patients with PU. This intervention study was a prospective, non-controlled trial with 5 PU patients.

SETTING

Geriatric ward of a rural clinical hospital in Japan.

PARTICIPANTS

Thirty-nine inpatients with PEG feeding were assessed for plasma arginine. Five of the 13 patients with PU and five of 26 patients without PU underwent amino acid profiling.

INTERVENTION

Five of the patients with PU received Arginaid Water supplementation.

MEASUREMENTS

Plasma amino acid measurements and biochemical analyses were performed. For those with PU on Arginaid Water supplementation, plasma arginine concentration and PU status were monitored every month.

RESULTS

Patients with PU showed significantly lower plasma arginine concentration compared to those without PU (control vs. PU; 80.2±21.3 vs 62.8±14.7 nmol/ml, p<0.01). After the addition of Arginaid Water, plasma arginine concentration increased (before vs 3 months later; 57.9±1.8 vs 83.1±8.5, p<0.01), and PU area, perimeter, DESIGN-R and PUSH scores significantly improved.

CONCLUSION

Plasma arginine was lower in PEG patients with PU. The healing rate of PU is improved with Arginaid Water supplementation. The findings from this study support the use of arginine supplementation in PEG patients with PU.

Interim analysis of a single-arm, phase II study of bevacizumab (BV) with modified OPTIMOX1 as first-line treatment of patients with metastatic colorectal cancer (mCRC): TCOG-GI0802

578

Background: BV is widely used for treatment of metastatic colorectal cancer (mCRC) patients. Although BV was often administrated to mCRC patients in combination with oxaliplatin, optimal schedule remains unclear. Many mCRC patients cannot continue to use oxalipatin because of cumulative neurotoxity, which decreases patient's QOL and motivation.We postulated that modification of oxaliplatin schedule would improve TTF in intermittent oxaliplatin usage. Therefore, we planned to use BV with original OPTIMOX1 adiministration schedule; modified oxaliplatin dose (85 mg/m3).

Methods: Patients were enrolled with the criteria excluding neuropathy, PS ≥ 1, or no previous usage of oxaliplatin and BV, and then were received modified FOLFOX6 regimen (L-OHP 85 mg/m2, l-LV 200 mg/m2, 5-FU 400 mg/m2 bolus, 5-FU 2,400 mg/m2 46h continuous infusion) plus BV (5 mg/kg) q2wks x 6 cycles, followed sLV5FU2 (omit L-OHP) plus BV x 12 cycles regimen. After that, oxaliplatin reintroduction was done and mFOLFOX6 plus BV regimen was continued until PD. The evaluation of antitumor effect was done according to RECIST Criteria.

Results: 40 patients accrued this trial. Median age was 65 years old. PS0: 89.5%, male: 75%, female: 25%, colon: 65.8%, rectal: 31.6%,colon + rectal: 2.6%. During initial 6 cycles of chemotherapy, 90% patients could continue chemotherapy. Response rate was 50%, and clinical benefit (including SD) was 92.1%. During Intial 6 cycles, G3 neuropathy occurred 2.6%, and G2 were 5%. Most frequent toxicity (≥G3) was neutropenia (30.8%) and anorexia (5.3%). One patient could complete the scheduled regimen. This patient continued mFOLFOX6+BV for 12 cycles after reintroduction keeping with PS 0, and was received FOLFIRI+BV regimen as second-line chemotherapy. Further information are under examination.

Conclusions: This administration schedule was well tolerated and could continue chemotherapy longer than usual method. sLV5FU2+BV regimen was not affected reintroduction rate and progression free survival. BV with mOPTIMOX1 regimen can be expected to become a good treatment options for mCRC patients.

No significant financial relationships to disclose.

Quasi-two-dimensional Fermi surfaces and coherent interlayer transport in KFe₂As₂

We report the results of the angular-dependent magnetoresistance oscillations (AMROs), which can determine the shape of bulk Fermi surfaces (FSs) in quasi-two-dimensional (Q2D) systems, in a highly hole-doped Fe-based superconductor KFe2As2 with Tc ≈ 3.7  K. From the AMROs, we determined the two Q2D FSs with rounded-square cross sections, correspond to 12% and 17% of the first Brillouin zone. The rounded-squared shape of the FS cross section is also confirmed by the analyses of the interlayer transport under in-plane fields. From the obtained FS shape, we infer the character of the 3d orbitals that contribute to the FSs.

Relative importance of the area and intensity of the orange spots of male guppies Poecilia reticulata as mating traits preferred by females

Digitally modified videos of male guppies Poecilia reticulata were used to examine the relative importance of the area and intensity of the orange spots as mating traits preferred by females. The females prioritized the area of the orange spots over intensity for their mate preference.