Effectiveness of Adding Docetaxel to Androgen Deprivation Therapy for Metastatic Hormone-Sensitive Prostate Cancer in Korean Real-World Practice

PURPOSE

Evidence in favor of adding docetaxel in treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has led to docetaxel in conjunction with androgen deprivation therapy (ADT) as standard therapy. The aim of this study was to examine the effectiveness of docetaxel with ADT for Korean patients with mHSPC in real-world practice.

MATERIALS AND METHODS

A retrospective cohort study was performed at six Korean hospitals for patients with mHSPC treated with docetaxel plus ADT. Patients were treated every 3 weeks for up to six cycles with 75 mg/m² of docetaxel. The primary endpoint was time to castration resistant prostate cancer (CRPC).

RESULTS

This study included 46 eligible patients from June 2016 to February 2021. Median age was 68.5 years (range, 52-84) and all patients present with de novo M1 with high-volume disease. The median prostate-specific antigen (PSA) level at ADT initiation was 205.4 (7.7-1933) ng/mL, and time from ADT to docetaxel was 2.4 months (0-5.3). All six planned cycles of docetaxel were delivered in 36 patients (78%), 7 patients (15%) discontinued treatment due to adverse events, and 3 patients (7%) discontinued due to progression. At the time of the analysis, CRPC had developed in 34 patients (74%), and the median time to CRPC was 18.0 (95% confidence interval, 14.1-21.9) months. PSA <0.2 ng/mL was achieved in 11 patients (24%) after 6 months of ADT and in 10 patients (22%) after 12 months. At last follow-up, 35 patients (76%) were alive; the median overall survival was not reached.

CONCLUSION

The effect of docetaxel combined with ADT for Korean patients with mHSPC is comparable with prior results in Western studies.

Mechanically Stable Flexible Organic Photovoltaics with Silver Nanomesh for Indoor Applications

Enhanced device performance of flexible organic solar cells (FOSCs) was achieved according to the development of organic solar cells (OSCs). OSCs are promising candidates as energy sources for low-power supply systems such as the Internet of Things (IoT) under indoor lighting environments. To apply FOSCs to flexible or wearable applications, they must be mechanically stable. In this study, we fabricated FOSCs with silver nanomesh (AgNM) as the bottom transparent conductive electrode (TCE). Instead of indium tin oxide (ITO), AgNMs were prepared using three pitches of 25, 50, and 100 μm with a square pattern, using a poly(ethylene terephthalate) (PET) substrate. Notably, the device using AgNMs with a pitch of 25 μm exhibited a power conversion efficiency (PCE) of 14.93% under 1 sun illumination and 17.91% under 1000 lux of light-emitting diode (LED) light conditions. Flexible devices using AgNMs maintained over 92% of their initial PCE under 1 sun illumination (PCE decreased to 12.98 from 14.04%) and over 92% when tested under 1000 lux of LED light illumination (PCE decreased to 16.57 from 17.91%) after 1000 instances of bending. These results demonstrate the advantages of using AgNMs as an alternative TCE under both 1 sun and indoor lightning environments and are promising candidates for flexible applications.

Development and Validation of a Deep Learning-Based Synthetic Bone-Suppressed Model for Pulmonary Nodule Detection in Chest Radiographs

Importance

Dual-energy chest radiography exhibits better sensitivity than single-energy chest radiography, partly due to its ability to remove overlying anatomical structures.

Objectives

To develop and validate a deep learning-based synthetic bone-suppressed (DLBS) nodule-detection algorithm for pulmonary nodule detection on chest radiographs.

Design, Setting, and Participants

This decision analytical modeling study used data from 3 centers between November 2015 and July 2019 from 1449 patients. The DLBS nodule-detection algorithm was trained using single-center data (institute 1) of 998 chest radiographs. The DLBS algorithm was validated using 2 external data sets (institute 2, 246 patients; and institute 3, 205 patients). Statistical analysis was performed from March to December 2021.

Exposures

DLBS nodule-detection algorithm.

Main Outcomes and Measures

The nodule-detection performance of DLBS model was compared with the convolution neural network nodule-detection algorithm (original model). Reader performance testing was conducted by 3 thoracic radiologists assisted by the DLBS algorithm or not. Sensitivity and false-positive markings per image (FPPI) were compared.

Results

Training data consisted of 998 patients (539 men [54.0%]; mean [SD] age, 54.2 [9.82] years), and 2 external validation data sets consisted of 246 patients (133 men [54.1%]; mean [SD] age, 55.3 [8.7] years) and 205 patients (105 men [51.2%]; mean [SD] age, 51.8 [9.1] years). Using the external validation data set of institute 2, the bone-suppressed model showed higher sensitivity compared with that of the original model for nodule detection (91.5% [109 of 119] vs 79.8% [95 of 119]; P < .001). The overall mean of FPPI with the bone-suppressed model was reduced compared with the original model (0.07 [17 of 246] vs 0.09 [23 of 246]; P < .001). For the observer performance testing with the data of institute 3, the mean sensitivity of 3 radiologists was 77.5% (95% [CI], 69.9%-85.2%), whereas that of radiologists assisted by DLBS modeling was 92.1% (95% CI, 86.3%-97.3%; P < .001). The 3 radiologists had a reduced number of FPPI when assisted by the DLBS model (0.071 [95% CI, 0.041-0.111] vs 0.151 [95% CI, 0.111-0.210]; P < .001).

Conclusions and Relevance

This decision analytical modeling study found that the DLBS model was more sensitive to detecting pulmonary nodules on chest radiographs compared with the original model. These findings suggest that the DLBS model could be beneficial to radiologists in the detection of lung nodules in chest radiographs without need of the specialized equipment or increase of radiation dose.

Determination of urinary metabolites of cannabidiol, Δ8-tetrahydrocannabinol, and Δ9-tetrahydrocannabinol by automated online μSPE-LC-MS/MS method

In this study, an automated online micro-solid-phase extraction (μSPE)-liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the detection of metabolites of cannabidiol (CBD), Δ⁸-tetrahydrocannabinol (Δ⁸-THC), and Δ⁹-tetrahydrocannabinol (Δ⁹-THC), particularly 7-carboxy- cannabidiol (7-COOH-CBD), 11-nor-9-carboxy-Δ⁸-tetrahydrocannabinol (Δ⁸-THCCOOH), 11-nor-9-carboxy-Δ⁹-tetrahydrocannabinol (Δ⁹-THCCOOH), and 11-nor-9-carboxy-Δ⁹- tetrahydrocannabinol-glucuronide (Δ⁹-THCCOOH-glu) in urine. An instrument top sample preparation (ITSP) cartridge was introduced to increase the sensitivity toward analytes and decrease the matrix effect of the urine. LC-MS/MS analysis was performed in the multiple-reaction monitoring mode, and the analytes were separated using an Acquity UPLC HSS T3 (2.1 × 100 mm, 1.8 µm) column and gradient elution with water containing 0.05 % acetic acid and methanol as the mobile phase. The calibration range was 0.5-200 ng/mL for all the analytes, with a correlation coefficient (r) of ≥0.996 and a weighting factor of 1/x². The limits of detection for 7-COOH-CBD, Δ⁸-THCCOOH, Δ⁹-THCCOOH, and Δ⁹-THCCOOH-glu were 0.06, 0.02, 0.03, and 0.1 ng/mL, respectively. The intra- and inter-day accuracy ranged from -8.0 to 6.2 % and -7.3 to 7.8 % with a precision of ≤7.2 % and ≤6.2 %, respectively. The method was also validated for selectivity, recovery, matrix effect, stability, and dilution integrity. The developed method was successfully applied to the analysis of 78 urine samples, and 7-COOH-CBD, Δ⁸-THCCOOH, Δ⁹-THCCOOH, and Δ⁹-THCCOOH-glu were detected in 54 urine samples at normalized concentrations of 1.1, 0.6-939.1, 0.9-2595.0, and 1.3-527.6 ng/mg creatinine, respectively.

Biochemical Characterization of Orange-Colored Rice Calli Induced by Target Mutagenesis of OsOr Gene

We generated an orange-colored (OC) rice callus line by targeted mutagenesis of the orange gene (OsOr) using the CRISPR-Cas9 system. The OC line accumulated more lutein, β-carotene, and two β-carotene isomers compared to the WT callus line. We also analyzed the expression levels of carotenoid biosynthesis genes by qRT-PCR. Among the genes encoding carotenoid metabolic pathway enzymes, the number of transcripts of the PSY2, PSY3, PDS, ZDS and β-LCY genes were higher in the OC line than in the WT line. In contrast, transcription of the ε-LCY gene was downregulated in the OC line compared to the WT line. In addition, we detected increases in the transcript levels of two genes involved in carotenoid oxidation in the OC lines. The developed OC lines also showed increased tolerance to salt stress. Collectively, these findings indicate that targeted mutagenesis of the OsOr gene via CRISPR/Cas9-mediated genome editing results in β-carotene accumulation in rice calli. Accordingly, we believe that this type of genome-editing technology could represent an effective alternative approach for enhancing the β-carotene content of plants.

Transcriptome and Metabolite Profiling of Tomato SGR-Knockout Null Lines Using the CRISPR/Cas9 System

Stay-green 1 (SGR1) protein is a critical regulator of chlorophyll degradation and senescence in plant leaves; however, the functions of tomato SGR1 remain ambiguous. Here, we generated an SGR1-knockout (KO) null line via clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9-mediated gene editing and conducted RNA sequencing and gas chromatography−tandem mass spectrometry analysis to identify the differentially expressed genes (DEGs). Solanum lycopersicum SGR1 (SlSGR1) knockout null line clearly showed a turbid brown color with significantly higher chlorophyll and carotenoid levels than those in the wild-type (WT) fruit. Differential gene expression analysis revealed 728 DEGs between WT and sgr#1-6 line, including 263 and 465 downregulated and upregulated genes, respectively, with fold-change >2 and adjusted p-value < 0.05. Most of the DEGs have functions related to photosynthesis, chloroplasts, and carotenoid biosynthesis. The strong changes in pigment and carotenoid content resulted in the accumulation of key primary metabolites, such as sucrose and its derivatives (fructose, galactinol, and raffinose), glycolytic intermediates (glucose, glucose-6-phosphate, and fructose-6-phosphate), and tricarboxylic acid cycle intermediates (malate and fumarate) in the leaves and fruit of the SGR-KO null lines. Overall, the SGR1-KO null lines developed here provide new evidence for the mechanisms underlying the roles of SGR1 as well as the molecular pathways involved in photosynthesis, chloroplasts, and carotenoid biosynthesis.

Advanced assessment through intact glycopeptide analysis of Infliximab’s biologics and biosimilar

Characterization of therapeutic monoclonal antibodies (mAbs) represents a major challenge for analytical sciences due to their heterogeneity associated with post-translational modifications (PTMs). The protein glycosylation requires comprehensive identification, which could influence on the mAbs’ structure and their function. Here, we demonstrated high-resolution tandem mass spectrometry with an ultra-high-performance liquid chromatography for characterization and comparison between biologics and biosimilar of infliximab at an advanced level. Comparing the N- and O-glycopeptides profiles, a total of 49 and 54 glycopeptides was identified for each product of the biologics and biosimilar, respectively. We also discovered one novel N-glycosylation site at the light chain from both biopharmaceuticals and one novel O-glycopeptide at the heavy chain from only biosimilar. Site-specific glycopeptide analysis process will be a robust and useful technique for evaluating therapeutic mAbs and complex glycoprotein products.

Preliminary Study of Different Treatment Responses between Bevacizumab, Aflibercept and Dexamethasone Implant According to Renal Function in Diabetic Macular Edema Patients

Background: The purpose of this study was to investigate the association between responses to intravitreal bevacizumab injection and renal function in diabetic macular edema (DME) patients. Methods: A retrospective study of the medical records of 104 treatment-naïve DME patients who received intravitreal bevacizumab injection (IVBI) was conducted. Based on the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2), the participants were classified into three groups. Intergroup comparisons of the best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) changes were performed after three-monthly consecutive IVBIs. In the groups with decreased renal function, the response to further treatment with a different drug was investigated. Results: A total of 104 participants were included in the study: 60 participants in the preserved renal function group (eGFR ≥ 60), 25 participants in the moderate chronic kidney disease (CKD) group (30 ≤ eGFR < 60), and 19 participants in the severe CKD group (eGFR < 30). After three-monthly consecutive IVBIs, BCVA (p < 0.001) and CST (p < 0.001) were significantly improved only in the preserved renal function group. Following further treatment of patients with decreased renal function, the treatment results were significantly better in those who were switched to aflibercept or dexamethasone implant than in those who were maintained on IVBI. Conclusions: From this preliminary study, we observed that renal function might affect the response to IVBI treatment in patients with DME. In the case of a poor response to initial IVBI treatment for DME in patients with moderate to severe CKD, our study supports switching to the aflibercept or dexamethasone implant.

Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters

BACKGROUND

The effects of statin on coronary physiology have not been well evaluated.

OBJECTIVES

The authors performed this prospective study to investigate changes in coronary flow indexes and plaque parameters, and their associations with atorvastatin therapy in patients with coronary artery disease (CAD).

METHODS

Ninety-five patients with intermediate CAD who received atorvastatin therapy underwent comprehensive physiological assessments with fractional flow reserve (FFR), coronary flow reserve, index of microcirculatory resistance, and intravascular ultrasound at the index procedure, and underwent the same evaluations at 12-month follow-up. Optimal low-density lipoprotein cholesterol (LDL-C) was defined as LDL-C <70 mg/dL or ≥50% reduction from the baseline. The primary endpoint was a change in the FFR.

RESULTS

Baseline FFR, minimal lumen area, and percent atheroma volume (PAV) were 0.88 ± 0.05, 3.87 ± 1.28, 55.92 ± 7.30, respectively. During 12 months, the percent change in LDL-C was -33.2%, whereas FFR was unchanged (0.87 ± 0.06 at 12 months; P = 0.694). Vessel area, lumen area, and PAV were significantly decreased (all P values <0.05). The achieved LDL-C level and the change of PAV showed significant inverse correlations with the change in FFR. In patients with optimally modified LDL-C, the FFR had increased (0.87 ± 0.06 vs 0.89 ± 0.07; P = 0.014) and the PAV decreased (56.81 ± 6.44% vs 55.18 ± 8.19%; P = 0.031), whereas in all other patients, the FFR had decreased (0.88 ± 0.05 vs 0.86 ± 0.06; P = 0.025) and the PAV remained unchanged.

CONCLUSIONS

In patients with CAD, atorvastatin did not change FFR despite a decrease in the PAV. However, in patients who achieved the optimal LDL-C target level with atorvastatin, the FFR had significantly increased with decrease of the PAV. (Effect of Atorvastatin on Fractional Flow Reserve in Coronary Artery Disease [FORTE]; NCT01946815).

Nationwide Trends of Gatekeeper to Invasive Coronary Angiography in Suspected Coronary Artery Disease

BACKGROUND AND OBJECTIVES

Real-world trends in the utility and type of gatekeeping studies in invasive coronary angiography (ICA) requires further investigation.

METHODS

We identified outpatients who underwent noninvasive cardiac tests or directly ICA for suspected coronary artery disease (CAD) from the nationwide Korea Health Insurance Review and Assessment Service-National Patient Sample database between 2012 and 2018.

RESULTS

Among 71,401 patients, the percentage of patients who were evaluated for suspected CAD was 34.7% for treadmill test (TMT), 4.2% for single-photon emission computed tomography (SPECT), 24.2% for coronary computed tomography angiography (CCTA), 1.6% for multiple gatekeepers, and 32.3% for directly ICA without noninvasive studies. The proportion of CCTA as a gatekeeper showed linear increase, (18.6% in 2012 and 28.8% in 2018; p<0.001), while those of TMT, SPECT, and direct ICA have decreased (p<0.001, p=0.03, and p<0.001, respectively). The overall incidence of downstream ICA after gatekeeper was 13.8% (6,662/48,346), and SPECT showed higher ICA rate in pairwise comparison with TMT and CCTA (p<0.001). Patients who performed gatekeepers before ICA showed higher rate of subsequent PCI (34.7% vs. 32.3%; p<0.001) and CABG (3.5% vs. 1.0%; p<0.001), compared to those who directly underwent ICA, and CCTA was associated with higher revascularization rate after ICA in pairwise comparison with TMT and SPECT (p<0.001).

CONCLUSIONS

Nationwide database demonstrated that CCTA is utilized increasingly as a gatekeeper for ICA and is associated with high revascularization rate after ICA in outpatients with suspected CAD.

Clinical Implications of BRCA Mutations in Advanced Biliary Tract Cancer

INTRODUCTION

Current standard chemotherapy for biliary tract cancer (BTC) has limited survival benefits, and the need for targeted therapies is increasing. This study investigated the genetic profiles and clinical implications of BRCA mutations in patients with advanced BTC.

METHODS

Targeted high-throughput sequencing was performed on samples obtained from 25 patients with advanced BTC who had received palliative first-line platinum-based chemotherapy.

RESULTS

Of the 25 patients, 16 (64.0%) were younger than 65 years of age and 16 (64.0%) were male. The BTC cases consisted of intrahepatic cholangiocarcinoma (9, 36.0%), extrahepatic cholangiocarcinoma (5, 20.0%), and gallbladder cancer (11, 44.0%). The median overall survival (OS) and progression-free survival (PFS) of all patients were 11.9 months (95% confidence interval [CI]: 9.2-14.6) and 5.6 months (95% CI: 3.8-7.3), respectively. Genomic alterations in TP53 (52.0%), BRCA (36.0%), ATM (32.0%), ERBB2 (24.0%), NOTCH1 (20.0%), and FGFR3 (20.0%) were frequently reported. TP53 and ATM mutations were associated with OS (TP53: hazard ratio [HR] 2.719, 95% CI: 1.074-6.881, p = 0.035; ATM: HR 2.780, 95% CI: 1.091-7.082, p = 0.032). Patients with BRCA mutations had a slightly improved PFS compared to those with intact BRCA (6.7 months [range, 2.7-10.7 months] vs. 5.3 months [range, 3.6-7.0 months], p = 0.090). However, there was no significant difference in OS between groups (BRCA mutant vs. intact: 10.6 months [range, 3.6-17.6 months] vs. 11.9 months [range, 7.5-16.3 months], p = 0.252). BRCA mutations were significantly associated with PFS in the multivariate analysis (HR 0.150, 95% CI: 0.034-0.655, p = 0.012).

CONCLUSION

This study demonstrated that BRCA mutations might have a role as predictive biomarkers for palliative first-line platinum-based chemotherapy in patients with advanced BTC.

High-resolution metabolomics-based biomarker discovery using exhaled breath condensate from patients with lung cancer

Early diagnosis and treatment are critical for improving the survival of patients with lung cancer, which is the leading cause of cancer-related deaths worldwide. In this study, we investigated whether the metabolomics analysis of exhaled breath condensate (EBC) from patients with lung cancer can provide biomarkers that can be used for noninvasive screening for lung cancer diagnosis. EBC samples obtained from patients with lung cancer (n = 20) and healthy individuals (n = 5) were subjected to high-resolution metabolomics (HRM) using liquid chromatography–mass spectrometry (LC–MS). Univariate analysis, with a false discovery rate (FDR), q = 0.05, and hierarchical clustering analysis were performed to discover significantly different metabolites between the healthy controls and patients with lung cancer. This was followed by the identification of the metabolites using the METLIN database. Pathway analysis based on the identified metabolites revealed that arachidonic acid (AA) metabolism was the most significantly affected pathway. Finally, 5-hydroxyicosatetraenoic acid (HETE) (m/z 343.2233, [M + Na]+), a metabolite involved in AA metabolism, was found to be significantly higher in patients with lung cancer than in healthy counterparts. Our finding suggested that the HRM of EBC samples is a useful approach for identifying biomarkers for noninvasive screening for lung cancer diagnosis.

Genome Editing of Golden SNP-Carrying Lycopene Epsilon-Cyclase (LcyE) Gene Using the CRSPR-Cas9/HDR and Geminiviral Replicon System in Rice

Lycopene epsilon-cyclase (LcyE) is a key enzyme in the carotenoid biosynthetic pathway of higher plants. Using the CRSPR/Cas9 and the geminiviral replicon, we optimized a method for targeted mutagenesis and golden SNP replacement of the LcyE gene in rice. We have exploited the geminiviral replicon amplification as a means to provide a large amount of donor template for the repair of a CRISPR-Cas-induced DNA double-strand break (DSB) in the target gene via homology-directed repair (HDR). Mutagenesis experiments performed on the Donggin variety achieved precise modification of the LcyE loci with an efficiency of up to 90%. In HDR experiments, our target was the LcyE allele (LcyE-H523L) derived from anther culture containing a golden SNP replacement. The phenotype of the homologous recombination (HR) mutant obtained through the geminiviral replicon-based template delivery system was tangerine color, and the frequency was 1.32% of the transformed calli. In addition, the total carotenoid content of the LcyEsg2-HDR1 and LcyEsg2-HDR2 lines was 6.8–9.6 times higher than that of the wild-type (WT) calli, respectively. The reactive oxygen species content was lower in the LcyEsg2-HDR1 and LcyEsg2-HDR2 lines. These results indicate that efficient HDR can be achieved in the golden SNP replacement using a single and modular configuration applicable to different rice targets and other crops. This work demonstrates the potential to replace all genes with elite alleles within one generation and greatly expands our ability to improve agriculturally important traits.

Opto-ultrasound biosensor for wearable and mobile devices: realization with a transparent ultrasound transducer

Mobile and wearable healthcare electronics are widely used for measuring bio-signals using various fusion sensors that employ photoplethysmograms, cameras, microphones, ultrasound (US) sensors, and accelerometers. However, the consumer demand for small form factors has significantly increased as the integration of multiple sensors is difficult in small mobile or wearable devices. This study proposes two novel opto-US sensors, namely (1) a wearable photoplethysmography (PPG)-US device and (2) a PPG sensor built-in mobile smartphone with a US sensor, seamlessly integrated using a transparent ultrasound transducer (TUT). The TUT exhibits a center frequency of 6 MHz with a 50% bandwidth and 82% optical transparency in visible and near-infrared regions. We developed an integrated wearable PPG-US device to demonstrate its feasibility and coupled the TUT sensor with a smartphone. We measured the heart rates optically and acoustically in human subjects and quantified the oxygen saturation optically by passing light through the TUT. The proposed proof-of-concept is a novel sensor fusion for mobile and wearable devices that require a small form factor and aim to improve digital healthcare. The results of this study can form the basis for innovative developments in sensor-based high-tech industrial applications, such as automobiles, robots, and drones, in addition to healthcare applications.

['Triangular Cord' Sign in Biliary Atresia]

Biliary atresia is an unknown etiology of extrahepatic bile duct obstruction with a 'fibrous ductal remnant,' which represents the obliterated ductal remnant in the porta hepatis. The sonographic'triangular cord' (TC) sign has been reported to indicate a fibrous ductal remnant in the porta hepatis. In this review, we discuss the correlations among surgicopathological and sonographic findings of the porta hepatis and the definition, objective criteria, diagnostic accuracy, and differential diagnosis of the TC sign in biliary atresia.

Predictors and Impact of Sulcal SAH after Mechanical Thrombectomy in Patients with Isolated M2 Occlusion

BACKGROUND AND PURPOSE

Data on SAH after M2 mechanical thrombectomy are limited. We aimed to determine the prevalence of sulcal SAH after mechanical thrombectomy for M2 occlusion, its associated predictors, and the resulting clinical outcome.

MATERIALS AND METHODS

The study retrospectively reviewed the data of patients with acute ischemic stroke who underwent mechanical thrombectomy for isolated M2 occlusion. The patients were divided into 2 groups according to the presence of sulcal SAH after M2 mechanical thrombectomy. Angiographic and clinical outcomes were compared. Multivariable analysis was performed to identify independent predictors of sulcal SAH and unfavorable outcome (90-day mRS, 3-6).

RESULTS

Of the 209 enrolled patients, sulcal SAH was observed in 33 (15.8%) patients. The sulcal SAH group showed a higher rate of distal M2 occlusion (69.7% versus 22.7%), a higher of rate of superior division occlusion (63.6% versus 43.8%), and a higher M2 angulation (median, 128° versus 106°) than the non-sulcal SAH group. Of the 33 sulcal SAH cases, 23 (66.7%) were covert without visible intraprocedural contrast extravasation. Distal M2 occlusion (OR, 12.04; 95% CI, 4.56-35.67; P < .001), superior division (OR, 3.83; 95% CI, 1.43-11.26; P = .010), M2 angulation (OR, 1.02; 95% CI, 1.01-1.04; P < .001), and the number of passes (OR, 1.58; 95% CI, 1.22-2.09; P < .001) were independent predictors of sulcal SAH. However, covert sulcal SAH was not associated with an unfavorable outcome (P = .830).

CONCLUSIONS

After mechanical thrombectomy for M2 occlusion, sulcal SAH was not uncommon and occurred more frequently with distal M2 occlusion, superior division, acute M2 angulation, and multiple thrombectomy passes (≥3). The impact of covert sulcal SAH was mostly benign and was not associated with an unfavorable outcome.

Fully integrated photoacoustic microscopy and photoplethysmography of human in vivo

Photoacoustic microscopy (PAM) is used to visualize blood vessels and to monitor their time-dependent changes. Photoplethysmography (PPG) measures hemodynamic time-series changes such as heart rate. However, PPG's limited visual access to the dynamic changes of blood vessels has prohibited further understanding of hemodynamics. Here, we propose a novel, fully integrated PAM and photoplethysmography (PAM-PPG) system to understand hemodynamic features in detail. Using the PAM-PPG system, we simultaneously acquire vascular images (by PAM) and changes in the blood volume (by PPG) from human fingers. Next, we determine the heart rate from changes in the PA signals, which match well with the PPG signals. These changes can be measured if the blood flow is not blocked. From the results, we believe that PAM-PPG could be a useful clinical tool in various clinical fields such as cardiology and endocrinology.

Investigation of the Hydrogen Sulfide Signaling Pathway in Schwann Cells during Peripheral Nerve Degeneration: Multi-Omics Approaches

N-ethylmaleimide (NEM) inhibits peripheral nerve degeneration (PND) by targeting Schwann cells in a hydrogen sulfide (H₂S)-pathway-dependent manner, but the underlying molecular and pharmacological mechanisms are unclear. We investigated the effect of NEM, an α,β-unsaturated carboxyl compound, on H₂S signaling in in vitro- and ex vivo-dedifferentiated Schwann cells using global proteomics (LC-MS) and transcriptomics (whole-genome and small RNA-sequencing (RNA-seq)) methods. The multi-omics analyses identified several genes and proteins related to oxidative stress, such as Sod1, Gnao1, Stx4, Hmox2, Srxn1, and Edn1. The responses to oxidative stress were transcriptionally regulated by several transcription factors, such as Atf3, Fos, Rela, and Smad2. In a functional enrichment analysis, cell cycle, oxidative stress, and lipid/cholesterol metabolism were enriched, implicating H₂S signaling in Schwann cell dedifferentiation, proliferation, and myelination. NEM-induced changes in the H₂S signaling pathway affect oxidative stress, lipid metabolism, and the cell cycle in Schwann cells. Therefore, regulation of the H₂S signaling pathway by NEM during PND could prevent Schwann cell demyelination, dedifferentiation, and proliferation.

Reduction in the Migration Activity of Microglia Treated with Silica-Coated Magnetic Nanoparticles and their Recovery Using Citrate

Nanoparticles have garnered significant interest in neurological research in recent years owing to their efficient penetration of the blood–brain barrier (BBB). However, significant concerns are associated with their harmful effects, including those related to the immune response mediated by microglia, the resident immune cells in the brain, which are exposed to nanoparticles. We analysed the cytotoxic effects of silica-coated magnetic nanoparticles containing rhodamine B isothiocyanate dye [MNPs@SiO2(RITC)] in a BV2 microglial cell line using systems toxicological analysis. We performed the invasion assay and the exocytosis assay and transcriptomics, proteomics, metabolomics, and integrated triple-omics analysis, generating a single network using a machine learning algorithm. The results highlight alteration in the mechanisms of the nanotoxic effects of nanoparticles using integrated omics analysis.

Constructing multi-enzymatic cascade reactions for selective production of 6-bromoindirubin from tryptophan in Escherichia coli

6-Bromoindirubin (6BrIR), found in Murex sea snails, is a precursor of indirubin-derivatives anticancer drugs. However, its synthesis remains limited due to uncharacterized biosynthetic pathways and difficulties in site-specific bromination and oxidation at indole ring. Here, we present an efficient 6BrIR production strategy in E. coli by using four enzymes, i.e., tryptophan 6-halogenase fused with flavin reductase Fre (Fre-L3-SttH), tryptophanase (TnaA), toluene 4-monooxygenase (PmT4MO) and flavin-containing monooxygenase (MaFMO). Although most indole oxygenases preferentially oxygenate the electronically active C3 position of indole, PmT4MO was newly characterized to perform C2 oxygenation of 6-bromoindole with 45 % yield to produce 6-bromo-2-oxindole. In addition, 6BrIR was selectively generated without indigo and indirubin byproducts by controlling the reducing power of cysteine and oxygen supply during the MaFMO reaction. These approaches led to 34.1 mg/L 6BrIR productions, making it possible to produce the critical precursor of the anticancer drugs only from natural ingredients such as tryptophan, NaBr and oxygen. This article is protected by copyright. All rights reserved.

Abstract 105: Inhibitory effect of Wnt/β-Catenin inhibitor CWP232228 on the growth of ovarian cancer cells

Ovarian cancer is a leading cause of death of women in worldwide. Frequent recurrence and becoming resistant to chemotherapy are one of the causes that makes ovarian cancer deadly. Since recent studies have demonstrated that aberrant Wnt signaling plays an important role in cancer stem cells (CSCs) which are responsible of recurrence, metastasis and treatment failure, we tested whether regulation of Wnt signaling can be effective in ovarian cancer treatment. By treating CWP232228 which is a potent inhibitor of Wnt signaling to ovarian cancer cell lines and to a mouse model, we found CWP232228 effectively inhibits the growth of ovarian cancer cells which expresses high level of b-catenin and induce apoptosis of ovarian cancer cells. Furthermore CWP232228 reduces ovarian cancer cell migration, invasion and colony formation ability. Moreover CWP232228 reduces key features of CSCs. Taken together, our study suggests CWP232228 as a potential substance which might be effective in treating epithelial ovarian cancer with avoiding treatment failure.

Citation Format: So-Jin Shin, Seungmee Lee, Hyewon Chung, Chi-Heum Cho, Eunyoung Ha, Jin Young Kim, Ji Hae Seo. Inhibitory effect of Wnt/β-Catenin inhibitor CWP232228 on the growth of ovarian cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 105.

High-speed optical resolution photoacoustic microscopy with MEMS scanner using a novel and simple distortion correction method

Optical resolution photoacoustic microscopy (OR-PAM) is a remarkable biomedical imaging technique that can selectively visualize microtissues with optical-dependent high resolution. However, traditional OR-PAM using mechanical stages provides slow imaging speed, making it difficult to biologically interpret in vivo tissue. In this study, we developed a high-speed OR-PAM using a recently commercialized MEMS mirror. This system (MEMS-OR-PAM) consists of a 1-axis MEMS mirror and a mechanical stage. Furthermore, this study proposes a novel calibration method that quickly removes the spatial distortion caused by fast MEMS scanning. The proposed calibration method can easily correct distortions caused by both the scan geometry of the MEMS mirror and its nonlinear motion by running an image sequence only once using a ruler target. The combination of MEMS-OR-PAM and distortion correction method was verified using three experiments: (1) leaf skeleton phantom imaging to test the distortion correction efficacy; (2) spatial resolution and depth of field (DOF) measurement for system performance; (3) in-vivo finger capillary imaging to verify their biomedical use. The results showed that the combination could achieve a high-speed (32 s in 2 × 4 mm) and high lateral resolution (~ 6 µm) imaging capability and precisely visualize the circulating structure of the finger capillaries.

Diagnosis of dengue virus infection using spectroscopic images and deep learning

Dengue virus (DENV) infection is one of the major health issues and a substantial epidemic infectious human disease. More than two billion humans are living in dengue susceptible regions with annual infection mortality rate is about 5%-20%. At initial stages, it is difficult to differentiate dengue virus symptoms with other similar diseases. The main objective of this research is to diagnose dengue virus infection in human blood sera for better treatment and rehabilitation process. A novel and robust approach is proposed based on Raman spectroscopy and deep learning. In this regard, the ResNet101 deep learning model is modified by exploiting transfer learning (TL) concept on Raman spectroscopic data of human blood sera. Sample size was selected using standard statistical tests. The proposed model is evaluated on 2,000 Raman spectra images in which 1,200 are DENV-infected of human blood sera samples, and 800 are healthy ones. It offers 96.0% accuracy on testing data for DENV infection diagnosis. Moreover, the developed approach demonstrated minimum improvement of 6.0% and 7.0% in terms of AUC and Kappa index respectively over the other state-of-the-art techniques. The developed model offers superior performance to capture minute Raman spectral variations due to the better residual learning capability and generalization ability compared to others deep learning models. The developed model revealed that it might be applied for diagnosis of DENV infection to save precious human lives.