Changes in maxillofacial morphology due to improvement of nasal obstruction in rats

OBJECTIVES

To investigate the effect of release of experimentally introduced nasal obstruction on maxillofacial morphology and percutaneous arterial oxygen saturation (SpO₂ ) in rats.

MATERIALS AND METHODS

Six-week-old male Wistar rats (n = 36) were divided into a control group (n = 6) and a nasal obstruction group (n = 30). In the nasal obstruction group, the right nostril was occluded with silicon, which was subsequently removed after a given experimental period (days 7, 21, 35, 49 and 63). These animals were then divided into groups D7, D21, D35, D49 and D63 (each n = 6), according to the day at which the obstruction was released. The SpO₂ was measured in rats with nasal obstruction at five experimental points. The maxillofacial morphology in rats on the first day and 63 days after the start of the experiment was evaluated by microcomputed tomography.

RESULTS

The SpO₂ was still lower at 2 weeks after the improvement of the nasal obstruction in the D49 group than in the control group. In addition, the height of the nasal maxillary complex of the D35, D49 and D63 groups was significantly decreased compared with the control group.

CONCLUSIONS

The results of this study suggest that long-term unilateral nasal obstruction in growing rats may affect the growth of the nasomaxillary complex and reduce the SpO₂ permanently. Therefore, early improvement of nasal obstruction in rats during the growth period may improve the SpO₂ and cranial development and promote normal growth and development.

Abstract OT2-06-02: A randomized phase II study of maintenance hormone therapy with or without capecitabine after induction therapy with bevacizumab plus paclitaxel in hormone receptor positive and HER2 negative metastatic breast cancer (KBCSG-TR1214)

Background: The combination therapy of Bevacizumab (B) and Paclitaxel (P) has proved to prolong progression free survival (PFS) in E2100 and MERiDiAN study for advanced and metastatic breast cancer(AMBC). Because of its longer PFS, developing optimal therapeutic strategy of B+P to improve survival, including management of toxicity is crucial. From the International Consensus Conference for Advanced Breast Cancer, most experts agreed the maintenance endocrine therapy after effective induction chemotherapy in AMBC. In KBCSG-TR 1214 study, we planned to examine the following clinical questions. 1. As a maintenance therapy, which is more effective either endocrine therapy alone (E) or endocrine therapy with capecitabine (E+C)? 2. Can maintenance therapy reduce toxicity of B+P and restore patient's QOL.? 3. How effective is B+P re-challenge after failure of maintenance therapy?

Methods: KBCSG-TR 1214 study is multicenter open-labeled randomized phase II trial for hormone receptor (HR)-positive and HER2-nagative patientswho have experienced none or one prior chemotherapy for AMBC. Patients will receive B (10mg/kg q2w) in combination with P (90mg/m2 on day 1, 8, and 15 q4w) as an induction therapy. Patients without progression after 6 cycles of B+P will be randomized to E or E+C. Endocrine treatment has been administrated by their physician's choice. Patients in E+C will receive endocrine therapy with capecitabine 1657mg/m2 on day1 to 21 q4w. Stratification factors for randomization are menopausal status, presence of target lesion, number of prior endocrine therapies for AMBC, with or without 1st line chemotherapy for AMBC. After progression of maintenance therapy (E or E+C), B+P will be started again as a re-challenge therapy. Primary end point is PFS of maintenance therapy. Secondary end points include time to failure of strategy from randomization, efficacy of re-challenge therapy, overall survival and safety of induction therapy. Translational research is also planned. VEGF, angiopoetin-1, and apelin in plasma will be measured at four points (before induction therapy, at the beginning of the maintenance therapy and the re-induction therapy, and at the end of the trial). The sample size was calculated by typeIerror (1-sided) of 0.05 and 80% power to estimate median PFS of each maintenance therapy 9 months with a threshold of 6 months. The target number of patients enrolled and randomized after induction therapy was 120 and 90, respectively.

Enrollment has been completed with 116 patients as of April, 2016 and 90 patients had been successful to shift to the maintenance phase with randomization. The last patient had been randomized on October, 2016. The first analysis will be planned during the second quarter of 2018 (UMIN000008662).

Citation Format: Yamaguchi M, Nakayama T, Yoshinami T, Ikeda M, Iwamoto M, Komoike Y, Takashima T, Tsurutani J, Yoshidome K, Yamada T, Morita S, Masuda N. A randomized phase II study of maintenance hormone therapy with or without capecitabine after induction therapy with bevacizumab plus paclitaxel in hormone receptor positive and HER2 negative metastatic breast cancer (KBCSG-TR1214) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-06-02.

15 Effects of Timed Artificial Insemination Protocol Using Prostglandin F2α and Estradiol Benzoate on Conception Rate in High-Producing Dairy Cows

For several years, milk production per Holstein cow has been increasing while reproductive performance has declined worldwide. Timed AI (TAI) protocols with synchronization of oestrus and ovulation are tools for the improvement of reproductive performance in high producing dairy herds. In protocols for synchronization of oestrus and ovulation, oestradiol benzoate (EB) has been used to increase the number of animals that show oestrous behaviour, synchronize ovulation, and improve conception rate (CR). The objective of this study was to compare a simple oestrus synchronization and TAI protocol using prostaglandin F2α (PG) and EB with a more complicated TAI protocol or oestrus detection and AI on CR in high-producing Holstein cows. The study was conducted from 2014 to 2016, using 1,036 Holstein cows from 3 commercial dairy herds in central Hokkaido, Japan. The average parity number was 2.6 ± 1.5, and days open averaged 152.2 ± 82.0 days. The average milk yield (305 days) was 11,348 ± 1,619 kg. Oestrus synchronization of cows was achieved using PG followed by EB and TAI (PG was given to cows with a cutoff for CL diameter of >20 mm by ultrasonography; EB (1 mg) was administered 24 h later and AI was carried out 24 to 48 h after EB injection), or by Heatsynch + CIDR [gonadotropin-releasing hormone (GnRH) injection and CIDR insertion at random stages of the oestrous cycle, CIDR removal, and PG injection 7 days later, EB injected 24 h after CIDR removal, and TAI 24 to 32 h after EB injection]. Cows observed in natural oestrus were used as controls. All cows were inseminated after the onset of standing heat or removal of the tail chalk (Paintstik®, LA-CO Industries, Elk Grove Village, IL, USA). Pregnancy diagnoses were performed using ultrasonography between 30 and 45 days after AI. The CR were compared using chi-square test. The CR (no. of pregnant cows/no. of total cows in the treatment group) of the natural oestrus group, PG + EB, and Heatsynch + CIDR cows were 39.2% (302/771), 38.7% (48/124), and 31.2% (44/141), respectively. Overall CR for the 3 groups was 38.0%. There were no significant differences in CR among the 2 groups (P > 0.07). These results show that a simple oestrus synchronization protocol with injection of PG followed by EB can be used effectively for high-producing dairy herds, yielding a satisfactory CR similar to that obtained with the Heatsynch + CIDR protocol or natural oestrus.

Treatment of cervical pregnancy with ultrasound-guided local methotrexate injection

OBJECTIVES

Cervical pregnancy (CP) is a rare type of ectopic pregnancy. While methotrexate (MTX) is generally the first-line method of choice for clinically stable women, there is still no consensus on the most appropriate treatment for this abnormal pregnancy. The aim of this study was to investigate the efficacy of a single local MTX injection under transvaginal ultrasound guidance for the initial treatment of CP and to assess post-treatment fertility.

METHODS

We reviewed retrospectively 15 patients with CP treated with local MTX injection under transvaginal ultrasound guidance. In all patients, the serum human chorionic gonadotropin (hCG) levels were monitored and the gestational sac was evaluated using ultrasonography after treatment. Magnetic resonance imaging (MRI) was performed as necessary. We evaluated the patients' clinical characteristics and clinical course after treatment, the efficacy of the treatment and the post-treatment fertility in patients desiring subsequent pregnancy.

RESULTS

The median estimated gestational age at the time of MTX injection was 6 + 2 (range, 5 + 2 to 11 + 0) weeks. All 15 patients were treated successfully, without the need for blood transfusion or surgical procedures; however, three patients required an additional local MTX injection due to a poor decline in serum hCG level following the initial injection, while one patient required uterine artery embolization due to persistent vaginal bleeding and an enlarging gestational sac with blood vessels visible on contrast-enhanced MRI. The mean time following initial MTX injection for hCG normalization was 43.8 (95% CI, 33.3-54.3) days and for resumption of menses was 68.4 (95% CI, 51.9-84.9) days. Seven of the 10 women desiring subsequent pregnancy following treatment had uneventful pregnancy, one became pregnant but miscarried spontaneously at 8 weeks of gestation, one was treated by laparoscopic surgery after diagnosis of a tubal pregnancy and one did not conceive.

CONCLUSIONS

A single, ultrasound-guided, local MTX injection is apparently effective for the treatment of CP without the need for concomitant procedures or surgical intervention. Furthermore, this conservative technique both preserves fertility and allows for the possibility of subsequent uneventful pregnancy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Rescuing the aberrant sex development of H3K9 demethylase Jmjd1a-deficient mice by modulating H3K9 methylation balance

Histone H3 lysine 9 (H3K9) methylation is a hallmark of heterochromatin. H3K9 demethylation is crucial in mouse sex determination; The H3K9 demethylase Jmjd1a deficiency leads to increased H3K9 methylation at the Sry locus in embryonic gonads, thereby compromising Sry expression and causing male-to-female sex reversal. We hypothesized that the H3K9 methylation level at the Sry locus is finely tuned by the balance in activities between the H3K9 demethylase Jmjd1a and an unidentified H3K9 methyltransferase to ensure correct Sry expression. Here we identified the GLP/G9a H3K9 methyltransferase complex as the enzyme catalyzing H3K9 methylation at the Sry locus. Based on this finding, we tried to rescue the sex-reversal phenotype of Jmjd1a-deficient mice by modulating GLP/G9a complex activity. A heterozygous GLP mutation rescued the sex-reversal phenotype of Jmjd1a-deficient mice by restoring Sry expression. The administration of a chemical inhibitor of GLP/G9a enzyme into Jmjd1a-deficient embryos also successfully rescued sex reversal. Our study not only reveals the molecular mechanism underlying the tuning of Sry expression but also provides proof on the principle of therapeutic strategies based on the pharmacological modulation of epigenetic balance.

In eukaryotes, DNA wraps an octamer of the core histones. Covalent modifications on the histones have diverse biological functions including transcriptional regulation. Histone H3 lysine 9 (H3K9) methylation is a hallmark of transcriptionally silenced chromatin. In mammals, the sex-determining gene Sry initiates testis differentiation in embryonic gonads. Sry expression in gonads is fine-tuned in both space and time. Here, we demonstrated that fine-tuning of Sry expression is achieved by the balance in activities between H3K9 demethylase and H3K9 methyltransferase. We found that the GLP/G9a complex is the enzyme catalyzing H3K9 methylation of Sry. Based on this finding, we tried to rescue the sex-reversal phenotype of the mutant mice by modulating the H3K9 methylation balance of Sry. We succeeded by modulating the H3K9 methylation balance not only with a genetic approach but also with a chemical approach using an inhibitor of GLP/G9a enzyme. Aberrant histone methylation levels are associated with diseases, including cancer, and intellectual disability. Our study provides proof for the principle of therapeutic strategies based on the pharmacological modulation of histone methylation balance.