Significance of glomerular activation of the alternative pathway and lectin pathway in lupus nephritis

The objective of the present study was to elucidate the association between glomerular complement depositions belonging to the alternative (AP) and lectin (LP) pathways, and clinical findings of lupus nephritis (LN). Immunofluorescence (IF) was performed on 17 LN patients using antibodies against factor B, factor H, properdin, mannose-binding lectin (MBL) and L-ficolin. Compared with factor B/factor H negative patients (n = 9), positive patients (n = 8) showed longer duration of LN (p < 0.05) and more severe interstitial fibrosis (p < 0.05). Eleven patients had properdin deposition in glomeruli, and in three of them, with a duration of LN of less than 1 month, factor B was undetectable. Compared with properdin negative patients (n = 6), positive patients (n = 11) showed significantly higher urinary protein excretion (p < 0.01). MBL/L-ficolin positive patients (n = 11) also had significantly higher urinary protein excretion (p < 0.05) compared with negative patients (n = 6). An independent association was found between glomerular deposition of properdin and that of MBL/L-ficolin (p < 0.01) in addition to factor B/factor H. Traces of glomerular activation of AP and LP reflected the clinical status of LN. It appears that glomerular deposition of each complement component, especially properdin, may be an index of the histological activity of LN.

Changes in serum S100A12 and sRAGE associated with improvement of the PaO(2)/FiO(2) ratio following PMX-DHP therapy for postoperative septic shock

BACKGROUND

Endotoxin (Et) adsorption therapy with a column of polymyxin B-immobilized fibers (PMX) is effective in improving the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO(2)/FiO(2) ratio) and increasing mean arterial blood pressure (MAP) in sepsis. S100A12 and soluble receptor for advanced glycation end product (sRAGE) are useful as early markers of acute lung injury.

PURPOSE

To investigate the effect of improving the PaO(2)/FiO(2) ratio by PMX-direct hemoperfusion (PMX-DHP) on production of S100A12 and sRAGE.

SUBJECTS AND METHODS

Sepsis patients after surgery for perforation of the lower gastrointestinal tract were adopted as the subjects. We retrospectively reviewed the cases of 20 patients on mechanical ventilation and continuous administration of norepinephrine. We recorded PaO(2)/FiO(2) ratio, MAP, and norepinephrine doses. S100A12, sRAGE, and Et levels were measured before and after PMX-DHP.

RESULTS

The PaO(2)/FiO(2) ratio and MAP improved significantly after PMX-DHP (p < 0.05). S100A12 and Et decreased significantly after PMX-DHP (p < 0.05). No differences were observed in sRAGE.

CONCLUSION

S100A12 is useful as a marker that reflected improvement in the PaO(2)/FiO(2) ratio after PMX-DHP. We consider PMX-DHP to be useful as adjunctive therapy for sepsis that reduces the Et and corrects the pathology in the early stage.

Sulfate complexation of element 104, Rf, in H2SO4/HNO3 mixed solution

The cation-exchange behavior of 261Rf (T 1/2= 78 s) produced in the 248Cm(18O, 5n) reaction was studied on a “one-atom-at-a-time” scale in 0.15–0.69 M H2SO4/HNO3 mixed solutions ([H+]=1.0 M) using an automated ion-exchange separation apparatus coupled with the detection system for alpha-spectroscopy (AIDA). It was found that adsorption probabilities ( decrease with an increase of [HSO4 −], showing a successive formation of Rf sulfate complexes. Rf exhibits a weaker complex formation tendency compared to the lighter homologues Zr and Hf. This is in good agreement with theoretical predictions including relativistic effects.

Preliminary study on glucose control with an artificial pancreas in postoperative sepsis patients

BACKGROUND

Glucose control is essential to avoid hypoglycemia in postoperative patients.

AIM

To conduct a preliminary examination to evaluate the feasibility of the use of an artificial pancreas for glucose control as well as the accuracy of assessment by the artificial pancreas of the insulin dose required.

SUBJECTS AND METHODS

Glucose control using an artificial pancreas was undertaken in 8 postoperative sepsis patients. The blood glucose level was set at 80-150 mg/dl. Blood glucose levels over time, insulin dose requirements, and occurrence of hypoglycemia (≤40 mg/dl) were recorded for each patient. The patients were divided into 2 groups based on the total insulin dose they received over the 7 days (HG, n = 4: consisting of patients who required a higher insulin dose; LG, n = 4: patients who required a lower insulin dose). The data of the 2 groups were analyzed retrospectively.

RESULTS

The blood glucose level before glucose control was 203.3 ± 9.9 mg/dl and could be controlled in all patients to within the target range. No hypoglycemia events were recorded for any of the patients. The insulin dose in the HG and LG groups was 21,824.8 ± 6,030.4 and 6,254.5 ± 3,402.3 mU/kg (p < 0.05).

CONCLUSIONS

Accurate glucose control could be achieved with the artificial pancreas.

Abstract P4-10-05: Factors Associated with Ipsilateral Breast Tumor Recurrence in Breast Cancer Patients Treated with Breast Conserving Surgery and Radiotherapy after Preoperative Chemotherapy

Background: Although preoperative chemotherapy (PCT) was originally used to make locally advanced breast cancers (BC) operable, it is now frequently utilized to make relatively large primary tumors small enough for breast conserving treatment (BCT). A large number of studies have been performed to identify risk factors of ipsilateral breast tumor recurrence (IBTR) after breast conserving treatment for originally small tumors. However, those studies for patients (Pts) who received BCT after PCT for relatively large tumors are limited. We have done a multicenter retrospective study to identify factors which were associated with IBTR in Pts treated with BCT after PCT.

Patients and methods: From 7 Japanese hospitals, data, which regard characteristics of tumors and Pts, and treatment, of Pts who fulfilled the following criteria; 1. Female BC Pts who started PCT before January 2007 2. Her tumor was invasive, clinically solitary, and 2 cm or largerby palpation at diagnosis 3. She received 3 or more cycles of PCT 4. She received breast conserving surgery as a definitive surgery after PCT including axillary dissection or sentinel node biopsy 5. She received radiotherapy at least to the conserved breast. Pts with inflammatory BC and BC Pts who received preoperative treatment(s) other than chemotherapy were excluded. Kaplan-Meier method was used to estimate cumulative recurrence rates. Log rank test and Cox's proportional hazard model were used for statistical analyses. Receiver Operating Characteristic (ROC) Curves and C statistics were used for evaluating the prediction ability of Cox's proportional hazard model about IBTR.

Results: A total of 324 Pts were registered. The median age at diagnosis of them was 48 years old. The median size of the primary tumors by palpation at diagnosis was 4 cm. For PCT anthracycline-based regimens were used for 83 Pts, taxane-based regimens were for 29, and anthracycline-taxane regimens were for 212. One hundred forty two Pts (43.8%) received postoperative chemotherapy, 180 (55.6%) had postoperative endocrine therapy, and only 7 had postoperative trastuzumab therapy. The median follow-up period was 45 months. Nineteen Pts (5.9%) developed IBTR. The cumulative 4-year IBTR rate was 5.5%. Univariate analyses revealed that estrogen receptor (ER) status both before and after PCT, pathological nodal status after PCT, and pathologically residual invasive tumor (solitary vs. multifocal, 1.7 cm or smaller vs. 1.8 cm or larger) were statistically significantly associated with IBTR (P &lt; 0.05 for all of them). Pathological margin status did not affect IBTR rate (P=0.73). ER status prior to PCT (positive vs. negative)(Hazard Ratio [HR], 6.76; P=0.012), size of the residual invasive tumor (1.7 cm or smaller vs. 1.8 cm or larger)(HR, 4.74; P=0.020), and pathological nodal status after PCT (0-3 positive nodes vs. 4 or more)(HR, 3.03; P=0.041) were associated with IBTR on multivariate analysis. C statistic was 78.3%.

Conclusion: Mastectomy may be a better choice for the Pts who have tumors with negative ER, pathologically large (1.8 cm or larger) residual invasive lesions after PCT, or 4 or more pathologically positive nodes after PCT in terms of local control.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-05.

Parasellar T2 dark sign on MR imaging in patients with lymphocytic hypophysitis

BACKGROUND AND PURPOSE

MR imaging findings of LYH and pituitary adenomas are similar, but the therapeutic strategies are completely different. The purpose of this study was to evaluate sellar and parasellar MR imaging findings in patients with both diseases, as well as characteristic clinical findings.

MATERIALS AND METHODS

Clinical findings, including endocrinologic study and MR images of 20 patients with LYH and 22 patients with pituitary adenoma, were retrospectively reviewed. We evaluated the MR images in relation to the following: 1) the PPHI on T1-weighted images, 2) thickened stalk (>3.5 mm), 3) pituitary symmetry, 4) pituitary enhancement pattern, 5) a dural tail, and 6) parasellar signal intensity on T2- and T1-weighted images.

RESULTS

Between patients with LYH and those with pituitary adenoma, a significant difference was identified for the number of patients with loss of PPHI, thickened stalk, pituitary symmetry, homogeneous enhancement, and parasellar dark signal intensity on T2-weighted images by statistical analysis (Fisher exact probability test, P < .05). Among them, only parasellar dark signal intensity on T2-weighted images had no false-positive cases.

CONCLUSIONS

The parasellar T2 dark sign can be a specific finding used to distinguish pituitary adenoma from LYH.

N-acetyl cysteine alleviates cytotoxicity of bone substitute

Lack of cytocompatibility in bone substitutes impairs healing in surrounding bone. Adverse biological events around biomaterials may be associated with oxidative stress. We hypothesized that a clinically used inorganic bone substitute is cytotoxic to osteoblasts due to oxidative stress and that N-acetyl cysteine (NAC), an antioxidant amino acid derivative, would detoxify such material. Only 20% of rat calvaria osteoblasts were viable when cultured on commercial deproteinized bovine bone particles for 24 hr, whereas this percentage doubled on bone substitute containing NAC. Intracellular ROS levels markedly increased on and under bone substitutes, which were reduced by prior addition of NAC to materials. NAC restored suppressed alkaline phosphatase activity in the bone substitute. Proinflammatory cytokine levels from human osteoblasts on the bone substitute decreased by one-third or more with addition of NAC. NAC alleviated cytotoxicity of the bone substitute to osteoblastic viability and function, implying enhanced bone regeneration around NAC-treated inorganic biomaterials.

Haplotype-based case-control study on human apurinic/apyrimidinic endonuclease 1/redox effector factor-1 gene and essential hypertension

BACKGROUND

Oxidative DNA damage is involved in the pathophysiology of essential hypertension (EH), which is a multifactorial disorder. Apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/REF-1) is an essential endonuclease in the base excision repair pathway of oxidatively damaged DNA, in addition to having reducing properties that promote the binding of redox-sensitive transcription factors. Blood pressure in APE1/REF-1-knockout mice is reported to be significantly higher than in wild-type mice. The aim of this study was to investigate the relationship between EH and the human APE1/REF-1 gene through a haplotype-based case-control study using single-nucleotide polymorphisms (SNPs).

METHODS

We selected five SNPs in the human APE1/REF-1 gene (rs1760944, rs3136814, rs17111967, rs3136817, and rs1130409), and performed case-control studies in 265 EH patients and 266 age-matched normotensive (NT) subjects.

RESULTS

rs17111967 was found to show nonheterogeneity among Japanese subjects. There were no significant differences in the overall distribution of genotypes or alleles for each SNP between EH and NT groups. In the overall distribution of the haplotype-based case-control study constructed based on rs1760944, rs3136817, and rs1130409, the frequency of the G-T-T haplotype was significantly higher in the EH group than in the NT group (2.1% vs. 0.0%, P = 0.001). Multiple logistic regression analysis also revealed significant differences for the G-T-T haplotype, even after adjustment for confounding factors (OR = 8.600, 95% CI: 1.073-68.951, P = 0.043).

CONCLUSIONS

Based on the present results, the G-T-T haplotype appears to be a genetic marker of EH, and the APE1/REF-1 gene appears to be a susceptibility gene for EH.

Utility of Breast CT in the Management of Breast Cancer – Results from a Prospective Multi-Institutional Study

Background:In order to obtain negative margins after breast conserving surgery (BCS), even repeated surgery is widely accepted. Before surgery, it is important to conduct a precise assessment of the extent of the breast cancer so that each patient can receive individualized surgery. To evaluate the utility of breast computed tomography (CT) as a tool to manage BCS, a multi-institutional prospective study was conducted in Japan.Patients and Methods:Patients were eligible to participate in this study if they had histologically proven breast cancer and were determined to be BCS candidates based on palpation, mammography (MMG) and ultrasonography (US). Written informed consent was obtained from each patient. First, the surgeon marked the line of planned excision on the skin using information from the MMG and US. Next, an expired angiographic catheter was placed on the mark to show the original surgical margin on the CT image. Breast CT was scanned 60 seconds after the bolus injection of the contrast material in the supine surgical position. The surgeon determined the extent of surgery based on the breast CT results. Surgical specimens were serially sectioned in 5-mm slices.Results:Three hundred and two patients were enrolled in this study. The CT scanners used in this study varied from a single helical CT to a 64-row multidetector CT. The results of the breast CT changed the extent of resection in 14.7% of patients. Among the 5 patients who were recommended to undergo a mastectomy, 4 patients had multicentric tumors pathologically and 1 patient had a widely spread intraductal component. The other patients were recommended to have a quadrantectomy based on the extent of breast cancer that was visualized by CT. Three patients (1%) who required conversion from a lumpectomy to quadrantectomy resulted in overexcision. In short, breast CT correctly changed the extent of surgery in 13.7% of the examined patients.Conclusion:This prospective study suggested that breast CT is useful for hospitals equipped with any type of CT and can be used to provide patients with individualized surgery.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5021.

Mechanism of the anti-obesity effects induced by a novel melanin-concentrating hormone 1-receptor antagonist in mice

BACKGROUND AND PURPOSE

Melanin-concentrating hormone (MCH) is an orexigenic neuropeptide expressed in the lateral hypothalamus that is involved in feeding and body weight regulation. Intracerebroventricular infusion of a peptidic MCH1 receptor antagonist ameliorated obesity in murine models. Recently, small molecule MCH1 receptor antagonists have been developed and characterized for the treatment of obesity. However, little is known of the mechanism of the anti-obesity effects of MCH1 receptor antagonists.

EXPERIMENTAL APPROACH

To examine the mechanisms of action of the anti-obesity effect of MCH1 receptor antagonists more precisely, we conducted a pair-feeding study in mice with diet-induced obesity (DIO), chronically treated with an orally active and highly selective MCH1 receptor antagonist and examined changes in mRNA expression levels in liver, brown and white adipose tissues. We also assessed the acute effects of the MCH1 receptor antagonist in energy expenditure under thermoneutral conditions.

KEY RESULTS

Treatment with the MCH1 receptor antagonist at 30 mg.kg(-1) for 1 month moderately suppressed feeding and significantly reduced body weight by 24%. In contrast, pair-feeding resulted in a smaller weight reduction of 10%. Treatment with the MCH1 receptor antagonist resulted in a higher body temperature compared with the pair-fed group. TaqMan and calorimetry data suggested that the MCH1 receptor antagonist also stimulated thermogenesis.

CONCLUSIONS AND IMPLICATIONS

Our results indicate that an MCH1 receptor antagonist caused anti-obesity effects im mice by acting on both energy intake and energy expenditure.

Osteoblast mechanoresponses on Ti with different surface topographies

During implant healing, mechanical force is transmitted to osteogenic cells via implant surfaces with various topographies. This study tested a hypothesis that osteoblasts respond to mechanical stimulation differently on titanium with different surface topographies. Rat bone-marrow-derived osteoblastic cells were cultured on titanium disks with machined or acid-etched surfaces. A loading session consisted of a 3-minute application of a 10- or 20-mum-amplitude vibration. Alkaline phosphatase activity and gene expression increased only when the cells were loaded in 3 sessions/day on machined surfaces, regardless of the vibration amplitude, whereas they were increased with 1 loading session/day on the acid-etched surface. The loading did not affect the osteoblast proliferation on either surface, but selectively enhanced the cell spreading on the machined surface. Analysis of the data suggests that osteoblastic differentiation is promoted by mechanical stimulation on titanium, and that the promotion is disproportionate, depending on the titanium surface topography. The frequency of mechanical stimulation, rather than its amplitude, seemed to have a key role.

Side population cells have the characteristics of cancer stem-like cells/cancer-initiating cells in bone sarcomas

Background:

Several human cancers have been found to contain cancer stem-like cells (CSCs) having cancer-initiating ability. However, only a few reports have shown the existence of CSCs in bone and soft tissue sarcomas. In this study, we identified and characterised side population (SP) cells that showed drug-resistant features in human bone sarcoma cell lines.

Methods:

In seven osteosarcoma cell lines (OS2000, KIKU, NY, Huo9, HOS, U2OS and Saos2) and in one bone malignant fibrous histiocytoma (MFH) cell line (MFH2003), the frequency of SP cells was analysed. Tumourigenicity of SP cells was assessed in vitro and in vivo. Gene profiles of SP cells and other populations (main population; MP) of cells were characterised using cDNA microarrays.

Results:

SP cells were found in NY (0.31%) and MFH2003 (5.28%). SP cells of MFH2003 formed spherical colonies and re-populated into SP and MP cells. In an NOD/SCID mice xenograft model, 1 × 10³ sorted SP cell-induced tumourigenesis. cDNA microarray analysis showed that 23 genes were upregulated in SP cells.

Conclusions:

We showed that SP cells existed in bone sarcoma cell lines. SP cells of MFH2003 had cancer-initiating ability in vitro and in vivo. The gene profiles of SP cells could serve as candidate markers for CSCs in bone sarcomas.

Haplotype-based case-control study of receptor (calcitonin) activity-modifying protein-1 gene in cerebral infarction

Calcitonin gene-related peptide (CGRP) receptor is a complex molecule that consists of calcitonin receptor-like receptor and receptor activity-modifying protein-1 (RAMP1). It was recently reported that RAMP1-deficient mice (RAMP1(-/-)) showed inflammatory responses with a transiently significant increase in serum CGRP levels and proinflammatory cytokines when compared with RAMP1(+/+) mice. The aim of this study was to investigate the relationship between the human RAMP1 gene and cerebral infarction (CI) using single-nucleotide polymorphisms (SNPs) in a Japanese population. We selected six SNPs in the human RAMP1 gene (rs3754701, rs3769048, rs7557078, rs1584243, rs10199956 and rs7590387) and performed a case-control study using each SNP and haplotype in 171 CI patients and 234 controls. There were no significant differences in overall distribution of genotype and allele frequencies of the SNPs between the CI and control groups. However, there was a significant difference in overall distribution between the CI and control groups (P<0.001) in the haplotype-based case-control study with the combinations of rs3754701-rs3769048-rs7590387. The T-A-C susceptibility haplotype for CI was significantly more frequent than in the control group (P=0.0024). The results suggest that the T-A-C haplotype is a genetic marker for CI, and that RAMP1 or neighbouring genes are associated with increased susceptibility to CI.

The purinergic receptor P2Y, G-protein coupled, 2 (P2RY2) gene associated with essential hypertension in Japanese men

P2RY2 has an important function in the regulation of blood pressure by activating adenosine triphosphate (ATP). The aim of this study was to investigate the association between the human P2RY2 gene and essential hypertension (EH) through a haplotype-based case-control study that included two gender groups. The 273 EH patients and 255 age-matched controls were genotyped for five single-nucleotide polymorphisms (SNPs) of the human P2RY2 gene (rs4944831, rs1783596, rs4944832, rs4382936 and rs10898909). Data were analysed for men and women separately and then as a combined total group. For the total and the men only groups, the genotype distribution of the T allele of rs4944831 and the recessive model (GG vs TG+TT) of rs4944831 differed significantly between the EH patients and controls (P=0.028 and 0.019; P=0.009 and 0.008, respectively). Logistic regression showed that for the total and men groups, the TG+TT genotype of rs4944831 was more prevalent in EH patients than in the controls (P=0.026 and 0.011, respectively). For men, the overall distribution of the haplotype (SNP2-SNP4-SNP5) was significantly different between the EH patients and the controls (P=0.006). As compared with controls, the frequency of the T-A-G haplotype was significantly higher, whereas the T-C-G haplotype was significantly lower for the EH patients (P=0.001 and 0.014, respectively). In conclusion, the present results indicate that rs4944831 and the T-A-G haplotype of the human P2RY2 gene might be genetic markers for EH in Japanese men.

Age-dependent degradation of the protein adsorption capacity of titanium

Reported bone-implant contact percentages are far below the ideal 100%. We tested a hypothesis that the protein adsorption capability of titanium, which is critical to the process of osseointegration, changes over time before its use. Machined, acid-etched, and sandblasted surfaces were prepared and stored under dark ambient conditions for 3 days, 1 week, or 4 weeks. For all surfaces, protein adsorption decreased as the storage time increased, and their decreasing rates were dependent on titanium topography. After 4 weeks, the amounts of albumin and fibronectin adsorbed by the acid-etched surface were only 20% and 35%, respectively, of that adsorbed by the fresh surface after 2 hours of incubation, and remained substantially low even after 24 hours. This time-dependent degradation in protein adsorption of titanium correlated with its naturally decreasing hydrophilicity, which was not observed for the nickel and chromium surfaces, indicating a titanium-specific biological aging.

Interaction of Hepatic Chromatin with Androgen-Receptor Complex

When the chromatin prepared from male rat livers interacted with [3H] testosterone-receptor complex prepared from male rat livers, the binding was much higher than when interacted with free [3H] testosterone, indicating that the formation of testosterone-receptor complex is prerequisite for interaction with chromatin. When the [3H] testosterone-receptor complex was interacted with the chromatin and the bound chromatin proteins were extracted into three fractions based on their extractability or solubility in salt solutions, higher radioactivities were found in the 0.35 M NaCl-extract and 2.0 M NaCl residual fraction. Chromatin was fractionated into 0.35 M NaCl-soluble, 2.0 M NaCl-soluble and insoluble fractions, and interaction of free [3H] testosterone or [3H] testosterone-receptor complex with chromosomal fractions was studied. The binding of the chromosomal fractions with free [3H] testosterone was negligible compared with that of [3H] testosterone-receptor complex. The binding of 0.35 M NaCl-soluble fraction with [3H] testosterone-receptor complex was higher than that of 2.0 M NaCl-soluble fraction. The binding ability of 2.0 M NaCl-insoluble fraction with [3H] testosterone-receptor complex was twice as much as that of the intact chromatin. This observation indicated that salt-soluble fractions of chromatin contributes only partly to the binding of chromatin with [3H] testosterone-receptor complex and that other components in 2.0 M NaCl-insoluble fraction may participate in the binding.

Sucrose feeding at weaning alters the preference for sucrose in adolescence

The present studies were undertaken to examine the hypothesis that sucrose feeding at weaning may alter the preference for sucrose in the adolescence. Chronological changes of hypothalamic dopamine (DA), its metabolite, 3,4-dihydroxy-phenylacetic acid (DOPAC) and norepinephrine (NE) contents were also measured by HPLC. In 21 day-aged rats, 10% sucrose or water was given as drinking water for 3 weeks. From 9 weeks, all animals were maintained under a free choice between 30% sucrose solution and water. Sucrose-ingested rats more preferred to 30% sucrose solution than control rats and body weight gain of sucrose group was significantly greater than that of controls. Hypothalamic DA content was significantly decreased at 6 and 13 weeks and the DOPAC/DA ratio increased at 3, 6, and 13 weeks later. In contrast, hypothalamic NE concentration was not changed at all. The data obtained herein suggest that sucrose feeding at weaning alters the preference for sucrose, resulting in an overweight gain, and that the observed increase of hypothalamic DA metabolism may be involved in the altered preference for sucrose.

Reduced ability of neutrophils to produce active oxygen species in streptozotocin-induced diabetic rats

We investigated a possible alteration in the ability of neutrophils to produce active oxygen species in streptozotocin (STZ)-induced diabetic rats. The production of superoxide of the neutrophils was assessed by luminol-dependent chemiluminescence (LDCL) after the stimulation by opsonized zymosan. Four days after STZ (60 mg/kg, ip) injection, blood glucose level increased by 399 +/- 9 mg/dl and the LDCL activity was significantly reduced in diabetic rats (control group: 5.12 +/- 1.53 KC/min2/10(6) cells, STZ group: 1.10 +/- 0.07 KC/min2/10(6) cells, p less than 0.01). At Day 17, blood glucose level was maintained high (598 +/- 8 mg/dl) and the LDCL activity (1.01 +/- 0.39 KC/min2/10(6) cells) was almost at the same level as that of diabetic rats at Day 4. Subcutaneous injection of insulin for 10 consecutive days increased the LDCL activity of diabetic rats in a dose-dependent manner (vehicle: 0.82 +/- 0.27 KC/min2/10(6) cells, 0.04 U/day: 1.61 +/- 0.09 KC/min2/10(6) cells, 0.40 U/day: 1.99 +/- 0.47 KC/min2/10(6) cells, 4.00 U/day: 3.33 +/- 0.43 KC/min2/10(6) cells). The data obtained herein indicate that an increased susceptibility to bacterial infection in diabetic rats results from impaired neutrophil function to produce active oxygen species.

Colonic temperature was not changed in the development of obesity after ovariectomy

We tested the hypothesis that altered heat production ability after ovariectomy may be involved in the development of obesity. Two weeks after ovariectomy, food intake of ovariectomized (Ovx) rats was increased and body weight gain was obvious, compared with sham-operated animals. However, colonic temperature of Ovx rats was not different from that of sham-operated animals. Food intake of Ovx rats was similar with that of sham-operated rats at 8 weeks later. In this period, colonic temperature of Ovx rats was not different from that of sham-operated animals and diurnal rhythmicity was maintained. The present data suggested that changes in heat production may be not an important inducer of obesity in both the dynamic and static phases of the development of obesity after ovariectomy.

Hypothermia in insulin-treated obese rats

Changes of colonic temperature were investigated to examine a mechanism of hypothermia in the obese rats which received subcutaneous administration of intermediate type-insulin (8 U/day) for 8 weeks. Although diurnal rhythmicity of colonic temperature levels was maintained similarly with those of vehicle-injected controls, the overall colonic temperature levels were significantly lowered in insulin-treated animals. In the condition of cold exposure at 5 degrees C, colonic temperature levels of insulin-treated animals were immediately and significantly decreased at 60 minutes after the start of cold exposure. The data obtained herein demonstrated that hyperinsulinemia accompanying with hyperphagia should be profoundly involved in hypothermia, observed in various experimental models of obesity.

Neoadjuvant exemestane for 24 weeks in postmenopausal women with hormone receptor positive stage II or IIIA breast cancer (JFMC34–0601)

591

Background: Exemestane (EXE) is a steroidal aromatase inhibitor and has shown efficacy for not only metastatic breast cancer but also for primary breast cancer situation. Recently it is reported that preoperative treatment with EXE for 24weeks (wks) is more effective than 8 or 16wks. This study aimed to evaluate 24wks treatment of EXE in the neoadjuvant setting for hormone receptor positive, stage II/IIIA, postmenopausal breast cancer. Methods: Stage II/IIIA pts were eligible with confirmed invasive breast cancer and ER/PgR status using needle biopsy. Primary endpoints were ORR and Safety. EXE 25mg/day was administered, and if pts were evaluated CR, PR, SD at 16wks, 8wks treatment was added. Additionally rates of breast conserving surgery (BCS), nodal status, biomarker changes and the relationship between response and survival are being investigated. Results: Between March 2006 and January 2008, 116 pts were enrolled (stage IIA:77%, IIB:20%, III:3%). All pts were ER +, and 80 (69%) were PgR+, and 29 (27.1%) were HER-2+, respectively. At 24 wks, 109pts were evaluable. OR rate was 53% (58/109) and SD rate was 39% (43/109) by investigator's evaluation. Two pts withdrew due to the adverse events. At diagnosis 14 pts would have required mastectomy and after treatment only 5 pts underwent mastectomy. Central pathological review exhibited that biomarker changes during the treatment correlated with tumor response. Conclusions: EXE has shown attractive response for hormone receptor positive breast cancer in neoadjuvant setting. Especially 24wks treatment seems effective with sufficient safety and tolerability. Additional investigations are conducted to explore predictive biomarkers for response and survival.

[Table: see text]

Prevention of neural tube defects by loss of function of inducible nitric oxide synthase in fetuses of a mouse model of streptozotocin-induced diabetes

AIMS/HYPOTHESIS

Maternal diabetes during pregnancy increases the risk of congenital malformations such as neural tube defects (NTDs). Although the mechanism of this effect is uncertain, it is known that levels of nitric oxide synthase (NOS) and nitric oxide are elevated in embryos of a mouse model of diabetes. We postulated that overproduction of nitric oxide causes diabetes-induced congenital malformations and that inhibition of inducible NOS (iNOS) might prevent diabetic embryopathy.

METHODS

Mice were rendered hyperglycaemic by intraperitoneal injection of streptozotocin. The incidence of congenital malformations including NTDs was evaluated on gestational day 18.5. We assessed the involvement of iNOS in diabetes-induced malformation by administering ONO-1714, a specific inhibitor of iNOS, to pregnant mice with streptozotocin-induced diabetic mice and by screening mice with iNOS deficiency due to genetic knockout (iNos(-/-)).

RESULTS

ONO-1714 markedly reduced the incidence of congenital anomalies, including NTDs, in fetuses of a mouse model of diabetes. It also prevented apoptosis in the head region of fetuses, indicating that iNOS is involved in diabetes-related congenital malformations. Indeed, no NTDs were observed in fetuses of diabetic iNos(-/-) mice and the incidence of other malformations was also markedly reduced.

CONCLUSIONS/INTERPRETATION

We conclude that increased iNOS activity during organogenesis plays a crucial role in the pathogenesis of diabetes-induced malformations and suggest that inhibitors of iNOS might help prevent malformations, especially NTDs, in diabetic pregnancy.

[Recurrence of thymoma as pleural dissemination 23-years after surgery]

A 63-year-old female, who was noticed a chest mass approximately 4 cm in diameter on a chest X-ray, was admitted to our hospital. We thought that it was a benign chest wall tumor such as a neurogenic tumor by the findings of the chest computed tomography (CT). Resection of the tumor was performed. Neurogenic tumor was suspected by the frozen section. But it turned out to be a thymoma type AB in permanent preparation. Since she had undergone thymothymectomy 23-years ago, the tumor was considered to be a pleural recurrence of thymoma. We thoroughly checked the chest CT again, and detected another tumor at the right of the thoracic vertebra. Third surgery was performed and the tumor was resected. We experienced recurrence of thymoma as pleural dissemination 23-years after surgery. Thymomas are low-grade malignant tumor, but long-term clinical follow-up is necessary.

CHD7 mutations in patients initially diagnosed with Kallmann syndrome--the clinical overlap with CHARGE syndrome

Kallmann syndrome (KS) is the combination of hypogonadotropic hypogonadism and anosmia or hyposmia, two features that are also frequently present in CHARGE syndrome. CHARGE syndrome is caused by mutations in the CHD7 gene. We performed analysis of CHD7 in 36 patients with KS and 20 patients with normosmic idiopathic hypogonadotropic hypogonadism (nIHH) in whom mutations in KAL1, FGFR1, PROK2 and PROKR2 genes were excluded. Three of 56 KS/nIHH patients had de novo mutations in CHD7. In retrospect, these three CHD7-positive patients showed additional features that are seen in CHARGE syndrome. CHD7 mutations can be present in KS patients who have additional features that are part of the CHARGE syndrome phenotype. We did not find mutations in patients with isolated KS. These findings imply that patients diagnosed with hypogonadotropic hypogonadism and anosmia should be screened for clinical features consistent with CHARGE syndrome. If such features are present, particularly deafness, dysmorphic ears and/or hypoplasia or aplasia of the semicircular canals, CHD7 sequencing is recommended.