Clinicopathological stages of carcinoma breast patient

Carcinoma of breast is the second most common cancer among women next to uterine cervical cancer in Bangladesh. It was well established that 5 years survival rates greatly vary among the different stages of carcinoma of breast disease. The study was carried out to see the stages of presentation of carcinoma of breast patient to a tertiary level hospital attended first time for medical help as well as to find out the factors responsible for the late (advanced) stage presentation. This descriptive type of cross sectional study was carried out in the department of surgery, Mymensingh Medical College and Hospital (MMCH) during the period of May 2010 to April 2011. A total of 110 cases admitted with carcinoma breast diagnosed by means of FNAC positive or suspicious findings were selected purposively during the study period. Patients were staged initially according to the TNM staging system by through clinical examination as well as final clinicopathological stages were done after histopathological examination of the resected specimen (breast with or without axillary lymphnode) in resectable cases. Among the advanced stage presentation, attempts were made to find out the factors responsible for advanced stage of the disease. The results showed that carcinoma of breast predominantly a disease of female and comparatively younger age group 40-49 years affected mostly in 40.9% cases with a mean age of 44.02 ± 10.32 years. Premenopausal lady mostly affected in 63.6% cases. Majority of patients presented in advanced stage of the disease in 62.8% cases. Multiple factors were observed responsible for the advanced stage of the disease - among them delay in hospital presentation, poor socioeconomic condition and illiteracy have found to be associated which were statistically significant (p<0.001). It was needed for mass awareness program against the breast cancer in our society. Necessary steps should be taken for the initiation of breast self examination (BSE) to patients and clinical breast examination (CBE) to health care providers.

Particle-yield modification in jetlike azimuthal dihadron correlations in Pb-Pb collisions at √s(NN)=2.76 TeV

The yield of charged particles associated with high-p(t) trigger particles (8<p(t)<15 GeV/c) is measured with the ALICE detector in Pb-Pb collisions at √s(NN)=2.76 TeV relative to proton-proton collisions at the same energy. The conditional per-trigger yields are extracted from the narrow jetlike correlation peaks in azimuthal dihadron correlations. In the 5% most central collisions, we observe that the yield of associated charged particles with transverse momenta p(t)>3 GeV/c on the away side drops to about 60% of that observed in pp collisions, while on the near side a moderate enhancement of 20%-30% is found.

Diversity arrays technology (DArT) markers in apple for genetic linkage maps

Diversity Arrays Technology (DArT) provides a high-throughput whole-genome genotyping platform for the detection and scoring of hundreds of polymorphic loci without any need for prior sequence information. The work presented here details the development and performance of a DArT genotyping array for apple. This is the first paper on DArT in horticultural trees. Genetic mapping of DArT markers in two mapping populations and their integration with other marker types showed that DArT is a powerful high-throughput method for obtaining accurate and reproducible marker data, despite the low cost per data point. This method appears to be suitable for aligning the genetic maps of different segregating populations. The standard complexity reduction method, based on the methylation-sensitive PstI restriction enzyme, resulted in a high frequency of markers, although there was 52-54% redundancy due to the repeated sampling of highly similar sequences. Sequencing of the marker clones showed that they are significantly enriched for low-copy, genic regions. The genome coverage using the standard method was 55-76%. For improved genome coverage, an alternative complexity reduction method was examined, which resulted in less redundancy and additional segregating markers. The DArT markers proved to be of high quality and were very suitable for genetic mapping at low cost for the apple, providing moderate genome coverage. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11032-011-9579-5) contains supplementary material, which is available to authorized users.

J/ψ polarization in pp collisions at √s=7 TeV

The ALICE Collaboration has studied J/ψ production in pp collisions at √s=7 TeV at the LHC through its muon pair decay. The polar and azimuthal angle distributions of the decay muons were measured, and results on the J/ψ polarization parameters λ(θ) and λ(φ) were obtained. The study was performed in the kinematic region 2.5<y<4, 2<p(t)<8 GeV/c, in the helicity and Collins-Soper reference frames. In both frames, the polarization parameters are compatible with zero, within uncertainties.

Isolation and characterization of multidrug-resistant Klebsiella spp. isolated from shrimp imported from Thailand

A study was undertaken to isolate and characterize tetracycline and nalidixic acid-resistant Klebsiella spp. in farm-raised, imported shrimp sold in the United States. Sixty-seven multiple antibiotic-resistant Klebsiella spp. strains were isolated from imported shrimp samples. Using morphological and biochemical methods, fifty-three strains were tentatively identified as Klebsiella pneumoniae and fourteen as K. oxytoca. Although all isolates were resistant to tetracycline, only 8 were resistant to nalidixic acid. These 8 isolates were further screened by PCR for quinolone resistance genes (qnrA, B, S, gyrA, B and parC). PCR protocols failed to amplify any qnr genes. The purified PCR amplicons of gyrA, gyrB and parC were sequenced and analyzed for point mutations that confer resistance to fluoroquinolone antibiotics. Analysis of the sequences of the gyrA amplicons from nalidixic acid-resistant Klebsiella spp. indicated two point mutations in gyrA at positions 83 (Ser→Phe) and 87 (Asp→Ala). Sequence analysis of the parC amplicons indicated an amino acid change at position 80 (Ser→Ile). No mutations were detected in gyrB. Template DNA from all isolates was screened for tetracycline resistance genes (tetA-E). Oligonucleotide primers specifically targeting a 305-bp region of tetB and a 477-bp region of tetD successfully amplified sequences from 91.0 and 44.0% of the isolates, respectively. None of the isolates contained tetA, tetC or tetE genes. Plasmids (2.0-16.0kb) were found in 23 of the 67 isolates. XbaI-PFGE identified 32 distinct macro restriction patterns (mrps) among the 61 multiple drug-resistant Klebsiella spp. that were typable. Our results indicate that imported shrimp is a reservoir for multidrug resistant Klebsiella spp. and potential health risks posed by such strains should not be underestimated.

Pattern of malignancy in clinically solitary thyroid nodule

Solitary thyroid nodule (STN) is a common thyroid disorder. Clinically recognized thyroid carcinoma constitutes less than 1% of human malignant tumours. The risk of malignancy in solitary thyroid nodule is greater than other thyroid swelling. The risk of malignancy in generalized thyroid swelling is about 3% and in solitary thyroid nodule it is about 15%. This study was carried out in Surgery and ENT Department, Mymensingh Medical college Hospital from November 2008 to October 2009 to see pattern of malignancy in clinically solitary thyroid nodule. Total 108 patients of STN was included in this study, majority of the patients were within 20-39 years age group with female predominance. In addition to thyroid swelling some patients presented with other symptoms like cervical lymphadenopathy in 6(5.56%), dysphagia 2(1.85%), hoarseness of voice 2(1.85%) and metastatic lesion in bone 1(0.92%) cases. Among 108 cases of solitary thyroid nodule only 19 cases were malignant. Patients with malignant lesion presented with shorter duration of symptoms. Out of 19 malignant cases 6(31.58%) cases presented with features of metastasis. Malignancy was more predominant in male (25.00%) than the female (14.47%) in STN. Out of 19 malignant cases, 12(63.16%) were papillary carcinoma, 5(26.31%) were follicular carcinoma and 2(10.53%) cases were medullary carcinoma. Study showed significant difference (p<0.01) between papillary & follicular carcinoma and significant difference (p<0.001) between papillary & medullary carcinoma. Papillary carcinoma was most common among all thyroid malignancies in patients with solitary thyroid nodule.

Day-case laparoscopic Nissen fundoplication

INTRODUCTION

For day-case laparoscopic surgery to be successful, patient selection is of the utmost importance. This study aimed to assess the feasibility of day-case laparoscopic Nissen fundoplication and to identify factors that may lead to readmission and overstay.

METHODS

A retrospective review of all patients who underwent day-case laparoscopic Nissen fundoplication over a 4-year period (2006 through 2010) was undertaken. Patient age, social circumstances, and other demographics were recorded as well as any comorbidities and ASA score. The primary endpoint measured was rate of readmission and overstay.

RESULTS

A total of 72 patients fulfilled the inclusion criteria for day-case surgery. Five patients (6.94%) required admission immediately following the procedure, ie, overstayed or were readmitted. The rates were 1.38% (P=.05, CI 95%) for readmission and 5.55% (P=.05, CI 95%) for overstay. Six (8.33%) patients were classified as ASA III, and 3 (50%) were readmitted or overstayed.

CONCLUSION

Day-case laparoscopic Nissen fundoplication is a feasible, safe option. The authors conclude that ASA score of III and increasing age correlate with an increasing incidence of overstay and readmission. Therefore, we would recommend the use of integrated pathways and advanced planning to reduce these rates.

P3-04-03: Identification of Hormone-Responsive Genes as Biomarkers for Menstrual Cycle Phases and Menopausal Status

Background

The definition and validation of biomarkers in archived breast tissue samples for prognostic research is limited by the fact that the exact menstrual cycle phases and menopausal status at the time of tissue sampling is often unknown or not accurate by patient survey. Biomarkers that vary with menstrual cycle phases in premenopausal women would be difficult to standardize. There are also significant differences in gene expression in pre- and post-menopausal women. Therefore, menstrual cycle fluctuation and menopausal status need to be considered for all candidate biomarkers as part of the validation process. The aim of this study is to identify genes responsive to different hormones to accurately define menstrual cycle phases and menopausal status.

Methods: We studied gene expression profiles of 18 random fine-needle aspirate (rFNA) samples from unaffected contralateral breast (8 pre-menopausal, mean age 44.5; 10 post-menopausal, mean age 58.8) and investigated the correlation between gene expression and serum hormone levels of estradiol (E2), progesterone (P4) and follicle stimulating hormone (FSH). Genes that were highly correlated with the serum levels of each hormone (Pearson correlation coefficient r &gt; 0.60) were considered as specific hormone-responsive genes (P &lt; 0.0085). The combined gene profiles of hormone-responsive genes were used to dissect samples in different menstrual cycle phases and menopausal status. Selected genes related to mammary gland development and hormone regulation based on gene function and gene network analysis were validated using qRT-PCR in 18 original rFNA samples and in 28 independent samples.

Results: From 35,964 genes and 12,838 undesignated transcripts, we identified genes/transcripts highly correlated with E2 (1091 genes), P4 (127 genes) or FSH (58 genes). The most significantly correlated genes in each group were selected to define four panels of genes: Panel A-21genes stimulated by E2 (r &gt; 0.78); Panel B-22 genes stimulated by P4 (r &gt; 0.75); Panel C-7 genes stimulated by FSH (r &gt; 0.65); and Panel D-10 genes suppressed by FSH (r &lt; −0.65). Hierarchical clustering analysis using the combination of gene panels dissected the samples into four clusters based on three phases of menstrual cycles and post-menopausal status. Specifically, high panel C and low panel D expression segregated post- from pre-menopausal samples. Low expression of panel A and B genes dissected early follicular phase from late follicular and luteal phases, while higher expression of panel B genes discriminated luteal phase from late follicular samples.

Conclusion: Our results indicate that the menstrual cycle phases and menopausal status determined by age, patient survey and serum hormone concentrations are reflected in the expression of specific gene sets in the normal breast. The combination of hormone-responsive gene panels would allow the classification of breast samples regarding to the menstrual phases and menopausal status at the time of sampling. It would also facilitate the selection and validation of breast cancer biomarkers that are independent of menstrual cycle fluctuation and menopausal variation for clinical use.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-04-03.

P4-11-09: Polymorphisms Related to Steroid Hormone Concentrations in Nipple Aspirate Fluid (NAF)

Background

The steroid hormone concentrations in NAF are variable, and differ significantly from systemic levels. Single nucleotide polymorphisms (SNPs) in genes associated with the metabolism of estradiol (E2) to 4-hydroxyestradiol (CYP1B1) and a transporter of steroid sulfate uptake (SLCO2B1) may partially determine the steroid hormone level in NAF, and thereby contribute to breast cancer risk. We determined the relationship between SNPs of interest and the measured concentrations of sex steroids in NAF.

Methods: Blood samples of 263 women at high risk of breast cancer who produced NAF were extracted for gDNA, and 40 ng of gDNA was used to determine the presence of the selected SNPs or their wild type genes in all subjects by the Taqman Drug Metabolism genotyping assays (Applied Biosystems). The concentrations of six steroid hormones, estradiol(E2), estrone (E1), progesterone (P4), testosterone (T), androstenedione (A4), and dehydroepiandrosterone (DHEA), from NAF were measured by immunoassay procedures after extraction and purification by High Pressure Liquid Chromatography. Comparisons of NAF steroid hormone concentrations were made for the polymorphism and wild type groups using the nonparametric Mann-Whitney tests (significance p &lt; 0.05, two-tailed).

Results: 46% of the subjects carried the V432K polymorphism of CYP1B1 (rs 1056836, C&gt;G), and 45% of the subjects carried the S486F polymorphism of SLCO2B1 (rs 2851069, C&gt;T). All NAF hormone concentrations are represented as a median with the quartile range (25%, 75%). The NAF P4 levels of the V432K mutation carriers of CYP1B1 were significantly lower than those of subjects with the wild type alleles: 3.54(1.62, 8.79) ng/mL and 7.65(2.13, 27.77) ng/mL, respectively (p = 0.002). Those with the S486F polymorphism of SLCO2B1 had significantly higher E1 levels than the wild type subjects: 0.35(0.14, 1.12) ng/mL and 0.25(0.11, 0.59) ng/mL, respectively (p = 0.026) and significantly lower P4 levels: 3.77(1.71, 11.53) ng/mL and 6.65 (2.34, 22.24) ng/mL, respectively (p=0.021). In addition, we found that the women carrying both the V432K and S486F mutations had significantly lower P4 levels than the women carrying only the S486F mutation: 2.43(1.45, 6.67) ng/mL and 6.94(2.13, 26.64) ng/mL (p=0.013). No associations were found between the other hormones and these polymorphisms.

Conclusions: The anticipated effects of CYP1B1 in increasing clearance of E2 and E1 were not observed. Instead, NAF E1 concentrations were significantly increased. In subjects with the S486F polymorphism of SLCO2B1 the expected decrease in E1 and E2 in NAF was not observed; nor was the DHEA concentration decreased. These expectations were based on the reported lower activity of the S486F gene product. The decreased concentrations of NAF P4 associated with both polymorphisms are difficult to explain. Additional studies are required to understand the observed associations, but these findings raise the possibility that low P4 levels in NAF may be genetically determined, and suggest the hypothesis that this polymorphism may be related to a decreased risk of breast cancer.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-11-09.

P5-01-09: Differences in Serum Estradiol and Prolactin Concentrations in Women Who Yield Nipple Aspiration Fluid and Those Who Do Not

Introduction: Nipple aspiration fluid, NAF is an important biosample for breast cancer research, but its utility is limited by the fact that the fraction of NAF-yielders varies from 35% to 90% in various studies. NAF yielders (Y) and non-yielders (NY) are known to differ in demographic characteristics, but the systemic endocrine profiles of Y and NY populations have not been studied, and may affect the generalizability of findings in studies of NAF.

Methods: A subset of participants from an ongoing case-control study was included (120 cases, 120 controls). Cases are women presenting to the Lynn Sage Breast Center with newly diagnosed unilateral breast cancer, and controls are women presenting to the Lynn Sage Mammography Center who do not have cancer. NAF collection was attempted on all consented subjects; those yielding ≥2 uL NAF were designated as Y and those yielding &lt;2 uL NAF were NY (120 Ys, 120 NYs). Menopausal status, age, race, menstrual cycle phase, mammographic density, and serum hormone levels were also collected. Differences between Y and NY groups were tested using a t-test for age, χ2 for race, and Wilcoxon Sum Rank Test for serum hormone levels. Mammographic density was quantitated using digital or digitized images and the CUMULUS software. Linear regression was used to test the relationship between a logged serum hormone values and if a patient yielded adjusting for phase of menstrual cycle in premenopausal women.

Results: Mean ages of Ys and NYs were not different 51.0 and 52.6, respectively (p=0.11). The distribution of Ys by race (Caucasian, African American, other), was not different (χ2 p=0.58). Median serum prolactin concentrations were higher in Ys than NYs for both pre- (7.0 and 2.5 ng/ml) and post-menopausal (5.6 and 2.4 ng/ml) women, respectively (both p&lt;0.01). Median serum estradiol was lower in yielding premenopausal patients only (pre- 90.5 and 64.3 pg/ml p=0.02; post- p=0.59). Stratifying the premenopausal women further into cases and controls, the difference only held for cases and not for controls (p=0.02, p=.033). In the premenopausal patients the regression models suggested that these relationships for estradiol and prolactin remain even after adjusting for phase of the menstrual cycle. No differences in Ys versus NYs were found for progesterone, follicle stimulating hormone, or sex hormone binding globulin. Mammographic density was not different for Ys as compared to NYs for pre- (22% and 20%, p=0.83), but was marginally lower for post-menopausal Ys versus NYs (11% and 15% density; p=0.07). Following stratification of the postmenopausal women into cases and controls, the cases who yielded had significantly lower than NYs (11% and 19% density, p=0.03), but the control Ys and NYs were not different (10% and 11% density, p=0.65).

Conclusion: Pre- and post-menopausal women who yield NAF display increased serum prolactin levels, whereas decreased estradiol levels were observed in premenopausal NAF Ys. These findings suggest that NAF yield has systemic endocrine determinants, with implications for biomarker research on NAF samples. Further characterization of Y and NY women is important, along with standardization of methods of NAF collection, since NAF yield varies widely between studies.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-01-09.

High tibial osteotomy in medial compartment osteoarthritis and varus deformity using the Taylor spatial frame: early results

We report the early results of high tibial osteotomy (HTO) in medial compartment osteoarthritis (OA) and varus deformity using the Taylor spatial frame (TSF). Between October 2005 and April 2007, 9 patients with medial compartment OA and varus deformity underwent TSF application and medial opening wedge HTO. Pre- and post-operative Oxford knee scores, SF-12 and visual analogue pain scores were recorded along with radiographic outcomes. Median follow-up was 19 months (range 15–35). Mean age at operation was 49 years (range 37–59). The median time spent in the frame was 18 weeks (range 12–37). The mean preoperative Oxford knee score was 28.7. This improved to a mean of 35.4 post-operatively (P = 0.0142). 6 (67%) patients had a documented pin-site infection. With TKR as an end point, the survival rate of HTOs was 88.9% at a median of 19 months follow-up. This study demonstrates that in selected patients the TSF provides a viable treatment option for performing HTO in medial compartment OA with varus deformity.

Forgotten urological stent

"Forgotten" Ureteral stent DJ stent related complication is not uncommon even in the era of modern urology in the developed world. In this context we have undertaken a retro-prospective study in relation to its various causes, complications, management and prevention of forgotten stents in a single teaching institute. The study period was from January'04 to December'09. The sample size was 60. The effect of "forgotten stent" in our study reflects mild UTI to various complications including severe renal failure. We had approached all of our cases judiciously using various modalities of minimal access endourological techniques either alone or in combinations with successful outcome. The study concluded that it is vary easy to prevent "forgotten stent" and so its complications. However if we confront such unwanted complications that could be managed successfully with the use of endourological techniques. We did not use other techniques like laparoscopy and open surgery in this study.

Correlation between clinical presentation, peroperative finding and histopathological report in acute appendicitis

Acute appendicitis is usually encountered clinically as acute abdomen. Typical cases are easy to diagnose, but sometimes it is very difficult to make a diagnosis in atypical cases. The objective of the study was to determine the diagnostic accuracy in patient of clinically diagnosed acute appendicitis. This prospective study conducted in Mymensingh medical college hospital on 1136 patients presented with acute abdomen and clinically diagnosed as acute appendicitis from July 2004 to June 2010. Emergency appendicectomy was done in all consecutive patients after relevant investigation. Intraoperative findings along with histopathological reports were compared with clinical diagnosis. On the basis of histopathological report, 85.65% were found to have acute appendicitis with misdiagnosis in rest of the subjects requiring unnecessary explorations. Negative exploration was more in emergency than office hour. This may be due to diagnostic inaccuracy and decision-making in the management of the acute appendicitis. Management errors can be significantly reduced by accurate preoperative diagnosis of acute appendicitis by improving clinical skill and appropriate investigations.

Spectral studies on Ag8+ ions irradiated LAHCl·H2O and LAHBr·H2O single crystals

L-arginine hydrochloride monohydrate and L-arginine hydrobromide monohydrate single crystals are irradiated by 100 MeV Ag8+ swift heavy ions. The residual gases liberated from the irradiated samples are monitored as a function of ion fluence using quadrupole mass analyzer. The C2H3+, C2H2, N2, CO, HCl and CO2 are the dominant gases liberated. Fourier transform infrared spectra of irradiated crystals explain the breaking of bonds in a localized region of the crystals. The crystallinity of irradiated crystals is analyzed by powder X-ray diffractions.

Malaria control in a forest fringe area of Assam, India: a pilot study

A study was conducted to evaluate the preventive efficacy of insecticide-treated mosquito nets (ITMNs) and mosquito repellent (MR) in a malaria-endemic foothill area of Assam, India, with forest ecosystem. During the first year, a survey was conducted in four demarcated sectors (A-D) to observe the malaria endemicity and vector prevalence patterns before implementing intervention measures. All four sectors were endemic for malaria. The prevalence of established malaria vectors such as Anopheles dirus, A. minimus and A. philippinensis was observed. During the second year, intervention measures were implemented in the four sectors as follows: A, ITMN + MR; B, ITMN; C, MR; D, no intervention. The most effective intervention was in sector A, followed by sectors B and C. Sectors A and B exhibited significantly higher (P < 0.001) malaria protective efficacy during both the first and second years of intervention compared with sector D. The total vector population in the three intervention sectors decreased significantly compared with that of the non-intervention one. Information-education-communication activities motivated the residents to participate actively in the intervention programme. The finding could be an effective model for containment of high malaria morbidity in inaccessible forest fringe areas of the northeastern region of India.

First evidence of chikungunya virus infection in Assam, Northeast India

During June-September 2008, an illness characterized by fever, headache and joint pain was reported in Assam state, northeast India. It presented characteristic features resembling chikungunya or dengue virus infection based on clinical symptoms. Dengue and chikungunya IgM antibody was detected in 10.0% (28/280) and 3.6% (10/280) patients respectively. The chikungunya positive patients did not travel to and from any endemic region confirming indigenous transmission. Persistent arthralgia and hearing loss has been observed in a recovered patient. Entomological surveys revealed the presence of vectors viz. Aedes aegypti and Aedes albopictus. This is the maiden report of chikungunya occurrence in Northeast India.

Mimicking both petal and lotus effects on a single silicon substrate by tuning the wettability of nanostructured surfaces

We describe a new method of fabricating large-area, highly scalable, "hybrid" superhydrophobic surfaces on silicon (Si) substrates with tunable, spatially selective adhesion behavior by controlling the morphologies of Si nanowire arrays. Gold (Au) nanoparticles were deposited on Si by glancing-angle deposition, followed by metal-assisted chemical etching of Si to form Si nanowire arrays. These surfaces were chemically modified and rendered hydrophobic by fluorosilane deposition. Au nanoparticles with different size distributions resulted in the synthesis of Si nanowires with very different morphologies (i.e., clumped and straight nanowire surfaces). The difference in nanowire morphology is attributed to capillary force-induced nanocohesion, which is due to the difference in nanowire porosity. The clumped nanowire surface demonstrated the lotus effect, and the straighter nanowires demonstrated the ability to pin water droplets while maintaining large contact angles (i.e., the petal effect). The high contact angles in both cases are explained by invoking the Cassie-Baxter wetting state. The high adhesion behavior of the straight nanowire surface may be explained by a combination of attractive van der Waals forces and capillary adhesion. We demonstrate the spatial patterning of both low- and high-adhesion superhydrophobicity on the same substrate by the simultaneous synthesis of clumped and straight silicon nanowires. The demonstration of hybrid superhydrophobic surfaces with spatially selective, tunable adhesion behavior on single substrates paves the way for future applications in microfluidic channels, substrates for biologically and chemically based analysis and detection where it is necessary to analyze a particular droplet in a defined location on a surface, and as a platform to study in situ chemical mixing and interfacial reactions of liquid pearls.

Anthocyanin production as a potential visual selection marker during plant transformation

A mutant allele of the transcription factor gene MYB10 from apple induces anthocyanin production throughout the plant. This gene, including its upstream promoter, gene coding region and terminator sequence, was introduced into apple, strawberry and potato plants to determine whether it could be used as a visible selectable marker for plant transformation as an alternative to chemically selectable markers, such as kanamycin resistance. After transformation, red coloured calli, red shoots and red well-growing plants were scored. Red and green shoots were harvested from apple explants and examined for the presence of the MYB10 gene by PCR analysis. Red shoots of apple explants always contained the MYB10 gene but not all MYB10 containing shoots were red. Strawberry plants transformed with the MYB10 gene showed anthocyanin accumulation in leaves and roots. No visible accumulation of anthocyanin could be observed in potato plants grown in vitro, even the ones carrying the MYB10 gene. However, acid methanol extracts of potato shoots or roots carrying the MYB10 gene contained up to four times higher anthocyanin content than control plants. Therefore anthocyanin production as result of the apple MYB10 gene can be used as a selectable marker for apple, strawberry and potato transformation, replacing kanamycin resistance.

The outcome of kidney transplants with multiple renal arteries

The use of grafts with multiple renal arteries has been considered a relative contraindication because of the increased incidence of vascular and urologic complications. The aim of this retrospective study is to determine whether the kidney grafts with multiple arteries have any adverse effect upon post transplant graft and patient survival. After reviewing the records of 35 adult kidney transplants done consecutively at Bangabandhu Sheik Mujib Medical University over a period of 3 years (Jan 2005 to Dec 2007). Mean age of recipients. 43.46±12.11 years and donors 40.33±11.46 years. Twenty patients (Group A) had grafts with single renal artery and 15 patients (Group B) had grafts with multiple renal arteries. The incidence of vascular complications, ureteral complications, post surgical haemorrhage, mean serum creatinine level and acute tubular necrosis in both Group A & B were observed. Complications developed in 15(43%) patients in this series. In Group A, 1(5%) developed post operative bleeding cause perinephric hematoma, 1(5%) technical obstruction of ureter, 1(5%) sloughed ureter, graft nephrectomy 1(5%) and acute tubular necrosis 1(5%) patient. In Group B, 2(13%) patients developed hematoma, urine leak 3(20%), sloughed ureter 1(6%), graft nephrectomy 1(6%) and acute tubular necrosis 3(20%) patients. Though the kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complication. In this series incidence of complication was 43%. The higher rate probably reflects the small number of living related donors.

Elliptic flow of charged particles in Pb-Pb collisions at sqrt[S(NN)] = 2.76 TeV

We report the first measurement of charged particle elliptic flow in Pb-Pb collisions at sqrt[S(NN)] =2.76 TeV with the ALICE detector at the CERN Large Hadron Collider. The measurement is performed in the central pseudorapidity region (|η|<0.8) and transverse momentum range 0.2<p t<5.0 GeV/c. The elliptic flow signal v₂, measured using the 4-particle correlation method, averaged over transverse momentum and pseudorapidity is 0.087 ± 0.002(stat) ± 0.003(syst) in the 40%-50% centrality class. The differential elliptic flow v₂ p t reaches a maximum of 0.2 near p t =3 GeV/c. Compared to RHIC Au-Au collisions at sqrt[S(NN)] 200 GeV, the elliptic flow increases by about 30%. Some hydrodynamic model predictions which include viscous corrections are in agreement with the observed increase.

Charged-particle multiplicity density at midrapidity in central Pb-Pb collisions at sqrt[S(NN)] = 2.76 TeV

The first measurement of the charged-particle multiplicity density at midrapidity in Pb-Pb collisions at a center-of-mass energy per nucleon pair √ S NN = 2.76 TeV is presented. For an event sample corresponding to the most central 5% of the hadronic cross section, the pseudorapidity density of primary charged particles at midrapidity is 1584 ± 4(stat) ± 76(syst), which corresponds to 8.3 ± 0.4(syst) per participating nucleon pair. This represents an increase of about a factor 1.9 relative to pp collisions at similar collision energies, and about a factor 2.2 to central Au-Au collisions at √ S NN = 2.76 TeV. This measurement provides the first experimental constraint for models of nucleus-nucleus collisions at LHC energies.

Abstract P2-06-20: Hormonal Criteria for Assessment of Menopause: Role of Anti-Mullerian Hormone

Introduction: The difficulty in establishing the time of menopause poses a problem in many breast cancer research studies. We sought to determine the value of adding anti-mullerian hormone (AMH) to the accuracy of designating hormonal signs of menopause in 179 women who were recruited for a case-control study of nipple aspirate fluid (NAF) biomarkers.

Methods: A questionnaire was administered to obtain medical and reproductive history, self-reported menstrual cycle length, last menstrual period and age. Serum estradiol, progesterone, FSH, and AMH were measured in a blood sample obtained on the day of the study encounter. Criteria for premenopause were: serum FSH &lt;30 mIU/ml, AMH &gt;0.08 ng/ml, estradiol (E2) &gt;30 pg/ml, and menstrual periods of 25 to 35 days. For postmenopause the inverse of the hormone levels and no menstrual periods for &gt;12 mo and age &gt;52 years was used. Serum progesterone (P4) concentration of &lt;3 ng/ml provided confirmation of postmenopause. Results: The age range was from 35 to 69 years (median 51). By self-report (amenorrhea &gt;12 mo and age) 76 subjects were premenopausal; 70 were postmenopausal and 33 subjects were perimenopausal. Table: Designation of menopausal state based on hormonal criteria: Concordance of individual measures with the designation based on all criteria (percentages).

Table

FSH was found to be discordant in 1 (1.1%) of premenopausal subjects and in 5 (5.3%) of postmenopausal subjects. AMH was found to be discordant in 21 (24.7%) of premenopausal subjects and 6 (6.4%) of postmenopausal subjects. Estradiol was discordant in 13 (15.3%) of premenopausal subjects and in 7 (7.4%) of postmenopausal subjects. Progesterone was &lt;3 ng/ml in all of the postmenopausal subjects. The combination of FSH and AMH predicted 100% of the grouping based on all measures; FSH and E2 predicted 99.9%. The absence of progesterone is a certain criterion for postmenopause but adds nothing to the designation of premenopause. Comment: An accurate determination of the hormonal and reproductive status of women is critically important in studies relating hormones to breast cancer risk. The loss of ovarian hormones has long-term implications, and the menopausal status at the time of sampling determines the recent and current hormonal exposure. Using the hormonal criteria, all women in this study could be classified as pre-or postmenopausal. Adding AMH to the usual hormones did not improve the designation based on the other criteria.

Factors limiting the health of semi-scavenging ducks in Bangladesh

Duck rearing is well suited to coastal and lowland areas in Bangladesh. It is an important component of sustainable livelihood strategies for poor rural communities as an additional source of household income. An epidemiological study was conducted during January 2005-June 2006 on 379 households in Chatkhil of the Noakhali District, Bangladesh which were using the recently devised "Bangladesh duck model". The overall objective of the study was to identify factors that significantly contributed to mortality and constrained productivity and to generate sufficient knowledge to enable establishment of a disease surveillance system for household ducks. The overall mortality was 15.0% in Chatkhil, with predation causing a significantly higher mortality compared with diseases (p < 0.001). Common diseases were duck plague and duck cholera. Morbid ducks frequently displayed signs associated with diseases affecting the nervous and digestive systems. Haemorrhagic lesions in various organs and white multiple foci on the liver were frequently observed in dead ducks. Epidemiological analysis with a shared frailty model that accounted for clustering of data by farm was used to estimate the association between survival time and risk factors. The overall mortality rate due to disease was significantly lower in vaccinated than in non-vaccinated ducks in all zones except zone 2 (p < 0.001). Only vaccinated ducks survived in zone 1. In conclusion, duck mortality and untimely sale of ducks appeared to be important constraints for household duck production in Chatkhil. Vaccination against duck plague appears to be an effective preventive strategy in reducing the level of associated duck mortality. A successful network was established amongst farmers and the surveillance team through which dead ducks, with accompanying information, were readily obtained for analysis. Therefore, there is an opportunity for establishing a long-term disease surveillance programme for rural ducks in Chatkhil of the Noakhali District of Bangladesh.

A young lady with secondary tuberculosis of breast

Tuberculosis of breast is an extremly rare form of extrapulmonary tuberculosis even in endemic area like Bangladesh and the incidence is 0.25-4.5% of all breast lesions. The diagnosis is difficult because of nonspecific clinical, radiological and histopathological findings. Very often biopsy specimens are inadequate and microscopy or culture is negative. It is usually suspected in a multiparous woman who may be immunocompromised. We report a case of breast tuberculosis in a 26 years old multiparous lady who previously present with two times attack of right sided breast lump and then diagnosed as a case of breast abscess and treated by incision and drainage with antibiotics in a nearby local hospital. During her third time attack she admitted into Mymensingh Medical College Hospital with right sided breast lump with multiple discharging sinuses for one month. Biopsy was taken from the lump and sinus tract and histopathological report confirmed the diagnosis as a case of tuberculosis of breast. Her X-ray chest showed tubercular lesion in lungs. So this is a case of secondary breast tuberculosis. This case highlights how difficult is the diagnosis of a case of breast tuberculosis for which the patient may require even mastectomy at very late case. So this case is reported.

Mosquito biodiversity of Dibru-Saikhowa biosphere reserve in Assam, India

Entomological surveys were conducted for three consecutive years in core and buffer zone of the Dibru-Saikhowa biosphere reserve in pre monsoon, monsoon and post-monsoon seasons. A total of 52 species of mosquitoes under eleven genera have been detected. The genus Anopheles (18 species) was the predominant followed by Culex, Aedes, Mansonia, Armigeres, Mimomyia, Ochlerostatus, Malaya, Toxorhynchites, Ficalbia and Aedeomyia. The buffer zone of the forest reserve where human habitations are there exhibited the presence of maximum number of species (49 species under 10 genera) in comparison to core zone (42 species under 10 genera). In buffer zone, maximum numbers of species (38) were recorded in monsoon season followed by post- monsoon (35 species) and Pre-monsoon season (34 species). Whereas in core zone, maximum number of species were collected in post monsoon season followed by pre monsoon season and monsoon season. In Core and buffer zone, the maximum species were recorded from the ground pool habitat and slow flowing stream respectively. Among the disease vectors, the potential Japanese encephalitis vectors incriminated in India were very much prevalent. This study provides the list of available mosquito species recorded for the first time in the Dibru-Saikhowa biosphere reserve.

Hemophilic pseudotumor--is there a role of radiotherapy? Literature review and a case report

We share the literature and management of an adult with moderate hemophilia a presented with a calcaneal pseudotumor and non healing ulcer by radiation therapy, factor VIII and cryoprecipitate supplement. Numerous literatures so far have quoted the satisfactory role of radiotherapy in hemophilic pseudotumor. We found it to be of great help as our case responded with radiotherapy, factor VIII and cryoprecipitate supplement and has a satisfactory 2 years follow up.

Midrapidity antiproton-to-proton ratio in pp collisons at sqrt[s]=0.9 and 7 TeV measured by the ALICE experiment

The ratio of the yields of antiprotons to protons in pp collisions has been measured by the ALICE experiment at sqrt[s]=0.9 and 7 TeV during the initial running periods of the Large Hadron Collider. The measurement covers the transverse momentum interval 0.45<p_{t}<1.05  GeV/c and rapidity |y|<0.5. The ratio is measured to be R_{|y|<0.5}=0.957±0.006(stat)±0.014(syst) at 0.9 TeV and R_{|y|<0.5}=0.991±0.005(stat)±0.014(syst) at 7 TeV and it is independent of both rapidity and transverse momentum. The results are consistent with the conventional model of baryon-number transport and set stringent limits on any additional contributions to baryon-number transfer over very large rapidity intervals in pp collisions.

Variation of resistance in barley against biotypes 1 and 2 of the Russian wheat aphid (Hemiptera: Aphididae)

The Russian wheat aphid, Diruaphis noxia (Kurdjumov) (Hemiptera: Aphididae), is globally one of the most devastating pests of bread wheat, Tritium aestivum L.; durum wheat, Triticum turgidum L.; and barley, Hordeum vulgare L. Host plant resistance is the foundation for cereal insect pest management programs, and several sources of D. noxia resistance have been incorporated in cultivars to manage D. noxia damage. The emergence of D. noxia North American biotype 2 (RWA2) in Colorado has made all known Dn genes vulnerable except the Dn7 gene from rye, Secale cereale, and has warranted exploration for sources of resistance to both RWA1 and RWA2. The category of resistance in resistant donor plants may exert selection pressure over the aphid population to form a new virulent population. In the current study, we report tolerance and antibiosis resistance to RWA1 and RWA2 in the barley genotype 'Stoneham'. The rate and degree of expression of resistance in Stoneham against RWA1 and RWA2, although not similar, are greater than the partial resistance in 'Sidney'. Antixenosis resistance to RWA1 or RWA2 was not observed in Sidney or Stoneham. The tolerance identified in Stoneham is encouraging because it may delay D. noxia biotype selection and fits well in a dryland barley cropping system.

An updated checklist of species of Aedes and Verrallina of northeastern India

A mosquito faunistic survey conducted during 1999-2005 in 7 different states of the northeastern (NE) region of India revealed that the region is very rich in mosquito fauna, particularly of the genus Aedes. From the present survey and earlier published reports, a total of 48 species of Aedes and a related genus Verrallina were recorded. The state of Assam contributed the highest number of species compared to the other 6 states, namely Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, and Tripura. Larvae of 46 species were collected from 16 different habitats and for some species the habitats were species specific. The known dengue vectors, Aedes aegypti and Ae. albopictus, were recorded from all 7 states, although Ae. aegypti was not known earlier from Mizoram, Nagaland, and Tripura states. Aedes albotaeniatus was a new addition to the Aedes fauna of the region.

Prevalence of obesity in Indian women

Comparison of two major studies conducted by National family health survey (NFHS-2) in 1998-1999 and NFHS-3 in 2005-2006 shows that prevalence of obesity among Indian women has elevated from 10.6% to 12.6% (increased by 24.52%). The prevalence is more profound in the women of age between 40-49 years (23.7%), residing in cities (23.5%), having high qualification (23.8%), belonging to Sikh community (31.6%) and households in the highest wealth quintile (30.5%). Highest percentage of obese women is found in Punjab (29.9%). Although this number seems small in the international perspective, it is significant because of the sheer size of population in India. While the problem of under-nutrition still exists in many parts of India, the additional burden of obesity due to increasing sedentary lifestyle, junk food habits in some urban and economically sound areas is really alarming. Prevention and control of this serious problem through awareness programmes to adopt diversified nutritional food and healthy lifestyle are strongly recommended.

Testicular torsion: a review

Torsion of the testis, also referred to as torsion of the spermatic cord, is a subject of debate among physicians and surgeons. Testicular torsion is an acute vascular event causing the rotation of the vascular pedicle of the testis, thereby impeding the blood flow to the testis and the scrotal contents. It could be either within or outside the tunica vaginalis. Testicular torsion causes immediate circulatory changes and long-term sequelae such as testicular function and fertility. It is considered a surgical emergency, as a delay causes irreversible testicular damage. The diagnosis and treatment of testicular torsion are discussed in this review, which also illustrates an algorithm and a scoring system for the diagnosis and management of this condition based on current literature.

Synthetic nitrogen fertilizers deplete soil nitrogen: a global dilemma for sustainable cereal production

Cereal production that now sustains a world population of more than 6.5 billion has tripled during the past 40 yr, concurrent with an increase from 12 to 104 Tg yr(-1) of synthetic N applied largely in ammoniacal fertilizers. These fertilizers have been managed as a cost-effective form of insurance against low yields, without regard to the inherent effect of mineral N in promoting microbial C utilization. Such an effect is consistent with a net loss of soil organic C recently observed for the Morrow Plots, America's oldest experiment field, after 40 to 50 yr of synthetic N fertilization that substantially exceeded grain N removal. A similar decline in total soil N is reported herein for the same site and would be expected from the predominantly organic occurrence of soil N. This decline is in agreement with numerous long-term baseline data sets from chemical-based cropping systems involving a wide variety of soils, geographic regions, and tillage practices. The loss of organic N decreases soil productivity and the agronomic efficiency (kg grain kg(-1) N) of fertilizer N and has been implicated in widespread reports of yield stagnation or even decline for grain production in Asia. A major global evaluation of current cereal production systems should be undertaken, with a view toward using scientific and technological advances to increase input efficiencies. As one aspect of this strategy, the input of ammoniacal N should be more accurately matched to crop N requirement. Long-term sustainability may require agricultural diversification involving a gradual transition from intensive synthetic N inputs to legume-based crop rotations.

Tuberculosis of the hand: clinical presentation and functional outcome in 32 patients

A prospective series of 32 cases with tuberculosis of the hand and wrist is presented. The mean age of the patients was 23.9 years (3 to 65), 12 had bony disease and 20 primarily soft-tissue involvement. The metacarpal of the little finger was the most commonly involved bone. Pain and swelling were the usual presenting features and discharging sinuses were seen in three cases. All patients were given anti-tubercular chemotherapy with four drugs. Operative treatment in the form of open or arthroscopic debridement, or incision and drainage of abscesses, was performed in those cases where no response was seen after eight weeks of ATT. Hand function was evaluated by the modified score of Green and O'Brien. The mean was 58.3 (25 to 80) before treatment and 90.5 (80 to 95) at the end. The mean follow-up was for 22.4 months (6 to 43). Conservative treatment was successful in 24 patients (75%). Eight who did not respond to chemotherapy within eight weeks required surgery. Although tuberculosis of hand has a varied presentation, the majority of lesions respond to conservative treatment.

Inheritance and categories of resistance in wheat to Russian wheat aphid (Hemiptera: Aphididae) biotype 1 and biotype 2

The Russian wheat aphid, Diruaphis noxia (Kudjumov) (Hemiptera: Aphididae), is globally one of the most devastating pests of wheat, Tritium aestivum L., and barley, Hordeum vulgare L. Host plant resistance is the foundation of cereal insect pest management programs, and several D. noxia resistance (Dn) genes from wheat have been introduced in commercial cultivars of wheat to manage Russian wheat aphid (RWA). Emergence of D. noxia biotype 2 (RWA2) in Colorado has made all known Dn genes, except the Dn7 gene from rye, Secale cereale L., vulnerable and has warranted exploration for sources of resistance to RWA1 and RWA2. Here, we report antibiosis resistance to RWA1 and RWA2 identified in the wheat breeding line KS94H871. Additional experiments indicated that tolerance and antixenosis are not operating in KS94H871. Segregation studies involving F2-derived F3 families indicated that KS94H871 resistance to RWA1 is controlled by one dominant gene and one recessive gene, whereas resistance to RWA2 is controlled by only one dominant gene. This new genetic resource may serve as a good source of resistance in future breeding programs with proper understanding of the genetics of resistance.

The stimulation of rat Leydig cell steroidogenesis by human ovarian steroidogenesis-inducing protein (SIP) may not require endogenous cAMP

Recently a protein from ovarian follicular fluid was isolated which stimulates steroid production in different cells (Khan et al., 1990). The present study was performed to further characterize the short term effects of this steroidogensis-inducing protein (SIP) on steroid production in isolated rat Leydig cells and to compare the effects with LH/hCG and LHRH. SIP stimulated testosterone production in a dose-dependent manner. In Leydig cells isolated from adult rats the degree of stimulation was much higher than that obtained with hCG, dibutyryl cAMP (db cAMP) or LHRH. Moreover, the stimulated steroid production in the presence of hCG or db cAMP was further enhanced by SIP. The time courses of hCG and SIP action on testosterone production were comparable and maximal stimulation of steroid production was obtained within one hour. In contrast to hCG, SIP did not stimulate cAMP production. An antagonist of LHRH action was unable to block the effects of SIP on Leydig cells indicating that SIP does not act via LHRH receptors. Neither SIP nor LH could further stimulate the steroid production in the presence of 22-R-OH-cholesterol, illustrating that both stimulators control the availability of cholesterol as substrate. An inhibitor of mitochondrial cholesterol side chain cleavage (CSCC), aminoglutethemide, completely blocked the stimulatory effects of SIP and LH/hCG. Thus the effects of SIP on steroid production are not the result of conversion of contaminating steroids in the SIP-preparation. SIP and LH/hCG actions were also blocked when the cells were incubated in the presence of cycloheximide.(ABSTRACT TRUNCATED AT 250 WORDS)

Jejunogastric intussusception

Retrograde Jejunogastric Intussusception (RJGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. It was first described by Bozzi in 1914 in a patient with gastrojejunostomy. Clinically it is of two types acute and chronic. Anatomically it is of three types. The acute form is a surgical emergency. In the acute form there is chance of strangulation of the intussuscepted loop if early intervention is not done. To avoid mortality, early diagnosis and prompt surgical intervention is mandatory. There is no medical treatment for jejunogastric intussusception and surgical intervention is required for the definite treatment. It usually presents with abdominal pain, nausea, vomiting, haematemesis and a palpable diffuse lump in the upper abdomen. A history of gastric surgery can help in making a diagnosis. X-ray can occasionally be diagnostic. Endoscopy performed by someone familiar with this rare entity, is certainly diagnostic. We herein report a case of jejunogastric intussusception who presented with acute abdomen, haematemesis and abdominal lump.

Xanthogranulomatous cholecystitis: a clinicopathological study from a tertiary care health institution

BACKGROUND

Xanthogranulomatous cholecystitis is an unusual and destructive form of chronic cholecystitis and is indistinguishable from other forms of cholecystitis which makes preoperative diagnosis and surgery difficult.

OBJECTIVES

To review the demographic and clinical aspects of xanthogranulomatous cholecystitis; to study the possibility of preoperative diagnosis and to identify the causes for difficult surgery.

MATERIALS AND METHODS

All cases histopathologically diagnosed as xanthogranulomatous cholecystitis over a period of six years from October 1999 to September 2005 at Kasturba Medical College Hospital, Manipal, India were included in the study. Data of the patients was collected retro and prospectively.

RESULTS

A total of 615 patients underwent cholecystectomy out of which 33 (5.2%) were diagnosed to have xanthogranulomatous cholecystitis. Ultrasound abdomen showed gallbladder wall thickening in 19 (57.5%) cases and gallstones in 32 (96.9%) cases. Thirty (90.9%) underwent open cholecystectomy. Gallbladder could be removed totally in 25 (75.6%) cases whereas five (15.2%) had to undergo partial cholecystectomy and in one patient, only cholecystostomy could be performed due to dense adhesions. Laparoscopic cholecystectomy was attempted in 11 patients but successful only in two patients with a conversion rate of 81.8%. Postoperative wound infection was seen in five (15.1%) patients and one (3%) had minor biliary leak which was treated conservatively. Histologically, xanthogranulomatous cholecystitis was associated with malignancy in one (3.03%) patient. There was no mortality.

CONCLUSION

Clinical presentation of xanthogranulomatous cholecystitis was indistinguishable from chronic cholecystitis. Ultrasonography may reveal only non specific findings of calculi and thickened gall bladder wall. Hence preoperative diagnosis is unlikely. Cholecystectomy was usually difficult owing to dense adhesions of gallbladder and Calot's triangle. Conversion rate of laparoscopic cholecystectomy is higher. Morbidity associated with surgery is significant.

Heyde syndrome: a common diagnosis in older patients with severe aortic stenosis

Heyde syndrome is a triad of aortic stenosis, an acquired coagulopathy and anaemia due to bleeding from intestinal angiodysplasia. The evidence that aortic stenosis is the root cause of this coagulopathy is compelling. Resolution of anaemia usually follows aortic valve replacement. This article discusses studies linking aortic stenosis with other conditions in the triad as well as diagnosis and management of this complex pathology.

Recurrent acute pancreatitis due to a santorinicele in a young patient

A cystic dilatation of the terminal portion of the minor pancreatic duct (duct of Santorini) is referred to as a santorinicele. It is usually associated with pancreas divisum and has been suggested to be a cause of relative stenosis of the minor papilla, often leading to recurrent pancreatitis. While this anomaly has been reported in the paediatric population, it is more commonly found in the elderly. We present a 27-year-old woman with recurrent acute pancreatitis attributed to a santorinicele with a dorsal duct-exclusive pancreatic drainage.

Disparity between serum and nipple aspirate fluid (NAF) estradiol concentrations during the menstrual cycle

Abstract #4077

Background: NAF, elicited from healthy women, may provide information about the hormonal environment of the breast and the potential risk for breast cancer. We have studied NAF sex hormone changes across the menstrual cycle and after menopause to determine the relationship to serum concentrations.&#x2028; Methods: Subjects were women attending the Lynn Sage Breast Center at Northwestern Memorial Hospital. Samples of NAF from 20 premenopausal and 23 postmenopausal women were evaluated. Premenopausal women were divided into groups 1 through 4, backdating from the day of menstruation, -28 through -19, -18 through -13, -12 through -6 and -5 through 0, respectively. NAF and venous blood were collected using standard methods. Total protein was measured by a fluorometric procedure. Unconjugated steroids, estradiol (E2), estrone, progesterone (P), and testosterone (T), were extracted into ethyl acetate-hexane (3:2) and were separated by HPLC on a C-18 column with gradient elution before assay. DHEA sulfate, estrone sulfate, and cathepsin D were measured in the aqueous fraction. All analytes were measured by immunoassays. Transformation of the data of all analytes to their natural logarithms normalized the data. Data were analyzed by ANOVA.&#x2028; Results: The protein concentration in the samples was similar among all groups, mean = 128 mg/ml (P=0.904). In NAF only E2 and P differed during the menstrual cycle, P = 0.064 and 0.007, respectively, but the pattern of NAF E2 followed that of NAF P and not serum E2. The figure shows the geometric mean values at each phase of the menstrual cycle. Ovulation should occur in group 2 (-18 through -13 days from menstruation). With the exception of P and DHEA sulfate, which were lower, analytes in samples from postmenopausal women were not significantly different from those from premenopausal women.&#x2028; &#x2028; Comment: The most significant finding is that NAF E2 does not parallel serum levels but follows closely NAF P levels. NAF E2 was actually lowest when serum E2 was highest. Changes in other analytes during the menstrual cycle were minimal. Estradiol, its direct precursors, and the E2-related protein, cathepsin D, were not decreased in NAF after menopause. (Supported by NIH R01 CA 120555-01).

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4077.

Differential gene expression associated with estrogen receptor status of breast cancer identified by microarray meta-analysis

Abstract #2041

Introduction: Estrogen receptor (ER) positive breast cancer can be prevented by Tamoxifen. Currently, there are no markers for breast cancer risk that discriminate between the risk of ER positive versus ER negative disease. To identify patients likely to benefit from endocrine chemoprevention, a robust marker predicting ER status is needed. Microarray technology has identified genomic classifiers for breast cancer prognosis and prediction. We therefore conducted a meta-analysis of microarray data to identify individual genes associated with ER status of breast cancer.&#x2028; Methods: Publicly available microarray gene expression data sets were mined using Gene Expression Omnibus (GEO), Oncomine, ArrayExpress, and Stanford Microarray Database (SMD). Study inclusion criteria are no prior drug treatment, known ER status, and raw data files available for at least 50 arrays. All analyses were conducted using Bioconductor Project's (http://www.bioconductor.org) open-source software in R statistical programming language. Packages used include limma, ArrayQualityMetrics, MetaArray, and GOstats. Data sets were individually normalized using rma, and differential gene expression was based on ER status. Meta-analytic test statistic was computed, multiple test correction was performed, and genes above the threshold of |Zscore| = 19.5 were included in further analysis.&#x2028; Results: The search identified 23 publicly available gene expression data sets of primary breast tumors with known ER status, ten of which met inclusion criteria. Four of the ten contained cDNA array data files from SMD and were combined since they contained redundant files. To minimize platform and methodology discrepancies, we chose to focus our analysis on the six data sets which utilized the Affymetrix U133A array. The six data sets each contain 99-245 arrays, and represent a total of 644 ER+ and 268 ER- breast tumors. Bioinformatic analysis of the 86 differentially expressed genes associated with ER status using the criteria described above was then performed. To enrich for gene expression changes in pre-neoplastic lesions, genes known to be involved in progression and metastasis were eliminated from further study. The remaining genes were searched in Oncomine for differential expression according to ER status, in PubMed for previous association with breast cancer, and with our unpublished data for Gene Ontology annotations associated with ER status in breast cancer. We further narrowed the resulting list of 22 to 15 (ESR1, TFF1, AGR2, SCUBE2, CYP21A2, PIP, DACH1, BCL2, PROM1, RARES1, TMSL8, SRD5A1, SLC39A6, SCGB2A2, and FOXA1) based on functional redundancy.&#x2028; Conclusion: Over the next 4 months, this gene set (along with 5 house-keeping genes) will be tested for differential expression in samples that we have collected from the contralateral unaffected breasts of women with ER positive and ER negative breast cancer. These studies are likely to identify candidate genes that may serve as markers of ER-specific risk.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2041.

Induction of hepatic peroxisomal beta-oxidation of fatty acids by dehydroepiandrosterone (DHEA) in male F-344 rats

Pharmacological administration of dehydroepiandrostenone (DHEA, 300 mg/kg, p.o.) for 2 weeks significantly increased (P < 0.01) the activity of hepatic peroxisomal beta-oxidation of fatty acids in male F-344 rats. Similar effects were observed following 8 week administration of DHEA. These results are discussed in the light of oxidative stress-mediated hepatocarcinogenesis.