Abstract P3-09-04: The associations between body mass index and breast cancer intrinsic subtypes in Japanese women

Purpose: The purpose of this study was to examine the associations between body mass index (BMI) and breast cancer intrinsic subtypes in Japanese women. A more complete understanding of the subtypes of breast cancer may help elucidate mechanisms affecting etiology and mortality associated with each subtype.

Methods: Tumor data on 531 invasive breast cancer cases subtyped by estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (Her2) status were obtained (luminal A, luminal B, TN, and Her2-type). Demographics (age at diagnosis, menopausal status, and BMI) were collected from medical records. Case-only odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression, adjusting for age at diagnosis.

Results: In all cases, the patients were Japanese. Of the 531 cases with IHC marker data, 333 (62.7%) were classified as luminal A, 85 (16.0%) were luminal B, 43 (8.1%) were Her2-type, and the remaining 70 cases (13.2%) were TN. The distribution of patient demographics (age at diagnosis, menopausal status, and BMI) did not differ significantly by breast cancer tumor subtype. Case-only ORs comparing each subtype to luminal A were caluculated. Of the TN cases, postmenopausal TN cases were more likely to be underweight (OR = 3.14, 95% CI = 1.19 to 8.01). Although some epidemiological studies have reported that higher BMI was associated with premenopausal TN cases compared with luminal A cases, this association was not found among premenopausal TN cases analyzed using BMI 18.5 to 24.9 kg/m2 as the reference in this analysis. However, there were no underweight cases (BMI < 18.5 kg/m2) among the premenopausal TN cases in the present study. Therefore, the association between BMI and the TN subtype was also analyzed using BMI < 25 kg/m2 as the reference. Compared to luminal A cases, premenopausal TN cases were more likely to be obese (OR = 4.11, 95% CI = 1.10 to 14.40), similar to reports from Western countries. Compared to luminal A cases, premenopausal luminal B cases were likely to be underweight (OR = 3.27, 95% CI = 0.88 to 11.39) or obese (≥ 25 kg/m2) (OR = 3.32, 95% CI = 0.98 to 10.81), yet this association was of borderline significance. Compared to luminal A cases, luminal B and Her2-type cases were likely to be underweight (BMI < 18.5 kg/m2), yet this association was of borderline significance (luminal B: OR = 2.12, 95% CI = 0.97 to 4.46; Her2-type: OR = 2.53, 95% CI = 0.92 to 6.36).

Conclusions: In the present study, significant heterogeneity of associations between BMI and tumor subtypes was observed. Breast cancer subtypes may have different etiologies associated with each subtype.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-09-04.

Abstract P3-02-02: Use of contrast-enhanced computed tomography in clinical staging of asymptomatic breast cancer patients to detect asymptomatic distant metastases

Objective: The use of computed tomography (CT) with regards to the clinical staging of breast cancer (BC) patients has been on the increase in clinical practice. However, NCCN guidelines recommended the use of imaginng only in cases with locally advanced disease or signs of distant metastases (DM), and the benefits of routine CT have yet to be fully clarified. This study investigated the value of employing contrast-enhanced CT (CECT) to screen for DM in patients with asymptomatic BC.

Methods: The clinical records of 483 patients with asymptomatic BC who underwent CECT, also in order to detect BC spread, between April 2006 and January 2011 were reviewed. The CECT results were classified into normal, true-positive (metastases) or false-positive findings.

Results: Abnormal CECT findings, including true- and false-positive results, were detected in 65 patients (13.5%). Of these, 26 patients (5.4%) showed confirmed true metastatic disease, including 18 lung metastases, 11 liver metastases and 13 bone metastases. Upstaging to stage IV due to the results of the CECT was significantly associated with only larger tumos size (odds ratio, 33.4; 95% CI 12.1–92.5; P < 0.0001) and lymph node status (odds ratio, 37.1; 95% CI 14.2–96.8; P < 0.0001.)

Nano-pulverization of poorly water soluble compounds with low melting points by a rotation/revolution pulverizer

We report a method for pulverizing poorly water soluble compounds with low melting points to nanoparticles without producing an amorphous phase using a rotation/revolution pulverizer. Fenofibrate, flurbiprofen, and probucol were used as crystalline model compounds. They were suspended in a methylcellulose aqueous solution and pulverized with zirconia balls by the rotation/revolution pulverizer. Beeswax, an amorphous compound, was also examined to investigate whether nano-pulverization of a compound with a low melting point was possible. Beeswax was suspended in ethyl alcohol cooled with liquid nitrogen and pulverized with zirconia balls by the rotation/revolution pulverizer. By optimizing the pulverization parameters, nanoparticles (D50 < 0.15 microm) of the crystalline compounds were obtained with narrow particle size distributions at a rotation/revolution speed of 1000 rpm and a rotation/revolution ratio of 1.0 when the vessel was 0 degrees C. Amorphous fenofibrate and flurbiprofen were not detected by differential scanning calorimetry or powder X-ray diffraction, whereas small amounts of amorphous probucol were detected. Beeswax was pulverized to nanoparticles (D50 = 0.14 microm) with ethyl alcohol cooled with liquid nitrogen. Fine nanoparticles of these poorly water soluble compounds with low melting points were obtained by controlling the rotation/revolution speed and reducing the vessel temperature.

Run-up to participation in ATACH II in Japan

Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality in Japan. Seventeen Japanese institutions are participating in the Antihypertensive Treatment for Acute Cerebral Hemorrhage (ATACH) II Trial (ClinicalTrials.gov no. NCT01176565; UMIN 000006526). This phase III trial is designed to determine the therapeutic benefit of early intensive systolic blood pressure (BP) lowering for acute hypertension in ICH patients. This report explains the long run-up to reach the start of patient registration in ATACH II in Japan, including our preliminary study, a nationwide survey on antihypertensive treatment for acute ICH patients, a multicenter study for hyperacute BP lowering (the SAMURAI-ICH study), revision of the official Japanese label for intravenous nicardipine, and construction of the infrastructure for the trial.

Incidence and possible pathogenesis of sentinel node micrometastases in ductal carcinoma in situ of the breast detected using molecular whole lymph node assay

Background:

The pathogenesis of lymph node metastases in preinvasive breast cancer – ductal carcinoma in situ (DCIS) – remains controversial. The one-step nucleic acid amplification (OSNA) assay is a novel molecular method that can assess a whole node and detect clinically relevant metastases. In this retrospective cohort study, we determined the performance of the OSNA assay in DCIS and the pathogenesis of node-positive DCIS.

Methods:

The subjects consisted of 623 patients with DCIS who underwent sentinel lymph node (SN) biopsy. Of these, 2-mm-sectioned nodes were examined using frozen-section (FS) histology in 338 patients between 2007 and 2009, while 285 underwent OSNA whole node assays between 2009 and 2011. The SN-positivity rate was compared between cohorts, and the characteristics of OSNA-positive DCIS were investigated.

Results:

The OSNA detected more cases of SN metastases than FS histology (12 out of 285, 4.2% vs 1 out of 338, 0.3%). Most of the metastases were micrometastases. The characteristics of high-risk DCIS (i.e., mass formation, size, grade, and comedo) and preoperative breast biopsy (i.e., methods or time to surgery) were not valid for OSNA assay–positive DCIS.

Conclusion:

The OSNA detects more SN metastases in DCIS than FS histology. Further examination of the primary tumours and follow-up of node-positive DCIS are needed to elucidate the pathogenesis.

Admission hyperglycemia causes infarct volume expansion in patients with ICA or MCA occlusion: association of collateral grade on conventional angiography

BACKGROUND AND PURPOSE

Hyperglycemia (HG) is associated with infarct volume expansion in acute ischaemic stroke patients. However, collateral circulation can sustain the ischaemic penumbra and limit the growth of infarct volume. The aim of this study was to determine whether the association between HG and infarct volume expansion is dependent on collateral circulation.

METHODS

We performed a retrospective analysis of 93 acute ischaemic stroke patients with internal carotid artery or middle cerebral artery occlusion within 24 h of onset were retrospectively studied. HG was diagnosed in patients with an admitting blood glucose value ≥140 mg/dl. Angiographic collateral grade 0-1 was designated as poor collateral circulation and grade 2-4 as good collateral circulation. Infarct volume was measured at admission and at again within 7 days using diffusion-weighted magnetic resonance images.

RESULTS

Among 34 patients with poor collateral grade, the change in infarct volume was significantly greater in the HG group than in the non-HG group (106.0 ml vs. 22.7 ml, P = 0.002). Among the 59 patients with good collateral circulation, the change in infarct volume was greater in the HG group than in the non-HG group (53.3 ml vs. 10.9 ml, P = 0.047). Multiple regression analysis indicated that admission HG (P = 0.004), baseline National Institutes of Health Stroke Scale score (P = 0.018), and poor collateral circulation (P = 0.040) were independently associated with infarct volume expansion.

CONCLUSIONS

Infarct volume expansion was greater in individuals with HG on admission regardless of collateral circulation status.

Spontaneously complete regression of pseudolymphoma of the remnant pancreas after pancreaticoduodenectomy

BACKGROUND

Pancreatic pseudolymphoma is extremely rare.

METHOD

We present multiple pseudolymphomas in the head and body of the pancreas. The hypoechoic lesions observed by endoscopic ultrasound were enhanced in late-phase angio-computed tomography and homogeneously hypointensive in T1-weighted magnetic resonance imaging (MRI). (18)F-fluorodeoxyglucose positron emission tomography showed strong accumulation in the lesions. The lesions were suspected to be non-functioning islet cell carcinoma. The intraoperative pathological diagnosis for the specimen obtained by a pylorus-preserving pancreaticoduodenectomy was non-neoplastic lymphoid cells. The remnant lesion in the pancreatic body was preserved.

RESULTS

Macroscopically, the mass was well-circumscribed gray-white colored lesion. The pathological diagnosis was pancreatic pseudolymphoma. The lesion in the remnant pancreas spontaneously disappeared within one year after the operation.

CONCLUSION

The differential diagnosis of pancreatic pseudolymphoma from malignant tumor is very difficult, however, the image findings demonstrated here may be informative. The spontaneous disappearance of pancreatic pseudolymphoma was firstly observed in the present case.

Coupling of magnetic and ferroelectric hysteresis by a multicomponent magnetic structure in Mn2GeO4

The olivine compound Mn(2)GeO(4) is shown to feature both a ferroelectric polarization and a ferromagnetic magnetization that are directly coupled and point along the same direction. We show that a spin spiral generates ferroelectricity, and a canted commensurate order leads to weak ferromagnetism. Symmetry suggests that the direct coupling between the ferromagnetism and ferroelectricity is mediated by Dzyaloshinskii-Moriya interactions that exist only in the ferroelectric phase, controlling both the sense of the spiral rotation and the canting of the commensurate structure. Our study demonstrates how multicomponent magnetic structures found in magnetically frustrated materials like Mn(2)GeO(4) provide a new route towards functional materials that exhibit coupled ferromagnetism and ferroelectricity.

Persistence of covalent bonding in liquid silicon probed by inelastic x-ray scattering

Metallic liquid silicon at 1787 K is investigated using x-ray Compton scattering. An excellent agreement is found between the measurements and the corresponding Car-Parrinello molecular dynamics simulations. Our results show persistence of covalent bonding in liquid silicon and provide support for the occurrence of theoretically predicted liquid-liquid phase transition in supercooled liquid states. The population of covalent bond pairs in liquid silicon is estimated to be 17% via a maximally localized Wannier function analysis. Compton scattering is shown to be a sensitive probe of bonding effects in the liquid state.

19 CHANGES IN PLASMA STEROID CONCENTRATIONS DURING GESTATION IN COWS WITH SPONTANEOUS ABORTION OF SOMATIC CELL CLONED FETUSES

Cloning of mammals by nuclear transfer frequently results in gestational failure with a variety of abnormalities that are likely due to inappropriate epigenetic reprogramming. Monitoring the placental function during gestation is important to clarify the cause of abnormalities in cloned animals. Sex steroids are produced in the bovine placenta and their levels in maternal peripheral blood are a useful measure of placentation. The objective of this study was to investigate changes in plasma concentrations of sex steroids during gestation in cows aborting cloned fetuses. Donor cells for nuclear transfer were obtained from subculture of cumulus cells retrieved from ovarian follicles of a Japanese Black cow. Recipient oocytes were derived from ovaries obtained at an abattoir and matured in vitro. Metaphase II oocytes were enucleated and each fused with a donor cell by DC pulses. Nuclear-transferred oocytes were activated and cultured for 7 days. Embryos developed to the blastocyst stage were each transferred into the uterine horn ipsilateral to the ovary bearing the CL of 39 multiparous Japanese Black and Holstein crossbred cows at 7 to 8 days after the day of standing oestrus (day 0). Fourteen recipient cows were diagnosed pregnant on Day 40 by ultrasonography and 7 cows delivered at full term. The other seven miscarried on Day 66, 81, 85, 89, 97, 104 and 211. Blood was collected from these cows at least once a week following the pregnancy diagnosis. Progesterone, estrone, oestradiol-17β and estrone sulfate in the blood plasma were measured by RIA and were compared with those in pregnant AI cows. Statistical differences at stages of gestation were analysed with repeated-measures ANOVA. In all miscarried cows, progesterone concentrations were similar to those in AI cows until several days before abortion and then rapidly decreased to the basal level. Concentrations of all estrogens stayed low until abortion in six cows aborting by day 104, whereas estrone and oestradiol-17β started to increase around Day 80 and estrone sulfate gradually increased from around Day 50 and started to increase drastically around Day 80 in AI cows. In another cow aborting on Day 211, profiles of estrone and oestradiol-17β were similar to those in AI cows until around Day 150. Thereafter, concentrations of these estrogens gradually decreased to the basal levels by Day 160 and stayed low until abortion. In this cow, gradual increase in estrone sulfate during Day 50 to 80 was not observed, but the difference in the concentration was not statistically significant from AI cows. The following profile of estrone sulfate was similar to those in active estrogens. The fetus was still alive on day 160 and fetal death was confirmed on day 180 by ultrasonography. These results suggest the possibility that developmental or functional failure of placenta associated with steroid synthesis may be a cause of mid-term miscarriage of a cloned fetus.

P3-07-08: Accurate Staging of Axillary Lymph Nodes from Breast Cancer Patients Using a Novel Molecular Method

Background: In breast cancer, the number of axillary lymph node metastases is the powerful prognostic factor. However, it is obvious that conventional histopathological examinations are non-standardized and limited in their ability to detect metastases accurately due to the partial evaluation of a node. This may lead to underestimation of nodal staging. The one-step nucleic acid amplification (OSNA) assay was developed to overcome this limitation of the histopathological examination. This assay can assess the whole lymph node and yields semi-quantitative results for the detection of clinically relevant nodal metastases by detection and amplification of cytokeratin 19 mRNA. This assay can classify the nodes into 4 categories, (++), (+I), (+), and negative. (++) and (+I) are theoretically regarded as macrometastasis and (+) as micrometastasis according to the American Joint Committee on Cancer (AJCC) staging system. We have shown the OSNA whole node assay detects more sentinel node (SN) metastases, particularly micrometastases than 2-mm-section frozen-section histology. Thus, we had hypothesized that the OSNA assay for non-sentinel nodes (nonSNs) in addition to SNs enables the classification of accurate nodal staging for breast cancer patients. In the present retrospective cohort study, we compared the performance of the OSNA assay with that of routine permanent histology for the detection of nonSN metastases among patients with positive SN biopsy who have undergone axillary dissection.

Patients and methods: Subjects comprised of consecutive 183 patients with clinically and ultrasonographically node-negative pT1-2 breast cancer who had undergone axillary dissection after positive SN biopsy with the OSNA assay between April 2009 and September 2010. Of these, for nonSN evaluation, 64 had single-section permanent histology while 119 patients underwent the OSNA whole node assay. We compared 1) detection rates of nonSN metastasis, including macro- and micrometastases and 2) upstaging rates from SN stage after the nonSN assessment according to the 7th AJCC staging system between both cohorts. We performed the two-population z test.

Results: 1) NonSNs were found to be positive for metastasis more frequently in the OSNA cohort than in the histology cohort (histology 13/64, 20.3%, 95% CI 11.7−32.6% vs. OSNA 66/119, 55.5%, 95% CI 46.1−64.5%; P&lt;0.001). We found no significant difference in the frequency of macrometastasis in nonSNs (12/64, 18.8%, 95% CI 10.5−30.8% vs. 30/119, 25.2%, 95% CI 17.9−34.2%; P=0.42). However, we found significant difference in the frequency of micrometastasis in nonSNs (1/64, 1.6%, 95% CI; 0.1−9.5% vs. 36/119, 30.3%, 95% CI; 22.3−39.5%; P&lt;0.001).

2) Total upstaging rates were similar in both cohorts (histology 9/64, 14.1%, 95% CI 7.0−25.5% vs. OSNA 20/119, 16.8%, 95% CI 10.8−25.0%; P=0.79).

Conclusion: The OSNA whole node assay detects a far greater proportion of nonSN metastases than single-section histology in patients with positive SN biopsy. However, in terms of the AJCC staging system, upstaging rates from the SN stage were similar in both cohorts. Follow-up of the OSNA cohort is required to clarify the prognostic implications of this technique; this may lead to the establishment of a new breast cancer staging.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-07-08.

OT1-02-01: Phase II Neoadjuvant Trial of Anthracycline Based Regimens Followed by a Combination with Nanoparticle Almumin-Bound Paclitaxel and Trastuzumab in Patients with Operable T2-3,N0-1,Her2 Positive Breast Cancer

Background: Anthracycline and taxane have been widely used and studied in neoadjuvant setting for treatment of locally advanced breast cancer. Various regimens have explored the addition of newer agents to determine safety and efficacy, and pathological complete response(pCR) has been demonstrated to be associated with favorable overall survival in primary breast cancer. In addition, Three year median follow-up data of the TECHNO Trial revealed that the neoadjuvant combination of trastuzumab and chemotherapy resulted in a high chance for a pCR. We conducted a clinical Phase II neoadjuvant trial of Anthracycline based regimens(EC,AC,FEC) followed by a combination with nanoparticle albumin-bound Paclitaxel and Trastuzumab in patients with operable T2-3,N0-1,Her2 positive breast cancer.

Patients and Methods: The study is designed to evaluate EC or AC or FEC followed a combination of nanoparticle almumin-bound Paclitaxel and Trastuzumab as neoadjuvant therapy in patients with Her2 positive locally advanced(T2-3,N0-1) breast cancer. Patients are treated with neoadjuvant EC(Epirubicin 90 mg/m2, Cyclophosphamide 600 mg/m2) or AC(Doxorubicin 90 mg/m2, Cyclophosphamide 600 mg/m2) or FEC(Fluorouracil 500mg/m2, Epirubicin 100 mg/m2, Cyclophosphamide 500 mg/m2) q21d x 4, follosed by a combination with nanoparticle almumin-bound Paclitaxel(260 mg/m2) and Trastuzumab q21d x 4.

Patients undergo surgery 4–6 weeks later from completing chemotherapy. pCR, the primary endpoint is defined as no evidence of invasive tumors in the final surgical sample both in the breast and axillary lymph nodes. Secondary endpoints include objective clinical response rate, disease-free interval, overall survival, rate of breast concerving surgery, and the safety of the treatment.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT1-02-01.

Accurate staging of axillary lymph nodes from breast cancer patients using a novel molecular method

Background:

The one-step nucleic acid amplification (OSNA) assay is a molecular-based lymph-node metastasis detection procedure that can assess a whole node and yields semi-quantitative results for the detection of clinically relevant nodal metastases. We aimed to determine the performance of the OSNA assay as an accurate nodal staging tool in comparison with routine histological examination.

Methods:

Subjects comprised 183 consecutive patients with pT1-2 breast cancer who underwent axillary dissection after positive sentinel-node (SN) biopsy with the OSNA assay. Of these, for non-SN evaluation, 119 patients underwent OSNA assay evaluation, whereas 64 had single-section histology. We compared the detection rates of non-SN metastasis and upstaging rates from the SN stage according to the American Joint Committee on Cancer staging between the OSNA and histology cohorts.

Results:

OSNA detected more cases of non-SN metastases than histology (OSNA 66/119, 55.5% vs histology 13/64, 20.3% P<0.001), particularly micrometastases (36/119, 30.3% vs 1/64, 1.6% P<0.001). Total upstaging rates were similar in both cohorts (20/119, 16.8% vs 9/64, 14.1%, P=0.79).

Conclusion:

OSNA detects a far greater proportion of non-SN micrometastases than routine histological examination. However, upstaging rates after axillary dissection were not significantly different between both cohorts. Follow-up of the OSNA cohort is required to determine its clinical relevance.

Chronic stress modulates neural and cardiovascular responses during reversal learning

Animal studies have revealed that chronic stress shifts cognitive strategies from the flexible goal-directed action to the simple and rigid habit action. In addition, stress-induced atrophy in the prefrontal cortex and dorsomedial striatum which are involved in the goal-directed action and hypertrophy of the dorsolateral striatum which is critical for the habit action were parallel with the effects of chronic stress on behaviors. The present study tested whether these previous findings in animal studies are compatible in humans by analyzing effects of chronic stress on neural and cardiovascular responses, which are likely important for performing appropriate actions. Twenty healthy men exposed to low or high chronic job stress performed a stochastic reversal learning task, which required cognitive flexibility and the goal-directed action. Regional cerebral blood flow was evaluated during the task using (15)O-water positron emission tomography, and cardiovascular parameters such as blood pressure and heart rate were also measured. During the reversal learning task, whereas participants with low chronic job stress exhibited activity in the anterior caudate, as well as orbitofrontal cortex, ventrolateral prefrontal cortex, insula, and midbrain, which might be related to the goal-directed action, participants with high chronic job stress exhibited no activity in such brain regions. Furthermore, participants with high chronic job stress exhibited less reactivity in diastolic blood pressure, which might be mediated by anterior cingulate cortical activity. These findings, in line with previous studies, suggested that chronic job stress correlates with less activity in brain regions related to the goal-directed action, and insensitive physiological responses in humans.

Improvement of sensitivity in high-resolution Rutherford backscattering spectroscopy

The sensitivity (limit of detection) of high-resolution Rutherford backscattering spectroscopy (HRBS) is mainly determined by the background noise of the spectrometer. There are two major origins of the background noise in HRBS, one is the stray ions scattered from the inner wall of the vacuum chamber of the spectrometer and the other is the dark noise of the microchannel plate (MCP) detector which is commonly used as a focal plane detector of the spectrometer in HRBS. In order to reject the stray ions, several barriers are installed inside the spectrometer and a thin Mylar foil is mounted in front of the detector. The dark noise of the MCP detector is rejected by the coincidence measurement with the secondary electrons emitted from the Mylar foil upon the ion passage. After these improvements, the background noise is reduced by a factor of 200 at a maximum. The detection limit can be improved down to 10 ppm for As in Si at a measurement time of 1 h under ideal conditions.

Plasma brain natriuretic peptide predicts death during hospitalization in acute ischaemic stroke and transient ischaemic attack patients with atrial fibrillation

BACKGROUND AND PURPOSE

atrial fibrillation (AF) is the most powerful predictor of early death in patients with acute ischaemic stroke. We investigated whether the plasma brain natriuretic peptide (BNP) level on admission can serve as a biological marker of in-hospital death in acute ischaemic stroke and transient ischaemic attack (TIA) patients with AF.

METHODS

we prospectively enrolled ischaemic stroke and TIA patients with AF within 24 h of onset and measured plasma BNP on admission. Patients were divided into two groups: the deceased group, who died during hospitalization, and the survival group. The factors associated with in-hospital death were investigated by multivariate logistic regression analysis.

RESULTS

a total of 221 patients with AF were enrolled. Death occurred in 24 (10.9%) patients. The mean ± SD of the plasma BNP level of the deceased group was significantly higher than that of the survival group (714.1 ± 716.3 vs. 320.0 ± 380.7 pg/ml, P < 0.0001). The optimal cutoff level, sensitivity, and specificity of BNP levels to distinguish the deceased group from the survival group were 320 pg/ml, 79.2, and 69.0%, respectively. Multivariate logistic regression analysis demonstrated that age per 10 years increase (OR, 3.56; 95% CI, 1.728-7.346, P = 0.0006), internal carotid artery occlusion (OR, 10.20; 95% CI, 2.525-41.177, P = 0.0011), NIHSS score of >17 (OR, 4.68; 95% CI, 1.137-19.286, P = 0.0325), and plasma BNP level of > 320 pg/ml (OR, 4.74; 95% CI, 1.260-17.800, P = 0.0213) were independent factors associated with in-hospital death.

CONCLUSION

the plasma BNP level on admission can predict in-hospital death in acute ischaemic stroke and TIA patients with AF.

Identification of a new adhesin-like protein from Lactobacillus mucosae ME-340 with specific affinity to the human blood group A and B antigens

AIMS

To identify and characterize a new adhesin-like protein of probiotics that show specific adhesion to human blood group A and B antigens.

METHODS AND RESULTS

Using the BIACORE assay, the adhesion of cell surface components obtained from four lactobacilli strains that adhered to blood group A and B antigens was tested. Their components showed a significant adhesion to A and B antigens when compared to the bovine serum albumin (BSA) control. The 1 mol l(-1) GHCl fraction extracted from Lactobacillus mucosae ME-340 contained a 29-kDa band (Lam29) using SDS-PAGE. The N-terminal amino acid sequence and homology analysis showed that Lam29 was 90% similar to the substrate-binding protein of the ATP-binding cassette (ABC) transporter from Lactobacillus fermentum IFO 3956. The complete nucleotide sequence (858 bp) of Lam29 was determined and encoded a protein of 285 amino acid residues. Phylogenetic analysis and multiple sequence alignments indicated this protein may be related to the cysteine-binding transporter.

CONCLUSIONS

The adhesion of ME-340 strain to blood group A and B antigens was mediated by Lam29 that is a putative component of ABC transporter as an adhesin-like protein.

SIGNIFICANCE AND IMPACT OF THE STUDY

Lactobacillus mucosae ME-340 expressing Lam29 may be useful for competitive exclusion of pathogens via blood group antigen receptors in the human gastrointestinal mucosa and in the development of new probiotic foods.

Neurological deficit after simultaneous open abdominal aortic surgery and thoracic aortic endovascular therapy

We examined a total of 12 cases; 8 cases were identified by searching the literature on Pubmed (excluding case reports published prior to 2000) and 4 cases were ones we personally encountered. We examined age, sex, history of smoking, and preoperative risk factors as preoperative factors, the access route and coverage of the descending aorta as perioperative factors, and complications and survival time as postoperative factors. Mean coverage of the thoracic aorta was 90.8 mm. In terms of perioperative deaths, 8.3% (1 patient) were due to coagulopathy. Perioperative complications occurred in 16.7% of cases (coagulopathy in 1 patient and paralysis in another). No patients experienced complications or underwent additional treatment during a mean follow-up of 22.9 months. This study suggested that simultaneous open abdominal aortic repair and thoracic aortic endovascular therapy is feasible and also involves few postoperative complications. Paraplegia and paralysis tended to occur less frequently than with two-stage surgery, but further study is needed to explain why this is true.

Experimental evidence of nonthermal acceleration of relativistic electrons by an intensive laser pulse

Nonthermal acceleration of relativistic electrons is investigated with an intensive laser pulse. An energy distribution function of energetic particles in the universe or cosmic rays is well represented by a power-law spectrum, therefore, nonthermal acceleration is essential to understand the origin of cosmic rays. A possible candidate for the origin of cosmic rays is wakefield acceleration at relativistic astrophysical perpendicular shocks. The wakefield is considered to be excited by large-amplitude precursor light waves in the upstream of the shocks. Substituting an intensive laser pulse for the large amplitude light waves, we performed a model experiment of the shock environments in a laboratory plasma. An intensive laser pulse was propagated in a plasma tube created by imploding a hollow polystyrene cylinder, as the large amplitude light waves propagated in the upstream plasma at an astrophysical shock. Nonthermal electrons were generated, and the energy distribution functions of the electrons have a power-law component with an index of ~2. We described the detailed procedures to obtain the nonthermal components from data obtained by an electron spectrometer.

145 EFFECT OF TRANSFER OF CATTLE ELONGATING EMBRYO TO A REPEAT BREEDER COW ON PREGNANCY RATE AND INCIDENCE OF A RETURN TO ESTRUS

In cattle, a low pregnancy rate directly affects calf and milk production and brings about economic loss to livestock producers. The number of repeat breeder cows in herds decreases the overall pregnancy rate. Therefore, many studies have focused on improving the cows’ reproductive performance. On the other hand, it has been demonstrated that the major embryonic loss occurs in the first or second week of pregnancy, after which mother cows recognize the presence of their embryos via a signal protein secreted by the embryos, interferon-τ. Therefore, to bypass the period with a high incidence of pregnancy loss in cattle, we used elongating embryos for embryo transfer (ET) to repeat breeder cows. Elongating embryos on Day 14 postoestrus were used for the present study because embryos of this stage have the ability to produce interferon-τ and embryos of later stages are easily damaged when they are collected from the uterus by flushing. In this study, Japanese Black cows were superovulated and inseminated when they showed standing oestrus. Elongating embryos were collected by nonsurgical uterine flushing. Collected embryos that had evident embryonic discs and intact trophectoderms were used for ET. These embryos were transferred, using plastic catheters or ET guns to ipsilateral uterine horns, to the corpus luteum of synchronized crossbred (Japanese Black × Holstein-Friesian) recipient cows. Recipient cows were divided into 2 groups according to the previous reproductive history of each cow: reproductively normal cows that were pregnant with fewer than 3 times of AI or regular ET (using Day 7 embryos) after every parturition (n = 33) and repeat breeder (RB) cows (n = 42). Elongating embryos were transfer on Day 14 after oestrus, and all cows were monitored for signs of standing oestrus twice a day until Day 80. Pregnancy was diagnosed with ultrasonography every 10 days from Day 30 to 80 postoestrus. The data were analysed by Fisher’s exact test. The pregnancy rate of reproductively normal cows was 54.5%. However, in repeat breeder cows, the pregnancy rate was significantly decreased (2.4%; P < 0.01). When the repeat breeder cows did not become pregnant, transfer of the elongating embryos was repeated another 5 times continuously and the incidence of a return of oestrus was monitored daily. At the first ET period, the average interestrus interval in nonpregnant repeat breeder cows was 50 ± 7.2 days. As the ET period proceeded, the interestrus intervals were gradually decreased, and at a sixth ET period, it approximated the normal oestrus cycle length (22.8 ± 0.8). These results indicated that although transfer of elongating embryos could bypass the critical period of high incidence of embryo loss, it did not improve the pregnancy rate of repeat breeder cows. Moreover, it suggests that the uterine environment of repeat breeder cows was gradually deteriorating in a time-dependent manner.

Abstract P3-03-02: Molecular Detection of Micrometastasis in Sentinel Lymph Nodes Using One-Step Nucleic Acid Amplification Assay for Breast Cancer Patients — Comparison with Routine Pathological Examination

Background:

In AJCC 7th edition, Stage I breast tumors have been subdivided into Stage IA and Stage IB; Stage IB includes small tumors (T1) with exclusively micrometastases in lymph nodes (N1mi), in order to facilitate further investigation. However, it is obvious that the current routine pathological examination has the limitation to detect micrometastasis, because it can examine only a part of lymph node.

One-Step Nucleic acid Amplification (OSNA) assay was developed to overcome this limitation of the routine pathological examination. This assay can classify the patients into 4 categories, (++), (+), (+I), and negative. (++) and (+I) are theoretically regarded as high-volume metastasis corresponding to macrometastasis, and (+) as low-volume metastasis corresponding to micrometastasis. Since OSNA has the potential for standardization and semi-quantitative assay for evaluating the amount of tumor cells in a lymph node, we decided to apply a whole node into OSNA assay to maximize the semi-quantitative advantage in clinical settings. In the present study, we report the results of sentinel node (SN) examination with whole node OSNA assay. And we compare the results with the pathological examination to reveal the characteristics of OSNA assay. Patients and Methods:

Data of 961 patients from January 2008 to March 2010 with clinically node-negative and pT1 breast cancer and having received SN biopsy with the radioactive tracer were evaluated. SNs were examined by whole node OSNA assay with Gene Amplification Detector RD-100i and Lynoamp®BC or 2mm-thick intraoperative frozen section with H&E staining for 442 and 519 patients respectively.

We compared the performance of whole node OSNA assay and the pathological examination. And we performed two-population-z-test. Results:

1) SN positive rates of whole node OSNA assay and the pathological examination in T1 patients were 88/442 (19.9%, 95% CI; 16.3-24.0%) and 77/519 (14.8%, 95% CI; 11.9-18.3%), respectively. The difference was 5.1% (95% CI; 0.1-9.6%, p=0.046).

2) The populations of OSNA (++) or (+I) and macrometastasis were 51/442 (11.5%, 95% CI; 8.8-15.0%) and 55/519 (10.6%, 95% CI; 8.1-13.6%), respectively. There was no significant difference. On the other hand, the populations of OSNA (+) and micrometastasis were 37/442 (8.4%, 95% CI; 6.0-11.5%) and 22/519 (4.2%, 95% CI; 2.7-6.4%), respectively. The difference was 4.1% (95% CI; 0.9-7.0%, p=0.012).

Conclusions:

OSNA assay could detect more low-volume metastases corresponding to micrometastasis than the routine pathological examination. Therefore, it is suggested that OSNA can select accurate SN/micrometastasis cohort. Follow up of the patients is required to clarify the prognosis of OSNA (+) patients, and as the result, it may be possible to establish the new breast cancer staging system using OSNA results.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-03-02.

High resolution, low hν photoelectron spectroscopy with the use of a microwave excited rare gas lamp and ionic crystal filters

The need for not only bulk sensitive but also extremely high resolution photoelectron spectroscopy for studying detailed electronic structures of strongly correlated electron systems is growing rapidly. Moreover, easy access to such a capability in one's own laboratory is desirable. Demonstrated here is the performance of a microwave excited rare gas (Xe, Kr, and Ar) lamp combined with ionic crystal filters (sapphire, CaF(2), and LiF), which can supply three strong lines near the photon energy of hnyu hν=8.4, 10.0, and 11.6 eV, with the hν resolution of better than 600 μeV for photoelectron spectroscopy. Its performance is demonstrated on some materials by means of both angle-integrated and angle-resolved measurements.

High failure rate of the dissolution tests for 500-mg amoxicillin capsules sold in Cambodia: is it because of the product or the test method?

OBJECTIVES

During the survey of substandard medicines in Cambodia in 2007, it was found that more than 90% of 500-mg amoxicillin (AMPC) capsules failed the United States Pharmacopeia (USP) 30 TEST 1 dissolution test. In the USP, several monographs provide multiple methods for performing the dissolution test. By using the 500-mg AMPC capsule as an example, we aimed to identify the problems and implications of the USP methods adopted for the dissolution test as a global standard.

METHODS

All AMPC samples were collected from the Cambodian market in 2007. For the quantitative test, we referred to USP 30. We performed the USP 28 and USP 30 TEST 2 dissolution tests and compared these results with those of the USP 30 TEST 1.

RESULTS

All 500-mg AMPC capsules used for the comparison passed the quantitative test. Samples that passed the USP 28 and USP 30 TEST 2 dissolution tests were identical, and the pass rate was 97.1% (34/35), whereas the pass rate with the USP 30 TEST 1 was 8.6% (3/35). The difference in the dissolution results between the three methods was significant (P<0.0001).

CONCLUSION

This study revealed that many users would select the most stringent method when multiple methods exist in the USP. This may lead to a high failure rate of the tests. Because USP is a global standard, we recommend that it take into consideration the developing countries and create a more detailed user-friendly manual for selection for appropriate methods.

Antimicrobial activity of sodium citrate against Streptococcus pneumoniae and several oral bacteria

AIMS

The aim of this study is to assess the antibacterial activity of sodium citrate against Streptococcus pneumoniae and several oral bacteria.

METHODS AND RESULTS

The antibacterial activity was determined by broth microdilution method. The results showed that although Enterocuccus faecium OB7084 and Klebsiella pneumoniae OB7088 had high tolerance to sodium citrate, several oral bacteria including Fusobacterium nucleatum JCM8532(T) , Streptococcus mutans JCM5705(T) and Strep. pneumoniae NBRC102642(T) were susceptible. Furthermore, the bactericidal activity of sodium citrate against Strep. pneumoniae NBRC102642(T) was not influenced by pH in the range of 5·0-8·0, whereas that of sodium lactate was weakened at neutral or weak alkaline pH. When Strep. pneumoniae NBRC102642(T) was treated with sodium citrate for 2 h, many burst cells were observed. However, addition of MgCl(2) or CaCl(2) to an assay medium weakened the antimicrobial activity although ZnCl(2) or MnCl(2) did not influence.

CONCLUSIONS

Independent of pH, sodium citrate inhibited the growth of oral bacteria, which suggests that the mechanism is different from that of sodium lactate.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results presented in this study would be available for understanding the antimicrobial property of sodium citrate.

Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

OBJECTIVES

Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following ICH.

METHODS

The Medline and Embase databases were searched in February 2008 using relevant key words, limited to human studies in the English language. Cohort studies of consecutive patients with ICH reporting mortality or functional outcome according to pre-ICH APT use were identified. Of 2,873 studies screened, 10 were judged to meet inclusion criteria by consensus of 2 authors. Additionally, we solicited unpublished data from all authors of cohort studies with >100 patients published within the last 10 years, and received data from 15 more studies. Univariate and multivariable-adjusted odds ratios (ORs) for mortality and poor functional outcome were abstracted as available and pooled using a random effects model.

RESULTS

We obtained mortality data from 25 cohorts (15 unpublished) and functional outcome data from 21 cohorts (14 unpublished). Pre-ICH APT users had increased mortality in both univariate (OR 1.41, 95% confidence interval [CI] 1.21 to 1.64) and multivariable-adjusted (OR 1.27, 95% CI 1.10 to 1.47) pooled analyses. By contrast, the pooled OR for poor functional outcome was no longer significant when using multivariable-adjusted estimates (univariate OR 1.29, 95% CI 1.09 to 1.53; multivariable-adjusted OR 1.10, 95% CI 0.93 to 1.29).

CONCLUSIONS

In cohort studies, APT use at the time of ICH compared to no APT use was independently associated with increased mortality but not with poor functional outcome.

Pisiferdiol and pisiferic acid isolated from Chamaecyparis pisifera activate protein phosphatase 2C in vitro and induce caspase-3/7-dependent apoptosis via dephosphorylation of Bad in HL60 cells

Protein phosphatase 2C (PP2C) dephosphorylates a broad range of substrates and regulates apoptosis, stress response and growth-related pathways. In the course of screening for PP2C activators from natural sources, we isolated abietane-type diterpenes, pisiferdiol and pisiferic acid from Chamaecyparis pisifera. Pisiferdiol having a unique seven-membered ring showed more specific PP2C activation activity (1.3-fold at 100 microM) than pisiferic acid having a normal six-membered ring and oleic acid, which is known to activate PP2C. Pisiferdiol and pisiferic acid showed mixed-type activation with respect to alpha-casein, and this differed from the non-competitive activation of oleic acid in vitro. In vivo, the cytotoxicity of pisiferdiol toward human promyelocytic leukemia cell line HL60 with an IC(50) value of 18.3 microM was 2-fold and 7-fold stronger than those of pisiferic acid and oleic acid, and pisiferdiol induced apoptosis through a caspase 3/7-dependent mechanism involving the dephosphorylation of Bad(1), which is a PP2C substrate. We thus conclude that pisiferdiol and pisiferic acid are novel PP2C activators, and the more specific activator, pisiferdiol, may be a useful chemical probe to study PP2C-mediated signaling pathways, and a lead compound for pharmaceutical agents.

Experimental evaluation of neutron performance in boron-doped low activation concrete

Reaction rate distribution in concrete with/without boron dopant up to a thickness of 60 cm was measured using Yayoi fast reactor located at University of Tokyo. The 7 reaction rates such as (197)Au(n,gamma), (59)Co(n,gamma), (115)In(n,n'), (55)Mn(n,gamma), (23)Na(n,gamma), (94)Zr(n,gamma) and (96)Zr(n,gamma) were measured at 12 different depths, and the reduction of the reaction rate as a result of boron doping was quantitatively analysed. These reaction rates were also used to determine epithermal neutron spectrum shape parameter. Monte Carlo simulations of the experimental setup were performed using the MCNP-5 code. Simulated depth profiles of reaction rates and the epithermal neutron spectrum shape parameter agreed with the experimental results with fair accuracy. This experimental results provide useful data to benchmark the accuracy of neutron transport codes in the prediction of transmission and neutron spectrum distortion in boron-doped concrete.