A color-coded orthotopic nude-mouse treatment model of brain-metastatic paralyzing spinal cord cancer that induces angiogenesis and neurogenesis

OBJECTIVE

Cancer of the spinal cord is highly malignant and often leads to paralysis and death. A realistic mouse model would be an important benefit for the better understanding and treatment of spinal cord glioma.

MATERIALS AND METHODS

To develop an imageable, patient-like model of this disease, U87 human glioma tumour fragments (expressing red fluorescent protein), were transplanted by surgical orthotopic implantation into the spinal cord of nontransgenic nude mice or transgenic nude mice expressing nestin-driven green fluorescent protein (ND-GFP). In ND-GFP mice, GFP is expressed in nascent blood vessels and neural stem cells. The animals were treated with temozolomide or vehicle control.

RESULTS

The intramedullary spinal cord tumour grew at the primary site, caused hind-limb paralysis and also metastasized to the brain. Temozolomide inhibited tumour growth (P<0.01) and prevented metastasis, as well as prevented paralysis in four mice and delayed paralysis in two mice of the six tested (P=0.005). In the ND-GFP-expressing host, ND-GFP cells staining positively for neuronal class III-beta-tubulin or CD31, surrounded the tumour. These results suggest that the tumour stimulated both neurogenesis and angiogenesis, respectively.

CONCLUSION

A patient-like model of spinal cord glioma was thus developed, which can be used for the discovery of new agents, including those that inhibit invasion and metastasis of the disease as well as those that prevent paralysis.

[Tricuspid annuloplasty, pulmonary valve replacement, ventricular septal defect (VSD) patch closure, and right-sided maze procedure 23-years after corrective repair of tetralogy of Fallot]

Postoperative pulmonary valve regurgitation, stenosis of the right ventricular outflow tract, conduit failure, ventricular septal patch leak, secondary tricuspid valve regurgitation, and various arrhythmias are the major complications that develop after surgical repair of tetralogy of Fallot in adults. A 27-year-old male with pulmonary regurgitation, tricuspid regurgitation, residual ventricular septal defect (VSD), low left ventricular function, and chronic atrial fibrillation underwent tricuspid annuloplasty, pulmonary valve replacement with a stentless aortic valve, VSD patch closure, and right-sided maze procedure, and the postoperative course was uneventful. The cardiothoracic ratio decreased, sinus rhythm was restored, and the patient's complaints were relieved. Reoperation at the optimal time after corrective repair of tetralogy of Fallot in adults may improve the outcome.

Re-implantation of tumour tissue treated by cryotreatment with liquid nitrogen induces anti-tumour activity against murine osteosarcoma

We evaluated the possible induction of a systemic immune response to increase anti-tumour activity by the re-implantation of destructive tumour tissue treated by liquid nitrogen in a murine osteosarcoma (LM8) model. The tumours were randomised to treatment by excision alone or by cryotreatment after excision. Tissue from the tumour was frozen in liquid nitrogen, thawed in distilled water and then re-implanted in the same animal. In addition, some mice received an immunological response modifier of OK-432 after treatment. We measured the levels of interferon-gamma and interleukin-12 cytokines and the cytotoxicity activity of splenocytes against murine LM8 osteosarcoma cells. The number of lung and the size of abdominal metastases were also measured.

Re-implantation of tumour tissue after cryotreatment activated immune responses and inhibited metastatic tumour growth. OK-432 synergistically enhanced the anti-tumour effect. Our results suggest that the treatment of malignant bone tumours by reconstruction using autografts containing tumours which have been treated by liquid nitrogen may be of clinical value.

Ilizarov technique for correction of the Shepherd's crook deformity: a report of two cases

We report 2 patients with fibrous dysplasia who underwent correction, using the Ilizarov technique, of Shepherd's crook deformities and pathological fractures of the left femurs. A 12-year-old boy underwent an opening wedge osteotomy and a 48-degree gradual correction, whereas a 43-year-old woman underwent a 34-degree acute correction without osteotomy at the fracture site. Both patients could initiate early weight bearing. Final leg function was excellent and alignment was maintained. No complications were encountered. Both patients had no difficulty sleeping and no major complaints about the Ilizarov technique. It is more important to achieve accurate alignment than resection of the lesion. The Ilizarov technique is effective for treating the Shepherd's crook deformity in patients with fibrous dysplasia.

Safety of external fixation during postoperative chemotherapy

We studied the safety of external fixation during post-operative chemotherapy in 28 patients who had undergone distraction osteogenesis (17, group A) or vascularised fibular grafting (11, group B) after resection of a tumour. Four cycles of multi-agent post-operative chemotherapy were administered over a mean period of 14 weeks (6 to 27). The mean duration of external fixation for all patients was 350 days (91 to 828). In total 204 wires and 240 half pins were used.

During the period of post-operative chemotherapy, 14 patients (11 in group A, 3 in group B) developed wire- and pin-track infection. A total of ten wires (4.9%) and 11 half pins (4.6%) became infected. Seven of the ten infected wires were in periarticular locations.

External fixation during post-operative chemotherapy was used safely and successfully for fixation of a vascularised fibular graft and distraction osteogenesis in 27 of 28 patients. Post-operative chemotherapy for malignant bone tumours did not adversely affect the ability to achieve union or cause hypertrophy of the vascularised fibular graft and had a minimal effect on distraction osteogenesis. Only one patient developed osteomyelitis which required further surgery.

39 CLONAL OFFSPRING DERIVED FROM SEPARATED BLASTOMERES IN CYNOMOLGUS MONKEYS (MACACA FASCICULARIS)

There are no reports of cloning by embryo splitting in the cynomolgus monkey, but production of genetically identical monkeys would have tremendous implications for biomedical research, especially for immunological studies, production of disease models, and behavioral science. Cloning would also reduce the number of animals required for the above research by increasing experimental reproducibility. In this study, we tried to produce cynomolgus monkey offspring by embryo splitting and embryo transfer. Controlled ovarian stimulation and oocyte recovery have been previously described by Torii et al. (2000 Primates 41, 39–47). Cumulus-free mature oocytes were fertilized by intracytoplasmic sperm injection. Single spermatozoa were individually immobilized by scoring their tails and picking them up with the injection pipette. The denuded oocyte was held by the holding pipette with the polar body in the 12 o'clock position. The injection pipette was then inserted at the 3 o'clock position and was introduced into the cytoplasm, breaking the ooplasmic membrane by pulling gently. One spermatozoon was injected into the cytoplasm. The injected oocytes were cultured at 38�C in 5% CO2, 5% O2 and 90% N2 in CMRL-1066 medium (Invitrogen, Grand Island, NY, USA) containing 20% calf serum (CS, Invitrogen) for 2–3 days. Splitting was performed using 4- to 7-cell-stage embryos. The zona pellucida was disrupted with acidic Tyrode's solution, and individual blastomeres were separated from the zona-free embryos by 0.25% trypsin-EDTA with added CaCl2 (<1 min). After transferring the zona-free embryos into TALP-HEPES medium, blastomeres were dissociated by pipetting with a 40–50 µm micropipette 4–5 times. These blastomeres were then transferred into empty zonae that had been produced from immature oocytes by the aspiration of ooplasm with a micromanipulator. Sixteen embryos underwent blastomere separation and a total of 33 split embryos were produced. After being cultured for 2–3 h in CMRL-1066 medium containing 20% CS, 30 of these split embryos, comprising 1–4 blastomeres each, were transferred into the oviducts of 23 fertile surrogate mothers at 0 to 5 days after ovulation. Pregnancy was confirmed in two animals (8.7%; 2/23) by ultrasound approximately 30 days after transfer. The pregnancies were uneventful and two normal healthy babies were born without any assistance 159 days after transfer. The low pregnancy rate could be due to the presence of fewer cells in the smaller split embryos, the ruptured zona pellucida, or the in vitro micromanipulation of embryos during blastomere separation and reconstruction. Here we report the first production of viable cloned offspring produced by blastomere separation in the cynomolgus monkey. Since we have previously succeeded in establishing ES cell lines from isolated blastomeres, in the future we will be able to produce genetically identical monkeys from a single 4- to 8-cell-stage embryo using those ES cell lines and the embryo splitting technique.

256 EFFECT OF EPIDERMAL GROWTH FACTOR ON IN VITRO MATURATION OF CYNOMOLGUS MONKEY (MACACA FASCICULARIS) OOCYTES

Collected oocytes include not only mature oocytes (metaphase II: MII), but also immature oocytes (germinal vesicle: GV, and metaphase I: MI). To establish a dependable artificial indoor breeding program in cynomolgus monkeys, we are planning to carry out in vitro maturation (IVM) using GV and MI oocytes. In this study, we attempted to determine whether different types of feeder layers and epidermal growth factor (EGF) were effective for IVM. Cumulus–oocyte complexes (COCs) were collected from ovaries of 4–10-year-old female cynomolgus monkeys stimulated by the combination of FSH (25 IU kg–1 × 9 days) and hCG (400 IU kg–1) (Torii 2000 Primates 39, 399–406). Oocytes were classified by morphological features: oocytes retaining an intact germinal vesicle nucleus (GV); oocytes that had undergone germinal vesicle breakdown without polar body formation (MI); and oocytes with a first polar body (MII). GV and MI oocytes were co-cultured on monkey cumulus cells (MCC), monkey follicular ovarian cells (MFOC), monkey oviductal cells (MOC), or human solubilized amnion product (HSAP), with TCM-199+10% fetal bovine serum containing epidermal growth factor (EGF; 10 ng mL–1 or 20 ng mL–1). The maturation rate from GV to MII oocytes was 6.7% (MCC), 18.0% (MFOC), 35.7% (MOC), and 28.6% (HSAP) (Table 1). Although higher maturity was observed in MOC and HSAP, the effect of EGF was not found in co-cultures using any feeder layers. The maturation rate from MI to MII oocytes was 33.3% (MCC), 27.8% (MFOC), 55.6% (MOC), and 44.0% (HSAP) (Table 1). The highest maturation rate from GV and MI was observed in co-cultures using MOC. The maturation rate from MI to MII oocytes in the presence of 10 ng mL–1 EGF was 75.0% (MCC) and 73.7% (HSAP) (Table 1), whereas the rate in the presence of 20 ng mL–1 EGF was 59.1% (MCC), 64.3% (MFOC), 92.3% (MOC), and 60.0% (HSAP) (Table 1). Thus, the best maturation rate was a co-culture using MOC as a feeder layer with 20 ng mL–1 EGF. According to our results, maturation rate during IVM depends on the cellular type of feeder layers and the concentration of EGF. EGF is especially effective for maturity from MI to MII oocytes, but not from GV to MI or MII oocytes. Thus, IVM should be carred out under optimal culture conditions, including suitable feeder layer and media plus supplements. In the future, it is important that intracytoplasmic sperm injection be carried out using in vitro-matured MII oocytes for establishment of an artificial indoor breeding program in cynomolgus monkeys. Table 1. Number of matured oocytes co-cultured with different feeder layers and EGF

60 INFLUENCE OF HOECHST STAINING FOR NUCLEAR TRANSFER ON PARTHENOGENETIC EMBRYOS IN CYNOMOLGUS MONKEYS (MACACA FASCICULARIS)

Nonhuman primates are valuable animal models for the study of human diseases, and somatic cell nuclear transfer (SCNT) is an important method for establishing tailor-made embryonic stem (ES) cells and transgenic animals in these model species. However, there have been few reports on SCNT in nonhuman primates. Moreover, the development of cloned blastocysts could be influenced by any chemical reagents and manipulations used in this technique. In this study we compared blastocyst developmental rates with and without Hoechst staining. Metaphase II (MII) oocytes were collected from hormone-treated adult female cynomolgus monkeys (Macaca fascicularis) under laparoscopic observation (Torii et al. 2000 Primates 41, 39–47). A pseudo-SCNT procedure, which consisted of cytochalasin B treatment, cytoplasm removal, and dissection of the oocyte membrane, was performed on MII oocytes either in the presence of (Experiment 1; Ex1) or in the absence of Hoechst 33342 (Experiment 2; Ex2). Hoffman modulation contrast microscopy was used in Ex1 and Nomarski differential interference contrast (DIC) was used in Ex2. In Ex1, cumulus-free MII oocytes were treated with Hoechst 33342 (5 mg mL–1; Sigma Chemical Co., St. Louis, MO, USA) for 5 min and the following pseudo-SCNT procedure was carried out: cytochalasin B (CB, 5 µg mL–1; Sigma) for 20 min, removal of a small amount of cytoplasm (pseudo-EN), and then dissection of the oocyte cytoplasmic membrane (pseudo-IN) under Hoffman modulation contrast microscopy. In Ex2, CB treatment, pseudo-EN, and pseudo-IN were performed under Nomarski DIC microscopy. After treatment, these oocytes were activated by parthenogenetic stimulation. Parthenogenesis was induced by 5-m ionomycin (Sigma) for 2 min and 2 mm 6-dimethylaminopurine (Sigma) for 4 h. As a control, cumulus-free MII oocytes were activated by only parthenogenetic stimulation, without the above manipulations. These activated oocytes were cultured in CMRL-1066 medium containing 20% calf serum at 38�C in 5% CO2, 5% O2, and 90% N2 for 7–8 days. The rates of development to blastocyst stage were 14% (1/7) in Ex1, 30% (3/10) in Ex2, and 29% (2/7) in the control. The developmental rate of parthenotes to the blastocyst stage in Ex2 was greater than that in Ex1 and similar to the control. These results suggest that treatment of cynomolgus monkey oocytes with Hoechst staining possibily decreases development to the blastocyst stage. Therefore, enucleation under Nomarski DIC will be a good alternative to Hoechst staining and could improve the potential development of nonhuman primate SCNT embryos.

290 A CYNOMOLGUS MONKEY EMBRYONIC STEM CELL LINE DERIVED FROM A SINGLE BLASTOMERE

The establishment of most embryonic stem (ES) cell lines requires the destruction of embryos. Some ES cell lines in mice and humans are currently derived from a single blastomere, so that remaining blastomeres can still develop into fetuses. However, the procedures currently in use for establishing these lines are very complicated, and other ES cell lines from the same species are needed (Chung et al. 2006 Nature 439, 216–219; Klimanskaya et al. 2006 Nature 444, 481–485). The objective of this study was to devise a method simpler than those previously described for establishing ES cell lines from a single blastomere in the cynomolgus monkey. Controlled ovarian stimulation and oocyte recovery have been described previously by Torii et al. (2000 Primates 41, 39–47). Cumulus-free mature oocytes were fertilized by intracytoplasmic sperm injection (ICSI), and then cultured at 38�C in 5% CO2, 5% O2 for 2 days. The zona pellucida of 4- to 5-cell-stage embryos was disrupted using acidic Tyrode's solution, and individual blastomeres were separated from the denuded embryos using trypsin. These blastomeres were cultured on mitomycin-C-treated mouse embryonic fibroblasts and ES medium containing adrenocorticotropic hormone (ACTH) (Ogawa et al. 2004 Genes to Cells 9, 471–477). After the formation of initial outgrowths, half of the medium was changed every other day until the outgrowths reached approximately 100 cells. Passage of putative monkey ES cells was performed by mechanical dispersion of the colonies and transfer to fresh feeders every 3–4 days until there were enough cells for enzymatic dispersion. One stable ES cell line was obtained from two 4- or 5-cell-stage embryos using ES medium containing ACTH. The morphology of this ES cell colony was consistent with the monkey ES cell colony previous described by Suemori et al. (2001 Dev. Dynamics 222, 273–279). The ES cell line was passaged more than 17 times, and the morphology of the ES cell colony did not differ between the first and seventeenth passages. The ES cells showed normal karyotype and retained pluripotency markers for primate ES cells including octamer-binding protein 4 (Oct-4), stage-specific embryonic antigen (SSEA)-4, tumor-rejection antigen (TRA)-1-60, and TRA-1-81. We are presently confirming whether this ES cell line possesses potencies to differentiate in all three embryonic germ layers using both an in vitro assay and teratoma formation. Here we showed that cynomolgus monkey ES cells can be derived from a single blastomere, without co-culturing another ES cell line, as has been done in previous studies on mice and humans. This method allows the establishment of ES cell lines from a single blastomere, leaving the other blastomeres available for embryo transfer. Thus, the method described here is simpler than previously described methods and alleviates some ethical concerns.

Ilizarov external fixator for burst fracture of the lumbar spine: a case report

A 50-year-old man presented with severe back pain and tenderness throughout the lumbar area after falling from a ladder. He had an unstable type-B burst fracture, with a spinal canal narrowing of 36% and an anterior height loss of 65%. His lower-limb neurological function was intact. An Ilizarov external spinal fixator was used; the pedicular half pins were inserted into the bilateral T11, T12, L2, and L3 pedicles; bilateral pedicular half pins were fixed at each level with external plates and rods. Postoperatively, the patient had a lordosis of 2 degrees and was able to walk 7 days later. The external fixator was removed at 10 weeks. Six years and 10 months after surgery, the patient had a kyphosis of 19 degrees that did not affect his activities of daily living.

Effect of rectal administration of rebamipide on dextran sulfate sodium-induced colitis: role of hepatocyte growth factor

OBJECTIVE AND DESIGN

Since rebamipide is effective for the treatment of ulcerative colitis (UC), we examined the involvement of hepatocyte growth factor (HGF) in the action of rebamipide.

MATERIALS

Fifty-five and forty female Balb/c mice, respectively, were used in Exp. 1 and 2.

TREATMENT

50 mg/kg/day rebamipide (Exp. 1) and 1 x 10(7) pfu pAxCAHGF (the CAG promoter-driving HGF gene in adenovirus vector) (Exp. 2) were intrarectally introduced after induction of colitis by 4 % dextran sulfate sodium (DSS).

METHODS

Therapeutic effects were assessed by cell proliferation and apoptosis.

RESULTS

Rebamipide caused proliferation of epithelial cells at 10 days after treatment, and decreased apoptosis at 10, 14 and 21 days, compared with controls. Expression of HGF was greatly increased in rebamipide-treated mice. pAxCAHGF caused cell proliferation and apoptosis, which showed the same pattern as with rebamipide treatment.

CONCLUSIONS

Rectal administration of rebamipide is effective for DSS-induced colitis in association with induction of HGF.

Interaction of local anaesthetics with lipid membranes under inflammatory acidic conditions

The clinical fact that local anaesthetics do not successfully work in the patients with inflammation has been generally interpreted on the basis of inflamed tissue acidification. In order to verify this hypothesis, the interaction of local anaesthetics with lipid membranes was studied by determining the drug-induced changes of membrane physicochemical property (membrane fluidity) at different pH covering inflammatory acidic conditions. At clinically relevant concentrations, lidocaine, procaine, prilocaine and bupivacaine fluidized 1,2-dipalmitoylphosphatidylcholine membranes with the potency decreased with lowering the pH from 7.9 to 5.9. When treated as the aqueous acidic solution (pH 4.0) similar to marketed injection solutions, lidocaine showed more pronounced pH dependence, so the reduction of its membrane-fluidizing effects at acidic pH theoretically correlated to that of its non-ionized membrane-interactive concentrations. Unlike phosphatidylcholine membranes, however, nerve cell model membranes consisting of different phospholipids and cholesterol were fluidized by lidocaine at pH 6.4-6.9 corresponding to the acidity of inflamed tissues. Cationic lidocaine was effective in fluidizing anionic phosphatidylserine and cardiolipin membranes at pH 6.4, but not zwitterionic phospholipid membranes, whereas it was ineffective on any membranes at pH 2.0 where membrane acidic phospholipids were not ionized. Local anaesthetics are considered to form the ion-pairs specifically with counter-ionic phospholipids and act on the membranes of nerve cells even under inflammatory acidic conditions. The drug and membrane interaction causable in inflamed tissue acidification does not support the conventional theory on the local anaesthetic failure associated with inflammation.

Detection of high-energy gamma rays from winter thunderclouds

A report is made on a comprehensive observation of a burstlike gamma-ray emission from thunderclouds on the Sea of Japan, during strong thunderstorms on 6 January 2007. The detected emission, lasting for approximately 40 sec, preceded cloud-to-ground lightning discharges. The burst spectrum, extending to 10 MeV, can be interpreted as consisting of bremsstrahlung photons originating from relativistic electrons. This ground-based observation provides the first clear evidence that strong electric fields in thunderclouds can continuously accelerate electrons beyond 10 MeV prior to lightning discharges.

Treatment of benign bone tumours using external fixation

We present a retrospective study of patients suffering from a variety of benign tumours in whom external fixators were used to treat deformity and limb-length discrepancy, and for the reconstruction of bone defects. A total of 43 limbs in 31 patients (12 male and 19 female) with a mean age of 14 years (2 to 54) were treated.

The diagnosis was Ollier’s disease in 12 limbs, fibrous dysplasia in 11, osteochondroma in eight, giant cell tumour in five, osteofibrous dysplasia in five and non-ossifying fibroma in two. The lesions were treated in the tibia in 19 limbs, in the femur in 16, and in the forearm in eight. The Ilizarov frame was used in 25 limbs, the Taylor Spatial Frame in seven, the Orthofix fixator in six, the Monotube in four and the Heidelberg fixator in one. The mean follow-up was 72 months (22 to 221).

The mean external fixation period was 168 days (71 to 352). The mean external fixation index was 42 days/cm (22.2 to 102.0) in the 22 patients who required limb lengthening. The mean correction angle for those with angular deformity was 23° (7° to 45°).

At final follow-up all patients had returned to normal activities. Four patients required a second operation for recurrent deformity of further limb lengthening. Local recurrence occurred in one patient, requiring further surgery.

Bone transport using hydroxyapatite loaded with bone morphogenetic protein in rabbits

The feasibility of bone transport with bone substitute and the factors which are essential for a successful bone transport are unknown. We studied six groups of 12 Japanese white rabbits. Groups A to D received cylindrical autologous bone segments and groups E and F hydroxyapatite prostheses. The periosteum was preserved in group A so that its segments had a blood supply, cells, proteins and scaffold. Group B had no blood supply. Group C had proteins and scaffold and group D had only scaffold. Group E received hydroxyapatite loaded with recombinant human bone morphogenetic protein-2 and group F had hydroxyapatite alone.

Distraction osteogenesis occurred in groups A to C and E which had osteo-conductive transport segments loaded with osteo-inductive proteins. We conclude that scaffold and proteins are essential for successful bone transport, and that bone substitute can be used to regenerate bone.

155 LAPAROSCOPIC EVALUATION OF OVARIAN REACTION TO HORMONE STIMULATION IN CYNOMOLGUS MONKEYS (MACACA FASCICULARIS)

Oocyte collection is a key step to development of a system for modeling human regenerative medicine and assisted reproductive technology in cynomolgus monkeys (Macaca fascicularis), but collecting oocytes at a suitable developmental stage (metaphase II) is difficult. Metaphase II (MII) oocytes can be collected from cynomolgus ovaries stimulated by hormone injection. In this study, we developed a useful method for collecting a large number of MII oocytes by monitoring the morphology and size of ovaries with laparoscopic observation. Controlled ovarian stimulation and oocyte recovery in mature cynomolgus monkeys have been previously described by Torii et al. (2000 Biochemistry 39, 3197–3205). Beginning at menses, levels of estrogens were down-regulated by the subcutaneous injection of a GnRH antagonist (Leuplin, 0.9 mg animal-1; Takeda Chemical Industries, Ltd., Osaka, Japan). Two weeks later, human follicle stimulating hormone (FSH, Fertinorm, 25 IU kg-1; Serono, Canton Zug, Switzerland) was administered for 9 days. On the day after that of the last FSH administration, human chorionic gonadotropin (hCG, Puberogen, 400 IU kg-1; Sankyo Co., Ltd., Tokyo, Japan) was intramuscularly injected. Follicular aspiration was performed at 404-41 hours post-hCG injection. Oocyte collection was monitored using a 3-mm laparoscope attached to a video system. Oocytes were aspirated from the follicles using a 20-guage needle. Follicle development of the ovary was rated morphologically as A (small follicles), B (many small follicles), or C (many large follicles), and size relative to the uterus was rated as 1 (no response), 2 (smaller), 3 (equal), or 4 (larger) at oocyte collection. Regarding morphology, the highest ratio of MII/total oocytes was obtained from B–C ovaries (rating of 2 ovaries, one each left or right with a rating of B or C, n = 8, 26.9 � 22.4, 70.7%), followed by B–B (n = 21, 19.5 � 14.3, 55.9%), and C–C (n = 19, 10.6 � 5.8, 51.9%). No MII oocytes were collected from A–A (n = 1, 0%) ovaries. Ovaries appeared to be over-stimulated in the ovaries rated C–C but under-stimulated in B–B. Regarding ovary size, the highest ratio of MII/total oocytes was obtained from 4–4 (both ovaries with rating of 4, n = 10, 21.9 � 11.2, 68.8%), followed by 3–3 (n = 21, 19.1 � 14.3, 58.2%), and 2–2 (n = 9, 11.6 � 6.5, 53.3%). No MII oocytes were collected from 1–1 ovaries (n = 1, 0%). The number of MII oocytes collected was directly related to ovary size: more MII oocytes were collected from larger ovaries. These data demonstrate that the number of oocytes collected is directly related to ovary size. Our results suggest that the ratio of MII oocytes can be predicted by the morphology and the size of ovaries. In addition, we found that ovarian development can be controlled by adjusting FSH dosage. Therefore, laparoscopic observation of ovaries during FSH treatment and adjusting FSH dosage are necessary to collect MII oocytes efficiently.

Anisotropy and Corotation of Galactic Cosmic Rays

The intensity of Galactic cosmic rays is nearly isotropic because of the influence of magnetic fields in the Milky Way. Here, we present two-dimensional high-precision anisotropy measurement for energies from a few to several hundred teraelectronvolts (TeV), using the large data sample of the Tibet Air Shower Arrays. Besides revealing finer details of the known anisotropies, a new component of Galactic cosmic ray anisotropy in sidereal time is uncovered around the Cygnus region direction. For cosmic-ray energies up to a few hundred TeV, all components of anisotropies fade away, showing a corotation of Galactic cosmic rays with the local Galactic magnetic environment. These results have broad implications for a comprehensive understanding of cosmic rays, supernovae, magnetic fields, and heliospheric and Galactic dynamic environments.

Clear cell sarcoma of tendons and aponeuroses: An analysis of 75 cases

9572

Background: Clear cell sarcoma (CCS) of tendons and aponeuroses is a rare malignant tumor that occurs most commonly in the extremities of young adults. Because of the rarity of the disease (1% of all soft tissue sarcomas), most reports about CCS have dealt with a few cases during a long time period. We conducted a multi-institutional study of CCS to clarify the clinical findings and prognostic factors of CCS treated during the era of modern multidisciplinary treatment. Methods: The records of 75 consecutive patients with histologically confirmed CCS treated at the JMOG affiliated institutions between 1980 and 2004 (follow-up; average 44 months) were reviewed. There were 41 men and 34 women with an average age of 36 years (range, 10–71 years). 65 tumors were in the extremities (foot 22, hand 13, thigh 9, others 21) and 10 were in the trunk. The tumor size ranged from 1 to 11 cm (mean, 4 cm). 52 patients presented with localized disease (M0) and 23 with metastatic disease (M1). Results: Surgical excision of the primary tumor was performed in 71 patients (limb-sparing surgery; 56, amputation; 15). Microscopic surgical margin was negative in 60 and positive in 11. 56 patients received chemotherapy (30 with measurable disease) and 17 had radiotherapy. Local recurrence occurred in 16 patients and 48 patients developed metastasis. The 5-year overall survival rate was 47% (M0; 55%, M1; 20%). On univariate analysis, sex (p=0.02), size (p=0.001), depth (p=0.002), TNM stage (p=0.001), IRS group (p=0.001) and surgical margin (p=0.04) were prognostic factors. On multivariate analysis, size (p=0.02) remained to be a significant prognostic factor. Objective response to chemotherapy was observed in 8 (27%) patients. In the group of M0 patients, those who received adjuvant chemotherapy had better prognosis (5-year survival, 65%) than those without chemotherapy (5-year survival, 23%)(p=0.03). Conclusions: The results support the contention that early diagnosis and initial excision with negative surgical margin are essential for favorable outcome of CCS. The role of chemotherapy for CCS should be further investigated.

No significant financial relationships to disclose.