Isotope Effect on Energy Confinement Time and Thermal Transport in Neutral-Beam-Heated Stellarator-Heliotron Plasmas

The isotope effect on energy confinement time and thermal transport has been investigated for plasmas confined by a stellarator-heliotron magnetic field. This is the first detailed assessment of an isotope effect in a stellarator heliotron. Hydrogen and deuterium plasmas heated by neutral beam injection on the Large Helical Device have exhibited no significant dependence on the isotope mass in thermal energy confinement time, which is not consistent with the simple gyro-Bohm model. A comparison of thermal diffusivity for dimensionally similar hydrogen and deuterium plasmas in terms of the gyroradius, collisionality, and thermal pressure has clearly shown robust confinement improvement in deuterium to compensate for the unfavorable mass dependence predicted by the gyro-Bohm model.

P2721FFRct analysis for screening of obstructive coronary artery disease: a propensity score adjusted study

Background

Guidelines recommend functional assessment in stable coronary artery disease (CAD) to guide further treatment. Computed tomography fractional flow reserve (FFRCT) has been proposed for non-invasive assessment of stable CAD. A cutoff value of FFRCT ≥0.8 has been shown cost-effective, and allowing to avoid inappropriate invasive coronary angiography (ICA). However, no results from real-life hospital registries have been reported yet.

Purpose

We aimed to compare the impact of FFRCT with conventional coronary CT angiography (CTA) for detecting obstructive CAD in the daily practice of a tertiary referral hospital.

Methods

Patients referred to CTA for suspected CAD between 2013 and 2017 were included. FFRCT analysis was introduced in 2015 and performed at the discretion of the radiologist by Heartflow Inc. FFRCT was considered abnormal if FFR was <0.8 in at least one of 3 main vessels. Obstructive CAD was defined on both CTA and ICA by the presence of a stenosis ≥50% in at least one of 3 main vessels, or an invasive FFR<0.8. Propension to perform a FFRCT was modeled, based on gender, cardiovascular risk factors, completion of stress test and echocardiography and presence of a lesion of more than 50% stenosis on CTA. A logistic regression adjusted for the propensity score was then performed on the use of ICA, the presence of significant CAD on ICA and revascularization rate either by PCI or CABG.

Results

2906 patients (50% of male, 56±12) were included in this registry. Diabetes, hypertension, dyslipidemia and smoking were present in respectively 12.3, 30.5, 27.5 and 9% of patients. A stress ECG and a transthoracic echo were obtained in respectively 37.1 and 49% of patients. FFRCT was performed in 757 (26%) and was abnormal in 323 (42.7%) of the patients. An ICA was performed in 622 (21.4%) patients and was abnormal in 292 (46.9%). After propensity score weighting, FFRCT was associated with an increase in ICA (OR=1.58, 95% CI: 1.23–2.02, p<0.01). There were no significant changes regarding ICA showing obstructive CAD with FFRCT (OR=1.13, 95% CI: 0.78–1.66, p=0.5) but a trend towards an increase of revascularization (OR=1.48, 95% CI: 0.98–2.24, p=0.06). In patient undergoing an ICA, a FFRCT ≥0.8 was decreasing the presence of significant CAD (OR=0.27, 95% CI: 0.16–0.48, p<0.001), whereas a FFRCT <0.8 increased the rate of revascularization (OR=24.7, 95% CI: 12.3–49.7, p<0.001).

Conclusion

These real life data showed that, adding FFRCT to conventional CTA, and interpreting only the numerical values of FFRCT, would increase the use of ICA in patients suspected of CAD. A trend towards an increase in revascularization was also observed. Therefore, another index than the minimal FFRCT should be used to improve discrimination regarding the presence of obstructive CAD. However, normal values of FFRCT were strong predictors of the absence of significant CAD, and abnormal values of FFRCT for the need of a revascularization.

P4661Increased levels of sST2 in patients with mitral annulus disjunction and ventricular arrhythmias

Background

Mitral annulus disjunction (MAD), a basal displacement of the mitral valve annulus, is described as a possible aetiology of sudden cardiac death. Stretch-induced fibrosis in the sub-valvular apparatus has been suggested as the substrate of arrhythmias.

Purpose

We hypothesized that the stretch related biomarker soluble Suppression of Tumorigenicity-2 (sST2) is a marker of ventricular arrhythmias in patients with MAD.

Methods

We included patients with ≥1 mm MAD on cardiac magnetic resonance imaging, and recorded left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) suggesting papillary muscle fibrosis. Circulating levels of sST2 were assessed by blood sampling. The occurrence of ventricular arrhythmias, defined as aborted cardiac arrest, sustained or non-sustained ventricular tachycardia, was assessed retrospectively.

Results

We included 72 patients with MAD [55 (35–62) years old, 48 (67%) female], of which 22 (31%) had ventricular arrhythmias. Patients with ventricular arrhythmias had lower LVEF (60±6% vs. 63±6%, p=0.04), more prevalent papillary muscle fibrosis [14 (64%) vs. 10 (20%), p<0.001] and higher sST2 levels [31.6±10.1 ng/mL vs. 25.3±9.2 ng/mL, p=0.01] compared to those without. Combining sST2-level, LVEF and papillary muscle fibrosis optimally detected individuals with arrhythmias (area under the curve 0.82, 95% CI 0.73–0.92) and improved the risk model (p<0.05) compared to individual parameters (Figure right panel).

Conclusion

Circulating sST2 levels were higher in patients with MAD and ventricular arrhythmias compared to patients without arrhythmias. Combining sST2, LVEF and LGE may improve risk stratification in patients with MAD.

Acknowledgement/Funding

This work was supported by public grant [203489/030] from the Norwegian Research Council, Oslo, Norway. E. Scheirlynck received an ESC research grant

P5652Catheter ablation outcome and heart failure hospitalization in atrial fibrillation patients with preserved left ventricular ejection fraction: insights from the Kansai plus atrial fibrillation (KPAF)

Background

Heart failure (HF) is the leading cause of death in patients with atrial fibrillation (AF), and AF is an independent prognostic factor in HF patients with preserved left ventricular ejection fraction (LVEF). Radiofrequency catheter ablation (RFCA) for AF is effective to maintain sinus rhythm.

Purpose

We sought to clarify incidence of HF hospitalization and whether AF ablation outcome influenced incidence of HF hospitalization after the procedures in patients with preserved LVEF.

Methods

We conducted a large-scale, prospective, multicenter, observational study. A total of 4522 consecutive patients with normal LVEF (>/- 50%) who underwent an initial RFCA for AF in 26 centers were enrolled (average age, 64±10 years; non-paroxysmal AF, 33.7%). The median follow-up duration was 2.9 years.

Results

The 3-year cumulative incidence of AF recurrence after a single procedure was 40.3%. Hospitalization for HF was observed in 60 patients (1.3%) and was significantly higher in patients with AF recurrence than those without it (2.63% vs 0.44%, log-rank p<0.001). After adjustment by age ≥65 years, estimated glomerular filtration rate ≤60ml/min, history of HF, and female, all of which were statistically associated with a risk of HF hospitalization, AF recurrence after the index RFCA was an independent predictor of HF hospitalization (hazard ratio; 4.75, 95% confidence interval; 2.59–9.42, p<0.001).

Conclusions

Recurrence after RFCA for AF was a significant risk of HF hospitalization among AF patients with preserved LVEF.

Acknowledgement/Funding

This study was supported by the Research Institute for Production Development in Kyoto, Japan.

P3587Tip detection method using the new short-tip IVUS with pull-back system which facilitates the 3D wiring technique in percutaneous coronary intervention for chronic total occlusion

Background

The strategy of intravascular ultrasound (IVUS)-guided wiring for CTO PCI, that is, leading the second guidewire into the true lumen under observing by IVUS from subintimal space, is the last resort. We developed the angiography-based 3D wiring method. During establishment of the angiography-based 3D wiring method, we deduced that observation of the guidewire tip as well as the shaft named “The tip detection method” simplifies and facilitates 3D wiring under IVUS-guided wiring. Therefore, we produced New CTO IVUS which is the upgraded version of Navifocus WR IVUS by adding the pull-back transducer system. This pull-back system enables us to detect the tip as well as the shaft of the second guidewire in real time (tip detection method), which facilitates the 3D wiring technique under IVUS-guided wiring.

Objective

We evaluated the efficacy of the tip detection method during 3D wiring for CTO PCI with New CTO IVUS.

Method

We created a target pinpoint penetration model and performed the procedures using an experimental heartbeat model. The target (a tube with a lumen 0.6 mm in diameter) was placed in the distal part of a CTO 20 mm in length made of 2.5% agar. After the second guidewire (Conquest-12g) was advanced into the CTO lesion to within 5mm of the target using the angiography-based wiring, IVUS-guided wiring was performed by using Navifocus WR or New CTO IVUS each five times.

Result

The frequency of the puncture time was reduced using the new CTO IVUS compared to the Navifocus WR (1.7±0.8 vs. 28.8±23.2, p=0.17). The procedure time was significantly shorter using the new CTO IVUS compared to the Navifocus WR (103±61 vs. 459±373 seconds, p=0.04).

Conclusion

The tip detection method during 3D wiring with the new short tip IVUS with the pull-back system enables us to easily perform 3D wiring and will change the CTO PCI strategy.

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

Background/Introduction

Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion.

Purpose

The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI).

Methods

From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions.

Results

Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69).

Restenosis rates in each segments

Conclusion

After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

P1029Catheter ablation outcome and heart failure hospitalization in atrial fibrillation patients: insights from the Kansai plus atrial fibrillation (KPAF) registry

Background

Heart failure (HF) is the leading cause of death in patients with atrial fibrillation (AF). Radiofrequency catheter ablation (RFCA) for AF is effective to maintain sinus rhythm.

Purpose

We sought to clarify whether AF ablation outcome influenced incidence of HF hospitalization after the procedures.

Methods

We conducted a large-scale, prospective, multicenter, observational study. A total of 5010 consecutive patients who underwent an initial RFCA for AF in 26 centers were enrolled (average age, 64±10 years; non-paroxysmal AF, 35.6%). The median follow-up duration was 2.9 years.

Results

The 3-year cumulative incidence of AF recurrence after a single procedure was 40.2%. The 3-year incidence of hospitalization for HF was observed in 92 patients (1.8%) and was significantly higher in patients with AF recurrence than those without it (3.3% vs 0.84%, log-rank p<0.001). After adjustment by advanced age,(≥65 years), reduced left ventricular ejection fraction (≤50%), low estimated glomerular filtration rate (≤60ml/min), and history of HF, all of which were statistically associated with a risk of HF hospitalization (p<0.1, respectively), AF recurrence after the index RFCA was an independent predictor of HF hospitalization (hazard ratio [HR]; 3.17, 95% confidence interval [CI]; 2.06–5.04, p<0.001).Even after multiple procedures (1425 re-ablation sessions in 1274 patients [25.4%]), AF recurrence after the last procedure was an independent predictor of HF hospitalization (HR; 2.83, 95% CI; 1.89–4.24, p<0.001).

Conclusions

Among AF patients receiving RFCA, those with AF recurrence were at greater risk of heart failure hospitalization than were patients without AF recurrence. These differences should be noted when treating AF patients in actual clinical practice.

Acknowledgement/Funding

This study was supported by the Research Institute for Production Development in Kyoto, Japan.

P6530Clinical outcomes of dialysis patients treated with current generation DES for left main distal bifurcation

Objectives

We assessed clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (ULM) using current generation drug eluting stents (cDES) in hemodialysis (HD) patients compared to general populations.

Methods

We identified 1269 consecutive patients who underwent PCI for ULM distal bifurcation lesions. Of them, 563 patients were treated with cDES (512 non HD and 51 HD patients). The primary endpoint was target lesion failure (TLF) at 3 years, defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI).

Results

HD group was more likely to have diabetes mellitus (70.0% vs. 45.8%, p=0.002), peripheral artery disease (56.0% vs. 14.9%, p<0.001), and lower ejection fraction (52.6% vs. 56.3%, p=0.026). The rate of TLF at 3 years was significantly higher in the HD group (adjusted Hazard ratio [HR] 2.59; 95% confidence interval [CI], 1.54–4.37; p<0.001). Cardiac mortality was significantly higher in the HD group (adjusted HR 4.49; 95% CI, 2.07–9.74; p<0.001). The rates of TLR for LM-left anterior descending artery (LAD) and left circumflex ostium (LCXos) were significantly higher in the HD group (LMT-LAD: adjusted HR 3.10; 95% CI, 1.31–7.33; p=0.01, LCXos: adjusted HR 2.56; 95% CI, 1.32–4.94; p=0.005). The rate of MI was similar between the 2 groups.

Conclusions

Hemodialysis was strongly associated with adverse events after PCI for ULM distal bifurcation lesions even with cDES.

P5577Preoperative transaortic pressure gradient predicts renal functional improvement after transcatheter aortic valve implantation in patients with chronic kidney disease

Introduction

Transcatheter aortic valve implantation (TAVI) theoretically increases renal blood flow through increasing cardiac output by relieving aortic valvular obstruction of blood flow from left ventricle, resulting in a renal functional recovery in patients with severe aortic valve stenosis (AS). However, procedural steps of TAVI including contrast use potentially damages renal medulla and may deteriorate renal function.

Purpose

The aim of this study was to investigate renal functional change and clarify preoperative predictors for renal functional improvement after TAVI in chronic kidney disease (CKD) patients with severe AS.

Methods

A total of 88 consecutive severe AS patients with CKD (grade >3) who underwent TAVI from 2015 to 2018 was enrolled in this observational study. They were divided into two groups depending on their renal functional improvement after TAVI that was defined as more than 10% increase in estimated glomerular filtration rate (eGFR) at discharge from their preoperative level.

Results

Among the whole candidates, 49 patients (55.7%) were improved their renal function. Patients with the lowest preoperative eGFR achieved the highest increase in eGFR after TAVI (CKD grade >4: +22.7±23.7%, Figure). Patients in the Improved group had lower hemoglobin level, higher mean transaortic pressure gradient (TAPG), and higher aortic valve gradient before TAVI, compared to those in the Non-improved group. However, contrast volume during the procedure was not significantly different between the groups. Multivariate logistic regression analysis revealed that high mean TAPG and low left ventricular ejection fraction (LVEF) before TAVI were independent predictors for the improvement of renal function (odds ratio (OR): 1.04, 95% confidence interval (CI): 1.00–1.08; OR: 0.94, 95% CI: 0.89–0.99, respectively), even after the adjustment of baseline eGFR level and hemoglobin level that were statistically significant on univariate logistic regression analysis. Receiver Operating Characteristic (ROC) curve showed the cut-off level of preoperative mean TAPG in renal functional improvement after TAVI as 47.0 mmHg (Sensitivity: 47.9%, Specificity: 79.5%, area under the curve: 0.62).

Correlation between CKDgrade and ΔeGFR

Conclusions

Preoperative high mean TAPG may predict renal functional improvement after TAVI in patients with deteriorated renal function. This non-invasive predictor may help clinicians to consider to perform TAVI in a challenging case with severe CKD.

P980Post-procedural plasma brain natriuretic peptide level early after catheter ablation predicts the future clinical outcome in patients with persistent atrial fibrillation and reduced ejection fraction

Background

Successful restoration of sinus rhythm (SR) by catheter ablation (CA) for persistent atrial fibrillation (AF) improves cardiac function, resulting in decrease of plasma brain natriuretic peptide (BNP) level. The exact significance and prognostic implications of this change have yet to be determined.

Purpose

To examine the impact of pre- and post-procedural BNP level on the clinical outcome after CA in patients with persistent AF and reduced left ventricular ejection fraction (LVEF).

Methods

Out of 242 patients with LVEF <50% who underwent first-time CA for persistent AF between March 2012 and September 2018 at our institute, we enrolled 137 patients (61±10 years, 83% male) whose plasma BNP level was available both at baseline and early after CA (during 1–3 month). We evaluated the impact of the BNP levels on future AF recurrence 3 months after CA as the primary endpoint. Additional secondary endpoints included heart failure (HF) hospitalization and cardiovascular death.

Results

All patients successfully restored SR at the end of CA. Within 3 months of a blanking period (BP), improvement of LVEF (from 39±10% to 65±12%, p<0.001) and reduction of BNP levels (from 178 [107–332] pg/ml to 42.3 [21.1–78.6] pg/ml, p<0.001) were observed. During the median follow-up of 21 months after BP, the incidence of AF recurrence, HF hospitalization, and cardiovascular death was 37% (n=50), 3% (n=4), and 1% (n=1), respectively. Cox proportional hazard regression analysis after adjustment for age and gender revealed that post-procedural BNP level was a significant predictor of the AF recurrence (hazard ratio [HR] per 100-pg/ml increase, 1.13; 95% confidence interval [CI], 1.02–1.25; p=0.023), but pre-procedural BNP level was not (1.02; 0.95–1.09; p=0.56). Receiver operating curve analysis determined the post-procedural BNP level of 55.5 pg/ml as the best cut-off value for predicting the AF recurrence, with area under the curve of 0.620 (95% CI, 0.534–0.702; p=0.018). The incidence of AF recurrence was significantly higher in patients with post-procedural BNP level >55.5 pg/ml (n=50) than the others (50% vs. 29%; HR, 3.99; 95% CI, 2.07–7.68; p<0.001). No patients with post-procedural BNP level ≤55.5 pg/ml experienced HF hospitalization and cardiovascular death (8% vs. 0% and 2% vs. 0%, p=0.006 and p=0.17, respectively)

Conclusions

Not pre-procedural but post-procedural BNP level early after CA predicted the future clinical outcome in patients with persistent AF and reduced LVEF. Decreased but still elevated BNP level after restoration of SR would identify the residual risk for developing unfavorable outcome.

P855Evaluation of epicardial coronary resistance using computed tomography angiography

Background

A Fractional flow reserve (FFR) pullback allows assessing the distribution of pressure loss along the vessel. FFR derived from CT (FFRCT) provides a virtual pullback curve that may also aid in the assessment of epicardial coronary resistance in the non-invasive setting.

Purpose

The present study aims to determine the accuracy of the virtual FFRCT pullback curve using a motorized invasive FFR pullback as reference in patients with stable coronary artery disease.

Methods

This is a single centre, prospective study of patients with stable coronary artery disease in whom FFRCT was performed as standard of care for non-invasive assessment. Patients referred to coronary angiography with clinically indicated invasive FFR measurement were included. FFRCT and invasive FFR values were extracted from coronary vessels every 1 mm to generate pullback curves. Invasive FFR pullbacks were acquired using a dedicated device at a speed of 1 mm/s. The area under the pullback curve (AUPC), defined as the sum of areas under the FFR pullback curve, was compared between FFRCT and invasive FFR pullbacks. Lesions were defined based on invasive angiography. FFR gradients in lesions and non-obstructive segments were defined as the difference between FFR values at the proximal and distal edge of the segments. FFR vessel gradient was defined as the difference between the most distal FFR value and the FFR at the ostium of the vessel. Mixed effect model was used to account for the correlation of FFR values within vessels. The agreement between FFRCT and FFR gradients was assessed using the Passing Bablok regression analysis and Bland-Altman methods at the vessel, lesion and non-obstructive level.

Results

A total of 3172 matched FFRCT and FFR values were obtained in 24 vessels. The correlation coefficient between FFRCT and FFR was 0.76 (95% CI 0.75 to 0.78; p<0.001). The mean difference between the FFRCT and invasive FFR pullback values was 0.07 (LOA −0.11 to 0.24). AUPC was similar between FFRCT and invasive FFR (79.0±16.1 vs. 85.3±16.4, p=0.097); the mean slope of FFRCT pullback curve was steeper compared to invasive FFR (p<0.001). The mean difference in lesion gradient was −0.07 (LOA −0.26 to 0.13) and −0.01 (LOA −0.06 to 0.05) in non-obstructive segments. There were no systematic or proportional differences between FFRCT and FFR gradients either in lesion or non-obstructive segments); however, vessel gradients were overestimated by FFRCT with a bias of −0.12 (LOA −0.35 to 0.12) driven by a higher mean difference in lesion gradients (−0.07; 95% CI −0.26 to 0.13).

Conclusions

The evaluation of epicardial coronary resistance using coronary CT angiography with FFRCT was feasible. FFRCT pullbacks were accurate in the assessment of lesion and non-obstructive gradients. FFRCT can identify the physiological pattern of coronary artery disease in the non-invasive setting.

Randomized clinical trial of extensive intraoperative peritoneal lavage versus standard treatment for resectable advanced gastric cancer (CCOG 1102 trial)

BACKGROUND

A survival benefit of extensive intraoperative peritoneal lavage (EIPL) has been reported in patients with gastric cancer with positive peritoneal cytology. The hypothesis of this study was that EIPL may reduce peritoneal recurrence in patients with advanced gastric cancer who undergo surgery with curative intent.

METHODS

This was an open-label, multi-institutional, randomized, phase 3 trial to assess the effects of EIPL versus standard treatment after curative gastrectomy for resectable gastric cancer of T3 status or above. The primary endpoint was disease-free survival (DFS); secondary endpoints were overall survival, peritoneal recurrence-free survival and incidence of adverse events.

RESULTS

Between July 2011 and January 2014, 314 patients were enrolled from 15 institutions and 295 patients were analysed (145 and 150 in the EIPL and no-EIPL groups respectively). The 3-year DFS rate was 63·9 (95 per cent c.i. 55·5 to 71·2) per cent in the EIPL group and 59·7 (51·3 to 67·1) per cent in the control group (hazard ratio (HR) 0·81, 95 per cent c.i. 0·57 to 1·16; P = 0·249). The 3-year overall survival rate was 75·0 (67·1 to 81·3) per cent in the EIPL group and 73·7 (65·9 to 80·1) per cent in the control group (HR 0·91, 0·60 to 1·37; P = 0·634). Peritoneal recurrence-free survival was not significantly different between the two groups (HR 0·92, 0·62 to 1·36; P = 0·676). No intraoperative complications related to EIPL were observed.

CONCLUSION

EIPL did not improve survival or peritoneal recurrence in patients who underwent gastrectomy for advanced gastric cancer. Registration number: 000005907 (http://www.umin.ac.jp/ctr/index.htm).

A New Hadrosaurine (Dinosauria: Hadrosauridae) from the Marine Deposits of the Late Cretaceous Hakobuchi Formation, Yezo Group, Japan

A nearly complete skeleton of a new hadrosaurid, Kamuysaurus japonicus gen. et sp. nov., was discovered from the outer shelf deposits of the Upper Cretaceous Hakobuchi Formation of the Yezo Group in Hobetsu area of Mukawa town in Hokkaido, Japan. Kamuysaurus belongs to the sub-clade of Hadrosaurinae, Edmontosaurini, and forms a monophyly with Laiyangosaurus and Kerberosaurus from the northern Far East. Kamuysaurus has a long anterior platform for the nasofrontal sutural surface, which may indicate the presence of a small supracranial crest, similar to a sub-adult form of Brachylophosaurus based on the extension of the nasofrontal sutural surface. The Dispersal Extinction Cladogenesis analysis with the 50% Majority Rule consensus tree suggests that the clade of Kamuysaurus, Laiyangosaurus, and Kerberosaurus may have dispersed into Asia prior to the late Campanian and the potential endemism of this clade during the late Campanian and early Maastrichtian in the northern Far East. The results of both Dispersal Extinction Cladogenesis and Ancestral State Reconstruction analyses imply that the marine-influenced environment in North America during the Campanian may have played an important role for the hadrosaurid diversification in its early evolutionary history.

Preterm birth is associated with higher prevalence of wheeze and asthma in a selected population of Japanese children aged three years

BACKGROUND

The present cross-sectional study investigated the associations between low birthweight (LBW), high birthweight, preterm birth (PTB), postterm birth, small for gestational age (SGA), and large for gestational age (LGA) and the prevalence of wheeze and asthma in Japanese children aged three years (age range, 33-54 months; mean age, 38.7 months).

METHODS

Study subjects were 6364 children. A questionnaire was used to collect all data. Wheeze and asthma were defined according to the criteria of the International Study of Asthma and Allergies in Childhood.

RESULTS

The prevalence values of wheeze and asthma were 19.5% and 7.7%, respectively. Of the 6364 subjects, 8.8% were classified as LBW (<2500g), 90.4% as normal birthweight, 0.8% as high birthweight (≥4000g), 4.8% as PTB (<37 weeks), 94.8% as term birth, 0.4% as postterm birth (≥42 weeks), 7.8% as SGA (<10th percentile), 82.5% as appropriate for gestational age, and 9.7% as LGA (>90th percentile). Compared with term birth, PTB was independently positively associated with wheeze and asthma: the adjusted ORs (95% CI) were 1.47 (1.11-1.92) and 1.52 (1.02-2.20), respectively. An independent positive association was shown between PTB and wheeze only in boys; the interaction between PTB and sex was significant. Such an interaction between PTB and sex was not seen for asthma. No evident associations were observed between LBW, high birthweight, postterm birth, SGA, or LGA and wheeze or asthma.

CONCLUSIONS

This is the first study in Japan to show that PTB, but not LBW or SGA, was significantly positively associated with childhood wheeze and asthma.

New approach to evaluating the effects of a drug on protein complexes with quantitative proteomics, using the SILAC method and bioinformatic approach

Protein-protein interactions (PPIs) lead the formation of protein complexes that perform biochemical reactions that maintain the living state of the living cell. Although therapeutic drugs should influence the formation of protein complexes in addition to PPI network, the methodology analyzing such influences remain to be developed. Here, we demonstrate that a new approach combining HPLC (high performance liquid chromatography) for separating protein complexes, and the SILAC (stable isotope labeling using amino acids in cell culture) method for relative protein quantification, enable us to identify the protein complexes influenced by a drug. We applied this approach to the analysis of thalidomide action on HepG2 cells, assessed the identified proteins by clustering data analyses, and assigned 135 novel protein complexes affected by the drug. We propose that this approach is applicable to elucidating the mechanisms of actions of other therapeutic drugs on the PPI network, and the formation of protein complexes.